以上六方，治危急痘证，有起死回生之妙。
独神散（即前穿山甲方）
天真膏 治黑陷干枯红紫，及斑不退，用此救之，十全四五。
初生小儿解下黑粪，用瓷罐收贮，加水银二两，麝香一钱，黄蜡封口，埋于土中，愈久愈妙，久则
化而为水。每遇前证，看儿大小，热毒盛者、量与二三茶匙，酒煎紫草汤对半和匀服之，立时红润活泽，
真秘方也，胜天灵盖枯臭无益之物万万矣，缘此粪原系母之真血所化，盖以血补血，且入土日久，又得阴
气多，故能解毒。百日内小儿热而烦躁，啼哭不止，用少许点入眼角，二三次便能神安气和而睡，
盖又能清心热也。
大成散 治痘出不快，或顶陷，或灰白黑陷，一切不起发之证俱可用之。
穿山甲（酒炒，一两） 甘草末（二钱） 雄黄 朱砂（各一钱半） 紫草（三钱） 麝香（二分）
上，每五岁儿用二分。冷证，热酒调下。热证，紫草汤下。寒者，加入治中散内用。热证，加入小无比散内。
无价散 治黑陷欲死者。
用无病小儿粪，腊月将倾银罐二个，上下合定，盐泥固济，火 通红，取出为末，蜜水调服一钱。一方，加
麝香冰片少许。
〔丹〕炉灰白色，静者，怯者，作寒看。躁者，勇者， 发者，作热看。凡痘疹白色，将靥如豆壳者，盖因
初起时饮水多，其靥不齐，俗呼倒靥，不妨，但服实表之剂，如毒瓦斯郁里，消息他大小便，如大便闭，通大便，小
便闭，通小便，无妨。
〔薛〕前证不起发，不红活者，此因脾肺气虚，用参 四圣散（起发）。顶陷灰白，
泻渴者，脾肺虚寒，用木香散、异功散（出不快）。〔张〕痘初出时色白者，气血虚也，
便宜大补气血，参、术、 、芎、升麻、干姜、甘草、木香、丁香、酒洗当归、白芍药，若大便泻，加诃子、肉
果。丹溪治吴店小儿，周岁痘疮，色白甚痒，药中每加参、 、半两，白术七分，丁香两个，当归一钱，官桂
三分，水煎服。
上，治虚寒例。
〔娄〕予族侄女笄年出痘，灰白色，身热喘嗽渴，脉洪有力，与八物汤加连翘、桔梗、犀角屑、半夏、木通、
紫草、干葛、石膏、杏、枳、连、芩、前胡、栝蒌仁服之，十帖后，色红活，喘嗽缓减渐微，但热未除，遂于前方
减、杏、胡、枳、连、芩、蒌、七味，服三十余帖而安，安后发皆落，月余方起，床虚之极也。又一男子二十
余岁，出痘已破，未破者灰白色，又杂间以黑陷倒靥者，发热，寒战，身痛，脉洪或时弦，亦与八物加木通、红
花、紫草、陈皮、连翘，服十余帖而安。
上，治虚热例。
凡血气不足，灰白顶陷不起者，宜内托散（即十宣散，见起发）加紫草，并乳汁调补。痘色灰白，浆不满足，
欲成倒塌，皮薄易破者，保元汤（大法）加芎、归、芍药、升麻、人乳、好酒、进之。
上，补虚例。
有一等白痘，似粉，医人所不识，有盘，有顶，而软肥者，以加减大紫草散主之。
加减大紫草散 治白痘似粉，人所不识者。
紫草 人参 茯苓 黄 白术 芍药 川芎 当归 甘草 糯米
上各等分，为粗散。每服四五钱，水煎服。一方，有木通，无黄 ，名紫草快 散。又一方，去甘草，加木
通、防风，名参 四圣散，治表里俱虚。
补元汤 治痘顶充满，而根盘不聚，色不红活，乃气有余而血不足也。
川芎 当归 白芍药（酒炒） 熟地黄（各一钱） 紫草 红花（各酒洗，七分） 陈皮 甘草（各三
分） 白术（土炒，一钱半）
酒水各半盏，糯米五十粒，枣二枚，煎服。
活血散 治痘色淡白。
当归 赤芍药（酒炒） 紫草 川芎 红花（各五钱） 血竭（一钱） 木香（二钱）
上为末。每五岁者服一钱，十岁以上者服二钱，好酒调下。热极血焦不红活者，酒煎紫草汤调下。
保生散 治气血俱虚，灰白色，不灌脓回浆者。
紫河车（一具，焙，为末） 龟板（酥炙，五钱）
一方，有鹿茸五钱。
上为末。每服五七分或一钱，气虚者保元汤下，血虚，芎、归、紫草煎汤下。
混元散 治同上。
紫河车（一具，分作五七块）
用白糯米三合，水淘净，入无油铫内同炒，以米黄色为度，同为末。每用五七分，儿大者一钱。极补气
血，能助灌浆，如神。缘糯米性温，得紫河车之气，纯化为河车，故其补功最速，譬之造酒，米从曲化意也。
内助丹
黄 （酒炒） 人参（酒炒） 白术 茯苓 当归 陈皮 半夏 浓朴 肉桂 山楂
姜三片，枣一枚，糯米五十粒，水煎服。如不食，加人乳一杯。痒甚，加大附子。寒战不止，加附子
防风。渴，加麦门冬。泻，加泽泻、猪苓。不
止，加诃子、肉果。
助阳丹 痒塌不起，根窠不红。
黄 人参 白芍药（各酒炒，一钱） 甘草（三分） 川芎 当归（各一钱） 红花（五分） 陈皮
（八分） 官桂（二分）
姜枣水煎服。
回生起死丹 治痘灰白，寒气逆上，不食，腹胀呕吐，肚痛泄泻清水，手足俱冷。
丁香（九枚） 干姜（一钱）
水煎，热服，被盖片时，令脾胃温暖，阴退阳回，痘自红活。
The above six formulas are used to treat critical smallpox conditions, possessing the miraculous efficacy of reviving the dying.
Shen San (Divine Powder) [Note: This refers to the Scaly Pangolin Formula mentioned previously].
Tian Zhen Gao (Heavenly True Ointment): Treats black sunken dryness and red-purple discoloration of pustules, as well as persistent macules. Using this formula for rescue yields a four or five out of ten success rate.
Black meconium (black feces) passed by newborn infants should be collected in a porcelain jar, mixed with two liang of Mercury (Hydrargyrum), one qian of Musk (Moschus), sealed with yellow beeswax, and buried in the soil. The longer it is stored, the better; eventually, it liquefies. Whenever encountering the aforementioned symptoms, depending on the child's age, if heat-toxin is severe, administer two or three tea spoons, mixed equally with half wine-decocted Zi Cao Tang (Purple Gromwell Decoction). The skin color will immediately become ruddy and lustrous. This is truly a secret prescription, vastly superior to Tian Ling Gai (Skull Cap), which is dry, smelly, and useless. This is because the feces originate from the mother's true blood; using blood to nourish blood, combined with long burial in the earth absorbing yin qi, enables it to resolve toxins. For infants within one hundred days who present with fever, irritability, and incessant crying, apply a small amount into the corner of the eye. After two or three applications, the spirit calms and breath regulates, allowing sleep, as it also clears Heart heat.
Da Cheng San (Great Success Powder): Treats slow eruption of smallpox, depressed pustule tops, gray-white or black sunken lesions, and any condition where eruption fails to rise.
Chuan Shan Jia (Scaly Pangolin Scale) (wine-fried, 1 liang), Gan Cao Mo (Licorice Root Powder) (2 qian), Xiong Huang (Realgar), Zhu Sha (Cinnabar) (each 1.5 qian), Zi Cao (Arnebiae Radix seu Lithospermi Radix) (3 qian), She Xiang (Moschus) (2 fen).
For every five years of age, use 2 fen. For cold patterns, mix with hot wine and take orally. For heat patterns, take with Zi Cao Tang. For cold patterns, add Zhi Zhong San (Regulate Middle Powder). For heat patterns, add Xiao Wu Bi San (Priceless Little Powder).
Wu Jia San (Priceless Powder): Treats black sunken lesions approaching death.
Use feces from a healthy infant. Near the end of the twelfth lunar month, place in two silver jars joined together, sealed tightly with salt mud, and heated over fire until red-hot. Remove, grind into powder, and take 1 qian mixed with honey water. Another variation adds a small amount of She Xiang (Moschus) and Bing Pian (Borneolum Syntheticum).
[Dan] Ash-gray white color: quietness indicates timidity, viewed as Cold; restlessness indicates bravery, viewed as Heat. Regarding smallpox/rash turning white, when scabbing resembles bean shells unevenly, this is due to excessive water intake at the onset, causing irregular scabbing, commonly called "Dao Ye" (Reverse Scabbing). This is not harmful; simply administer formulas that consolidate the exterior. If toxic vapors are stagnant internally, adjust bowel and bladder functions appropriately: if constipated, unblock bowels; if urinary retention, unblock urine. No harm ensues.
[Xue] The aforementioned symptoms of failure to erupt and lack of ruddy vitality are due to Spleen and Lung Qi deficiency. Use Shen Si Sheng San (Ginseng Four Sages Powder) to promote eruption. Depressed, gray-white tops with diarrhea and thirst indicate Spleen and Lung deficiency-cold. Use Mu Xiang San (Costus Root Powder) or Yi Gong San (Extraordinary Efficacy Powder) to facilitate eruption. [Zhang] White color upon initial eruption indicates Qi and Blood deficiency. Immediately supplement Qi and Blood abundantly using Ren Shen (Ginseng), Bai Zhu (Atractylodis Macrocephalae Rhizoma), [missing character], Chuan Xiong (Ligustici Chuanxiong Rhizoma), Sheng Ma (Cimicifugae Rhizoma), Gan Jiang (Zingiberis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Xiang (Aucklandiae Radix), Ding Xiang (Caryophylli Flos), Jiu Xi Dang Gui (Angelica Sinensis Root washed in wine), and Bai Shao Yao (Paeoniae Radix Alba). If diarrhea occurs, add He Zi (Terminalia Chebulae Fructus) and Rou Guo (Myristicae Semen). Danxi treated a one-year-old child from Wudian with smallpox; the lesions were very white and intensely pruritic. In his prescriptions, he added Ban Liang (half tael) each of Ren Shen and [missing character], 7 qian Bai Zhu, 2 Ding Xiang, 1 qian Dang Gui, and 3 fen Guan Gui (Cinnamomi Cortex), decocted in water and administered.
Above: Examples of treating deficiency-cold.
[Lou] My clan niece erupted smallpox upon reaching adulthood. The color was gray-white, accompanied by fever, asthma, cough, thirst, and a surging, forceful pulse. I prescribed Ba Wu Tang (Eight Substance Decoction) plus Lian Qiao (Forsythiae Fructum), Jie Geng (Platycodonis Radix), Xi Jiao Xie (Rhinocerotis Cornu Section - *note: substitute with Buffalo Horn in modern practice*), Ban Xia (Pinelliae Rhizoma), Mu Tong (Akebiae Caulis), Zi Cao, Gan Ge (Puerariae Radix), Shi Gao (Gypsum Fibrosum), Xing Ren (Armeniacae Semen Amarum), Zhi Shi (Aurantii Fructus Immaturus), Lian Qiao (again? likely Lian Zi or similar context dependent, but text says Lian), Huang Qin (Scutellariae Radix), Qian Hu (Peucedani Radix), and Gua Lou Ren (Trichosanthis Semen). After ten doses, the color became ruddy, asthma and cough alleviated significantly, but heat remained. Thus, I removed seven herbs ([missing char], Xing Ren, Qian Hu, Zhi Shi, Lian, Qin, Lou) from the previous formula and continued for thirty-plus doses until stability. After recovery, scabs fell off, and full recovery took over a month due to extreme depletion from bedrest. Another case: A man in his twenties had ruptured smallpox; unruptured ones were gray-white, interspersed with black sunken reverse scabs. Symptoms included fever, chills, body pain, and a surging or occasionally wiry pulse. I similarly prescribed Ba Wu Tang plus Mu Tong, Hong Hua (Carthami Flos), Zi Cao, Chen Pi (Citri Reticulatae Pericarpium), and Lian Qiao. After ten-plus doses, he stabilized.
Above: Examples of treating deficiency-heat.
For all cases of insufficient Qi and Blood, presenting with gray-white color and depressed, non-rising pustules, use Nei Tuo San (Internal Support Powder, i.e., Shi Xuan San) plus Zi Cao, and supplement with breast milk. For gray-white color, insufficient pus filling, impending collapse, thin skin prone to rupture, use Bao Yuan Tang (Preserve Origin Decoction, basic principle) plus Chuan Xiong, Dang Gui, Shao Yao, Sheng Ma, human milk, and good wine, administered orally.
Above: Examples of tonifying deficiency.
There is a type of white smallpox resembling flour, unrecognized by physicians, characterized by a base plate and top, soft and plump. Treat primarily with Jia Jian Da Zi Cao San (Modified Great Purple Gromwell Powder).
Jia Jian Da Zi Cao San: Treats white smallpox resembling flour, unrecognized by people.
Zi Cao, Ren Shen, Fu Ling (Poria), Huang Qi (Astragali Radix), Bai Zhu, Shao Yao, Chuan Xiong, Dang Gui, Gan Cao, Nu Mi (Glutinous Rice).
All in equal parts, made into coarse granules. Take 4-5 qian per dose, decoct in water and drink. Another variation includes Mu Tong but excludes Huang Qi, named Zi Cao Kuai Dou San (Purple Gromwell Rapid Smallpox Powder). Yet another variation removes Gan Cao, adds Mu Tong and Fang Feng (Saposhnikoviae Radix), named Shen Huang Si Sheng San (Ginseng Astragalus Four Sages Powder), treating simultaneous deficiency of interior and exterior.
Bu Yuan Tang: Treats filled pustule tops but dispersed base plates, lacking ruddy vitality, indicating excess Qi and deficient Blood.
Chuan Xiong, Dang Gui, Bai Shao Yao (wine-fried, each 1 qian), Shu Di Huang (Rehmanniae Radix Preparata, each 1 qian), Zi Cao, Hong Hua (wine-washed, each 7 fen), Chen Pi, Gan Cao (each 3 fen), Bai Zhu (earth-fried, 1.5 qian).
Decoct with half cup wine and half cup water, along with 50 glutinous rice grains and 2 jujubes.
Huo Xue San: Treats pale white smallpox color.
Dang Gui, Chi Shao Yao (wine-fried), Zi Cao, Chuan Xiong, Hong Hua (each 5 qian), Xue Jie (Dragon's Blood), Mu Xiang (2 qian).
Grind into powder. Children aged five take 1 qian; those over ten take 2 qian, taken with good wine. For extreme heat causing scorched blood and lack of ruddiness, take with wine-decocted Zi Cao Tang.
Bao Sheng San: Treats simultaneous deficiency of Qi and Blood, gray-white color, failure to fill with pus and return fluid.
Zi He Che (Human Placenta) (one unit, baked, powdered), Gui Ban (Testudinis Carapax et Plastrum) (prepared with butter, 5 qian).
Another variation includes Lu Rong (Cervi Cornu Pantotrichum) 5 qian.
Grind into powder. Take 5-7 fen or 1 qian per dose. For Qi deficiency, take with Bao Yuan Tang; for Blood deficiency, take with decoction of Chuan Xiong, Dang Gui, and Zi Cao.
Hun Yuan San: Treats the same as above.
Zi He Che (one unit, divided into 5-7 pieces).
Take 3 he of white glutinous rice, wash clean, stir-fry in an oil-free ding pot with the placenta until the rice turns yellow. Grind together into powder. Take 5-7 fen, or 1 qian for older children. Extremely supplements Qi and Blood, assists in pus formation, effective as magic. This is because glutinous rice is warm-natured; receiving the Qi of Zi He Che, it transforms purely into Placenta Qi, thus its tonifying effect is fastest, analogous to rice transforming via yeast in winemaking.
Nei Zhu Dan
Huang Qi (wine-fried), Ren Shen (wine-fried), Bai Zhu, Fu Ling, Dang Gui, Chen Pi, Ban Xia, Hou Po (Magnoliae Officinalis Cortex), Rou Gui (Cinnamomi Cortex), Shan Zha (Crataegi Fructus).
Three slices of ginger, one jujube, 50 glutinous rice grains, decoct in water and drink. If unable to eat, add one cup of human milk. If itching is severe, add Da Fu Zi (Aconiti Lateralis Radix Preparata). If chills persist, add Fu Zi and Fang Feng. If thirsty, add Mai Men Dong (Ophiopogonis Tuber). If diarrhea, add Ze Xie (Alismatis Rhizoma) and Zhu Ling (Polyporus). If [diarrhea/bleeding] does not stop, add He Zi and Rou Guo.
Zhu Yang Dan: Itching, collapse, failure to rise, non-red root bases.
Huang Qi, Ren Shen, Bai Shao Yao (wine-fried, each 1 qian), Gan Cao (3 fen), Chuan Xiong, Dang Gui (each 1 qian), Hong Hua (5 fen), Chen Pi (8 fen), Guan Gui (2 fen).
Decoct with ginger and jujube water.
Hui Sheng Qi Si Dan: Treats gray-white smallpox, counter-flow of Cold Qi, anorexia, abdominal distension, vomiting, abdominal pain with watery diarrhea, cold hands and feet.
Ding Xiang (9 cloves), Gan Jiang (1 qian).
Decoct in water, take hot. Cover with blankets for a moment to warm the Spleen and Stomach, causing Yin to retreat and Yang to return, making the smallpox naturally ruddy and vital.