年长出痘总不宜，真阴亏损元气虚，一逢出痘毒冲炽，水不胜火岂能支，夹热参麦
清补剂，攻浆参归鹿茸宜。
【注】男子自十六岁后，皆谓之年长。嗜欲情开，元精走泄，又遇痘毒之火冲炽，则
真阴亏损。水虚不能制火。故每至行浆之际，口渴心烦，鼻衄咽痛，不能成脓、结痂者有
之。治者不可妄用寒凉。五六日前，只宜参麦清补汤调治，至七八日如脓浆不行，急宜
攻浆，以参归鹿茸汤内调鸡冠血酒治之。但得浆行，庶可无虞。
参麦清补汤
当归 川芎 花粉 白芍（酒炒） 生地 人参 生黄 前胡 桔梗 牛蒡子（炒、研）
生甘草 红花 南山楂 麦冬（去心）
引用生姜，水煎服。
【方歌】参麦清补用归芎，花粉白芍生地同，参 前桔牛蒡草，红花山楂麦门冬。
参归鹿茸汤（方见灌浆证治）
鸡冠血酒（方见灰陷白陷）
妇女发痘遇经行，当期毒解不须惊，非期凉血解毒治，过期四物解毒从，去血过多
气血弱，十全大补服通灵。
【注】女子出痘，或遇经行，须问其是期非期。如期而出者，则毒热随血解去，不须
施治，其证自愈。若非期而至者，此毒火内扰于胞中，致血妄行，以凉血解毒汤治之；若
过期不止，乃毒热乘入血室，以四物解毒汤加元参、甘草主之。若行浆时去血过多，此
气血虚弱不能统摄也，急用十全大补汤。治若稍缓，痘浆不行，则无救矣。
凉血解毒汤（方见结痂落痂证治）
四物解毒汤
当归 白芍（酒炒） 生地 元参 栀子（炒） 川芎 生甘草 黄连（酒炒）
黄柏（酒炒） 黄芩（酒炒）
水煎服。
【方歌】四物解毒汤如神，归芍生地共元参，栀子川芎生甘草，黄连黄柏共黄芩。
十全大补汤（方见结痂落痂证治）
It is generally inadvisable for adult men to develop smallpox, as their True Yin (Zhen Yin) is depleted and their Original Qi (Yuan Qi) is deficient. Once the toxic heat of the pox surges violently, the Water element cannot control Fire, making it impossible for the body to withstand it. If accompanied by heat, Shenmai Qingbu Tang (Ginseng and Ophiopogon Clearing and Tonifying Decoction) should be used; if the goal is to promote pus formation, Shenguilurong Tang (Ginseng, Angelica, and Deer Antler Decoction) is appropriate.
[Note] Men are considered adults from the age of sixteen onwards. Due to indulgence in desires and emotional arousal, Essence (Jing) is leaked. Coupled with the violent surge of toxic fire from the pox, True Yin becomes depleted. The deficiency of Water fails to control Fire. Therefore, during the stage of pus formation, symptoms such as thirst, vexation, epistaxis, and sore throat often occur, and some patients fail to suppurate or form scabs. Practitioners must not recklessly use cold and bitter drugs. In the first five to six days, only Shenmai Qingbu Tang should be used for regulation and treatment. By the seventh or eighth day, if pus does not form, urgent measures to promote pus formation are required, using Shenguilurong Tang mixed with Ji Guan Xue Jiu (Rooster Comb Blood Wine). As long as pus formation proceeds, there will be no cause for alarm.
Shenmai Qingbu Tang (Ginseng and Ophiopogon Clearing and Tonifying Decoction)
Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Hua Fen (Tian Huafen, Trichosanthis Radix), Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Sheng Di Huang (Rehmanniae Radix), Ren Shen (Ginseng Radix et Rhizoma), Sheng Huang Qi (Astragali Radix), Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix), Niu Bang Zi (Arctii Fructus, stir-fried and ground), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Hong Hua (Carthami Flos), Nan Shan Zha (Crataegi Fructus), Mai Dong (Ophiopogonis Radix, heart removed).
Add fresh ginger as a guide, decoct in water, and take orally.
[Prescription Verse] Shenmai Qingbu uses Dang Gui and Chuan Xiong, Hua Fen, Bai Shao, and Sheng Di together; Ginseng, Qian Hu, Jie Geng, and Niu Bang Zi, along with Hong Hua, Shan Zha, and Mai Dong.
Shenguilurong Tang (Ginseng, Angelica, and Deer Antler Decoction) (See section on Pus Formation Treatment)
Ji Guan Xue Jiu (Rooster Comb Blood Wine) (See section on Ashen and White Collapse)
When women develop smallpox and menstruation occurs simultaneously, if it happens at the expected time, the toxin resolves naturally, and there is no need for alarm. If it occurs unexpectedly, treat with cooling blood and detoxifying methods; if it persists beyond the expected period, follow the formula Siwu Jiedu Tang. If excessive blood loss leads to Qi and Blood deficiency, administer Shiquan Dabu Tang to restore vitality.
[Note] When women develop smallpox and experience menstruation, one must determine whether it is at the expected time. If it occurs at the expected time, the toxic heat is expelled with the menstrual blood, requiring no treatment, and the condition heals spontaneously. If it occurs unexpectedly, this indicates that toxic fire disturbs the uterus internally, causing reckless bleeding; treat with Liangxue Jiedu Tang (Cooling Blood and Detoxifying Decoction). If it persists beyond the expected period, the toxic heat has entered the Blood Chamber; treat primarily with Siwu Jiedu Tang plus Xuan Shen (Scrophulariae Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma). If excessive blood loss occurs during the pus formation stage, this indicates that Qi and Blood are too weak to contain the blood; urgently administer Shiquan Dabu Tang (Great Ten Tonifying Decoction). If treatment is delayed even slightly, and pus fails to form, the condition becomes incurable.
Liangxue Jiedu Tang (Cooling Blood and Detoxifying Decoction) (See section on Scabbing and Falling Off Treatment)
Siwu Jiedu Tang (Four Substances Detoxifying Decoction)
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Sheng Di Huang (Rehmanniae Radix), Xuan Shen (Scrophulariae Radix), Zhi Zi (Gardeniae Fructus, stir-fried), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Lian (Coptidis Rhizoma, stir-fried with wine), Huang Bo (Phellodendri Cortex, stir-fried with wine), Huang Qin (Scutellariae Radix, stir-fried with wine).
Decoct in water and take orally.
[Prescription Verse] Siwu Jiedu Tang works like magic, combining Dang Gui, Bai Shao, Sheng Di, and Xuan Shen; Zhi Zi, Chuan Xiong, and Sheng Gan Cao, along with Huang Lian, Huang Bo, and Huang Qin.
Shiquan Dabu Tang (Great Ten Tonifying Decoction) (See section on Scabbing and Falling Off Treatment)