诊后夜来大便三次，午后看视，堆沙甚薄，额准诸痘，枯瘪少浆，可见元气日虚，里毒
无以领载而出。今日理进攻托，迟则恐其干涸塌陷。
黄 当归 僵蚕 桑虫浆 防风 炙草 山甲 木香汁
次日 浆有五分，不肯肥饱充顶。昨停凉药，寝食大物颇宜。顷灯燃看视，自云畏寒。
∶形寒饮冷为肺损，盖见肺主一身气化，气虚性薄，皮腠不营，法当参、 益气，气充浆成
矣，近日幼科以毒为疑虑，吾谓气壮毒化，邪与正不并立也。
归身 人参 川芎 炙草 黄 官桂 广皮 木香
次用钱氏异功散加木香。
次用四浆散。
又 首乌 茯苓 百合 炒芍 米仁 沙参
四朝半 汗出卫疏，肌肉柔嫩，气虚证也。今日犹在六日前，宜和血脉升顶，少候形充
，即商内托。至于保护脾胃，犹不可缺。
川芎 僵蚕 紫矿 广皮 当归 炙草 丹皮 鸡顶血
五朝 赖有形红润色泽，得以营运浆汁；而呕恶泄泻，脾胃气弱，已见一斑。五行火能
生土，况肺金温暖，气化流行，如阳春布德同旨。
人参 炙草 浓朴 官桂 丁香 木香 腹皮 当归
六朝 清浆已有六七，色颇鲜明，气血有生长之机。助元正所以化毒，兼理脾胃。
保元汤，加川芎、木香、肉果、黄米。
七朝 浆已八分，其色淡白。要知气血不足，到此便顾脾胃，色渐苍黄，即可回痂，以
杜气弱难收之弊窦。议钱氏异功意。
人参 白术 广皮 茯苓 炙草 米仁
八朝 痘至回痂，皮毛内应乎肺，此音低咳嗽，有自来矣。古人进清凉以助结痂，譬之
秋令收藏，万物乃登。小便频长，腑无留毒壅滞，非徒为虚而呆补为也。
米仁 苦皮百合 甘草梢 茯苓 地骨皮 淡竹叶
九朝 回痂嗽呛音低，痘气由里传及肺部，气之所至，即为热气熏灼，只因脾气未实，
亦犯禁忌，故小便欲长，验肺气降也。轻清凉解，毋伤中也。古人云∶疹前痘后，最宜详慎
淡黄芩 绿豆皮 米仁 甘草梢 地骨皮 金银花 连翘 茯苓
五朝 痘已大发，面部细粒繁冗，界地不清，抑且神躁不安，身软痿顿，毒火时疠并重
此血热大险之痘。今日痘热虽透，所谓痘虽出，毒犹在里，大剂寒凉，疏利气血，使时火去
，神识清，颧颊诸痘绽立，厘清界地，乃是好处。
犀角 楂肉 川连 连翘 元参 青皮 羚羊 丹皮 紫矿 大力 赤芍 木通
四朝 议用清火解毒、活血疏滞。痘繁干燥，乃不得起胀之象，险重。
犀角 楂肉 生地 连翘 元参 羚羊 丹皮 金汁 土贝 紫草 黄连膏 猪尾血膏
银花汤煎。
五朝 两日来大剂清解，痘粒仍属干萎，可见火毒蒙蔽气血，邪胜正怯何疑？毒不外透
在里蒸，搏痰侵咽，呛逆来矣。总频与清凉，痘之润泽，非成浆形色，至险至险！议以牛黄
、珍珠护心包以利毒痰，汤药方法，不越寒凉范围矣。
川黄连 犀角汁 土贝 丹皮 金汁 生地 地龙汁 羚羊汁 连翘 桔梗 元参
六朝 三次大便，竟是药汁，乃胃中谷气已少，苦寒直从下走。究竟痘形干痿，肢泡累
然，并无毒肯解化之兆也。已经洞泄，其滑润又当酌进，必得胃苏纳谷，希冀堆沙发臭。
黄连 土贝 羚羊角 丹皮 黄芩 桔梗 连翘 紫茸
七朝 虽是清浆，颜色呆钝，仍是郁毒，尚多气血不足宣布之象。况肢腿发泡，瘙痒损
泄，皆伏危机。今日清解滋血，佐以攻托，务使胃苏进谷，稳过十二朝，方有好意。
黄连 生地 银花 僵蚕 桑虫汁 黄芩 丹皮 连翘 紫茸
银花、地丁汤煎。
九朝 神衰困倦，夜来缭舌切牙，烦不肯寐，况进粥食甚，是勉强，犹非全好光景，古
重恙必进寝食。今阳火与痘毒尚亢，而阴血、津液暗烁，清凉多进，热不尽解；攻蒸两投，
毒未熔化，摩挨多日，究无实济，因思《内经》云∶寒之不寒为无水，当养其阴。拟此连进
三天，扶过十二朝再议。
炒熟地 茯神 麦冬 天门冬 川斛 米仁
头面有收敛之象，虽曰回痂，而食物不加，便溲未调，究竟毒未尽化，正气先怯，危机
。连进苦寒攻毒以来，胃气受药，亦致废食。凡欲自思进之物，皆能醒豁脾胃之性，停药以
和胃，越二日再议。
三朝 时疠毒火兼盛，表里不清，烦躁神昏，布痘不爽，痘属险笃。幸赖年已十三，能
耐摧拔，庶可幸成。
石膏 大黄 青皮 连翘 红花 方诸水 黄芩 桃仁泥 楂肉 牛蒡 滑石
四朝 时疠毒火，当蔽心包络，所以昏愦谵妄。况痘子界地隐隐夹疹，血热烦蒸已极。
不独治痘，先须清神为要，议三黄解毒汤。
淡芩 黄柏 石膏 黄连 滑石 黑栀
五朝 神识颇清，全赖苦降之力。论年长出痘，人事已晓，肝中相火，肾脏龙火，皆得 腾
升发。少阴脉循咽挟舌，厥阴脉贯膈绕咽，一水不能制伏，恐其阻塞咽喉，阳气燔灼，吐涌
涎沫为胶，原在难治之例矣。经云∶火淫于内，治以苦寒，佐以咸寒。咸能润下，直入至阴
。温邪宜润忌燥，不仅痘门通套已也。
川连 元参 黑山栀 犀角 方诸水 川柏 生地 龙胆草 丹皮
六朝
川连膏 丹参 犀角汁 连翘 生地膏 元参 丹皮 羚羊汁 土贝
银花汤煎。
又 川连膏 天冬 麦冬 连翘 银花 元参 生地 川贝 生草
十一朝 浆满回痂，毒瓦斯已泄，口唇痘子，未若肌表浆痂，必成熟腐而落。此最动之处
，最易变疳，明日便约疳医洗治为要。
川贝 生草 天冬 银花 麦冬 元参 知母 连翘
又 天冬 生首乌 生黄 银花 麦冬 小胡麻 地骨皮 连翘
又 金石斛 天冬 生首乌 连翘 地骨皮 麦冬 金银花 山豆根
十八朝 虎潜丸。
八朝 火毒即是血热，理用寒凉；气虚乃元弱不领毒外达，治宜内托，二症相反，有如
，若之火毒便非气虚。今周岁婴孩，面有清浆五六，背部根晕皆散，八日来不思纳谷，反现
呕恶切牙、泄泻渴烦等象，全属里虚毒陷，若不急保脾胃，温养气血以营运浆汁，必致延挨
告变。陈文中云∶渴泻呕恶，或腹胀，十一味木香散主之。凭理考古，不敢因循苟且也。
九朝 七味豆蔻丸，研入米饮内服。
十朝 泻止能食，最是好处，但痂疮甚薄，浆汁不浓，毒未化尽，半月后恐有余毒缠绵
解毒为凉药，脾胃尚弱，未可骤进，姑与健脾利水一二日，当停药安谷。至初十间再行解毒
熟白术 炙甘草 米仁 炒陈皮 白茯苓 炒白芍 炒谷芽 炒泽泻
三朝 正面不 发，色犹郁伏。时气固从热论，验形体已属不足，刻下轻润凉解活血六
七日，受补可疗，然症象已繁多属险。
犀角 紫草 连翘 木通 滑石 楂肉 丹皮 甘草 红花 笋尖
四朝 正痘皆发，形软蓬松，色娇皮嫩，是气虚形色大着。或以身夹斑点为血热，此乃
混入血中，非本体之见端，故六日前清凉活血，皆解邪之法；七日间助元内托，乃养正之法
，仍以轻清，议用∶
犀角 红花 紫草 杏仁 僵蚕 羚羊 丹皮 甘草 连翘 楂肉
加鸡冠血。
五朝 不肯光华，形象扁塌，此气血俱馁，未能领载毒瓦斯以化浆，则知寒凉解毒乃通套
常方，而煦提气血，方称工巧。
川芎 炙草 僵蚕 紫茸 归身 楂肉 角刺 桔梗
加鸡冠血。
气血寒凉太过，脾胃伤则呕涩，议用异功散。
寒战切牙，泄利清滑，粥食不受。从前寒滑，重伤脾骨，致毒不尽，神内怯，肠中滑不
自持，虽参、术亦从滑下，惟有陈氏法急固下利。七味豆蔻丸。
脾气初结，未可解毒凉润。
白术炭 建莲 山药 炙黑草 薏苡仁 茯苓 泽泻
二朝 时气与内毒痹结，喘促，痘不发越，宜通气血，调畅六腑。
石膏 大黄（酒炒制） 红花 青皮 滑石 楂肉 桃仁 木通
三朝 痘形八九不得均匀，而形色干烧，已为火象，清解凉血透毒为治。
犀角尖 楂肉 连翘 丹皮 生草 羚羊角 紫茸 牛蒡 桔梗
四朝 羚羊角 元参 僵蚕 生地 紫茸 川黄连 桔梗 楂肉 丹皮 鸡冠血
银花汤煎。
五朝 火毒未化，切牙呛咳，呕恶腹膨，清解兼疏滞。
羚羊角 楂肉 僵蚕 紫茸 连翘 川黄连 广皮 土贝 丹皮 桔梗
银花汤煎。
六朝 火毒未为尽透，腹膨便溏，不欲进食，此脾正亏，而肠胃中滞气不行也，议以养
营托里，疏理滞气之法。
川芎 腹皮 僵蚕 浓朴 当归 广皮 角针 青皮
八朝 攻毒以来，浆末鼎充，再腹膨呕逆身热，二便颇通，岂云食滞，口之脾胃间尚有
蕴伏热毒，阻挠流行气机。脾滞为胀，胃逆为呕，若不清理痘中杂病，须防喘急疳钳。
竹茹 枳实 麦冬 青皮 川连 橘红 茯苓 腹皮
九朝 川黄连 黄芩 桔梗 银花 橘红 益元散 连翘 川贝 地丁
痘形色不雄伟 发，是属气虚，议进透肌安表。
荆芥 赤芍 楂肉 桔梗 笋尖 牛蒡 红花 广皮 甘草
四朝 痘已发齐，稠密不准，额准盘松不绽，诸部亦少光彩。气虚毒重，八九恐生痒塌
。今议用升顶提透，不可擅用寒凉。
川芎 归身 紫茸 僵蚕 鸡顶血 桔梗 红花 楂肉 甘草 酒浆
五朝 元虚痘密，起发成浆最难。今日再进提托，少候形充，即商内托，受补为佳。
川芎 炙草 僵蚕 楂肉 羊肉 归身 广皮 角针 紫茸 鸡顶血
六朝 地阁颐颊稍稍光润，所谓行浆之色。奈何天庭枯白，形似蛇皮，阳位不宣，究非
善状，急急温补气血，从内托毒，迟则变症，补必无益矣。
人参 川芎 广皮 楂肉 黄 当归 炙草 鸡顶血
七朝 人参 川芎 当归 广皮 黄 鹿茸 炙草 楂肉
八朝 浆有四分，阔塌发痒，慎之。
人参 黄 炙草 木香 归身 鹿茸 坎气 广皮 肉果
九朝 面部清浆欲涸，周身晕散塌阔，切牙泄泻，纳谷不多，两日痒甚，今日稍和，表
里正虚，毒陷欲涸，再当攻发，继进木香异功散，理肺安脾为要。
十一朝 头面半浆回痂，肢体灰陷不荣，虚中留毒，险笃在于明后，今寒战切牙不食，
则正气欲脱，拟以附子理中汤加茯苓。
四朝 身小痘多，气虚血热。今时气未尽，尚宜疏解。五日后盒饭补托，犹宜加意，可
荆芥 楂肉 红花 桔梗 冬米 牛蒡 僵蚕 川芎 丹皮
五朝 身小痘多，元气甚薄。凡起胀灌浆，全要精神，待毒自发热，体少安适，至七八
，神气已经耗损，故痘书云∶小舟重载。八九风波可见，元气日薄，痒塌，内外症象都在是
期，虚中夹毒，明明险象。今议用和血提顶起胀方法。
川芎 炙草 紫茸 木香 鸡顶血 当归 广皮 炒查 僵蚕
六朝 痘虽放白，已具行浆之势，所嫌顶不高耸，况又切牙，大便频下，内虚之象，已
见一斑。今急急补托，使精神稍振，可以送毒化浆。
黄 炙草 木香 僵蚕 归身 川芎 广皮 黄米
七朝 色白不能红润，大便频下，是精神内竭，有下陷之象。拟进参归鹿茸汤，冀其元
气稍振，便可侥幸成功。
本方加肉果、诃子皮、炒广皮、木香。
八朝 浆水不行，切牙腹痛泄泻，此正虚气滞毒凝，补托极妥，虑虚不承受。陈文中云
∶渴泻腹胀，可与木香异功散，以安中疏滞。
人参 苏梗 浓朴 丁香 当归 木香 前胡 青皮 腹皮 川芎 加炒黄米
六朝 形钝色扁，是痘发毒郁于里，不肯成浆，焉得毒化。况内证如不食、口臭下利，
元气为毒拘束之象已着。无对症之药，不得已，以当世通行凉解，实无济也。
犀角 紫矿 僵蚕 生地 连翘 丹皮 楂肉
银花汤煎。
六朝 肉部肿疮枯，周身形象不伟，本虚气血不行，毒瓦斯漫无拘束，必得痘形充长，颜
色润泽，方有成浆之望。议以清毒内托，两和气血。
黄连 归身 丹皮 广皮 川芎 炙草 紫矿 僵蚕 鸡顶血
七朝 色稍润，形尚瘪，血有承载之基，气少煦运之力。古人每以十宣保元勃气，翁氏
亦主六日后专运气血为主。今日初见浆来，疮家气血耗损，深虑两日间痒塌。
人参 木香 川芎 酒浆 归身 炙草 楂肉
九朝
人参 僵蚕 归身 黄 甲末 广皮
十朝 浆未充盈，泄泻粘腻，虽痰咳，上焦未肃，理必急护脾阳，此陈氏方法，何惮不
人参 酒炒当归 炙草 肉果 黄 酒炒白芍 木香 广皮
炒黄米汤煎，此后十一朝方。
十一朝 鼎不充满，皮壳已腐，不任攻发，惟宜补托。
人参 焦术 丁香 诃子皮 肉桂 广皮 浓朴 肉果 炒黄米，此前九朝方。
十二朝
炒白芍 茯苓 甘草 丹皮 生米仁 骨皮 银花 泽泻
七朝 音哑痰潮，下利粘腻。翁仲仁云∶喘急见于泻后，总是气虚而断。呕恶不食，脾
肺两败，危如朝露矣。陈氏异攻散温里托毒，急救太阴脏真。
八朝 内症安和，宜理阳。
人参 丁香 肉果 肉桂 茯苓 白术 木香 姜附
炒黄米汤煎。
[Background Information]
Book: Selected Prescriptions from Meishou Hall (Mei Shou Tang Fang An Xuan Cun)
Author: Ye Tianshi (Ye Tian-shi)
Dynasty: Qing Dynasty
Chapter: Smallpox Treatment (Dou Ke) Part 1/2
Category: Formulas
After examination, there were three bowel movements during the night. In the afternoon, upon inspection, the smallpox eruption was sparse and thin. The pustules on the forehead and nasal root were dry, collapsed, and had little pus, indicating that the primordial Qi (vital energy) is daily weakening, and the internal toxins cannot be led out by the body's resistance. Today, the treatment should focus on attacking the pathogen while supporting the healthy Qi to push the toxin outward; delay may lead to drying up and collapse of the lesions.
Prescription: Dang Gui (Angelicae Sinensis Radix), Jiang Can (Bombyx Batryticatus), Sang Chong Jiang (Decoction of桑螵蛸 - Mantis Egg Case), Fang Feng (Saposhnikoviae Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Shan Jia (Manis Squama), Mu Xiang汁 (Juice of Aucklandiae Radix).
The next day, the pus filled only half of the pustules and failed to become plump and rise. Yesterday, cold-natured medicines were stopped, and sleep and appetite greatly improved. Just now, under lamplight, the patient reported feeling aversion to cold.
Commentary: Physical chills and consumption of cold drinks damage the Lung. This is because the Lung governs the Qi transformation of the whole body. When Qi is deficient and nature is thin, the skin and interstices do not receive nourishment. The method should involve using Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) to tonify Qi; when Qi is sufficient, pus will form. Recently, pediatricians worry about toxins; I believe that when Qi and Blood are strong, toxins transform, and evil and healthy Qi cannot coexist.
Prescription: Gui Shen (Radix Angelicae Sinensis), Ren Shen (Ginseng Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Huang Qi (Astragali Radix), Guan Gui (Cinnamomi Cortex), Guang Pi (Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix).
Subsequently, Qian Shi Yi Gong San (Mr. Qian’s Extra-Efficacy Powder) with added Mu Xiang was used.
Then, Si Jiang San (Four Pus Powders) was used.
Another consultation: Shou Wu (Polygoni Multiflori Preparata Radix), Fu Ling (Poria), Bai He (Lilii Bulbus), Chao Shao Yao (Fried Paeoniae Radix Alba), Mi Ren (Coicis Semen), Sha Shen (Glehniae Radix).
On the fourth and a half days, sweating caused the Wei Qi (Defensive Qi) to scatter, and muscles were tender, which is a sign of Qi deficiency. Currently still within the first six days, it is appropriate to harmonize the blood vessels and lift the top of the lesions. Wait for the form to fill out, then discuss internal support. Protecting the Spleen and Stomach remains indispensable.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jiang Can (Bombyx Batryticatus), Zi Kuang (Dragon’s Blood Resin), Guang Pi (Citri Reticulatae Pericarpium), Dang Gui (Angelicae Sinensis Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Dan Pi (Moutan Cortex), Ji Ding Xue (Rooster Comb Blood).
On the fifth day, relying on the ruddy color of the lesions, the fluid generation can circulate; however, vomiting, nausea, and diarrhea indicate weak Spleen and Stomach Qi, already showing a glimpse. In the Five Elements, Fire generates Earth. Moreover, if Lung Metal is warm and Qi transformation flows, it is similar to the benevolence of spring sunshine.
Prescription: Ren Shen (Ginseng Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Guan Gui (Cinnamomi Cortex), Ding Xiang (Eugeniae Flos), Mu Xiang (Aucklandiae Radix), Fu Pi (Arecae Pericarpium), Dang Gui (Angelicae Sinensis Radix).
On the sixth day, clear pus has reached sixty or seventy percent, and the color is quite bright, showing a mechanism of Qi and Blood growth. Assisting the primordial Zheng Qi (Upright Qi) is precisely to transform toxins, while simultaneously regulating the Spleen and Stomach.
Prescription: Bao Yuan Tang (Protect the Primordial Decoction), plus Chuan Xiong (Ligustici Chuanxiong Rhizoma), Mu Xiang (Aucklandiae Radix), Rou Guo (Myristicae Semen), Huang Mi (Setaria Italica).
On the seventh day, the pus has reached eighty percent, but the color is pale white. One must know that due to insufficient Qi and Blood, at this stage one must care for the Spleen and Stomach. As the color gradually turns sallow, scabbing can occur, preventing the drawback of difficult closure due to weak Qi. It is proposed to follow the idea of Qian Shi Yi Gong San.
Prescription: Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Guang Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Mi Ren (Coicis Semen).
On the eighth day, as the smallpox reaches the scabbing stage, the skin and hair correspond internally to the Lung. Thus, low voice and coughing have arisen naturally. Ancients used cooling herbs to assist scabbing, likening it to autumn storage, so that all things mature. Frequent and long urination indicates no residual toxins stagnating in the fu organs; this is not merely a case of deficiency requiring static tonification.
Prescription: Mi Ren (Coicis Semen), Ku Pi Bai He (Lilii Bulbus with bitter peel), Gan Cao Shao (Tip of Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Di Gu Pi (Lycii Cortex), Dan Zhu Ye (Lophatheri Herba).
On the ninth day, scabbing with coughing, wheezing, and low voice indicates that the smallpox qi has transmitted from the interior to the Lung. Wherever Qi arrives, it becomes scorched by heat. Because the Spleen Qi is not yet solid, taboos were also violated, hence the desire for long urination, verifying the descent of Lung Qi. Use mild cooling and resolving methods without damaging the Middle Jiao. The ancients said: Before rash and after smallpox, utmost caution is required.
Prescription: Dan Huang Qin (Scutellariae Radix), Lv Dou Pi (Vigna Radiata Testa), Mi Ren (Coicis Semen), Gan Cao Shao (Tip of Glycyrrhizae Radix et Rhizoma), Di Gu Pi (Lycii Cortex), Yin Hua (Lonicerae Japonicae Flos), Lian Qiao (Forsythiae Fructus), Fu Ling (Poria).
On the fifth day (Note: Sequence implies a different case or progression), the smallpox has erupted vigorously. The facial granules are numerous and crowded, boundaries unclear. Furthermore, the spirit is restless, the body soft and listless. Toxin fire and seasonal pestilence are heavy. This is a severe and dangerous smallpox of Blood Heat. Although the toxin heat has penetrated today, as it is said, "though the pox appears, the toxin remains inside." Large doses of cold-natured medicines should be used to vent and promote Qi and Blood circulation, removing seasonal fire, clearing the spirit, making the cheek lesions stand open and clarifying boundaries. This is the favorable outcome.
Prescription: Xi Jiao (Rhinocerotis Cornu), Zha Rou (Crataegi Fructus), Chuan Lian (Coptidis Rhizoma), Lian Qiao (Forsythiae Fructus), Yuan Shen (Scrophulariae Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Ling Yang (Capricornu Saigae Tataricae), Dan Pi (Moutan Cortex), Zi Kuang (Dragon’s Blood Resin), Da Li (Arctii Fructus), Chi Shao (Paeoniae Radix Rubra), Mu Tong (Akebiae Caulis).
On the fourth day, it is discussed to use clearing fire, detoxifying, invigorating blood, and relieving stagnation. The dense and dry lesions indicate failure to swell, which is critical and dangerous.
Prescription: Xi Jiao (Rhinocerotis Cornu), Zha Rou (Crataegi Fructus), Sheng Di (Rehmanniae Radix), Lian Qiao (Forsythiae Fructus), Yuan Shen (Scrophulariae Radix), Ling Yang (Capricornu Saigae Tataricae), Dan Pi (Moutan Cortex), Jin Zhi (Gold Juice), Tu Bei (Fritillariae Thunbergii Bulbus), Zi Cao (Arnebiae Radix et Rhizoma), Huang Lian Gao (Coptidis Extract), Zhu Wei Xue Gao (Pig Tail Blood Extract). Decocted with Yin Hua (Lonicerae Japonicae Flos) soup.
On the fifth day, despite large doses of clearing and resolving over two days, the lesions remain dry and withered. It is evident that fire-toxin obscures Qi and Blood; there is no doubt that evil prevails while healthy Qi is weak. The toxin does not exit externally but steams internally, clashing with phlegm and invading the throat, leading to choking and counterflow. Continuously using cooling medicines, the lesion's moisture is not forming pus texture. Extremely dangerous! It is proposed to use Niu Huang (Bovis Calculus) and Zhen Zhu (Concha Margaritifera) to protect the Pericardium and facilitate the discharge of toxic phlegm. The decoction method stays within the scope of cold-natured medicines.
Prescription: Chuan Huang Lian (Coptidis Rhizoma), Xi Jiao Zhi (Rhinocerotis Cornu Juice), Tu Bei (Fritillariae Thunbergii Bulbus), Dan Pi (Moutan Cortex), Jin Zhi (Gold Juice), Sheng Di (Rehmanniae Radix), Di Long Zhi (Pheretima Juice), Ling Yang Zhi (Capricornu Saigae Tataricae Juice), Lian Qiao (Forsythiae Fructus), Jie Geng (Platycodonis Radix), Yuan Shen (Scrophulariae Radix).
On the sixth day, three bowel movements consist entirely of medicinal juice, indicating that grain Qi in the Stomach is scarce, and bitter-cold medicines pass directly downward. Ultimately, the lesion shape is dry and withered, limbs have accumulated blisters, and there is no sign of toxin resolution. Having suffered profuse diarrhea, lubricating measures should be considered. Only when Stomach Qi recovers and food intake resumes can we hope for the eruption and odor of the smallpox.
Prescription: Huang Lian (Coptidis Rhizoma), Tu Bei (Fritillariae Thunbergii Bulbus), Ling Yang Jiao (Capricornu Saigae Tataricae), Dan Pi (Moutan Cortex), Huang Qin (Scutellariae Radix), Jie Geng (Platycodonis Radix), Lian Qiao (Forsythiae Fructus), Zi Rong (Dragon’s Blood Resin).
On the seventh day, although there is clear pus, the color is dull, indicating lingering toxin and signs of insufficient Qi and Blood distribution. Moreover, blistering on limbs and legs, itching, and loss cause hidden crises. Today, clearing and resolving while nourishing blood, assisted by attacking and supporting, aims to restore Stomach function and food intake, stabilizing past the twelfth day for a better prognosis.
Prescription: Huang Lian (Coptidis Rhizoma), Sheng Di (Rehmanniae Radix), Yin Hua (Lonicerae Japonicae Flos), Jiang Can (Bombyx Batryticatus), Sang Chong Zhi (Juice of Mantis Egg Case), Huang Qin (Scutellariae Radix), Dan Pi (Moutan Cortex), Lian Qiao (Forsythiae Fructus), Zi Rong (Dragon’s Blood Resin). Decocted with Yin Hua (Lonicerae Japonicae Flos) and Di Ding (Vincae Herba) soup.
On the ninth day, spirit is depleted and fatigued. At night, tongue rolling and teeth grinding occurred, with restlessness and insomnia. Food intake is minimal, forced rather than natural. Ancient texts state that serious illness requires recovery of sleep and appetite. Currently, Yang fire and smallpox toxin are still hyperactive, while Yin Blood and body fluids are secretly consumed. Excessive cooling fails to resolve heat; attacking and steaming treatments fail to melt the toxin. After many days of dragging, there is no substantial benefit. Recalling the *Neijing*: "If cold does not cure, it is due to lack of Water (Yin); one must nourish Yin." This prescription will be taken for three days to support past the twelfth day before re-evaluating.
Prescription: Chao Shu Di (Fried Rehmanniae Radix Praeparata), Fu Shen (Poria with Hostwood), Mai Dong (Ophiopogonis Radix), Tian Men Dong (Asparagi Radix), Chuan Hu (Dendrobii Caulis), Mi Ren (Coicis Semen).
The head and face show signs of convergence. Although called scabbing, food intake has not increased, and excretion is unregulated. Ultimately, the toxin is not fully transformed, and healthy Qi is weak first, posing a crisis. Since administering bitter-cold detoxifying medicines, Stomach Qi has been damaged, leading to anorexia. Any food desired by the patient can awaken the Spleen and Stomach nature. Stop medication to harmonize the Stomach, and re-evaluate in two days.
On the third day, seasonal pestilence toxin fire is abundant, interior and exterior are unclear, with irritability and confusion. Eruption is uneven, indicating critical smallpox. Fortunately, the patient is thirteen years old and can withstand the strain, offering a chance of success.
Prescription: Shi Gao (Gypsum Fibrosum), Da Huang (Rhei Radix et Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Lian Qiao (Forsythiae Fructus), Hong Hua (Carthami Flos), Fang Zhu Shui (Water from Stone Jar), Huang Qin (Scutellariae Radix), Tao Ren Ni (Persicae Semen Paste), Zha Rou (Crataegi Fructus), Niu Bang (Arctii Fructus), Hua Shi (Talcum).
On the fourth day, seasonal pestilence toxin fire likely obstructs the Pericardium Collateral, causing confusion and delirium. Moreover, the smallpox boundaries are faint with interspersed rash, and Blood Heat irritation is extreme. Besides treating smallpox, clearing the spirit is paramount. It is proposed to use San Huang Jie Du Tang (Three Yellow Detoxifying Decoction).
Prescription: Dan Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex), Shi Gao (Gypsum Fibrosum), Huang Lian (Coptidis Rhizoma), Hua Shi (Talcum), Hei Zhi (Gardeniae Fructus).
On the fifth day, mental clarity has largely returned, relying on the descending power of bitter substances. Discussing adult-onset smallpox, where consciousness is established, the Ministerial Fire in the Liver and Dragon Fire in the Kidney ascend freely. The Shaoyin meridian circles the throat and ties to the tongue; the Jueyin meridian passes through the diaphragm and winds around the throat. If one Water element cannot control them, obstruction of the throat may occur, with Yang fire blazing, vomiting saliva into glue-like consistency. This falls under difficult cases. The Classics state: "When fire dominates internally, treat with bitter-cold, assisted by salty-cold." Salty substances moisten and descend, entering the deepest Yin. Warm pathogens require moistening and avoid dryness, not just a general rule for smallpox.
Prescription: Chuan Lian (Coptidis Rhizoma), Yuan Shen (Scrophulariae Radix), Hei Shan Zhi (Gardeniae Fructus), Xi Jiao (Rhinocerotis Cornu), Fang Zhu Shui (Water from Stone Jar), Chuan Bai (Phellodendri Cortex), Sheng Di (Rehmanniae Radix), Long Dan Cao (Gentianae Radix), Dan Pi (Moutan Cortex).
On the sixth day
Prescription: Chuan Lian Gao (Coptidis Extract), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Xi Jiao Zhi (Rhinocerotis Cornu Juice), Lian Qiao (Forsythiae Fructus), Sheng Di Gao (Rehmanniae Radix Extract), Yuan Shen (Scrophulariae Radix), Dan Pi (Moutan Cortex), Ling Yang Zhi (Capricornu Saigae Tataricae Juice), Tu Bei (Fritillariae Thunbergii Bulbus). Decocted with Yin Hua (Lonicerae Japonicae Flos) soup.
Another prescription: Chuan Lian Gao (Coptidis Extract), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Lian Qiao (Forsythiae Fructus), Yin Hua (Lonicerae Japonicae Flos), Yuan Shen (Scrophulariae Radix), Sheng Di (Rehmanniae Radix), Chuan Bei (Fritillariae Cirrhosae Bulbus), Sheng Cao (Raw Glycyrrhizae Radix et Rhizoma).
On the eleventh day, pus is full and scabs form; toxin vapor has discharged. Lip lesions differ from body surface scabs, maturing and rotting before falling. This area is highly active and prone to becoming mouth ulcers (gan). Tomorrow, consulting a specialist for washing treatment is crucial.
Prescription: Chuan Bei (Fritillariae Cirrhosae Bulbus), Sheng Cao (Raw Glycyrrhizae Radix et Rhizoma), Tian Dong (Asparagi Radix), Yin Hua (Lonicerae Japonicae Flos), Mai Dong (Ophiopogonis Radix), Yuan Shen (Scrophulariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Lian Qiao (Forsythiae Fructus).
Another prescription: Tian Dong (Asparagi Radix), Sheng Shou Wu (Polygoni Multiflori Radix), Sheng Huang Qi (Astragali Radix), Yin Hua (Lonicerae Japonicae Flos), Mai Dong (Ophiopogonis Radix), Xiao Hu Ma (Sesami Semis Nigrum), Di Gu Pi (Lycii Cortex), Lian Qiao (Forsythiae Fructus).
Another prescription: Jin Shi Hu (Dendrobii Caulis), Tian Dong (Asparagi Radix), Sheng Shou Wu (Polygoni Multiflori Radix), Lian Qiao (Forsythiae Fructus), Di Gu Pi (Lycii Cortex), Mai Dong (Ophiopogonis Radix), Jin Yin Hua (Lonicerae Japonicae Flos), Shan Dou Gen (Sophorae Tonkinensis Radix).
On the eighteenth day, Hu Huan Wan (Tiger Crouching Pill).
On the eighth day, Fire Toxin is Blood Heat, treated with cold-natured herbs; Qi deficiency is primordial weakness failing to lead toxin outward, treated with internal support. These two conditions are contradictory, like ice and charcoal. If Fire Toxin exists, it is not Qi deficiency. Now, a one-year-old infant has five or six clear pustules on the face, back晕 (halos) scattered. For eight days, no desire for food, instead showing vomiting, teeth grinding, diarrhea, thirst, and irritability. This belongs entirely to interior deficiency and toxin sinking. Without urgently protecting the Spleen and Stomach and warming/nourishing Qi and Blood to circulate pus, delay will lead to deterioration. Chen Wenzhong said: "Thirst, diarrhea, vomiting, or abdominal distension, treat with Shi Yi Wei Mu Xiang San (Eleven-Ingredient Mu Xiang Powder)." Based on reasoning and ancient texts, I dare not be negligent.
On the ninth day, Qi Wei Dou Kou Wan (Seven-Ingredient Cardamom Pill), ground and taken with rice water.
On the tenth day, diarrhea stops and appetite returns, which is very good. However, scabs are very thin, pus is not thick, and toxin is not fully transformed. Half a month later, lingering residual toxin is feared. Detoxifying uses cold medicines; the Spleen and Stomach are still weak, so sudden administration is inadvisable. Temporarily use spleen-fortifying and water-draining herbs for one or two days, then stop medication to stabilize grain intake. Re-evaluate detoxification around the tenth day.
Prescription: Shu Bai Zhu (Prepared Atractylodis Macrocephalae Rhizoma), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Mi Ren (Coicis Semen), Chao Chen Pi (Fried Citri Reticulatae Pericarpium), Bai Fu Ling (White Poria), Chao Bai Shao (Fried Paeoniae Radix Alba), Chao Gu Ya (Fried Hordei Fructus Germinatus), Chao Ze Xie (Fried Alismatis Rhizoma).
On the third day, the front does not erupt, color is depressed. Seasonal qi is indeed discussed as heat, but the physical form shows insufficiency. Currently, mild moistening, cooling, resolving, and blood-invigorating herbs for six or seven days allow for subsequent tonification, though symptoms are complex and dangerous.
Prescription: Xi Jiao (Rhinocerotis Cornu), Zi Cao (Arnebiae Radix et Rhizoma), Lian Qiao (Forsythiae Fructus), Mu Tong (Akebiae Caulis), Hua Shi (Talcum), Zha Rou (Crataegi Fructus), Dan Pi (Moutan Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hong Hua (Carthami Flos), Sun Jian (Bamboo Shoot Tip).
On the fourth day, true smallpox erupts, shape soft and fluffy, color delicate and skin tender, indicating prominent Qi deficiency in form and color. Some might think spots on the body indicate Blood Heat, but this is mixed into the blood, not the primary manifestation. Thus, cooling and blood-invigorating herbs in the first six days resolve evil; assisting Yuan Qi and internal support in the seventh day nourishes Zheng Qi. Still using light and clear methods, it is proposed:
Prescription: Xi Jiao (Rhinocerotis Cornu), Hong Hua (Carthami Flos), Zi Cao (Arnebiae Radix et Rhizoma), Xing Ren (Armeniacae Semen Amarum), Jiang Can (Bombyx Batryticatus), Ling Yang (Capricornu Saigae Tataricae), Dan Pi (Moutan Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Lian Qiao (Forsythiae Fructus), Zha Rou (Crataegi Fructus). Add Ji Guan Xue (Rooster Comb Blood).
On the fifth day, lacking luster, shape flat and collapsed, indicating both Qi and Blood are exhausted, unable to carry toxin vapor to transform into pus. Thus, one knows that cold-natured detoxifying formulas are common routines, whereas warming and lifting Qi and Blood demonstrates skill.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Jiang Can (Bombyx Batryticatus), Zi Rong (Dragon’s Blood Resin), Gui Shen (Radix Angelicae Sinensis), Zha Rou (Crataegi Fructus), Jiao Ci (Urticae Flos), Jie Geng (Platycodonis Radix). Add Ji Guan Xue (Rooster Comb Blood).
Excessive cold and cooling of Qi and Blood damages the Spleen and Stomach, causing vomiting and blockage. It is proposed to use Yi Gong San.
Chills, teeth grinding, clear slippery diarrhea, inability to accept porridge. Previous cold and slippery herbs severely damaged Spleen bone, causing incomplete toxin resolution, internal fear of spirit, and intestinal slipping. Even Ren Shen and Bai Zhu slide down. Only Chen’s method to urgently secure diarrhea is applicable. Qi Wei Dou Kou Wan (Seven-Ingredient Cardamom Pill).
Spleen Qi has just begun to consolidate; detoxifying and cooling-moistening herbs are contraindicated.
Prescription: Bai Zhu Tan (Charred Atractylodis Macrocephalae Rhizoma), Jian Lian (Nelumbinis Nuculus), Shan Yao (Dioscoreae Rhizoma), Zhi Hei Cao (Honey-charred Glycyrrhizae Radix et Rhizoma), Yi Yi Ren (Coicis Semen), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma).
On the second day, seasonal qi and internal toxin bind together, causing panting, and smallpox fails to emerge. It is appropriate to unblock Qi and Blood and regulate the Six Fu organs.
Prescription: Shi Gao (Gypsum Fibrosum), Da Huang (Rhei Radix et Rhizoma, wine-fried), Hong Hua (Carthami Flos), Qing Pi (Citri Reticulatae Pericarpium Viride), Hua Shi (Talcum), Zha Rou (Crataegi Fructus), Tao Ren (Persicae Semen), Mu Tong (Akebiae Caulis).
On the third day, smallpox shapes are uneven, and form/color is dry and burning, indicating Fire pattern. Treatment involves clearing, resolving, cooling blood, and penetrating toxin.
Prescription: Xi Jiao Jian (Tip of Rhinocerotis Cornu), Zha Rou (Crataegi Fructus), Lian Qiao (Forsythiae Fructus), Dan Pi (Moutan Cortex), Sheng Cao (Raw Glycyrrhizae Radix et Rhizoma), Ling Yang Jiao (Capricornu Saigae Tataricae), Zi Rong (Dragon’s Blood Resin), Niu Bang (Arctii Fructus), Jie Geng (Platycodonis Radix).
On the fourth day, Ling Yang Jiao (Capricornu Saigae Tataricae), Yuan Shen (Scrophulariae Radix), Jiang Can (Bombyx Batryticatus), Sheng Di (Rehmanniae Radix), Zi Rong (Dragon’s Blood Resin), Chuan Huang Lian (Coptidis Rhizoma), Jie Geng (Platycodonis Radix), Zha Rou (Crataegi Fructus), Dan Pi (Moutan Cortex), Ji Guan Xue (Rooster Comb Blood). Decocted with Yin Hua (Lonicerae Japonicae Flos) soup.
On the fifth day, Fire Toxin not resolved, teeth grinding, choking cough, vomiting, abdominal distension. Clearing and resolving combined with relieving stagnation.
Prescription: Ling Yang Jiao (Capricornu Saigae Tataricae), Zha Rou (Crataegi Fructus), Jiang Can (Bombyx Batryticatus), Zi Rong (Dragon’s Blood Resin), Lian Qiao (Forsythiae Fructus), Chuan Huang Lian (Coptidis Rhizoma), Guang Pi (Citri Reticulatae Pericarpium), Tu Bei (Fritillariae Thunbergii Bulbus), Dan Pi (Moutan Cortex), Jie Geng (Platycodonis Radix). Decocted with Yin Hua (Lonicerae Japonicae Flos) soup.
On the sixth day, Fire Toxin not fully penetrated, abdominal distension, loose stool, lack of appetite. This indicates Spleen deficiency and stagnant Qi in intestines and stomach. It is proposed to nourish Ying and support interior, and relieve stagnant Qi.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fu Pi (Arecae Pericarpium), Jiang Can (Bombyx Batryticatus), Hou Po (Magnoliae Officinalis Cortex), Dang Gui (Angelicae Sinensis Radix), Guang Pi (Citri Reticulatae Pericarpium), Jiao Zhen (Urticae Flos), Qing Pi (Citri Reticulatae Pericarpium Viride).
On the eighth day, since attacking toxin, pus has not fully risen. Again, abdominal distension, vomiting, counterflow, fever, with relatively free bowel and bladder movements. How can this be food stagnation? There is still latent heat-toxin between Stomach and Spleen, obstructing Qi flow. Spleen stagnation causes distension; Stomach counterflow causes vomiting. If miscellaneous diseases in smallpox are not cleared, one must guard against panting urgency and mouth ulcers.
Prescription: Zhu Ru (Bambusae Caulis in Taenia), Zhi Shi (Aurantii Fructus Immaturus), Mai Dong (Ophiopogonis Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Chuan Lian (Coptidis Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Fu Ling (Poria), Fu Pi (Arecae Pericarpium).
On the ninth day, Chuan Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Jie Geng (Platycodonis Radix), Yin Hua (Lonicerae Japonicae Flos), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Yi Yuan San (Benefit Origin Powder), Lian Qiao (Forsythiae Fructus), Chuan Bei (Fritillariae Cirrhosae Bulbus), Di Ding (Vincae Herba).
Smallpox form and color are not majestic; eruption indicates Qi deficiency. It is proposed to penetrate muscle and stabilize the exterior.
Prescription: Jing Jie (Schizonepetae Spica), Chi Shao (Paeoniae Radix Rubra), Zha Rou (Crataegi Fructus), Jie Geng (Platycodonis Radix), Sun Jian (Bamboo Shoot Tip), Niu Bang (Arctii Fructus), Hong Hua (Carthami Flos), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma).
On the fourth day, smallpox has erupted fully, densely but irregularly. Forehead and nasal root are loose and not opening; other parts lack luster. Qi deficiency and heavy toxin suggest itching and collapse around the eighth or ninth day. Now, it is proposed to lift the top and penetrate, avoiding arbitrary use of cold-natured medicines.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gui Shen (Radix Angelicae Sinensis), Zi Rong (Dragon’s Blood Resin), Jiang Can (Bombyx Batryticatus), Ji Ding Xue (Rooster Comb Blood), Jie Geng (Platycodonis Radix), Hong Hua (Carthami Flos), Zha Rou (Crataegi Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Jiu Jiang (Wine Decoction).
On the fifth day, primordial deficiency and dense smallpox make swelling and pus formation most difficult. Today, further lifting and supporting; wait for form to fill, then discuss internal support. Accepting tonification is best.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Jiang Can (Bombyx Batryticatus), Zha Rou (Crataegi Fructus), Yang Rou (Mutton Meat), Gui Shen (Radix Angelicae Sinensis), Guang Pi (Citri Reticulatae Pericarpium), Jiao Zhen (Urticae Flos), Zi Rong (Dragon’s Blood Resin), Ji Ding Xue (Rooster Comb Blood).
On the sixth day, chin and cheeks are slightly smooth, the color of moving pus. Alas, the forehead is dry and white, shape like snake skin. Yang positions are not ventilated, ultimately not a good sign. Urgently warm and tonify Qi and Blood, internally supporting toxin expulsion. Delay leads to changes; tonification will be useless.
Prescription: Ren Shen (Ginseng Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Guang Pi (Citri Reticulatae Pericarpium), Zha Rou (Crataegi Fructus), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Ji Ding Xue (Rooster Comb Blood).
On the seventh day, Ren Shen (Ginseng Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Guang Pi (Citri Reticulatae Pericarpium), Huang Qi (Astragali Radix), Lu Rong (Cervi Cornu Pantotrichum), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Zha Rou (Crataegi Fructus).
On the eighth day, pus is forty percent, wide and collapsed, itching. Caution.
Prescription: Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Mu Xiang (Aucklandiae Radix), Gui Shen (Radix Angelicae Sinensis), Lu Rong (Cervi Cornu Pantotrichum), Kan Qi (Human Placenta), Guang Pi (Citri Reticulatae Pericarpium), Rou Guo (Myristicae Semen).
On the ninth day, facial clear pus is drying up, body halos scatter and collapse wide, teeth grinding, diarrhea, poor food intake. Itching was severe for two days, slightly relieved today. Interior and exterior healthy Qi are deficient, toxin sinks and dries up. Attack and emit again, then continue Mu Xiang Yi Gong San, regulating Lung and calming Spleen is key.
On the eleventh day, head and face half-scabbed, limbs gray and sunken, not thriving. Deficiency with retained toxin, critical danger tomorrow or next day. Now chills, teeth grinding, no food, indicating healthy Qi about to collapse. Proposed: Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) plus Fu Ling (Poria).
On the fourth day, small body, many smallpox, Qi deficiency and Blood Heat. Current seasonal qi not fully gone, still suitable for venting and resolving. After five days, box meal (likely typo for 'should') tonify and support, still needs attention.
Prescription: Jing Jie (Schizonepetae Spica), Zha Rou (Crataegi Fructus), Hong Hua (Carthami Flos), Jie Geng (Platycodonis Radix), Dong Mi (Winter Rice), Niu Bang (Arctii Fructus), Jiang Can (Bombyx Batryticatus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dan Pi (Moutan Cortex).
On the fifth day, small body, many smallpox, primordial Qi very thin. Swelling and pus formation rely entirely on spirit. Wait for toxin to self-fever, body slightly comfortable. By seventh or eighth day, spirit and Qi are depleted. Hence, smallpox books say: "Small boat carrying heavy load." Waves visible at eighth or ninth day. Daily thinning of primordial Qi, itching and collapse. Internal and external symptoms appear in this period. Deficiency with夹杂 toxin, clearly dangerous signs. Now, it is proposed to harmonize blood, lift top, and induce swelling.
Prescription: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Zi Rong (Dragon’s Blood Resin), Mu Xiang (Aucklandiae Radix), Ji Ding Xue (Rooster Comb Blood), Dang Gui (Angelicae Sinensis Radix), Guang Pi (Citri Reticulatae Pericarpium), Chao Cha (Fried Tea/Crataegus?), Jiang Can (Bombyx Batryticatus).
On the sixth day, smallpox turned white, having momentum of moving pus. Disliked is high peak. Moreover, teeth grinding, frequent bowel movements, signs of interior deficiency already visible. Urgently tonify and support to slightly振奋 spirit, sending toxin to transform into pus.
Prescription: Huang Qi (Astragali Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Mu Xiang (Aucklandiae Radix), Jiang Can (Bombyx Batryticatus), Gui Shen (Radix Angelicae Sinensis), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Guang Pi (Citri Reticulatae Pericarpium), Huang Mi (Setaria Italica).
On the seventh day, white color not ruddy, frequent bowel movements, indicating internal exhaustion of spirit, signs of sinking. Proposed: Shen Gui Lu Rong Tang (Ginseng, Angelica, Deer Horn Decoction), hoping primordial Qi slightly revives for lucky success.
Add to this formula: Rou Guo (Myristicae Semen), He Zi Pi (Terminalia Chebula Pericarpium), Chao Guang Pi (Fried Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix).
On the eighth day, pus water not flowing, teeth grinding, abdominal pain, diarrhea. This is healthy Qi deficiency, Qi stagnation, toxin condensation. Tonifying and supporting is appropriate, fearing deficiency cannot bear it. Chen Wenzhong said: "Thirst, diarrhea, abdominal distension, can use Mu Xiang Yi Gong San to calm middle and relieve stagnation."
Prescription: Ren Shen (Ginseng Radix), Su Geng (Perillae Caulis), Hou Po (Magnoliae Officinalis Cortex), Ding Xiang (Eugeniae Flos), Dang Gui (Angelicae Sinensis Radix), Mu Xiang (Aucklandiae Radix), Qian Hu (Peucedani Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Fu Pi (Arecae Pericarpium), Chuan Xiong (Ligustici Chuanxiong Rhizoma), add Chao Huang Mi (Fried Setaria Italica).
On the sixth day, shape blunt, color flat, indicating toxin emitted and depressed inside, unwilling to form pus, how can toxin transform? Moreover, internal symptoms like anorexia, bad breath, diarrhea show Yuan Qi constrained by toxin. With no specific medicine, reluctantly using current popular cooling and resolving methods is truly ineffective.
Prescription: Xi Jiao (Rhinocerotis Cornu), Zi Kuang (Dragon’s Blood Resin), Jiang Can (Bombyx Batryticatus), Sheng Di (Rehmanniae Radix), Lian Qiao (Forsythiae Fructus), Dan Pi (Moutan Cortex), Zha Rou (Crataegi Fructus). Decocted with Yin Hua (Lonicerae Japonicae Flos) soup.
On the sixth day, flesh boils dry, whole body image not grand, original deficiency with Qi and Blood not flowing, toxin vapor unrestrained. Must get smallpox shape full and long, color lustrous,才有 hope of forming pus. Proposed: Clear toxin and support internally, harmonize Qi and Blood.
Prescription: Huang Lian (Coptidis Rhizoma), Gui Shen (Radix Angelicae Sinensis), Dan Pi (Moutan Cortex), Guang Pi (Citri Reticulatae Pericarpium), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Zi Kuang (Dragon’s Blood Resin), Jiang Can (Bombyx Batryticatus), Ji Ding Xue (Rooster Comb Blood).
On the seventh day, color slightly moist, shape still collapsed. Blood has basis to carry, Qi lacks warming power. Ancients often used Shi Xuan Bao Yuan Bo Qi (Ten Acupoints Protect Primordial Boost Qi), Mr. Weng also advocated focusing on moving Qi and Blood after sixth day. Today seeing first pus, wound family Qi and Blood depleted, deeply worrying about itching and collapse in two days.
Prescription: Ren Shen (Ginseng Radix), Mu Xiang (Aucklandiae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jiu Jiang (Wine Decoction), Gui Shen (Radix Angelicae Sinensis), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Zha Rou (Crataegi Fructus).
On the ninth day
Prescription: Ren Shen (Ginseng Radix), Jiang Can (Bombyx Batryticatus), Gui Shen (Radix Angelicae Sinensis), Huang Qi (Astragali Radix), Jia Mo (Testudinis Carapax et Plastrum Powder), Guang Pi (Citri Reticulatae Pericarpium).
On the tenth day, pus not full, diarrhea sticky, even with phlegm cough, Upper Jiao not cleared. Reasonably must urgently protect Spleen Yang. This is Chen’s method, why hesitate?
Prescription: Ren Shen (Ginseng Radix), Jiu Chao Dang Gui (Wine-fried Angelicae Sinensis Radix), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Rou Guo (Myristicae Semen), Huang Qi (Astragali Radix), Jiu Chao Bai Shao (Wine-fried Paeoniae Radix Alba), Mu Xiang (Aucklandiae Radix), Guang Pi (Citri Reticulatae Pericarpium). Decocted with Chao Huang Mi Tang (Fried Setaria Italica Soup), following this is the eleventh day prescription.
On the eleventh day, cauldron not full, skin shell already rotten, cannot bear attack and emission, only suitable for tonifying and supporting.
Prescription: Ren Shen (Ginseng Radix), Jiao Zhu (Charred Atractylodis Macrocephalae Rhizoma), Ding Xiang (Eugeniae Flos), He Zi Pi (Terminalia Chebula Pericarpium), Rou Gui (Cinnamomi Cortex), Guang Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex), Rou Guo (Myristicae Semen), Chao Huang Mi (Fried Setaria Italica), previous ninth day prescription.
On the twelfth day
Prescription: Chao Bai Shao (Fried Paeoniae Radix Alba), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Dan Pi (Moutan Cortex), Sheng Mi Ren (Raw Coicis Semen), Gu Pi (Lycii Cortex), Yin Hua (Lonicerae Japonicae Flos), Ze Xie (Alismatis Rhizoma).
On the seventh day, hoarse voice, tidal phlegm, sticky diarrhea. Weng Zhongren said: "Panting urgency seen after diarrhea is always Qi deficiency breaking." Vomiting, nausea, anorexia, Spleen and Lung both failed, critical as morning dew. Chen’s Yi Gong San warms interior and supports toxin, urgently saving Taiyin organ truth.
On the eighth day, internal symptoms peaceful, suitable to regulate Yang.
Prescription: Ren Shen (Ginseng Radix), Ding Xiang (Eugeniae Flos), Rou Guo (Myristicae Semen), Rou Gui (Cinnamomi Cortex), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mu Xiang (Aucklandiae Radix), Jiang Fu (Zingiberis Rhizoma Preparatum and Aconiti Lateralis Radix Praeparata). Decocted with Chao Huang Mi Tang (Fried Setaria Italica Soup).