（下皆徐仲光所言。）
一儿年十五，血热毒重，而无颗粒，正额略见分珠，而又稠密，唇焦口肿，舌有黑刺，大热大渴，先用羌
活汤调下催蛰丹、退火丹。虽起发，呕哕特甚，用芩、连、荆、防、翘、蒡、楂、蝉、犀角、紫草、石膏、大
黄，二剂。痘乃稍润，又加芎、归、冬、知、甘、桔、生地、丹皮、红花、元参，痘渐滋长，呕哕渐止。八九
朝，复呕，背痘平塌，仍用芎、归、芩、连、蝉、翘、防、羌、蒡、陈、藿、石膏，黄土澄水煎服，随以桑虫
浆、鸡脑各二个，入催蛰丹、震蛰丹各五分。至夜，狂躁作渴，以陈冬米、麦冬，煎汤频饮。至天明，熟睡，
痘转而起灌矣。但大便溏数，加 、术、楂、橘、炮姜、人参三四分，调理而愈。
一儿痘成浆倒陷，吐哕不止，急用攻发药，以起其痘，于安胃药中加参、 、黑姜、陈米、白术，黄泥澄
水煎治愈。
一儿痘标点，哕吐，面色枯，口唇焦，胃气已脱，毒不出，三日而死。
一痘六朝，匀朗光泽，外症顺而胃气损，闻食则哕，浆虽满不能收拾苍老，变倒靥而死。吐蛔者更重。
一痘后烦渴，乳多则吐，身热喜凉，此余毒在胃，竹叶石膏汤治之而愈。
一痘后哕腐，或有用香砂丸，克伐太过，遂变泄泻而死。
万密斋治一儿，痘本轻，因伤食腹痛而呕，用平胃散加砂仁、藿香叶、煨姜而呕止。
一小儿因食生冷，伤脾胃而呕，痘变灰白，用钱氏异功散加砂仁、丁香、桂而呕止。
一小儿痘甚密，喉舌都是，将闭时，呛水呕食，杂脓血痂皮痰涎而出，用甘桔汤加牛蒡，频呷之，调理而安。
一小儿脓成将靥，忽作干呕，虽饮食，常自呕哕，其痘不作脓，不满顶。曰∶此逆痘也。乃诵木陈叶落，
弦断声嘶之言以告之，后失音闷绝而死。
庠生余光庭，年十九，出痘，脓成将靥，忽作咳逆，（即哕也，又名呃逆。）脉促成代。或谓咳逆者，恶症
也。促代者，怪脉也。痘疮顺正，饱壮明润，何以得此？曰∶咳逆三症，一曰胃寒，二曰水逆，三曰胃败，皆与
此不合。经曰∶诸逆冲上，皆属于火。此火炎上之象，乃问其大便如何，则自出痘至今，七日未更衣。曰∶此燥
矢壅塞，下窍不通，火炎上窍，故咳逆也。促代之脉，得之气逆，脉亦逆矣。以猪胆导之，下燥矢，咳逆即止，
而脉亦调匀而起。
(The following are medical cases recorded by Xu Zhongguang.)
A fifteen-year-old boy suffered from severe blood heat and toxicity, yet his smallpox pustules failed to erupt into distinct granules. Only faintly visible on the forehead were bead-like spots, densely distributed. His lips were cracked, mouth swollen, tongue coated with black prickles, accompanied by high fever and intense thirst. Initially, Qianghuo Tang (Notopterygium Decoction) was used to administer Cuizhe Dan (Stimulating Pustule Eruption Pill) and Tuihuo Dan (Fire-Reducing Pill). Although the eruption began, vomiting and hiccups were particularly severe. Therefore, Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Shanzha (Crataegi Fructus), Chantui (Cicadae Periostracum), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), Zicao (Lithospermi Radix), Shigao (Gypsum Fibrosum), and Dahuang (Rhei Radix et Rhizoma) were prescribed for two doses. The pustules became slightly moistened. Subsequently, Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Dongdong (Asparagi Radix), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Honghua (Carthami Flos), and Yuanshen (Scrophulariae Radix) were added. The pustules gradually grew plump, and vomiting and hiccups subsided. On the eighth or ninth day, vomiting recurred, and the back pustules flattened. The same formula (Chuanxiong, Danggui, Huangqin, Lianqiao, Chantui, Lianqiao, Fangfeng, Qianghuo, Niubangzi, Chenpi, Huoxiang, Shigao) was decocted in clarified water prepared from yellow soil. Afterwards, Sangchong Jiang (Mulberry Insect Paste) and Jinao (Chicken Brain) were administered, each two units, along with Cuizhe Dan and Zhenzhe Dan (Shocking Pustule Eruption Pill), five fen each. By nightfall, the patient became manic, restless, and thirsty. Chencongmi (Stored Rice) and Maidong (Ophiopogonis Radix) were decocted as tea for frequent sipping. By dawn, the patient slept soundly, and the pustules transformed into filled, suppurating lesions. However, due to loose stools and frequent bowel movements, Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Shanzha, Ju pi (Citri Reticulatae Pericarpium), Paojiang (Prepared Ginger), and Renshen (Ginseng Radix et Rhizoma, 3-4 fen) were added for conditioning, leading to recovery.
Another child experienced smallpox involution after suppuration, with incessant vomiting and hiccups. Urgent emollient and eruptive medicines were used to promote pustule formation. Within stomach-soothing formulas, Renshen, Baishao, Heijiang (Charred Ginger), Chencongmi, and Baizhu were added. The medicine was decocted in clarified water prepared from yellow mud, resulting in a cure.
In another case, a child presented with smallpox just emerging as spots, accompanied by hiccups and vomiting, withered complexion, and cracked lips. The Stomach Qi had already collapsed, and the toxin could not be excreted externally; the child died three days later.
One case involved smallpox on the sixth day, evenly distributed, lustrous, and bright. The external symptoms were favorable, but Stomach Qi was damaged. The child hiccuped upon smelling food. Although the pustules were full of pus, they failed to mature and harden properly, eventually becoming inverted and scabbing abnormally, leading to death. Cases involving vomiting of roundworms are even more severe.
After smallpox, one child suffered from irritability and thirst. Excessive milk intake caused vomiting. The body felt hot and preferred coolness. This indicated residual toxins remaining in the Stomach. Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) was used for treatment, resulting in recovery.
Another child suffered from foul-smelling hiccups after smallpox. Someone administered Xiangsha Wan (Aucklandia and Amomum Pill), but the excessive purgative action led to diarrhea and subsequent death.
Wan Mizhai treated a child whose smallpox was originally mild. Due to food stagnation causing abdominal pain and vomiting, Pingwei San (Calm the Stomach Powder) was modified with Sharen (Amomi Fructus), Huoxiangye (Agastaches Herba), and Weijiang (Roasted Ginger). The vomiting ceased.
A child vomited due to consuming raw and cold foods, damaging the Spleen and Stomach. The smallpox turned grayish-white. Qian's Yigong San (Beneficial Labor Powder) was modified with Sharen, Dingxiang (Caryophylli Flos), and Guizhi (Cinnamomi Ramulus). The vomiting stopped.
A child had extremely dense smallpox covering the throat and tongue. As scabbing was about to occur, the child choked on water and vomited food, expelling mixed pus, blood, scabs, and phlegm. Ganjie Tang (Licorice and Platycodon Decoction) with added Niubangzi was given for frequent sipping. Conditioning led to stabilization.
A child, when pus formed and scabbing was imminent, suddenly developed dry heaves. Even after eating, spontaneous vomiting and hiccups persisted. The pustules did not suppurate and lacked fullness at the apex. It was stated: "This is an adverse smallpox pattern." The saying "When wood ages, leaves fall; when strings break, the voice hoarsens" was cited to indicate poor prognosis. The child subsequently lost their voice, fainted, and died.
Xiangsheng Yu Guangting, aged nineteen, contracted smallpox. When pus formed and scabbing was imminent, he suddenly developed coughing and reversing qi (Ke Ni, i.e., hiccups/belching). The pulse was Cu Dai (Hasty and Intermittent). Some argued that Ke Ni is a malignant symptom and Cu Dai pulse is an abnormal pulse. Since smallpox should present with fullness, robustness, brightness, and moisture, how did this occur? I replied: The three types of Ke Ni are Stomach Cold, Water Reversal, and Stomach Failure, none of which fit this case. The Classics state: "All rebellious qi rushing upward belongs to Fire." This is a manifestation of fire flaming upward. Upon inquiry, the patient reported no bowel movement for seven days since the onset of smallpox. I said: "This is dry stool obstructing the lower orifice, preventing unblocking, causing fire to flare up to the upper orifices, hence the Ke Ni." The Cu Dai pulse arises from rebellious Qi, causing the pulse to become chaotic. Zhu Dan Dao (Pig Gallbladder Suppository) was used to evacuate the dry stool. Immediately, the Ke Ni ceased, and the pulse returned to regularity and strength.