费建中治故友孙真老子，四岁，庚寅暮春，痘甚匀朗，稀疏而绽突。其热宜和，其神宜爽，乃躁乱干热，
头汗如雨。盖枭热内扰，邪火外烁也。头为诸阳之首，先贤谓毒参阳位者死。幸初见势虽腾涌，而毒尚未有定
位耳。大黄二钱，黄连六分，石膏、生地各三钱，佐以地丁、青皮、荆芥、蝉蜕、木通、山楂，三剂头汗收，
热势减。减石膏、黄连，加丹皮、滑石、牛蒡，四剂。五朝仍壮热，红晕如珠，此痘起齐，毒火尽外发也。躁
乱如前而更渴，大便日三四次，前方复用石膏、黄连，倍加生地。至九朝，浆甚老而乏滋润，红晕未淡，胃气
不开，热亦未减，寐亦未安。再服，十二朝渐愈。（《救偏琐言》。）
严氏子一周，痘稀朗且红润，乃身热如烙，愁楚不堪，兼颗粒不松，此内有伏毒也。以大黄六分，石膏、
生地各一钱半，荆芥、丹皮、山楂、蝉蜕、葛根、青皮，二剂，大便三四次。又二剂，热和神定，根窠亦松，
宛然顺症矣。有阻之者，遂勿药。至八朝，仍热，叫哭失音，头面擦破，身上紫滞，幸未焦隐，前方倍大黄、
生地、黄连，减葛根，入大桑虫，日二剂，以化毒丹调油胭脂如膏药贴之，次日痒止红活。又二剂，浆足热
和。十二朝，用红花、地丁、生地、牛蒡、荆芥、木通、甘草、连翘、山楂，渐愈矣。痘初似顺，一有伏毒，
便至如此，余可知矣。
臧氏子八岁，患疳，仅存皮骨。庚寅仲春见痘，羸惫如此，似宜培补矣。乃身热如烙，目红如火，燥渴不
已，溺血如膏，椒红点滞，此枭毒挟烈火，发即内攻，若不通变，七日即内溃也。以大黄四钱，石膏七钱，生
地两许，佐以桃仁、赤芍、荆芥、牛蒡、木通，临服，和猪尾血一盏，日二剂或三剂。六日，加黄连。自始至
终，一方而已。约用大黄斤余，生地、石膏二十余两，猪尾血十余碗。良以毒火猛炽，苟不涤除净尽，功亏
一篑矣。痘后精神焕发，饮食大进，肌肉生长，是以泻为补之一验也。
张仲文子癸未仲冬忽身热如火，神即昏愦，舌刺如煤，唇口焦黑，血斑无数，溺色红鲜，肉 筋惕，有如
惊悸，宛然闷痘，断非轻剂可挽。即用石膏一两，大黄五钱，黄连三钱，生地一两，佐以青皮、荆芥、地丁、
丹皮，天寒稍配蜜炒麻黄三分，姜一斤以行之。灌下即呕，费曰∶毒火上冲，水火搏激，两不相下故耳。十余
剂见痘，及见，则以数记，唇犹黑，溺血依然。至九日后，黑退津生，神气渐省。十二日，溺血始淡，胃气日
开，十六日全愈。服过大黄十余两，石膏、生地约二斤，是早图之一验也。
Fei Jianzhong treated the grandson of his late friend Sun Zhenlao, aged four. In the late spring of the Gengyin year, the child developed smallpox (Xiaodu). The pustules were evenly distributed and bright, sparse, and protruding. Normally, the heat should be harmonized, and the spirit refreshed; however, the child was restless, irritable, dry-heat intense, with profuse sweating on the head like rain. This indicated that the fierce toxin (Xiaodu) was disturbing internally, while pathogenic fire was scorching externally. The head is the meeting point of all Yang meridians; ancient sages stated that if toxins invade Yang positions, death ensues. Fortunately, although the initial presentation was surging, the toxin had not yet settled into a fixed position. The prescription consisted of Dahuang (Rhei Radix et Rhizoma) 2 qian, Huanglian (Coptidis Rhizoma) 6 fen, Shigao (Gypsum Fibrosum) and Shengdi (Rehmanniae Radix) each 3 qian, assisted by Diziduo (Violaris Herba), Qingpi (Aurantii Fructus Immaturus Pericarpium), Jingjie (Schizonepetae Spica), Chantui (Cicadae Periostracum), Mutong (Akebiae Caulis), and Shanzha (Crataegi Fructus). After three doses, head sweating ceased, and the heat subsided. The dosages of Shigao and Huanglian were reduced, and Mudanpi (Moutan Cortex), Huashi (Talcum), and Niubangzi (Arctii Fructus) were added for another four doses. On the fifth day, high fever persisted, with red halos around the pustules resembling beads. This indicated that the smallpox had fully erupted, and the toxic fire was entirely venting outward. The child remained restless and more thirsty, with bowel movements three to four times daily. The previous formula was reused with Shigao and Huanglian, and Shengdi was doubled. By the ninth day, the pustular fluid was mature but lacked moisture, the red halos had not faded, the Stomach Qi was not opening, the heat had not decreased, and sleep was undisturbed. Continuing the same prescription, the condition gradually improved by the twelfth day. (From *Jiu Pian Suoyan*.)
The son of Mr. Yan, one week old, presented with sparse, bright, and ruddy smallpox lesions, yet his body felt hot as if branded, causing unbearable distress. Additionally, the pustule bases were tight, indicating latent toxins within. The prescription included Dahuang (Rhei Radix et Rhizoma) 6 fen, Shigao (Gypsum Fibrosum) and Shengdi (Rehmanniae Radix) each 1.5 qian, along with Jingjie (Schizonepetae Spica), Mudanpi (Moutan Cortex), Shanzha (Crataegi Fructus), Chantui (Cicadae Periostracum), Gegen (Puerariae Lobatae Radix), and Qingpi (Aurantii Fructus Immaturus Pericarpium). After two doses, there were three to four bowel movements daily. After another two doses, the heat harmonized, the spirit stabilized, and the pustule bases loosened, appearing as a favorable progression. However, due to interference, treatment was stopped. By the eighth day, fever returned, accompanied by crying, loss of voice, abrasions on the head and face, and purplish stagnation on the body. Fortunately, there was no blackening or sinking. The previous formula was modified: Dahuang (Rhei Radix et Rhizoma), Shengdi (Rehmanniae Radix), and Huanglian (Coptidis Rhizoma) were doubled, Gegen (Puerariae Lobatae Radix) was reduced, and Dasangchong (Mantis Ootheca) was added. Two doses per day were administered. Additionally, Huadu Dan (Toxin-Resolving Pill) was mixed with oil and red pigment to make a paste plaster applied topically. By the next day, itching stopped, and the color became vibrant red. After two more doses, the pustular fluid was sufficient, and the heat harmonized. On the twelfth day, Honghua (Carthami Flos), Diziduo (Violaris Herba), Shengdi (Rehmanniae Radix), Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Spica), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma), Lianqiao (Forsythiae Fructus), and Shanzha (Crataegi Fructus) were used, leading to gradual recovery. Initially, the smallpox seemed favorable, but once latent toxins were present, the outcome could be dire; other cases can be inferred similarly.
The son of Mr. Zang, aged eight, suffered from Gan disease (malnutrition syndrome), being merely skin and bones. In mid-spring of the Gengyin year, smallpox appeared. Given such emaciation and exhaustion, tonification might seem appropriate. However, the body was hot as if branded, eyes red as fire, unquenchable thirst, urine bloody like paste, and anal retention with pepper-red spots. This indicated the fierce toxin combined with raging fire, attacking inward upon eruption. Without adaptive changes, internal ulceration would occur within seven days. The prescription used Dahuang (Rhei Radix et Rhizoma) 4 qian, Shigao (Gypsum Fibrosum) 7 qian, and Shengdi (Rehmanniae Radix) over 1 liang, assisted by Taoren (Persicae Semen), Chishao (Paeoniae Radix Rubra), Jingjie (Schizonepetae Spica), Niubangzi (Arctii Fructus), and Mutong (Akebiae Caulis). Before administration, it was mixed with one cup of pig tail blood. Two to three doses per day were given. On the sixth day, Huanglian (Coptidis Rhizoma) was added. Throughout the entire course, only this single formula was used. Approximately over 1 jin of Dahuang (Rhei Radix et Rhizoma), over 20 liang of Shengdi (Rehmanniae Radix) and Shigao (Gypsum Fibrosum), and over ten bowls of pig tail blood were consumed. This was necessary because the toxic fire was intensely fierce; without thorough elimination, the effort would be in vain. Post-smallpox, the spirit revived, appetite increased significantly, and muscles grew. This verified the principle of "using purgation as tonification."
The son of Zhang Zhongwen suddenly developed high fever like fire in mid-winter of the Guiwei year, with immediate confusion and stupor. The tongue was prickly like coal, lips and mouth scorched black, numerous petechiae appeared, urine was bright red, muscles twitched, and tendons jerked, resembling palpitations. It was clearly Mense Du (smallpox suppressed internally), and light formulas could not save him. Immediately, Shigao (Gypsum Fibrosum) 1 liang, Dahuang (Rhei Radix et Rhizoma) 5 qian, Huanglian (Coptidis Rhizoma) 3 qian, and Shengdi (Rehmanniae Radix) 1 liang were used, assisted by Qingpi (Aurantii Fructus Immaturus Pericarpium), Jingjie (Schizonepetae Spica), Diziduo (Violaris Herba), and Mudanpi (Moutan Cortex). Due to cold weather, slightly added 3 fen of honey-fried Mahuang (Ephedrae Herba), and 1 jin of Shengjiang (Zingiberis Rhizoma Recens) to promote circulation. Upon ingestion, vomiting occurred immediately. Fei said: "This is toxic fire rushing upward, with water and fire clashing, neither yielding." After more than ten doses, smallpox appeared. Once visible, counted numerically, lips remained black, and hematuria persisted. By the ninth day, blackness receded, fluids generated, and spirit gradually recovered. On the twelfth day, urine lightened, Stomach Qi opened daily, and full recovery was achieved by the sixteenth day. Over 10 liang of Dahuang (Rhei Radix et Rhizoma) and about 2 jin of Shigao (Gypsum Fibrosum) and Shengdi (Rehmanniae Radix) were taken. This served as proof of early intervention.