（附脓泡）
万密斋治李氏子，一岁出痘，起发时，都似水痘。曰∶痘乃胎毒，五脏各具一症，肝为水泡，肺为脓泡，
心为斑，脾为疹，肾为黑陷。此乃肝脏之症，喜皮肉浓坚，而色苍蜡。若皮薄色娇，不可治也。乃以四君子汤
加黄 、防风、牛蒡，母子同服，十三日安。
梁大尹公子出痘，起发时多成脓泡。曰∶此险症也，治晚矣。越二日痒作而殒。
郑氏子九岁出痘，起发时，额上两颊皆成脓泡。曰∶逆痘，不可治也。痘症自有次序，初出一点，血化为
水，水化为脓成而毒解矣。如苗而秀，秀而实。今方苗而秀，恐早发还先萎也。七日后更论，未及期，大痒而
死。
一儿发斑，身热，口燥舌干，化斑汤及小柴胡汤加黄连而愈。
一儿发斑，狂烦，面赤咽痛，栀子仁汤治愈。
一痘后发斑紫色，身热便秘，过于温补也。四顺清凉饮及解毒化斑之剂而愈。
一夏月发斑咽痛，升麻、葛根、元参、甘草、桔梗、牛蒡子治愈。
一发斑，因以胎毒，治以犀角地黄汤，砭去恶血而愈。有用犀角、大青，犀角解毒汤。
一发斑紫色，烦躁，便秘溺赤，此毒盛也，用黑奴丸而愈。
一发斑赤色，腹胀便秘，此内伤也。调胃承气汤下之，反肢厥脉沉。附子理中汤、六君子汤治愈。
一夏月发斑，由于暑毒，用化斑汤合香薷饮而愈。
一夏月发斑，势盛狂烦，此瘟毒也。用五瘟丹、黄连陈皮汤，治之而愈。
一发斑身热，头疼咳嗽，由于风热，芎蓟散、葛根汤而愈。
一痘出斑如锦纹，而间有颗粒，色赤，壮热烦，燥舌苔，便秘，此斑疹并出，调胃承气汤。又用白虎汤合
葛根汤而愈。
万密斋治罗氏妇，年二十七岁，出痘遍身，红斑如蚊迹，咸谓不治。视其神识精明，语言清亮，诊其六脉
调匀，问其饮食如常，大小便调，不烦不渴，但遍身红斑，稠密无缝，色且艳。曰∶此夹斑痘也，解去其斑，
则痘自见。以荆防败毒散加元参、升麻，作大剂，一服，次早斑退痘显。再一服，痘起发，调理半月而愈。
本邑各衙出痘，先二衙一子一女，长子后发热，见红斑，疑是夹斑症。三四日后，其斑尽收，热退身凉，
痘不出。又四衙众出痘，一子发热，亦出红斑，亦亡恙，乃信人言有不出痘者。或发斑，或发疹，或发水痘，
皆可折过也，必在正出痘时方论。以上皆徐仲光所治而言之者。
(Note: Pustules)
Wan Mizhai treated the son of the Li family, who was one year old when developing smallpox. During the eruption phase, the lesions resembled chickenpox. He stated: Smallpox is caused by fetal toxin; each of the five zang organs manifests a specific symptom. The liver presents as water vesicles (shui pao), the lungs as pustules (nong pao), the heart as macules/papules (ban), the spleen as papules/rash (zhen), and the kidneys as black depression (hei xian). This case belongs to the liver's manifestation. The patient prefers thick and firm flesh with a sallow-waxy complexion. If the skin is thin and delicate, it is incurable. Therefore, he prescribed Sijunzi Tang (Four Gentlemen Decoction) supplemented with Huangqi (Astragali Radix), Fangfeng (Saposhnikoviae Radix), and Niubangzi (Arctii Fructus), administered to both mother and child. The condition stabilized after thirteen days.
The young master of Vice-Commander Liang developed smallpox, forming numerous pustules during the eruption phase. He remarked: This is a critical condition; treatment was delayed. Two days later, severe itching occurred, leading to death.
The son of the Zheng family, aged nine, developed smallpox. During the eruption phase, pustules formed on his forehead and cheeks. He stated: This is an adverse smallpox (ni dou); it is incurable. Smallpox follows a natural sequence: initially appearing as a spot, blood transforms into fluid, fluid transforms into pus, and upon pus formation, the toxin is resolved. It is like a seedling shooting up and then bearing fruit. Now that it has only just shot up, it may wither prematurely. Re-evaluation would be scheduled for seven days later, but before that time arrived, he died from severe itching.
A child presented with exanthema (ban), fever, dry mouth, and dry tongue. He recovered after taking Huaban Tang (Macule-Resolving Decoction) and Xiaochaihu Tang (Minor Bupleurum Decoction) supplemented with Huanglian (Coptidis Rhizoma).
Another child presented with exanthema, mania, restlessness, red face, and sore throat. He was cured using Zhizi Ren Tang (Gardeniae Semen Decoction).
A patient developed purple exanthema after smallpox, accompanied by fever and constipation, due to excessive warm-tonifying treatment. He recovered after taking Sishun Qingliang Yin (Four-Obedience Cooling Drink) and detoxifying macule-resolving agents.
A patient developed exanthema and sore throat in summer. He was cured using Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Xuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), and Niubangzi (Arctii Fructus).
A patient presented with exanthema due to fetal toxin. Treatment involved Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and phlebotomy (bian) to remove bad blood, resulting in recovery. Others used Xijiao (Rhinocerotis Cornu), Daqingye (Isatidis Folium), or Xijiao Jiedu Tang (Rhinoceros Horn Detoxification Decoction).
A patient presented with purple exanthema, irritability, constipation, and dark urine, indicating intense toxin accumulation. He recovered after taking Heinu Wan (Black Slave Pill).
A patient presented with red exanthema, abdominal distension, and constipation, indicating internal injury. After administering Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) to purge, he paradoxically developed cold limbs and a deep pulse. He was subsequently cured using Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) and Liujunzi Tang (Six Gentlemen Decoction).
A patient developed exanthema in summer due to summerheat toxin. He recovered using Huaban Tang combined with Xiangru Yin (Elsholtzia Drink).
A patient developed exanthema in summer with intense severity, mania, and restlessness, indicating plague toxin. He was cured using Wuwen Dan (Five Plagues Pill) and Huanglian Chenpi Tang (Coptidis and Tangerine Peel Decoction).
A patient presented with exanthema, fever, headache, and cough due to wind-heat. He recovered using Xiongji San (Ligusticum and Leucadendron Powder) and Gegen Tang (Pueraria Decoction).
A patient had smallpox eruptions resembling brocade patterns with interspersed granules, red color, high fever, restlessness, dry tongue with coating, and constipation. This indicated simultaneous eruption of macules and papules. He was treated with Tiaowei Chengqi Tang, followed by Baihu Tang (White Tiger Decoction) combined with Gegen Tang, resulting in recovery.
Wan Mizhai treated Lady Luo, aged twenty-seven, who had smallpox all over her body with red macules resembling mosquito bites. Everyone considered it incurable. Observing her clear spirit and bright speech, and finding her six pulses regular, normal diet, and normal bowel/bladder functions without thirst or irritability, despite dense, seamless, bright red macules, he stated: This is smallpox complicated with macules (jia ban dou). Resolving the macules will reveal the smallpox. He prescribed Jingfang Baidu San (Schizonepeta and Saposhnikovia Toxin-Expelling Powder) supplemented with Xuanshen and Shengma, in a large dose. After one dose, the macules receded and smallpox became visible the next morning. After another dose, the smallpox erupted. She recovered after half a month of conditioning.
In this county, various government offices experienced smallpox cases. First, the second office had a son and daughter; the eldest son later developed fever and red macules, suspected to be complicated smallpox. Three to four days later, the macules disappeared, fever subsided, and the body cooled, but no smallpox appeared. Later, the fourth office had a son develop fever and red macules, yet he remained unharmed. Thus, people believed some do not develop smallpox. Whether presenting as macules, rash, or chickenpox, the condition can be overcome; judgment should only be made during the typical smallpox eruption period. The above cases were treated and recounted by Xu Zhongguang.