徐仲光治一儿，痘浆足，盗汗，此阴虚也。用保元汤加浮小麦，治之而愈。
一痘后盗汗，肌瘦烦躁，此阳虚也。补中益气汤倍 ，加麦冬而愈。
曾世荣治衡阳侯自牧次子，五岁，盛夏泄泻，面垢烦渴，耳尻冷，惊悸。诊其心肝脉浮而洪大，脾肺脉虚
而细数。曰∶面垢渴泻，脉虚细数者，此中暑也。惊悸发热，耳尻俱冷，肝心脉洪大者，此痘疮欲出也。先服
黄连香薷散，解利暑毒，续投陈氏异功散，再加附子，与之实脾。二日泻止，三日疮见，不旬余而全功，此隆
暑用附子之效也。（《幼幼心书》。）
费建中治钟氏小女痘，值炎天受暑，烦扰非常，壮热如焚，痘色干红，累日不起，渴思井水，仅与碗许，
便觉爽朗，求之不止，竟饮及二斗，通身微汗，神怡始快，痘顿起，色亦红活，终以清火解毒收功。
徐仲光治一痘，浆足，渐苍老，宜静以养之。有谓脾主结痂，用异功散加山药、白芍，喘渴身热。此实症
而用补剂，内外皆热也，治以宽中汤。又口龈发疳，以清火解毒汤而愈。
一痘八朝浆满，身热而渴，咳有痰涎，火盛津液涸也，用白虎汤而愈。
一痘起胀，烦渴不已，寒之不寒，是无水也。宜壮水之主，以制阳光，六味地黄丸料加麦冬、五味，多服
而愈。
一人十九岁痘，六朝匀朗绽突，淡白少神，渴甚不已，此虚弱而津液竭。以人参二两，麦冬五钱，水煎渐
服。又以补中益气汤加枸杞二剂，保元汤加冬、芍、归、杞。九朝，浆足渴止，用人参一斤而愈。
一痘起胀，干红焦紫，根窠坚实，便结烦渴，用黄连解毒汤而愈。
一痘六日起胀，形色顺，不食引饮，此胃弱也，调脾内托散治之即愈。亦有毒壅而不食引饮者，不可不辨。
徐仲光治一痘，八日浆半足，热甚引饮。有用保元汤，而烦渴益甚。余当倍加人参，用人参二两，麦冬两
半，煎成频饮而渴止。此渴甚药轻，不能生津以自救也。
一痘九日，空壳无浆，根血干红，壮热口渴，与保元汤而渴愈甚。此肾水枯涸，不能生火。宜壮水之主，
六味地黄丸料加人参、当归、知母、麦冬、枸杞子、菟丝子而愈。
一新婚后出痘，燥热而渴，与冷冻饮料即睡，醒则复索饮不已。时大冷大寒，此亦肾水涸，不能制火，乃孤阳
绝阴。后虽行浆，二三日而卒，无阴则阳无以化，正谓此也。（雄按∶何以不投甘寒壮水之剂？）
一新婚后出痘，燥热引饮，亦宜壮水制火，用八味地黄丸料加人参、麦冬、五味子，又用补中益气汤，而
渴止热减。
一痘七朝潮热，口渴自利，下臭秽陈积，此脾胃热蒸而下也，虽虚而无寒，以保元汤固中之剂而愈。若用
燥热之剂，如木香散，祸不旋踵。
一痘浆期，壮热烦渴，舌干口燥。或疑津液不足，与保元汤加麦冬而热渴愈甚，痘色焦紫。此症本热而衣
被火炉过暖，用补反助其热。宜清凉，以黄连解毒汤加牛蒡而愈。
一痘后热渴能食，便秘溺赤，咽干口燥，此心胃二经受邪也，用白虎汤而愈。
一痘后口干舌燥，咽干，食少便调，此脾胃虚，津液不足也。用参苓白术散及参、冬、甘、术、升、葛、
麦冬、花粉、五味、粳米而愈。
一痘后口渴食少、小便数，此食伤胃气，津液不生，故渴而溺数也。用补中益气汤加麦冬、五味而愈。
一痘黑陷黄色，不食，性好饮酒，顺其性与饮，红绽而愈。
一冬月出痘，顶陷紫黑，饮食药饵俱不用，以当归浸酒与之，而痘起胀收功。
一痘火毒闭而形若死，移弃外庭，遇豪雨而苏，此以水制其火也。
一险痘热壅，索饮不已，连与井水数升，渴止而痘起。
万密斋治邹氏子痘，养脓时，大渴不止。议用人参麦冬散，彼即根据本方修合。曰∶疮太甚，津液不足之症，
白术燥津液，茯苓渗津液，皆所禁也。乃以本方去茯苓、白术，加升麻、生地、花粉、知母、淡竹叶，一
服渴止。
万氏子痘，养脓时，大渴不止，即用前加减方，作大剂代汤饮之，一帖而止。
Xu Zhongguang treated a child patient whose smallpox pustules were full, but who suffered from night sweats; this indicated Yin deficiency. He used Baoyuan Decoction (Preserve the Origin Decoction) with added Triticum Aestivum Fructum Levisticum (Fuxiaomai), and the disease was cured.
Another child patient suffered from night sweats after smallpox, with emaciation and irritability; this indicated Yang deficiency. He used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled dosage of [missing character, typically Astragalus or Ginseng], plus Ophiopogon Japonicus Radix (Maidong), and the disease was cured.
Zeng Shirong treated the second son of Marquis Zimu of Hengyang, aged five. In midsummer, he suffered from diarrhea, greasy complexion, irritability, and thirst, with cold ears and sacrum, and palpitations. Palpation revealed the Heart and Liver pulses as floating and surging-large, while the Spleen and Lung pulses were deficient, fine, and rapid. He said: "Greasy complexion, thirst, and diarrhea with deficient, fine, and rapid pulses indicate heatstroke. Palpitations, fever, cold ears and sacrum, and surging-large Heart and Liver pulses indicate that smallpox is about to erupt." First, he administered Huanglian Xiangru San (Coptis and Elsholtzia Powder) to resolve summerheat toxicity; subsequently, he administered Chen's Yigong San (Chen's Extraordinary Efficacy Powder) with added Aconitum Carleilii Radix Preparata (Fuzi) to solidify and warm the Spleen. Diarrhea stopped in two days, eruptions appeared on the third day, and recovery was achieved in less than ten days. This demonstrates the efficacy of using Aconite during peak summerheat. (From *Youyou Xinshu*.)
Fei Jianzhong treated a young girl of the Zhong family for smallpox. It was hot summer, and she had contracted summerheat, suffering extreme irritability, high fever like burning, dry red eruptions that failed to rise for many days, and intense craving for well water. Given only a bowlful, she felt refreshed, but continued to demand more, eventually drinking nearly two dou. After slight sweating over the whole body, her spirit became tranquil and comfortable, eruptions rose immediately, and their color became ruddy and vibrant. Treatment concluded with clearing fire and resolving toxicity.
Xu Zhongguang treated a smallpox case where pustules were full and becoming firm and old; quiet rest was appropriate. Someone argued that the Spleen governs scabbing and prescribed Yigong San with Dioscorea Opposita Rhizoma (Shanyao) and Paeonia Lactiflora Radix Alba (Baishao), resulting in wheezing, thirst, and fever. This was an excess syndrome treated with tonics, causing internal and external heat. It was treated with Kuanzhong Tang (Widen the Middle Decoction). Additionally, gingival canker sores were cured with Qinghuo Jiedu Tang (Clear Fire and Resolve Toxicity Decoction).
In another case, eight days after eruption, pustules were full, with fever, thirst, cough with phlegm, indicating excessive fire depleting fluids. Baihu Tang (White Tiger Decoction) was used and cured it.
In another case, during the swelling stage, there was incessant irritability and thirst. Cooling measures failed to reduce heat, indicating "water deficiency" (Yin fluid insufficiency). The principle of "strengthening the master of water to control sunlight" (nourishing Kidney Yin to subdue hyperactive Yang) was applied using Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) formula with added Ophiopogon Japonicus Radix (Maidong) and Schisandra Chinensis Fructus (Wuweizi). Multiple doses led to recovery.
A nineteen-year-old patient showed uniform, distinct, and protruding eruptions by the sixth day, with pale white color lacking spirit, and extreme thirst, indicating weakness and exhaustion of fluids. Two taels of Ginseng Radix et Rhizoma (Renshen) and five qian of Ophiopogon Japonicus Radix (Maidong) were decocted in water and taken gradually. Subsequently, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Lycium Chinense Fructus (Gouqi) for two doses, followed by Baoyuan Decoction (Preserve the Origin Decoction) with Ophiopogon, Paeonia, Angelica Sinensis Radix (Danggui), and Lycium fruit. By the ninth day, when pustules were full and thirst ceased, one jin of Ginseng Radix et Rhizoma (Renshen) was used to achieve cure.
In another case, during the swelling stage, eruptions were dry, red, and scorched purple, with firm roots, constipation, irritability, and thirst. Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) was used and cured it.
In another case, on the sixth day of swelling, the appearance was favorable, but the patient refused food and drank water continuously, indicating weak Stomach Qi. Tiaopi Neituo San (Regulate Spleen and Support Interior Expulsion Powder) was used for immediate recovery. Note that some cases refuse food and drink due to toxin stagnation, which must be distinguished.
Xu Zhongguang treated a smallpox case where, on the eighth day, half-pustules were full, with severe heat and thirst. Using Baoyuan Decoction made the irritability and thirst worse. I increased the dose of Ginseng Radix et Rhizoma (Renshen) to two taels and Ophiopogon Japonicus Radix (Maidong) to one tael and half, decocted and given frequently, stopping the thirst. This occurred because the thirst was severe and the medication too light to generate fluids for self-rescue.
In another case, on the ninth day, the pustules were empty shells without fluid, roots were dry red, with high fever and thirst. Giving Baoyuan Decoction worsened the thirst. This indicated dried-up Kidney Water unable to generate fire. The principle of strengthening the master of water was applied using Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) formula with added Ginseng Radix et Rhizoma (Renshen), Angelica Sinensis Radix (Danggui), Anemarrhena Asphodeloides Rhizoma (Zhimu), Ophiopogon Japonicus Radix (Maidong), Lycium Chinense Fructus (Gouqi), and Cuscuta Chinensis Semen (Tusizi), leading to recovery.
A newlywed woman developed smallpox with dryness, heat, and thirst. She drank chilled beverages and slept, waking up demanding more drinks. Despite the cold weather, this indicated dried-up Kidney Water unable to control fire, representing isolated Yang and absolute Yin. Although pus formed later, she died within two or three days. Without Yin, Yang cannot transform; this illustrates the point. (Xiong notes: Why not administer sweet-cold formulas to strengthen water?)
Another newlywed woman developed smallpox with dryness, heat, and continuous drinking. Strengthening water to control fire was appropriate. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) formula with Ginseng Radix et Rhizoma (Renshen), Ophiopogon Japonicus Radix (Maidong), and Schisandra Chinensis Fructus (Wuweizi) was used, along with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), stopping thirst and reducing heat.
A child patient had tidal fever on the seventh day of smallpox, thirst, spontaneous diarrhea of foul, accumulated matter, indicating steaming heat in the Spleen and Stomach descending. Although deficient, there was no cold. Baoyuan Decoction (Preserve the Origin Decoction), a middle-solidifying agent, cured it. If hot-drying agents like Muxiang San (Costus Powder) were used, disaster would follow swiftly.
During the pus-forming stage, a child patient had high fever, irritability, thirst, dry tongue, and dry mouth. Suspecting fluid deficiency, someone gave Baoyuan Decoction with Ophiopogon Japonicus Radix (Maidong), but heat and thirst worsened, and eruptions turned scorched purple. The condition was originally heat-based, exacerbated by excessive clothing and heating, making tonics assist the heat. Cooling methods were needed; Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) with Arctii Fructus (Niubangzi) cured it.
After smallpox, a patient had heat, thirst, good appetite, constipation, dark urine, dry throat, and dry mouth, indicating pathogen invasion of the Heart and Stomach meridians. Baihu Tang (White Tiger Decoction) cured it.
After smallpox, a patient had dry mouth and tongue, dry throat, poor appetite, and normal stool, indicating Spleen and Stomach deficiency with insufficient fluids. Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) combined with Ginseng Radix et Rhizoma (Renshen), Ophiopogon Japonicus Radix (Maidong), Glycyrrhiza Uralensis Radix et Rhizoma (Gancao), Atractylodes Macrocephala Rhizoma (Baizhu), Bupleuri Radix (Chaihu), Bupleuri Radix (Shengma - note: text says Sheng, likely Shengma or Chaihu contextually, here interpreted as lifting herbs), Puerariae Lobatae Radix (Ge), Ophiopogon Japonicus Radix (Maidong), Trichosanthes Kirilowii Radix (Huafen), Schisandra Chinensis Fructus (Wuweizi), and Oryza Sativa (Jingmi) cured it.
After smallpox, a patient had thirst, poor appetite, and frequent urination, indicating dietary injury to Stomach Qi, failure to generate fluids, hence thirst and frequent urination. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Ophiopogon Japonicus Radix (Maidong) and Schisandra Chinensis Fructus (Wuweizi) cured it.
A patient with black, sunken, yellow smallpox refused food but loved alcohol. Following his preference, he was given alcohol, and eruptions became red and distinct, leading to recovery.
A winter smallpox case showed sunken, purple-black tops. Food and medicine were refused. Angelica Sinensis Radix (Danggui) infused in wine was given, leading to swelling and recovery.
A critical case of smallpox toxin closure resembled death and was discarded outside. The patient revived upon encountering heavy rain, demonstrating the use of water to control fire.
A critical case with heat stagnation involved incessant drinking requests. Several sheng of well water were given continuously, stopping thirst and allowing eruptions to rise.
Wan Mizhai treated a boy of the Zou family for smallpox. During the pus-nourishing stage, there was incessant great thirst. It was proposed to use Renshen Maidong San (Ginseng and Ophiopogon Powder), which the family prepared according to the original formula. Wan said: "The sores are severe, indicating fluid deficiency. Atractylodes Macrocephala Rhizoma (Baizhu) dries fluids, and Poria cocos (Fuling) leaches fluids; both are contraindicated." Thus, Fuling and Baizhu were removed from the base formula, and Cimicifugae Rhizoma (Shengma), Rehmanniae Radix Recens (Shengdi), Trichosanthes Kirilowii Radix (Huafen), Anemarrhena Asphodeloides Rhizoma (Zhimu), and Lophatherum Gracile Herba (Dan Zhuye) were added. One dose stopped the thirst.
Wan's own son had smallpox with incessant great thirst during the pus-nourishing stage. The aforementioned modified formula was used in large doses as a tea substitute, stopping the thirst after one dose.