施季泉治臧玉涵次郎，年十六，因新婚兼酒食，忽感痘，咸以为不可治。至八日，浆清寒战，切牙谵语，
神思恍惚，咸欲进保元汤大补之。施季泉以为不然，改用犀角地黄汤，得愈。脱痂后，呕吐，大便燥结，淹延
一年。缪仲淳视其舌有裂纹，曰∶必当时未曾解阳明之毒，故有是症。以石膏一两，人参一两，麦冬五钱，枇
杷叶、橘红、竹茹、童便为佐，一剂即安。再剂，膈中如冷物隔定。只以人参投之，服两许，即索粥食，晚得
大便，夙疾顿愈。（《广笔记》。）
孙生东治郑黄门子痘，血热大盛，初起即以犀角地黄汤治之，不效。至用白芍八钱，一泄毒解，徐补收功。
（同上。）
家弟元着，一发热即谵语，唇肿齿黑，痘欲出不出，医者以为发斑伤寒也。延仲淳，季泉不至，予曰∶事
急矣。以生地八钱，白芍五钱，苓、连各二钱，稍加发药，日三剂，势稍定，痘渐次而出。又减地黄、白芍之半，
复于助浆药中，兼清凉之剂。九十朝，浆始足，卒伤一目，靥后，方大便，此真血热也。若重用解毒，轻于补
剂，则目亦可以不眇矣。（同上。）
黄绮云治一儿初痘，血热甚，用生地三两，煎浓汁频饮，其痘紫立转红色。（同上。）
一儿痘毒盛，又遇火令，用白花地丁汁，和淡白酒少许，服之立解。
一儿痘稠密绽突，但色紫暗，壮热烦渴，谵语，目赤便秘，乃毒火亢极也。以四顺清凉饮加大黄六钱，微
利二度，其势稍减。再剂服之，又利二次，病去其半。再以前方加人参三钱，前症悉平，色见淡白，精神疲倦。
邪虽去而正气不足，宜大补之，又以保元汤加芎、归、芍、术而愈。
一儿痘出夏月，起胀而干红，壮热烦渴，舌燥不眠，溺赤，此内外热极也。以黄连解毒汤合化斑汤而愈。
一儿痘值六月，六朝，痘痛烦渴，气急便秘，乃心肺实热也。恣与凉水梨汁饮之，前症悉平。
一儿痘出，匀朗绽突，但枯燥而不肥泽，皮肤皱揭，皆属于燥。经曰∶燥胜则干。治以养血清金润燥之剂，
又保元合四物加麦冬，治之而愈。
万密斋治邹氏之子，五岁出痘。或以保元汤，热益甚。或以为险。曰∶此顺症也，期十八日安，不须服药。
盖痘不可以日期算，出已尽，发已透，脓已满，而后收靥可期也。今痘出而热转盛者，出未尽也。由服保元汤
犯实实之戒，故令出迟，靥亦迟也。夫善攻不如善守，无他症，何以药为？已而果愈。
万子妇患痘，大热大渴，眼红唇裂，自利清水，妄见妄语，循衣摸床，遍身红斑如蚊迹，皆逆症也。此毒
在三焦，表里俱热，非大发大下之剂，不可救也。乃以通圣散全料，大剂与之，一服而前症悉去，痘出甚密。
复用十全大补汤去桂加防风、连翘、银花、桔梗，调理而愈。其痘自下收起，亦奇事也。
一小儿痘后发热，大小便难，疮瘢带赤。或言虚，欲用保元汤。曰∶不可，此实热也，因食辛热之物得之。
果因食鸡而得，以三黄丸而愈。
Shi Jiquan treated the second son of Zang Yuhan, aged sixteen. Due to recent marriage and consumption of alcohol and rich food, he suddenly contracted smallpox (Dou). Everyone considered it incurable. By the eighth day, the pustules were filled with clear fluid, accompanied by chills, teeth grinding, delirium, and mental confusion. Most wanted to administer Baoyuan Tang (Preserve the Origin Decoction) for strong tonification. Shi Jiquan disagreed and instead used Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction), resulting in recovery. After the scabs fell off, vomiting and dry constipation occurred, prolonging the illness for a year. Miu Zhongchun observed cracks on the tongue and stated, "This must be due to the failure to resolve Yangming channel heat-toxin at that time." He prescribed Shigao (Gypsum Fibrosum) 1 liang, Renshen (Ginseng Radix et Rhizoma) 1 liang, Maidong (Ophiopogonis Tuber) 5 qian, assisted by Pipaye (Loquat Leaf), Juhong (Tangerine Peel), Zhuru (Bamboo Shavings), and Tongbian (Child's Urine). One dose brought stability. A second dose resulted in a sensation of cold obstruction in the chest. Only Renshen was administered; after taking approximately 2 liang, the patient requested porridge, passed stool that evening, and the chronic ailment was cured. (From *Guang Biji*.)
Sun Shengdong treated the son of Zheng Huangmen for smallpox with severe blood-heat. Initially, Xijiao Dihuang Tang was used without effect. Later, using Baishao (White Peony Root) 8 qian, the toxin was cleared in one instance, followed by gradual tonification to complete the cure. (Ibid.)
My younger brother, Yuanzhe, experienced delirium upon fever onset, with swollen lips and blackened teeth. The pustules failed to erupt properly. Physicians diagnosed it as macular typhoid. When summoned, Miu Zhongchun arrived but Shi Jiquan did not. I said, "The situation is critical." I prescribed Shengdi (Rehmanniae Radix) 8 qian, Baishao 5 qian, Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) 2 qian each, with a slight addition of dispersing herbs, administered three times daily. The condition stabilized slightly, and pustules began to emerge gradually. The dosage of Shengdi and Baishao was then halved, and cooling agents were added to the formula supporting pus formation. By the ninetieth day, the pustules were fully formed. Unfortunately, one eye was damaged. Stool passage only occurred after scabbing. This was truly blood-heat. Had toxic-resolving herbs been heavily used while tonics were neglected, blindness might have been avoided. (Ibid.)
Huang Qiyun treated a child with early-stage smallpox and severe blood-heat. He prescribed Shengdi 3 liang, decocted into a concentrated juice to be drunk frequently. The purple color of the pustules immediately turned red. (Ibid.)
Another child with intense smallpox toxin, encountering hot weather, was treated with Baihua Diding (Viola Herba) juice mixed with a little light white wine, leading to immediate relief.
A child presented with dense, protruding pustules that were dark purple, accompanied by high fever, irritability, thirst, delirium, red eyes, and constipation. This indicated extreme hyperactivity of poison-fire. Sishun Qingliang Yin (Four-Obedience Cooling Drink) was used with Dahuang (Rhei Radix et Rhizoma) 6 qian added. Mild diarrhea occurred twice, reducing the severity slightly. A second dose caused two more diarrheal episodes, eliminating half the disease. The previous formula was repeated with Renshen 3 qian added. All prior symptoms subsided, color became pale white, and spirit was fatigued. Although the pathogen was gone, righteous qi was insufficient, requiring strong tonification. Baoyuan Tang was used with Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao, and Baizhu (Atractylodis Macrocephalae Rhizoma) added, resulting in recovery.
A child developed smallpox in summer. The swelling phase showed dry, red pustules, high fever, irritability, thirst, dry tongue, insomnia, and red urine, indicating extreme internal and external heat. Huanglian Jiedu Tang (Scutellaria, Coptis, Phellodendron, and Gardenia Decoction) combined with Huaban Tang (Resolve Macula Decoction) led to recovery.
A child developed smallpox in June. On the sixth day, symptoms included painful pustules, irritability, thirst, rapid breathing, and constipation, indicating excess heat in the Heart and Lungs. Cold water and pear juice were freely given, resolving all prior symptoms.
A child presented with evenly distributed, smooth, protruding pustules that were dry and lacked luster, with wrinkled and peeling skin. These signs belong to Dryness. The Classic states: "Excess dryness leads to desiccation." Treatment employed formulas to nourish blood, clear the Lung metal, and moisten dryness. Baoyuan Tang combined with Siwu Tang (Four Substances Decoction) plus Maidong was used, resulting in recovery.
Wan Mizhai treated the son of the Zou family, aged five, developing smallpox. Some suggested Baoyuan Tang, which intensified the heat. Others considered it a dangerous case. Wan Mizhai said, "This is a favorable course. Recovery is expected by the eighteenth day; no medication is needed." Smallpox cannot be judged solely by days. Once eruption is complete, development is thorough, and pus is full, scabbing can be expected. Currently, heat intensifies after eruption because the eruption is incomplete. Administering Baoyuan Tang violated the prohibition against reinforcing excess (shí shí zhī jiè), causing delayed eruption and scabbing. Skillful defense is superior to skillful attack. With no other complications, why use medicine? The child subsequently recovered.
Madam Wan suffered from smallpox with high fever, intense thirst, red eyes, cracked lips, spontaneous discharge of clear fluid, hallucinations, delirium, picking at clothes and bedrails, and widespread red spots resembling mosquito bites. These are adverse signs. The toxin was in the Sanjiao (Triple Burner), with heat in both exterior and interior. Only powerful diaphoretic or purgative formulas could save her. Tongsheng San (Unimpeded Powder) in full dosage was administered in large amounts. One dose eliminated all prior symptoms, and pustules emerged densely. Then, Shiquan Dabu Tang (Ten Thousand Complete Great Tonifying Decoction) was used with Guizhi (Cinnamomi Ramulus) removed, and Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Yinhua (Lonicerae Japonicae Flos), and Jiegeng (Platycodonis Radix) added for regulation and recovery. The pustules receded from bottom to top, which was remarkable.
A child had fever, difficulty urinating and defecating, and reddish scars after smallpox. Some argued for deficiency and suggested Baoyuan Tang. Wan Mizhai said, "No, this is excess heat caused by consuming spicy and hot foods." It was indeed caused by eating chicken. Sanhuang Wan (Three Yellows Pill) led to recovery.