者，洗肝明目散主之。从子懋锟，痘后两目生翳，羞明特甚，时余与家兄从宜兴试，归视之，则窗牖帷 ，皆以
衣被重重覆蔽，就明展两脾，白膜已遍覆黑睛，泪如涌泉，婴科、眼科，投药不效，束手告技穷矣。余亦
莫知为计，家兄曰，女弟垂死之证，弟能生之，岂遂技穷于是，试精思之。余返书室，闭户而思，目者，清
阳之所走也，而忽焉有翳膜，是浊阴犯之也，浊阴乌敢与阳光敌，故羞明特甚尔，吾得治法矣。乃以黄 助清阳
之气为君，生地黄、当归、养目中真血为臣，羌活、独活、防风、白芷、川芎、甘菊花、薄荷、荆芥、升清阳，
黄芩、猪胆汁、车前子、茯苓降浊阴为佐，雄猪肝作引煎服，仍间服泻青丸。八剂而目开，彻帏 ，翳已去矣。
时眼科所进点洗之药，一切屏不用，止用橄榄核磨汁敷眼胞而已。盖婴儿柔脆，点洗之药，必有所伤故也。治法
方论，详大科眼目门，并本门眼目条内。
凉肝明目散 痘后羞明。
当归 龙胆草 密蒙花 川芎 柴胡 防风 酒连
各等分，雄猪肝煮汤，煎服。
望月沙散 痘后，暗室中不能开者。
谷精草 密蒙花（酒洗） 蝉蜕（去翅足。各五钱） 望月沙（一两）
上为末。雄猪肝一两，竹刀批破，用药一钱，掺入肝内，水煮熟，饮汁食肝，效。
羌菊散 治痘疹后毒瓦斯不散，生翳障，及暴赤眼。
羌活 蝉蜕（去土） 防风 蛇蜕 菊花 谷精草 木贼 甘草 栀子 白蒺藜 大黄 黄连（各少许）
上为末。每一钱，米汤泔水温服。
【便秘】痘后毒入腹中，热气并于小肠则小便不通，并于大肠则大便不通，如前后部俱不通者，热势愈甚。小
便不通者五苓散（惊）、导赤散（心）。大便不通者三黄丸、四顺饮（并发热）、三乙承气汤。大小便俱不通者，八正
散、通关散（并痘便闷）斟酌用之。
【泄泻】痘后泄泻，其证有二。如能食而渴，脉盛者，此热入大肠也，渴者，内热也，食能多者，热消谷也，
脉盛而数，热证谛也，宜黄芩汤（痘泄利）加黄连。如食少不渴脉微小者，此里气虚，不能禁固水谷也，宜四君
子汤加诃子肉、豆蔻，或理中汤丸加熟附子。甚者，以肉豆蔻丸止之（俱痘泄利）。
【便脓血】痘后便脓血者，此热毒入大肠也，宜四物汤（失血）加黄芩、黄连、枳壳、荆
芥穗，或黄连解毒汤（烦躁）加生地黄。勿作倒靥，及用劫涩药也。
【呕吐】胃主纳而不出，大小肠主出而不纳，痘后呕吐者，是余毒在胃也，然有冷热二证。如心烦作渴，
食乳甚急，聚满胸中，然后吐出如射，其人面色带赤，手足心热，居处喜凉，此热吐也，橘皮汤（痘吐逆）加黄连、
竹茹主之。如乳食水浆随吐，面色青白，手足冷，大小便自利，此冷吐也，益黄散（脾）主之。痘后余毒，
多是热邪，其间冷证，十有一二也。亦有伤食而呕者，但闻会臭即吐，不欲食，木香大安丸或养脾丸，并用
生姜汤下。有饮水多而吐者，必吐清水，名水逆，五苓散主之。
木香大安丸
木香（二钱） 黄连 陈皮 白术（各三钱） 枳实 山楂肉 莱菔子（炒） 连翘 神曲（炒） 麦
（炒） 砂仁（各一钱五分）
上为末。神曲糊为丸。陈廪米汤下。
养脾丸
人参 白术 当归 川芎（各一钱半） 木香 青皮 黄连 陈皮（各一钱） 砂仁 山楂
肉神曲（炒） 麦芽（炒。各五分）
上为细末。水调神曲糊、丸如麻子大。每服三五十丸，陈仓米饮下。
【发热】痘疮自初以来一向发热，至于瘥后犹不少减者，此有虚实二证。如大便难，小便赤，能食而烦渴者，
此实热也，以三黄丸或四顺饮（并发热）先解利里热，后用升麻葛根汤（初热）加地骨皮解表热也，盖升麻葛
根汤治疮疹未发之先、已发之后身热药也。如大便不秘，小便不赤，坐立振摇，饮食不甚进者，此虚热也，以
保元汤（大法）加知母、麦门冬，虚甚者加炒干姜成熟附子少许，引火归源。〔薛〕陈文宿先生云∶痘疮收靥之后，
浑身经日不除，别无他证，用柴胡麦门冬散。如不退，服人参白术散（痘渴）。若风热咳嗽，咽喉不利，用桔梗甘
草防风汤。窃谓前证有因热毒未解者，有因胃气虚热者，有因胃气实热者，其因不能枚举，当临证制宜而药之。一
小儿咽痛壮热，痘痕色赤，手微热。此余毒未解。用柴胡麦门冬散而安。七日之后复热，手指初捏似热，久捏则冷，
此脾气虚也，用五味异功散而痊。一小儿痘咽痛，大便不实，口渴饮汤，手足不热，此脾胃虚弱也。用人参白术
散而大便实，但不时寒热，用加味逍遥散而愈。一小儿痘咽痛，发热作渴，面赤饮冷。此胃经实
热也。用射干鼠粘子汤而愈。因食浓味复发，手足并热，用泻黄散一剂而痊。一小儿痘咽痛，发热饮冷，大便黄色，
手足指热，此脾胃实热也。用泻黄、清胃、二散各一剂而愈。后因乳母食浓味，儿口角流涎不能吮乳，仍用前药
治母而愈。小儿痘咽痛，足热。余谓此禀足三阴虚，而无根之火上炎也。古人有云∶痘归肾经，必不可救，当用壮
水之剂，亦有生者，奈彼不悟，翌日果腰痛咽哑，始信余言，乃用大剂地黄丸料加五味子，并补中益气汤而愈。一男
子出痘，上体甚热，两足俱冷，喉痛作渴，疮亦不起发。此禀肾经虚热也。以六味地黄丸料煎与恣饮，渐愈，
又用八珍汤而痊。一小儿面色素白，出痘咽痛，发热面赤，作渴饮汤，手足指冷。此禀足三阴虚也。用大剂加减八味
丸料煎与恣饮，又以益气汤助其脾肺，以滋化源，痛止热退而愈。
柴胡麦门冬散（痘发热）
柴胡栀子散 治肝胆经有热，疮毒不愈，或发热不止。
柴胡 山栀 牡丹皮（各一钱） 川芎 芍药 茯苓（各七分） 白术（炒） 甘草（各五分） 当归
牛蒡子（炒。各七分）
上，水煎，母、子同服。
小柴胡汤 治发热甚而呕者，宜服之。
柴胡 人参 黄芩（各三两） 甘草（炙） 半夏（各二两半，汤泡七次）
上为粗末。每服三钱，水一盏，生姜三片，枣子一枚，同煎至半盏，去滓温服。咳嗽者，加五味子煎服。
头痛发热，肢节疼痛者，四味升麻汤。大便不通者，四顺饮。若大便自利黄黑色者，此毒亦有所出，不
必广与汤剂，恐重增他病，大便自然通，不得以温药助之，疮疹亦稀少。自快利，只与四味升麻汤、荆芥
散，虽大便利，不可以温药助之。其下利甚者，却与少温之。
槐花散 治 疮余热不退。
槐花 赤小豆（各炒，二钱） 麝香（少许）
上为细末。每服半钱，蜜汤调服，不拘时候。
黄 散 治壮热不退，可凉肌肤，散热。
黄 柴胡 干葛 甘草（炙。各等分）
上为末。每服一钱，薄荷三叶，水半盏，煎至三分，约三呷，空心服。此药治
发热数日未退者，其热是疮疹者，量其虚实用之也。
【中风】痘后忽然口噤涎潮，角弓反张，手足螈 ，身青黑色，此中风也，疮痘方愈，荣卫正弱，不知避忌，
忽遇节令气交，八方不正之气，乘虚而入，故为此证。宜消风散二钱、入蝉蜕末一钱、分为三服，投生姜薄
荷汁及酒各数点，温汤浸之，连二三服。或作瘾疹，或再出肤疹而愈。
消风散（见痘中风）
钩藤汤 痘后口噤僵直，绕脐腹痛。
钩藤 红花 木香 川芎 当归 白芍 甘草 白术 青皮 黄连 官桂 生姜
各等分，水煎，不拘时服。
【骨节作痛】俗名痘风，丹溪分气血虚实，以日子守之，多带气血不足。虚则黄 生血之剂助之，略佐以风药。
实则白芍药、黄芩、为君，连翘、白芷、续断之类为佐。若属虚寒，陈氏方可用。余详痘中风门。
【拘挛】痘后手足拘挛，屈伸不便，起居艰苦者，乃血耗气虚，不能荣养于筋，宜十全大补汤去地黄、白茯苓，
加川续断，多服乃佳。气虚者少加川乌炮过、行经，
不可误作风治，妄行发散，反耗阴血也。
当归桂枝汤 治痘后手足不能屈伸。
当归 川芎 黄 甘草 薄桂 黄柏 苍术（炒）
各等分，水煎。如气虚，少加川乌以行经，加人参为主。如感风寒，以致骨节疼痛，加羌活、防风。
【昏昧妄言】痘后昏昧，不解识人，口中常妄言，如邪祟状，此移热入心包络，宜导赤散（心）吞
安神丸（痘谵妄），待醒后以保元汤加麦门冬、生地黄，四物汤加石菖蒲、木通、山栀子仁，相间服之。
若卒然昏昏喜睡，状如眩晕，身无热，口中无妄语，其人痘出必重，又乳食少，今毒瓦斯已解，正气未复，
故邪退而喜睡，乃否极泰来之象，不须妄治，逡巡苏醒矣。
【厥逆】手足厥冷，盖覆不温，此痘疹逆候也，若在正盛之时，十无一生，今病已愈，气血久虚，脾
胃大困，其厥逆宜矣，用保元汤加当归身、熟附子、主之。
【咳嗽】咳嗽频频，涕唾稠粘，此痘疹常证也，有寒有热，有虚有实，不可拘泥一定之法。如自初出咳
嗽到今未愈者，此肺中余邪未尽也，宜甘桔汤（咽喉）合泻白散
（肺）加牛蒡子、马兜铃主之。如咳而热，大便难，小便赤者，此热毒也，宜葶苈丸主之（痘喘）。大便润
者，人参白虎汤（痘渴）合甘桔汤主之。如咳而大便溏，小便清，无大热渴者，此虚也，宜人参清膈散主之
（痘咳嗽）。如咳而血出者，甘桔汤加牛蒡子、茅根汁、阿胶主之。如向不咳，今始咳者，此风寒外感也，
麻黄汤主之（痘喘）。
灯心汤 治疮痘出后，烦喘小便不利者，宜进之。
灯心（一把） 鳖甲（醋煮黄，二两）
上锉为散。每服一两，用水八合，煎取四分服之，各量大小加减。
咳嗽之时胁痛者，经云∶左右者，阴阳之道路，左右，两胁之谓也，由余毒在中，阴阳之气，不能升降，故
胁为之疼也，但当解毒，毒瓦斯去，则真气行，所苦自平矣，小柴胡加枳桔汤主之。
赤茯苓汤 治小儿疹痘，疮出后咳逆胁痛，不下食。
赤茯苓 甘草（炙） 大青 升麻 枳壳（麸炒，各半两） 栀子（一分）
上为粗末。每服一钱，水一小盏，入苦竹叶七片，豆豉三十粒，同煎至五分盏，
去滓，分为三服，日三四服，看儿大小，以意加减。本方称疹痘出后胁痛者，由
病后毒瓦斯溷乱，阻于升降，左右为阴阳之道路，气之所行处，令气滞，为胁痛，以枳壳宽肠下气，令气顺，
胁不痛也，大青、栀子去蕴热，升麻解毒，赤茯苓导心火，利小肠，无热以克肺气，而效逆自平尔。
【腹痛】疮疹未出而腹痛者，乃 毒内攻也，今毒已解，无复壅遏矣，而腹中痛者，其证有二。一则因大便
未通，燥屎作痛，备急丸主之（大便闭）。一则因食过多，胃虚不能消谷而作痛，如便秘者，丁香脾积丸（伤食），便利
者，木香大安丸（伤食）主之。但燥屎痛者，病在下焦，伤食痛者，病在上焦，手不可按，若原食少，又便
常润，忽尔作痛者，此虚寒证也，病在中焦，必喜用手按摩，黄 建中汤主之。
【渴】痘家作渴，亦是常事，至痘后则不宜有渴，乃忽然渴而引饮者，余毒留于心胃，膈焦咽燥故也，其人必
能食，大便秘，小便赤，舌燥咽干，宜人参白虎汤加黄连主之。若食少，大小便自调，虽好饮汤，咽舌不燥，此
脾胃虚，津液不足也，宜人参白术散，不愈，人参麦门冬散加天花粉主之（并痘渴）。
【失音】痘后失音有二。咽痛不能言者，此毒瓦斯结于咽喉之间，痰壅作痛，而不能言，天花散主之（痘失音）。
心热不能言者，心中邪热未彻，肾虚不能上接于阳，
虽有声而不能言，四物汤去川芎，加麦门冬、白茯苓、主之。
【不喜食】痘后邪气尽退，正气将复，脾胃略纾，宜渐能食也，若原不食，今因喜食太过，或原能食，今
又骤加以致恶食不食者，此皆内伤有余证也，宜木香大安丸主之（伤食）。如向未食，今又不喜食者，此脾胃中
气不足，宜七珍散（痘不能食）或人参白术散去葛根加陈皮、木香，研末，取二两，另用糯米、绿豆、各二两，各
炒熟研末相和，枣汤调服，稍能食，更兼进养脾丸。
【寒热】痘后忽发寒热如疟状，至后如期即发者，此脾虚气弱，失于将息，重感风寒，宜先以柴葛桂枝汤发去
新受表邪，后以保元汤加当归、陈皮、白术、砂仁、乌梅、生姜、调之。
大和散 治疮痘后，寒热往来，嗜卧顿闷躁乱。
生地黄 当归 地骨皮 人参 甘草（炙） 白芍药（各等分）
上 咀。每服一钱，水半盏，煎至三分，去滓温服。
柴葛桂枝汤（见初热）
【肿胀】痘后面目虚浮，或久则一身皆肿者，此表气不足，出风太早，风邪乘虚
而入，其治在肺，宜五皮汤先加桂枝微汗之，后只服本方，若遍身皆肿，以胃苓汤合五皮汤主之。
痘后腹虚肿胀满，或气喘粗者，此宿垢在里，不问余毒、食积、蓄水，并先利之，宜塌气丸，
利后以胃苓汤去甘草，加人参、黄 、大腹皮调之，其治在脾。如因新食作胀不肿者，只木香大安丸。
五皮汤
桑白皮 地骨皮 生姜皮 大腹皮 五加皮（各等分）
(If symptoms such as photophobia and tearing occur), Xi Gan Ming Mu San (Wash Liver Brighten Eyes Powder) is the primary formula. The patient's son, Mao Kun, developed corneal opacities in both eyes after smallpox, with extreme photophobia. At that time, my brother and I returned from Yixing after taking the imperial examinations to visit him. We found that windows and curtains were covered layer by layer with clothes and quilts. When he opened his eyes in the dim light, white membranes had completely covered the black pupils, and tears flowed like a spring. Pediatricians and ophthalmologists failed to respond to medication, holding their hands in helplessness and claiming exhaustion of skills. I also had no solution. My brother said, "This is a critical condition on the verge of death. If you can cure it, how could you claim skill exhaustion? Please think carefully." I returned to my study, closed the door, and pondered. The eyes are the pathways where clear Yang Qi circulates. The sudden appearance of opacities indicates invasion by turbid Yin. How dare turbid Yin oppose the sunlight? Hence the extreme photophobia. I have found the treatment method. Therefore, Huangqi (Astragali Radix) was used as the sovereign herb to assist the clear Yang Qi; Shengdihuang (Rehmanniae Radix Recens) and Danggui (Angelicae Sinensis Radix) were used as minister herbs to nourish the true blood of the eyes; Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ganhua Ju (Chrysanthemi Flos), Bohe (Menthae Haplocalycis Herba), and Jingjie (Schizonepetae Spica) were used to ascend the clear Yang; Huangqin (Scutellariae Radix), Zhu Danzhi (Porci Bile), Cheqianzi (Plantaginis Semen), and Fuling (Poria) were used to descend the turbid Yin as assistant herbs; and male pig liver was used as a guiding herb for decoction and administration. Meanwhile, Xie Qing Wan (Drain Green Pill) was taken intermittently. After eight doses, the eyes opened, the curtains were removed, and the opacities disappeared. All eye drops and washes prescribed by ophthalmologists at that time were completely discontinued and not used; only juice ground from olive pits was applied to the eyelids. This is because infants have delicate and fragile constitutions, and eye drops/washes would inevitably cause damage. The treatment methods and formula discussions are detailed in the Major Department of Ophthalmology section and within the Ophthalmology entries of this section.
Liang Gan Ming Mu San (Cool Liver Brighten Eyes Powder): Treats photophobia after smallpox.
Danggui (Angelicae Sinensis Radix), Longdancao (Gentianae Radix), Mimenghua (Descurainiae Semen seu Fructus), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Jiu Lian (Scutellariae Radix prepared with wine). Equal parts. Decoct with soup boiled from male pig liver for oral administration.
Wang Yue Sha San (Moon Sand Powder): Treats inability to open eyes in dark rooms after smallpox.
Gujingcao (Euphrasiae Herba), Mimenghua (Descurainiae Semen seu Fructus, washed with wine), Chantui (Cicadae Periostracum, wings and feet removed, 5 qian each), Wangyuesha (Leporini Os, 1 liang).
Grind all into powder. Take 1 liang of male pig liver, slice open with a bamboo knife, insert 1 qian of the powder into the liver, boil in water until cooked. Drink the broth and eat the liver. Effective.
Qiang Ju San (Notopterygium and Chrysanthemum Powder): Treats lingering toxic qi after variola/rubella that fails to dissipate, causing corneal opacities, and acute red eyes.
Qianghuo (Notopterygii Rhizoma et Radix), Chantui (Cicadae Periostracum, cleaned of soil), Fangfeng (Saposhnikoviae Radix), Shetui (Bombyx Batryticatus), Juhua (Chrysanthemi Flos), Gujingcao (Euphrasiae Herba), Muzei (Equiseti Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Baijili (Tribuli Fructus), Dahuang (Rhei Radix et Rhizoma), Huanglian (Coptidis Rhizoma). Small amounts of each.
Grind all into powder. Take 1 qian per dose, administer warm with rice water (starch water).
[Constipation] When toxic qi enters the abdomen after smallpox, heat gathers in the Small Intestine leading to urinary retention, or gathers in the Large Intestine leading to fecal impaction. If both anterior and posterior passages are blocked, the heat pathogen is even more severe. For urinary retention, use Wuling San (Five-Ingredient Powder with Poria) [for cases due to fright] or Dao Chi San (Direct Outward Redness Powder) [for Heart heat]. For fecal impaction, use Sanhuang Wan (Three-Yellow Pill), Sishun Yin (Four-Smooth Decoction) [if accompanied by fever], or San Yi Chengqi Tang (Three-Efficiency Bowel-Unblocking Decoction). For both urinary and fecal retention, use Bazheng San (Eight-Correctness Powder) or Tongguan San (Pass-the-Gate Powder) [for smallpox with abdominal distension and constipation]; use these with discretion.
[Diarrhea] Diarrhea after smallpox presents in two patterns. If the patient can eat and feels thirsty with a full pulse, this indicates heat entering the Large Intestine. Thirst signifies internal heat; increased appetite signifies heat consuming grain; a full and rapid pulse confirms the heat pattern. Use Huangqin Tang (Scutellaria Decoction) [for smallpox diarrhea/dysentery] added with Huanglian (Coptidis Rhizoma). If the patient eats little, feels no thirst, and has a faint/small pulse, this indicates deficiency of interior Qi failing to secure fluids and food. Use Sijunzi Tang (Four-Gentlemen Decoction) added with Hezi Rou (Arecae Semen Pericarpium) and Doukou (Cardamomi Fructus Rotundus), or Lizhong Wan/Tang (Regulate the Middle Pill/Decoction) added with Shu Fuzi (Prepared Aconiti Lateralis Radix). For severe cases, use Roudoukou Wan (Myristica Pill) to stop diarrhea (both applicable to smallpox diarrhea).
[Purulent Bloody Stool] Purulent bloody stool after smallpox indicates heat-toxin entering the Large Intestine. Use Siwu Tang (Four-Substance Decoction) [for blood loss] added with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhiqiao (Aurantii Fructus), and Jingjie Sui (Schizonepetae Spica tip); or Huanglian Jiedu Tang (Coptis Detoxification Decoction) [for irritability] added with Shengdihuang (Rehmanniae Radix Recens). Do not treat this as inverted smallpox lesions, nor use astringent drugs to forcibly stop discharge.
[Vomiting] The Stomach receives but does not expel; the Small and Large Intestines expel but do not receive. Vomiting after smallpox indicates residual toxin in the Stomach. However, there are cold and hot patterns. If there is mental restlessness, thirst, urgent nursing, accumulation in the chest followed by projectile vomiting, reddish complexion, hot palms/soles, and preference for cool environments, this is Heat Vomiting. Treat with Jupi Tang (Tangerine Peel Decoction) [for smallpox vomiting/reflux] added with Huanglian (Coptidis Rhizoma) and Zhuru (Bambusae Caulis in Taeniam). If milk/food/water is vomited immediately upon intake, with bluish-white complexion, cold limbs, and normal urination/defecation, this is Cold Vomiting. Treat with Yihuang San (Yellow Regulating Powder) [for Spleen deficiency-cold]. Residual toxins after smallpox are mostly heat pathogens; cold patterns account for one or two out of ten. There are also cases of vomiting due to food stagnation: vomiting upon smelling odors, anorexia. Treat with Muxiang Da'an Wan (Costus Great Peace Pill) or Yangpi Wan (Nourish Spleen Pill), administered with Ginger Decoction. Cases of excessive water intake leading to vomiting, specifically vomiting clear fluid, are named Water Inversion (Shui Ni). Treat with Wuling San (Five-Ingredient Powder with Poria).
Muxiang Da'an Wan (Costus Great Peace Pill)
Muxiang (Aucklandiae Radix, 2 qian), Huanglian (Coptidis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian each), Zhishi (Aurantii Fructus Immaturus), Shanzha Rou (Crataegi Fructus), Laifuzi (Radish Seed, stir-fried), Lianqiao (Forsythiae Fructus), Shenqu (Massae Fermentatae Medicamentosa, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried), Sharen (Amomi Fructus, 1.5 qian each).
Grind into powder. Form pills using Shenqu paste. Administer with aged barn rice soup.
Yangpi Wan (Nourish Spleen Pill)
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, 1.5 qian each), Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma), Chenpi (Citri Reticulatae Pericarpium, 1 qian each), Sharen (Amomi Fructus), Shanzha Rou (Crataegi Fructus), Shenqu (Massae Fermentatae Medicamentosa, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried, 0.5 qian each).
Grind into fine powder. Mix with water and Shenqu paste to form pills the size of hemp seeds. Take 30-50 pills per dose, administered with aged barn rice drink.
[Fever] Fever persisting from the onset of smallpox through recovery without reduction indicates either Excess or Deficiency patterns. If there is difficult defecation, red urine, ability to eat, and irritability/thirst, this is Excess Heat. First resolve interior heat with Sanhuang Wan (Three-Yellow Pill) or Sishun Yin (Four-Smooth Decoction) [if accompanied by fever], then release exterior heat with Shengma Gegen Tang (Kudzu and Cimicifuga Decoction) [for initial fever] added with Digupi (Phellodendri Cortex). Shengma Gegen Tang treats fever before and after the eruption of rashes. If defecation is not obstructed, urine is not red, but the patient sits/restlessly shakes and has poor appetite, this is Deficiency Heat. Use Baoyuan Tang (Preserve Origin Decoction) [general principle] added with Zhimu (Anemarrhenae Rhizoma) and Maidong (Ophiopogonis Tuber). For severe deficiency, add stir-fried Ganjiang (Zingiberis Rhizoma) and a small amount of Shu Fuzi (Prepared Aconiti Lateralis Radix) to guide fire back to its source. [Xue] Mr. Chen Wensu stated: After smallpox scabs fall off, if whole-body fever persists for days without other symptoms, use Chaihu Maidong San (Bupleurum and Ophiopogon Powder). If fever persists, use Renshen Baizhu San (Ginseng and Atractylodes Powder) [for smallpox thirst]. For wind-heat cough and throat obstruction, use Jiegan Gancao Fangfeng Tang (Platycodon, Licorice, and Saposhnikovia Decoction). I believe the aforementioned conditions arise from unresolved heat-toxin, Stomach Qi deficiency-heat, or Stomach Qi excess-heat. Etiologies cannot be exhaustively listed; treatment must be adapted to clinical presentation.
Case 1: A child with sore throat, high fever, red smallpox scars, and slightly warm hands. This is unresolved residual toxin. Cured with Chaihu Maidong San (Bupleurum and Ophiopogon Powder). Seven days later, fever recurred; fingers felt warm initially but cold upon prolonged touch, indicating Spleen Qi deficiency. Cured with Wuwei Yigong San (Six-Gentleman Powder modified).
Case 2: A child with post-smallpox sore throat, loose stools, thirst for hot drinks, and cold limbs. This is Spleen-Stomach weakness. Cured with Renshen Baizhu San (Ginseng and Atractylodes Powder) resulting in formed stools; intermittent chills/fever resolved with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
Case 3: A child with post-smallpox sore throat, fever, thirst, red face, and preference for cold drinks. This is Stomach Meridian excess heat. Cured with Shegan Niu Bang Zi Tang (Belamcanda and Burdock Seed Decoction). Relapse after rich diet caused heat in limbs; cured with one dose of Xiehuang San (Drain Spleen Powder).
Case 4: A child with post-smallpox sore throat, fever, preference for cold drinks, yellow stool, and hot toes. This is Spleen-Stomach excess heat. Cured with one dose each of Xiehuang San (Drain Spleen Powder) and Qingwei San (Clear Stomach Powder). Later, salivation and inability to nurse due to wet nurse's rich diet; cured by treating the mother with previous formulas.
Case 5: A child with post-smallpox sore throat and hot feet. I diagnosed congenital deficiency of the Foot Three Yin meridians with floating rootless fire. Ancients said: "Smallpox involving the Kidney meridian is incurable," recommending tonifying Water agents. Some survived this way, but they did not understand. The next day, lower back pain and hoarseness confirmed my diagnosis. Cured with large dose of Dihuang Wan (Rehmannia Pill) material added with Wuweizi (Schisandrae Fructus) and Buzhong Yiqi Tang (Center-Supplementing and Qi-Boosting Decoction).
Case 6: A man with smallpox, very hot upper body, cold legs, sore throat, thirst, and non-erupting lesions. This is congenital Kidney Meridian deficiency heat. Cured gradually by drinking large amounts of Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) material, then fully recovered with Bazhen Tang (Eight-Treasure Decoction).
Case 7: A child with pale complexion, post-smallpox sore throat, fever, red face, thirst for hot drinks, and cold toes. This is congenital Foot Three Yin deficiency. Cured by drinking large amounts of Jiawei Bawei Wan (Modified Eight-Ingredient Pill) material, assisted by Yiqi Tang (Qi-Boosting Decoction) to support Spleen-Lung and nourish the source of transformation. Pain stopped, fever subsided.
Chaihu Maidong San (Bupleurum and Ophiopogon Powder) [Smallpox Fever]
Chaihu Zizisan (Bupleurum and Gardenia Powder): Treats Liver/Gallbladder heat, persistent rash toxin, or unremitting fever.
Chaihu (Bupleuri Radix), Shan Zhi (Gardeniae Fructus), Mudanpi (Moutan Cortex, 1 qian each), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba), Fuling (Poria, 0.7 qian each), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian each), Danggui (Angelicae Sinensis Radix), Niubangzi (Arctii Fructus, stir-fried, 0.7 qian each).
Decoct in water. Mother and child take together.
Xiao Chaihu Tang (Minor Bupleurum Decoction): Treats severe fever with vomiting.
Chaihu (Bupleuri Radix), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix, 3 liang each), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Banxia (Pinelliae Rhizoma, 2.5 liang each, soaked in boiling water seven times).
Grind into coarse powder. Take 3 qian per dose with 1 cup of water, 3 slices of ginger, and 1 jujube. Decoct to half a cup, strain, and take warm. For cough, add Wuweizi (Schisandrae Fructus) and decoct.
For headache, fever, and joint pain, use Simaishengma Tang (Four-Ingredient Kudzu and Cimicifuga Decoction). For constipation, use Sishun Yin (Four-Smooth Decoction). If spontaneous loose stools are yellow-black, toxin is exiting; do not broadly administer decoctions to avoid aggravating other conditions. Spontaneous bowel movement will occur naturally; do not use warming herbs to assist, as rashes will become sparse. If stools are freely passing, give Simaishengma Tang (Four-Ingredient Kudzu and Cimicifuga Decoction) or Jingjie San (Schizonepeta Powder). Even with free stools, do not use warming herbs. If diarrhea is severe, administer slight warming herbs.
Huaihua San (Sophora Flower Powder): Treats lingering heat after smallpox.
Huaihua (Sophorae Flos), Chixiaodou (Adzuki Bean, stir-fried, 2 qian each), Shexiang (Moschus, small amount).
Grind into fine powder. Take 0.5 qian per dose, mixed with honey water, anytime.
Huangqi San (Astragalus Powder): Treats unremitting high fever, cools skin, dissipates heat.
Huangqi (Astragali Radix), Chaihu (Bupleuri Radix), Gange (Puerariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, equal parts).
Grind into powder. Take 1 qian per dose with 3 mint leaves and half a cup of water. Decoct to one-third cup. Drink in three sips on an empty stomach. This medicine treats fever lasting several days; if the heat is from smallpox, adjust dosage based on deficiency/excess.
[Stroke] Sudden lockjaw, salivation, opisthotonos, convulsions of limbs, and cyanotic/blackish body color after smallpox indicate Stroke. Just after smallpox recovery, Ying and Wei Qi are weak. Failure to observe precautions leads to invasion of abnormal Qi from seasonal changes. Treat with Xiaofeng San (Wind-Expelling Powder) 2 qian, added with 1 qian Chantui (Cicadae Periostracum) powder, divided into three doses. Add a few drops of ginger-mint juice and wine. Soak in warm water. Take 2-3 doses consecutively. Recovery may occur via hives or secondary skin eruptions.
Xiaofeng San (Wind-Expelling Powder) [See Smallpox Stroke]
Gouteng Tang (Uncaria Decoction): Treats post-smallpox lockjaw, stiffness, and periumbilical abdominal pain.
Gouteng (Uncariae Ramulus cum Uncis), Honghua (Carthami Flos), Muxiang (Aucklandiae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma), Guigui (Cinnamomi Cortex), Shengjiang (Zingiberis Rhizoma Recens). Equal parts. Decoct in water, take anytime.
[Joint Pain] Commonly called "Smallpox Wind." Danxi distinguished Qi/Blood deficiency/excess, calculating by days, often involving Qi/Blood insufficiency. For deficiency, use Huangqi (Astragali Radix) blood-nourishing formulas with slight wind-expelling herbs. For excess, use Baishao (Paeoniae Radix Alba) and Huangqin (Scutellariae Radix) as sovereign herbs, with Lianqiao (Forsythiae Fructus), Baizhi (Angelicae Dahuricae Radix), and Xuduan (Dipsaci Radix) as assistants. For deficiency-cold, refer to Chen's formulas. See Smallpox Stroke section for details.
[Contracture] Post-smallpox limb contracture, difficulty bending/extending, and hardship in daily life result from blood consumption and Qi deficiency failing to nourish tendons. Use Shiquan Dabu Tang (Ten-Increment Great Tonifying Decoction) removing Dihuang (Rehmanniae Radix) and Baifuling (Poria), adding Xuanduan (Dipsaci Radix). Take in large quantities for best results. For Qi deficiency, add a small amount of processed Chuanwu (Aconiti Radix) to promote circulation. Do not mistake this for Wind syndrome and wrongly apply dispersing methods, which would consume Yin blood.
Danggui Guizhi Tang (Angelica and Cinnamon Twig Decoction): Treats post-smallpox inability to bend/extend limbs.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqi (Astragali Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Bao Gui (Cinnamomi Cortex thin), Huangbai (Phellodendri Cortex), Cangzhu (Atractylodis Rhizoma, stir-fried). Equal parts. Decoct in water. For Qi deficiency, add small amount of Chuanwu (Aconiti Radix) and prioritize Renshen (Ginseng Radix). If affected by wind-cold causing joint pain, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix).
[Confusion and Delirium] Post-smallpox confusion, failure to recognize people, and constant delirium resembling possession indicate heat transferring to the Pericardium. Use Dao Chi San (Direct Outward Redness Powder) [Heart heat] to swallow Anshen Wan (Calming Spirit Pill) [smallpox delirium]. After waking, alternate Baoyuan Tang (Preserve Origin Decoction) added with Maidong (Ophiopogonis Tuber) and Shengdihuang (Rehmanniae Radix Recens), and Siwu Tang (Four-Substance Decoction) added with Shichangpu (Acori Tatarinowii Rhizoma), Mutong (Akebiae Caulis), and Shanzhiren (Gardeniae Fructus).
If suddenly drowsy, resembling vertigo, without fever or delirium, and having had severe smallpox with poor intake, the toxin has resolved but Zheng Qi has not recovered. Thus, evil retreats and drowsiness occurs, representing the transition from extreme yin to yang. No treatment is needed; awakening will occur spontaneously.
[Cold Extremities] Cold limbs unwarmed by blankets indicate an adverse sign of smallpox. If occurring during peak disease, survival is rare. Now that the disease has resolved, long-standing Qi/Blood deficiency and Spleen/Stomach exhaustion make cold extremities expected. Use Baoyuan Tang (Preserve Origin Decoction) added with Danggui Shen (Angelicae Sinensis Radix radix portion) and Shu Fuzi (Prepared Aconiti Lateralis Radix).
[Cough] Frequent coughing with thick sticky sputum is a common smallpox symptom, presenting with cold/heat and deficiency/excess. Do not adhere rigidly to fixed methods. If cough persists from onset to recovery, residual pathogen remains in the Lung. Use Ganjie Tang (Licorice and Platycodon Decoction) [throat] combined with Xiebai San (Drain White Powder) [Lung] added with Niubangzi (Arctii Fructus) and Malouling (Aristolochiae Fructus). If cough with fever, difficult defecation, and red urine, this is heat-toxin. Use Tingli Wan (Descurainia Seed Pill) [smallpox wheezing]. If stools are moist, use Renshen Baihu Tang (Ginseng and White Tiger Decoction) [smallpox thirst] combined with Ganjie Tang (Licorice and Platycodon Decoction). If cough with loose stools, clear urine, and no significant fever/thirst, this is deficiency. Use Renshen Qingge San (Ginseng Clear Diaphragm Powder) [smallpox cough]. If cough with hemoptysis, use Ganjie Tang (Licorice and Platycodon Decoction) added with Niubangzi (Arctii Fructus), Maogen Juice (Imperatae Rhizoma Juice), and Ejiao (Asini Corii Colla). If previously no cough but now starting, this is external wind-cold. Use Mahuang Tang (Ephedra Decoction) [smallpox wheezing].
Dengxin Tang (Juncus Decoction): Treats irritability, wheezing, and difficult urination after smallpox eruption.
Dengxin (Junci Medulla, 1 bunch), Biejia (Trionycis Carapax, vinegar-boiled until yellow, 2 liang).
Cut into pieces. Take 1 liang per dose with 8 he of water. Decoct to 4 fen. Adjust dosage by age/size.
When cough is accompanied by hypochondriac pain, the Classics state: "Left and right are the pathways of Yin and Yang," referring to the hypochondrium. Residual toxin in the middle obstructs Yin-Yang Qi ascent/descent, causing pain. Only detoxification is needed; once toxin clears, True Qi flows, and suffering resolves. Use Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Zhike (Aurantii Fructus) and Jiegeng (Platycodonis Radix).
Chi Fuling Tang (Red Poria Decoction): Treats children with rubella/smallpox, cough/retrograde qi, hypochondriac pain, and anorexia after eruption.
Chi Fuling (Poria with Red Host), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Daqing (Isatidis Folium), Shengma (Cimicifugae Rhizoma), Zhike (Aurantii Fructus, bran-roasted, 0.5 liang each), Zhizi (Gardeniae Fructus, 1 fen).
Grind into coarse powder. Take 1 qian per dose with 1 small cup of water, 7 bitter bamboo leaves, and 30 fermented soybeans. Decoct to 0.5 cup. Strain, divide into three doses. Take 3-4 times daily. Adjust according to child's size. The formula states post-rash hypochondriac pain is due to chaotic toxic qi obstructing ascent/descent. Left/right are Yin/Yang pathways. Qi stagnation causes pain. Zhike broadens intestines and directs Qi downward. Daqing/Zhizi clear accumulated heat. Shengma detoxifies. Chi Fuling guides Heart fire and benefits Small Intestine. Without heat overcoming Lung Qi, retrograde qi resolves.
[Abdominal Pain] Abdominal pain before smallpox eruption indicates internal attack by toxin. Now that toxin has resolved, abdominal pain presents in two patterns. One is due to unpassed dry stool causing pain; treat with Beiji Wan (Emergency Pill) [constipation]. The other is due to overeating with weak Stomach failing to digest; if constipated, use Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill) [food stagnation]; if stools are loose, use Muxiang Da'an Wan (Costus Great Peace Pill) [food stagnation]. Dry stool pain is in the Lower Jiao; food stagnation pain is in the Upper Jiao, intolerant to pressure. If originally low intake, normally moist stools, but sudden pain occurs, this is deficiency-cold in the Middle Jiao, preferring massage. Use Huangqi Jianzhong Tang (Astragalus and Middle-Regulating Decoction).
[Thirst] Thirst is common in smallpox patients but should not occur post-recovery. Sudden intense thirst indicates residual toxin remaining in Heart/Stomach, scorching the diaphragm and drying the pharynx. Patient likely eats well, has constipation, red urine, dry tongue/throat. Use Renshen Baihu Tang (Ginseng and White Tiger Decoction) added with Huanglian (Coptidis Rhizoma). If poor intake, normal urination/defecation, desire for hot drinks but non-dry throat/tongue, this is Spleen-Stomach deficiency with insufficient fluids. Use Renshen Baizhu San (Ginseng and Atractylodes Powder). If ineffective, use Renshen Maidong San (Ginseng and Ophiopogon Powder) added with Tianhuafen (Trichosanthis Radix) [both for smallpox thirst].
[Aphonia] Two types of post-smallpox aphonia. Sore throat preventing speech indicates toxin knotting in the pharynx with phlegm obstruction and pain. Use Tianhua San (Trichosanthes Powder) [smallpox aphonia]. Heart heat preventing speech indicates incomplete clearance of pathogenic heat in the Heart, with Kidney deficiency failing to connect to Yang above. Voice exists but cannot form words. Use Siwu Tang (Four-Substance Decoction) removing Chuanxiong (Ligustici Chuanxiong Rhizoma), added with Maidong (Ophiopogonis Tuber) and Baifuling (Poria).
[Anorexia] After smallpox, evil qi retreats, Zheng Qi recovers, and Spleen-Stomach relaxes, so appetite should gradually return. If previously anorexic but now overeats, or previously ate well but now suddenly develops aversion/anorexia due to overeating, these are Excess Internal Injury patterns. Use Muxiang Da'an Wan (Costus Great Peace Pill) [food stagnation]. If previously ate nothing and still dislikes eating, this is insufficient Central Qi in Spleen-Stomach. Use Shizhen San (Ten-Treasure Powder) [smallpox anorexia] or Renshen Baizhu San (Ginseng and Atractylodes Powder) removing Gegen (Puerariae Radix), adding Chenpi (Citri Reticulatae Pericarpium) and Muxiang (Aucklandiae Radix), grind to powder, take 2 liang. Mix with 2 liang each of stir-fried glutinous rice and mung bean powder. Administer with jujube soup. As appetite improves, add Yangpi Wan (Nourish Spleen Pill).
[Chills and Fever] Sudden chills and fever resembling malaria after smallpox, recurring regularly, indicates Spleen deficiency and Qi weakness, neglect of care, and re-infection with wind-cold. First use Chaige Guizhi Tang (Bupleurum, Kudzu, and Cinnamon Twig Decoction) to release new exterior pathogen, then regulate with Baoyuan Tang (Preserve Origin Decoction) added with Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Sharen (Amomi Fructus), Wumei (Mume Fructus), and Shengjiang (Zingiberis Rhizoma Recens).
Dahe San (Great Harmony Powder): Treats post-smallpox alternating chills/fever, lethargy, oppression, and irritability.
Shengdihuang (Rehmanniae Radix Recens), Danggui (Angelicae Sinensis Radix), Digupi (Phellodendri Cortex), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Baishao (Paeoniae Radix Alba, equal parts).
Chop. Take 1 qian per dose with half a cup of water. Decoct to one-third cup. Strain and take warm.
Chaige Guizhi Tang (Bupleurum, Kudzu, and Cinnamon Twig Decoction) [See Initial Fever]
[Edema] Post-smallpox facial puffiness or generalized edema over time indicates insufficient Exterior Qi and premature exposure to wind, allowing wind-pathogen to invade. Treatment focuses on the Lung. Use Wupi Tang (Five-Bark Decoction) first added with Guizhi (Cinnamomi Ramulus) to induce mild sweating, then continue with the base formula. For generalized edema, use Weiling Tang (Atractylodes and Poria Decoction) combined with Wupi Tang (Five-Bark Decoction).
Post-smallpox abdominal distension/edema or coarse breathing indicates retained waste internally. Regardless of residual toxin, food stagnation, or water retention, first purge. Use Taqi Wan (Collapse Qi Pill). After purging, regulate with Weiling Tang (Atractylodes and Poria Decoction) removing Gancao (Glycyrrhizae Radix et Rhizoma), adding Renshen (Ginseng Radix), Huangqi (Astragali Radix), and Dafupi (Arecae Pericarpium). Treatment focuses on the Spleen. If distension without edema due to recent food intake, use only Muxiang Da'an Wan (Costus Great Peace Pill).
Wupi Tang (Five-Bark Decoction)
Sangbaipi (Mori Cortex), Digupi (Phellodendri Cortex), Shengjiangpi (Zingiberis Pericarpium), Dafupi (Arecae Pericarpium), Wujia pi (Acanthopanacis Cortex, equal parts).