〔钱〕疮疹三日不出，或出不快，即微发之（鼠粘子汤之类。）如疮发后不多出，即加药
（如一日一帖即加至二帖。）加药不出，即大发之（升麻、葛根、防风、羌活、独活、
麻黄、桂枝之类。）如发后不多，及脉平无证，即疮本稀，不可更发也。有大热者当利小便（四圣
散、六一散、四苓、之类，）小热者当解毒，若不快，勿发，勿下攻，止用抱龙丸治之。〔娄〕
钱氏消毒散、化毒汤，《活人》鼠粘子汤，皆发疮痘温平温凉药，钱氏所谓微发之者是也。如微发
不出者，即就与前项药该每服二钱者，即加至三四钱，该每日二服者，即加至三四
服，如加药又不出者，即用升麻、葛根、麻黄、桂枝大发之。如大发后不多，及脉
平无事者，即疮稀不可更发。如脉洪有热，有大热者当用四圣、导赤、八正辈利小
便，有小热者当用芩、连及金花丸辈解毒。若利小便解毒后，又不快，则勿发勿下，
止用抱龙丸治之。此钱氏心法也。〔洁〕若出不快，清便自调，知其在表不在里，
当微发，升麻葛根汤。若青干黑陷，身不大热，大小便涩，则是热在内，煎大黄
汤下宣风散。若身表大热者，表证未罢，不可下。若 已出，见小热，小便不
利，当以八正散利之。
〔海〕太阳出不快（身之后也） 荆芥甘草防风汤。
阳明出不快（身之前也），升麻加紫草汤（圣惠方升麻、葛根加紫草。）
少阳出不快（身之侧也），连翘防风汤（即连翘散）。
四肢出不快 防风芍药甘草汤。
〔吕〕凡痘疮出不快者有五证，临病审而调之。一证，天时严寒，为寒所折，
不能起发，宜散寒温表，冬三月，寒甚，红 初见，宜五积散、正气散、参苏饮、
杨氏调解散（俱初热）、陈氏木香散（泄利）。一证，炎暑隆盛，烦渴昏迷，疮出不快，宜辰
砂五苓散煎生地黄、麦门冬汤调服。身热者，小柴胡加生地黄。热甚烦渴而便实者，
白虎加人参汤。轻者，人参竹叶汤加生地黄（俱伤寒）煎服。一证，服凉药损伤脾胃，
或胃虚吐利，当温中益气，宜理中汤（泄利）。吐利甚者加附子，或陈氏异功散（出不快）、木
香豆蔻丸（泄利）。一证，或成血 ，一半尚是红点，此毒瓦斯发越不透，必不能食，大
便如常者，宜半温里半助养之剂，用四圣散加减，及紫草木香汤、丝瓜汤、阮氏万
全散、汤氏安 汤。一证，外实之人，皮肤浓，肉腠密，毒瓦斯难以发泄，因出不
快，宜消毒饮、透肌散。如大便秘实，于消毒饮内加大黄、栀子仁煎服。疮出太
稠，宜犀角地黄汤、张氏解毒防风汤。血气不足，宜十奇散。咽嗌不利，宜如圣汤
加薄荷、枳壳。口中气热，咽痛口舌生疮，宜甘露饮子。惊风搐搦，宜抱龙丸。烦
渴，宜独参汤、黄 六一汤。
〔张〕疮已出而不遍匀者，闻人氏云∶惟透肌解毒，无壅塞之患，则自然出匀，
以必胜散、大紫草饮、胡荽酒之类主之。痘出不长，隐于肌肤者，人参透肌散
主之。出不快，有数证不同，内虚热极而不发者，朱汝明用四君子加黄 、紫草
发之。有内虚甚而生寒，大便利而出不快者，宜理中姜附辈以温之，则气不消剥，
自不伏陷。有内实而兼诸热证出不快者，用四圣散、加味四圣散、紫草饮子、紫草
木香汤、紫草木通汤、快斑散、丝瓜汤，俱可选用。或气实痰郁而发不出者，苍术、
白芷、防风、升麻、黄芩、芍药、连翘、当归（孰为主痰郁之药乎）等分煎服，兼化抱龙丸。
若毒根在里，或血气虚弱，或邪秽冲触内陷而出不快者，托里散。
彭氏云∶疹痘发未透，宜四君子汤加黄 、紫草、糯米煎，凡医百病，不可
损胃气，故用四君子及糯米等助其胃气。服此药后，若患者身全不热，又以菟丝
子醋制为末（方在后），大人一钱，小儿七分或三分托之，则痘疏疏出矣。此药大补助火，
不可多，多则托出太多矣。隐于肌肉不起，宜紫草饮子煎服，又不可过用，候三
日，齐后，以保元汤加好酒人乳一二服，最稳。紫草二两，细锉，以百沸汤一大
盏沃之，以器合定，勿令泄气，量儿大小，温温服。
〔微发〕
消毒散 治疮未出，或已出未能匀遍，又治一切疮，凉膈去痰，治咽喉痛。
牛蒡子（炒，三两） 甘草（炙，半两） 荆芥穗（二钱半）
上，同为粗末。每服三钱，水一盏半，煎七分，去滓温服。（海藏云∶此药皆温平之剂。
一云加防风薄荷）
鼠粘子汤 治小儿痘疮欲出，未能得透皮肤，热气攻咽喉，眼赤心烦。
鼠粘子（炒，四两） 荆芥穗 甘草（各一两） 防风（半两）
上为细末。沸汤点服，临卧。大利咽喉，化痰涎，止嗽，皆宜（海藏云，太阳、少阳之
剂，首论温平者此也）
又法 用牛蒡子炒熟为末，同荆芥煎服。
上三方，消毒饮加减法也。
化毒汤 治小儿痘疮，已出，未出，并宜服之。
紫草茸 升麻 甘草（炙，各等分）
上 咀。水二钟，粳米五十粒同煎。此阳明之药也。
（海藏云，出不快者、化毒汤。《本事方》用糯米、去粳米）
〔丹〕亚玉痘出两日，不甚透，食稍进，汗微出，热略减，但食物口中觉有恶味，此
出得迟，发未透，须微微表之。
升麻 甘草（炙） 紫草 白术 陈皮 芍药（炒，半钱）
作一帖，加少酒同煎，白芍须炒。见其大便虽出不多，却白、带溏滑。
透肌汤 治痘不透。
紫草 白芍药 升麻 秫米粉（炒。各半两）
上三方，皆化毒汤加减法也。
〔大发〕头面出不快，此太阳经也，当用荆芥、甘草、羌活、防风、天麻共
煎。胸胁出不快，此少阳经也，当用柴胡、黄芩、紫草、木通、紫苏共煎。四
肢出不快，此阳明经也，当用升麻、葛根、紫苏、芍药、甘草、连须葱白共煎。
遍身都出不快，当用九味羌活汤。以上四证，药味内各加姜葱为佐，连进二服，
痘出快矣。
九味羌活汤
羌活 防风 苍术 细辛（少） 白芷 黄芩 川芎 生地黄（宜以芍药易之） 甘草
水煎，量大小、轻重、加减。
〔散寒〕五积散 正气散 调解散（三方俱见初热）
〔清暑〕
辰砂五苓散 （五苓散、加辰砂细研末，是也）
人参竹叶汤 治夏月吐逆，烦躁口渴，心闷不宁，及疹后余热不退，小便赤，或赤
斑者。
人参 半夏 麦门冬 当归 淡竹叶（各等分）
上锉散。每服三钱，水一盏，生姜一片，煎服。
白虎汤
石膏（四两） 甘草节（八钱） 知母（一两六钱）
上为粗末。每服三钱，水一盏，粳米二十粒，同煎至半盏，去滓温服，不拘时。
加入人参一两二钱，名人参白虎汤。《圣惠方》加干葛。
小柴胡汤（发热）
〔攻里〕汪机云∶有红斑点出，日数未尽，其内实而肌热者，宜疏利之。
〔紫草例〕海藏云∶小儿疮疹，出未快，可浓煎紫草汁服。
按∶紫草通腠理，利九窍，凉血活血，故为痘家欲出未出必用之药，若出已
透而大便利者，忌之。
紫草散 发 疹。
钓藤钩子 紫草茸（各等分）
上为细末。每服一字，或五分、一钱，温酒调下，无时。
四圣散 治疮疹出不快及倒靥。一方，有黄 。
紫草茸 木通 甘草（炙） 枳壳（麸炒）
上等分，为粗末。每服一钱，水一钟，煎至八分，温服无时。（刘提点云∶疹痘最要大
小分晓，钱氏四圣散用木通、枳壳、极好，若大小流利，不必苦泥）
紫草回 散 小儿痘疹出不快，或倒靥，毒瓦斯入腹。
紫草茸 黄 桑白皮 木通 枳壳 白术（各等分）
上为粗末。每服三钱，水酒各半盏，麝香少许，同煎服。
紫草木通散 治小儿疮疹。
紫草 木通 人参 茯苓 粳米（各等分） 甘草（减半）
上为末。每服四钱，水煎。此小便不利之剂也。
人参蝉蜕散 治小便不利，疮痘不散，烦躁多渴，戛牙咬齿，气粗喘满。
人参 蝉蜕 白芍药 木通 赤茯苓 甘草 紫草茸（各等分）
上，用水煎服。
透肌散
紫草茸 绿升麻 粉甘草（各一钱）
上细切。水煎服。或与消毒饮同煎服，尤妙。
紫草透肌汤 治痘热而出不快，及顶陷者。
紫草（一钱） 升麻 木香（各五分） 牛蒡子 防风 荆芥 黄 （各八分） 甘草（三分）
上，姜水煎服。如色紫腹痛，加蝉蜕一钱。
紫草快 汤 治痘疹血气不足，不能发出，色不红活等证。（即紫草汤）
紫草 人参 白术 茯苓 当归 川芎 芍药 木通 甘草 糯米
上，每服二钱，水煎。
乌金膏 治发热至七日以前，或因风寒，痘不起发，或红紫，或惊搐，俱可用。
僵蚕（酒洗） 全蝎（去足尾，酒洗） 甘草 紫草 白附子（味苦内白者真） 麻黄（各五钱）
穿山甲（炒、末，二钱半） 蝉蜕（去头足，酒洗净，二钱）
上为末，将红花、紫草各一两，好酒二钟，熬去大半，去滓，入蜜五两，慢火
同熬，滴水成珠为度，丸如龙眼核大。每服一丸，灯心汤化下。
紫金散 治痘疮出不快，及倒靥，亦治远年不愈恶疮。
紫草 蛇蜕（炒焦） 牛蒡子（炒。各五钱）
上为细末。每服一钱，水半钟，煎减半，温服。
独胜散（初热）
萝卜汤 治痘疹出不快者。
上，用开花萝卜煎汁，时时饮之。盖痘疹气匀即出快，萝卜治嗽定喘，下气消胀，解毒。
野通散 治痘疮出不快，及伤寒不语。
干野人粪（即猕猴粪，火烧、存性） 冰片 真麝香（各等分）
上为细末。每服五分，看大小，用新汲水入蜜调下。十岁以上者，服一钱。
按∶野人粪治蜘蛛咬疮，此治痘出不快大效。若蜘蛛咬疮久而不愈，其丝生皮肤，
延蔓遍身不愈者，加雄黄、青黛水调，以蜘蛛试之，立化为水，屡验，盖此三
味，是治疮疹当用之药，取山中者，若人家所养之猴，食物味杂，即不效，失其
本真也。
补虚例
〔丹〕勉奴痘已出，第三日色淡不肯发，此血气俱虚，与此方。
人参 诃子（煨。各一钱） 白术（炒） 黄 （酒炙） 当归身（酒洗，各二钱） 陈皮（二分）
甘草（炙，少许） 豆蔻（煨，一钱半）
上煎。入好酒些少，饮之。
六一汤（见灌浆）
秘传大透肌散
人参 芍药 川芎 甘草 茯苓 白术 木通 陈皮 黄 糯米
上，各等分，为粗散。每服四钱，水煎服。
〔活〕活血散 治疮子，或出不快，用白芍药末酒调，如欲止痛，只用温热水调，咽
下。（海藏云，张和之治四肢出不快，加防风大效，此证、乃太阴药也）
〔世〕四物汤 治痘疮出不快，不甚红活，不起根窠，缘血虚故也，此药能活血，调
顺痘疾，无如此方，自古及今，用之如宝，只加甘草服之。
通天散 治痘发热不出，或已出而色不红活。
人参 陈皮 桂枝（各八分） 川芎 熟地黄 芍药（各一钱） 当归 紫草（各一钱半） 红花
木香（各三分） 甘草（六分） 知母（八分） 荔枝壳（十个）
上，用鸡汁一钟，枣三枚，糯米一撮，煎服。初服到颈，再服到脐，三服到脚，
神效。
人参透肌散 治痘疮虚而有热，虽能出快，长不齐整，隐于肌肤间者。
人参 紫草（如无，以红花代之） 白术 茯苓 当归 芍药 木通 蝉蜕 甘草 糯
米（各等分）
上，每服三钱，水一盏半，煎半盏，徐徐服。
升均汤 治痘疮已出不均，或吐泻热渴。
升麻 干葛 芍药 人参 白术 茯苓 甘草 紫草茸（如无，红花代之）
上，每服三五钱，姜水煎，量服之。
秘方 菟丝子一味，醋浸一宿，焙干为末，发热时每一岁儿服七分，量儿大小加减，
好酒调服。甚易发、易胀、易靥，且后无余证。此方，气血弱者未出之先可用，
既出之后不可用，用则托出太多。此方，系胡黄谷祖仰山公宦游广东得之，用
者百发百中，但元气浓者，服之不免太密，乃大补助火故也。或曰痘未出之先既
可服此，又奚取于保婴丹乎，殊不知保婴以解毒而使之稀，此则气血弱，不能出
者，服此而托之使出也。
又方 腊月梅花，将开时采，晒干为末，炼蜜为丸，未出之先、量儿大小三四服，
可令豆稀，加朱砂尤妙。
二花散 治痘疹已出未出，不发不起，隐在皮肤之间，热证并治。
梅花（一两，阴干） 丝瓜（五钱，阴干） 桃花（五钱，阴干） 朱砂（二钱，水飞过）
甘草（一钱，去皮，火煨）
上为细末。每服五分半，未痘时，蜜水调下。
服前药仍不快，无诸恶候者，可服八味二花散。（见大法）
〔虚寒例〕
〔丹〕女子疟后出痘，血气俱虚，又值冬寒，热易退，不出。
丁香（五粒） 附子 肉桂 陈皮 当归（酒洗。各五分） 人参（半两） 黄 （一钱）
甘草（炙，二分）
〔陈〕异功散 治痘疮已出之间，不光泽，不起发，根窠不红，谓之表虚。
木香 当归（各三钱） 桂枝 白术 茯苓（各二钱） 陈皮（去白） 浓朴（姜制） 人参（去芦） 肉
[Qian Yi] If the sores and rashes have not fully erupted after three days, or if their eruption is sluggish, a mild dispersing method should be employed (such as Niubangzi Tang [Burdock Seed Decoction]). If the number of eruptions remains low after the initial onset, the dosage should be increased (e.g., from one decoction per day to two). If they still do not erupt despite the increased dosage, a vigorous dispersing method should be used (involving herbs such as Shengma [Cimicifugae Rhizoma], Gegen [Puerariae Lobatae Radix], Fangfeng [Saposhnikoviae Radix], Qianghuo [Notopterygii Rhizoma et Radix], Qianghuo [Notopterygii Rhizoma et Radix], Duhuo [Angelicae Pubescentis Radix], Mahuang [Ephedrae Herba], Guizhi [Cinnamomi Ramulus], etc.). If, after vigorous dispersing, the eruptions remain sparse and the pulse is calm without other symptoms, it indicates that the rash was originally sparse, and further dispersing is contraindicated. In cases of high fever, promoting urination is indicated (using formulas such as Sisheng San [Four-Sage Powder], Liuyi San [Six-to-One Powder], Siling San [Four-Ingredient Powder], etc.); for mild fever, resolving toxicity is indicated. If the condition does not improve quickly, neither dispersing nor purging should be attempted; instead, Baolong Wan [Dragon-Holding Pill] should be used.
[Lou Quanshan] Qian Yi's Xiaodu San [Dispel-Toxin Powder], Huadu Tang [Resolve-Toxin Decoction], and the Shuniuzi Tang [Burdow Seed Decoction] from *Baoren* are all formulas with neutral or slightly cool properties for inducing measles/smallpox eruptions, representing Qian Yi's concept of "mild dispersing." If mild dispersing fails to induce eruption, the dosage should be increased from the standard two qian per dose to three or four qian, and from twice daily to three or four times daily. If eruption still does not occur, vigorous dispersing with Shengma, Gegen, Mahuang, and Guizhi is required. If eruptions remain sparse after vigorous dispersing and the pulse is calm, indicating no serious pathology, further dispersing is contraindicated due to the sparsity of the rash. For patients with a surging pulse and significant heat, promoting urination with Sisheng San, Daochi San [Guide-Out Redness Powder], or Bazheng San [Eight-Righteousness Powder] is appropriate for high fever; for mild heat, resolving toxicity with Huangqin [Scutellariae Radix], Huanglian [Coptidis Rhizoma], and Jinhua Wan [Golden Flower Pill] is indicated. If promotion of urination and detoxification fail to improve the eruption speed, neither dispersing nor purging should be used; Baolong Wan alone should be administered. This constitutes Qian Yi's core methodology.
[Li Dongyuan] If eruptions are sluggish but bowel movements and urination are normal, the pathogen is in the exterior rather than the interior, warranting mild dispersing with Shengma Gegen Tang [Cimicifuga and Kudzu Root Decoction]. If the lesions are dark, dry, black, and sunken, accompanied by minimal body heat and obstructed urination/bowel movements, the heat is internal; Da Huang Tang [Rhubarb Decoction] should be decocted to administer Xuanfeng San [Dispel-Wind Powder]. If there is significant surface heat, the exterior syndrome has not resolved, and purging is contraindicated. If eruptions have appeared with mild heat and obstructed urination, Bazheng San should be used to promote urination.
[Zhang Yuansu] For sluggish eruptions in the Taiyang region (back), use Jingjie Gancao Fangfeng Tang [Schizonepeta, Licorice, and Saposhnikovia Decoction]. For the Yangming region (face and anterior body), use Shengma Jia Zicao Tang [Cimicifuga with Arnebia Decoction] (i.e., Shengma Gegen Tang from *Huimin Heji Ju Fang* plus Zicao). For the Shaoyang region (lateral body), use Lianqiao Fangfeng Tang [Forsythia and Saposhnikovia Decoction] (i.e., Lianqiao San). For sluggish eruptions on the limbs, use Fangfeng Shaoyao Gancao Tang [Saposhnikovia, Peony, and Licorice Decoction].
[Lv Fu] There are five types of syndromes causing sluggish smallpox eruptions, which must be carefully assessed and treated:
1. Severe cold weather suppresses the eruption due to cold constraint. Disperse cold and warm the exterior. In winter, when red spots first appear under severe cold, use Wuji San [Five-Accumulations Powder], Zhengqi San [Upright-Qi Powder], Rensu Yin [Ginseng and Perilla Decoction], Yangshi Jieji San [Yang's Harmonizing Powder] (for early heat stage), or Chen's Muxiang San [Aucklandia Powder] (for diarrhea).
2. Intense summer heat causes thirst, coma, and sluggish eruptions. Use Chensha Wuling San [Cinnabar Five-Ingredient Powder] decocted with Shengdihuang [Rehmanniae Radix] and Maidong [Ophiopogonis Tuber], taken as a suspension. For fever, use Xiao Chaihu Tang [Minor Bupleurum Decoction] plus Shengdihuang. For severe heat, thirst, and constipation, use Baihu Jia Renshen Tang [White Tiger Plus Ginseng Decoction]. For mild cases, Renshen Zhuye Tang [Ginseng and Bamboo Leaf Decoction] plus Shengdihuang (for cold damage syndromes).
3. Cooling medicines damaged the spleen and stomach, or stomach deficiency caused vomiting and diarrhea. Warm the middle and boost qi using Lizhong Tang [Regulate the Middle Decoction] (for diarrhea). Add Fuzi [Aconiti Lateralis Radix Praeparata] for severe vomiting/diarrhea, or use Chen's Yigong San [Extraordinary Merit Powder] (for sluggish eruptions) or Muxiang Doukou Wan [Aucklandia and Cardamom Pill] (for diarrhea).
4. Blood stasis forms, with half remaining as red spots, indicating incomplete toxin release. The patient cannot eat, but bowels are normal. Use a formula that half-warms the interior and half-nourishes, such as modified Sisheng San, Zicao Muxiang Tang [Arnebia and Aucklandia Decoction], Sigua Tang [Luffa Decoction], Ruan's Wanquan San [Ruan's Complete-Health Powder], or Tang's An Gong Niu Huang Wan [Dragon-Holding Pill with Calculus Bovis].
5. Individuals with excess exterior constitution have thick skin and dense pores, preventing toxin release. Use Xiaodu Yin [Dispel-Toxin Decoction] or Touji San [Penetrate-Muscle Powder]. If constipated, add Dahuang [Rhei Radix et Rhizoma] and Zhizi [Gardeniae Fructus] to Xiaodu Yin. For dense eruptions, use Xijiao Dihuang Tang [Rhinoceros Horn and Rehmannia Decoction] or Zhang's Jiedu Fangfeng Tang [Detoxifying Saposhnikovia Decoction]. For blood and qi deficiency, use Shiqi San [Ten-Rarities Powder]. For throat obstruction, use Rusheng Tang [Like-Sage Decoction] plus Bohe [Menthae Haplocalycis Herba] and Zhike [Aurantii Fructus]. For hot breath, sore throat, and mouth ulcers, use Ganlu Yin [Sweet Dew Decoction]. For convulsions, use Baolong Wan. For thirst, use Dushen Tang [Single Ginseng Decoction] or Huangqi Liuyi Tang [Astragalus Six-to-One Decoction].
[Zhang Jingyue] If eruptions are uneven, Wenren Shi stated that penetrating muscle and resolving toxicity without obstruction will naturally lead to even eruptions. Use Bisheng San [Victory-Guarantee Powder], Da Zicao Yin [Major Arnebia Decoction], or Huyijiu [Coriander Wine]. For smallpox that fails to grow and remains hidden in the skin, use Renshen Touji San [Ginseng Penetrating-Muscle Powder].
For sluggish eruptions due to extreme internal heat with deficiency, Zhu Ruming uses Sijunzi Tang [Four-Gentlemen Decoction] plus Huangqi [Astragali Radix] and Zicao [Arnebiae Radix]. For severe internal deficiency generating cold, with free stool but sluggish eruptions, use Lizhong Tang plus Jiang [Zingiberis Rhizoma] and Fuzi to warm, preventing collapse. For internal excess with heat signs, use Sisheng San, Jiawei Sisheng San, Zicao Yinzi, Zicao Muxiang Tang, Zicao Mutong Tang [Arnebia and Akebia Decoction], Kuaiban San [Speed-Up Rash Powder], or Sigua Tang. For qi excess with phlegm stagnation, use Cangzhu [Atractylodis Rhizoma], Baizhi [Angelicae Dahuricae Radix], Fangfeng, Shengma, Huangqin, Shaoyao [Paeoniae Radix], Lianqiao [Forsythiae Fructus], Danggui [Angelicae Sinensis Radix] (adjusting based on whether qi or phlegm is primary), decocted equally, combined with Huabalong Wan. For toxins rooted internally, blood/qi weakness, or foul pathogens causing inward collapse, use Tuoli San [Support-Interior Powder].
Peng Shi stated: For incomplete eruption, use Sijunzi Tang plus Huangqi, Zicao, and Nuomi [Glutinous Rice]. Physicians must not damage stomach qi; thus, Sijunzi and Nuomi support the stomach. If the patient has no heat after taking this, use Tusizi [Cuscutae Semen] processed with vinegar as powder: adults take 1 qian, children 7 fen or 3 fen, to support eruption. This formula strongly supports fire; do not overuse. For lesions hidden in muscles, use Zicao Yinzi, but do not overuse. After three days, once eruptions are uniform, use Baoyuan Tang [Preserve-Origin Decoction] plus good wine and human milk for stability. Zicao [Arnebiae Radix] (2 liang), finely cut, steeped in boiling water, covered to retain vapor, warmed and given according to age.
[Mild Dispersing Methods]
Xiaodu San: Treats sores/rashes before eruption or uneven eruption; also treats general sores, cools the chest, resolves phlegm, and treats sore throat.
Niubangzi [Burdock Seed] (stir-fried, 3 liang), Gancao [Licorice Root] (honey-fried, 0.5 liang), Jingjie Sui [Schizonepeta Spike] (0.25 liang).
Grind into coarse powder. Take 3 qian with 1.5 cups of water, decoct to 0.7 cup, strain, and take warm. (Haizang notes: These are neutral/warm agents. Some add Fangfeng and Bohe.)
Shuniuzi Tang [Burdow Seed Decoction]: Treats pediatric smallpox/measles欲出 (desiring to erupt) but failing to penetrate skin, with heat attacking the throat, red eyes, and irritability.
Shuniuzi [Burdock Seed] (stir-fried, 4 liang), Jingjie Sui, Gancao (honey-fried, each 1 liang), Fangfeng (0.5 liang).
Grind into fine powder. Take with boiling water before bed. Benefits the throat, resolves phlegm, stops cough. (Haizang notes: This is a Taiyang/Shaoyang agent, noted for its neutrality.)
Alternative method: Stir-fry Niubangzi, grind to powder, decoct with Jingjie.
These three formulas are variations of Xiaodu Yin.
Huadu Tang [Resolve-Toxin Decoction]: Suitable for pediatric smallpox/measles whether erupted or not.
Zicao Rong [Arnebia Bud], Shengma [Cimicifugae Rhizoma], Gancao (honey-fried, equal parts).
Chop. Decoct with 2 cups of water and 50 grains of Jingmi [Rice]. This targets the Yangming channel. (Haizang notes: Use for sluggish eruptions. *Ben Shi Fang* uses Nuomi instead of Jingmi.)
[Dantuo Kanglai] Ya Yu had smallpox for two days, not fully transparent, slight appetite, slight sweat, slight fever reduction, but bad taste in mouth from food. This is delayed eruption, incomplete release; requires mild exterior dispersing.
Shengma, Gancao (honey-fried), Zicao, Baizhu [Atractylodis Macrocephalae Rhizoma], Chenpi [Citri Reticulatae Pericarpium], Shaoyao (stir-fried, 0.5 qian).
Make one decoction, add a little wine, decoct together. Shaoyao must be stir-fried. Stool may be scanty, white, and loose.
Touji Tang [Penetrate-Muscle Decoction]: Treats incomplete smallpox eruption.
Zicao, Shaoyao [Paeoniae Radix], Shengma, Shumi Fen [Millet Flour] (stir-fried, each 0.5 liang).
These three formulas are variations of Huadu Tang.
[Vigorous Dispersing Methods]
Head/face sluggish eruption (Taiyang channel): Jingjie, Gancao, Qianghuo, Fangfeng, Tianma [Sinomenii Caulis] decocted together.
Chest/hypochondrium sluggish eruption (Shaoyang channel): Chaihu [Bupleuri Radix], Huangqin, Zicao, Mutong [Akebiae Caulis], Zisu [Perillae Folium] decocted together.
Limbs sluggish eruption (Yangming channel): Shengma, Gegen, Zisu, Shaoyao, Gancao, Congbai [Allii Fistulosi Bulbus] decocted together.
Whole body sluggish eruption: Jiuwei Qianghuo Tang [Nine-Ingredient Notopterygium Decoction].
Add ginger and scallion to all above formulas, take two doses consecutively for rapid eruption.
Jiuwei Qianghuo Tang
Qianghuo, Fangfeng, Cangzhu, Xixin [Asari Radix et Rhizoma] (small amount), Baizhi, Huangqin, Chuanxiong [Ligustici Chuanxiong Rhizoma], Shengdihuang [Rehmanniae Radix] (replace with Shaoyao if preferred), Gancao.
Decoct in water, adjust dosage based on age and severity.
[Dispel Cold] Wuji San, Zhengqi San, Jieji San (all seen in early heat stage).
[Cool Summer Heat]
Chensha Wuling San (Wuling San plus Cinnabar powder).
Renshen Zhuye Tang: Treats summer vomiting, irritability, thirst, heart oppression, lingering heat after rash, red urine, or red spots.
Renshen [Ginseng Radix et Rhizoma], Banxia [Pinelliae Rhizoma], Maidong, Danggui, Danzhuye [Bambusae Folium] (equal parts).
Cut into pieces. Take 3 qian with 1 cup water and one slice of ginger, decoct and take.
Baihu Tang [White Tiger Decoction]
Shigao [Gypsum Fibrosum] (4 liang), Gancao Jie [Licorice Joint] (8 qian), Zhimu [Anemarrhenae Rhizoma] (1 liang 6 qian).
Coarse powder. Take 3 qian with 1 cup water and 20 grains of Jingmi, decoct to half cup, strain, take warm anytime.
Add Renshen (1 liang 2 qian) to make Ren Shen Bai Hu Tang. *Shenghui Fang* adds Ge Gen [Puerariae Lobatae Radix].
Xiao Chaihu Tang [Minor Bupleurum Decoction] (for fever).
[Purge Interior] Wang Ji stated: If red spots appear but days are not finished, with internal excess and muscular heat, promote drainage.
[Arnebia/Zicao Examples] Haizang stated: For pediatric sores/rashes with sluggish eruption, decoct Zicao [Arnebiae Radix] concentrated and drink.
Note: Zicao opens interstices, benefits orifices, cools blood, and invigorates blood; essential for impending eruptions. Contraindicated if already fully erupted with free stools.
Zicao San [Arnebia Powder]: Induces rash.
Doutenggou [Uncariae Ramulus cum Uncis], Zicao Rong (equal parts).
Fine powder. Take 1 zi, or 5 fen, or 1 qian, with warm wine, anytime.
Sisheng San [Four-Sage Powder]: Treats sluggish eruption and inverted crusts. One variation includes Huangqi [Astragali Radix].
Zicao Rong, Mutong, Gancao (honey-fried), Zhike [Aurantii Fructus] (bran-fried).
Equal parts, coarse powder. Take 1 qian with 1 cup water, decoct to 0.8 cup, take warm anytime. (Liu Tidian notes: Differentiating urinary/bowel status is crucial. Qian Yi's use of Mutong and Zhike is excellent; if urination/stools are free, avoid bitter/cloying herbs.)
Zicao Huiyang San [Arnebia Restore-Yang Powder]: Treats pediatric smallpox/measles sluggish eruption or inversion, with toxins entering the abdomen.
Zicao Rong, Huangqi, Sangbaipi [Mori Cortex], Mutong, Zhike, Baizhu (equal parts).
Coarse powder. Take 3 qian with half cup water and half cup wine, plus a little Shexiang [Moschus], decoct and take.
Zicao Mutong San [Arnebia and Akebia Decoction]: Treats pediatric sores/rashes.
Zicao, Mutong, Renshen, Fuling [Poria], Jingmi (equal parts), Gancao (half amount).
Powder. Take 4 qian, decoct in water. This promotes urination.
Renshen Chantui San [Ginseng and Cicada Slough Powder]: Treats obstructed urination, unresolved sores/rashes, irritability, thirst, teeth grinding, rough breathing, and distension.
Renshen, Chantui [Cicadae Perioateron], Shaoyao, Mutong, Chifuling [Poria cum Parergon], Gancao, Zicao Rong (equal parts).
Decoct in water and take.
Touji San [Penetrate-Muscle Powder]
Zicao Rong, Lv Shengma [Green Cimicifugae Rhizoma], Fen Gancao [Powdered Licorice] (each 1 qian).
Finely cut. Decoct in water. Or decoct with Xiaodu Yin for better effect.
Zicao Touji Tang [Arnebia Penetrating-Muscle Decoction]: Treats smallpox heat with sluggish eruption and sunken tops.
Zicao (1 qian), Shengma, Muxiang [Aucklandiae Radix] (each 0.5 fen), Niubangzi, Fangfeng, Jingjie, Huangqi (each 0.8 fen), Gancao (0.3 fen).
Decoct in ginger water. If purple color and abdominal pain, add Chantui (1 qian).
Zicao Kuaiban Tang [Arnebia Speed-Up Rash Decoction]: Treats smallpox/measles due to blood/qi deficiency, failure to erupt, non-vibrant color. (Also known as Zicao Tang).
Zicao, Renshen, Baizhu, Fuling, Danggui, Chuanxiong, Shaoyao, Mutong, Gancao, Nuomi [Glutinous Rice].
Take 2 qian, decoct in water.
Wujin Gao [Black Gold Ointment]: Treats fever within seven days, or failure to erupt due to wind-cold, purple/red color, or convulsions.
Jiangcan [Bombyx Batryticatus] (wine-washed), Quanxie [Scorpio] (remove feet/tail, wine-washed), Gancao, Zicao, Baifu Zi [Radix Bungeae] (bitter inside, white outside is authentic), Mahuang (each 5 qian).
Shanjiachuan [Manis Squama] (fried, powdered, 2.5 qian), Chantui (remove head/feet, wine-washed, 2 qian).
Grind to powder. Simmer Honghua [Carthami Flos] and Zicao (each 1 liang) in 2 cups of good wine until reduced by half, strain, add 5 liang honey, simmer slowly until drops form pearls. Roll into pills size of longan seeds. Take one pill dissolved in Dengxin Tang [Junci Medulla Decoction].
Zijin San [Purple Gold Powder]: Treats sluggish smallpox eruption and inversion; also treats chronic malignant sores.
Zicao, She Tui [Boa Skin] (fried until charred), Niubangzi (stir-fried, each 5 qian).
Fine powder. Take 1 qian with half cup water, decoct to half, take warm.
Dusheng San [Single Victory Powder] (for early heat).
Luobo Tang [Radish Decoction]: Treats sluggish smallpox/measles.
Decoct flowering radish juice, drink frequently. Radish harmonizes qi for eruption, stops cough/asthma, directs qi downward, reduces distension, and resolves toxins.
Yetong San [Wild Man Pass Powder]: Treats sluggish smallpox and mutism from cold damage.
Gan Yeren Fen [Dried Wild Human Feces] (i.e., macaque feces, burned to retain nature), Bingpian [Borneolum Syntheticum], Zhen Shexiang [Real Moschus] (equal parts).
Fine powder. Take 5 fen, adjusted by age, mixed with fresh water and honey. Those over ten years old take 1 qian.
Note: Wild man feces treats spider bites; highly effective for sluggish smallpox. For chronic spider bites with thread-like growths, add Xionghuang [Realgar] and Qingdai [Indicum], mix with water, test with spider (dissolves instantly). These three herbs are essential for sores/rashes; wild-sourced is best. Domestic monkeys eat mixed foods, losing efficacy.
[Nourishing Deficiency Examples]
[Dantuo Kanglai] Miannu had smallpox, pale color on day 3, reluctant to erupt, indicating blood/qi deficiency. Prescribe:
Renshen, Hezi [Terminalia Chebulae Fructus] (baked, each 1 qian), Baizhu (stir-fried), Huangqi (wine-fried), Danggui Shen [Angelica Sinensis Root Heart] (wine-washed, each 2 qian), Chenpi (2 fen), Gancao (honey-fried, small amount), Doukou [Cardamomi Fructus] (baked, 1.5 qian).
Decoct. Add a little good wine and drink.
Liuyi Tang [Six-to-One Decoction] (seen in pustule stage).
Secretly Transmitted Da Touji San [Great Penetrating-Muscle Powder]
Renshen, Shaoyao, Chuanxiong, Gancao, Fuling, Baizhu, Mutong, Chenpi, Huangqi, Nuomi.
Equal parts, coarse powder. Take 4 qian, decoct in water.
[Huo Ren Shu] Huoxue San [Invigorate-Blood Powder]: Treats sores/rashes, sluggish eruption. Use Baishaoyao [White Peony Root] powder mixed with wine. For pain relief, use warm water. (Haizang notes: Zhang Hezhi added Fangfeng for limb eruptions with great effect; this targets the Taiyin channel.)
[Shi Yi] Siwu Tang [Four-Substance Decoction]: Treats sluggish smallpox eruption, lack of vibrancy, poor root formation due to blood deficiency. Invigorates blood, regulates disease. Considered a treasure since ancient times. Add Gancao and take.
Tongtian San [Heaven-Penetrating Powder]: Treats smallpox fever with no eruption, or eruption with non-vibrant color.
Renshen, Chenpi, Guizhi (each 0.8 fen), Chuanxiong, Shudihuang [Prepared Rehmannia Root], Shaoyao (each 1 qian), Danggui, Zicao (each 1.5 qian), Honghua, Muxiang (each 3 fen), Gancao (6 fen), Zhimu (8 fen), Lizhi Qiao [Litchi Shell] (10 pieces).
Decoct with 1 cup chicken juice, 3 dates, and a pinch of glutinous rice. First dose reaches neck, second to navel, third to feet. Divine effect.
Renshen Touji San [Ginseng Penetrating-Muscle Powder]: Treats smallpox with deficiency and heat, fast but uneven eruption, hidden in skin.
Renshen, Zicao (substitute Honghua if unavailable), Baizhu, Fuling, Danggui, Shaoyao, Mutong, Chantui, Gancao, Nuomi (equal parts).
Take 3 qian with 1.5 cups water, decoct to half cup, take slowly.
Shengjun Tang [Level-Rising Decoction]: Treats uneven smallpox eruption, vomiting/diarrhea, heat/thirst.
Shengma, Gegen, Shaoyao, Renshen, Baizhu, Fuling, Gancao, Zicao Rong (substitute Honghua if unavailable).
Take 3-5 qian, decoct in ginger water, adjust dose.
Secret Formula: Cuscuta Semen [Cuscutae Semen] alone, soaked in vinegar overnight, baked, ground to powder. At fever onset, give 7 fen per year of age, adjusted by size, mixed with good wine. Facilitates eruption, swelling, and crusting, with no residual symptoms. Use before eruption for weak blood/qi; not after, as it pushes too much. Obtained by Hu Huanggu Zu Yangshan Gong in Guangdong. Highly effective, but those with strong yuan qi may get too dense eruptions due to strong fire-support. Note: Baoying Dan [Infant-Protection Pill] resolves toxins to thin eruptions; this formula supports weak blood/qi to push eruptions out.
Another Formula: Plum blossoms picked in December before blooming, dried, ground, made into pills with refined honey. Take 3-4 doses before eruption to thin spots; adding Zhusha [Cinnabar] is excellent.
Erhua San [Two-Flower Powder]: Treats smallpox/measles erupted or not, non-erupting, hidden in skin, treating heat syndromes.
Meihua [Plum Blossom] (1 liang, shade-dried), Sigua [Luffa Fruit] (5 qian, shade-dried), Taohua [Peach Blossom] (5 qian, shade-dried), Zhusha (2 qian, water-washed), Gancao (1 qian, peeled, fire-roasted).
Fine powder. Take 5.5 fen before eruption, mixed with honey water.
If previous medicines fail and no evil signs exist, take Bawei Erhua San [Eight-Ingredient Two-Flower Powder] (see General Methods).
[Deficient-Cold Examples]
[Dantuo Kanglai] Woman had smallpox after malaria, blood/qi deficient, winter cold, heat easily subsided, no eruption.
Dingxiang [Caryophylli Flos] (5 buds), Fuzi, Rougui [Cinnamomi Cortex], Chenpi, Danggui (wine-washed, each 5 fen), Renshen (0.5 liang), Huangqi (1 qian), Gancao (honey-fried, 2 fen).
[Chen Zhongwen] Yigong San [Extraordinary Merit Powder]: Treats smallpox after eruption, lacking luster, not erupting, roots not red, termed exterior deficiency.
Muxiang, Danggui (each 3 qian), Guizhi, Baizhu, Fuling (each 2 qian), Chenpi (peeled), Houpo [Magnoliae Officinalis Cortex] (ginger-processed), Renshen (rhizome removed), Rougui.