豆蔻(各二钱半) 丁香 半夏(姜制) 附子(炮,去皮。各一钱半)
上 咀。每服二钱,水一盏,姜五片,枣三枚,煎服。
上治虚寒。(虚而不寒者、宜用前方血气俱虚之剂,不宜用此,必脉虚细、四肢身体冷者,方
可用之)
十补散 滋养气血,调养脾胃,能使疮毒速出,有寒证者用之。加紫草、木香、
糯米、名参 内托散。
黄 人参 当归(各二钱) 浓朴 桔梗 川芎 防风 白芷 甘草(各一钱) 桂心(三分)
每服四钱,水煎服,或为末,温水调下一钱五分。
〔虚热例〕
蓝根散 治疮疹出不快,及倒靥,一名二圣散,救小儿垂死。
板蓝根(一两) 甘草(炙,七钱半)
上,末。每服半钱,取雄鸡冠血三两点,同温酒少许,食后调下,无时。甚则
三五服,立效。(丹溪云,蓝,能分散败血。)
丝瓜散 发疮疹最妙,丝瓜连皮烧灰,存性,百沸汤调下,或以紫草、甘草煎汤调
服尤佳,米汤亦可。
萝卜汤(见前)
〔烦不得眠例〕
痘疹烦不得眠者。甘桔加栀子汤
桔梗 甘草 栀子
上,各等分,煎服。
〔活〕治痘出不快,烦躁不得眠者,水解散、麻黄黄芩汤、升麻黄芩汤主之。(海藏
云∶莫若定其气血,用石膏栀子之类,尤佳,麻黄黄芩汤、升麻黄芩汤、亦当求责的是太阳阳明,
方可用之。)
水解散 治天行头疼壮热一二日,兼治 疮未出烦躁,或出尚身体发热者。
麻黄(去节,四两) 大黄 黄芩 桂心 甘草(炙) 芍药(各二两)
上为粗末。患者以生熟汤浴讫,以暖水调下二钱,相次二服,得汗利便瘥。强
人服二方寸匕。风实之人,三伏中亦宜用之。若去大黄,春夏通用。
升麻黄芩汤 治痘疮出不快,烦躁不得眠。麻黄黄芩汤治痘疮出不快,益烦躁
昏,或出尚身疼热者。(二方见小儿伤寒门。)
胡萎酒 胡荽一味,细切四两,以好酒二盏,煎一二沸,入胡荽再煎少时,用物合
定,放温,每吸一大口、微喷,从顶至足匀遍,勿喷头面,病患左右常令有胡荽
气,即能辟去污气,疮疹出快。
《指南》有禁疮之说,云痘毒奔溃,由气血虚弱,不能拘领其毒,以致毒盛而聚
于腠虚之处,故痘之初出也,或一点二点见于隐僻腠节之处,及方广四肢之间,此痘
一出,则诸痘不得宣发成浆矣,故曰禁疮。其禁有五,一曰胃禁,二曰火禁,三曰
水禁,四曰风禁,五曰寒禁。胃禁者,毒火炙胃,不能发散于肌表,脾胃溃烂,
其外证之痘,出于唇口之间者,或二三四五点相连,诸痘未浆,此痘已先黄熟,知
由热毒内攻,胃已腐烂,故诸痘不得成浆也。如唇口一见此痘,当察其面色烦红,
气粗热甚,口臭异常者,是其验也。火禁者,小儿初发之际,或因身发寒热而误
以火熏炙其衣被,或睡卧于火箱之中,使皮肤干燥,故痘毒发泄不出,又兼气虚而
不能拘其毒,则毒停皮肤之内,隐隐不能发出肌表也。细看皮内,觉有红点无头无
脚,或于四肢头面方广之处,见一二点痘子,则诸痘皆从此痘上发泄为孽,而皮内
隐隐不出之痘,终不能快出,名为火禁。以水杨加荆芥煎汤浴之,则诸痘自发矣,
轻则升麻和解散主之。水禁者,初发热之际,阴阳未分,毒瓦斯方炽,或误食生冷,
则毒停于皮肉之间,隐隐有红点,或于方广两胁手足头面之际,发有水泡者是也,
盖冷气在内则腹疼肚胀,在外则发热恶寒,此其验也。以丁、桂、茯苓、升麻、大
腹之类逐之,冷食遗积脾胃,须防下泄,再加山楂。风禁者,发热之初,失于
不避风,则风入肌表,痘不能发,或肌肤麻木,不知痛痒,或不麻木而干燥,或毛
直而干焦,或皮痒欲搔,或重则狂烦谵语,此风与火搏故也。治法,以升麻汤加羌
活、荆芥、以逐之,甚则蒺藜、蝉蜕、以攻也。寒禁者,发热之初,误经冷水沐
浴,或睡卧于铁漆寒冷之处,或衣被单薄,感冒寒气,则痘必不能宣露,有手足麻
木不知痛痒,有四肢冷痛不能举动者,有麻木冷痛之处不出痘子,惟于委曲避风之
处,或头面发际之上,痘出如瘾疹者,是其验也。内以丁、桂、川芎、升麻逐之,
外用绵衣以温之。曾见小儿年十一二岁,发热之初,卧新漆床上,初因热极,父母
不防出痘,任小儿手贴漆床而卧,致令寒气侵入手臂,其余四肢面腹方广之处、俱出
有痘,唯一臂麻木不仁,无一点痘见,诸医视之,并不知其故,请予至,详察其由,
乃以前方治之,后见一臂痘发出比他处尤为稠密,臂痘一出,诸痘俱起,九日而平
复如故。
Cardamomi Fructus (2.5 qian each), Dingxiang (Caryophylli Flos), Banxia (Ginger-processed), Fuzii Radix et Rhizoma Praeparata (Pao, peeled; 1.5 qian each).
Crush the above herbs. Take 2 qian per dose, add one lamp of water, five slices of fresh ginger, and three jujubes, decoct and take orally.
This formula treats deficiency-cold syndrome. (For cases with deficiency but no cold, the preceding formula for dual deficiency of qi and blood is suitable; this formula should not be used. It can only be used when the pulse is deficient and fine, and the limbs and body are cold.)
Shibu San (Ten-Tonifying Powder): Nourishes qi and blood, regulates spleen and stomach, and facilitates the rapid eruption of toxin in sores. Use it if there are cold signs. Adding Zicao (Arnebiae Radix seu Cortex), Muxiang (Aucklandiae Radix), and Nuomici (Oryza Sativa Glutinosa Semen) is called Shen Neituo San.
Huangqi (Astragali Radix), Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix) (2 qian each), Houpo (Magnoliae Officinalis Cortex), Jiegeng (Platycodonis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian each), Guixin (Cinnamomi Ramulus) (3 fen).
Take 4 qian per dose, decoct in water and take orally; or grind into powder and mix with warm water to take 1.5 qian.
[Deficiency-Heat Example]
Langen San (Isatidis Root Powder): Treats slow eruption of sores/rashes and inverted crusting (retraction of pustules). Also known as Ersheng San, used to save critically ill children.
Banlangen (Isatidis Radix) (1 liang), Gancao (Licorice Root, honey-fried) (7.5 qian).
Grind into fine powder. Take half a qian per dose, mix with three to two drops of rooster comb blood and a little warm wine, take after meals, at any time. For severe cases, take three to five doses for immediate effect. (Danxi said: Lan root can disperse stagnant blood.)
Sigua San (Luffa Powder): Most excellent for promoting the eruption of sores/rashes. Burn luffa fruit with skin to ash, preserving its medicinal property. Mix with boiling water to take. Alternatively, decoct Zicao (Arnebiae Radix seu Cortex) and Gancao (Glycyrrhizae Radix et Rhizoma) to mix and take; rice soup is also acceptable.
Luobo Tang (Radish Decoction) (see previous text).
[Irrestlessness and Insomnia Example]
For smallpox/rash patients with irritability and inability to sleep, use Ganjie Jia Zhizi Tang (Licorice and Platycodon Decoction plus Gardenia).
Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus).
Equal parts of the above, decoct and take.
[Huo] For smallpox/rash with slow eruption, irritability, and insomnia, treat with Shuijie San, Mahuang Huangqin Tang, or Shengma Huangqin Tang. (Haizang said: It is better to determine the state of qi and blood and use Shi Gao (Gypsum Fibrosum) and Zhizi (Gardeniae Fructus), which is especially good. Mahuang Huangqin Tang and Shengma Huangqin Tang should only be used after confirming Taiyang and Yangming syndromes.)
Shuijie San (Water-Resolving Powder): Treats epidemic headache and high fever for one to two days; also treats irritability before sore eruption, or continued fever after eruption.
Mahuang (Ephedrae Herba, nodes removed) (4 liang), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Guixin (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Shaoyao (Paeoniae Radix Alba) (2 liang each).
Grind into coarse powder. After the patient bathes in a mixture of raw and boiled water, take 2 qian mixed with warm water. Follow with a second dose. Recovery occurs with sweating and unobstructed bowel movement. Strong individuals take two fangcunbi (square-inch scoops). Individuals with wind-excess constitution may also use it during the dog days of summer. If Dahuang is omitted, it is suitable for spring and summer.
Shengma Huangqin Tang (Codonopsis and Scutellaria Decoction): Treats slow eruption of smallpox/rash, irritability, and insomnia. Mahuang Huangqin Tang treats slow eruption of smallpox/rash with increased irritability and drowsiness, or body pain and fever after eruption. (Both formulas are found in the Pediatric Cold Damage section.)
Huwu Jiu (Coriander Wine): Use only Coriandrum sativum Herb (Husu). Finely chop 4 liang, add two lamps of good wine, boil for one or two boils, add Husu again and boil briefly. Cover tightly, let cool to warm. Inhale a large mouthful and spray gently from head to toe evenly, avoiding the head and face. Keep the patient surrounded by the aroma of Husu to dispel foul qi and promote rapid eruption of sores/rashes.
The "Zhinan" mentions the prohibition of treating sores, stating that the collapse of smallpox toxin is due to weak qi and blood failing to contain the toxin, causing the toxin to accumulate where the couli (interstices) are empty. Thus, when smallpox first erupts, one or two spots may appear in hidden interstitial joints or between the limbs. Once these spots erupt, other spots cannot develop properly into pustules, hence called "Prohibited Sores." There are five prohibitions: Stomach Prohibition, Fire Prohibition, Water Prohibition, Wind Prohibition, and Cold Prohibition.
Stomach Prohibition: Toxic fire scorches the stomach, preventing dispersion to the muscle surface, leading to spleen and stomach ulceration. Externally, sores appearing on the lips and mouth, such as two to five connected spots, where other sores have not yet formed pus while this spot has already turned yellow and matured, indicates internal attack by heat-toxin and rotting of the stomach, preventing other sores from forming pus. Upon seeing such sores on the lips/mouth, observe if the complexion is flushed red, breathing is coarse and hot, and breath is unusually foul; this confirms the diagnosis.
Fire Prohibition: At the initial stage of onset, if the child has chills and fever and is mistakenly fumigated with fire or sleeps in a heating box, drying the skin, the toxin cannot be excreted. Combined with qi deficiency failing to contain the toxin, the toxin stays within the skin, faintly unable to emerge. Carefully observing the skin reveals red spots without heads or feet, or one or two spots in broad areas of limbs/head/face. Other sores then erupt destructively from these spots, and the faintly hidden sores fail to erupt quickly, named Fire Prohibition. Bathing with Yangliu (Salix Twig) plus Jingjie (Schizonepetae Herba) decoction allows other sores to erupt naturally; mild cases are treated with Shengma Hejie San.
Water Prohibition: At the initial fever stage, when yin and yang are undifferentiated and toxin is strong, mistaken consumption of cold/raw food causes toxin to stay between skin and flesh, showing faint red spots or blisters in broad areas of ribs/hands/feet/head/face. Internal cold causes abdominal pain and distension; external cold causes fever and aversion to wind, confirming the diagnosis. Expel using Ding (Dingxiang), Gui (Rougui), Fuling (Poria), Shengma (Cimicifugae Rhizoma), Dafu (Arecae Pericarpium), etc. Prevent diarrhea from cold food retention in spleen/stomach by adding Shanzha (Crataegi Fructus).
Wind Prohibition: At the onset of fever, failure to avoid wind allows wind to enter the muscle surface, preventing eruption. Symptoms include numbness of skin without pain/itch sensation, or dryness, straight/dry hair, itchy skin wanting to scratch, or severe mania and delirium due to wind-fire binding. Treatment: Use Shengma Tang plus Qianghuo (Notopterygii Rhizoma et Radix) and Jingjie (Schizonepetae Herba) to expel; for severe cases, use Jili (Tribuli Fructus) and Chantui (Bombyx Dispar Cicadae Periostracum) to attack.
Cold Prohibition: At the onset of fever, mistaken bathing in cold water, sleeping on iron/paint cold surfaces, or thin clothing exposing to cold causes smallpox to fail to emerge. Symptoms include numb hands/feet without pain/itch, cold painful limbs immobile, no sores in numb/cold painful areas, but sores appearing like urticaria in sheltered areas or hairline. This confirms the diagnosis. Internally expel with Ding (Dingxiang), Gui (Rougui), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengma (Cimicifugae Rhizoma); externally warm with cotton clothes. I once saw an 11-12 year old child who slept on a newly lacquered bed during initial fever. Parents did not anticipate smallpox, allowing the child's hand to touch the lacquer bed, causing cold qi to invade the arm. Sores appeared on other limbs/face/abdomen, but the arm was numb with no sores. Doctors did not know the cause. Upon my examination, I treated with the aforementioned formula. Later, the arm erupted with denser sores than elsewhere. Once arm sores emerged, all other sores rose, and recovery occurred in nine days.