〔万〕痘疮之证，热三日，出三日，后方起发，此常论也。盖先出者先起，后出
者后起，痘疏毒轻，气禀浓者，自易出易发易靥。痘密毒重，气禀薄者，自难出难
发难靥，未可拘定日数。时师不知虚实补泻之理，但于起发之初，便用补脾，果内
气不足少食者，用之允当，若内实便秘能食之人，宁不党邪为恶乎，非徒无益，而
反害之。痘疮之出，有轻有重，观其形状，即可知之，如一发便出尽者必重也。疮
夹疹者，半轻半重也。出稀者轻。里外微红者轻。外黑里赤微重也。外白里黑者至
重也。疮端里黑点如针孔者势剧也。青干紫陷，昏睡汗出，烦躁热渴，腹胀啼喘，
大小便不通者困也。善用药者，能使轻者易安，重者不致大困，斯可谓之十全矣。
凡痘疮疏则无毒，密则有毒，痘疏毒少者，邪不胜正，其气和，其势顺，不须服药。
痘疏密布散，邪正相持，其气病，其势险，此宜抑邪扶正，使邪气亟夺，不为正气
之贼。痘稠密无缝，正不胜邪，其气乖，其势逆，善治者什可救其二三，不善治者
束手待毙而已。故顺者不必治，逆者不可治，险者贵治，此以下专言险逆者之证治
也。痘子轻者作三四次出，大小不一等，其起发亦先后循次，大小分明，不相连
串，颗粒尖圆，根窠红活，光壮肥泽，此表无病。饮食如常，小大便清润，此里无
病。表里无病，大吉之兆，不须服药。凡痘密者，多难起顶，但欲皮浓有脓，浆色
以灯影之，苟非皮薄水泡光润，虽平，亦无伤。
凡痘子出得稀疏者，自然易发易靥，不可妄治，若疮稠密，常患其发不能透，
宜细视之，但红活不甚长大者，气不足也，用四君子汤合匀气散、加烧人屎治之。
如肿色带红紫者，血热也，用四物汤（失血）合消毒饮（见形）加烧人屎治之。如不润泽而
干者，此血弱也，用活血散加消毒饮与之。如不起发，不红活，平 灰白者，此气
血俱虚也，用十全大补汤（汗）加烧人屎、牛蒡子与之。如有青干者，内服快 汤（见形）加
烧人屎、合夺命丹（见形）与之，外用四圣散（痘疔）合胭脂涂法，或用胡荽酒（俱见形），或
用水杨汤浴法，务求光壮红活而后已。如中间有成水泡者，防其痒 ，宜先补脾胃，疏
风泻火，使肌肉实，不作痒可也，十全大补汤（汗）加防风、大力子主之。
疮子起发，只以出匀为期，不可拘定日数，疮出以渐，其发亦以渐，谓之适中，
若已一齐涌出，便皮肉虚肿，一齐 发者，此表气虚，毒瓦斯奔溃而出，表虚不能收
敛，必生痒 ，或成溃烂，急宜救表，十宣散调无价散、活血散合消毒饮相间服
之。若出已尽，当起不起，或起不透，此里气虚，毒瓦斯留伏壅遏而不出，必增烦躁
腹满喘促，或后为痈毒，急宜救里，十全大补汤合匀气散，或参苓白术散调无价散
服之。痘至四五，停住不甚起者，少后力，宜助之，用生黄 三五钱，人参二三
钱，当归、鹿茸一二钱，煎服，或磨入木香少许，儿大者倍之，俟浆满足而止。
十宣散（见形）
活血散（即芎归汤）
当归 川芎（各等分）
上为细末。每服一钱，红花汤调服。
消毒饮（见形） 十全大补汤（汁） 匀气散（见形） 参苓白术散（渴） 无价散（倒
靥）
参 四圣散 治痘疮已出六七日，不能长，不生脓，或痒塌。
当归 芍药（炒） 黄 川芎（各五分） 白术 伏苓 紫草（如无红花代之） 木通
防风（各三分） 糯米（二百粒）
上，水煎。母同服。
胎元散 痘不起发，不红润，是血气俱虚。
胎元焙干为末，加麝香少许，酒调服三五分。
独参汤 治阳气虚弱，痘疮不起发，不红活，或脓清不满，或结痂迟缓，或痘痕色
白，或嫩软不固，或脓水不干，或时作痒，或畏风寒。
用好人参一两、生姜五片、大枣五枚、水二钟，煎八分，徐徐温服。婴儿乳母亦服。
〔干枯灰白红紫青黯〕〔丹〕如将出成就之际，却色淡不正者属血虚，宜用补血
药当归、川芎、白芍酒洗之类，或加红花。如将成就之际，却色紫不正者属热，宜
用凉药解毒，升麻、芩、连、桔梗、连翘之类，甚者用犀角屑（如用后项诸药，色仍不正者，宜
兼用二法治之。）
痘疮之毒，必气以 之、血以濡之，而后可得成熟也，故于起发之时光壮者，
气有余也。肥泽者，血有余也。气血有余，表里俱和，不须服药。如形长大而色枯
燥者，此气至而血不荣也，宜四物汤（失血）加人参、麦门冬。色红润而形平陷者，此血
至而气不充也，宜四君子汤（不能食）加黄 、官桂、川芎。形平陷，色枯萎者，此气血
俱不足也，宜十全大补汤（汗）合无价散（倒靥）主之。色灰白者，气虚也，四君子汤加黄 、
当归、官桂。色红紫者，血热也，四物汤加红花、地骨皮、牡丹皮。
凡痘疮起发迟滞，顶平，色灰白者，气虚也，其人平日食少，脾胃不足，人参
白术散（渴）去葛根、加桂，十全大补汤（汗）去地黄、加木香主之。如曾有吐泻，以致气弱
者，四君子汤（不能食）合益黄散（脾）主之。泻未止者，四君子汤吞肉豆蔻丸（泄利），甚者陈氏
木香散主之（泄利）。若红紫色 肿者，血热也，四物汤（失血）合消毒饮（见形）加红花，外用胭
脂涂法（见形）解之。干枯者，血虚也，四物汤加人参、麦门冬、地骨皮，外用胭脂涂
法、水杨汤浴法。（灰白另立门在下卷。）
起发之时，根窠红活，形色润泽者，此血随气行，灌注诸疮，自然红活肥泽，
不须服药。如虽起发，干枯无水，谓之不肥泽。带青紫黯色，谓之不红活。其变为
黑陷，乃血虚也，四物汤（失血）加人参及麦门冬、紫草、红花，间进，调无价散（倒靥）或
吞服夺命丹（见形），外用胭脂涂法（见形）。
水杨汤
水杨柳五斤，净洗，春冬用枝，秋夏用枝叶，锉断，用长流水一大釜，煎
六七沸，先将三分中一分，置浴盆内，以手试，不甚热，亦不可太温，先服宜用
汤药，然后浴洗，渐渐添汤，以痘起发光壮为度，不拘次数。
祛邪汤 痘号天花，最忌诸秽臭、恶血，五六朝间，痘本美丽鼎峻，而一时失防，或
触于腥血，或感于秽臭，倏忽更变，外宜祛邪汤浴之，而内服玉枢正气丹可也。
鸡毛（拔细软者） 升麻 荆芥 木通 紫苏 荔枝壳 水杨条
上，用水煎浓，去滓，洗浴。
玉枢正气丹
玉枢正气神功捷，生地红花并甘桔，参 须倍橘红扛，蝉蜕防风羲爱觅，寅谷
相朝嫩桃杪，五个和姜甘草列，煎浓投酒服须臾，不觉痘自还元吉。
〔顶陷〕起发之时不徐不疾，以渐长大，尖圆磊落，光壮坚实，根脚红活，此气
充足，载血而行，透彻诸疮，自然尖圆光壮，不须服药。如虽红活，顶平中陷，不
成尖圆，色嫩皮薄，不能坚浓，其变为痒 ，为留伏壅遏，乃气虚也，四君子汤（不能
食）合匀气散（见形）加黄 、官桂，或人参白术散（渴）加黄 、官桂、防风，或调元汤（大法）加
官桂、防风、白芷、荆芥穗，或十全大补汤（汗）去地黄、加防风、白芷，或十宣散（见形）
皆可选用。若疮皮薄，色娇，淫淫如湿者，此气不胜血，宜补气凉血，四君子汤、四
物汤去川芎、地黄，加黄 、官桂、防风、荆芥穗。如浮囊虚起，壳中无水者，此
气不根据血，血不附气，其变为痒 ，为痈肿，十全大补汤去白术，加大力子、连翘、
防风、烧人屎。痘疮起发，尖圆为贵，如四围起，中心平陷者，此有二种。有血化
成水，四围高起，心中略低凹者，俗呼为茱萸豆，此中气不足，发未透彻故耳，能
食者至养浆之时，尽充满而起矣，不能食者，宜扶中气，人参白术散主之。有四围
沸起，中心落陷无水，犹是死肉，其形如钱，宜急攻之，若待渐变黑点，不可为矣，
此名鬼痘，四君子汤合九味顺气散加烧人屎，或紫草饮（出不快），或紫草饮子，连进服
之，外更用胭脂涂法（见形）。出齐后，痘有小孔，自顶直下至脚，不黑不白，与痘色
相同，名为蛀痘，皆因表虚而腠理不密，成此证也，失于早治，大泄元气，不起不
发，祸不旋踵，急用保元汤下生糯米、川芎、肉桂、丁香，其孔自密，甚为快捷方式，
连进二三服，必待孔闭而痘自起。孔若黑色，则为疔矣。顶陷色白，皮薄晶光者，
气虚也，大下保元，倍加酒炒黄 、肉桂、川芎、丁香、茯苓皮、人乳、好酒、进之。
九味顺气散 （又名匀气散）
白术 白茯苓 青皮 白芷 陈皮 乌药 人参（各五分） 甘草（炙，二分半） 木香（一分半）
上锉细。水一盏，煎七分，去滓，温服。
紫草饮子
紫草茸 人参 白芍药 蝉蜕 甘草 穿山甲（土拌，炒。各等分）
上锉细。用水一盏，煎五分，作三四次温服。
内托散 治痘疮毒根在里，顶陷，灰白色，不起发，根窠不红，内托毒化，立验。
人参 甘草 肉桂 白芷 白芍药 川芎（各一两） 黄 （一两五钱） 桔梗 防风（各二两）
用当归（五钱） 木香（二钱）
上，水煎服。泻，加诃子内、肉豆蔻。有 ，减肉桂，加紫草、酒炒黄芩、
黄连、牛蒡子之类。
治痘塌陷不起，回阳丹
此方用于四五朝前，其效甚速，若用于六七日后，则噬脐矣。制法，将弥月将
生胞羊，酒洗净，随用黄麻缠拢一团，把腊糟裹外，置新瓦上四围炭火炙之，俟
其外糟焦了如墨样，削去其糟，再焙干，另为末，入官桂末、丁香末各五钱，
人参末一两，木香末三钱，再研极细。升麻煎酒浆调服，十岁以上服二钱，十岁
以下服一钱，十五岁以上服三钱，年多服多，年少服少，加减而用，无不获效。
若加大附子一两，去木香，则为附子回生丹。胞羊须预嘱屠肆，遇便收制，若特
杀伤生，大不祥。
〔顶凸〕痘疮起发，有心中凸起，四围干平无水者，或里红外黑者，此由平日
感受风寒，皮肤坚木，以致痘毒郁而不散，宜桂枝葛根汤（初热）十宣散（见形）以散表邪，
外用水杨汤浴之（见前）。
〔粘连〕痘疮起发，贵于颗粒分明，如其彼此相串，皮肿肉浮，或于本痘四傍，
旋出小痘，攒聚胖长，渐成一块，此候最重，宜以快 汤合消毒饮（俱见形）加烧人屎服
之，更宜禁忌，以防瘙痒之变。
〔陷伏〕凡痘疮，以起发光壮，红活肥泽为顺，若将起发之时，中间有干黑不
起者，须急治之，不可因循，以致传变加多，不可救药矣。
痘疮内而不出谓之伏，外而复入谓之陷，疮痘黑陷，当分四证。
一则感风寒肌窍闭塞，血凝而不行，必身痛，四肢微厥， 点不长，或变黑色，
或青紫瘾疹，此为倒伏也。宜温肌发散，桂枝葛根汤（初热）加麻黄、蝉蜕，或以紫草饮
（出不快）吞夺命丹（见形），外用胡荽酒喷之，须令温散寒邪，然后热气复行，则其 自长矣。
二则毒瓦斯太盛，内外蒸烁，毒复入里，必心烦狂躁，气喘妄言，如见鬼神，大
小便秘，渴而腹胀，此为倒陷伏也。病邪轻者，宜利小便解毒，连翘汤、通关散
（俱便闷），甚者以百祥丸、牛李膏（俱黑陷），以泻膀胱之毒，令阳气复还，脾胃温暖，服之
身温，欲饮水者可治，是脾强胜肾，陷者当复出矣，若加以寒战身冷汗出，耳尻反热，
死。然百祥丸太峻，今以宣风散（发热）、三乙承气汤（便闷）代之，外以水杨汤浴之（见前）。
三则内虚而不能使阳气以副荣卫者，出而复没， 点白色，或黑色，其人必不
能乳食，大便自利，或呕或厥，此胃虚而不出，谓之陷伏也，宜用温中之剂，令其
胃暖，荣卫复行，则当自出矣，宜调元汤（大法）加丁香、官桂，理中汤（泄利）加黄 、官
桂，甚则陈氏木香散（泄利）异攻散（出不快）皆可用也。外用胡荽酒（见形）喷之。或因误下
之后，毒瓦斯入里而黑陷者，则宜温养而表出之，先以理中汤温养其里，后以桂枝葛根汤疏解
于表也，不出，再加麻黄。
四则被房室等杂秽恶气冲触而黑陷者，则宜熏解之，内服紫草饮子（见前），外用胡荽
酒喷之，及茵陈熏法。（余详前禁忌条内）
茵陈熏法
用干茵陈研末，捣枣膏、和丸如鸡子大，晒干。烈火烧烟熏之。
〔大便〕痘疮自起发之后，大便常宜坚实，缘小儿脆弱，身热而大便不通者则
易实，大便自利者则易虚，虽四五日不便，无忧也，不能食者听其自便，赖旧谷气
为养，至五日后则脓成毒化，解利之剂可用也。能食者三日后不通，不腹满，不里
急后重，则亦不必攻之，可用胆导法（便闷）导之，不通，以当归丸（便闷）微令润过，使气
道升降，无壅遏之患，不可妄下。凡能食者，大便喜润，赖新谷以为养，而旧污之
不留，自然脏腑流利，血气和平，不可妄用温补，反增里热之证。胃主腐熟水谷，
大肠主传送已化之物，故食多少，可以知人谷气之虚实，大便滑涩，可以知人脏腑
[Wan Quan] Regarding the manifestation of smallpox, fever lasts for three days, eruption occurs for three days, and then the pustules begin to rise; this is the general theory. Generally, those that erupt first rise first, and those that erupt later rise later. If the pustules are sparse and the toxin is light, and the constitution is robust, they will naturally be easy to erupt, easy to rise, and easy to crust over. If the pustules are dense and the toxin is heavy, and the constitution is weak, they will naturally be difficult to erupt, difficult to rise, and difficult to crust over; one should not rigidly adhere to fixed days. Contemporary physicians do not understand the principles of deficiency/excess and tonification/draining. They merely use spleen-tonifying methods at the initial stage of rising. If the internal qi is deficient and appetite is poor, this approach is appropriate. However, if the person has internal excess, constipation, and a good appetite, would it not be aiding the pathogen and worsening the condition? This is not only ineffective but harmful. The eruption of smallpox varies in severity; its shape indicates the degree. For instance, if all pustules erupt at once, the condition is likely severe. Pustules accompanied by rashes indicate moderate severity. Sparse eruption indicates mildness. Slight redness inside and out indicates mildness. Black on the outside and red on the inside indicates slight severity. White on the outside and black on the inside indicates extreme severity. Black spots like needle holes at the tip of the pustule indicate a critical condition. Cyanosis, dryness, purple depression, lethargy with sweating, irritability, heat, thirst, abdominal distension, crying, wheezing, and obstruction of urination and defecation indicate a critical and difficult state. A skilled practitioner can make mild cases stable and prevent severe cases from becoming critically dangerous, which can be considered perfect treatment.
Generally, sparse smallpox has no toxin, while dense smallpox has toxin. When pustules are sparse and the toxin is light, the pathogen cannot overcome the healthy qi; the qi is harmonious, and the disease progression is smooth, requiring no medication. If pustules are sparse but scattered, the pathogen and healthy qi contend; the qi is diseased, and the progression is perilous; this requires suppressing the pathogen and supporting the healthy qi, so that the pathogen is quickly deprived and does not become a thief to the healthy qi. If pustules are dense without gaps, the healthy qi cannot overcome the pathogen; the qi is disordered, and the progression is adverse. A skilled practitioner may save two or three out of ten, while an unskilled one can only wait for death with hands tied. Therefore, favorable cases need not be treated, adverse cases are hard to treat, and perilous cases require timely treatment. The following specifically discusses the treatment of perilous and adverse cases.
Mild smallpox erupts in three or four batches, varying in size. Their rising follows a sequence, distinct in size, not connected in strings, with sharp, round grains, red and vibrant roots, and a lustrous, plump appearance; this indicates no exterior pathology. Normal diet and clear, moist urine and stool indicate no interior pathology. No exterior or interior pathology is an auspicious sign, requiring no medication. Dense smallpox often struggles to form peaks. As long as the skin is thick with pus, and the color appears normal under lamplight, even if flat, it is not damaging, provided it is not thin-skinned with watery blisters.
Sparse smallpox naturally rises and crusts easily; do not treat rashly. If pustules are dense and struggle to emerge fully, examine carefully. If they are red and vibrant but do not grow much, it indicates qi deficiency; treat with Sijunzi Tang (Four Gentlemen Decoction) combined with Yunqi San (Harmonizing Qi Powder), plus burnt human feces. If swollen with red-purple color, it indicates blood heat; treat with Siwu Tang (Four Substances Decoction) combined with Xiaodu Yin (Detoxifying Decoction), plus burnt human feces. If not moist but dry, it indicates blood weakness; treat with Huoxue San (Blood-Invigorating Powder) combined with Xiaodu Yin. If they do not rise, are not red/vibrant, and are flat/gray-white, it indicates dual deficiency of qi and blood; treat with Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) plus burnt human feces and Niubangzi (Arctii Fructus). If cyanotic and dry, internally administer Kuaiban Tang (Rapid Eruption Decoction) plus burnt human feces and Huoxue Dan (Life-Restoring Pill); externally apply Six Saints Powder (Six Saints Powder) combined with Rouge Application Method, or use Huisu Jiu (Coriander Wine), or Yangliu Tang Bath Method, until the lesions become lustrous, robust, and red/vibrant. If water blisters form in the center, to prevent itching, first tonify the spleen and stomach, dispel wind, and drain fire to solidify the muscles and prevent itching; treat with Shiquan Dabu Tang plus Fangfeng (Saposhnikoviae Radix) and Dalizi (Arctii Fructus).
The rising of pustules should be judged by uniformity of eruption, not fixed days. Gradual eruption leads to gradual rising, which is termed "moderate." If they erupt all at once, the skin and flesh become vacuously swollen; simultaneous rising indicates exterior qi deficiency, with toxins bursting forth due to inability of the deficient exterior to consolidate. This inevitably causes itching or ulceration; urgently rescue the exterior by alternating administration of Shixuan San (Ten Acupoints Powder) blended with Wuji San (Priceless Powder), Huoxue San, and Xiaodu Yin. If eruption is complete but rising fails or is incomplete, it indicates interior qi deficiency, with toxins lingering and obstructed; this inevitably increases irritability, abdominal fullness, and wheezing, or later develops into carbuncles/toxins; urgently rescue the interior with Shiquan Dabu Tang combined with Yunqi San, or Shenling Baizhu San blended with Wuji San. At day four or five, if development stalls slightly due to lack of strength, assist it with Sheng Huangqi (Astragali Radix) 3-5 qian, Renshen (Ginseng Radix) 2-3 qian, Danggui (Angelicae Sinensis Radix) and Lurong (Cervum Cornu Degelatinatum) 1-2 qian, decocted and taken orally, or mixed with a little Muxiang (Aucklandiae Radix); double the dose for older children; stop when the pus is full.
Shixuan San (See Jianxing Chapter)
Huoxue San (i.e., Xiong Gui Tang)
Danggui, Chuanxiong (equal parts)
Grind into fine powder. Take 1 qian per dose, administered with Honghua (Carthami Flos) decoction.
Xiaodu Yin (See Jianxing Chapter) Shiquan Dabu Tang (See Zhiye Chapter) Yunqi San (See Jianxing Chapter) Shenling Baizhu San (See Ke Chapter) Wuji San (See Dao Ye Chapter)
Can [Note: Likely refers to a specific ingredient or context missing in snippet, kept as text] Six Saints Powder Treats smallpox erupted for six to seven days, unable to grow, unable to produce pus, or itchy and collapsed.
Danggui, Shaoyao (stir-fried), Huangqi, Chuanxiong (each 5 fen), Baizhu, Fuling, Zicao (substitute Honghua if unavailable), Mutong, Fangfeng (each 3 fen), Nuomi (200 grains)
Decoct in water. Mother takes it together.
Taiyuan San Smallpox fails to rise, lacks redness/luster, indicating dual deficiency of qi and blood.
Bake Taiyuan (Fetal Remains) until dry, grind into powder, add a little Shexiang (Moschus), mix with wine, take 3-5 fen.
Dushen Tang Treats yang qi deficiency, smallpox failing to rise, lacking redness/luster, or pus is clear/incomplete, scabbing is slow, scars are white, tender/soft/unstable, pus water doesn't dry up, occasional itching, or aversion to wind/cold.
Use high-quality Renshen 1 liang, Shengjiang (Fresh Ginger) 5 slices, Dazao (Jujubae Fructus) 5 pieces, water 2 zhong, decoct to 8 fen, take warm slowly. Infants' mothers also take it.
[Withered, Gray-White, Red-Purple, Cyan-Dark] [Dan Bo Yuanjian] At the stage of nearing completion, if the color is pale and abnormal, it belongs to blood deficiency; use blood-tonifying herbs like Danggui, Chuanxiong, Baishao (wine-washed), or add Honghua. If nearing completion, the color is purple and abnormal, it belongs to heat; use cooling detoxifying herbs like Shengma (Cimicifugae Rhizoma), Qin (Scutellariae Radix), Lian (Coptidis Rhizoma), Jiegeng (Platycodonis Radix), Lianqiao (Forsythiae Fructus). Severe cases use Xijiao Xie (Rhinocerotis Cornu). (If using the aforementioned drugs and color remains abnormal, combine both treatments.)
The toxin of smallpox must be propelled by qi and nourished by blood to mature. Thus, at the rising stage, lustrous/plump indicates surplus qi. Plump/moist indicates surplus blood. Surplus qi and blood with harmony inside and out require no medication. If large in shape but withered/dry, qi has arrived but blood does not nourish; use Siwu Tang plus Renshen and Maidong (Ophiopogonis Radix). If red/lustrous but flat/depressed, blood has arrived but qi does not fill; use Sijunzi Tang plus Huangqi, Guigui (Cinnamomi Cortex), and Chuanxiong. If flat/depressed and withered/withered, dual deficiency of qi and blood; use Shiquan Dabu Tang combined with Wuji San. Gray-white color indicates qi deficiency; Sijunzi Tang plus Huangqi, Danggui, Guigui. Red-purple color indicates blood heat; Siwu Tang plus Honghua, Digupi (Lycii Cortex), Mudanpi (Moutan Cortex).
Generally, delayed rising, flat tops, gray-white color indicate qi deficiency. The patient usually eats little, with insufficient spleen/stomach. Use Renshen Baizhu San remove Gegen, add Guizhi; or Shiquan Dabu Tang remove Dihuang, add Muxiang. If there was vomiting/diarrhea leading to qi weakness, use Sijunzi Tang combined with Yihuang San. If diarrhea persists, swallow Rudoukou Wan (Nutmeg Pill) with Sijunzi Tang; severe cases use Chen's Muxiang San. If red-purple and swollen, blood heat; Siwu Tang combined with Xiaodu Yin plus Honghua, externally apply Rouge Method. Withered/dry indicates blood deficiency; Siwu Tang plus Renshen, Maidong, Digupi, externally apply Rouge Method and Yangliu Tang Bath. (Gray-white has a separate section in Vol. 2.)
At the rising stage, red/vibrant roots and moist/colorful appearance indicate blood following qi, irrigating the pustules, naturally becoming red/vibrant and plump; no medication needed. If rising but withered/dry without water, it is called "not plump/moist." With cyan/purple/dark color, it is called "not red/vibrant." Transformation into black depression is due to blood deficiency; Siwu Tang plus Renshen, Maidong, Zicao, Honghua, taken intermittently, blended with Wuji San or swallowed with Huoming Dan, externally apply Rouge Method.
Yangliu Tang
Take 5 jin of Yangliu (Populus/Twillow branch), wash clean. In spring/winter use branches, autumn/summer use branches and leaves. Chop. Use a large pot of running water, boil 6-7 times. Put one-third in the bath basin. Test with hand: not too hot, not too warm. First take herbal medicine, then bathe. Gradually add water until the smallpox becomes lustrous and robust. Number of baths unrestricted.
Quxie Tang Smallpox, known as Tianhua, most fears filth, bad odors, and evil blood. Between days five and six, although the smallpox is originally beautiful and prominent, a momentary lapse in prevention, touching fishy blood, or sensing foul odors, can cause sudden changes. Externally bathe with Quxie Tang, internally take Yushu Zhengqi Dan.
Chicken feathers (fine and soft ones), Shengma, Jingjie, Mutong, Zisu, Lizhi Qiao (Lychee shell), Yangliu Tiao
Decoct strongly in water, strain, bathe.
Yushu Zhengqi Dan
Yushu Zhengqi divine power is swift, Shengdi, Honghua, Gancao, Jiegeng. Ginseng whiskers doubled, Orange peel supports. Cicada slough and Fangfeng seek diligently, Yin Valley faces morning tender peach tips. Five pieces with ginger and Gancao arranged. Decoct strong, throw into wine, take shortly, unconsciously smallpox returns to original auspiciousness.
[Flat Top] Rising steadily, gradually growing, sharp/round and upright, lustrous/plump/solid, red/vibrant roots, indicates sufficient qi carrying blood through the pustules, naturally sharp/round/lustrous; no medication needed. If red/vibrant but top is flat/depressed, not sharp/round, tender color/thin skin, unable to become firm/thick, transforming into itching or lingering obstruction, it is qi deficiency. Sijunzi Tang combined with Yunqi San plus Huangqi, Guigui; or Renshen Baizhu San plus Huangqi, Guigui, Fangfeng; or Tiaoyuan Tang plus Guigui, Fangfeng, Baizhu, Jingjie Sui; or Shiquan Dabu Tang remove Dihuang, add Fangfeng, Baizhu; or Shixuan San, all selectable. If skin is thin, delicate color, moist-looking, qi cannot control blood; tonify qi and cool blood. Sijunzi Tang, Siwu Tang remove Chuanxiong, Dihuang, add Huangqi, Guigui, Fangfeng, Jingjie Sui. If floating vesicles rise empty without water, qi does not root in blood, blood does not attach to qi, transforming into itching or carbuncles; Shiquan Dabu Tang remove Baizhu, add Dalizi, Lianqiao, Fangfeng, burnt human feces. Sharp/round is precious in rising. If surrounding rises but center is flat/depressed, there are two types. One where blood transforms to water, surrounding rises high, center slightly concave,俗称 Zhu Yu Dou (Dogwood Bean), this is middle qi deficiency, eruption not thorough. Those who can eat will fill up and rise during the pus-nourishing stage; those who cannot eat, tonify middle qi with Renshen Baizhu San. One where surrounding boils up, center sinks empty without water, still dead flesh, coin-shaped; urgently attack. If waiting for black spots, it is hopeless. This is named Ghost Smallpox. Sijunzi Tang combined with Jiwei Shunqi San plus burnt human feces, or Zicao Yin, or Zicao Yinzi, continuous administration, externally apply Rouge Method. After complete eruption, smallpox has small holes from top to foot, neither black nor white, same color as smallpox, named Worm Smallpox. Due to exterior deficiency and loose pores. Failure to treat early greatly drains yuan qi, causing failure to rise/erupt, disaster follows swiftly. Urgently use Baoyuan Tang plus Sheng Nuomi, Chuanxiong, Rougui, Dingxiang. The holes will close naturally, very fast. Continuous 2-3 doses, wait for holes to close and smallpox rises. If hole is black, it is a Ding (carbuncle). Flat top, white color, thin crystal-clear skin, qi deficiency. Large dose of Baoyuan, double wine-fried Huangqi, Rougui, Chuanxiong, Dingxiang, Fuling Pi, Renru (Human Milk), Haojiu (Good Wine), administer.
Jiwei Shunqi San (Also Yunqi San)
Baizhu, Baifuling, Qingpi, Baizhi, Chenpi, Wuyao, Renshen (each 5 fen), Gancao (roasted, 2.5 fen), Muxiang (1.5 fen)
Chop finely. Water 1 zhan, decoct to 7 fen, strain, take warm.
Zicao Yinzi
Zicaorong, Renshen, Baishaoyao, Chantui, Gancao, Chuanshanjia (soil-mixed, fried. Equal parts)
Chop finely. Water 1 zhan, decoct to 5 fen, take warm in 3-4 doses.
Neituo San Treats smallpox toxin rooted in interior, flat top, gray-white, failing to rise, non-red roots, internally pushes out toxin transformation, immediate effect.
Renshen, Gancao, Rougui, Baizhi, Baishaoyao, Chuanxiong (each 1 liang), Huangqi (1.5 liang), Jiegeng, Fangfeng (each 2 liang), Danggui (5 qian), Muxiang (2 qian)
Decoct in water. Diarrhea, add Hezi Rou, Rudoukou. Heat, reduce Rougui, add Zicao, wine-fried Huangqin, Huanglian, Niubangzi.
Huiyang Dan for Treating Collapsed Smallpox Not Rising
This formula is effective quickly if used before day four or five. If used after day six or seven, it is too late. Preparation: Take a pregnant sheep near term, wash with wine, wrap tightly with yellow hemp, wrap outer layer with wax dregs, place on new tile, roast around with charcoal fire until outer dregs are black like ink. Scrape off dregs, bake dry, grind to powder. Add Guigui powder, Dingxiang powder each 5 qian, Renshen powder 1 liang, Muxiang powder 3 qian, grind extremely fine. Mix with Shengma wine paste. Over 10 years old: 2 qian. Under 10 years old: 1 qian. Over 15 years old: 3 qian. More age more dose, less age less dose, adjust accordingly, always effective. If adding Fuzi 1 liang, remove Muxiang, it becomes Fuzi Huisheng Dan. Sheep must be ordered from butcher beforehand; if specially killed fresh, it is highly inauspicious.
[Protruding Top] Smallpox rising, center protrudes, surrounding dry/flat without water, or red inside/black outside. Due to daily exposure to wind/cold, skin tough/firm, causing smallpox toxin to stagnate and not disperse. Use Guizhi Gegen Tang combined with Shixuan San to disperse exterior pathogen, externally bathe with Yangliu Tang.
[Adhesion] Smallpox rising values distinct grains. If they connect to each other, skin swollen/flesh floating, or small pustules appear around the main pustule, gathering and growing fat/long, gradually forming a mass, this condition is heaviest. Use Kuaiban Tang combined with Xiaodu Yin plus burnt human feces. Strictly observe taboos to prevent itching transformations.
[Depression/Submersion] Generally, smallpox rising lustrous/plump, red/vibrant/plump is favorable. If at the rising stage, center is dry/black and not rising, must treat urgently, do not delay, lest transmission worsens and becomes incurable.
Smallpox internal but not emerging is called Fu (Submerged); external but re-entering is called Xian (Depressed). Black depression of smallpox divides into four syndromes.
First, wind/cold contraction closes muscle pores, blood coagulates and does not flow,必定 body pain, limbs slightly cold, spots do not grow, or turn black, or cyan/purple urticaria, this is Daofu (Reverse Submersion). Warm muscle and disperse, Guizhi Gegen Tang plus Mahuang, Chantui, or swallow Huoming Dan with Zicao Yin, externally spray Huisu Jiu. Must warm-disperse cold pathogen, then heat qi returns, spots grow.
Second, toxin qi too strong, steaming inside/outside, toxin re-enters interior,必定 heart vexation/manic agitation, wheezing delirium, seeing ghosts, constipation of urine/stool, thirst with abdominal distension, this is Daoxianfu (Reverse Depression-Submersion). Mild pathogens, promote urination and detoxify, Lianqiao Tang, Tongguan San. Severe cases, Baixiang Wan, Niuli Gao, to drain bladder toxin, let yang qi return, spleen/stomach warm. Taking it, body warms, desire to drink water indicates treatable; spleen strong overcomes kidney, depressed ones should re-emerge. If added chills, cold sweat, ears/buttocks hot, death. Baixiang Wan is too harsh, now substitute with Xuanfeng San, Sanyi Chengqi Tang, externally bathe with Yangliu Tang.
Third, internal deficiency unable to support ying/wei with yang qi, emerges then disappears, spots white or black, patient unable to suck/eat, spontaneous diarrhea, or vomiting/cold limbs, this is stomach deficiency not emerging, called Xianfu. Use warming middle agents to warm stomach, ying/wei return, self-emerge. Tiaoyuan Tang plus Dingxiang, Guigui; Lizhong Tang plus Huangqi, Guigui. Severe cases, Chen's Muxiang San, Yigong San all usable. Externally spray Huisu Jiu. Or after mistaken purgation, toxin enters interior and black depresses; warm-nourish and surface-exit. First Lizhong Tang warm-nourish interior, then Guizhi Gegen Tang disperse exterior. If not emerging, add Mahuang.
Fourth, touched by bedroom filth/evil qi causing black depression; fumigate and resolve. Internally take Zicao Yinzi, externally spray Huisu Jiu, and Yinchen Fumigation Method. (Details in previous Taboo sections.)
Yinchen Fumigation Method
Dry Yinchen grind to powder, mix with Jujube paste, form pills egg-sized, sun-dry. Burn fiercely to smoke fumigate.
[Stool] After smallpox rising, stool should generally be firm. Because children are fragile, fever with constipation makes it easy to become solid; spontaneous diarrhea makes it easy to become deficient. Even if no stool for 4-5 days, no worry. Those unable to eat, let them have spontaneous stool, relying on old grain qi for nourishment. After 5 days, pus forms and toxin transforms, resolving/detoxifying agents can be used. Those able to eat, no stool after 3 days, no abdominal fullness, no tenesmus, no need to purge. Use Gall Suppository Method. If no stool, use Danggui Wan to mildly moisten, allowing qi mechanism to ascend/descend, no obstruction risk. Do not purge rashly. Those able to eat, stool prefers moisture, relies on new grain for nourishment, old waste not retained, naturally organs/intestines smooth, qi/blood peaceful. Do not use warming-tonifying rashly, lest increasing interior heat syndrome. Stomach governs rotting/ripening food/grain, Large Intestine governs transporting transformed matter. Thus, amount of food eaten knows grain qi deficiency/excess; smooth/sluggish stool knows organ status.