照前三豆散治之,其效如神。
此因小儿出痘多服凉药,血寒气滞,以致毒发色白。若再以凉药服之,其毒流走,患生
不一,久则生管成漏,漏久必生多骨,害人不浅。凡遇此症,须用小金丹(见阴疽门),服
之
孔
等
家
果
又方∶虾蟆灰散(见痈毒诸方)敷之,亦极神效。
出峨蚕茧,不拘多少,将生明矾末入内填满,烧令汁尽成灰为末,掺之即愈。
参看前二十四顶方。妊妇出痘,痘家最忌,盖痘毒出于五脏,痘毒发越则风火相搏,必
致动胎,胎动则气血耗散,热必不能送毒行浆,况痘家用药多主温补,如半夏、肉桂之类,
皆妊妇所忌,而黄芩、乌药又非痘家所宜,此孕妇出痘,所以最难调治也。遇此,总以清热
安胎为主。
有孕之妇遇出痘时,急宜远出回避。若至出痘,当发热时即以保胎为本,以托痘为标,
仍用升麻葛根汤加酒炒黄芩、土妙白术,以保护其胎元。夫黄芩寒凉易至冰毒,若无孕不敢
早用,然有孕而毒火熏蒸,不用黄芩以清内热,胎必不能保矣。至于出齐热或未清,黄芩亦
不妨再用。
孕妇出痘始终以安胎为主,故见点后多服安胎饮为佳。若口渴者,则用人参白术散加减
,滞者则用黄芩汤合四君子汤加诃子,血动者用芩连四物汤,腰疼者保胎散宜早服。总之,
不拘轻重,悉以清热安胎为主。
安胎饮∶台白党、白术、条芩、当归、白芍、川芎、砂仁、苏叶、陈皮、熟地、甘草,
生姜三片,红枣三枚,水煎,温服。
黄芩汤合四君子汤∶黄芩、白芍、人参、茯苓、白术、诃子、甘草。
芩连四物汤∶当归、白芍、地黄、川芎、黄芩、黄连。
保胎散∶玉竹四钱(酒蒸)、当归三钱(酒洗),续断(酒炒)、杜仲(盐水炒)各钱半,
茯苓
Treat it according to the method of San Dou San (Three Bean Decoction), and its efficacy is miraculous.
This occurs because children with smallpox often take cooling medicines, leading to cold blood and stagnant qi, causing the toxin to erupt with a pale color. If cooling medicines are administered again, the toxin will spread, resulting in various complications; over time, fistulas may form, and prolonged fistulas will inevitably produce sequestra (dead bone), causing significant harm. In such cases, Xiao Jin Dan (Little Gold Pill) (see section on Yin Abscesses) must be used, and its administration yields excellent results. The family of Kong et al. indeed adopted another prescription: applying Xia Ma Hui San (Toad Ash Powder) (see prescriptions for carbuncles and toxins externally) also proved extremely effective.
Take tea leaves (remove stems), soak thoroughly in hot water, spread them on the bed, and sleep on them overnight; the pus and fluid will dry up naturally.
Take silkworm cocoons, in any quantity, fill them with powder of raw alum until full, burn until the juice is exhausted and turns into ash, grind into powder, and sprinkle it on the affected area for cure.
Combine Huang Dan (Lead Oxide), Huang Qin (Scutellaria Root), Huang Bo (Phellodendron Bark), Da Huang (Rhubarb Root), and Qing Fen (Calomel), grind them together into powder, mix with lard, and apply externally.
Refer to the previous formula Twenty-Four Ding Formulas. Smallpox during pregnancy is strictly contraindicated in smallpox treatment, as the smallpox toxin originates from the five zang organs. When the toxin erupts, wind and fire contend, inevitably disturbing the fetus. Fetal disturbance leads to consumption and dispersion of qi and blood, preventing heat from driving the toxin to form pustules. Moreover, medications for smallpox generally emphasize warming and tonifying, such as Ban Xia (Pinellia Tuber) and Rou Gui (Cinnamon Bark), which are contraindicated for pregnant women. Meanwhile, Huang Qin (Scutellaria Root) and Wu Yao (Lindera Fruit) are not suitable for smallpox treatment. This is why managing smallpox in pregnant women is particularly difficult. In such instances, the primary principle is always to clear heat and calm the fetus.
When a pregnant woman encounters smallpox, she should immediately seek isolation away from others. If she has already developed smallpox, when fever arises, preserving the fetus should be the root treatment, while supporting the eruption of the rash is the branch treatment. Use Sheng Ma Ge Gen Tang (Bupleurum and Kudzu Decoction) added with wine-fried Huang Qin (Scutellaria Root) and earth-fried Bai Zhu (Atractylodes Rhizome) to protect the fetal origin. Huang Qin (Scutellaria Root) is cold and cooling, which may cause the toxin to become frozen and difficult to erupt; thus, it is not used early if there is no pregnancy. However, if there is pregnancy and the toxin-fire steams internally, failing to use Huang Qin (Scutellaria Root) to clear internal heat means the fetus cannot be preserved. Even after the rash has fully erupted and heat persists, Huang Qin (Scutellaria Root) can still be used appropriately.
For pregnant women with smallpox, calming the fetus remains the primary goal throughout; therefore, taking An Tai Yin (Fetus-Calming Drink) frequently after the appearance of spots is advisable. For those with thirst, modify Ren Shen Bai Zhu San (Ginseng and Atractylodes Macrocephala Powder); for those with stagnation, combine Huang Qin Tang (Scutellaria Decoction) with Si Jun Zi Tang (Four Gentlemen Decoction) plus He Zi (Chebula Fruit); for those with blood movement, use Qin Lian Si Wu Tang (Scutellaria and Coptis Four Substances Decoction); for those with lower back pain, Bao Tai San (Fetus-Preserving Powder) should be taken early. In summary, regardless of severity, the main approach is always clearing heat and calming the fetus.
An Tai Yin (Fetus-Calming Drink): Tai Dang Shen (Codonopsis Root), Bai Zhu (Atractylodes Rhizome), Tiao Qin (Scutellaria Root), Dang Gui (Angelica Sinensis Root), Bai Shao (White Peony Root), Chuan Xiong (Sichuan Lovage Rhizome), Sha Ren (Amomum Fruit), Su Ye (Perilla Leaf), Chen Pi (Citrus Peel), Shu Di Huang (Prepared Rehmannia Root), Gan Cao (Licorice Root), three slices of Sheng Jiang (Fresh Ginger), three red dates, decocted in water, taken warm.
Huang Qin Tang (Scutellaria Decoction) combined with Si Jun Zi Tang (Four Gentlemen Decoction): Huang Qin (Scutellaria Root), Bai Shao (White Peony Root), Ren Shen (Ginseng Root), Fu Ling (Poria), Bai Zhu (Atractylodes Rhizome), He Zi (Chebula Fruit), Gan Cao (Licorice Root).
Qin Lian Si Wu Tang (Scutellaria and Coptis Four Substances Decoction): Dang Gui (Angelica Sinensis Root), Bai Shao (White Peony Root), Di Huang (Rehmannia Root), Chuan Xiong (Sichuan Lovage Rhizome), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome).
Bao Tai San (Fetus-Preserving Powder): Yu Zhu (Polygonatum Rhizome) 4 qian (steamed with wine), Dang Gui (Angelica Sinensis Root) 3 qian (washed with wine), Xu Duan (Dipsacus Root, stir-fried with wine), Du Zhong (Eucommia Bark, stir-fried with salt water) each 1.5 qian, Fu Ling (Poria)...