世传方云∶痘疮吐逆无痰，益黄散。有痰，二陈汤或橘皮汤、半夏汤，不止加丁香。若吐而泻者，亦宜益黄散，及
陈氏木香散、异功散。吐而身热烦渴，腹满气促，大小便涩而赤者，当利小便。窃谓前症若手足并冷，渴饮热汤，或
腹作痛，中气虚寒也，宜用益黄散。手足不冷，吐逆痰涎，中气虚弱也，宜用橘皮半夏汤。手足并热，热毒壅滞也，宜
用导赤散。口干饮乳不彻，胃经气热也，宜用竹薷汤。吐逆不乳，或吐乳酸秽，此脾气虚而乳食停滞也，宜用枳术丸。
一小儿痘不红活，手足微冷，此阳气虚弱也，先用五味异功散加干姜、肉桂二剂，乃去干姜，加木香，又二剂而愈。
一小儿十一岁出痘，第九日吐逆不食，手足并冷，此阳气虚寒之极也，用十二味异功散，一剂顿愈，用五味异功散
而安，用参 四圣散而靥。
一小儿吐逆作渴，手足并热，此胃经有热也，用竹茹汤而热稍止；用人参胃爱汤而吐亦止；用化毒汤而贯脓；四圣
散而结靥。
一小儿吐逆作泻，腹胀烦渴，痘出不快，手指微冷，用
七味白术散，而诸症退；用四圣散，而诸痘出；用人参蝉蜕散，而诸痘靥。
一小儿吐逆腹胀，发热作渴，大便干臭，此因肠胃实热，用竹茹汤加黄连、枳壳，诸症稍退，用紫草快 汤，疮
势顿发，如期而靥。
一小儿痘出甚密，呕逆饮冷，手足并热，此胃经热甚，先用葛根麦门冬散，一剂热症顿退；又用泻黄散末一钱，用
米饭调服而安；用白术散而痊。
人参胃爱散 治痘疮已发未发，吐泻不止，不思饮食，或吐逆等症。
人参 藿香 紫苏 甘草（炒） 丁香 茯苓 木瓜（各等分） 糯米
上每服三钱，姜、枣水煎。
葛根麦门冬散 治热毒 疹，头痛壮热，心神烦闷，乱吐逆者。（方见顶陷心烦）
按∶此阳明胃经之药也，外除表邪，内清胃火，兼补元气。若非发热作渴，表里俱实者，不可用。若表里俱虚而发
热作渴，宜用人参麦门冬散。
七味竹茹汤
橘红 半夏（各等分） 白茯苓（二分） 甘草 竹茹 黄连（姜炒） 葛根（各二分）
上姜水煎服。
人参蝉蜕散 治小便不利，痘疮不发，烦躁作渴，切牙喘满。
人参 蝉蜕 白芍药 木通 赤芍药 甘草 紫草茸
上每服三四钱，水煎。
橘皮半夏汤
橘皮 半夏（等分）
上每服三钱，姜、枣水煎。
化 汤（方见水痘麻痘）
紫草快 汤（方见痘陷心烦）
六君子汤（方见痘腹胀）
导赤散（方见风邪搏于肌肉）
十一味木香散
十二味异功散（二方见痘灰白色）
六味地黄丸
七味白术散（二方见发热属阴阳）
四圣散（方见涕唾稠粘）
五味异功散（方见寒战切牙）
民间流传的方剂记载：痘疮出现呕吐逆乱且无痰者，使用益黄散。若有痰，使用二陈汤或橘皮汤、半夏汤，若症状不止可加丁香。若呕吐兼腹泻，也适宜用益黄散，以及陈氏木香散、异功散。若呕吐且身体发热、烦躁口渴，腹部胀满、气短急促，大小便涩滞且色赤，应当通利小便。
我认为前述病症中，若手足均冷，口渴想喝热汤，或腹部作痛，这是中气虚寒所致，适宜用益黄散。若手足不冷，呕吐逆乱且有痰涎，这是中气虚弱所致，适宜用橘皮半夏汤。若手足均热，这是热毒壅滞所致，适宜用导赤散。若口干想喝乳汁但喝不饱足，这是胃经气热所致，适宜用竹薷汤（即竹茹汤）。若呕吐逆乱拒绝吃奶，或吐出酸臭乳秽物，这是脾气虚弱导致乳食停滞所致，适宜用枳术丸。
有一个小儿出痘颜色不红活，手足微冷，这是阳气虚弱所致，先用五味异功散加干姜、肉桂服用两剂，然后去掉干姜，加入木香，又服两剂而痊愈。
有一个十一岁小儿出痘，第九天呕吐逆乱不能进食，手足均冷，这是阳气虚寒到了极点，用十二味异功散，一剂就立刻痊愈，后用五味异功散使病情安定，再用参四圣散使痘疮结痂。
有一个小儿呕吐逆乱并感到口渴，手足均热，这是胃经有热所致，用竹茹汤使热势稍止；用人参胃爱汤使呕吐停止；用化毒汤使痘疮贯脓；用四圣散使痘疮结痂。
有一个小儿呕吐逆乱并腹泻，腹部胀满烦躁口渴，痘疮出不顺畅，手指微冷，用七味白术散，各种症状消退；用四圣散，各种痘疮发出；用人参蝉蜕散，各种痘疮结痂。
有一个小儿呕吐逆乱且腹部胀满，发热并感到口渴，大便干燥发臭，这是因为肠胃实热所致，用竹茹汤加黄连、枳壳，各种症状稍退，用紫草快痘汤，痘疮势头顿时发出，如期结痂。
有一个小儿痘疮出得非常密集，呕吐逆乱想喝冷水，手足均热，这是胃经热邪极盛，先用葛根麦门冬散，一剂后热症顿时消退；又用泻黄散末一钱，用米饭调服而安定；用白术散而痊愈。
人参胃爱散：治疗痘疮已发或未发，呕吐腹泻不止，不想饮食，或呕吐逆乱等症状。
组成：人参、藿香、紫苏、甘草（炒）、丁香、茯苓、木瓜（各等分）、糯米。
用法：每次服用三钱，用生姜、大枣水煎服。
葛根麦门冬散：治疗热毒引起的疹病，头痛高热，心神烦躁闷乱，频繁呕吐逆乱。（方剂见“顶陷心烦”条）
按语：这是阳明胃经的药物，外除表邪，内清胃火，兼补元气。如果不是发热口渴、表里俱实的证候，不可使用。如果表里俱虚而发热口渴，适宜用人参麦门冬散。
七味竹茹汤
组成：橘红、半夏（各等分）、白茯苓（二分）、甘草、竹茹、黄连（姜炒）、葛根（各二分）。
用法：用姜水煎服。
人参蝉蜕散：治疗小便不利，痘疮不发，烦躁口渴，咬牙气喘胸满。
组成：人参、蝉蜕、白芍药、木通、赤芍药、甘草、紫草茸。
用法：每次服用三四钱，水煎服。
橘皮半夏汤
组成：橘皮、半夏（等分）。
用法：每次服用三钱，用生姜、大枣水煎服。
化毒汤（方剂见“水痘麻痘”条）
紫草快痘汤（方剂见“痘陷心烦”条）
六君子汤（方剂见“痘腹胀”条）
导赤散（方剂见“风邪搏于肌肉”条）
十一味木香散
十二味异功散（两个方剂见“痘灰白色”条）
六味地黄丸
七味白术散（两个方剂见“发热属阴阳”条）
四圣散（方剂见“涕唾稠粘”条）
五味异功散（方剂见“寒战切牙”条）
The folk-transmitted prescriptions state: For smallpox accompanied by vomiting and regurgitation without phlegm, use Yihuang San (Benefit the Yellow Powder). If there is phlegm, use Erchen Tang (Two-Cured Decoction), or Jupi Tang (Tangerine Peel Decoction) or Banxia Tang (Pinellia Decoction); if symptoms persist, add Dingxiang (Clove). If vomiting is accompanied by diarrhea, Yihuang San (Benefit the Yellow Powder), as well as Chen's Muxiang San (Costus Powder by Master Chen) and Yigong San (Five-Ingredient Benefit the Work Powder) are also suitable. If vomiting occurs with fever, restlessness, thirst, abdominal distension, shortness of breath, and scanty, dark red urine and stool, one should promote urination.
I believe that in the aforementioned conditions, if both hands and feet are cold, the patient is thirsty and desires hot drinks, or experiences abdominal pain, this indicates deficiency-cold of the Middle Qi (Middle Jiao energy), and Yihuang San (Benefit the Yellow Powder) is suitable. If hands and feet are not cold, but vomiting and regurgitation involve phlegm-saliva, this indicates weakness of the Middle Qi, and Jupi Banxia Tang (Tangerine Peel and Pinellia Decoction) is suitable. If both hands and feet are hot, this indicates stagnation of heat-toxin, and Daochi San (Guide Out Redness Powder) is suitable. If the mouth is dry and the desire to drink milk is insatiable, this indicates qi-heat in the Stomach Meridian, and Zhuru Tang (Bamboo Juice Decoction) is suitable. If vomiting and regurgitation prevent feeding, or if sour, foul-smelling milk residue is vomited, this indicates spleen-qi deficiency leading to food stagnation, and Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) is suitable.
A child presented with smallpox lesions that were not vibrant red, with slightly cold hands and feet; this indicated deficiency of yang qi. Initially, Wutong Yigong San (Five-Ingredient Benefit the Work Powder) was administered with Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark) for two doses. Then, Ganjiang was removed, Muxiang (Costus Root) was added, and after another two doses, the child recovered.
An eleven-year-old child developed smallpox. On the ninth day, he suffered from vomiting, regurgitation, inability to eat, and cold hands and feet; this indicated extreme deficiency-cold of yang qi. Shierwei Yigong San (Twelve-Ingredient Benefit the Work Powder) was used, resulting in immediate recovery after one dose. Subsequently, Wutong Yigong San (Five-Ingredient Benefit the Work Powder) stabilized the condition, and Shengsan San (Four-Sage Powder) facilitated scabbing.
A child presented with vomiting, regurgitation, thirst, and hot hands and feet; this indicated heat in the Stomach Meridian. Zhuru Tang (Bamboo Juice Decoction) slightly stopped the heat; Ren Shen Wei Ai Tang (Ginseng Stomach-Loving Decoction) stopped the vomiting; Huadu Tang (Resolve Toxin Decoction) promoted suppuration; and Shengsan San (Four-Sage Powder) facilitated scabbing.
A child presented with vomiting, regurgitation, diarrhea, abdominal distension, restlessness, thirst, slow eruption of smallpox, and slightly cold fingers. Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) caused all symptoms to recede; Shengsan San (Four-Sage Powder) promoted the eruption of all lesions; and Renshen Chantui San (Ginseng and Cicada Slough Powder) facilitated scabbing.
A child presented with vomiting, regurgitation, abdominal distension, fever, thirst, and dry, foul-smelling stools; this was due to excess-heat in the intestines and stomach. Zhuru Tang (Bamboo Juice Decoction) was used with Huanglian (Coptis Rhizome) and Zhike (Immature Bitter Orange), causing slight relief of symptoms. Zicao Kuai Dou Tang (Arnebia Rapid Smallpox Decoction) caused the rash to erupt vigorously, and it scabbed on schedule.
A child presented with very dense smallpox lesions, vomiting, regurgitation, desire for cold drinks, and hot hands and feet; this indicated severe heat in the Stomach Meridian. Gegen Maidong San (Kudzu and Ophiopogon Powder) was used first, causing heat symptoms to recede immediately after one dose. Then, Xiehuang San (Drain the Yellow Powder) powder, one qian, was taken mixed with rice paste, bringing stability. Baizhu San (Atractylodes Macrocephala Powder) led to recovery.
Ren Shen Wei Ai San (Ginseng Stomach-Loving Powder): Treats smallpox whether erupted or not, with persistent vomiting and diarrhea, loss of appetite, or vomiting and regurgitation.
Ingredients: Ren Shen (Ginseng Radix), Huo Xiang (Patchouli Herba), Zi Su (Perilla Fructus), Gan Cao (Licorice Radix et Rhizoma, stir-baked), Ding Xiang (Caryophylli Flos), Fu Ling (Poria), Mugua (Chaenomelis Fructus) (all in equal parts), Nuomi (Oryza Sativa Glutinosa Semen).
Usage: Take 3 qian per dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) in water.
Gegen Maidong San (Kudzu and Ophiopogon Powder): Treats rashes caused by heat-toxin, headache, high fever, mental restlessness and oppression, and frequent vomiting and regurgitation. (Formula see "Depressed Crown with Restless Heart" entry.)
Note: These are herbs for the Yangming Stomach Meridian. They expel exterior pathogens externally, clear stomach fire internally, and supplement primordial qi. They should not be used unless there are fever and thirst with excess conditions in both interior and exterior. If there are deficiency conditions in both interior and exterior with fever and thirst, Ren Shen Maidong San (Ginseng and Ophiopogon Powder) is suitable.
Qiwei Zhuru Tang (Seven-Ingredient Bamboo Juice Decoction)
Ingredients: Ju Hong (Citri Reticulatae Pericarpium Rubrum), Ban Xia (Pinelliae Rhizoma) (equal parts), Bai Fu Ling (Poria with Hostwood, 2 fen), Gan Cao (Licorice Radix et Rhizoma), Zhu Ru (Bambusae Caulis in Taenia), Huang Lian (Coptidis Rhizoma, stir-fried with ginger juice), Ge Gen (Puerariae Lobatae Radix) (each 2 fen).
Usage: Decoct with ginger water and take orally.
Renshen Chantui San (Ginseng and Cicada Slough Powder): Treats difficult urination, failure of smallpox to erupt, restlessness and thirst, teeth-grinding, and wheezing with chest fullness.
Ingredients: Ren Shen (Ginseng Radix), Chan Tui (Cicadae Periostracum), Bai Shao Yao (Paeoniae Radix Alba), Mu Tong (Akebiae Caulis), Chi Shao Yao (Paeoniae Radix Rubra), Gan Cao (Licorice Radix et Rhizoma), Zicao Rong (Arnebiae Radix et Rhizoma).
Usage: Take 3-4 qian per dose, decoct in water.
Jupi Banxia Tang (Tangerine Peel and Pinellia Decoction)
Ingredients: Ju Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma) (equal parts).
Usage: Take 3 qian per dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) in water.
Huadu Tang (Resolve Toxin Decoction) (Formula see "Water Pox and Chickenpox" entry.)
Zicao Kuai Dou Tang (Arnebia Rapid Smallpox Decoction) (Formula see "Depressed Smallpox with Restless Heart" entry.)
Liu Junzi Tang (Six-Gentleman Decoction) (Formula see "Smallpox Abdominal Distension" entry.)
Daochi San (Guide Out Redness Powder) (Formula see "Wind Pathogen Contending in Muscles" entry.)
Shiyiwei Muxiang San (Eleven-Ingredient Costus Powder)
Shierwei Yigong San (Twelve-Ingredient Benefit the Work Powder) (Both formulas see "Ashen-White Smallpox" entry.)
Liuli Dihuang Wan (Six-Ingredient Rehmannia Pill)
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) (Both formulas see "Fever Belonging to Yin and Yang" entry.)
Shengsan San (Four-Sage Powder) (Formula see "Thick and Sticky Nasal Discharge and Saliva" entry.)
Wutong Yigong San (Five-Ingredient Benefit the Work Powder) (Formula see "Chills and Teeth-Grinding" entry.)