痘疮日期,有太过不及,故兹不以朝数定限。假如起胀迟者,则虽起胀日期,犹当
类采见点时药,灌脓迟者,则虽灌脓日期。犹当类采起胀时药,每限更分气虚血热两条
药例,使便于按门采用。二症相兼者,则二症药相参采用。如此,则期之太过不及,与
候之气血虚实,备得其宜矣。
重感风寒,宜独活、羌活、麻黄、细辛、桂枝、防风、干葛、柴胡、僵蚕、枳壳、橘红、紫
苏、川芎、白芷、蝉蜕、荆芥、葱白,生姜之类,随候采用。
轻冒风热,宜防风、荆芥、全胡、陈皮、川芎、天麻、牛蒡、桔梗、杏仁、甘草、蝉
脱、连翘、玄参、木通、山楂、芫荽之类,随候采用。
气虚症,宜防风、荆芥、川芎、桔梗、陈皮、甘草、茯苓、苏叶、蝉蜕、僵蚕、穿
山甲、胡荽、笋尖、桑虫、酒酿、鸡冠血之类,随候采用。或气弱甚而不能出者,于发
表药中加参、桂少许。
血热症,宜升麻、干葛、防风、荆芥、蝉蜕、天虫、川芎、丹皮、红花、赤芍、生
地、紫草、犀角、羚羊角、穿山甲、桑虫、鸡冠血、牛蒡、连翘、玄参、桔梗、甘草、
山楂、陈皮、腹皮、木通、笋尖、芦根、大黄、石膏之类,随候采用。血热痘症,用羚
羊角较犀角更佳。盖犀角凉心而毒则凝滞,羚羊角则凉肝而治血热清肺而肃上焦,又能
上安心而益气,下除热而益阴,且性散结而不滞,故尤效耳。
痘疮的病程日期,有进展过快或过慢的情况,因此不以具体的天数作为严格限制。假如起胀(痘疹隆起)迟缓者,即使到了起胀的日期,仍应当参考见点(痘疹初现)时的用药原则;灌脓(痘疹化脓)迟缓者,即使到了灌脓的日期,仍应当参考起胀时的用药原则。每个阶段又分为气虚和血热两种证型的用药范例,以便于按类别选用。若两种症状兼夹出现,则将两症的药物参合使用。如此,则对于病程时间的太过与不及,以及候证的气血虚实,都能得到适宜的处理。
若重感风寒,宜选用独活、羌活、麻黄、细辛、桂枝、防风、干葛、柴胡、僵蚕、枳壳、橘红、紫苏、川芎、白芷、蝉蜕、荆芥、葱白、生姜等药物,根据具体证候选用。
若轻冒风热,宜选用防风、荆芥、全胡荽、陈皮、川芎、天麻、牛蒡子、桔梗、杏仁、甘草、蝉蜕、连翘、玄参、木通、山楂、芫荽等药物,根据具体证候选用。
气虚证,宜选用防风、荆芥、川芎、桔梗、陈皮、甘草、茯苓、苏叶、蝉蜕、僵蚕、穿山甲、胡荽、笋尖、桑虫、酒酿、鸡冠血等药物,根据具体证候选用。如果气弱严重导致痘毒不能透发者,可在发表药中加入少量人参、桂枝。
血热证,宜选用升麻、干葛、防风、荆芥、蝉蜕、天虫、川芎、丹皮、红花、赤芍、生地、紫草、犀角、羚羊角、穿山甲、桑虫、鸡冠血、牛蒡子、连翘、玄参、桔梗、甘草、山楂、陈皮、腹皮、木通、笋尖、芦根、大黄、石膏等药物,根据具体证候选用。治疗血热型痘疮,使用羚羊角比犀角效果更好。因为犀角虽能凉心,但易致毒邪凝滞;而羚羊角能凉肝,治疗血热,清肺肃降上焦,又能上安心神并益气,下除热邪并益阴,且其性散结而不凝滞,所以疗效更佳。
The duration of smallpox varies, with some cases progressing too fast and others too slow; therefore, strict limits based on days are not set. If the swelling stage is delayed, even when the scheduled time for swelling arrives, one should still refer to the medicinal principles used during the initial appearance stage. If the suppuration stage is delayed, even when the scheduled time for suppuration arrives, one should still refer to the medicinal principles used during the swelling stage. Each stage is further divided into two categories of prescriptions: Qi deficiency and Blood heat, facilitating selection by category. If both symptoms coexist, medicines from both categories should be combined. In this way, both the timing (whether too early or too late) and the condition of Qi and Blood (deficiency or excess) can be appropriately managed.
In cases of severe contraction of Wind-Cold, herbs such as Radix Angelicae Pubescentis (Duhuo), Radix Notopterygii (Qianghuo), Herba Ephedrae (Mahuang), Radix Asari (Xixin), Ramulus Cinnamomi (Guizhi), Radix Saposhnikoviae (Fangfeng), Radix Puerariae Lobatae (Gange), Radix Bupleuri (Chaihu), Bombyx Batryticatus (Jiangcan), Fructus Aurantii (Zhiqiao), Pericarpium Citri Reticulatae (Juhong), Folium Perillae (Zisu), Radix Chuanxiong (Chuanxiong), Rhizoma Ligustici Wallichii (Baizhi), Periostracum Cicadae (Chantui), Herba Schizonepetae (Jingjie), Rhizoma Zingiberis Recens (Congbai), and Rhizoma Zingiberis (Shengjiang) are suitable, selected according to the specific syndrome.
In cases of mild contraction of Wind-Heat, herbs such as Radix Saposhnikoviae (Fangfeng), Herba Schizonepetae (Jingjie), Herba Coriandri Sativi (Quan Huchu), Pericarpium Citri Reticulatae (Chenpi), Radix Chuanxiong (Chuanxiong), Rhizoma Gastrodiae (Tianma), Semen Arctii (Niubang), Radix Platycodi (Jiegeng), Semen Armeniacae Amarum (Xingren), Radix Glycyrrhizae (Gancao), Periostracum Cicadae (Chantui), Flos Forsythiae (Lianqiao), Radix Scrophulariae (Xuanshen), Caulis Akebiae (Mutong), Fructus Crataegi (Shanzha), and Herba Coriandri Sativi (Yansui) are suitable, selected according to the specific syndrome.
For Qi deficiency syndromes, herbs such as Radix Saposhnikoviae (Fangfeng), Herba Schizonepetae (Jingjie), Radix Chuanxiong (Chuanxiong), Radix Platycodi (Jiegeng), Pericarpium Citri Reticulatae (Chenpi), Radix Glycyrrhizae (Gancao), Poria (Fuling), Folium Perillae (Suye), Periostracum Cicadae (Chantui), Bombyx Batryticatus (Jiangcan), Squama Manis (Chuanshanjia), Herba Coriandri Sativi (Husu), Bamboo Shoot Tips (Sunjian), Bombyx Mori (Sangchong), Fermented Rice Wine (Jiuniang), and Cock Comb Blood (Jiguanxue) are suitable, selected according to the specific syndrome. If Qi is extremely weak preventing eruption, a small amount of Radix Ginseng (Renshen) and Ramulus Cinnamomi (Guizhi) may be added to the exterior-releasing formulas.
For Blood heat syndromes, herbs such as Radix Cimicifugae (Shengma), Radix Puerariae Lobatae (Gange), Radix Saposhnikoviae (Fangfeng), Herba Schizonepetae (Jingjie), Periostracum Cicadae (Chantui), Bombyx Batryticatus (Tianchong), Radix Chuanxiong (Chuanxiong), Cortex Moutan (Danpi), Flos Carthami (Honghua), Radix Paeoniae Rubra (Chishao), Radix Rehmanniae Preparata (Shengdi), Radix Lithospermi (Zicao), Cornu Rhinocerotis (Xijiao), Cornu Saigae Tataricae (Lingyangjiao), Squama Manis (Chuanshanjia), Bombyx Mori (Sangchong), Cock Comb Blood (Jiguanxue), Semen Arctii (Niubang), Flos Forsythiae (Lianqiao), Radix Scrophulariae (Xuanshen), Radix Platycodi (Jiegeng), Radix Glycyrrhizae (Gancao), Fructus Crataegi (Shanzha), Pericarpium Citri Reticulatae (Chenpi), Pericarpium Citri Reticulatae Viride (Fupi), Caulis Akebiae (Mutong), Bamboo Shoot Tips (Sunjian), Rhizoma Phragmitis (Lugen), Radix Rhei (Dahuang), and Gypsum Fibrosum (Shigao) are suitable, selected according to the specific syndrome. For treating smallpox with Blood heat, Cornu Saigae Tataricae (Lingyangjiao) is superior to Cornu Rhinocerotis (Xijiao). This is because while Xijiao cools the Heart, it may cause toxin stagnation; Lingyangjiao cools the Liver, treats Blood heat, clears the Lungs, descends turbidity in the Upper Jiao, calms the Spirit and tonifies Qi above, removes heat and nourishes Yin below, and its nature disperses nodules without causing stagnation, thus yielding better efficacy.