痘后牙疳毒热攻，口臭龈肿多疼痛，内服清毒凉血饮，外敷中白散极灵。
[注]
痘后生牙疳者，乃余毒未解，上攻牙齿而然也，
初起口臭龈肿，牙缝出血，尚觉疼痛，
甚则色黑腐烂，牙齿脱落，穿腮破颊，蚀透鼻唇，多至不救，
见之须急急调治，内服清毒凉血饮，外敷人中白散。
(清毒凉血饮) 知母 石膏 生地 黄连 当归 赤芍 大黄 山栀子
丹皮 荆芥穗 连翘去心 水煎服。
(方歌)
清毒凉血治牙疳，知母石膏生地连，归芍大黄山栀子，丹皮荆穗连翘煎。
(人中白散)
人中白二钱煆 雄黄八分 冰片四分 硼砂 青黛 儿茶各一钱
共为细末，擦敷患处。
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痘中杂证
舌乃心苗五内通，毒火一犯先见形，赤紫黑肿并舒弄，总以清热犀角平。
[注]
舌为心苗，内通五脏，毒热举发，舌先受之，
或赤或紫，或黑或肿，舒舌弄舌，种种不一，
要皆热留于心而使然也，治宜清热为主，以加味犀角汤治之。
(加味犀角汤)
荆芥 防风 牛蒡子炒 生甘草 桔梗 升麻 犀角 麦冬去心
栀子 黄连 石膏煆 水煎服。
(方歌)
加味犀角能散热，荆防牛蒡同甘桔，升麻犀角麦门冬，栀子黄连石膏捷。
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痘中杂证
咽喉之地司出入，毒火冲炽痛难堪，内用甘桔利咽剂，外吹牛黄散即安。
[注]
咽者饮食之道，喉者呼吸之门，乃最紧要之处，
若痘毒不能发越于外，火热壅塞膈间，上冲咽喉，则或肿痛，或哑呛，
甚而不能呼吸，饮食难入，
速用加味甘桔汤治之，或用加减利咽解毒汤，外用牛黄散吹入肿处。
(加味甘桔汤) 方见失音。
(利咽解毒汤) 防风 山豆根 麦冬去心 牛蒡子炒 黑参 苦桔梗
生甘草 菉豆 水煎服
(方歌)
利咽偋毒用防风，山豆根与麦门冬，牛蒡黑参昔桔梗，甘草菉豆共煎浓。
(牛黄散) 川黄连生 黄蘖生 薄荷各八分 雄黄 火硝 青黛各一分半
牛黄 冰片 硼砂 朱砂各一分 共为细末，每用少许，吹患处。
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痘中杂证
痘疹痊愈后出现的牙疳，是由于余留的毒热之邪向上攻冲所致。症状表现为口臭、牙龈肿胀以及剧烈的疼痛。治疗上，内服清毒凉血饮，外敷中白散（即人中白散），疗效极佳。
[注释]
痘疹之后发生牙疳，是因为体内的余毒未能完全解除，向上攻冲至牙齿而引发的疾病。
初期表现为口臭、牙龈肿胀，牙缝出血，并伴有疼痛感；
严重时则出现牙龈颜色发黑、腐烂，牙齿脱落，甚至穿透腮帮、破损脸颊，侵蚀鼻孔和嘴唇，这种情况大多难以救治。
一旦发现此症，必须立即进行调治，内服清毒凉血饮，外敷人中白散。
【清毒凉血饮】组成：知母、石膏、生地黄、黄连、当归、赤芍药、大黄、山栀子、牡丹皮、荆芥穗、连翘（去心）。以上药材用水煎煮后服用。
【方歌】
清毒凉血治牙疳，知母石膏生地连，归芍大黄山栀子，丹皮荆穗连翘煎。
【人中白散】组成：人中白二钱（煅烧）、雄黄八分、冰片四分、硼砂、青黛、儿茶各一钱。将上述药材共同研磨成细末，直接涂抹擦拭于患处。
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痘疹过程中的其他杂证
舌头是心的外候，与五脏内部相通。当毒火侵犯时，首先会在舌头上显现出征象。若见舌色红赤、紫暗、黑色或肿胀，以及伸舌、弄舌等异常动作，总的原则是以清热泻火、使用犀角来平抑病情为主。
[注释]
舌头是心的苗窍，内部连通五脏。当毒热之邪发作时，舌头最先受到侵害。
表现为舌色或红或紫，或黑或肿，以及伸舌、弄舌等各种不同症状，
这些情况都是由于热邪滞留于心所导致的。治疗应以清热为主，使用加味犀角汤进行治疗。
【加味犀角汤】组成：荆芥、防风、炒牛蒡子、生甘草、桔梗、升麻、犀角、麦冬（去心）、栀子、黄连、煅石膏。以上药材用水煎煮后服用。
【方歌】
加味犀角能散热，荆防牛蒡同甘桔，升麻犀角麦门冬，栀子黄连石膏捷。
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痘疹过程中的其他杂证
咽喉部位主管呼吸与饮食的出入。若毒火冲逆炽盛，会导致难以忍受的疼痛。内服甘桔利咽剂，外用牛黄散吹入患处，即可安宁。
[注释]
咽是饮食通过的通道，喉是呼吸进出的门户，这是人体最紧要的部位。
如果痘毒不能向外透发，导致火热之邪壅塞在膈间，向上冲逆至咽喉，就会出现肿痛，或者声音嘶哑、呛咳；
严重时甚至无法呼吸，饮食难以下咽。
此时应迅速使用加味甘桔汤治疗，或者使用加减利咽解毒汤，同时外用牛黄散吹入肿胀处。
【加味甘桔汤】方剂详情见“失音”章节。
【利咽解毒汤】组成：防风、山豆根、麦冬（去心）、炒牛蒡子、黑参（玄参）、苦桔梗、生甘草、绿豆。以上药材用水煎煮后服用。
【方歌】
利咽解毒用防风，山豆根与麦门冬，牛蒡黑参昔桔梗，甘草菉豆共煎浓。（注：“昔”应为“苦”之误，此处依原文转录但意译时修正为苦桔梗）
【牛黄散】组成：生川黄连八分、生黄柏八分、薄荷八分、雄黄一分半、火硝一分半、青黛一分半、牛黄一分、冰片一分、硼砂一分、朱砂一分。将上述药材共同研磨成细末，每次取少量，吹撒于患处。
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痘疹过程中的其他杂证
The tooth gangrene occurring after smallpox is caused by the upward attack of residual toxic heat. Symptoms include bad breath, swollen gums, and severe pain. Treatment involves internal administration of Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction) and external application of Zhongbai San (Human Urine Deposit Powder), which yields excellent results.
[Note]
Tooth gangrene arising after smallpox occurs because residual toxins in the body have not been fully resolved and attack upwards towards the teeth.
In the early stage, symptoms include bad breath, swollen gums, bleeding from the gum margins, and pain;
In severe cases, the gums turn black and rot, teeth fall out, and the condition may penetrate the cheeks, damage the face, and erode the nose and lips. Such cases are often incurable.
Upon observing this condition, immediate treatment is required: internally administer Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction) and externally apply Renzhongbai San (Human Urine Deposit Powder).
[Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction)] Ingredients: Anemarrhenae Rhizoma (Zhimu), Gypsum Fibrosum (Shigao), Rehmanniae Radix Recens (Shengdi), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Rubra (Chishao), Rheii Radix et Rhizoma (Dahuang), Gardeniae Fructus (Shanzhizi), Moutan Cortex (Danpi), Schizonepetae Spica (Jingjiesui), Forsythiae Fructum (Lianqiao) with heart removed. Decoct in water and take orally.
[Prescription Song]
Qingdu Liangxue treats tooth gangrene, Zhi Mu, Shi Gao, Sheng Di, Lian combined,
Gui, Shao, Da Huang, Shan Zhi Zi, Dan Pi, Jing Sui, Lian Qiao decocted.
[Renzhongbai San (Human Urine Deposit Powder)] Ingredients: Human Urine Deposit (Ren Zhong Bai) 2 qian (calcined), Realgar (Xiong Huang) 8 fen, Borneolum Syntheticum (Bing Pian) 4 fen, Borax (Peng Sha), Indigo Naturalis (Qing Dai), Camellia Seed Tea (Er Cha) each 1 qian. Grind all into a fine powder and rub/apply to the affected area.
%
Miscellaneous syndromes during smallpox
The tongue is the sprout of the Heart and connects internally with the five zang organs. When toxic fire invades, it first manifests on the tongue. Whether the tongue appears red, purple, black, or swollen, or exhibits abnormal movements like protruding or playing with the tongue, the general principle is to clear heat and use Rhinoceros Horn (Xi Jiao) to calm the condition.
[Note]
The tongue is the sprout of the Heart and connects internally with the five zang organs. When toxic heat erupts, the tongue is affected first.
It may appear red, purple, black, or swollen, or exhibit various abnormalities such as protruding or playing with the tongue.
All these conditions are caused by heat lingering in the Heart. Treatment should focus on clearing heat, using Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction).
[Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction)] Ingredients: Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng),炒牛蒡子 (Chao Niubangzi - Stir-fried Arctii Fructus), Raw Licorice Root (Sheng Gancao), Platycodonis Radix (Jiegeng), Cimicifugae Rhizoma (Shengma), Rhinoceros Horn (Xi Jiao), Ophiopogonis Radix (Maidong) with heart removed, Gardeniae Fructus (Zhizi), Coptidis Rhizoma (Huanglian), calcined Gypsum Fibrosum (Huan Shi Gao). Decoct in water and take orally.
[Prescription Song]
Jiawei Xijiao can dissipate heat, Jingjie, Fangfeng, Niubang together with Gancao and Jiegeng,
Shengma, Xi Jiao, Maidong, Zhizi, Huanglian, Shi Gao act swiftly.
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Miscellaneous syndromes during smallpox
The throat and pharynx govern the entry and exit of air and food. If toxic fire rushes and blazes fiercely, it causes unbearable pain. Internally using Ganjie Wanjie Ji (Licorice and Platycodon Throat-Relieving Agent), and externally blowing Niu Huang San (Calculus Bovis Powder) into the affected area brings immediate relief.
[Note]
The pharynx is the pathway for food and drink, and the larynx is the gate for respiration; this is the most critical area.
If the smallpox toxin cannot vent outward, causing fire and heat to obstruct between the diaphragm and rush upwards to the throat, it results in swelling and pain, hoarseness, or choking;
In severe cases, breathing becomes impossible, and swallowing food is difficult.
Quickly use Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction) for treatment, or use Jiajian Liyan Jiedu Tang (Modified Throat-Relieving and Toxin-Clearing Decoction), while externally blowing Niu Huang San (Calculus Bovis Powder) into the swollen area.
[Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction)] See formula under "Loss of Voice".
[Liyan Jiedu Tang (Throat-Relieving and Toxin-Clearing Decoction)] Ingredients: Saposhnikoviae Radix (Fangfeng), Sophorae Tonkinensis Radix (Shandougen), Ophiopogonis Radix (Maidong) with heart removed, stir-fried Arctii Fructus (Chao Niubangzi), Black Ginseng (Heishen - usually refers to Prepared Scrophulariae Radix or similar dark-tonic herbs in this context, often Xuan Shen), Bitter Platycodon Root (Ku Jiegeng), Raw Licorice Root (Sheng Gancao), Mung Bean (Lv Dou). Decoct in water and take orally.
[Prescription Song]
Liyan Jiedu uses Fangfeng, Shandougen and Maidong, Niubang, Heishen, Ku Jiegeng,
Gancao and Lv Dou decocted thickly.
[Niu Huang San (Calculus Bovis Powder)] Ingredients: Raw Chuan Lianlian (Chuan Huanglian) 8 fen, Raw Phellodendri Cortex (Huangbo) 8 fen, Menthae Haplocalycis Herba (Bohe) 8 fen, Realgar (Xiong Huang) 1.5 fen, Saltpeter (Huoxiao) 1.5 fen, Indigo Naturalis (Qing Dai) 1.5 fen, Calculus Bovis (Niu Huang) 1 fen, Borneolum Syntheticum (Bing Pian) 1 fen, Borax (Peng Sha) 1 fen, Cinnabar (Zhusha) 1 fen. Grind all into a fine powder. Use a small amount each time, blown into the affected area.
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Miscellaneous syndromes during smallpox