【方歌】痘痈毒留经络中，发无定处肿不红，留于肌肉为治易，
结于骨节难成功。
【注】此证因出大痘，浆灌不足，以致毒浆不得透发，留结经
络之中，随处可生。小如李者为毒，大如桃者为痈，漫
肿不红，亦无焮痛，身热多烦。若生单个者，毒在肌肉
属顺，易治；连发数处者，船小载重属险；若结于骨节
之间，或成对发出者，其毒已盛，溃破之后，渗泄气血
，不能敛口属逆。初发不可强消，俱宜服透脓散，外敷
乌龙膏；脓熟针之，加味太乙膏贴之；若气血虚弱者，
兼服保元汤。溃后潮热全退，毒气方净，否则他处又发
。忌生冷、硬面、发物。
方剂：保元汤
组成：人参 白术（土炒）
当归 黄耆（各一钱）
甘草（炙，三分）
生姜一片，红枣肉二枚，水二钟，煎八分，食远服
。
【方歌】保元汤补真元气，脾胃虚弱服更宜，人参白术炙甘草，
当归姜枣共黄耆。
又方：透脓散、乌龙膏（见肿疡门）
加味太乙膏（见溃疡门）
【方歌】葡萄疫同葡萄状，感受疠疫郁凝生，遍身发点青紫色，
毒攻牙齿类疳形。
【注】此证多因婴儿感受疠疫之气，郁于皮肤，凝结而成。大
、小青紫斑点色，状如葡萄，发于遍身，惟腿胫居多；
甚则邪毒攻胃，以致牙龈腐烂，臭味出血，形类牙疳，
而青紫斑点，其色反淡，久则令人虚羸。初起宜服羚羊
角散，久虚者宜服胃脾汤，米疳水漱口。以非疳散日擦
四、五次即效。近见中年之人下虚者，亦患此证，治法
同前。
方剂：羚羊角散
组成：羚羊角（镑） 麦冬（去心）
黄芩 知母
牛蒡子（炒，研） 防风
元参（各八分） 甘草（生，二分）
水二钟，竹叶十片，煎六分，食远服。
【方歌】羚羊角散麦冬芩，知蒡防风草元参，葡萄疫发初宜服，
煎加竹叶效如神。
又方：胃脾汤
组成：白术（土炒） 远志（去心）
麦冬（去心） 沙参
茯神 陈皮（各六分）
五味子 甘草（炙，各五分）
水二钟，煎六分，食远服。虚弱自汗者，去沙参，
加人参、黄耆各五分。
【方歌】胃脾汤治葡萄疫，日久虚添羸弱宜，术远麦冬五味子，
沙参甘草茯陈皮。
又方：非疳散
组成：冰片（四分）
人中白（〔火段〕去臭气，存性）
五倍子（炒茶褐色，存性，各一两）
共研细末；先用米泔水漱口，后擦此药。
【方歌】非疳中白〔火段〕五倍，二味同研冰片兑，医治诸疳患
处擦，清热止疼去臭秽。
【方歌】痘痈的毒邪滞留于经络之中，发病部位不固定，肿胀但不发红；若毒邪停留在肌肉层面则治疗容易，若结聚在骨节之间则难以治愈。
【注】这种病症是因为出痘时浆液灌注不足，导致毒邪和浆液无法透发，从而留结在经络之中，随处都可能发生。小如李子大小的称为“毒”，大如桃子大小的称为“痈”，表现为漫肿且不红，也没有红肿热痛的感觉，伴有身体发热、烦躁不安。如果只生单个病灶，说明毒邪在肌肉层面，属于顺证，容易治疗；如果连续在多处发作，如同小船装载重物，属于险证；如果结聚在骨节之间，或者成对发出，说明毒邪已经旺盛，溃破之后，气血渗出泄漏，伤口不能愈合，属于逆证。初发时不可强行消散，都适宜服用透脓散，外用敷贴乌龙膏；脓液成熟后用针穿刺排脓，再加味太乙膏贴敷；如果气血虚弱的人，兼服保元汤。溃破后潮热完全消退，毒气才算干净，否则会在其他部位再次发作。忌食生冷食物、硬面条以及发物。
方剂：保元汤
组成：人参、白术（用土炒制）、当归、黄耆（黄芪）（各一钱）、甘草（炙过，三分）、生姜一片、红枣肉两枚。用水二钟，煎至八分，饭后服用。
【方歌】保元汤能补益真元之气，脾胃虚弱者服用更为适宜，由人参、白术、炙甘草、当归、生姜、红枣共同配合黄耆组成。
又一方：透脓散、乌龙膏（见肿疡门章节）
加味太乙膏（见溃疡门章节）
【方歌】葡萄疫的症状同葡萄状相似，因感受疠疫之气郁结凝滞而生，遍身发出青紫色的斑点，毒邪攻冲牙齿，形态类似疳积。
【注】这种病症多因婴儿感受疠疫之气，郁结于皮肤，凝结而成。大小不一的青紫斑点，形状像葡萄，发于遍身，多见于腿胫部位；严重时邪毒攻冲胃部，导致牙龈腐烂，有臭味并出血，形态类似牙疳，而青紫斑点的颜色反而变淡，时间久了会让人变得虚弱消瘦。初起时适宜服用羚羊角散，久病体虚者适宜服用胃脾汤，用米泔水漱口。使用非疳散每日擦拭四到五次即可见效。近来见到中年人体质下虚的人也患此病，治疗方法同上。
方剂：羚羊角散
组成：羚羊角（镑片）、麦冬（去心）、黄芩、知母、牛蒡子（炒熟研碎）、防风、元参（玄参）（各八分）、甘草（生用，二分）。用水二钟，竹叶十片，煎至六分，饭后服用。
【方歌】羚羊角散包含麦冬、黄芩，知母、牛蒡子、防风、甘草、元参，葡萄疫初起适宜服用，煎煮时加入竹叶效果如神。
又一方：胃脾汤
组成：白术（用土炒制）、远志（去心）、麦冬（去心）、沙参、茯神、陈皮（各六分）、五味子、甘草（炙过，各五分）。用水二钟，煎至六分，饭后服用。体质虚弱自汗的人，去掉沙参，加人参、黄耆各五分。
【方歌】胃脾汤治疗葡萄疫，日久导致虚弱羸弱者适宜服用，由白术、远志、麦冬、五味子、沙参、甘草、茯神、陈皮组成。
又一方：非疳散
组成：冰片（四分）、人中白（煅烧去臭气，保留药性）、五倍子（炒至茶褐色，保留药性，各一两）。共同研成细末；先用米泔水漱口，然后擦拭此药。
[Prescription Verse] The toxin of carbuncle (carbuncle) remains within the meridians, appearing at unpredictable locations with swelling but no redness; if it stays in the muscles, treatment is easy, but if it knots in the joints, success is difficult.
[Annotation] This condition arises because the pustules during smallpox were insufficiently filled with fluid, causing the toxin and fluid to fail to emerge, thus remaining and knotting within the meridians, potentially occurring anywhere. Those small as a plum are termed "toxin" (du), while those large as a peach are termed "carbuncle" (yong). They present as diffuse swelling without redness, nor with burning pain, accompanied by fever and irritability. If a single lesion appears, the toxin is in the muscles, which is a favorable pattern (shun) and easy to treat; if multiple lesions appear consecutively, it is like a small boat carrying heavy weight, indicating a dangerous pattern (xian); if it knots between joints or appears in pairs, the toxin is abundant, and after ulceration, the leakage of qi and blood prevents wound closure, indicating an unfavorable pattern (ni). At the initial stage, do not force resolution; all cases should take Tou Nong San (Penetrating Pus Powder) externally applied with Wu Long Gao (Black Dragon Ointment); once pus matures, puncture with a needle and apply Jia Wei Tai Yi Gao (Modified Tai Yi Plaster); for those with deficient qi and blood, concurrently take Bao Yuan Tang (Protect the Origin Decoction). After ulceration, tidal fever must completely subside before the toxin is considered cleared; otherwise, it will reappear elsewhere. Avoid raw/cold foods, hard noodles, and triggering foods.
Formula: Bao Yuan Tang (Protect the Origin Decoction)
Composition: Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix) (each 1 qian), Gan Cao (Licorice Radix et Rhizoma, honey-fried, 3 fen), Sheng Jiang (Zingiberis Rhizoma Recens, one slice), Hong Zao (Jujubae Fructus, flesh, two pieces). Use two zhong of water, decoct to eight fen, take far from meals.
[Prescription Verse] Bao Yuan Tonifies true yuan qi, especially suitable for spleen-stomach deficiency; Ginseng, Atractylodes, honey-fried Licorice, together with Angelica, Ginger, and Jujuba complement Astragalus.
Another Formula: Tou Nong San (see Chapter on Swelling and Ulceration), Wu Long Gao (see Chapter on Swelling and Ulceration).
Jia Wei Tai Yi Gao (see Chapter on Ulceration).
[Prescription Verse] Grape plague resembles grapes, arising from epidemic qi stagnation and condensation; purple-blue spots erupt over the body, toxin attacks teeth resembling canker sores.
[Annotation] This condition often occurs when infants contract epidemic qi, which stagnates in the skin and condenses into formation. Large and small purple-blue spots, shaped like grapes, erupt over the body, mostly on the lower legs; severely, pathogenic toxin attacks the stomach, causing gum rot, foul odor, and bleeding, resembling dental canker (ya gan), while the purple-blue spots become paler, leading to emaciation over time. At onset, Ling Yang Jiao San (Antelope Horn Powder) is suitable; for chronic deficiency, Wei Pi Tang (Stomach-Spleen Decoction) is suitable, rinsing with rice wash water. Applying Fei Gan San (Non-Canker Powder) four to five times daily yields quick results. Recently, middle-aged individuals with lower jiao deficiency have also suffered this condition, treated similarly.
Formula: Ling Yang Jiao San (Antelope Horn Powder)
Composition: Ling Yang Jiao (Saiga Tataricae Cornu, sliced), Mai Dong (Ophiopogonis Radix, heart removed), Huang Qin (Scutellariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Niu Bang Zi (Arctii Fructus, stir-fried and crushed), Fang Feng (Saposhnikoviae Radix), Xuan Shen (Scrophulariae Radix) (each 8 fen), Gan Cao (Licorice Radix et Rhizoma, raw, 2 fen). Use two zhong of water, ten leaves of Zhu Ye (Bambusae Folium), decoct to six fen, take far from meals.
[Prescription Verse] Antelope Horn Powder contains Ophiopogon, Scutellaria, Anemarrhena, Arctium, Saposhnikovia, Licorice, and Scrophularia; suitable for early grape plague, adding Bamboo Leaves makes efficacy divine.
Another Formula: Wei Pi Tang (Stomach-Spleen Decoction)
Composition: Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Yuan Zhi (Polygalae Radix, heart removed), Mai Dong (Ophiopogonis Radix, heart removed), Sha Shen (Glehniae Radix), Fu Shen (Poria with Hostwood), Chen Pi (Citri Reticulatae Pericarpium) (each 6 fen), Wu Wei Zi (Schisandrae Fructus), Gan Cao (Licorice Radix et Rhizoma, honey-fried, each 5 fen). Use two zhong of water, decoct to six fen, take far from meals. For weak persons with spontaneous sweating, remove Glehnia, add Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) each 5 fen.
[Prescription Verse] Stomach-Spleen Decoction treats grape plague, suitable for long-term weakness and emaciation; Atractylodes, Polygala, Ophiopogon, Schisandra, Glehnia, Licorice, Poria, and Citrus peel.
Another Formula: Fei Gan San (Non-Canker Powder)
Composition: Bing Pian (Borneolum Syntheticum, 4 fen), Ren Zhong Bai (Hominis Urinae Depuratum, calcined to remove odor, preserving nature), Wu Bei Zi (Gallae Chinensis, stir-fried to tea-brown color, preserving nature, each 1 liang). Grind into fine powder; first rinse mouth with rice wash water, then apply this medicine.
[Prescription Verse] Non-Canker uses Calcined Human Urine Salt and Gallnut, ground together with Borneol; rub on various canker sites to clear heat, stop pain, and remove foul odor.