发热三朝渐见点，热减形疏色润红，应出不出出犹热，已出复稳涌出凶，
赤紫黑白分亮黯，平板稠连辨紧松，当审风寒毒火制，气血虚失领载能。
[注]
发热三朝渐渐见点者，谓见点不疾不徐也，
热减者，谓痘出齐而热减退也，
形疏者，谓痘稀疏颗粒分明也，
色润红者，谓色红而润泽也，皆见点顺痘也，
应出不出者，谓发热三日之后而不见点，此毒伏于内也，
出犹热者，痘已出齐，而犹身热不退，此毒热盛也，
已出复稳者，谓痘已见点，复稳藏不见，此毒陷内攻也，
涌出者，谓发热不待三日，其痘一齐涌出，此毒火迅烈也，
此皆逆而主凶之痘也，
赤紫黑白者，谓痘色红为正，或深红赤色，深赤紫色，
紫甚黑色，不红白色，皆非正色也，
分亮黯者，谓非正色之痘，又当分亮黯而取治焉，亮者多虚，黯者多实，
赤紫黑色明亮者，尚有活动可治之机，
若滞黯则为毒热凝滞而不行也，
色白亮者，乃气血因虚不荣也，
白而黯者，谓气血为毒所制也，
平板稠连者，谓痘形平塌不起，板□不绽，或稠密成攒，
联系不分，皆非正形也，
辨紧松者，谓非正形之痘，当辨紧松而取治焉，
紧松者，根脚之紧松也，紧者毒滞，松者毒松，
平板稠连，根形松绽，尚有活动可治之机，
若根形紧束，则为毒盛瘀滞，难治之痘也，当审风寒毒火，
制者，谓已上痘之形色各有所困，当审其为风寒外郁，火毒内锢也，
气血虚失领载能者，谓或因气虚不能领毒，血虚不能载毒，
使毒不能发于肌表，而失领载之能也。
%
苏解散 归宗汤 保元汤 升麻葛根汤
应出不出表苏解，羌苏升葛枯荆防，川芎前薄查通草，裹热毒伏归宗汤，
不足不出无表裹，参耆甘草保元汤，毒轻升麻葛根并，毒重攻毒救正良。
[注]
痘发热三朝，期应见点而不见点，则为应出不出，
若有表邪风寒外郁不出，宜用苏解散发之，表开自然出也，
若无表证而有里热者，此为毒火内伏不出，宜用归宗汤攻之，
里开自然出也，
若形气不足，应出不出，无表里证者，是正气虚而不能发出也，
若毒轻热微，宜用保元汤合升麻葛根汤并而用之，补正除邪可也，
若有表里证，或毒重热甚，则不宜补，恐助火毒，
宜苏解散或归宗汤攻邪救正为良法也。
(苏解散)
前胡 川芎 牛蒡子炒 南山查 木通 生甘草 羌活 苏叶 升麻
葛根 桔梗 荆芥 防风 引加芫荽水煎服。
(归宗汤) 方见发热证治。
(保元汤) 人参 黄耆制 甘草炙 引加生姜水煎服。
(升麻葛根汤) 方见发热证治。
%
凉血攻毒饮 清热解毒汤
已出犹热分表裹，在内凉血攻毒佳，红花紫草丹蝉葛，合上归宗减去查，
在外清热解毒治，归宗大赤不须加，更人前连丹蝉蜕，紫花地丁滑红花．
[注]
痘已见形，身热当减，若仍热不退，此属毒火盛也，须分表里施治，
若见在内毒火盛之证，宜用凉血攻毒饮攻之，
其方即红花，紫草，丹皮，蝉蜕，葛根，合上归宗汤药，减去山查也，
若见在外毒火盛之证，宜用清热解毒汤解之，
其方即归宗汤减去大黄，赤芍，更加前胡，黄连，丹皮，蝉蜕，
紫花地丁，滑石，红花是也。
(凉血攻毒饮)
大黄 荆芥穗 木通 牛蒡子炒 赤芍 生地 青皮 蝉蜕 红花 紫草
葛根 丹皮引加灯心水煎服。
(清热解毒汤)
荆芥穗 木通 牛蒡子炒 生地 青皮 山查丹皮 红花 蝉蜕 前胡
紫花地丁 黄连 滑石 引加灯心水煎服。
%
苏解散 必胜汤 保元汤 千金内托散
已出复稳谓之陷，外邪闭塞苏解良，内毒必胜桃花葛，丁蝉地龙归宗汤，
气虚陷人保元主，无热千金内托方，保元加桂归芎芍，白芷查朴木香防。
[注]
痘已见点复稳藏不见者，谓之毒气内陷也，
外邪闭塞者，有外感风邪证闭塞其毒，故以苏解散解之也，
内毒者，火毒内攻，故以必胜汤攻之也，
其方即桃仁，红花，葛根，紫花，地丁，蝉蜕，地龙，合上归宗汤也，
若形气不足，中气不能载毒而复陷入者，宜以保元汤主之也，
若不见热证者，虚而兼寒，宜用千金内托散补而温之，
其方即保元汤
加官桂，当归，川芎，白芍，白芷，山查，厚朴，木香，防风也。
(苏解散) 方见本条证治。
(必胜汤)
大黄 荆芥穗 赤芍 青皮 生地黄 山查 木通 牛蒡子炒 桃仁 紫花地丁
蝉蜕 葛根 地龙 红花 芦根水煎药服。
(保元汤) 方见本条证治。
(千金内托散) 人参 黄耆制 甘草炙 官桂 当归 白芍药炒 川芎 白芷
南山查 厚朴姜炒 木香 防风 引加生姜水煎服。
%
南金散 必胜汤
见点外触诸邪秽，痘陷灰滞黑焦塌，轻虚南金蚕荷叶，重实必胜最为佳。
[注]
痘至见点之后，房中最要洁净，一被邪秽所触，则毒即陷于内矣，
灰滞者，谓痘色灰白暗滞也，
黑者，谓痘色紫黑也，
焦者，谓痘形枯焦也，
塌者，谓痘形平塌也，
轻虚者，谓毒轻形气虚也，以南金散主之，
重实者，谓毒重形气实也，以必胜汤主之。
(南金散)
白僵蚕取直者炒 紫背荷叶各等分取霜后搭水者 以上为末，
每服五分，或一钱，芫荽汁和黄酒少许调下。
(必胜汤) 方见本条证治。
%
加味归宗汤
热未三朝齐涌出，毒火内发迅难当，归宗汤内加紫草，石膏犀连归尾良。
[注]
热未三朝者，发热或半日或一日也，
涌出者，痘涌出不循序也，
此由毒火迅烈莫能约束，
以归宗汤加紫草，石膏，犀角，黄连，归尾治之。
(归宗汤) 方见发热证治。
%
清热解毒汤 凉血攻毒饮 千金内托散 归宗汤
赤紫明泽解毒治，黑暗焦枯攻毒良，灰白亮虚内托散，灰白滞郁归宗汤。
[注]
凡痘见点，贵察其色，如赤紫明亮者，此毒盛血热也，以清热解毒汤主之，
如黑暗干枯者，此毒锢血凝也，以凉血攻毒饮主之，
如灰白明亮者，此血气虚而不荣也，以千金内托散主之，
如灰白暗滞者，此毒气郁滞而不行也，以归宗汤主之。
(清热解毒汤) (凉血攻毒饮) (千金内托散)方俱见本条证治
(归宗汤)方见发热证治
%
紫草饮子 归宗汤
平塌板□根松散，气虚紫草饮木通，紫甲查蝉参枳壳，根脚紧束主归宗。
[注]
凡痘见点，贵观其形，
若顶平不起，根脚松散，此气虚不能载毒 而痘难宣发也，以紫草饮主之，
若根脚紧束，此毒盛气滞而内伏也，以归宗汤主之。
(紫草饮子) 紫草 蝉蜕 人参 穿山甲炒 枳壳麸炒 山查 木通 水煎服。
(归宗汤) 方见发热证治。
%
归宗汤
痘出稠密或粘连，总是枭毒不必言，惟以归宗攻毒主，根松犹可紧□难。
[注]
痘出之形，贵审疏密，
若稠密攒簇，粘连不分，总属枭毒为害，以归宗汤攻毒为主，
其痘根脚松者，犹属可治，若紧束板□者，难治。
(归宗汤) 方见发热证治
%
发热三天后逐渐出现痘点，热势减退、形体稀疏、色泽红润光亮，这是顺证；应当出而未出，或已出而身热不退，或已出后又隐没难见、反而涌出急促，这些都属于凶险之证。
痘色有赤、紫、黑、白之分，需辨别其明亮与晦暗；形态有平板、稠密相连之别，需辨别其根脚紧束与松弛。应当审察是风寒外郁还是毒火内盛，以及气血虚弱是否导致无法承载和透发毒邪。
[注]
“发热三朝渐渐见点”，是指痘点出现得不急不缓；
“热减”，是指痘出齐后热势减退；
“形疏”，是指痘粒稀疏、颗粒分明；
“色润红”，是指颜色红润且有光泽；以上都是见点期的顺证。
“应出不出”，是指发热三日之后仍不见痘点，这是因为毒邪伏于体内；
“出犹热”，是指痘虽出齐但身体热度仍不退，这是因为毒热炽盛；
“已出复稳”（此处原文为“复稳”，结合语境及后文解释应为“复隐”或“复敛”，指痘点出现后又隐藏不见），是指痘点刚出现又藏匿不见，这是因为毒邪内陷攻里；
“涌出”，是指发热未满三日，痘点一齐涌出，这是因为毒火迅猛猛烈；
以上这些都是逆证，主凶险。
关于痘色：红色为正色，若呈深红、赤色、深赤紫色，甚则紫色转为黑色，或不红而呈白色，都不是正色。
关于明暗：非正色的痘，还需分辨其明亮与晦暗来制定治疗方案。明亮的多属虚证，晦暗的多属实证。
赤、紫、黑色的痘若明亮，尚有活动可治的生机；若滞涩晦暗，则是毒热凝滞而不行。
白色的痘若明亮，是气血因虚而不能荣养；白色且晦暗，是气血被毒邪所遏制。
关于形态：平板、稠密相连，是指痘形平塌不起，板结不绽开，或稠密成簇，联系不分，都不是正常的形态。
关于紧松：非正常形态的痘，应当辨别其根脚的紧束与松弛来治疗。紧松指的是根脚的紧松。紧束者毒邪停滞，松弛者毒邪较散。
若痘形平板稠连，但根脚松弛绽开，尚有活动可治的生机；若根脚紧束，则是毒盛瘀滞，属于难治的痘。
应当审察是风寒外郁还是火毒内锢。所谓“制”，是指上述痘的形色各有困阻，应当审察是因为风寒外郁，还是火毒内固。
所谓“气血虚失领载能”，是指或因气虚不能统领毒邪外发，血虚不能承载毒邪，使毒邪不能发于肌表，从而失去了领载的功能。
苏解散、归宗汤、保元汤、升麻葛根汤
对于应当出而未出的情况，若有表邪，用苏解散解表；若毒邪伏于内，用归宗汤。
若无表证也无里实，而是正气不足导致不出，用保元汤；若毒轻，用升麻葛根汤；若毒重，则宜攻毒救正。
[注]
痘发热三天，预期应见点却未见，称为“应出不出”。
若有表邪风寒外郁导致不出，宜用苏解散发散，表气开通自然就会发出。
若无表证而有里热，这是毒火内伏不出，宜用归宗汤攻逐，里气通畅自然就会发出。
若形体元气不足，应出不出，且无表里实证，这是正气虚而不能发出。
若毒轻热微，宜用保元汤合升麻葛根汤并用，以补正气除邪气。
若有表里实证，或毒重热甚，则不宜补益，恐助长火毒，宜用苏解散或归宗汤攻邪救正为好方法。
(苏解散)
前胡、川芎、炒牛蒡子、南山查（山楂）、木通、生甘草、羌活、苏叶、升麻、葛根、桔梗、荆芥、防风。引药加芫荽，水煎服。
%
凉血攻毒饮、清热解毒汤
痘已出而身热仍存，需分表里施治。毒在内在宜用凉血攻毒饮；毒在外宜用清热解毒汤。
红花、紫草、丹皮、蝉蜕、葛根，配合归宗汤减去山楂，即为凉血攻毒饮。
清热解毒汤则在归宗汤基础上，去掉大黄、赤芍，加入前胡、黄连、丹皮、蝉蜕、紫花地丁、滑石、红花。
[注]
痘已见形，身热应当减退，若仍不退，此属毒火炽盛。须分表里施治。
若见毒火盛在内里的证候，宜用凉血攻毒饮攻逐。
该方即由红花、紫草、丹皮、蝉蜕、葛根，配合归宗汤药物，减去山查组成。
若见毒火盛在外表的证候，宜用清热解毒汤解除。
该方即归宗汤减去大黄、赤芍，更加入前胡、黄连、丹皮、蝉蜕、紫花地丁、滑石、红花。
(凉血攻毒饮)
大黄、荆芥穗、木通、炒牛蒡子、赤芍、生地、青皮、蝉蜕、红花、紫草、葛根。引药加灯心草，水煎服。
(清热解毒汤)
荆芥穗、木通、炒牛蒡子、生地、青皮、山查、丹皮、红花、蝉蜕、前胡、紫花地丁、黄连、滑石。引药加灯心草，水煎服。
%
苏解散、必胜汤、保元汤、千金内托散
痘已出后又隐没，称为“陷”。外邪闭塞所致，用苏解散良；内毒所致，用必胜汤加桃花（桃仁）、葛根、紫花地丁、蝉蜕、地龙、归宗汤。
气虚下陷，主用保元汤；无热象者，用千金内托方。保元汤加官桂、当归、川芎、白芍、白芷、山查、厚朴、木香、防风。
[注]
痘已见点却又隐藏不见，称为毒气内陷。
外邪闭塞，是有外感风邪证闭塞了毒邪出路，故用苏解散解表。
内毒，是火毒内攻，故用必胜汤攻逐。
该方即桃仁、红花、葛根、紫花地丁、蝉蜕、地龙，配合归宗汤组成。
若形体元气不足，中气不能承载毒邪而复陷入者，宜以保元汤为主。
若不见热证，属虚而兼寒，宜用千金内托散补益温阳。
该方即保元汤加官桂、当归、川芎、白芍、白芷、山查、厚朴（姜炒）、木香、防风。
(苏解散) 方剂见本条证治。
(必胜汤)
大黄、荆芥穗、赤芍、青皮、生地黄、山查、木通、炒牛蒡子、桃仁、紫花地丁、蝉蜕、葛根、地龙、红花。芦根煎药服。
(保元汤) 方剂见本条证治。
(千金内托散)
人参、制黄耆、炙甘草、官桂、当归、炒白芍药、川芎、白芷、南山查、姜炒厚朴、木香、防风。引药加生姜，水煎服。
%
南金散、必胜汤
见点期外触各种邪秽，导致痘陷、灰滞、黑焦、塌平。轻虚证用南金散（蚕、荷叶）最佳；重实证用必胜汤最为适宜。
[注]
痘至见点之后，房中最要洁净，一旦被邪秽触碰，毒邪即会内陷。
灰滞，是指痘色灰白暗滞。
黑，是指痘色紫黑。
焦，是指痘形枯焦。
塌，是指痘形平塌。
轻虚，是指毒轻而形气虚，以南金散主治。
重实，是指毒重而形气实，以必胜汤主治。
(南金散)
白僵蚕（取直者炒）、紫背荷叶（各等分，取霜后搭水者）。以上研为末，每服五分或一钱，用芫荽汁和少许黄酒调下。
(必胜汤) 方剂见本条证治。
%
加味归宗汤
热未满三日便一齐涌出，毒火内发迅猛难以抵挡。在归宗汤内加紫草、石膏、犀角、黄连、归尾疗效好。
[注]
热未三朝，是指发热仅半天或一天。
涌出，是指痘涌出不按次序。
这是由于毒火迅猛猛烈，不能约束。
用归宗汤加紫草、石膏、犀角、黄连、归尾治疗。
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清热解毒汤、凉血攻毒饮、千金内托散、归宗汤
赤紫明亮者用解毒法（清热解毒汤）；黑暗焦枯者用攻毒法（凉血攻毒饮）；灰白明亮属虚者用内托法（千金内托散）；灰白暗滞属郁者用归宗汤。
[注]
凡痘见点，贵在观察其颜色。如赤紫明亮者，此毒盛血热，以清热解毒汤主治。
如黑暗干枯者，此毒锢血凝，以凉血攻毒饮主治。
如灰白明亮者，此血气虚而不荣，以千金内托散主治。
如灰白暗滞者，此毒气郁滞而不行，以归宗汤主治。
(清热解毒汤)、(凉血攻毒饮)、(千金内托散) 方剂俱见本条证治。
(归宗汤) 方剂见“发热证治”条。
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紫草饮子、归宗汤
平塌板结、根脚松散者，属气虚，用紫草饮子（含木通、紫草、穿山甲、山查、蝉蜕、人参、枳壳）。根脚紧束者，主用归宗汤。
[注]
凡痘见点，贵在观察其形态。
若顶平不起，根脚松散，此气虚不能载毒，而痘难宣发，以紫草饮主治。
若根脚紧束，此毒盛气滞而内伏，以归宗汤主治。
(紫草饮子)
紫草、蝉蜕、人参、炒穿山甲、麸炒枳壳、山查、木通。水煎服。
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归宗汤
痘出稠密或粘连，总是枭毒为害，不必多言。惟以归宗汤攻毒为主。根脚松者尚可治，根脚紧束板结者难治。
[注]
痘出之形态，贵在审察疏密。
若稠密攒簇，粘连不分，总属枭毒为害，以归宗汤攻毒为主。
其痘根脚松者，犹属可治；若紧束板结者，难治。
After three days of fever, the smallpox spots gradually appear. If the fever subsides, the distribution is sparse, and the color is moist and red, it is a favorable condition (Shun Zheng). If they should appear but do not, or if they appear yet the fever persists, or if they reappear after vanishing, or if they erupt suddenly and rapidly, these are all ominous conditions (Ni Zheng).
The colors of the spots vary among red, purple, black, and white; one must distinguish between bright/lustrous and dull/dark. The shapes may be flat/level or densely clustered; one must distinguish between tight/contracted roots and loose/spread roots. One must examine whether the cause is external constraint by wind-cold or internal accumulation of toxic heat, and whether deficiency of Qi and Blood has resulted in the inability to lead and carry the toxin outward.
[Annotation]
"Gradual appearance after three days of fever" means the spots emerge neither too fast nor too slow.
"Fever subsiding" means the fever decreases after the spots have fully erupted.
"Sparse form" means the spots are scattered with distinct granules.
"Moist red color" means the color is red and lustrous. These are all favorable signs during the spotting stage.
"Should appear but do not" refers to no spots appearing after three days of fever, indicating the toxin is latent within.
"Erupting yet fever persists" means although the spots have fully erupted, the body heat remains unreduced, indicating excessive toxic heat.
"Reappearing after vanishing" (original text says "Fu Wen", context implies hiding/vanishing) means spots appear then hide again, indicating the toxin has collapsed inward attacking the interior.
"Sudden eruption" means spots erupt all at once before three days of fever are complete, indicating fierce and rapid toxic fire.
These are all adverse conditions predicting misfortune.
Regarding color: Red is the correct color. Deep red, crimson, deep crimson-purple, turning black from purple, or non-red white are all incorrect colors.
Regarding brightness: For incorrect colors, treatment depends on brightness. Brightness often indicates deficiency; dullness often indicates excess.
Red, purple, black spots that are bright still have dynamic potential for treatment. If stagnant and dull, it indicates toxic heat stagnation without flow.
White spots that are bright indicate Qi and Blood failing to nourish due to deficiency. White and dull indicates Qi and Blood constrained by toxin.
Regarding shape: Flat, level, dense, and connected forms—where the spot is flat and does not rise, board-like without opening, or densely clustered and indistinguishable—are not normal forms.
Regarding tightness vs. looseness: For abnormal forms, treat based on root tightness. Tightness indicates toxin stagnation; looseness indicates dispersed toxin.
If flat and dense but with loose, spreading roots, there is still dynamic potential for treatment. If roots are tightly contracted, it indicates severe toxin and blood stasis, making it difficult to treat.
One must examine whether it is external constraint by wind-cold or internal fixation of fire-toxin. "Constraint" refers to the various impediments of the aforementioned spot colors and shapes; determine if it is due to external wind-cold constraint or internal fire-toxin fixation.
"Loss of Qi and Blood's leading and carrying ability" means either Qi deficiency fails to lead the toxin out, or Blood deficiency fails to carry the toxin, preventing the toxin from manifesting on the skin surface, thus losing its guiding and carrying function.
Su Jie San (Perilla Decoction for Release), Gui Zong Tang (Return to Origin Decoction), Bao Yuan Tang (Protect the Primordial Decoction), Sheng Ma Ge Gen Tang (Kudzu and Cimicifuga Decoction).
For "should appear but do not": If there is an exterior pathogen, use Su Jie San to release the exterior; once the exterior opens, eruption will naturally occur. If the toxin is latent internally, use Gui Zong Tang.
If there is neither exterior syndrome nor interior excess, but insufficiency of Zheng Qi causing failure to erupt, use Bao Yuan Tang. If the toxin is mild, use Sheng Ma Ge Gen Tang. If the toxin is heavy, attack the toxin and rescue the righteous Qi.
[Annotation]
Smallpox fever lasts three days; if spots should appear but do not, it is called "should appear but do not."
If caused by exterior wind-cold constraint preventing eruption, use Su Jie San to disperse; opening the exterior allows natural eruption.
If there is no exterior syndrome but interior heat exists, this is latent toxic fire; use Gui Zong Tang to attack; clearing the interior allows natural eruption.
If physical constitution and Qi are insufficient, causing failure to erupt without exterior/interior excess syndromes, this is deficiency of Zheng Qi unable to emit.
If the toxin is mild and heat slight, combine Bao Yuan Tang and Sheng Ma Ge Gen Tang to tonify righteousness and eliminate evil.
If there are exterior/interior excess syndromes, or heavy toxin with intense heat, tonification is contraindicated as it may aid fire-toxin; using Su Jie San or Gui Zong Tang to attack evil and rescue righteousness is the good method.
(Su Jie San)
Qian Hu (Peucedani Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chao Niu Bang Zi (Arctii Fructus Preparatus), Nan Shan Zha (Crataegi Fructus), Mu Tong (Akebiae Caulis), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Su Ye (Perillae Folium), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Jie Geng (Platycodonis Radix), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix). Guide: Yan Sui (Coriandri Fructus), decoct in water.
(Gui Zong Tang) See "Fever Syndrome Treatment".
(Bao Yuan Tang)
Ren Shen (Ginseng Radix), Zhi Huang Qi (Astragali Radix Preparatus), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparatus). Guide: Sheng Jiang (Zingiberis Rhizoma Recens), decoct in water.
(Sheng Ma Ge Gen Tang) See "Fever Syndrome Treatment".
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Liang Xue Gong Du Yin (Blood-Cooling Toxin-Attacking Decoction), Qing Re Jie Du Tang (Heat-Clearing Toxin-Resolving Decoction).
If fever persists after eruption, distinguish between interior and exterior. For interior toxicity, Liang Xue Gong Du Yin is excellent. Hong Hua (Carthami Flos), Zi Cao (Arnebiae Radix), Dan Pi (Moutan Cortex), Chan Tui (Bombyx Batryticatus), Ge Gen (Puerariae Lobatae Radix), combined with Gui Zong Tang minus Shan Zha (Crataegi Fructus), constitutes Liang Xue Gong Du Yin.
For exterior toxicity, Qing Re Jie Du Tang is used. This is Gui Zong Tang minus Da Huang (Rhei Radix et Rhizoma), Chi Shao (Paeoniae Radix Rubra), plus Qian Hu (Peucedani Radix), Huang Lian (Coptidis Rhizoma), Dan Pi (Moutan Cortex), Chan Tui (Bombyx Batryticatus), Zi Hua Di Ding (Violae Herba), Hua Shi (Talcum), Hong Hua (Carthami Flos).
[Annotation]
Once spots are visible, fever should subside. If it persists, it belongs to excessive toxic fire. Treatment must distinguish between interior and exterior.
If signs of excessive toxic fire in the interior are seen, use Liang Xue Gong Du Yin to attack.
This formula consists of Hong Hua, Zi Cao, Dan Pi, Chan Tui, Ge Gen, combined with Gui Zong Tang ingredients, removing Shan Zha.
If signs of excessive toxic fire in the exterior are seen, use Qing Re Jie Du Tang to resolve.
This formula is Gui Zong Tang removing Da Huang and Chi Shao, adding Qian Hu, Huang Lian, Dan Pi, Chan Tui, Zi Hua Di Ding, Hua Shi, and Hong Hua.
(Liang Xue Gong Du Yin)
Da Huang (Rhei Radix et Rhizoma), Jing Jie Sui (Schizonepetae Spica), Mu Tong (Akebiae Caulis), Chao Niu Bang Zi (Arctii Fructus Preparatus), Chi Shao (Paeoniae Radix Rubra), Sheng Di (Rehmanniae Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Chan Tui (Bombyx Batryticatus), Hong Hua (Carthami Flos), Zi Cao (Arnebiae Radix), Ge Gen (Puerariae Lobatae Radix), Dan Pi (Moutan Cortex). Guide: Deng Xin Cao (Junci Medulla), decoct in water.
(Qing Re Jie Du Tang)
Jing Jie Sui (Schizonepetae Spica), Mu Tong (Akebiae Caulis), Chao Niu Bang Zi (Arctii Fructus Preparatus), Sheng Di (Rehmanniae Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Shan Zha (Crataegi Fructus), Dan Pi (Moutan Cortex), Hong Hua (Carthami Flos), Chan Tui (Bombyx Batryticatus), Qian Hu (Peucedani Radix), Zi Hua Di Ding (Violae Herba), Huang Lian (Coptidis Rhizoma), Hua Shi (Talcum). Guide: Deng Xin Cao (Junci Medulla), decoct in water.
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Su Jie San (Perilla Decoction for Release), Bi Sheng Tang (Sure Victory Decoction), Bao Yuan Tang (Protect the Primordial Decoction), Qian Jin Nei Tuo San (Thousand Gold Internal-Supporting Powder).
Eruption followed by hiding is called "collapse." Caused by external pathogen closure, Su Jie San is good. Caused by internal toxin, Bi Sheng Tang with Tao Ren (Persicae Semen), Ge Gen (Puerariae Lobatae Radix), Zi Hua Di Ding (Violae Herba), Chan Tui (Bombyx Batryticatus), Di Long (Pheretima), and Gui Zong Tang is used.
For Qi deficiency collapse, Bao Yuan Tang is primary. For cases without heat, use Qian Jin Nei Tuo Fang. Bao Yuan Tang added with Guan Gui (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Bai Zhi (Angelicae Dahuricae Radix), Shan Zha (Crataegi Fructus), Hou Po (Magnoliae Officinalis Cortex), Mu Xiang (Aucklandiae Radix), Fang Feng (Saposhnikoviae Radix).
[Annotation]
Spots appearing then hiding is called internal collapse of toxic Qi.
External pathogen closure means external wind-pathogen blocks the toxin's exit; thus, Su Jie San is used to release.
Internal toxin means fire-toxin attacks inward; thus, Bi Sheng Tang is used to attack.
This formula consists of Tao Ren, Hong Hua, Ge Gen, Zi Hua Di Ding, Chan Tui, Di Long, combined with Gui Zong Tang.
If physical constitution and Qi are insufficient, and Middle Qi cannot carry the toxin, causing collapse, Bao Yuan Tang is primary.
If no heat signs are present, indicating deficiency with cold, use Qian Jin Nei Tuo San to tonify and warm.
This formula is Bao Yuan Tang added with Guan Gui, Dang Gui, Chuan Xiong, Bai Shao, Bai Zhi, Shan Zha, Hou Po (stir-fried with ginger), Mu Xiang, Fang Feng.
(Su Jie San) See syndrome treatment in this section.
(Bi Sheng Tang)
Da Huang (Rhei Radix et Rhizoma), Jing Jie Sui (Schizonepetae Spica), Chi Shao (Paeoniae Radix Rubra), Qing Pi (Citri Reticulatae Pericarpium Viride), Sheng Di Huang (Rehmanniae Radix), Shan Zha (Crataegi Fructus), Mu Tong (Akebiae Caulis), Chao Niu Bang Zi (Arctii Fructus Preparatus), Tao Ren (Persicae Semen), Zi Hua Di Ding (Violae Herba), Chan Tui (Bombyx Batryticatus), Ge Gen (Puerariae Lobatae Radix), Di Long (Pheretima), Hong Hua (Carthami Flos). Decoct in Lu Gen (Phragmitis Rhizoma) water.
(Bao Yuan Tang) See syndrome treatment in this section.
(Qian Jin Nei Tuo San)
Ren Shen (Ginseng Radix), Zhi Huang Qi (Astragali Radix Preparatus), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparatus), Guan Gui (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix), Chao Bai Shao Yao (Paeoniae Radix Alba Preparatus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Nan Shan Zha (Crataegi Fructus), Jiang Chao Hou Po (Magnoliae Officinalis Cortex Stir-fried with Ginger), Mu Xiang (Aucklandiae Radix), Fang Feng (Saposhnikoviae Radix). Guide: Sheng Jiang (Zingiberis Rhizoma Recens), decoct in water.
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Nan Jin San (Southern Metal Powder), Bi Sheng Tang (Sure Victory Decoction).
Exposure to filth and evil pathogens during the spotting stage causes collapse, gray-stagnant, black, scorched, or flat spots. For mild deficiency, Nan Jin San (Can Sang, He Ye) is best. For severe excess, Bi Sheng Tang is most suitable.
[Annotation]
After the spotting stage, cleanliness in the room is crucial. Contact with evil filth causes immediate internal collapse of the toxin.
Gray-stagnant: Gray-white and dark/dull color.
Black: Purple-black color.
Scorched: Withered and scorched shape.
Flat: Level and sunken shape.
Mild deficiency: Light toxin with deficient physical constitution; treated with Nan Jin San.
Severe excess: Heavy toxin with robust physical constitution; treated with Bi Sheng Tang.
(Nan Jin San)
Bai Jiang Can (Bombyx Batryticatus, straight ones, stir-fried), Zi Bei He Ye (Perfoliate Polygonati Folium, equal parts, harvested after frost); powdered. Take 0.5 qian or 1 qian per dose, mixed with Yan Sui juice and a little yellow wine.
(Bi Sheng Tang) See syndrome treatment in this section.
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Jia Wei Gui Zong Tang (Modified Return to Origin Decoction).
Eruption before three days of fever, sudden and rapid due to internal toxic fire. Add Zi Cao (Arnebiae Radix), Shi Gao (Gypsum Fibrosum), Xi Jiao (Rhinocerotis Cornu - *Note: Substitute with Niuxuhuang or similar in modern practice*), Huang Lian (Coptidis Rhizoma), Gui Wei (Radix Angelicae Sinensis Tail) to Gui Zong Tang.
[Annotation]
"Heating less than three days" means fever lasting half a day or one day.
"Sudden eruption" means erupting without order.
This is due to fierce toxic fire lacking restraint.
Treat with Gui Zong Tang added with Zi Cao, Shi Gao, Xi Jiao, Huang Lian, Gui Wei.
(Gui Zong Tang) See "Fever Syndrome Treatment".
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Qing Re Jie Du Tang (Heat-Clearing Toxin-Resolving Decoction), Liang Xue Gong Du Yin (Blood-Cooling Toxin-Attacking Decoction), Qian Jin Nei Tuo San (Thousand Gold Internal-Supporting Powder), Gui Zong Tang (Return to Origin Decoction).
Red/purple and bright: Treat with detoxification (Qing Re Jie Du Tang). Dark/black and scorched/dry: Treat with toxin-attacking (Liang Xue Gong Du Yin). Gray/white and bright (deficiency): Treat with internal support (Qian Jin Nei Tuo San). Gray/white and dull/stagnant: Treat with Gui Zong Tang.
[Annotation]
Observing color upon spotting is crucial. Red/purple and bright indicates excessive toxin and blood heat; treat with Qing Re Jie Du Tang.
Dark/black and dry indicates toxin binding and blood coagulation; treat with Liang Xue Gong Du Yin.
Gray/white and bright indicates Qi and Blood deficiency failing to nourish; treat with Qian Jin Nei Tuo San.
Gray/white and dull/stagnant indicates stagnant and obstructed toxic Qi; treat with Gui Zong Tang.
(Qing Re Jie Du Tang), (Liang Xue Gong Du Yin), (Qian Jin Nei Tuo San) See syndrome treatment in this section.
(Gui Zong Tang) See "Fever Syndrome Treatment".
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Zi Cao Yin Zi (Arnebia Decoction), Gui Zong Tang (Return to Origin Decoction).
Flat, board-like, loose roots: Qi deficiency, use Zi Cao Yin Zi (Mu Tong, Zi Cao, Chuan Shan Jia, Shan Zha, Chan Tui, Ren Shen, Zhi Ke). Tight roots: Primary treatment with Gui Zong Tang.
[Annotation]
Observing shape upon spotting is crucial.
If the top is flat/non-rising and roots are loose, this is Qi deficiency failing to carry the toxin, making eruption difficult; treat with Zi Cao Yin Zi.
If roots are tightly contracted, this is excessive toxin and Qi stagnation latent within; treat with Gui Zong Tang.
(Zi Cao Yin Zi)
Zi Cao (Arnebiae Radix), Chan Tui (Bombyx Batryticatus), Ren Shen (Ginseng Radix), Chuan Chuan Shan Jia (Manis Squama, stir-fried), Fu Chao Zhi Ke (Aurantii Fructus, bran-fried), Shan Zha (Crataegi Fructus), Mu Tong (Akebiae Caulis). Decoct in water.
(Gui Zong Tang) See "Fever Syndrome Treatment".
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Gui Zong Tang (Return to Origin Decoction).
Dense or adherent spots are always caused by "Xiao Du" (fierce toxin). Primary treatment is attacking the toxin with Gui Zong Tang. Loose roots are still treatable; tight/board-like roots are difficult to treat.
[Annotation]
Observing density is crucial.
Dense clustering and adhesion belong to harm by Xiao Du; primary treatment is attacking toxin with Gui Zong Tang.
Loose roots are still treatable; tight and board-like roots are difficult to treat.
(Gui Zong Tang) See "Fever Syndrome Treatment".