郑都谏春寰公长君，四岁患痘，稠密烦躁，医者星罗，皆以为热盛不退，形枯色紫，
顶有焦
势，症逆，必不可为，将辞去。予至，细观之，见两太阳圆净，神气苍浓，谓当急为凉血
解
毒。用赤芍药、生地黄各三钱，紫草二钱，连翘、黄芩、贝母、山楂、木通各一钱，蝉蜕、
甘草各五分，药成剂，而众止之曰∶麻要清凉痘要温，故《博爱心鉴》以保元汤为良，吾侪
将剂而进之，乃公独主寒凉，保元之谓何？予曰∶用药贵对症，保元汤良矣，必血活热清而
后可用。今血热毒盛而用温剂，是火炽添油也。众曰∶若虑毒未解，吾苕酵法甚佳，用桑
虫、鸡冠血调酒服之，痘即立起。而慎氏、王氏、茅氏，皆苕上专门名家，亦以为言。予曰
∶此法亦可用于清解之后。经曰∶诸痛疮疡，皆属心火。火未退而用，是以毒攻毒，其势愈炽
。予故欲先清解，而后保元也。惟楚铜壁山人黄桂峰者，治痘高手也。独语郑公曰；孙公之
剂，
实与症对，众论皆胶固不达变者，第恐清解之剂，用迟一日尔。试煎服之，以观其后。郑公
命
仆速煎，众犹持议曰∶如必服此剂，亦当拣去贝母、山楂。郑公听其减去。至夜予始闻，
随语桂峰曰∶减去二味，恐七八日后不能无它症。桂峰曰∶何以故？予曰∶此痘内伤外感俱
未清
楚，今带热而出，故其腹犹膨胀，去贝母，恐抢喉；去山楂，恐泄泻，七八日痘毒出尽，腹
内
空虚，变从虚出，诸君素以痘专科，何不虑及此。其夜服药后，即嗒然而睡，天明痘色明润
，
焦顶尽退，血亦渐活，惟呕哕抢喉。众又以昨日之剂太寒所致。予曰∶此火毒未尽彻也，宜
进竹茹汤。而慎云峰怫然早∶吾家世世业痘，年亦七十有五，曾未见治痘用竹茹者。春寰公令
弟乐津公，捡痘疹全书用竹茹者以正，慎语塞，悻然而去。药进而哕
止。至八日，果泄泻、发痒。予以保元汤加白术以治泻，大加何首乌以止痒，一帖而痒止。
至十四
日，天庭两颧皆回浆作靥，惟两颐浆未回，泄泻不止。予因偶出北门，半日归，见其口开项
软，手足痘气尽瘪，复又作胀，已成内攻。举家啼泣，予亦茫然，不遑为计，叹息出门。乐津
公把而送之，少间揖别，而闻衣间痘臭，语乐津公曰∶公闻臭乎？曰∶闻。予曰∶似有生意，
亟还起之。予思两颐乃肾经部位，独不回浆者，肾元虚也。峻补肾元，庶可使活。先以紫
河车一钱，用洒浆调服，固其元气，服后即睡。继以人参一两，黄 、菟丝子各三钱，作
大剂服之，一日夜服人参一两八钱。黄桂峰是夜自松江还，时已四鼓，亟叩门而入，郑语之
变，且告之服药。黄曰∶俟吾看作何状。见其结靥之下，腹灌一钱黄浆，赠痘尽起。桂峰曰∶
万全矣!非孙公不能起此病。桂峰由此益昵予，出必联舟，归则同榻，相印正者三年。郑公感
予而作序以赠，亲书孙宪副公册后，识不忘也。
郑都谏春寰公的长子，四岁时患痘疮（天花），痘疹稠密且伴有烦躁不安。医生众多，如星星般罗列，都认为这是热邪亢盛不退，导致形体枯瘦、面色紫暗，痘顶有焦枯之势，属于逆证，必定无法治愈，正准备离去。我到达后，仔细观察，发现他两侧太阳穴部位圆润洁净，神气苍劲浓郁，认为应当紧急采用凉血解毒的方法。处方用赤芍药、生地黄各三钱，紫草二钱，连翘、黄芩、贝母、山楂、木通各一钱，蝉蜕、甘草各五分。药煎好后，众人阻止说：“治疗麻痘宜清凉，治疗痘疮宜温补，所以《博爱心鉴》认为保元汤是良方，我们打算将保元汤煎好进服，唯独您主张使用寒凉药物，那保元汤的意义何在呢？”我说：“用药贵在对症，保元汤固然好，但必须等到血活热清之后才能使用。如今血热毒盛却使用温补药剂，这如同火上浇油。”众人说：“如果担心毒邪未解，我们苕溪地区的疗法很好，用桑虫、鸡冠血调酒服用，痘疮就会立刻起发。”而慎氏、王氏、茅氏，都是苕溪地区专门研究痘疹的名家，也以此说法相劝。我说：“这种方法也可以在清热解之后使用。《内经》说：‘各种疼痛和疮疡，都属于心火。’火邪未退就使用温补，是以毒攻毒，火势会更加炽盛。所以我想要先清热解，然后再用保元汤。”只有楚地铜壁山人黄桂峰，是治疗痘疹的高手。他独自对郑公说：“孙先生的药方，确实与病症相符，众人的议论都是拘泥固执、不懂变通的，只是恐怕清热解的药剂用得稍迟了一天罢了。试着煎服看看，以观察后续情况。”郑公命令仆人迅速煎药，众人仍然坚持意见说：“如果一定要服用这个药方，也应该去掉贝母、山楂。”郑公听从了他们，减去了这两味药。到了晚上我才听说此事，随即告诉黄桂峰说：“减去这两味药，恐怕七八日后不能没有其它症状。”黄桂峰问：“为什么？”我说：“这痘疮内伤外感都没有清除干净，现在带着热邪发出，所以腹部仍然膨胀。去掉贝母，恐怕会导致咽喉阻塞；去掉山楂，恐怕会导致泄泻。七八天后痘毒出尽，腹部空虚，病变会从虚证产生，各位素来以痘科专家自居，为何不考虑这一点呢？”当晚服药后，孩子便酣然入睡，天亮时痘色明润，焦枯的痘顶全部消退，血液也逐渐流通，只是出现呕吐呃逆和咽喉阻塞的症状。众人又认为是昨天药方太寒凉所致。我说：“这是火毒没有完全清除的缘故，应该进服竹茹汤。”而慎云峰勃然大怒说：“我家世代从事痘科工作，今年也已七十五岁，从未见过治痘使用竹茹的。”春寰公的弟弟乐津公，查找《痘疹全书》中有使用竹茹的记载来纠正他，慎云峰语塞，生气地离开了。药进服后，呃逆停止。到了第八天，果然出现泄泻、发痒的症状。我用保元汤加白术来治疗泄泻，大量加入何首乌来止痒，一帖药后瘙痒停止。到了第十四天，天庭和两颧都已经回浆结痂，只有两颊的浆液未回，泄泻不止。我因偶然出门到北门，半天后回来，见其口张项软，手足痘气全部瘪陷，又重新胀起，已成内攻之象。全家啼哭流泪，我也茫然无措，来不及想办法，叹息着走出门外。乐津公握着我的手送别，片刻后作揖告别，但我闻到衣服间有痘疮的臭味，对乐津公说：“您闻到臭味了吗？”回答说：“闻到了。”我说：“似乎还有生机，赶快回去抢救。”我思考两颊是肾经的部位，唯独不回浆，是因为肾元虚弱。峻补肾元，或许可以挽救生命。先用紫河车一钱，用酒浆调服，以固护元气，服后即睡。继用人参一两，黄芪、菟丝子各三钱，组成大剂服用，一天一夜服用人参一两八钱。黄桂峰这天晚上从松江回来，当时已是四更天，急忙敲门进入，郑公告知病情变化，并告诉他已服药。黄桂峰说：“等我看看是什么状况。”看到结痂之下，腹部灌满一钱厚的黄浆，痘疮全部起发。黄桂峰说：“万无一失了！不是孙先生不能治好这个病。”黄桂峰从此更加亲近我，外出必同船，回家必同榻，互相印证探讨医术长达三年。郑公感激我并作序赠送，亲笔写在孙宪副公册子后面，表示不忘恩情。
Mr. Zheng Chunhuan, the Grand Commandant of Censorate, had his eldest son who, at four years old, contracted smallpox (Dòuchuang). The pustules were dense and accompanied by restlessness. Physicians were numerous, scattered like stars, all believing it was excessive heat that would not subside, leading to a withered physique and purple complexion, with the tops of the pustules showing signs of scorching. This was considered a adverse syndrome (Nìzhèng), deemed incurable, and they were preparing to leave. Upon my arrival, I observed carefully and saw that both temples were round and clean, with vigorous and dense spiritual energy (Shénqì). I stated that urgent cooling of blood and detoxification were required. The prescription consisted of Chi Shaoyao (Radix Paeoniae Rubra) and Sheng Dihuang (Radix Rehmanniae Preparata) each at 3 qian, Zicao (Herba Leonuri) at 2 qian, Lianqiao (Fructus Forsythiae), Huangqin (Radix Scutellariae), Beimu (Bulbus Fritillariae Cirrhosae), Shanzha (Fructus Crataegi), Mutong (Caulis Akebiae) each at 1 qian, Chantui (Periostracum Cicadae) and Gancao (Radix Glycyrrhizae) each at 5 fen. After the medicine was prepared, the crowd stopped me, saying: "Treatment for measles should be cooling, while treatment for smallpox should be warming; thus, *Bo Ai Xin Jian* regards Baoyuan Tang as excellent. We intend to administer Baoyuan Tang, yet you alone advocate cold and cool herbs. What then is the purpose of Baoyuan Tang?" I replied: "Medication must suit the syndrome. Although Baoyuan Tang is good, it can only be used after the blood circulation improves and heat clears. Now, with severe blood heat and toxin accumulation, using warm tonics is like adding oil to a raging fire." They said: "If you worry that the toxin is not resolved, our method in the Tiaoxi region is very effective: use silkworm pupae (Sangchong) and rooster comb blood mixed with wine to drink, and the smallpox will rise immediately." Shen Shi, Wang Shi, and Mao Shi, all renowned specialists in smallpox in the Tiaoxi area, also advocated this view. I said: "This method can also be used after clearing heat and resolving toxins. The *Classic of Medicine* states: 'All pain and sores belong to Heart Fire.' Using [warm tonics] before the fire subsides is using toxin to attack toxin, which will intensify the condition. Therefore, I wish to clear heat and resolve toxins first, and then use Baoyuan Tang." Only Huang Guifeng, a scholar from Tongbi Mountain in Chu, who was an expert in treating smallpox, spoke privately to Mr. Zheng: "Master Sun's prescription truly matches the syndrome. The opinions of the others are rigid and fail to adapt. I only fear that the clearing and resolving agents were administered one day too late. Try brewing and taking it to observe the outcome." Mr. Zheng ordered his servant to brew it quickly. The others still insisted: "If we must take this prescription, we should remove Beimu and Shanzha." Mr. Zheng agreed to their reduction. By nightfall, I heard of this and told Guifeng: "Removing these two herbs may lead to other symptoms in seven or eight days." Guifeng asked: "Why?" I said: "The internal injury and external pathogenic factors in this smallpox case have not been cleared thoroughly. It is now emerging with heat, hence the abdomen remains distended. Removing Beimu risks throat obstruction (Qianghou); removing Shanzha risks diarrhea. Seven or eight days later, when the toxin is fully expelled, the abdomen will be empty, and changes will arise from deficiency. You gentlemen pride yourselves as smallpox specialists; why did you not consider this?" That night, after taking the medicine, the child fell into a deep sleep. At dawn, the color of the smallpox became bright and moist, the scorched tops receded, and the blood circulation gradually improved. However, vomiting, hiccups, and throat obstruction occurred. The crowd again blamed yesterday's overly cold prescription. I said: "This is because the fire toxin has not been completely cleared. One should administer Zhuru Tang." Shen Yunfeng angrily retorted: "My family has practiced smallpox treatment for generations, and I am seventy-five years old. I have never seen Zhuru used in treating smallpox." Lejin Gong, the younger brother of Chunhuan Gong, consulted the *Complete Book of Smallpox and Measles* to find references to Zhuru usage, silencing Shen, who left in anger. After administering the medicine, the hiccups ceased. On the eighth day, diarrhea and itching indeed occurred. I treated the diarrhea with Baoyuan Tang added with Baizhu, and stopped the itching by significantly adding Heshouwu. After one dose, the itching stopped. By the fourteenth day, the forehead and both cheeks had returned to pus formation and crusting, but the pus on both jawlines had not returned, and diarrhea persisted. Due to an accidental trip to the North Gate, upon returning half a day later, I found his mouth open, neck soft, and the qi of the smallpox on hands and feet completely collapsed, with re-distension occurring, indicating internal invasion. The whole family wept. I was at a loss and unable to devise a plan, sighing as I exited. Lejin Gong held my hand to see me off. After a short while, we bowed and parted, but I smelled the odor of smallpox in his clothes and said to Lejin Gong: "Do you smell the odor?" He replied: "Yes." I said: "There seems to be a sign of life. Hurry back to rescue him." I reasoned that the jawlines correspond to the Kidney meridian. The failure to return to pus indicated Kidney Yuan deficiency. Profoundly tonifying the Kidney Yuan might save him. First, I used Ziheche (Placenta Humana) at 1 qian, mixed with wine and rice gruel, to consolidate the primordial Qi; he slept after taking it. Subsequently, I prescribed Ren Shen (Radix Ginseng) at 1 liang, Huangqi (Radix Astragali), and Tusizi (Semen Cuscutae) each at 3 qian, in a large dose. Over one day and night, he consumed 1 liang 8 qian of Ren Shen. Huang Guifeng returned from Songjiang that night, around the fourth watch (midnight to 2 AM). He urgently knocked and entered. Mr. Zheng informed him of the change and the medication taken. Guifeng said: "Let me examine the condition." Seeing yellow pus filling the abdomen under the crusts and the smallpox rising entirely, Guifeng said: "It is completely secure! Only Master Sun could revive this patient." From then on, Guifeng grew closer to me; we traveled together by boat and slept in the same bed, verifying and correcting each other's medical knowledge for three years. Grateful, Mr. Zheng wrote a preface as a gift and inscribed it personally behind the register of Vice-Censor-in-Chief Sun, expressing that he would not forget the kindness.