鼻者,肺之外窍也。水苗种法,以苗塞鼻中,其气先传于肺;肺主皮毛,肺传于心;
心主血脉,心传于脾;脾主肌肉,脾传于肝;肝主筋,肝传于肾。肾主骨,痘毒藏骨髓之
内。感苗气而发,其毒自骨髓尽达于筋,肾脏之毒解矣;自筋尽达于肌肉,肝脏之毒解
矣;自肌肉尽达于血脉,脾脏之毒解矣;自
血脉尽达于皮毛,心脏之毒解矣;自皮毛尽达于颗粒,肺脏之毒解矣。五脏之毒层递而
解,然后毒化浆成,收靥落痂。此种痘传送之次序也,不可不知。
旱苗种法,用银管约长五六寸,曲其颈,碾痘痂极细,纳于管端。按男左、女右,对
准鼻孔吹入之,至七日而亦发热。今时多用此法,盖取其简便捷入,不致脱落而有透泄
苗气之患也。第恐后人用之不善,轻吹之则不骤入,重吹之则迅烈难当。且恐流涕过多,
苗随涕去,往往不验。今欲垂法后世,当取其法之和平稳当万全者,而则效之。此所以独取于水苗也。
小儿出痘者,当长浆浆足之时,则彼痘气充盛,取其贴身里衣,与未出痘之儿女服
之,服二三日,夜间亦不脱下,至九日、十一日始发热,此乃衣传。然恐气薄不透,多
有不热不出,其法不灵,故不可用。
择小儿出痘之顺者,取其痘浆以棉拭之,分男左、女右,塞入鼻中,亦能发痘。但取
痘浆之时,不令本家知觉,捏破痘浆,盗以作种,使彼真气宣泄,毒不能解,此忍心害
理不仁之事也。同志者切宜深恶而痛绝之,又岂可尤而效之也哉!
鼻子,是肺脏在体外的开窍之处。水苗种痘法,是将痘苗塞入鼻中,痘苗的气机首先传入肺脏;肺脏主管皮毛,肺气随后传于心;心脏主管血脉,心气随后传于脾;脾脏主管肌肉,脾气随后传于肝;肝脏主管筋脉,肝气随后传于肾。肾脏主管骨骼,痘毒便藏匿于骨髓之内。感受了痘苗之气而发病时,其毒性从骨髓完全通达于筋,肾脏的毒邪便解除了;从筋完全通达于肌肉,肝脏的毒邪便解除了;从肌肉完全通达于血脉,脾脏的毒邪便解除了;从血脉完全通达于皮毛,心脏的毒邪便解除了;从皮毛完全通达于颗粒(指痘疹结痂前的形态),肺脏的毒邪便解除了。五脏的毒邪层层递进地解除,然后毒邪化为浆液形成脓疱,最后收靥(痘疮凹陷)并脱落结痂。这就是种痘过程中毒邪传送的次序,是不可不知道的。
旱苗种痘法,使用长约五六寸的银管,弯曲其颈部,将痘痂碾磨得极细,放入管端。按照男左女右的原则,对准鼻孔吹入,到第七天也会发热。当今时代多采用这种方法,大概是取其简便快捷、易于进入,且不会因脱落而导致透泄苗气的隐患。只是担心后人使用不当,轻吹则不能迅速进入,重吹则猛烈难以承受。而且恐怕流涕过多,痘苗随鼻涕排出,往往无效。如今想要留下方法供后世效法,应当选取平和稳妥、万无一失的方法,并加以效仿。这就是唯独推崇水苗法的原因。
小儿出痘时,当痘浆充盈饱满之时,此时痘气充盛,取患儿贴身穿着的内衣,给未出痘的儿童服用,连续穿二三日,夜间也不脱下,直到第九日或第十一日开始发热,这叫做“衣传”。然而恐怕气力薄弱无法透达,大多会出现不发热不出痘的情况,此法不灵验,所以不可用。
选择出痘顺利的儿童,取其痘浆用棉拭取,分男左女右,塞入鼻中,也能引发出痘。但在取痘浆时,不让患儿家属察觉,捏破痘浆,偷偷拿来作为种痘材料,致使患儿真气外泄,毒邪无法化解,这是残忍违背伦理的不仁之事。志同道合者务必深恶痛绝,又怎么能跟着效仿呢!
The nose is the external orifice of the Lung. In the water-variola inoculation method (Shuimiao Zhongfa), the variola seed is inserted into the nose; its qi first transmits to the Lung. The Lung governs the skin and hair, and transmits to the Heart. The Heart governs the blood vessels, and transmits to the Spleen. The Spleen governs the muscles, and transmits to the Liver. The Liver governs the sinews, and transmits to the Kidney. The Kidney governs the bones, and the variola toxin hides within the bone marrow. Upon contracting the seed qi and manifesting the disease, the toxin travels from the bone marrow completely to the sinews, resolving the Kidney's toxin; from the sinews completely to the muscles, resolving the Liver's toxin; from the muscles completely to the blood vessels, resolving the Spleen's toxin; from the blood vessels completely to the skin and hair, resolving the Heart's toxin; from the skin and hair completely to the granules (the stage before scabbing), resolving the Lung's toxin. The toxins of the five Zang organs are resolved in a sequential manner, after which the toxin transforms into pus, forming pustules, followed by involution (Shouye) and scab shedding. This is the sequence of toxin transmission in variola inoculation, which must not be ignored.
In the dry-variola inoculation method (Hanmiao Zhongfa), a silver tube approximately five or six cun long, with a curved neck, is used. The variola scabs are ground extremely fine and placed at the end of the tube. Following the principle of male left and female right, it is blown into the nostril, causing fever on the seventh day. Currently, this method is widely used, likely because it is simple, convenient, and avoids the risk of the seed falling out and leaking the seed qi. However, there is concern that future practitioners may use it improperly: blowing lightly prevents rapid entry, while blowing heavily results in intensity that is difficult to bear. Moreover, excessive rhinorrhea may carry the seed away, often rendering it ineffective. To establish a method for posterity, one should select a peaceful, steady, and foolproof method to emulate. This is why only the water-variola method is exclusively adopted.
When children develop smallpox, during the time when the pustules are full of pus, the variola qi is abundant. One may take the inner garments worn closely by the patient and have uninfected children wear them for two or three days, without removing them at night. Fever begins on the ninth or eleventh day; this is called "garment transmission" (Yichuan). However, the qi may be too weak to penetrate, resulting in cases where there is no fever and no eruption. Since this method is unreliable, it should not be used.
Select children who have had a favorable course of smallpox, wipe their pustular fluid with cotton, and insert it into the nostrils according to the male-left/female-right rule, which can also induce smallpox. However, obtaining the pustular fluid without the family's knowledge involves rupturing the pustules and stealing the material for inoculation, causing the child's true qi to leak and the toxin to remain unresolved. This is a cruel and unethical act. Those with shared principles should detest and reject it utterly; how could one possibly follow such an example?