者，洗肝明目散主之。从子懋锟，痘后两目生翳，羞明特甚，时余与家兄从宜兴试，归视之，则窗牖帷 ，皆以
衣被重重覆蔽，就明展两脾，白膜已遍覆黑睛，泪如涌泉，婴科、眼科，投药不效，束手告技穷矣。余亦
莫知为计，家兄曰，女弟垂死之证，弟能生之，岂遂技穷于是，试精思之。余返书室，闭户而思，目者，清
阳之所走也，而忽焉有翳膜，是浊阴犯之也，浊阴乌敢与阳光敌，故羞明特甚尔，吾得治法矣。乃以黄 助清阳
之气为君，生地黄、当归、养目中真血为臣，羌活、独活、防风、白芷、川芎、甘菊花、薄荷、荆芥、升清阳，
黄芩、猪胆汁、车前子、茯苓降浊阴为佐，雄猪肝作引煎服，仍间服泻青丸。八剂而目开，彻帏 ，翳已去矣。
时眼科所进点洗之药，一切屏不用，止用橄榄核磨汁敷眼胞而已。盖婴儿柔脆，点洗之药，必有所伤故也。治法
方论，详大科眼目门，并本门眼目条内。
凉肝明目散 痘后羞明。
当归 龙胆草 密蒙花 川芎 柴胡 防风 酒连
各等分，雄猪肝煮汤，煎服。
望月沙散 痘后，暗室中不能开者。
谷精草 密蒙花（酒洗） 蝉蜕（去翅足。各五钱） 望月沙（一两）
上为末。雄猪肝一两，竹刀批破，用药一钱，掺入肝内，水煮熟，饮汁食肝，效。
羌菊散 治痘疹后毒瓦斯不散，生翳障，及暴赤眼。
羌活 蝉蜕（去土） 防风 蛇蜕 菊花 谷精草 木贼 甘草 栀子 白蒺藜 大黄 黄连（各少许）
上为末。每一钱，米汤泔水温服。
【便秘】痘后毒入腹中，热气并于小肠则小便不通，并于大肠则大便不通，如前后部俱不通者，热势愈甚。小
便不通者五苓散（惊）、导赤散（心）。大便不通者三黄丸、四顺饮（并发热）、三乙承气汤。大小便俱不通者，八正
散、通关散（并痘便闷）斟酌用之。
【泄泻】痘后泄泻，其证有二。如能食而渴，脉盛者，此热入大肠也，渴者，内热也，食能多者，热消谷也，
脉盛而数，热证谛也，宜黄芩汤（痘泄利）加黄连。如食少不渴脉微小者，此里气虚，不能禁固水谷也，宜四君
子汤加诃子肉、豆蔻，或理中汤丸加熟附子。甚者，以肉豆蔻丸止之（俱痘泄利）。
【便脓血】痘后便脓血者，此热毒入大肠也，宜四物汤（失血）加黄芩、黄连、枳壳、荆
芥穗，或黄连解毒汤（烦躁）加生地黄。勿作倒靥，及用劫涩药也。
【呕吐】胃主纳而不出，大小肠主出而不纳，痘后呕吐者，是余毒在胃也，然有冷热二证。如心烦作渴，
食乳甚急，聚满胸中，然后吐出如射，其人面色带赤，手足心热，居处喜凉，此热吐也，橘皮汤（痘吐逆）加黄连、
竹茹主之。如乳食水浆随吐，面色青白，手足冷，大小便自利，此冷吐也，益黄散（脾）主之。痘后余毒，
多是热邪，其间冷证，十有一二也。亦有伤食而呕者，但闻会臭即吐，不欲食，木香大安丸或养脾丸，并用
生姜汤下。有饮水多而吐者，必吐清水，名水逆，五苓散主之。
木香大安丸
木香（二钱） 黄连 陈皮 白术（各三钱） 枳实 山楂肉 莱菔子（炒） 连翘 神曲（炒） 麦
（炒） 砂仁（各一钱五分）
上为末。神曲糊为丸。陈廪米汤下。
养脾丸
人参 白术 当归 川芎（各一钱半） 木香 青皮 黄连 陈皮（各一钱） 砂仁 山楂
肉神曲（炒） 麦芽（炒。各五分）
上为细末。水调神曲糊、丸如麻子大。每服三五十丸，陈仓米饮下。
【发热】痘疮自初以来一向发热，至于瘥后犹不少减者，此有虚实二证。如大便难，小便赤，能食而烦渴者，
此实热也，以三黄丸或四顺饮（并发热）先解利里热，后用升麻葛根汤（初热）加地骨皮解表热也，盖升麻葛
根汤治疮疹未发之先、已发之后身热药也。如大便不秘，小便不赤，坐立振摇，饮食不甚进者，此虚热也，以
保元汤（大法）加知母、麦门冬，虚甚者加炒干姜成熟附子少许，引火归源。〔薛〕陈文宿先生云∶痘疮收靥之后，
浑身经日不除，别无他证，用柴胡麦门冬散。如不退，服人参白术散（痘渴）。若风热咳嗽，咽喉不利，用桔梗甘
草防风汤。窃谓前证有因热毒未解者，有因胃气虚热者，有因胃气实热者，其因不能枚举，当临证制宜而药之。一
小儿咽痛壮热，痘痕色赤，手微热。此余毒未解。用柴胡麦门冬散而安。七日之后复热，手指初捏似热，久捏则冷，
此脾气虚也，用五味异功散而痊。一小儿痘咽痛，大便不实，口渴饮汤，手足不热，此脾胃虚弱也。用人参白术
散而大便实，但不时寒热，用加味逍遥散而愈。一小儿痘咽痛，发热作渴，面赤饮冷。此胃经实
热也。用射干鼠粘子汤而愈。因食浓味复发，手足并热，用泻黄散一剂而痊。一小儿痘咽痛，发热饮冷，大便黄色，
手足指热，此脾胃实热也。用泻黄、清胃、二散各一剂而愈。后因乳母食浓味，儿口角流涎不能吮乳，仍用前药
治母而愈。小儿痘咽痛，足热。余谓此禀足三阴虚，而无根之火上炎也。古人有云∶痘归肾经，必不可救，当用壮
水之剂，亦有生者，奈彼不悟，翌日果腰痛咽哑，始信余言，乃用大剂地黄丸料加五味子，并补中益气汤而愈。一男
子出痘，上体甚热，两足俱冷，喉痛作渴，疮亦不起发。此禀肾经虚热也。以六味地黄丸料煎与恣饮，渐愈，
又用八珍汤而痊。一小儿面色素白，出痘咽痛，发热面赤，作渴饮汤，手足指冷。此禀足三阴虚也。用大剂加减八味
丸料煎与恣饮，又以益气汤助其脾肺，以滋化源，痛止热退而愈。
柴胡麦门冬散（痘发热）
柴胡栀子散 治肝胆经有热，疮毒不愈，或发热不止。
柴胡 山栀 牡丹皮（各一钱） 川芎 芍药 茯苓（各七分） 白术（炒） 甘草（各五分） 当归
牛蒡子（炒。各七分）
上，水煎，母、子同服。
小柴胡汤 治发热甚而呕者，宜服之。
柴胡 人参 黄芩（各三两） 甘草（炙） 半夏（各二两半，汤泡七次）
上为粗末。每服三钱，水一盏，生姜三片，枣子一枚，同煎至半盏，去滓温服。咳嗽者，加五味子煎服。
头痛发热，肢节疼痛者，四味升麻汤。大便不通者，四顺饮。若大便自利黄黑色者，此毒亦有所出，不
必广与汤剂，恐重增他病，大便自然通，不得以温药助之，疮疹亦稀少。自快利，只与四味升麻汤、荆芥
散，虽大便利，不可以温药助之。其下利甚者，却与少温之。
槐花散 治 疮余热不退。
槐花 赤小豆（各炒，二钱） 麝香（少许）
上为细末。每服半钱，蜜汤调服，不拘时候。
黄 散 治壮热不退，可凉肌肤，散热。
黄 柴胡 干葛 甘草（炙。各等分）
上为末。每服一钱，薄荷三叶，水半盏，煎至三分，约三呷，空心服。此药治
发热数日未退者，其热是疮疹者，量其虚实用之也。
【中风】痘后忽然口噤涎潮，角弓反张，手足螈 ，身青黑色，此中风也，疮痘方愈，荣卫正弱，不知避忌，
忽遇节令气交，八方不正之气，乘虚而入，故为此证。宜消风散二钱、入蝉蜕末一钱、分为三服，投生姜薄
荷汁及酒各数点，温汤浸之，连二三服。或作瘾疹，或再出肤疹而愈。
消风散（见痘中风）
钩藤汤 痘后口噤僵直，绕脐腹痛。
钩藤 红花 木香 川芎 当归 白芍 甘草 白术 青皮 黄连 官桂 生姜
各等分，水煎，不拘时服。
【骨节作痛】俗名痘风，丹溪分气血虚实，以日子守之，多带气血不足。虚则黄 生血之剂助之，略佐以风药。
实则白芍药、黄芩、为君，连翘、白芷、续断之类为佐。若属虚寒，陈氏方可用。余详痘中风门。
【拘挛】痘后手足拘挛，屈伸不便，起居艰苦者，乃血耗气虚，不能荣养于筋，宜十全大补汤去地黄、白茯苓，
加川续断，多服乃佳。气虚者少加川乌炮过、行经，
不可误作风治，妄行发散，反耗阴血也。
当归桂枝汤 治痘后手足不能屈伸。
当归 川芎 黄 甘草 薄桂 黄柏 苍术（炒）
各等分，水煎。如气虚，少加川乌以行经，加人参为主。如感风寒，以致骨节疼痛，加羌活、防风。
【昏昧妄言】痘后昏昧，不解识人，口中常妄言，如邪祟状，此移热入心包络，宜导赤散（心）吞
安神丸（痘谵妄），待醒后以保元汤加麦门冬、生地黄，四物汤加石菖蒲、木通、山栀子仁，相间服之。
若卒然昏昏喜睡，状如眩晕，身无热，口中无妄语，其人痘出必重，又乳食少，今毒瓦斯已解，正气未复，
故邪退而喜睡，乃否极泰来之象，不须妄治，逡巡苏醒矣。
【厥逆】手足厥冷，盖覆不温，此痘疹逆候也，若在正盛之时，十无一生，今病已愈，气血久虚，脾
胃大困，其厥逆宜矣，用保元汤加当归身、熟附子、主之。
【咳嗽】咳嗽频频，涕唾稠粘，此痘疹常证也，有寒有热，有虚有实，不可拘泥一定之法。如自初出咳
嗽到今未愈者，此肺中余邪未尽也，宜甘桔汤（咽喉）合泻白散
（肺）加牛蒡子、马兜铃主之。如咳而热，大便难，小便赤者，此热毒也，宜葶苈丸主之（痘喘）。大便润
者，人参白虎汤（痘渴）合甘桔汤主之。如咳而大便溏，小便清，无大热渴者，此虚也，宜人参清膈散主之
（痘咳嗽）。如咳而血出者，甘桔汤加牛蒡子、茅根汁、阿胶主之。如向不咳，今始咳者，此风寒外感也，
麻黄汤主之（痘喘）。
灯心汤 治疮痘出后，烦喘小便不利者，宜进之。
灯心（一把） 鳖甲（醋煮黄，二两）
上锉为散。每服一两，用水八合，煎取四分服之，各量大小加减。
咳嗽之时胁痛者，经云∶左右者，阴阳之道路，左右，两胁之谓也，由余毒在中，阴阳之气，不能升降，故
胁为之疼也，但当解毒，毒瓦斯去，则真气行，所苦自平矣，小柴胡加枳桔汤主之。
赤茯苓汤 治小儿疹痘，疮出后咳逆胁痛，不下食。
赤茯苓 甘草（炙） 大青 升麻 枳壳（麸炒，各半两） 栀子（一分）
上为粗末。每服一钱，水一小盏，入苦竹叶七片，豆豉三十粒，同煎至五分盏，
去滓，分为三服，日三四服，看儿大小，以意加减。本方称疹痘出后胁痛者，由
病后毒瓦斯溷乱，阻于升降，左右为阴阳之道路，气之所行处，令气滞，为胁痛，以枳壳宽肠下气，令气顺，
胁不痛也，大青、栀子去蕴热，升麻解毒，赤茯苓导心火，利小肠，无热以克肺气，而效逆自平尔。
【腹痛】疮疹未出而腹痛者，乃 毒内攻也，今毒已解，无复壅遏矣，而腹中痛者，其证有二。一则因大便
未通，燥屎作痛，备急丸主之（大便闭）。一则因食过多，胃虚不能消谷而作痛，如便秘者，丁香脾积丸（伤食），便利
者，木香大安丸（伤食）主之。但燥屎痛者，病在下焦，伤食痛者，病在上焦，手不可按，若原食少，又便
常润，忽尔作痛者，此虚寒证也，病在中焦，必喜用手按摩，黄 建中汤主之。
【渴】痘家作渴，亦是常事，至痘后则不宜有渴，乃忽然渴而引饮者，余毒留于心胃，膈焦咽燥故也，其人必
能食，大便秘，小便赤，舌燥咽干，宜人参白虎汤加黄连主之。若食少，大小便自调，虽好饮汤，咽舌不燥，此
脾胃虚，津液不足也，宜人参白术散，不愈，人参麦门冬散加天花粉主之（并痘渴）。
【失音】痘后失音有二。咽痛不能言者，此毒瓦斯结于咽喉之间，痰壅作痛，而不能言，天花散主之（痘失音）。
心热不能言者，心中邪热未彻，肾虚不能上接于阳，
虽有声而不能言，四物汤去川芎，加麦门冬、白茯苓、主之。
【不喜食】痘后邪气尽退，正气将复，脾胃略纾，宜渐能食也，若原不食，今因喜食太过，或原能食，今
又骤加以致恶食不食者，此皆内伤有余证也，宜木香大安丸主之（伤食）。如向未食，今又不喜食者，此脾胃中
气不足，宜七珍散（痘不能食）或人参白术散去葛根加陈皮、木香，研末，取二两，另用糯米、绿豆、各二两，各
炒熟研末相和，枣汤调服，稍能食，更兼进养脾丸。
【寒热】痘后忽发寒热如疟状，至后如期即发者，此脾虚气弱，失于将息，重感风寒，宜先以柴葛桂枝汤发去
新受表邪，后以保元汤加当归、陈皮、白术、砂仁、乌梅、生姜、调之。
大和散 治疮痘后，寒热往来，嗜卧顿闷躁乱。
生地黄 当归 地骨皮 人参 甘草（炙） 白芍药（各等分）
上 咀。每服一钱，水半盏，煎至三分，去滓温服。
柴葛桂枝汤（见初热）
【肿胀】痘后面目虚浮，或久则一身皆肿者，此表气不足，出风太早，风邪乘虚
而入，其治在肺，宜五皮汤先加桂枝微汗之，后只服本方，若遍身皆肿，以胃苓汤合五皮汤主之。
痘后腹虚肿胀满，或气喘粗者，此宿垢在里，不问余毒、食积、蓄水，并先利之，宜塌气丸，
利后以胃苓汤去甘草，加人参、黄 、大腹皮调之，其治在脾。如因新食作胀不肿者，只木香大安丸。
五皮汤
桑白皮 地骨皮 生姜皮 大腹皮 五加皮（各等分）
（若出现）翳膜遮蔽瞳孔的症状，以洗肝明目散为主治方剂。患者子懋锟，出痘后双眼生翳，极度畏光。当时我与家兄正前往宜兴参加科举考试，归来探望时，只见窗户和帷帐都被衣服和被褥层层严密遮盖，他在微光下睁开双眼，白膜已完全覆盖黑睛，泪水如泉水般涌出。儿科、眼科医生投药均无效，束手无策，声称技穷。我也无可奈何，家兄说：“妹妹已是垂死之证，你若能救活她，怎能就此说技穷呢？请仔细思考。”我回到书房，闭门沉思，眼睛是清阳之气运行的部位，忽然出现翳膜，这是浊阴之气侵犯所致。浊阴怎敢与阳光对抗，所以特别畏光。我找到了治疗方法。于是用黄芪助益清阳之气作为君药，生地黄、当归滋养眼中真血作为臣药，羌活、独活、防风、白芷、川芎、甘菊花、薄荷、荆芥升发清阳，黄芩、猪胆汁、车前子、茯苓降泄浊阴作为佐药，以雄猪肝为引煎服，同时间歇服用泻青丸。服药八剂后眼睛睁开，揭开帷帐，翳膜已去除。当时眼科所进用的点眼、洗眼药物，全部停用，仅用橄榄核磨汁敷于眼睑。因为婴儿体质柔脆，点洗类药物必然会造成损伤。具体的治法方论，详见大科眼目门及本门眼目条内。
凉肝明目散：主治痘后畏光。
当归、龙胆草、密蒙花、川芎、柴胡、防风、酒黄连，各等分。用雄猪肝煮汤，煎药服用。
望月沙散：主治痘后在暗室中无法睁眼。
谷精草、密蒙花（酒洗）、蝉蜕（去翅足，各五钱）、望月沙（一两）。
以上研为细末。取雄猪肝一两，用竹刀剖开，将药末一钱掺入肝内，用水煮熟，饮汁并吃肝，有效。
羌菊散：治疗痘疹后毒气不散，生成翳障，以及突发赤眼。
羌活、蝉蜕（去土）、防风、蛇蜕、菊花、谷精草、木贼、甘草、栀子、白蒺藜、大黄、黄连（各少许）。
以上研为细末。每次服一钱，用米泔水温服。
【便秘】痘后毒气入腹，热气并入小肠则小便不通，并入大肠则大便不通，如果前后二便都不通，热势更加严重。小便不通者，用五苓散（因惊致闭）、导赤散（心经热盛）。大便不通者，用三黄丸、四顺饮（并发热症状）、三乙承气汤。大小便俱不通者，斟酌使用八正散、通关散（兼痘便闷塞）。
【泄泻】痘后泄泻，其证候有两种。如果能进食且口渴，脉象盛大，这是热邪入大肠。口渴是因为内热，能多食是因为热消谷，脉象盛大而数，确为热证，宜用黄芩汤（痘泄利）加黄连。如果食少不渴，脉象微小，这是里气虚弱，不能固摄水谷，宜用四君子汤加诃子肉、豆蔻，或理中汤丸加熟附子。严重的，用肉豆蔻丸止泻（均属痘泄利范畴）。
【便脓血】痘后大便带脓血，这是热毒入大肠，宜用四物汤（失血）加黄芩、黄连、枳壳、荆芥穗，或黄连解毒汤（烦躁）加生地黄。不要当作痘疮倒靥（痘疮内陷），也不要用劫涩（强行收敛止泻）的药物。
【呕吐】胃主受纳而不吐出，大小肠主排出而不受纳。痘后呕吐，是余毒在胃。但有冷、热两种证候。如果心烦口渴，吃奶很急，乳汁聚满胸中，然后喷射状吐出，面色带红，手足心热，喜居凉处，这是热吐，用橘皮汤（痘吐逆）加黄连、竹茹主治。如果乳食水浆随吐而出，面色青白，手足冷，大小便自利，这是冷吐，用益黄散（脾虚寒）主治。痘后余毒，多是热邪，其中冷证占十之一二。也有因伤食而呕吐的，闻到食物臭味就吐，不想吃东西，用木香大安丸或养脾丸，并用生姜汤送服。有饮水多而呕吐的，必定吐出清水，名为水逆，用五苓散主治。
木香大安丸
木香（二钱）、黄连、陈皮、白术（各三钱）、枳实、山楂肉、莱菔子（炒）、连翘、神曲（炒）、麦芽（炒）、砂仁（各一钱五分）。
以上研为细末。用神曲糊制作成丸。用陈廪米汤送服。
养脾丸
人参、白术、当归、川芎（各一钱半）、木香、青皮、黄连、陈皮（各一钱）、砂仁、山楂肉、神曲（炒）、麦芽（炒，各五分）。
以上研为细末。用水调神曲糊，制成如麻子大的丸药。每次服三五十丸，用陈仓米饮送服。
【发热】痘疮从初发到痊愈一直发热，直到病愈后仍不少减的，这有虚、实两种证候。如果大便难，小便赤，能进食且烦渴，这是实热，用三黄丸或四顺饮（并发热）先解利里热，后用升麻葛根汤（初热）加地骨皮解表热。因为升麻葛根汤是治疗疮疹未发之前、已发之后身热的药物。如果大便不秘结，小便不赤，坐立不安振摇，饮食不进，这是虚热，用保元汤（大法）加知母、麦门冬，虚甚者加炒干姜、少许熟附子，引火归源。〔薛〕陈文宿先生说：痘疮收靥之后，浑身经日不退热，别无其他证候，用柴胡麦门冬散。如果不退热，服人参白术散（痘渴）。如果有风热咳嗽，咽喉不利，用桔梗甘草防风汤。我认为前述证候有因热毒未解的，有因胃气虚热的，有因胃气实热的，病因不能一一列举，应当临证制宜用药。一个小儿咽痛壮热，痘痕色红，手微热。这是余毒未解。用柴胡麦门冬散而安。七日后又发热，手指初捏似热，久捏则冷，这是脾气虚，用五味异功散而痊愈。一个小儿痘后咽痛，大便不实，口渴饮汤，手足不热，这是脾胃虚弱。用人参白术散而大便变实，但不时寒热，用加味逍遥散而愈。一个小儿痘后咽痛，发热作渴，面赤饮冷。这是胃经实热。用射干鼠粘子汤而愈。因吃浓味食物复发，手足并热，用泻黄散一剂而痊愈。一个小儿痘后咽痛，发热饮冷，大便黄色，手足指热，这是脾胃实热。用泻黄散、清胃散各一剂而愈。后来因乳母吃浓味食物，小儿口角流涎不能吮乳，仍用前药治母而愈。小儿痘后咽痛，足热。我认为这是禀赋足三阴虚，无根之火上炎。古人说：痘归肾经，必不可救，当用壮水之剂，也有治愈的，无奈他们不理解，第二天果然腰痛咽哑，才相信我的话，于是用大剂量地黄丸料加五味子，并补中益气汤而愈。一个男子出痘，上体甚热，两足俱冷，喉痛作渴，疮亦不起发。这是禀赋肾经虚热。以六味地黄丸料煎服恣饮，渐愈，又用八珍汤而痊愈。一个小儿面色素白，出痘咽痛，发热面赤，作渴饮汤，手足指冷。这是禀赋足三阴虚。用大剂量加减八味丸料煎服恣饮，又以益气汤助其脾肺，以滋化源，痛止热退而愈。
柴胡麦门冬散（痘发热）
柴胡栀子散：治疗肝胆经有热，疮毒不愈，或发热不止。
柴胡、山栀、牡丹皮（各一钱）、川芎、芍药、茯苓（各七分）、白术（炒）、甘草（各五分）、当归、牛蒡子（炒，各七分）。
以上水煎，母亲、孩子同服。
小柴胡汤：治疗发热甚而呕吐者，宜服之。
柴胡、人参、黄芩（各三两）、甘草（炙）、半夏（各二两半，汤泡七次）。
以上为粗末。每次服三钱，水一盏，生姜三片，枣子一枚，同煎至半盏，去滓温服。咳嗽者，加五味子煎服。
头痛发热，肢节疼痛者，用四味升麻汤。大便不通者，用四顺饮。若大便自利呈黄黑色，这是毒气有所排出，不必广泛给予汤剂，恐重增他病，大便自然通，不得用温药助之，疮疹亦稀少。自快利，只给四味升麻汤、荆芥散，虽大便利，不可以温药助之。其下利甚者，却给予少量温药。
槐花散：治疗痘疮余热不退。
槐花、赤小豆（各炒，二钱）、麝香（少许）。
以上为细末。每次服半钱，蜜汤调服，不拘时候。
黄芪散：治疗壮热不退，可凉肌肤，散热。
黄芪、柴胡、干葛、甘草（炙，各等分）。
以上为末。每次服一钱，薄荷三叶，水半盏，煎至三分，约喝三口，空心服。此药治疗发热数日未退者，其热是疮疹者，量其虚实用之。
【中风】痘后忽然口噤流涎，角弓反张，手足抽搐，身青黑色，这是中风。疮痘刚愈，营卫正气正弱，不知避忌，忽遇节气交替，八方不正之气，乘虚而入，故为此证。宜用消风散二钱、加入蝉蜕末一钱、分为三服，投入生姜薄荷汁及酒各数点，温汤浸之，连服二三服。或发作瘾疹，或再出肤疹而愈。
消风散（见痘中风）
钩藤汤：痘后口噤僵直，绕脐腹痛。
钩藤、红花、木香、川芎、当归、白芍、甘草、白术、青皮、黄连、官桂、生姜。
各等分，水煎，不拘时服。
【骨节作痛】俗名痘风，丹溪分气血虚实，以日子守之，多带气血不足。虚则用黄芪生血之剂助之，略佐以风药。实则用白芍药、黄芩为君，连翘、白芷、续断之类为佐。若属虚寒，陈氏方可用。其余详见痘中风门。
【拘挛】痘后手足拘挛，屈伸不便，起居艰苦，乃血耗气虚，不能荣养于筋，宜用十全大补汤去地黄、白茯苓，加川续断，多服乃佳。气虚者少加炮过的川乌以行经，不可误作风治，妄行发散，反耗阴血也。
当归桂枝汤：治疗痘后手足不能屈伸。
当归、川芎、黄芪、甘草、薄桂、黄柏、苍术（炒）。
各等分，水煎。如气虚，少加川乌以行经，加人参为主。如感风寒，以致骨节疼痛，加羌活、防风。
【昏昧妄言】痘后昏昧，不识人，口中常妄言，如邪祟状，这是移热入心包络，宜用导赤散（心）吞服安神丸（痘谵妄），待醒后以保元汤加麦门冬、生地黄，四物汤加石菖蒲、木通、山栀子仁，相间服之。
若突然昏昏喜睡，状如眩晕，身无热，口中无妄语，其人痘出必重，又乳食少，今毒瓦斯已解，正气未复，故邪退而喜睡，乃否极泰来之象，不须妄治，逡巡苏醒矣。
【厥逆】手足厥冷，盖覆不温，这是痘疹逆候。若在正盛之时，十无一生。今病已愈，气血久虚，脾胃大困，其厥逆宜矣，用保元汤加当归身、熟附子主治。
【咳嗽】咳嗽频频，涕唾稠粘，这是痘疹常证。有寒有热，有虚有实，不可拘泥一定之法。如自初出咳嗽到今未愈者，这是肺中余邪未尽，宜用甘桔汤（咽喉）合泻白散（肺）加牛蒡子、马兜铃主治。如咳而热，大便难，小便赤者，这是热毒，宜用葶苈丸主治（痘喘）。大便润者，用人参白虎汤（痘渴）合甘桔汤主治。如咳而大便溏，小便清，无大热渴者，这是虚，宜用人参清膈散主治（痘咳嗽）。如咳而血出者，用甘桔汤加牛蒡子、茅根汁、阿胶主治。如向不咳，今始咳者，这是风寒外感，用麻黄汤主治（痘喘）。
灯心汤：治疗疮痘出后，烦喘小便不利者，宜进之。
灯心（一把）、鳖甲（醋煮黄，二两）。
以上锉为散。每次服一两，用水八合，煎取四分服之，各量大小加减。
咳嗽之时胁痛者，经云：左右者，阴阳之道路，左右，两胁之谓也，由余毒在中，阴阳之气，不能升降，故胁为之疼也，但当解毒，毒瓦斯去，则真气行，所苦自平矣，用小柴胡加枳桔汤主治。
赤茯苓汤：治疗小儿疹痘，疮出后咳逆胁痛，不下食。
赤茯苓、甘草（炙）、大青、升麻、枳壳（麸炒，各半两）、栀子（一分）。
以上为粗末。每次服一钱，水一小盏，入苦竹叶七片，豆豉三十粒，同煎至五分盏，去滓，分为三服，日三四服，看儿大小，以意加减。本方称疹痘出后胁痛者，由病后毒瓦斯溷乱，阻于升降，左右为阴阳之道路，气之所行处，令气滞，为胁痛，以枳壳宽肠下气，令气顺，胁不痛也，大青、栀子去蕴热，升麻解毒，赤茯苓导心火，利小肠，无热以克肺气，而效逆自平尔。
【腹痛】疮疹未出而腹痛者，乃痘毒内攻也。今毒已解，无复壅遏矣，而腹中痛者，其证有二。一则因大便未通，燥屎作痛，备急丸主治（大便闭）。一则因食过多，胃虚不能消谷而作痛，如便秘者，丁香脾积丸（伤食），便利者，木香大安丸（伤食）主治。但燥屎痛者，病在下焦，伤食痛者，病在上焦，手不可按，若原食少，又便常润，忽尔作痛者，此虚寒证也，病在中焦，必喜用手按摩，黄芪建中汤主治。
【渴】痘家作渴，亦是常事，至痘后则不宜有渴。乃忽然渴而引饮者，余毒留于心胃，膈焦咽燥故也。其人必能食，大便秘，小便赤，舌燥咽干，宜人参白虎汤加黄连主治。若食少，大小便自调，虽好饮汤，咽舌不燥，此脾胃虚，津液不足也，宜人参白术散，不愈，人参麦门冬散加天花粉主治（并痘渴）。
【失音】痘后失音有二。咽痛不能言者，此毒瓦斯结于咽喉之间，痰壅作痛，而不能言，天花散主治（痘失音）。心热不能言者，心中邪热未彻，肾虚不能上接于阳，虽有声而不能言，四物汤去川芎，加麦门冬、白茯苓主治。
【不喜食】痘后邪气尽退，正气将复，脾胃略纾，宜渐能食也。若原不食，今因喜食太过，或原能食，今又骤加以致恶食不食者，此皆内伤有余证也，宜木香大安丸主治（伤食）。如向未食，今又不喜食者，此脾胃中气不足，宜七珍散（痘不能食）或人参白术散去葛根加陈皮、木香，研末，取二两，另用糯米、绿豆、各二两，各炒熟研末相和，枣汤调服，稍能食，更兼进养脾丸。
【寒热】痘后忽发寒热如疟状，至后如期即发者，此脾虚气弱，失于将息，重感风寒，宜先以柴葛桂枝汤发去新受表邪，后以保元汤加当归、陈皮、白术、砂仁、乌梅、生姜、调之。
大和散：治疗疮痘后，寒热往来，嗜卧顿闷躁乱。
生地黄、当归、地骨皮、人参、甘草（炙）、白芍药（各等分）。
以上咀。每次服一钱，水半盏，煎至三分，去滓温服。
柴葛桂枝汤（见初热）
【肿胀】痘后面目虚浮，或久则一身皆肿者，此表气不足，出风太早，风邪乘虚而入，其治在肺，宜五皮汤先加桂枝微汗之，后只服本方，若遍身皆肿，以胃苓汤合五皮汤主治。
痘后腹虚肿胀满，或气喘粗者，此宿垢在里，不问余毒、食积、蓄水，并先利之，宜塌气丸，利后以胃苓汤去甘草，加人参、黄芪、大腹皮调之，其治在脾。如因新食作胀不肿者，只木香大安丸。
(If) nebulae obscure the pupil, Xi Gan Ming Mu San (Wash Liver Brighten Eyes Powder) is the primary formula. The patient Zi Mokon developed nebulae in both eyes after smallpox, with extreme photophobia. At that time, I and my elder brother were traveling to Yixing for the imperial examinations. Upon returning to visit him, we found that the windows and curtains were heavily covered with clothes and quilts. When he opened his eyes in the dim light, white membranes had completely covered the black cornea, and tears flowed like a spring. Pediatricians and ophthalmologists administered medicines without effect, holding their hands in helplessness and claiming exhaustion of skills. I was also at a loss. My elder brother said, "Your sister is on the verge of death; if you can save her, how can you claim skill exhaustion? Please think carefully." I returned to my study, closed the door, and pondered. The eyes are the pathways where clear Yang Qi circulates. The sudden appearance of nebulae indicates invasion by turbid Yin Qi. How dare turbid Yin oppose the sunlight? Hence the extreme photophobia. I have found the treatment method. Thus, Huangqi (Astragali Radix) was used as the sovereign herb to assist clear Yang Qi; Shengdihuang (Rehmanniae Radix Recens) and Danggui (Angelicae Sinensis Radix) were used as minister herbs to nourish the true blood of the eyes; Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ganhua Ju (Chrysanthemi Flos), Bohe (Menthae Haplocalycis Herba), and Jingjie (Schizonepetae Spica) were used to ascend clear Yang; Huangqin (Scutellariae Radix), Zhu Danzhi (Porci Bile), Cheqianzi (Plantaginis Semen), and Fuling (Poria) were used to descend turbid Yin as assistant herbs; male pig liver was used as a guide herb for decoction and administration, while Xie Qing Wan (Drain Green Pill) was taken intermittently. After eight doses, the eyes opened, the curtains were unveiled, and the nebulae disappeared. All point-eye and wash-eye medicines prescribed by ophthalmologists were discontinued; only juice ground from olive pits was applied to the eyelids. This is because infants have fragile constitutions, and eye drops/washes would inevitably cause injury. Detailed discussions on treatment methods and formulas can be found in the Major Section on Eye Diseases and within the Eye Disease entries of this section.
Liang Gan Ming Mu San (Cool Liver Brighten Eyes Powder): Indicated for photophobia after smallpox.
Danggui (Angelicae Sinensis Radix), Longdancao (Gentianae Radix), Mimenghua (Tubiflorae Centipedas Flower), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Jiu Lian (Scutellariae Radix prepared with wine). Equal parts. Decoct with soup boiled from male pig liver for oral administration.
Wang Yue Sha San (Moon Sand Powder): Indicated for inability to open eyes in dark rooms after smallpox.
Gujingcao (Evodiae Fructus), Mimenghua (Tubiflorae Centipedas Flower, washed with wine), Chantui (Cicadae Perioaterum, wings and feet removed, 5 qian each), Wangyuesha (Asini Corneum, 1 liang).
Grind into fine powder. Take 1 liang of male pig liver, slice open with a bamboo knife, insert 1 qian of the powder into the liver, boil in water until cooked. Drink the broth and eat the liver. Effective.
Qiang Ju San (Notopterygium and Chrysanthemum Powder): Treats residual toxic qi not dispersing after measles/smallpox, causing nebulae/obstruction, and acute red eyes.
Qianghuo (Notopterygii Rhizoma et Radix), Chantui (Cicadae Perioaterum, cleaned of soil), Fangfeng (Saposhnikoviae Radix), Shetui (Bombyx Batryticatus), Juhua (Chrysanthemi Flos), Gujingcao (Evodiae Fructus), Muzei (Equiseti Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Baijili (Tribuli Fructus), Dahuang (Rhei Radix et Rhizoma), Huanglian (Coptidis Rhizoma). Small amounts of each.
Grind into fine powder. Take 1 qian per dose, warm with rice wash water.
[Constipation] After smallpox, if toxic qi enters the abdomen and heat merges into the Small Intestine, urination becomes obstructed; if it merges into the Large Intestine, defecation becomes obstructed. If both anterior and posterior orifices are blocked, the heat pathogen is even more severe. For urinary obstruction, use Wuling San (Five-Ingredient Powder with Poria) [for obstruction due to fright] or Dao Chi San (Direct Outward Red Powder) [for Heart heat]. For fecal obstruction, use Sanhuang Wan (Three-Yellow Pill), Sishun Yin (Four-Smooth Decoction) [if accompanied by fever], or Yi Yi Chengqi Tang (Yi Yi Bowel-Relieving Decoction). For simultaneous obstruction of both urine and stool, use Bazheng San (Eight-Righteous Powder) or Tongguan San (Pass-the-Gate Powder) [for smallpox with abdominal distension and constipation], adjusting according to circumstances.
[Diarrhea] Diarrhea after smallpox presents in two patterns. If the patient can eat and feels thirsty with a surging pulse, this indicates Heat entering the Large Intestine. Thirst signifies internal heat; ability to eat much signifies heat consuming grain; a surging and rapid pulse confirms the heat pattern. Use Huangqin Tang (Scutellaria Decoction) [for smallpox diarrhea] plus Huanglian (Coptidis Rhizoma). If food intake is low, no thirst, and the pulse is minute and weak, this indicates deficiency of interior Qi failing to secure fluids and food. Use Sijunzi Tang (Four-Gentlemen Decoction) plus Hezi Rou (Arecae Seed Endocarp) and Doukou (Cardamomi Fructus Rotundus), or Lizhong Wan/Tang (Regulate the Middle Pill/Decoction) plus Shu Fuzi (Prepared Aconiti Lateralis Radix). For severe cases, use Roudoukou Wan (Myristica Pill) to stop diarrhea (all under smallpox diarrhea).
[Purulent Bloody Stool] Purulent bloody stool after smallpox indicates Heat-Toxin entering the Large Intestine. Use Siwu Tang (Four-Substance Decoction) [for blood loss] plus Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhike (Aurantii Fructus Immaturus), and Jingjiesui (Schizonepetae Spica); or Huanglian Jiedu Tang (Coptis Detoxification Decoction) [for irritability] plus Shengdihuang (Rehmanniae Radix Recens). Do not treat as inverted smallpox lesions, nor use astringent drugs to forcibly stop discharge.
[Vomiting] The Stomach receives but does not expel; the Small and Large Intestines expel but do not receive. Vomiting after smallpox indicates residual toxin in the Stomach, presenting as either Cold or Heat. If there is mental restlessness, thirst, urgent milk intake, milk accumulating in the chest before being vomited forcefully (like shooting), reddish complexion, hot palms/soles, and preference for cool environments, this is Heat vomiting. Use Jupi Tang (Tangerine Peel Decoction) [for smallpox vomiting/reversal] plus Huanglian (Coptidis Rhizoma) and Zhuru (Bambusae Caulis in Taeniam). If milk/water is vomited immediately upon ingestion, with bluish-white complexion, cold extremities, and normal urination/defecation, this is Cold vomiting. Use Yihuang San (Yellow Benefit Powder) [for Spleen deficiency-cold]. Residual toxins after smallpox are mostly Heat pathogens; Cold patterns account for one or two out of ten. Vomiting due to food stagnation occurs when smelling food triggers vomiting and loss of appetite; use Muxiang Da'an Wan (Costus Peaceful Security Pill) or Yangpi Wan (Nourish Spleen Pill) with Shengjiang (Zingiberis Rhizoma Recens) decoction. Vomiting after excessive water drinking, specifically vomiting clear fluid, is named Shui Ni (Water Reversal); treat with Wuling San (Five-Ingredient Powder with Poria).
Muxiang Da'an Wan (Costus Peaceful Security Pill)
Muxiang (Aucklandiae Radix, 2 qian), Huanglian (Coptidis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian each), Zhishi (Aurantii Fructus Immaturus), Shanzha Rou (Crataegi Fructus), Laifuzi (Radish Seed, stir-fried), Lianqiao (Forsythiae Fructus), Shenqu (Massa Medicata Fermentata, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried), Sharen (Amomi Fructus, 1.5 qian each).
Grind into powder. Form pills using Shenqu paste. Administer with aged barn-rice decoction.
Yangpi Wan (Nourish Spleen Pill)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, 1.5 qian each), Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma), Chenpi (Citri Reticulatae Pericarpium, 1 qian each), Sharen (Amomi Fructus), Shanzha Rou (Crataegi Fructus), Shenqu (Massa Medicata Fermentata, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried, 0.5 qian each).
Grind into fine powder. Mix with water and Shenqu paste to form pills the size of hemp seeds. Take 30-50 pills per dose with aged barn-rice drink.
[Fever] Fever persisting from the onset of smallpox through recovery without reduction indicates either Excess or Deficiency patterns. If difficult defecation, red urine, eating capacity with irritability/thirst exist, this is Excess Heat. First resolve interior heat with Sanhuang Wan (Three-Yellow Pill) or Sishun Yin (Four-Smooth Decoction) [with fever], then release exterior heat with Shengma Gegen Tang (Kudzu and Cimicifuga Decoction) [initial heat] plus Digupi (Lycii Cortex). Shengma Gegen Tang treats fever before and after rash eruption. If no constipation, no red urine, but restlessness/shaking and poor appetite, this is Deficiency Heat. Use Baoyuan Tang (Preserve Origin Decoction) [general principle] plus Zhimu (Anemarrhenae Rhizoma) and Maidong (Ophiopogonis Radix). For severe deficiency, add Chao Ganjiang (Stir-fried Zingiberis Rhizoma) and a little Shu Fuzi (Prepared Aconiti Lateralis Radix) to guide fire back to its source. [Xue] Mr. Chen Wensu stated: After smallpox scabs fall, if whole-body fever persists for days without other symptoms, use Chaihu Maidong San (Bupleurum and Ophiopogon Powder). If fever persists, use Renshen Baizhu San (Ginseng and Atractylodes Powder) [smallpox thirst]. For wind-heat cough and throat discomfort, use Jiegan Gancao Fangfeng Tang (Platycodon, Licorice, and Saposhnikovia Decoction). I believe these conditions arise from unresolved heat-toxin, Stomach Qi deficiency-heat, or Stomach Qi excess-heat. Causes vary; treatment must be adapted clinically. Case 1: Child with sore throat, high fever, red smallpox scars, slightly hot hands. Residual toxin unresolved. Treated with Chaihu Maidong San, condition stabilized. Seven days later, fever recurred; fingers felt hot initially but cold upon prolonged touch, indicating Spleen Qi deficiency. Treated with Wuwei Yigong San (Five-Ingredient Extra-Effort Powder), recovered. Case 2: Child with post-smallpox sore throat, loose stools, thirst for hot drinks, cold extremities. Spleen-Stomach weakness. Treated with Renshen Baizhu San, stools solidified, but intermittent chills/fever remained. Treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), recovered. Case 3: Child with post-smallpox sore throat, fever/thirst, red face, desire for cold drinks. Stomach Meridian Excess Heat. Treated with Shegan Niu Bang Zi Tang (Belamcanda and Burdock Seed Decoction), recovered. Relapse after rich diet, hot extremities. Treated with Xiehuang San (Drain Yellow Powder), recovered. Case 4: Child with post-smallpox sore throat, fever/cold drink desire, yellow stool, hot toes. Spleen-Stomach Excess Heat. Treated with Xiehuang San and Qingwei San (Clear Stomach Powder), recovered. Later, salivation prevented suckling due to wet nurse's rich diet. Treated mother with previous formula, child recovered. Case 5: Child with post-smallpox sore throat, hot feet. Root deficiency of Foot Three Yin meridians, floating fire ascending. Ancients say: "Smallpox involving Kidney Meridian is incurable," recommending Water-Nourishing agents. Some recover. Patient ignored advice, next day had lower back pain and hoarseness. Believed me. Treated with large dose Dihuang Wan (Rehmannia Pill) material plus Wuweizi (Schisandrae Fructus) and Buzhong Yiqi Tang (Middle-Boosting and Qi-Invigorating Decoction), recovered. Case 6: Male with smallpox, upper body very hot, cold feet, sore throat/thirst, rash failed to erupt. Kidney Meridian Deficiency Heat constitution. Treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) material decocted for free drinking, gradually improved, then Ba Zhen Tang (Eight-Treasure Decoction) for full recovery. Case 7: Pale child, post-smallpox sore throat, fever/red face, thirst/hot drink desire, cold toes. Foot Three Yin deficiency. Treated with large dose Jiawei Bawei Wan (Modified Eight-Ingredient Pill) material, plus Yiqi Tang (Qi-Invigorating Decoction) to support Spleen-Lung and generate fluids. Pain stopped, fever subsided, recovered.
Chaihu Maidong San (Bupleurum and Ophiopogon Powder) [Smallpox Fever]
Chaihu Zizhi San (Bupleurum and Gardenia Powder): Treats Liver/Gallbladder Heat, unresolved rash toxicity, or persistent fever.
Chaihu (Bupleuri Radix), Shan Zhi (Gardeniae Fructus), Mudanpi (Moutan Cortex, 1 qian each), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba), Fuling (Poria, 0.7 qian each), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian each), Danggui (Angelicae Sinensis Radix), Niubangzi (Arctii Fructus, stir-fried, 0.7 qian each).
Decoct in water. Mother and infant take together.
Xiao Chaihu Tang (Minor Bupleurum Decoction): Treats severe fever with vomiting.
Chaihu (Bupleuri Radix), Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix, 3 liang each), Gancao (Licorice Root, honey-fried), Banxia (Pinelliae Rhizoma, 2.5 liang each, soaked in boiling water seven times).
Coarse powder. Take 3 qian per dose, 1 cup water, 3 slices ginger, 1 jujube. Decoct to half cup, strain, take warm. Add Wuweizi (Schisandrae Fructus) if coughing.
For headache, fever, joint pain, use Simei Shengma Tang (Four-Ingredient Cimicifuga Decoction). For constipation, use Sishun Yin (Four-Smooth Decoction). If spontaneous loose stools are yellow-black, toxin is exiting; do not broadly administer decoctions to avoid aggravating other conditions. Stools will naturally clear. Do not use warming herbs to assist; rashes will be sparse. For spontaneous loose stools, only give Simei Shengma Tang and Jingjie San (Schizonepeta Powder). Even with profuse loose stools, do not use warming herbs. For severe diarrhea, administer slight warming agents.
Huaihua San (Sophora Flower Powder): Treats lingering heat after smallpox/measles.
Huaihua (Sophorae Flos), Chixiaodou (Adzuki Bean, stir-fried, 2 qian each), Shexiang (Moschus, small amount).
Fine powder. Take 0.5 qian per dose, mix with honey water. Anytime.
Huangqi San (Astragalus Powder): Treats unremitting high fever, cools skin, dissipates heat.
Huangqi (Astragali Radix), Chaihu (Bupleuri Radix), Gange (Puerariae Lobatae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, equal parts).
Powder. Take 1 qian per dose, 3 mint leaves, half cup water. Decoct to one-third cup. Sip three times. Take on empty stomach. Use for fever lasting days, attributing heat to smallpox/measles, adjusting for deficiency/excess.
[Stroke] Sudden jaw clenching, salivation, opisthotonos, limb convulsions, cyanotic/blackish body after smallpox indicates Stroke. Rash just healed, Ying-Wei Qi is weak. Failure to observe precautions leads to invasion of irregular Qi from eight directions during seasonal transitions. Treat with Xiaofeng San (Eliminate Wind Powder) 2 qian, mixed with 1 qian Chantui (Cicadae Perioaterum) powder, divided into three doses. Add few drops of Shengjiang (Zingiberis Rhizoma Recens) and Bohe (Menthae Haplocalycis Herba) juice and wine. Soak in warm water. Take 2-3 doses. May manifest as hives or secondary skin eruptions before recovery.
Xiaofeng San (Eliminate Wind Powder) [See Smallpox Stroke]
Gouteng Tang (Uncaria Decoction): Post-smallpox jaw clenching/stiffness, periumbilical pain.
Gouteng (Uncariae Ramulus cum Uncis), Honghua (Carthami Flos), Muxiang (Aucklandiae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma), Guigui (Cinnamomi Cortex), Shengjiang (Zingiberis Rhizoma Recens). Equal parts. Decoct in water. Take anytime.
[Joint Pain] Commonly called "Smallpox Wind." Danxi differentiated Qi/Blood deficiency/excess, observing over days; often involves Qi/Blood insufficiency. For deficiency, use Huangqi (Astragali Radix) blood-nourishing agents assisted by wind-dispelling herbs. For excess, use Baishao (Paeoniae Radix Alba) and Huangqin (Scutellariae Radix) as sovereigns, assisted by Lianqiao (Forsythiae Fructus), Baizhi (Angelicae Dahuricae Radix), Xuduan (Dipsaci Radix). For deficiency-cold, use Chen's formula. See Smallpox Stroke section for details.
[Contracture] Limb contracture, difficulty bending/extending, hardship in movement after smallpox indicates Blood consumption and Qi deficiency failing to nourish tendons. Use Shiquan Dabu Tang (Ten-Accumulations Great Tonifying Decoction) removing Dihuang (Rehmanniae Radix) and Bai Fuling (Poria), adding Xuanduan (Dipsaci Radix). Take frequently for best results. For Qi deficiency, add small amount of processed Chuanwu (Aconiti Radix) to move channels. Do not mistake for Wind-pattern; mistaken dispersing will consume Yin-Blood.
Danggui Guizhi Tang (Angelica and Cinnamon Twig Decoction): Treats post-smallpox limb immobility.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqi (Astragali Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Bao Gui (Cinnamomi Cortex), Huangbai (Phellodendri Cortex), Cangzhu (Atractylodis Rhizoma, stir-fried). Equal parts. Decoct in water. For Qi deficiency, add small Chuanwu (Aconiti Radix) to move channels, add Renshen (Ginseng Radix et Rhizoma) as principal. For Wind-Cold causing joint pain, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix).
[Confusion and Delirium] Post-smallpox confusion, failure to recognize people, constant delirious speech resembling possession indicates Heat shifting to Pericardium. Use Dao Chi San (Direct Outward Red Powder) [Heart] swallowed with Anshen Wan (Calming Spirit Pill) [smallpox delirium]. After waking, alternate Baoyuan Tang (Preserve Origin Decoction) plus Maidong (Ophiopogonis Radix), Shengdihuang (Rehmanniae Radix Recens) with Siwu Tang (Four-Substance Decoction) plus Shichangpu (Acori Tatarinowii Rhizoma), Mutong (Akebiae Caulis), Shanzhiren (Gardeniae Semen).
If sudden drowsiness, vertigo-like state, no fever, no delirium, following severe smallpox with poor intake, toxin has resolved, Zheng Qi not yet restored. Evil retreats, leading to sleep (turning point from bad to good). Do not treat blindly; will awaken spontaneously.
[Cold Extremities] Cold limbs, unwarmed by cover, indicates adverse sign of smallpox/measles. If occurring during peak disease, mortality is nearly 100%. Now that disease has healed, long-term Qi/Blood deficiency and Spleen-Stomach exhaustion make cold extremities expected. Use Baoyuan Tang (Preserve Origin Decoction) plus Dangguishen (Angelicae Sinensis Radix Stem) and Shu Fuzi (Prepared Aconiti Lateralis Radix).
[Cough] Frequent coughing with thick sticky sputum/nasal discharge is common in smallpox/measles. Patterns include Cold/Heat, Deficiency/Excess; do not adhere rigidly. If cough persisted from onset, residual Lung pathogen remains. Use Ganjie Tang (Licorice and Platycodon Decoction) [throat] combined with Xiebai San (Drain White Powder) [Lung] plus Niubangzi (Arctii Fructus) and Madouling (Aristolochiae Fructus). If cough with heat, constipation, red urine, Heat-Toxin is present. Use Tingli Wan (Descurainia Pill) [smallpox wheezing]. If stools are moist, use Renshen Baibu Tang (Ginseng and White Tiger Decoction) [smallpox thirst] combined with Ganjie Tang (Licorice and Platycodon Decoction). If cough with loose stools, clear urine, no significant heat/thirst, Deficiency is present. Use Renshen Qingge San (Ginseng Clear Diaphragm Powder) [smallpox cough]. If cough with hemoptysis, use Ganjie Tang (Licorice and Platycodon Decoction) plus Niubangzi (Arctii Fructus), Maogen Juice (Imperatae Rhizoma Juice), Ejiao (Colla Corii Asini). If previously no cough but now coughing, Wind-Cold external contraction. Use Mahuang Tang (Ephedra Decoction) [smallpox wheezing].
Dengxin Tang (Juncus Decoction): Treats irritability, wheezing, and dysuria after rash eruption.
Dengxin (Junci Medulla, 1 bundle), Biejia (Testudinis Carapax et Plastrum, vinegar-boiled yellow, 2 liang).
Cut into pieces. Take 1 liang per dose, 8 cups water. Decoct to 4 cups. Adjust dosage by age/size.
Cough with hypochondriac pain: Classics state left/right are pathways of Yin/Yang, referring to hypochondrium. Residual toxin in middle obstructs Yin/Yang Qi ascent/descent, causing pain. Resolve toxin; once toxin clears, True Qi moves, pain subsides. Use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Zhike (Aurantii Fructus Immaturus) and Jiegeng (Platycodi Radix).
Chi Fuling Tang (Red Poria Decoction): Treats pediatric rash/smallpox post-eruption cough/reversal, hypochondriac pain, anorexia.
Chi Fuling (Poria with Red Host), Gancao (Licorice Root, honey-fried), Daqing (Isatidis Folium), Shengma (Cimicifugae Rhizoma), Zhike (Aurantii Fructus Immaturus, bran-fried, 0.5 liang each), Zhizi (Gardeniae Fructus, 0.1 liang).
Coarse powder. Take 1 qian per dose, small cup water, 7 bitter bamboo leaves, 30 fermented soybeans. Decoct to half cup. Strain. Divide into three doses. Take 3-4 times daily. Adjust by child's size. Formula states post-rash hypochondriac pain is due to chaotic toxic qi obstructing ascent/descent. Left/right are Yin/Yang pathways. Qi stagnation causes pain. Zhike broadens intestines and directs Qi downward. Daqing/Zhizi clear latent heat. Shengma resolves toxin. Chi Fuling guides Heart Fire, benefits Small Intestine. Without Heat overcoming Lung Qi, cough reverses and settles.
[Abdominal Pain] Abdominal pain before rash eruption indicates internal attack of toxin. Now toxin resolved, no longer obstructed, yet pain persists. Two patterns: 1. Unpassed dry stool causing pain. Beiji Wan (Emergency Pill) [constipation]. 2. Overeating with deficient Stomach failing to digest. If constipated, Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill) [food stagnation]. If unobstructed, Muxiang Da'an Wan (Costus Peaceful Security Pill) [food stagnation]. Dry stool pain is Lower Jiao; food stagnation pain is Upper Jiao, intolerant to pressure. If originally low intake, normally moist stools, sudden pain indicates Deficiency-Cold in Middle Jiao, relieved by massage. Huangqi Jianzhong Tang (Astragalus Regulate Middle Decoction).
[Thirst] Thirst is common in smallpox families but inappropriate after recovery. Sudden thirst with desire to drink indicates residual toxin in Heart/Stomach, scorching diaphragm and drying pharynx. Patient eats well, constipated, red urine, dry tongue/pharynx. Use Renshen Baibu Tang (Ginseng and White Tiger Decoction) plus Huanglian (Coptidis Rhizoma). If low intake, normal urination/defecation, desires hot drinks but no dryness, Spleen-Stomach deficiency with insufficient fluids. Use Renshen Baizhu San (Ginseng and Atractylodes Powder). If ineffective, Renshen Maidong San (Ginseng and Ophiopogon Powder) plus Tianhuafen (Trichosanthis Radix) [both smallpox thirst].
[Aphonia] Two types post-smallpox: 1. Sore throat preventing speech. Toxin knotting in pharynx, phlegm obstruction causing pain. Tianhua San (Trichosanthes Powder) [smallpox aphonia]. 2. Heart Heat preventing speech. Pathogenic Heat in Heart not cleared, Kidney deficiency failing to connect to Yang. Voice exists but cannot articulate. Siwu Tang (Four-Substance Decoction) remove Chuanxiong (Ligustici Chuanxiong Rhizoma), add Maidong (Ophiopogonis Radix), Bai Fuling (Poria).
[Anorexia] After smallpox, evil qi retreats, Zheng Qi restores, Spleen-Stomach relaxes, appetite should gradually return. If previously anorexic, now overeating; or previously ate, now sudden aversion/anorexia, all indicate Internal Injury with Excess. Use Muxiang Da'an Wan (Costus Peaceful Security Pill) [food stagnation]. If previously didn't eat, still doesn't want to, Spleen-Stomach Central Qi deficiency. Use Shizhen San (Ten-Treasure Powder) [smallpox anorexia] or Renshen Baizhu San (Ginseng and Atractylodes Powder) remove Gegen (Puerariae Lobatae Radix), add Chenpi (Citri Reticulatae Pericarpium), Muxiang (Aucklandiae Radix). Grind to powder, take 2 liang. Mix with 2 liang each of glutinous rice and mung bean, stir-fried and ground separately. Mix powders, take with jujube decoction. Once able to eat slightly, add Yangpi Wan (Nourish Spleen Pill).
[Chills and Fever] Sudden chills/fever like malaria after smallpox, recurring regularly, indicates Spleen deficiency/weak Qi, neglect of care, heavy Wind-Cold contraction. First use Chaige Guizhi Tang (Bupleurum-Kudzu-Cinnamon Twig Decoction) to release new exterior pathogen, then regulate with Baoyuan Tang (Preserve Origin Decoction) plus Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Sharen (Amomi Fructus), Wumei (Mume Fructus), Shengjiang (Zingiberis Rhizoma Recens).
Dahe San (Great Harmony Powder): Treats post-rash alternating chills/fever, lethargy, oppression, agitation.
Shengdihuang (Rehmanniae Radix Recens), Danggui (Angelicae Sinensis Radix), Digupi (Lycii Cortex), Renshen (Ginseng Radix et Rhizoma), Gancao (Licorice Root, honey-fried), Baishao (Paeoniae Radix Alba). Equal parts.
Chop. Take 1 qian per dose, half cup water. Decoct to one-third cup. Strain, take warm.
Chaige Guizhi Tang (Bupleurum-Kudzu-Cinnamon Twig Decoction) [See Initial Heat]
[Edema] Post-smallpox facial puffiness or generalized edema indicates Exterior Qi insufficiency, early exposure to wind, Wind-Evil invading deficiency. Treatment focuses on Lung. Use Wupi Tang (Five-Bark Decoction) first plus Guizhi (Cinnamomi Ramulus) for mild sweating, then continue with base formula. If generalized edema, use Weiling Tang (Gastrodia and Poria Decoction) combined with Wupi Tang (Five-Bark Decoction).
Post-smallpox abdominal distension/edema or coarse breathing indicates retained waste internally. Regardless of residual toxin, food stagnation, or water retention, first drain. Use Taqi Wan (Collapse Qi Pill). After draining, use Weiling Tang (Gastrodia and Poria Decoction) remove Gancao (Licorice Root), add Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Dafupi (Arecae Pericarpium) to regulate. Treatment focuses on Spleen. If distension from new food without edema, only use Muxiang Da'an Wan (Costus Peaceful Security Pill).
Wupi Tang (Five-Bark Decoction)
Sangbaipi (Mori Cortex), Digupi (Lycii Cortex), Shengjiangpi (Zingiberis Pericarpium), Dafupi (Arecae Pericarpium), Wujia pi (Acanthopanacis Cortex). Equal parts.