（下皆徐仲光所言。）
一儿年十五，血热毒重，而无颗粒，正额略见分珠，而又稠密，唇焦口肿，舌有黑刺，大热大渴，先用羌
活汤调下催蛰丹、退火丹。虽起发，呕哕特甚，用芩、连、荆、防、翘、蒡、楂、蝉、犀角、紫草、石膏、大
黄，二剂。痘乃稍润，又加芎、归、冬、知、甘、桔、生地、丹皮、红花、元参，痘渐滋长，呕哕渐止。八九
朝，复呕，背痘平塌，仍用芎、归、芩、连、蝉、翘、防、羌、蒡、陈、藿、石膏，黄土澄水煎服，随以桑虫
浆、鸡脑各二个，入催蛰丹、震蛰丹各五分。至夜，狂躁作渴，以陈冬米、麦冬，煎汤频饮。至天明，熟睡，
痘转而起灌矣。但大便溏数，加 、术、楂、橘、炮姜、人参三四分，调理而愈。
一儿痘成浆倒陷，吐哕不止，急用攻发药，以起其痘，于安胃药中加参、 、黑姜、陈米、白术，黄泥澄
水煎治愈。
一儿痘标点，哕吐，面色枯，口唇焦，胃气已脱，毒不出，三日而死。
一痘六朝，匀朗光泽，外症顺而胃气损，闻食则哕，浆虽满不能收拾苍老，变倒靥而死。吐蛔者更重。
一痘后烦渴，乳多则吐，身热喜凉，此余毒在胃，竹叶石膏汤治之而愈。
一痘后哕腐，或有用香砂丸，克伐太过，遂变泄泻而死。
万密斋治一儿，痘本轻，因伤食腹痛而呕，用平胃散加砂仁、藿香叶、煨姜而呕止。
一小儿因食生冷，伤脾胃而呕，痘变灰白，用钱氏异功散加砂仁、丁香、桂而呕止。
一小儿痘甚密，喉舌都是，将闭时，呛水呕食，杂脓血痂皮痰涎而出，用甘桔汤加牛蒡，频呷之，调理而安。
一小儿脓成将靥，忽作干呕，虽饮食，常自呕哕，其痘不作脓，不满顶。曰∶此逆痘也。乃诵木陈叶落，
弦断声嘶之言以告之，后失音闷绝而死。
庠生余光庭，年十九，出痘，脓成将靥，忽作咳逆，（即哕也，又名呃逆。）脉促成代。或谓咳逆者，恶症
也。促代者，怪脉也。痘疮顺正，饱壮明润，何以得此？曰∶咳逆三症，一曰胃寒，二曰水逆，三曰胃败，皆与
此不合。经曰∶诸逆冲上，皆属于火。此火炎上之象，乃问其大便如何，则自出痘至今，七日未更衣。曰∶此燥
矢壅塞，下窍不通，火炎上窍，故咳逆也。促代之脉，得之气逆，脉亦逆矣。以猪胆导之，下燥矢，咳逆即止，
而脉亦调匀而起。
（以下均为徐仲光所述医案。）
一个十五岁的男孩，血分热毒深重，但痘疹未能透发成颗粒状，仅在前额隐约可见如珍珠般的点状分布，且分布稠密。他嘴唇焦裂、口部肿胀，舌头上有黑色芒刺，伴有高热和大渴。先用羌活汤送服催蛰丹和退火丹。虽然痘疹开始起发，但呕吐和呃逆症状特别严重。于是使用黄芩、黄连、荆芥、防风、连翘、牛蒡子、山楂、蝉蜕、犀角、紫草、石膏、大黄，共两剂药。痘疹变得稍显润泽，又加入川芎、当归、天冬、知母、甘草、桔梗、生地、丹皮、红花、玄参，痘疹逐渐滋长饱满，呕吐和呃逆也逐渐停止。到了第八九天，再次出现呕吐，背部痘疹平塌，仍然使用川芎、当归、黄芩、黄连、蝉蜕、连翘、防风、羌活、牛蒡子、陈皮、藿香、石膏，用黄土澄清的水煎服，随后给予桑虫浆、鸡脑各两个，并加入催蛰丹、震蛰丹各五分。到了夜晚，患者狂躁并作渴，用陈仓米、麦冬煎汤频频饮用。到天亮时，患者熟睡，痘疹转为充盈化脓。只是大便溏薄且次数多，加入白芍、白术、山楂、橘皮、炮姜、人参三四分进行调理而痊愈。
另一个孩子痘疹成浆后发生倒陷，呕吐呃逆不止，紧急使用攻散发痘的药物以促使痘疹起发，在安胃药中加入人参、白芍、黑姜、陈仓米、白术，用黄泥澄清的水煎服治愈。
还有一个孩子痘疹刚出标点，就出现呃逆呕吐，面色枯槁，口唇焦裂，胃气已经脱绝，毒邪不能外透，三天后死亡。
有一个痘疹出到第六天，分布均匀朗润光泽，外部症候顺遂但胃气受损，闻到食物气味就呃逆，虽然痘浆已满但不能收束苍老，最终变为倒靥而死。吐蛔虫的情况更为严重。
有一个痘后出现烦渴，乳汁吃得多了就呕吐，身体发热喜欢凉爽，这是余毒留在胃中，用竹叶石膏汤治疗而痊愈。
有一个痘后呃逆腐臭，有人用了香砂丸，因攻伐太过，最终变成泄泻而死。
万密斋治疗一个孩子，痘疹本来轻微，因为伤食导致腹痛而呕吐，用平胃散加砂仁、藿香叶、煨姜，呕吐停止。
一个小孩子因为吃了生冷食物，损伤脾胃而呕吐，痘疹变为灰白色，用钱氏异功散加砂仁、丁香、桂枝，呕吐停止。
一个小孩子痘疹非常密集，喉部和舌头都有，即将结痂时，呛水呕吐食物，混杂着脓血痂皮痰涎一起吐出，用甘桔汤加牛蒡子，频繁呷服，调理后安定。
一个小孩子脓液形成即将结痂时，忽然干呕，即使进食也常常自发性地呕吐呃逆，他的痘疹不化脓，也不饱满隆起。我说：这是逆证痘疹。于是引用“木陈叶落，弦断声嘶”的话告诉他预后不良，后来失音闷绝而死。
庠生余光庭，十九岁，出痘，脓液形成即将结痂时，忽然出现咳逆（即呃逆，又名打嗝），脉象促代。有人说咳逆是恶症，促代脉是怪脉。痘疮顺证应当饱满壮实明亮润泽，怎么会得这种病？我说：咳逆三种病症，一是胃寒，二是水逆，三是胃败，都不符合此情况。经书说：各种气逆冲上的症状，都属于火。这是火炎上炎的征象。于是询问他大便情况，他说自从出痘至今，七天没有排便。我说：这是燥屎壅塞，下窍不通，火气上炎上窍，所以咳逆。促代的脉象，是因为气逆，脉也随之逆乱。用猪胆汁导便，排出燥屎，咳逆立即停止，脉象也调匀恢复。
(The following are medical cases recorded by Xu Zhongguang.)
A fifteen-year-old boy suffered from severe blood heat and toxicity, yet his smallpox pustules failed to erupt into distinct granules. Only faintly visible on the forehead were bead-like spots, densely distributed. His lips were cracked, mouth swollen, tongue coated with black prickles, accompanied by high fever and intense thirst. Initially, Qianghuo Tang (Notopterygium Decoction) was used to administer Cuizhe Dan (Stimulating Pustule Eruption Pill) and Tuihuo Dan (Fire-Reducing Pill). Although the eruption began, vomiting and hiccups were particularly severe. Therefore, Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Shanzha (Crataegi Fructus), Chantui (Cicadae Periostracum), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), Zicao (Lithospermi Radix), Shigao (Gypsum Fibrosum), and Dahuang (Rhei Radix et Rhizoma) were prescribed for two doses. The pustules became slightly moistened. Subsequently, Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Dongdong (Asparagi Radix), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Honghua (Carthami Flos), and Yuanshen (Scrophulariae Radix) were added. The pustules gradually grew plump, and vomiting and hiccups subsided. On the eighth or ninth day, vomiting recurred, and the back pustules flattened. The same formula (Chuanxiong, Danggui, Huangqin, Lianqiao, Chantui, Lianqiao, Fangfeng, Qianghuo, Niubangzi, Chenpi, Huoxiang, Shigao) was decocted in clarified water prepared from yellow soil. Afterwards, Sangchong Jiang (Mulberry Insect Paste) and Jinao (Chicken Brain) were administered, each two units, along with Cuizhe Dan and Zhenzhe Dan (Shocking Pustule Eruption Pill), five fen each. By nightfall, the patient became manic, restless, and thirsty. Chencongmi (Stored Rice) and Maidong (Ophiopogonis Radix) were decocted as tea for frequent sipping. By dawn, the patient slept soundly, and the pustules transformed into filled, suppurating lesions. However, due to loose stools and frequent bowel movements, Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Shanzha, Ju pi (Citri Reticulatae Pericarpium), Paojiang (Prepared Ginger), and Renshen (Ginseng Radix et Rhizoma, 3-4 fen) were added for conditioning, leading to recovery.
Another child experienced smallpox involution after suppuration, with incessant vomiting and hiccups. Urgent emollient and eruptive medicines were used to promote pustule formation. Within stomach-soothing formulas, Renshen, Baishao, Heijiang (Charred Ginger), Chencongmi, and Baizhu were added. The medicine was decocted in clarified water prepared from yellow mud, resulting in a cure.
In another case, a child presented with smallpox just emerging as spots, accompanied by hiccups and vomiting, withered complexion, and cracked lips. The Stomach Qi had already collapsed, and the toxin could not be excreted externally; the child died three days later.
One case involved smallpox on the sixth day, evenly distributed, lustrous, and bright. The external symptoms were favorable, but Stomach Qi was damaged. The child hiccuped upon smelling food. Although the pustules were full of pus, they failed to mature and harden properly, eventually becoming inverted and scabbing abnormally, leading to death. Cases involving vomiting of roundworms are even more severe.
After smallpox, one child suffered from irritability and thirst. Excessive milk intake caused vomiting. The body felt hot and preferred coolness. This indicated residual toxins remaining in the Stomach. Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) was used for treatment, resulting in recovery.
Another child suffered from foul-smelling hiccups after smallpox. Someone administered Xiangsha Wan (Aucklandia and Amomum Pill), but the excessive purgative action led to diarrhea and subsequent death.
Wan Mizhai treated a child whose smallpox was originally mild. Due to food stagnation causing abdominal pain and vomiting, Pingwei San (Calm the Stomach Powder) was modified with Sharen (Amomi Fructus), Huoxiangye (Agastaches Herba), and Weijiang (Roasted Ginger). The vomiting ceased.
A child vomited due to consuming raw and cold foods, damaging the Spleen and Stomach. The smallpox turned grayish-white. Qian's Yigong San (Beneficial Labor Powder) was modified with Sharen, Dingxiang (Caryophylli Flos), and Guizhi (Cinnamomi Ramulus). The vomiting stopped.
A child had extremely dense smallpox covering the throat and tongue. As scabbing was about to occur, the child choked on water and vomited food, expelling mixed pus, blood, scabs, and phlegm. Ganjie Tang (Licorice and Platycodon Decoction) with added Niubangzi was given for frequent sipping. Conditioning led to stabilization.
A child, when pus formed and scabbing was imminent, suddenly developed dry heaves. Even after eating, spontaneous vomiting and hiccups persisted. The pustules did not suppurate and lacked fullness at the apex. It was stated: "This is an adverse smallpox pattern." The saying "When wood ages, leaves fall; when strings break, the voice hoarsens" was cited to indicate poor prognosis. The child subsequently lost their voice, fainted, and died.
Xiangsheng Yu Guangting, aged nineteen, contracted smallpox. When pus formed and scabbing was imminent, he suddenly developed coughing and reversing qi (Ke Ni, i.e., hiccups/belching). The pulse was Cu Dai (Hasty and Intermittent). Some argued that Ke Ni is a malignant symptom and Cu Dai pulse is an abnormal pulse. Since smallpox should present with fullness, robustness, brightness, and moisture, how did this occur? I replied: The three types of Ke Ni are Stomach Cold, Water Reversal, and Stomach Failure, none of which fit this case. The Classics state: "All rebellious qi rushing upward belongs to Fire." This is a manifestation of fire flaming upward. Upon inquiry, the patient reported no bowel movement for seven days since the onset of smallpox. I said: "This is dry stool obstructing the lower orifice, preventing unblocking, causing fire to flare up to the upper orifices, hence the Ke Ni." The Cu Dai pulse arises from rebellious Qi, causing the pulse to become chaotic. Zhu Dan Dao (Pig Gallbladder Suppository) was used to evacuate the dry stool. Immediately, the Ke Ni ceased, and the pulse returned to regularity and strength.