徐仲光治一痘,五日,形色少神,腹胀喘急,肠鸣肢冷。或拟内伤者,或拟陷伏者,殊不知内伤者按必痛,
陷伏者必烦闷。今便利安宁而虚鸣者,乃阴阳二气不和,伤冷之症,或服凉药也。经曰∶中虚不足,则腹满肠
鸣。以理中汤加木香、陈皮、官桂等,疏逐冷气,诸症悉平。又以补中益气汤,调理而愈。
一痘因春夏久雨,为寒湿之气所侵,不能起者,五苓散加苍术、防风,多服之佳,或平胃快斑汤。
松江黄绮云,疗徐氏儿痘,儿幼,遇冬月,痘不起,炽炭围炉,抱儿火边,以酒浆挹火,火气熏儿,痘立
起发。(《广笔记》。)
费建中治朱氏子痘,稠密干红,或以色滞,便用清火兼升发,累日不起。见其鼻流清涕,身凉且静,时在
春初,寒风凛凛,此热毒轻而感寒重,毒火为外邪所闭也。以温肌透毒散、陈皮、枳壳、荆芥,连二剂,身渐
暖,顿起发。次日,鼻塞眼封,而痘发煌,身渐热,清解治毒,调理收功。
一儿痘稠密不松,眉愁,腹痛不寐,毒盛也。苍白干滞,涕吐稠粘,头温足冷,邪闭也。急疏风攻毒,四
朝,体渐热,痘渐起,色渐红活。但筋脉时惕,以活血驱毒而愈。
一儿痘三日,目红鼻塞,喷涕甚浓,气粗热壮,痘甚稀,色滞干红,无甚内症,以荆芥穗、葛根、前胡、
黄芩、牛蒡、木通、丹皮、蝉蜕、青皮、赤芍,三剂,起发沛然,六日肥绽,顺叙收功。
徐仲光治疗一名患痘疮的患儿,病程已达五日,痘疹形态色泽缺乏神气,伴有腹部胀满、气喘急促、肠鸣音亢进及四肢厥冷。有人将其拟诊为内伤证,有人拟诊为痘毒陷伏证,殊不知内伤证按压腹部必然疼痛,陷伏证必然出现烦闷不安。如今患儿二便通利且安宁,仅见虚性肠鸣,这是阴阳二气不和,属于受寒之症,或是误服了凉药所致。《内经》说:“中焦虚弱不足,则会出现腹部胀满和肠鸣。”于是使用理中汤(温中祛寒、补气健脾的方剂)加入木香、陈皮、官桂等药物,以疏泄驱逐冷气,所有症状全部平息。随后又用补中益气汤(补益脾胃、升举阳气的方剂)进行调理,最终痊愈。
另一名患儿的痘疮因为春夏季节长期下雨,受到寒湿之邪侵袭,导致痘疹不能起发,使用五苓散(利水渗湿的方剂)加入苍术、防风,多服用效果良好,或者使用平胃快斑汤。
松江人黄绮云,治疗徐家的孩子出痘,孩子年幼,正值冬季,痘疹不起发,便在周围烧旺炭火围成炉状,抱着孩子在火边取暖,用酒浆浇在火上,让火气熏蒸孩子,痘疹立刻起发。(出自《广笔记》。)
费建中治疗朱家的儿子出痘,痘疹稠密、干燥且发红,有人因为颜色晦滞,便立即使用清火兼升发的方法,连续多日痘疹仍不起发。观察到患儿鼻流清涕,身体凉爽且安静,当时正值春初,寒风凛冽,这是热毒轻微而感寒严重,毒火被外邪闭塞所致。使用温肌透毒散(温肌透疹的方剂)、陈皮、枳壳、荆芥,连续服用两剂,身体逐渐变暖,痘疹顿时起发。次日,出现鼻塞、眼睑闭合,但痘疹发出光彩,身体逐渐发热,改用清热解表的方法治疗毒邪,调理后收功。
另一名患儿痘疹稠密且不疏松,眉头紧锁,腹痛无法入睡,这是毒邪炽盛的表现。面色苍白且干涩滞涩,鼻涕和呕吐物稠厚粘腻,头部温热而足部寒冷,这是邪气闭塞的表现。急需疏风攻毒,经过四天左右,身体逐渐发热,痘疹逐渐起发,颜色逐渐红润鲜活。只是筋脉偶尔抽搐,通过活血驱毒的方法而痊愈。
另一名患儿出痘三天,眼睛发红、鼻塞,喷嚏浓重,呼吸粗重、高热壮盛,痘疹非常稀疏,颜色晦滞、干燥发红,没有严重的内部症状,使用荆芥穗、葛根、前胡、黄芩、牛蒡子、木通、丹皮、蝉蜕、青皮、赤芍,服用三剂,痘疹充沛地起发,第六天饱满绽开,按照顺证的顺序调理收功。
Xu Zhongguang treated a pediatric patient with smallpox. After five days, the lesions lacked vitality in appearance and color, accompanied by abdominal distension, panting and urgency, borborygmus, and cold limbs. Some physicians suspected an internal injury pattern, while others suspected a sinking-and-entrapment pattern. However, it is unknown that internal injury patterns present with pain upon palpation, whereas sinking-and-entrapment patterns must present with irritability and oppression. In this case, the patient’s excretion was smooth and peaceful, with only empty borborygmus; this indicates disharmony between Yin and Qi, a condition caused by cold damage or the ingestion of cooling medicines. The Classics state: "When the middle Jiao is deficient and insufficient, abdominal fullness and borborygmus occur." Therefore, Lizhong Tang (Cinnamon Twig and Ginger Decoction) was administered with added Xiangmu (Aucklandiae Radix), Chenpi (Citri Reticulatae Pericarpium), and Guigui (Cinnamomi Cortex) to disperse and expel cold qi, after which all symptoms subsided. Subsequently, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used for regulation, leading to recovery.
Another patient contracted smallpox during the spring and summer seasons due to prolonged rain, invaded by cold-damp qi, resulting in failure of the lesions to erupt. Wuling San (Five-Ingredient Poria Decoction) with added Cangzhu (Atractylodis Rhizoma) and Fangfeng (Saposhnikoviae Radix) was prescribed for frequent administration, which yielded good results; alternatively, Pingwei Kuaiban Tang could be used.
Huang Qiyun from Songjiang treated a child of the Xu family for smallpox. The child was young, and it was winter when the lesions failed to erupt. Hot charcoal fires were lit around the stove, and the child was held near the fire. Wine and liquids were poured onto the fire so that the heat vaporized and fumigated the child, causing the smallpox lesions to erupt immediately. (From *Guang Biji*.)
Fei Jianzhong treated Zhu’s son for smallpox. The lesions were dense, dry, and red. Because the color appeared stagnant, some physicians immediately employed methods to clear fire and promote eruption. After several days, the lesions still did not erupt. Upon observation, the patient had a runny nose with clear mucus, a cool body, and remained quiet. It was early spring, with biting cold winds. This indicated that the heat toxin was mild but the cold pathogen was severe; the toxic fire was closed off by the external pathogen. Wenji Toudusan (Warm the Muscles and Uncover the Toxin Powder) with Chenpi (Citri Reticulatae Pericarpium), Zhike (Aurantii Fructus Immaturus), and Jingjie (Schizonepetae Spica) were administered for two doses. The body gradually warmed, and the lesions suddenly erupted. The next day, nasal congestion and sealed eyes occurred, but the lesions shone brightly, and the body temperature gradually rose. Qingjie (Clearing and Resolving) methods were used to treat the toxin, followed by regulation to conclude the treatment.
Another child presented with dense, non-loose smallpox lesions, furrowed brows, abdominal pain, and insomnia, indicating excessive toxin. The complexion was pale, dry, and stagnant, with thick, sticky snot and vomit, a warm head, and cold feet, indicating closure by pathogens. Urgent wind-dispersing and toxin-attacking measures were taken. After four days, the body gradually heated up, the lesions began to erupt, and the color became progressively ruddy and vibrant. However, there were occasional spasms of the sinews and vessels. Recovery was achieved through blood-invigorating and toxin-expelling methods.
Another child, three days into smallpox, presented with red eyes, nasal congestion, thick sneezing, coarse breathing, and high fever. The lesions were very sparse, with stagnant, dry, and red coloration, and no severe internal symptoms. Jingjiesui (Schizonepetae Spica), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Huangqin (Scutellariae Radix), Niubangzi (Arctii Fructus), Mutong (Akebiae Caulis), Danpi (Moutan Cortex), Chantui (Cicadae Periostracum), Qingpi (Citri Reticulatae Pericarpium Viride), and Chishao (Paeoniae Radix Rubra) were administered for three doses. The lesions erupted abundantly. By the sixth day, they became plump and opened, following the normal progression for recovery.