徐仲光治一儿，痘后溏泄，腿肿，睡卧不宁，足三阴虚也，四君子汤加陈皮、归、芍、枸杞、泽泻、石斛、
川牛膝，继以八味丸而愈。
一儿痘后劳役，痢虽愈，而胫膝结核成鹤膝风，此足三阴虚而邪袭之也。驱风散间八味丸加苡仁、牛膝、
菟丝、当归。
一儿痘，先从脚底出起，逆上至头面，回至心窝，内攻而死。此症早治，俟其头面出齐，重用升提，
保元汤加川芎，及先护心，以黄连解毒汤一剂，使其起灌收痂，自上而下，可保无事。
朱应我治其侄孙，七个月，见标三日，点粒甚朗，但红白不甚分明，混混暗暗，似少神彩，即以带
补带表药，以和其阴阳。至七日，犹不活动，速以人参黄 保元汤带血药进之。至十一二朝，亦灌淡浆，
而脸色菜黄且暗，速加参、 。至十七八九朝，询之，日则疲睡，精神短少，略无嬉笑之容，熟察右一边
疤皆白暗，右手足皆萎僵不动，至左边疤红，而手足亦动跃如常，用以揉面者，系左手也。不早治，恐
成痿废。以补中益气汤二剂，柴胡多升麻一倍，又加黄柏，虽不见儿喜，而右手足之浮肿渐退。原方用
升麻升清气于左旋，用柴胡升清气于右旋，故用柴胡多于升麻，所以治其右也。加黄柏，使足力涌出。用
方得宜，其症渐愈。
此症右手足肿大不红，初以为湿痰流注，不成肿毒，所以用补中益气汤，可以消平。至二十三日复
视之，神气犹减，右手足仍不能起动，遂加桂技二分。越二三日犹不定耐，改方为十全大补。见其右手
能握物，而右足背生疖，高穿出脓，其安停药侯消息，此亦得将息法也。听之，计服过参六七钱，
幸徐徐元气少复，得以再用平补而愈。未周之儿，用药至三十余帖，亦非常法也。
徐仲光曰∶一痘养浆，而内却无水，干涸空虚，此气虚伏陷也。若得人事清爽，饮食如常，痘无损
处，宜补中益气汤、归茸汤主之。若喘胀呕泄，烦闷外剥者，不治。
一痘浆充满，根血淡红，痰涎壅盛，日晡潮热，皆谓气不足，以保元加芎、归、贝母、陈皮，治之
不愈，不知此乃阴虚火盛生痰也。以六味地黄丸料，内加参、附、肉桂温之，而痰绝热去，又与补中益
气汤而愈。
一痘浆充满痰盛，少食便溏，此乃脾胃虚弱，不能运化精微，津液凝滞所致，以六君子汤加炮姜。
一痘浆足，忽泄泻，身冷自汗，此本于脾胃气虚也，以保元合附子理中汤愈。或加肉果。
一痘浆不易充足，而色淡白，亦脾胃气虚也，以大保元汤主之，又归茸汤益之。
一痘浆足，而色不易苍腊，乃脾弱之故，脾主结痂也。用保元加白术、白芍、陈皮、官桂、莲肉，收浓靥
而愈。若收如麸薄，只以参苓白术散主之。
一痘七日，无浆倒靥，独根窠敛束，以保元加山甲、官桂，又以水汤浴洗头面手足，良久复起，成脓而愈。
一痘九日，平塌无浆，自口以下俱红绽，能食便溏，乃元气不足，不能上升于面，以保元加白术、白芍、
官桂、肉果、升麻，十一朝，空地满出增痘，俱行浆。又与异功散而愈。
一痘正面浆足结痂，身肢无浆，能食便溏，完谷不化，乃脾阴不足，不能以充灌，用参苓白术散加附子、
菟丝、肉果，又与河车散而愈。
一痘八日，空壳无浆，因气血不足，不能振作以制其毒，用补中益气治之，发疔四五处而愈。经曰∶发痈
发疔者生也。
一痘八日倒靥，灰白色，泄泻烦渴，切牙寒战，此乃气血虚寒也，以异功散治愈。若治之不止，反加昏闷
者死。
一痘八朝顶陷，浆滞不行，色见焦紫，乃风寒壅腠里，气滞血凝之故。宜升提发散之剂，内服紫苏饮，外
浴水杨汤，使药气藉汤气上升，毒随暖气而发。若儿弱，只浴头面手足，痘即光润，随服补中益气汤调理。凡
用此汤，须量气血充足，的为风寒所闭则可浴。若浴后不起，又加闷乱者死。
一痘养浆时，昏睡不苏，便溏能食，乃脾主困，因便溏而脾虚，倦怠而昏睡也，归脾汤加白芍、山药、米
仁、莲肉愈。
一痘浆充足，忽尔一齐结痂干紫，能食便调，此是火迫而收之太急，乃倒靥也。投以补益攻发之剂，十四
日，四肢肿痛成靥，脓成毒化。若不食，便溏哕呛，则为内虚倒靥，毒归于内，喘胀而卒。
一痘浆不易充足，根血赤色，烦渴溺涩，舌燥便秘。皆云气虚而津液不足，以保元加麦冬治之，愈甚。浆
滞不行，此乃血热未解，温补反助其邪，乃火盛水涸之义。更以犀角地黄汤，又四顺清凉饮利之，前症悉平，
浆满而愈。经曰∶毒未尽解而温补，则毒蕴盛而不能化浆也。
一痘九朝，死而弃之沙滩，视其手足动掣，色虽焦紫，形尚绽突，乃毒火闷瞀，一时而死，得水气而火减，
故复苏也，抱回治以犀角地黄汤而愈。然亦有得土气而解者。
一痘七日，根窠赤痛，便秘溺涩，烦躁饮水，或清解之剂未应。乃热毒内郁也，以大黄、当归、赤芍、甘
草之类一剂，又与犀角地黄汤而愈。
一痘养浆时，大便下血，或尿血，或神昏不醒，或多睡。盖心主血，虚邪乘而入心，神昏乱之，故宜犀角
地黄汤、安神丸。若治而不已者，至二十日而卒。若毒尽外出，当以补中益气汤加麦冬、枣仁。
一痘浆足，脓俱紫黑，热甚便秘，乃血热毒壅也，以黄连解毒汤加翘、蒡愈。
一女季春患痘，妄言卓立，日夜不能眠睡，至七朝，尚未安宁。视其形色俱顺，而妄言卓立者，心胆火炽
也，以犀角地黄加柴胡、龙胆治愈。
万密斋治汪氏子，痘出脓成时，头面腹背皆饱满，惟手足自肘膝至掌指，犹未起发。曰∶脾主四肢，此子
脾胃何甚弱也？乃由去胎失乳，故用建中汤加黄 、防风，一服，尽起胀作脓矣。其家奉信鲁湖黑神，此子寄
名于神，未出痘，神先降坛云∶吾保老黑痘出必少。至是痘出甚密，乃以计逐之使去。
徐仲光治疗一个患儿，出痘后出现大便稀溏、腿部肿胀、睡眠不安的症状，这是足三阴经（肝、脾、肾）虚损所致。使用四君子汤（补气基础方）加入陈皮、当归、白芍、枸杞子、泽泻、石斛、川牛膝，随后服用八味丸（即金匮肾气丸，温补肾阳）而痊愈。
另一个患儿出痘后因劳累过度，痢疾虽然好了，但小腿和膝盖处形成结核状肿块，发展为鹤膝风（膝关节肿大变形如鹤膝），这是足三阴经虚损且外邪侵袭所致。使用驱风散与八味丸交替服用，并加入薏苡仁、牛膝、菟丝子、当归。
还有一个患儿出痘，痘疹先从脚底发出，逆向向上蔓延至头面部，再回缩至心窝部，内攻脏腑导致死亡。此症如果早期治疗，等待其头面部痘疹出齐后，重用升提药，使用保元汤加川芎，并先护心，服用一剂黄连解毒汤（清热燥湿、泻火解毒），使其顺利起浆结痂，痘势自上而下消退，便可保全性命。
朱应我治疗他的侄孙，七个月大，出痘见标三天，痘粒清晰可见，但红白界限不甚分明，色泽混浊暗淡，似乎缺乏神采，于是采用兼具补益和解表作用的药物，以调和阴阳。到了第七天，痘势仍未活跃，迅速用人参、黄芪配合保元汤，并加入活血药物服用。到了第十一二天，痘浆依然清淡，面色萎黄且晦暗，迅速增加人参用量。到了第十七八九天，询问得知，孩子白天疲倦嗜睡，精神短少，完全没有嬉笑的神态，仔细检查发现右侧的痘痂皆呈白色晦暗，右手足都萎缩僵硬不动；左侧的痘痂红润，手足也活动自如如常，平时用来揉面的也是左手。如果不早治疗，恐怕会发展成痿废之症。使用补中益气汤两剂，柴胡用量多于升麻一倍，又加入黄柏，虽然未见孩子喜悦，但右手足的浮肿逐渐消退。原方用升麻将清气向左上升，用柴胡将清气向右上升，所以柴胡用量多于升麻，以此治疗右侧病症。加入黄柏，使足力涌出。用药得当，病情逐渐好转。
此症右手足肿大但不红，起初以为是湿痰流注，未形成肿毒，所以用补中益气汤可以消除平复。到第二十三天再次诊视，神气依然减弱，右手足仍不能活动，于是加入桂枝二分。过了两三天仍不稳定，改方为十全大补汤。看到右手能握物，而右脚背生疖子，高凸出脓，便暂停用药观察调养情况，这也是得宜的调养方法。听任其自然恢复，计算服过人参六七钱，幸好元气慢慢稍复，得以再用平和补益之法而痊愈。未满周岁的婴儿，用药多达三十余帖，也不属于常规治法。
徐仲光说：有一例痘疮养浆时，内部却没有水浆，干涸空虚，这是气虚伏陷所致。如果病人人事清爽，饮食正常，痘疮没有损伤之处，适宜用补中益气汤、归茸汤主治。如果出现喘胀呕吐泄泻、烦闷向外剥落等症状，则属不治之症。
有一例痘疮浆液充满，根部血色淡红，痰涎壅盛，傍晚时分潮热，这都是气不足的表现，用保元汤加川芎、当归、贝母、陈皮治疗不愈，不知道这其实是阴虚火旺生痰所致。用六味地黄丸的药料，内加人参、附子、肉桂温补，痰绝热去，再服用补中益气汤而痊愈。
有一例痘疮浆液充满且痰多，食量减少、大便稀溏，这是脾胃虚弱，不能运化精微物质，导致津液凝滞所致，用六君子汤加炮姜治疗。
有一例痘疮浆液充足后，突然发生泄泻，身体发冷自汗，这是由于脾胃气虚所致，用保元汤合附子理中汤治愈。或者加入肉豆蔻。
有一例痘疮浆液不易充足，颜色淡白，也是脾胃气虚所致，以大保元汤主治，再用归茸汤辅助。
有一例痘疮浆液充足，但颜色不易转为苍蜡色，是脾弱的缘故，脾主结痂。用保元汤加白术、白芍、陈皮、官桂、莲肉，收浓靥（结痂）而痊愈。如果结痂薄如麸皮，只用参苓白术散主治。
有一例痘疮七日，无浆倒靥（痘疹未灌浆而提前收靥），只有痘根收敛束紧，用保元汤加穿山甲、官桂，又用水杨汤洗浴头面手足，良久之后痘疹重新起发，成脓而痊愈。
有一例痘疮九日，平塌无浆，从口以下全部红绽，能进食但大便稀溏，这是元气不足，不能上升于面部，用保元汤加白术、白芍、官桂、肉豆蔻、升麻，第十一朝，空地处长出增痘，全部行浆。又服用异功散而痊愈。
有一例痘疮正面浆足结痂，身体四肢无浆，能进食但大便稀溏，完谷不化（食物未经消化排出），这是脾阴不足，不能充灌滋养，用参苓白术散加附子、菟丝子、肉豆蔻，又服用河车散而痊愈。
有一例痘疮八日，空壳无浆，因气血不足，不能振奋以制约毒素，用补中益气汤治疗，发出疔疮四五处而痊愈。经书说：发出痈疽疔疮者生还。
有一例痘疮八日倒靥，呈灰白色，泄泻烦渴，切牙寒战，这是气血虚寒所致，用异功散治愈。如果治疗不止，反而加重昏闷的则死。
有一例痘疮八朝顶陷，浆液停滞不行，颜色焦紫，这是风寒壅塞腠理，气滞血凝的缘故。适宜用升提发散的药物，内服紫苏饮，外浴水杨汤，使药气借助汤气上升，毒素随暖气而发散。如果孩子体弱，只洗浴头面手足，痘疹即光亮润泽，随后服用补中益气汤调理。凡是用此汤，必须衡量气血充足，确认为风寒所闭才可洗浴。如果洗浴后不起发，又加重闷乱的则死。
有一例痘疮养浆时，昏睡不醒，大便稀溏但能进食，这是脾主困倦，因便溏导致脾虚，倦怠而昏睡，用归脾汤加白芍、山药、薏苡仁、莲肉治愈。
有一例痘疮浆液充足，忽然一齐结痂干紫，能进食、大便调畅，这是火迫而收结太急，属于倒靥。投予补益攻发的药物，十四日时，四肢肿痛成靥，脓成毒化。如果不进食，便溏呃逆呛咳，则为内虚倒靥，毒素归于体内，喘胀而死。
有一例痘疮浆液不易充足，根部血色赤红，烦渴尿涩，舌燥便秘。都说这是气虚而津液不足，用保元汤加麦冬治疗，病情反而加重。浆液停滞不行，这是血热未解，温补反而助长邪气，这是火盛水涸的道理。改用犀角地黄汤，再用四顺清凉饮利导，前症悉平，浆满而愈。经书说：毒素未尽解而用温补，则毒素蕴盛而不能化浆。
有一例痘疮九朝，死后被弃置沙滩，查看其手足仍有抽动，颜色虽焦紫，形态尚突起，这是毒火闷瞀（神志昏迷），一时而死，得到水气而火减，所以复苏，抱回后用犀角地黄汤治疗而痊愈。然而也有得到土气而解的。
有一例痘疮七日，痘根窠赤痛，便秘尿涩，烦躁饮水，如果用清解剂未见效。这是热毒内郁所致，用大黄、当归、赤芍、甘草之类一剂，又服用犀角地黄汤而痊愈。
有一例痘疮养浆时，大便下血，或尿血，或神昏不醒，或多睡。盖因心主血，虚邪乘虚而入心，扰乱神志，所以适宜用犀角地黄汤、安神丸。如果治疗不止，到二十日而死。如果毒素尽外出，应当用补中益气汤加麦冬、枣仁。
有一例痘疮浆足，脓液全呈紫黑色，热甚便秘，这是血热毒壅所致，用黄连解毒汤加连翘、牛蒡子治愈。
有一个女孩在季春时节患痘，胡言乱语站立，日夜不能入睡，到第七朝，尚未安宁。看其形色俱顺，而胡言乱语站立，是心胆火炽所致，用犀角地黄汤加柴胡、龙胆草治愈。
万密斋治疗汪氏之子，痘出脓成时，头面腹背都饱满，只有手足从肘膝到掌指，还未起发。说：脾主四肢，这个孩子的脾胃为何如此虚弱？是因为出生时失乳，所以用建中汤加黄芪、防风，一服药后，全部起胀作脓了。其家信奉鲁湖黑神，此子寄名于神，未出痘时，神先降坛说：我保佑老黑痘出必少。至此痘出很密，于是用计策将其赶走。
Xu Zhongguang treated a child who, after smallpox, suffered from loose stools, leg swelling, and restless sleep. This was due to deficiency of the three Yin meridians of the foot (Liver, Spleen, Kidney). He prescribed Si Jun Zi Tang (Four Gentlemen Decoction) with added Chen Pi (Tangerine Peel), Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Gou Qi Zi (Goji Berry), Ze Xie (Alisma), Shi Hu (Dendrobium), and Chuan Niu Xi (Cyathula Root). Subsequently, Ba Wei Wan (Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan) was administered, leading to recovery.
Another child, after smallpox, contracted dysentery due to overexertion. Although the dysentery resolved, tubercles formed in the shins and knees, developing into He Xi Feng (Crane Knee Wind, characterized by swollen knee joints). This resulted from deficiency of the three Yin meridians of the foot combined with pathogenic invasion. Feng Qu San (Wind-Expelling Powder) and Ba Wei Wan were alternated, with added Yi Yi Ren (Coix Seed), Niu Xi (Achyranthes Root), Tu Si Zi (Cuscuta Seed), and Dang Gui (Angelica Sinensis).
A third child’s smallpox rash started from the soles of the feet, moved upward to the head and face, then retreated to the epigastrium, attacking the interior organs and causing death. If treated early, once the rash on the head and face had fully erupted, strong ascending and lifting herbs should be used. Bao Yuan Tang (Preserve the Origin Decoction) with Chuan Xiong (Ligusticum Chuanxiong) should be administered, along with protecting the Heart using one dose of Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) to ensure proper pustule formation and scabbing, allowing the rash to recede from top to bottom, thereby saving the life.
Zhu Yingwo treated his great-nephew, aged seven months. After three days of visible rash, the pustules were distinct, but the red and white colors were indistinct, appearing muddy and dull, lacking vitality. He used herbs that both tonify and release the exterior to harmonize Yin and Yang. By the seventh day, the eruption remained inactive. He quickly administered Ren Shen (Ginseng) and Huang Qi (Astragalus) via Bao Yuan Tang (Preserve the Origin Decoction) with blood-invigorating herbs. By the eleventh or twelfth day, the pus was still thin, and the complexion was sallow and dark. He rapidly increased the dosage of Ren Shen (Ginseng). By the seventeenth to nineteenth day, it was reported that the child slept tiredly during the day, lacked spirit, and showed no signs of playfulness. Careful examination revealed that the scars on the right side were white and dull, and the right hand and foot were atrophic, stiff, and immobile. In contrast, the left-side scars were red, and the left hand and foot moved normally; the child also used the left hand for rubbing the face. Without early treatment, this might develop into flaccid paralysis. Two doses of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) were given, with the dosage of Chai Hu (Bupleurum Root) being double that of Sheng Ma (Cimicifuga Rhizome), plus Huang Bo (Phellodendron Bark). Although the child did not show joy, the edema in the right hand and foot gradually subsided. The original formula uses Sheng Ma (Cimicifuga Rhizome) to ascend clear Qi to the left and Chai Hu (Bupleurum Root) to ascend clear Qi to the right; thus, more Chai Hu (Bupleurum Root) than Sheng Ma (Cimicifuga Rhizome) was used to treat the right side. Huang Bo (Phellodendron Bark) was added to stimulate strength in the legs. With appropriate prescription, the condition gradually improved.
Initially, the right hand and foot were swollen but not red, suspected as damp-phlegm flowing into the collaterals without forming a toxic swelling, so Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was deemed suitable for resolution. On the twenty-third day, upon re-examination, the spirit was still diminished, and the right hand and foot remained immobile. Therefore, Gui Zhi (Cinnamon Twig) was added. After two or three days, the condition remained unstable, and the prescription was changed to Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction). Seeing that the right hand could grasp objects, but a boil appeared on the dorsum of the right foot, exuding pus, medication was paused to observe recuperation methods, which proved effective. It was calculated that 6–7 qian of Ren Shen (Ginseng) had been consumed. Fortunately, the primordial Qi slowly recovered slightly, allowing for further mild tonification until recovery. For an infant under one year old, taking over thirty doses is unconventional.
Xu Zhongguang stated: In cases where smallpox fails to form pus internally, resulting in dryness and emptiness, this indicates Qi deficiency and sinking. If the patient is alert and eating normally, with no damage to the pustules, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) or Gui Rong Tang (Deer Antler and Angelica Decoction) should be used. However, if symptoms include wheezing, distension, vomiting, diarrhea, restlessness, and outward peeling, it is incurable.
In another case, although the smallpox was full of pus, the root color was pale red, with excessive phlegm-saliva and afternoon tidal fever, indicating Qi deficiency. Treatment with Bao Yuan Tang (Preserve the Origin Decoction) plus Chuan Xiong (Ligusticum Chuanxiong), Dang Gui (Angelica Sinensis), Bei Mu (Fritillaria Bulb), and Chen Pi (Tangerine Peel) failed. This was actually Yin deficiency with hyperactive fire generating phlegm. Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) ingredients were used, supplemented with Ren Shen (Ginseng), Fu Zi (Aconite Root), and Rou Gui (Cinnamon Bark) to warm and tonify. Once the phlegm ceased and fever subsided, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered, leading to recovery.
In a case with abundant pus and phlegm, reduced appetite, and loose stools, this was due to Spleen-Stomach weakness failing to transform and transport essence, causing fluid stagnation. Liu Jun Zi Tang (Six Gentlemen Decoction) with Pao Jiang (Processed Ginger) was used.
In a case where pus was sufficient but sudden diarrhea, cold body, and spontaneous sweating occurred, this stemmed from Spleen-Stomach Qi deficiency. Bao Yuan Tang (Preserve the Origin Decoction) combined with Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) cured it, optionally adding Rou Dou Kou (Nutmeg).
In a case where pus was difficult to fill and the color was pale white, this was also Spleen-Stomach Qi deficiency. Da Bao Yuan Tang (Great Preserve the Origin Decoction) was used, assisted by Gui Rong Tang (Deer Antler and Angelica Decoction).
In a case where pus was sufficient but the color did not turn dark yellow, this was due to weak Spleen, which governs scabbing. Bao Yuan Tang (Preserve the Origin Decoction) with Bai Zhu (Atractylodes Macrocephala), Bai Shao (White Peony Root), Chen Pi (Tangerine Peel), Guan Gui (Cinnamon Bark), and Lian Rou (Lotus Seed Flesh) was used to thicken the scabs and cure the condition. If scabs were thin like bran, Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Magnifica Powder) alone was sufficient.
In a case on the seventh day where there was no pus and premature scabbing occurred, only the roots contracting, Bao Yuan Tang (Preserve the Origin Decoction) with Shan Jia (Pangolin Scales) and Guan Gui (Cinnamon Bark) was used. Additionally, bathing the head, face, hands, and feet in Shui Yang Tang (Water Willow Decoction) caused the lesions to rise again after some time, forming pus and curing the disease.
In a case on the ninth day with flat, pus-less lesions, redness below the mouth, ability to eat, but loose stools, this indicated insufficient Yuan Qi unable to ascend to the face. Bao Yuan Tang (Preserve the Origin Decoction) with Bai Zhu (Atractylodes Macrocephala), Bai Shao (White Peony Root), Guan Gui (Cinnamon Bark), Rou Dou Kou (Nutmeg), and Sheng Ma (Cimicifuga Rhizome) was used. By the eleventh day, new pustules filled the empty spaces and formed pus. Yi Gong San (Extraordinary Efficacy Powder) was then administered for recovery.
In a case where the front face had sufficient pus and scabs, but the limbs lacked pus, with ability to eat, loose stools, and undigested food in feces, this indicated Spleen Yin deficiency failing to nourish. Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Magnifica Powder) with Fu Zi (Aconite Root), Tu Si Zi (Cuscuta Seed), and Rou Dou Kou (Nutmeg) was used, followed by He Che San (Placenta Powder) for recovery.
In a case on the eighth day with empty shells and no pus due to Qi and Blood deficiency failing to control toxins, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used. Four or five ding (hard nodules) emerged, leading to recovery. The Classics state: "Emergence of carbuncles or ding indicates survival."
In a case on the eighth day with inverted scabbing, gray-white color, diarrhea, thirst, teeth grinding, and chills, this was Qi and Blood deficiency-cold. Yi Gong San (Extraordinary Efficacy Powder) cured it. If treatment failed and drowsiness worsened, death would ensue.
In a case on the eighth day with depressed tops, stagnant pus, and scorched-purple color, this was due to Wind-Cold blocking the interstices, causing Qi stagnation and Blood coagulation. Ascending and dispersing agents were needed. Zi Su Yin (Perilla Infusion) was taken internally, and Shui Yang Tang (Water Willow Decoction) used externally to help medicinal qi ascend with the steam, expelling toxins through warmth. For weak children, only the head, face, hands, and feet should be bathed, after which the lesions become smooth, followed by Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for regulation. This bath is only suitable if Qi and Blood are sufficient and clearly blocked by Wind-Cold. If no rise occurs after bathing and confusion worsens, death results.
In a case during pus formation with lethargy, loose stools, but ability to eat, this indicated Spleen fatigue due to looseness causing deficiency and drowsiness. Gui Pi Tang (Restore the Spleen Decoction) with Bai Shao (White Peony Root), Shan Yao (Chinese Yam), Yi Yi Ren (Coix Seed), and Lian Rou (Lotus Seed Flesh) cured it.
In a case where sufficient pus suddenly scabbed dry and purple, with normal eating and bowel movements, this was rapid scabbing due to Fire forcing closure, known as inverted scabbing. Tonifying and resolving agents were administered. By the fourteenth day, limbs swelled and scabbed, forming pus and resolving toxicity. If the child refused food, had loose stools, hiccups, and choking, it indicated internal deficiency inverted scabbing, toxin returning inward, leading to death from wheezing and distension.
In a case where pus was hard to fill, with red roots, thirst, scanty urine, dry tongue, and constipation, often attributed to Qi deficiency and fluid lack, treating with Bao Yuan Tang (Preserve the Origin Decoction) plus Mai Dong (Ophiopogon Tuber) worsened the condition. Stagnant pus indicated unresolved Blood Heat; warming tonics aided the pathogen, reflecting Fire excess and Water depletion. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) was switched to, followed by Si Shun Qing Re Yin (Four Smooth Cooling Decoction) to promote urination. All prior symptoms resolved, pus filled, and recovery occurred. The Classics state: "If toxins are not cleared and warming tonics are used, toxins accumulate and fail to form pus."
In a case on the ninth day, a child died and was abandoned on a beach. Limbs twitched, color was scorched-purple, but shape remained protruded. This was toxin-fire causing coma and sudden death. Contact with water cooled the fire, leading to revival. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) cured him. Some recover through contact with earth.
In a case on the seventh day with red painful roots, constipation, scanty urine, irritability, and thirst, if clearing agents failed, this indicated internal郁 Heat-Toxin. Da Huang (Rhubarb), Dang Gui (Angelica Sinensis), Chi Shao (Red Peony Root), and Gan Cao (Licorice) were given for one dose, followed by Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) for recovery.
In a case during pus formation with bloody stool, hematuria, coma, or excessive sleep, this was because the Heart governs Blood, and deficient pathogens entered the Heart, disturbing the Spirit. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) and An Shen Wan (Spirit-Calming Pill) were indicated. If treatment failed, death occurred by the twentieth day. If toxins exited completely, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Mai Dong (Ophiopogon Tuber) and Zao Ren (Ziziphus Seed) should be used.
In a case with sufficient pus, black-purple suppuration, severe heat, and constipation, this was Blood Heat and Toxin congestion. Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) plus Lian Qiao (Forsythia) and Niu Bang Zi (Arctium Fruit) cured it.
A girl suffering from smallpox in late spring spoke deliriously, stood up constantly, and could not sleep for seven days. Her appearance and color were compliant, but the delirious standing indicated Hyperactive Fire of the Heart and Gallbladder. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) with Chai Hu (Bupleurum Root) and Long Dan Cao (Gentian Root) cured her.
Wan Mizhai treated Wang’s son. When smallpox reached the pus stage, the head, face, abdomen, and back were full, but the hands and feet from elbows/knees to palms/fingers had not erupted. He said: The Spleen governs the four limbs; this child’s Spleen-Stomach must be very weak. Due to loss of milk at birth, Jian Zhong Tang (Establish the Middle Decoction) with Huang Qi (Astragalus) and Fang Feng (Saposhnikovia Root) was given. One dose caused all lesions to swell and form pus. The family worshipped the Black God of Lu Lake. The child was named after the god. Before eruption, the god descended saying he would protect against few smallpox spots. Since many spots erupted, they used a trick to drive the god away.