万密斋治罗野松,年十六出痘。或曰∶凡出痘者,春夏为顺,秋冬为逆。今冬出,时逆也。痘起发,头面
要肿,今被寒气遏抑,毒不得出,故头面不肿,症逆也。曰∶不然,春夏为顺,秋冬为逆,非以时言,以症言
也。盖春夏者,发生长养之令也;秋冬者,收敛闭藏之令也。痘本阳毒,自出现而起发,自起发而成脓,如苗
而秀,秀而实,故曰春夏为顺。如应出不出,应发不发,谓之陷伏,故曰秋冬为逆。头面不肿,顺症也。头浮
肿者,险症也。头面预肿者,逆痘也。今痘本磊落尖圆坚实,其毒轻微,故不肿。若顶平根阔,肌肉鲜红,此
为毒盛,不待起发而头面先肿矣。或又曰∶起发太迟,宜服温补。曰∶痘无病,不须服药。此症红润鲜明,表
气足也。大小便调,里气充也。无热无渴,无他病也。若补之,谓之实实。此症不十数日必收靥矣。果不药而
安。(雄按∶此乃千古名言。)
吴氏子五岁出痘,起发时,顶平而陷。曰∶顺症也,凡出痘以气血和平为主。尖圆坚实者,气也。红活明
润者,血也。红活平陷者,血至而气不足也。圆实而色白者,气至而血不足也。平塌灰白者,气血俱不足也。
肿红绽者,气血俱有热也。今痘出即密,时日未到,气血未周,以渐起发,得其常也,故曰顺症。不须服药,
已而果然。(看痘之法,尽此数语。)
万密斋诊治罗野松,十六岁出痘。有人说:“凡是出痘,春夏季节为顺证,秋冬季节为逆证。现在是冬天出痘,时令上是逆证。痘疹起发时,头面部应该肿胀,现在被寒气遏制抑制,毒邪不能透出,所以头面部不肿胀,这是症候上的逆证。”万密斋说:“不对,春夏为顺、秋冬为逆,不是以时令而言,而是以症候而言的。大概春夏是发生长养的时令;秋冬是收敛闭藏的时令。痘疹本是阳毒,从出现到起发,从起发到成脓,如同禾苗抽穗,抽穗后结实,所以说春夏为顺。如果应当出而不出,应当发而不发,称为陷伏,所以说秋冬为逆。头面部不肿胀,是顺证。头面部浮肿的,是险证。头面部预先肿胀的,是逆痘。现在痘疹本来磊落、尖圆、坚实,其毒邪轻微,所以不肿胀。如果痘顶平、根阔、肌肉鲜红,这才是毒盛,不用等到起发阶段,头面部就会先肿胀了。”有人又说:“起发太迟,适宜服用温补药物。”万密斋说:“痘疹没有病态,不需要服药。此症红润鲜明,说明表气充足。大小便正常,说明里气充盛。无发热无口渴,没有其他病症。如果此时进补,叫做‘实实’(使实证更实)。此症不过十几天必然收靥(结痂脱落)。”果然没有用药而平安无事。(熊应雄按语:这是千古名言。)
吴氏的儿子五岁出痘,在起发阶段,痘顶平坦下陷。万密斋说:“这是顺证。凡是出痘,以气血平和为主。痘形尖圆坚实的,是气足的表现。痘色红活明润的,是血足的表现。痘色红活但平坦下陷的,是血已至而气不足。痘形圆实但颜色白的,是气已至而血不足。痘形平塌且灰白色的,是气血都不足。痘形肿胀发红绽开的,是气血都有热。现在痘出即密集,时日未到,气血尚未周遍,逐渐起发,符合常理,所以说是顺证。不需要服药,后来果然如此。(看痘的方法,尽在这几句话中。)
Wan Mizhai treated Luo Yesong, who was sixteen years old and suffering from smallpox. Someone said, "In general, the eruption of smallpox is a favorable condition (Shun) in spring and summer, but an unfavorable condition (Ni) in autumn and winter. Since it erupted in winter, this is unfavorable according to the season. When smallpox erupts, the head and face should swell. Now, suppressed by cold qi, the pathogenic toxin cannot emerge, hence the lack of swelling on the head and face; this indicates an unfavorable symptom pattern." Wan Mizhai replied, "Incorrect. The distinction between favorable in spring/summer and unfavorable in autumn/winter is not based on the season, but on the symptom pattern. Spring and summer are seasons of growth and nourishment; autumn and winter are seasons of convergence and storage. Smallpox is fundamentally a yang toxin. It emerges, then rises, and finally suppurates, similar to a plant heading and bearing fruit; therefore, spring and summer are considered favorable. If the eruption or rising fails to occur as expected, it is termed 'sunken and stagnant' (Xianfu); thus, autumn and winter are considered unfavorable. Lack of swelling on the head and face is a favorable sign. Swelling of the head and face indicates a critical condition. Premature swelling of the head and face indicates an unfavorable smallpox case. Currently, the pustules are distinct, pointed, round, firm, and solid, indicating mild toxicity, hence no swelling. If the tops were flat, roots broad, and flesh bright red, that would indicate severe toxicity, where the head and face would swell before the rising stage even begins." Another person said, "The rising stage is too delayed; warm tonification should be administered." Wan Mizhai said, "There is no pathological deviation in the smallpox itself; medication is unnecessary. The brightness and ruddy color indicate sufficient exterior qi. Normal urination and defecation indicate sufficient interior qi. There is no fever, no thirst, and no other diseases. Administering tonification now would constitute 'tonifying excess' (Shi Shi). This case will naturally scab over within ten days." Indeed, the patient recovered safely without medication. (Comment by Xiong Yingxiong: This is a timeless maxim.)
The son of Mr. Wu was five years old when he contracted smallpox. During the rising stage, the pustule tops were flat and sunken. Wan Mizhai said, "This is a favorable condition. In smallpox, the harmony of qi and blood is paramount. Pointed, round, and firm shapes indicate sufficient qi. Ruddy, vibrant, and moist colors indicate sufficient blood. Ruddy yet flat and sunken shapes indicate that blood has arrived but qi is insufficient. Round and solid shapes with white color indicate that qi has arrived but blood is insufficient. Flat, collapsed, and ash-white shapes indicate insufficiency of both qi and blood. Swollen, red, and bursting shapes indicate heat in both qi and blood. Currently, the eruptions are dense, but the timing is premature, and the qi and blood have not yet fully circulated. The gradual rising conforms to normal physiological processes; therefore, it is deemed a favorable condition. Medication is unnecessary." Subsequently, the prediction proved correct. (The method for assessing smallpox is contained entirely in these few sentences.)