Planting Smallpox

夫痘胎毒也伏於有形之始因感而𤼵為生人所不能免然其𤼵也或染時氣或感風寒或因飲食或由驚恐以病引病為患多端變更莫測且其間順吉者少險逆者多有千方百計而不能冀其愈於萬一者此其所以為難也

Now smallpox is fetal poison. It lies hidden from the beginning of having form; owing to being affected [by something], it breaks out; it is what living people cannot avoid. But its breaking out: either one is infected by seasonal qi, or affected by wind and cold, or owing to food and drink, or from fright; illness drawing out illness, the harm is of many kinds, its changes unfathomable. Moreover among [cases], the smooth and auspicious are few, the dangerous and adverse many; there are those for whom a thousand prescriptions and a hundred plans cannot hope for recovery in one out of ten thousand. This is why it is difficult.

Smallpox is a fetal poison.1 It lies hidden in the body from the moment the body takes shape, and it breaks out when something sets it off. No one born can escape it. It may break out when a child catches a seasonal qi,2 or is chilled by wind and cold, or from food and drink, or from a fright. One illness leads to another, the harm takes many forms, and its changes cannot be foreseen. Besides, few cases go smoothly and many are dangerous. In some, a thousand remedies and a hundred plans cannot give one chance in ten thousand of recovery. That is why it is so hard [to treat].

1. Chinese doctors held that smallpox came from a poison every child received in the womb. It lay hidden until something drew it out, and the illness then drove it from the body.
2. Qi was the vital breath or energy that Chinese thinkers saw in the body and in the world. A seasonal qi was a harmful influence of the weather at a given time of year.

古有種痘一法起自江右達於京畿究其所源云自宋真宗時峨眉山有神人出為丞相王旦之子種痘而愈遂傳於世其説雖似渺茫然以理揆之實有參贊化育之功因時制宜之妙盖正痘感於得病之後而種痘則施於未病之先正痘治於成病之時而種痘則調於無病之日自表傳裏由裏達表既無諸證夾雜於其中復有善方引導於其外薫蒸漸染胎毒盡出又何慮乎為患多端變更莫測以致良工束手於無可如何之地耶此誠去險履平避危就安之良法也

Of old there is a method of planting smallpox, which arose from Jiangyou and reached the capital region. Inquiring into its source, it is said that in the time of Song Zhenzong a divine person came out of Mount Emei and planted smallpox for the son of the chancellor Wang Dan, who recovered; thereupon it was handed down in the world. Although the account seems vague and far off, yet measured by principle, it truly has the merit of assisting the transforming and nurturing [of Heaven and Earth], and the subtlety of fitting measures to the time. For natural smallpox is caught after one has fallen ill, while planted smallpox is applied before illness; natural smallpox is treated at the time the illness is formed, while planted smallpox is regulated on a day without illness. From the exterior it passes to the interior; from the interior it reaches the exterior; there are no [other] signs mixed in within, and there are good prescriptions guiding it from outside; steaming and gradually imbuing, the fetal poison all comes out. Then why worry about harm of many kinds and unfathomable changes, such that good physicians are bound hand [and foot] in a place where nothing can be done? This truly is a good method for leaving danger and treading the level, avoiding peril and approaching safety.

In the past there was a method of planting smallpox.3 It began in Jiangyou4 and spread to the capital region. As for where it came from, people tell a story from the time of Emperor Zhenzong of the Song.5 A holy man came out of Mount Emei6 and planted smallpox in the son of the chancellor Wang Dan, and the boy recovered. From then on it was handed down in the world. The story may seem far-fetched. But judged by reason, the method truly helps [Heaven and Earth] in their work of creating and nourishing life, and it wisely suits the treatment to the time. Natural smallpox is caught after one falls ill, but planted smallpox is given before any illness. Natural smallpox is treated when the illness has already taken hold, but planted smallpox is managed on a day when the child is well. [The seed's qi] passes inward from the surface, and [the poison] comes back out from inside to the surface. No other illnesses are mixed in, and good prescriptions guide it from outside. Steamed out little by little, the fetal poison comes out completely. Then why fear harm of many kinds and changes no one can foresee, which leave good doctors helpless? This is truly a fine method for leaving danger behind and walking on level ground, for avoiding peril and reaching safety.

3. 種痘 zhongdou: giving a healthy child smallpox on purpose, from the scabs or fluid of a mild case, so that it would have a milder illness and never catch the disease again.
4. Jiangxi province, in southeastern China.
5. Zhenzong reigned 997–1022, more than seven hundred years before this book. Wang Dan (957–1017) was his chief minister.
6. One of the four sacred mountains of Chinese Buddhism, in Sichuan, in western China.

然種痘一科多口傳心授方書未載恐後人視為虛誕之辭相沿日久無所考稽使至理良法竟置無用之地神功湮没豈不大可惜哉今将種痘一法細加研究審度精詳纂輯成書永垂千古庶為種痘之津梁咸登赤子於夀域也

But the specialty of planting smallpox has mostly been transmitted by mouth and taught heart [to heart]; prescription books have not recorded it. [We] fear later people will regard it as empty and absurd words; continuing so for a long time, there will be nothing to examine, causing the perfect principle and good method finally to be put in a useless place and its divine merit buried and lost. Would that not be greatly regrettable? Now we take the method of planting smallpox, study it in detail, examine and weigh it precisely and carefully, compile it into a book to hand down for a thousand ages, hoping it may be a ford and bridge for planting smallpox, and bring all red infants up into the realm of long life.

But planting smallpox has mostly been taught by word of mouth, from teacher to pupil, and medical books have not recorded it. We fear that later generations will take it for empty, foolish talk. If this goes on for long, there will be nothing to check it against. Then this perfect principle and good method will be cast aside as useless, and its wonderful power will be lost. Would that not be a great pity? So we have studied the method of planting smallpox in detail, weighed it carefully and precisely, and compiled it into a book to hand down for a thousand ages. We hope it will be a bridge for those who plant smallpox, and bring every infant safely to a long life.

嘗考種痘之法有謂取痘粒之漿而種之者有謂服痘兒之衣而種之者有謂以痘痂屑乾吹入鼻中種之謂之旱苗者有謂以痘痂屑濕納入鼻孔種之謂之水苗者然即四者而較之水苗為上旱苗次之痘衣多不應騐痘漿太渉殘忍故古法獨用水苗盖取其和平稳當也近世始用旱苗法雖㨗徑㣲覺迅烈若痘衣痘漿之説則斷不可從

I have examined the methods of planting smallpox. Some say take the fluid of the pox pustules and plant it; some say wear the clothes of a pox child and plant [so]; some say take pox-scab powder dry and blow it into the nose to plant, calling this the dry sprout; some say take pox-scab powder moist and put it into the nostril to plant, calling this the water sprout. But comparing these four, the water sprout is best, the dry sprout next; pox clothes mostly do not take effect; pox fluid is too cruel. So the ancient method used only the water sprout, taking its gentleness and safety. In recent times they began to use the dry sprout method; though quick and direct, it is felt to be slightly swift and violent. As for the pox-clothes and pox-fluid [methods], they must absolutely not be followed.

We have looked into the methods of planting smallpox. Some take the fluid from the pustules and plant that. Some dress a child in the clothes of a child with smallpox. Some grind the scabs to powder and blow it dry into the nose; this is called the dry seed.7 Some moisten the scab powder and put it into the nostril; this is called the water seed. Comparing the four, the water seed is best and the dry seed next. Smallpox clothes usually do not take, and smallpox fluid is too cruel. So the old method used only the water seed, because it is gentle and safe. In recent times people began to use the dry seed. It is quick and direct, but it is felt to be a little too fast and violent. As for smallpox clothes and smallpox fluid, those methods must never be followed.

7. 苗 miao, literally “sprout” or “seedling”: the matter used to plant the pox, usually scabs from a child with a mild case.

夫水苗之所以善者以其勢甚和平不疾不徐漸次而入既種之後小兒無受傷之處胎毒有漸發之機百發百中㨗於影響盡善盡美可法可傳為種痘之最優者其次則旱苗雖烈猶與水苗之法相近兒體壮盛猶或可施

Now the reason the water sprout is good: because its force is very gentle, neither fast nor slow, entering by degrees. After it is planted, the child has no place of injury; the fetal poison has the opportunity of coming out gradually; a hundred shots, a hundred hits, quicker than shadow and echo; wholly good and wholly beautiful, to be taken as a model and handed down; it is the best of [ways of] planting smallpox. Next to it is the dry sprout; though violent, it is still close to the water-sprout method; if the child’s body is strong and robust, it may perhaps still be applied.

The water seed is good because it acts very gently. Neither fast nor slow, it enters little by little. After it is planted, the child suffers no harm, and the fetal poison has a chance to come out gradually. It succeeds every time, as surely as a shadow follows a body or an echo a sound. It is perfect in every way, a method to follow and hand down, the best way of planting smallpox. Next comes the dry seed. It is violent, but still close to the water-seed method, and it may be used if the child is strong and sturdy.

種痘之時要細閲小兒氣血冲和臟腑均平内無痰熱食積所傷外無六淫之氣相侵方可用上好痘痂種之一嵗者用二十餘粒三四嵗者用三十餘粒置於淨磁鍾内以栁木作杵碾為細末以淨水滴三五㸃入鍾内春温用冬熱用乾則再加水幾㸃總以調匀為度不燥不濕用新棉些須攤極薄片裹所調痘屑在内揑成棗核様以紅線拴定仍留寸許長則剪去将苗納入鼻孔分男左女右不可離人時時㸔守倘小兒用手拈弄急禁止之或被𡁲出急将苗塞鼻内不可稍緩恐洩苗氣下苗後必以六個時辰為度然後取出如遇天氣嚴寒多留數刻若遇時令和暖早取數刻亦可要在臨時斟酌痘苗取出之後其苗氣漸次而入傳遍五藏至七日始𤼵熱發熱三日而苗見見苗三日而出齊出齊三日而灌漿漿足三日而回水結痂大功成矣

At the time of planting smallpox, one must examine closely [that] the small child’s qi and blood are harmonious and the viscera evenly balanced; inside, no harm from phlegm-heat or food accumulation; outside, no qi of the six excesses invading; only then may one use top-quality pox scabs to plant it. A one-year-old uses twenty-odd grains; a three- or four-year-old uses thirty-odd grains. Put them in a clean porcelain cup, make a pestle of willow wood, and grind them to fine powder; with clean water drip three to five drops into the cup; spring: use [it] warm; winter: use [it] hot; if dry, then add a few more drops of water; in all, take evenly mixed as the measure, not dry, not wet. Use a little new cotton, spread into an extremely thin sheet, wrap the mixed pox powder inside, pinch it into the shape of a jujube pit, fasten it with red thread, still leaving about a cun; [what is] long, cut off. Put the sprout into the nostril, dividing male left, female right. One must not leave [the child]; constantly watch and guard. If the child takes it with the hand and plays with it, urgently stop it; if it is sneezed out, urgently stuff the sprout into the nose; one must not delay even slightly, fearing the sprout qi leaks. After placing the sprout, one must take six shichen as the measure, then take it out. If meeting severe cold weather, leave it several ke more; if meeting a mild and warm season, taking it out several ke early is also possible; the essential lies in weighing it at the time. After the pox sprout is taken out, its sprout qi gradually enters and passes through all five organs; at the seventh day fever first breaks out. Fever three days, then the sprouts [spots] appear; spots appear three days, then they come out evenly [are complete]; complete three days, then they fill with fluid; fluid full three days, then the water returns and scabs form; the great work is accomplished.

At the time of planting, examine the child closely. Its qi and blood must be in harmony and its organs in balance. Inside, it must not be troubled by phlegm, heat, or undigested food. Outside, it must not be under attack from the qi of the six excesses.8 Only then plant it, using the best scabs. For a child of one year, use twenty-some pieces of scab; for a child of three or four, thirty-some. Put them in a clean porcelain cup and grind them to a fine powder with a willow-wood pestle. Drip three to five drops of clean water into the cup, warm in spring and hot in winter. If the mixture is dry, add a few drops more. What matters is to mix it evenly, neither dry nor wet. Spread a little new cotton into a very thin sheet, wrap the mixed scab powder in it, and pinch it into the shape of a jujube pit. Tie it with red thread, leaving about an inch9 of thread, and cut off the rest. Put the seed into the nostril, the left for a boy and the right for a girl.10 Someone must stay with the child and watch it all the time. If the child plays with the seed, stop it at once. If the child sneezes it out, put it back in the nose at once, without the least delay, or the seed’s qi may leak away. Once the seed is in, leave it for six double hours,11 then take it out. In bitter cold, leave it in a little longer; in mild, warm weather, it may come out a little earlier. The point is to judge at the time. After the seed is taken out, its qi enters little by little and passes through all five organs.12 On the seventh day, fever begins. After three days of fever, the spots appear. Three days later, all the spots are out. Three days after that, they fill with fluid. Three days after they are full, the fluid dries up and they form scabs, and the great work is done.

8. The six excesses were wind, cold, summer heat, damp, dryness, and fire: kinds of harmful qi from the weather that doctors thought could invade the body from outside.
9. Chinese inches (cun). A Qing cun was a little longer than an English inch.
10. The left side belonged to yang and to males, the right to yin and to females, so boys and girls were treated on opposite sides.
11. The Chinese day was divided into twelve double hours (shichen), so six double hours made half a day.
12. The five organs were the heart, liver, spleen, lungs, and kidneys. The next section of the book, left out here, traces the seed’s qi from the nose to the lungs and on through the other four.

旱苗種法用銀管約長五六寸曲其頸碾痘痂極細納於管端按男左女右對凖鼻孔吹入之至七日而亦𤼵熱今時多用此法蓋取其簡便㨗入不致脱落而有透洩苗氣之患也苐恐後人用之不善輕吹之則不驟入重吹之則迅烈難當且恐流涕過多苗隨涕去往往不騐今欲垂法後世當取其法之和平稳當萬全者而則效之此所以獨取於水苗也

The dry-sprout planting method: use a silver tube about five or six inches long, bend its neck; grind the pox scabs very fine and put [the powder] in the end of the tube; following male left, female right, aim it accurately at the nostril and blow it in; by the seventh day there is likewise fever. Nowadays this method is much used, because it is simple and convenient, enters quickly, and does not lead to falling out with the trouble of the sprout’s qi leaking away. But [we] fear later people will use it badly: blown lightly, it does not enter at once; blown heavily, it is swift and violent and hard to bear; and [we] fear [that with] too much running of the nose, the sprout goes away with the mucus, and often it does not take. Now, wishing to hand down a method to later ages, one should take the method that is gentle, safe, and wholly secure and follow it. This is why we take only the water sprout.

For the dry-seed method, use a silver tube about five or six inches long, bent near the end. Grind the smallpox scabs very fine and put the powder in the end of the tube. Aim it carefully at the nostril, the left for a boy and the right for a girl, and blow the powder in. By the seventh day there is fever, [as with the water seed]. Many people use this method nowadays. It is simple and quick, and the seed cannot fall out and let its qi escape. But we fear that later people will use it badly. Blown too lightly, the powder does not go in at once; blown too hard, it acts too fast and violently for the child to bear. Then too, if the nose runs too much, the seed washes out with the mucus, and often it does not take. Since we wish to hand down a method to later ages, we should choose the gentle, safe, and wholly reliable one and follow it. That is why we choose only the water seed.

小兒出痘者當長漿漿足之時則彼痘氣充盛取其貼身裏衣與未出痘之兒女服之服二三日夜間亦不脱下至九日十一日始𤼵熱此乃衣傳然恐氣薄不透多有不熱不出其法不靈故不可用

When a child having smallpox is at the time of growing fluid, when the fluid is full, then its pox qi is abundant; take its inner clothes worn next to the body and give them to a boy or girl who has not had smallpox to wear; wear them two or three days, at night too not taking them off; by the ninth or eleventh day fever begins. This is transmission by clothes. But [we] fear the qi is thin and does not penetrate; often there is no fever and [the pox] does not come out; the method is not effective, so it may not be used.

When a child with smallpox reaches the stage when the pustules fill with fluid, and they are full, its smallpox qi is at its strongest. Take the shirt that child wears next to the skin, and have a boy or girl who has not had smallpox wear it for two or three days, without taking it off at night. On the ninth or eleventh day, fever begins. This is passing it on by clothing. But we fear the qi may be too thin to get through. Often there is no fever and no pox comes out. The method is unreliable, so it must not be used.

擇小兒出痘之順者取其痘漿以棉拭之分男左女右塞入鼻中亦能發痘但取痘漿之時不令本家知覺揑破痘漿盜以作種使彼真氣宣洩毒不能解此忍心害理不仁之事也同志者切宜深惡而痛絶之又豈可尤而效之也哉

Choose a child whose smallpox comes out smoothly, take its pox fluid, wipe it with cotton, and, dividing male left and female right, stuff it into the nose; it too can bring out the pox. But at the time of taking the pox fluid, without letting the family know, [people] pinch and break the pustules and steal [the fluid] to make seed, causing that [child’s] true qi to leak out, so that the poison cannot be resolved. This is a hard-hearted, unprincipled, inhumane thing. Those of like mind should earnestly hate it deeply and cut it off utterly; how could they blame it and yet imitate it?

Choose a child whose smallpox is going smoothly. Wipe up the fluid from its pustules with cotton, and put the cotton into the nose, the left for a boy and the right for a girl. This too can bring out the pox. But when they take the fluid, people pinch the pustules open without the family knowing, and steal it to use as seed. This lets the sick child’s true qi leak out, so that its poison cannot be cleared. It is a cruel, wrong, and inhumane thing to do. All who agree with us should hate it deeply and put a complete stop to it. How could anyone condemn it and then do it himself?