分气虚、血虚，补之。气虚，用参、术、苓、甘加解毒药；血虚，四物加解毒药，酒炒黄连是解毒药，但见红点便
忌，升麻葛根汤发得表虚也。吐泻少食为里实，里实而补，则结痈陷伏靥灰白为表虚，或用烧人中黄子和方，黑陷
甚者烧人屎，红活锭凸为表实，表实复用表药，则溃烂不结痂，吐泻、陷伏二者俱见，为表里俱虚。痘疮初出或未出
时，见人有患者宜预此药，多者可少，重者可轻，其方用丝瓜近蒂者三寸，连瓜子皮都烧灰存性，为末，沙糖拌干吃，
入朱砂未亦可。解痘疮毒方，丝瓜、升麻、酒芍药、生甘草、棠 、黑豆、犀角、赤小豆。又方，解痘疮已出未出
皆可用，朱砂为末，蜜水调服，多可减少，少者可无。小儿豆疮泄泻发渴，切不可与蜜水、西瓜、红柿生冷之物，可
进木香散，陈文中小儿方内求之。疮疹未发出证的，以胭脂涂眼眶不生痘疮。痘疮脓溃沾衣者，可用腊月黄牛粪烧
灰挹睡，免生痘疮痈。头面豆痂剥去脓血出，以真酥油润之，免成癣。痘斑疮，心躁，眠不安，升麻汁绵蘸洗拭。
痘疮气虚而发不出者，黄 、人参、酒芍药、当归、川芎、
酒红花，如豆许，木香、紫草。气实痰郁而不发者，苍术、白芷、防风、升麻、黄芩、赤芍药、连翘、当归须。
血热而发得势甚者，下焦成疮，无皮口渴，天花粉、黄芩、芍药、葛根、甘草、石膏、滑石。血气俱弱而黑陷者，酒
芍药、人参、黄 、白芷、木香、桂皮、川芎、当归。血为湿，头靥而灰白者，红花、苏木、白术、苍术、芍药、当
归、川芎，加酒少许。发后为外恶气所伤而倒靥，人参、芍药、连翘、黄 梢、甘草梢、白芷、酒当归、川芍、木香
少许。凡痘疮，须分人之清浊，就形气上取勇怯。黑陷二种气虚而不能尽出者，用酒炒黄 、人参、酒紫草。颜色
正，如上法欲成就却淡；色不正者，用芎，归，芍药、红花酒之类，欲成就却紫色属热，用升、葛、芩、连、桂、翘之
类。甚者，犀角屑大解痘毒。炉灰白色，静者、怯者作寒看；齐者、勇者、躁者、 发者作热看。全白色将靥时如豆
壳，盖因初起时饮水过多，其靥不齐，俗呼为倒靥，不妨，但服实表之剂。消息他大小便，如大便秘，则通大便；如小
便闭，则通小便。有初起烦躁谵语，狂渴引饮，若饮水，则后来靥不齐，急以凉药解其标，如益元散之类亦可用。痒
塌者，于形色脉上分虚实。实，则脉有力气壮；虚，则脉无力气怯。虚痒，以实表之剂加凉血药；实痒或大便秘者，以
大黄寒凉药少与之，下其结粪。气怯轻者，用淡蜜水调滑石末，以羽润疮上。疏则无毒，密则有毒，用凉药解之，虽
十数帖亦不妨，后无害眼之患。干者，便用退火，湿者，便用泻湿。退火，用轻剂，荆芥、升麻、甘、葛之类；泻湿乃
肌表间湿，用风药，白芷、防风之类。痘疮伤眼，必用山栀、决明、赤芍药、当归须、黄芩、黄连、防风、连翘、升
麻、桔梗，为末，作小剂调服。如无光，过百日后气血复，
当自明。痘痈多是表实、血热所成，分上下治，一日不可缓也。成脓，必用出凉药为主，赤芍药、甘草节、连翘、桔
梗，上引用升麻、葛根，下引用槟榔、牛膝，助以贝母、忍冬草、白芷、栝蒌之类。大便燥用大黄；发热用黄芩、黄
柏。痘疮黑属血热，凉血为主；白属气虚，补气为主。中黑陷而外白，起得迟，则相兼而治。初起时，自汗不妨，盖
湿热熏蒸而起故也。痘分气、血、虚、实，以日子守之，多带气血不足处。虚则黄 ，生血活血之剂助之，略佐以风
药；实则白芍药、黄芩为君，白芷、连翘佐之。若属寒者，陈氏方亦可用。已发未发并与参苏饮为当。调解之法，
大率活血调气，安表和中，轻清消毒，温凉之剂二者得兼而已，温如当归、黄 、木香辈；凉如前胡、甘葛、升麻辈。
佐之以川芎、芍药、枳壳、桔梗、木通、紫草、甘草之属。初起时自汗不妨，盖湿热熏蒸而然。痘痈敷药∶贝母 南
星僵蚕 天花粉 白芷 草乌 大黄 猪牙皂角等分 寒水石倍用 上为末，醋调敷。一男子，年二十余患痘疮，
靥谢后，忽口噤不开，四肢强直，不能舒屈，时绕脐痛，痛一阵则冷汗出如雨，痛定则汗止，时止时作，其脉弦紧而
急，如直 状，询知此子极劳苦，意其因劳倦伤血，且山居多风寒乘虚而感，之后，因痘出其血又虚，当用温药养血，
辛凉散风，遂以当归身、白芍药为君，以川芎、青皮、钩藤为臣，白术、陈皮为佐，甘草、桂皮、南木香、黄芩为使，
加以红花少许，煎服而愈。予从子，六七岁时出痘，身热，微渴，自利，医用木香散加丁香十粒。予观其出迟，固因自
利而气弱，然其所下皆臭滞，盖因热蒸而下，恐未必寒，急止之，已投一帖矣，与黄连解毒汤加白术，近十帖以解之，
利止，痘亦出。其肌常微热，手足生肿，又与凉补，一月
安。一人年十七，出痘发热而昏倦甚，脉大而似数，与参、术、 、归、陈皮，大料浓汤饮之，二十帖痘出，又与
二十帖，则脓胞成，身无全肤，或用陈氏本方与之，予曰但虚无寒，又与前方，至六十帖而安。
Differentiate between Qi deficiency and Blood deficiency, and tonify them. For Qi deficiency, use Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), and Glycyrrhizae Radix et Rhizoma (Gancao) added with detoxifying herbs; for Blood deficiency, use Siwu Tang (Four Substances Decoction) added with detoxifying herbs. Wine-fried Coptidis Rhizoma (Huanglian) is a detoxifying herb, but it should be avoided when red spots appear, as Shengma Gegen Tang (Cimicifugae and Puerariae Decoction) may exacerbate exterior deficiency. Vomiting, diarrhea, and poor appetite indicate interior excess; tonifying interior excess will cause the pustules to collapse, become flat, and turn grayish-white, indicating exterior deficiency. Alternatively, use Shaorenzhonghuang Zi Fang (Burning Human Excrement Ash Formula) or burned human feces for severe black depression. Red, vibrant, and convex pustules indicate exterior excess; reusing exterior-releasing herbs for exterior excess will lead to ulceration without scabbing. The simultaneous presence of vomiting/diarrhea and collapsed pustules indicates both exterior and interior deficiency. When pustules are just emerging or have not yet emerged, if one encounters a patient, this medicine should be taken prophylactically: reduce the dose for severe cases and increase it for mild ones. The formula uses three cun of loofah near the stem, including seeds and skin, burned to charcoal while retaining its nature, ground into powder, mixed with dry rock sugar for oral consumption, or mixed with Cinnabar (Zhusha) powder. A formula to resolve toxin from smallpox includes Luffae Fructus (Sigua), Cimicifugae Rhizoma (Shengma), wine-fried Paeoniae Radix Alba (Baishao), raw Glycyrrhizae Radix et Rhizoma (Sheng Gancao), Pyri Fructus (Tangli), Sojae Semen Nigrum (Heidou), Rhinocerotis Cornu (Xijiao), and Phaseoli Semen Rubrum (Chixiaodou). Another formula for resolving smallpox toxin can be used whether the rash has emerged or not: grind Cinnabar (Zhusha) into powder, mix with honey water for administration; take more for severe cases, less for mild, or none at all. For children with smallpox accompanied by diarrhea and thirst, absolutely avoid honey water, watermelon, persimmons, and other cold/raw foods. Instead, administer Muxiang San (Aucklandia Powder), which can be found in Chen's pediatric formulas. For rashes that have not yet manifested symptoms, apply carmine to the eye orbits to prevent pustule formation. If pus from smallpox sores stains clothing, apply ash from yellow cow dung burned in the twelfth lunar month to the sleeping area to prevent carbuncles. If head and face scabs peel off with pus and blood, lubricate with pure butter to prevent tinea. For smallpox spots with mental restlessness and sleep disturbance, wash and wipe with juice of Cimicifugae Rhizoma (Shengma). For smallpox failing to emerge due to Qi deficiency, use Astragali Radix (Huangqi), Ginseng Radix et Rhizoma (Renshen), wine-fried Paeoniae Radix (Baishao), Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Safflower (Honghua) fried in wine (size of a bean), Aucklandiae Radix (Muxiang), and Lithospermi Radix (Zicao). For failure to emerge due to Qi excess and phlegm stagnation, use Atractylodis Rhizoma (Cangzhu), Angelicae Dahuricae Radix (Baizhi), Saposhnikoviae Radix (Fangfeng), Cimicifugae Rhizoma (Shengma), Scutellariae Radix (Huangqin), Paeoniae Radix Rubra (Chishao), Forsythiae Fructus (Lianqiao), and Angelicae Sinensis Radix radix (Danggui Xu). For severe eruption due to Blood heat, with lower jiao sores, lack of skin, and thirst, use Trichosanthis Radix (Tianhuafen), Scutellariae Radix (Huangqin), Paeoniae Radix (Shaoyao), Puerariae Radix (Gegen), Glycyrrhizae Radix et Rhizoma (Gancao), Gypsum Fibrosum (Shigao), and Talcum (Huashi). For Black depression due to joint Qi and Blood weakness, use wine-fried Paeoniae Radix (Jiu Shaoyao), Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Angelicae Dahuricae Radix (Baizhi), Aucklandiae Radix (Muxiang), Cinnamomi Cortex (Guipi), Ligustici Chuanxiong Rhizoma (Chuanxiong), and Angelicae Sinensis Radix (Danggui). For Blood trapped by dampness with grayish-white head/face scabs, use Safflower (Honghua), Sappan Lignum (Sumu), Atractylodis Macrocephalae Rhizoma (Baizhu), Atractylodis Rhizoma (Cangzhu), Paeoniae Radix (Shaoyao), Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), adding a little wine. For retroverted scabs after eruption due to external evil qi injury, use Ginseng Radix et Rhizoma (Renshen), Paeoniae Radix (Shaoyao), Forsythiae Fructus (Lianqiao), Scutellariae Caulis (Huangqin Shao), Glycyrrhizae Radix et Rhizoma caulis (Gancao Shao), Angelicae Dahuricae Radix (Baizhi), wine-fried Angelicae Sinensis Radix (Jiu Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), and a little Aucklandiae Radix (Muxiang). In all smallpox cases, distinguish the patient's clear/turbid constitution and assess courage/fear based on physique and Qi. For two types of black depression due to Qi insufficiency preventing full emergence, use wine-fried Astragali Radix (Jiu Huangqi), Ginseng Radix et Rhizoma (Renshen), and wine-fried Lithospermi Radix (Jiu Zicao). If color is normal but pale despite following the above method to mature, or if color is abnormal, use Ligustici Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Paeoniae Radix (Shaoyao), and Safflower wine. If purple upon maturation indicating heat, use Cimicifugae Rhizoma (Shengma), Puerariae Radix (Gegen), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Cinnamomi Cortex (Gui), and Forsythiae Fructus (Lianqiao). For severe cases, use Rhinocerotis Cornu (Xijiao) slices to strongly resolve toxins. Ash-gray white color in quiet/timid patients indicates cold; neat/courageous/restless/feverish patients indicate heat. Full white color resembling bean shells during scabbing is due to excessive water intake initially, causing uneven scabbing, commonly called "retroverted scab"; this is harmless, merely requiring exterior-consolidating agents. Monitor urination and defecation: if constipated, unblock bowels; if urinary retention, unblock urine. For initial restlessness, delirium, mania, and extreme thirst, drinking water leads to uneven scabbing; urgently resolve the branch with cooling herbs like Yi Yuan San (Benefit Prime Powder). For itching and collapsing, differentiate deficiency/excess via appearance, color, and pulse. Excess: strong pulse, robust Qi. Deficiency: weak pulse, timid Qi. For deficiency itch, use exterior-consolidating agents plus blood-cooling herbs. For excess itch or constipation, give small amounts of Rhei Radix et Rhizoma (Dahuang) and other cold herbs to purge accumulated stool. For mild Qi timidity, apply talcum powder mixed with light honey water to sores with a feather. Sparse rashes are non-toxic; dense rashes are toxic; resolve with cooling herbs, even over ten doses, without harming eyes later. Dryness requires fire-retarding methods; dampness requires damp-draining methods. Fire-retarding uses mild agents like Schizonepetae Spica (Jingjie), Cimicifugae Rhizoma (Shengma), Glycyrrhizae Radix et Rhizoma (Gancao), and Puerariae Radix (Gegen). Damp-draining addresses surface dampness using wind-dispersing herbs like Angelicae Dahuricae Radix (Baizhi) and Saposhnikoviae Radix (Fangfeng). For smallpox eye injury, use Gardeniae Fructus (Shanzhi), Cassiae Semen (Juemingzi), Paeoniae Radix Rubra (Chishao), Angelicae Sinensis Radix radix (Danggui Xu), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Saposhnikoviae Radix (Fangfeng), Forsythiae Fructus (Lianqiao), Cimicifugae Rhizoma (Shengma), and Platycodonis Radix (Jiegeng), ground to powder, taken in small doses. If vision is impaired, clarity returns after 100 days as Qi and Blood recover. Carbuncles are mostly caused by exterior excess and Blood heat; treat upper and lower separately, urgency is critical. For suppuration, prioritize cooling herbs: Paeoniae Radix Rubra (Chishao), Glycyrrhizae Radix et Rhizoma nodulus (Gancao Jie), Forsythiae Fructus (Lianqiao), Platycodonis Radix (Jiegeng); ascend with Cimicifugae Rhizoma (Shengma) and Puerariae Radix (Gegen); descend with Arecae Semen (Binglang) and Achyranthis Bidentatae Radix (Niuxi); assist with Fritillariae Bulbus (Beimu), Lonicerae Japonicae Caulis (Rendongcao), Angelicae Dahuricae Radix (Baizhi), and Trichosanthis Fructus (Gualou). Use Rhei Radix et Rhizoma (Dahuang) for dry stools; Scutellariae Radix (Huangqin) and Phellodendri Cortex (Huangbai) for fever. Black smallpox belongs to Blood heat, primarily cool blood; white belongs to Qi deficiency, primarily tonify Qi. Central black depression with peripheral white and late emergence requires combined treatment. Initial spontaneous sweating is acceptable due to damp-heat steaming. Smallpox is divided into Qi/Blood and Deficiency/Excess, monitored daily, often involving Qi/Blood insufficiency. For deficiency, use Astragali Radix (Huangqi) and blood-generating/moving agents, slightly assisted by wind-dispersing herbs. For excess, use Paeoniae Radix Alba (Baishao) and Scutellariae Radix (Huangqin) as sovereigns, Angelicae Dahuricae Radix (Baizhi) and Forsythiae Fructus (Lianqiao) as ministers. For cold patterns, Chen's formulas are applicable. Shen Su Yin (Ginseng and Perilla Decoction) is appropriate whether erupted or not. The regulatory method generally involves activating blood, regulating Qi, calming the exterior, harmonizing the middle, lightly clearing toxicity, combining warm and cool agents. Warm agents include Angelicae Sinensis Radix (Danggui), Astragali Radix (Huangqi), Aucklandiae Radix (Muxiang); cool agents include Peucedani Radix (Qianhu), Glycyrrhizae Radix et Rhizoma (Gancao), Puerariae Radix (Gegen), Cimicifugae Rhizoma (Shengma). Assist with Ligustici Chuanxiong Rhizoma (Chuanxiong), Paeoniae Radix (Shaoyao), Aurantii Fructus Immaturus (Zhike), Platycodonis Radix (Jiegeng), Akebiae Caulis (Mutong), Lithospermi Radix (Zicao), Glycyrrhizae Radix et Rhizoma (Gancao). Initial spontaneous sweating is acceptable due to damp-heat steaming. Topical paste for carbuncles: Fritillariae Bulbus (Beimu), Arisaematis Rhizoma (Nanxing), Bombyx Batryticatus (Jiangcan), Trichosanthis Radix (Tianhuafen), Angelicae Dahuricae Radix (Baizhi), Aconiti Lateralis Radix Praeparata (Caowu), Rhei Radix et Rhizoma (Dahuang), Gleditsiae Sinensis Fructus (Zhuyazaojiao) in equal parts, Halloysitum Rubrum (Han Shui Shi) doubled. Grind to powder, mix with vinegar for application. A man in his twenties suffered from smallpox; after scab shedding, he suddenly developed lockjaw, rigid limbs unable to flex/extend, periumbilical pain with profuse cold sweat during attacks, stopping when pain ceased, intermittent episodes. Pulse was wiry, tight, and rapid, like a straight string. He was extremely laborious, likely injuring blood through fatigue, contracting wind-cold in mountainous areas, further depleting blood during eruption. Treatment required warming herbs to nourish blood and acrid-cool herbs to disperse wind. Sovereign: Angelicae Sinensis Radix (Danggui Shen), Paeoniae Radix Alba (Baishao). Ministers: Ligustici Chuanxiong Rhizoma (Chuanxiong), Citri Reticulatae Pericarpium (Qingpi), Uncariae Ramulus cum Uncis (Gouteng). Assists: Atractylodis Macrocephalae Rhizoma (Baizhu), Citri Reticulatae Pericarpium (Chenpi). Guide: Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamomi Cortex (Guipi), Aquilariae Resina (Nanmuxiang), Scutellariae Radix (Huangqin), plus little Safflower (Honghua). Decocted and administered, resulting in cure. My nephew, aged six or seven, had smallpox with fever, slight thirst, and diarrhea. The physician prescribed Muxiang San (Aucklandia Powder) with ten cloves (Dingxiang). I observed delayed eruption, partly due to Qi weakness from diarrhea, but the foul, stagnant stool indicated heat steaming downward, not cold. I urgently stopped the previous prescription (already one dose given) and prescribed Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxin) plus Atractylodis Macrocephalae Rhizoma (Baizhu) for nearly ten doses to resolve heat. Diarrhea stopped, and pustules emerged. His skin remained slightly hot with swollen hands/feet; treated with cooling-tonifying herbs, recovered in one month. A seventeen-year-old had smallpox with fever and severe drowsiness, pulse large and seemingly rapid. Prescribed Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Astragali Radix (Huangqi), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Chenpi) in large, concentrated decoction. After twenty doses, pustules emerged; after another twenty, pustules formed, leaving no intact skin. Someone suggested Chen's original formula; I said as long as there is no deficiency-cold, continue the previous formula. Recovered after sixty doses.