痘有缓急，治宜权变。红紫 肿兮，凉血为上；灰白平陷兮，补气最良。出不快
兮，为表实而发散可用；中气不足者又宜审详二便秘兮，是里实而疏利为要。禀元怯弱
者犹恐相妨，毒不能以速散；毒甚者令微汗之发起，热不能以尽除。热剧者使小便之清
长，三阴甚而多寒，必投辛热；三阳效而多热，无过苦凉。补元气，参 白术；养荣
血，归芍地黄。发散表邪，轻紫葛而重桂枝；疏通实热，微枳壳而甚大黄。解热毒，
芩连枝子；快斑疹，紫草荆防、牛蒡、连翘是疮中之要领，及夫甘草，乃药中之君王，
元参桔梗，治乎咽痛，木通车前，利其膀胱。气逆兮，陈皮青皮，胃寒兮，丁香木
香，泄泻兮，诃子豆蔻，呕吐兮，砂仁藿香，祛风热兮，蝉蜕白芷，定惊搐兮，天麻
僵蚕，头痛兮，川芎蒿本，蔓荆可用，腰痛兮杜仲牛膝，元胡堪尝。麦冬干葛能清心而
止烦渴，浓朴腹皮疗水肿而消腹胀，五味杏仁，润肺止嗽，而定喘，山楂枳实，消食行
滞以为良，痰实则半夏南星贝母，汗秘则羌活紫苏麻黄，红花牡丹皮，可除血热，鹿茸
穿山甲能起痘疮。食积则神曲麦芽草果，后重则枳壳槟榔木香，犀角羚羊，解乎心肺之
热，秦艽香附退乎脾胃之黄，乳香没药止痛，干姜附子回阳，前胡苏子能消痰嗽，猪
苓泽茯清利小肠，此是药味加减之权宜，临症何可以执方。
Smallpox (Xiaochu) presents with varying degrees of severity and urgency; treatment requires flexibility. When the lesions are red, purple, swollen, and distended, cooling the blood (Liangxue) is superior; when they are grayish-white, flat, and sunken, tonifying Qi (Buqi) is most beneficial. If eruption is slow due to exterior excess (Biao Shi), dispersing methods (Fasan) may be used; for deficiency of middle Qi (Zhong Qi Bu Zu), careful examination is required. Constipation and difficulty urinating indicate interior excess (Li Shi), making purgation and diuresis essential. In cases of constitutional weakness of primordial Qi (Yuan Qi), one must fear that medications might interfere, preventing rapid dispersion of toxins. For severe toxicity, inducing slight sweating helps expel pathogens, though heat may not be entirely eliminated. For intense heat, promoting clear and long urination is effective; in severe Shaoyin, Taiyin, and Jueyin syndromes characterized by cold, acrid-warm herbs (Xin Re) must be administered; in Yangming, Taiyang, and Shaoyang syndromes characterized by heat, bitter-cool herbs (Ku Liang) are appropriate. To tonify primordial Qi, use Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu); to nourish Ying and Blood, use Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), and Rehmanniae Radix (Dihuang). To disperse exterior pathogens, use Kudzu Root (Zige) lightly but Cinnamon Twig (Guizhi) heavily; to unblock interior heat, use Aurantii Fructus Immaturus (Zhiqiao) mildly but Rheum Palmatum Radix et Rhizoma (Dahuang) heavily. To resolve heat-toxicity, use Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Gardeniae Fructus (Zhizi); to facilitate the eruption of macules and papules, use Arnebiae Radix seu Rhizoma (Zicao), Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Arctii Fructus (Niubangzi), and Forsythiae Fructus (Lianqiao). These are key principles in treating sores; among all herbs, Licorice Root (Gancao) is the sovereign. Scrophulariae Radix (Xuanshen) and Platycodonis Radix (Jiegeng) treat sore throat; Tetrapanacis Medulla (Mutong) and Plantaginis Seed (Cheqianzi) promote bladder function. For rebellious Qi, use Tangerine Peel (Chenpi) and Green Tangerine Peel (Qingpi); for stomach cold, use Clove (Dingxiang) and Costus Root (Muxiang); for diarrhea, use Chebulae Fructus (Hezi) and Cardamomi Fructus (Doukou); for vomiting, use Amomi Fructus Rotundus (Sharen) and Agastachis Herba (Huoxiang); for dispelling wind-heat, use Bombyx Batryticatus (Chantui) and Angelicae Dahuricae Radix (Baizhi); for calming convulsions, use Gastrodiae Rhizoma (Tianma) and Bombyx Cicadae (Jiangcan); for headache, use Ligustici Chuanxiong Rhizoma (Chuanxiong), Libanocedris Rhizoma (Gaoben), and Viticis Fructus (Manjingzi) can be used; for lower back pain, use Eucommiae Cortex (Duzhong), Achyranthis Bidentatae Radix (Niuxi), and Corydalis Rhizoma (Yanhusuo) are suitable. Ophiopogonis Radix (Maidong) and Puerariae Lobatae Radix (Gegen) clear the Heart and relieve thirst and irritability; Magnoliae Officinalis Cortex (Houpo) and Tugest Fruit (Fupi) treat edema and reduce abdominal distension; Schisandrae Fructus (Wuweizi) and Armeniacae Semen Amarum (Xingren) moisten the Lungs and stop coughing while calming asthma; Crataegi Fructus (Shanzha) and Immature Bitter Orange (Zhishi) digest food and move stagnation effectively. For phlegm excess, use Pinelliae Rhizoma Preparatum (Banxia), Typhonii Rhizoma (Tian Nanxing), and Fritillariae Cirrhosae Bulbus (Beimu); for closure of sweat and bowels, use Notopterygii Rhizoma et Radix (Qianghuo), Perillae Folium (Zisu), and Ephedrae Herba (Mahuang). Safflower (Honghua) and Moutan Cortex (Mudanpi) remove blood heat; Antler (Lurong) and Pangolin Scale (Chuanshanjia) help erupt smallpox lesions. For food stagnation, use Massae Fermentatae Medicinatae (Shenqu), Hordeum Vulgare Fructus Germinatum (Maiya), and Arecae Catharticae Semen (Caoguo); for tenesmus, use Aurantii Fructus Immaturus (Zhiqiao), Areca Seed (Binglang), and Costus Root (Muxiang); Rhinocerotis Cornu (Xijiao) and Saiga Tataricae Cornu (Lingyangjiao) resolve Heat in the Heart and Lungs; Gentianae Macrophyllae Radix (Qinjiao) and Cyperi Rhizoma (Xiangfu) retreat jaundice from the Spleen and Stomach; Frankincense (Ruxiang) and Myrrh (Moyao) stop pain; Dried Ginger (Ganjiang) and Aconitum Lateralis Radix Praeparata (Fuzi) restore Yang; Peucedani Radix (Qianhu) and Perillae Fructus (Suzi) eliminate phlegm and cough; Polyporus (Zhuling), Alisma Rhizoma (Zexie), and Poria (Fuling) clear and drain the Small Intestine. These represent the flexible adjustments of herbal ingredients; how can one adhere rigidly to a fixed prescription during clinical practice?