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Since ancient times, in the art of medicine, internal disorders are diagnosed based on pulse patterns (Mai Xiang), while external manifestations are judged by physical signs and symptoms (Xing Zhuang). Among external diseases, smallpox (Dou Zheng) is of paramount importance. Although there are numerous records of smallpox in ancient printed editions, the treatment methods remain relatively sparse. Recently, the presentation of smallpox has changed significantly compared to the past; improper regulation and treatment have made it difficult to manage. In our prefecture, the Yuan, Shen, and Yu families possess handwritten manuscripts on treating smallpox. Their discussions on symptoms and differentiation of signs are very clear. The selection of herbs for specific symptoms is extremely detailed and cautious. Therefore, we gathered like-minded individuals to have these texts carved onto wooden blocks and published, to widely disseminate this knowledge. Regarding the severity of the disease, the cold or heat of the season, and the dryness or dampness of the region, it is up to skilled physicians to adjust prescriptions according to circumstances, undoubtedly not sticking rigidly to ancient methods.

On the third day after the Summer Solstice (Changzhi Festival), the Master Dongnong respectfully wrote this preface.

Smallpox originates from the Five Zang Organs (Wu Zang), while measles (Zhen Zheng) arises from the Six Fu Organs (Liu Fu). Both are triggered by the Ministerial Fire of the Gate of Life (Mingmen Xiang Huo)—the fire residing in the Kidneys that governs reproduction, development, and warms the body—and once exposed to seasonal pathogens, they vent the Yin-Yang congenital toxins within. However, since smallpox originates from the Five Zang Organs, it presents with visible signs. Why is measles mostly associated with the Lung? This is because the Lung belongs to Metal, its clear Qi floats upward, and it is prone to coughing. Thus, all cases of measles involve coughing; severe coughing indicates stagnant fire in the Lung. All cases of measles involve sore throat; a sore throat indicates blockage of the Lung orifices. Lung fire rushing upward to the throat causes pain, which leads to hoarseness. Measles often involves abdominal pain because the Large Intestine and Lung are exterior-interior paired organs; lung fire rushing inward causes abdominal pain. Measles often involves diarrhea because the Large Intestine serves as the official organ for conveying waste from the Lung; downward pouring of lung fire causes diarrhea. Measles often involves wheezing, which signifies excessive Lung Qi. Measles often involves phlegm, which results from lung fire steaming and corrupting fluids.

The method for treating measles, since it does not originate outside the Lung, initially should employ lifting and dispersing methods. When rashes appear on the head, face, and back but have not yet reached the hands and feet, one should use "light descending" methods (descending within lifting). If the rash has not reached the fingernails, one must absolutely avoid using heavy descending herbs; instead, use herbs that descend within lifting. Before the rash is fully erupted, even if critical symptoms resembling fierce poison or blazing fire appear, only "enemy-breaking" methods (attacking pathogens) should be used. Herbs such as Shi Gao (Gypsum Fibrosum), Da Huang (Rhei Radix et Rhizoma), Li Zi, Shan Zha (Crataegi Fructus), Jing Jie (Schizonepetae Herba), and Gan Ge (Puerariae Radix) can be used, assisted by Jie Geng (Platycodonis Radix), Bo He (Menthae Haplocalycis Herba), Mu Tong (Akebiae Caulis), Xing Ren (Armeniacae Semen Amarum), and Su Zi (Perillae Fructus). If there is blood stasis, add Chi Shao (Paeoniae Radix Rubra) and Hong Hua (Carthami Flos); if there is abdominal pain, add Tao Ren (Persicae Semen) and Qing Pi (Citri Reticulatae Pericarpium Viride); if there is no sweat, add Ma Huang (Ephedrae Herba). This approach is named "Wan Ji." Once the rash is fully erupted, heavily use Gua Lou (Trichosanthis Fructus), Hua Fen (Trichosanthis Radix), Sheng Di Huang (Rehmanniae Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Ling Yang Jiao (Capris Cornu), Shan Zhi (Gardeniae Fructus), and Huang Qin (Scutellariae Radix). If black prickles appear on the tongue, add Xi Jiao (Rhino CeratUs—note: substitute with synthetic alternatives or water buffalo horn in modern practice) and Huang Lian (Coptidis Rhizoma); these are also suitable for epistaxis. For sore throat, add Yuan Shen (Scrophulariae Radix) and Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma); these can also be used for swollen gums. For red eyes and eye pain, add Ju Hua (Chrysanthemi Flos), Mu Zei Cao (Equiseti Herba), and Chai Hu (Bupleuri Radix). For abdominal pain caused by intestinal parasites, add Hu Lian (Coptidis Rhizoma - note: usually Hu Lian refers to Coptis chinensis var. chinensis or similar, distinct from Huang Lian), Shi Jun Zi (Quisqualis Fructus), Lei Wan (Omphalodii Fructus), Bing Lang (Arecae Semen), and Hua Jiao (Zanthoxyli Pericarpium).

However, such purgative or attacking herbs should be used where the toxin has not fully manifested; afterward, lingering fire will inevitably harass the body. If stools are thick and urine is scant, one must guard against symptoms of wheezing caused by premature constriction. One should use Da Huang and Qing Pi to penetrate and release the pathogen, then add Zi Cao (Arnebiae Radix seu Rhizoma) and Chi Shao to guide out blood stasis. Gradually concluding the treatment in this manner ensures safety. One must absolutely avoid wind exposure, which could cause pore closure and lead to the retraction of the rash.