小儿痘疮有正痘与水痘之不同，新安张季明云∶其疮皮不薄，如赤根白头，渐
渐赤肿，而有脓瘥迟者，谓之大痘，此里证，发于脏也。其疮皮薄如水泡，破即易干，而出无渐次，白色
或淡红，冷冷有水浆者，谓之水痘，此表证，发于腑也。亦与疹子同，又轻于疹，发热一二日而出，出而即
消，易出易靥，不宜燥温，但用轻剂解之，麦汤散主之，羌活散、消毒饮、麦煎散俱可服，又当服大连翘汤
以解之。如心闷，烦蹂，发热，及大小便涩，口舌生疮者，通关散主之。水痘夹黑，出来黑水流，或手足冷
者，前胡、甘草、生地、玄参、连翘、茯苓、木通、蝉蜕、麦门冬、川芎、陈皮、当归、生姜水煎服。
麦汤散 治水痘。
地骨皮 滑石 甘草（各半钱） 甜葶苈 麻黄 大黄 知母 羌活 人参（各一钱）
上锉散。水一盏，每服二三钱，小麦七粒，煎六分，不拘时温服，分二帖。
麦煎散 治小儿夹惊伤寒，吐逆壮热，表里不解，气粗喘急，面赤自汗。或狂语惊叫，或不语无汗，
及瘾疹遍身赤痒，往来潮热。时行麻痘疹子余毒未尽，浑身浮肿，痰涎咳嗽。或变急慢惊风，手足
搐搦，眼目上视，及伤风头疼，并治之。
滑石 地骨皮 赤芍药 石膏 白茯苓 杏仁 知母 甘草 葶苈子（炒） 人参
麻黄（一两半）
上为末。每服一钱，麦子煎汤下。如初生芽儿，感冒风冷，鼻塞身热，喷嚏多啼，每一字，用麦子煎汤
调下。一方，去地骨皮、滑石，加羌活、川芎，薄荷煎汤调下。
羌活散（初热） 消毒饮（即牛蒡荆芥甘草三味） 大连翘汤（便闷） 通关散（便闷）
按∶水痘，今小儿患之者，大率无害，如无内证，不必服药，无事生事也。前后四方，不为轻剂，非热
甚不解，二便秘涩，烦闷不宁，不宜轻服。
In children, smallpox (disease characterized by pustules) differs between true smallpox (Zheng Dou) and chickenpox (Shui Dou). Zhang Jiming from Xin'an stated: Those lesions with thick skins, resembling a red base with a white head, gradually becoming swollen and red, containing pus, and healing slowly, are called large smallpox (Da Dou); this is an interior syndrome (Li Zheng), originating from the Zang organs. Those lesions with thin skins like water blisters, drying easily upon rupture, appearing without a distinct sequence, colored white or pale red, cold to the touch and containing serous fluid, are called chickenpox (Shui Dou); this is an exterior syndrome (Biao Zheng), originating from the Fu organs. Chickenpox is similar to measles (Zhen Zi) but milder; it appears one to two days after fever onset, resolves quickly after eruption, and heals easily. It should not be treated with drying and warming agents, but rather with mild resolving formulas. The main formula is Maidang Tang (Wheat Decoction). Qianghuo San (Notopterygium Powder), Xiaodu Yin (Detoxification Decoction), and Maijian San (Wheat-Boiled Powder) may also be used. Additionally, Dalianqiao Tang (Large Forsythia Decoction) should be taken to resolve toxicity. If symptoms include chest stuffiness, restlessness, fever, difficulty in urination and defecation, and sores in the mouth and tongue, Tongguan San (Passage-Opening Powder) is indicated. If chickenpox presents with black discoloration, black fluid discharge, or cold hands and feet, decoct the following herbs in water: Peucedani Radix (Qianhu), Glycyrrhizae Radix et Rhizoma (Gancao), Rehmanniae Radix (Shengdi), Scrophulariae Radix (Xuanshen), Forsythiae Fructus (Lianqiao), Poria (Fuling), Akebiae Caulis (Mutong), Cicadae Periostracum (Chantui), Ophiopogonis Radix (Maidong), Chuanxiong Rhizoma (Chuanxiong), Citri Reticulatae Pericarpium (Chenpi), Angelicae Sinensis Radix (Danggui), and Zingiberis Rhizoma Recens (Shengjiang).
Maidang Tang (Wheat Decoction): Treats chickenpox.
Ingredients: Cortex Lycii Radicis (Digupi), Talcum (Huashi), Glycyrrhizae Radix et Rhizoma (Gancao) (each 0.5 qian); Thladianthae Fructus (Tiantili), Ephedrae Herba (Mahuang), Rhei Radix et Rhizoma (Dahuang), Anemarrhenae Rhizoma (Zhimu), Notopterygii Rhizoma et Radix (Qianghuo), Ginseng Radix et Rhizoma (Renshen) (each 1 qian).
Preparation and Administration: Coarsely crush into a powder. Use one cup of water, take 2–3 qian per dose, add seven grains of wheat, decoct until reduced to 6/10 volume, warm and take at any time, divided into two doses.
Maijian San (Wheat-Boiled Powder): Treats pediatric cold damage complicated by fright, vomiting, high fever, unresolved exterior and interior pathogens, coarse breathing and asthma, flushed face with spontaneous sweating. Also treats delirious speech, startled crying, silence without sweat, generalized urticaria with redness and itching, alternating tidal fever. It addresses residual toxins from epidemic smallpox/measles/rash, general edema, phlegm-saliva and cough. It also treats transformation into acute or chronic convulsive disorders, hand-foot spasms, upward gaze, and wind-cold headache.
Ingredients: Talcum (Huashi), Cortex Lycii Radicis (Digupi), Paeoniae Radix Rubra (Chishaoyao), Gypsum Fibrosum (Shigao), Poria (Fuling), Armeniacae Semen Amarum (Xingren), Anemarrhenae Rhizoma (Zhimu), Glycyrrhizae Radix et Rhizoma (Gancao), Thladianthae Fructus (Tinglizi, stir-fried), Ginseng Radix et Rhizoma (Renshen), Ephedrae Herba (Mahuang, 1.5 liang).
Preparation and Administration: Grind into fine powder. Take 1 qian per dose, administered with wheat decoction. For newborns suffering from wind-cold invasion with nasal congestion, fever, sneezing, and excessive crying, administer "one zi" amount mixed with wheat decoction. Another variation removes Cortex Lycii Radicis and Talcum, adds Notopterygii Rhizoma et Radix and Chuanxiong Rhizoma, administered with mint decoction.
Qianghuo San (for initial heat stage); Xiaodu Yin (composed of Arctii Fructus, Schizonepetae Herba, and Glycyrrhizae Radix et Rhizoma); Dalianqiao Tang (for stool constipation/stuffiness); Tongguan San (for stool constipation/stuffiness).
Commentary: Chickenpox in modern children is generally harmless. If there are no interior syndromes, medication is unnecessary to avoid causing trouble where none exists. The four preceding formulas are not considered mild agents; they are not suitable for cases without severe heat, constipation, restlessness, and agitation.