痘中夹疹因时气，毒火触动发其机，临期休将痘疮治，速将升葛透疹宜。
【注】痘已见形，其中又有颗粒细密如麻子者，此夹疹也。因出痘时恰遇天行时疫，感
受其气，一时并发。不须治痘，当先治疹，以升麻葛根汤加荆芥、防风、蝉蜕、牛蒡、犀
角，疹散而痘自起矣！
升麻葛根汤（方见发热证治）
片片结就如云头，毒伤阴血浮火游，表散荆防败毒剂，清热黄连解毒投。
【注】 乃血之余也。因毒火郁遏，伤于阴血，血热相搏，故浮游之火，散布皮肤之
间，与痘相夹而出，片片如云头突起，谓之夹 ，以荆防败毒散主之。七日后见此，谓
之发 ，乃血热不故也，以黄连解毒汤主之。
荆防败毒散
羌活 独活 柴胡 前胡 荆芥 防风 生甘草 川芎 枳壳（麸炒） 桔梗 赤茯苓
引用生姜，水煎服。
【方歌】夹 宜用疏解剂，荆防败毒进莫迟，羌独柴前荆防草，川芎枳桔赤苓宜。
黄连解毒汤（方见结痂落痂证治）
痧形发时粟一般，颗硬形圆顶又尖，粒中含水清浆样，败毒调治自然安。
【注】痧亦疹类，但形如粟米，尖圆自硬，内含清水为异，此亦热毒所发，往往夹痘而
出，宜于疏散，以荆防败毒散主之。
荆防败毒散（方见夹 ）
水痘皆因湿热成，外证多与大痘同，形圆顶尖含清水，易胀易靥不浆脓。初起荆防
败毒散，加味导赤继相从。
【注】水痘发于脾、肺二经，由湿热而成也，初起与大痘相似，面赤唇红，眼光如水，
咳嗽喷嚏，唾涕稠粘，身热二三日而始出，其形尖圆而大，内含清水，易胀易靥，不作脓
浆。初起荆防败毒散主之，继以加味导赤散治之。
荆防败毒散（方见夹 ）
加味导赤散
生地 木通 生甘草 连翘 黄连 滑石 赤苓 麦冬（去心）
引用灯心，水煎服。
【方歌】加味导赤除湿热，生地木通甘草协，翘连滑石苓麦冬，引加灯心称妙诀。
In the context of smallpox (Dou), the occurrence of measles-like eruptions (Zhen) is due to contracting seasonal epidemic pathogens; toxic fire stirs up and triggers the pathological mechanism. At the time of onset, do not treat it as typical smallpox; instead, it is appropriate to rapidly use Shengma Gegen Tang (Cinnamon Twig and Rhizome Decoction) to vent and release the eruptions.
[Note] When the lesions of smallpox have already manifested their form, yet there appear within them granules that are fine and dense like millet seeds, this is termed "smallpox with accompanying measles" (Jia Zhen). This occurs because, during the eruption of smallpox, one happens to encounter a seasonal epidemic, contracting its qi, leading to simultaneous manifestation. There is no need to specifically treat the smallpox; rather, one should first treat the measles. Use Shengma Gegen Tang (Cinnamon Twig and Rhizome Decoction) added with Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Chantui (Cicadae Periostracum), Niubangzi (Arctii Fructus), and Xijiao (Rhinocerotis Cornu). Once the measles eruptions dissipate, the smallpox will naturally rise!
Shengma Gegen Tang (See formula in the section on Fever Syndrome Treatment)
The eruptions cluster in patches resembling cloud heads; toxic fire damages Yin blood, causing floating fire to wander. One should use Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity) for exterior dispersion, and employ Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity) for clearing heat.
[Note] (Measles eruptions) are the surplus of blood. Due to toxic fire being constrained and suppressed, Yin blood is injured; blood heat and pathogenic factors contend with each other, so the wandering fire spreads between the skin layers, erupting alongside the smallpox. These patches protrude like cloud heads, which is called "smallpox with accompanying measles." The primary formula is Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity). If this appears after seven days, it is termed "delayed eruption," caused by restless blood heat; the primary formula is Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity).
Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity)
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata without Honey), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus, stir-fried with bran), Jiegeng (Platycodonis Radix), Chi Fuling (Poria with Red Core).
Reference: Fresh ginger, decocted in water and taken orally.
[Formula Song] For accompanying eruptions, suitable dispersing and resolving agents should be used; take Jingfang Baidu San without delay. Qianghuo, Duhuo, Chaihu, Qianhu, Jingjie, Fangfeng, Gancao; Chuanxiong, Zhike, Jiegeng, and Chi Fuling are appropriate.
Huanglian Jiedu Tang (See formula in the section on Scabbing and Falling-off Syndrome Treatment)
When Sha-like eruptions manifest, they resemble millet grains; the particles are hard, round, with pointed tops. They contain clear fluid resembling water inside. Treatment with Baidu San (Powder to Overcome Toxicity) will naturally lead to peace and recovery.
[Note] Sha eruptions are also a type of rash, but their shape resembles millet grains, being sharp and round, naturally hard, and containing clear fluid internally, which distinguishes them. These are also caused by heat toxicity and often erupt alongside smallpox. They are suitable for dispersing and resolving treatment, primarily using Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity).
Jingfang Baidu San (See formula in the section on Accompanying Measles)
Water pox (Shui Dou) all arise from damp-heat. The external manifestations are mostly similar to those of regular smallpox. The shape is round with a pointed top, containing clear fluid. They easily swell and easily resolve (dry up) but do not form pus or thick fluid. At the initial stage, use Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity), followed by Jiawei Daochi San (Modified Guiding Outward Decoction).
[Note] Water pox originates from the Spleen and Lung meridians and is formed by damp-heat. Initially, it resembles regular smallpox: red face, red lips, watery eyes, coughing, sneezing, thick saliva and nasal discharge. Body fever lasts two to three days before eruption begins. The lesions are large, round with pointed tops, containing clear fluid. They easily swell and easily resolve (dry up) without forming pus. At the initial stage, use Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity) as the primary formula, followed by Jiawei Daochi San (Modified Guiding Outward Decoction) for treatment.
Jingfang Baidu San (See formula in the section on Accompanying Measles)
Jiawei Daochi San (Modified Guiding Outward Decoction)
Shengdi (Rehmanniae Radix Preparata), Mutong (Akebiae Caulis), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata without Honey), Lianqiao (Forsythiae Fructus), Huanglian (Coptidis Rhizoma), Huashi (Talcum), Chi Fuling (Poria with Red Core), Maidong (Ophiopogonis Radix, heart removed).
Reference: Dengxin (Junci Medulla), decocted in water and taken orally.
[Formula Song] Modified Daochi San removes damp-heat; Shengdi, Mutong, and Gancao cooperate. Lianqiao, Huanglian, Huashi, Chi Ling, and Maidong; adding Dengxin as a guide is considered a wonderful secret.