《痘疹方》云∶初起时，自汗不妨，盖湿热熏蒸而然也。窃谓前症因邪在经络，自能发散，使邪气外泄，若见此症，
不当用 、桂之属，以实腠理，且自汗则痘热已轻，升麻葛根之类，在所当禁，恐发泄太甚，则津液内耗，阴随阳散，
难以收靥。靥后最宜审治，若血虚者，用当归补血汤。气虚者，用四君子加黄 。气血不足者，十全大补汤。若饮食自
汗者，异功散。杨氏云∶痘疮一见红点，升麻、葛根，便不可用。此语甚是。但此为表虚，及无表症者而论。若或邪在
表，痘赤绽 者，又当用麻黄甘草汤。汗之肿 作痛者，用活命饮加麻黄散之。盖自汗、盗汗，为病不同。自汗者，汗
无时而自出也，属阳虚。盗汗者，睡则汗出，寐则汗收也，属阴虚。汗者，血之所化，阴气不能闭藏，所以睡则汗出也。
痘家当以补血为主。若当归补血汤、六味地黄丸、八珍汤、人参养荣汤之类，皆可因症施治。又有胃虚者，宜用四君及
浮麦散。食积内热者，宜用四君、曲、 。未靥之际，恐致气血虚而不能结痂，既靥之后，尤防血脱阴虚，阳无所附矣。
一小儿痘将出，自汗作渴发搐，此心肝二经热甚，用柴胡麦门冬散，而热症退；用紫草快 汤，痘悉见；又用四圣
散而结靥。
一小儿痘出，自汗发搐流涎，此木火侮土，先用五味异功散加钩藤钩，诸症顿减；次以五味异功散加柴胡而安。
一女子出痘，色赤自汗，发搐作呕，此肝火侮土，先用五味异功散加柴胡、钩藤钩，热搐悉愈；又用托里散，浆贯
而愈。
一小儿痘出自汗，面赤作渴，手足并热，大便干黄。此肠胃皆热，用泻黄散末，一服诸症顿退；又用托里散、异功
散加山栀、麦门冬而痊。
人参养荣汤 治气血俱虚，发热恶寒，肢体倦怠，食少作泻，或久病虚损，口干咳而下痢惊热，自汗盗汗。
白芍药（炒，一钱半） 人参 陈皮 黄 （炒） 桂心 当归 白术（炒） 甘草（炙。各一钱） 熟地黄（自
制，七分） 五味子（杵卅，七分） 远志（五分）
上每服二三钱，姜、枣水煎。
麻黄甘草汤
麻黄 甘草（等分）
上每服一钱，水煎。
浮麦汤
浮麦不拘多少（炒香）
上每服三五钱，水煎。
当归六黄汤 治血气不足，虚火内动，烦躁，自汗盗汗不止。（方见烦躁）
《痘疹方》中说：在痘疮初起阶段，自汗（白天不因活动而自然出汗）是可以接受的，这是因为湿热之气熏蒸所致。我认为上述症状是因为邪气停留在经络中，身体能够自行发散，使邪气向外排泄。如果见到这种症状，不应当使用附子、桂枝之类的药物来闭塞腠理（皮肤毛孔），况且既然已经自汗，说明痘毒的热势已经减轻，升麻、葛根这类升散透发的药物，应当在禁忌之列，恐怕发散太过，会导致体内津液耗损，阴液随着阳气外散，从而难以使痘疮收靥（结痂愈合）。痘疮收靥之后最应当仔细辨证治疗，如果是血虚的，使用当归补血汤；气虚的，使用四君子汤加黄芪；气血都不足的，使用十全大补汤。如果是因饮食不当导致的自汗，使用异功散。杨氏说：痘疮一旦出现红点，升麻、葛根就不可再用。这话很有道理。但这主要是针对表虚以及没有表证的患者而言。如果邪气仍在体表，痘疮颜色红赤且绽开的，又应当使用麻黄甘草汤发汗。如果因为发汗导致肿胀疼痛的，使用活命饮加麻黄以消散之。大概自汗和盗汗（夜间睡眠中出汗，醒来即止），病因是不同的。自汗是汗液无时而出，属于阳虚；盗汗是睡着时出汗，醒来后汗止，属于阴虚。汗是由血液化生的，阴气不能固摄闭藏，所以睡着时会出汗。治痘疮应当以补血为主。像当归补血汤、六味地黄丸、八珍汤、人参养荣汤这类方剂，都可以依据症状进行治疗。又有胃气虚弱的，适宜使用四君子汤及浮麦散。有食积内热的，适宜使用四君子汤加神曲、麦芽。在痘疮未收靥之前，担心导致气血虚弱而不能结痂；在痘疮已收靥之后，更要防止血脱阴虚，导致阳气无所依附。
有一个小儿痘疮将要发出，出现自汗、口渴、抽搐，这是心经和肝经热盛，使用柴胡麦门冬散，热症消退；使用紫草快斑汤，痘疮全部发出；又使用四圣散使痘疮结痂。
有一个小儿痘疮发出，出现自汗、抽搐、流口水，这是木火侮土（肝火犯脾），先用五味异功散加钩藤钩，各种症状顿时减轻；接着用五味异功散加柴胡而痊愈。
有一个女子出痘，颜色红赤、自汗、抽搐、呕吐，这是肝火侮土，先用五味异功散加柴胡、钩藤钩，热症和抽搐全部治愈；又使用托里散，待痘浆充满而痊愈。
有一个小儿出痘伴自汗，面色红赤、口渴、手足发热，大便干结发黄。这是肠胃都有热，使用泻黄散的药末，一服后各种症状顿时消退；又使用托里散、异功散加山栀、麦门冬而痊愈。
人参养荣汤 治疗气血俱虚，发热恶寒，肢体倦怠，食欲不振、腹泻，或者久病虚损，口干咳嗽并伴有下痢惊热、自汗盗汗。
白芍药（炒，一钱半） 人参 陈皮 黄芪（炒） 桂心 当归 白术（炒） 甘草（炙。各一钱） 熟地黄（自制，七分） 五味子（捣碎三十粒，七分） 远志（五分）
以上每服二三钱，用生姜、大枣水煎煮。
According to the *Douzhen Fang* (Formulas for Smallpox and Measles): In the initial stage of smallpox, spontaneous sweating (daytime sweating not caused by activity) is acceptable, as it results from the steaming effect of damp-heat. I believe that the aforementioned symptoms occur because pathogenic factors are lodged in the meridians, allowing the body to naturally disperse them and expel the pathogens outward. If such symptoms are observed, one should not use herbs like Fuzi (Aconite Lateralis Radix Praeparata) or Guizhi (Cinnamomi Ramulus) to close the couli (skin pores). Moreover, since spontaneous sweating has already occurred, it indicates that the heat of the pox has lightened; therefore, dispersing and ascending herbs like Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix) should be contraindicated. Excessive dispersion may lead to the depletion of body fluids internally, with yin dissipating along with yang, making it difficult for the pox to crust over (heal). After the pox have crusted over, careful syndrome differentiation and treatment are essential. For blood deficiency, Danggui Buxue Tang (Dang Gui Bu Xue Decoction) should be used; for qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) plus Huangqi (Astragali Radix); for both qi and blood deficiency, Shiquan Dabu Tang (Ten Complete Tonifying Decoction) should be used. For spontaneous sweating caused by dietary irregularities, Yigong San (Yi Gong Powder) is indicated. Yang Shi stated: "Once red spots appear in smallpox, Shengma and Gegen must not be used." This statement is very sound. However, this applies specifically to patients with exterior deficiency or those lacking exterior syndromes. If pathogenic factors remain on the exterior, and the pox are red and blooming, Mahuang Gancao Tang (Ephedra and Licorice Decoction) should be used to induce sweating. If swelling and pain result from excessive sweating, Huoming Yin (Life-Saving Decoction) plus Mahuang should be used to dissipate the swelling. Generally, spontaneous sweating and night sweats (sweating during sleep, stopping upon waking) differ in etiology. Spontaneous sweating occurs without specific timing and belongs to yang deficiency; night sweats occur during sleep and cease upon waking, belonging to yin deficiency. Sweat is transformed from blood; when yin qi fails to consolidate and store, sweating occurs during sleep. In treating smallpox, nourishing blood should be the primary principle. Formulas such as Danggui Buxue Tang, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Bazhen Tang (Eight Treasures Decoction), and Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction) can all be applied according to the syndrome. For stomach qi deficiency, Sijunzi Tang combined with Fumai San (Floating Wheat Powder) is suitable. For internal heat due to food stagnation, Sijunzi Tang combined with Shenqu (Massa Medicata Fermentata) and Maiya (Hordei Fructus Germinatus) is appropriate. Before the pox crust over, one must fear that qi and blood deficiency will prevent scabbing; after they crust over, one must especially guard against blood loss and yin deficiency, which leaves yang without a foundation.
Case 1: A child presented with impending smallpox, spontaneous sweating, thirst, and convulsions. This indicated severe heat in the Heart and Liver meridians. Chaihu Maimendong San (Bupleurum and Ophiopogon Powder) was used, resolving the heat symptoms; Zicao Kuaban Tang (Arnebia Rapid-Eruption Decoction) was used, causing the pox to fully erupt; and Sixian San (Four Holy Powders) was used to facilitate crusting.
Case 2: A child presented with erupted smallpox, spontaneous sweating, convulsions, and drooling. This indicated Wood Fire insulting Earth (Liver Fire invading the Spleen). Wuyi Yigong San (Five-Flavor Yi Gong Powder) plus Goutenggou (Uncariae Ramulus cum Uncis) was administered first, rapidly reducing all symptoms; subsequently, Wuyi Yigong San plus Chaihu (Bupleuri Radix) was used to achieve recovery.
Case 3: A woman presented with smallpox characterized by red color, spontaneous sweating, convulsions, and vomiting. This indicated Liver Fire insulting Earth. Wuyi Yigong San plus Chaihu and Goutenggou was used first, curing the heat and convulsions completely; Tuoli San (Support the Interior Powder) was then used, leading to recovery once the pustules filled with pus.
Case 4: A child presented with smallpox, spontaneous sweating, red face, thirst, hot hands and feet, and dry yellow stool. This indicated heat in the Intestines and Stomach. Xiehuang San (Drain Yellow Powder) in powder form was administered, resolving all symptoms after one dose; Tuoli San and Yigong San plus Zhizi (Gardeniae Fructus) and Maimendong (Ophiopogonis Radix) were then used to cure the condition.
Renshen Yangrong Tang treats dual deficiency of qi and blood, fever with aversion to cold, limb fatigue, poor appetite with diarrhea, or chronic illness with debility, dry mouth, cough accompanied by dysentery, fright-heat, spontaneous sweating, and night sweats.
Baishao Yao (Stir-fried White Peony Root, 1.5 qian), Renshen (Ginseng Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Huangqi (Stir-fried Astragali Radix), Guixin (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix), Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma), Gancao (Roasted Licorice Root. Each 1 qian), Shudihuang (Homemade Prepared Rehmanniae Radix, 0.7 qian), Wuweizi (Schisandrae Fructus, pounded thirty grains, 0.7 qian), Yuanzhi (Polygalae Radix, 0.5 qian).
Take 2–3 qian per dose, decoct with fresh ginger and jujube water.
Mahuang Gancao Tang
Mahuang (Ephedrae Herba), Gancao (Licorice Root) in equal proportions.
Take 1 qian per dose, decoct with water.
Fumai Tang
Fumai (Floating Wheat) as needed (stir-fried until fragrant).
Take 3–5 qian per dose, decoct with water.
Danggui Liuhuang Tang treats insufficiency of blood and qi, internal movement of deficient fire, irritability, and incessant spontaneous and night sweats. (Formula see under "Irritability")