人之一身。本乎气血。气为卫。血为荣。气阳而血阴也。阳主动。所以冲畅隧道。运动
枢机
者也。阴主静。所以弃溢脏腑。灌溉周身者也。然其所重。则又在乎脾胃。是故脾胃者。五
脏
六腑。生化之大源也。经云。人之所受气者。谷也。谷之所注者。胃也。胃者水谷气血之海
也。至于痘疮。则全资气血。但得气血充畅。则易出易收。气血不足。则变症百出。故始出
之际
。赖气血以载毒外出。继则因气血以起胀灌浆。终之以结靥落痂。莫非气血为之运化。倘气
血
稍虚。脾胃一损。则生机息而化源绝矣。奈何宋麟祥之痘疹正宗。误用寒凉攻伐。致令愚盲
幼
科。避诸大家之烦。贪痘疹正宗归宗汤一方之易。遂至一时翕然用之。不分虚实寒热。妄行
攻下。以致阴阳脾胃之气俱伤。变症因之蜂起。因而死者多矣。盖妄汗伤阳。则凡起发灌浆
收靥之力。皆失所赖。势必变为 烂音哑。皮薄痒 。外剥而死。故前人于痘疮见点之
后。便禁用升麻葛根汤。恐发得表虚也。妄下伤阴。则凡脏腑化源。精神锁钥。饮食仓
廪。皆为所败。是必变为陷伏。不起发。不灌浆。灰白倒靥。手足逆冷。吐利不食。寒战咬
牙。腹痛虚胀。内攻而死。故前人禁用大黄石膏枳壳生地鼠粘紫草芩连栀子
之属。恐攻得里虚也。故钱氏曰。疮疹惟用温平药治之。不可妄下及妄攻伐。良有以也。陈
氏云。痘以太阴脾肺二经为主。肺宜温而脾宜燥。万氏云。痘疮始终以脾胃为主。胃尝养而
脾当补。马氏云。痘以少阴心经为主。火不可太清。血不可太凉。三说皆是也。盖脾为孤脏
。能
灌四旁。则四脏皆赖一脏以养之。况脾属土而主肌肉。若能化水谷。成津液。灌溉诸经。令
肌肉不枯。气血得其助。痘何难成。但寒土不能生物。必有阳气熏蒸于下。而后能成发育也
。如草木之根在土。而冬月何以不生。以真阳之气息也。可见脾受水谷。化生津液。必藉火
气。始能成腐化之功。所谓火能生土。火乃土之母也。心为君火。能役相火。主乎血脉。若
心火不息。血不寒凝。自能与脾之津液相为流通。痘自红润而鲜艳。所谓血主濡之。气主
之。气无血不走。血无气不行。气乃血之帅也。气行血亦行。肺统一身之气。主乎皮毛。若
肺
气充盈。自能与心之血脉相为周运。痘自尖圆而肥润。是血气充资足。交会于前。脾生津液
。
助养于后。痘之成功。三脏缺一不可。若肝脏则无与焉。至于肾脏。如攻伐太过。或经泄泻
。肾气损伤。则痘疮变黑。归肾而死矣。薛氏曰。凡痘疮在四五日之间死者。毒瓦斯盛真气虚
而不能起发也。六七日之间死者。元气虚而不能灌脓也。旬日之外死者。邪气去。脾胃败
。而元气内脱也。治者但能决其死。而不知其死必本于气血亏损。苟能逆推其因。而豫为调
补。岂断无生理哉。盖起发灌脓结痂。三者皆由脾胃荣养。不可妄投表下攻伐之剂。庶不误
人于夭札也。业幼科者。可不戒哉。请更言之。试问痘疹正宗。专以归宗汤一方。肆用寒凉
攻伐。欲以应无穷之痘。有是理乎。不待明智之士。自能觉其非矣。何幼科昧心丧良。故蹈
其辙也。有力仁人。若能火其书毁其板。使邪说息而正道行。则于婴儿造福不浅矣。
人的身体，根本在于气血。气属于卫外功能，血属于营内营养。气属阳而血属阴。阳主动，所以能冲畅经络隧道，运动关节枢纽。阴主静，所以能排泄脏腑溢出的浊物，灌溉全身。然而其中最重要的，又在于脾胃。因此，脾胃是五脏六腑生化之源的大本营。医经说：人赖以生存的气，来源于饮食谷物；谷物所注归的地方，是胃。胃是水谷和气血的海洋。至于痘疮（天花），则完全依赖气血。只要气血充盛通畅，痘疹就容易发出也容易收靥（结痂脱落）。如果气血不足，就会变症百出。所以在痘疹刚开始发出的时候，依靠气血来载毒外出；接着依靠气血来使痘粒起胀、灌浆；最后依靠气血来完成结痂、落痂的过程。没有不是由气血来运化完成的。倘若气血稍微虚弱，脾胃一旦受损，那么生机就会停止，化源就会断绝。
为什么宋麟祥的《痘疹正宗》误用寒凉攻伐的药物，致使那些愚昧盲目的儿科医生，避开各大名医诊疗的繁琐，贪图《痘疹正宗》中“归宗汤”这一方子的简便，于是当时一致采用它。不分虚实寒热，妄行攻下法，导致阴阳和脾胃之气都受到损伤，变症因此蜂拥而起，因而死亡的人很多。大概是因为妄用发汗法会损伤阳气，那么凡是用以起发、灌浆、收靥的力量，都失去了依赖，势必变成烂喉音哑、皮薄瘙痒、外部剥脱而死。所以前人对于痘疮见点（出现红点）之后，便禁用升麻葛根汤，恐怕导致表虚。妄用攻下法会损伤阴液，那么凡是脏腑的化源、精神的锁钥、饮食的仓廪，都会因此败坏。这必然会导致痘疹陷伏不起发、不灌浆、灰白倒靥、手足逆冷、呕吐腹泻不能进食、寒战咬牙、腹痛虚胀，从内部攻伐致死。所以前人禁用大黄、石膏、枳壳、生地、鼠粘子（牛蒡子）、紫草、黄芩、黄连、栀子这类药物，恐怕导致里虚。
所以钱乙说：疮疹只用温和平缓的药治疗，不可妄用攻下及妄用攻伐。这是有道理的。陈氏说：痘疮以太阴脾肺二经为主，肺宜温而脾宜燥。万全说：痘疮始终以脾胃为主，胃宜养而脾宜补。马莳说：痘以少阴心经为主，火不可太清，血不可太凉。这三种说法都是正确的。因为脾是孤脏，能灌溉四周，那么其他四脏都依赖这一脏来滋养。况且脾属土而主肌肉，如果能消化水谷，生成津液，灌溉各条经脉，令肌肉不枯槁，气血得到它的帮助，痘疮有什么难成的？但是寒土不能生长万物，必须有阳气在下熏蒸，然后才能生长发育。就像草木的根在土中，为什么冬天不生？是因为真阳之气在息育的缘故。可见脾受纳水谷，化生津液，必须借助火气，才能完成腐熟消化的功能。所谓火能生土，火是土的母亲。心为君火，能役使相火，主宰血脉。如果心火不息，血液不寒凝，自然能与脾的津液相互流通，痘疮自然红润鲜艳。所谓血主濡润它，气主固护它。气没有血就不能运行，血没有气就不能行走，气是血的统帅。气行则血亦行。肺统一身的之气，主宰皮毛。如果肺气充盈，自然能与心的血脉相互周流运转，痘疮自然尖圆而肥润。这是血气充盛资助，交会于前，脾生津液，助养于后，痘疮的成功，这三脏缺一不可。至于肝脏则与此无关。至于肾脏，如果攻伐太过，或者经过泄泻，肾气损伤，那么痘疮会变黑，归于肾而死。
薛己说：凡是痘疮在四五日之间死亡的，是毒瓦斯盛而真气虚，不能起发；六七日之间死亡的，是元气虚而不能灌脓；十天之外死亡的，是邪气已去，脾胃败坏，而元气在内脱失。治疗者只要能判断其必死，却不知道其死必然根源于气血亏损。如果能够逆推其原因，预先进行调补，难道完全没有生机吗？大概起发、灌脓、结痂，这三者都由脾胃荣养决定，不可妄投发表和攻下的药物，这样才不会误害人在夭折之年。从事儿科的医生，能不警惕吗？请再进一步说明。试问《痘疹正宗》，专门以归宗汤一方，肆意使用寒凉攻伐，想要以此来应对无穷无尽的痘疮，有这样的道理吗？不需要明智之士，自然能察觉其错误。为什么儿科医生昧着良心，故意重蹈覆辙呢？有力量的仁人君子，如果能烧掉这本书，毁掉刻板，使邪说平息而正道施行，那么对婴儿造福就不浅了。
The human body is fundamentally based on Qi and Blood. Qi belongs to the defensive (Wei) function, while Blood belongs to the nutritive (Ying) function. Qi is Yang and Blood is Yin. Yang is active; thus, it unblocks the meridians and collaterals and moves the joints and pivot mechanisms. Yin is static; thus, it eliminates excess from the Zang-Fu organs and irrigates the entire body. However, what is most important lies in the Spleen and Stomach. Therefore, the Spleen and Stomach are the great source of generation and transformation for the five Zang organs and six Fu organs. The Classics state: "The Qi that humans receive comes from grain. Where grain enters is the Stomach. The Stomach is the sea of water-grain, Qi, and Blood." As for smallpox (Dou Chuang), it relies entirely on Qi and Blood. If Qi and Blood are sufficient and unobstructed, the eruption will be easy to produce and easy to resolve (scab over). If Qi and Blood are insufficient, myriad complications will arise. Thus, at the initial stage of eruption, Qi and Blood carry the toxin outward; subsequently, they cause the lesions to swell and fill with pus; finally, they complete the scabbing and shedding process. None of this occurs without the transformation driven by Qi and Blood. If Qi and Blood are slightly deficient, and the Spleen and Stomach are damaged, then the vital energy ceases, and the source of transformation is cut off.
Why did Song Linxiang's *Dou Zhen Zheng Zong* (Orthodox Manual on Smallpox) mistakenly use cold and purgative drugs, causing ignorant and blind pediatricians to avoid the complexities of renowned physicians' treatments and greedily rely on the simplicity of the single formula *Gui Zong Tang* from *Dou Zhen Zheng Zong*? Consequently, everyone adopted it indiscriminately, regardless of deficiency, excess, cold, or heat, practicing reckless purgation. This resulted in damage to both Yin-Yang and Spleen-Stomach Qi, leading to a swarm of complications and many deaths. Generally speaking, reckless sweating damages Yang Qi, thereby depriving the processes of eruption, filling, and scabbing of their necessary support. This inevitably leads to rotting throat, hoarseness, thin skin, itching, external peeling, and death. Therefore, predecessors prohibited the use of *Sheng Ma Ge Gen Tang* (Cimicifugae Rhizoma and Puerariae Radix Decoction) after the appearance of macules, fearing it would cause exterior deficiency. Reckless purgation damages Yin fluids, thereby ruining the generative sources of the Zang-Fu organs, the locks of spirit, and the granaries of food and drink. This inevitably leads to sunken lesions that fail to erupt or fill, grayish-white inverted scabs, cold extremities, vomiting and diarrhea with anorexia, chills, teeth grinding, abdominal pain with false distension, and internal collapse leading to death. Therefore, predecessors prohibited the use of Da Huang (Rhei Radix et Rhizoma), Shi Gao (Gypsum Fibrosum), Zhi Ke (Aurantii Fructus Immaturus), Sheng Di Huang (Rehmanniae Radix), Niu Bang Zi (Arctii Fructus), Zi Cao (Lithospermi Radix), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Zhi Zi (Gardeniae Fructus), fearing it would cause interior deficiency.
Thus, Qian Yi stated: "For sores and rashes, only warm and neutral medicines should be used; one must not practice reckless purgation or attack." This is well-founded. Chen Shi said: "Smallpox primarily involves the Taiyin Spleen and Lung meridians; the Lung should be warmed, and the Spleen dried." Wan Quan said: "Smallpox always centers on the Spleen and Stomach; the Stomach should be nourished, and the Spleen tonified." Ma Shi said: "Smallpox primarily involves the Shaoyin Heart meridian; Fire should not be cleared too excessively, and Blood should not be cooled too much." All three statements are correct. Because the Spleen is a solitary organ that irrigates the four directions, the other four Zang organs all rely on this one organ for nourishment. Moreover, the Spleen belongs to Earth and governs muscles. If it can transform water-grain into Jin-Ye (body fluids) and irrigate the meridians, keeping the muscles from withering and assisting Qi and Blood, how could smallpox be difficult to form? However, cold Earth cannot generate things; there must be Yang Qi steaming from below to enable growth and development. Just as plant roots are in the soil, why do they not grow in winter? It is due to the nurturing breath of True Yang. Thus, it is evident that when the Spleen receives water-grain and transforms Jin-Ye, it must rely on Fire Qi to accomplish the work of decomposition and transformation. This is what is meant by "Fire generates Earth"; Fire is the mother of Earth. The Heart is the Sovereign Fire, which can command Ministerial Fire and govern the blood vessels. If Heart Fire does not cease, and Blood does not congeal from cold, it will naturally circulate with the Spleen's Jin-Ye, making the smallpox lesions red and vibrant. This means Blood moistens them, and Qi protects them. Qi cannot move without Blood, and Blood cannot travel without Qi; Qi is the commander of Blood. When Qi moves, Blood moves with it. The Lung unifies the Qi of the whole body and governs the skin and hair. If Lung Qi is abundant, it will naturally circulate with the Heart's blood vessels, making the smallpox lesions pointed, round, plump, and moist. This indicates that sufficient Qi and Blood converge beforehand, and the Spleen produces Jin-Ye to assist and nourish afterward. For the success of smallpox, these three Zang organs are indispensable. The Liver has no part in this. As for the Kidney, if attacked too severely, or following diarrhea, Kidney Qi is damaged, causing the smallpox lesions to turn black, returning to the Kidney and resulting in death.
Xue Ji stated: "Those who die between the fourth and fifth days have excessive toxin and deficient True Qi, unable to erupt; those who die between the sixth and seventh days have deficient Yuan Qi, unable to fill with pus; those who die after ten days have exhausted pathogens and failed Spleen-Stomach, with Yuan Qi collapsing internally." Practitioners may judge that death is inevitable, but they do not realize that death is fundamentally rooted in the depletion of Qi and Blood. If one could trace back the cause and provide preventive regulation and tonification, surely there would be a chance for life. Eruption, filling, and scabbing all depend on Spleen-Stomach nourishment; one must not recklessly administer exterior-releasing or purgative agents, lest one harm patients during their vulnerable years. Pediatricians should beware! Let me explain further. Ask yourself: Does *Dou Zhen Zheng Zong*, relying solely on *Gui Zong Tang* and recklessly using cold and purgative methods, truly possess the logic to address the infinite variations of smallpox? Any wise person would naturally perceive its error. Why do pediatricians act against their conscience and deliberately tread this path? Benevolent individuals with influence should burn the book and destroy the printing blocks, silencing heretical doctrines and allowing the orthodox way to prevail. This would bring immense benefit to infants.