痘疮收靥落痂之后。其婴儿气血必虚。盖自初热伤阴。以至出齐起发灌浆结靥落痂。莫
非气
血之所为。且或体虚痘密。遍体不留余隙。果能一一冲托成实。则是周身气血。皆为痘用。
周身气血皆为痘用。则未有不耗伤者。气血既皆为痘耗伤。则凡于落痂之后。必宜加意培补
。
纵有他症。皆当以末治之。务令气血得以充足撤消。不致遗后日多疾之患。譬如以人搏虎。
虎虽毙而人之气力伤矣。人之气力既伤。未有不需饮食酒肉以将息者。奈何近日俗习。不知
此理
。每于痘疮。皆喜进清凉之剂。于落痂之后。亦妄用黄连栀子苦寒之属。谬曰败毒。致使脾
胃生气大伤。饮食减少。 羸孱弱。卒难撤消。或即变生他症。仍归夭亡。可胜浩叹。嗟乎
。痘不成浆。由气血不能运化。痘既成浆。毒瓦斯已解。果使浆稠痂浓。则毒瓦斯全解。痂落之
后。尚何余毒之可清。在禀赋壮实。血热瘢紫者。或堪其谬。若瘢色红淡。或雪白者。服之
必死。妇人无知。庸医谬习。沉迷痼结。祸世已深。仆思挽救。是以不惜谆复其词。用以代
铎。以振世之聋聩云。
粤稽上古之世。民物贞淳。人心恬淡。并无所谓痘疮一症者。迨至有唐以后。风俗浇漓
。人
情穿凿。淫 嗜好。醇酒膏粱。六淫外干。七情内扰。脏腑郁蒸。气精滓浊。及至分形受质
。两情相感。一气浑融。错杂之邪。交相施泻胚胎之始。毒即伏焉。既
生之后。必待天地时行疫疠之气。或挟外感内伤之邪。触之斯发。乃至遁为传染。比户
皆然。为婴儿所必不能免。此父母遗毒之为害也如此。加以近日医无善术。用药乖离。遂至
险逆相寻。死亡略半。
此庸医之为害也又如此。嗟乎。父母爱子之心。何所不至。劬劳鞠育。惟疾之忧。一旦
为庸医所误。呼救何从。甚且宗祀攸关。赖此一线。抑或贞嫠忘死。守此藐孤。一遇差迟。
衔冤更惨。真令人言之痛心。闻之堕泪者也。幸至有宋。有神人出。而立种痘一法。乘儿无
病之时而种之。其种出之痘。少者不过数粒。多者不过数十粒而已。且不需服药。诚挽回造
化。避危就安。万举万全之良法也。
本朝高宗纯皇帝。仁被万方。德逾千古。悯兹良法方书未载。恐日久湮没失传。特于御
宗金鉴书内。编辑种痘心法要旨。仰见仁慈。恩深保赤者矣。第迩来能种之子。皆有力之家
。单寒之儿。犹然自出。岂不大负国家及在昔神人之初念乎。原其所以。屈于力有所不能耳
。今喜博爱堂诸君子。发心择请种师。并资助衣食。广为贫家儿女种痘。洵慈幼之盛举
也。予甚乐焉。用是特缀数语。并冀广为劝导。使人人皆能效法诸君子。于以修福而广皇
仁。端在是矣。功德岂有量哉。
一种痘原所以去险履平。避危就安而设。务宜用种出之痘。所落之痂作苗。其气纯正。无天
行时毒外感内伤之邪。夹杂于中。种出自然稀疏顺吉。应时成功。决无愆忒。若夫时痂。则
断不可用。至于种法。宜以水苗为上。
一下苗之后。调摄禁忌。不可不慎。自始至终。不可稍忽。如避寒热。慎饮食是也。假
气严寒。盖覆宜温暖。勿使受寒。恐被寒气所触。则痘不得出。亦不可过于重棉叠褥。火器
熏靠衣被。致热气壅滞。使痘不得宣发。天气和暖。盖覆宜适中。恐客热与毒相并。致增烦
热。亦不可轻易着单露体。致风寒外侵。阻遏生发之气。此寒热所以贵得其平也。卧处常要
无风。夜静不断灯火。不离亲人看守。一切食饮。宜豫为现成。以备不时之需。如时有迅雷
烈风之变。宜谨帷帐。添盖覆。多烧辟秽香。以辟一时不正之气。至于饮食。人之气血。藉
以生化。痘之始终。全赖乎此。若饮食亏少。气血何所资助乎。但不可过甚。若过饮。则饮停
不化津液。过食。则食滞壅遏气机。大凡吮乳之儿。不多乳。不阙乳。能食之儿。勿餐生冷
粘硬。勿啖辛热炙爆。勿恣意茶水。勿饮凉浆。食不过饱。亦不令饥。此饮食所以贵得
其平也。寒热饮食而外。则凡举止动作。既不可任意骄纵。亦不可过于拂逆。惟在调摄之人
。
耐其性情。兢兢业业。善为保护。不但慎于既种之后。且当慎于未种之先。不但慎于见苗之
初。犹当慎于落痂之后。种师宜谆谆告诫。务期详细。使彼知关系匪轻。心存谨慎。如法
调摄。可保万全。至于禁忌。亦最紧要。凡种痘之家。房中最要洁净。切忌冲犯。宜明亮。
不
宜幽暗。勿詈骂呼怒。勿言语惊慌。勿对梳头。勿对搔痒。勿嗜酒。勿歌唱。凡房中淫
气。妇人经候气。腋下狐臭气。行远劳汗气。误烧头发气。误烧鱼骨气。吹灭灯烛气。硫黄
蚊烟柴烟气。煎炒炙爆气。葱蒜醉酒气。沟渠污浊气。霉烂蒸湿气。溷圊厕桶气。病患
秽恶气。新丧 秽气。以上务宜谨慎遵守。毋稍懈忽。倘自不经心。致令触犯。咎难他
诿也。仍宜谨伺房门。勿令生人及僧尼孝服人辄入。宜将此刷印。人给一张。俾各自慎。
痘疮结痂脱落之后，婴儿的气血必然虚弱。因为从初期的发热伤及阴液，一直到出齐、起发、灌浆、结痂、落痂，整个过程无不是依靠气血的作用。况且如果体质虚弱而痘疹密集，全身不留空隙，若能一一托毒外出并成实，那么周身的气血都被痘疹所消耗。既然周身气血都被痘疹消耗，就必然会有耗损和损伤。气血既然都被痘疹耗伤，那么在落痂之后，务必注意培补元气。即使有其他病症，也都应当作为次要问题来处理，务必要让气血得以充足恢复，不致留下日后多病的隐患。这就好比人与老虎搏斗，老虎虽然死了，但人的气力也受损了。人的气力既已受伤，没有不需要通过饮食酒肉来调养休息的。为什么近世的习俗，不知道这个道理？每当遇到痘疮，都喜欢使用清凉的药物；在落痂之后，也胡乱使用黄连、栀子等苦寒性质的药物，荒谬地称之为“败毒”，致使脾胃的生气大受损伤，饮食减少，身体瘦弱，最终难以恢复，或者反而变生其他病症，导致夭折，这真是令人浩叹不已。唉！痘疹不能成浆，是因为气血不能运化；痘疹既然已经成浆，毒邪之气已经解除。果真使浆液稠厚、痂皮浓密，那么毒邪之气已经完全解除，落痂之后，还有什么余毒需要清除呢？对于禀赋壮实、血热且瘢痕呈紫色的人，或许还可以承受这种误治。但如果瘢痕颜色红淡，或雪白者，服用苦寒药物必定致死。妇人无知，庸医谬习，沉迷于这种顽固的错误观念，祸害世人已经很深了。我思考如何挽救，因此不惜反复陈述这些道理，用以唤醒世人的聋聩。
回想上古时代，民风淳朴，人心恬淡，并没有所谓痘疮这一病症。等到唐朝以后，风俗浇薄，人情巧诈，放纵嗜好，饮酒吃肉过多，六淫（风、寒、暑、湿、燥、火）外侵，七情（喜、怒、忧、思、悲、恐、惊）内扰，脏腑郁蒸，精气浑浊。等到胎儿成形受质时，父母两情相感，一气浑融，错杂的邪气在胚胎形成之初就交相施泻，毒邪便潜伏其中。出生后，必须等待天地间的时行疫疠之气，或者夹杂外感内伤的邪气，触动它才会发作，进而演变为传染病，家家户户都如此，这是婴儿所不能避免的。这就是父母遗毒的危害如此之大。再加上近世医生医术不高明，用药背离正道，导致险逆之症相继出现，死亡者占了一半。这是庸医的危害又如此之大。唉！父母爱子之心，无所不至，辛勤养育，只担忧孩子的疾病。一旦因庸医误诊，呼救无门。甚至关系到宗族祭祀的大业，依赖这唯一的后代；或者是寡妇忘死守节，守护这孤弱的孩子，一旦遇到差错，含冤更惨，真令人言之痛心，闻之落泪。幸好到了宋代，有神明之人出现，创立了种痘的方法。在孩子没有生病的时候进行接种，种出来的痘，少的不过几粒，多的不过几十粒而已。而且不需要服药，这确实是挽回造化、避危就安、万无一失的好方法。
本朝高宗纯皇帝，仁德覆盖万方，德行超过千古，怜悯这种良法方书未载，担心日久湮没失传，特别在《御纂医宗金鉴》书中，编辑了《种痘心法要旨》，体现了仁慈之恩，深厚地保护婴儿。只是近来能接种的孩子，都是有势力的家庭，贫寒的孩子，仍然自然出痘，这岂不是大大辜负了国家以及往昔神人创立此法的初衷吗？究其原因，是屈于财力不足罢了。现在高兴的是博爱堂的各位君子，发心聘请种痘师傅，并资助衣食，广泛为贫家儿女种痘，这确实是慈爱儿童的盛大举动。我非常乐意，因此特意写下几句话，并希望广为劝导，使人人都能效仿各位君子，以此修福并广布皇恩，关键就在这里。功德哪里有限量呢？
种痘原本是为了去除危险、踏上平安，避开危难、走向安全而设立的。务必使用种出的痘所落的痂作为“苗”（疫苗原料），其气纯正，没有天行时毒、外感内伤的邪气夹杂其中，种出来自然稀疏顺吉，按时成功，决不会有差错。至于时候的痂（自然患痘后落的痂），则绝对不可用。至于种法，以水苗法为上。
一下苗之后，调摄禁忌，不可不谨慎。从头到尾，不可稍有疏忽。比如避寒热、慎饮食就是这类。假如天气严寒，盖被应该温暖，不要让他受寒，恐怕被寒气触动，则痘出不来。也不可以过于厚重棉褥，用火器熏烤衣被，导致热气壅滞，使痘不得宣发。天气和暖，盖被应该适中，恐怕客热与毒邪相并，导致增加烦热。也不可以轻易穿单衣露体，导致风寒外侵，阻遏生发之气。这就是寒热之所以贵在得其平的原因。卧处常要无风，夜间不断灯火，不离亲人看守。一切饮食，宜预先准备好现成的，以备不时之需。如时有迅雷烈风的变故，应谨守帷帐，增添盖被，多烧辟秽香，以辟一时不正之气。至于饮食，人的气血，借此生化，痘的始终，全赖于此。如果饮食亏少，气血从哪里得到资助呢？但是不可以过分。如果过饮，则饮水停聚不化为津液；过食，则食物停滞壅遏气机。大凡吮乳的婴儿，不多喂，也不缺喂；能吃饭的孩子，不要吃生冷粘硬的食物，不要吃辛辣热性烧烤的食物，不要肆意喝茶水，不要喝凉浆。吃不过饱，也不令其饥饿。这就是饮食之所以贵得其平的原因。除了寒热饮食之外，凡是举止动作，既不可以任意骄纵，也不可以过于拂逆。只在调摄的人，耐住孩子的性情，兢兢业业，善于保护。不但要谨慎于种痘之后，还要谨慎于种痘之前；不但要谨慎于见苗之初，还要谨慎于落痂之后。种痘师傅宜谆谆告诫，务必详细，使他们知道关系重大，心存谨慎，依法调摄，可保万全。至于禁忌，也最紧要。凡是种痘的家庭，房中最要紧洁净，切忌冲犯，宜明亮，不宜幽暗。不要骂人呼怒，不要言语惊慌，不要对着梳头，不要对着搔痒，不要嗜酒，不要歌唱。凡是房中淫气、妇人经候气、腋下狐臭气、行远劳汗气、误烧头发气、误烧鱼骨气、吹灭灯烛气、硫黄蚊烟柴烟气、煎炒炙爆气、葱蒜醉酒气、沟渠污浊气、霉烂蒸湿气、溷圊厕桶气、病患秽恶气、新丧秽气，以上务宜谨慎遵守，毋稍懈怠疏忽。如果自己不经心，导致触犯，罪责难以推诿给别人。仍宜谨守房门，不要让生人及僧尼孝服人随意进入。宜将此刷印，人手一张，让他们各自谨慎。
After the smallpox scabs fall off, the infant's Qi and Blood must be deficient. From the initial fever damaging Yin, to the eruption, rising, pustule formation, scabbing, and finally scab shedding, every stage relies on the action of Qi and Blood. Moreover, if the constitution is weak and the rash is dense, leaving no space on the body, if one can successfully push out each lesion to maturity, then the Qi and Blood of the entire body are utilized by the smallpox. Since the Qi and Blood of the entire body are consumed by the smallpox, there will inevitably be depletion and injury. Once Qi and Blood are depleted by the smallpox, it is essential to focus on tonification after the scabs fall off. Even if other symptoms appear, they should be treated as secondary matters, ensuring that Qi and Blood become sufficient and recover, preventing future illnesses. It is like a person fighting a tiger; although the tiger dies, the person's strength is injured. Once a person's strength is injured, there is no one who does not need diet, wine, and meat to recuperate. Why do recent customs ignore this principle? Whenever encountering smallpox, people prefer to administer cooling agents. After the scabs fall off, they recklessly use bitter-cold substances such as Coptidis Rhizoma (Huanglian, 黄连) and Gardeniae Fructus (Zhizi, 栀子), absurdly calling it "resolving toxicity." This severely damages the generating Qi of the Spleen and Stomach, reduces appetite, leads to emaciation and weakness, making recovery difficult, or even causing other symptoms to arise, resulting in premature death. This is truly sigh-worthy. Alas! Smallpox fails to form pus because Qi and Blood cannot transform and transport it. Once the smallpox forms pus, the toxic vapors have already resolved. If the pus is thick and the scabs dense, the toxic vapors are completely resolved. After the scabs fall off, what residual toxicity remains to be cleared? For those with robust constitutions, blood heat, and purple scars, they might tolerate this error. However, for those with pale red or snow-white scars, taking these drugs will certainly lead to death. Women are ignorant, quacks follow erroneous practices, deeply entrenched in delusion, harming the world significantly. I ponder how to rescue them, hence I do not hesitate to repeat these words to awaken the deaf and blind of the world.
Looking back to ancient times, the people were honest and simple, hearts tranquil, and there was no such disease as smallpox. After the Tang Dynasty, customs became frivolous, human nature crafty, indulging in desires, drinking alcohol, and eating rich foods. The Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) invaded externally, while the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright) disturbed internally. Organs and bowels steamed and stagnated, essence and Qi became turbid. When the fetus took shape and received its endowment, the mutual feeling of parents merged into one Qi. Mixed evils were transmitted together at the beginning of embryogenesis, and toxins lay dormant within. After birth, one had to wait for the epidemic Qi of the heavens and earth, or pathogens mixed with external contraction and internal injury, to trigger the onset. Thus, it evolved into a contagious disease, affecting every household, unavoidable for infants. This is the harm caused by parental residual toxins. Added to this, recent doctors lack good skills and prescribe medications incorrectly, leading to dangerous complications and half the deaths. This is the harm caused by quacks. Alas! Parents' love for their children knows no bounds. They toil and nurture, worrying only about illness. Once misled by quacks, where can they cry for help? It may concern the continuation of the family line, relying on this single thread; or a widow risking death to guard this orphan. One mistake brings deeper grievance. Truly, it makes one's heart ache to speak of it and tears to hear of it. Fortunately, in the Song Dynasty, a divine person appeared and established the method of inoculation. Inoculating when the child is healthy, the resulting smallpox is few, not more than a few grains, or at most dozens. And no medication is needed. This is indeed a good method to reverse fate, avoid danger, and ensure safety, infallible in ten thousand attempts.
His Majesty Emperor Gaozong of our dynasty, whose benevolence covers all directions and virtue surpasses millennia, pitied that this good method was not recorded in medical books and feared it would be lost over time. He specially edited "Essential Principles of Smallpox Inoculation" in the "Imperial Collection of Medical Formulas," showing his benevolent grace and deep protection of infants. Yet recently, only children from wealthy families can be inoculated, while poor children still naturally contract smallpox. Does this not greatly betray the original intention of the state and the divine founder? The reason lies in financial inability. Now, I am pleased that the gentlemen of Bo'ai Hall have taken the initiative to hire inoculators and provide food and clothing subsidies, widely inoculating children of poor families. This is indeed a grand act of loving children. I am very happy and thus write a few words, hoping to widely advocate so that everyone imitates these gentlemen, thereby accumulating merit and extending imperial benevolence. How boundless is this merit!
Inoculation is designed to remove danger and walk on flat ground, avoiding peril and seeking safety. It is essential to use the scabs fallen from inoculated smallpox as the "seed" (vaccine material). Its Qi is pure, without mixing with epidemic toxins, external contractions, or internal injuries. The resulting inoculation will naturally be sparse and auspicious, succeeding on time, without deviation. Scabs from natural smallpox outbreaks must absolutely not be used. Among inoculation methods, water-seed method is superior.
After inoculation, care and taboos must be strictly observed. From start to finish, no negligence is allowed. Such as avoiding cold and heat, and being cautious with diet. If the weather is extremely cold, coverings should be warm to prevent cold invasion, which might hinder eruption. But do not use overly heavy cotton mats or heat lamps, causing heat stagnation that prevents eruption. If the weather is mild, coverings should be moderate to prevent external heat combining with toxin, increasing irritability. Do not wear thin clothes or expose the body, allowing wind-cold to invade and obstruct generating Qi. Thus, balancing cold and heat is crucial. Sleeping areas should be draft-free, lights kept on at night, and relatives constantly watching. All food and drink should be prepared in advance for emergencies. If sudden storms occur, secure curtains, add coverings, and burn aromatic incense to dispel abnormal Qi. Regarding diet, human Qi and Blood rely on it for generation; the course of smallpox depends entirely on it. If diet is insufficient, where does Qi and Blood come from? But excess is also bad. Overdrinking causes fluid retention failing to transform into Jin-Ye; overeating causes food stagnation blocking Qi mechanism. Infants breastfeeding should not be overfed nor underfed. Children eating solid food should avoid raw, cold, sticky, hard foods, spicy, hot, roasted foods, excessive tea/water, and cool beverages. Eat until full but not stuffed, hungry but not starving. Thus, balancing diet is crucial. Besides cold/heat and diet, behavior should not be spoiled nor overly restricted. Caregivers must patiently manage the child's temperament, diligently protecting them. Caution is needed not only after inoculation but before; not only when seeds appear but after scabs fall. Inoculators should earnestly warn, detailing everything, so patients understand the gravity, remain cautious, and follow regulations for safety. Taboos are also vital. Rooms must be clean, bright, not dark. No scolding, shouting, panic, combing hair nearby, scratching nearby, drinking alcohol, or singing. Avoid foul odors: sexual fluids, menstrual blood, armpit odor, sweat from long walks, burnt hair smell, burnt fish bone smell, extinguished candle smoke, sulfur/mosquito coil/wood smoke, fried/roasted smells, garlic/onion/alcohol breath, ditch sewage smell, moldy dampness smell, toilet bucket smell, sick person's filth smell, fresh funeral corpse smell. Strictly observe all above. Negligence leading to violation brings blame upon oneself. Guard doors, keep strangers, monks, nuns, and mourners out. Print this, give one copy to each person, so everyone remains cautious.