表实之状。初热之时。壮热无汗。恶寒头疼身痛。脉浮紧数。如在冬月寒胜之时。宜人
参
败毒散主之。如时令暄热。宜升麻葛根汤主之。如不寒不热天气温和之时。宜柴归饮主之。
然此皆为表实者宜之。设或禀赋素虚。或表邪不甚。或肢体潮润。或已见点。虽升麻葛根汤
亦不宜用。矧败毒散乎。倘误表之。必致溃烂之变。其次若面赤唇紫。眼红鼻塞。皮焦肤赤
。手足热甚者。宜搜毒煎。或加柴胡。或柴归饮主之。若已见点。而痘色红紫。 肿疼痛。
或皮浓而硬。或痈肿 疔。脉见浮洪滑实。里气亦实者。四味消毒饮。鼠粘子汤之类主之。
若已见点。而身热不退者。宜滋营气。芎归汤主之。不得肆用表散。盖妄汗能致 烂也。慎
之慎之。若已见点。而偶为风寒所感。痘出不快。身热加增者。此又宜微表之也。柴归饮主
之。
表寒之状。不起发。不红活。根窠淡白。宜保元汤。六物煎。参 内托散之类。少加酒
同煎
主之。若已起发。而身凉痒 。倒陷干枯者。宜保元汤。六气煎。十全大补汤之类作大剂。
亦少加酒煎主之。不应者。加鹿茸附子。
表热之状。肌肤大热。气粗喘满。烦躁狂言。宜羌活散郁汤。柴归饮之类主之。若身外
热甚
。而唇润不渴。目无赤脉。大小便调。身虽大热。但 然。柴归饮主之。若已出而根窠红
紫。宜四物汤。凉血养营煎之类主之。若已见点。而顶赤发 。凉血养营煎。犀角散之类主
之。若头面红肿。紫黑焦枯。紫草快 汤。凉血养营煎。六味地黄汤之类主之。若夹 夹疹
。眼红唇裂。凉血养营煎主之。
表实证的表现。在发热初期，出现高热无汗、怕冷、头痛及全身疼痛的症状，脉象浮紧且数，这类似于冬季寒气盛时的状况，适宜用人参败毒散来主治。如果正值气候温暖炎热的时节，适宜用升麻葛根汤来主治。如果在既不寒冷也不炎热、天气温和的时候，适宜用柴归饮来主治。然而，这些方剂都只适用于表实证患者。假如患者先天体质虚弱，或者表邪不重，或者肢体潮湿润泽，或者痘疹已经显现，即使是升麻葛根汤也不宜使用，更何况是人参败毒散呢？如果误用发汗解表的方法，必然会导致溃烂的变证。其次，如果见面色红赤、嘴唇紫暗、眼睛发红、鼻塞、皮肤干燥焦枯、肤色红赤，手足热得厉害的情况，适宜用搜毒煎，或者加入柴胡，或者用柴归饮来主治。如果痘疹已经显现，但痘色红紫，肿胀疼痛，或者皮厚而坚硬，或者形成痈肿疔疮，脉象呈现浮洪滑实，里气也充实的，适宜用四味消毒饮、鼠粘子汤之类的方剂来主治。如果痘疹已经显现，但身体发热不退的，适宜滋养营气，用芎归汤来主治，不可肆意使用发散解表的药物，因为妄自发汗会导致溃烂，务必谨慎再谨慎。如果痘疹已经显现，偶然被风寒所感，导致痘出不快，身体发热增加的，这又适宜轻微地解表，用柴归饮来主治。
表寒证的表现。痘疹不起发，颜色不红活，根部周围（根窠）淡白，适宜用保元汤、六物煎、人参内托散之类的方剂，少加酒同煎后主治。如果痘疹已经起发，但身体发凉、瘙痒，出现倒陷干枯的情况，适宜用保元汤、六气煎、十全大补汤之类的方剂，制成大剂量，也少加酒煎后主治。如果服用上述方剂无效，则加入鹿茸、附子。
表热证的表现。肌肤大热，呼吸粗重，气喘胸闷，烦躁不安，胡言乱语，适宜用羌活散郁汤、柴归饮之类的方剂来主治。如果体表热势很盛，但嘴唇湿润且不口渴，眼睛没有红血丝，大小便正常，虽然身体大热，但精神倦怠无力，用柴归饮来主治。如果痘疹已经发出，但根部周围红紫，适宜用四物汤、凉血养营煎之类的方剂来主治。如果痘疹已经显现，但顶部红赤、发泡，用凉血养营煎、犀角散之类的方剂来主治。如果头面部红肿，颜色紫黑焦枯，用紫草快斑汤、凉血养营煎、六味地黄汤之类的方剂来主治。如果夹杂痧疹，眼睛红、嘴唇裂开，用凉血养营煎来主治。
Manifestations of Exterior Excess Syndrome. During the initial stage of fever, there is high fever without sweating, aversion to cold, headache, and body pain; the pulse is floating, tight, and rapid. This resembles conditions during winter when cold is predominant, and Ren Shen Bai Du San (Ginseng Decoction for Resolving Toxins) is indicated. If the season is warm and hot, Sheng Ma Ge Gen Tang (Bupleurum and Kudzu Root Decoction) is indicated. If the weather is neither cold nor hot but mild, Chai Gui Yin (Bupleurum and Angelica Decoction) is indicated. However, these are suitable only for patients with exterior excess. If a patient has a constitutionally deficient physique, or the exterior pathogenic factor is not severe, or the limbs are moist, or the rash spots have already appeared, even Sheng Ma Ge Gen Tang should not be used, let alone Ren Shen Bai Du San. If misused as a diaphoretic treatment, it will inevitably lead to ulceration. Secondly, if the face is red, lips are purple, eyes are red, nasal congestion occurs, skin is dry and scorched, complexion is red, and hands and feet are extremely hot, Sou Du Jian (Toxin-Searching Decoction) is indicated, possibly with added Chai Hu (Bupleuri Radix), or Chai Gui Yin is indicated. If spots have appeared, yet the rash color is red-purple, swollen and painful, or the skin is thick and hard, or carbuncles and sores form, and the pulse is floating, surging, slippery, and full, indicating that interior qi is also excess, Si Wei Xiao Du Yin (Four-Ingredient Toxin-Resolving Decoction) or Niu Bang Zi Tang (Arctii Fructus Decoction) are indicated. If spots have appeared but fever persists, Zi Ying Qi (Nourishing Ying Qi) is required, using Xiong Gui Tang (Ligusticum and Angelica Decoction); one must not recklessly use dispersing and releasing methods, as reckless sweating can cause ulceration. Be extremely cautious. If spots have appeared but were accidentally affected by wind-cold, causing slow eruption and increased fever, mild release of the exterior is indicated, using Chai Gui Yin.
Manifestations of Exterior Cold Syndrome. The rash fails to erupt, lacks redness and vitality, and the base (root area) is pale white. Bao Yuan Tang (Protect the Origin Decoction), Liu Wu Jian (Six-Material Decoction), or Ren Shen Nei Tuo San (Ginseng Interior-Supporting Powder) are indicated, with a small amount of wine added for decoction. If the rash has erupted but the body feels cool and itchy, with collapse and dryness, large doses of Bao Yuan Tang, Liu Qi Jian (Six-Qi Decoction), or Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) are indicated, also with a small amount of wine added for decoction. If there is no response, add Lu Rong (Cervus Nippon Cornu) and Fu Zi (Aconiti Lateralis Radix Praeparata).
Manifestations of Exterior Heat Syndrome. Skin is very hot, breathing is coarse with panting and chest fullness, restlessness, mania, and delirium occur. Qiang Huo San Yu Tang (Notopterygium Decoction for Dispersing Stagnation) or Chai Gui Yin are indicated. If external heat is severe but lips are moist and thirst is absent, eyes lack red vessels, urination and defecation are normal, and although the body is very hot, the spirit is listless, Chai Gui Yin is indicated. If the rash has emerged but the base is red-purple, Si Wu Tang (Four-Material Decoction) or Liang Xue Yang Ying Jian (Cool Blood and Nourish Ying Decoction) are indicated. If spots have appeared but the apex is red and vesicular, Liang Xue Yang Ying Jian or Xi Jiao San (Rhinoceros Horn Powder) are indicated. If the head and face are swollen and red, turning purple-black and scorched, Zi Cao Kuai Ban Tang (Arnebia Rapid-Rash-Decoupling Decoction), Liang Xue Yang Ying Jian, or Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill) are indicated. If complicated by sand-rash, with red eyes and cracked lips, Liang Xue Yang Ying Jian is indicated.