咳嗽者，痘疹常症也。有寒有热，有实有虚。如自初出而咳嗽，至今未愈者，此肺
气不敛也，宜敛之润之。如咳而热，大便难，小便赤，或咳出血，肺叶焦举者，此热
毒也，宜清利之。如咳而大便溏，小便清，身无大热，而不渴者，此为虚也，宜补益
之。若向不咳而今始咳，兼有鼻流清涕等候者，此风寒外感也，宜疏散之。更有咳嗽而
两胁疼痛者，是余毒在中而阴阳之气不能升降也。《经》曰∶左右者，阴阳之道路，两
胁之谓也，治宜但为解毒顺气。然亦有气血两亏，阴阳不畅者，则宜调养气血而所苦自己。
痘后而吐利蛔者，此热毒入里，其虫为热所蒸而出，热在胃即吐蛔，热在肠即利
蛔，利者黄芩汤，加桃仁、艾叶；吐者，黄芩半夏汤，加乌梅、川椒。更有素不吐利。
若闻食臭即吐而食已易饥者，此因胃虚已久，虫无所食，故闻食臭即吐而食已易饥
也。若吐蛔而手足厥冷者，是为蛔厥，并宜理中汤，加乌梅、川椒主之、切不可投以史
君，槟榔之类。虫未伤而入先困也。更有虽不吐利而内蚀脏腑，乃为狐惑之症，其人好
睡，嘿嘿不欲食，如上唇有疮，则虫蚀其肛，下唇有疮，则虫蚀其脏，其声哑嘎，上
下不安，故名狐惑。亦因水谷久虚，虫无所食，故内蚀脏腑及肛而外见唇口也。此候最
恶，麻疹后成者尤多，治宜化慝丸主之。如便结者。则以桃仁承气汤加槐子利之。若至
唇落鼻崩，牙脱失声者，不治。更有只于牙齿龈肉溃烂者，此因痘 脱去，痰水浸溃，
为疳蚀疮也，宜用绵茧散敷之。若气臭而血出者，此又名为走马疳疮，是由热在阳明
也，宜内用黄连解毒汤，外敷马鸣散。若至唇肿而浮，穿鼻破颊，溃喉腐肉，饮食不下
者，不治。凡口唇生疮而赤者，名曰赤口疮，热在心脾二经也。白者，名曰白口疮，
又名鹅口疮，热在心肺二经也。并用洗心散服之。大便秘者，并用四顺饮利之。然有脉
微无力，脾元中气虚寒，不能按纳下焦。阴火上浮而为口疮者，宜服附子理中汤即愈。
咳嗽是痘疹（天花、麻疹等出疹性传染病）的常见症状。其病机有寒热之分，也有虚实之别。如果从皮疹初发时就开始咳嗽，至今未愈，这是肺气不能收敛所致，适宜采用收敛和滋润的方法治疗。如果咳嗽伴有发热，大便干结难解，小便颜色深红，或者咳出血来，导致肺叶焦枯上举，这是热毒炽盛，适宜采用清热利湿的方法治疗。如果咳嗽伴有大便稀溏，小便清长，身体没有高热，且不口渴，这属于虚证，适宜采用补益的方法治疗。如果之前不咳嗽，现在才开始咳嗽，并且伴有流清鼻涕等症状，这是风寒外感所致，适宜采用疏散风寒的方法治疗。还有咳嗽并伴有两侧胁肋部疼痛的，这是余毒滞留体内，导致阴阳之气升降失常。《黄帝内经》说：“左右两侧，是阴阳之气运行的道路”，指的就是两胁部位，治疗应当以解毒顺气为主。然而也有气血两亏、阴阳运行不畅的情况，则适宜调养气血，病痛自然消除。
痘疹痊愈后出现呕吐和腹泻蛔虫的，这是热毒深入体内，蛔虫被热气蒸腾而出。热邪在胃就会引起吐蛔，热邪在肠就会引起下利蛔虫。对于下利蛔虫者，用黄芩汤，加入桃仁、艾叶；对于吐蛔者，用黄芩半夏汤，加入乌梅、川椒。更有平时并不吐利蛔虫的人，如果闻到食物的气味就呕吐，且吃完食物后又容易感到饥饿，这是因为胃气虚弱已久，蛔虫没有食物可吃，所以闻到食味就呕吐，进食后容易饥饿。如果吐出蛔虫并伴有手脚冰冷，这就称为“蛔厥”，都适宜用理中汤，加入乌梅、川椒来主治，切不可使用使君子、槟榔之类的药物，因为此时虫子尚未造成严重伤害，而人体正气已经困顿衰弱。还有虽然不吐利蛔虫，但虫毒在内侵蚀脏腑的，这就是“狐惑”病症。患者喜欢睡觉，神情沉默不想吃东西，如果上唇有疮疡，说明虫蚀肛门；如果下唇有疮疡，说明虫蚀内脏。患者声音嘶哑，上下不安宁，所以名叫狐惑。这也是因为水谷精微长期亏损，蛔虫无食可吃，所以在内侵蚀脏腑及肛门，在外表现为唇口生疮。这种候症最为凶险，麻疹后形成的尤其多见，治疗适宜用化慝丸主治。如果大便秘结的，就用桃仁承气汤加入槐子来通利大便。如果发展到嘴唇脱落、鼻子塌陷、牙齿脱落、失声的程度，就无法治愈了。还有只在牙龈肉溃烂的，这是因为痘疹消退后，痰湿水气浸渍溃烂，形成疳蚀疮，适宜用绵茧散外敷。如果口气臭秽且出血的，这又名为“走马疳疮”，是由阳明经热盛所致，适宜内服黄连解毒汤，外用马鸣散敷贴。如果发展到嘴唇肿胀浮肿，穿鼻破颊，喉咙溃烂腐肉，饮食无法下咽的程度，也无法治愈了。凡是口唇生疮且发红的，名叫“赤口疮”，病位在心经和脾经。发白的，名叫“白口疮”，又名“鹅口疮”，病位在心经和肺经。这两种情况都用洗心散内服。大便秘结的，都用四顺饮来通利。然而也有脉象微弱无力，脾胃元气和中气虚寒，不能固摄下焦，导致阴火上浮而形成口疮的，适宜服用附子理中汤即可痊愈。
Cough is a common manifestation of variola (smallpox) and exanthematous diseases. Its pathogenesis involves cold and heat, as well as excess and deficiency. If coughing begins from the initial eruption of the rash and persists without resolution, this indicates that Lung Qi fails to consolidate; treatment should focus on consolidating and moistening. If coughing is accompanied by fever, difficult defecation, dark red urine, or hemoptysis leading to the desiccation and elevation of lung lobes, this signifies intense heat toxin; treatment should employ clearing and draining methods. If coughing is accompanied by loose stools, clear urine, absence of high fever, and no thirst, this constitutes a deficiency syndrome; treatment should utilize tonification. If one did not previously cough but now develops coughing along with symptoms such as clear nasal discharge, this is due to external contraction of wind-cold; treatment should employ dispersing and diffusing methods. Additionally, coughing accompanied by pain in both hypochondriac regions indicates residual toxins lingering within, causing dysfunction in the ascending and descending of Yin and Yang energies. The *Classic* states: "The left and right are the pathways of Yin and Yang," referring to the hypochondriac regions; treatment should prioritize resolving toxins and regulating Qi. However, in cases of dual deficiency of Qi and Blood with unsmooth circulation of Yin and Yang, treatment should focus on nourishing and regulating Qi and Blood, after which the suffering will naturally cease.
Post-variolous vomiting and diarrhea of roundworms indicate that heat toxin has penetrated inward, and the worms are driven out by the steaming heat. Heat in the Stomach causes vomiting of worms, while heat in the Intestines causes diarrhea of worms. For diarrhea of worms, use Huangqin Tang (Scutellaria Decoction) added with Tao Ren (Peach Kernel) and Ai Ye (Mugwort Leaf); for vomiting of worms, use Huangqin Banxia Tang (Scutellaria and Pinellia Decoction) added with Wu Mei (Mume Fruit) and Chuan Jiao (Sichuan Pepper). Furthermore, individuals who do not typically vomit or pass worms may vomit upon smelling food odor and feel hungry soon after eating; this occurs because long-standing Stomach deficiency leaves the worms without food, causing them to react to food odors with vomiting and leading to rapid hunger post-prandially. If vomiting of worms is accompanied by cold extremities, it is termed "Hui Jue" (Roundworm Syncope); treatment for all such cases should utilize Lizhong Tang (Regulate the Middle Decoction) added with Wu Mei and Chuan Jiao. One must absolutely avoid using drugs like Shijunzi (Quisqualis Seed) or Binglang (Areca Nut), as the parasites have not yet caused severe damage, but the body's righteous Qi is already exhausted. There are also cases where, although there is no vomiting or diarrhea of worms, internal erosion of Zang-Fu organs occurs, known as "Hu Huo" (Fox-Huo Syndrome). Patients exhibit somnolence, taciturnity, and anorexia. If ulcers appear on the upper lip, it indicates worm erosion of the anus; if ulcers appear on the lower lip, it indicates worm erosion of the viscera. The voice becomes hoarse, and the patient experiences restlessness above and below, hence the name Hu Huo. This results from prolonged deficiency of water and grain essences, leaving worms without sustenance, thus eroding viscera and anus internally while manifesting as ulcers on lips and mouth externally. This condition is extremely malignant, particularly common after measles. Treatment should primarily utilize Huote Wan (Resolve Malice Pill). In cases of constipation, Taoren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) added with Huaizi (Sophora Seed) should be used to promote bowel movement. If the condition progresses to lip sloughing, nasal collapse, tooth loss, and aphonia, it is incurable. Cases involving only ulceration and rotting of the gingiva occur after the exanthem subsides, due to phlegm-fluid infiltration and erosion, forming Gan Shi Chuang (Gan Erosion Ulcer); these should be treated with topical application of Mianjian San (Silkworm Cocoon Powder). If foul breath and bleeding occur, it is termed "Zou Ma Gan Chuang" (Running Horse Gan Ulcer), caused by heat in the Yangming channel; internal treatment requires Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), and external treatment requires topical application of Mamingsan. If the condition advances to swollen and edematous lips, perforation of the nose and cheeks, throat ulceration with necrotic tissue, and inability to ingest food, it is incurable. Any ulcers on the lips that are red are named "Chi Kou Chuang" (Red Mouth Ulcer), indicating heat in the Heart and Spleen channels. Those that are white are named "Bai Kou Chuang" (White Mouth Ulcer), also known as "E Kou Chuang" (Goose Mouth Ulcer), indicating heat in the Heart and Lung channels. Both types are treated internally with Xixin San (Heart-Cleansing Powder). In cases of constipation, Sixun Yin (Four-Obedience Drink) is used to promote purgation. However, in cases where the pulse is faint and weak, and the Spleen Yuan and Middle Qi are deficient and cold, failing to secure the Lower Jiao, causing Yin fire to float upward resulting in mouth ulcers, treatment with Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction) will lead to recovery.