痘后失音，其症有二，咽痛而不能言者，此因毒瓦斯结于咽喉之间，乃痰壅作痛而
不能言也，治宜清热化痰，利咽解毒为主。更有心热不能言者，是因心中邪热未彻，肾
虚不能上接清阳，虽有声而不能言也，治宜清热养心，滋阴益肾，以使坎离既济也。
夫痘后忽寒热如疟，如期即发者，此因脾虚气弱，失于将忌，重感风寒，盖脾主
人，所以如期耳，宜先以柴胡桂枝汤。发去新感表邪，后以调元汤加减主之。更有痘后
气血两虚，是以气虚生外寒，血虚生内热，而似疟非疟者，切忌发散，惟宜大补气血而寒热自己也。
骨节作痛，俗名痘风，宜分气血虚实。是毒非毒，是风非风，虚则补气血之剂，略
佐风药，实则清凉之剂，亦略佐以风药，风者治风，毒者解毒，仍须以养血为主，而风
毒自化于中。若治之不愈，则大滋肝肾，盖骨节之所，肝肾之属也。
痘后有非时搐搦者，亦有二症，有因余毒在于心，留而不去，热甚生风，风火相搏
者，其人则必喉中有痰，目直上视，面赤引饮，居处喜冷，治宜清心泻肝为主。又有病
后多食而胃弱不能胜谷，是以食蒸发搐者，其人则必潮热而腹满多烦，大便酸臭，秘泻
不调，或呕吐腹痛，治宜为之消食佐以养胃，推扬谷气而已。更有手足拘挛，屈伸不
便者，乃血耗气虚，不能荣养于筋，宜用十全大补汤，切忌误作风治，反耗阴血也。更
有痘后昏昧，不解识人，口常妄语。如邪祟状者，此热毒移入心包络也，治宜清心调
元。更有身不热，口无妄，但卒然喜睡、状如眩晕者，此因其人食少而正气素弱，痘出
又重，幸调理得当，毒解得安。然邪气既解，则正气将生，乃否极泰来之象，宜调元
汤，轻轻少与咽之，待其自醒，不可扰乱人不知此，凡见闷乱，便将抱动呼唤号哭，
神气一散，为不救者多矣。更有手足如冰，名为厥逆者。若发于痘出正盛之时，则十无
一生。若于病愈，气血久虚，脾胃大困者，亦宜调元汤加减用之。
痘疹痊愈后出现失音，主要有两种证型。咽喉疼痛导致无法说话，这是因为毒邪结聚在咽喉部位，痰浊壅盛引起疼痛从而不能言语，治疗应以清热化痰、利咽解毒为主。还有因心热导致无法说话的，是因为心中的邪热未清，肾虚不能上承清阳之气，虽然有声带发声但不能成言，治疗应以清热养心、滋阴益肾为主，以使心肾相交（坎离既济）。
痘疹之后突然发冷发热像疟疾一样，且按时发作的，这是因为脾虚气弱，护理不当，再次感受风寒之邪。因为脾主肌肉四肢，所以症状如期而发，宜先用柴胡桂枝汤发散新感的风寒表邪，后用调元汤加减来主治。还有痘疹后气血两虚，因此气虚产生外寒，血虚产生内热，表现为类似疟疾但并非疟疾的症状，切忌使用发散药物，只宜大补气血，那么寒热症状自然消除。
骨节疼痛，俗称“痘风”，应分辨气血的虚实。这既是毒邪又是风邪，既非纯毒也非纯风，虚证则用补益气血的方剂，略微佐以祛风药；实证则用清凉方剂，也略微佐以祛风药。治风则治风，解毒则解毒，但仍须以养血为主，风毒自然在中焦化解。如果治疗不愈，则需大滋肝肾，因为骨节属于肝肾所主的范围。
痘疹后出现非正常时间的抽搐痉挛，也有两种证型。有因余毒留在于心，停留不去，热极生风，风火相搏的，患者必然喉中有痰，眼睛直视向上，面色红赤想喝水，居住环境喜欢凉爽，治疗应以清心泻肝为主。又有病后饮食过多而胃弱不能消化食物，因此食积化热引发抽搐的，患者必然有潮热且腹部胀满多烦躁，大便酸臭，便秘与泄泻交替不调，或者呕吐腹痛，治疗应为消食导滞并佐以养胃，推扬谷气即可。还有手足拘挛，屈伸不便的，这是血耗气虚，不能荣养筋脉所致，宜用十全大补汤，切忌误当作风证治疗，反而耗伤阴血。还有痘疹后神志昏昧，不认识人，口中常胡言乱语，如同被邪祟附身一样的，这是热毒移入心包络所致，治疗应以清心调元为主。还有身体不发热，口无妄语，只是突然喜欢睡觉、状态像眩晕一样的，这是因为患者平时吃得少且正气素来虚弱，痘疹出得又重，幸好调理得当，毒邪已解得以安宁。然而邪气既然已解，正气即将恢复，这是否极泰来的景象，宜用调元汤，轻轻少量喂服，等待其自行苏醒，不可扰乱病人，不知此理的人，凡见到病人烦闷混乱，就将病人抱起摇动呼唤哭喊，导致神气涣散，大多无法救治。还有手足冰冷，名为厥逆的。如果在痘疹发出正旺盛的时候发生，则十无一活。如果在病愈后，气血久虚，脾胃极度困顿的情况下，也宜用调元汤加减使用。
Hoarseness or aphonia after smallpox presents with two main patterns. When throat pain prevents speech, it is due to toxic pathogens accumulating in the throat, where phlegm obstruction causes pain leading to inability to speak; treatment should focus on clearing heat and resolving phlegm, benefiting the throat, and detoxifying (Qingre Huatan, Liyan Jiedu). In cases of aphonia due to heart heat, it is because pathogenic heat in the heart has not been fully cleared, and kidney deficiency fails to ascend clear yang; although vocalization is possible, coherent speech is absent. Treatment should focus on clearing heat and nourishing the heart, and yin-nourishing and tonifying the kidney, to achieve the intersection of water and fire (Kan-Li Ji-Ji).
Sudden chills and fever resembling malaria occurring at regular intervals after smallpox are caused by spleen deficiency and qi weakness, improper nursing, and secondary contraction of wind-cold. Since the spleen governs the muscles, symptoms manifest regularly. Initial treatment should use Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to disperse new exterior wind-cold pathogens, followed by Tiaoyuan Tang (Regulating Origin Decoction) with modifications as the main treatment. In cases of dual deficiency of qi and blood after smallpox, qi deficiency generates external cold, and blood deficiency generates internal heat, presenting as malaria-like but not true malaria. Dispersing methods are strictly contraindicated; instead, substantial tonification of qi and blood is required, after which the chills and fever will resolve spontaneously.
Pain in bone joints, commonly known as "smallpox wind" (Doufeng), requires differentiation between qi-blood deficiency and excess. It involves both toxin and wind. For deficiency patterns, formulas tonifying qi and blood are used with slight additions of wind-dispelling herbs; for excess patterns, cooling formulas are used with slight additions of wind-dispelling herbs. Treating wind addresses wind, detoxification addresses toxins, but nourishing blood remains primary, allowing wind-toxins to transform internally. If treatment fails, substantial nourishment of the liver and kidney is necessary, as joints belong to the domain of the liver and kidney.
Non-timed convulsions and spasms after smallpox present with two patterns. One pattern arises from residual toxins remaining in the heart, causing extreme heat to generate wind, with wind and fire battling; patients exhibit phlegm in the throat, upward staring eyes, red face, thirst, preference for cool environments, and treatment focuses on clearing the heart and purging the liver (Qingxin Xiegan). Another pattern results from overeating after illness while the stomach is weak and unable to digest food, causing food stagnation to transform into heat and trigger convulsions; patients exhibit tidal fever, abdominal fullness, irritability, sour-smelling stools, alternating constipation and diarrhea, vomiting, and abdominal pain. Treatment should focus on promoting digestion and assisting stomach nourishment, promoting grain qi transformation. Additionally, limb contracture and difficulty in flexion and extension result from blood consumption and qi deficiency failing to nourish the sinews; Shiquan Dabu Tang (Complete Great Tonifying Decoction) is indicated. Mistaking this for a wind-pattern is strictly contraindicated, as it would further consume yin-blood. Post-smallpox confusion, failure to recognize people, and constant delirium resembling possession indicate heat-toxin transferring to the pericardium collateral (Xinbaoluo); treatment focuses on clearing the heart and regulating origin. Cases without fever or delirium, but characterized by sudden drowsiness and vertigo-like states, occur in patients with poor appetite and inherent weak righteous qi who suffered severe smallpox. With proper nursing and resolution of toxins, recovery follows. As evil qi resolves and righteous qi regenerates, indicating a turn from adversity to prosperity, Tiaoyuan Tang should be administered lightly and in small amounts until spontaneous awakening. Disturbing the patient, shaking, calling, or inducing crying disperses the spirit and often leads to untreatable conditions. Cold hands and feet, termed Jue-Ni (Reversal Cold), if occurring during the peak eruption of smallpox, are almost invariably fatal. However, in post-recovery states with prolonged qi-blood deficiency and severe spleen-stomach exhaustion, Tiaoyuan Tang with modifications is appropriate.