凡女子一向崩漏未止，气血已虚。若再感患疮疹，则必不能以任其毒，宜用十全大
补汤，以补气血为主，若灰白平陷，难发难浆者，加熟附子一二片，使里气充足，毒无
停留而自能饮食，自能起胀庶可保全，否则倒塌不治矣。更凡正当起发泡浆之时，最宜
表里无病，饮食如常。若遇经行过三日而不止者，人但虑其秽气触动，殊不知身中之血
一去，百脉之气皆虚，毒邪乘虚陷入，或难灌浆，顶平形塌，或为黑陷，灰白色矣。惟
元气素壮，又能食者，必无是变。如气虚食少之人，未有不如是也，宜十全大补汤主
之。若虚甚者，则少加热附子可也。然服此而出赠痘者为吉。若寒战切牙，喘急肿满，
手足厥冷者，此为内脱，不治之症矣。
凡孕妇出痘，热能动胎，胎落则气血衰败而痘不能起发灌浆矣。故始终以安胎为
主，外用细软之帛，坚兜肚上，切不可用丁桂燥热之品，及食牛虱毒物之类，以致触
犯，其条芩、白术、艾叶、砂仁之类，与候相宜者，采而用之。其初发热，则以参苏欲
发之，痘既出后，则多服安胎饮保之。渴者，则用人参白术散加减，泄者则用黄芩汤
合四君子汤，内加诃子。血虚者，则以四物汤加牝药，色灰白而起发较迟者，则用十全
大补汤，去桂服之。总之，不问轻重，悉以清热安娠为主。更有孕妇出痘，正当盛时，
勿临正产者，热必气血俱虚，亦只以十全大补汤，大补气血为主，虚寒者少加热附。若
腹中微痛者，此恶路未尽也，宜四物汤加干姜，桂心、木香。黑痘，用熟地黄而去芍
药，盖恐寒凉有伤生气，然有当用者，酒炒用之。若寒战切牙，腹胀不渴，达足冷身热
者，此乃脾胃内虚，外作假热也，宜参、 、归、附、木香之类。一二剂而愈者，
吉。不者，凶。若孕妇肥胖者，则气居于表而欢于内也。人参可多，黄 宜少，多加带
壳缩砂，切忌脱蒂果子之类。至有痘浆收靥，忽作泄泻口渴饮水，小便短少，其痘胖
壮红润者，此内热也，宜用五苓散内加黄芩、芍药之类。若滑泄不止，食少腹胀而足
冷，痘色灰白，脉细无力者，此犯五虚必死之症也。
一凡方产之后，或半月左右，适逢出痘者，此无胎孕系累者，气血尚虚，治宜大补
荣卫为主。若痘出多者，则加连翘。粘子之类。大便自利者，则用肉果、炮姜之类。余
即照常一例而治，不必多疑，反生他误。至于孕妇出痘，在于初出之时，胎落者，则血
气虽为大虚，然热毒亦因走泄，兼之未经起胀灌浆，则血气未曾外耗。倘痘非险逆，加
以大补托里，每多可生。至于收靥之时，胎落者，则毒已出表，消散亦多无事，但重虚
而元气易脱，倍宜补益耳。若正当起胀灌浆而胎落者，则气血衰败，内外两虚，既不能
遂毒以外出，则毒必乘虚而内攻，为不救者多矣。
凡是女子一向患有崩漏（非经期阴道大量出血或淋漓不尽）且未停止，气血已经虚弱。如果此时再感染患疮疹（天花或水痘等出疹性疾病），则必然不能承受其毒邪，适宜使用十全大补汤，以补益气血为主。如果出现痘色灰白、平坦下陷，难以发出和灌浆的情况，加熟附子一两片，使体内正气充足，毒邪没有停留之处而自然能进食，自然能起胀，这样才可以保全生命，否则就会塌陷死亡，无法救治。另外，凡是在正当起发泡浆的时候，最适宜表里无病，饮食如常。如果遇到月经来潮超过三天而不止的人，人们只担心秽气触动胎元，却不知道身体中的血液一去，百脉之气都虚弱，毒邪乘虚陷入，或者难以灌浆，痘顶平、形体塌陷，或者变成黑陷，呈现灰白色。只有元气素来强壮，又能吃饭的人，必定不会有这种变化。如果是气虚食少的人，没有不这样的，适宜用十全大补汤主治。如果虚损严重的，那么稍微加热附子就可以了。然而服用此药后而出痘者为吉兆。如果出现寒战咬牙、喘急肿满、手足厥冷的情况，这是内脱症，属于不治之症。
凡是孕妇出痘，热邪会扰动胎元，胎元坠落则气血衰败而痘不能起发灌浆。所以始终以安胎为主，外用细软的布帛，紧紧兜住腹部，切不可使用丁香、肉桂等燥热的药物，以及食用牛虱毒物之类，以致触犯禁忌。像条芩（黄芩）、白术、艾叶、砂仁之类，与病情相宜的，选取使用。在初期发热时，则以参苏饮帮助发散；痘既发出后，则多服安胎饮保护胎元。口渴的，则用人参白术散加减；泄泻的则用黄芩汤合四君子汤，内部加入诃子。血虚的，则以四物汤加白芍；痘色灰白而起发较迟的，则用十全大补汤，去掉桂枝服用。总之，不问轻重，都以清热安胎为主。更有孕妇出痘，正当盛期，却遇到临产正产的，热邪必致气血俱虚，也只以十全大补汤，大补气血为主，虚寒者稍加热附子。如果腹中微痛，这是恶露未尽，适宜用四物汤加干姜、桂心、木香。黑痘，用熟地黄而去掉芍药，大概恐怕寒凉有伤生气，然而有应当用的，酒炒后使用。如果出现寒战咬牙、腹胀不渴、足冷身热的情况，这是脾胃内部虚弱，外部出现假热，适宜用人参、黄芪、当归、附子、木香之类。一二剂而痊愈的，为吉兆。不愈的，为凶兆。如果孕妇肥胖的，则气居于体表而壅滞于内部。人参可以多用，黄芪宜少用，多加带壳缩砂仁，切忌吃脱蒂果子之类。至于痘浆收靥（结痂脱落）时，忽然出现泄泻口渴饮水，小便短少，其痘胖壮红润的，这是内热，适宜用五苓散内部加黄芩、芍药之类。如果滑泄不止，食少腹胀而足冷，痘色灰白，脉细无力，这是犯五虚症，必死的病症。
凡是刚生产之后，或半个月左右，适逢出痘的，这是因为没有胎孕牵累，气血尚且虚弱，治疗适宜以大补营卫为主。如果痘出的多的，则加连翘、牛蒡子之类。大便自利的，则用肉豆蔻、炮姜之类。其余就照常一例而治，不必多疑，反而产生其他误治。至于孕妇出痘，在于初出之时，胎落（流产）的，则血气虽然为大虚，但热毒也因走泄而减轻，加之未经起胀灌浆，则血气未曾外耗。倘若痘不是险逆重症，加大补托里药，大多可以生还。至于收靥之时，胎落的，则毒已出表，消散也多无事，只是重伤虚损而元气容易脱失，倍加补益即可。如果正当起胀灌浆而胎落的，则气血衰败，内外两虚，既然不能随毒邪以外出，则毒邪必乘虚而内攻，成为不救的多矣。
Whenever a woman has been suffering from *beng lou* (metrorrhagia and metrostaxis, i.e., non-menstrual uterine bleeding) without cessation, her Qi and Blood are already deficient. If she subsequently contracts pox or rashes (such as smallpox or chickenpox), she will certainly not be able to withstand the pathogenic toxin. It is appropriate to use Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification) with the primary focus on tonifying Qi and Blood. If the lesions appear grayish-white, flat, and depressed, making it difficult for them to erupt and fill with pus, add one or two slices of Shu Fuzi (Prepared Aconite Root) to ensure sufficient interior Zheng Qi (Upright Qi), so that the toxin has no place to linger, allowing natural appetite and swelling to occur; only then can life be preserved. Otherwise, collapse will occur, leading to untreatable death. Furthermore, during the critical stage when blisters are forming and filling with fluid, it is most essential that there be no disease in the exterior or interior, and that diet remain normal. If menstruation persists for more than three days, people often worry about foul qi disturbing the fetus; however, they fail to realize that once blood is lost, the Qi of all vessels becomes deficient, allowing pathogenic toxins to sink in due to deficiency. This may result in difficulty in filling with pus, flat tops, collapsed forms, black depression, or grayish-white discoloration. Only those whose Yuan Qi (Primal Qi) is naturally robust and who have a good appetite will avoid such complications. For those with Qi deficiency and poor appetite, such outcomes are inevitable, and Shiquan Dabu Tang should be used as the main prescription. In cases of severe deficiency, adding a small amount of Jia Fuzi (Processed Aconite) is acceptable. However, if the patient recovers after taking this formula, it is an auspicious sign. Conversely, if symptoms include chills, teeth grinding, panting, swelling, and cold extremities, this indicates internal collapse (Nei Tuo), which is an untreatable condition.
In pregnant women contracting pox, heat can disturb the fetus; if the fetus falls, Qi and Blood decline, preventing the pox from erupting and filling with pus. Therefore, the treatment should always prioritize stabilizing the fetus. Externally, use soft cloth to firmly bind the abdomen. One must strictly avoid hot and drying herbs like Dingxiang (Clove) and Rongui (Cinnamon Bark), as well as toxic foods like cow lice, to prevent triggering complications. Herbs suitable for the condition, such as Tiao Qin (Scutellariae Radix, specifically strip-like Huangqin), Baizhu (Atractylodis Macrocephalae Rhizoma), Aye (Mugwort Leaf), and Sharen (Amomi Fructus), should be selected and used. During the initial fever stage, Shen Su Yin (Ginseng and Perilla Decoction) is used to promote eruption. After the pox appears, An Tai Yin (Fetus-Stabilizing Decoction) should be taken frequently to protect the fetus. For thirst, modify Ren Shen Bai Zhu San (Ginseng and Atractylodes Powder). For diarrhea, combine Huangqin Tang (Scutellaria Decoction) with Si Jun Zi Tang (Four Gentlemen Decoction), adding Hezi (Chebulae Fructus). For Blood deficiency, use Si Wu Tang (Four Substances Decoction) with added Mu Yao (Paeoniae Radix Alba, White Peony Root). For grayish-white pox with delayed eruption, use Shiquan Dabu Tang but remove Guizhi (Cinnamon Twig). In summary, regardless of severity, the primary approach is clearing heat and stabilizing the pregnancy. In cases where a pregnant woman with severe pox goes into labor, the heat causes both Qi and Blood to become deficient; thus, Shiquan Dabu Tang is used to greatly tonify Qi and Blood, with a small addition of Jia Fuzi for deficiency-cold. If there is slight abdominal pain, it indicates incomplete expulsion of lochia; use Si Wu Tang with Ganjiang (Zingiberis Rhizoma, Dried Ginger), Guixin (Cinnamomi Cortex), and Muxiang (Aucklandiae Radix). For black pox, use Shu Dihuang (Rehmanniae Radix Praeparata) but remove Shaoyao (Paeoniae Radix), fearing that cold-natured herbs might damage the vital generating Qi; however, if indicated, use Jiuchao (Wine-fried) preparations. If chills, teeth grinding, abdominal distension without thirst, cold feet, and body heat occur, this indicates Spleen-Stomach interior deficiency presenting as exterior false heat; use Ren Shen (Ginseng), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Fuzi (Aconiti Lateralis Radix Praeparata), and Muxiang. Recovery within one or two doses is auspicious; otherwise, it is ominous. For obese pregnant women, Qi resides at the exterior and stagnates internally; Ren Shen dosage can be higher, while Huangqi should be lower, with increased Daikesuosha (Amomi Fructus Cum Calice, Amomum with husk). Avoid fruits detached from their stems. When the pox crusts fall off, sudden diarrhea, thirst with drinking, and scanty urine indicate interior heat; use Wuling San (Five-Ingredient Powder with Poria) with added Huangqin and Shaoyao. If sliding diarrhea persists, accompanied by poor appetite, abdominal distension, cold feet, grayish-white pox, and a fine, forceless pulse, this constitutes the "Five Deficiencies" syndrome, which is fatal.
For women who contract pox shortly after childbirth (around half a month later), since there is no fetal burden, Qi and Blood remain deficient; treatment should primarily focus on greatly tonifying Ying (Nutritive Qi) and Wei (Defensive Qi). If many pox erupt, add Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus). If spontaneous loose stools occur, use Rouguou (Myristicae Semen) and Paojiang (Zingiberis Rhizoma Preparatum, Fried Ginger). Otherwise, treat according to standard protocols without excessive doubt to avoid further errors. Regarding pregnant women with pox: if miscarriage occurs during the initial eruption phase, although Qi and Blood are severely deficient, the heat-toxin is also expelled through bleeding, and since the pox has not yet swollen or filled with pus, external consumption of Qi and Blood has not occurred. If the pox is not dangerous or adverse, using strong tonifying and supporting interior formulas often leads to survival. If miscarriage occurs during the crusting phase, the toxin has emerged to the exterior and dissipates with little issue; however, due to severe deficiency, Yuan Qi is prone to collapse, requiring doubled tonification efforts. If miscarriage occurs precisely when the pox is swelling and filling with pus, Qi and Blood are exhausted, resulting in both interior and exterior deficiency. Since the toxin cannot exit outward with the Qi and Blood, it attacks inward due to deficiency, leading to untreatable conditions in most cases.