痘疮作痒者，当先分明皮肤。皮是皮，肤是肤，皮肤不分，如何能明痘疮作痒之本源？
如人
津液尽归于皮之外，肤之内。痘窠之中，正气虚，不能达痘中行浆、化脓、结痂，以致瘟毒
外不得出肤，内不得入皮，毒在皮外肤里，故作痒。医家遵《素问》“诸疮痛痒，皆属于火
”之句，随用清凉之品，克伐生气，不但作痒不止，胃气转伤。有专用补气者，气愈补而血
愈瘀。血瘀，气更不能外达于皮肤。斑此时用补气破血之剂，通开血道，气直达于皮肤，未
有不一药而痒即止者。
此方无论痘形攒簇，蒙头覆釜，周身细碎成片，或夹疹夹斑，浮衣水泡，其色或紫、或
暗、
其方中药性，不大寒大热，不大攻大下，真是良方也。
桃仁（八钱，研） 红花（四钱） 赤芍（三钱） 山甲（四钱，炒） 皂刺（六钱） 连翘（三
钱，去心） 地龙（三钱，去心） 柴胡（一钱） 麝香（三厘，绢包）
水煎服。
大便干燥，加大黄二钱，便利去之。五六日后，见清浆、白浆，将麝香去之，加黄 五
钱，
若一二岁，分两可减半，若八九岁，分两可加一半。
方歌
通经甲皂麝香龙，逐瘀赤芍桃与红，
连翘柴胡毒可解，便干微用大黄攻。
此方治痘五六天后，饮水即呛。
桃仁（五钱，炒） 红花（五钱） 甘草（三钱） 桔梗（三钱） 生地（四钱） 当归（二钱）
元参（一钱） 柴胡（一钱） 枳壳（二钱） 赤芍（二钱）
水煎服。
此方指五六天后呛水而言。若痘后抽风兼饮水即呛者，乃气虚不能使会厌盖严气管，照
抽风方治之。
方歌
会厌逐瘀是病源，桃红甘桔地归元，
柴胡枳壳赤芍药，水呛血凝立可痊。
痘疮出现瘙痒症状时，应当首先明确区分皮肤的概念。皮与肤是不同的，如果不加区分，如何能阐明痘疮作痒的根本原因？
当人体的津液全部汇聚在皮之外、肤之内的区域时，痘窠（痘疹的凹陷处）内部正气虚弱，无法推动痘疹行浆、化脓和结痂，导致瘟毒向外不能透达于肤，向内不能深入于皮，毒邪郁结在皮外肤里，因此产生瘙痒。
医生们遵循《素问》中“各种疮疡的疼痛和瘙痒，都归属于火”的说法，随即使用清凉的药物，克制伐伤人体的生气，不仅不能止痒，反而损伤了胃气。有的医生专门使用补气的方法，结果气越补，血液瘀滞就越严重。血液瘀滞，气就更不能向外通达于皮肤。此时对于斑疹，应当使用补气破血的方剂，疏通血脉通道，使气能够直接到达皮肤，没有服用一剂药后瘙痒就停止不了的。
这个方子无论痘形是聚集成簇，还是像倒扣的锅一样覆盖头部，或是周身细碎成片，或者夹杂疹子和斑疹，呈现浮衣水泡状，颜色或者是紫色、或者是暗色，方中的药物性质，既不大寒也不大热，既不猛烈攻下也不峻猛泻下，确实是良方。
桃仁（八钱，研磨），红花（四钱），赤芍（三钱），穿山甲（四钱，炒制），皂角刺（六钱），连翘（三钱，去心），地龙（三钱，去心），柴胡（一钱），麝香（三厘，用绢布包裹）。
用水煎服。
如果大便干燥，加大黄二钱；如果大便通畅，则去掉大黄。服药五六日后，见到清浆、白浆，将麝香去掉，加入黄芪五钱。
如果是两三岁的孩子，剂量可以减少一半；如果是八九岁的孩子，剂量可以增加一半。
方歌：
通经甲皂麝香龙，逐瘀赤芍桃与红，
连翘柴胡毒可解，便干微用大黄攻。
此方治疗痘疮发病五六天后，饮水即发生呛咳的症状。
桃仁（五钱，炒制），红花（五钱），甘草（三钱），桔梗（三钱），生地黄（四钱），当归（二钱），玄参（一钱），柴胡（一钱），枳壳（二钱），赤芍（二钱）。
用水煎服。
此方针对的是痘疮发病五六天后出现的饮水呛咳症状。如果是痘后出现抽搐惊风并兼有饮水即呛的情况，这是由于气虚不能使会厌严密盖住气管所致，应参照治疗抽风的方剂进行治疗。
When chickenpox lesions present with itching, it is essential to first clearly distinguish between the skin layers. The epidermis (skin surface) and dermis (subcutaneous tissue) are distinct; without this distinction, one cannot understand the root cause of itching in chickenpox.
When body fluids accumulate entirely outside the epidermis and inside the dermis, the qi within the pock pits (depressions of the lesions) becomes deficient. This deficiency prevents the progression of pus formation, suppuration, and scabbing. Consequently, the epidemic toxin cannot exit outward through the dermis nor enter inward into the epidermis. The toxin remains trapped between the outer epidermis and inner dermis, causing itching.
Physicians, adhering to the *Suwen* principle that "all sores and ulcers involving pain and itching belong to fire," often indiscriminately use cooling agents. This suppresses the vital qi, failing to stop the itching while further damaging stomach qi. Others rely solely on tonifying qi, which exacerbates blood stasis. As blood stasis worsens, qi is even less able to reach the skin. For macules at this stage, a formula combining qi-tonifying and blood-breaking properties should be used to unblock the blood vessels, allowing qi to directly reach the skin. There is no case where such a single dose fails to immediately cease the itching.
This formula is effective regardless of whether the lesions are clustered, covering the head like an inverted pot, scattered finely across the body, or accompanied by rashes and macules presenting as vesicles. Whether the color is purple or dark, the herbs in this prescription are neither excessively cold nor hot, nor do they aggressively purge or downbear. It is indeed an excellent formula.
* Tao Ren (Persicae Semen, 8 qian, ground)
* Hong Hua (Carthami Flos, 4 qian)
* Chi Shao (Paeoniae Radix Rubra, 3 qian)
* Shan Jia (Homo Squama, 4 qian, stir-fried)
* Zao Ci (Gleditsiae Spina, 6 qian)
* Lian Qiao (Forsythiae Fructus, 3 qian, heart removed)
* Di Long (Pheretima, 3 qian, heart removed)
* Chai Hu (Bupleuri Radix, 1 qian)
* She Xiang (Moschus, 3 li, wrapped in silk)
Decoct in water and take orally.
If stool is dry, add Da Huang (Rhei Radix et Rhizoma, 2 qian); if bowel movements are normal, remove Da Huang. After five to six days, when clear or white pus appears, remove She Xiang and add Huang Qi (Astragali Radix, 5 qian).
For children aged two or three, halve the dosage; for children aged eight or nine, increase the dosage by half.
Formula Verse:
Tong Jing uses Shan Jia, Zao Ci, She Xiang, and Di Long,
Zhu Yu employs Chi Shao, Tao Ren, and Hong Hong.
Lian Qiao and Chai Hu resolve the toxin,
If stool is dry, use a little Da Huang to purge.
This formula treats choking upon drinking that occurs five to six days after the onset of chickenpox.
* Tao Ren (Persicae Semen, 5 qian, stir-fried)
* Hong Hua (Carthami Flos, 5 qian)
* Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian)
* Jie Geng (Platycodonis Radix, 3 qian)
* Sheng Di Huang (Rehmanniae Radix Praeparata, 4 qian)
* Dang Gui (Angelicae Sinensis Radix, 2 qian)
* Yuan Shen (Scrophulariae Radix, 1 qian)
* Chai Hu (Bupleuri Radix, 1 qian)
* Zhi Ke (Aurantii Fructus Immaturus, 2 qian)
* Chi Shao (Paeoniae Radix Rubra, 2 qian)
Decoct in water and take orally.
This formula specifically addresses choking upon drinking occurring five to six days post-onset. If convulsions occur after chickenpox accompanied by choking upon drinking, this is due to qi deficiency failing to allow the epiglottis to tightly cover the trachea. In such cases, treat according to formulas for convulsions.
Formula Verse:
Hui Yan Zhu Yu targets the disease source,
Tao Ren, Hong Hua, Gan Cao, Jie Geng, Sheng Di, Dang Gui, and Yuan Shen.
Chai Hu, Zhi Ke, and Chi Shao,
Choking from water and blood stasis will heal immediately.