〔万〕疮疹渴者，里热也。盖三焦者，水谷之道路，津液者，水谷之精华，变化流行，以灌溉乎三焦也。
疮疹之火起之于内，销烁水谷，不得以变化津液，灌溉脏腑，故渴也。又疮本稠密，津液外泄，化为脓浆，
不能滋养真气，亦渴也。小渴者，
常病也，不须治之，大渴者，视其虚实以法治之，切不可以冷水、红柿、梨、橘、西瓜、等物与之，恐损脾胃，
致生灾异也。〔薛〕前证，若二便自调，饮食温和，口渴饮汤，手足不热，是为虚热，不可食生冷之物。若
二便秘结，饮食喜冷，口渴饮水，手足并热，是为实热，可与冷水饮之。凡痘出而热未止者，既出尽，则热自止。
如发热时便大渴者，热在里也，葛根解毒汤主之，不止，更加黄连以泻心火之有余，黄柏、知母、以滋肾
水之不足，舌润则生，舌如芒刺则死。盖舌乃心之苗，少阴之脉，荣于舌也，如发热自利而渴者，津液不足也，黄芩
汤加人参、白术、麦门冬主之。丹溪云∶初热烦躁渴引饮者，急以凉药解其标。钱氏云∶身热烦渴，
腹满而喘，大小便涩而赤，闷乱大吐，此当利小便，不瘥者，宣风散下之。
葛根解毒汤
葛粉 天花粉 麦门冬 生地黄 升麻（各等分） 甘草（减半）
上锉细。取糯米泔水一盏，煎七分，去滓，入茅根自然汁一合，服之。
黄芩汤（痘泄利） 五苓散（惊） 宣风散（痘发热）
如疮已出，或起发，或收靥，一向渴不止者，人参麦门冬散主之。海藏云∶若身热小渴者，六味人参麦门冬
散治之。如不愈，或身热大渴者，七味人参白术散治之。又不愈，十一味木香散。
人参麦门冬散
麦门冬 葛粉（各二钱） 人参 甘草 升麻 白术（各一钱）
上锉细。加粳米一合，淡竹叶七片，水一盏，煎米熟，去滓温服。
六味人参麦门冬散
麦门冬（去心，一两） 人参（去芦） 甘草（炙） 陈皮 白术 浓朴（姜制。各半两）
上 咀。每服三钱，水一盏，煎至六分，去滓温服。虚人减浓朴。
〔庞氏〕 地黄膏（见形）
退火回生散 治痘血热，枯涩发渴。
滑石 辰砂（各一钱） 冰片（三厘）
上为细末。冷水调服一分，睡片时，必转红活矣。
如能食而渴者，肺热也。经曰∶心移热于肺，传为膈消，由心火上炎，乘于肺
金，熏蒸焦膈，传耗津液，故渴也。治在上焦，人参白虎汤加黄连主之。
人参白虎汤（又名化 汤）
人参 甘草（各一钱） 知母（三钱） 石膏（五钱） 粳米（一合）
上锉细。水二盏，煎待米熟，去滓温服，无时。
竹叶石膏汤 治痘疮表里俱虚，胸中烦闷，小便赤涩，多渴。成赤 点者，又宜服犀角散。
石膏 知母（各二两） 麦门冬 甘草（各一两）
上锉散。每服三钱，水一盏，淡竹叶一握，煎半盏，温服，不拘时。
麦门冬汤 治 疹烦渴吐泻，及痂后余热。
麦门冬 人参 甘菊 赤芍药 赤茯苓 升麻（各一钱） 甘草（五分） 石膏（三钱）
上，用水煎服。
如不能食而渴者，脾虚也。叔和云∶口干，饶饮水，多食亦饥，虚由脾素弱，
不能为胃行其津液，故渴也。治在中焦，参苓白术散主之。
人参白术散（又名参苓白术散）
人参 白术 藿香 木香 甘草 白伏苓（各一钱） 干葛（二钱）
上锉细。加生姜一片，水一盏，煎七分，去滓，温服无时。
〔丹〕陈十妹、年二十岁，出痘，而有孕七个半月，大渴，不甚出透，寒热交作，血虚气虚。
人参 白术 黄 陈皮 甘草（炙） 当归身（各一钱）
姜三片，酒水各半盏，煎服。
自利而渴，轻则人参白术散，甚则陈氏木香散。自利而渴者邪传肾也，《正理论》云∶自利而渴者，属
少阴虚，故引水自救，盖肾主五液，其脉络于肺，系舌本，邪传于肾，则开阖不司，故自利，利则津液
下走，肾水干，不能上润于舌，故大渴也，治在下焦，宜温之，陈氏异攻散主之（出不快）。
面白腹胀，自利而渴者，陈氏十一味木香散主之。文中云∶腹胀渴者，泻渴者，足指冷渴者，惊悸渴者，
身温渴者，身热面 白色渴者，寒战渴不止者，气急切牙渴者，饮水转水泻不已者，以上九证，即非热也，
乃津液少，脾胃肌肉虚故也，宜木香散治之。如不愈，更加丁香、官桂。（此说，必加审用之，胀渴、泻渴、惊
悸渴、寒战渴、切牙
渴、亦多属热者，不可不察）如渴而大便秘者，宜利之，四顺清凉饮主之（热）。海藏云∶疮疹大
肠闭涩，或发热，四君子加栝蒌根、桔梗主之。
痘子稠密，津液少者，十全大补汤（汗）。
生脉散 止烦渴，首尾通用。
人参 五味子 麦门冬
水煎，当茶饮。
神功散 治痘作渴。
人参 黄 甘草 牛蒡子 红花 生地黄 前胡 紫草 白芍药
上，水煎服。
红花汤 治同上。
红花或子，随意煎汤饮，其渴即止，纵口中如烟，饮之即止。加牛蒡子尤妙。
【万全论述】疮疹出现口渴，是因为体内有热。三焦是水谷运行的通道，津液是水谷化生的精华，它们变化流行，以此灌溉三焦。
疮疹之火从体内发起，消耗水谷，导致无法化生津液来灌溉脏腑，所以产生口渴。另外，疮疹如果稠密，津液外泄化为脓浆，不能滋养真气，也会引起口渴。轻微口渴是常见病症，不需要治疗；严重口渴，要根据虚实情况用相应方法治疗，千万不要给患者喝冷水、吃红柿、梨、橘子、西瓜等食物，恐怕损伤脾胃，导致病情恶化。
【薛己论述】上述症状，如果大小便正常，饮食温和，口渴想喝热水，手脚不发热，这是虚热，不能吃生冷食物。如果大小便便秘，喜欢冷食，口渴想喝水，手脚都发热，这是实热，可以喝冷水。凡是痘疮发出后热势未停的，等痘疮出齐了，热势自然停止。如果在发热时大便通畅但极度口渴，说明热在里，用葛根解毒汤主治；如果无效，再加黄连以清泻心火有余，加黄柏、知母以滋补肾水不足，舌苔湿润则生，舌面如芒刺则死。因为舌是心的苗窍，少阴经脉荣养于舌。如果发热且自利（腹泻）而口渴，是津液不足，用黄芩汤加人参、白术、麦门冬主治。朱丹溪说：初起发热烦躁、口渴引饮的，急用凉药解其标证。钱乙说：身体发热烦渴，腹部胀满气喘，大小便涩滞且色赤，闷乱剧烈呕吐，这应当通利小便，如果不愈，用宣风散攻下。
葛根解毒汤
葛粉、天花粉、麦门冬、生地黄、升麻（各等分），甘草（减半）。
以上药材切碎。取糯米淘米水一盏，煎至七分，去渣，加入茅根自然汁一合，服用。
黄芩汤（用于痘疮泄利）、五苓散（用于惊风）、宣风散（用于痘疮发热）。
如果疮疹已经发出，或正在起发，或正在结痂，一直口渴不止的，用人参麦门冬散主治。张元素（海藏）说：如果身体发热轻微口渴的，用六味人参麦门冬散治疗。如果不好，或者身体发热严重口渴的，用七味人参白术散治疗。如果还不好，用十一味木香散。
人参麦门冬散
麦门冬、葛粉（各二钱），人参、甘草、升麻、白术（各一钱）。
以上药材切碎。加粳米一合，淡竹叶七片，水一盏，煎至米熟，去渣温服。
六味人参麦门冬散
麦门冬（去心，一两），人参（去芦），甘草（炙），陈皮，白术，浓朴（姜制，各半两）。
以上药材切碎。每次服三钱，水一盏，煎至六分，去渣温服。体虚者减少浓朴用量。
【庞氏论述】地黄膏（见于见形期）。
退火回生散：治疗痘疮血热，干枯涩滞引起的口渴。
滑石、辰砂（各一钱），冰片（三厘）。
以上研为细末。用冷水调服一分，睡一会儿，痘疮必然转为红活。
如果能进食而口渴，是肺热。经书说：心将热移于肺，传变为膈消，由于心火上炎，乘袭肺金，熏蒸胸膈，耗伤津液，所以口渴。病位在上焦，用人参白虎汤加黄连主治。
人参白虎汤（又名化斑汤）
人参、甘草（各一钱），知母（三钱），石膏（五钱），粳米（一合）。
以上切碎。水二盏，煎至米熟，去渣温服，不限时间。
竹叶石膏汤：治疗痘疮表里俱虚，胸中烦闷，小便赤涩，多渴。若出现赤斑，又宜服用犀角散。
石膏、知母（各二两），麦门冬、甘草（各一两）。
以上切碎。每次服三钱，水一盏，淡竹叶一把，煎至半盏，温服，不限时间。
麦门冬汤：治疗麻疹烦渴吐泻，以及结痂后的余热。
麦门冬、人参、甘菊、赤芍药、赤茯苓、升麻（各一钱），甘草（五分），石膏（三钱）。
以上用水煎服。
如果不能进食而口渴，是脾虚。王叔和说：口干，频繁饮水，多吃也感到饥饿，这是因为脾素来虚弱，不能为胃行使其津液，所以口渴。病位在中焦，用参苓白术散主治。
人参白术散（又名参苓白术散）
人参、白术、藿香、木香、甘草、白茯苓（各一钱），干葛（二钱）。
以上切碎。加生姜一片，水一盏，煎至七分，去渣，温服，不限时间。
【丹波氏记载】陈十妹，二十岁，出痘，怀孕七个半月，大渴，痘出不透，寒热交替，属于血虚气虚。
人参、白术、黄芪、陈皮、甘草（炙）、当归身（各一钱）。
姜三片，酒和水各半盏，煎服。
自利（腹泻）而口渴，轻症用人参白术散，重症用陈氏木香散。自利而口渴是邪气传入肾，《正理论》说：自利而口渴，属于少阴虚，所以引水自救。因为肾主五液，其脉络联系于肺，系于舌本，邪气传入肾，则开阖功能失调，所以自利，利则津液下走，肾水干燥，不能上润于舌，所以大渴。病位在下焦，宜温补，用陈氏异攻散主治（用于痘出不快）。
面色苍白腹胀，自利而口渴的，用陈氏十一味木香散主治。文中说：腹胀渴、腹泻渴、脚趾冷渴、惊悸渴、身体温渴、身体热面色白渴、寒战渴不止、气急咬牙渴、饮水后转水泻不已者，以上九种证候，都不是热证，而是津液少，脾胃肌肉虚弱所致，宜用木香散治疗。如果不好，再加丁香、官桂。（此说法必须审慎使用，腹胀渴、腹泻渴、惊悸渴、寒战渴、咬牙渴，也多属于热证，不可不仔细辨别。）如果口渴且大便秘结，宜通利，用四顺清凉饮主治（属热证）。张元素说：痘疮大肠闭涩，或发热，用四君子汤加栝蒌根、桔梗主治。
痘子稠密，津液少的，用十全大补汤（用于汗后）。
生脉散：止烦渴，病程始终通用。
人参、五味子、麦门冬。
水煎，当茶饮用。
[Wan Quan's Discussion] Thirst occurring during the eruption of sores and rashes is due to internal heat. The San Jiao (Triple Burner) is the pathway for food and fluids; Jin Ye (Body Fluids) are the essence derived from food and fluids, which transform and circulate to irrigate the San Jiao.
The fire of sores and rashes arises from within, consuming food and fluids, preventing the transformation of Jin Ye to irrigate the Zang-Fu organs, thus causing thirst. Furthermore, if the sores are dense, Jin Ye leaks outward and transforms into pus, failing to nourish the True Qi, which also causes thirst. Mild thirst is a common condition and requires no treatment; severe thirst should be treated according to deficiency or excess. One must absolutely not give cold water, persimmons, pears, oranges, watermelons, etc., as this may damage the Spleen and Stomach, leading to adverse outcomes.
[Xue Ji's Discussion] Regarding the aforementioned symptoms: if urination and defecation are normal, diet is moderate, thirst is relieved by drinking hot water, and the hands and feet are not hot, this indicates Deficient Heat; raw and cold foods should be avoided. If there is constipation in both bowels and urine, a preference for cold food, thirst relieved by drinking water, and heat in both hands and feet, this indicates Excess Heat; cold water may be given. Generally, when fever persists after the eruption of smallpox, it will cease naturally once the eruption is complete. If there is profuse thirst during fever with normal bowel movements, the heat is in the interior; Ge Gen Jie Du Tang (Kudzu Root Detoxification Decoction) is the primary formula. If ineffective, add Huang Lian (Coptis Rhizome) to drain excess Heart Fire, and add Huang Bai (Phellodendron Bark) and Zhi Mu (Anemarrhena Rhizome) to nourish deficient Kidney Water. A moist tongue indicates survival; a tongue covered with prickles like thorns indicates death. The tongue is the sprout of the Heart, and the Shaoyin Meridian nourishes the tongue. If there is fever, spontaneous diarrhea, and thirst, it indicates insufficiency of Jin Ye; Huang Qin Tang (Scutellaria Decoction) added with Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), and Mai Men Dong (Ophiopogon Tuber) is indicated. Dan Xi stated: In the initial stage, if there is fever, restlessness, and intense thirst, urgently use cooling herbs to resolve the branch symptoms. Qian Yi stated: If there is body heat, irritability, and thirst, abdominal distension, panting, astringent and red urine and stool, severe distress, and vomiting, one should promote urination. If unimproved, use Xuan Feng San (Promoting Wind Powder) to purge.
Ge Gen Jie Du Tang (Kudzu Root Detoxification Decoction)
Ge Fen (Puerariae Radix Powder), Tian Hua Fen (Trichosanthis Radix), Mai Men Dong (Ophiopogonis Tuber), Sheng Di Huang (Rehmanniae Radix), Sheng Ma (Cimicifugae Rhizoma) (equal parts); Gan Cao (Licorice Root) (half dose).
Crush finely. Take one cup of rice washing water, decoct until reduced to 70%, remove dregs, add one heaping spoon of fresh juice from Imperata root, and take orally.
Huang Qin Tang (for smallpox diarrhea), Wu Ling San (for fright/convulsions), Xuan Feng San (for smallpox fever).
If the sores have erupted, or are rising, or are crusting over, but thirst persists continuously, Ren Shen Mai Men Dong San (Ginseng and Ophiopogon Powder) is indicated. Hai Zang (Zhang Yuansu) stated: If there is mild body heat and slight thirst, Liu Wei Ren Shen Mai Men Dong San (Six-Ingredient Ginseng and Ophiopogon Powder) treats it. If unimproved, or if there is high body heat and severe thirst, Qi Wei Ren Shen Bai Zhu San (Seven-Ingredient Ginseng and Atractylodes Powder) treats it. If still unimproved, use Shi Yi Wei Mu Xiang San (Eleven-Ingredient Costus Powder).
Ren Shen Mai Men Dong San (Ginseng and Ophiopogon Powder)
Mai Men Dong (Ophiopogonis Tuber), Ge Fen (Puerariae Radix Powder) (each 2 qian); Ren Shen (Ginseng), Gan Cao (Licorice Root), Sheng Ma (Cimicifugae Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 1 qian).
Crush finely. Add one heaping spoon of Jing Mi (Rice), seven leaves of Dan Zhu Ye (Lophatherum Herb), one cup of water, decoct until the rice is cooked, remove dregs, and take warm.
Liu Wei Ren Shen Mai Men Dong San (Six-Ingredient Ginseng and Ophiopogon Powder)
Mai Men Dong (Ophiopogonis Tuber) (decored, 1 liang), Ren Shen (Ginseng) (remove rhizome), Gan Cao (Licorice Root) (roasted), Chen Pi (Citrus Reticulatae Pericarpium), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Hou Po (Magnoliae Officinalis Cortex) (processed with ginger, each half liang).
Chop finely. Take 3 qian per dose, one cup of water, decoct until reduced to 60%, remove dregs, and take warm. Reduce Hou Po dosage for deficient patients.
[Pang Anshi's Discussion] Di Huang Gao (Rehmannia Paste) (seen during the manifestation stage).
Tui Huo Hui Sheng San (Retreating Fire and Reviving Life Powder): Treats thirst caused by blood heat and dryness/astringency in smallpox.
Hua Shi (Talcum), Chen Sha (Cinnabar) (each 1 qian), Bing Pian (Borneolum Syntheticum) (3 li).
Grind into fine powder. Mix with cold water, take 1 fen, sleep for a while, and the sores will surely turn red and vibrant.
If the patient can eat but feels thirsty, it is Lung Heat. The Classics state: "Heart transfers heat to the Lung, transmitting as Ge Xiao (Diaphragmatic Consumption)." This occurs because Heart Fire flares upward, attacking Lung Metal, steaming the diaphragm, and consuming Jin Ye, thus causing thirst. The pathology is in the Upper Jiao; Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction) added with Huang Lian is indicated.
Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction) (also known as Hua Ban Tang)
Ren Shen (Ginseng), Gan Cao (Licorice Root) (each 1 qian), Zhi Mu (Anemarrhenae Rhizoma) (3 qian), Shi Gao (Gypsum Fibrosum) (5 qian), Jing Mi (Rice) (one heaping spoon).
Crush finely. Two cups of water, decoct until the rice is cooked, remove dregs, and take warm at any time.
Zhu Ye Shi Gao Tang (Lophatherum and Gypsum Decoction): Treats smallpox with deficiency in both exterior and interior, chest oppression, red and astringent urine, and excessive thirst. If red macules appear, Xi Jiao San (Rhinoceros Horn Powder) is suitable.
Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma) (each 2 liang), Mai Men Dong (Ophiopogonis Tuber), Gan Cao (Licorice Root) (each 1 liang).
Crush into powder. Take 3 qian per dose, one cup of water, a handful of Dan Zhu Ye (Lophatherum Herb), decoct until half a cup remains, take warm, at any time.
Mai Men Dong Tang (Ophiopogon Decoction): Treats measles with irritability, thirst, vomiting, and diarrhea, as well as residual heat after crusting.
Mai Men Dong (Ophiopogonis Tuber), Ren Shen (Ginseng), Gan Ju (Chrysanthemi Flos), Chi Shao Yao (Paeoniae Radix Rubra), Chi Fu Ling (Poria with Red Mycelium), Sheng Ma (Cimicifugae Rhizoma) (each 1 qian), Gan Cao (Licorice Root) (5 fen), Shi Gao (Gypsum Fibrosum) (3 qian).
Decoct in water and take orally.
If the patient cannot eat but feels thirsty, it is Spleen Deficiency. He Chao (Wang Shuhe) stated: "Dry mouth, frequent desire to drink, hunger despite eating much," is due to inherent Spleen weakness, unable to transport and transform Jin Ye for the Stomach, thus causing thirst. The pathology is in the Middle Jiao; Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Powder) is indicated.
Ren Shen Bai Zhu San (Ginseng and Atractylodes Powder) (also known as Shen Ling Bai Zhu San)
Ren Shen (Ginseng), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huo Xiang (Agastaches Herba), Mu Xiang (Aucklandiae Radix), Gan Cao (Licorice Root), Bai Fu Ling (Poria), Ge Gen (Puerariae Lobatae Radix) (each 1 qian).
Crush finely. Add one slice of Sheng Jiang (Zingiberis Rhizoma Recens), one cup of water, decoct until reduced to 70%, remove dregs, and take warm at any time.
[Dan Bo's Record] Chen Shimei, aged twenty, suffering from smallpox, pregnant for seven and a half months, experiencing severe thirst, incomplete eruption, alternating chills and fever, indicating Blood and Qi deficiency.
Ren Shen (Ginseng), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), Chen Pi (Citrus Reticulatae Pericarpium), Gan Cao (Licorice Root) (roasted), Dang Gui Shen (Angelicae Sinensis Radix) (each 1 qian).
Three slices of Sheng Jiang (Zingiberis Rhizoma Recens), half a cup of wine and half a cup of water, decoct and take.
Spontaneous diarrhea with thirst: mild cases use Ren Shen Bai Zhu San; severe cases use Chen Shi Mu Xiang San. Spontaneous diarrhea with thirst indicates pathogen transmission to the Kidney. Zheng Li Lun states: "Spontaneous diarrhea with thirst belongs to Shaoyin Deficiency," hence the desire to drink water to save oneself. The Kidney governs the five fluids, its meridians connect to the Lung, and its vessels tie to the base of the tongue. When pathogen transmits to the Kidney, opening and closing functions fail, causing spontaneous diarrhea; fluids flow downward, Kidney Water dries up, and cannot moisten the tongue upward, causing severe thirst. The pathology is in the Lower Jiao, suitable for warming; Chen Shi Yi Gong San (Chen's Yi Gong Powder) is indicated (for slow eruption).
Pale complexion, abdominal distension, spontaneous diarrhea with thirst: Chen Shi Shi Yi Wei Mu Xiang San (Chen's Eleven-Ingredient Costus Powder) is indicated. The text states: Abdominal distension with thirst, diarrhea with thirst, cold toes with thirst, palpitations with fright with thirst, warm body with thirst, body heat with pale face with thirst, uncontrollable chills with thirst, urgent breathing with clenched teeth with thirst, drinking water turning immediately into watery diarrhea without cessation—these nine syndromes are not Heat, but rather insufficient Jin Ye and deficiency of Spleen/Stomach muscles. Mu Xiang San is suitable. If unimproved, add Ding Xiang (Caryophylli Flos) and Guan Gui (Cinnamomi Cortex). (Note: This view must be applied cautiously; abdominal distension with thirst, diarrhea with thirst, palpitations with fright with thirst, chills with thirst, and clenched teeth with thirst often belong to Heat, so careful differentiation is required.) If thirst accompanies constipation, promotion of urination/purging is suitable; Si Shun Qing Liang Yin (Four Compliance Cooling Drink) is indicated (Heat). Hai Zang stated: For smallpox with large intestine obstruction or fever, Si Jun Zi Tang (Four Gentlemen Decoction) added with Gua Lou Gen (Trichosanthis Radix) and Jie Geng (Platycodonis Radix) is indicated.
Dense smallpox with insufficient Jin Ye: Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) (after sweating).
Sheng Mai San (Generate Pulse Powder): Stops irritability and thirst, applicable throughout the course.
Ren Shen (Ginseng), Wu Wei Zi (Schisandrae Fructus), Mai Men Dong (Ophiopogonis Tuber).
Decoct in water, drink as tea.
Shen Gong San (Divine Efficacy Powder): Treats thirst in smallpox.
Ren Shen (Ginseng), Huang Qi (Astragali Radix), Gan Cao (Licorice Root), Niu Bang Zi (Arctii Fructus), Hong Hua (Carthami Flos), Sheng Di Huang (Rehmanniae Radix), Qian Hu (Peucedani Radix), Zi Cao (Arnebiae Radix), Bai Shao Yao (Paeoniae Radix Alba).
Decoct in water and take orally.
Hong Hua Tang (Safflower Decoction): Treatment same as above.
Hong Hua (Carthami Flos) or Hong Hua Zi (Carthami Semen), decoct in water as desired; thirst will cease immediately. Even if the mouth feels smoky, drinking it stops the sensation. Adding Niu Bang Zi is particularly effective.