夫人习尚不同。趋舍各异。痘疹一门。向得涵高兄采辑诸家方论。备列医通。其间方药多有
以意参易者。惜乎笔削未竣。完璧难求。志儿心折其学。因命续貂。系以麻疹诸例。庶不失先哲
二者并名之义云。
小儿在胎时。食母五脏血秽。生后其毒当出。故痘疹所发。皆五脏之液。肝水泡。其色青小。
肺脓泡。色白而大。心为斑。其色赤小。脾为疹。其色赤黄。疮疹欲出。五脏证具。惟肾无候。
但耳凉尻冷是也。疮疹出时。辨视轻重。一发便出尽者。必重也。疮夹疹者。半轻半重也。出稀
者轻。里外微红者轻。外黑里赤者。微重也。外白里黑者。大重也。疹端里黑点如针孔者。势甚
也。青干紫陷。昏睡汗出不止。烦躁热渴。腹胀啼喘。大小便不通者。困极也。凡疮疹当令乳母
慎口。不可令饥。及受风冷。致归肾变黑难治也。有大热当利小便。有小热宜解毒。若黑紫干陷者。
百祥丸下之。不黑者慎勿下。更看时月轻重。大抵痘疹属阳。出则春夏为顺。秋冬为逆。又当辨
春脓泡。夏黑陷。秋斑。冬疹。亦不顺也。黑者。无问何时。十难救一。其候寒战噤牙。或身黄
肿紫。急宜百祥丸下之。复恶寒不已。身冷汗出。耳尻反热者死。肾气大旺。脾虚不能制故也。
下后身热气温。欲饮水者可治。脾旺胜肾。寒去而温热也。治之宜解毒。不可妄下。下则内虚。多归于肾。
若能食而痂头焦起。或未焦而喘。实者。四顺清凉饮下之。若身热烦渴。腹满而喘。大小便涩。
面赤闷乱大吐。此当利小便。不瘥者。宣风散下之。若五六日痂不焦。是内发热。热湿蒸于皮中。
故痂不得焦。宜宣风散导之。用生犀磨汁解之。便热退痂脱矣。疮疹欲出。先欠呵顿闷。肝也。
时发惊悸。心也。乍凉乍热。手足冷多睡。脾也。面腮颊赤。咳嗽喷嚏。肺也。此四脏证俱见。
惟黑者属肾也。疮疹乃五脏之毒。内一脏受秽多者。出则归其脏矣。
人的风俗习惯各不相同，取舍标准也各异。关于痘疹这一门类，先前由涵高兄搜集整理各家方论，详细列于《医通》之中。其中的方药多有根据个人见解进行修改的地方，可惜删改工作尚未完成，想要得到完美的定本很难。我钦佩志儿的折服于其学问，因此命他续写补遗，并附上麻疹的各种案例，这样才不失去先哲将痘、疹二者并列命名的意义。
小儿在母胎中时，摄取母亲五脏的血秽之气，出生后这些毒素应当排出体外。所以痘疹的发发，都是五脏之液的表现：肝对应水泡，颜色青而小；肺对应脓泡，颜色白而大；心对应斑，颜色赤而小；脾对应疹，颜色赤黄。疮疹将要发出时，五脏的证候都具备，只有肾没有外在征象，只是表现为耳朵凉、尾骶骨（尻）冷。
观察疮疹发出时的轻重：一发出来就出尽的，病情必然重；疮夹带疹的，半轻半重；发出稀疏的，病情轻；表里微红的，病情轻；外表黑而里面赤的，稍微重一些；外表白而里面黑的，非常重；疹子顶端里面有像针孔一样的黑点，病势很盛；出现青色干枯、紫色凹陷、昏睡、汗出不止、烦躁、热渴、腹胀、啼哭喘息、大小便不通的，是困顿至极的表现。
凡是疮疹，应当让乳母谨慎饮食，不可让婴儿饥饿，也不要受风冷侵袭，否则会导致毒气归入肾脏，变成黑色难以治疗。如果有大热，应当通利小便；有小热适宜解毒。如果痘疹黑紫干枯凹陷，用百祥丸攻下；如果不黑，千万不要攻下。还要看季节时令判断轻重。大体上痘疹属阳，在春夏季发出为顺，秋冬季发出为逆。还应当辨别春季出脓泡、夏季出黑陷、秋季出斑、冬季出疹，这些都不顺。黑色的痘疹，无论何时发生，十难救一。其证候表现为寒战咬牙，或者身体发黄肿胀发紫，急需用百祥丸攻下。如果攻下后仍然恶寒不止，身体冷汗出，耳朵和尾骶骨反而发热，这是死证，因为肾气大旺，脾虚不能制约的缘故。攻下后如果身体发热但脉气温和，想喝水的可以治愈，这是因为脾旺胜肾，寒气去除而转为温热。治疗应当解毒，不可妄用攻下法，攻下会导致内虚，多导致毒气归于肾。如果能进食且痂头焦枯翘起，或者未焦枯却气喘，属于实证，用四顺清凉饮攻下。如果身体发热烦渴，腹部胀满气喘，大小便涩滞，面红闷乱剧烈呕吐，这应当通利小便；无效的，用宣风散攻下。如果五六天后痂皮不焦枯，是内部发热，湿热蒸腾于皮肤中，所以痂皮不能焦枯，宜用宣风散导泻，配合生犀角磨汁解毒，大便通畅后热退痂脱。
疮疹将要发出时，先打哈欠、呵欠、神情呆闷，这是肝的证候；时常惊悸，是心的证候；乍冷乍热，手足冷多睡，是脾的证候；面颊腮部红赤，咳嗽喷嚏，是肺的证候。这四脏的证候都见到，只有黑色的属于肾。疮疹是五脏的毒素，内脏某一脏受秽浊之气多的，发出时就会归属于该脏。
People's customs and habits differ, and their choices and rejections vary. Regarding the category of smallpox and measles (Douzhen), previously, my brother Han Gao collected and compiled formulas and theories from various schools, listing them comprehensively in *Yitong* (Comprehensive Medical Guide). The medicinal prescriptions therein were often modified according to personal judgment. Alas, the editing was not completed, making a perfect version hard to obtain. Admiring Zhi'er's scholarly dedication, I ordered him to continue the work with supplementary additions, attaching cases of measles, so as not to lose the original intent of the ancient sages who named both diseases together.
While in the womb, the infant consumes the blood impurities of the mother's five zang organs. After birth, these toxins must be expelled. Therefore, the eruptions of smallpox and measles are manifestations of the fluids of the five zang organs: the Liver corresponds to blisters (shui pao), which are blue-green and small; the Lungs correspond to pustules (nong pao), which are white and large; the Heart corresponds to macules/petechiae (ban), which are red and small; the Spleen corresponds to papules/rash (zhen), which are red-yellow. When the eruptions are about to appear, signs of all five zang organs are present, except for the Kidney, which shows no external signs other than cool ears and a cold sacrum (kao).
To distinguish severity when eruptions appear: those that erupt completely at once are severe; those where sores are mixed with rash are moderately severe; sparse eruptions are mild; slight redness inside and out is mild; black exterior with red interior is slightly severe; white exterior with black interior is very severe; if the tip of the rash has black dots like needle holes inside, the condition is critical; cyanosis, dryness, purple depression, lethargy, incessant sweating, restlessness, heat, thirst, abdominal distension, crying and wheezing, and obstruction of urination and defecation indicate extreme exhaustion.
During eruptions, the nursing mother should be cautious with her diet and avoid letting the infant go hungry or be exposed to wind and cold, otherwise the toxin may retreat into the Kidneys, turning black and becoming difficult to treat. For high fever, promote diuresis; for low fever, resolve toxicity. If the lesions are black, purple, dry, and depressed, administer Baixiang Wan (Hundred-Auspicious Pills) to purge; if not black, do not purge. Consider the season for severity assessment. Generally, smallpox and measles belong to Yang; eruption in Spring and Summer is favorable (Shun), while in Autumn and Winter is unfavorable (Ni). One must also note that eruptions of pustules in Spring, black depression in Summer, macules in Autumn, and rashes in Winter are all unfavorable. Black lesions, regardless of the season, have a mortality rate of nine out of ten. Signs include chills and teeth grinding, or yellowish swollen purple body. Urgently administer Baixiang Wan to purge. If chills persist after purging, accompanied by cold sweat and heat returning to the ears and sacrum, it is a fatal sign due to excessive Kidney Qi and Spleen deficiency failing to control it. If after purging, body heat remains but pulse temperature normalizes and thirst arises, it is treatable, indicating Spleen Earth overcoming Kidney Water, removing cold and transforming into warmth. Treatment should focus on resolving toxicity; do not recklessly purge, as this causes internal deficiency and allows toxins to retreat to the Kidneys. If the patient can eat and scabs become dry and raised, or if there is wheezing before scabbing, indicating excess syndrome, administer Sixun Qingliang Yin (Four-Obstacles Clearing and Cooling Decoction) to purge. If there is fever, irritability, thirst, abdominal fullness, wheezing, difficulty in urination and defecation, facial redness, mental confusion, and severe vomiting, promote diuresis. If ineffective, use Xuanfeng San (Wind-Dispersing Powder) to purge. If scabs do not dry after five to six days, it indicates internal heat steaming dampness within the skin, preventing scabbing. Use Xuanfeng San to guide out the pathogen, combined with fresh Rhinoceros Horn juice (Sheng Xi) to resolve toxicity; once stool flows freely, heat subsides and scabs fall off.
Before eruptions appear, yawning and drowsiness indicate the Liver; frequent palpitations and fright indicate the Heart; alternating cold and heat, cold extremities, and excessive sleep indicate the Spleen; red cheeks and face, coughing, and sneezing indicate the Lungs. These four zang signs are visible, while black coloration belongs to the Kidney. Eruptions are toxins of the five zang organs; whichever internal organ accumulates more turbidity will manifest its specific eruption pattern.