陈氏曰∶凡痘疮已靥未愈之间，五脏未实，肌肉尚虚，血气未复，被风邪所搏，则津液涩
滞，遂成疳蚀，宜用雄黄散、绵茧散等药治之。久而不愈，则多致不起。
薛氏曰∶前方乃解毒杀虫之剂，若毒发于外，元气未伤者，用之多效，若元气伤损，邪
火上炎者，用大芜荑汤、六味丸。若赤痛者，用小柴胡汤加生地黄。若肝脾疳证，必用四味肥
儿丸，及人参白术散，更佐以九味芦荟丸。
万氏曰∶凡痘后疳蚀疮，至毒壅肌肉，内透筋骨，外连皮肤，时痛出血，日久不痊者，
此毒在脾经，甚为恶候，乃不足之证也，内服十全大补汤，外用绵茧散贴之。疳蚀出血者，难治。
人参 益元气，生精血，复元神，补五脏。凡痘疮表散、起胀、灌浆、收靥，始终皆赖之。
黄 固腠理，补元气，内托陷下皆用之。
当归 生血、养血，活血止血，痘疮赖以调血，凡虚者能补，滞者能行。欲其升散，当
佐以川芎；欲其敛附，当佐以芍药。
熟地黄 痘疹之病，形质之病也，形质之本在精血。熟地以至静之性，以至甘至浓之味，
实精血形质中第一品纯浓之药。凡痘疮起发灌浆收敛之用，以参 配之，其功乃倍。且其得升、
柴则能发散，得桂、附则能回阳，得参、 则入气分，得归、芍则入血分。今见痘家、伤寒家
多不用此，岂亦古人之未之及耶？抑不知四物汤为何物耶？
生地黄 凉血，行血，养血，治痘疮血热血燥，凡吐血衄血，痘疮红紫，及解毒药中皆
宜用之。
芍药 可升可降，能清能敛，治痘疮血散不归，赖以收之使附气分。能泻肝脾之火，故
止腹之热痛，亦能止汗。
川芎 能升能散，能引清气上行头角，以起头面之痘；能佐参、 以行阳分而解肌表之邪，
此可为引导通行之使。但性多辛散，凡火在上而气虚者当避之。
白术 健脾利水，燥湿温中。能补气故能发痘，能固脾故能止泻。
甘草 味甘平，得土气之正，故能补中和中而兼达四脏，佐理阴阳。惟其甘和而润，故能
解刚暴之毒，泻枯涸之火。
麦门冬 生津止渴，清肺滋阴，除烦热，解燥毒。痘疹阴虚而多火者宜之。
糯米 善滋脾胃，益中气，助血生浆，能制痘毒，不能内攻。
扁豆 健脾和中，养胃止呕。
柴胡 发散热邪，泻肝胆之火，解肌开表，退往来寒热。
升麻 升阳气，达肌表，散风寒，善走阳明。
防风 散风热，解表邪，举陷气，佐黄 能托里祛毒。
干葛 解肌清热，凉散表邪，故能止渴。
荆芥穗 解风热，消疮毒，利肌表，退肿清咽，亦散头目之风邪。
白芷散 风邪，逐寒湿，止头疼，除搔痒，化痈毒，善走阳明，故能起头面之痘，亦托
肌肉之脓。
麻黄 阴寒沉滞之邪，非此不能散，亦痘家之要药，而人多畏之，由不能察也。
薄荷 散风热，清头目，能利咽喉，亦能解毒。
羌活散 肌表之毒风，利筋骨，走经铬，故能止周身之痛。
官桂 味甘辛，能养营解表，性温热，能暖血行经。凡痘疮营卫不充而见寒滞者，必用
此以导达血气，且善行参、 、熟地之功。
附子 脾肾虚寒，元阳大亏，凡泄泻呕吐不能止，寒战厥逆不能除者，非此不可以益火之源。
生姜 辟恶气，散寒气，温中气，开脾胃，止呕吐之要药。若欲理中寒，止腹痛，则炮干
姜尤胜。
陈皮 和脾胃，达阴阳，开痰行气，和胃消胀，可降可升。
山楂 消食快胃，解利宿滞，开导六腑，无辛香之耗，故可为参、术之导引。
木香 调诸气，和胃行滞止泻，除胸腹痛，亦能温中。若气虚烦热者不宜轻用。
丁香 暖胃逐寒，顺气止呕，且除腹痛寒滞者不可少也。
肉豆蔻 固肠温中，行滞止泻，中寒滑泄者最宜之。
茯苓 利水益脾去湿热，故能止泻除烦以通津液。
泽泻 利水下行，能去湿热以消肿，亦导诸药以降火。
木通 大利小水，善泄心与小肠之火，能使痘疮湿热之毒从小便而出。凡内热毒盛者宜
之，若热退中虚者不可概用。
桔梗 性味轻浮，能载药上升，清火解毒，故治喉痹。
鼠粘子 性味清凉，能润肺散气，利咽退肿，欲解痘疹热毒，此不可缺。
紫草 味苦性寒，能凉血活血，制热邪，解痘毒，滑利大便。程氏曰∶大抵凡下紫草，
必下糯米五十粒以制其
冷性，庶不损胃气而致泄泻，惟大热便秘者不必糯米也。
蝉蜕 散风清热疏邪气，故能解痘疮之毒风。
僵蚕 散风消痰解毒，尤利咽喉。
穿山甲 性窜而利，善通经脉，直达病所。凡痘有毒盛而郁遏不能出者，宜此达之，
然必藉血气诸药为之主，而以此为佐引则可。
犀角 解心火及肝脾之火，凡痘中血热吐衄，及焦黑惊搐，烦躁不宁等证，皆可用之以解
热毒。
蜂蜜 益脾生津润燥，可结痂亦可落痂。
朱砂 镇心气，除热毒，坠痰涎，安惊悸，定神魂，凡心经痘毒，及痰火上壅有余之证，
皆宜用之。
琥珀 安神定志，利水镇惊。
玄参 能解血中之热，清游火，滋肝肺，除痘疹之热毒。
黄连 解诸热毒，泻心肝大肠之火。
滑石 甘凉下降，利水道，清解六阳之烦热。
石膏 清肃大寒，善降阳明之火，凡属阳明实热，而为头痛目肿，口疮咽痛，身热烦渴，
狂躁便结者，非此不能解。
连翘 清三焦浮游之火，解痘疹痈疡之毒。
栀子 利小水，降脾肺膀胱之火，使从小便中出。
龙胆草 性寒而降，大清肝肾之火，上退眼目之赤痛，下清足膝之热肿。
黄芩 性味轻浮，能清肺金大肠之火。
大黄 通壅滞，逐瘀血，退热攻坚，非有大实证，则不可轻用。
陈氏说：凡是痘疮已经结痂但尚未痊愈的期间，五脏功能尚未充实，肌肉依然虚弱，血气未能恢复，若被风邪侵袭，就会导致津液涩滞，从而形成疳蚀疮，适宜使用雄黄散、绵茧散等药物治疗。如果长期不愈，往往会导致死亡。
薛氏说：前面的方剂是解毒杀虫的药物，如果毒邪发于体表，元气未受损伤，使用这些药物多有效；如果元气受损，邪火上炎，应使用大芜荑汤、六味丸。如果患处红肿疼痛，应使用小柴胡汤加生地黄。如果是肝脾疳证，必须使用四味肥儿丸及人参白术散，并配合九味芦荟丸辅助治疗。
万氏说：凡是痘后出现的疳蚀疮，毒性壅塞在肌肉，内透筋骨，外连皮肤，时常疼痛出血，日久不愈的，这是毒邪在脾经，属于非常凶险的征候，乃是正气不足的证候，内服十全大补汤，外用绵茧散贴敷。疳蚀出血的，难以治愈。
人参：能益元气，生成精血，恢复元神，补益五脏。凡是痘疮从表散、起胀、灌浆到收靥的全过程，始终都依赖人参。
当归：能生血、养血，活血止血，痘疮依靠它来调理血液，凡是虚证能补，瘀滞能行。如果想要其升散作用，应当佐以川芎；如果想要其收敛附着作用，应当佐以芍药。
熟地黄：痘疹这类疾病，属于形质方面的病，形质的根本在于精血。熟地黄以其至静的性质，以及至甘至浓的味道，成为实精血形质中第一品纯浓的药物。凡是痘疮起发、灌浆、收敛的作用，用人参和黄芪配伍熟地黄，功效加倍。而且熟地黄得到升麻、柴胡则能发散，得到肉桂、附子则能回阳，得到人参、黄芪则入气分，得到当归、芍药则入血分。如今见痘科、伤寒科医生大多不用此药，难道也是古人未曾顾及吗？还是不知道四物汤是什么东西呢？
生地黄：能凉血，行血，养血，治疗痘疮血热血燥，凡是吐血、鼻衄，痘疮颜色红紫，以及在解毒药中都适宜使用。
芍药：可升可降，能清能敛，治疗痘疮血散不归经，依靠它能收敛使气血附着于气分。能泻肝脾之火，所以能止腹部的热痛，也能止汗。
川芎：能升能散，能引导清气上行至头角，以促使头面部的痘疮发出；能佐助人参、黄芪以运行阳分而解除肌表的邪气，这可以作为引导通行的使药。但其性多辛散，凡是火在上而气虚的人应当避开它。
白术：健脾利水，燥湿温中。能补气所以能发痘，能固脾所以能止泻。
甘草：味甘平，得土气之正，所以能补中和中兼达四脏，佐理阴阳。因其甘和而润，所以能解刚暴之毒，泻枯涸之火。
麦门冬：生津止渴，清肺滋阴，除烦热，解燥毒。痘疹阴虚而多火者适宜使用。
糯米：善于滋脾胃，益中气，助血生浆，能制约痘毒，但不能内攻。
升麻：升阳气，达肌表，散风寒，善于走阳明经。
荆芥穗：解风热，消疮毒，利肌表，退肿清咽，也能散头目之风邪。
白芷散：散风邪，逐寒湿，止头疼，除搔痒，化痈毒，善于走阳明经，所以能起头面之痘，也能托肌肉之脓。
麻黄：阴寒沉滞之邪，非此药不能散，也是痘家的重要药物，但人多畏惧它，是因为不能明察罢了。
官桂（肉桂）：味甘辛，能养营解表，性温热，能暖血行经。凡是痘疮营卫不充而见寒滞者，必须用此药以导达血气，且善于发挥人参、黄芪、熟地黄的功效。
附子：脾肾虚寒，元阳大亏，凡是泄泻呕吐不能止，寒战厥逆不能除者，非此药不可以益火之源。
生姜：辟恶气，散寒气，温中气，开脾胃，是止呕吐的要药。如果想治疗中寒，止腹痛，则炮干姜尤为胜过。
山楂：消食快胃，解利宿滞，开导六腑，无辛香之耗散，所以可作为人参、白术的引导。
木香：调诸气，和胃行滞止泻，除胸腹痛，也能温中。若气虚烦热者不宜轻用。
木通：大利小便，善于泄心与小肠之火，能使痘疮湿热之毒从小便而出。凡内热毒盛者适宜使用，若热退中虚者不可一概使用。
鼠粘子（牛蒡子）：性味清凉，能润肺散气，利咽退肿，想要解痘疹热毒，此药不可缺。
紫草：味苦性寒，能凉血活血，制热邪，解痘毒，滑利大便。程氏说：大致凡是用紫草，必下糯米五十粒以制约其冷性，这样才不损胃气而导致泄泻，惟有大热便秘者不必用糯米。
穿山甲：性窜而利，善于通经脉，直达病所。凡是痘有毒盛而郁遏不能出者，宜用此药达之，然而必须借血气诸药为主，而以穿山甲为佐引才可以。
犀角：解心火及肝脾之火，凡是痘中血热吐衄，及焦黑惊搐，烦躁不宁等证，皆可用之以解热毒。
朱砂：镇心气，除热毒，坠痰涎，安惊悸，定神魂，凡是心经痘毒，及痰火上壅有余之证，皆适宜使用。
石膏：清肃大寒，善降阳明之火，凡是属阳明实热，而为头痛目肿，口疮咽痛，身热烦渴，狂躁便结者，非此药不能解。
Chen stated: During the period when smallpox pustules have crusted but not yet fully healed, the five zang organs are not yet solid, muscles remain deficient, and qi and blood have not recovered. If attacked by wind pathogens, body fluids become stagnant, leading to gan erosion sores (gan erosion). It is appropriate to use medicines such as Xionghuang San (Realgar Powder) and Mianjian San (Cocoon Powder) for treatment. If it persists for a long time without healing, it often leads to death.
Xue stated: The aforementioned formulas are agents for detoxification and killing parasites. If the toxin manifests externally and the primordial qi is undamaged, using these agents is effective. If primordial qi is damaged and evil fire flares upward, Da Wuyi Tang (Large Coix Seed Decoction) or Liuwei Wan (Six-Ingredient Rehmannia Pill) should be used. If there is redness and pain, Xiao Chaihu Tang (Minor Bupleurum Decoction) with Sheng Dihuang (Raw Rehmannia Root) should be used. For liver-spleen gan syndrome, Siwei Fei'er Wan (Four-Ingredient Fattening Child Pill) and Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) must be used, assisted by Jiwei Lujian Wan (Nine-Ingredient Aloe Pill).
Wan stated: Gan erosion sores occurring after smallpox, where toxicity obstructs muscles, penetrates internally to bones and sinews, connects externally to skin, causes frequent pain and bleeding, and fails to heal for a long time, indicates toxin in the spleen meridian. This is a very ominous sign and a deficiency syndrome. Internally, Shiquan Dabu Tang (Complete Great Tonifying Decoction) should be taken; externally, Mianjian San (Cocoon Powder) should be applied. Gan erosion with bleeding is difficult to treat.
Renshen (Ginseng): Benefits primordial qi, generates essence and blood, restores original spirit, and tonifies the five zang organs. Throughout the entire process of smallpox—from surface dispersion, swelling, pus formation, to crusting—it is indispensable.
Huangqi (Astragalus Root): Consolidates the interstices (cou li), benefits primordial qi, and is used for internal support of sunken lesions.
Danggui (Angelica Sinensis): Generates, nourishes, invigorates blood, and stops bleeding. Smallpox relies on it to regulate blood; it tonifies deficiency and moves stagnation. To promote ascending and dispersing actions, it should be assisted by Chuanxiong (Sichuan Lovage Rhizome); to promote astringency and attachment, it should be assisted by Shaoyao (Peony Root).
Shudihuang (Prepared Rehmannia Root): Smallpox and rashes are diseases of form and substance, whose root lies in essence and blood. Shudihuang, with its nature of utmost stillness and taste of utmost sweetness and richness, is the premier pure and rich medicine for solidifying essence, blood, and form. In the stages of smallpox development, pus formation, and crusting, combining it with Renshen (Ginseng) and Huangqi (Astragalus) doubles its efficacy. Furthermore, combined with Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root), it can disperse; combined with Guizhi (Cinnamon Twig) and Fuzi (Aconite Root), it can restore yang; combined with Renshen (Ginseng) and Huangqi (Astragalus), it enters the qi level; combined with Danggui (Angelica Sinensis) and Shaoyao (Peony Root), it enters the blood level. Nowadays, practitioners of smallpox and cold damage rarely use this herb. Is it because ancients overlooked it? Or do they not know what Sigyi Tang (Four Substance Decoction) is?
Shengdihuang (Raw Rehmannia Root): Cools blood, moves blood, nourishes blood, and treats heat-blood and dry-blood conditions in smallpox. It is suitable for hematemesis, epistaxis, purplish-red smallpox lesions, and within detoxifying formulas.
Shaoyao (Peony Root): Can ascend and descend, clear and astringe. It treats scattered blood that does not return to the vessels, helping to consolidate and attach qi to the qi level. It drains fire from the liver and spleen, thus stopping abdominal heat-pain, and can also stop sweating.
Chuanxiong (Sichuan Lovage Rhizome): Can ascend and disperse, guiding clear qi upward to the head and angles to promote facial smallpox eruption. It assists Renshen (Ginseng) and Huangqi (Astragalus) in moving the yang level to resolve exterior pathogens, serving as a guiding agent. However, its nature is largely acrid and dispersing; those with fire above and qi deficiency should avoid it.
Baizhu (Atractylodes Macrocephala): Strengthens the spleen, promotes urination, dries dampness, and warms the middle. Its qi-tonifying property promotes smallpox eruption; its splea-fortifying property stops diarrhea.
Gancao (Licorice Root): Sweet and neutral, possessing the correct earth qi, it tonifies and harmonizes the middle, reaches the four zang organs, and assists in balancing yin and yang. Due to its sweet, harmonious, and moistening nature, it resolves harsh toxins and drains withered fire.
Maimendong (Ophiopogon Tuber): Generates fluids, stops thirst, clears the lungs, nourishes yin, removes irritability and heat, and resolves dryness-toxin. Suitable for smallpox/rash cases with yin deficiency and excessive fire.
Nuomi (Glutinous Rice): Nourishes the spleen and stomach, benefits middle qi, assists blood in generating pus, controls smallpox toxin, but cannot attack internally.
Bidou (Lablab Bean): Strengthens the spleen, harmonizes the middle, nourishes the stomach, and stops vomiting.
Chaihu (Bupleurum Root): Disperses heat pathogens, drains liver and gallbladder fire, resolves the muscle layer, opens the exterior, and relieves alternating chills and fever.
Shengma (Cimicifuga Rhizome): Raises yang qi, reaches the muscle layer, disperses wind-cold, and travels well along the Yangming meridian.
Fangfeng (Saposhnikovia Root): Disperses wind-heat, resolves exterior pathogens, raises sinking qi, and assists Huangqi (Astragalus) in supporting the interior and expelling toxins.
Gegen (Kudzu Root): Resolves the muscle layer, clears heat, cools and disperses exterior pathogens, thus stopping thirst.
Jingjie Sui (Schizonepeta Flower Spike): Resolves wind-heat, eliminates sore toxins, benefits the muscle layer, reduces swelling, clears the throat, and disperses wind pathogens in the head and eyes.
Baizhi Powder (Angelica Dahurica Powder): Disperses wind pathogens, drives out cold-dampness, stops headaches, relieves itching, transforms carbuncle toxins, travels well along the Yangming meridian, thus promoting facial smallpox eruption and supporting pus in the muscles.
Mahuang (Ephedra Stem): Yin-cold and stagnant pathogens cannot be dispersed without this herb. It is a key medicine for smallpox, though many fear it due to lack of understanding.
Bohe (Mint Leaf): Disperses wind-heat, clears the head and eyes, benefits the throat, and detoxifies.
Qianghuo (Notopterygium Rhizome): Disperses toxic wind on the muscle layer, benefits sinews and bones, travels through meridians, thus stopping whole-body pain.
Guigui (Cinnamon Bark): Sweet and acrid, nourishes the nutritive level and resolves the exterior; warm and hot in nature, warms blood and moves channels. Essential for smallpox cases with insufficient nutritive and defensive qi presenting with cold stagnation, it guides qi and blood and enhances the effects of Renshen (Ginseng), Huangqi (Astragalus), and Shudihuang (Prepared Rehmannia Root).
Fuzi (Aconite Root): For spleen-kidney deficiency-cold and severe depletion of primordial yang, where diarrhea/vomiting cannot be stopped or cold tremors/cold limbs cannot be resolved, this herb is necessary to benefit the source of fire.
Shengjiang (Fresh Ginger): Expels evil qi, disperses cold qi, warms the middle, opens the spleen and stomach, and is a key medicine for stopping vomiting. For treating middle-cold and stopping abdominal pain, Pao Ganjiang (Processed Dried Ginger) is superior.
Chenpi (Tangerine Peel): Harmonizes spleen and stomach, balances yin and yang, opens phlegm, moves qi, harmonizes the stomach, reduces distension, and can descend or ascend.
Shanzha (Hawthorn Fruit): Digests food, quickens the stomach, resolves old stagnation, opens the six fu organs, lacks acrid-aromatic consumption, and thus serves as a guide for Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala).
Muxiang (Costus Root): Regulates various qi, harmonizes the stomach, moves stagnation, stops diarrhea, removes chest/abdominal pain, and warms the middle. Not suitable for mild use in cases of qi deficiency with irritability and heat.
Dingxiang (Clove): Warms the stomach, drives out cold, regulates qi, stops vomiting, and is essential for removing abdominal pain and cold stagnation.
Roudoukou (Nutmeg): Secures the intestines, warms the middle, moves stagnation, stops diarrhea; most suitable for middle-cold with slippery diarrhea.
Fuling (Poria): Promotes urination, benefits the spleen, removes damp-heat, thus stopping diarrhea, removing irritability, and unblocking body fluids.
Zexie (Alisma Rhizome): Promotes downward urination, removes damp-heat to reduce swelling, and guides other herbs to descend fire.
Mutong (Akebia Stem): Strongly promotes urination, effectively drains heart and small intestine fire, allowing damp-heat toxin from smallpox to exit via urine. Suitable for cases with severe internal heat-toxin; not generally applicable if heat has subsided and middle qi is deficient.
Jiegeng (Platycodon Root): Light and floating in nature/flavor, carries herbs upward, clears fire, detoxifies, thus treating throat obstruction.
Niubangzi (Arctium Fruit): Cool and clear in nature/flavor, moistens lungs, disperses qi, benefits the throat, reduces swelling; indispensable for resolving smallpox heat-toxin.
Zicao (Arnebia Root/Lithospermum Root): Bitter and cold, cools and invigorates blood, controls heat pathogens, resolves smallpox toxin, and lubricates the bowels. Cheng stated: Generally, when using Zicao, 50 grains of Nuomi (Glutinous Rice) must be added to counteract its cold nature, preventing stomach damage and diarrhea. Only in cases of severe heat and constipation is Nuomi unnecessary.
Chantui (Cicada Slough): Disperses wind, clears heat, and vents pathogens, thus resolving toxic wind in smallpox.
Jiangcan (Bombyx Batryticatus): Disperses wind, eliminates phlegm, and detoxifies, especially benefiting the throat.
Chuanshanjia (Pangolin Scales): Penetrating and unblocking in nature, excels at unblocking meridians and reaching the disease site directly. Suitable for smallpox where heavy toxin is depressed and cannot erupt; however, it must be supported by blood/qi tonics as the main agents, with Chuanshanjia as an assistant guide.
Xijiao (Rhinoceros Horn): Clears heart fire and liver/spleen fire. Applicable for smallpox cases with heat-blood causing vomiting/epistaxis, blackened lesions, convulsions, irritability, and restlessness, to resolve heat-toxin.
Fengmi (Honey): Benefits the spleen, generates fluids, moistens dryness, aids scab formation, and helps scabs fall off.
Zhusha (Cinnabar): Calms heart qi, removes heat-toxin, sinks phlegm, calms palpitations/fright, stabilizes spirit. Suitable for heart meridian smallpox toxin and excess syndromes of phlegm-fire blocking upward.
Hupo (Amber): Calms spirit, stabilizes will, promotes urination, and calms fright.
Xuanshen (Scrophularia Root): Clears heat in the blood, drains wandering fire, nourishes liver and lungs, removes smallpox heat-toxin.
Huanglian (Coptis Rhizome): Resolves various heat-toxins, drains heart, liver, and large intestine fire.
Huashi (Talcum): Sweet and cool, descending, promotes water passages, clears irritability and heat of the six yang levels.
Shigao (Gypsum Fibrosum): Clears severe cold, descends Yangming fire effectively. Essential for Yangming excess-heat presenting with headache, eye swelling, mouth ulcers, sore throat, body heat, irritability/thirst, mania, and constipation.
Lianqiao (Forsythia Fruit): Clears wandering fire of the triple burner, resolves smallpox and carbuncle toxins.
Zhizi (Gardenia Fruit): Promotes urination, descends fire of spleen, lungs, and bladder, allowing exit via urine.
Longdancao (Gentiana Root): Cold and descending, strongly clears liver and kidney fire, reduces redness/pain in eyes above, and clears heat-swelling in feet/knees below.
Huangqin (Scutellaria Root): Light and floating in nature/flavor, clears lung metal and large intestine fire.
Dahuang (Rhubarb Root): Unblocks stagnation, expels blood stasis, reduces heat, attacks hardness. Should not be used lightly unless there is a major excess syndrome.