朱丹溪曰∶痘疹初出时，或未出时，见时人有患者，宜预服此药，多者令小，重者令轻。以丝瓜近蒂三寸，
连皮、子烧灰存性，为末，砂糖拌匀，干吃。入朱砂末更妙。
霖按∶近世所传稀痧疹方，用经霜老丝瓜一个风干，除夕日在新瓦上 灰，摊地出火气，研末，以百沸汤冲
服。每岁如此，服至三四次，云小儿永不患痧疹矣。此亦丹溪之遗法也。
万密斋曰∶春温、夏暑、秋清、冬寒，此四时之正气也。冬应寒而反温，阳气暴泄，火令早行，人感之者，
至于来春，必发疮疥，未出痘疹者，必感而出。虽曰胎毒，未有不由天行者。故一时传染，大小相似。但见痘疹
之出，宜先服消毒保婴丹、代天宣化丸，以预解之，可使毒彻，不为已甚也。
消毒保婴丹
缠豆藤（或黄豆或绿豆梗上缠绕细红丝者，是于八月间生气日采之，阴干听用，一两五钱） 黑大豆（三十粒）
赤小豆（七十粒） 新升麻（七钱五分） 山楂
肉（一两） 荆芥（连穗，五钱） 防风（去芦，五钱） 当归（酒洗，五钱） 赤芍药（七钱五分）
黄连（去枝梗，五钱） 生地黄（酒浸，焙，一两） 川独活（五钱） 甘草（生，五钱） 桔梗（五钱）
辰砂（别研，水飞，一两） 牛蒡子（炒，一两） 老丝瓜（隔年经霜者二个，取连藤蒂五寸，烧存性）
上一十七味，各研细末，和匀，用净砂糖拌，丸如李核大，每服一丸，浓煎甘草汤下。
代天宣化丸
甘草（甲巳年为君土） 黄芩（乙庚年为君金） 黄柏（丙辛年为君水） 山栀（丁壬年为君木）
黄连（戊癸年为君火） 连翘（佐） 山豆根（佐） 牛蒡子（佐）
先视其年所属者为君，次四味为臣。君药倍用，臣药减半，佐视臣又减半。共为极细末。于冬至日修合，取
雪水煮升麻汁，打面糊为丸，辰砂为衣，竹叶煎汤下。
嘉靖甲午春，痘毒流行，病死者十八九，乃一厄也。时有预服三豆子汤、丝瓜辰砂散者，凡方书所载预解痘
毒之法，靡不用之，未见效者，余窃思痘疹疫疠之毒，因岁运灾眚之变，难以药解；而人事未尽，又不可诿之天
数也。于是检阅古方，乃于《韩氏医通》得五瘟丹，以五运为主，喜曰∶此解毒神药也。根据方修合，施售于人。但
报之者，莫不轻疏，人皆神之。因命之曰代天宣化丸。
张隐庵曰∶夫稀痘疹之方法虽多，未有如元兔丸之理甚精微，验若桴鼓。盖痘疹乃先天之毒，天一生水，地二
生火，水火相济，阴阳互交，乃水中之火毒也。元乃水天之色；参者参也，参天地之化育者也。菟丝子一名女萝，
《尔雅》名为玉女。盖兔乃月魄纯阴之物，故有玉女之称。《抱朴子》云∶菟丝初生之根，其形如兔握，割其
血以和丹药，立能变化，神异之品也。夫凡物得清凉水土之气，而后能发芽。兔丝秉纯阴之性，故得火暖而丝
长。此物理阴阳之妙用也。《内经》云∶骨者，至阴也。至阴者，盛水也。肺者，太阴也。少阴者，冬脉也。故
其本在肾，
其末在肺，皆积水也，是肺肾天水之相通也。（肺属天。）玄参具水天之性色，能于水中以清发其天花；菟丝有阴阳
之妙用，能于至阴之中而透其阳毒。是以婴儿在百日内，与此丸服之，或服至三岁，则毒盛者稀而毒微者不出
矣。即热毒盛者，亦无险逆之虞。同邑卢子由先生，五十无子，得一种子奇方，即生二男，皆为痘坏。盖种子方
中，不无多热药耳。后复生子，皆以玄菟丸服之。至六十有五，连举六男六女，俱已长成，皆不为痘疹所坏。
玄菟之功效，岂浅浅哉。
卢氏玄菟丹
菟丝子（八两） 玄参（四两）
不经铁器，各为末，砂糖调服。初生者一钱，量加至一两。叶子容曰∶菟丝养先天之水，玄参清肾家之火。
一养一清，则痘疹之毒自减。童年久服，不特稀痘，且免痨瘵。
叶子容曰∶三豆汤为扁鹊之方。黑归肾以制相火，赤归心以制君火，绿归阳明以制胃火。三豆皆凉品，而
寓生发之意，常服而不嫌其峻烈，功缓而实取其稳便。未出痘疹时，及将出发热时，皆可服之。
三豆汤
黑大豆 赤小豆 绿豆（各一升） 生甘草（三两）
先将三豆淘净，甘草锉碎。用腊雪水同煮，至豆烂为度。去甘草，取豆晒干，入汁再浸再晒，以汁尽晒干。
瓷瓶收贮。逐日取一二两，用长流水两大钟，煎成一钟，面东温服。或以人中黄易甘草，加入经霜老丝瓜一个同
煮，更妙。
霖按∶稀痘疹诸方，率多苦寒之品，久服固妨脾胃，将出又恐冰毒。三豆汤一方，平善无弊，然究未若玄
菟丹之义精理微，效如桴鼓。惟因疫疠流行，则代天宣化丸又可参因。但避风远秽，节饮食，适寒暄，为预防之
第一义，不可不知也。
朱丹溪说：在痘疹刚要发出或尚未发出时，如果看到周围有人患病，应当预先服用此药，可以使病情重者变轻，多者变少。取靠近瓜蒂三寸长的丝瓜，连同皮和籽一起烧成灰但保留药性（存性），研成细末，用砂糖拌匀，干服。加入朱砂末效果更好。
叶霖按语：近代流传的预防稀发痧疹的方子，是用经过霜冻的老丝瓜一个，风干后，在除夕日放在新瓦上烧成灰，摊在地上散发火气，然后研成细末，用滚开的热水冲服。每年如此服用三四次，据说小儿就永远不会患痧疹了。这也是朱丹溪遗留下来的方法。
万密斋说：春温、夏暑、秋清、冬寒，这是四季的正常气候。冬天应该寒冷却反而温暖，阳气突然泄露，火令提前到来，人感染这种邪气，到了来年春天，必定会发作疮疥，还没有出痘疹的人，也一定会因此感邪而发病。虽然说是胎毒所致，但没有不是由天行疫气引起的。所以一时之间互相传染，大小孩子的症状都相似。只要见到痘疹将要发出，应当先服用消毒保婴丹、代天宣化丸，以预先解除毒邪，可以使毒邪彻底排出，不至于过于严重。
消毒保婴丹
配方：缠豆藤（或者黄豆梗或绿豆梗上缠绕的细红丝，是在八月间生气日采集的，阴干备用，一两五钱）、黑大豆（三十粒）、赤小豆（七十粒）、新升麻（七钱五分）、山楂肉（一两）、荆芥（连穗，五钱）、防风（去芦头，五钱）、当归（酒洗，五钱）、赤芍药（七钱五分）、黄连（去枝梗，五钱）、生地黄（酒浸，焙干，一两）、川独活（五钱）、甘草（生用，五钱）、桔梗（五钱）、辰砂（另研，水飞法处理，一两）、牛蒡子（炒，一两）、老丝瓜（隔年且经霜的两个，取连藤蒂五寸，烧至存性）。
以上十七味药，分别研成细末，混合均匀，用干净的砂糖拌和，制成如李核大小的丸剂。每次服用一丸，用浓煎的甘草汤送服。
代天宣化丸
配方：甘草（甲年和己年属土，故为君药）、黄芩（乙年和庚年属金，故为君药）、黄柏（丙年和辛年属水，故为君药）、山栀（丁年和壬年属木，故为君药）、黄连（戊年和癸年属火，故为君药）、连翘（佐药）、山豆根（佐药）、牛蒡子（佐药）。
首先观察当年所属的五运五行确定君药，其次四味药作为臣药。君药用量加倍，臣药用量减半，佐药的用量再比臣药减半。共同研成极细末。在冬至日配制，取雪水煮升麻汁，用来打面糊制作丸剂，用辰砂做衣，竹叶煎汤送服。
嘉靖甲午年春天，痘毒流行，病死的人有十分之八九，这是一次大灾难。当时有预先服用三豆子汤、丝瓜辰砂散的人，凡是医书中记载的预防解除痘毒的方法，没有不使用的，但没有见效的。我私下思考，痘疹疫疠的毒邪，是因为岁运灾变的缘故，难以单纯靠药物解除；但是人事努力还没有穷尽，又不能推卸给天命天数。于是检阅古方，在《韩氏医通》中得到了五瘟丹，以五运为主旨，高兴地说：“这是解毒的神药。”依据方子配制，施舍售卖给人。但回报的人，都说效果轻微疏淡，人们都把它视为神药。因此命名为代天宣化丸。
张隐庵说：预防痘疹的方法虽然多，但没有像元兔丸那样道理精微，验证起来像敲鼓应声一样灵验。因为痘疹是先天之毒，天一生水，地二生火，水火相济，阴阳互交，这是水中的火毒。元是水天的颜色；参是参与的意思，参与天地化育万物。菟丝子又名女萝，《尔雅》称为玉女。因为兔是月魄纯阴之物，所以有玉女的称呼。《抱朴子》说：菟丝初生的根，形状像兔子握着东西，割取其血来调和丹药，立刻能变化，是神异的物品。大凡物体得到清凉水土之气，然后才能发芽。菟丝秉承纯阴的性质，所以得到火暖之后丝才生长。这是物理阴阳的妙用。《内经》说：骨，是至阴。至阴，是盛水的地方。肺，是太阴。少阴，是冬脉。所以其根本在肾，其标末在肺，都是积水之处，这是肺肾天水相通。（肺属天。）玄参具备水天的性质和颜色，能在水中清发天花之毒；菟丝有阴阳的妙用，能在至阴之中透出阳毒。因此婴儿在百日内，给予此丸服用，或者服用到三岁，那么毒盛的人就会稀少，毒微的人就不会发出来了。即使是热毒盛的，也没有危险逆证的忧虑。同乡卢子由先生，五十岁没有儿子，得到一个奇特的种子方，生了两个男孩，都因痘疹而受损。大概种子方中不免多用热药。后来再生孩子，都用玄菟丸服用。到六十五岁，接连生了六个男孩六个女孩，都已长成，都没有被痘疹损害。玄菟的功效，难道浅薄吗？
卢氏玄菟丹
配方：菟丝子（八两）、玄参（四两）。
不经过铁器，分别研成细末，用砂糖调服。初生婴儿服一钱，酌情加至一两。叶子容说：菟丝滋养先天之水，玄参清除肾家的火。一养一清，那么痘疹的毒自然减少。童年长期服用，不仅能使痘疹稀少，而且能免除痨瘵。
叶子容说：三豆汤是扁鹊的方子。黑大豆入肾以制约相火，赤小豆入心以制约君火，绿豆入阳明以制约胃火。三豆都是凉性药物，而蕴含生发之意，常服而不嫌其峻烈，功效缓慢但实际上取其稳妥方便。在痘疹未发出时，以及即将出发热时，都可以服用。
三豆汤
配方：黑大豆、赤小豆、绿豆（各一升）、生甘草（三两）。
先将三豆淘洗干净，甘草切碎。用腊雪水同煮，直到豆子煮熟烂为止。去掉甘草，将豆子晒干，放入药汁中再浸泡再晒干，直到汁液吸尽晒干。用瓷瓶收藏储存。每天取一二两，用长流水两大钟，煎成一钟，面向东方温服。或者用人中黄代替甘草，加入经霜的老丝瓜一个同煮，效果更好。
叶霖按语：预防痘疹的各种方子，大多含有苦寒的药物，长期服用固然妨碍脾胃，将要发出时又恐怕冰伏毒邪。三豆汤一方，平和善良没有弊端，然而终究不如玄菟丹的道理精微，效验如敲鼓应声。只是因为在疫疠流行时，代天宣化丸又可以参考使用。但是避风远秽，节制饮食，适应寒暖变化，才是预防的第一要义，不可不知道。
Zhu Danxi said: When the smallpox or measles rash is just beginning to appear or has not yet appeared, if one observes that others in the vicinity are suffering from the disease, it is advisable to take this medicine in advance. This can make severe cases lighter and numerous cases fewer. Take three cun (approx. 10 cm) of loofah vine near the stem, including the skin and seeds, burn them into ash while preserving their medicinal properties (cun xing), grind into powder, mix with brown sugar, and take dry. Adding cinnabar powder is even better.
Ye Lin noted: The method for preventing sparse smallpox/measles transmitted in recent times uses one old loofah that has been exposed to frost, dried by wind. On New Year's Eve, it is burned into ash on a new tile, spread on the ground to release the fire energy, then ground into powder. It is taken by沖 (chong - rinsing/mixing) with boiling water. Doing so annually for three or four doses is said to ensure children never suffer from measles/rash. This is also a legacy method of Danxi.
Wan Mingzhai said: Spring warmth, summer heat, autumn coolness, and winter cold are the correct qi of the four seasons. If winter should be cold but turns warm instead, yang qi leaks suddenly, and the fire command arrives early. Those who contract this pathogen will inevitably develop sores and boils in the following spring; those who have not yet had smallpox/measles will definitely contract it and manifest symptoms. Although it is said to be due to fetal toxin, none arise without the influence of heavenly epidemic qi. Thus, during a period of contagion, symptoms are similar regardless of age. Upon seeing the onset of smallpox/measles, one should first administer Xiao Du Bao Ying Dan (Disinfect and Protect Infants Pill) and Dai Tian Xuan Hua Wan (Heavenly Substitute Transforming Pill) to preemptively resolve the toxin, allowing the toxin to be thoroughly expelled and preventing excessive severity.
Xiao Du Bao Ying Dan (Disinfect and Protect Infants Pill)
Ingredients: Chan Dou Teng (Vine wrapping beans, specifically fine red threads wrapping yellow or green bean stems, harvested on the 'Sheng Qi' day in August, air-dried, 1 liang 5 qian); Hei Da Dou (Black Soybean, 30 grains); Chi Xiao Dou (Red Adzuki Bean, 70 grains); Xin Sheng Ma (Fresh Cimicifugae Rhizoma, 7 qian 5 fen); Shan Zha Rou (Hawthorn Fruit Flesh, 1 liang); Jing Jie (Schizonepetae Herba, including spikes, 5 qian); Fang Feng (Saposhnikoviae Radix, removed rhizome, 5 qian); Dang Gui (Angelicae Sinensis Radix, wine-washed, 5 qian); Chi Shao Yao (Paeoniae Radix Rubra, 7 qian 5 fen); Huang Lian (Coptidis Rhizoma, removed branches/stems, 5 qian); Sheng Di Huang (Rehmanniae Radix, wine-soaked, baked, 1 liang); Chuan Du Huo (Angelicae Pubescentis Radix, 5 qian); Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 5 qian); Jie Geng (Platycodonis Radix, 5 qian); Chen Sha (Cinnabaris, separately ground, water-suspended, 1 liang); Niu Bang Zi (Arctii Fructus, fried, 1 liang); Lao Si Gua (Old Loofah, aged one year and exposed to frost, two fruits, taking 5 cun including vine and stem, burned to preserve nature).
The above seventeen ingredients are each ground into fine powder, mixed evenly, combined with clean brown sugar, and formed into pills the size of a plum pit. Each dose is one pill, taken with strong decoction of Gan Cao Tang (Licorice Decoction).
Dai Tian Xuan Hua Wan (Heavenly Substitute Transforming Pill)
Ingredients: Gan Cao (Glycyrrhizae Radix et Rhizoma - Ruler herb for Jia/Yi years associated with Earth); Huang Qin (Scutellariae Radix - Ruler herb for Yi/Geng years associated with Metal); Huang Bo (Phellodendri Cortex - Ruler herb for Bing/Xin years associated with Water); Shan Zhi (Gardeniae Fructus - Ruler herb for Ding/Ren years associated with Wood); Huang Lian (Coptidis Rhizoma - Ruler herb for Wu/Gui years associated with Fire); Lian Qiao (Forsythiae Fructus - Assistant); Shan Dou Gen (Sophorae Tonkinensis Radix - Assistant); Niu Bang Zi (Arctii Fructus - Assistant).
First, determine the Ruler herb based on the year's Five Movements (Wu Yun). The next four ingredients serve as Ministers. The Ruler herb dosage is doubled, the Minister herbs are halved, and the Assistant herbs are halved again relative to the Ministers. All are ground into extremely fine powder. Prepared on the Winter Solstice, using snow water to decoct Sheng Ma (Cimicifugae Rhizoma) juice, which is used to make a wheat paste for forming pills. Coated with Chen Sha (Cinnabaris), taken with Zhu Ye Tang (Bamboo Leaf Decoction).
In the spring of Jiawu year during the Jiajing reign, smallpox toxin was prevalent, with nine out of ten dying, constituting a major disaster. At that time, some took San Dou Zi Tang (Three Bean Seed Decoction) and Si Gua Chen San San (Loofah Cinnabar Powder) in advance. All methods recorded in medical books for preemptively resolving smallpox toxin were employed, yet none showed efficacy. I privately pondered that the toxin of smallpox epidemics arises from changes in annual movements and disasters, making it difficult to resolve solely with medicine; however, human effort is not exhausted, nor can it be dismissed as fate. Thus, I reviewed ancient formulas and found Wu Wen Dan (Five Plagues Pill) in *Han Shi Yi Tong* (Medical Insights of Han Family), which focuses on the Five Movements. Joyfully, I said: "This is a divine detoxifying medicine." I prepared it according to the formula and distributed/sold it to people. Those who reported back said its effects were mild and slight, yet people regarded it as miraculous. Hence, I named it Dai Tian Xuan Hua Wan.
Zhang Yin'an said: Although there are many methods for preventing sparse smallpox/measles, none possess principles as subtle as Yuan Tu Wan (Yuan Rabbit Pill) nor verify as promptly as a drumstick striking a drum. Smallpox/measles is a congenital toxin. Heaven generates Water (One), Earth generates Fire (Two). Water and Fire harmonize, Yin and Yang interact; this is fire toxin within water. 'Yuan' refers to the color of water and heaven; 'Can' means to participate, participating in the transformation and nurturing of heaven and earth. Tuscae Semen (Cuscutae Semen), also known as Nu Luo, is called Yu Nu (Jade Maiden) in *Erya*. Since the rabbit is a pure yin object of the moon's soul, it bears the name Jade Maiden. *Baopuzi* states: The root of newly born Tuscae Semen resembles a rabbit's grasp; cutting its blood to mix with elixir materials causes immediate transformation, a miraculous item. Generally, objects sprout only after receiving the qi of cool water and soil. Tuscae Semen possesses pure yin nature, thus its vines grow long when warmed by fire. This is the wonderful application of yin and yang in physical principles. *Neijing* states: Bones are Supreme Yin. Supreme Yin is where Water abounds. The Lung is Taiyin. Shaoyin is the Winter pulse. Therefore, its root is in the Kidney, its branch in the Lung, both accumulating water; this is the connection between Lung and Kidney regarding Heavenly Water. (Lung belongs to Heaven.) Xuanshen (Scrophulariae Radix) possesses the nature and color of water and heaven, capable of clearing and emitting天花 (smallpox/measles) toxin from within water; Tuscae Semen has the wondrous use of yin and yang, capable of penetrating yang toxin from within Supreme Yin. Therefore, administering this pill to infants within 100 days, or up to three years of age, results in those with heavy toxin becoming sparse, and those with light toxin not manifesting at all. Even with severe heat toxin, there is no danger of adverse conditions. Mr. Lu Ziyoun of my county, childless at fifty, obtained a unique conception formula and gave birth to two sons, both damaged by smallpox. Likely because conception formulas often contain many hot medicines. Later, upon having more children, he administered Xuan Tu Wan. By sixty-five, he had six sons and six daughters, all grown, none damaged by smallpox/measles. Is the efficacy of Xuan Tu shallow?
Lu's Xuan Tu Dan (Xuan Tu Pill)
Ingredients: Tuscae Semen (Cuscutae Semen, 8 liang); Xuanshen (Scrophulariae Radix, 4 liang).
Do not use iron tools. Grind each into powder separately, mix with brown sugar and take. Initial dose for newborns is 1 qian, gradually increased to 1 liang. Ye Zirong said: Tuscae Semen nourishes congenital Water; Xuanshen clears Kidney Fire. One nourishes, one clears, thus smallpox/measles toxin naturally diminishes. Long-term use in childhood not only reduces smallpox/measles incidence but also prevents consumption (lao zhai).
Ye Zirong said: San Dou Tang (Three Bean Decoction) is a formula from Bian Que. Hei Da Dou (Black Soybean) enters the Kidney to control Minister Fire; Chi Xiao Dou (Red Adzuki Bean) enters the Heart to control Sovereign Fire; Lv Dou (Mung Bean) enters Yangming to control Stomach Fire. The three beans are cooling agents but contain the intent of generation/vitality. They can be taken regularly without being too harsh; their action is slow but truly steady and convenient. They can be taken before the appearance of smallpox/measles and when fever is about to erupt.
San Dou Tang (Three Bean Decoction)
Ingredients: Hei Da Dou (Black Soybean), Chi Xiao Dou (Red Adzuki Bean), Lv Dou (Mung Bean) (each 1 sheng); Sheng Gan Cao (Raw Licorice Root, 3 liang).
First, wash the three beans clean, chop the Gan Cao. Boil together with wax snow water until the beans are soft and rotten. Remove the Gan Cao, sun-dry the beans. Soak them in the juice again and sun-dry again until the juice is fully absorbed and dry. Store in porcelain bottles. Daily, take 1-2 liang, decoct in two zhong of running water until reduced to one zhong. Take warm facing east. Alternatively, replace Gan Cao with Ren Zhong Huang (Human Urine Sediment), add one old loofah exposed to frost, and boil together for even better effect.
Ye Lin noted: Most formulas for preventing sparse smallpox/measles consist largely of bitter-cold substances. Long-term use certainly hinders the Spleen and Stomach, and when eruption is imminent, it may freeze the toxin. San Dou Tang is mild and harmless, yet ultimately not as profound in principle and effective as Xuan Tu Dan. However, during epidemic outbreaks, Dai Tian Xuan Hua Wan can be considered. But avoiding wind and filth, regulating diet, and adapting to temperature changes are the primary principles of prevention, which must not be ignored.