凡痘灰白，不红绽，不起发，昏暗顶陷，为表寒而虚，参 补气，兼四物养血。凡二便清
利，身凉，口气冷，少食，唇白，涕清，为里寒而虚，四物养血，兼参 补气。皆宜温脾胃、补
气血，加木香、肉桂之类，助成浆收靥。凡红紫干滞，黑陷焦枯，属表热而实，清凉兼解毒。次
分利小便（导赤散之类）凡二便秘涩，身热气盛，鼻干燥渴，属里热而实，解毒兼清凉，微通
利大便（四顺饮之类。）皆宜化毒汤、六一散，黄芩、黄连、丹皮、红花、蝉蜕、荆芥之类。
寒则虚，实则热。虚寒温补，实热清利，气虚补气，血虚补血。气热则清凉，血热则解毒。
凡顶陷不起，不坚实、不碍手、不起胀、不行浆，皆气虚。保元汤倍酒炒黄 、川芎、肉桂、木
香，人乳、好酒浆同服。凡根窠不红，或红色不紧圈痘根而铺散，手摸过变白色，痘上如寒毛竖
起，枯涩不红润，皆血虚。保元汤加归、芎、酒洗红花；加山楂消参、 之滞；加木香少许，行
气活血。凡用参、 ，在痘尽出之后。凡用丁香、木香、桂，在毒尽解之时。凡用地黄（姜制，）
芍药（酒炒，） 当归（酒洗；泄泻，土炒。） 其大黄、车前、滑石、生地、牛蒡、枳壳，过
用则气陷内攻。麻黄、干葛、升麻、羌活、防风、荆芥、蝉蜕、穿山甲、人牙（火 ，用一、二厘，）过用则表虚痒塌。
凡是痘疹颜色灰白，不红润舒展，不起发，顶部昏暗下陷，这是表寒且虚的证候，应当用人参补气，兼用四物汤养血。凡是大小便清利通畅，身体凉爽，口气冷，食欲少，嘴唇苍白，鼻涕清稀，这是里寒且虚的证候，应当用四物汤养血，兼用人参补气。这些情况都适宜温补脾胃、补益气血，加入木香、肉桂之类的药物，以助成浆和结痂收靥。凡是痘色红紫干枯滞涩，黑陷焦枯，属于表热且实的证候，宜用清凉兼解毒的方法。其次分利小便（如导赤散之类）。凡是大小便秘涩不通，身体发热气息盛，鼻干口渴，属于里热且实的证候，宜解毒兼清凉，轻微通利大便（如四顺饮之类）。这些都适宜使用化毒汤、六一散，以及黄芩、黄连、丹皮、红花、蝉蜕、荆芥之类的药物。
寒证多属虚，实证多属热。虚寒证用温补法，实热证用清利法，气虚则补气，血虚则补血。气分有热则用清凉法，血分有热则用解毒法。凡是痘顶下陷不起，不坚实、不碍手、不起胀、不行浆液，都是气虚的表现。可用保元汤加倍酒炒黄芪，加川芎、肉桂、木香，与人乳、好酒调成的浆液同服。凡是痘根周围不红，或红色不紧束包围痘根而铺散，手摸过后变白色，痘上如寒毛竖起，干枯涩滞不红润，都是血虚的表现。可用保元汤加当归、川芎、酒洗红花；加山楂消除人参、黄芪的壅滞；加少许木香，以行气活血。凡是用参、芪，应在痘疹完全发出之后。凡是用丁香、木香、肉桂，应在毒邪完全解除之时。凡是用熟地黄（姜制）、芍药（酒炒）、当归（酒洗；若泄泻则土炒），若过用大黄、车前子、滑石、生地黄、牛蒡子、枳壳等药，则会导致气陷内攻。若过用麻黄、干葛、升麻、羌活、防风、荆芥、蝉蜕、穿山甲、人牙（火煅，用一、二厘），则会导致表虚痒塌。
When the smallpox lesions are grayish-white, not red and spreading, failing to erupt, with a dim and depressed apex, this indicates exterior cold and deficiency. Use Ginseng Radix (Renshen) to tonify Qi, combined with Siwu Decoction (Four Substances Decoction) to nourish Blood. When urination and defecation are clear and free, the body is cool, breath is cold, appetite is poor, lips are white, and nasal discharge is clear, this indicates interior cold and deficiency. Use Siwu Decoction to nourish Blood, combined with Ginseng Radix to tonify Qi. In all these cases, it is appropriate to warm the Spleen and Stomach, tonify Qi and Blood, adding such herbs as Aucklandiae Radix (Muxiang) and Cinnamomi Cortex (Rougui) to assist in the formation of pus and scabbing. When the lesions are red-purple, dry and stagnant, black and depressed, scorched and withered, this belongs to exterior heat and excess. Use cooling methods combined with detoxification. Secondly, promote diuresis (such as Daochi San). When both urination and defecation are difficult and obstructed, the body is hot with vigorous qi, the nose is dry with thirst, this belongs to interior heat and excess. Use detoxification combined with cooling, and slightly promote bowel movement (such as Sishun Yin). All these cases are suitable for using Huadu Decoction, Liuyi San, and herbs such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Moutan Cortex (Danpi), Carthami Flos (Honghua), Cicadae Periostracum (Chantui), and Schizonepetae Herba (Jingjie).
Cold patterns tend to be deficient, while excess patterns tend to be hot. Deficient cold is treated with warming and tonification; excess heat is treated with clearing and draining. Qi deficiency is treated by tonifying Qi; Blood deficiency is treated by nourishing Blood. Heat in Qi is treated with cooling; Heat in Blood is treated with detoxification. When the lesion apex is depressed and does not rise, is not firm, does not hinder the hand, does not swell, and does not produce pus, it is due to Qi deficiency. Use Baoyuan Decoction with doubled amount of Astragali Radix (Huangqi) stir-fried with wine, plus Chuanxiong Rhizoma (Chuanxiong), Cinnamomi Cortex (Rougui), and Aucklandiae Radix (Muxiang), taken together with human milk and good wine prepared as a decoction. When the base of the lesion is not red, or the redness does not tightly encircle the root but spreads out, turns white upon touch, and the lesion surface stands up like goosebumps, being dry, astringent, and lacking luster, it is due to Blood deficiency. Use Baoyuan Decoction added with Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), and Carthami Flos (Honghua) washed with wine; add Hawthorn Fruit (Shanzha) to eliminate the stagnation caused by Ginseng Radix and Astragali Radix; add a small amount of Aucklandiae Radix (Muxiang) to move Qi and invigorate Blood. Ginseng Radix and Astragali Radix should be used only after the smallpox has completely erupted. Zingiberis Rhizoma Recens (Dingxiang), Aucklandiae Radix (Muxiang), and Cinnamomi Cortex (Rougui) should be used only when the pathogenic toxin has been completely resolved. Shu Dihuang (Prepared Rehmanniae Radix processed with ginger), Shaoyao (Paeoniae Radix stir-fried with wine), and Danggui (Angelicae Sinensis Radix washed with wine; if diarrhea occurs, stir-fried with earth) should be used cautiously. Overuse of Rhei Radix et Rhizoma (Dahuang), Plantaginis Semen (Cheqian), Talcum (Huashi), Shengdihuang (Raw Rehmanniae Radix), Arctii Fructus (Niubang), and Aurantii Fructus (Zhike) will cause Qi sinking and internal attack. Overuse of Ephedrae Herba (Mahuang), Puerariae Radix (Gange), Cimicifugae Rhizoma (Shengma), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Schizonepetae Herba (Jingjie), Cicadae Periostracum (Chantui), Manis Squama (Chuanshanjia), and Human Tooth (Renya, calcined, 1-2 li) will cause exterior deficiency, itching, and collapse.