一疹后报痘，不易长大，干咳，连声不续，此过于发散也。保元汤加贝、味、甘、桔、橘红而愈。
一疹后出痘，失于解散，咽喉肿痛，声哑水呛，饮食不进，倒靥而死。
一疹后，痘出三日，痰咳喘急，亦失于解散，甘、桔、蒡、膏、陈、枳壳、蝉蜕、苏子，疏邪解毒清金而愈。
一儿身热咳嗽，疹出隐隐，以药发之，而不见不没。此风寒郁而不散，此瘾疹也，非正疹论，芎苏散治愈。
一儿痘出数颗而夹疹，遍身圆朗红活，两日尽没。有识者曰∶痘没者，必闷乱烦躁，此却安静，且正痘宛
在，乃疹没非痘伏也。以剂调之而愈。
一痘报点粗肥，有红盘，间有细密隐隐者，此水痘夹疹也。内症安宁，但表邪宜散，葛根汤加荆、防、翘、
芷，二剂而愈。
一水痘不脓而干枯，身热烦躁，此失解同于倒陷也。治以葛根汤加荆芥、防风、连翘、牛蒡子、木通、蝉
蜕，遍身发红点，此余毒散也。又用荆防解毒汤而愈。
万密斋治一女，二岁出痘，遍身红点，大小相杂无空处，此夹疹夹斑痘也。以升麻葛根汤加荆、防、元参、
翘、蒡、淡竹叶、木通，一服减，再服再减，三服痘显而愈。
（附夹疮）
徐仲光治一痘，匀朗，容易肥大，淡白少神，烦躁不宁，因头上素患肥疮太甚，耗泄真气故也。先用白芨
膏，纸封头疮，后用保元汤而愈。
一痘正面匀朗绽突，少神，身肢平塌，色暗，因手足脓疥踵痛，泄气故也。恐浆虽满，不能收功，用保元
汤加芎、蒡、 、芍、归、甘、陈、防、桂、术，调理而愈。此症虽补而不保脾，则必致泄泻而不能收功。
一痘靥后，平陷瘙痒，遂发血风疮。用苦参、栀、翘、防风、独活、苡仁、黄芩，蜜丸服，并灸风池、三
里二穴，各五七壮愈。
一痘出脓疥后，见其疤痕黑，大有似痘疔，须审头面痘颗明白。初起疏散凉血，七八日后，根窠红黑不
消，亦宜凉血解毒。十一二日，根窠淡红，宜生血补剂愈。
一儿痘三日，耳前红肿如桃，用葛根汤加荆芥、防风、桔梗、牛蒡而愈。
一痘匀朗红润，左腮肿块青紫，热甚烦躁。此痘先块青，名鬼捏，真恶候也，急与紫金救焚散而愈。若
此症治迟，必毒攻于心，发惊窜而死。
一例患儿出疹后并发痘疮，痘粒难以长大，伴有干咳，连续咳嗽无法接续，这是由于治疗时过度使用发散药物所致。使用保元汤加入贝母、五味子、甘草、桔梗、橘红，病情痊愈。
一例患儿出疹后并发痘疮，因未能及时疏散邪气，导致咽喉肿痛，声音嘶哑，饮水呛咳，饮食难进，最终因痘毒内陷（倒靥）而死亡。
一例患儿出疹后，痘疮发出三天，出现痰多咳嗽、气喘急促的症状，也是因未能及时疏散邪气所致。使用甘草、桔梗、牛蒡子、石膏、陈皮、枳壳、蝉蜕、苏子，起到疏解邪气、解毒、清肺的作用，病情痊愈。
一例患儿身体发热咳嗽，疹子隐约可见，用药发汗透疹，但疹子既不出也不没。这是风寒郁结在体内未能发散，属于瘾疹（风团），不属于正疹（天花/麻疹类），使用芎苏散治愈。
一例患儿痘疮刚出几颗就夹杂疹子，全身痘粒圆润光亮、红润鲜活，两天后全部隐没。有见识的医生指出：痘疮隐没通常会导致闷乱烦躁，但这名患儿却安静，且正痘依然存在，说明是疹子隐没而非痘毒内伏。经过药剂调理后痊愈。
一例患儿痘点粗大肥厚，周围有红晕，间杂有细密隐约的皮疹，这是水痘夹杂疹子。内部症状安宁，只需表散邪气，使用葛根汤加入荆芥、防风、连翘、白芷，两剂药后痊愈。
一例患儿水痘未化脓反而干枯，身体发热烦躁，这属于失于解散，等同于痘毒内陷。治疗使用葛根汤加入荆芥、防风、连翘、牛蒡子、木通、蝉蜕，全身发出红色斑点，这是余毒外散的表现。随后又使用荆防解毒汤治愈。
万密斋治疗一名两岁女童，出痘时全身布满红点，大小混杂无空隙，这是夹疹夹斑的痘疮。使用升麻葛根汤加入荆芥、防风、玄参、连翘、牛蒡子、淡竹叶、木通，服用一剂后症状减轻，再服一次继续减轻，服用三剂后痘形显现并痊愈。
（附：夹疮案例）
徐仲光治疗一例痘疮，痘形均匀光亮，容易长大，但颜色淡白缺乏神采，烦躁不安，这是因为患儿头部原本患有严重的肥疮（头癣/脓疱疮），耗泄了真气所致。先用白芨膏，用纸封住头部疮口，然后使用保元汤治愈。
一例痘疮正面均匀光亮突起，但缺乏神采，身体四肢平塌，颜色暗淡，这是因为手足患有脓疥且脚后跟疼痛，导致气机泄越所致。担心虽然浆液饱满，但不能收功愈合。使用保元汤加入川芎、牛蒡子、（原文缺字，推测为某药）、芍药、当归、甘草、陈皮、防风、桂枝、白术，经过调理后痊愈。此症虽然采用补法，但如果不能保护脾胃，必然导致腹泻而不能收功。
一例痘疮结痂脱落后，局部平陷瘙痒，随即引发血风疮。使用苦参、栀子、连翘、防风、独活、薏苡仁、黄芩，制成蜜丸服用，并艾灸风池穴、足三里穴各五至七壮，痊愈。
一例患儿出痘并发脓疥后，发现疤痕发黑，大有类似痘疔的样子，必须仔细审视头面部的痘颗情况。初起时应疏散邪气、凉血，七八日后，如果痘根红黑色不消退，也宜用凉血解毒之法。十一二日，如果痘根呈淡红色，宜用生血补益之剂治愈。
一例患儿出痘三天，耳前红肿如桃子大小，使用葛根汤加入荆芥、防风、桔梗、牛蒡子治愈。
一例痘疮均匀红润，但左腮肿块青紫，热势严重且烦躁。这是痘疮先出现青块，名为“鬼捏”，是真正的恶候。紧急给予紫金救焚散治愈。如果此症治疗迟缓，必然导致毒邪攻心，引发惊厥窜动而死。
A case of smallpox appearing after measles, which failed to mature and grow, accompanied by dry coughing that was continuous yet interrupted, was caused by excessive use of dispersing methods. It was cured using Baoyuan Decoction (Preserve the Origin Decoction) added with Fritillariae Bulbus (Beimu), Schisandrae Fructus (Wuweizi), Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng), and Citri Reticulatae Pericarpium (Juhong).
In another case, smallpox appeared after measles, but due to failure in timely dispersal, the patient suffered from sore throat and swelling, hoarseness, choking on water, and inability to eat, ultimately dying from inverted smallpox (Dao Ye, where pustules fail to form or retract abnormally).
In a third case, three days after measles, the patient developed phlegm, cough, and acute asthma, also due to failure in timely dispersal. It was cured using Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng), Arctii Fructus (Niubangzi), Gypsum Fibrosum (Shigao), Citri Reticulatae Pericarpium (Chenpi), Aurantii Fructus Immaturus (Zhike), Bombyx Batryticatus (Chantui), and Perillae Fructus (Suzi), which dispersed pathogenic factors, resolved toxicity, and cleared the lungs.
A child presented with fever and cough, with faintly visible rashes. After medication to induce sweating and expel rashes, the rash neither fully emerged nor disappeared. This was wind-cold stagnation failing to disperse, identified as Urticaria (Yin Zhen, hives), not true measles/smallpox. It was cured using Xiong Su San.
A child had a few spots of smallpox mixed with rashes; the body lesions were round, bright, red, and vibrant, but all vanished within two days. An experienced physician noted: "When smallpox vanishes, it usually causes restlessness and irritability; however, this patient remained quiet, and the genuine smallpox marks were still present. Thus, it was the rash that vanished, not the smallpox toxin hiding." The condition was cured with appropriate herbal regulation.
A child had coarse and plump smallpox spots with red halos, interspersed with fine, faint rashes, identified as chickenpox mixed with rashes. Internal symptoms were calm, requiring only dispersion of exterior pathogens. It was cured with Gegen Tang (Kudzu Root Decoction) added with Schizonepetae Herba (Jingjie), Saposhnikoviae Radix (Fangfeng), Forsythiae Fructum (Lianqiao), and Angelicae Dahuricae Radix (Baizhi) over two doses.
A case of chickenpox that became dry and shriveled without suppuration, accompanied by fever and irritability, resulted from failure to disperse, similar to inverted collapse. Treatment used Gegen Tang (Kudzu Root Decoction) added with Schizonepetae Herba (Jingjie), Saposhnikoviae Radix (Fangfeng), Forsythiae Fructum (Lianqiao), Arctii Fructus (Niubangzi), Akebiae Caulis (Mutong), and Bombyx Batryticatus (Chantui). Red spots appeared all over the body, indicating the dispersion of residual toxins. Subsequently, Jingfang Jiedu Tang (Schizonepeta and Saposhnikovia Detoxification Decoction) cured the condition.
Wan Mizhai treated a two-year-old girl whose entire body was covered with red spots of varying sizes with no gaps, identified as smallpox mixed with rashes and macules. She was treated with Shengma Gegen Tang (Cimicifugae Radix and Kudzu Root Decoction) added with Schizonepetae Herba (Jingjie), Saposhnikoviae Radix (Fangfeng), Scrophulariae Radix (Xuanshen), Forsythiae Fructum (Lianqiao), Arctii Fructus (Niubangzi), Lophatheri Herba (Dan Zhuye), and Akebiae Caulis (Mutong). Symptoms decreased after one dose, further decreased after the second, and resolved after three doses when the smallpox morphology became clear.
(Attached: Cases of Mixed Sores)
Xu Zhongguang treated a case of smallpox that was uniform and bright, easy to mature, but pale and lacking spirit, with irritability and restlessness. This was due to severe chronic sores on the head (Fei Chuang, likely tinea capitis or impetigo) exhausting the True Qi. First, Baiji Gao (Bletilla Paste) was applied, and the head sores were sealed with paper, followed by treatment with Baoyuan Decoction (Preserve the Origin Decoction) for cure.
Another case showed smallpox that was uniform, bright, and protruding on the face, but lacked spirit, with flat limbs and dark color, due to qi leakage from suppurative sores on hands and feet and heel pain. There was fear that even if the pus filled, healing would not occur. Baoyuan Decoction (Preserve the Origin Decoction) was added with Chuanxiong Rhizome (Chuanxiong), Arctii Fructus (Niubangzi), [missing herb], Paeoniae Radix Alba (Baishao), Angelicae Sinensis Radix (Danggui), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Saposhnikoviae Radix (Fangfeng), Cinnamomi Ramulus (Guizhi), and Atractylodis Macrocephalae Rhizoma (Baizhu) for regulation and cure. Although tonification was used, protecting the Spleen was crucial; otherwise, diarrhea would prevent healing.
After smallpox scabs fell off, a case presented with flat, itchy areas developing into Blood Wind Sores. Kushen Wan (Sophora and Gardenia Pills) made from Sophorae Radix (Kushen), Gardeniae Fructus (Zhizi), Forsythiae Fructum (Lianqiao), Saposhnikoviae Radix (Fangfeng), Angelicae Pubescentis Radix (Duohuo), Coicis Semen (Yiren), and Scutellariae Radix (Huangqin) was taken as honey pills. Additionally, Fengchi (GB20) and Zusanli (ST36) acupoints were moxibusted with 5-7 moxa cones each, resulting in cure.
After a child’s smallpox and suppurative sores, black scars resembling smallpox carbuncles were observed. The facial spots must be examined clearly. Initially, disperse pathogens and cool blood. After 7-8 days, if roots remain red/black, cool blood and resolve toxicity. By day 11-12, if roots are light red, use blood-nourishing and tonifying agents for cure.
A child, three days after smallpox onset, had ear preauricular swelling like a peach. It was cured with Gegen Tang (Kudzu Root Decoction) added with Schizonepetae Herba (Jingjie), Saposhnikoviae Radix (Fangfeng), Platycodonis Radix (Jiegeng), and Arctii Fructus (Niubangzi).
A case of uniform, red, and bright smallpox presented with a blue-purple mass on the left cheek, severe heat, and irritability. This blue patch appearing first is called "Ghost Pinch" (Gui Nie), a true ominous sign. Zijin Jiufen San (Purple Gold Rescue Fire Powder) was urgently administered for cure. If treated late, toxin would attack the Heart, causing convulsions and death.