经云∶诸寒为痛。又云∶痛则为实，内快外痛，为外实内虚，外快内痛，为内实外虚。今痘疮身痛者，是皮
肤浓，肉理密，或为外寒相搏，或热毒内作，或血虚不能荣养，宜审而治之。沧洲翁云∶凡疮发身痛，不
为外寒所折，则肉腠浓密，
宜分而治之。若红点方见，为寒所折，而内体有热，宜木香参苏饮，轻者消毒饮，或葛根升麻加芍药汤。肉腠密者，
宜活血散合匀气散。外寒搏者，必兼有表证，如和解汤、攻毒散去柴胡、前胡，皆可用。若兼发热头痛、恶寒
咳嗽者，参苏饮主之。热毒内作血瘀而痛者，先用活命饮（疮疡），次用消毒救苦汤（痘大法）。血虚而瘀，因作痛者，
四物汤之类。遍身如啮，色黑者，毒瓦斯壅滞而血凝也，乃是危证，若二便秘结、喘急烦躁，用栀子仁汤，或猪尾膏
血调片脑治之。自利不食者，不治。
消毒饮
牛蒡子（三钱，炒） 荆芥（一钱） 甘草（半钱，生用） 防风（去芦，半钱）
上细切。作一服，水煎。加生犀角尤妙。
葛根升麻加芍药汤（升麻葛根汤、倍芍药是也）
活血散（出不快）
匀气散 （即《济生方》八味顺气散、加木香也）
白术 白茯苓 青皮 白芷 陈皮 乌药 人参（各五钱） 甘草（炙，二分半） 木香（一分半）
上细切。作一服，水一盏，煎七分服。或细末，酒调亦可。
《黄帝内经》说：各种寒邪会导致疼痛。又说：疼痛属于实证，如果体表感觉舒适而体内疼痛，这是外实内虚；如果体表疼痛而体内感觉舒适，这是内实外虚。如今痘疮（天花）患者出现全身疼痛，是因为皮肤致密、肌肉纹理紧密，或者是被外寒侵袭搏结，或者是热毒在体内发作，或者是血虚不能濡养身体，应当仔细辨证后进行治疗。沧洲翁说：凡是痘疮发出时伴有身痛，如果不是因为外寒遏制，就是由于肉腠致密，应当分情况治疗。如果红点刚刚出现，是被寒邪遏制，而体内有热，适宜用木香参苏饮，轻症用消毒饮，或者葛根升麻加芍药汤。如果是肉腠致密的，适宜用活血散配合匀气散。如果是被外寒搏结的，必定兼有表证，如和解汤、攻毒散去柴胡和前胡，都可以使用。如果兼有发热头痛、恶寒咳嗽的症状，以参苏饮为主治方剂。如果是热毒在体内发作导致血瘀而疼痛的，先用活命饮（用于疮疡），再用消毒救苦汤（痘疹治疗的根本大法）。如果是血虚且伴有瘀滞因而作痛的，用四物汤之类的方剂。如果全身像被虫咬一样疼痛，颜色发黑的，是毒气壅滞导致血液凝结，这是危重证候，如果同时大小便不通畅、气喘急促烦躁，用栀子仁汤，或者用猪尾膏调和片脑（冰片）来治疗。如果出现自发性腹泻且不能进食的，属于不治之症。
消毒饮
牛蒡子（三钱，炒制） 荆芥（一钱） 甘草（半钱，生用） 防风（去芦头，半钱）
以上药材切碎。作为一服量，用水煎煮。加入生犀角效果更佳。
葛根升麻加芍药汤（即升麻葛根汤，芍药用量加倍）
活血散（用于痘出不快）
匀气散（即《济生方》中的八味顺气散，加上木香）
白术 白茯苓 青皮 白芷 陈皮 乌药 人参（各五钱） 甘草（炙烤，二分半） 木香（一分半）
以上药材切碎。作为一服量，用水一盏，煎至七分，服用。也可以研成细末，用酒调服。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All pains caused by cold." It also states: "Pain indicates excess. If the exterior feels comfortable while the interior is painful, it is exterior excess and interior deficiency; if the exterior is painful while the interior feels comfortable, it is interior excess and exterior deficiency." In cases of smallpox (Dou Chuang) accompanied by generalized body pain, this occurs because the skin is dense and the muscle texture is tight, or due to conflict with external cold pathogens, or due to internal heat-toxin activation, or due to blood deficiency failing to nourish the body. One must carefully examine the syndrome before treating. Master Cangzhou said: "Whenever sores erupt accompanied by body pain, if not suppressed by external cold, it is due to dense flesh and pores; treatment should be differentiated." If red spots are just appearing, suppressed by cold, yet there is heat in the interior, Muxiang Rensu Yin (Wood-Aromatic Ginseng and Perilla Decoction) is suitable; for mild cases, Xiaodu Yin (Detoxification Decoction), or Gegen Shengma Jia Shaoyao Tang (Kudzu Root and Cimicifuga Decoction with Added Peony) may be used. For those with dense flesh and pores, Huoxue San (Blood-Invigorating Powder) combined with Yunqi San (Qi-Balancing Powder) is appropriate. For those conflicted by external cold, there will inevitably be exterior syndromes; Hejie Tang (Harmonizing Decoction) or Gongdu San (Toxin-Attacking Powder, without Chaihu and Qianhu) can all be used. If accompanied by fever, headache, aversion to cold, and cough, Rensu Yin (Ginseng and Perilla Decoction) is the primary prescription. For pain caused by internal heat-toxin activation and blood stasis, first use Huoming Yin (Life-Saving Decoction, indicated for carbuncles and sores), followed by Xiaodu Jiuku Tang (Detoxification and Suffering-Relief Decoction, a fundamental method for smallpox). For pain due to blood deficiency and stasis, formulas similar to Siwu Tang (Four Substances Decoction) are used. If the whole body feels as if bitten by insects, with black discoloration, this indicates toxic qi stagnation and blood coagulation, which is a critical condition. If accompanied by constipation of both bowels, rapid breathing, and irritability, Zhizi Ren Tang (Gardenia Seed Decoction) or Zhuwei Gao (Pig Tail Paste) mixed with Pian Nao (Borneol) should be used. If spontaneous diarrhea and anorexia occur, it is considered incurable.
Xiaodu Yin (Detoxification Decoction)
Niu Bang Zi (Arctii Fructus, three qian, stir-fried) Jing Jie (Schizonepetae Herba, one qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, half qian, raw) Fang Feng (Saposhnikoviae Radix, remove rhizome, half qian)
Finely cut. Prepare as one dose, decoct in water. Adding Sheng Xi Jiao (Rhinocerotis Cornu, fresh) is especially excellent.
Gegen Shengma Jia Shaoyao Tang (Kudzu Root and Cimicifuga Decoction with Added Peony)
(Note: This is Shengma Gegen Tang, with doubled Shaoyao dosage.)
Huoxue San (Blood-Invigorating Powder)
(Indicated for slow eruption of sores.)
Yunqi San (Qi-Balancing Powder)
(Note: This is Ba Wei Shun Qi San from *Ji Sheng Fang*, with added Mu Xiang.)
Bai Zhu (Atractodis Rhizoma) Bai Fu Ling (Poria) Qing Pi (Citri Reticulatae Pericarpium Viride) Bai Zhi (Angelicae Dahuricae Radix) Chen Pi (Citri Reticulatae Pericarpium) Wu Yao (Linderae Radix) Ren Shen (Ginseng Radix et Rhizoma) [each five qian] Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, two fen and half) Mu Xiang (Aucklandiae Radix, one fen and half)
Finely cut. Prepare as one dose, decoct in one zhen of water until reduced to seven tenths, then take. Alternatively, grind into fine powder and mix with wine.