痘出有三阳三阴之异，常须辨之，勿令误也。太阳病寒，身热小便赤涩，出
不快，宜荆芥甘草防风汤。少阳病，乍寒乍热，出不快，宜连翘防风汤。阳明
病，身热目赤，大便闭实，疮遍肌肉，出不快，宜升麻葛根汤（初热）加紫草。太阴病，
自利，四肢逆冷，宜附子理中汤（泻）、木香散（泻）。少阴病，黑陷，口舌干燥，宜四物
汤加紫草红花。厥阴病，卵缩舌卷，时发厥逆，宜大异功散（出不快）加防风、青皮。
三阴病，法当救里，故宜以温剂助之。
（凡痘疹、春夏为顺，当纯阳之时也，古人治法，与伤寒同。）
足胫热 两腮红 大便秘 小便涩 渴不止 上气急 脉洪数
以上七证，不宜服热药。
疮疹一发，有密如蚕种者，或如糠 者，合清表，宜连翘升麻汤（见形）。或未出
而先发搐，是兼外感风寒之邪，宜茶汤下解毒丸（痘惊），及犀角地黄汤（失血）。疮出不
快，清便自调，知其在表，当微发散，升麻葛根汤（初热）。若疮青干黑陷，身不大
热，大小便涩滞，是热蓄于内，宜煎大黄汤下宣风散（发热）。若表大热者不可下。黑
陷甚者百祥丸（黑陷）。若疮已发，稠密微喘，渴欲饮水，宜微下之，当归丸及庞氏地
黄膏（见形），外以黄柏膏（见形）涂面。值盛夏暑热正炽，适疮大发，烦渴大便实者，宜
玉露散（吐泻）及甘露饮子（咽痛）。或昏冒不知人，时作搐搦，疮倒靥、黑陷者，宜猪心龙
脑膏（黑陷）。
痘疹的出疹过程有太阳、阳明、少阳三阳经，以及太阴、少阴、厥阴三阴经的不同差异，必须仔细辨别，以免误诊。
若属太阳病（太阳经受邪所致的病证），表现为恶寒、身体发热、小便短赤且排尿涩痛，痘疹发出迟缓不畅，适宜使用荆芥甘草防风汤。
若属少阳病（少阳经受邪所致的病证），表现为忽冷忽热，痘疹发出迟缓不畅，适宜使用连翘防风汤。
若属阳明病（阳明经受邪所致的病证），表现为身体发热、眼睛发红、大便干结不通，痘疹遍布肌肉表面但发出迟缓不畅，适宜在升麻葛根汤（用于初热阶段）的基础上加入紫草。
若属太阴病（太阴脾经受邪所致的病证），表现为自发性腹泻、四肢逆冷，适宜使用附子理中汤（针对腹泻）或木香散（针对腹泻）。
若属少阴病（少阴肾经受邪所致的病证），表现为痘疹黑陷、口舌干燥，适宜使用四物汤加入紫草和红花。
若属厥阴病（厥阴肝经受邪所致的病证），表现为睾丸收缩、舌头卷曲、时常发生四肢厥冷逆乱，适宜在大异功散（用于痘疹出不快时）的基础上加入防风、青皮。
对于三阴经的病证，治疗原则应当急救里虚，因此适宜使用温补药剂来辅助治疗。
（一般来说，痘疹在春夏季节出现为顺证，因为此时处于纯阳之气旺盛的时节，古人的治疗方法与伤寒病相同。）
足胫部发热、两侧面颊发红、大便秘结、小便涩滞、口渴不止、气逆急促、脉象洪大数急，以上七种证候，不适宜服用热性药物。
痘疹刚发出时，如果皮疹密集如蚕种，或者稀疏如糠秕，应当采用清解表邪的方法，适宜使用连翘升麻汤（用于见形阶段）。如果痘疹尚未发出而先出现抽搐，这是兼夹了外感风寒之邪，适宜用茶汤送服解毒丸（针对痘疹惊风），以及犀角地黄汤（针对失血）。如果痘疹发出迟缓，大小便正常调和，说明病邪在体表，应当轻微发散，适宜使用升麻葛根汤（用于初热阶段）。如果痘疹颜色青紫、干枯、黑色下陷，身体发热不明显，大小便涩滞不通，这是热毒蓄积于体内，适宜煎煮大黄汤送服宣风散（针对发热）。如果体表有大热症状，则不可使用泻下法。如果痘疹黑陷严重，适宜使用百祥丸（针对黑陷）。如果痘疹已经发出，稠密且伴有轻微喘息，口渴想喝水，适宜轻微泻下，使用当归丸及庞氏地黄膏（用于见形阶段），外用黄柏膏（用于见形阶段）涂抹面部。正值盛夏暑热正盛，恰逢痘疹大发，出现烦躁口渴、大便干实者，适宜使用玉露散（针对吐泻）及甘露饮子（针对咽痛）。如果出现昏迷不知人事、时常发生抽搐，痘疹倒靥、黑陷者，适宜使用猪心龙脑膏（针对黑陷）。
The eruption of smallpox and chickenpox presents differences according to the Taiyang, Yangming, Shaoyang (the Three Yang meridians), and Taiyin, Shaoyin, Jueyin (the Three Yin meridians). These must be carefully differentiated to avoid misdiagnosis.
If it is a Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang meridian), characterized by aversion to cold, fever, scanty dark urine with dysuria, and slow or difficult eruption, Jingjie Gancao Fangfeng Tang (Schizonepeta, Licorice, and Saposhnikovia Decoction) is indicated.
If it is a Shaoyang disease (a syndrome caused by pathogenic invasion of the Shaoyang meridian), characterized by alternating chills and fever, and slow or difficult eruption, Lianqiao Fangfeng Tang (Forsythia and Saposhnikovia Decoction) is indicated.
If it is a Yangming disease (a syndrome caused by pathogenic invasion of the Yangming meridian), characterized by high fever, red eyes, constipation with dry stools, eruptions covering the muscles but erupting slowly, Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) [for initial heat] added with Zicao (Arnebiae Radix seu Lithospermi Radix) is indicated.
If it is a Taiyin disease (a syndrome caused by pathogenic invasion of the Taiyin spleen meridian), characterized by spontaneous diarrhea and cold extremities, Fuzi Lizhong Tang (Aconite and Atractylodes Macrocephala Decoction) [for diarrhea] or Muxiang San (Costus Powder) [for diarrhea] is indicated.
If it is a Shaoyin disease (a syndrome caused by pathogenic invasion of the Shaoyin kidney meridian), characterized by black sinking of eruptions and dryness of the mouth and tongue, Siwu Tang (Four Substances Decoction) added with Zicao (Arnebiae Radix seu Lithospermi Radix) and Honghua (Carthami Flos) is indicated.
If it is a Jueyin disease (a syndrome caused by pathogenic invasion of the Jueyin liver meridian), characterized by retraction of the testicles, curling of the tongue, and frequent episodes of cold limbs and reversal, Dayigong San (Great Yi Gong Powder) [for slow eruption] added with Fangfeng (Saposhnikovia Root) and Qingpi (Citrus Reticulata Pericarpium Viride) is indicated.
For diseases of the Three Yin meridians, the treatment principle is to rescue the interior deficiency; therefore, warm tonifying agents are indicated to assist the treatment.
(Generally, eruptions appearing in spring and summer are considered favorable because these seasons correspond to the time of pure yang qi. The ancient methods of treatment are similar to those for Shanghan [Cold Damage].)
Symptoms such as heat in the lower legs and shins, redness of both cheeks, constipation, dysuria, unquenchable thirst, rapid breathing, and a surging and rapid pulse—these seven syndromes should not be treated with hot medicines.
When eruptions first appear, if they are dense like silkworm eggs or sparse like bran, surface-clearing methods should be used, indicating Lianqiao Shengma Tang (Forsythia and Cimicifuga Decoction) [for the manifestation stage]. If convulsions occur before the eruptions emerge, this indicates an concurrent external contraction of wind-cold pathogens. It is appropriate to administer Jiedu Wan (Detoxification Pill) [for smallpox convulsions] with tea water, as well as Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) [for hemorrhage]. If eruptions are slow to emerge but bowel movements and urination are normal, the pathogen is known to be at the exterior; mild diaphoresis should be induced, indicating Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) [for initial heat]. If eruptions are blue, dry, black, and sunken, with little body heat and obstructed urination and defecation, heat is accumulated internally. Da Huang Tang (Rhubarb Decoction) should be decocted to administer Xuanfeng San (Wind-Dispersing Powder) [for fever]. If there is significant exterior heat, purgatives should not be used. For severe black sinking, Baixiang Wan (Baixiang Pill) [for black sinking] is indicated. If eruptions have emerged, are dense, accompanied by slight wheezing, and thirst with desire to drink, mild purgation is indicated, using Danggui Wan (Angelica Sinensis Pill) and Pangshi Dihuang Gao (Pang's Rehmannia Paste) [for the manifestation stage], and externally applying Huangbai Gao (Phellodendron Paste) [for the manifestation stage] to the face. In midsummer when summer heat is intense, coinciding with severe eruptions, irritability, thirst, and solid stools indicate Yulu San (Jade Dew Powder) [for vomiting and diarrhea] and Ganlu Yinzi (Sweet Dew Drink) [for sore throat]. If coma, loss of consciousness, frequent convulsions, inverted healing, and black sinking occur, Zhuxin Longnao Gao (Pig Heart and Borneol Paste) [for black sinking] is indicated.