痘痕赤白，各有所因，治法亦异。凡痕赤而作痒，血虚而有热也，用五味、牡丹皮。赤而作痛，余热也，用四君、
连翘、金银花。若发热而大便调和者，脾胃虚热也，用五味异功散。若发热而大便秘结者，肠胃内热也，用圣济犀角地
黄汤。若母有肝火，用加味逍遥散。若母有郁怒，用加味归脾汤，佐以加味逍遥散治之。痕白者多属气虚而血衰也，宜
固元气为本。痒而作渴者，气血俱虚也，十全大补汤之类。乳食减少，四肢倦怠者，中气虚也，五味异功散之类。气虚
发热者，补中益气汤之类。血虚发热者，当归补血汤之类，须参兼变之症治之。此症若服药而渐红活者，可治；色不转
者，不治，虽经年后，多患泻利而死。若妄投攻伐，祸在反掌。
一小儿痘疮，如期而愈，痕赤如赭，余谓此乳母有热也，诊之果有肝脾郁火，先用加味逍遥散四剂，与母服之，子
各饮少许，而并愈。
一小儿痘痕色赤作痛，热渴喜冷，大便不利，先用前胡枳壳散，便利渴止，再用圣济犀角地黄汤而安，又用芹菜汁
而靥。
一小儿痘痕色赤，大便不利，小便赤涩，作渴饮冷，此上焦实热也，先君用泻黄散，一剂顿愈；又用圣济犀角地黄
汤及芹菜汁而痊。
一小儿痘愈而痕赤作痛，内热作渴，二便不利，先君谓胃经热毒，用济生犀角地黄汤及芹菜汁而痊。
一小儿痘痕色白，时痛时痒，作渴饮汤，大便稀溏，此脾胃虚热也，用五味异功散加当归、黄 而瘥。
一小儿十六岁，痘痕白，用独参汤数斤，色渐如旧，又用地黄丸、大补汤而安。
一小儿痘后，因母怒痕赤，时或作痛，先用加味小柴胡汤、加味逍遥散，治其母而愈。
一小儿因乳母食膏粱之味，痘痕色赤，用清胃散治其母，而儿自愈。
一小儿痘痕色白，作痒发热，大便不实，诸药不应，余用五味异功散，每剂用人参一两，四剂之后，其热稍退，仍
用前药，兼服四神丸而愈。
一小儿痘痕白色，时或作痒，先君谓气血俱虚，不信，反服解毒之药，后变慢脾风而殁。
一男子患此，色白作痒，搔破脓水淋漓，恶寒体倦，余谓脾肺气虚，不信，反祛风败毒，果发搐而死。
一小儿患此，恶寒发热，或痒或痛，或白或赤，余谓气血俱虚，不悟，反降火祛风，发痉而死。
一小儿痘痕色白，服克伐之剂，致泻不止，余谓此脾气下陷也，不信，果殁，遍身如白敷粉，信气虚矣。
葛花解醒汤 治乳母酒醉后，乳儿遗热为患。
白豆蔻 砂仁 葛花（各五钱） 干生姜 白术（炒） 泽泻 神
曲（炒黄。各一钱） 白茯苓 陈皮 人参 猪苓 木香（各五分） 青皮（三分）
上为末，每二钱，白汤调服。
四顺清凉饮 治血脉壅实，脏腑蓄热，颊赤作渴，五心烦热，睡卧不安，四肢惊掣，或头面生疮，目赤咽痛，
痘疹余毒。（方见大便不通）
四君子汤（方见不靥闷乱）
前胡枳壳汤（方见痘涕唾）
加味逍遥散（方见痘潮热）
泻黄散（方见痘渴泻）
独参汤（方见腹胀气促）
六味地黄丸（方见发热属阴阳）
十全大补汤（方见腹胀气促）
五味异功散（方见寒战切牙）
四物汤（方见痘出迟）
圣济归脾汤（方见痘痈）
犀角地黄汤（即圣济犀角地黄汤，方见顶陷心烦）
清胃散（方见痘痈）
痘痕呈现红色或白色，各有其病因，治疗方法也各不相同。凡是痘痕发红且伴有瘙痒的，是血虚兼有内热所致，使用五味子、牡丹皮治疗。痘痕发红且伴有疼痛的，是余热未清所致，使用四君子汤、连翘、金银花治疗。如果发热但大便正常调和的，是脾胃虚热所致，使用五味异功散治疗。如果发热且大便秘结不通的，是肠胃内部有实热所致，使用圣济犀角地黄汤治疗。如果母亲体内有肝火，（患儿）使用加味逍遥散治疗。如果母亲情绪抑郁易怒，使用加味归脾汤，并佐以加味逍遥散共同治疗。痘痕发白的，多属于气虚而血衰，应当以巩固元气为根本原则。如果痘痕发白且伴有瘙痒和口渴，是气血两虚所致，使用十全大补汤之类的方剂。如果乳食减少、四肢倦怠无力，是中气虚弱所致，使用五味异功散之类的方剂。如果是气虚引起的发热，使用补中益气汤之类的方剂。如果是血虚引起的发热，使用当归补血汤之类的方剂，必须参考伴随变化的症状进行治疗。这种病症如果服药后痘痕逐渐变得红润鲜活，是可以治愈的；如果颜色没有转变，则难以治愈，即使经过多年，也多因患腹泻痢疾而死。如果胡乱投用攻伐药物，灾祸就在顷刻之间。
有一个小儿痘疮，如期痊愈，痘痕红得像赭石色，我认为这是乳母体内有热所致，诊察后发现确实存在肝脾郁火，先给乳母服用四剂加味逍遥散，让小儿也喝少许，结果母子一同痊愈。
有一个小儿痘痕颜色发红且疼痛，发热口渴喜欢冷饮，大便不通利，先用前胡枳壳散治疗，待大便通畅、口渴停止后，再用圣济犀角地黄汤使病情安定，最后又用芹菜汁帮助痘痂脱落愈合。
有一个小儿痘痕颜色发红，大便不通利，小便赤涩，口渴想喝冷水，这是上焦实热所致，我的父亲（薛己之父）使用泻黄散，一剂药后立刻痊愈；随后又用圣济犀角地黄汤及芹菜汁而康复。
有一个小儿痘疮痊愈后痘痕发红且疼痛，体内发热口渴，大小便都不通利，我父亲认为是胃经热毒所致，使用济生犀角地黄汤及芹菜汁而康复。
有一个小儿痘痕颜色发白，时而疼痛时而瘙痒，口渴想喝热水，大便稀溏，这是脾胃虚热所致，使用五味异功散加入当归、黄芪而痊愈。
有一个十六岁的小儿，痘痕发白，服用了数斤独参汤，颜色逐渐恢复正常，后来又用地黄丸、大补汤而病情安定。
有一个小儿出痘后，因为母亲发怒导致痘痕发红，偶尔伴有疼痛，先用加味小柴胡汤、加味逍遥散治疗其母亲，从而痊愈。
有一个小儿因为乳母食用肥甘厚味的食物，导致痘痕颜色发红，用清胃散治疗其母亲，孩子也就自愈了。
有一个小儿痘痕颜色发白，伴有瘙痒发热，大便不成形，各种药物无效，我用五味异功散，每剂用人参一两，服用四剂后，发热稍退，仍然继续服用前药，并兼服四神丸而痊愈。
有一个小儿痘痕白色，偶尔瘙痒，我父亲认为是气血两虚，家属不信，反而服用解毒药物，后来转变为慢脾风而死亡。
有一个男子患此症，痘痕白色且瘙痒，抓破后脓水淋漓，恶寒身体疲倦，我认为是脾肺气虚，家属不信，反而使用祛风败毒药物，果然出现抽搐而死亡。
有一个小儿患此症，恶寒发热，有时瘙痒有时疼痛，痘痕或白或红，我认为是气血两虚，家属不醒悟，反而使用降火祛风药物，导致发生痉挛而死亡。
有一个小儿痘痕颜色发白，服用克伐（攻伐）药剂，导致腹泻不止，我认为是脾气下陷所致，家属不信，果然死亡，全身皮肤像涂了白粉一样，这证实了气虚的判断。
葛花解醒汤：治疗乳母酒后醉酒，乳汁残留热气给婴儿带来危害。
配方：白豆蔻、砂仁、葛花（各五钱），干生姜、白术（炒）、泽泻、神曲（炒黄，各一钱），白茯苓、陈皮、人参、猪苓、木香（各五分），青皮（三分）。
制法与用法：以上药材研为细末，每次取二钱，用白开水调服。
四顺清凉饮：治疗血脉壅滞实证，脏腑蓄积热邪，脸颊发红口渴，五心烦热，睡眠不安，四肢惊厥抽搐，或者头面生疮，眼睛发红咽喉疼痛，痘疹余毒。（此方见“大便不通”章节）
四君子汤（此方见“痘痂不脱闷乱”章节）
前胡枳壳汤（此方见“痘涕唾”章节）
加味逍遥散（此方见“痘潮热”章节）
泻黄散（此方见“痘渴泻”章节）
独参汤（此方见“腹胀气促”章节）
六味地黄丸（此方见“发热属阴阳”章节）
十全大补汤（此方见“腹胀气促”章节）
五味异功散（此方见“寒战切牙”章节）
四物汤（此方见“痘出迟”章节）
圣济归脾汤（此方见“痘痈”章节）
犀角地黄汤（即圣济犀角地黄汤，此方见“顶陷心烦”章节）
清胃散（此方见“痘痈”章节）
Red or white marks left by smallpox have different causes, and their treatment methods also vary. When the marks are red and itchy, it is due to blood deficiency with internal heat; use Wuwei Zi (Schisandra Fruit) and Mudan Pi (Moutan Cortex). When the marks are red and painful, it is due to residual heat; use Sijunzi Tang (Four Gentlemen Decoction), Lianqiao (Forsythia Fruit), and Jinyinhua (Honeysuckle Flower). If there is fever but the stool is normal and harmonious, it is due to deficiency-heat of the spleen and stomach; use Wuyi Yigong San (Five Agents for Extraordinary Efficacy Powder). If there is fever accompanied by constipation, it is due to internal excess-heat in the intestines and stomach; use Shengji Xijiao Dihuang Tang (Shengji Rhinoceros Horn and Rehmannia Decoction). If the mother has liver fire, treat the child with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If the mother has emotional depression and anger, treat with Jiawei Guipi Tang (Modified Heart-Spleen Tonic Decoction), assisted by Jiawei Xiaoyao San. White marks mostly belong to qi deficiency and blood decline; the fundamental approach should be to consolidate the original qi. If the marks are white with itching and thirst, it is due to deficiency of both qi and blood; use Shiquan Dabu Tang (Ten Complete Tonifying Decoction) and similar formulas. If milk intake decreases and limbs feel fatigued, it is due to deficiency of middle qi; use Wuyi Yigong San and similar formulas. For fever caused by qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For fever caused by blood deficiency, use Danggui Buxue Tang (Angelica Tonify Blood Decoction); one must consider accompanying variable symptoms in treatment. If, after taking medicine, the marks gradually become red and vibrant, the condition is treatable; if the color does not change, it is untreatable. Even years later, death often occurs due to diarrhea and dysentery. Blindly administering attacking/draining medicines brings disaster in an instant.
A child’s smallpox healed on schedule, leaving marks as red as ochre. I stated that this was due to heat in the wet nurse. Examination confirmed liver-spleen depressed fire. First, four doses of Jiawei Xiaoyao San were given to the mother, and a small amount to the child, resulting in recovery for both.
A child had red, painful marks, fever, thirst preferring cold drinks, and difficulty defecating. First, Qianhu Zhike San (Peucedanum and Aurantium Powder) was used. Once bowel movements normalized and thirst ceased, Shengji Xijiao Dihuang Tang was administered to stabilize the condition, followed by celery juice to facilitate scab detachment.
A child had red marks, difficult defecation, dark and scanty urination, and thirst for cold water. This was excess-heat in the upper jiao. My father treated with Xiehuang San (Drain Yellow Powder), achieving immediate cure after one dose; subsequently, Shengji Xijiao Dihuang Tang and celery juice were used for full recovery.
A child had red, painful marks after smallpox resolution, internal heat, thirst, and difficulty in both urination and defecation. My father attributed this to heat-toxin in the stomach meridian and treated with Jisheng Xijiao Dihuang Tang and celery juice for recovery.
A child had white marks, intermittent pain and itching, thirst for hot drinks, and loose stools. This was deficiency-heat of the spleen and stomach. Treatment with Wuyi Yigong San added with Danggui (Angelica Sinensis) and Huangqi (Astragalus) led to recovery.
A sixteen-year-old child had white marks. Several jin of Dushen Tang (Single Ginseng Decoction) were consumed, and the color gradually returned to normal. Subsequently, Dihuang Wan (Rehmannia Pill) and Dabu Tang (Great Tonifying Decoction) stabilized the condition.
After a child recovered from smallpox, marks turned red and occasionally painful due to the mother’s anger. Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) and Jiawei Xiaoyao San were used to treat the mother, leading to recovery.
A child had red marks because the wet nurse consumed rich, greasy foods. Qingwei San (Clear Stomach Powder) was used to treat the mother, resulting in the child's spontaneous recovery.
A child had white marks with itching, fever, and loose stools; other medicines were ineffective. I used Wuyi Yigong San, adding one liang of Renshen (Ginseng Root) per dose. After four doses, the fever subsided slightly. Continuing the previous prescription while simultaneously administering Sishen Wan (Four Spirits Pill) led to recovery.
A child had white marks with occasional itching. My father diagnosed deficiency of both qi and blood. The family did not believe this and instead administered detoxifying medicines. The condition later transformed into Manpi Feng (Slow Spleen Wind) and resulted in death.
A man suffered from this condition: white, itchy marks, oozing pus when scratched, aversion to cold, and body fatigue. I diagnosed spleen-lung qi deficiency. The family did not believe this and used wind-dispelling and toxin-resolving medicines. Convulsions ensued, leading to death.
A child suffered from this condition: aversion to cold and fever, intermittent itching or pain, marks varying between white and red. I diagnosed deficiency of both qi and blood. The family failed to understand, using fire-draining and wind-dispelling medicines instead. Spasms developed, leading to death.
A child had white marks and took draining medicines, causing incessant diarrhea. I diagnosed sinking of spleen qi. The family did not believe this, and the child died. The entire body became white like powdered flour, confirming the diagnosis of qi deficiency.
Ge Hua Jie Xing Tang (Kudzu Flower Relieving Intoxication Decoction): Treats residual heat transmitted to the infant through breast milk after the wet nurse consumes alcohol.
Ingredients: Baidoukou (Cardamom Seed), Renchen (Amomum Fructus), Ge Hua (Puerariae Flos) (each 5 qian); Ganshengjiang (Dried Ginger), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried), Zexie (Alisma Rhizome), Shenqu (Medicated Leaven, stir-fried until yellow) (each 1 qian); Baifuling (Poria), Chenpi (Citrus Reticulata Peel), Renshen (Ginseng Root), Zhuling (Polyporus), Muxiang (Aucklandiae Radix) (each 5 fen); Qingpi (Green Citrus Peel) (3 fen).
Preparation and Administration: Grind all ingredients into powder. Take 2 qian each time, mixed with warm water.
Sishun Qingliang Yin (Four Harmonious Cooling Clearing Drink): Treats blood vessel congestion and excess patterns, accumulation of heat in zang-fu organs, red cheeks with thirst, five-palm heat, restless sleep, limb convulsions, sores on the head and face, red eyes, and sore throat; also addresses residual toxins from exanthematous diseases. (Formula see "Constipation")
Sijunzi Tang (Four Gentlemen Decoction) (Formula see "Failure of Scabs to Fall with Restlessness")
Qianhu Zhike Tang (Peucedanum and Aurantium Decoction) (Formula see "Smallpox Nasal Discharge and Saliva")
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (Formula see "Smallpox Tidal Fever")
Xiehuang San (Drain Yellow Powder) (Formula see "Smallpox Thirst and Diarrhea")
Dushen Tang (Single Ginseng Decoction) (Formula see "Abdominal Distension and Shortness of Breath")
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (Formula see "Fever Attributed to Yin and Yang")
Shiquan Dabu Tang (Ten Complete Tonifying Decoction) (Formula see "Abdominal Distension and Shortness of Breath")
Wuyi Yigong San (Five Agents for Extraordinary Efficacy Powder) (Formula see "Chills and Teeth Grinding")
Siwu Tang (Four Substance Decoction) (Formula see "Delayed Smallpox Eruption")
Shengji Guipi Tang (Shengji Heart-Spleen Tonic Decoction) (Formula see "Smallpox Carbuncle")
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) (i.e., Shengji Xijiao Dihuang Tang, Formula see "Depressed Vertex and Mental Restlessness")
Qingwei San (Clear Stomach Powder) (Formula see "Smallpox Carbuncle")