变蒸一症乃小儿蒸皮长骨变幻精神不须服药其有兼伤风寒咳嗽痰涎鼻塞声
重蒸蒸发热宜服此方
人参 白术 白茯苓 甘草（炙） 白芍药（炒） 天花粉 桔梗（各五钱） 细辛 薄荷叶
（各二钱五分）
上为粗末每服三钱水四盏煎二盏服不拘时候
治麻症及斑疹初因外感不解热蕴于内而成宜用葛根汤以解散痘疮初觉发热亦宜用之若见
标则不宜用也（方见春类）
消毒饮治 疹热甚紫黑者或痘未出时亦宜服
牛蒡子（一名鼠粘子炒研三钱） 荆芥（去根一钱） 连翘（一钱） 防风（去芦） 甘草（生
各五分） 犀角（二分另磨入）
上作一服水煎热服
治痘三法按博爱心鉴治痘症立逆顺险三法极其详明而效验亦神谨按其法之大概以所宜用
之方随变症加减详于三法之下以广其幼幼之仁也
顺者一二日间初出之象如粟于口鼻腮耳年寿之间先发三五点淡红润色者吉之兆也气得其
正血
得其行其毒浅而轻不得妄行所以不须服药如七八日内贯浆之时略服保元汤一二点以助其气血
也
人参（二钱） 黄 （三钱） 甘草（一钱） 加川芎（五分） 当归（七分）
引助血分上用姜
逆者初出于天庭司空太阳印堂结喉心胸方广之处先发者逆形如蚕种紫黑干枯气涩血滞致
毒深妄
参阳位难当其势也以前保元汤内用人参一钱黄 甘草各一钱加白芍药一钱牛蒡子黄芩黄连玄
参丝瓜灰当归川芎连翘（各五分）陈皮官桂（各三分）防风羌活荆芥前胡（各四分）姜三片葱一根
煎服一以解毒一以助气血取汗以泄其毒开其滞涩或幡然如云雾之散而白日出见此一救而可得
生者十中二三七八日内病势沉重色白毒深又用保元汤加大黄芒硝枳实（炒）浓朴川芎当归水煎
服大下之下后而身温再出红润此则十中可活一二乃起死回生之妙也
险者初出圆晕成形干红少润其一二日间出现者毒尚浅气血未离可治以俟其气血交会也以
保元汤加桂（三分）兼活血匀气之剂如毒若盛兼解毒之药
“变蒸”这一病症，是指小儿通过皮肤蒸腾、骨骼生长来变化精神面貌的过程，通常不需要服药。如果兼有风寒损伤，出现咳嗽、痰涎增多、鼻塞、声音沉重、持续发热等症状，适宜服用此方：
人参、白术、白茯苓、甘草（炙烤）、白芍药（炒制）、天花粉、桔梗（各五钱）；细辛、薄荷叶（各二钱五分）。
将上述药材捣成粗末，每次服用三钱，加水四盏，煎煮至两盏，随时服用，不拘泥于特定时间。
治疗麻疹及斑疹，初起因外感邪气未能解除，热邪蕴结于体内而成，适宜使用葛根汤以解散表邪。痘疮初起感觉发热时，也适宜使用此方。但如果见到“标”证（指病情危重或出现逆象），则不宜使用。（该方见春季类章节）
消毒饮用于治疗疹色热势极盛、呈紫黑色者；或者在痘疮尚未发出时，也适宜服用。
牛蒡子（又名鼠粘子，炒后研碎，三钱）、荆芥（去根，一钱）、连翘（一钱）、防风（去芦头）、甘草（生用，各五分）、犀角（二分，单独磨汁兑入）。
以上药材作为一剂，用水煎煮，热服。
治疗痘疮的三种方法：参考《博爱心鉴》，治疗痘疮确立了逆、顺、险三种法则，极其详细明确且疗效神奇。现谨按其法的大概内容，列出适宜使用的方剂，并根据变化的症状进行加减，详述于这三种法则之下，以推广其爱护幼童的仁心。
所谓“顺”，是指在发病的一两天内，痘疮初出的迹象像粟米一样，先在口鼻、腮部、耳朵、年寿（鼻准）之间出现，先发三五点，颜色淡红润泽，这是吉祥的征兆。此时正气得到调和，血液运行通畅，毒邪浅而轻，不会妄行扩散，所以不需要服药。如在七八天内进入化脓灌浆阶段，可略服保元汤一二点，以辅助气血。
保元汤组成：人参（二钱）、黄芪（三钱）、甘草（一钱），加川芎（五分）、当归（七分）。引经药为姜，助血分上行。
所谓“逆”，是指痘疮初出在天庭、司空、太阳、印堂、结喉、心胸等宽阔部位先发出的，属于逆证。形态如蚕种，颜色紫黑干枯，气息涩滞，血液停滞，导致毒邪深重，妄犯阳气高位，难以承受其势头。对此，以前述保元汤为基础，用人参一钱、黄芪、甘草各一钱，加入白芍药一钱、牛蒡子、黄芩、黄连、玄参、丝瓜灰、当归、川芎、连翘（各五分）、陈皮、官桂（各三分）、防风、羌活、荆芥、前胡（各四分），生姜三片、葱一根，煎服。目的在于解毒并辅助气血，取汗以泄出毒邪，开通滞涩。若病情突然好转，如云雾消散般清晰，白日重现生机，这是一种救治手段，十人中能救活二三。若在七八天内病势沉重，颜色发白，毒邪深重，又使用保元汤加大黄、芒硝、枳实（炒制）、厚朴、川芎、当归，水煎服，进行强力攻下。泻下之后身体回暖，痘疮再次发出红润之色，这十人中可救活一二，是起死回生的妙法。
所谓“险”，是指痘疮初出呈圆晕成形，干燥发红但少润泽，在一两天内出现的，说明毒邪尚浅，气血未离散，可以治愈，等待气血交会即可。使用保元汤加肉桂（三分），兼用活血匀气的方剂。如果毒邪旺盛，兼用解毒的药物。
"Bian Zheng" (Variable Evaporation) is a condition in infants characterized by skin evaporation and bone growth to transform their spirit and vitality; it generally requires no medication. However, if complicated by wind-cold injury, presenting with cough, phlegm, nasal congestion, heavy voice, and persistent fever (Zhen Zhen Fa Re), this formula is suitable:
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Gan Cao (Licorice Root, honey-fried), Bai Shao Yao (White Peony Root, stir-baked), Tian Hua Fen (Trichosanthes Root), Jie Geng (Platycodon Root) (each 5 qian); Xi Xin (Asarum), Bo He Ye (Menthae Haplocalycis Herba) (each 2.5 qian).
Grind the above into a coarse powder. Take 3 qian per dose, add 4 zhan of water, decoct until 2 zhan remain. Take at any time, without restriction on timing.
For treating measles (Ma Zheng) and maculopapular rashes, initially caused by unresolved external contraction leading to heat accumulation internally, Ge Gen Tang (Kudzu Decoction) should be used to release the exterior. For early-stage smallpox (Dou Chuang) presenting with fever, this formula is also suitable. However, if "Biao" (superficial or critical signs indicating contraindication) appears, it should not be used. (See Formula in Spring Category).
Xiao Du Yin (Disinfect Toxin Decoction) is used for rashes with intense heat and purple-black coloration, or when smallpox has not yet erupted.
Niu Bang Zi (Arctii Fructus, roasted and ground, 3 qian), Jing Jie (Schizonepetae Spica, roots removed, 1 qian), Lian Qiao (Forsythiae Fructus, 1 qian), Fang Feng (Saposhnikoviae Radix, awn removed), Gan Cao (Licorice Root, raw, each 0.5 qian), Xi Jiao (Rhinocerotis Cornu, 2 fen, separately ground and added).
Prepare as one dose, decoct in water, and take hot.
Three Methods for Treating Smallpox: Referencing *Bo Ai Xin Jian*, methods for treating smallpox are established into three categories: Shun (Smooth/Favorable), Ni (Reverse/Unfavorable), and Xian (Dangerous). These are detailed and effective. Here, we summarize the general principles and list appropriate formulas with modifications based on changing symptoms, under these three methods, to extend benevolence to children.
**Shun (Smooth):** In the first one or two days, the initial eruption resembles millet grains, appearing first around the mouth, nose, cheeks, ears, and nose tip (Nian Shou). The emergence of three to five spots that are pale red and moist is an auspicious sign. Qi is regulated, blood flows smoothly, and the toxin is shallow and mild, preventing erratic spread. Therefore, medication is usually unnecessary. If during the seventh or eighth day, when pus formation occurs, taking a small amount of Bao Yuan Tang (Preserve Origin Decoction) can assist Qi and Blood.
*Bao Yuan Tang Composition:* Ren Shen (Ginseng Radix, 2 qian), Huang Qi (Astragali Radix, 3 qian), Gan Cao (Licorice Root, 1 qian), plus Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.5 qian), Dang Gui (Angelicae Sinensis Radix, 0.7 qian). Use Sheng Jiang (Zingiberis Rhizoma Recens) as a guide to assist the blood level.
**Ni (Reverse):** Eruption starting in broad areas such as Ting Tian, Si Kong, Tai Yang, Yin Tang, Jie Hou, or the chest/heart region is considered reverse. The lesions resemble silkworm eggs, are purple-black, dry, and withered, with stagnant Qi and blood, leading to deep toxins that overwhelm the Yang positions. Treatment uses a modified Bao Yuan Tang: Ren Shen (1 qian), Huang Qi and Gan Cao (each 1 qian), plus Bai Shao Yao (1 qian), Niu Bang Zi, Huang Qin, Huang Lian, Xuan Shen, Si Gua Hui (Ash from Loofah Sponge), Dang Gui, Chuan Xiong, Lian Qiao (each 0.5 qian), Chen Pi, Guan Gui (Cinnamomi Cortex, each 0.3 qian), Fang Feng, Qiang Huo, Jing Jie, Qian Hu (each 0.4 qian), Sheng Jiang (3 slices), Cong Bai (Scallion Stem, 1 root). Decoct and take hot. This aims to detoxify, assist Qi and Blood, induce sweating to vent toxins, and open stagnation. If the condition suddenly clears like dispersing clouds, revealing life, this rescue method saves two or three out of ten. If after seven or eight days the disease is severe, color is white, and toxin is deep, use Bao Yuan Tang combined with Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), Zhi Shi (Aurantii Fructus, fried), Hou Po (Magnoliae Officinalis Bark), Chuan Xiong, Dang Gui. Decoct in water and administer strong purgation. After purgation, if the body warms and red eruptions reappear, this miraculous method saves one or two out of ten, bringing the dead back to life.
**Xian (Dangerous):** Initial eruptions form circular halos, are dry and red but lack moisture, appearing within one or two days. The toxin is still shallow, and Qi and Blood have not dispersed; it is treatable while waiting for Qi and Blood to converge. Use Bao Yuan Tang plus Rou Gui (Cinnamomi Cortex, 0.3 qian), combined with formulas that invigorate blood and harmonize Qi. If the toxin is vigorous, add detoxifying herbs.