夫痘毒麻毒所属不同，痘毒出于脏，麻毒出于腑。盖自孕成之初，先有脏而后有
腑，脏为积受之，地腑为传送之所。脏属阴，受毒为最深；腑属阳，受毒为差浅。痘
之发触于天行时气，疹之发中于时气风寒，本非寻常并发者，盖因痘出之际，毒趋百
窍，被风寒阻塞腠理，是以血热壅遏，击动府毒，因乃并出，是皆不顺之候。如痘稀
疏，可以升麻汤解之，疹散痘出，其势自顺矣。若痘太盛，则其疹虽解，殊不知气血已
受亏于前矣。诚恐气弱血伤，不能始终以化其毒，是尚未可议其有生也。然痘当从外
解，疹当从内解，麻疹之发，轻而勿解。若有不解者，乃为内热而外中风寒之盛也，治
法惟宜轻表凉内，切勿汗下妄施，表轻则肌松而邪散，内凉则血和而毒透，骤汗则气泄
而亡阳，迅下则里虚而毒陷。然麻疹多属于肺，故嗽而始出，起而成粒，匀净而小，兼
阳气从上，故头面愈多者为佳，治宜升麻葛根汤，小柴胡汤，重则麻黄汤，以表散为
主，疹散而痘得单成为妙。若如此而不散，则肺气既伤，肝荣亦损，凶之候也。若夫丹
疹者，多属于脾隐在皮肤之间，或成块而赤，或云头而突，多起于手足身背之间。发
则多痒，或有麻木，是兼湿痰之殊，色红者，兼火化也。总之，浮游之火，壅血散漫
于皮肤耳。治宜先以轻剂散火，兼用凉血解毒之药，然痘内而夹丹疹者，可不必治之，
但以托痘为主，痘出而此自淡矣。
痘毒与麻毒的性质归属不同，痘毒源于五脏，麻毒源于六腑。这是因为在胚胎形成的初期，先有脏的形成而后才有腑的形成；脏是积聚受纳的场所，腑是传导排泄的处所。脏属阴，受毒最深；腑属阳，受毒较浅。痘疹的发生触犯了天行时气（流行性疫病之气），麻疹的发生中于时气风寒，本不是寻常同时并发的情况。大概是因为痘毒发出之际，毒邪趋向百窍，被风寒阻塞了腠理（皮肤纹理及汗孔），导致血热壅滞遏阻，击动了腑中的毒邪，因而一并发出，这都是不顺的征候。如果痘疹稀疏，可以用升麻汤来解除；若麻疹消散而痘毒透出，其病势自然就会顺遂。如果痘毒太盛，那么即使麻疹解除了，却不知道气血此前已经受到亏损。实在担心气弱血伤，不能始终将毒邪化解，这种情况下还谈不上有生机。然而痘毒应当从体表解除，麻疹应当从体内解除。麻疹发作时，病情轻者不要急于治疗。如果有未能自愈的情况，那是由于内热兼外感风寒严重所致，治疗方法只宜用轻宣透表、清解内热的方法，切勿妄用发汗或攻下法。表散轻则肌腠疏松而邪气散去，内清热则血液调和而毒邪透出；骤然发汗会导致气泄而亡阳，迅速攻下会导致里虚而毒邪内陷。然而麻疹多归属于肺，所以咳嗽后始出，起而成颗粒，均匀洁净且小，兼有阳气向上，所以头面部越多者为佳，治疗适宜用升麻葛根汤、小柴胡汤，重症用麻黄汤，以表散为主，待麻疹消散而痘毒单独透发为妙。如果这样仍不消散，则肺气既已受伤，肝血亦受损，这是凶险的征候。至于丹疹，多归属于脾，隐伏在皮肤之间，有的成块而红，有的如云头突起，多起于手足身背之间。发作时大多瘙痒，或有麻木感，这是兼夹湿痰的特殊表现，颜色红的，是兼夹火化所致。总之，这是浮游之火，壅滞血液散漫于皮肤罢了。治疗适宜先用轻剂散火，兼用凉血解毒的药物。然而痘毒内部夹杂丹疹的，可以不必专门治疗，只需以托举痘毒为主，痘毒透出后此症自然消退。
The nature and origin of the toxic factors in smallpox (Dou) and measles (Ma) are different. The toxic factor of smallpox originates from the Zang organs, while that of measles originates from the Fu organs. This is because at the initial stage of embryonic formation, the Zang organs form first, followed by the Fu organs; the Zang organs are the sites for accumulation and reception, while the Fu organs are the channels for transmission and excretion. The Zang organs belong to Yin and receive the toxic factor deeply; the Fu organs belong to Yang and receive the toxic factor more superficially. Smallpox erupts due to contact with epidemic Qi (Tianxing Shiqi), and measles erupts due to contracting seasonal Wind-Cold. They do not typically occur simultaneously. Generally, when the smallpox toxin is emerging, it tends toward the hundred orifices, but if blocked by Wind-Cold obstructing the Couli (skin pores and interstices), blood heat becomes stagnant and suppressed, stirring up the toxic factor in the Fu organs, causing both to erupt together. This is an unfavorable prognosis. If the smallpox eruption is sparse, Shengma Tang (Cimicifugae Decoction) can be used to resolve it; once the measles rash disperses and the smallpox emerges, the disease process will naturally become favorable. However, if the smallpox is too severe, even if the measles resolves, one must realize that the Qi and Blood have already been depleted. There is a genuine fear that weak Qi and damaged Blood will fail to transform the toxin completely, making survival uncertain. Nevertheless, smallpox should be resolved from the exterior, while measles should be resolved from the interior. For mild cases of measles, treatment should be avoided initially. If resolution does not occur spontaneously, it indicates severe internal Heat combined with external Wind-Cold. The treatment method should only involve light exterior-releasing and interior-cooling strategies; reckless use of sweating or purging methods must be avoided. Light exterior release relaxes the muscles and scatters pathogens; interior cooling harmonizes the Blood and allows the toxin to emerge. Sudden sweating leads to Qi leakage and collapse of Yang; rapid purging leads to interior deficiency and sinking of the toxin. Measles mostly belongs to the Lung, so it appears after coughing, rises into granules, is uniform and clean, and small. Since Yang Qi moves upward, having more eruptions on the head and face is auspicious. Treatment should prioritize Shengma Gegen Tang (Cimicifugae and Puerariae Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction); in severe cases, Mahuang Tang (Ephedra Decoction) is used, focusing on exterior release. It is ideal for the measles rash to disperse while the smallpox emerges independently. If they still do not disperse under such conditions, Lung Qi is injured and Liver Blood is damaged, indicating a ominous sign. As for Danzhen (scarlet-like rash), it mostly belongs to the Spleen, hiding between the skin layers. It may appear as red patches or cloud-like protrusions, often starting on the limbs, trunk, and back. Eruptions are usually itchy or numb, indicating a combination with Dampness and Phlegm. Red coloration indicates a combination with Fire transformation. In essence, this is floating Fire stagnating Blood and spreading diffusely in the skin. Treatment should first use light agents to scatter Fire, combined with herbs that cool the Blood and detoxify. However, if Danzhen occurs internally alongside smallpox, specific treatment for the rash is unnecessary; the focus should remain on supporting the emergence of the smallpox, after which the rash will naturally fade.