痘有寒战切牙者，或谓心火热甚亢极而战，反兼水化制之，是为病热。或曰∶俱属
于寒，如严冬之气，伏阳在内不胜其寒，是以手足战栗而齿自动，故陈氏以异功散而取
效，非寒而何？嗟嗟！偏寒偏热，皆未得病之旨，斯症有先后之序，用药有缓急之分。
凡七日以前寒战者，乃心火亢极也，当以表热治之。七日以前切牙者，乃阳明胃热，以
其经走上下齿龈也，当清之。若七日以后寒战者，乃阴凝于阳，阳分虚则阴入气道而作
寒战也，宜以气虚治之，大用参 ，加姜桂以温阳分。七日以后切牙者，乃阳陷于阴，
阴分虚则阳入血道而作切牙也，主血虚，宜补之，大用参 加芎、归、黑姜，以实阴
虚。七日前而有此症者，属热而凶，七日后而有此症者，属虚，而亦有可治。若单于寒
战者，则当与补气之中而兼补血。单于切牙者，则于补血之中而兼助气。然阳气虚寒，
固有寒战；风火相搏，亦有寒战。阳明胃热，固有切牙；肝肾虚寒亦有切牙。故不若
观痘色之红白，二便之秘利，喜饮之寒热，脉息之迟数，起发之难易，则寒热洞然矣。
大抵发于痘初，多因心肝胃火，盖热毒不得尽出，内与正气相搏，筋脉因而动摇，实热
症也。若发于痘后，则多由肝肾两虚，虽有热症，乃假热也。如切牙面赤作渴，至夜为
甚者，此阴虚也，宜地黄丸料恣饮之。故曰∶切牙者，齿槁也。至若疮色焦黑，不省
人事，闭目无魂，谵语狂烦，寻衣摸缝，门牙不已者，此皆气血将尽，纵毒内攻矣。
痘疹出现寒战和切牙（牙齿咬紧）症状的，有人认为是心火极度亢盛而引发战栗，这是热极反兼水化来制约它，属于病热。也有人认为：这都属于寒证，就像严冬的气候一样，体内的伏阳无法抵御外寒，因此手足颤抖、牙齿自动咬合，所以陈氏用异功散取得疗效，如果不是寒证是什么？唉！片面地认为是寒或热，都没有抓住疾病的本质。这种病症有发病先后的顺序，用药也有缓急的区别。
凡是出痘后七天以前出现寒战的，是心火极度亢盛，应当按表热证治疗。七天以前出现切牙的，是阳明胃热，因为阳明经循行经过上下齿龈，应当清热。如果是七天以后出现寒战的，是阴气凝结于阳气之中，阳气分虚弱则阴气侵入气道而产生寒战，适宜按气虚治疗，大量使用人参，加入生姜、肉桂以温补阳气分。七天以后出现切牙的，是阳气下陷于阴分，阴分虚弱则阳气进入血道而产生切牙，主因是血虚，应当补血，大量使用人参，加入川芎、当归、炮姜，以充实阴虚。
在七日前出现这些症状的，属于热证且病情凶险；七日后出现这些症状的，属于虚证，但也有可治的可能。如果仅有寒战症状，应当在补气中兼以补血。如果仅有切牙症状，应当在补血中兼以助气。然而，阳气虚寒，自然会有寒战；风火相互搏结，也会有寒战。阳明胃热，自然会有切牙；肝肾虚寒也会有切牙。所以不如观察痘色的红白、二便的通利与闭塞、口渴喜饮的冷热、脉息的迟与数、痘疹起发的难易，那么寒热的性质就一目了然了。
大抵来说，发于痘疹初期的，多因心、肝、胃之火，这是因为热毒不能完全透出，在内与正气相搏结，导致筋脉动摇，属于实热证。如果发于痘疹后期，则多由肝、肾两脏虚弱所致，虽然有热症表现，那是假热。比如切牙、面赤、口渴，到了夜晚加重的，这是阴虚，适宜大量饮用六味地黄丸的方料。所以说：切牙，意味着牙齿枯槁。至于那些疮色焦黑、神志不清、闭目无魂、胡言乱语狂躁烦闷、伸手抓摸衣缝、门牙不停颤动的，这些都是气血即将耗尽，毒邪内攻的表现。
In cases of smallpox presenting with chills and teeth grinding (teeth clenching), some argue that it is due to excessive heart fire causing tremors, where the extreme heat counteracts itself by generating water-like properties, indicating a pathological heat condition. Others contend: these all belong to cold syndromes, similar to the climate of severe winter, where latent yang within the body cannot withstand the cold, leading to trembling limbs and automatic clenching of teeth; thus, Chen used Yigong San (Isolated Efficacy Powder) with success—if this were not cold, what would it be? Alas! Partially attributing it to either cold or heat fails to grasp the essence of the disease. This syndrome has a sequence of onset, and medication requires distinction between urgency and moderation.
For chills occurring before the seventh day after eruption, it is due to extreme hyperactivity of heart fire, and should be treated as exterior heat. For teeth grinding occurring before the seventh day, it is due to Yangming stomach heat, as the Yangming meridian traverses the upper and lower gums, and should be cleared. If chills occur after the seventh day, it is due to yin condensing upon yang; when the yang aspect is deficient, yin enters the qi pathway causing chills, suitable for treating qi deficiency with large doses of Renshen (Ginseng Radix et Rhizoma), added with Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) and Rougui (Cinnamomi Cortex, Cinnamon Bark) to warm the yang aspect. If teeth grinding occurs after the seventh day, it is due to yang sinking into yin; when the yin aspect is deficient, yang enters the blood pathway causing teeth grinding, primarily due to blood deficiency, requiring tonification with large doses of Renshen (Ginseng Radix et Rhizoma, Ginseng Root and Rhizome), added with Xiong (Chuanxiong Rhizoma, Szechwan Lovage Rhizome), Danggui (Angelicae Sinensis Radix, Dong Quai Root), and Heijiang (Zingiberis Rhizoma Preparatum, Prepared Ginger) to solidify yin deficiency.
Symptoms appearing before the seventh day belong to heat and are ominous; symptoms appearing after the seventh day belong to deficiency but may still be treatable. If only chills are present, one should supplement qi while simultaneously nourishing blood. If only teeth grinding is present, one should nourish blood while simultaneously assisting qi. However, yang deficiency and cold naturally cause chills; wind and fire battling each other also cause chills. Yangming stomach heat naturally causes teeth grinding; liver and kidney deficiency-cold also cause teeth grinding. Therefore, it is better to observe the redness or pallor of the rash, the patency or constipation of urination and defecation, the preference for hot or cold drinks, the slowness or rapidity of the pulse, and the ease or difficulty of eruption, so that the nature of cold and heat becomes clear.
Generally speaking, eruptions at the initial stage are mostly due to fire in the heart, liver, and stomach. Because heat toxins cannot fully emerge, they struggle internally with healthy qi, causing the sinews and vessels to tremble; this is an excess-heat syndrome. If eruptions occur at the later stage, it is mostly due to deficiency of both the liver and kidneys. Although there may appear to be heat symptoms, these are false heat. For instance, teeth grinding, red face, thirst, worsening at night indicates yin deficiency; one should freely drink the decoction of Dihuang Wan (Rehmannia Pill). Thus it is said: "Teeth grinding indicates withered teeth." As for cases where the sores are scorched black, consciousness is lost, eyes are closed without spirit, delirium and mania prevail, seeking clothes and picking seams, and the incisors tremble incessantly—these are all signs that qi and blood are nearly exhausted, and toxic pathogens have attacked inward.