夫百病以神气清爽为第一，其烦躁二侯，虽似轻症、实为精神耗竭之机，杂症痘
疹，均非所宜也。然合而言之，烦躁皆热也。析而分之，烦者，阳也，热之轻者∶躁
着，阴也，热之甚者。故曰∶火入于肺则烦，火入于肾则躁，总皆心火为之，盖火旺
则金铄水亏也。肺热而烦者，坐卧不安，肾热而躁者，必曾自利，但宜审于何时？如初
发热便烦者，此毒火内郁也。如疮发见而犹烦者，此毒伏于内，未尽出也。如疮出尽，
又已起发而犹烦者，此阴亏也。如扬手掷足，动挠衣破者，此热甚于表也。如神识昏
迷，反复颠倒者，此热甚于里也。如吐利不食而烦躁者，是正气虚也。如津干口渴，虚
烦不得卧者，是津液不足也。六七日不大便而烦躁者，此内实有燥粪也。如昼日烦躁夜
则安静者，此阳盛于昼，至夜则阳气退而安静也，宜用气分药加栀子仁以主之。如昼日
明，子便则烦躁者，此阳陷入阴，至夜则阴气盛而阴阳相争，故烦躁也，宜用血分药，
加栀子仁以主之。如大便色黑，面黄狂妄，烦躁喘渴，腹胀或痛者，则有瘀血在里也，
甚则用桃仁承气汤主之。若至吐利厥逆，腹胀喘促而烦躁者，并昏不知人，谵妄狂扰而
烦躁者，是谓闷乱，俱为不治之症。
夫汗乃心之液，内因热气熏蒸，腠理开泄，故液随气而出，虽有盗汗自汗之别，总
能虚人。如未灌之时而汗者，则不能灌，灌而汗者，则不能靥，靥而汗者，则必至于血
脱阳虚，变为他症，故宜急为调理。然有甚与不甚之别焉，丹溪曰∶自汗不妨，是湿热
熏蒸而然也，特言夫未甚者耳。未甚者，不惟无妨，且亦痘中之美候。甚者，则气血为
之走泄，故宜急用参 之类，内加浮小麦以敛之；有热者，更加酒芩。如盗汗者，宜用
芩、连、归、 、白芍、生地之类。若身冷恶寒而反汗者，急进参、附、桂、苓、甘
草、黄 之类。如寒而不已者，汗出发润，大喘不止者，汗缀如珠者，汗而昏沉者，汗
流烦渴者，肺绝而汗出如油者，并为不治。
凡无因而至者为自汗。若睡中而得者为盗汗。若腰以上，烦热而多汗者为胃实汗。
若热甚汗多，汗出而热解者为邪热汗。若汗流不止而热反剧者，为阳虚汗。然在痘以汗
为美者，以初起而有微汗，则阴阳气和，荣卫通畅邪气不留，易出而解也。在行浆时而
有微汗，亦是气血充足之征也。然有过表，腠虚而多汗者；有心热而睡汗者；有六阳虚
而头颅或颈多汗不过胸者；有胃虚而颈胸脐间多汗者；有肝木侮土自汗发搐流涎者；有
胃实而四肢多汗，面赤作渴者；有痂落表虚而多汗者；随所因而治之。总之，汗者，血
之所化，阴气不能内藏也。若因阳虚自汗者，大补其气以敛之；若因睡而汗出者，当
以补血为主而兼补气；若荣中伏热，津液流溢妄泄者，宜于补养之中，佐以凉血之药。
凡是各种疾病，都以神气清爽为第一要务。烦躁这两种症状，虽然看似轻微，实则是精神耗竭的征兆，在杂症、痘疹中都不适宜出现。然而综合来说，烦躁都属于热证。分析开来，烦属于阳，是较轻的热；躁属于阴，是较重的热。所以说：火邪入肺则产生烦，火邪入肾则产生躁，总归都是心火作祟，因为火旺则灼伤肺金、亏损肾水。肺热而烦的，表现为坐卧不安；肾热而躁的，必定曾经有过腹泻，但应当审察发生在什么时候？如果初起发热时就烦，这是毒火内郁；如果痘疮发出后仍然烦，这是毒伏于体内，尚未完全透出；如果痘疮出尽，且已经起发但仍然烦，这是阴液亏损；如果扬手掷足，扰动衣物破损，这是热势盛于体表；如果神识昏迷，身体反复颠倒，这是热势盛于体内；如果呕吐腹泻不能进食而烦躁，这是正气虚弱；如果津液干枯口渴，虚烦不得安卧，这是津液不足；六七天不大便而烦躁，这是内有燥屎结实；如果白天烦躁，夜间安静，这是阳气盛于白天，到了夜晚阳气衰退所以安静，宜用气分药加栀子仁来主治；如果白天清醒，夜间却烦躁，这是阳气陷入阴分，到了夜晚阴气盛而阴阳相争，所以烦躁，宜用血分药加栀子仁来主治；如果大便色黑，面色黄，狂妄，烦躁气喘口渴，腹胀或痛，这是里有瘀血，严重时用桃仁承气汤主治。如果发展到呕吐腹泻、四肢厥冷，腹胀喘促而烦躁，并且昏不知人，胡言乱语狂乱扰动的烦躁，这叫做闷乱，都属于不治之症。
汗是心的体液，因内部热气熏蒸，腠理开泄，所以津液随气外出，虽然有盗汗、自汗的区别，但总体都能使人虚弱。如果在痘疮未灌浆时出汗，则不能灌浆；灌浆时出汗，则不能结痂；结痂时出汗，则必然导致血脱阳虚，变为其他病症，所以应当紧急调理。然而有严重与不严重的区别。丹溪说：自汗不妨碍，这是湿热熏蒸所致，特指那些不严重的情况。不严重的，不仅无妨，而且是痘疹中的好征兆。严重的，则气血为之走泄，所以应当紧急用人参之类，内加浮小麦以收敛；有热的，再加酒炒黄芩。如果是盗汗，宜用黄芩、黄连、当归、地黄、白芍、生地之类。如果身冷恶寒反而出汗，紧急进用人参、附子、桂枝、茯苓、甘草、黄芪之类。如果寒象不止，出汗后头发湿润，大喘不止，汗珠如串珠状，出汗后昏沉，汗流不止且烦躁口渴，肺绝而汗出如油，都属于不治之症。
凡是没有原因而来的出汗叫自汗。如果在睡眠中出汗的叫盗汗。如果腰部以上烦热而多汗的叫胃实汗。如果热势很盛汗很多，出汗后热退解的是邪热汗。如果汗流不止而热势反而加剧的，是阳虚汗。然而在痘疹中认为出汗是好的，是因为初起时有微汗，则阴阳气和，营卫通畅，邪气不留，容易透出而解除。在行浆阶段而有微汗，也是气血充足的征象。然而也有过用发表药，腠理空虚而多汗的；有心热而睡中出汗的；有六腑阳气虚而头部或颈部多汗不过胸部的；有胃虚而颈胸脐间多汗的；有肝木侮土导致自汗并发搐流涎的；有胃实而四肢多汗，面赤作渴的；有痂落表虚而多汗的；根据各自的原因进行治疗。总之，汗是由血液所化生，阴气不能在内固藏。如果因阳虚自汗的，大补其气以收敛它；如果因睡觉而出汗的，应当以补血为主兼补气；如果营分中有伏热，津液流溢妄泄的，宜在补养之中，佐以凉血的药物。
In all diseases, the clarity and freshness of Shen Qi (Spiritual Energy) is the primary concern. The two conditions of Fan (Restlessness/Agitation) and Zao (Irritability/Fidgeting), although appearing as mild symptoms, are actually signs of spiritual exhaustion and are not suitable in miscellaneous diseases or smallpox/rubella. However, speaking generally, both Fan and Zao belong to Heat syndromes. Analyzing them separately, Fan belongs to Yang and represents milder Heat; Zao belongs to Yin and represents severer Heat. Therefore, it is said: when Fire enters the Lung, Fan occurs; when Fire enters the Kidney, Zao occurs. Ultimately, all are caused by Heart Fire, because excessive Fire scorches Metal (Lung) and depletes Water (Kidney). When Lung Heat causes Fan, there is restlessness in sitting and lying down; when Kidney Heat causes Zao, there must have been prior diarrhea, but one must examine when this occurred. If Fan appears at the initial stage of fever, this is internal depression of toxic Fire. If Fan persists after the eruption of sores, this is toxin hidden internally, not yet fully expelled. If the sores have fully erupted and risen but Fan persists, this is Yin deficiency. If the patient throws hands and feet about, disturbing clothes and breaking them, this indicates severe Heat on the exterior. If consciousness is confused and the body turns repeatedly, this indicates severe Heat in the interior. If vomiting, diarrhea, inability to eat, and irritability occur together, this is deficiency of Righteous Qi. If dry fluids, thirst, vexation without true heat, and inability to sleep occur, this is insufficiency of Body Fluids. If there is no bowel movement for six or seven days accompanied by irritability, this is internal excess with dry feces. If the patient is irritable during the day but quiet at night, this is due to Yang abundance during the day; at night, Yang recedes, leading to quietness; Qi-level formulas should be used with Gardenia Seed (Zhi Zi Ren) as the main treatment. If the patient is clear during the day but irritable at night, this is due to Yang sinking into Yin; at night, Yin becomes abundant, causing conflict between Yin and Yang, resulting in irritability; Blood-level formulas should be used with Gardenia Seed (Zhi Zi Ren) as the main treatment. If the stool is black, the face is yellow, the patient is delirious, irritable, panting, thirsty, with abdominal distension or pain, this indicates blood stasis in the interior; in severe cases, Tao Ren Cheng Qi Tang (Peach Kernel Draining the Interior Decoction) should be used. If the condition progresses to vomiting, diarrhea, cold limbs, abdominal distension, panting, and irritability, along with unconsciousness, delirium, and manic disturbance, this is called Men Luan (Confusion and Chaos), which constitutes untreatable conditions.
Sweat is the fluid of the Heart. Internally, due to steaming by Heat, the Cou Li (pores/skin texture) open and leak, so fluids exit with Qi. Although there are distinctions between Dao Han (Night Sweats) and Zi Han (Spontaneous Sweats), all can lead to deficiency in the person. If sweating occurs before the pustules fill with pus, they cannot fill; if sweating occurs while filling, they cannot crust over; if sweating occurs after crusting, it will inevitably lead to blood depletion and Yang deficiency, transforming into other diseases, so urgent regulation is required. However, there are degrees of severity. Danxi stated: Spontaneous sweating is not harmful; this is due to steaming by Damp-Heat, specifically referring to mild cases. In mild cases, it is not only harmless but also a favorable sign in smallpox. In severe cases, Qi and Blood leak away, so urgent use of Ginseng (Ren Shen) type herbs, added with Floating Wheat (Fu Xiao Mai) to astringe, is needed; if there is Heat, add Wine-fried Scutellaria Root (Jiu Huang Qin). For night sweats, use Scutellaria Root (Huang Qin), Coptis Rhizome (Huang Lian), Angelica Sinensis (Dang Gui), Rehmannia Root (Shu Di Huang), White Peony Root (Bai Shao), and Raw Rehmannia Root (Sheng Di Huang). If the body is cold and aversion to cold exists but sweating occurs, urgently administer Ginseng (Ren Shen), Aconite Root (Fu Zi), Cinnamon Twig (Gui Zhi), Poria (Fu Ling), Licorice Root (Gan Cao), and Astragalus Root (Huang Qi). If coldness persists, sweating wets the hair, panting does not stop, sweat beads like pearls, sweating leads to drowsiness, profuse sweating with vexation and thirst, or lung failure with oily sweat, these are all untreatable.
Sweating without an apparent cause is called spontaneous sweating (Zi Han). Sweating during sleep is called night sweating (Dao Han). Sweating above the waist with vexation and heat is called Stomach Excess Sweat (Wei Shi Han). Sweating profusely with high heat that resolves upon sweating is called Pathogenic Heat Sweat (Xie Re Han). Sweating continuously with worsening heat is called Yang Deficiency Sweat (Yang Xu Han). However, in smallpox, sweating is considered auspicious because slight sweating at the beginning indicates harmony of Yin and Yang, smooth flow of Ying and Wei, non-retention of pathogenic factors, and ease of eruption and resolution. Slight sweating during the pus-forming stage is also a sign of sufficient Qi and Blood. However, there are cases of excessive release of exterior pathogens leading to empty Cou Li and profuse sweating; cases of Heart Heat causing night sweats; cases of deficiency of Yang organs causing sweating on the head or neck not extending below the chest; cases of Stomach deficiency causing sweating on the neck, chest, and umbilicus; cases of Liver Wood insulting Earth causing spontaneous sweating with convulsions and salivation; cases of Stomach excess causing sweating on the four limbs, red face, and thirst; cases of scab falling with exterior deficiency causing profuse sweating. Treatment follows the specific cause. In summary, sweat is transformed from Blood; it indicates that Yin Qi cannot be stored internally. If spontaneous sweating is due to Yang deficiency, greatly tonify Qi to astringe it; if sweating occurs during sleep, primarily nourish Blood while supplementing Qi; if latent Heat in Ying level causes leakage of Body Fluids, add Blood-cooling herbs within the context of nourishment.