第一犯猿猴跳锁。凡儿未患痘时，先感冒风邪，身如火烙，头痛自汗，咳嗽不已，
或伤寒之后，而痘随出者，则元气嚣漓，须急疏风解热，补血滋阴，调元固表。诀曰∶
一犯伤寒势欲危，医须斟酌痘无亏，如将汤药柴胡用，婴儿含花死可悲。
第二犯观音拂痤。凡儿饮食不克樽节，暑湿不能护养，是以脾胃损伤频多，泄泻饮
食懒飧，肢体羸瘦，其愈未几而痘随出者，则脾虚津耗，元气衰微，治宜温养脾元，补
益中气则痘可起胀成脓结实矣。诀曰∶遍后俄然痘症临，脾虚元耗势沉沉，急宜培土将
元益，冷药毫厘不可侵。
第三犯马驰剑道。凡儿饮食寒暑不能樽节，是以疟疾缠身，寒热消灼，肌肉渐瘦，
其愈未几，而痘随出者，凡常山、草果断不可用，惟宜参苓白术以扶正气。诀曰∶婴儿
疟后痘相迎，元气嚣离不可闻，草果柴胡宜悉去，滋阴补卫效通神。
第四犯一苇航海。凡儿元体薄劣，身发大热，干渴恶嗽，疹出未几，其痘随出者，
此与循常先疹后痘者不同。凡先痘后疹者谓之逆，先疹后痘者谓之顺，然此身弱发热，
恶嗽干渴，继又出疹，百痘随后则势颇危，
须急补阴清肺，养胃扶脾，若黄 补肺之剂，切宜禁绝。诀曰∶小儿疹出太阴虚，痘
症随形毒客脾，宜急清金与培土，黄 若用嗽来催。
第五犯三仙入洞。凡儿平时患成疳积，肚大青筋，四肢羸瘦，变为丁奚，倏然而痘
随出者，宜治痘为主。诀曰∶丁奚疳积痘交关，且把花来发透全，切禁消磨并冷药，槟
榔浓朴及川连。
第六犯倒挂银瓶。凡儿风热腠理时发，大热自头达身，丹瘤遍起，其愈未几，若尚
未愈而痘随形者，宜犀角、生地、丹皮之类，以清肝心二经。诀曰∶丹瘤未愈痘形
身，又属肝心是二经，最怕枭红根座绕，解炎祛毒痘方明。
第七犯桥霜印迹。凡儿火烙脸赤，眼睛直竖，手足掣搐，惊厥屡次，口燥谵语，其
愈不数日，而痘随形者，此与循常先惊后痘者不同，盖因痘而起者从心经，故不过时微
惊惕即甚，亦不过临痘时也。此则其惊已甚，治宜且与治痘为主，夫镇心凉脏之剂，
皆不可投。诀曰∶惊厥新痊痘症随，朱砂金石莫相追，若还即见惊无歇，只管升花更与
培。
第八犯藕池渗水。凡儿身热自汗口中咯血，或鼻衄溺血，其愈不数日而痘见形者，
此心官失守，致血妄行，治宜清心抑火，切不可妄用寒凉。诀曰∶诸血皆由热犯心，清
心抑火自归营，切休轻用寒凉剂，花萎花栏悔实深。
第九犯石鼓阴鸣。凡儿未痘之前，身发火热，饮食懒飧，肚腹胀膨，眼泡浮肿，睡
卧不安，未数日而痘见者，治宜补脾理气。诀曰∶腹中膨胀不思飧，气阻脾虚痘必难，
宜速补脾调气血，更加升表自然安。
第十犯赤泽栽莲。凡儿身发恶热，自汗不止，眼睛昏花，阿欠啼叫，其症才愈，而
痘随形者，治宜敛汗而用黄 熬人乳以频饮之，更投以调荣益卫之剂。诀曰∶汗流恶热
已亡元，痘犯心肝十不全，急补心肝并敛汗，痘如鼎灌自然痊。
第十一犯崖头走马。凡儿其 损伤不数日而痘即见者，治宜调血活血兼与扶脾可
也。诀曰∶跌扑惊伤未愈时，个中透出好花枝，安经活血调脾脉，自得群花朵朵奇。
第十二犯逐鹿亡羊。凡儿往来潮热，腹生痞块，日积月累，身体羸瘦，面黄力弱，
而痘随出者不宜治痞。诀曰∶病痞花开宜补元，扶脾益胃莫迟延，尤须治痘培根本，何
怕花儿命不全。
第十三犯推车陷雪。凡儿禀父母胎毒，身患杨梅广疮，不时寒热，其症未愈，而痘
随形者，将何所治？诀曰∶恶疮未愈出天花，当用升麻药不差，莫假连翘诸败毒，误
将熏点浪涂搽。
第十四犯霜逐梧桐。凡儿身如火烙，不时呕吐，不能饮食，投诸时气而痘随见者，
将何所治？诀曰∶呕吐惊惶胃不和，忽看花痘又相磨，应须安胃兼升表，自得成功患可
无。
第十五犯倦龙行雨。凡儿饮食不节，致伤脾胃，四肢不收，发热恶寒，而痘随见
者，将何所治？诀曰∶儿伤饮食正逢灾，痘又阳明胃里来，宜略内消兼补胃，更加升表
自花开。
第十六犯秋蝉泣露。凡儿发痘之前，因感湿热之气乃患赤白痢疾，其痘未愈，而痘
随见者，将何所治？诀曰∶痢痘自宜除湿热，更加培土和气血，还须表痘复滋花，根
本调微灾自灭。
第十七犯冻鳞出谷。凡儿因误持刃致伤手足，是以寒热往来而痘随形者，将何所
治？诀曰∶金疮未痊痘来呈，活血还兼开滞凝，更要升花期表暴，扶持鼎峻自安宁。
第十八犯浪里渔舟。凡儿每发惊厥，或患风痫，未久而见痘者，将何以治？诀曰∶
风痫复苦痘来催，只把花栏着意培，灌得浆来花朵朵，不愁风雨更颠危。
各书所载名目不同，总痘前十八犯专意培花为重，若痘后犯此十八条，则又以专补
元气为要耳。
第一犯：猿猴跳锁。凡是小儿在出痘之前，先感染了风邪，身体发热如火烧，头痛且自汗，咳嗽不止；或者在伤寒病之后，痘疹随即发出，此时元气极度虚弱，必须紧急采用疏风清热、补血滋阴、调理元气并巩固体表的方法。口诀说：一旦感染伤寒病情危急，医生需谨慎斟酌以免痘症受损，若使用柴胡汤类方药，婴儿可能因含花（指痘毒内陷或误治）而死，令人悲哀。
第二犯：观音拂痤。凡是小儿饮食不知节制，暑湿之邪未能妥善养护，导致脾胃频繁受损，出现泄泻、食欲不振、肢体消瘦，病愈不久痘疹随即发出，这是脾虚津液耗损，元气衰微的表现，治疗应当温养脾元，补益中气，这样痘疹才能起胀、成脓、结实。口诀说：痘症突然来临，脾虚元气耗损，病情沉重，急需培补脾胃以增益元气，丝毫不可侵犯冷性药物。
第三犯：马驰剑道。凡是小儿饮食寒热不知节制，导致疟疾缠身，寒热交替消耗肌肉，身体逐渐消瘦，病愈不久痘疹随即发出，此时凡常山、草果等药绝对不可使用，只适宜用参苓白术散来扶助正气。口诀说：婴儿患疟疾后痘疹相迎，元气离散不可听闻，草果和柴胡应当全部去除，滋阴补卫的效果神奇通神。
第四犯：一苇航海。凡是小儿体质薄弱，身体发大热，口干渴且厌恶咳嗽，疹子发出不久，痘疹随即发出，这与通常先出疹后出痘的情况不同。凡是先出痘后出疹的称为逆证，先出疹后出痘的称为顺证，然而此例身体虚弱发热，厌恶咳嗽口干渴，随后又出疹，紧接着百颗痘疹随之而来，形势颇为危险，必须紧急补阴清肺，养胃扶脾，若是黄芪补肺的药剂，切切记禁绝。口诀说：小儿疹出太阴虚，痘症随形毒客脾，宜急清金与培土，黄 若用嗽来催。
第五犯：三仙入洞。凡是小儿平时患有疳积，肚子大青筋暴露，四肢消瘦，变成丁奚疳，突然痘疹随之发出，治疗应以治痘为主。口诀说：丁奚疳积与痘疹交错，暂且让痘疹透发完全，切记禁止使用消磨攻伐及冷性药物，如槟榔、厚朴及黄连。
第六犯：倒挂银瓶。凡是小儿风热在腠理间发作，大热从头至身，丹瘤遍起，病愈不久，若尚未痊愈而痘疹随即显现，适宜用犀角、生地、丹皮之类，以清肝心二经的热毒。口诀说：丹瘤未愈痘形现于身，又属肝心二经病变，最怕枭红根座绕，解炎祛毒痘方明。
第七犯：桥霜印迹。凡是小儿面部火烙般发红，眼睛直竖，手足抽搐，惊厥屡次发生，口燥谵语，病愈不数日，痘疹随即显现，这与通常先惊厥后出痘不同，因为痘疹引起的惊惕多在心经，所以不过时轻微惊惕即甚，也不过临痘时也。此则其惊已甚，治疗适宜且以治痘为主，那些镇心凉脏的药剂，都不可投用。口诀说：惊厥新痊痘症随，朱砂金石莫相追，若还即见惊无歇，只管升花更与培。
第八犯：藕池渗水。凡是小儿身体发热自汗，口中咯血，或鼻衄溺血，病愈不数日而痘疹见形者，这是心官失守，导致血液妄行，治疗适宜清心抑火，切不可妄用寒凉药物。口诀说：诸血皆由热犯心，清心抑火自归营，切休轻用寒凉剂，花萎花栏悔实深。
第九犯：石鼓阴鸣。凡是小儿未出痘前，身体发火热，饮食懒食，肚腹胀膨，眼泡浮肿，睡卧不安，未数日而痘见者，治疗适宜补脾理气。口诀说：腹中膨胀不思飧，气阻脾虚痘必难，宜速补脾调气血，更加升表自然安。
第十犯：赤泽栽莲。凡是小儿身体发恶热，自汗不止，眼睛昏花，阿欠啼叫，其症才愈，而痘随形者，治疗适宜敛汗而用黄芪熬人乳以频饮之，更投以调荣益卫之剂。口诀说：汗流恶热已亡元，痘犯心肝十不全，急补心肝并敛汗，痘如鼎灌自然痊。
第十一犯：崖头走马。凡是小儿跌扑损伤不数日而痘即见者，治疗适宜调血活血兼与扶脾可也。口诀说：跌扑惊伤未愈时，个中透出好花枝，安经活血调脾脉，自得群花朵朵奇。
第十二犯：逐鹿亡羊。凡是小儿往来潮热，腹生痞块，日积月累，身体羸瘦，面黄力弱，而痘随出者不宜治痞。口诀说：病痞花开宜补元，扶脾益胃莫迟延，尤须治痘培根本，何怕花儿命不全。
第十三犯：推车陷雪。凡是小儿禀父母胎毒，身患杨梅广疮，不时寒热，其症未愈，而痘随形者，将何所治？口诀说：恶疮未愈出天花，当用升麻药不差，莫假连翘诸败毒，误将熏点浪涂搽。
第十四犯：霜逐梧桐。凡是小儿身如火烙，不时呕吐，不能饮食，投诸时气而痘随见者，将何所治？口诀说：呕吐惊惶胃不和，忽看花痘又相磨，应须安胃兼升表，自得成功患可无。
第十五犯：倦龙行雨。凡是小儿饮食不节，致伤脾胃，四肢不收，发热恶寒，而痘随见者，将何所治？口诀说：儿伤饮食正逢灾，痘又阳明胃里来，宜略内消兼补胃，更加升表自花开。
第十六犯：秋蝉泣露。凡是小儿发痘之前，因感湿热之气乃患赤白痢疾，其痘未愈，而痘随见者，将何所治？口诀说：痢痘自宜除湿热，更加培土和气血，还须表痘复滋花，根本调微灾自灭。
第十七犯：冻鳞出谷。凡是小儿因误持刃致伤手足，是以寒热往来而痘随形者，将何所治？口诀说：金疮未痊痘来呈，活血还兼开滞凝，更要升花期表暴，扶持鼎峻自安宁。
第十八犯：浪里渔舟。凡是小儿每发惊厥，或患风痫，未久而见痘者，将何以治？口诀说：风痫复苦痘来催，只把花栏着意培，灌得浆来花朵朵，不愁风雨更颠危。
各书所载名目不同，总痘前十八犯专意培花为重，若痘后犯此十八条，则又以专补元气为要耳。
First Violation: Ape Jumping through Locks. Whenever a child, before developing smallpox, first contracts wind-pathogens, the body feels hot as if branded by fire, accompanied by headache and spontaneous sweating, with incessant coughing; or if smallpox erupts immediately after an attack of cold damage (Shanghan), the primordial qi is extremely depleted. Urgent treatment should focus on dispersing wind and clearing heat, nourishing blood and yin, regulating primordial qi, and consolidating the exterior. The verse states: Once contracted cold damage, the condition becomes critical; physicians must deliberate carefully to avoid harming the smallpox eruption. If Chaihu Decoction is used, the infant may die tragically due to internalized toxins, a sorrowful outcome.
Second Violation: Guanyin Brushing Acne. Whenever a child’s diet is unregulated, and summer-dampness pathogens are not properly guarded against, the spleen and stomach are frequently damaged. This leads to diarrhea, loss of appetite, and emaciation of the limbs. If smallpox erupts shortly after recovery, it indicates spleen deficiency and fluid depletion, with primordial qi being weak. Treatment should warm and nourish the spleen's primordial qi and tonify middle-jiao qi, so that the smallpox pustules can swell, suppurate, and firm up. The verse states: When smallpox symptoms suddenly appear, spleen deficiency and primordial depletion cause a heavy condition. Urgently cultivate earth (spleen) to benefit primordial qi; do not invade with even a grain of cold medicines.
Third Violation: Horse Galloping on Sword Path. Whenever a child’s diet lacks regulation regarding cold and heat, leading to malaria lingering in the body, alternating chills and fever consuming muscles, and gradual emaciation, if smallpox erupts shortly after recovery, Changshan (Rhizoma Coptidis) and Caoguo (Fructus Tsaoko) must absolutely not be used. Only Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) should be used to support righteous qi. The verse states: After infantile malaria, smallpox welcomes the patient; primordial qi dispersion is alarming. Remove Caoguo and Chaihu completely; nourishing yin and supplementing defense yields miraculous effects.
Fourth Violation: One Reed Crossing the Sea. Whenever a child has a frail constitution, develops high fever, dry thirst, and aversion to coughing, and if smallpox erupts shortly after rash eruption, this differs from the normal sequence of rash preceding smallpox. Normally, smallpox preceding rash is termed "counter-flow" (Ni), while rash preceding smallpox is termed "smooth" (Shun). However, in this case, with weak body, fever, aversion to cough, dry thirst, followed by rash and then numerous smallpox lesions, the situation is perilous. Urgent treatment must nourish yin, clear lung heat, nourish the stomach, and support the spleen. Huangqi (Astragalus) formulas for tonifying the lung must be strictly prohibited. The verse states: When rash emerges, Taiyin deficiency exists; smallpox toxins lodge in the spleen. Urgently clear metal (lung) and cultivate earth (spleen); using Huangqi will hasten the cough.
Fifth Violation: Three Immortals Entering the Cave. Whenever a child suffers from chronic Gan accumulation (malnutrition/parasitic disease) with a distended abdomen and visible veins, emaciated limbs, progressing to Dingxi Gan (severe malnutrition), and smallpox suddenly erupts, treatment should prioritize managing the smallpox. The verse states: Dingxi Gan accumulation intersects with smallpox; allow the flowers (pustules) to fully emerge. Strictly prohibit draining and cold medicines such as Binglang (Areca Seed), Houpo (Magnolia Bark), and Chuanlian (Coptis Rhizome).
Sixth Violation: Inverted Silver Vase. Whenever wind-heat pathogens manifest in the couli (interstices), causing high fever from head to body, and Danliu (erysipelas-like tumors) appear everywhere, if smallpox erupts before full recovery, use Xijiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Shengdi (Rehmannia Root), and Danpi (Moutan Cortex) to clear heat from the Liver and Heart meridians. The verse states: Danliu unresolved, smallpox forms appear on the body; this belongs to the Liver and Heart meridians. Most feared is the red root encircling; clearing inflammation and removing toxins clarifies the smallpox.
Seventh Violation: Bridge Frost Imprint. Whenever a child’s face is red as if branded, eyes staring straight, limbs twitching, frequent convulsions, dry mouth, and delirious speech, and if smallpox appears within a few days of recovery, this differs from the usual sequence of convulsion preceding smallpox. Since smallpox-induced fright relates to the Heart meridian, mild fright usually subsides when smallpox appears. Here, the fright is severe. Treatment should prioritize smallpox management; sedating-heart and cooling-viscera formulas must not be administered. The verse states: After new recovery from convulsions, smallpox follows; do not pursue Zhusha (Cinnabar) and Jinshi (mineral drugs). If fright persists without rest, continue promoting eruption and nurturing.
Eighth Violation: Lotus Pond Seeping Water. Whenever a child has fever, spontaneous sweating, hemoptysis, epistaxis, or hematuria, and if smallpox lesions appear within a few days of recovery, this indicates Heart organ failure leading to reckless blood movement. Treatment should clear the Heart and suppress fire; cold-cooling medicines must never be used recklessly. The verse states: All bleeding stems from heat invading the Heart; clearing the Heart and suppressing fire returns blood to the Ying level. Do not lightly use cold-cooling agents; regret over wilted flowers will be deep.
Ninth Violation: Stone Drum Yin Resonance. Before smallpox eruption, if a child has feverish heat, poor appetite, abdominal distension, puffy eyelids, and restless sleep, and smallpox appears within a few days, treatment should tonify the spleen and regulate qi. The verse states: Abdominal distension and loss of appetite indicate qi obstruction and spleen deficiency, making smallpox difficult. Quickly tonify the spleen and regulate qi and blood; adding exterior-releasing measures ensures natural peace.
Tenth Violation: Red Marsh Planting Lotuses. If a child experiences aversion to heat, incessant spontaneous sweating, blurred vision, yawning, and crying, and smallpox erupts immediately after symptom resolution, treatment should stop sweating using Huangqi (Astragalus) decocted in human milk for frequent drinking, combined with formulas regulating Ying and Wei. The verse states: Sweating profusely and aversion to heat deplete primordial qi; smallpox affecting Heart and Liver leaves less than ten percent chance of survival. Urgently tonify Heart and Liver and stop sweating; smallpox filling like a tripod will naturally heal.
Eleventh Violation: Cliffside Galloping Horses. If smallpox appears within a few days of traumatic injury, treatment should regulate and invigorate blood while supporting the spleen. The verse states: During unresolved trauma and fright injury, good flower branches emerge from within. Calm meridians, invigorate blood, and regulate spleen pulse; naturally, all flowers bloom wonderfully.
Twelfth Violation: Hunting Deer, Losing Sheep. If a child has tidal fevers, abdominal masses accumulating over time, emaciation, sallow complexion, and weakness, and smallpox erupts, treating the mass is inappropriate. The verse states: When illness-masses bloom like flowers, tonify primordial qi. Support spleen and stomach without delay; especially treat smallpox to cultivate the root. Why fear the flower's life incomplete?
Thirteenth Violation: Pushing Cart into Snow. If a child inherits parental fetal toxins, suffers from Yangmei Guangchuang (chancre/syphilis-like sores), intermittent chills and fever, and smallpox erupts before recovery, how to treat? The verse states: When malignant sores are unresolved and variola erupts, Shengma (Cimicifuga) medicine is accurate. Do not rely on Lianqiao (Forsythia) and other detoxifying herbs; mistakenly applying fumigation or ointments causes error.
Fourteenth Violation: Frost Chasing Wutong Trees. If a child’s body is hot as if branded, with frequent vomiting, inability to eat, and smallpox appears amidst seasonal pathogens, how to treat? The verse states: Vomiting and panic indicate stomach disharmony; suddenly seeing flower-smallpox grinding each other. Must soothe the stomach and release the exterior; success will ensure no harm.
Fifteenth Violation: Tired Dragon Bringing Rain. If improper diet damages spleen and stomach, causing limbs to refuse movement, fever, and aversion to cold, and smallpox appears, how to treat? The verse states: Infant injured by diet meets disaster; smallpox comes from Yangming Stomach. Slightly resolve interior accumulation and tonify stomach; adding exterior release lets flowers bloom naturally.
Sixteenth Violation: Autumn Cicada Weeping Dew. Before smallpox eruption, if damp-heat pathogens cause dysentery (red and white stools), and smallpox appears before dysentery resolves, how to treat? The verse states: Dysentery-smallpox naturally requires draining damp-heat; further cultivate earth and harmonize qi and blood. Also, release smallpox to nourish flowers again; adjusting the root extinguishes disaster.
Seventeenth Violation: Frozen Scales Emerging from Valley. If accidental blade injury to hands and feet causes alternating chills and fever, and smallpox appears, how to treat? The verse states: Metal wounds unresolved, smallpox presents; invigorate blood and open stagnation. Further promote eruption and release exterior; supporting the tripod ensures peace.
Eighteenth Violation: Fishing Boat in Waves. If a child frequently suffers convulsions or wind-phlegm epilepsy, and smallpox appears shortly after, how to treat? The verse states: Wind-epilepsy suffers again from smallpox urging; focus on cultivating the flower fence. Fill with pus, let flowers bloom; do not fear wind and rain causing instability.
Although books record different names, the eighteen violations before smallpox all emphasize nurturing the flowers (smallpox eruption). If these eighteen violations occur after smallpox eruption, the priority shifts entirely to tonifying primordial qi.