夫人得天地之气以有生，禀父母之气以成形。然难免痘疹之患者何也？盖因淫火中
于有形之先，发于有生之后，遇岁火太过，热毒流行，则痘毒因之而发，是症也，必假
气血而后出，而后解。其始之候，与伤寒相似，但伤寒从表入里，则见一经形症。痘疹
从里出表，而五脏之症皆见。其脏之症独见多者，即主其脏之毒特甚而治之。故其发热
烦燥，而脸唇红，面色燥者，因火游行也。身热头痛而腰脊强者，属太阳经也。年寒年
热者，阴阳相抑也。喷嚏者属肺也。吹欠者，属脾也。咳喘痰涎，或烦燥惊悸，鼻孔气粗者，肺心热也。
窜眼者，膀胱起于目内 也。惊搐者，肝主筋而身热乘之，是以如风之症也。口舌疼痛者，脾心热也。
咽喉疼痛者，肺热也。肚腹疼痛者，是脾肝也。狂闷者，亦脾胃热也。昏睡者，热甚而神疲也。自汗者表虚
而腠理开，又或湿热重蒸也。下利者热毒下注，或又伤食故也，呕吐者火毒上逼也。发热者热盛于外也。
不发热者是壮气也。然始亦有外因伤风等候，时气传染而得，有内因伤食呕吐而得，有因诸跌扑惊恐蓄
血而得。症候多端，卒未易辨，亦须以耳冷鼻尖冷， 冷，（ ，臀尖也。）足冷验之。盖痘疹属阳，
出则肾脏无症，耳与 足俱属于肾，故肾之部独冷，又须视其耳后有红丝，赤缕突出，且脉洪大而弦数，
心窝有红色点子，眼目困倦，色如秋水，耳尻中指俱冷，两颧之间有花纹见，及诸眼睛黄，目胞赤，
手足鼻冷，小便赤少，大便不通，又或泻世，昏倦多睡，不恶寒面惟恶热，身略见热而常惊惕者，此
最可以稽验矣。然治痘之法，惟察其表里寒热虚实而已，外重则治表为本，内重则治里为要，寒者温
之，热者平之，虚者益之，实者损之，折其郁气，滋其化源，以平为期，治之略也。如里实而又
实里，则必结成痈毒，表实而又实表，则必溃烂不痂，故一二日宜于解表，使痘易出，三四日清凉解毒，
使痘易长，六七八九日温补气血，使易灌浆，若与十一二日清利收敛，使痘易靥，此治痘之常法也。然
痘亦有先期而速，后期而迟者，岂可执一而治之哉！苟痘未尽出而清凉，则痘得寒而凝滞，热毒未尽解
而温补，则毒蕴蓄而不能化浆，至于靥后不过慎风寒，节饮食而已，治痘所当慎者，在于六日之前，斟酌
用药，则轻者可以高枕无忧。重者亦可扶危奏绩矣。
人依靠天地的精气而生存，禀受父母的精气而形成形体。然而为什么难免患上痘疹呢？这是因为淫火（过盛的相火）在形体形成之前就已经潜伏于体内，在有生命之后发作，如果遇到岁运中火气太过、热毒流行的年份，痘毒就会随之发作。这种病症，必须依赖气血的充盛才能发出，也只有通过气血的运行才能解除。
初期的症状表现，与伤寒相似，但伤寒病邪是从体表传入体内，所以只表现出某一经络的症状；痘疹则是从体内透发至体表，所以五脏的症状都会显现出来。如果某一脏的症状特别突出且多见，就表明该脏的毒邪特别严重，治疗时应针对该脏进行。
因此，出现发热、烦躁、脸颊嘴唇发红、面色干燥的，是因为火邪游走所致。身体发热、头痛且腰脊强直的，属于太阳经病变。忽冷忽热的，是阴阳相互抑制的结果。打喷嚏的，病位在肺。打哈欠的，病位在脾。咳嗽气喘、痰多涎盛，或者烦躁惊悸、鼻孔呼吸粗重的，是肺和心有热。眼睛红肿窜痛的，因为膀胱经起于目内眦。惊厥抽搐的，因为肝主筋，身体发热侵袭了肝，所以表现为类似风证的病症。口舌疼痛的，是脾和心有热。咽喉疼痛的，是肺有热。肚腹疼痛的，病位在脾和肝。狂躁闷乱的，也是脾胃有热。昏睡的，是因为热势太盛导致神气疲乏。自汗出的，是因为表虚导致腠理疏松，或者是湿热熏蒸所致。腹泻的，是热毒下注，或者又因伤食引起。呕吐的，是火毒上冲逼迫所致。发热的，是热邪盛于体表。不发热的，是正气壮实。
然而，初期也有因外感风邪引起的，有时气传染而得的，有因内伤饮食、呕吐而得的，有因各种跌打损伤、惊恐导致瘀血蓄积而得的。症状表现多种多样，短时间内难以辨别，也必须通过检查耳朵、鼻尖、臀部尖端和脚部是否发冷来验证。大概因为痘疹属阳证，出痘时肾脏没有明显的症状表现，而耳朵和臀部尖端、脚都归属于肾，所以肾所主的部位单独发冷。此外，还需要观察耳后是否有红丝、赤缕突出，脉象是否洪大弦数，心窝处是否有红色点子，眼睛是否困倦、色泽如秋水般清澈，耳垂、臀尖、中指是否都冷，两颧之间是否有花纹显现，以及诸眼珠发黄、眼睑发红、手足鼻头冷、小便短赤、大便不通，或者腹泻、昏倦多睡、不恶寒反而怕热、身体略微发热且经常惊惕的，这些是最可以用来稽考验证的指征。
然而治疗痘疹的方法，只是考察其表里、寒热、虚实罢了。表证重则以治表为本，里证重则以治里为要。寒证用温法，热证用平法，虚证用补益法，实证用攻损法，疏解郁结之气，滋养化生之源，以平衡为准则，这是治疗的概要。如果里实证再用药攻伐里实，则必然结成痈毒；表实证再用药攻伐表实，则必然溃烂不能结痂。所以，第一二天宜于解表，使痘疹容易发出；第三四天宜于清凉解毒，使痘疹容易生长；第六七八九天宜于温补气血，使痘疹容易灌浆；到了第十十一二天宜于清利收敛，使痘疹容易收靥，这是治疗痘疹的常规方法。然而痘疹也有先期而出且快速的，有后期而出且迟缓的，怎么能拘泥于一种方法去治疗呢！如果痘疹尚未完全发出就用清凉药，那么痘疹遇到寒气就会凝滞；热毒尚未完全解除就用温补药，那么毒邪就会蕴蓄而不能化为脓浆。至于痘疹收靥之后，不过是谨慎避免风寒、节制饮食罢了。治疗痘疹应当谨慎的，在于六日之前的用药斟酌，这样轻症可以高枕无忧，重症也可以扶危救急取得疗效。
Human beings rely on the Qi of Heaven and Earth to sustain life, and inherit the Qi of parents to form their physical structure. However, why is it inevitable to suffer from smallpox (痘疹)? This is because excessive ministerial fire (Yin Huo) lies latent within the body before the physical form is established, and erupts after life begins. When encountering years where the Fire element is overly abundant and heat-toxins are prevalent, the smallpox toxin is triggered to manifest. This condition must rely on the sufficiency of Qi and Blood to erupt, and only through the movement of Qi and Blood can it be resolved.
The initial symptoms resemble those of Cold Damage (Shanghan). However, in Cold Damage, pathogens enter from the exterior into the interior, thus presenting symptoms of a single meridian. In contrast, smallpox emerges from the interior to the exterior, so symptoms of all five Zang organs may appear. If symptoms of a specific Zang organ are particularly prominent and frequent, it indicates that the toxin in that organ is especially severe, and treatment should target that organ.
Therefore, fever, irritability, redness of the cheeks and lips, and dry complexion indicate the wandering of Fire. Body heat, headache, and stiffness of the waist and spine belong to the Taiyang Meridian. Alternating chills and fever indicate the mutual suppression of Yin and Yang. Sneezing belongs to the Lung. Yawning belongs to the Spleen. Cough, asthma, profuse phlegm and saliva, or irritability with palpitations and coarse nasal breathing indicate Heat in the Lung and Heart. Swelling and pain in the eyes occur because the Bladder Meridian originates at the inner canthus. Convulsions and tremors occur because the Liver governs the sinews, and body heat invades the Liver, resulting in symptoms resembling Wind. Pain in the mouth and tongue indicates Heat in the Spleen and Heart. Throat pain indicates Heat in the Lung. Abdominal pain involves the Spleen and Liver. Mania and oppression also stem from Heat in the Spleen and Stomach. Lethargy and sleepiness result from excessive Heat causing spiritual fatigue. Spontaneous sweating occurs due to exterior deficiency leading to open pores, or due to steaming by Damp-Heat. Diarrhea results from Heat-Toxin sinking downward, or from food stagnation. Vomiting is caused by Fire-Toxin forcing its way upward. Fever indicates excess Heat in the exterior. Absence of fever indicates robust Zheng Qi (Upright Qi).
However, initially, there are cases caused by external wind invasion, seasonal epidemic transmission, internal food injury with vomiting, or blood stasis accumulation due to falls, trauma, or fright. The manifestations are diverse and difficult to distinguish quickly. One must also verify by checking if the ears, nose tip, buttock tip, and feet are cold. Generally, smallpox belongs to Yang; when erupting, the Kidney shows no specific symptoms. Since the ears, buttock tips, and feet all belong to the Kidney, the areas governed by the Kidney alone become cold. Additionally, one must observe for red threads or protruding red vessels behind the ears, whether the pulse is surging, wiry, and rapid, if there are red spots in the epigastrium, if the eyes are tired with clear color like autumn water, if the earlobes, buttock tips, and middle fingers are all cold, if patterns appear between the cheekbones, if the sclerae are yellow, eyelids red, extremities and nose cold, urine scanty and dark, stool constipated, or if there is diarrhea, lethargy, hypersomnia, aversion to heat rather than cold, slight fever with frequent startles—these are the most reliable indicators for verification.
However, the method for treating smallpox lies solely in examining the exterior/interior, cold/heat, and deficiency/excess. If the exterior syndrome is heavy, treat the exterior as the root; if the interior syndrome is heavy, treat the interior as the priority. For Cold, use warming methods; for Heat, use cooling/pacifying methods; for Deficiency, use tonification; for Excess, use reduction/draining. Resolve stagnant Qi, nourish the source of transformation, and aim for balance. This is the general principle. If an interior Excess pattern is treated with harsh draining herbs, abscesses and toxins will surely form; if an exterior Excess pattern is treated with harsh dispersing herbs, ulceration without scabbing will surely occur. Therefore, on days 1-2, release the exterior to facilitate eruption; on days 3-4, clear heat and detoxify to facilitate growth; on days 6-7-8-9, warm and tonify Qi and Blood to facilitate pustule formation; on days 10-11-12, clear and astringe to facilitate drying/scabbing. These are the standard methods for treating smallpox. However, smallpox may erupt early and rapidly, or late and slowly. How can one rigidly adhere to a single method? If cooling herbs are used before the rash has fully erupted, the rash will stagnate due to cold; if warming tonics are used before the heat-toxin is fully resolved, the toxin will accumulate and fail to transform into pus. After the rash has crusted over, one need only avoid wind-cold and regulate diet. The critical period for cautious treatment is before the sixth day; careful medication selection then allows mild cases to rest easy and severe cases to recover from danger.