自来医之一道，内症凭脉象，外症凭形状。外症惟痘 最关紧要，痘症见于古人坊本者
甚多，而于治 则尚略。迩来痘 ，迥非昔比，调治非时，变为棘手。吾郡袁氏沈氏虞氏，有
治抄本，其论症辨状，甚为了然。对症用药，亦极详慎，爰纠同志，登诸梨枣，以广厥传。
至症之轻重，时之寒热，地之燥湿，则尤在高明者因宜增减，谅不泥于古也。
长至节后三日东农主人谨序
痘出于五脏，疹由于六腑，皆是命门相火，一感时生，发泄阴阳胎毒。然痘出于五
脏，俱有见症，而疹于肺居多，何也？盖肺属金，清气上浮而多嗽。故疹未有不嗽者，若
嗽多者肺之郁火也；疹未有不喉痛者，喉痛肺之窍塞也。肺火上冲于喉故痛，痛者哑之
由也。疹多腹痛，大肠与肺相表里，肺火上冲于内故腹痛。疹多泄泻，大肠为肺传逮之
官，肺火下注故泄泻。疹多喘，喘者肺气大盛也。疹多痰，痰者肺火蒸腐也。疹症不出
于肺，治疹之法，初宜升提，头面背部俱出，未至手足者，用升中之轻降。如未至爪甲者，
切不可重用降药，宜降中之升药。疹未出齐，虽有枭毒烈火诸症，只可用破敌之法，如石
膏、大黄、力子、山楂、荆芥、干葛，佐以桔梗、薄荷、木通、杏仁、苏子之类。瘀血
加赤芍、红花，腹痛加桃仁、青皮，无汗加麻黄，名曰完济。待至出齐，重用栝蒌、花
粉、生地、丹参、知母、羚羊、山栀、黄芩。舌上黑刺，加犀角、黄连，鼻衄亦宜投。咽
痛加元参、山豆根，龈肿亦可用。睛红目痛，加菊花、木贼草、柴胡之类。虫积肚痛，加
胡连、使君子、雷丸、槟榔、花椒。然此类宜毒有未发之地，后必余火缠扰，若下稠上
疏，须防收紧作喘之症，当用大黄、青皮以透之，再加紫草、赤芍，以导其瘀，徐徐收
去，方为无害。切不可风吹，致毛窍闭塞而即没矣。
自古以来，医学之道中，内伤杂病依靠脉象来诊断，外部病症依靠形态表现来判断。在外部病症中，唯有痘症最为关键重要。古代坊间刻印的书籍中关于痘症的记载非常多，但在治疗方法上却尚显简略。近来痘症的情况，与过去大不相同，若调理治疗不当，就会变得棘手难治。我们郡县中的袁氏、沈氏、虞氏三家，拥有治疗痘症的抄本手稿，其中对症状和体征的辨析非常清晰明了。针对症状用药，也极为详细谨慎，于是纠集志同道合者，将其刊印出版（雕版印刷），以广泛传播其学术成果。至于病情的轻重、气候的寒热、地域的燥湿等因素，则更需高明医生根据具体情况灵活增减药味，相信不会拘泥于古法。
长至节（夏至）后第三天，东农主人恭敬作序。
痘症源于五脏，疹症源于六腑，二者皆由命门相火（寄居于肾中的阳气，主生殖发育及温煦全身之火）引发，一旦感受时令邪气，便会发泄体内的阴阳胎毒。然而痘症源于五脏，都有相应的可见症状；而疹症多与肺有关，为什么呢？因为肺属金，清气上浮且容易咳嗽。所以出疹没有不伴随咳嗽的，如果咳嗽严重，那是肺气郁结化火所致；出疹没有不伴随咽喉痛的，咽喉痛是因为肺窍闭塞。肺火上冲至咽喉故引起疼痛，疼痛是声音嘶哑的原因。出疹多伴有腹痛，因为大肠与肺互为表里，肺火上冲入内故引起腹痛。出疹多伴有泄泻，因为大肠是肺传导糟粕的官职，肺火下注导致泄泻。出疹多伴有气喘，气喘是因为肺气过盛。出疹多伴有痰液，痰液是因为肺火蒸腾腐浊津液而成。
治疗疹症的方法，既然不出于肺以外的其他脏腑，初期宜用升提之法。当头面背部均出现皮疹，但尚未蔓延至手足时，应使用“轻降”之法（即在升提中兼以轻清下降）。如果皮疹尚未蔓延至指甲处，切不可重用沉降药物，宜用“升中之降”的药物（即具有轻微沉降作用的升提药）。在皮疹未完全透发之前，即使出现如枭毒烈火般的危重症状，也只能采用“破敌”之法（攻逐邪气），可用石膏、大黄、枳子（此处疑为某种特定药材或笔误，暂译）、山楂、荆芥、干葛（葛根），佐以桔梗、薄荷、木通、杏仁、苏子等药物。若有瘀血，加赤芍、红花；若腹痛，加桃仁、青皮；若无汗，加麻黄，此法名为“完济”。待皮疹完全透发后，重用栝蒌、花粉（天花粉）、生地（生地黄）、丹参、知母、羚羊角、山栀（栀子）、黄芩。若舌上有黑刺，加犀角、黄连，鼻出血也适宜投用这些药物。若咽喉痛，加玄参、山豆根，牙龈肿胀也可使用。若眼睛红痛，加菊花、木贼草、柴胡等药物。若有虫积引起的肚痛，加胡连（胡黄连）、使君子、雷丸、槟榔、花椒。
然而这类攻伐药物宜在毒邪尚未完全发作之地使用，之后必然有余火缠扰身体。若大便稠密小便疏少，须防止因收敛太急而导致气喘的症状，应当用大黄、青皮来透达邪气，再加紫草、赤芍，以引导瘀血排出，徐徐收功，这才是无害的。切不可让风吹，导致毛孔闭塞而使疹毒内陷。
Since ancient times, in the art of medicine, internal disorders are diagnosed based on pulse patterns (Mai Xiang), while external manifestations are judged by physical signs and symptoms (Xing Zhuang). Among external diseases, smallpox (Dou Zheng) is of paramount importance. Although there are numerous records of smallpox in ancient printed editions, the treatment methods remain relatively sparse. Recently, the presentation of smallpox has changed significantly compared to the past; improper regulation and treatment have made it difficult to manage. In our prefecture, the Yuan, Shen, and Yu families possess handwritten manuscripts on treating smallpox. Their discussions on symptoms and differentiation of signs are very clear. The selection of herbs for specific symptoms is extremely detailed and cautious. Therefore, we gathered like-minded individuals to have these texts carved onto wooden blocks and published, to widely disseminate this knowledge. Regarding the severity of the disease, the cold or heat of the season, and the dryness or dampness of the region, it is up to skilled physicians to adjust prescriptions according to circumstances, undoubtedly not sticking rigidly to ancient methods.
On the third day after the Summer Solstice (Changzhi Festival), the Master Dongnong respectfully wrote this preface.
Smallpox originates from the Five Zang Organs (Wu Zang), while measles (Zhen Zheng) arises from the Six Fu Organs (Liu Fu). Both are triggered by the Ministerial Fire of the Gate of Life (Mingmen Xiang Huo)—the fire residing in the Kidneys that governs reproduction, development, and warms the body—and once exposed to seasonal pathogens, they vent the Yin-Yang congenital toxins within. However, since smallpox originates from the Five Zang Organs, it presents with visible signs. Why is measles mostly associated with the Lung? This is because the Lung belongs to Metal, its clear Qi floats upward, and it is prone to coughing. Thus, all cases of measles involve coughing; severe coughing indicates stagnant fire in the Lung. All cases of measles involve sore throat; a sore throat indicates blockage of the Lung orifices. Lung fire rushing upward to the throat causes pain, which leads to hoarseness. Measles often involves abdominal pain because the Large Intestine and Lung are exterior-interior paired organs; lung fire rushing inward causes abdominal pain. Measles often involves diarrhea because the Large Intestine serves as the official organ for conveying waste from the Lung; downward pouring of lung fire causes diarrhea. Measles often involves wheezing, which signifies excessive Lung Qi. Measles often involves phlegm, which results from lung fire steaming and corrupting fluids.
The method for treating measles, since it does not originate outside the Lung, initially should employ lifting and dispersing methods. When rashes appear on the head, face, and back but have not yet reached the hands and feet, one should use "light descending" methods (descending within lifting). If the rash has not reached the fingernails, one must absolutely avoid using heavy descending herbs; instead, use herbs that descend within lifting. Before the rash is fully erupted, even if critical symptoms resembling fierce poison or blazing fire appear, only "enemy-breaking" methods (attacking pathogens) should be used. Herbs such as Shi Gao (Gypsum Fibrosum), Da Huang (Rhei Radix et Rhizoma), Li Zi, Shan Zha (Crataegi Fructus), Jing Jie (Schizonepetae Herba), and Gan Ge (Puerariae Radix) can be used, assisted by Jie Geng (Platycodonis Radix), Bo He (Menthae Haplocalycis Herba), Mu Tong (Akebiae Caulis), Xing Ren (Armeniacae Semen Amarum), and Su Zi (Perillae Fructus). If there is blood stasis, add Chi Shao (Paeoniae Radix Rubra) and Hong Hua (Carthami Flos); if there is abdominal pain, add Tao Ren (Persicae Semen) and Qing Pi (Citri Reticulatae Pericarpium Viride); if there is no sweat, add Ma Huang (Ephedrae Herba). This approach is named "Wan Ji." Once the rash is fully erupted, heavily use Gua Lou (Trichosanthis Fructus), Hua Fen (Trichosanthis Radix), Sheng Di Huang (Rehmanniae Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Ling Yang Jiao (Capris Cornu), Shan Zhi (Gardeniae Fructus), and Huang Qin (Scutellariae Radix). If black prickles appear on the tongue, add Xi Jiao (Rhino CeratUs—note: substitute with synthetic alternatives or water buffalo horn in modern practice) and Huang Lian (Coptidis Rhizoma); these are also suitable for epistaxis. For sore throat, add Yuan Shen (Scrophulariae Radix) and Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma); these can also be used for swollen gums. For red eyes and eye pain, add Ju Hua (Chrysanthemi Flos), Mu Zei Cao (Equiseti Herba), and Chai Hu (Bupleuri Radix). For abdominal pain caused by intestinal parasites, add Hu Lian (Coptidis Rhizoma - note: usually Hu Lian refers to Coptis chinensis var. chinensis or similar, distinct from Huang Lian), Shi Jun Zi (Quisqualis Fructus), Lei Wan (Omphalodii Fructus), Bing Lang (Arecae Semen), and Hua Jiao (Zanthoxyli Pericarpium).
However, such purgative or attacking herbs should be used where the toxin has not fully manifested; afterward, lingering fire will inevitably harass the body. If stools are thick and urine is scant, one must guard against symptoms of wheezing caused by premature constriction. One should use Da Huang and Qing Pi to penetrate and release the pathogen, then add Zi Cao (Arnebiae Radix seu Rhizoma) and Chi Shao to guide out blood stasis. Gradually concluding the treatment in this manner ensures safety. One must absolutely avoid wind exposure, which could cause pore closure and lead to the retraction of the rash.