痘形已现。当谨慎养护。不可过饱与过饥。五味亦不可偏胜。父母爱子。无所不至。任意刁吮。
诸症并起。岂不反害于子耶。非余之琐琐言乎。
痘忽痛痒极。内有蛆虫或已炒焦。痘从腹出。或痘正兴。忽生泡子。致痘不出。当看 子是何色。
即随脏辨之。肝青心赤脾黄肺白肾黑。随脏处方加减。以保元汤加牛蒡子当归荆芥连翘。肝青柴胡。
心赤加黄连。脾黄加熟大黄。肺白加桔梗。肾黑加人齿或无价散调服。如痘一起时。原因风寒。次痘
虽出。而有寒门内症。表里汗下亦可详之。
夫痘名脓 。是胎毒所干肺脏而所生也。一发热时至六七日中。脓 正兴。而又出痧子。名曰痧。
盖痘是也。俱是胎毒先干肺脏已出脓 。次于肝脏。又出痧子。此肺金肝木俱受胎热之毒侮。其所不
胜也。治宜清肺金。乃泻其火也。养肝木。滋其水也。以保元汤加麦冬知母黄芩类。则安。如痧子亦
不为凶也。
脓 既生。六七日间。正旺而又复出 子。况 乃心火协相火炽甚而生。肺复受火邪所克。如
少者为
吉。如多者再兼喘咳。必不能保生也。
痘之一出。胎毒已彰。是为吉也。而又兼出水痘。水痘者是外感时气而所生也。亦少者为顺。多
者逆也。治之宜清肺保脾解热而安。亦不重剂耳。
夫痘之一症。为顺尚有变异。何况再疔毒痈疽。岂不毒之又甚耶。宜谨慎调护。稍可复生。若有
一差。失之千里。然疔毒痈疽。皆详于前。治宜保元加减。睹之于后矣。
痘疹的形态已经显现。此时应当谨慎地护理，不可让孩子吃得过饱或处于饥饿状态，五味（酸、苦、甘、辛、咸）也不可偏嗜。父母疼爱孩子，往往无微不至，但如果随意喂养、过度吮食，导致各种病症同时发作，岂不是反而伤害了孩子吗？这并非我啰嗦多言。
如果痘疹突然感到极度的疼痛和瘙痒，观察痘内是否有蛆虫或者痘体已经焦黑；如果痘疹从腹部发出，或者痘疹正在发过程中，突然生出水泡，导致痘毒无法透发出来。这时应当观察水泡的颜色，随即根据五脏进行辨证：肝对应青色，心对应赤色，脾对应黄色，肺对应白色，肾对应黑色。根据所属脏腑对处方进行加减调整，以保元汤为基础，加入牛蒡子、当归、荆芥、连翘。若见青色（属肝），加柴胡；若见赤色（属心），加黄连；若见黄色（属脾），加熟大黄；若见白色（属肺），加桔梗；若见黑色（属肾），加入人齿或无价散调服。如果痘疹初起时是因为风寒所致，虽然痘疹已出，但体内仍有寒邪内阻的症状，表证、里证、汗法、下法等治法也可据此详细辨析。
所谓“痘”名为脓疱，这是胎毒侵犯肺脏而形成的。在发热后的六七天中，脓疱正旺盛之时，又出了痧子，这就叫作“痧”。其实痘就是痧的一种表现。这都是因为胎毒先侵犯肺脏，发出脓疱后，接着侵犯肝脏，又发出痧子。这说明肺金和肝木都受到了胎热之毒的克制（即其所不胜者侮之）。治疗应当清泻肺金之火，滋养肝木之水。使用保元汤加上麦冬、知母、黄芩等药物，病情就能安定。如果痧子也不严重，则不凶险。
脓疱既然已经生成，在六七天之间正值旺盛，却又再次出现脓疱。况且这种脓疱是心火与相火炽盛而生成的，肺脏又受到火邪的克制。如果数量少则为吉兆；如果数量多，再兼有气喘咳嗽的症状，就必然不能保全生命了。
痘疹一旦发出，说明胎毒已经显露，这算是吉兆。但如果又兼出水痘，水痘是由于外感时行疫气而形成的。水痘数量少为顺证，数量多为逆证。治疗应当清肺、保脾、解热，使身体安宁，也不需要用到重剂量的药物。
痘疹这一病症，即使是顺证尚且有变异，何况再加上疔毒、痈疽呢？那毒性不是更加严重吗？应当谨慎调理护理，稍加注意或许还能恢复生机。如果稍有差错，就会失之千里。然而关于疔毒、痈疽的详细论述在前面已有提及，治疗宜用保元汤加减，详见后文。
The morphology of the variola (smallpox) has appeared. At this time, careful nursing is required; one must avoid overfeeding or starving the child, and the five flavors (sour, bitter, sweet, pungent, salty) should not be excessively favored. Parents love their children with utmost care, but if they feed arbitrarily or allow excessive sucking/eating, causing various symptoms to arise simultaneously, would it not harm the child? This is not merely my trivial words.
If the variola suddenly becomes extremely painful and itchy, observe whether there are maggots inside or if the pustules have turned scorched/black. If the variola erupts from the abdomen, or if blisters suddenly appear while the variola is developing, preventing the eruption of the toxic matter, one must examine the color of the blisters and differentiate according to the Zang organs: Green corresponds to the Liver, Red to the Heart, Yellow to the Spleen, White to the Lung, and Black to the Kidney. Adjust the prescription based on the affected organ, using Baoyuan Tang (Preserve the Origin Decoction) as a base, adding Niubangzi (Arctii Fructus), Danggui (Angelicae Sinensis Radix), Jingjie (Schizonepetae Herba), and Lianqiao (Forsythiae Fructus). If green (Liver), add Chaihu (Bupleuri Radix); if red (Heart), add Huanglian (Coptidis Rhizoma); if yellow (Spleen), add Shu Dahuang (Rhei Radix et Rhizoma Praeparated); if white (Lung), add Jiegeng (Platycodonis Radix); if black (Kidney), add Renchi (Human Teeth) or Wuji San (Priceless Powder) mixed for administration. If the initial onset of variola was due to Wind-Cold, and although the variola has erupted, there are internal symptoms of Cold in the Gate (Hanmen), the methods of exterior resolution, interior purgation, sweating, and downward draining can be detailed accordingly.
The term "variola" refers to pus-filled pustules, which are generated because fetal toxin invades the Lung organ. During the sixth to seventh day after fever begins, when the pustules are flourishing, if sand-rash (Sha) also appears, it is called "Sha". Essentially, variola is a form of Sha. This occurs because fetal toxin first invades the Lung, producing pustules, and then invades the Liver, producing sand-rash. This indicates that both Lung Metal and Liver Wood are being insulted by the heat of fetal toxin (the element that does not overcome them is overcoming them). Treatment should focus on clearing Lung Metal to drain fire, and nourishing Liver Wood to moisten water. Using Baoyuan Tang (Preserve the Origin Decoction) added with Maidong (Ophiopogonis Tuber), Zhimu (Anemarrhenae Rhizoma), and Huangqin (Scutellariae Radix) will bring stability. If the sand-rash is not severe, it is not ominous.
Once the pustules have formed, during the sixth to seventh day when they are at their peak, if pustules reappear, consider that these pustules are generated by the blazing of Heart Fire and Ministerial Fire, and the Lung is again subjected to the constraint of Fire. If the quantity is small, it is auspicious; if large, accompanied by wheezing and coughing, life cannot be preserved.
When variola erupts, the fetal toxin is revealed, which is considered auspicious. However, if it is accompanied by water-variola (shui dou), which is caused by external contraction of seasonal epidemic qi, a small quantity is favorable (Shun), while a large quantity is unfavorable (Ni). Treatment should involve clearing the Lung, protecting the Spleen, and resolving heat to achieve peace, without the need for heavy doses.
Regarding the disease of variola, even favorable cases may undergo variations; how much more so if Ding poison (carbuncle/furuncle toxin) and Yongju (abscesses) are present? The toxicity would be even more severe. Careful regulation and nursing are essential; slight attention may lead to recovery. A slight error could result in a miss of a thousand li. However, details regarding Ding poison and Yongju have been discussed previously; treatment should use modified Baoyuan Tang (Preserve the Origin Decoction), as seen in the subsequent sections.