豆蔻（各二钱半） 丁香 半夏（姜制） 附子（炮，去皮。各一钱半）
上 咀。每服二钱，水一盏，姜五片，枣三枚，煎服。
上治虚寒。（虚而不寒者、宜用前方血气俱虚之剂，不宜用此，必脉虚细、四肢身体冷者，方
可用之）
十补散 滋养气血，调养脾胃，能使疮毒速出，有寒证者用之。加紫草、木香、
糯米、名参 内托散。
黄 人参 当归（各二钱） 浓朴 桔梗 川芎 防风 白芷 甘草（各一钱） 桂心（三分）
每服四钱，水煎服，或为末，温水调下一钱五分。
〔虚热例〕
蓝根散 治疮疹出不快，及倒靥，一名二圣散，救小儿垂死。
板蓝根（一两） 甘草（炙，七钱半）
上，末。每服半钱，取雄鸡冠血三两点，同温酒少许，食后调下，无时。甚则
三五服，立效。（丹溪云，蓝，能分散败血。）
丝瓜散 发疮疹最妙，丝瓜连皮烧灰，存性，百沸汤调下，或以紫草、甘草煎汤调
服尤佳，米汤亦可。
萝卜汤（见前）
〔烦不得眠例〕
痘疹烦不得眠者。甘桔加栀子汤
桔梗 甘草 栀子
上，各等分，煎服。
〔活〕治痘出不快，烦躁不得眠者，水解散、麻黄黄芩汤、升麻黄芩汤主之。（海藏
云∶莫若定其气血，用石膏栀子之类，尤佳，麻黄黄芩汤、升麻黄芩汤、亦当求责的是太阳阳明，
方可用之。）
水解散 治天行头疼壮热一二日，兼治 疮未出烦躁，或出尚身体发热者。
麻黄（去节，四两） 大黄 黄芩 桂心 甘草（炙） 芍药（各二两）
上为粗末。患者以生熟汤浴讫，以暖水调下二钱，相次二服，得汗利便瘥。强
人服二方寸匕。风实之人，三伏中亦宜用之。若去大黄，春夏通用。
升麻黄芩汤 治痘疮出不快，烦躁不得眠。麻黄黄芩汤治痘疮出不快，益烦躁
昏，或出尚身疼热者。（二方见小儿伤寒门。）
胡萎酒 胡荽一味，细切四两，以好酒二盏，煎一二沸，入胡荽再煎少时，用物合
定，放温，每吸一大口、微喷，从顶至足匀遍，勿喷头面，病患左右常令有胡荽
气，即能辟去污气，疮疹出快。
《指南》有禁疮之说，云痘毒奔溃，由气血虚弱，不能拘领其毒，以致毒盛而聚
于腠虚之处，故痘之初出也，或一点二点见于隐僻腠节之处，及方广四肢之间，此痘
一出，则诸痘不得宣发成浆矣，故曰禁疮。其禁有五，一曰胃禁，二曰火禁，三曰
水禁，四曰风禁，五曰寒禁。胃禁者，毒火炙胃，不能发散于肌表，脾胃溃烂，
其外证之痘，出于唇口之间者，或二三四五点相连，诸痘未浆，此痘已先黄熟，知
由热毒内攻，胃已腐烂，故诸痘不得成浆也。如唇口一见此痘，当察其面色烦红，
气粗热甚，口臭异常者，是其验也。火禁者，小儿初发之际，或因身发寒热而误
以火熏炙其衣被，或睡卧于火箱之中，使皮肤干燥，故痘毒发泄不出，又兼气虚而
不能拘其毒，则毒停皮肤之内，隐隐不能发出肌表也。细看皮内，觉有红点无头无
脚，或于四肢头面方广之处，见一二点痘子，则诸痘皆从此痘上发泄为孽，而皮内
隐隐不出之痘，终不能快出，名为火禁。以水杨加荆芥煎汤浴之，则诸痘自发矣，
轻则升麻和解散主之。水禁者，初发热之际，阴阳未分，毒瓦斯方炽，或误食生冷，
则毒停于皮肉之间，隐隐有红点，或于方广两胁手足头面之际，发有水泡者是也，
盖冷气在内则腹疼肚胀，在外则发热恶寒，此其验也。以丁、桂、茯苓、升麻、大
腹之类逐之，冷食遗积脾胃，须防下泄，再加山楂。风禁者，发热之初，失于
不避风，则风入肌表，痘不能发，或肌肤麻木，不知痛痒，或不麻木而干燥，或毛
直而干焦，或皮痒欲搔，或重则狂烦谵语，此风与火搏故也。治法，以升麻汤加羌
活、荆芥、以逐之，甚则蒺藜、蝉蜕、以攻也。寒禁者，发热之初，误经冷水沐
浴，或睡卧于铁漆寒冷之处，或衣被单薄，感冒寒气，则痘必不能宣露，有手足麻
木不知痛痒，有四肢冷痛不能举动者，有麻木冷痛之处不出痘子，惟于委曲避风之
处，或头面发际之上，痘出如瘾疹者，是其验也。内以丁、桂、川芎、升麻逐之，
外用绵衣以温之。曾见小儿年十一二岁，发热之初，卧新漆床上，初因热极，父母
不防出痘，任小儿手贴漆床而卧，致令寒气侵入手臂，其余四肢面腹方广之处、俱出
有痘，唯一臂麻木不仁，无一点痘见，诸医视之，并不知其故，请予至，详察其由，
乃以前方治之，后见一臂痘发出比他处尤为稠密，臂痘一出，诸痘俱起，九日而平
复如故。
豆蔻（各二钱半）、丁香、半夏（姜制）、附子（炮制，去皮。各一钱半）。
以上药材切碎。每次服用二钱，加水一盏，生姜五片，大枣三枚，煎煮后服用。
此方主治虚寒证。（若只有虚象而无寒象者，适宜使用前方治疗气血俱虚的方剂，不宜使用此方；必须出现脉象虚细、四肢及身体发冷的症状，方可使用此方。）
十补散：滋养气血，调养脾胃，能使疮毒迅速透出，对于有寒证的患者适用。若加入紫草、木香、糯米，则名为参内托散。
黄芪、人参、当归（各二钱）、厚朴、桔梗、川芎、防风、白芷、甘草（各一钱）、桂心（三分）。
每次服用四钱，加水煎服；或研为粉末，用温水调服一钱五分。
〔虚热例〕
蓝根散：治疗疮疹发出缓慢，以及倒靥（痘疹回缩），又名二圣散，可挽救垂危的小儿。
板蓝根（一两）、甘草（炙，七钱半）。
以上药材研为细末。每次服用半钱，取雄鸡冠血三两点，同少许温酒一起调服，不限时间。病情严重者服用三至五剂，立即见效。（朱丹溪说，蓝根能分散败血。）
丝瓜散：发散疮疹效果极佳。将丝瓜连皮烧成灰，保留药性，用滚开水调服；或者用紫草、甘草煎汤调服更好，米汤也可以。
萝卜汤（见前文）。
〔烦不得眠例〕
痘疹患者烦躁无法入睡的，使用甘桔加栀子汤。
桔梗、甘草、栀子。
以上药材各等分，煎煮后服用。
〔活〕治疗痘疹发出缓慢，烦躁无法入睡的，以水解散、麻黄黄芩汤、升麻黄芩汤为主治方。（张元素云：不如确定气血状况，使用石膏、栀子之类的药物，尤其好；麻黄黄芩汤、升麻黄芩汤，也应当确认为太阳病、阳明病，方可使用。）
水解散：治疗时行感冒引起的头痛、高热一二天，兼治疮疹未发出时的烦躁，或已发出但身体仍发热的情况。
麻黄（去节，四两）、大黄、黄芩、桂心、甘草（炙）、芍药（各二两）。
以上药材捣碎为粗末。患者用生水和熟水混合洗浴完毕后，用暖水调下二钱，随后再服一次，得到汗出和大便利落即可痊愈。体质强壮的人服用两个方寸匕的量。风邪实盛的人，在三伏天中也适宜使用。如果去掉大黄，春夏季节通用。
升麻黄芩汤：治疗痘疮发出缓慢，烦躁无法入睡。麻黄黄芩汤治疗痘疮发出缓慢，更加烦躁昏沉，或已发出但身体疼痛发热的情况。（这两个方剂见小儿伤寒门。）
胡萎酒：仅用胡荽一味药，细切四两，用好酒两盏，煎煮一至二沸，放入胡荽再煎片刻，用器物盖住，放温后，每次吸一大口，微微喷洒全身，从头到脚均匀喷洒，不要喷头部和面部，让病患左右常闻到胡荽的气味，就能驱除污秽之气，促使疮疹迅速发出。
《指南》中有禁止疮疹的说法，认为痘毒奔溃，是因为气血虚弱，不能约束统领痘毒，导致毒气旺盛而聚集在腠理空虚之处，所以痘疹刚发出时，有时一两点出现在隐蔽的腠理关节处，以及四肢宽阔之间，这一颗痘一出，其他的痘就不能宣发成浆了，所以称为禁疮。其禁忌有五种：一是胃禁，二是火禁，三是水禁，四是风禁，五是寒禁。
所谓胃禁，是指毒火灼烧胃部，不能发散于肌表，导致脾胃溃烂，外部症状表现为痘疹出现在唇口之间，或二三三四五点相连，其他痘疹还未成浆，这颗痘已经先变黄成熟，知道是由热毒内攻，胃已腐烂，所以其他痘疹不能成浆。如唇口一见这种痘，应当观察其面色烦红，气粗热甚，口臭异常，这就是验证。
所谓火禁，是指小儿初发病时，或因身体发寒热而误用火熏炙衣被，或睡卧在火箱之中，使皮肤干燥，导致痘毒发泄不出，又兼气虚不能约束痘毒，则毒停在皮肤之内，隐隐约约不能发出肌表。仔细看皮内，感觉有红点无头无脚，或在四肢头面宽阔之处，见到一两点痘子，则其他痘都从此痘上发泄为祸患，而皮内隐隐不出的痘，最终不能快出，这叫做火禁。用水杨加荆芥煎汤沐浴，则其他痘自然会发出，轻症用升麻和解散主治。
所谓水禁，是指初发热之际，阴阳未分，毒气正盛，或误食生冷，则毒停在皮肉之间，隐隐有红点，或在宽阔两胁手足头面之际，发出有水泡的情况，这是因为冷气在内则腹痛肚胀，在外则发热恶寒，这是验证。用丁香、肉桂、茯苓、升麻、大腹皮之类驱逐它，冷食遗积在脾胃，须防腹泻，再加山楂。
所谓风禁，是指发热之初，失于避风，则风进入肌表，痘不能发出，或肌肤麻木，不知痛痒，或不麻木而干燥，或毛发直而干焦，或皮肤痒想搔抓，或重则狂烦谵语，这是风与火搏结的缘故。治疗方法，用升麻汤加羌活、荆芥，以驱逐它，严重时用蒺藜、蝉蜕，以攻伐它。
所谓寒禁，是指发热之初，误用冷水沐浴，或睡卧在铁漆寒冷之处，或衣被单薄，感冒寒气，则痘必然不能宣露，有的手足麻木不知痛痒，有的四肢冷痛不能举动，有的麻木冷痛之处不出痘子，只在弯曲避风之处，或头面发际之上，痘出像瘾疹一样，这是验证。内部用丁香、肉桂、川芎、升麻驱逐它，外部用绵衣温暖它。曾见一个十一二岁的小儿，发热之初，睡在新漆的床上，起初因为热极，父母没有防备出痘，任由小儿手贴漆床而卧，致使寒气侵入手臂，其余四肢面腹宽阔之处，都出了痘，只有一只手臂麻木不仁，没有一点痘出现，各位医生查看，都不知道原因，请我诊治，详细考察其原因，于是用前面的方剂治疗，后来看见一只手臂的痘发出比其他地方尤为稠密，手臂痘一出，其他痘都起来了，九天就平复如故。
Cardamomi Fructus Rotundus (each 2.5 qian), Dingxiang (Caryophylli Flos), Banxia (Ginger-processed), Fuzii Radix et Rhizoma Praeparata (Pao, peeled. Each 1.5 qian).
The above herbs are cut into small pieces. For each dose, take 2 qian, add one lamp of water, five slices of fresh ginger, and three jujubes, decoct and administer orally.
This formula treats deficiency-cold syndrome. (For cases with deficiency but without cold, the preceding formula for tonifying both qi and blood is suitable; this formula should not be used. It can only be used when the pulse is deficient and fine, and the limbs and body are cold.)
Shibu San (Ten-Tonifying Powder): Nourishes qi and blood, regulates the spleen and stomach, and enables the toxin of sores to emerge rapidly; it is used for patients with cold syndromes. If Zicao (Arnebiae Radix seu Rhizoma), Muxiang (Aucklandiae Radix), and Nuomici (Oryza Sativa Glutinosa) are added, it is named Shen Neituo San (Ginseng Internal-Supporting Powder).
Huangqi (Astragali Radix), Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix) (each 2 qian), Houpo (Magnoliae Officinalis Cortex), Jiegeng (Platycodonis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian), Guixin (Cinnamomi Ramulus) (3 fen).
Take 4 qian per dose, decoct in water and administer orally; or grind into powder, mix with warm water, and take 1.5 qian.
[Example of Deficiency-Heat]
Langen San (Isatidis Root Powder): Treats slow eruption of sores/rashes and retroverted sores (inward collapse of pustules); also known as Ersheng San (Two-Sages Powder), it saves critically ill children.
Banlangen (Isatidis Radix) (1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (7.5 qian).
Grind the above herbs into fine powder. Take half a qian per dose, mix with three to two drops of rooster comb blood and a little warm wine, and swallow after meals, at any time. For severe cases, take three to five doses for immediate effect. (Zhu Danxi said: Lan root can disperse stagnant blood.)
Sigua San (Luffa Fruit Powder): Most excellent for promoting the eruption of sores/rashes. Burn luffa fruit with its skin to ash, preserving its medicinal property, and take mixed with boiling water; or better yet, take mixed with decoction of Zicao (Arnebiae Radix seu Rhizoma) and Gancao (Glycyrrhizae Radix et Rhizoma); rice soup is also acceptable.
Luobo Tang (Radish Decoction) (see previous text).
[Example of Restlessness and Insomnia]
For measles/rubella patients with restlessness and inability to sleep, use Ganjie Jia Zhizi Tang (Licorice and Platycodon Decoction with Gardenia).
Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus).
Take equal parts of the above herbs, decoct and administer orally.
[Huo] For measles/rubella with slow eruption, restlessness, and inability to sleep, Shuijie San (Water-Resolving Powder), Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction), and Shengma Huangqin Tang (Cimicifugae and Scutellaria Decoction) are the primary treatments. (Zhang Yuansu said: It is better to determine the state of qi and blood and use drugs like Shigao (Gypsum Fibrosum) and Zhizi (Gardeniae Fractus), which is especially good. Mahuang Huangqin Tang and Shengma Huangqin Tang should only be used if Taiyang disease and Yangming disease are confirmed.)
Shuijie San (Water-Resolving Powder): Treats headache and high fever caused by epidemic pathogens for one or two days; also treats restlessness before sores erupt, or continued fever after eruption.
Mahuang (Ephedrae Herba, nodes removed) (4 liang), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Guixin (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Shaoyao (Paeoniae Radix Alba) (each 2 liang).
Grind the above herbs into coarse powder. After the patient bathes with a mixture of raw and cooked water, take 2 qian mixed with warm water, followed by a second dose; recovery occurs with sweating and free bowel movement. Strong individuals take two fangcun bi (square-inch spoons). Individuals with excess wind pathogen may also use this during the dog days of summer. If Dahuang (Rhei Radix et Rhizoma) is omitted, it is suitable for spring and summer.
Shengma Huangqin Tang (Cimicifugae and Scutellaria Decoction): Treats slow eruption of smallpox/measles, restlessness, and inability to sleep. Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction) treats slow eruption of smallpox/measles with increased restlessness and drowsiness, or body pain and fever after eruption. (These two formulas are found in the section on Pediatric Taiyang-Yangming Cold Damage.)
Huyou Jiu (Coriander Wine): Use only Huyu (Coriandri Fructus), finely cut 4 liang, decoct in two lamps of good wine for one or two boils, add Huyu (Coriandri Fructus) and simmer briefly. Cover tightly, let cool to warm temperature. Inhale a large mouthful and gently spray over the body from head to toe evenly, avoiding the head and face. Keep the patient surrounded by the aroma of Coriander to dispel foul air and promote rapid eruption of sores/rashes.
The "Guide" mentions the prohibition of sores/rashes, stating that the collapse of smallpox toxin is due to deficiency of qi and blood, which cannot contain the toxin, causing the toxin to accumulate where the couli (interstices) are deficient. Thus, when smallpox first appears, one or two spots may appear in hidden interstitial joints or between the limbs. Once these spots appear, other spots cannot erupt and form pus, hence called "prohibited sores." There are five prohibitions: one is Stomach Prohibition, two is Fire Prohibition, three is Water Prohibition, four is Wind Prohibition, and five is Cold Prohibition.
Stomach Prohibition refers to toxic fire scorching the stomach, preventing dispersion to the muscle surface, leading to ulceration of the spleen and stomach. The external sign is sores appearing around the lips and mouth, or two to five connected spots. While other sores have not formed pus, this specific sore has already turned yellow and matured, indicating internal attack by heat-toxin and rotting of the stomach, preventing other sores from forming pus. If such a sore appears at the lips/mouth, observe if the complexion is flushed red, breathing is coarse and hot, and breath is exceptionally foul; this confirms the diagnosis.
Fire Prohibition refers to the initial stage of illness where, due to chills and fever, clothing and bedding are mistakenly heated by fire, or the child sleeps in a heating box, drying the skin. This prevents toxin release. Combined with qi deficiency failing to contain the toxin, the toxin stays within the skin, faintly unable to reach the surface. Carefully observing the skin reveals red spots without heads or feet, or one or two spots in broad areas of limbs/face/head. Other sores then erupt destructively from these spots, while those faintly under the skin fail to erupt quickly, termed Fire Prohibition. Bathing with decoction of Shuiyang (Salix Tatarica) and Jingjie (Schizonepetae Herba) allows other sores to erupt naturally; mild cases are treated with Shengma Hejie San (Cimicifuga Harmonizing Powder).
Water Prohibition refers to the initial fever stage where yin and yang are undifferentiated and toxins are rampant. Mistaken consumption of cold/raw food causes toxins to stay between skin and flesh, showing faint red spots or blisters in broad areas of ribs, hands, feet, head, and face. Internal cold causes abdominal pain and distension; external cold causes fever and aversion to wind, confirming the diagnosis. Expel with Ding (Caryophylli Flos), Gui (Cinnamomi Ramulus), Fuling (Poria), Shengma (Cimicifugae Rhizoma), Dafupi (Arecae Pericarpium), etc. Prevent diarrhea from retained cold food in spleen/stomach by adding Shanzha (Crataegi Fructus).
Wind Prohibition refers to the initial fever stage where failure to avoid wind allows wind to enter the muscle surface, preventing eruption. Symptoms include numbness of skin/muscles, loss of pain/itch sensation, dryness, stiff/dry hair, itchy skin, or severe agitation and delirium due to wind-fire interaction. Treat with Shengma Tang (Cimicifuga Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix) and Jingjie (Schizonepetae Herba) to expel; severely, use Jili (Tribuli Fructus) and Chantui (Cicadae Periostracum) to attack.
Cold Prohibition refers to the initial fever stage where mistaken bathing in cold water, sleeping in cold iron/lacquer places, or thin clothing leads to cold invasion, preventing eruption. Symptoms include numbness/pain in limbs, inability to move, absence of sores in numb/cold painful areas, and sores resembling urticaria only in sheltered areas or hairline. Confirm by these signs. Internally expel with Ding (Caryophylli Flos), Gui (Cinnamomi Ramulus), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengma (Cimicifugae Rhizoma); externally warm with cotton clothes. I once saw an 11-12 year old child who, during initial fever, slept on a newly lacquered bed. Due to extreme heat, parents did not suspect smallpox, allowing the child's hand to touch the lacquer bed. Cold invaded the arm. Sores appeared on all other limbs, face, and abdomen, but the arm was numb and had no sores. Doctors could not explain it. Upon my examination, I used the aforementioned formula. Later, the arm erupted with denser sores than elsewhere. Once arm sores appeared, others followed, and the child recovered in nine days.