〔万〕痘疮之病，皆由父母胎毒，蓄于命门之中，命门者，上肾相火也，为人身
生化之本，故毒藏焉。如遇冬令温和，阳气暴泄，人则感之，触动相火，至春夏生
长之时，其毒乃发，传染相似，是谓天行疫疠也。未出痘疹者，但觉冬温，即当预
防，宜服解毒之药，如辰砂散、三豆汤、代天宣化丸、皆可用也，频频与之，使疮
疹之毒轻减，自然易出易收，无陷伏郁遏留连之患。其辰砂散、三豆汤、代天宣
化丸，以解时行疫疠之毒则可，或因父母精血不足者，或其人素有他疾者，或发热
之时别脏形证发见者，并宜兼而治之，不可徒恃解毒而竟忘其本也。如脾胃素弱者，
宜以养脾为重，解毒次之，养脾丸服三之二，解毒三之一。如因父母奉养过浓，精
血蓄毒，素多胎病者，宜二毒并解，以溯源解毒汤、代天宣化丸、相间服之。丹
溪云∶痘疹初出时，或未出时，见时人有患者，宜预服此药，多者令少，重者令轻。
以丝瓜近蒂三寸，连皮子烧灰，存性为末，沙糖拌匀干吃，入朱砂末更妙。
三豆汤
赤小豆 黑大豆 绿豆（各一升，生） 小甘草（三两，生锉）
上，以三豆淘净，同甘草用雪水八升（如无，用长流水代之）煮，豆熟为度，去甘草，将
豆晒干，又入汁再浸再晒，汁尽为度，逐日取豆、水煮，任意食之。
代天宣化丸（即韩氏五瘟丹加减也）
人中黄（属土，甲巳年为君） 黄芩（属金，乙庚年为君） 黄柏（属水，丙辛年为君）
栀子仁（属木，丁壬年为君）
黄连（属火，戊癸年为君） 苦参（佐） 荆芥穗（佐） 防风（去芦，佐） 连翘（酒洗，佐） 山
豆根（佐） 牛蒡子（酒淘、炒，佐） 紫苏叶（佐）
先视其年所属，取其药以为君，其余主岁者为臣，为君者倍之，为臣者半之，
为佐者如臣四分之三，于冬至日修合为末，取雪水煮升麻，和竹沥，调神曲为丸，
外用辰砂、雄黄为衣。每服，竹叶汤下。
制人中黄法，取甘草大者不拘多少，用新竹一节，纳甘草于中，仍紧塞无节空
处，放屎缸中浸七七日，取出晒干，听用。
溯源解毒汤
当归身 川芎 生地黄 白芍药 人参 连翘 黄连 生甘草 陈皮 木通（各等分）
上锉细。加淡竹叶十片，水一盏，煎半盏，去滓，温服，无时。
养脾丸
人参 白术 当归 川芎（各一钱半） 木香 青皮 黄连 陈皮（各一钱） 砂仁 山楂
肉神曲（炒） 麦芽（炒。各五分）
上为细末。水调神曲糊丸，如麻子大。每服三五十丸，陈仓米饮下。
消瘟丹（未曾出痘、及临出者，宜择疗病日、预服）
辰砂（研为极细末，水飞过，周岁以下者五六分，一岁以上者服一钱） 丝瓜（近蒂者、三寸，烧、
存性为末，亦如前数）
上，用蜜调下。或将鸽子及鸠煮熟，以辰砂搽上，令儿服之亦可。屡试有验。
秘传保婴丹
真紫草（去芦，酒洗，勿犯铁器） 缠豆藤（烧灰、存性。各四两，二味为君） 升麻（取新者盐水炒，
引下，不使侵肺气） 川防风（去芦及叉） 荆芥穗（去梗） 牛蒡子（炒。各二两，四味为臣）
真天竹黄 蟾酥（自取，勿用赤眼者） 真牛黄（三味各一钱二分） 大朱砂（麻黄紫草荔枝壳煮过，
就将其汤飞研、取净末三钱四味为佐） 甘草梢（去皮，二两和） 赤小豆 黑小豆 绿豆（各四十
九粒，炒、勿令焦三味为使）
上，各取细末和匀，另用紫草三两，入水三碗煎，去滓，熬成膏半碗，入生砂
糖半碗，和剂为丸如芡实大，另用飞过朱砂为衣。未出痘之先，浓煎甘草汤，每
服，小儿磨一丸，大人二丸。如已发热之时，生姜汤磨服，浓盖取汗，多者可少，
少者可无，大有神效。
袁氏痘前治法 凡欲治痘，须在未发之先，预识其证而分别用药，重者可轻，
轻者必愈，但未痘而愈，则医者无功，故多不肯尽心，及其既发，又无及矣，仁者
须以救生保婴为心，宁我无功，不可使婴儿失命，备陈十八证治法于后。
孩儿未痘之先，感冒风邪，身中火烙，头痛自汗，咳嗽不已，伤寒未愈而痘随
出焉，痘家谓之猿猴跳锁。伤寒之后，元气嚣漓、须滋阴补血，解热疏风，有滋阴
三宝散可服。
滋阴三宝散
当归 黄 生地 白茯苓 芍药 川芎 橘红 甘草 防风 玄参 麦门冬（二味加倍）
上锉细。姜枣煎。
有饮食不能樽节，暑湿不能护养，肚腹伤坏，泄泻频仍，饮食懒进，肢体羸瘦，
愈未几而痘随出焉，痘家谓之观音拂座。此与先泄而出痘者不同，平居无恙，忽泄
而痘出，此则毒随泄减，其痘反美，今久泄初愈而痘出，则脾虚元气弱，如单服补
药，恐来虚胀，若冷药则毫厘不可用者，只宜调脾，如四制白术之类可也。
四制白术散
白术八两，分作四分，一分、砂仁炒，一分、糯米炒，一分、麸皮炒，一分、
壁土炒，拣净，为末，量大小，乳酒调服。
患疟之后，寒热消烁，肌肉渐瘦，或乍愈而痘出，或带疟而患痘，名为马驰剑
道。多有湿热酿成此祸，草果、常山断不可用，即柴胡亦是劫药，须参、苓、白术，
微加消食祛热之药，如八珍膏、卫元汤可用也。
八珍膏
人参（一两） 蜜（四两） 乳汁 梨汁（同熬）
上，加制过紫河车，酒服两匙。
卫元汤
人参 白术 全蝎 山楂 半夏 当归 橘红 枳壳 乌梅
上，姜枣煎，加乳服。
小儿才五六岁，元体薄劣，身发火热，干渴患嗽，疹出未几而痘随出焉，此太
阴脾经症也，痘家谓之一苇航海。此与寻常先疹后痘者不同，凡先痘后疹者谓之逆，
先疹后痘者谓之顺，此则身弱发热，原患嗽渴，又病疹初愈而痘随后出，其势颇危，
须补阴、清肺、培脾，黄 毫厘难犯，内托至奇汤可用也。
内托至奇汤
天门冬 麦门冬 人参 白术 当归 茯苓 薏苡仁 川芎 陈皮 甘草 桔梗 银杏（去皮）
上，加糯米煎，频频服。
小儿平时患疳积，肚大有青筋，四肢羸瘦，变为丁奚，倏然痘发，此谓之三仙
入洞。治之且莫消疳积，浓朴、槟榔、柴、连冷药及抱龙丸之类，皆不可用，宜服
益黄散、滴滴金可也。
滴滴金
虾蟆肚内有黄金，取出金来和酒服。
小儿风寒腠理，时发火热，自头连身，遍启丹瘤，愈未几而痘随形焉，痘家谓
之倒挂银瓶。多发肝心二经痘，忌用三黄，宜犀角地黄汤、紫草散可也。
犀角地黄汤
犀角（用乳汁磨，一钱） 牡丹皮 芍药 生地黄
上，加灯草，水煎服。
小儿未痘之前，火烙脸赤，眼睛直竖，手足撒搐，口燥 语，惊厥屡次，不数
日而痘随形焉，痘家谓之霜桥印迹。此与寻常惊后出痘者不同，凡先惊后痘，痘出
惊止，决系心经之痘，多是吉征，此则惊甚体虚，或见痘而惊不止，朱砂、金石毫
不可用，宜茯神汤可也。
茯神汤
生地 当归 甘草 白芍药 茯神 远志 桔梗
上，加灯草、姜煎服。
小儿未痘之前，身热自汗，口中咯血，或鼻衄，或溺血，不数日而痘随形焉，
谓之藕池踏水。心官失守，致血妄行，宜清心按火，不可妄用寒凉之剂，野仙独圣
散可用也。
野仙独圣散
匾柏 玄参 地榆 血见愁 生地黄 木通 芍药 当归身 甘草 干姜
小儿未痘之先，身发火热，饮食懒飧，肚腹膨胀，眼胞浮肿，睡卧不安，不数
日而痘随形焉，谓之石鼓无鸣。宜理脾补气，参苓白术散加减用之可也。
参苓白术散加减
人参 茯苓 山药 白扁豆 白术 陈皮 莲肉 薏苡仁 当归 防风 枳实
上，锉为散。随宜加减。
小儿身发火热，自汗不止，眼睛昏花，呵欠啼叫，未愈而痘随见焉，谓之赤泽
栽莲。宜敛汗补肝，宜黄 熬人乳，频频服之，并固真汤可用也。
固真汤
绵黄 （二两，蜜炒） 酸枣仁（四两） 人参 白芍药 当归 生地黄 茯苓 甘草 陈皮
上 咀。生姜煎服。
小儿平时父母不能护从，恣其出入，跌磕伤损头面肢体，未愈而痘随出焉，谓
之破瓮澄浆。宜补血扶脾，笼金汤可用也。
笼金汤
木香 生地黄 芍药 红花 当归 甘草 白芷 土木鳖 橘红 木通 桔梗 白术
上，加姜枣煎服。
儿辈胸膈饱胀，饮食厌恶，身发火热，呕吐频频，未愈而痘随发焉，医家谓之
逐鹿亡羊。此与寻常先吐后出痘者不同，大凡因发痘而吐，毒随吐减，出痘必轻，
今则先因胃气有伤，腹胀恶食，吐又频频不止，则危迫之象矣，须要调理脾胃，如
紫霞黄露饮可用也。
紫霞黄露饮
干姜 半夏 藿香 砂仁 枳壳 陈皮 豆蔻 白术（炒） 青皮
上 咀。水煎服。
小儿面色萎黄，时作潮热，眼胞浮肿，肚腹绞痛，此为小HT 未愈而痘随出焉，
医家谓之推车陷雪。此因脾胃有伤，渐成疳积，祛虫逐积之药，俱不可用，惟调理
脾胃为上策，龙旋散最妙。
龙旋散
青皮 干姜 官桂 玄胡索（醋炒） 丁香 豆蔻 砂仁 枳壳 槟榔 浓朴 香附
山楂 艾叶
小儿遍身生疮，头颈脓窠旋绕，手足关轴，如蛇皮缠裹，寒热不时，喷嚏不止，
未愈而痘随出焉，医家谓之霜逐梧桐。法宜凉血卫脾，贞元散可用也。
贞元散
甘草 桔梗 人参 白芍药 黄 茯苓 木通 红花 白术 生地黄 白芷
升麻 陈皮 天花粉
上，用灯草煎服。
孩儿心中刺痛，未愈而痘随出焉，医家谓之犯夺天梯。此非气逆，即为寒积，
龙蟠饮可用也。
龙蟠饮
人参 当归 枳壳 白豆蔻 丁香 木香 官桂 青皮 半夏 山楂 三棱 二蚕砂 浓朴
上，用生姜酒煎服
小儿两眼风热，红肿羞明，刺痛难忍，未愈而痘随出焉，医家谓之弹打天乌。
法宜清肝祛火，滋玄窖，提阴气，谷精龙胆散可用也。
谷精龙胆散
生地黄 红花 荆芥 龙胆草 木通 甘草 赤勺药 谷精草 白茯苓 鼠粘子
上，加灯心煎服。
小儿饮食过度，伤损脾胃，或饱闷，或吞酸，或吐泻，未愈而痘随出焉，医家
谓之风燕失巢。痘全资脾胃，急宜消食理脾，消导饮、磨积散相兼而用可也。
消导饮
浓朴 枳实 砂仁 山楂肉 半夏 神曲 槟榔 三棱 蓬术 丁香
上，加干姜煎服。
磨积散
干蒿 陈皮 麦芽 二蚕砂
上，加生姜煎服。
儿辈小腹硬胀刺痛，小便赤涩难通，欲尿则啼，不尿则痛，未愈而痘随发焉，
医家谓之断桥失渡。此系心经郁火，积于小肠，浚牛膏是对证之药。
浚牛膏
大田螺，用葱盐加少麝，捣烂为膏，热烘，细绢摊贴小腹，用手摩之。
【万全】痘疮这一疾病，都是由父母的胎毒积蓄在命门之中。命门，就是肾中的相火，它是人体生命活动的根本，所以毒素藏匿于此。如果遇到冬季气候温暖，阳气突然外泄，人感受了这种邪气，就会触动相火，到了春夏季万物生长的时节，体内的毒素就会发作，具有传染性且症状相似，这被称为天行疫疠（流行性传染病）。尚未出痘疹的人，只要觉得冬天有温邪侵袭，就应当进行预防，适宜服用解毒的药物，如辰砂散、三豆汤、代天宣化丸，都可以使用，频繁地给孩子服用，使痘疹的毒素减轻，自然容易发出也容易收没，没有陷伏、郁遏、留连不去的祸患。辰砂散、三豆汤、代天宣化丸，用来解除时行疫疠的毒素是可以的；但如果是因为父母精血不足，或者孩子平素患有其他疾病，或者在发热时出现其他脏腑的症状和体征，都应当兼顾治疗，不能仅仅依赖解毒而忘记了根本。如果脾胃素来虚弱，应当以养脾为主，解毒为辅，服用养脾丸的比例占三分之二，解毒药占三分之一。如果是由于父母奉养过于丰厚，导致精血中蓄积毒素，平素多有胎病的孩子，应当双管齐下同时解毒，交替服用溯源解毒汤和代天宣化丸。朱丹溪说：痘疹刚开始发出或尚未发出时，看到周围有人患病，应当预先服用此药，多的能变少，重的能变轻。用靠近瓜蒂的丝瓜三寸，连同皮和籽一起烧成灰，保留药性，研成粉末，与沙糖拌匀干吃，加入朱砂末效果更好。
三豆汤
赤小豆、黑大豆、绿豆（各一升，生用）、小甘草（三两，生切）
以上药材，将三豆淘洗干净，同甘草一起用八升雪水（如果没有，用流动的长流水代替）煮，直到豆子煮熟为止，去掉甘草，将豆子晒干，再放入之前的药汁中浸泡，然后再晒干，直到药汁被吸尽为止。每天取这些豆子和水煮，让孩子随意食用。
代天宣化丸（即韩氏五瘟丹加减而成）
人中黄（属土，甲年和己年为君药）、黄芩（属金，乙年和庚年为君药）、黄柏（属水，丙年和辛年为君药）、栀子仁（属木，丁年和壬年为君药）、黄连（属火，戊年和癸年为君药）、苦参（佐药）、荆芥穗（佐药）、防风（去芦头，佐药）、连翘（酒洗，佐药）、山豆根（佐药）、牛蒡子（酒淘洗、炒，佐药）、紫苏叶（佐药）。
先观察当年的天干所属，选取对应的药物作为君药，其余对应主岁的药物作为臣药。君药的用量加倍，臣药的用量减半，佐药的用量是臣药的四分之三。在冬至日制作成药粉，用雪水煎煮升麻，混合竹沥，调和神曲制成丸剂，外用辰砂、雄黄包裹作为衣层。每次服用时，用竹叶汤送服。
制人中黄的方法：取大甘草不拘多少，用一节新竹筒，将甘草塞入其中，紧紧塞满无节的空处，放入屎缸中浸泡七十七天，取出晒干，备用。
溯源解毒汤
当归身、川芎、生地黄、白芍药、人参、连翘、黄连、生甘草、陈皮、木通（各等分）
以上药材切碎。加淡竹叶十片，水一盏，煎至半盏，去渣，温服，不限时间。
养脾丸
人参、白术、当归、川芎（各一钱半）、木香、青皮、黄连、陈皮（各一钱）、砂仁、山楂肉、神曲（炒）、麦芽（炒，各五分）
以上药材研成细末。用水调神曲糊制成丸剂，如麻子大小。每次服用三五十丸，用陈仓米饮送下。
消瘟丹（未曾出痘及即将出痘者，宜选择疗病日预先服用）
辰砂（研为极细末，水飞法处理，周岁以下者服五六分，一岁以上者服一钱）、丝瓜（靠近瓜蒂部分，三寸，烧存性研末，剂量同上）
以上药材，用蜂蜜调服。或者将鸽子及斑鸠煮熟，将辰砂涂抹在上面，让孩子服用也可以。多次试验有效。
秘传保婴丹
真紫草（去芦头，酒洗，勿接触铁器）、缠豆藤（烧灰存性，各四两，这两味为君药）、升麻（取新者用盐水炒，引药下行，不使其侵扰肺气）、川防风（去芦头及叉枝）、荆芥穗（去梗）、牛蒡子（炒，各二两，这四味为臣药）、真天竹黄、蟾酥（自行获取，勿用红眼的）、真牛黄（这三味各一钱二分，为佐药）、大朱砂（用麻黄、紫草、荔枝壳煮过的汤，直接以此汤水飞研取净末三钱，这四味为佐药）、甘草梢（去皮，二两合用）、赤小豆、黑小豆、绿豆（各四十九粒，炒，勿令焦，这三味为使药）。
以上各取细末混合均匀，另取紫草三两，加水三碗煎煮，去渣，熬成半碗膏，加入生砂糖半碗，和剂制成如芡实大小的丸剂，另用飞过朱砂为衣。在未出痘之前，浓煎甘草汤，每次小儿磨服一丸，大人服两丸。如果已经发热时，用生姜汤磨服，厚盖被子取汗，多的能变少，少的能不出，大有神效。
袁氏痘前治法：凡是想要治疗痘疮，必须在未发作之前，预先识别其证候并分别用药，重的可以变轻，轻的必定痊愈。但是如果在痘未发时就治愈了，医生就没有功劳，所以大多不肯尽心竭力，等到痘发了，又来不及了。仁慈的医生必须以救生保婴为心志，宁愿我没有功劳，也不能让婴儿失去生命。现将十八种证候的治法陈述如下。
孩儿在未出痘之前，感冒风邪，体内如火灼烧，头痛自汗，咳嗽不止，伤寒未愈而痘随之而出，痘医称之为“猿猴跳锁”。伤寒之后，元气耗损，须滋阴补血，解热疏风，可服用滋阴三宝散。
滋阴三宝散
当归、黄芪、生地、白茯苓、芍药、川芎、橘红、甘草、防风、玄参、麦门冬（后两味加倍）
以上药材切碎。加姜枣煎服。
有饮食不能节制，暑湿不能防护养护，导致肚腹损伤，泄泻频繁，饮食懒惰不进，肢体消瘦，不久之后痘随之而出，痘医称之为“观音拂座”。这与先泄泻而后出痘不同，平时无恙，忽然泄泻而出痘，这是毒素随泄泻减少，痘反而好。现在是久泄初愈而痘出，则是脾虚元气弱，如果单服补药，恐怕会导致虚胀，如果用冷药则丝毫不可用，只宜调理脾胃，如四制白术散之类即可。
四制白术散
白术八两，分为四分，一分用砂仁炒，一分用糯米炒，一分用麸皮炒，一分用壁土炒，拣选干净，研成末，根据年龄大小，用乳汁或酒调服。
患疟疾之后，寒热消耗肌肉，身体逐渐消瘦，或者刚痊愈而痘出，或者带着疟疾患痘，名为“马驰剑道”。多由湿热酿成此祸，草果、常山绝对不可用，就连柴胡也是劫夺正气的药，须用人参、茯苓、白术，微加消食祛热的药，如八珍膏、卫元汤可用。
八珍膏
人参（一两）、蜜（四两）、乳汁、梨汁（一同熬制）
以上，加入制过的紫河车，用酒服两匙。
卫元汤
人参、白术、全蝎、山楂、半夏、当归、橘红、枳壳、乌梅
以上，加姜枣煎服，加乳汁服用。
小儿才五六岁，元气薄弱，身体发热，口干渴患咳嗽，疹子出来不久而痘随之而出，这是太阴脾经的症候，痘医称之为“一苇航海”。这与寻常先疹后痘者不同，凡先痘后疹称为逆，先疹后痘称为顺，这里是身体虚弱发热，原本患咳嗽口渴，又病疹初愈而痘随后出，形势颇为危险，须补阴、清肺、培脾，黄芪丝毫难犯，内托至奇汤可用。
内托至奇汤
天门冬、麦门冬、人参、白术、当归、茯苓、薏苡仁、川芎、陈皮、甘草、桔梗、银杏（去皮）
以上，加糯米煎煮，频频服用。
小儿平时患疳积，肚子大且有青筋，四肢消瘦，变成丁奚病，突然痘发，这叫做“三仙入洞”。治疗时暂且不要消除疳积，厚朴、槟榔、柴胡、黄连等冷药及抱龙丸之类，都不可用，宜服用益黄散、滴滴金。
小儿感受风寒于腠理，时常发热，从头到身，遍起丹瘤，不久之后痘随之显现，痘医称之为“倒挂银瓶”。多发于肝心二经的痘，忌用三黄，宜犀角地黄汤、紫草散。
犀角地黄汤
犀角（用乳汁磨，一钱）、牡丹皮、芍药、生地黄
以上，加灯草，水煎服。
小儿未出痘之前，火热灼脸赤，眼睛直竖，手足抽搐，口燥谵语，惊厥屡次，不数日而痘随之显现，痘医称之为“霜桥印迹”。这与寻常惊后出痘者不同，凡先惊后痘，痘出惊止，决系心经之痘，多是吉兆，这里是惊甚体虚，或者见痘而惊不止，朱砂、金石类药物丝毫不可用，宜茯神汤。
茯神汤
生地、当归、甘草、白芍药、茯神、远志、桔梗
以上，加灯草、姜煎服。
小儿未出痘之前，身热自汗，口中咯血，或鼻衄，或尿血，不数日而痘随之显现，谓之“藕池踏水”。心官失守，导致血液妄行，宜清心降火，不可妄用寒凉之剂，野仙独圣散可用。
野仙独圣散
侧柏叶、玄参、地榆、血见愁、生地黄、木通、芍药、当归身、甘草、干姜
小儿未出痘之前，身体发热，饮食懒惰，肚腹膨胀，眼胞浮肿，睡卧不安，不数日而痘随之显现，谓之“石鼓无鸣”。宜理脾补气，参苓白术散加减使用。
参苓白术散加减
人参、茯苓、山药、白扁豆、白术、陈皮、莲肉、薏苡仁、当归、防风、枳实
以上，锉为散剂。随宜加减。
小儿身体发热，自汗不止，眼睛昏花，呵欠啼叫，未愈而痘随之显现，谓之“赤泽栽莲”。宜敛汗补肝，宜黄芪熬人乳，频频服用，并固真汤可用。
固真汤
绵黄芪（二两，蜜炒）、酸枣仁（四两）、人参、白芍药、当归、生地黄、茯苓、甘草、陈皮
以上切碎。生姜煎服。
小儿平时父母不能保护跟随，恣意出入，跌磕伤损头面肢体，未愈而痘随之而出，谓之“破瓮澄浆”。宜补血扶脾，笼金汤可用。
笼金汤
木香、生地黄、芍药、红花、当归、甘草、白芷、土木鳖、橘红、木通、桔梗、白术
以上，加姜枣煎服。
孩子们胸膈饱胀，厌恶饮食，身体发热，呕吐频繁，未愈而痘随之发作，医家称之为“逐鹿亡羊”。这与寻常先吐后出痘者不同，大凡因发痘而吐，毒素随吐减少，出痘必轻，现在是先因胃气受伤，腹胀恶食，吐又频繁不止，则是危迫之象，须要调理脾胃，如紫霞黄露饮可用。
紫霞黄露饮
干姜、半夏、藿香、砂仁、枳壳、陈皮、豆蔻、白术（炒）、青皮
以上切碎。水煎服。
小儿面色萎黄，时常潮热，眼胞浮肿，肚腹绞痛，此为小儿疳积未愈而痘随之而出，医家称之为“推车陷雪”。这是因为脾胃受伤，渐成疳积，驱虫逐积的药物，都不可用，唯有调理脾胃为上策，龙旋散最妙。
龙旋散
青皮、干姜、官桂、玄胡索（醋炒）、丁香、豆蔻、砂仁、枳壳、槟榔、厚朴、香附、山楂、艾叶
小儿遍身生疮，头颈脓窠环绕，手足关节如蛇皮缠裹，寒热不时，喷嚏不止，未愈而痘随之而出，医家称之为“霜逐梧桐”。治法宜凉血卫脾，贞元散可用。
贞元散
甘草、桔梗、人参、白芍药、黄芪、茯苓、木通、红花、白术、生地黄、白芷、升麻、陈皮、天花粉
以上，用灯草煎服。
孩子心中刺痛，未愈而痘随之而出，医家称之为“犯夺天梯”。这不是气逆，就是寒积，龙蟠饮可用。
龙蟠饮
人参、当归、枳壳、白豆蔻、丁香、木香、官桂、青皮、半夏、山楂、三棱、二蚕砂、厚朴
以上，用生姜酒煎服。
小儿两眼风热，红肿羞明，刺痛难忍，未愈而痘随之而出，医家称之为“弹打天乌”。治法宜清肝祛火，滋玄窖，提阴气，谷精龙胆散可用。
谷精龙胆散
生地黄、红花、荆芥、龙胆草、木通、甘草、赤芍药、谷精草、白茯苓、鼠粘子
以上，加灯心煎服。
小儿饮食过度，伤损脾胃，或饱闷，或吞酸，或吐泻，未愈而痘随之而出，医家称之为“风燕失巢”。痘全靠脾胃，急宜消食理脾，消导饮、磨积散相兼使用。
消导饮
厚朴、枳实、砂仁、山楂肉、半夏、神曲、槟榔、三棱、蓬术、丁香
以上，加干姜煎服。
孩子们小腹硬胀刺痛，小便赤涩难通，想尿则哭，不尿则痛，未愈而痘随之发作，医家称之为“断桥失渡”。这是心经郁火，积于小肠，浚牛膏是对证的药。
浚牛膏
大田螺，用葱盐加少许麝香，捣烂为膏，加热烘暖，用细绢摊贴在小腹上，用手按摩。
[Wan Quan] The disease of smallpox (Dou Chuang) is caused by fetal toxins (Tai Du) accumulated in the Mingmen (Gate of Life). The Mingmen refers to the Ministerial Fire (Xiang Huo) of the Kidney, which is the root of life and transformation in the human body; thus, toxins reside there. If one encounters warm weather in winter, causing Yang Qi to suddenly leak out, the person contracts this pathogen, stirring up the Ministerial Fire. When spring and summer arrive—the seasons of growth—the toxins erupt. With similar contagious symptoms, this is called Tian Xing Yi Li (epidemic pestilence). For those who have not yet manifested smallpox or chickenpox rashes, if they feel the influence of winter warmth, preventive measures should be taken immediately. It is appropriate to administer detoxifying medicines, such as Chen Sha San (Cinnabar Powder), San Dou Tang (Three Beans Decoction), and Dai Tian Xuan Hua Wan (Heavenly Envoy Transforming Pill), all of which can be used. Administer them frequently to reduce the toxicity of the rash, ensuring that the eruption is easy and recovery smooth, avoiding complications such as sinking, stagnation, or lingering persistence. While Chen Sha San, San Dou Tang, and Dai Tian Xuan Hua Wan are suitable for resolving epidemic toxins, if the cause lies in insufficient essence and blood from parents, or if the child has pre-existing conditions, or if other organ-related signs and symptoms appear during fever, treatment must address these concurrently. One cannot rely solely on detoxification while neglecting the root. For children with inherently weak Spleen and Stomach, nourishing the Spleen should be prioritized over detoxification; use two-thirds Nourishing Spleen Pill and one-third detoxifying agents. If toxins were accumulated due to excessive indulgence of parents leading to toxic essence and blood, and the child has a history of fetal diseases, both sources of toxin should be resolved simultaneously by alternating Su Yuan Jie Du Tang (Trace-Source Detoxification Decoction) and Dai Tian Xuan Hua Wan. Zhu Danxi stated: When smallpox or chickenpox is about to emerge or has just begun, and others around are suffering from the illness, one should take this medicine preventively to reduce severity. Use three cun of loofah near the stem, including skin and seeds, burn to ash retaining its nature, powder it, mix with rock sugar, and consume dry. Adding Cinnabar powder is even better.
San Dou Tang (Three Beans Decoction)
Vigna angularis (Red Bean), Glycine max (Black Soybean), Phaseolus radiatus (Green Bean) (each 1 sheng, raw); Glycyrrhiza uralensis (Licorice Root) (3 liang, raw and cut).
Wash the three beans thoroughly. Boil with Licorice Root in 8 sheng of snow water (if unavailable, use flowing river water) until beans are cooked. Remove Licorice Root. Dry the beans, then soak them in the decoction again and dry again, repeating until the liquid is absorbed. Daily, boil these beans in water and allow free consumption.
Dai Tian Xuan Hua Wan (Heavenly Envoy Transforming Pill) [Modified from Han Shi Wu Wen Dan]
Ren Zhong Huang (Human Waste Yellow; Earth element, Sovereign in Ji/Gui years); Scutellaria baicalensis (Huang Qin; Metal element, Sovereign in Yi/Geng years); Phellodendron amurense (Huang Bai; Water element, Sovereign in Bing/Xin years); Gardenia jasminoides (Zhi Zi Ren; Wood element, Sovereign in Ding/Ren years); Coptis chinensis (Huang Lian; Fire element, Sovereign in Wu/Gui years); Sophora flavescens (Ku Shen; Assistant); Schizonepeta tenuifolia (Jing Jie Sui; Assistant); Saposhnikovia divaricata (Fang Feng, removed rhizome, Assistant); Forsythia suspensa (Lian Qiao, wine-washed, Assistant); Menispermum dauricum (Shan Dou Gen; Assistant); Arctium lappa (Niu Bang Zi, wine-rinsed and stir-fried, Assistant); Perilla frutescens (Zi Su Ye; Assistant).
First, determine the heavenly stem of the year to select the Sovereign herb. Other herbs corresponding to the ruling element serve as Ministers. Double the dose of the Sovereign, halve the dose of Ministers, and set Assistants at three-quarters of the Minister's dose. Prepare into powder on the Winter Solstice. Decoct Cimicifuga foetida (Sheng Ma) in snow water, mix with bamboo sap (Zhu Li), and bind with Medicated Leaven (Shen Qu) into pills. Coat with Cinnabar (Chen Sha) and Realgar (Xiong Huang). Take with Bamboo Leaf Decoction (Zhu Ye Tang).
Preparation of Ren Zhong Huang: Take large Glycyrrhiza uralensis (Licorice Root) in any quantity. Insert into a section of fresh bamboo tube, tightly packing empty spaces without nodes. Immerse in a latrine pit for 77 days. Remove, dry, and store for use.
Su Yuan Jie Du Tang (Trace-Source Detoxification Decoction)
Angelica sinensis (Dang Gui Shen), Ligusticum chuanxiong (Chuan Xiong), Rehmannia glutinosa (Sheng Di Huang), Paeonia lactiflora (Bai Shao Yao), Panax ginseng (Ren Shen), Forsythia suspensa (Lian Qiao), Coptis chinensis (Huang Lian), Glycyrrhiza uralensis (Sheng Gan Cao), Citrus reticulata (Chen Pi), Akebia quinata (Mu Tong) (equal parts).
Cut finely. Add ten leaves of Bambusa vulgaris var. nana (Dan Zhu Ye). Decoct one cup of water to half a cup. Strain and take warm, anytime.
Yang Pi Wan (Nourishing Spleen Pill)
Panax ginseng (Ren Shen), Atractylodes macrocephala (Bai Zhu), Angelica sinensis (Dang Gui), Ligusticum chuanxiong (Chuan Xiong) (each 1.5 qian); Aucklandia decurrens (Mu Xiang), Citrus reticulata 'Chachi' (Qing Pi), Coptis chinensis (Huang Lian), Citrus reticulata (Chen Pi) (each 1 qian); Amomum villosum (Sha Ren), Crataegus pinnatifida (Shan Zha Rou), Medicated Leaven (Shen Qu, stir-fried), Hordeum vulgare (Mai Ya, stir-fried) (each 0.5 qian).
Grind into fine powder. Bind with Medicated Leaven paste made with water into pills the size of hemp seeds. Take 30-50 pills per dose, washed down with aged rice water.
Xiao Wen Dan (Plague-Extinguishing Pill) [For prevention before or during early eruption]
Cinnabar (Chen Sha, ground to ultra-fine powder, processed by water flotation; <1 year old: 5-6 fen; >1 year old: 1 qian); Loofah (Si Gua, 3 cun near stem, burned to retain nature, powdered; same dosage as above).
Mix with honey and take orally. Alternatively, cook pigeon or turtledove, apply Cinnabar powder to the meat, and feed to the child. Proven effective through repeated trials.
Mi Chuan Bao Ying Dan (Secret Preserved Infant Protection Pill)
Arnebia euchroma/Lithospermum erythrorhizon (Zhen Zi Cao, remove rhizome, wash with wine, avoid iron); Vitis amurensis vine (Chan Dou Teng, burned to ash, retain nature; each 4 liang, these two are Sovereigns); Cimicifuga foetida (Sheng Ma, new material, salt-water stir-fried to guide downward and protect Lung Qi); Saposhnikovia divaricata (Chuan Fang Feng, remove rhizome and forks); Schizonepeta tenuifolia (Jing Jie Sui, remove stems); Arctium lappa (Niu Bang Zi, stir-fried; each 2 liang, these four are Ministers); Borneolum Syntheticum/Tribulus terrestris resin? (Zhen Tian Zhu Huang - likely Tribulus or specific mineral/resin context here, traditionally associated with clearing heat/phlegm); Toad venom (Chan Su, self-collected, avoid red-eyed toads); Bovis Calculus (Zhen Niu Huang) (these three, each 1.2 qian, are Assistants); Large Cinnabar (Da Zhu Sha, processed using decoction of Ephedrae Herba, Arnebiae Radix/Lithospermi Radix, and Litchi shell; water-flattened and refined to 3.4 qian); Glycyrrhiza uralensis tip (Gan Cao Shao, peeled, 2 liang combined); Vigna angularis (Chi Xiao Dou), Black Soybean (Hei Xiao Dou), Phaseolus radiatus (Lu Dou) (each 49 grains, stir-fried, do not burn; these three are Envoys).
Grind each into fine powder and mix uniformly. Separately, decoct 3 liang of Arnebiae Radix/Lithospermi Radix in three bowls of water, strain, and simmer into half a bowl of paste. Add half a bowl of raw rock sugar. Form pills the size of Euryale ferox seeds (Qian Shi). Coat with water-flattened Cinnabar. Before eruption, decoct strong Licorice Root soup. Children grind one pill; adults take two. If fever has started, grind with Ginger Decoction, cover thickly to induce sweating. This reduces heavy cases to light, and light cases to none, with miraculous effect.
Yuan Shi Pre-Eruption Treatment Methods: To treat smallpox effectively, one must identify the syndrome beforehand and prescribe accordingly. Severe cases become mild, mild cases heal. However, curing before eruption yields no merit for the physician, so many lack diligence. By the time eruption occurs, it may be too late. Benevolent physicians must prioritize saving lives and protecting infants. I would rather have no merit than let an infant die. The following eighteen syndromes and treatments are detailed.
Before eruption, if the child catches Wind Pathogen, feels internal burning heat, suffers headache, spontaneous sweating, and persistent cough, and smallpox emerges before the cold resolves, this is called "Monkey Jumping Lock" (Yuan Hou Tiao Suo). After Typhoid Fever, when Yuan Qi is depleted, nourish Yin and tonify Blood, clear heat and disperse Wind. Ziyin Sanbao San (Nourishing Yin Three Treasures Powder) is indicated.
Ziyin Sanbao San
Angelica sinensis (Dang Gui), Astragalus membranaceus (Huang Qi), Rehmannia glutinosa (Sheng Di), Poria cocos (Bai Fu Ling), Paeonia lactiflora (Shao Yao), Ligusticum chuanxiong (Chuan Xiong), Citrus reticulata peel (Ju Hong), Glycyrrhiza uralensis (Gan Cao), Saposhnikovia divaricata (Fang Feng), Scrophularia ningpoensis (Xuan Shen), Ophiopogon japonicus (Mai Men Dong - double dose).
Cut finely. Decoct with Ginger and Jujube.
If diet is unregulated and Summer-Dampness is not guarded against, damaging the abdomen, leading to frequent diarrhea, loss of appetite, and emaciation, followed shortly by smallpox eruption, this is called "Guanyin Sweeping Seat" (Guan Yin Fo Zuo). This differs from diarrhea preceding eruption where toxin is expelled with stool, resulting in milder smallpox. Here, post-prolonged diarrhea weakness means Spleen deficiency and weak Yuan Qi. Pure tonics may cause false distension; pure cooling herbs are contraindicated. Regulate the Spleen only, e.g., Si Zhi Bai Zhu San (Four-Processed Atractylodes Powder).
Si Zhi Bai Zhu San
Atractylodes macrocephala (Bai Zhu, 8 liang). Divide into four parts: stir-fry one part with Amomum villosum (Sha Ren), one with Glutinous Rice (Nuomi), one with Bran (Fupi), one with Wall Soil (Bi Tu). Clean, powder, and take with milk or wine according to age.
After Malaria, wasting fever thins muscles. If eruption occurs upon recovery or concurrent with malaria, it is called "Horse Galloping Sword Path" (Ma Chi Jian Dao). Often caused by Damp-Heat. Caolu (Tsao-Ku) and Changshan (Dichroa) are strictly forbidden. Chai Hu (Bupleurum) is also a harsh herb that depletes Zheng Qi. Use Ren Shen (Ginseng), Fu Ling (Poria), Bai Zhu (Atractylodes), slightly adding digestion-promoting and heat-clearing herbs. Bazhen Gao (Eight Treasures Paste) or Wei Yuan Tang (Guarding Origin Decoction) may be used.
Bazhen Gao
Panax ginseng (Ren Shen, 1 liang), Honey (Mi, 4 liang), Milk, Pear Juice (simmer together).
Add processed Placenta Hominis (Zi He Che). Take two spoonfuls with wine.
Wei Yuan Tang
Panax ginseng (Ren Shen), Atractylodes macrocephala (Bai Zhu), Scorpio (Quan Xie), Crataegus pinnatifida (Shan Zha), Pinellia ternata (Ban Xia), Angelica sinensis (Dang Gui), Citrus reticulata peel (Ju Hong), Aurantium indicum (Zhi Ke), Prunus mume (Wu Mei).
Decoct with Ginger and Jujube. Take with added milk.
At age five or six, if Yuan constitution is weak, fever arises, thirst and cough occur, and smallpox follows shortly after chickenpox, this is a Taiyin Splein Meridian syndrome, called "Single Reed Crossing Sea" (Yi Wei Hang Hai). Unlike the favorable sequence of chickenpox then smallpox, this critical state requires nourishing Yin, clearing Lung heat, and fortifying Spleen. Huang Qi (Astragalus) is difficult to use here. Neituo Zhiqi Tang (Interior-Supporting Miraculous Odd Decoction) is indicated.
Neituo Zhiqi Tang
Asparagus cochinchinensis (Tian Men Dong), Ophiopogon japonicus (Mai Men Dong), Panax ginseng (Ren Shen), Atractylodes macrocephala (Bai Zhu), Angelica sinensis (Dang Gui), Poria cocos (Fu Ling), Coix seed (Yi Yi Ren), Ligusticum chuanxiong (Chuan Xiong), Citrus reticulata (Chen Pi), Glycyrrhiza uralensis (Gan Cao), Platycodon grandiflorus (Jie Geng), Ginkgo biloba (Yin Xing, peeled).
Decoct with Glutinous Rice. Take frequently.
If the child has chronic malnutrition (Gan Ji) with abdominal distension, visible veins, emaciated limbs (Ding Xi syndrome), and sudden smallpox eruption, this is called "Three Immortals Entering Cave" (San Xian Ru Dong). Do not attempt to eliminate Gan Ji immediately. Hou Po (Magnolia Bark), Bing Lang (Areca Seed), Chai Hu, Huang Lian, cold herbs, and Bao Long Wan are contraindicated. Use Yihuang San (Yellow-Protecting Powder) or Didijin (Dripping Gold).
Didijin
Extract the golden substance from the belly of a toad (Xia Ha). Mix with wine and take.
If Wind-Cold affects the pores, causing recurrent fever spreading from head to body, with carbuncles appearing, followed by smallpox, this is called "Inverted Silver Vase" (Dao Gua Yin Ping). Often involves Liver and Heart meridians. Avoid San Huang (Three Yellows). Use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) or Zicao San (Arnebia Powder).
Xijiao Dihuang Tang
Rhinoceros horn (Xi Jiao, ground with milk, 1 qian); Paeonia suffruticosa (Mu Dan Pi); Paeonia lactiflora (Shao Yao); Rehmannia glutinosa (Sheng Di Huang).
Add Juncus effusus (Deng Cao). Decoct in water and take.
Before eruption, if face is red from heat, eyes stare straight, limbs twitch, mouth is dry with delirious speech, and convulsions recur, followed by smallpox, this is called "Frost Bridge Imprint" (Shuang Qiao Yin Ji). Unlike typical post-convulsion eruption (which indicates Heart meridian involvement and good prognosis), here severe convulsions indicate extreme deficiency. Cinnabar and metallic minerals are strictly forbidden. Fushen Tang (Poria Spirit Decoction) is indicated.
Fushen Tang
Rehmannia glutinosa (Sheng Di), Angelica sinensis (Dang Gui), Glycyrrhiza uralensis (Gan Cao), Paeonia lactiflora (Bai Shao Yao), Poria cocos with wood (Fu Shen), Polygala tenuifolia (Yuan Zhi), Platycodon grandiflorus (Jie Geng).
Add Juncus effusus (Deng Cao) and Ginger. Decoct and take.
Before eruption, if fever, spontaneous sweating, hemoptysis, epistaxis, or hematuria occur, followed by smallpox, this is called "Lotus Pond Wading" (Ou Chi Ta Shui). Heart organ failure leads to reckless blood movement. Clear Heart fire; do not use indiscriminate cold/cooling agents. Yexian Dusheng San (Wild Immortal Single Saint Powder) is indicated.
Yexian Dusheng San
Platycladi Cacumen (Bai Bai), Scrophularia ningpoensis (Xuan Shen), Sanguisorba officinalis (Di Yu), Commelina communis (Xue Jian Chou), Rehmannia glutinosa (Sheng Di Huang), Akebia quinata (Mu Tong), Paeonia lactiflora (Shao Yao), Angelica sinensis (Dang Gui Shen), Glycyrrhiza uralensis (Gan Cao), Zingiber officinale (Gan Jiang).
Before eruption, if fever, anorexia, abdominal distension, eyelid edema, and restlessness occur, followed by smallpox, this is called "Stone Drum Silent" (Shi Gu Wu Ming). Regulate Spleen and tonify Qi. Canji Ling Baizhu San (Ginseng, Poria, and Atractylodes Powder) modified is indicated.
Canji Ling Baizhu San Modified
Panax ginseng (Ren Shen), Poria cocos (Fu Ling), Dioscorea opposita (Shan Yao), Lablab purpureus (Bai Bian Dou), Atractylodes macrocephala (Bai Zhu), Citrus reticulata (Chen Pi), Lotus seed (Lian Rou), Coix seed (Yi Yi Ren), Angelica sinensis (Dang Gui), Saposhnikovia divaricata (Fang Feng), Ziziphus jujuba pit/Aurantii Fructus (Zhi Shi).
Grind into powder. Modify as needed.
If fever, continuous sweating, blurred vision, yawning, crying, and smallpox emergence occur, this is called "Red Marsh Planting Lotus" (Chi Ze Zai Lian). Astringe sweat and nourish Liver. Decoct Huang Qi (Astragalus) in human milk and take frequently. Guzhen Tang (Solidify True Decoction) is also indicated.
Guzhen Tang
Astragalus membranaceus (Mian Huang Qi, 2 liang, honey-fried), Ziziphus jujuba seed (Suan Zao Ren, 4 liang), Panax ginseng (Ren Shen), Paeonia lactiflora (Bai Shao Yao), Angelica sinensis (Dang Gui), Rehmannia glutinosa (Sheng Di Huang), Poria cocos (Fu Ling), Glycyrrhiza uralensis (Gan Cao), Citrus reticulata (Chen Pi).
Cut coarsely. Decoct with Ginger.
If parents fail to protect the child, allowing injuries to head/limbs from falls, and smallpox erupts before healing, this is called "Broken Jar Clarifying Liquid" (Po Weng Cheng Jiang). Tonify Blood and support Spleen. Longjin Tang (Golden Cage Decoction) is indicated.
Longjin Tang
Aucklandia decurrens (Mu Xiang), Rehmannia glutinosa (Sheng Di Huang), Paeonia lactiflora (Shao Yao), Carthamus tinctorius (Hong Hua), Angelica sinensis (Dang Gui), Glycyrrhiza uralensis (Gan Cao), Angelica dahurica (Bai Zhi), Elaeagnus angustifolia/Momordica charantia seed? (Tu Mu Bie - likely Momordica seed in pediatric context), Citrus reticulata peel (Ju Hong), Akebia quinata (Mu Tong), Platycodon grandiflorus (Jie Geng), Atractylodes macrocephala (Bai Zhu).
Decoct with Ginger and Jujube.
If chest fullness, food aversion, fever, and frequent vomiting occur before smallpox eruption, this is called "Chasing Deer Losing Sheep" (Zhu Lu Wang Yang). Unlike vomiting reducing toxin load, here stomach Qi is damaged, causing distension, aversion to food, and incessant vomiting—a critical sign. Regulate Spleen and Stomach. Zixia Huanglu Yin (Purple Cloud Yellow Dew Drink) is indicated.
Zixia Huanglu Yin
Zingiber officinale (Gan Jiang), Pinellia ternata (Ban Xia), Agastache rugosa (Huo Xiang), Amomum villosum (Sha Ren), Aurantium indicum (Zhi Ke), Citrus reticulata (Chen Pi), Cardamom (Dou Kou), Atractylodes macrocephala (Bai Zhu, stir-fried), Citrus reticulata 'Chachi' (Qing Pi).
Cut coarsely. Decoct in water.
If sallow complexion, tidal fever, eyelid edema, and abdominal colic occur with smallpox eruption, this is "Pushing Cart into Snow" (Tui Che Xian Xue), indicating unresolved childhood malnutrition (Gan Ji) from Spleen/Stomach damage. Deworming and accumulation-dispersing drugs are forbidden. Regulating Spleen/Stomach is best. Longxuan San (Dragon and Spinning Top Powder) is excellent.
Longxuan San
Citrus reticulata 'Chachi' (Qing Pi), Zingiber officinale (Gan Jiang), Cinnamon twig (Guan Gui), Cyperus rotundus/Paezia? (Xuan Hu Suo, vinegar-fried), Syzygium aromaticum (Ding Xiang), Cardamom (Dou Kou), Amomum villosum (Sha Ren), Aurantium indicum (Zhi Ke), Areca seed (Bing Lang), Magnolia bark (Hou Po), Cyperus rotundus (Xiang Fu), Hawthorn (Shan Zha), Mugwort leaf (Ai Ye).
If widespread sores, head/neck pus-filled lesions, limb joints wrapped like snake skin, intermittent fever/chills, and sneezing precede smallpox, this is "Frost Chasing Paulownia" (Shuang Zhu Wu Tong). Cool Blood and protect Spleen. Zhenyuan San (True Origin Powder) is indicated.
Zhenyuan San
Glycyrrhiza uralensis (Gan Cao), Platycodon grandiflorus (Jie Geng), Panax ginseng (Ren Shen), Paeonia lactiflora (Bai Shao Yao), Astragalus membranaceus (Huang Qi), Poria cocos (Fu Ling), Akebia quinata (Mu Tong), Carthamus tinctorius (Hong Hua), Atractylodes macrocephala (Bai Zhu), Rehmannia glutinosa (Sheng Di Huang), Angelica dahurica (Bai Zhi), Cimicifuga foetida (Sheng Ma), Citrus reticulata (Chen Pi), Angelica gigas/Peucedanum? (Tian Hua Fen).
Decoct with Juncus effusus (Deng Cao).
If sharp heart pain precedes smallpox, this is "Violating Heaven's Ladder" (Fan Duo Tian Ti). Not Qi rebellion, but Cold accumulation. Longpan Yin (Dragon Pool Drink) is indicated.
Longpan Yin
Panax ginseng (Ren Shen), Angelica sinensis (Dang Gui), Aurantium indicum (Zhi Ke), White Cardamom (Bai Dou Kou), Syzygium aromaticum (Ding Xiang), Aucklandia decurrens (Mu Xiang), Cinnamon twig (Guan Gui), Citrus reticulata 'Chachi' (Qing Pi), Pinellia ternata (Ban Xia), Hawthorn (Shan Zha), Bupleurum root? (San Leng - actually Curcuma zedoaria), Two silkworm sands? (Er Can Sha - likely insect remedy), Magnolia bark (Hou Po).
Decoct with Ginger and Wine.
If wind-heat in eyes causes redness, swelling, photophobia, and unbearable pain before smallpox, this is "Shooting Heavenly Darkness" (Dan Da Tian Wu). Clear Liver, dispel fire, nourish the "Mysterious Vault" (Kidney/Yin), and raise Yin Qi. Gujing Longdan San (Glory Flower and Gentian Powder) is indicated.
Gujing Longdan San
Rehmannia glutinosa (Sheng Di Huang), Carthamus tinctorius (Hong Hua), Schizonepeta tenuifolia (Jing Jie), Gentiana scabra (Long Dan Cao), Akebia quinata (Mu Tong), Glycyrrhiza uralensis (Gan Cao), Red Paeonia (Chi Shao Yao), Centipeda minima (Gu Jing Cao), Poria cocos (Bai Fu Ling), Arctium lappa (Shu Niu Zi).
Add Juncus effusus (Deng Xin). Decoct and take.
If overeating damages Spleen/Stomach, causing fullness, acid regurgitation, or vomiting/diarrhea before smallpox, this is "Wind Swallow Losing Nest" (Feng Yan Shi Chao). Smallpox relies entirely on Spleen/Stomach. Urgently digest food and regulate Spleen. Xiaodao Yin (Digestion-Guiding Drink) and Moji San (Accumulation-Grinding Powder) combined are indicated.
Xiaodao Yin
Magnolia bark (Hou Po), Immature Bitter Orange (Zhi Shi), Amomum villosum (Sha Ren), Hawthorn flesh (Shan Zha Rou), Pinellia ternata (Ban Xia), Medicated Leaven (Shen Qu), Areca seed (Bing Lang), Curcuma zedoaria (San Leng), Curcuma phaeocaulis (Peng Zhu), Syzygium aromaticum (Ding Xiang).
Add Zingiber officinale (Gan Jiang). Decoct and take.
Moji San
Artemisia annua? (Gan Hao - likely Artemisia capillaris or similar drying herb), Citrus reticulata (Chen Pi), Hordeum vulgare (Mai Ya), Two silkworm sands (Er Can Sha).
Add Zingiber officinale (Sheng Jiang). Decoct and take.
If lower abdominal hardness/pain, dark/scanty urination, crying when needing to urinate, and pain when not, precede smallpox, this is "Broken Bridge Lost Ferry" (Duan Qiao Shi Du). Heart meridian stagnant fire accumulates in Small Intestine. Jun Niu Gao (Ox-Dredging Paste) is the specific remedy.
Jun Niu Gao
Large pond snail (Da Tian Luo). Mix with Green Onion, Salt, and a little Moschus (She Xiang). Pound into paste. Heat gently, spread on fine silk, and apply to lower abdomen. Massage with hand.