咳嗽痰喘。虽属肺热。然有气虚腠理不固。风邪侵肺。而嗽吐稀痰者。参苏饮。头痛身热。
鼻塞喘嗽者。风寒也。芎苏散。若咳嗽不已。无表证者。此肺虚为痘毒所乘。补肺汤。喘胀便秘
者。肺热也。黄芩泻肺汤。有汤水入口即咳而吐出者。肺胃热痰胶固也。先与栀子豉汤加葱白、桔
梗探吐。后服如圣饮。面白手足冷喘促者。此虚寒也。白术散。亦有肺脘有痘。淫淫作痒。习习
如梗。阻碍气道而为咳嗽。痘收自愈。有不咳嗽但喘者。若初出喷嚏。鼻流清水而喘。风寒客肺
也。参苏饮。痘点干红。腹胀便秘而喘。毒盛气不舒畅也。宜清火解毒。有气虚不能逐邪外出。毒
伏于内而喘胀者。乃闷痘证。不治。有泻后喘者。脾气下陷。虚火上拥。下气不续也。补中益气汤
。有吐后喘者。胃虚不能制伏相火也。六君子汤。痘四五日。伏陷喘胀。必再攻发。复起可治。痘
浆半足而倒 喘胀者。宜补兼攻发。复肿灌为吉。有误服参、 腹胀而喘。枳壳汤。有痘密以致鼻塞。
而口中气促似乎喘者。非喘也。以喘治之误矣。
痘疮要涕唾稠粘。则热毒容易蒸发。若涕唾稠粘。身热鼻塞。大便如常。小便黄赤。芎苏散
加减。如痰盛壮热。胸中烦闷。大便坚实。卧则喘急。前胡枳壳汤微利之。庶元气不伤。痘疮易出。
咳嗽、咳痰、气喘，虽然属于肺热，但也有因气虚导致腠理（皮肤毛孔及其附属组织）不固，风邪侵袭肺部，从而引起咳嗽并吐出稀薄痰液的情况。可用参苏饮。出现头痛、身体发热、鼻塞、气喘咳嗽的，是风寒所致。可用芎苏散。如果咳嗽不止，且没有表证（外感病初期症状），这是肺气虚弱被痘毒所乘袭。可用补肺汤。出现气喘、腹胀、便秘的，是肺热。可用黄芩泻肺汤。如果有汤水入口即引发咳嗽并吐出的，是肺胃中热痰胶结牢固。先用栀子豉汤加入葱白、桔梗来催吐，之后服用如圣饮。面色苍白、手脚发冷、气喘急促的，这是虚寒证。可用白术散。也有肺窍中有痘疹，感觉瘙痒不适，像有异物梗塞，阻碍气道而导致咳嗽的，待痘疹消退后自然痊愈。有不咳嗽但气喘的，如果在痘疹初出时打喷嚏、流清鼻涕而气喘，是风寒客居于肺。可用参苏饮。痘疹颜色干红，伴有腹胀、便秘而气喘，是毒盛气机不畅。宜用清热泻火解毒法。有因气虚不能将邪气驱逐外出，毒邪潜伏在体内而导致气喘腹胀的，这是闷痘证，难以治愈。有腹泻后出现气喘的，是脾气下陷，虚火上冲，下焦之气接续不上。可用补中益气汤。有呕吐后出现气喘的，是胃虚不能制约相火。可用六君子汤。痘疹四五日，伏陷不起且气喘腹胀，必须再次攻散发汗，若痘疹重新起发则有望治愈。痘浆已半满却发生倒靥（痘疹塌陷）且气喘腹胀的，宜用补益兼攻发的方法，若痘疹重新肿胀灌浆为吉兆。有误服人参等补药导致腹胀而气喘的，可用枳壳汤。有因痘疹密集导致鼻塞，口中气息急促似乎气喘的，这不是气喘，按气喘治疗是错误的。
痘疮应当涕唾稠粘，这样热毒容易蒸发出来。如果涕唾稠粘，身体发热、鼻塞，大便正常，小便黄赤，可用芎苏散加减。如果痰多、高热，胸中烦闷，大便坚实，躺下时气喘急促，可用前胡枳壳汤轻微通利大便，这样既损伤不到元气，又有利于痘疹发出。
Cough, expectoration of phlegm, and wheezing (asthma-like breathing), although belonging to Lung heat (Lung heat), also occur due to Qi deficiency causing the Couli (pores and interstices) to be insecure, allowing Wind pathogen to invade the Lung, resulting in cough with expectoration of thin sputum. Can use Shen Su Yin (Ginseng and Perilla Decoction). Headache, fever, nasal congestion, wheezing, and cough are caused by Cold-Wind (Cold-Wind). Can use Xiong Su San (Ligusticum and Perilla Powder). If cough persists without exterior syndrome (exterior syndrome), this is Lung deficiency being attacked by smallpox toxin. Can use Bu Fei Tang (Tonify Lung Decoction). Wheezing, abdominal distension, and constipation indicate Lung heat. Can use Huang Qin Xie Fei Tang (Scutellaria Decoct to Drain the Lung). If fluids cause immediate coughing and vomiting upon entry, it indicates sticky and solidified Phlegm-Heat in the Lung and Stomach. First use Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) added with Cong Bai (Scallion White) and Jie Geng (Platycodon Root) to induce vomiting, then take Ru Sheng Yin (Like Sage Drink). Pale complexion, cold hands and feet, and rapid wheezing indicate Deficient-Cold (Deficient-Cold). Can use Bai Zhu San (Atractylodes Macrocephala Powder). There are also cases where pustules exist in the Lung orifice, causing itching and a sensation of obstruction in the airway leading to cough; this resolves spontaneously when the pustules recede. Cases of wheezing without cough: if sneezing, runny clear nose, and wheezing occur at the initial eruption of pustules, it is Cold-Wind lodging in the Lung. Can use Shen Su Yin. Dry-red pustules accompanied by abdominal distension, constipation, and wheezing indicate excessive toxin and stagnant Qi. Clearing Heat (Clearing Heat) and detoxifying (Detoxification) should be employed. When Qi deficiency fails to expel pathogens outward, toxin lingers internally causing wheezing and abdominal distension, this is Men Dou (Trapped Smallpox Syndrome), which is difficult to treat. Wheezing after diarrhea indicates Spleen Qi sinking, defying Fire rising, and failure of lower Qi to continue. Can use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Wheezing after vomiting indicates Stomach deficiency failing to control Ministerial Fire (Ministerial Fire). Can use Liu Jun Zi Tang (Six Gentlemen Decoction). On the fourth or fifth day of smallpox, if lesions sink inward with wheezing and abdominal distension, they must be re-invigorated for eruption; recovery is possible if they rise again. If pustules are half-filled but invert (invert) with wheezing and abdominal distension, tonification combined with invigoration for eruption is suitable; swelling and suppuration are auspicious signs. Abdominal distension and wheezing caused by erroneous administration of Ginseng (Ren Shen) can be treated with Zhi Ke Tang (Immature Bitter Orange Decoction). Nasal congestion due to dense pustules, with rapid breathing resembling wheezing, is not true wheezing; treating it as such is an error.
Smallpox should present with thick and sticky nasal discharge and saliva, facilitating the evaporation of Heat-Toxin (Heat-Toxin). If discharge is thick and sticky, accompanied by fever, nasal congestion, normal stool, and yellow-red urine, modify Xiong Su San (Ligusticum and Perilla Powder). If there is abundant phlegm, high fever, chest oppression, hard stool, and urgent wheezing when lying down, slightly purge with Qian Hu Zhi Ke Tang (Peucedanum and Immature Bitter Orange Decoction) to preserve Yuan Qi (Primary Qi) and facilitate smallpox eruption.