血热痘疹。只宜清凉发散。不宜峻用苦寒。过投芩、连之属。必致内伤脾胃。外闭肌肉。脾
胃伤。则饮食减而泄泻。重则洞泄无度。遂致虚寒。肌肉闭则热蒸之气不行。腠理涩滞。则痘不
起发。不行浆。遂成伏陷。此热证变虚之验。虚证既形。便从虚治。不可胶执而畏参、 、丁、
桂也。六七日后见之。则木香、异功皆可应用。但中病即止。不可过剂。以招竭泽之祸也。
毒盛壅遏。固宜升提发散。而佐以清凉。使热毒得平而止。若发散太过。必致肌表空虚。元
气耗散。内灌清浆。或虚肿空壳。或痒塌外剥。或溃烂不收。百变皆至。而内气亦不能自守。略
伤饮食。则成泄泻。泄泻不止。遂变虚寒。而气脱烦渴闷乱。寒战切牙。无所不至矣。夫始出之
时。虽为血热壅遏。至三四日后。身反不热。痘疮不长。焉得不进温和之剂。如观桂、川芎、干
姜之类。使内气一暖。则外气自和。泄泻之后。其内必虚。虽有腹胀烦渴喘急。焉得复为实热。
不过内虚伏陷毒瓦斯内攻而然。故实热之证。七八九日曾经泄泻。皆从虚治。有木香异功证。便进
木香、异功。如无冰硬之证。非泄泻之后。切勿误投温剂。盖塌陷倒 干枯。而无冰硬泄泻之患
者。多因热毒内攻而然。又当用百祥丸、猪尾膏等方治之。误投温热。卢扁不能复图也。
痘疹因血热所致，只适宜使用清凉发散的方法治疗，不应当猛烈地使用苦寒药物。如果过量投用黄芩、黄连这类药物，必然会导致内伤脾胃，外闭肌肉腠理。脾胃受损，则饮食减少并出现泄泻；严重的会出现洞泄无度（腹泻如水，毫无节制），进而导致虚寒证。肌肉腠理闭塞，则蒸腾透发的热气无法运行，腠理涩滞，导致痘疹不能起发，也不能灌浆，最终形成伏陷（痘疹内陷）的危候。这是热证转变为虚证的验证。一旦虚证的表现已经形成，就应当按照虚证来治疗，不可固执拘泥而畏惧使用人参、丁香、肉桂等温补药物。如果在发病六七日后见到这种情况，木香散、异功散都可以应用。但必须中病即止（药到病除就停药），不可过量用药，以免招致竭泽而渔般的祸患。
毒邪炽盛且壅滞遏阻，固然适宜采用升提发散的方法，并辅以清凉药物，使热毒得以平息而停止。如果发散太过，必然导致肌表空虚，元气耗散，内部灌注清稀浆液，或者出现虚肿空壳，或者瘙痒塌陷外皮剥落，或者溃烂难以收口，各种变证都会出现，而且内部正气也无法自我固守。稍微损伤饮食，就会造成泄泻；泄泻不止，就会转变为虚寒证，进而出现气脱、烦躁口渴、胸闷神乱、寒战咬牙等症状，无所不至。在痘疹刚发出时，虽然是因为血热壅遏，但到了三四天后，身体反而不再发热，痘疮也不生长，怎么能不进服温和的药物呢？如观桂（可能指某种桂类或特定方剂成分，此处依原文保留）、川芎、干姜之类。使体内正气温暖，则体表之气自然调和。泄泻之后，体内必然虚弱，即使有腹胀、烦躁口渴、气喘急促等症状，又怎能再认为是实热证呢？这不过是内部虚弱，伏陷的毒瓦斯向内攻冲所致。所以，实热证如果在七八九日曾经发生过泄泻，都应当按照虚证来治疗。如果有木香散或异功散的适应证，就进服木香散或异功散。如果没有冰硬（坚硬冰冷）的症状，且在泄泻之后，切勿误投温补药物。因为出现塌陷倒靥、干枯，而没有冰硬和泄泻问题的，多是因为热毒内攻所致，这时应当使用百祥丸、猪尾膏等方剂进行治疗。如果误投温热药物，即使是卢医扁鹊再生也无法救治了。
For varicella and rashes caused by blood heat, only cool and dispersing methods are suitable; harsh bitter-cold drugs should not be used vigorously. Over-administration of herbs such as Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) will inevitably damage the Spleen and Stomach internally and close the muscles externally. Damage to the Spleen and Stomach leads to reduced appetite and diarrhea; in severe cases, it results in profuse watery diarrhea without restraint, eventually leading to deficiency-cold syndrome. Closure of the muscles prevents the steaming and transforming Qi from circulating; stagnation of the interstices causes the rash to fail to erupt and fill with pus, ultimately resulting in collapse (internal sinking of the rash). This is the evidence of a heat syndrome transforming into a deficiency syndrome. Once deficiency manifestations appear, treatment should follow the principle of treating deficiency; one must not be rigidly attached and fear using warming tonics such as Ginseng Radix et Rhizoma (Renshen), Caryophylli Flos (Dingxiang), and Cinnamomi Ramulus (Guizhi). If observed on the sixth or seventh day, both Muxiang San (Aucklandia Powder) and Yigong San (Yi Gong Decoction) can be applied. However, stop medication once the disease is cured; do not overdose to avoid the disaster of draining the pond to catch all fish.
When toxin is abundant and obstructed, it is indeed appropriate to use lifting and dispersing methods assisted by cooling agents, so that the heat-toxin may be pacified and cease. If dispersing is excessive, it will inevitably lead to emptiness of the muscle surface and dispersion of Yuan Qi (Original Qi), causing clear fluid to pour internally, or resulting in empty swollen shells, itching and collapse with external peeling, or ulceration that fails to heal. All kinds of variations may occur, and internal Qi cannot guard itself. A slight injury to diet will cause diarrhea; if diarrhea does not stop, it transforms into deficiency-cold, leading to Qi collapse, irritability, thirst, chest oppression, mental confusion, chills, and teeth grinding—symptoms that know no bounds. At the initial eruption, although it is due to blood heat obstruction, after three or four days, if the body becomes fever-free and the lesions do not grow, how can one refrain from administering mild-warming agents? Such as Guanyuan (possibly referring to specific cinnamon preparations or ingredients), Chuanxiong Rhizoma (Chuanxiong), and Zingiberis Rhizoma Recens (Ganjiang). When internal Qi is warmed, external Qi naturally harmonizes. After diarrhea, the interior must be deficient; even if there are abdominal distension, irritability, thirst, panting, and urgency, how can this still be considered excess-heat? It is merely due to internal deficiency and the internal attack of sunken toxins. Therefore, for excess-heat syndromes that have experienced diarrhea on the seventh, eighth, or ninth day, treatment should always address deficiency. If there are indications for Muxiang San or Yigong San, administer them. Unless there are signs of ice-hardness (hard and cold texture), especially after diarrhea, never mistakenly administer warming agents. Because cases presenting with collapse, inversion, dryness, and withering, but without ice-hardness or diarrhea, are mostly caused by internal attack of heat-toxin; in such cases, Baixiang Wan (Baixiang Pill) and Zhuwei Gao (Pig Tail Paste) should be used. Mistakenly administering warming agents would render even Lu Yi (Bian Que) unable to save the patient.