痘疮终始皆以脾胃为主，但能饮食，则气血充实，而凡起发灌浆收靥，无不赖之。故能食者，
虽痘疮稠密，亦自无害；不能食者，虽痘疮稀少，亦为可虞，此脾胃之调，所当先也。然证有不同
，最须详审施治。
一、痘有毒瓦斯正盛而不食者，当痘疮正出之时，虽不欲食，但得痘色真正，不为害也。盖热毒
未解，于将出未出之际，多有不欲食者，待毒瓦斯尽出自能食矣。其有痘已尽出而仍不欲食者，当徐
用四物汤加神曲、砂仁、陈皮，一、二剂必能食矣，
一、痘见灰白，别无大热停滞等证，而食少或不食者，必脾胃虚也，宜五味异功散，或四君子
汤。若胃中阳气不足，不能运化而食少者，此处而且寒也，宜温胃饮、养中煎，或六气煎主之。
一、凡命门元畅不足，则中焦胃气不暖，故多痞满不食，下焦肾气不化，故多二阴不调，此必
用理阴煎加减治之，自见神效，勿谓小儿无阴虚证也。
一、凡泄泻，或见恶心，或呕吐而不食者，尤属胃气虚寒也，轻则理中汤、六气煎；甚则陈氏
十二味异功散，或用六气煎合二仙散主之。
一、凡脾气不虚，但胃口寒滞，或痛或呕而不食者，宜益黄散。
一、凡停食多食而不食者，宜大小和中饮以清宿滞，或五味异功散加山查、麦茅、神曲、砂仁，
或合匀气散治之。
一、凡口疮不能进食，或咽喉疼痛而不能食者，但清其咽，痛止自会矣，宜廿桔汤，或加味甘
桔汤。
一、凡外感风寒，邪入胃口则不能食，须表散寒邪，邪散自能食矣，宜加减参苏饮，或柴陈煎
，或五味异功散加柴胡。
一、痘后别无他证而饮食不进者，此惟脾气不足，宜五味异功散，或温胃饮、养中煎之类主之。
程氏曰∶凡水谷不能运化而饮食不进者，只用保元汤加陈皮、麦茅、神曲、砂仁、扁豆、生姜
，呕者加真藿香。
徐氏曰∶痘疮不乳食者，有虚实二证∶或吐或利，面目青白或青黑色者为虚寒，宜温之补之；
若大小二便干涩，面赤而气壅，或渴或热，或目睛黄赤，气粗中满者为实热，宜清之利之。
痘疮的整个病程始终以脾胃为核心，只要患者能够进食，气血就会充实，那么凡是需要起发、灌浆、收靥等阶段，无不依赖于此。因此，能进食的人，即使痘疮密集，也不会造成危害；不能进食的人，即使痘疮稀少，也值得担忧，所以调理脾胃是首要任务。然而病情各不相同，必须详细审察后施治。
一、痘毒邪气正盛而食欲不振者，在痘疮刚发出之时，虽然不想吃东西，但只要痘色正常，就不会有害。因为热毒未解，在即将发出或尚未发出的时候，很多人会出现不想吃的情况，等到毒邪散尽自然就能进食了。如果有痘疮已经全部发出但仍然不想吃东西的，应当慢慢使用四物汤加入神曲、砂仁、陈皮，服用一两剂后必定能进食。
一、痘疮呈现灰白色，没有其他大热停滞等症状，但吃得少或不吃的，一定是脾胃虚弱，适宜用五味异功散，或者四君子汤。如果胃中阳气不足，不能运化食物而导致吃得少的，这是中焦有寒，适宜用温胃饮、养中煎，或者以六气煎为主治疗。
一、凡是命门元气不足，导致中焦胃气不温暖，所以多有痞满不想吃东西的情况；下焦肾气不能气化，所以多有前后二阴功能不调的情况，这必须用理阴煎加减来治疗，自见神奇疗效，不要说小儿没有阴虚证。
一、凡是出现泄泻，或者见到恶心，或者呕吐而不吃东西的，尤其属于胃气虚寒，轻症用理中汤、六气煎；重症用陈氏十二味异功散，或者用六气煎合二仙散为主治疗。
一、凡是脾气不虚，只是胃口寒滞，或者疼痛或者呕吐而不吃东西的，适宜用益黄散。
一、凡是因停食或多食而导致不想吃东西的，适宜用大小和中饮来清除宿食积滞，或者用五味异功散加山楂、麦冬、茅根、神曲、砂仁，或者配合匀气散治疗。
一、凡是口疮导致不能进食，或者咽喉疼痛而不能吃东西的，只要清利咽喉，疼痛停止自然就好了，适宜用廿桔汤，或者加味甘桔汤。
一、凡是外感风寒，邪气侵入胃口导致不能吃东西的，需要发散寒邪，邪气散去自然能进食了，适宜用加减参苏饮，或者柴陈煎，或者五味异功散加柴胡。
一、痘疮之后没有其他病症但饮食不进者，这只是脾气不足，适宜用五味异功散，或者温胃饮、养中煎之类为主治疗。
程氏说：凡是水谷不能运化而饮食不进者，只用保元汤加陈皮、麦冬、茅根、神曲、砂仁、扁豆、生姜，呕吐者加真藿香。
徐氏说：痘疮不吃奶食的，有虚实两种证候：或者呕吐或者腹泻，面目青白或青黑色的是虚寒，适宜温补；如果大小便干涩，面赤且气壅，或者口渴或者发热，或者眼睛黄赤，气粗胸中胀满的是实热，适宜清热利湿。
The entire course of smallpox centers on the Spleen and Stomach. As long as the patient can eat, Qi and Blood will be sufficient, making all stages such as eruption, pustule formation, and scabbing dependent on this foundation. Therefore, those who can eat will not suffer harm even if the lesions are dense; those who cannot eat are a cause for concern even if the lesions are sparse. Thus, regulating the Spleen and Stomach is the priority. However, since syndromes vary, treatment must be administered after careful examination.
1. In cases where toxic heat is abundant and appetite is lost, during the initial eruption of lesions, although the patient may lack desire to eat, there is no harm provided the lesion color is authentic. Since the heat-toxin has not yet resolved, many lack appetite before or during eruption. Once the toxin dissipates naturally, appetite will return. If lesions have fully erupted but appetite remains absent, Siwu Tang (Four Substances Decoction) should be slowly administered with added Shenqu (Medicated Leaven), Sharen (Amomum Fruit), and Chenpi (Tangerine Peel). One or two doses will surely restore appetite.
2. If lesions appear grayish-white without other signs of severe heat stagnation, but food intake is low or absent, it indicates Spleen-Stomach deficiency. Wuyi Yigong San (Five-Ingredient Yigong Powder) or Sijunzi Tang (Four Gentlemen Decoction) is appropriate. If insufficient Yang Qi in the Stomach fails to transform food leading to poor appetite, this indicates Cold in the Middle Jiao. Wenwei Yin (Stomach-Warming Decoction), Yangzhong Jian (Middle-Nourishing Decoction), or Liuqi Jian (Six-Qi Decoction) should be used as the primary treatment.
3. When Mingmen Yuanqi (Primordial Qi of the Gate of Life) is insufficient, the Middle Jiao Stomach Qi lacks warmth, resulting in fullness and anorexia. When Lower Jiao Kidney Qi fails to transform, dysfunction of the anterior and posterior orifices often occurs. This requires treatment with Liyin Jian (Yin-Regulating Decoction) with modifications, which will show miraculous effects. Do not assume children do not suffer from Yin Deficiency syndromes.
4. In cases of diarrhea, nausea, or vomiting with anorexia, this particularly belongs to Stomach Qi Deficiency and Cold. For mild cases, Lizhong Tang (Center-Regulating Decoction) or Liuqi Jian (Six-Qi Decoction) is used; for severe cases, Chen's Twelve-Ingredient Yigong San or a combination of Liuqi Jian and Erxian San (Two Immortals Powder) is indicated.
5. If Spleen Qi is not deficient, but the Stomach opening is cold and stagnant, causing pain or vomiting with anorexia, Yihuang San (Yellow-Enhancing Powder) is appropriate.
6. For anorexia caused by food retention or overeating, Daxiao Hezhong Yin (Large and Small Harmonizing-Middle Decoctions) should be used to clear old stagnation. Alternatively, Wuyi Yigong San with added Shanzha (Hawthorn Fruit), Maidong (Ophiopogon Root), Maogen (Imperata Rhizome), Shenqu (Medicated Leaven), and Sharen (Amomum Fruit), or combined with Yunqi San (Qi-Harmonizing Powder), may be employed.
7. For inability to eat due to mouth ulcers or throat pain, clearing the throat will resolve the pain and restore eating ability naturally. Njie Tang (Twenty-Platycodon Decoction) or Jiawei Ganjie Tang (Modified Sweet Licorice-Pplatycodon Decoction) is suitable.
8. When external Wind-Cold pathogenic factors invade the Stomach opening causing anorexia, the Cold pathogen must be dispersed. Once the pathogen dissipates, appetite returns. Jiawei Rensu Yin (Modified Ginseng-Sophora Decoction), Chaichen Jian (Bupleurum-Chenpi Decoction), or Wuyi Yigong San with added Chaihu (Bupleurum Root) is appropriate.
9. If anorexia persists after smallpox without other symptoms, it is solely due to Spleen Qi insufficiency. Wuyi Yigong San, Wenwei Yin (Stomach-Warming Decoction), or Yangzhong Jian (Middle-Nourishing Decoction) should be used as the primary treatment.
Master Cheng stated: For cases where water and grain cannot be transformed and food intake is poor, only Baoyuan Tang (Protect-Yuan Decoction) with added Chenpi (Tangerine Peel), Maidong (Ophiopogon Root), Maogen (Imperata Rhizome), Shenqu (Medicated Leaven), Sharen (Amomum Fruit), Bidou (Lablab Bean), and Shengjiang (Fresh Ginger) should be used. For vomiting, add Zhen Huoxiang (True Pogostemon Herb).
Master Xu stated: Anorexia in smallpox presents as either Deficiency-Cold or Excess-Heat. Vomiting or diarrhea with blue-white or blue-black complexion indicates Deficiency-Cold, requiring warming and tonification. Dryness and astringency of stool and urine, red face with Qi stagnation, thirst or fever, yellow-red eyes, coarse breathing, and abdominal fullness indicate Excess-Heat, requiring clearing and draining.