相传痘疮稀少，不过数十粒，或百余粒，根颗圆绽者，以为状元痘，可不服药。遇则以为三、四
日间，亦须用辛凉解毒药一帖，无庸多服；七、八日间，亦宜用甘温托浆药一帖，多不过二帖，务令浆
行满足。所以然者何？愚尝见稀少之痘，竟有浆行不足，结痂后患目，毒流心肝二经，或数月，或半年
后，烦躁而死，不可救药者。
痘证限期，近日时医，以为十二日结痂之后，便云收功；古传百日内，皆痘科事也。愚有表侄
女，于三、四月间出痘，浆行不足，百日内患目，目珠高出眼外，延至次年二月方死，死时面现五色，
忽而青而赤而黄而白而黑，盖毒瓦斯遍历五脏，三昼夜而后气绝。至今思之，犹觉惨甚，医者可不慎
哉！十二日者，结痂之限也，况结痂之限，亦无定期。儿生三岁以后者，方以十二日为准，若初周以
后，只九日限耳，未周一岁之孩，不过七日限。
近时人心不古，竞尚粉饰，草草了事。痘顶初浑，便云浆足，病家不知，惟医是听。浆不足者，发
痘毒犹可医治；若发于关节隐处，亦致丧命，或成废人；患目烦躁者，百无一生，即不死而双目失明
矣。愚经历不少，浆色大约以黄豆色为准，痘多者腿脚稍清犹可。愚一生所治之痘，痘后毫无遗患，
无他谬巧，行浆足也。近时之弊，大约有三∶一由于七日前过用寒凉，七日后又不知补托，畏温药如
虎，甚至一以大黄从事，此用药之不精也；二由于不识浆色，此目力之不精也；三由于存心粉饰，心
地之不慈也。余存心不敢粉饰，不忍粉饰，口过直而心过慈，以致与世不合，目击儿之颠连疾苦而莫
能救，不亦大可哀哉！今作此论，力矫时弊，实从数十年经历中得来。见痘后之证，百难于痘前。
盖痘前有浆可上，痘后无浆可行；痘前自内而外出，外出者顺，痘后自外而内陷，内陷者逆也。毒陷
于络，犹可以法救之；毒陷于脏而脏真伤，考古竟无良法可救。由逆痘而死者，医可以对儿；由治法
不精，而遗毒死者，其何以对小儿哉？阅是论者，其思慎之于始乎！
相传痘疮稀少，不过数十粒，或百余粒，根颗圆绽者，以为状元痘，可不服药。遇则以为三、四日间，亦须用辛凉解毒药一帖，无庸多服；七、八日间，亦宜用甘温托浆药一帖，多不过二帖，务令浆行满足。所以然者何？愚尝见稀少之痘，竟有浆行不足，结痂后患目，毒流心肝二经，或数月，或半年后，烦躁而死，不可救药者。
人们传说痘疮数量很少，只有几十粒或一百多粒，且痘根圆润饱满的，被称为“状元痘”，认为可以不用服药。但我认为，即使遇到这种情况，在发病后的第三、四天，也必须服用一剂辛凉解毒药（具有辛散凉性、清除热毒功效的药物），不需要多服；到了第七、八天，也应当使用一剂甘温托浆药（具有甘甜温热性质、促使痘浆充盈的药物），最多不超过两剂，务必让痘浆运行并达到饱满的状态。为什么会这样呢？我曾见过痘疮稀少的患者，竟然出现痘浆生成不足的情况，在结痂之后患上眼疾，毒邪流入心和肝两条经脉，有的在几个月后，有的在半年的后，因烦躁不安而死亡，成为无法救治的绝症。
痘证限期，近日时医，以为十二日结痂之后，便云收功；古传百日内，皆痘科事也。愚有表侄女，于三、四月间出痘，浆行不足，百日内患目，目珠高出眼外，延至次年二月方死，死时面现五色，忽而青而赤而黄而白而黑，盖毒瓦斯遍历五脏，三昼夜而后气绝。至今思之，犹觉惨甚，医者可不慎哉！十二日者，结痂之限也，况结痂之限，亦无定期。儿生三岁以后者，方以十二日为准，若初周以后，只九日限耳，未周一岁之孩，不过七日限。
关于痘病的限期，近时的医生认为十二天结痂之后，就可以说治疗成功了；但古代传说百日之内，都属于痘科疾病的范畴。我有一个表侄女，在三、四月间出痘，痘浆生成不足，在百日之内患上了眼疾，眼球突出眼眶之外，拖延到第二年二月才去世，去世时面部呈现五种颜色，一会儿发青，一会儿发红，一会儿发黄，一会儿发白，一会儿发黑，这是因为毒气遍历了五脏，经过三天三夜后才断气。现在回想起来，仍然觉得非常悲惨，医生们能不谨慎吗！十二天是结痂的期限，况且结痂的期限也没有固定的标准。孩子出生三岁以后的，才可以以十二天为标准；如果是一周岁以后出生的，只有九天的期限；不满一周岁的孩子，只有七天的期限。
近时人心不古，竞尚粉饰，草草了事。痘顶初浑，便云浆足，病家不知，惟医是听。浆不足者，发痘毒犹可医治；若发于关节隐处，亦致丧命，或成废人；患目烦躁者，百无一生，即不死而双目失明矣。愚经历不少，浆色大约以黄豆色为准，痘多者腿脚稍清犹可。愚一生所治之痘，痘后毫无遗患，无他谬巧，行浆足也。近时之弊，大约有三∶一由于七日前过用寒凉，七日后又不知补托，畏温药如虎，甚至一以大黄从事，此用药之不精也；二由于不识浆色，此目力之不精也；三由于存心粉饰，心地之不慈也。余存心不敢粉饰，不忍粉饰，口过直而心过慈，以致与世不合，目击儿之颠连疾苦而莫能救，不亦大可哀哉！今作此论，力矫时弊，实从数十年经历中得来。见痘后之证，百难于痘前。盖痘前有浆可上，痘后无浆可行；痘前自内而外出，外出者顺，痘后自外而内陷，内陷者逆也。毒陷于络，犹可以法救之；毒陷于脏而脏真伤，考古竟无良法可救。由逆痘而死者，医可以对儿；由治法不精，而遗毒死者，其何以对小儿哉？阅是论者，其思慎之于始乎！
近来人心不如古人淳朴，竞相追求表面装饰，草率地处理事情。痘顶刚刚浑浊，就声称痘浆已足，病人家属不知道实情，只听信医生的话。痘浆不足的，引发痘毒还可以医治；但如果毒发在关节隐蔽之处，也会导致丧命，或者成为残疾人；患上眼疾且烦躁的，一百个人中没有一个是能活下来的，即使不死也会双目失明。我经历的病例不少，痘浆的颜色大致以黄豆色为标准，痘多的患者腿部脚部稍微清澈一些还可以接受。我一生治疗的痘病患者，痘后没有任何遗留的后遗症，没有其他的巧妙方法，只是因为让痘浆充盈充足罢了。近时的弊端，大概有三点：一是因为在七天之前过度使用寒凉药物，七天之后又不懂得补益托毒，害怕温性药物像怕老虎一样，甚至一味地使用大黄进行治疗，这是用药不精准；二是因为不认识痘浆的颜色，这是视力判断不精准；三是因为存心进行粉饰，这是心地不够仁慈。我心里不敢粉饰，也不忍心粉饰，说话过于直率而内心过于慈悲，以至于与世俗格格不入，亲眼看着孩子们遭受困苦却无法拯救，这难道不是非常可悲的吗！现在我撰写这篇论述，极力纠正时下的弊端，这确实是从我几十年的临床经验中得来的。我发现痘后的病症，比痘前的病症难治百倍。因为痘前有浆液可以上升，痘后没有浆液可以运行；痘前是从内部向外部发散，向外发散的是顺证，痘后是从外部向内部陷入，向内陷入的是逆证。毒邪陷入经络，还可以用方法救治；毒邪陷入脏腑而损伤脏腑真气，考察古代竟然没有好的方法可以救治。因为逆证痘病而死亡的，医生还可以面对患儿家属；因为治疗方法不精准，导致遗留毒邪而死亡的，医生又有什么脸面面对患儿呢？阅读这篇论述的人，应该思考在开始时就保持谨慎吧！
It is traditionally believed that smallpox with few lesions, consisting of only dozens or over a hundred spots, where the base and crown are round and distinct, are called "Zhuangyuan Smallpox" (Scholar Champion Smallpox), implying that medication may not be necessary. However, I hold that even in such cases, during the third or fourth day of onset, one dose of Xinliang Jiedu Yao (Acrid-Cool Detoxifying Medicine) must be administered; excessive dosage is unnecessary. By the seventh or eighth day, one dose of Ganwen Tuojiang Yao (Sweet-Warm Supporting Pustule Medicine) should be used, not exceeding two doses in total, ensuring that the pustules fill adequately. Why is this so? I have witnessed cases of sparse smallpox where the pus formation was insufficient. After scabbing, patients developed eye diseases, with toxic heat flowing into the Heart and Liver meridians. Some died months or half a year later due to restlessness and irritability, becoming incurable.
Regarding the time limits for smallpox progression, contemporary physicians often believe that treatment is successful once scabs form after twelve days. However, ancient traditions state that all aspects of smallpox management extend within one hundred days. I had a niece who contracted smallpox in March or April. Her pus formation was insufficient, and within one hundred days, she developed severe eye disease, with her eyeballs protruding from the sockets. She survived until February of the following year before passing away. At the time of death, her face displayed five colors: alternating between cyan, red, yellow, white, and black. This indicated that toxic vapors had traversed all five Zang organs, and she expired after three days and nights. Reflecting on this now, it remains deeply tragic. Can physicians afford to be careless? Twelve days is the limit for scabbing, yet even this limit varies. For children born after the age of three, twelve days can serve as the standard. For those born after their first birthday, the limit is only nine days. For infants under one year old, the limit is merely seven days.
In recent times, people's hearts have lost their simplicity, favoring superficial decoration and handling matters hastily. When the top of the pimple first becomes turbid, they claim the pus is sufficient. The patient's family, unaware of the truth, relies solely on the physician. If pus is insufficient and toxic eruption occurs, it might still be treatable. However, if it erupts in hidden areas like joints, it can lead to death or disability. Patients suffering from eye complications and restlessness rarely survive; even if they do not die, they will go blind. Having treated many cases, I consider the color of the pus to be roughly that of a soybean. In cases with many lesions, if the legs and feet remain relatively clear, it is acceptable. Throughout my life, the smallpox patients I treated left no sequelae afterward. There were no other tricks involved; it was simply because the pus formation was adequate. The current malpractices can be summarized in three points: First, overuse of cold and cool medicines before the seventh day, followed by a failure to use tonifying and supporting methods afterwards, coupled with a fear of warm medicines akin to fearing tigers, sometimes even relying solely on Dahuang (Rhei Radix et Rhizoma). This reflects imprecise prescription practices. Second, an inability to recognize the color of the pus, reflecting poor diagnostic observation. Third, a deliberate intent to deceive for appearance's sake, reflecting a lack of compassion. I dare not and cannot engage in deception. My speech is too blunt, and my heart too compassionate, causing me to clash with worldly norms. Witnessing children suffer helplessly without being able to save them is truly mournful. I wrote this treatise to vigorously correct these contemporary evils, drawing from decades of clinical experience. I observe that post-smallpox conditions are a hundred times more difficult to manage than pre-smallpox conditions. Before smallpox, there is pus to rise; after smallpox, there is no pus to circulate. Pre-smallpox pathology moves from interior to exterior, which is favorable (Shun); post-smallpox pathology sinks from exterior to interior, which is unfavorable (Ni). If toxic heat sinks into the collaterals, it can still be treated. If it sinks into the Zang organs and damages their true Qi, historical records show no effective cure exists. Physicians can face the families of those who die from unfavorable smallpox patterns, but how can they face the families of those who die due to residual toxins caused by imprecise treatment? Readers of this treatise should reflect on the importance of caution from the very beginning.