《素问》曰∶治病必求其本。盖不知其本，举手便误，后虽有锦绣心思，皆鞭长莫及矣。治痘明
家，古来不下数十，可称尽善，不比温病毫无把握，尚俟愚陋之鄙论也。但古人治法良多，而议病究
未透彻来路，皆由不明六气为病，与温病之源。故论痘发之源者，只及其半，谓痘证为先天胎毒，
由肝肾而脾胃而心肺，是矣。总未议及发于子午卯酉之年，而他年罕发者何故。盖子午者，君火
司天；卯酉者，君火在泉；人身之司君火者，少阴
也。少阴有两脏，心与肾也。先天之毒，藏于肾脏，肾者，坎也，有二阴以恋一阳，又以太阳寒水为
腑，故不发也，必待君火之年，与人身君火之气相搏，激而后发也。故北口外寒水凝结之所，永不
发痘。盖人生之胎毒如火药，岁气之君火如火线，非此引之不发。以是知痘证与温病之发同一类也。
试观《六元正纪》所载温厉大行，民病温厉之处，皆君相两火加临之候，未有寒水湿土加临而病温
者，亦可知愚之非臆说矣。
表药者，为寒水之气郁于人之皮肤经络，与人身寒水之气相结，不能自出而设者也。痘证由君
火温气而发，要表药何用？以寒水应用之药，而用之君火之证，是犹缘木而求鱼也。缘木求鱼，无后
灾；以表药治痘疮，后必有大灾。盖痘以筋骨为根本，以肌肉为战场，以皮肤结痂为成功之地。用表
药虚表先坏其立功之地，故八、九朝灰白塌陷，切牙寒战，例靥黑陷之证，蜂起矣。古方精妙不可
胜数，惟用表药之方，吾不敢信。今人且恣用羌、防、柴、葛、升麻、紫苏矣。更有愚之愚者，用表药
以发闷证是也。痘发内由肝肾，外由血络，闷证有紫白之分∶紫闷者，枭毒把持太过，法宜清凉败毒，
古用枣变百祥丸，从肝肾之阴内透，用紫雪芳凉，从心包之阳外透；白闷则本身虚寒，气血不支之
证，峻用温补气血，托之外出，按理立方，以尽人力，病在里而责之表，不亦愚哉！
《素问》说：治疗疾病必须探求其根本。如果不知道疾病的根本，一出手就会出错，即使后来有再精妙的构思，也无力回天了。古代精通治疗痘证的名家，不下几十位，他们的疗法可以称得上尽善尽美，不像温病那样毫无把握，还需要我这浅陋之人的粗浅议论。但是，古人虽然治疗方法很多，但在探讨病因的根源上却不够透彻，这都是因为不明白六气致病以及温病的源头。所以，论述痘疹发生源头的说法，只说对了一半，认为痘证是先天胎毒，由肝肾传至脾胃，再传至心肺，这是正确的。但始终没有讨论为什么在子、午、卯、酉年份容易发作，而其他年份很少发作的原因。这是因为“子”和“午”年，是君火主管天气；“卯”和“酉”年，是君火主管地气；人体中主管君火的脏腑是少阴经。少阴包括两个脏腑，即心和肾。先天的胎毒藏于肾脏，肾在五行中属坎卦，有两个阴爻眷恋一个阳爻，并且以太阳寒水作为其腑，所以毒素不会轻易发作，必须等到君火之年，与人体内的君火之气相互搏击，激发之后才会发作。所以在北方口外那些寒水凝结的地方，永远不会发生痘证。可以说，人身上的胎毒就像火药，每年的岁气君火就像引线，没有这个引子就不会爆发。由此可知，痘证与温病的发作属于同一类性质。试看《六元正纪》中记载温热厉气大行，百姓患温热厉气的地方，都是君火和相火加临的征候，从来没有寒水和湿土加临时而患温病的，这也足以证明我的观点并非凭空臆测。
所谓表药（解表药），是为了应对寒水之气郁结在人的皮肤经络，与人体内的寒水之气相结合，不能自行排出而设立的。痘证是由君火温气引发的，哪里用得着表药？用针对寒水病症的药物，去治疗君火性质的痘证，这就像爬树去捞鱼一样徒劳。爬树捞鱼，顶多没有收获，不会有后患；但用表药治疗痘疮，日后必定会引发严重的灾祸。因为痘证以筋骨为根本，以肌肉为战场，以皮肤结痂为痊愈的标志。使用表药会使体表的正气虚弱，首先破坏了建立功业的地方，所以在第八、第九天出现痘色灰白、塌陷，咬牙寒战，按照惯例出现痘靥黑陷的危重证候，便纷纷出现了。古代的方剂精妙不可胜数，唯独使用表药的方剂，我不敢相信。现在的人更是肆意使用羌活、防风、柴胡、葛根、升麻、紫苏等药物。更有愚昧至极的人，竟然用表药来发散闷证（痘毒内陷）。痘疹的发生，内部源于肝肾，外部通过血络透出。闷证分为紫色和白色两种：紫色闷证，是因为枭毒把持太过严重，治法应当清凉败毒，古法使用枣变百祥丸，从肝肾之阴向内透发，使用紫雪丹芳香清凉，从心包之阳向外透发；白色闷证则是本身虚寒，气血无法支撑的证候，应当峻猛地使用温补气血的方法，托毒外出。按理制定方剂，尽力救治，病邪在里却责治于表，这不也是愚昧吗！
The *Suwen* (Basic Questions) states: "In treating diseases, one must seek the root." If one does not understand the root, every action will be erroneous; no matter how brilliant the subsequent thoughts may be, it will be too late to remedy the situation. Ancient masters proficient in treating variola (smallpox/variolous eruptions) have numbered dozens, and their methods can be considered perfect. This is unlike warm diseases (Wenbing), which lack certainty and still await my humble opinions. However, although ancient people had many treatment methods, their discussion on the origin of diseases was not thorough enough. This stems from a failure to understand pathogenesis caused by the Six Qi (Six Atmospheric Influences) and the source of warm diseases. Therefore, discussions on the origin of variolous eruptions only cover half the truth. They state that variolous eruptions are congenital fetal toxins, originating from the Liver and Kidney, transmitting to the Spleen and Stomach, and then to the Heart and Lung. This is correct. Yet, they never discuss why these eruptions occur frequently in years of Zi (Rat), Wu (Horse), Mao (Rabbit), and You (Rooster), but rarely in other years. This is because in Zi and Wu years, the Sovereign Fire (Jun Huo) governs the Heaven (upper atmosphere); in Mao and You years, the Sovereign Fire governs the Earth (lower atmosphere). In the human body, the organs governing the Sovereign Fire are the Shaoyin (Lesser Yin) channel. Shaoyin comprises two zang organs: the Heart and the Kidney. The congenital toxin is stored in the Kidney. The Kidney corresponds to Kan (Water trigram), characterized by two yin lines clinging to one yang line, and its fu organ is Taiyang Cold Water. Therefore, the toxin does not erupt easily; it must wait for a year of Sovereign Fire to clash with the Sovereign Fire qi within the body, stimulating eruption. Thus, in regions north of the Great Wall where cold water condenses, variolous eruptions never occur. One can say that the fetal toxin in humans is like gunpowder, and the annual Sovereign Fire qi is like the fuse; without this ignition, there is no explosion. From this, we know that variolous eruptions and warm diseases belong to the same category. Observe the records in the *Liuyuan Zhengji* (Treatise on the Correct Records of the Six Origins): where warm pathogens run rampant and people suffer from warm fevers, these are always signs of Sovereign and Ministerial Fires descending. There has never been a case of warm disease occurring under the influence of Cold Water or Damp Earth. This confirms that my view is not mere speculation.
"Exterior-releasing medicines" (Biao Yao) were established to address Cold Water qi stagnating in the skin and meridians, binding with the body's internal Cold Water qi, preventing its natural expulsion. Variolous eruptions erupt due to Sovereign Fire and Warm Qi; what use are exterior-releasing medicines? Using medicines intended for Cold Water conditions to treat a Sovereign Fire condition is like climbing a tree to catch fish. Climbing a tree to catch fish yields nothing but no disaster; however, using exterior-releasing medicines to treat variolous eruptions will inevitably lead to severe disasters later. The variolous eruption takes the sinews and bones as its root, muscles as the battlefield, and scabbing of the skin as the place of success. Using exterior-releasing medicines weakens the exterior, destroying the very ground where healing should occur. Consequently, around the eighth or ninth day, eruptions turn gray-white and collapse, accompanied by teeth chattering and cold shivering, leading to the frequent occurrence of black sunken scabs (a critical sign). While ancient prescriptions are countless and exquisite, I dare not trust those containing exterior-releasing medicines. Nowadays, people recklessly use Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), and Zisu (Perillae Folium). Even more foolishly, some use exterior-releasing medicines to disperse "Men Zheng" (stagnant/collapsed eruptions). Eruptions originate internally from the Liver and Kidney and externally through blood collaterals. Men Zheng is divided into purple and white types. Purple Men Zheng results from excessive dominance of toxic pathogens; the method should be cooling and detoxifying. Anciently, Zaobian Baixiang Wan (Jujube-Modified Baixiang Pill) was used to penetrate inward from the Yin of the Liver and Kidney, and Zixue San (Purple Snow Powder) was used for its aromatic coolness to penetrate outward from the Yang of the Pericardium. White Men Zheng indicates inherent deficiency-cold and inability of Qi and Blood to support the body; it requires vigorous warming and tonification of Qi and Blood to push the toxin outward. Prescribing according to reason and exerting all human effort is appropriate; blaming the exterior when the disease is in the interior is indeed foolish!