（田万密斋。此乃痘证之快捷方式，初学宜熟读。）
痘本胎毒，俗曰天疮，虽厉气之传染，实杀机之显彰。变迁莫测，酷恶难当。肌
肉溃脱兮，若蛇蜕皮龙蜕骨；精神困顿兮，如蚓在灰 在汤。疮有疏密兮，疏者轻而
密者重；毒有微甚兮，微则祥而甚则殃。笑彼拘于日数者，未达迟速之变；悲夫惑于鬼神者，不求医药之良。
乾坤妙合，震巽分张。受气于父兮，得阳精而凝结；成形于母兮，赖阴血以培养。
民多嗜欲，气匪淳庞，淫火炽于衽席，食秽蓄于膏粱。精血禀其毒瓦斯兮甚于射罔，形
体负其杀气兮险于锋芒。或谓去其口血兮，不过脱空之语；或谓解其胎毒兮，未见抵圣之方。
五运统于南北兮，有大有少；六气分于主客兮，曰阴曰阳。变化各正，胜复靡
常。得其序而气治兮，国无 疠；失其序而气乱兮，民有疹疡。应至而不至兮其气
徐，贵迎之以夺其势；未应至而至者其气暴，姑持之以避其强。不知此而妄作兮，违
时者败；能审此而慎动兮，顺天者昌。
春令温和而升生，夏令暑热而浮长，秋令清凉而降收，冬令寒冽而沉藏，是得四
时之正，不为万物之伤。冬反燠暖兮勾萌早发，春反栗烈兮蛰虫且藏，夏反清肃兮
凉风袭肉，秋反蒸溽兮暑汗沾裳。若此逆气兮，染之者即成疫疠；又有虚风兮，中之者必致夭伤。
受父母之秽毒兮，隐于黝僻；触天地
之疠气兮，发其伏藏。自内而出兮，布于四体；自外而散兮，根于五脏。肝主泪而
为水泡，肺主涕而作脓囊，心则斑而且赤，脾则疹而又黄，肾乃封藏之本，变则黑陷
之象。可喜者苗而秀，秀而实，如鸟之脱距；所恶者枯而陷，陷而伏，如虎之负岗。
东赤南白，西黄北黑，各分布而有定；春生夏长，秋收冬藏，自流行而无疆。初
出血点兮红鲜，得生之气；次化水液兮白莹，渐长之状。脓成而色黄兮，欲收之候；
痂结而色黑兮，已藏之象。谓肾无证者，似去冬不能成岁；谓黑为逆者，如废北何以调阳。
方其发生兮，春夏为顺而秋冬非吉；及其收敛兮，秋冬为顺而春夏不藏。应发生
而反收敛者，谓之陷伏；应收敛而反发生者，谓之澜洋。顺者不必治兮，待其平复；
逆者不可治兮，避其怨谤。若逢险证，必在奇方。治不乖兮，险变顺而春回幽谷；药不对病兮，险变逆而火烈昆岗。
病似顺而反逆兮，认之要惯；病似逆而反顺兮，察之贵详。似粟堆聚坚硬兮，孰
若磊落而稠密；如丹艳赤娇嫩兮，不如淡白而老苍。初出现而函水，乍起发而戴浆。
脓主成而干黑，囊未满而萎黄。早发先萎兮，如园林之花蕊；暴长遽消兮，似沟涧
之潦潢。是谓夺命之证，休夸折肱之良。
轻或变重兮，误服药而或犯禁忌；重或变轻兮，得遇医而且善调养。蚊迹蚤斑
兮，不旋踵而告变；蛇皮蚕壳兮，惟束手以待亡。夹 夹疹兮， 疹消而足喜；顶
平顶陷兮，平陷起而莫惶。切戒临病挥霍，最宜用药审详。病有标本兮，视急缓以立
不法；药有补泻兮，因虚实而立方。
噫嘻兮医无定法，迷乱者药无定方。大率贱攻而贵补，故多喜温而恶凉。设若病
遇虚寒兮，温补有效；假如证属实热兮，辛香敢尝。辛热下咽，阳之盛者必困；苦寒
入胃，阴之盛者乃戕。戒汗下于首尾兮，恶攻之说；补脾土以制肾水兮，喜补之常。不
识补者之短，奚论攻者之长。
形尖圆而光壮兮，气之充拓；色鲜明而润泽兮，血之涵养。可以勿药，是谓无
恙。灰白平陷兮，气血虚而补之以温；红艳 肿兮，气血热而泻之以凉。气至而血
不足兮，虽起发而根窠不肥；血至而气不足兮，虽明润而郛郭不长。泥章句以举一
隅者，守株安可得兔；驰辨说而执两端者，多岐必然亡羊。脾为水谷之本，固不可以
不补；肾为津液之源，尤不可以不将。土虽为水之防，水不能制火之亢。肾主骨髓
兮，倒陷入于骨髓者莫救；肾司闭藏兮，变黑至于闭藏者可防。是皆归肾之害，岂可
谓肾之强。毒之燔灼兮肾水且涸，营气败坏兮脾土亦伤。故补脾不如救肾，而养阴所以济阳。
炅则气血淖泽而不敛，寒则气血凝涩而不彰。气血失养，痘疹受伤。或受于热
兮，为烦躁为赤为痛；或受于寒兮，为振 为白为痒。顺时令之寒暄，禁人畜之来
往。勿动溷厕之臭，勿烧兰麝之香，恐乘虚而易入，反助毒以为殃。痘虽吉而犯多
凶，屡经怪变；证虽恶而调治善，终见安康。
若夫疮疹之热，相似内外之伤。邪火 赫兮，玉石俱焚；真水静顺兮，波浪不
扬。喷嚏咳嗽兮，肺金流烁；项急顿闷兮，肝木被创。呵欠惊悸兮，心虽君主而不宁；
吐泻昏睡兮，脾则仓廪而不藏。各脏各证，惟肾无象，不受秽毒之火，独见耳 之凉。
热微兮毒少，热甚兮火旺。大热安静兮，毒随热出而无虑；小热烦躁兮，毒与
热伏而可防。凶灾莫测兮，又热又渴；轻疏可许兮，乍热乍凉。吐泻勿止兮，使毒
得越而无遏；惊悸不定兮，恐毒深入而反藏。血妄泄于空窍兮，死期速于弹指；语妄涉于鬼神兮，变候易于反掌。
形证定其疏密，部位决其存亡。如痘纷布兮，且颗粒而其疏已定；如麻堆聚兮，
更模糊而其密堪伤。挨颊绕口兮，庚戊阳
明之位；颧间额上兮，王丙太阳之乡。头为元首之尊，最怕蒙头；项乃关津之要，偏
嫌项锁。鼻准初出兮，淫毒犯于天根；耳叶先现兮，邪火侵乎玉堂。
渐次出兮吉兆，齐涌出兮凶状。痘将出而热减兮，药勿妄服；痘正出而热剧兮，
医宜早防。解其火毒兮，恐郁遏而干枯；养其气血兮，欲流行而舒畅。远寒热之犯兮，
损之益之而必欲和平；助春夏之令兮，达之发之而必使长旺。治其未乱兮，彻桑土
于迨雨；知其必渐兮，戒坚冰于履霜。
出欲尽而不留，发欲透而齐长。苗渐成窠兮，气之所煦；血渐化水兮，血之所
养。疏而毒少兮，头面不肿而休怕；密而毒多兮，气血不充而莫慌。时日既足兮，自
翘翘而杂起；表里无邪兮，勿汲汲以作汤。此谓良将用兵，善攻不如善守，又曰上农治田，勿助生于勿忘。
咽喉忽痛兮，勿违时而早治；头面预肿兮，但引日以必亡。小便欲清兮，大便
却欲其坚实；淡味可食兮，浓味不可以啖尝。茹淡者胃气不损，养浓者火邪益亢。或
见黑黯兮，点之速以胭脂；或遇干枯兮，浴之贵以水杨。瘙痒忽生兮，取茵陈以熏燎；
爬搔不宁兮，虽卢扁而彷徨。
痘长满水，毒化成浆。爱其稠脓兮，恶其清淡；取其满足兮，舍其虚洋。欲知透
与不透兮，于手足而细察；欲知足与不足兮，于辅颊以端详。设四末之未透，取脾
胃而服药；如一方之未足，视经络以求方。譬如为山兮，勿功亏于篑土；又如执热兮，宁濯先于探汤。
面颊最嫌破顶，肩背尤怕焦囊。肿忽消兮，气脱；语忽妄兮，神亡。食谷则呕
兮，胃烂；饮水则呛兮，咽伤。切牙兮，肝火炽而肾败；寒战兮，阳气弱而阴强。脓
反干兮，倒陷；脓不成兮，伏藏。叫哭不止兮，毒攻肠胃；闷乱不宁兮，火烈膏肓。
仓廪不藏兮，魂魄归于溟漠；水泉不止兮，姻亲泣于北邙。
脓血已化，收靥相当。兆自唇吻兮，浆吐结如珠粒；断自人中兮，部分默以意量。
令行秋冬兮，根据先后而不乱；气应阴阳兮，循上下而有常。颧上乎轻兮，虑乎倒靥；颧
间先收兮，谓之不祥。痂不着而壅肿兮，由荣血之淖溢；疮尽裂而皱揭兮，此卫气之残伤。
当靥不靥，当藏不藏。便秘不通兮，里气热而凉导；便溏不实兮，中气虚而温养。
热伤皮毛兮，怪肺金不收余气；湿伤肌肉兮，责脾土不燥残浆。头疮堆脓不平兮，孤
阳似鳏而不生；足疮包水不干兮，纯阴如寡而不长。饮食减少兮，迤逦引日而毙；烦
躁增剧兮，倏忽绝命而亡。
若问痂皮之不脱，其间病气之相妨。痘若败坏兮，补空痘勿疑番次；疮如溃烂兮，
成溃脓莫靥脓浆。遍身浸淫兮，粘被席而最苦；正面肿灌兮，息腥臭而再妨。利多
水液兮，此畜水之病也，水去尽而自止；便多脓血兮，此倒靥之证也，脓去尽而可祥。
瘢痕凹凸兮，陷者虚而突者实；皮痂嫩薄兮，里则困而外则疡。
邪气尽而正复，痂皮脱而身康，苟幼躯之多病，即余毒之有藏。出或未尽兮，无
空痘须防卒暴；发或未透兮，无溃脓必发疽疡。不及期兮早收，毒火陷而可怕；或
过期兮不靥，邪气留而堪怅。身热审其虚羸，咽哑观乎呕呛。勿洒淅而肌热兮，知
风寒之外感；暴吐泻而腹痛兮，必饮食之内伤。
病有苦而眩运兮，凶多吉少之占；身无邪而昏瞀兮，否去泰来之象。声音不出
兮，求诸肺肾之经；斑疹复现兮，责其心脾之藏。疳蚀出血者难治，洞泄完谷者莫
医。勿谓痘收而纵弛，勿谓毒去而迨遑。正气浸长而未复，邪气方消而未央。特犯禁
忌兮今即生变，恣食肥甘兮后必有殃。
疥癞腐溃兮，一面 瘢而似鬼。痈疽流注兮，四肢残废而如 。目肿亦痛兮，冷
痘入而成翳；齿黑烂兮，热毒浸而溃床。虽
曰余毒之为害，抑皆定数之莫防。形容顿改兮令人骇愕，调治悔迟兮空自惆怅。谓
人不能胜天兮，何以立乎医药；谓医不如用巫兮，安能格乎穷苍。
但逢出痘之岁，多求解毒之方。重者必轻兮，轻者不出；凶者变吉兮，吉者何
妨。其方则有，其效未常，与其先事而轻妄，孰若卧时以精详。审岁气之灾祥兮，必
解其郁；视形气之勇怯兮，各平其脏。欲避疠气传染兮，必先择地之善；欲仗药力调护兮，尤要识医之良。
惺惺参苏乃发散之妙剂，（惺惺散、参苏散。）人参通圣诚疫疠之奇方。（人参败毒散、防风通圣
散。）热而惊悸兮，导赤泻青兮用；（导赤散、泻青丸。）热而焦渴兮，柴胡葛根作汤。（小柴胡汤，
升麻葛根汤。）自利兮黄芩，（黄芩芍药汤）不便兮清凉。（四顺清凉饮。）腹痛毒攻兮，匀气散再加枳
实；腰痛病剧兮，败毒散更入木香。调元可补兮，表里实者勿饮；（调元饮。）承气可攻
兮，脾胃弱者莫尝。（小承气汤。）
养正兮黄 、人参、甘草，解毒兮连翘、山豆、牛蒡。咽喉苦痛兮，甘橘汤中
加大力；斑疹夹出兮，防风散内去硝黄。（防风通圣散。）小便赤涩兮，连翘、导赤；（连翘饮，
导赤汤。）大便滑泄兮，豆蔻、木香。（豆蔻丸，木香散。）疮若干枯兮，四物合乎凉膈，（四物汤，东
垣凉膈散。）痘如黑陷兮，夺命助以水杨。（夺命丹，水杨浴法。）赤艳 肿兮，解毒入生黄归芍；
（黄连解毒汤。）灰白平塌兮，异功用桂枝、 防。
（异功散。）
气虚而毒盛者，无价、四君、枳实；（无价散，四君子汤。）血虚而毒盛者，无价、四物、
牛蒡。（四物汤。）气血两虚兮，十全无价；（十全大补汤。）便溺俱阻兮，八正、三黄。（八正散，三
黄丸。）再用胆泻之法，以泻毒瓦斯之藏。黑陷审其虚实，虚者大补而实者凉膈；（十全大补汤，河间凉膈散。）
痒塌分其急缓，急者异功而缓者调阳。（陈氏异功散，调阳即谓元汤。）昏闷谵妄
兮，龙脑膏孰知其妙；虚烦迷乱兮，抱龙丸莫及其良。
满面燥痛兮，百花调水；（百花膏。）遍身溃烂兮，败草铺床。（败草散。）蝉蜕去目中之
肤翳，（蝉蜕散。）苦参治身上之淫疮。（苦参丸。）虚热多汗兮，调元汤引用浮麦；食积常痛兮，
脾积丸饮以原汤。饥不喜飧兮，异功宜久；（钱氏异功散。）渴欲饮水兮，白术可常。（白术散。）
败毒、通圣，允矣冲阵之先锋；（人参败毒散、防风通圣散。）调元、异功，信乎殿后之大员。（调元汤，钱氏异功散。）
大抵医要识证，药不执方。专行温补者，则宗乎文宗；喜用凉泻者，则师乎仲
阳。不解其书兮，似瞽冥行于溪径；不察其神兮，如矮仰望于宫墙。叹吾年之耋兮，
欲深造而力不足；惧斯道之晦兮，特发明而言不章。呕尽心肺兮，非欲立异；劳费
颊舌兮，岂敢恃长。幸取正于具眼，徒见笑于大方。
痘疮本源于胎中积聚的毒邪，民间称为“天疮”，虽然可以通过厉气（烈性致病邪气）传染，但实际上是杀机（致死因素）的显现。病情变化莫测，残酷凶险难以承受。肌肉溃烂脱落，如同蛇蜕皮、龙蜕骨一般；精神困顿萎靡，如同蚯蚓在灰烬或沸水中挣扎。痘疮分布有疏有密，稀疏者病轻而密集者病重；毒邪有轻微与严重之分，轻微则预后吉祥，严重则招致灾殃。可笑那些拘泥于发病日数的人，不懂得迟速变化的道理；可悲那些迷信鬼神的人，不寻求良医良药。
天地阴阳奇妙结合，震卦（雷/阳）与巽卦（风/阴）分别舒展。禀受父亲之气，得到阳精而凝结；形成形体依靠母亲，依赖阴血以培养。百姓多纵欲，风气不再淳朴，淫火（相火妄动）在床席间炽盛，饮食肥甘厚味积蓄秽浊。禀受的精血含有毒瓦斯，比射罔（一种毒药）更甚；形体背负杀气，比锋利的刀刃更危险。有人说去除口内血污即可，这不过是脱空之语；有人说解除胎毒即可，却未见能抵得上圣人的方剂。
五运统摄于南北，有大运与小运之分；六气分为主气与客气，分为阴与阳。变化各有定规，胜复（五行生克制化的异常变化）无常。得其秩序则气化调和，国家无瘟疫；失其秩序则气化紊乱，民众患疹疡。应至而未至的气，其势缓慢，贵在迎前夺取其势头；未应至而至的气，其势暴烈，姑且持守以避开其强势。不知此理而妄动，违背时令必败；能审察此理而谨慎行动，顺应天道必昌。
春季气候温和利于升发生发，夏季暑热利于浮长，秋季清凉利于降收，冬季寒冽利于沉藏，这是符合四时正气，不为万物所伤。若冬季反常温暖，勾萌（植物嫩芽）过早萌发；春季反常凛冽，蛰虫仍潜伏不出；夏季反常清肃，凉风侵袭肌肤；秋季反常蒸湿，暑汗沾湿衣裳。像这样的逆气，染上的人就会成为疫疠；又有虚风（非时之风），中伤者必然导致夭折受伤。
禀受父母的秽毒，隐藏于幽暗偏僻之处；触犯天地的疠气，引发伏藏的毒邪。从体内发出，布散于四肢；从体表散发，根源于五脏。肝主泪而为水泡，肺主涕而作脓囊，心则出现斑而且红，脾则出现疹而且黄，肾乃封藏之本，病变则呈现黑陷之象。可喜的是苗秀、秀实，如鸟脱去距爪；所厌恶的是枯陷、陷伏，如老虎背负山岗。东赤南白，西黄北黑，各分布而有定规；春生夏长，秋收冬藏，自然流行而无边界。初起出血点鲜红，得生发之气；次化水液晶莹洁白，渐长的状态；脓成而色黄，是欲收敛的征候；痂结而色黑，是已封藏的象。说肾没有证候，就像冬天不能成就岁终；说黑色为逆证，就像废弃北方何以调阳。
当其发生之时，春夏为顺而秋冬非吉；及其收敛之时，秋冬为顺而春夏不藏。应发生而反收敛的，称为陷伏；应收敛而反发生的，称为澜洋（泛滥）。顺证不必治疗，等待其平复；逆证不可乱治，避免招致怨恨诽谤。若逢险证，必用奇方。治疗不乖谬，险变可转为顺，如春回幽谷；药不对症，险变转为逆，如火烈昆冈。
病似顺而反逆，认识要习惯；病似逆而反顺，察辨贵详细。像粟米堆聚坚硬，不如磊落而稠密好；如丹砂艳红娇嫩，不如淡白而老苍好。初出现而含水，乍起发而戴浆。脓主成熟而干黑，囊未满而萎黄。早发先萎，如园林之花蕊；暴长遽消，似沟涧之积水。这叫夺命之证，不要夸耀折肱（经验丰富）的良医。
轻证可能变重，误服药或犯禁忌；重证可能变轻，得遇良医且善调养。如蚊迹蚤斑，转眼即告变证；如蛇皮蚕壳，只能束手待亡。夹疹，疹消而足喜；顶平顶陷，平陷起而莫慌。切戒临病挥霍无度，最宜用药审慎详查。病有标本，视急缓以立法；药有补泻，因虚实而立方。
唉！医生没有固定之法，迷乱者药无定方。大率轻视攻伐而重视补益，所以多喜温补而恶寒凉。若病遇虚寒，温补有效；假如证属实热，辛香敢尝。辛热下咽，阳盛者必困；苦寒入胃，阴盛者乃伤。戒汗下于首尾，厌恶攻伐之说；补脾土以制肾水，是喜补的常态。不识补者的短处，何论攻者的长处。
形尖圆而光壮，是气之充拓；色鲜明而润泽，是血之涵养。可以不用药，这叫无恙。灰白平陷，气血虚而补之以温；红艳肿胀，气血热而泻之以凉。气至而血不足，虽起发而根窠不肥；血至而气不足，虽明润而郛郭不长。拘泥章句举一隅者，守株安可得兔；驰骋辩说执两端者，多岐必然亡羊。脾为水谷之本，固不可以不补；肾为津液之源，尤不可以不将护。土虽为水之防，水不能制火之亢。肾主骨髓，倒陷入于骨髓者莫救；肾司闭藏，变黑至于闭藏者可防。这都是归咎于肾的害处，岂可说是肾强。毒之燔灼，肾水且涸；营气败坏，脾土亦伤。故补脾不如救肾，而养阴所以济阳。
热则气血淖泽而不敛，寒则气血凝涩而不彰。气血失养，痘疹受伤。或受于热，为烦躁为赤为痛；或受于寒，为振栗为白为痒。顺时令之寒暄，禁人畜之来往。勿动溷厕之臭，勿烧兰麝之香，恐乘虚而易入，反助毒以为殃。痘虽吉而犯多凶，屡经怪变；证虽恶而调治善，终见安康。
至于疮疹之热，相似内外之伤。邪火赫奕，玉石俱焚；真水静顺，波浪不扬。喷嚏咳嗽，肺金流烁；项急顿闷，肝木被创。呵欠惊悸，心虽君主而不宁；吐泻昏睡，脾则仓廪而不藏。各脏各证，惟肾无象，不受秽毒之火，独见耳后之凉。热微则毒少，热甚则火旺。大热安静，毒随热出而无虑；小热烦躁，毒与热伏而可防。凶灾莫测，又热又渴；轻疏可许，乍热乍凉。吐泻勿止，使毒得越而无遏；惊悸不定，恐毒深入而反藏。血妄泄于空窍，死期速于弹指；语妄涉于鬼神，变候易于反掌。
形证定其疏密，部位决其存亡。如痘纷布，且颗粒而其疏已定；如麻堆聚，更模糊而其密堪伤。挨颊绕口，庚戊阳明之位；颧间额上，王丙太阳之乡。头为元首之尊，最怕蒙头；项乃关津之要，偏嫌项锁。鼻准初出，淫毒犯于天根；耳叶先现，邪火侵乎玉堂。
渐次出为吉兆，齐涌出为凶状。痘将出而热减，药勿妄服；痘正出而热剧，医宜早防。解其火毒，恐郁遏而干枯；养其气血，欲流行而舒畅。远寒热之犯，损之益之而必欲和平；助春夏之令，达之发之而必使长旺。治其未乱，彻桑土于迨雨；知其必渐，戒坚冰于履霜。
出欲尽而不留，发欲透而齐长。苗渐成窠，气之所煦；血渐化水，血之所养。疏而毒少，头面不肿而休怕；密而毒多，气血不充而莫慌。时日既足，自翘翘而杂起；表里无邪，勿汲汲以作汤。此谓良将用兵，善攻不如善守，又曰上农治田，勿助生于勿忘。
咽喉忽痛，勿违时而早治；头面预肿，但引日以必亡。小便欲清，大便却欲其坚实；淡味可食，浓味不可以啖尝。茹淡者胃气不损，养浓者火邪益亢。或见黑黯，点之速以胭脂；或遇干枯，浴之贵以水杨。瘙痒忽生，取茵陈以熏燎；爬搔不宁，虽卢扁而彷徨。
痘长满水，毒化成浆。爱其稠脓，恶其清淡；取其满足，舍其虚洋。欲知透与不透，于手足而细察；欲知足与不足，于辅颊以端详。设四末之未透，取脾胃而服药；如一方之未足，视经络以求方。譬如为山，勿功亏于篑土；又如执热，宁濯先于探汤。
面颊最嫌破顶，肩背尤怕焦囊。肿忽消，气脱；语忽妄，神亡。食谷则呕，胃烂；饮水则呛，咽伤。切牙，肝火炽而肾败；寒战，阳气弱而阴强。脓反干，倒陷；脓不成，伏藏。叫哭不止，毒攻肠胃；闷乱不宁，火烈膏肓。仓廪不藏，魂魄归于溟漠；水泉不止，姻亲泣于北邙。
脓血已化，收靥相当。兆自唇吻，浆吐结如珠粒；断自人中，部分默以意量。令行秋冬，根据先后而不乱；气应阴阳，循上下而有常。颧上乎轻，虑乎倒靥；颧间先收，谓之不祥。痂不着而壅肿，由荣血之淖溢；疮尽裂而皱揭，此卫气之残伤。当靥不靥，当藏不藏。便秘不通，里气热而凉导；便溏不实，中气虚而温养。热伤皮毛，怪肺金不收余气；湿伤肌肉，责脾土不燥残浆。头疮堆脓不平，孤阳似鳏而不生；足疮包水不干，纯阴如寡而不长。饮食减少，迤逦引日而毙；烦躁增剧，倏忽绝命而亡。
若问痂皮之不脱，其间病气之相妨。痘若败坏，补空痘勿疑番次；疮如溃烂，成溃脓莫靥脓浆。遍身浸淫，粘被席而最苦；正面肿灌，息腥臭而再妨。利多水液，此畜水之病也，水去尽而自止；便多脓血，此倒靥之证也，脓去尽而可祥。瘢痕凹凸，陷者虚而突者实；皮痂嫩薄，里则困而外则疡。
邪气尽而正复，痂皮脱而身康，苟幼躯之多病，即余毒之有藏。出或未尽，无空痘须防卒暴；发或未透，无溃脓必发疽疡。不及期早收，毒火陷而可怕；或过期不靥，邪气留而堪怅。身热审其虚羸，咽哑观乎呕呛。勿洒淅而肌热，知风寒之外感；暴吐泻而腹痛，必饮食之内伤。
病有苦而眩晕，凶多吉少之占；身无邪而昏瞀，否去泰来之象。声音不出，求诸肺肾之经；斑疹复现，责其心脾之藏。疳蚀出血者难治，洞泄完谷者莫医。勿谓痘收而纵弛，勿谓毒去而迨遑。正气浸长而未复，邪气方消而未央。特犯禁忌，今即生变；恣食肥甘，后必有殃。
疥癞腐溃，一面瘢痕而似鬼。痈疽流注，四肢残废而如槁。目肿亦痛，冷痘入而成翳；齿黑烂，热毒浸而溃床。虽曰余毒之为害，抑皆定数之莫防。形容顿改令人骇愕，调治悔迟空自惆怅。谓人不能胜天，何以立乎医药；谓医不如用巫，安能格乎穷苍。
但逢出痘之岁，多求解毒之方。重者必轻，轻者不出；凶者变吉，吉者何妨。其方则有，其效未常，与其先事而轻妄，孰若卧时以精详。审岁气之灾祥，必解其郁；视形气之勇怯，各平其脏。欲避疠气传染，必先择地之善；欲仗药力调护，尤要识医之良。
惺惺参苏乃发散之妙剂。（惺惺散、参苏散。）人参通圣诚疫疠之奇方。（人参败毒散、防风通圣散。）热而惊悸，导赤泻青兮用；（导赤散、泻青丸。）热而焦渴，柴胡葛根作汤。（小柴胡汤，升麻葛根汤。）自利兮黄芩，（黄芩芍药汤）不便兮清凉。（四顺清凉饮。）腹痛毒攻，匀气散再加枳实；腰痛病剧，败毒散更入木香。调元可补，表里实者勿饮；（调元饮。）承气可攻，脾胃弱者莫尝。（小承气汤。）
养正兮黄芪、人参、甘草，解毒兮连翘、山豆、牛蒡。咽喉苦痛，甘橘汤中加大力；斑疹夹出，防风散内去硝黄。（防风通圣散。）小便赤涩，连翘、导赤；（连翘饮，导赤汤。）大便滑泄，豆蔻、木香。（豆蔻丸，木香散。）疮若干枯，四物合乎凉膈，（四物汤，东垣凉膈散。）痘如黑陷，夺命助以水杨。（夺命丹，水杨浴法。）赤艳肿胀，解毒入生黄归芍；（黄连解毒汤。）灰白平塌，异功用桂枝、防风。（异功散。）
气虚而毒盛者，无价、四君、枳实；（无价散，四君子汤。）血虚而毒盛者，无价、四物、牛蒡。（四物汤。）气血两虚，十全无价；（十全大补汤。）便溺俱阻，八正、三黄。（八正散，三黄丸。）再用胆泻之法，以泻毒瓦斯之藏。黑陷审其虚实，虚者大补而实者凉膈；（十全大补汤，河间凉膈散。）痒塌分其急缓，急者异功而缓者调阳。（陈氏异功散，调阳即谓元汤。）昏闷谵妄，龙脑膏孰知其妙；虚烦迷乱，抱龙丸莫及其良。
满面燥痛，百花调水；（百花膏。）遍身溃烂，败草铺床。（败草散。）蝉蜕去目中之肤翳，（蝉蜕散。）苦参治身上之淫疮。（苦参丸。）虚热多汗，调元汤引用浮麦；食积常痛，脾积丸饮以原汤。饥不喜飧，异功宜久；（钱氏异功散。）渴欲饮水，白术可常。（白术散。）
败毒、通圣，允矣冲阵之先锋；（人参败毒散、防风通圣散。）调元、异功，信乎殿后之大员。（调元汤，钱氏异功散。）
大抵医要识证，药不执方。专行温补者，则宗乎文宗；喜用凉泻者，则师乎仲阳。不解其书，似瞽冥行于溪径；不察其神，如矮仰望于宫墙。叹吾年之耋，欲深造而力不足；惧斯道之晦，特发明而言不章。呕尽心肺，非欲立异；劳费颊舌，岂敢恃长。幸取正于具眼，徒见笑于大方。
(Tian Wan Mi Zhai. This is a concise method for treating smallpox; beginners should read it thoroughly.)
Smallpox originates from fetal toxins, commonly known as "Heavenly Sores." Although it can be transmitted by pestilential qi (severe pathogenic factors), it is essentially the manifestation of lethal potential. Its changes are unpredictable, and its cruelty is unbearable. Muscles and flesh ulcerate and slough off like snakes shedding skin or dragons shedding bones; spirit and energy are exhausted like earthworms struggling in ash or boiling water. Lesions vary in density: sparse ones indicate mild disease, while dense ones indicate severe disease. Toxins vary in severity: mild toxicity brings auspicious outcomes, while severe toxicity brings disaster. It is laughable to those who rigidly adhere to the number of days without understanding the variations of speed; it is pitiable to those confused by ghosts and gods who do not seek good medicine.
The subtle union of Heaven and Earth causes Zhen (Thunder/Yang) and Xun (Wind/Yin) to expand. Qi is received from the father, condensing with Yang essence; form is shaped by the mother, nurtured by Yin blood. The people indulge in desires, and the qi is no longer pure. Lustful fire blazes on the bedchamber, and food filth accumulates in rich meats. The Jing (Essence) and Blood inherit toxic vapors worse than She Wang (a type of poison); the body bears killing energy more dangerous than sharp blades. Some say removing oral blood suffices, which is empty talk; some say resolving fetal toxins suffices, yet no formula rivals the Sages.
The Five Movements are governed in North and South, having major and minor phases; the Six Qi are divided into Host and Guest, Yin and Yang. Changes follow their own rules, and Victory and Repetition (abnormal interactions of the Five Phases) are constant. When order is obtained, Qi is harmonious, and there are no plagues in the state; when order is lost, Qi is chaotic, and people suffer from rashes and sores. Qi that should arrive but does not arrives slowly; one must anticipate and seize its momentum. Qi that should not arrive but does so arrives violently; one must hold steady to avoid its strength. Ignoring this and acting rashly leads to defeat due to violating the season; examining this and acting cautiously leads to prosperity by following Heaven.
Spring is warm and promotes growth; Summer is hot and promotes floating and lengthening; Autumn is cool and promotes descending and gathering; Winter is cold and promotes sinking and storing. This follows the correct Four Seasons and does not harm all things. If Winter is unusually warm, buds sprout early; if Spring is unusually bitter, hibernating insects remain hidden; if Summer is unusually crisp, cool winds strike the flesh; if Autumn is unusually humid, summer sweat wets clothes. Such contrary Qi, once contracted, becomes epidemic; also, Empty Wind (non-seasonal wind) striking causes premature death.
Receiving parents' filth and toxin, it hides in dark places; touching Heaven and Earth's pestilential Qi, it triggers latent storage. Emerging from within, it spreads to four limbs; dispersing from outside, it roots in five Zang organs. The Liver governs tears forming water blisters; the Lung governs nasal discharge forming pus sacs; the Heart presents macules and redness; the Spleen presents papules and yellowish hue; the Kidney is the root of storage, and pathology manifests as black depression. Joyful signs include budding, flowering, and fruiting, like birds shedding spurs; hateful signs include withering and depression, like tigers carrying mountains. East is red, South is white, West is yellow, North is black, each distributed with certainty; Spring generates, Summer grows, Autumn harvests, Winter stores, flowing naturally without boundaries. Initially bleeding spots are bright red, receiving generating Qi; next transforming into clear fluid, a sign of gradual growth; pus formation with yellow color indicates desire to gather; scabbing with black color indicates sealed storage. Saying the Kidney has no symptoms is like saying winter cannot complete the year; saying black is adverse is like abandoning the North to regulate Yang.
During emergence, Spring and Summer are favorable, Autumn and Winter are not auspicious; during consolidation, Autumn and Winter are favorable, Spring and Summer do not store. Emergence reversing to consolidation is called Depression/Fixation; consolidation reversing to emergence is called Overflow. Favorable cases need not be treated, waiting for recovery; adverse cases should not be treated recklessly to avoid blame. For dangerous cases, unique formulas are necessary. Correct treatment turns danger to favor, like spring returning to valleys; incorrect medication turns danger to adversity, like fire raging on Kunlun.
Diseases seeming favorable but actually adverse require habitual recognition; diseases seeming adverse but actually favorable require detailed examination. Piles resembling millet and hard are inferior to distinct and dense lesions; bright red and tender like cinnabar are inferior to pale white and aged lesions. Initial appearance holding water, sudden eruption wearing pus. Pus signifies maturity and drying black; incomplete sacs withered and yellow. Early eruption withering first resembles garden flower buds; rapid growth and disappearance resemble ditch puddles. This is a life-snatching syndrome; do not boast of experienced physicians.
Mild may become severe due to wrong medication or taboos; severe may become mild by meeting a good doctor and proper care. Mosquito bites and flea marks change instantly; snake skins and silkworm shells mean waiting for death. Accompanying rashes, relief when rashes subside; flat tops and depressions, anxiety when they rise. Avoid reckless behavior at bedside; use medication with caution. Disease has root and branch, legislate based on urgency; medicines have tonification and purgation, prescribe based on deficiency and excess.
Alas! Doctors have no fixed methods; confused doctors have no fixed formulas. Generally despising attack and valuing tonification, preferring warmth over coolness. If disease encounters deficiency-cold, warming tonification is effective; if syndrome encounters excess-heat, pungent-aromatics are dared. Pungent-hot entering the throat traps abundant Yang; bitter-cold entering the stomach injures abundant Yin. Avoid sweating and purging at beginning and end; dislike attacking theories; tonify Spleen Earth to control Kidney Water, the norm of liking tonification. Not knowing the shortcomings of tonifiers, how to discuss the strengths of attackers?
Sharp, round, and lustrous forms indicate充盈 Qi; bright, clear, and moist colors indicate nourished Blood. No medication needed, called healthy. Gray-white and flat-depressed indicate Qi-Blood deficiency, tonify with warmth; red-bright and swollen indicate Qi-Blood heat, drain with coolness. Qi arrives but Blood is insufficient, though erupting, the base is not plump; Blood arrives but Qi is insufficient, though bright/moist, the border does not grow. Clinging to chapters and corners, guarding trees to catch rabbits is impossible; galloping debates holding two ends, many paths lead to losing sheep. Spleen is the root of grain and water, must be tonified; Kidney is the source of fluids, must be protected. Earth prevents Water, but Water cannot control Fire's hyperactivity. Kidney governs marrow; inversion into marrow is incurable; Kidney governs closure; turning black to closure can be prevented. These are harms attributed to Kidney, not signs of Kidney strength. Burning toxins dry Kidney Water; ruined Ying Qi injures Spleen Earth. Thus, tonifying Spleen is less effective than saving Kidney, and nourishing Yin aids Yang.
Heat makes Qi-Blood slippery and unconsolidated; cold makes Qi-Blood stagnant and obscure. Qi-Blood loss damages pox/rashes. Heat causes irritability, redness, pain; cold causes shivering, whiteness, itching. Follow seasonal temperature changes, forbid human/livestock contact. Do not disturb toilet odors, do not burn orchid/musk incense, fearing entry through deficiency, aiding toxin disaster. Smallpox is auspicious but violations bring凶 (misfortune), frequent strange changes; syndromes are evil but good treatment brings health.
Regarding pox/rash heat, similar to internal/external injuries. Evil fire blazing burns jade and stone alike; True Water calm raises no waves. Sneezing/coughing scorches Lung Metal; neck stiffness/sudden stuffiness injures Liver Wood. Yawning/startling, Heart Monarch is unsettled; vomiting/diarrhea/sleeping, Spleen Granary fails to store. Each organ/syndrome, only Kidney has no image, not receiving filth/toxin fire, uniquely showing ear-back coolness. Mild heat means little toxin; severe heat means strong fire. High heat quiet, toxin exits with heat, no worry; low heat irritable, toxin hides with heat, preventable. Unpredictable disaster, both hot and thirsty; mild/sparsely allowed, alternating hot/cool. Vomiting/diarrhea not stopping allows toxin to escape without blockage; unsettled startling fears toxin deepening and hiding. Blood leaking from orifices, death faster than snapping fingers; delirious talk of ghosts, changes easier than flipping palms.
Form/syndrome determines density; location decides survival. Scattered smallpox, granular, density determined; clustered measles, blurred, density hurts. Cheek/mouth area, Geng/Wu Yangming position; Cheek/forehead area, Wang/Bing Taiyang region. Head is chief, fears covering head; Neck is pass, dislikes neck lock. Nose tip emerging, lust toxin attacks Tian Gen; Ear leaf appearing, evil fire invades Yu Tang.
Gradual emergence is auspicious; simultaneous surge is ominous. Smallpox about to emerge with reduced heat, do not take medicine rashly; smallpox emerging with intense heat, doctor should prevent early. Resolve fire toxin, fear stagnation/dryness; nourish Qi-Blood, desire flow/smoothness. Avoid cold/heat invasion, damage/nourish seeking peace; assist Spring/Summer commands, reach/release seeking growth. Treat before chaos, repair mulberry roots before rain; know gradual nature, beware ice when treading frost.
Emerge wanting completion without leaving; erupt wanting penetration growing together. Buds gradually forming nests, warmed by Qi; Blood gradually turning to water, nourished by Blood. Sparse/few toxins, face not swollen, do not fear; Dense/many toxins, Qi-Blood not full, do not panic. Time sufficient, naturally rising mixed; Exterior/Interior free of evil, do not rush to make decoctions. This is like a good general using troops, good attack不如 good defense; also like a good farmer tending fields, do not help growth nor forget.
Sudden throat pain, treat early not delaying time; Pre-swelling of head/face, prolonging days leads to death. Urine wants clear, stool wants firm; Light flavors edible, heavy flavors not to taste. Eating light preserves Stomach Qi; Nourishing heavy increases Fire Evil. Seeing black-dark, quickly dot with rouge; Encountering dry/withered, bath with Populus/Salix. Sudden itching, take Artemisia capillaris for fumigation; Restless scratching, even Lu Bian would hesitate.
Smallpox fills with water, toxin transforms to paste. Love thick pus, hate thin/clear; Take fullness, discard empty/overflow. Want to know penetration, examine hands/feet carefully; Want to know sufficiency, inspect cheeks/cheeks. If extremities not penetrated, take Spleen/Stomach medication; If one side insufficient, view meridians for formula. Like building a mountain, do not fail due to basket soil; Like holding heat, better to wash in boiling water first.
Cheeks dislike broken tops; Shoulders/back fear scorched sacs. Swelling suddenly disappears, Qi escapes; Speech suddenly delirious, Spirit perishes. Eating grains causes vomiting, Stomach rots; Drinking water causes choking, Throat injured. Teeth grinding, Liver fire blazing and Kidney failing; Chills, Yang Qi weak and Yin strong. Pus reverses to dry, inversion; Pus not formed, fixation. Crying endlessly, toxin attacks intestines/stomach; Confusion/restlessness, fire raging in Gaohuang. Granary not storing, souls return to darkness; Springs not stopping, relatives weep on Beimang.
Pus/blood transformed, scabbing appropriate. Signs start from lips, paste gathers like pearls; Ends at Renzhong, parts measured mentally. Commands act in Autumn/Winter, following sequence不乱; Qi responds to Yin/Yang, circulating up/down with regularity. Cheek upper light, fear inverted scabbing; Cheek middle receding first, called inauspicious. Scab not adhering and swelling, due to Ying Blood overflow; Wounds fully cracking and peeling, this Wei Qi residual injury. When scabbing not scabbing, when storing not storing. Constipation not passing, interior heat guided by cool; Loose stool not solid, middle Qi deficient nourished by warm. Heat damaging skin/hair, blame Lung Metal not collecting remaining Qi; Damp damaging muscle, blame Spleen Earth not drying residual paste. Head wounds piling pus uneven, solitary Yang like widower not generating; Foot wounds wrapping water not drying, pure Yin like widow not growing. Diet decreasing, lingering days leading to death; Irritability increasing, sudden life ending.
If asking why scabs do not fall off, between them disease Qi interferes. Smallpox ruined, fill empty holes doubtlessly; Wounds like ulcerated, formed pus not scabbed paste. Whole body oozing, sticking sheets most bitter; Frontal swelling pouring, smelling foul again interfering. Frequent watery discharge, this retaining water disease, water gone stops itself; Stool frequent pus/blood, this inverted scabbing syndrome, pus gone becomes auspicious. Scars concave/convex, depressed deficient and protruding excess; Skin scabs tender/thin, inside troubled and outside sore.
Evil Qi exhausted and Zheng returns, scabs fall and body healthy, if young body often sick, then residual toxin has storage. Erupting not fully, no empty holes must prevent sudden violence; Erupting not penetrated, no ulcerated pus must develop carbuncles. Receiving early, toxin/fire sinks scary; Or overdue not scabbing, evil Qi staying regrettable. Body heat examine deficiency/emaciation, hoarse voice observe vomiting/choking. Do not feel chills and muscle heat, know Wind-Cold external contraction; Sudden vomiting/diarrhea and abdominal pain, must diet internal injury.
Disease painful and dizzy, mostly凶 few吉 omen; Body no evil and drowsy, Pi goes and Tai comes image. Voice not coming, seek Lung/Kidney meridians; Macules/rashes reappearing, blame Heart/Spleen Zang organs. Gan erosion bleeding difficult to treat, hole diarrhea whole grain cannot be cured. Do not say smallpox received and relax, do not say toxin gone and delay. Zheng Qi growing but not recovered, Evil Qi just消散 but not ended. Specifically violating taboos, now immediately generate change; Indulge eating fat/sweet, later surely have disaster.
Scabies/leprosy ulcerated, one side scar like ghost. Carbuncles/metastatic abscesses, four limbs disabled like withered. Eyes swollen and painful, cold smallpox enters forming nebula; Teeth black/rotten, hot toxin浸s destroying bed. Though said residual toxin causing harm, also all fixed numbers unpreventable. Appearance suddenly changed shocking people, treatment regret late empty self sighing. Say humans cannot conquer Heaven, how establish medicine? Say doctors不如 using witchcraft, how reach窮苍?
But encountering years of smallpox, mostly seeking detoxifying formulas. Severe must become mild, mild not erupting;凶 becoming吉, what harm to吉? Formulas exist, effects not always, rather beforehand lightly rash,不如 lying down carefully detailed. Examine year Qi disaster/auspiciousness, must resolve stagnation; View form Qi bravery/timidity, each level its Zang organs. Want to avoid pestilential transmission, must first choose good land; Want rely on medicine power protection, especially recognize good doctor.
Xingxing Renshen Suxu is wonderful agent for dispersing (Xingxing San, Renshen Suxu San). Renshen Tongsheng truly odd formula for epidemics (Renshen Baidu San, Fangfeng Tongsheng San). Hot and startling palpitations, Daochi Xieqing used (Daochi San, Xieqing Wan). Hot and scorched thirst, Chaihu Gegen made soup (Xiao Chaihu Tang, Shengma Gegen Tang). Self-diarrhea Huangqin (Huangqin Shaoyao Tang); Inconvenient Qingliang (Sishun Qingliang Yin). Abdominal pain toxin attacking, Yunqi San add Zhishi; Lower back pain severe, Baidu San add Muxiang. Tiaoyuan can tonify, exterior/interior excess do not drink (Tiaoyuan Yin). Chengqi can attack, Spleen/Stomach weak do not taste (Xiao Chengqi Tang).
Nourish Zheng Huangqi, Renshen, Gancao; Detox Lianqiao, Shandou, Niubang. Throat bitter pain, Ganju Tang add Dali; Macules/rashes mixed out, Fangfeng San remove Xiaohuang (Fangfeng Tongsheng San). Urine red/astringent, Lianqiao, Daochi (Lianqiao Yin, Daochi Tang); Stool slippery loose, Doukou, Muxiang (Doukou Wan, Muxiang San). Wounds dry/withered, Siwu combine Liangge (Siwu Tang, Dongyuan Liangge San). Smallpox like black depression, Duoming assist Shuiyang (Duoming Dan, Shuiyang Bath Method). Red-bright swelling, Jiedu enter Shenghuang Guishaohuo (Huanglian Jiedu Tang). Gray-white flat, Yigong use Guizhi, Fangfeng (Yigong San).
Qi deficient and toxin盛, Wuja, Sijun, Zhishi (Wujia San, Sijunzi Tang). Blood deficient and toxin盛, Wuja, Siwu, Niubang (Siwu Tang). Qi-Blood both deficient, Shiquan Wuja (Shiquan Dabu Tang). Urination/defecation blocked, Bazheng, Sanhuang (Bazheng San, Sanhuang Wan). Again use Gallbladder draining method, to drain toxin/vapor storage. Black depression examine deficiency/excess, deficient great tonify and excess Liangge (Shiquan Dabu Tang, Hejian Liangge San). Itching/depression divide urgent/slow, urgent Yigong and slow Tiaoyang (Chen's Yigong San, Tiaoyang refers to Yuan Tang). Drowsy/confused delirious, Longnao Gao who knows its wonder; Deficient irritable confused, Baolong Wan none matches its good.
Full face dry/painful, Baihua mix water (Baihua Gao). Whole body ulcerated, Baicao spread bed (Baicao San). Chan Tui remove eye skin nebula (Chan Tui San). Kushen treat body lust sores (Kushen Wan). Deficient heat much sweating, Tiaoyuan Tang reference Fumai; Food accumulation often pain, Pi Ji Wan drink Yuan Tang. Hungry not liking meal, Yigong suitable long (Qian's Yigong San). Thirsty wanting water, Baizhu can often (Baizhu San).
Baidu, Tongsheng, indeed vanguard charging; Tiaoyuan, Yigong, indeed rear guard great officials (Tiaoyuan Tang, Qian's Yigong San).
Generally doctors must recognize syndromes, medicines do not stick to formulas. Specializing in warm tonification, follow Wenzong; Liking cool draining, model after Zhongyang. Not understanding books, like blind walking in streams; Not observing spirit, like dwarf looking at palace walls. Sigh my age old, want deep study but strength insufficient; Fear this way obscure, specially clarify words not clear. Vomit heart/lungs, not wanting to stand out; Labor jaws/tongue, dare not rely on length. Fortunately take correction from knowledgeable eyes, vainly laughed at by great masters.