一日发热苏发散，二日还宜根据本方，三日见苗方解毒，四日紫黑花斑汤。五日夹
疹大中出，若有内热紫葛汤。六日齐兼看颜色，托里散法正相当。若还内中有陷痘，
本方加减实为良。七日正当痘上浆，虚者俱用大补汤。痘疮起从八日来，根据法调治
甚奇哉。心中活法皆要用，错过一日枉思量。九日浆儿正当出，只恐气血不周全。四
物汤中兼八物，仔细观察定阴阳。十日期来专留意，霍乱之中莫放空。逐日工夫十
一来，四物汤方莫放开。犹恐切牙并气咳，本方数剂两和谐。十二浆完未灌顶，作泻
虚寒生战来。异功散方真稳当，根据方调理定无差。痘疮已满十二安，心上工夫活法
看。一看疤色定除热，散毒方中皆要诀。逐日工夫逐日用，虚实加减始为良。气虚理
气为之主，无血生血理之常。药不执方因活用，秘传心法活工夫。若还不遵诸秘诀，徒劳心力损婴儿。
凡发热三日内，有痘疹痘面痛甚，或作寒热，或发惊搐切牙，目白睛红，皮肤
紧急，或无汗，此是痘毒在内，毒之盛也。痘出，不轻用十解散以遏其势。凡初出无
诸毒，只吐泻不止，不能饮食，宜用和中
汤。凡初发热不能合眼，狂躁大渴，身体壮热，或舌尖热，此毒根在内也。或血从
口出，或从二便出，此乃心经证也。宜用大解散发之，缓一日则难疗矣。或二三日
口上稠密，或疔毒郁斑点，在肌肤之中欲出不出者，以紫草透肌汤，笑逢散治之。本
日即出，如不用此二方，则变陷焦枯而死。凡痘出七八日未遍，浆未满，乃毒之不行
也。用七真汤加穿山甲三片助其成浆。如其不睡不痛，是毒不收，宜牙托散收之，如
过日期则难治矣。如有黑陷者，宜拔疔丹挑破点之。凡痘初发热，因胃气虚弱，因
泄泻发肿而毒陷者，以大剂散或四君子汤加肉豆蔻，再用实肠散，泻止仍用保元汤
加芎归以助气血。凡痘三次灌浆，顶陷不起，须仔细看年寿上。可起发如不起发可
忧；如手上痘不起发，是毒在内，急用升天散一服；如再不起发，看天庭上可起发，
若起发再用半剂升天散可收全功。庸医不识痘色，只看周身光亮，即为顺证，殊不
知全以年寿、天庭、耳后浆足为主。凡痘九日内、如天庭、印堂、离宫、坎宫不起
发，用升天散治之，此药服过一时不起，再进一服；若不起发，乃断不能救，决死之
证。凡痘收后，唇口不起皮，急用清血退心汤治之。如若不治，定变走马牙疳难治
之证。凡痘收后，壳薄灰燥，气血尽矣。急用大力解毒汤一剂，后用四君子汤治之。凡
痘后壳薄剥落，挫喉谵语，急用独活消痰饮治之。凡痘寒战切牙，急用香苏散去其
邪气，倘若痘毒攻心，则难治矣。凡痘后不能饮食，只能吃汤，此乃心经之证也。倘
毒攻喉，须服开关散，切勿太过，只略退心经之热。凡痘后只能饮食，又兼泻者，此
系阴阳不和，内有余毒，须服补阴汤以解其毒。凡痘后久痢不止者，此系阴阳有毒，
脾胃不和，可用消积散，可以转愁生笑；不然用止痢汤治之。凡痘后有痈者，此乃余
毒发于外也，急用败毒散凉其血气，连服三五剂自消。凡痘出两脸，或胸膛、天堂、
印堂生串毒形如蚕种，不分颗粒，隐在皮肤，最难起发；或舌上有紫黑色，或痘疔，
或一点，或二点如吕字，或三点如品字，四点如器字，五点如梅花，或头面四肢发紫
红大泡，浑身痘如大红，此等形状，皆不能治者。如初月急宜用换痘方换之，如应
手后用十解散治之。凡痘发热作呕，腰疼热一日，两脸点如针苗，次日才起，饮食
如常，此为吉证；若以腰痛为凶，但见作呕为吉，一日兼标者多也，只要起顶黄润为吉。
第一天出现发热，应使用苏发散；第二天仍宜根据原方继续服用。第三天痘疹显现苗头时才进行解毒，第四天若见紫黑色花斑则用紫黑花斑汤。第五天痘疹大量发出时，若有内热则用紫葛汤。第六天需全面观察颜色，托里散法最为恰当。如果痘疹内部有凹陷，在原方基础上加减变化确实是很好的方法。第七天正是痘疹灌浆的时候，体虚者全部使用大补汤。痘疮从第八天开始起发，按照法则调治非常奇妙。心中要有灵活的方法都要运用上，错过一天就是白费心思。第九天浆液正当排出，只担心气血不周全。在四物汤中加入八珍汤（注：原文“八物”通常指八珍汤或类似补气养血组合，此处依文意译为八珍汤或保留八物概念，结合后文“四物...兼八物”，实为气血双补之意，此处暂译作八珍汤以符合中医常规，或直译八物药），仔细观察以确定阴阳状况。第十天到来时要特别留意，霍乱症状中不要疏忽大意。逐日调理的功夫延续到十一天，四物汤方剂不可放下不用。还恐怕出现咬牙和气咳的症状，用本方几剂使身体和谐平衡。十二天浆液完成但未灌顶，出现腹泻、虚寒和战栗。异功散方剂确实稳妥得当，根据方剂调理一定没有差错。痘疮已满十二天且安稳，心上功夫要灵活看待。一看疤痕颜色确定是否除热，散毒方中的要领都要掌握。逐日的功夫逐日使用，虚实加减才是良策。气虚以理气为主，无血则生血是常理。用药不拘泥于固定方剂而因活用，这是秘传的心法活工夫。如果不遵循这些秘诀，徒劳心力反而损伤婴儿。
凡是发热三天内，如果有痘疹且面部疼痛剧烈，或者出现寒热往来，或者发生惊厥抽搐、咬牙，眼白睛发红，皮肤紧绷紧急，或者无汗，这是痘毒在体内，毒势旺盛的表现。痘疹发出时，不要轻易使用十解散来遏制其势头。凡是初出痘疹没有各种毒象，只是呕吐腹泻不止，不能饮食，适宜使用中合汤。凡是刚开始发热就不能闭眼，狂躁大渴，身体壮热，或者舌尖发热，这是毒根在体内的表现。或者血液从口部流出，或者从大小便流出，这是心经的证候。适宜用大解散发泄，拖延一天就难以治疗了。或者二三天口唇周围稠密，或者疔毒郁结斑点，在肌肤之中欲出未出的，用紫草透肌汤、笑逢散治疗。当天即出，如不使用这两个方子，就会变成陷伏焦枯而死。凡是痘疹发出七八天还未遍布全身，浆液未满，这是毒邪不行畅的表现。用七真汤加穿山甲三片帮助成浆。如果患者不睡不痛，是毒邪不收敛，适宜用牙托散收敛它，如果过了日期就难治了。如果有黑陷的情况，适宜用拔疔丹挑破点涂。凡是痘疹初发热，因为胃气虚弱，因为泄泻导致浮肿而毒邪内陷的，用大剂散或者四君子汤加肉豆蔻，再用实肠散，泻止后仍用保元汤加川芎、当归以助气血。凡是痘疹三次灌浆，顶部凹陷不起，须仔细看年寿部位。可以起发的如不起发可担忧；如果手上痘疹不起发，是毒邪在体内，急用升天散一服；如果再不起发，看天庭部位是否可以起发，如果起发再用半剂升天散可以收全功。庸医不认识痘色，只看周身光亮，就认为是顺证，殊不知完全以年寿、天庭、耳后浆液充足为主。凡是痘疹九日内，如果天庭、印堂、离宫、坎宫不起发，用升天散治疗，此药服用过一个时辰不起发，再进一服；如果不起发，乃是断然不能救，决死的证候。凡是痘疹收靥后，唇口不起皮，急用清血退心汤治疗。如果不治疗，一定变成走马牙疳这种难治的证候。凡是痘疹收靥后，壳薄灰燥，气血已经耗尽。急用大力解毒汤一剂，后用四君子汤治疗。凡是痘后壳薄剥落，挫喉谵语，急用独活消痰饮治疗。凡是痘疹寒战咬牙，急用香苏散去其邪气，倘若痘毒攻心，就难治了。凡是痘后不能饮食，只能喝汤，这是心经的证候。倘若毒邪攻喉，须服开关散，切勿太过，只需略微退去心经的热邪。凡是痘后只能饮食，又兼腹泻的，这是阴阳不和，内有残余毒邪，须服补阴汤以解除其毒。凡是痘后久痢不止的，这是阴阳有毒，脾胃不和，可用消积散，可以转愁生笑；不然用止痢汤治疗。凡是痘后有痈肿的，这是余毒发于体外，急用败毒散凉其血气，连服三五剂自然消散。凡是痘疹出在两脸，或者胸膛、天堂、印堂生出串状毒形如蚕种，不分颗粒，隐在皮肤，最难起发；或者舌上有紫黑色，或者痘疔，或者一点，或者二点如吕字，或者三点如品字，四点如器字，五点如梅花，或者头面四肢发紫红大泡，浑身痘如大红，这种形状，都是不能治疗的。如果初月急宜用换痘方更换之，如果应手后用十解散治疗。凡是痘疹发热作呕，腰疼热一日，两脸点如针苗，次日才起，饮食如常，此为吉证；如果以腰痛为凶，但见作呕为吉，一日兼标者多也，只要起顶黄润为吉。
On the first day, when fever appears, Su San (Perilla Powder) should be used; on the second day, it is still appropriate to follow the original prescription. On the third day, detoxification should only be performed once the pockmarks begin to emerge; on the fourth day, if purple-black mottled spots appear, Zi Hei Hua Ban Tang (Purple-Black Mottled Spot Decoction) is indicated. On the fifth day, when the rashes erupt in large numbers, if there is internal heat, Zi Ge Tang (Puerariae Radix Decoction) should be used. On the sixth day, one must comprehensively observe the coloration; Tuo Li San (Support the Interior Powder) is the most appropriate method. If there are depressed lesions internally, modifying the base formula is indeed a good approach. On the seventh day, when the pustules are filling with pus, those with deficiency should all use Da Bu Tang (Great Tonifying Decoction). The eruption of smallpox begins on the eighth day; regulating according to the principles is truly remarkable. One must employ flexible methods in mind; missing a single day renders all effort vain. On the ninth day, when the pus is properly discharging, one only fears that Qi and Blood may be incomplete. Combining Si Wu Tang (Four Substances Decoction) with Ba Zhen Tang (Eight Treasures Decoction), carefully observe to determine Yin and Yang. On the tenth day, special attention must be paid; do not neglect cases involving Huo Luan (Cholera-like syndrome). Daily care continues through the eleventh day; do not abandon Si Wu Tang (Four Substances Decoction). One must also fear symptoms such as teeth grinding and coughing due to Qi stagnation; several doses of the base formula will harmonize the body. By the twelfth day, if the pus is complete but the apex has not filled, diarrhea, deficiency-cold, and chills may arise. Yi Gong San (Yi Gong Powder) is truly stable and appropriate; following this prescription for regulation ensures no error. When the smallpox is fully erupted and stable after twelve days, mental effort should be applied flexibly. First, examine the scar color to determine if heat has been cleared; the key points in San Du Fang (Detoxification Powder) must be mastered. Apply daily care day by day; adjusting for excess or deficiency is the optimal strategy. For Qi deficiency, regulating Qi is primary; for Blood deficiency, generating Blood is the constant principle. Medicines should not be rigidly fixed to formulas but used flexibly; this secret transmission is the art of living methods. If these secrets are not followed, effort is wasted and the infant is harmed.
Whenever fever persists for three days, if there are rashes with severe facial pain, or alternating chills and fever, or convulsions, twitching, and teeth grinding, redness of the sclera, tight and urgent skin, or absence of sweating, this indicates that the toxin is trapped inside and the pathogenic factor is vigorous. When the rash erupts, do not lightly use Shi Jie San (Ten Releases Powder) to suppress its momentum. Whenever the initial eruption lacks various toxic signs, but vomiting and diarrhea persist without cessation, and eating is impossible, Zhong He Tang (Harmonizing Middle Decoction) is suitable. Whenever initial fever prevents closing the eyes, accompanied by mania, extreme thirst, high body heat, or heat at the tip of the tongue, this indicates the root of the toxin is internal. If blood flows from the mouth or from the two bowels, this is a Syndrome of the Heart Channel. It is suitable to use Da Jie Fa (Major Release Method/Decoction) to vent it; delaying by one day makes treatment difficult. If the area around the mouth is dense on the second or third day, or if Ding Du (Ding Toxin) manifests as郁结 (stagnant) spots within the skin欲出不出 (wanting to emerge but unable to), treat with Zi Cao Tou Ji Tang (Arnebia Skin-Penetrating Decoction) and Xiao Feng San (Eliminate Wind Powder). If they erupt on the same day, failing to use these two formulas will result in collapse, scorching, and death. If the rash has erupted for seven or eight days but has not covered the whole body, and the pus is not full, this indicates the toxin is not circulating freely. Use Qi Zhen Tang (Seven True Decoction) plus three slices of Chuan Shan Jia (Pangolin Scale) to assist in forming pus. If the patient does not sleep or feel pain, it means the toxin is not being contained; Ya Tuo San (Tooth Support Powder) should be used to contain it. If the time limit passes, it becomes difficult to treat. If there are black depressions, Ba Ding Dan (Ding-Toxin Removing Pill) should be used to pierce and apply locally. Whenever smallpox initially presents with fever due to weak Stomach Qi, leading to edema from diarrhea and toxin sinking, use a large dose of San (Powder) or Si Jun Zi Tang (Four Gentlemen Decoction) added with Rou Dou Kou (Nutmeg), followed by Shi Chang San (Intestine-Solidifying Powder); once diarrhea stops, resume Bao Yuan Tang (Protect Origin Decoction) added with Xiong Gui (Ligusticum and Angelica) to aid Qi and Blood. Whenever smallpox undergoes three rounds of pus-filling, but the apex remains depressed and does not rise, carefully inspect the Nian Shou (Area between nose and upper lip). If it can rise but does not, worry is warranted; if the rash on the hands does not rise, the toxin is internal, urgently administer one dose of Sheng Tian San (Ascend to Heaven Powder); if it still does not rise, check the Tian Ting (Forehead area); if it rises, another half dose of Sheng Tian San can achieve full success. Quack doctors do not recognize pock colors; they only see the brightness of the whole body and consider it a favorable progression, unaware that the key lies entirely in the sufficiency of pus in Nian Shou, Tian Ting, and behind the ears. Within nine days of smallpox, if Tian Ting, Yin Tang, Li Gong, and Kan Gong do not rise, treat with Sheng Tian San. If this medicine fails to produce results after one hour, administer another dose; if it still does not rise, rescue is impossible, and it is a fatal syndrome. After the smallpox crusts fall off, if the lips and mouth do not peel, urgently treat with Qing Xue Tui Xin Tang (Clear Blood and Retreat Heart Decoction). If untreated, it will definitely transform into Zou Ma Ya Gan (Running Horse Gum Rot), a difficult-to-treat condition. After the smallpox crusts fall off, if the shells are thin and ash-dry, Qi and Blood are exhausted. Urgently use Da Li Jie Du Tang (Great Strength Detoxification Decoction) for one dose, followed by Si Jun Zi Tang (Four Gentlemen Decoction). After smallpox, if the shells are thin and peeling, accompanied by throat trauma and delirious speech, urgently treat with Du Huo Xiao Tan Yin (Angelica Pubescens Phlegm-Resolving Drink). If there are chills and teeth grinding after smallpox, urgently use Xiang Su San (Cyperus and Perilla Powder) to dispel evil Qi; if the toxin attacks the Heart, it becomes difficult to treat. If after smallpox one cannot eat, only drinking soup is possible, this is a Syndrome of the Heart Channel. If the toxin attacks the throat, Guan Kai San (Open Gate Powder) must be taken; do not overdo it, merely slightly clearing the heat of the Heart Channel. If after smallpox one can eat but also has diarrhea, this is Disharmony of Yin and Yang with residual internal toxin; Bu Yin Tang (Tonify Yin Decoction) must be taken to resolve the toxin. If after smallpox dysentery persists for a long time, this is Toxic Yin-Yang Disharmony and Spleen-Stomach Disharmony; Xiao Ji San (Accumulation-Resolving Powder) can be used to turn sorrow into joy; otherwise, use Zhi Li Tang (Stop Dysentery Decoction). If after smallpox there are carbuncles, this is residual toxin manifesting externally; urgently use Bai Du San (Eliminate Toxin Powder) to cool the Qi and Blood, taking three to five doses consecutively for natural resolution. If smallpox erupts on both cheeks, or if string-like toxins resembling silkworm eggs appear on the chest, Tian Tang, and Yin Tang, indistinguishable as individual grains and hidden in the skin, they are hardest to rise; or if there is purple-black color on the tongue, or pock-dings, or one dot, or two dots like the character 'Lu', or three dots like 'Pin', or four dots like 'Qi', or five dots like 'Plum Blossom', or large purple-red blisters on the head, face, and limbs, with the whole body's pocks appearing bright red—these shapes are all untreatable. In the early stage, urgently use Huan Dou Fang (Change Pock Formula) to change them; if effective, follow up with Shi Jie San (Ten Releases Powder). Whenever smallpox presents with fever and vomiting, lower back pain and heat for one day, with cheek spots like needle shoots rising only the next day, while appetite remains normal, this is an auspicious sign; regarding lower back pain as ominous is wrong, but seeing vomiting as auspicious is correct; many cases have combined superficial and deep signs on the first day. As long as the apex rises with yellow moisture, it is auspicious.