痘疮内外宜宣畅，秘结气血鲜流荡，大便不通四顺宜，小便秘涩八正当。
【注】凡出痘，二便最喜通畅。以痘属毒火，惟通畅然后经络疏利，气血流动，而无
壅遏之患。一有不通，则毒火不能外达，必至内攻而生患。初出大便秘者，四顺清凉饮
主之；小便秘者，八正散主之。若至成浆时，切勿轻用。
四顺清凉饮
白芍药 当归身 甘草（生） 生大黄
水煎服。
【方歌】四顺清凉治秘结，大便不通毒火烈，白芍当归大黄草，急急煎服效最捷。
八正散
车前子 瞿麦 蓄 栀子仁 大黄 甘草（生） 木通 滑石
引用灯心，水煎服。
【方歌】八正散治小便秘，车前瞿麦与 蓄，栀子大黄木通草，更入滑石煎成剂。
初热作泻柴苓先，脾虚冷泻木香煎，色黄酸臭胃苓治，灌浆虚滑豆蔻丸。
【注】痘证不喜秘结，更忌泻利。初出时泻，尚具开通之功，火热由利而解。若泻甚，
则是邪气并于肠胃，迫而下降，使传化失常也，宜柴苓汤主之。起胀时泻，手足逆冷，痘
不起，其色淡白，此冷泻也，以陈氏木香散主之。如中满恶食，泻黄酸臭，手足心热，面
赤疮红，此胃热作泻，以胃苓汤主之。惟成浆时尤为紧要，盖痘疮至此，津液已衰，脾
胃已弱，复加泄泻，则百变丛生，急以豆蔻丸主之。
柴苓汤
黄芩 半夏（姜炙） 白术（土炒） 甘草（生） 赤茯苓 猪苓 泽泻 柴胡
引用生姜、灯心，水煎服。
【方歌】痘形未见先泄泻，柴苓疏利功最捷，芩半术甘赤茯苓，猪苓柴胡共泽泻。
陈氏木香散（方见厥逆）
胃苓汤
陈皮 浓朴（姜炒） 赤茯苓 苍术（米泔水浸、炒） 猪苓 泽泻 白术（土炒）
引用灯心，水煎服。
【方歌】里实作泻胃苓治，陈皮浓朴赤茯苓，苍术猪苓并泽泻，减桂倍术效无穷。
豆蔻丸
白龙骨（ ） 肉豆蔻（面裹，煨，去油） 木香（煨） 砂仁 诃黎勒肉（面裹煨，各五钱）
赤石脂（ ，七钱半） 白枯矾（三钱）
共为细末，面糊为丸，如黍米大。每服三五十丸，米饮下。
痘疮的内外环境应当保持宣通顺畅，如果发生秘结（大便不通），气血就会缺乏流动。大便不通时适宜使用四顺清凉饮，小便涩滞时适宜使用八正散。
【注】凡是出痘，大小便最希望通畅。因为痘疮属于毒火之邪，只有通畅才能使经络疏利，气血流动，从而避免壅遏的祸患。一旦有不通畅的情况，毒火就不能向外透达，必然向内攻伐而产生祸患。初起阶段大便秘结的，以四顺清凉饮为主治方；小便不通的，以八正散为主治方。如果到了成浆阶段，千万不要轻易使用这些方剂。
【方歌】四顺清凉饮治疗秘结，大便不通毒火猛烈，白芍、当归、大黄、甘草，急忙煎服效果最快。
八正散
车前子、瞿麦、蓄草、栀子仁、大黄、甘草（生）、木通、滑石
引用灯心草为引，用水煎服。
【方歌】八正散治疗小便不通，车前、瞿麦与蓄草，栀子、大黄、木通、甘草，再加入滑石煎成药剂。
初热阶段出现腹泻先用柴苓汤，脾虚冷泻用木香散煎服，颜色黄且气味酸臭的用胃苓汤治疗，灌浆阶段虚滑腹泻用豆蔻丸。
【注】痘证不喜欢秘结，更忌讳腹泻。初起时腹泻，尚且具有开通的作用，火热之邪可以通过腹泻而解除。如果腹泻严重，则是邪气并合于肠胃，逼迫而下陷，导致传化功能失常，适宜用柴苓汤主治。起胀阶段腹泻，手足逆冷，痘疹不起发，颜色淡白，这是冷泻，以陈氏木香散主治。如果腹部胀满、厌恶饮食，腹泻黄色且气味酸臭，手心发热，面色红赤、疮色红，这是胃热导致的腹泻，以胃苓汤主治。特别是成浆阶段尤为紧要，因为痘疮到了这个阶段，津液已经衰退，脾胃已经虚弱，再加上泄泻，就会变症丛生，急忙用豆蔻丸主治。
柴苓汤
黄芩、半夏（姜炙）、白术（土炒）、甘草（生）、赤茯苓、猪苓、泽泻、柴胡
引用生姜、灯心草为引，用水煎服。
【方歌】痘形尚未显现先出现泄泻，柴苓汤疏利功效最快，黄芩、半夏、白术、甘草、赤茯苓，猪苓、柴胡共配泽泻。
陈氏木香散（方剂见厥逆章节）
胃苓汤
陈皮、浓朴（姜炒）、赤茯苓、苍术（米泔水浸、炒）、猪苓、泽泻、白术（土炒）
引用灯心草为引，用水煎服。
【方歌】里实导致的腹泻用胃苓汤治疗，陈皮、浓朴、赤茯苓，苍术、猪苓和泽泻，减去肉桂加倍白术效果无穷。
豆蔻丸
白龙骨（煅）、肉豆蔻（面裹，煨，去油）、木香（煨）、砂仁、诃黎勒肉（面裹煨，各五钱）
赤石脂（煅，七钱半）、白枯矾（三钱）
共同研为细末，用面糊做成丸药，如黍米大小。每次服用三五十丸，用米饮送下。
The interior and exterior of smallpox lesions should be kept open and unobstructed. If constipation occurs, the flow of Qi and Blood will be scanty. For constipation (blockage of stool), Sishun Qingliang Yin is appropriate; for difficult and scanty urination, Bazheng San is appropriate.
[Note] In cases of eruptive diseases like smallpox, free passage of both bowel movements and urine is highly desirable. Since smallpox belongs to toxic fire pathogens, only through patency can the meridians be smoothed and Qi and Blood flow freely, thereby avoiding the hazard of stagnation and obstruction. Once there is any blockage, the toxic fire cannot reach the exterior, and must attack internally, giving rise to complications. In the initial stage, if constipation occurs, Sishun Qingliang Yin is the primary prescription; if urinary difficulty occurs, Bazheng San is the primary prescription. However, when the disease reaches the pustule formation stage, these prescriptions should never be used lightly.
Sishun Qingliang Yin (Four-Obedience Cooling Decoction)
Bai Shaoyao (Radix Paeoniae Alba), Danggui Shen (Radix Angelicae Sinensis Root), Gancao Sheng (Raw Radix Glycyrrhizae), Sheng Dahuang (Raw Radix et Rhizoma Rhei).
Decoct in water and take orally.
[Prescription Song] Sishun Qingliang treats constipation, where stool is blocked and toxic fire is fierce; Bai Shao, Dang Gui, Da Huang, and Gan Cao, hastily decocted and taken, yield the swiftest effect.
Bazheng San (Eight-Righteousness Powder)
Cheqianzi (Semen Plantaginis), Qumai (Herba Dianthi), Lvxue (Herba Polygoni Avicularis), Zhizi Ren (Semen Gardeniae), Dahuang (Radix et Rhizoma Rhei), Gancao Sheng (Raw Radix Glycyrrhizae), Mutong (Caulis Akebiae), Huashi (Talcum).
Use Dengxincao (Medulla Junci) as a guide, decoct in water and take orally.
[Prescription Song] Bazheng San treats difficult urination, with Cheqian, Qumai, and Luxue; Zhizi, Dahuang, Mutong, and Gancao, plus Huashi decocted into the preparation.
In the initial heat stage, diarrhea is first treated with Chailing Tang; for spleen-deficiency cold diarrhea, Muxiang Jian is decocted; for yellow, sour-smelling diarrhea, Weiling Tang is used; during the pustule formation stage, for deficiency-type slippery diarrhea, Doukou Wan is administered.
[Note] Eruptive diseases dislike constipation and are even more contraindicated with diarrhea. Diarrhea in the initial stage still possesses the function of opening and venting, allowing heat-fire pathogens to resolve through evacuation. However, severe diarrhea indicates that evil qi has merged into the intestines and stomach, forcing downward movement and causing dysfunction of transmission and transformation; Chailing Tang is appropriate here. During the swelling stage, if diarrhea occurs accompanied by cold extremities, failure of lesions to swell, and pale white color, this is cold diarrhea, treated with Chen's Muxiang San. If there is abdominal fullness, anorexia, yellow sour-smelling diarrhea, hot palms and soles, red face, and red lesions, this is stomach-heat-induced diarrhea, treated with Weiling Tang. The pustule formation stage is particularly critical; at this point, body fluids are depleted and the spleen and stomach are weak. Adding diarrhea leads to myriad complications, so Doukou Wan should be urgently administered.
Chailing Tang (Bupleurum and Poria Decoction)
Huangqin (Radix Scutellariae), Banxia Jiangzhi (Rhizoma Pinelliae Prepared with Ginger), Baizhu Tuchao (Rhizoma Atractylodis Macrocephalae Stir-fried with Soil), Gancao Sheng (Raw Radix Glycyrrhizae), Chi Fuling (Poria with Red Mycelium), Zhuling (Poria), Zexie (Rhizoma Alismatis), Chaihu (Radix Bupleuri).
Use Shengjiang (Fresh Rhizoma Zingiberis) and Dengxincao (Medulla Junci) as guides, decoct in water and take orally.
[Prescription Song] Before the smallpox shape appears, diarrhea occurs first; Chailing Tang's smoothing and draining power is swiftest; Huang Qin, Ban Xia, Bai Zhu, Gan Cao, and Chi Fuling, combined with Zhu Ling, Chai Hu, and Ze Xie.
Chen's Muxiang San (See section on Cold Extremities for formula)
Weiling Tang (Gastrointestinal Regulation Decoction)
Chenpi (Pericarpium Citri Reticulatae), Nongpo Jiangchao (Cortex Magnoliae Officinalis Stir-fried with Ginger), Chi Fuling (Poria with Red Mycelium), Cangzhu Mixiantshui Jin Chao (Rhizoma Atractylodis Lanceae Soaked in Rice Wash Water and Stir-fried), Zhuling (Poria), Zexie (Rhizoma Alismatis), Baizhu Tuchao (Rhizoma Atractylodis Macrocephalae Stir-fried with Soil).
Use Dengxincao (Medulla Junci) as a guide, decoct in water and take orally.
[Prescription Song] Interior excess diarrhea is treated with Weiling Tang; Chen Pi, Nong Po, and Chi Fuling, Cang Zhu, Zhu Ling, and Ze Xie; removing Gui Zhi and doubling Bai Zhu yields infinite efficacy.
Doukou Wan (Nutmeg Pill)
Bailonggu Du (Calcined Os Longorum), Rou Doukou Mianbao Wei Qu You (Nux Vomica wrapped in flour, baked, oil removed), Muxiang Wei (Stir-fried Radix Aucklandiae), Sharen (Fructus Amomi), Helile Rou Mianbao Wei (Pericarpium Terminaliae Chebulae wrapped in flour, baked, each 5 qian), Chishizhi Du (Calcined Halloysit Rubrum, 7.5 qian), Bai Kufan (White Calcined Alum, 3 qian).
Grind all into fine powder, form pills with flour paste, sized like millet seeds. Take 30–50 pills per dose, washed down with rice drink.