痘疹元无种，平生只一遭，火威酷若吏，风利快如刀，作害侵空窍，攻坚入不毛，收成犹故我，造化小儿曹。
此章指痘疹致目病而言。夫痘疹本难疮。曰天花，曰大小果子，讳辞也。为毒最重，中其毒，等常病亦最烈。
盖禀受以来，蕴积诸邪，深入脏腑，迨痘疹天行，感其气则六经百脉清纯太和之地皆被搅拢，有失生长化毓之源。
是以毒内攻者痘疹必坏，毒上升者眼目必灾。且肝胆乃谋决之官，邪正理不并立，而眼目又清虚之府，秽浊安可
熏蒸。故痘疹放点即上目，至收 始作者，然又有说，非劳顿不堪，恐怀藏
太重。或元气未复膏粱过味，或饔飧不继忧苦倍常。病发多端，症成则一∶有为流泪、赤烂，有为凝脂、黄液，
有为花白、聚星，有为星月翳蚀，继则有凸者、焦者、冰瑕者、蟹睛者，有转风为 斜、为振跳牵引者。总宜慎
思明辨，各随人之轻重虚实，按经投药，是症虽险，亦有以出之之法。倘冥顽不识，恃能种痘，明目张胆将人家
好儿女平白结果，是不用刃而杀人。亦有村妇愚夫，咸曰种痘稳于天行，盖痴望痘师担当、痘娘保佑故也。讵知
痘师那讨得返魂丹耶！治法∶不问痘之好歹，但见目有泪、畏光、微赤，急用黄丹、轻粉、威灵仙为散，吹耳中。
不退，点以银朱或咽脂雪、飞雄丹。又不退，须调活血散、升解散，不则消毒饮、化毒汤或暂除参、 ，虽未必
就痊，准可抑疾使缓，化重为轻。然是症有专科，《活幼心法》、《幼幼集成》，暇时潜心领略，治目不无小补。
余同怀两兄弟皆八子，孙曾兄倍之，荷天之宠，无一殇于痘。表兄朱某二子，已成童，俊而慧。虑种子自过
多麻面，择能稀痘名手，设坛特种，苗发遽毙命。使听其自然，不惑妖言，未必尔尔。后竟无嗣。呜呼！医乃仁
术，种痘者，其矢人哉。
痘疹原本没有人工接种的方法，人这一生通常只感染一次。其火热之威猛烈如同酷吏，其风邪之利迅疾快如利刀。它作害时侵入头面空窍，攻坚时深入毛发稀疏之处（指皮肤薄弱或无毛处）。待痘疹结痂脱落之后，身体依然恢复如初，这不过是造化弄人罢了。
本章主要论述痘疹引发的眼部疾病。痘疹本属于难治的疮疡类疾病。被称为“天花”、“大小果子”，这些都是避讳的说法。其毒性最为沉重，一旦中毒，病情比普通疾病更为剧烈。
大概是因为人体自出生以来，体内蕴积了各种邪气，深入脏腑。等到痘疹这种天行疫病流行时，感受了疫气，导致六经百脉中清纯太和的气机都被搅乱，失去了正常生长化育的源头。
因此，毒邪向内攻陷则痘疹必然恶化，毒邪向上冲逆则眼睛必然受灾。况且肝胆是主谋略决断的脏器，邪气与正气不能并存，而眼睛又是清虚之府，秽浊之气怎么可以熏蒸呢？所以痘疹在出点阶段就波及眼睛，或者到收靥阶段才发病的，其中另有说法：并非劳累过度难以承受，就是恐怕体内藏毒太重。或者是元气尚未恢复却过食肥甘厚味，或者是饮食不继、忧愁痛苦加倍于平常。病症发作虽然多种多样，但症状形成后归结为一类：有的表现为流泪、眼缘赤烂；有的表现为凝脂翳、黄液上冲；有的表现为花白翳、聚星障；有的表现为星月翳蚀，随后又有凸起者、焦枯者、冰瑕翳者、蟹睛者，有的转为风牵偏视、眼睑振跳牵引。总之应当审慎思考明辨，根据每个人的病情轻重虚实，按照经络辨证投药。这个病症虽然危险，但也有应对的方法。如果愚昧不识，倚仗能种痘的技术，明目张胆地白白害死人家的好儿女，这是不用刀刃杀人。也有乡村妇女愚夫，都说种痘比自然感染天行痘疹稳妥，大概是痴心指望痘师担当责任、痘娘保佑的缘故。哪里知道痘师哪里找得到返魂丹呢！治疗方法：不问痘疹的好坏，只要见到眼睛有泪、畏光、微红，急用黄丹、轻粉、威灵仙研为散剂，吹入耳中。如果不退，用银朱或咽脂雪、飞雄丹点眼。如果还不退，必须调配活血散、升解散，否则使用消毒饮、化毒汤，或者暂时去除人参、[此处原文缺字，推测为某补益药]，虽然未必就能痊愈，但也可以抑制疾病使其缓和，将重症化为轻症。然而这个病症有专科治疗，《活幼心法》、《幼幼集成》等书，闲暇时潜心研读领会，治疗眼病无不小有补益。
我的同父兄弟两人都各有八个儿子，堂兄孙辈人数加倍，蒙受上天宠爱，没有一个因痘疹夭折。表兄朱某的两个儿子，已经长成儿童，聪明伶俐。担心孩子太多会长麻脸，选择擅长稀痘的名手，设坛专门接种，结果苗发出来就立即毙命。如果听其自然，不被妖言迷惑，未必会这样。后来竟然没有后代。唉！医学是仁术，那些种痘的人，难道是制造弓箭（暗喻害人）的人吗？
Smallpox and chickenpox originally had no method of artificial inoculation; one typically contracts them only once in a lifetime. Their fiery intensity is as severe as that of cruel officials, and their wind-like sharpness is as swift as a blade. They cause harm by invading the hollow orifices and attacking the solid tissues deep within, reaching areas where hair does not grow. Upon recovery, when the lesions scab and fall off, the body returns to its original state, yet this is merely the whims of nature (Zaohua).
This chapter refers to eye diseases caused by smallpox and chickenpox. Smallpox and chickenpox are inherently difficult-to-cure sores. Terms such as "Tianhua" (Heavenly Flower) and "Da Xiao Guo Zi" (Big and Little Fruit Seeds) are euphemisms. The toxicity is extremely heavy; contracting it results in a condition often more violent than ordinary diseases.
Generally, from the time of endowment, various pathogenic factors accumulate deeply within the Zang-Fu organs. When the epidemic of smallpox and chickenpox occurs, infection with its Qi disturbs the pure and harmonious regions of the Six Channels and Hundred Meridians, disrupting the source of growth and nurturing.
Therefore, if the toxin attacks inward, the rash will deteriorate; if the toxin rises upward, the eyes will suffer disaster. Moreover, the Liver and Gallbladder are the offices of strategy and decision-making; evil and righteous Qi cannot coexist. The eyes are the residence of clarity and emptiness; how can turbid filth be allowed to fumigate them? Thus, whether eye disease appears immediately upon the eruption of the rash or only during the resolution phase, there are underlying reasons: either extreme exhaustion is unbearable, or the internal accumulation of toxin is too heavy. Alternatively, the Yuan Qi has not recovered, yet rich and greasy foods are overconsumed; or food supply is interrupted, accompanied by double the usual worry and bitterness. Although the causes of onset are diverse, the resulting symptoms converge into one category: some present with tearing and red, ulcerated eyelids; some with corneal opacity resembling congealed fat (Ningzhi) or yellow fluid rising (Huangye Shangchong); some with flower-white opacities or clustered star-shaped nebulae (Juxing); some with star-moon corneal erosion. Subsequently, protruding, necrotic, ice-fleck-like, or crab-pupil-like opacities may appear. Some transform into strabismus due to wind, or involve twitching and traction. Generally, one must think carefully and distinguish clearly, prescribing medication according to the meridians based on each individual's severity and deficiency/excess patterns. Although this condition is dangerous, there are methods to manage it. If one is ignorant and stubborn, relying on the ability to inoculate, and boldly ruining healthy children for no reason, it is akin to killing without a blade. There are also village women and foolish men who claim that inoculation is safer than natural epidemic infection, largely out of a naive hope that the inoculator will take responsibility and the "inoculation mother" will offer protection. How could an inoculator possibly possess a "Soul-Returning Pill"! Treatment methods: Regardless of the quality of the smallpox/chickenpox, if tears, photophobia, and slight redness are observed in the eyes, immediately use Huangdan (Lead Oxide), Qingfen (Calomel), and Weilingxian (Symplocos Root) ground into powder and blown into the ear. If symptoms do not recede, apply Yinzhu (Cinnabar) or Yanzhixue (Throat Fat Snow), Feixiong Dan (Flying Male Arsenic Pill). If still ineffective, regulate with Huoxue San (Blood-Invigorating Powder) or Shengjie San (Ascending and Resolving Powder); otherwise, use Xiaodu Yin (Toxin-Clearing Decoction) or Huadu Tang (Toxin-Transforming Decoction), or temporarily remove Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala). Although a complete cure may not be guaranteed, the disease can be suppressed and alleviated, transforming a severe condition into a mild one. However, this condition has specialized treatments. Works such as *Huoyou Xinfa* (Essential Methods for Pediatric Care) and *Youyou Jicheng* (Compendium of Infant Care) should be studied diligently in spare time, which will undoubtedly provide minor assistance in treating eye diseases.
My two full brothers each had eight sons, and my cousin's descendants doubled that number. Blessed by Heaven, none died of smallpox. My cousin Zhu had two sons who were already childhood age, handsome and intelligent. Worried that having too many children would result in pockmarked faces, he selected a famous expert skilled in attenuating smallpox and set up an altar for specific inoculation. The vaccine took hold, but the child died immediately. Had they left it to nature and not been confused by demonic talk, perhaps things would not have ended this way. Eventually, they had no heirs. Alas! Medicine is a benevolent art; those who perform inoculation—are they makers of arrows intended to kill?