见点九朝成浆之期，孩提先天禀薄，痘形陷伏，根脚不齐，浆清色白，便溏食少，嗜卧
无神
，一派气血虚寒之象。亟亟温补内托，尚有生机，医犹以为肌热未退，火毒未消，药仍清解
，误之甚矣。夫痘证发热，此其正候，盖不热则表不能透，标不能长，浆不能蒸，靥不能结
，故痘证始终无不赖此热力为之主持。若欲尽攻其热，罔顾戕损其元，元气受伤，安能送毒
归窠，苗而不秀，能成实者鲜矣。外科论痈疽，谓有脓则生，无脓则死，痘证亦然。又伤寒
有养汗之法，痘证有养浆之法，伤寒须七朝以前，邪气未传，尚可养得汗来，痘证须七朝以
前，逆证未见，尚可养得浆来。倘至七朝以外，生气已离，再思养浆，亦犹伤寒邪气已传，
再思养汗，其可得乎?无脓痒塌，势所必至，十二险关，虑有风波。勉议保元汤合参归鹿茸
一法，冀其堆沙发臭，或可侥幸图成。
安波按∶近时痘医，辄以辛凉解毒，苦寒退热，往往致成败证，束手无策。良可叹也
。
肝者，将军之官，谋虑出焉。情志不舒，木郁为病。据谕恙起数年，左季胁下不时作痛
，饮
食入胃，其气常注于左，不行于右。经言左右者，阴阳之道路也。肝位居左，其气常行于右
，脾位居右，其气常行于左。左升右降，如环无端。今气偏注一隅，岂非升降失司，肝脾不
和之所使然。目前虽无大患，窃恐肝病日久，土困木横，冲胃为呕，攻脾为胀，可不早为曲
突徙薪之计乎?
看到痘疹出现红点后的第九天，正是应该形成脓浆的时期。但这孩子先天禀赋薄弱，痘形凹陷伏陷，根基不整齐，浆液清稀、颜色发白，大便溏薄、食欲减退，嗜睡且精神萎靡，呈现出一派气血虚弱寒凉的征象。此时急需采用温补并内托毒邪的方法治疗，尚有一线生机。然而医生却认为肌肤发热尚未消退，火毒尚未清除，用药仍然以清热解表为主，这是极大的误治啊。
痘疹病症中的发热，是它的正常表现。大概是因为如果不发热，则表气不能透达，痘苗不能生长，浆液不能蒸化成熟，结痂不能形成。所以痘疹从头到尾无不依赖这种热力来主持全局。如果想要完全攻伐其热，不顾及损伤元气，一旦元气受伤，怎么能将毒邪送入痘窠（归巢）呢？就像庄稼只长苗而不秀穗，能长成结实果实的很少了。
外科论述痈疽时说，有脓就能生还，无脓就会死亡，痘疹病症也是如此。另外，伤寒病有“养汗”的方法，痘疹病有“养浆”的方法。伤寒病必须在七天以前，邪气尚未传变时，还可以培养出汗来；痘疹病也必须在七天以前，逆证尚未出现时，才可以培养出浆来。如果到了七天以后，生气已经离散，再想着培养浆液，也就像伤寒病邪气已经传变，再想着培养汗液一样，怎么可能做到呢？没有脓液、瘙痒塌陷，是必然的趋势，十二道险关，令人担忧会有变故。勉强建议采用保元汤合参归鹿茸这一法，希望痘疮能够堆起发亮、散发臭味（指毒随浆出），或许可以侥幸成功。
安波按语：近时的痘科医生，往往使用辛凉解毒、苦寒退热的药物，常常导致病情转化为败证，束手无策，实在令人叹息。
肝被称为将军之官，谋略思虑由此产生。情志不畅，导致肝木郁结而发病。据您所说，此病起于数年前，左侧胁下不时疼痛，饮食进入胃后，气机常注向左边，而不运行到右边。医经说，左右是阴阳运行的道路。肝位居左，其气机常向右运行；脾位居右，其气机常向左运行。左边升发，右边肃降，如环无端循环往复。现在气机偏注于一隅，难道不是升降功能失调、肝脾不和所导致的吗？目前虽然没有什么大患，但我私下担心肝病日久，会导致土（脾）困顿而木（肝）横逆，冲犯胃部引起呕吐，攻伐脾脏引起胀满，怎能不早点采取“曲突徙薪”（比喻事先采取措施防止灾祸发生）的办法呢？
Upon observing the ninth day after the appearance of spots, which is the period when pustules should mature into pus, the child exhibits a thin congenital constitution. The pockmarks are depressed and sunken, with irregular bases; the pus is clear and white. There is loose stool, poor appetite, lethargy, and lack of spirit, presenting a picture of deficiency-cold in both Qi and Blood. Urgent warm-tonification and internal support (to push toxins out) are needed to preserve life. However, the physician still believed that the skin heat had not subsided and the fire-toxin was not cleared, continuing to use clearing and resolving (heat/toxin) methods. This is a grave error.
Fever in variola (smallpox/variolous diseases) is its normal manifestation. Generally, without heat, the exterior cannot be vented, the marks cannot grow, the pus cannot be steamed and matured, and the scabs cannot form. Therefore, throughout the course of variolous diseases, this thermal force is indispensable for governing the process. If one attempts to completely attack the heat while disregarding the damage to the Yuan Qi (Original Qi), once the Yuan Qi is injured, how can it send the toxin back to its nest? Just as seedlings fail to flower, few will bear fruit.
Surgical texts discuss carbuncles and sores, stating that presence of pus indicates survival, while absence indicates death; the same applies to variolous diseases. Furthermore, just as Shanghan (Cold Damage) has the method of "nurturing sweat," variolous diseases have the method of "nurturing pus." For Shanghan, before the seventh day, when the pathogenic qi has not yet transmitted, it is still possible to nurture sweat. Similarly, for variolous diseases, before the seventh day, if adverse patterns have not appeared, it is still possible to nurture pus. If one waits until after the seventh day, when the vital energy has already departed, and then thinks of nurturing pus, it is akin to waiting until the pathogenic qi of Shanghan has transmitted and then thinking of nurturing sweat—can this be achieved? The absence of pus, accompanied by itching and collapse, is inevitable. One must worry about complications arising at the twelve critical passes. I tentatively propose Baoyuan Tang (Preserve the Origin Decoction) combined with Ginseng, Angelica Sinensis, and Deer Antler, hoping that the pustules will rise and emit a foul odor (indicating toxin expulsion), perhaps allowing for a lucky recovery.
An Bo's Note: In recent times, physicians specializing in variolous diseases often use acrid-cool detoxifying and bitter-cold antipyretic methods, frequently leading to failure patterns where they are left helpless. This is truly lamentable.
The Liver is the Official of the General, from whom strategies and deliberations emerge. Emotional stagnation leads to Liver Wood depression and disease. As you mentioned, the illness began several years ago, with intermittent pain under the left hypochondrium. After food enters the stomach, the Qi often flows to the left rather than the right. The Classics state that the left and right are the pathways of Yin and Yang. The Liver resides on the left, but its Qi typically moves to the right; the Spleen resides on the right, but its Qi typically moves to the left. Left ascends, right descends, forming an endless cycle. Now, since the Qi deviates to one corner, is it not due to the dysfunction of ascending and descending mechanisms, resulting in disharmony between the Liver and Spleen? Although there are no major issues currently, I fear that long-standing Liver disease may lead to Earth (Spleen) being constrained and Wood (Liver) becoming rampant. This could assault the Stomach causing vomiting, or attack the Spleen causing distension. Should we not take early preventive measures ("bending the chimney and moving the firewood" to prevent disaster)?