顺 发热始终温和，三日见痘，标于年寿、鼻准、人中、口角、唇吻、腮颊、两耳、面之下
部。单粒圆绽，如珠如粟，陆续增出，大小不等，淡红润泽，顶尖光彩，碍手出快，根窠红活。
头面稀少，胸背全无。乳食如常，神气清朗，四肢温和，二便如前，不必服药，严守禁忌，根据法
调理。
胡荽悬床前，并作汤饮，泡酒喷房内，切避风寒，毋令痘儿怒气助火。饮食宜淡，忌辛辣、
甘甜、鸡、鱼、猪肉、枣、柿、栗、葱、蒜、醋及荔枝与酒（皆能发痒、）难化浓味。房中宜烧
乳香、苍术、大枣。
老幼伏侍∶戒少年男妇（恐犯淫秽） 房事、月经（用东向土炒黄，囊悬阴前、）生人、家人远归
、粪秽气、腋臭、疮毒人、蚊烟、吹灭灯烛、误烧发骨、煎炒气、葱韭腥气、麝香、叫骂、梳头
、瘙痒、荒急言、饮食、歌乐、扫地。
轻变重∶不忌口，常泄泻，冒风寒，犯房事，过服凉药，秽气相触，生人辄至。
重变轻∶节饮食、避风寒，常和暖，严禁忌。用药得宜（能戒煎炒、调理谨慎。）
险 壮热，二日见痘，气粗胸满，烦躁不宁，饮食减少，口渴泄泻，痘标丛出，见于头额、天
庭、山根、印堂、眉棱、方广、两颧、耳后、项颈、面之上部，心胸稀少。痘粒虽多而成颗分；
头虽琐碎而
陆续增出，但干枯而不红润。或昏暗而带滞涩，或夹疹（惟表痘出而疹自消，）或见干红紫黑，大便
秘结。微下之（不然，恐毒火不暂泄而变黑陷。）痘色红紫，忌升麻，但宜发表（勿谓有火用芩
、连、翘、芥。）忌凉药（寒则凝滞难出。）或有虚候，忌补气药（参、 补，则热毒愈甚，而
腠理闭密，痘难出。）或吐血者，服药可愈（犀角地黄汤之类。）痘至脚底，方为出齐。
主方 川芎 前胡 桔梗 山楂 陈皮 木通 枳壳（等分） 甘草（减半）水煎服。
大便不实去枳壳。热甚加干葛根，后剂加防风、牛蒡、蝉蜕。色红加生地（酒洗、）红花、
当归。小泻去当归、生地。如不甚热，面容青惨见 白，精神懒怯，痘出不振， 乳、便溏泻，
属虚寒证。前方去前胡、木通、枳壳，加白芷。泻加白术、生姜煎。
如毒火壅遏，身热面赤，毛焦皮燥，睡卧不宁，大便秘，小便赤，此属实热之证。
防风 荆芥 桔梗 川芎 连翘 黄芩 牛蒡子 甘草 生地 葛根 羌活 木通 灯心
或升麻葛根汤合导赤散，随服羌活散郁汤（方见后。）
如初发壮热，腮红脸赤，毛焦色枯，渴欲饮水，日夜啼哭，好睡冷处，此属血热之证。
川芎 桔梗 木通 连翘 丹皮 赤芍 归尾 红花（酒洗） 大腹皮 生地黄 加灯心煎。
热极便实，暂加大黄。渴不止，加天粉、滑石，或退火回生丹。但干红紫色，二便不利，即
宜疏利，导赤散加酒制芩、连、大黄，或四顺清凉饮。不然，后成黑陷（出之太骤，毒火极盛者，
用冰肌散一服略敛之。轻者戒用。）
逆大热烙手，一日见痘，一齐壅出，如 如麸，如蚕种稠密成片，不分颗粒，红紫焦枯。报
痘即丛出，见于天庭、方广、司空、太阳。毒邪太盛，妄参于面之上截阳位。头额多，谓之蒙头
；颈项多，
谓之琐项；两腮多，谓之托腮；口唇多，谓之攒口。或隐隐不起，或出而复没，谵语狂言，胸满
喘急，饮食不进，唇焦音哑，不能言语，眼目无神，大小便秘，大渴吐蛔，舌卷囊缩。痘色青干
或红紫黑陷，或夹斑疔、贼痘（后各有条）。前证姑从实热治。
顺证：发热始终温和，第三天出现痘疹，首发于年寿（鼻根部）、鼻准（鼻尖）、人中、口角、唇吻、腮颊、两耳、面部下部。痘粒单颗圆润绽开，如珠如粟，陆续增多，大小不等，颜色淡红润泽，顶端有光彩，触手碍指且出得快，根部红活。头面部稀少，胸背部完全没有。乳食如常，神气清朗，四肢温和，二便正常，不必服药，严守禁忌，根据法则调理。
胡荽悬挂在床前，并煮汤饮用，泡酒喷洒房内，切避风寒，不要让痘儿动怒助火。饮食宜清淡，忌辛辣、甘甜、鸡、鱼、猪肉、枣、柿、栗、葱、蒜、醋及荔枝与酒（皆能发痒、难消化浓味）。房中宜烧乳香、苍术、大枣。
老幼护理：戒除少年男女（恐犯淫秽）房事、月经（用东向土炒黄，囊悬阴前）、生人、家人远归、粪秽气、腋臭、疮毒人、蚊烟、吹灭灯烛、误烧发骨、煎炒气、葱韭腥气、麝香、叫骂、梳头、瘙痒、荒急言、饮食、歌乐、扫地。
轻变重：不忌口，常泄泻，冒风寒，犯房事，过服凉药，秽气相触，生人辄至。
重变轻：节饮食、避风寒，常和暖，严禁忌。用药得宜（能戒煎炒、调理谨慎。）
险证：壮热，第二天见痘，气粗胸满，烦躁不宁，饮食减少，口渴泄泻，痘疹丛生，见于头额、天庭、山根、印堂、眉棱、方广、两颧、耳后、项颈、面部上部，心胸稀少。痘粒虽多而成颗分开；头虽琐碎而陆续增多，但干枯而不红润。或昏暗而带滞涩，或夹疹（惟表痘出而疹自消），或见干红紫黑，大便秘结。微下之（不然，恐毒火不暂泄而变黑陷。）痘色红紫，忌升麻，但宜发表（勿谓有火用芩、连、翘、芥。）忌凉药（寒则凝滞难出。）或有虚候，忌补气药（参、 补，则热毒愈甚，而腠理闭密，痘难出。）或吐血者，服药可愈（犀角地黄汤之类。）痘至脚底，方为出齐。
主方：川芎、前胡、桔梗、山楂、陈皮、木通、枳壳（等分）、甘草（减半），水煎服。
大便不实去枳壳。热甚加干葛根，后剂加防风、牛蒡、蝉蜕。色红加生地（酒洗）、红花、当归。小泻去当归、生地。如不甚热，面容青惨见白，精神懒怯，痘出不振，乳、便溏泻，属虚寒证。前方去前胡、木通、枳壳，加白芷。泻加白术、生姜煎。
如毒火壅遏，身热面赤，毛焦皮燥，睡卧不宁，大便秘，小便赤，此属实热之证。
防风、荆芥、桔梗、川芎、连翘、黄芩、牛蒡子、甘草、生地、葛根、羌活、木通、灯心。或升麻葛根汤合导赤散，随服羌活散郁汤（方见后。）
如初发壮热，腮红脸赤，毛焦色枯，渴欲饮水，日夜啼哭，好睡冷处，此属血热之证。
川芎、桔梗、木通、连翘、丹皮、赤芍、归尾、红花（酒洗）、大腹皮、生地黄，加灯心煎。
热极便实，暂加大黄。渴不止，加天粉、滑石，或退火回生丹。但干红紫色，二便不利，即宜疏利，导赤散加酒制芩、连、大黄，或四顺清凉饮。不然，后成黑陷（出之太骤，毒火极盛者，用冰肌散一服略敛之。轻者戒用。）
逆证：大热烙手，一天见痘，一齐壅出，如麸如蚕种稠密成片，不分颗粒，红紫焦枯。报痘即丛出，见于天庭、方广、司空、太阳。毒邪太盛，妄参于面之上截阳位。头额多，谓之蒙头；颈项多，谓之琐项；两腮多，谓之托腮；口唇多，谓之攒口。或隐隐不起，或出而复没，谵语狂言，胸满喘急，饮食不进，唇焦音哑，不能言语，眼目无神，大小便秘，大渴吐蛔，舌卷囊缩。痘色青干或红紫黑陷，或夹斑疔、贼痘（后各有条）。前证姑从实热治。
Shun (Smooth) Pattern: Fever remains mild throughout. On the third day, the smallpox rash appears, initially on the Nianshou (root of nose), Bizhun (tip of nose), Renzhong (philtrum), corners of the mouth, lips, cheeks, ears, and lower face. The lesions are single, round, and blooming like pearls or millet grains, emerging successively in varying sizes. They are pale red and lustrous, with bright tips that feel raised to the touch and emerge quickly. The roots are vibrant red. There are few lesions on the head and face, and none on the chest and back. Milk intake and appetite are normal, spirit is clear, limbs are warm, and urination and defecation are normal. No medication is needed; strictly observe dietary and behavioral taboos and manage according to principles.
Coriandrum sativum (Huisu) should be hung before the bed, decocted for drinking, soaked in wine and sprayed in the room. Strictly avoid wind and cold. Do not allow the child to become angry, which would aggravate fire. Diet should be bland. Avoid spicy, sweet, chicken, fish, pork, dates, persimmons, chestnuts, scallions, garlic, vinegar, lychee, and alcohol (all can induce itching and are hard to digest). Incense such as Boswellia carterii (Ruxiang), Atractylodes macrocephala (Cangzhu), and Jujube (Dazao) should be burned in the room.
Care by elderly and young: Prohibit sexual intercourse among young men and women (fear of impurity), menstruation (use soil from east-facing land stir-fried yellow, hung in a bag before the yin area), strangers, family members returning from long journeys, fecal odor, body odor, persons with sores/toxins, mosquito smoke, extinguishing lamps/candles, accidentally burning hair/bones, frying/cooking odors, scallion/garlic fishy odors, musk, shouting/scolding, combing hair, itching, hasty speech, eating, singing/music, sweeping.
Light turning Severe: Failure to observe dietary taboos, frequent diarrhea, exposure to wind and cold, engaging in sexual activity, overuse of cooling medicines, contact with foul odors, presence of strangers.
Severe turning Light: Regulate diet, avoid wind and cold, maintain warmth, strictly observe taboos. Use appropriate medications (refrain from frying/cooking, manage cautiously).
Xian (Dangerous) Pattern: High fever, rash appears on the second day. Rough breathing, chest fullness, restlessness, decreased appetite, thirst, diarrhea. Rash emerges densely, seen on the forehead, Tianting (forehead center), Shangen (root of nose), Yintang (between eyebrows), brow ridge, Fangguang (upper forehead), cheekbones, behind ears, neck, and upper face. Few lesions on chest and heart area. Although numerous, lesions are distinct. Though fragmented, they emerge successively, but are dry and lack luster. Or dull and sluggish, or accompanied by measles (once the surface rash emerges, measles resolve spontaneously), or appear dry, red, purple, or black. Constipation. Mild purgation is indicated (otherwise, fear toxin-fire will not temporarily release and turn into black depression). If rash color is red-purple, avoid Cimicifugae Rhizoma (Shengma); instead, use diaphoretic methods (do not assume fire exists and use Scutellariae Radix (Huangqin), Coptidis Rhizome (Hlian), Forsythiae Fructus (Lianqiao), or Sinapis Semen (Jiezi)). Avoid cooling medicines (cold causes stagnation and difficulty in emergence). If deficiency signs exist, avoid Qi-tonifying medicines (Ginseng (Renshen), etc., tonify, then heat-toxin becomes worse, pores close tightly, rash difficult to emerge). If hematemesis occurs, medication can cure (such as Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction)). Rash reaching the soles indicates complete emergence.
Main Formula: Chuanxiong Rhizome (Chuanxiong), Peucedani Radix (Qianhu), Platycodonis Radix (Jiegeng), Hawthorn Fruit (Shanzha), Citrus reticulata peel (Chenpi), Akebia Caulis (Mutong), Aurantium Fructus (Zhiqiao) (equal parts); Licorice Root (Gancao) (half dose). Decoct in water and take orally.
If stool is loose, remove Zhiqiao. If heat is severe, add Puerariae Radix (Gegen); in subsequent doses, add Saposhnikoviae Radix (Fangfeng), Arctii Fructus (Niubangzi), and Cicada Slough (Chantui). If color is red, add Rehmanniae Radix (Shengdi) (wine-washed), Carthami Flos (Honghua), and Angelicae Sinensis Radix (Danggui). If slight diarrhea, remove Danggui and Shengdi. If heat is not severe, face appears cyanotic/pale, spirit is lazy/timid, rash lacks vigor, milk/stool is loose, it belongs to Deficiency-Cold pattern. Remove Qianhu, Mutong, Zhiqiao from the previous formula, add Angelicae Dahuricae Radix (Baizhi). For diarrhea, add Atractylodis Macrocephalae Rhizoma (Baizhu) and Ginger (Shengjiang) to decoct.
If toxin-fire is obstructed, body heat, red face, dry hair, dry skin, restless sleep, constipation, dark urine, this belongs to Excess-Heat pattern.
Saposhnikoviae Radix (Fangfeng), Schizonepeta Spike (Jingjie), Platycodonis Radix (Jiegeng), Chuanxiong Rhizome (Chuanxiong), Forsythiae Fructus (Lianqiao), Scutellariae Radix (Huangqin), Arctii Fructus (Niubangzi), Licorice Root (Gancao), Rehmanniae Radix (Shengdi), Puerariae Radix (Gegen), Notopterygii Rhizoma et Radix (Qianghuo), Akebia Caulis (Mutong), Juncus effusus pith (Dengxin). Or combine Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) with Daochi San (Guide Out Red Powder), followed by Qianghuo Sanyu Tang (Notopterygium Dispersion-Depression Decoction) (formula see later).
If initial high fever, red cheeks/face, dry hair/dull color, thirst wanting to drink, crying day and night, preferring cold places, this belongs to Blood-Heat pattern.
Chuanxiong Rhizome (Chuanxiong), Platycodonis Radix (Jiegeng), Akebia Caulis (Mutong), Forsythiae Fructus (Lianqiao), Moutan Cortex (Danpi), Paeoniae Radix Rubra (Chishao), Angelicae Sinensis Radix tail (Guiwei), Carthami Flos (Honghua) (wine-washed), Arecae Pericarpium (Dafupi), Rehmanniae Radix (Shengdi), add Juncus effusus pith (Dengxin) to decoct.
If extreme heat and solid stool, temporarily add Rheum palmatum (Dahuang). If thirst persists, add Tianfen (likely Trichosanthes root powder) and Talcum (Huashi), or Tuohuo Huisheng Dan (Fire-Reducing Life-Restoring Pill). If only dry red-purple color and difficulty in urination/defecation, immediately use draining methods: Daochi San plus wine-processed Huangqin, Hlian, Dahuang, or Sishun Qingliang Yin (Four-Obedience Cooling Clear Drink). Otherwise, it may later develop into black depression (if emerging too rapidly with extreme toxin-fire, use Bingji San (Ice-Skin Powder) once to slightly收敛 (astringe/restrain). Light cases forbid its use.)
Ni (Reverse) Pattern: Intense heat burning to the touch, rash appears on the first day, all erupting at once densely like bran or silkworm seeds, forming patches without distinct particles, red-purple and scorched-dry. Rash emerges densely immediately, seen on Tianting, Fangguang, Sikong, Taiyang. Toxin-pathogen is too strong, wrongly participating in the Yang positions of the upper face. Many on forehead called Mengtou (Covering Head); many on neck called Suoxiang (Scattered Neck); many on cheeks called Tuosai (Supporting Cheeks); many on lips called Zuankou (Gathering Mouth). Or faintly not rising, or emerging then disappearing again, delirious speech, chest fullness, panting, inability to eat, dry lips, hoarse voice, inability to speak, lifeless eyes, constipation of both bowels/bladder, extreme thirst vomiting roundworms, curled tongue, contracted scrotum. Rash color cyanotic-dry or red-purple-black depressed, or accompanied by macules/boils, thief-pox (each has separate sections later). The aforementioned patterns should tentatively be treated as Excess-Heat.