小儿痘疮，皆由父母交媾之时，淫火炽甚而得。所谓先天之毒，禀于有生之初者也。盖
痘本
先天淫毒，伏藏于肝肾之内，触四时不正之气， 然发泄，气领血载，达于肌肤之外，良由
卫气运于脉外，营血行于脉中，气能祛毒外出，血能载毒上行。凡原气之强盛者，不满旬日
，成痂而愈矣。若元气羸弱，气血偏虚，寒热偏胜，毒不能尽达肌表，遗留而上逆，则目中
生痘，损坏瞳神。又或成浆之后，毒出肌肤，五内之元气已虚，药饵之补益不济，有余之毒
，不能出外，反深入于内，因而目中星遮翳蔽，变症不一。惟验其靥之白色者，属于气虚，
淡红者，属于血虚，紫色者，属于余毒未清。若过期而靥不脱者，乃气血大亏之象，调其寒
热温凉，益其偏虚血气，则目明翳消而得愈矣。疹者痘之末疾，发于脾肺二经，内应手足太
阴，感天地间 戾之气，故名疹也。然名各有异，苏松谓之痧子，浙江谓之 子，湖广呼为
麻子，北直谓之疹子，山陕谓之肤疮，曰糠疮，曰赤疮，名虽不同，其症则一。总由君相二
火燔灼，太阴脾肺受之。故其为症，必喷嚏咳嗽，面肿颊红，目胞肿胀，眼泪汪汪，惟气旺
邪浅者易治。邪盛正虚，不胜其毒，则危机立至。更有愈后余热未清，上乘空窍，肝木受克
，则黑珠星障昏花，羞明涕泪。切忌酸寒伐胃，宜清养肺阴，补其气血。若误认为风，设以
表散，犹之抱薪救火矣。
小儿患痘疮，都是因为父母在交合之时，淫火过于炽盛而导致的。这就是所谓的先天之毒，是在生命形成之初禀受而来的。大抵痘疮本是先天的淫毒，潜伏藏匿在肝肾之内，遇到四时不正之气，于是得以发泄。气引领、血承载，使毒素到达肌肤之外。这主要是因为卫气运行于脉管之外，营血运行于脉管之中，气能够驱除毒素向外排出，血能够承载毒素向上输送。凡是原气强盛的人，不满十天，结痂后就能痊愈。如果元气虚弱，气血偏虚，寒热偏胜，毒素不能完全达于肌表，遗留下来并向上逆冲，就会在眼中生出痘疮，损坏瞳神。或者在出浆之后，毒素虽已发出至肌肤，但五脏内部的元气已经虚弱，药物补益又跟不上，剩余的毒素不能向外排出，反而深入体内，从而导致眼中出现星点遮翳，变症不一。只要查验其痘靥（痘疮结的痂）颜色白色的，属于气虚；淡红色的，属于血虚；紫色的，属于余毒未清。如果过了期限痘靥还不脱落，这是气血大亏的现象，调理其寒热温凉，补益其偏虚的气血，那么眼睛明亮、翳障消除就能痊愈了。疹是痘疮的末疾，发于脾肺二经，内应手足太阴经，感受天地间戾气，所以叫作疹。然而名称各有不同，苏州、松江一带叫作痧子，浙江叫作疹子（注：原文此处缺字，结合语境及后文“北直谓之疹子”，推测为江浙地区特有称呼或泛指，此处依原文留白处理或译为通用名），湖广称为麻子，北直隶称为疹子，山西、陕西称为肤疮，也叫糠疮、赤疮，名称虽然不同，症状却是一样的。总归是由于君火和相火燔灼，太阴脾肺受到侵害。所以它的症状，必定有喷嚏咳嗽、面部肿胀脸颊发红、眼睑肿胀、眼泪汪汪，只有气旺邪浅的容易治疗。如果邪气盛正气虚，承受不住毒素，那么危险立刻到来。更有痊愈后余热未清，上乘空窍（指头面五官孔窍），肝木受到克制，就会出现黑珠（黑睛）上有星障、视物昏花、羞明流泪。切忌使用酸寒药物损伤胃气，应当清养肺阴，补益气血。如果误认为是风邪，使用发散解表的方法，就如同抱着柴草去救火一样。
Pediatric smallpox (Xiaoe Douchuang) is caused by excessive sexual fire during the conception of parents. This is referred to as congenital toxin (Xiantian Zhi Du), acquired at the very beginning of life. Generally, smallpox is essentially a congenital sexual toxin, hidden within the Liver and Kidneys. When triggered by abnormal Qi of the four seasons, it erupts. Qi leads and Blood carries, delivering the toxin to the exterior of the skin. This is because Wei Qi (Defensive Qi) circulates outside the vessels, while Ying Blood (Nutritive Blood) circulates inside the vessels; Qi can expel toxins outward, and Blood can carry toxins upward. For those with strong Yuan Qi (Primal Qi), scabbing occurs within ten days, leading to recovery. If Yuan Qi is weak, with deficiency in Qi and Blood, or excess of Cold/Heat, the toxin cannot fully reach the skin surface. The remaining toxin rises and reverses upward, causing smallpox lesions in the eyes and damaging the pupil (Tongshen). Alternatively, after the pustule stage, although the toxin has erupted on the skin, the internal Yuan Qi of the Five Viscera is already deficient, and medicinal tonification is insufficient. The residual toxin fails to exit externally and instead penetrates deeply inward, resulting in star-like opacities and obscuration in the eyes, with various complications. By examining the color of the scabs: white indicates Qi deficiency; pale red indicates Blood deficiency; purple indicates residual toxin not yet cleared. If scabs do not fall off after the expected period, it signifies severe depletion of Qi and Blood. Regulating cold, heat, warmth, and coolness, and supplementing deficient Qi and Blood will restore clear vision and eliminate opacities.
Rash (Zhen) is a minor disease following smallpox, originating from the Spleen and Lung meridians, internally corresponding to the Hand and Foot Taiyin meridians. It is caused by pathogenic Li Qi (Malignant Qi) from heaven and earth, hence named Rash. However, names vary: in Suzhou and Songjiang, it is called Sha Zi (Sand Children); in Zhejiang, it is called [missing character] Zi; in Huguang, Ma Zi (Hemp Children); in Zhili, Zhen Zi (Rash Children); in Shanxi and Shaanxi, Fu Chuang (Skin Sores), also known as Kang Chuang (Bran Sores) or Chi Chuang (Red Sores). Although names differ, symptoms are identical. It is generally due to the blazing of Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo), affecting the Taiyin Spleen and Lung. Thus, symptoms necessarily include sneezing, coughing, facial swelling, red cheeks, swollen eyelids, and watery eyes. Cases where Qi is robust and pathogen is shallow are easy to treat. If pathogen is strong and Zheng Qi (Upright Qi) is weak, unable to withstand the toxin, crisis ensues immediately. Furthermore, after recovery, if residual heat remains unclarified and ascends to the orifices, suppressing Wood of the Liver, it causes star-like obstructions on the black pearl (cornea/lens area), blurred vision, photophobia, and tearing. One must strictly avoid sour and cold herbs that damage the Stomach; instead, one should clear and nourish Lung Yin, and supplement Qi and Blood. Mistaking this for Wind and using dispersing/superficial-releasing methods is like adding fuel to the fire.