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The manifestation of "He Jiang" (Dried Pustule), also known as the alias "Kong Ke" (Empty Shell), refers to a pustule that appears round and opened but is actually empty inside. Shortly thereafter, it becomes extremely dried up, and its color changes as well. Although this is indeed due to deficiency of both Qi and Blood, it is unknown that it is also caused by Fire scorching and Lung Metal drying up. Since Fire flares upward, and Xiao Du (intense toxic pathogen) attacks and rushes, causing blood heat that cannot transform into pus. Lung Metal receives dryness while Kidney Water dries up, leading to sinking of Qi and resulting in internal deficiency. Therefore, upon seeing such signs, one should urgently use Huang Lian (Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix), Xi Jiao (Rhinocerotis Cornu), and Zi Cao (Arnebiae Radix et Rhizoma) to clear Fire toxicity. Subsequently, use Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Di Huang (Rehmanniae Radix Praeparata) to nourish and tonify Yin and Yang, preventing dryness before it arises, and continuing True Yuan (Original Qi) before it is exhausted, so that there may be hope for recovery. If even slightly delayed, it will certainly be difficult to treat. If the patient can still eat, the source of transformation (Spleen and Stomach's digestive function) is not yet severed; adding further nourishment might save one out of ten.

Qi is the marker of Blood, and Blood is the root of Qi. Within the body, Ying (Nutritive Qi) and Wei (Defensive Qi) generate each other, Yin and Yang interact, each following its own governance, and they cannot be separated for even a moment. During the third, fourth, fifth, or sixth day after the eruption of smallpox/variolous lesions, if swelling appears first on the face and eyes with a shiny appearance, it is because Yin Blood is insufficient to carry the toxin out, allowing Yang to invade the Yin aspect, preventing the toxin from being vented. Since Blood is already deficient, like the root having been removed, it leads to vacuous movements, with toxic vapors spreading wildly and running disorderly through the muscle layers. Once such symptoms occur, the toxin becomes even harder to vent. It must wait until after the seventh day, when the transmission through meridians is complete, at which point Qi retreats and toxin sinks, Yin and Yang lose their respective functions, leaving nothing left to treat! Thus, the practitioner must not fail to pre-adjust Qi and Blood to protect the vital essence. However, if the lesions have fully erupted and are swollen, but the facial swelling is not severe, urgent large-dose tonification of Qi and Blood to raise and vent the lesion toxin is necessary, perhaps offering a chance of survival. If the lesions have not yet swollen but the face swells first, this is a condition of Pure Yang without Yin. One must strictly avoid using Ren Shen (Ginseng Radix et Rhizoma) to tonify Qi. Instead, it is appropriate to use only Si Wu Tang (Four Substance Decoction) mixed with human milk and good wine, causing both the lesions and the face to swell. This embodies the meaning of "Nourishing Yin to Supplement Yang," and pulse diagnosis should be combined for differentiation.

When pus forms and turns yellow, this is the correct color of Central Earth. Moreover, since the source of pus transformation comes from the Stomach, it naturally should be yellow, moist, and lustrous. Therefore, regarding pustules, fullness is valued, but especially prized is the yellow, active, and moist nature of the pus, which follows natural principles. If Yin and Yang depart from righteous Qi, and Xiao Du (intense toxic pathogen) acts cruelly, then the pouches are scorched away, and the pus infused within becomes greasy, stagnant, and firmly adherent. Like a withered object turning yellow, this indicates that Qi and Blood fail to nourish internally, resulting in lifelessness, stiffness, lack of activity, dryness like wax, and dull yellow color. Upon touch, it feels consolidated and board-like, named "Ban Huang" (Board-like Yellow). There is completely no bright, moist, or lustrous Qi, and the mechanism of transformation source has already ceased. What is there left to treat!