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[Dan Bo Yuan Jian] Itchiness and collapse of smallpox lesions should be differentiated as excess or deficiency based on the complexion, morphology, and pulse. In excess patterns, the pulse is forceful and the qi is robust; in deficiency patterns, the pulse is weak and the qi is timid. Excess itchiness presents with a vigorous pathological trend, while deficiency itchiness presents with timid qi.

For deficiency-induced itchiness, use a formula that consolidates the exterior combined with blood-cooling herbs; for excess-induced itchiness, administer a small amount of cold and cool herbs such as *Rhei Radix et Rhizoma* (Dahuang) to purge accumulated feces. Smallpox lesions with itchiness and collapse should not be covered/obscured.

*Psoraleae Fructus* (Baizhu, 1 qian 5 fen), *Astragali Radix* (Huangqi, roasted, 0.5 qian), *Angelicae Sinensis Radix* (Danggui), *Citri Reticulatae Pericarpium* (Chenpi, each 0.5 fen), *Glycyrrhizae Radix et Rhizoma* (Gancao, roasted, appropriate amount). Decoct in water and take warm.

I treated a seven-year-old boy who, at the stage when smallpox was about to erupt but had not yet fully emerged, suffered several episodes of diarrhea with black-colored stool. The lesion bases did not elevate. Three days later, he developed itchiness and collapse; scratching turned the lesions black. He experienced thirst. The lesion bases resembled vesicles, were not red and lustrous, failed to elevate, and he had poor appetite. His pulse was floating, rapid, and forceful, but empty upon deep pressure. I used *Ginseng Radix* (Renshen), *Astragali Radix* (Huangqi), *Angelicae Sinensis Radix* (Danggui), *Atractylodis Macrocephalae Rhizoma* (Baizhu), *Citri Reticulatae Pericarpium* (Chenpi), and *Myristicae Semen* (Roudoukou) as the principal herbs, with roasted *Glycyrrhizae Radix et Rhizoma* (Zhi Gancao), *Terminalia Chebula Retusa* (Hezi), and *Cinnamomi Ramulus* (Guizhi) as assisting and guiding herbs. After decocting in water, a small amount of good wine was added for administration. The itchiness stopped immediately, and appetite returned immediately. The lesion bases became red and lustrous and began to elevate. He recovered completely after two doses.

[Dan Bo Yuan Jian] For mild cases, mix fine powder of *Talcum* (Huashi) with light honey water, and apply it to the lesions using a chicken feather.

[Chen Shi] When smallpox itchiness is unbearable, leading to sores from scratching with pus or blood discharge, treat with Baicao San (Decoction of Defective Grass). Do not apply ash from cow dung under any circumstances, as this will cause foul odor and excessive scarring.

Wu Lan Cao (Rotting grass found on roofs; if unavailable, rotting grass on walls can also be used. This grass has been nourished by frost, snow, rain, and dew, absorbing the qi of heaven and earth, and is effective in resolving toxin accumulation in sores).
Take the above single herb, grind into fine powder. If the entire body is covered with broken sores with continuous pus discharge, sticking to clothes and making sitting or sleeping difficult, spread two or three sheng of the powder on the bed mattress, allowing the child to sit and lie on it. The effect is miraculous.

For children with unbearable smallpox itchiness, accidental scratching causing sores, and scabs that are reluctant to fall off: apply pure white honey to the lesions. This facilitates easy shedding of scabs and prevents purple-black scars.
(Tradition holds: After the smallpox crusts fall off, if the toxin remains incomplete, it may transform into leprosy-like tinea with unbearable itchiness. Applying aged rendered lard is miraculously effective.)

Another prescription: Use sheep bone marrow, boil for one or two boils, add a small amount of *Calomelas* (Qingfen), grind into a white paste, store in a porcelain container, and apply to the lesions for efficacy.