（痂，居牙切，疮靥曰痂）
〔海〕 疹脓而不焦，此本治失清凉之气。有如五谷得阳气而成熟，非凉风至则不能实也，天地严肃之气
一加，则万物秀而实矣，与 疹何异？须察何经而清凉之，或下而成严肃之气，则疮气必不至于脓而不
痂矣。要当知之，余毒不尽而疾作，盖出于此。（当是清凉饮子下之是也。）非阳和则苗不秀，非严肃则
秀不实。刘洙疮子诀云∶痘发如脓窠不肯靥者，但调砂糖水与吃。刘提点云∶亦曾试用，但后来结瘢痕白。
〔钱〕五七日痂不焦，是内发热蒸于外，故不得焦痂也，宜宣风散导之，用生犀磨汁解之，必着痂矣。
〔陈〕痘已靥未愈之间，忽被风邪搏之，成疳疮，宜雄黄散、绵茧散治之。又不愈，多渍骨伤筋杀人。
雄黄散 治小儿牙龈生疳蚀疮。
雄黄（一钱） 铜绿（二钱）
上二味，同研极细。每用，量疮大小干贴。
绵茧散 治小儿因痘疮身体及肢节上生疳蚀疮，脓水不绝。
用出蛾绵茧，以生白矾捶碎入茧内令满，炭火烧，令白矾汁尽，取出，研极细。每用，干贴疮口上。
〔钱〕凡痘疮方才着痂，即用菜油不住润之，可揭则揭，若不润及迟揭，疮痂硬即隐成瘢痕矣。
〔陈〕痘痂虽落，其瘢犹黯，或凹凸肉起，当用灭瘢药涂之。
韶粉（一两） 轻粉（一字）
上研细，入炼过猪脂油拌和如膏，涂瘢上。
(Scab, pronounced Ju Ya Qie, refers to the crust formed after a sore heals.)
[Haizang] If the pustules of measles or smallpox do not scorch and form dry scabs, it is because the cooling energy was lost during treatment. This is akin to grains ripening under yang energy; without the arrival of cool wind, they cannot become full and solid. Once the austere and cold energy of heaven and earth descends, all things become beautiful and solid. How is this different from the condition of measles? One must examine which meridian is affected and apply cooling methods, or induce purgation to create an austere energy, so that the pathogenic qi of the sore will not remain in a state of suppuration without scabbing. It is essential to understand this: if residual toxins are not fully cleared and the disease recurs, it often stems from this cause. (This likely refers to using Qingliang Yin [Cooling Decoction] for purgation.) Without yang and harmonious energy, seedlings cannot flower; without austere energy, flowering cannot lead to fruiting. Liu Zhu stated in *Cuangzi Jue* [Manual on Pustular Diseases]: "If smallpox eruptions resemble pus-filled sockets and refuse to heal/scab, simply prepare sugar water for the patient to drink." Director Liu noted: "I have also tried this method, but the resulting scars were white."
[Qian Yi] If scabs do not dry out by the fifth to seventh day, it is due to internal heat steaming outward, preventing the formation of dry scabs. It is appropriate to use Xuanfeng San [Promoting Wind Powder] to guide out stagnation, and grind fresh rhinoceros horn for juice to resolve toxicity. Scabbing will surely occur.
[Chen Wenzhong] Between the time when smallpox scabs have formed and full recovery, if suddenly attacked by wind-pathogens, gan-sores [ulcerative lesions associated with malnutrition/toxins] may form. These should be treated with Xionghuang San [Realgar Powder] and Mianjian San [Silkworm Cocoon Powder]. If still unhealed, the condition often erodes bones and damages tendons, leading to death.
Xionghuang San [Realgar Powder] treats gan-erosive sores on the gums of children.
Realgar (1 qian)
Bronze Green (2 qian)
Grind these two ingredients together into an extremely fine powder. For each application, sprinkle dry powder onto the sore according to its size.
Mianjian San [Silkworm Cocoon Powder] treats gan-erosive sores appearing on the body and limbs of children caused by smallpox, characterized by continuous discharge of pus and fluid.
Take silkworm cocoons from which moths have emerged. Crush raw alum [Alumen] and stuff it into the cocoon until full. Burn over charcoal fire until the alum juice is completely drained. Remove, grind into an extremely fine powder. For each application, sprinkle dry powder onto the wound.
[Qian Yi] Whenever smallpox scabs first form, continuously moisten them with rapeseed oil. If they can be peeled off, do so. If not moistened and removal is delayed, the hard scab will hide and form scars.
[Chen Wenzhong] Although the smallpox scabs have fallen off, the scars may remain dark, or present as uneven, raised flesh. One should apply scar-removing medicine.
Shao Fen [Tin Powder] (1 liang)
Qing Fen [Calomel] (1 zi)
Grind these into fine powder, mix with refined lard [Suis Medulla/Adipis Suilli Praeparatus] to form a paste, and apply to the scars.