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Article 114
When the pustular fluid of variola (smallpox) is clear and thin, the lesions are sunken and lack redness, and the scab skin is wrinkled with incomplete crusting, Jia Wei Bao Yuan Ji (Modified Formula for Preserving Vitality) should be administered promptly to replenish Qi and Blood, thereby facilitating the completion of the healing process.
[Note]
Dao Ye (Reversed Crusting) refers to a condition where the lesion color is clear and insufficient, the root base is pale white without a surrounding halo, and the entire body resembles empty shells. The sore skin is wrinkled, appearing as if forming a crust but not actually doing so. By the time of the crusting stage, it ultimately fails to form a scab. This is due to deficiency in both Qi and Blood, lacking the strength to support and lift the toxin outward. It is suitable for treatment with Jia Wei Bao Yuan Tang (Modified Decoction for Preserving Vitality).
(Jia Wei Bao Yuan Tang) Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix) honey-fried, Gan Cao (Licorice Radix et Rhizoma) fried, Quan Dang Gui (Angelicae Sinensis Radix) wine-washed, Bai Shao (Paeoniae Radix Alba) wine-stir-fried, Mu Xiang (Aucklandiae Radix) baked, Bai Zhu (Atractylodis Macrocephalae Rhizoma) soil-stir-fried, Guan Gui (Cinnamomi Cortex), decocted with water from old rice.
(Verse)
Jia Wei Bao Yuan treats reversed crusting, Ginseng, Astragalus, and Licorice cooperate; Angelica, White Peony, and Costus root follow, Atractylodes and Cinnamon make the effect more swift.

Article 115
Dou Ding (Smallpox Carbuncle), harboring venomous toxicity that disrupts normal lesions, appears purple-black and dark, with a hard and firm shape. It often emerges and grows before other smallpox lesions, hindering their development. It should be pricked with a needle and immediately covered with Si Sheng Gao (Four Sages Plaster) for good efficacy.
[Note]
The formation of Dou Ding results from the accumulation and latent hiding of venomous toxins, which are sealed within the muscles. The carbuncle appears before the smallpox erupts and grows before the smallpox matures. Its color is purple-black, and its shape is hard and firm. Each Zang organ has specific manifestations:
Xin Ding (Heart Carbuncle) is red in color and arises on the malar eminence, chest, and breast areas;
Gan Ding (Liver Carbuncle) is purple in color and arises at the left Taiyang point, left hypochondrium, eyelids, and bilateral gluteal eminences;
Pi Ding (Spleen Carbuncle) is initially yellow then turns black, arising at the cheeks, Zhongting (below the xiphoid process), corners of the mouth, abdomen, and hands/feet;
Fei Ding (Lung Carbuncle) is initially gray then turns black, arising at the right Taiyang point, right hypochondrium, neck, and laryngeal prominence;
Shen Ding (Kidney Carbuncle) is black in color, arising at the Dihe posterior (near the tailbone), behind the ears and neck, back and buttocks, lumbar spine, and penis.
Upon discovery, silver needles should urgently be used to pierce the lesion to drain toxic blood, followed by the application of Si Sheng Gao (Four Sages Plaster) to the affected area. If treatment is delayed, it may cause the smallpox to fail to erupt, swell, or suppurate as expected, leading to various complications.
(Si Sheng Gao) Lv Dou (Vigna Radiata Seed) 49 grains, Wan Dou (Pisum Sativum Seed) 49 grains, both burnt to ash while retaining their properties; Zhen Zhu (Margarita) 1 fen, calcined; Tou Fa (Capilli Humanii) 1 fen, burnt to ash. Grind the above into fine powder, mix with Mian Yan Zhi Shui (water prepared from cotton rouge) to form a paste. Use a silver needle to open the head of the sore, then apply the paste.