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Clause 116
To treat Dou Ding (pox carbuncle), needle picking must be used. The manipulation should be neither too heavy nor too light, neither too fast nor too slow, but appropriate. It is strictly forbidden to pierce the top of the pox or penetrate deeply to damage the muscle. When the pus fills the pox, it must be picked immediately without hesitation.

[Note]
When using a needle to pick Dou Ding (pox carbuncle), hold the needle with two fingers and insert it horizontally into the pox. Break the meridians and collaterals within the pox so that other poxes will erupt. However, during the picking process, the degree of lightness, heaviness, speed, and slowness must be appropriate. Do not pierce the top of the pox, nor insert the needle heavily to damage the muscle. One must wait until the third, fourth, fifth, or sixth day when the pox begins to fill with pus (Xing Jiang stage). Only when the pox can hold the needle tip can the picking be performed. After the seventh day, this method is useless. Practitioners should memorize this carefully.

(Boiling Needle Method) Equal parts of Gancao Sheng (Raw Glycyrrhizae Radix et Rhizoma), Gansui (Kansui Radix), Chuanwu (Aconiti Radix), and Caowu (Aconiti Kusnezoffii Radix). Use one zhong (approx. 200 ml) of water, place in a clay pot, and boil until the water is dry. Each time, four or five needles can be boiled. After boiling, store them in a goose feather tube and seal the mouth with yellow beeswax.

Shengma Gegen Tang (Bupleurum and Kudzu Decoction) for exterior heat with no sweat; Xiaojian Xiaodu Yin (Modified Detoxification Decoction) is good for interior heat with sweat; Qingdu Huoxue Tang (Detoxifying and Blood-Activating Decoction) for toxic steaming during the pus-filling stage; Lianqiao Fang (Forsythia Formula) for residual heat after scabbing.

[Note]
In the case of smallpox/pox diseases, the heat cannot be completely eliminated from beginning to end. This is because the heat is not Zhuang Re (high fever), but rather a mild heat. Cold causes contraction, while heat causes dissemination. Fever with no sweat indicates heat in the Exterior (Biao); the primary formula is Shengma Gegen Tang (Puerariae Radix and Bupleuri Decoction) plus Jingjie Sui (Schizonepetae Spica) and Fangfeng (Saposhnikoviae Radix). Steaming heat with sweat indicates heat in the Interior (Li); the primary formula is Xiaojian Xiaodu Yin (Modified Detoxification Decoction). If the heat does not subside during the Xing Jiang (pus-filling) stage, this is due to toxic heat steaming. Qingdu Huoxue Tang (Detoxifying and Blood-Activating Decoction) should be used. If constipation is present, remove Renshen (Ginseng Radix) and Huangqi (Astragali Radix), and add Jiuchao Dahuang (Rhubarb Radix stir-fried with wine). After scabbing, if there is high fever, heat in the chest, abdomen, hands, and feet, and difficulty in urination and defecation, this is due to excessive residual toxins. Dalianqiao Yin (Large Forsythia Decoction) should be used for treatment.

(Shengma Gegen Tang [Puerariae Radix and Bupleuri Decoction]) See the section on "Treatment of Fever Symptoms".
(Xiaojian Xiaodu Yin [Modified Detoxification Decoction]) Composition: Shengma (Cimicifugae Rhizoma), Niubangzi Chao Yan (Arctii Fructus, fried and ground), Shandougen (Sophorae Tonkinensis Radix), Zicao (Lithospermi Radix), Lianqiao Qu Xin (Forsythiae Fructus, heart removed), Sheng Dihuang (Rehmanniae Radix Recens), Chi Shao (Paeoniae Radix Rubra), Chuan Huanglian (Coptidis Rhizoma), Gancao Sheng (Glycyrrhizae Radix et Rhizoma). Decoct with Dengxin Cao (Junci Medulla) as a guiding herb.
(Folk Song/Formula Verse)
Xiaojian Xiaodu Yin works like magic,
Shengma, Niubang, and Shandougen are key.
Zicao, Lianqiao, Shengdi, and Chi Shao,
Huanglian and Gancao, with Dengxin as the guide.
(Qingdu Huoxue Tang [Detoxifying and Blood-Activating Decoction]) See the section on "Treatment of Pus-Filling Symptoms".
(Dalianqiao Yin [Large Forsythia Decoction]) See the section on "Treatment of Scabbing Symptoms".

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Miscellaneous syndromes in pox diseases