条文：108
痘疮皮薄根不红，待得成脓浆淡清，溶溶破烂不完整，气血虚弱证多凶，
速服十全大补剂，气充血足始堪生。
[注]
痘疮赖气血以成功，气血充实，则痘皮苍老，肥满坚厚，
若气血虚缩，痘必光亮软皱，溶溶如湿，
须用十全大补汤峻补气血，庶毒化浆行，可保安全矣。
(十全大补汤) 人参 黄耆蜜炙 茯苓 当归 白术土炒 肉桂 甘草炙
白芍酒炒 熟地黄 川芎 引用煨姜水煎服。
(方歌)
十全大补汤最灵，人参黄耆白茯苓，当归白术肉桂草，白芍熟地及川芎。
%
条文：109
痘壳圆融浆不行，有虚有实要分明，根色淡白血虚弱，紫紧由于血热凝，
千金内托同四物，因证施治莫迟停。
[注]
痘至行浆时，头面过身，外虽胀而内实无浆，名曰空壳，当别虚实治之，
如根色淡白者，此血虚不能化毒成浆也，宜千金内托散，
根紧而紫者，此气行血滞，毒热伏于血分，而不能成浆也，
宜加味四物汤治之。
(千金内托散) 方见见点证治。
(加味四物汤)
生地酒洗 川芎白芍酒炒 当归酒洗 连翘去心 紫草茸酒洗 水煎服。
(方歌)加味四物汤，当归生地黄，川芎白芍药，紫茸连翘食。
%
条文：110
痘根虽红顶塌陷，此证多缘气虚见，面白肢冷食懒尝，虚烦便溏身怠倦，
急用补中益气汤，气充顶升浆充贵。
[注]陷顶者，由中气微弱不能振扬，故灌浆时，根虽红润，顶却微塌，
现证面白肢冷，不思饮食，虚烦便溏，身体怠倦也，
治宜补气为主，用补中益气汤，则气足浆升，而顶自起矣。
(补中益气汤) 黄耆蜜炙 白术土炒 人参 升麻炒 柴胡炒，
陈皮 甘草 当归身并引用煨姜大枣水煎服。
(方歌)
补中益气效如神，黄耆白术共人参，升麻柴胡陈皮草，煨姜大枣及归身。
%
Clause: 108
The smallpox lesions have thin skin and the base is not red; when suppuration occurs, the pus is pale and clear. The lesions melt, break open, and are incomplete. This indicates Qi and Blood deficiency, and the prognosis is mostly ominous.
One must quickly administer Shiquan Dabu Decoction (Ten Complete Tonic Decoction). Only after Qi is sufficient and Blood is full can life be preserved.
[Commentary]
Smallpox relies on Qi and Blood to complete its development. If Qi and Blood are substantial, the lesion skin becomes tough, plump, firm, and thick.
If Qi and Blood are deficient and contracted, the lesions will necessarily be shiny, soft, wrinkled, and melted like wetness.
One must use Shiquan Dabu Decoction (Ten Complete Tonic Decoction) to vigorously tonify Qi and Blood, so that the toxin transforms into pus and circulates, ensuring safety.
(Shiquan Dabu Decoction / Ten Complete Tonic Decoction) Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix, honey-fried), Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Rou Gui (Cinnamomi Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted), Bai Shao (Paeoniae Radix Alba, wine-fried), Shu Di Huang (Rehmanniae Radix Praeparata), Chuan Xiong (Ligustici Chuanxiong Rhizoma). Decoct with water, using ginger water prepared by roasting as a guide.
(Verse for the Formula)
Shiquan Dabu Decoction is most effective, Ginseng, Astragalus, and Poria white; Angelica, Atractylodes, Cinnamon bark, and Licorice, White Peony, Prepared Rehmannia, and Ligusticum combine.
Clause: 109
The pustule shell is round and smooth, but the pus does not form; one must clearly distinguish between deficiency and excess patterns. A pale root color indicates Blood deficiency, while purple tightness results from Blood heat coagulation.
Use Qianjin Neituo San (Thousand Gold Internal Support Powder) combined with Siwu Tang (Four Substance Decoction); treat according to the syndrome without delay.
[Commentary]
When smallpox reaches the stage of pus formation, the head and face exceed the body in swelling, yet internally there is no pus. This is named "Empty Shell" (Kong Ke). One must differentiate deficiency and excess to treat it.
If the root color is pale and white, this is Blood deficiency unable to transform toxins into pus; Qianjin Neituo San (Thousand Gold Internal Support Powder) is appropriate.
If the root is tight and purple, this is Qi stagnation causing Blood stasis, with toxic heat lurking in the Blood level, preventing pus formation; Jiawei Siwu Tang (Modified Four Substance Decoction) is appropriate.
(Qianjin Neituo San / Thousand Gold Internal Support Powder) See the section on Treatment of Appearance Stage Syndromes.
(Jiawei Siwu Tang / Modified Four Substance Decoction) Sheng Di Huang (Rehmanniae Radix, washed with wine), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba, wine-fried), Dang Gui (Angelicae Sinensis Radix, washed with wine), Lian Qiao (Forsythiae Fructum, heart removed), Zi Cao Rong (Arnebiae Radix, washed with wine). Decoct with water.
(Verse for the Formula) Modified Siwu Tang, Dang Gui and Sheng Di Huang, Chuan Xiong and Bai Shao, Zi Rong and Lian Qiao consumed.
Clause: 110
Although the smallpox root is red, the apex is collapsed. This syndrome is mostly due to Qi deficiency. The patient presents with a pale complexion, cold limbs, poor appetite, empty irritability, loose stools, and physical fatigue.
Urgently use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). When Qi is sufficient, the apex rises, and the filling of pus is precious.
[Commentary]
Apical collapse is caused by weak Middle Qi failing to uplift. Therefore, during the pus-filling stage, although the root is ruddy, the apex slightly collapses.
Presenting symptoms include a pale face, cold limbs, lack of desire for food, empty irritability, loose stools, and physical fatigue.
Treatment should focus on tonifying Qi. Using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) will make Qi sufficient and Pus rise, causing the apex to naturally elevate.
(Buzhong Yiqi Tang / Tonify the Middle and Augment the Qi Decoction) Huang Qi (Astragali Radix, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Ren Shen (Ginseng Radix), Sheng Ma (Cimicifugae Rhizoma, stir-fried), Chai Hu (Bupleuri Radix, stir-fried), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Dang Gui Shen (Angelicae Sinensis Radix, root body). Decoct with water, using roasted ginger and Jujube fruit as guides.
(Verse for the Formula)
Buzhong Yiqi works like a spirit, Astragalus, Atractylodes, and Ginseng together; Sheng Ma, Chai Hu, Chen Pi, and Licorice, Roasted Ginger, Jujube, and Angelica root body.