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Clause: 102
The appearance of blood blisters (Xue Pao, blood-filled vesicles) within smallpox is caused by Lung heat; the color may be purple or red, distinguishing the severity of the toxin. Internally administer Liang Xue Jie Du Tang (Cool Blood and Resolve Toxin Decoction); externally, use needle puncture to drain the foul blood.

[Note]
When smallpox enters the distension stage, small vesicles suddenly appear interspersed with the pustules, gradually enlarging to the size of a ginkgo nut. If the toxin is severe, the color is purple; if mild, it is red. All are termed blood blisters. This occurs because toxic heat resides in the Lung and transmits to the skin, varying in size. One must internally administer Liang Xue Jie Du Tang (Cool Blood and Resolve Toxin Decoction) and externally puncture with a silver needle to drain the foul blood, ensuring safety. If not treated urgently and allowed to rupture spontaneously, the foul exudate will spread, causing the pustules to become red and ulcerated. Physicians should record this carefully.
(The formula Liang Xue Jie Du Tang [Cool Blood and Resolve Toxin Decoction] is found in the section on Crusting and Scabbing.)

Clause: 103
Water blisters (Shui Pao, clear fluid-filled vesicles) result from excessive dampness overcoming the Spleen meridian; they are dense on the hands and feet but lighter on the rest of the body. Internally administer Jia Wei Bao Yuan Ji (Modified Bao Yuan Formula); externally apply Hu Su Guan Fen Ling (Coriander and Official Powder Liniment).

[Note]
Water blisters are characterized by large size and thin skin, containing a sac of clear fluid. This is likely due to damp pathogenic factors invading and overcoming the Spleen meridian. Therefore, they are scarce on the face and body but dense on the hands and feet, as the four limbs belong to the Spleen. One must take Jia Wei Bao Yuan Tang (Modified Bao Yuan Decoction), puncture with a silver needle, and apply official powder mixed with coriander wine to the affected area. If treatment is delayed, it may transform into itching and collapse, becoming difficult to save.
(Jia Wei Bao Yuan Tang [Modified Bao Yuan Decoction]: Ren Shen (Ginseng Radix), Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Huang Qi (Astragali Radix, honey-fried), Chi Fu Ling (Poria with Red Core), Gan Cao (Licorice Root, roasted).
Decoct with fresh ginger water for oral administration.
(Verse Formula)
Jia Wei Bao Yuan acts most swiftly,
Ren Shen, Zhu Ling, and Ze Xie together;
Bai Zhu, Huang Qi, and Chi Fu Ling,
With Gan Cao and fresh ginger in one list.
(Hu Su Jiu [Coriander Wine])
Four liang of chopped Coriandri Fructus (Hu Su Zi/Hu Su Ye context implies herb, here likely leaf/stem given "cut up"), half jin of yellow wine, decoct together without letting the aroma escape. When warm, mix with official powder and apply to the ruptured area.

Clause: 104
Before the smallpox rises and distends, the flesh swells and floats; the skin is smooth and brightly colored, causing great worry. If bright red, treat with Qiang Huo Jiu Ku Tang (Notopterygium Decoction for Saving from Misery); if pale red, seek efficacy with Shen Gui Da Bu Tang (Ginseng and Angelica Great Tonification Decoction). If the entire body is red, indicating blazing toxic heat, quickly administer Gui Zong Tang (Gui Zong Decoction) early.

[Note]
When smallpox enters the distension stage, from head to body, it gradually rises along with the pustules. This indicates that Qi leads and Blood carries, allowing the toxin to emerge outward. If the flesh of the head and body swells first, with the skin appearing bright red while the pustules themselves do not swell, this signifies excess toxic pathogens not restrained by healthy Qi. Use Qiang Huo Jiu Ku Tang (Notopterygium Decoction for Saving from Misery). If the skin appears pale red, it indicates deficiency of Qi and Blood, unable to contain the toxic Qi; use Shen Gui Da Bu Tang (Ginseng and Angelica Great Tonification Decoction). Furthermore, if the entire body's skin is completely red, this indicates blazing toxic fire burning the Blood level; use Gui Zong Tang (Gui Zong Decoction).
(Qiang Huo Jiu Ku Tang [Notopterygium Decoction for Saving from Misery]: Man Jing Zi (Vittatae Chrysanthemi Fructus), Qiang Huo (Notopterygii Rhizoma et Radix), Niu Bang Zi (Arctii Fructus, stir-fried), Sheng Ma (Cimicifugae Rhizoma), Huang Qi (Astragali Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Lian Qiao (Forsythiae Fructus, heart removed), Jie Geng (Platycodonis Radix), Bai Zhi (Angelicae Dahuricae Radix), Fang Feng (Saposhnikoviae Radix), Ren Zhong Huang (Human Excrement Yellow).
Decoct with lotus leaf water for oral administration.
(Verse Formula)
Qiang Huo Jiu Ku Tang is excellent,
Sheng Ma and Chuan Xiong combined with Qiang and Fang;
Niu Bang, Huang Qi, Bai Zhi, and Lian Qiao,
Man Jing, Jie Geng, and Ren Zhong Huang.
(Shen Gui Da Bu Tang [Ginseng and Angelica Great Tonification Decoction]): Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Gan Cao (Licorice Root), Bai Zhi (Angelicae Dahuricae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Zi Cao Rong (Arnebiae Radix), Mu Xiang (Aucklandiae Radix), Nan Shan Zha (Crataegi Fructus), Hou Po (Magnoliae Officinalis Cortex, stir-fried with ginger), Jie Geng (Platycodonis Radix).
Decoct with fresh ginger water for oral administration.
(Verse Formula)
Shen Gui Da Bu is most spiritual,
Ren Shen, Huang Qi, Dang Gui, Jie Geng, and Chuan Xiong;
Fang Feng, Bai Zhi, Mu Xiang, and herbs,
Hou Po, Shan Zha, and Zi Cao Rong.
(The formula Gui Zong Tang [Gui Zong Decoction] is found in the section on Fever.)