凡痘七八九日，渐贯脓，脓水之盈虚，视血气之盛衰也，故须调和脾胃，滋补血气，令易脓，易靥。
夫出痘历七日当贯脓，八日九日肥满光泽，苍蜡色，如果黄熟者，不须服药，贯脓三日，有他证，照后论治。
七日前后，见五陷者，气不足也，血不足不能收血，而毒不能成浆，盖气不盛毒故也，以保元汤加川芎、
官桂、糯米温胃助气。
七日前后，倒陷者，气血衰也，以保元汤加白术、茯苓、肉豆蔻。渴，以参苓白术散主之。
七日前后，见寒战者，表虚也；切牙者，内虚也。七日后，见
寒战者，气虚也；切牙者，血虚也。气虚以保元汤加桂以温阳；血虚加川芎、当归以益阴分。
凡痘疮七八日不贯脓，灰白陷顶，寒战切牙，腹胀口渴。渴非
因热，津液少也。内托散倍加丁、桂、参、 。腹痛加丁香、干姜；泻，以木香散下豆蔻丸。
凡痘当贯脓之时，虽若起胀，而中空干燥并无脓血者，死。若略有清水，或根窠起胀，血红而活，
犹有生意者，内托散倍加参、 、归，又将人乳、好酒各半盏，和入温服，此贯脓之巧法也。
凡贯脓肥满，庶易结靥，若痘虽胀满，光泽可观，然摸过软而皮皱者，虽有脓，不甚满足，后必不能
收靥，或痘皆贯脓，中间几颗不贯者，终变虚寒痒塌之证，宜内托散倍加补血气排脓之药。
凡痘陷无脓，虽因服内托药而暂起，不久又陷者，贯脓不满故
也，宜内托散倍参、 、归、人乳、好酒之类。盖贯脓既满，必无陷伏之患矣。
凡因虚发痒，遍身抓破，脓血淋漓，不能坐卧者，宜内托散去桂，倍白芷止痒，当归和血，木香调气，气
行血运，其痒自止，外用败草散敷之，庶免破处感风变证，以致上痰咳嗽声哑。若变遍身
抓破，并无脓血清水，皮白干如豆壳者，死。
凡秽气冲触，发痒抓破者，宜内托散照前加减，外用祛秽散焚熏。如黑陷不起，煎内托散调下无价散服之。
此当八九日贯脓之时，最不宜寒药解毒，以伤脾胃，凝气血不能贯脓，尤忌食鱼以助痰气。
Whenever smallpox reaches the seventh, eighth, or ninth day after eruption, it gradually suppurates. The fullness or emptiness of the pus depends on the prosperity or decline of Qi and Blood; therefore, it is necessary to harmonize the Spleen and Stomach and nourish Qi and Blood, facilitating suppuration and scabbing.
After seven days of eruption, suppuration should begin. On the eighth and ninth days, if the pustules are plump and lustrous with a pale waxy color, resembling ripe yellow fruit, no medication is required. If other syndromes appear three days into suppuration, treat according to the following discussion.
Around the seventh day, if five types of inversions (Wu Xian) appear, it indicates insufficient Qi. Insufficient Blood cannot retain blood, preventing toxins from transforming into pus, due to weak Qi failing to resolve toxins. Use Baoyuan Tang (Preserve the Origin Decoction) added with Chuanxiong Rhizome (Chuanxiong), Guizhi Twig (Guizhi), and glutinous rice to warm the Stomach and assist Qi.
Around the seventh day, if inversion occurs, it indicates the decline of Qi and Blood. Use Baoyuan Tang (Preserve the Origin Decoction) added with Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), and Myristica Seed (Roudoukou). For thirst, use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) as the primary treatment.
Around the seventh day, chills indicate Exterior Deficiency; teeth grinding indicates Interior Deficiency. After the seventh day, chills indicate Qi Deficiency; teeth grinding indicates Blood Deficiency. For Qi Deficiency, use Baoyuan Tang (Preserve the Origin Decoction) added with Cinnamon Twig (Guizhi) to warm Yang; for Blood Deficiency, add Chuanxiong Rhizome (Chuanxiong) and Angelica Sinensis Radix (Danggui) to benefit Yin.
If smallpox does not suppurate by the seventh or eighth day, appearing gray-white with depressed tops, accompanied by chills, teeth grinding, abdominal distension, and thirst: this thirst is not due to Heat but due to scanty Body Fluids. Use Neituo San (Interior-Supporting Powder) with doubled doses of Clove Bud (Dingxiang), Cinnamon Twig (Guizhi), Ginseng Root (Renshen), and [character missing in original]. For abdominal pain, add Clove Bud (Dingxiang) and Dried Ginger (Ganjiang); for diarrhea, administer Mu Xiang San (Costus Root Powder) with Rou Dou Wan (Nutmeg Pills).
When smallpox is at the stage of suppuration, even if it appears swollen, if the center is empty and dry without pus or blood, the prognosis is fatal. If there is a slight amount of clear fluid, or if the base swells with vibrant red blood, indicating vitality, use Neituo San (Interior-Supporting Powder) with doubled doses of Ginseng Root (Renshen), [character missing], and Angelica Sinensis Radix (Danggui). Mix half a cup of Human Milk and half a cup of good wine, and take warm. This is an ingenious method for the suppuration stage.
If suppuration is plump, scabbing will be easy. If the pustules are swollen and lustrous but feel soft and wrinkled to the touch, although pus is present, it is insufficient, and scabbing will likely fail later. Or, if most pustules have suppurated but a few in the middle have not, they will eventually transform into a syndrome of deficiency-cold, itching, and collapse. It is appropriate to use Neituo San (Interior-Supporting Powder) with doubled doses of herbs that tonify Qi and Blood and drain pus.
If pustules are depressed without pus, and although they temporarily rise after taking interior-supporting herbs, they soon sink again, it is because suppuration is incomplete. It is appropriate to use Neituo San (Interior-Supporting Powder) with doubled doses of Ginseng Root (Renshen), [character missing], Angelica Sinensis Radix (Danggui), Human Milk, and good wine. Once suppuration is complete, there will be no risk of depression.
If itching arises from deficiency, leading to scratching all over the body, dripping pus and blood, making sitting or lying impossible, use Neituo San (Interior-Supporting Powder) removing Cinnamon Twig (Guizhi), doubling Bai Zhi (Angelica Dahurica Root) to stop itching, Dang Gui (Angelica Sinensis Radix) to harmonize Blood, and Mu Xiang (Aucklandiae Radix) to regulate Qi. When Qi moves, Blood circulates, and itching stops. Externally apply Bai Cao San (Decayed Grass Powder) to prevent wind invasion at broken sites, which could cause phlegm accumulation, cough, and hoarseness. If the condition worsens to widespread scratching with no pus, blood, or clear fluid, and the skin becomes white and dry like bean shells, the prognosis is fatal.
If foul qi causes itching and scratching, adjust Neituo San (Interior-Supporting Powder) as previously described, and externally fumigate with Qu Hui San (Remove Filth Powder). If black depression occurs without rising, decoct Neituo San (Interior-Supporting Powder) and mix with Wu Jia San (Priceless Powder) for oral administration.
During the seventh, eighth, and ninth days of suppuration, it is most inadvisable to use cold-natured herbs to detoxify, as this damages the Spleen and Stomach and congeals Qi and Blood, hindering suppuration. One must especially avoid eating fish, which generates phlegm and qi stagnation.