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1. Generally, when the smallpox reaches the tenth day or eleven to twelve days, the pustules gradually scab over and fall off. Scabbing from the head downwards is considered a favorable progression (Shun); scabbing from the bottom upwards is considered an unfavorable progression (Ni). Even if the entire body has scabbed over, if a few spots remain unscabbed, it can still be fatal. This is analogous to a snake shedding its skin: even if only one segment fails to shed due to injury, the snake will die.

2. By the tenth to eleventh day, if scabbing should occur but does not, and the patient lacks high fever but experiences mental restlessness and agitation, gasping when lying down, irritability, thirst, and teeth grinding, Yi Gong San (Extraordinary Efficacy Powder) with added Muxiang (Aucklandiae Radix) and Danggui (Angelicae Sinensis Radix) should be used to rescue the imbalance of Yin-Yang and interior-exterior. If cold foods such as honey water, watermelon, or red persimmons are consumed, death will ensue rapidly.

3. In cases where scabbing should occur but does not, accompanied by diarrhea, chills, teeth grinding, and scratching until the skin is broken, this indicates a deficiency-cold syndrome. Yi Gong Tang (Extraordinary Efficacy Decoction) is appropriate for treatment.

4. In cases where excessive use of hot-natured medicines leads to rampant heat-toxin and hyperactive Qi-Blood, causing pustules to ulcerate without scabbing, Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Zhu Wei Gao (Pig Tail Ointment) should be taken internally to resolve the toxin. Baicao San (Decayed Grass Powder) should be applied externally to the affected areas.

5. In cases where smallpox does not scab over, accompanied by rapid breathing, phlegm in the throat, hoarseness, closed eyes, and lack of spirit, the prognosis is fatal. Red scars after scabbing indicate a good omen; white, bloodless scars indicate that toxic vapors are stagnating internally, which may lead to residual complications.

6. For treating smallpox lesions scratched open, resulting in dripping pus and blood, Baicao San (Decayed Grass Powder) is suitable.
Baicao San:
Use rotten grass from roofs that have been there for many years, or rotten grass from walls. These grasses, having been exposed to frost and dew, have absorbed the Yin-Yang Qi of Heaven and Earth, possessing the power to detoxify sores. Their efficacy cannot be fully described.
Take an unspecified amount of grass, dry it in the sun or bake it until dry, then grind it into powder. Apply the dry powder directly to the sores. If the whole body is covered with broken sores with incessant pus flow, sticking to clothes and making sitting or lying difficult, spread two or three sheng (a unit of volume) of the powder on a mat and let the child sit or lie on it. The effect is miraculous. Continue to administer Muxiang San (Aucklandia Powder) with Dingxiang (Caryophylli Flos) and Guigui (Cinnamomi Cortex) added, decocted together for oral administration.

Xiao Dan Gao (Nitre and Gall Ointment):
Xiao Dan Gao treats lips that fail to close, foul-smelling and rotting scar tissue with flowing blood and pus. Grind various animal gallbladders with Mangxiao (Natrii Sulfas) finely and apply to the affected area; the disease will heal spontaneously.

Zhu Wei Gao (Pig Tail Ointment):
Grind Longnao (Borneolum Syntheticum) finely (half zi quantity), mix with fresh pig heart blood to form pills, coat with Chen Sha (Cinnabar), and swallow using Zicao Tang (Arnebiae seu Lithospermi Radix Decoction).

7. For treating scratched and ulcerated smallpox/rash, place premium honey inside silkworm cocoons, bake them on new tiles until dry, burn them to ash while preserving their medicinal nature, and grind into powder. If the wound is wet, sprinkle the dry powder; if dry, mix with sesame oil and apply. This is effective.

8. A three-year-old child suffered from fever for seven days, with inverted black smallpox lesions, cold lips and mouth, indicating a critical condition. The family prayed to gods and spirits exhaustively. They encountered a scholar who said, "This disease can be cured with medicine." After administering a small amount, the child's complexion returned to normal redness and vitality shortly thereafter. Desiring the prescription regardless of cost, the method is as follows: Take seven houseflies found on dogs, crush them finely, mix with a little vinegar and wine, and administer orally. These flies are abundant and easy to obtain in summer; in winter, they hide in ears. One must know this refers specifically to the flies found on dogs in summer.

9. Smallpox cases belonging to deficiency-cold syndromes may persist for ten-plus days before death; those belonging to severe toxin transformation with color changes usually result in death within seven to eight days. This is because smallpox represents fetal toxin emerging from the interior to the exterior. It typically erupts completely by the second or third day, at which point the toxic vapors are still largely internal. By the sixth day, they should have all emerged outward. By the seventh, eighth, and ninth days, pus forms and scabs develop. If the toxic vapors are too strong to emerge completely, after the sixth day, the toxin may re-enter the Zang-Fu organs. Therefore, before the sixth day, when the toxic vapors are all emerging, urgent administration of Blood-cooling and Toxin-resolving medicines is required to drive them out. After the sixth day, medical intervention is futile, leading to rapid death. In contrast, weak patients with less toxic vapor suffer only from insufficient Qi-Blood failing to generate pus and complete the lesion process, resulting in a prolonged course before death. This distinguishes the severity between deficiency/excess conditions.