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[Ulceration] When smallpox pustules mature and ulcerate, it is a common occurrence. However, if they ulcerate before pus has formed, this is termed "Lan" (Ulceration). The causes of "Lan" are: first, when the pathogen should be dispersed but fails to be, leading to blockage of toxic qi, resulting in panting, shortness of breath, chest oppression, and restlessness; second, when dispersion is mistakenly employed despite being contraindicated, causing heat toxins to burst out suddenly with the yang qi, leading to widespread ulceration of skin and flesh. This is the fault of improper use of exterior-releasing methods. Treatment should focus on regulating the spleen and stomach, promoting appetite, ensuring proper bowel movements, nourishing Ying (Nutritive) and Wei (Defensive) qi, promoting muscle regeneration, and detoxifying. Detoxification should not be overly cold, and nourishment should not be overly hot; this constitutes a good method. It is advisable to use Shiquan Dabu Tang (Ten Complete Tonifying Decoction), removing Guizhi (Cinnamon Twig), adding Fangfeng (Saposhnikovia Root) and Jingjie Sui (Schizonepeta Spike), taken frequently for better results. If constipation occurs, use Dan Dao Fa (Gallbladder Suppository Method) to moisten the intestines. If pus fluid does not dry up, apply Baicao San (Decayed Grass Powder) as a dressing. If ulceration with pus formation causes severe pain, apply Tianshui San (Heavenly Water Powder, i.e., Liuyi San) mixed with Baihua Gao (Hundred Flowers Ointment) topically. In cases where exterior-releasing was excessive, leading to external ulceration and internal deficiency, with yang qi failing to hold fast and spontaneous diarrhea due to visceral dysfunction, urgent treatment should rescue the interior while releasing the exterior, primarily using Chen's Muxiang San (Aucklandia Powder). For cold limbs, Yigong San (Yi Gong Powder) is indicated.

[Banhuang / Rigid Yellow][Yuan] When smallpox pus clarifies, toxins are exhausted and health is restored; how could there be "Banhuang"? One must understand that the value of jade lies not in its thickness but in its purity; the value of a pearl lies not in its size but in its luster; the quality of smallpox pus lies not in its fullness but in its yellow color and vitality. "Yellow" is the correct color of Central Earth, and since pus is drawn from the Spleen, its yellow hue naturally appears moist and upright. In healthy cases, Qi protects without rebellion, Blood nourishes Ying without injury, the pustule sac is loose, and the clarified pus flows within, active without stickiness or blockage, bright and moist without a lifeless appearance. Where would such a thing as "Banhuang" exist? If Yin and Yang deviate from righteous qi, and fierce toxins act cruelly, the pustule root is shallow and inferior, the sac collapses flat, and the clarified pus becomes rigid and sticky, hardening into a dead blockage without activity, drying like wax without bright yellow luster. Upon finger pressure, it remains congealed and fixed. This indicates excessive heat in the Five Zang organs and severance of Yin and Yang Qi, which is called "Banhuang." If only the forehead shows Banhuang while the rest is moist and vital, abscesses will surely form at the brain and nape. If the cheeks and face show Banhuang while the four limbs are moist and beautiful, smallpox abscesses will erupt on the shoulders. If the abdomen shows Banhuang, abscesses arise at Quchi (LI11) and Zusanli (ST36). If the back shows Banhuang, abscesses knot at the lateral sacral bones. Generalized Banhuang leads to death. Banhuang at the front and back of the neck leads to death. Banhuang on the head leads to death. Banhuang around the eye sockets and above the lips leads to death. Banhuang on the flanks and scrotum leads to death. Observing these signs, one sees that while smallpox pus should indeed be full and yellow, it is even more crucial that it be moist and vital.

Chengquan San treats Banhuang in smallpox.
Huangqi (Astragali Radix) [Superior grade], Danggui (Angelicae Sinensis Radix) [Medium grade], Honghua (Carthami Flos) [Inferior grade].
Mix these with wine, seal tightly in a jar, and boil. Separately, grind Chan Tui (Cicada Slough) and Jin Wan (Golden Pill, i.e., the hard stone behind the rooster's tail) into fine powder, and take with the medicinal wine.

Zhuanhuan Dan
One chicken, cooked thoroughly with Renshen (Ginseng Radix), [missing character], Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), Guizhi (Cinnamomi Ramulus), honey, and wine, then consumed.