痘疮灌浆满足。干靥结痂。数日之间脱尽。疤色红润如桃花色者为吉。若痂浓色苍。当落不
落。乃火盛之故。宜清余热。或有半月二旬。痂皮粘着不脱。此名丁疤。或脱去痂薄。疤痕凹陷。
干枯色白。或潮热发痒者。皆表虚无力收敛。发表太过所致。人参固肌汤。痂 半粘半脱。疤色
红紫。 肿痒痛。重复作脓者。此名翻疤。为风热余毒。急宜凉血。犀角地黄汤。若发痒剥去痂
皮。或出血。或无血。仍复灌浆如疮疥者。此血热气虚。十全大补汤去桂加红花、紫草、牛蒡子。
不愈。名疳蚀疮。出血不收者。名阳疮。俱危。痂落不光。淡白全无血色。疤平不满者。名蓑衣
痘。元气虚寒之故。当大补脾胃。补中益气汤加桂。若痂不落。反见昏沉不省人事者。此脾胃虚
也。归脾汤。若抓破被风侵袭作痛。屡愈屡破。为血风疮。虽多用养血消毒之剂。亦难速效。若
结痂干燥。深入肌肉不落。即以真酥或蜜水润之。迟延日久。则成瘢痕矣。脱后疤痕凸起。紫赤
作痛者。余毒不解也。解毒防风汤。瘢下湿者。密陀僧、滑石、白芷为散。干则蜜水调敷。湿则
干掺。须避风日。可免瘢痕也。痘收靥干黑。粘着皮肉不脱。而身热烦渴。夜卧不宁者。热毒不
化也。犀角地黄汤加连翘、牛蒡。若妄言谵语。四物汤合生脉散加枣仁。若痂薄如麸。昏睡少食
者。此脾胃虚也。大剂保元汤补中益气。并加穿山甲。预防发痈之患。有收靥后。身热咳嗽。声
哑吐痰而衄者。此毒火乘金。越出上窍也。犀角地黄汤加芩、连、门冬、牛蒡子。有脱痂后自汗
不止。疤痕色淡而手足清者。气虚也。十全大补汤。若身热手足自汗不止而疤痕紫赤者。胃中余
热傍达四末也。犀角地黄汤。夏暑。人参白虎汤。脱痂后能食便秘。身热口渴者。此胃中积热上
蒸。须防口疳齿
之患。清胃散。有脱痂后午后潮热脸赤。烦闷错语昏沉者。此火从虚发也。保元汤加归、芍。有
收靥后复发斑疹紫色者。此余毒炽盛也。犀角地黄汤加荆、防、连翘、牛蒡、人中黄。若服药后
反加溏泻。或喘胀者不治。凡痘疤色白。急当调补中气为主。若服药而渐红活为吉。色不转者危。
虽二三年后。多患泻痢而死。若妄投攻伐。祸在反掌。
The pustules of smallpox are filled with pus, dry out, and form scabs. Within a few days, they all fall off. If the scar color is ruddy and resembles peach blossoms, it is an auspicious sign. If the scab is thick and dark greenish in color and fails to fall off when it should, this is due to excessive fire pathogen; clearing residual heat is appropriate. If after half a month or twenty days the scab remains adherent and does not detach, this is named "Ding Ba" (Nail Scar). If the scab falls off too thinly, leaving a depressed, dry, and white scar, or if tidal fever and itching occur, these are caused by deficiency of the exterior failing to consolidate, and excessive release of the exterior (sweating). Ren Shen Gu Ji Tang (Ginseng Muscle-Solidifying Decoction) is indicated. If the scab is half-adherent and half-detached, the scar is red-purple, accompanied by swelling, itching, pain, and recurrent suppuration, this is named "Fan Ba" (Reversed Scar), caused by residual toxins of wind-heat; cooling the blood is urgently required. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated. If itching leads to peeling off the scab, resulting in bleeding or no bleeding, but the wound refills with pus like sores, this indicates blood heat and qi deficiency. Shi Quan Da Bu Tang (Ten Substance Great Tonifying Decoction) without Gui Zhi (Cinnamon Twig), plus Hong Hua (Safflower), Zi Cao (Arnebiae Radix seu Lithospermi Radix), and Niu Bang Zi (Arctii Fructus) is indicated. If the condition persists, it is called "Gan Shi Chuang" (Keratic Erosive Sore); if bleeding cannot be stopped, it is called "Yang Chuang" (Yang Sore); both are critical. If after scab detachment the surface is not smooth, pale white without blood color, and the scar is flat and incomplete, it is called "Suo Yi Dou" (Raincoat Pox), due to deficiency and cold of primordial qi; greatly tonifying the spleen and stomach is necessary. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Gui Zhi (Cinnamon Twig) is indicated. If the scab does not fall off and instead drowsiness and unconsciousness appear, this is due to spleen-stomach deficiency. Gui Pi Tang (Restore the Spleen Decoction) is indicated. If scratching breaks the skin and wind pathogens invade causing pain, healing repeatedly only to break again, this is called "Xue Feng Chuang" (Blood Wind Sore); although blood-nourishing and detoxifying agents are used extensively, rapid effect is difficult to achieve. If the scab is dry, deeply embedded in the muscle, and does not fall off, moisten it with real butter or honey water; delaying for a long time will result in keloids. If after detachment the scar protrudes, is purple-red, and painful, it is because residual toxins are not resolved. Jie Du Fang Feng Tang (Detoxify Toxins and Saposhnikovia Decoction) is indicated. If the area under the scar is damp, use Mi Tuo Seng (Lithargyri), Hua Shi (Talcum), and Bai Zhi (Angelicae Dahuricae Radix) as powder; apply with honey water if dry, sprinkle dry powder if damp. Avoid wind and sun to prevent scarring. If the smallpox crusts become dry, black, and hard, adhering to the skin and not falling off, accompanied by fever, irritability, thirst, and restless sleep at night, it is because heat toxins are not transformed. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) plus Lian Qiao (Forsythiae Fructus) and Niu Bang Zi (Arctii Fructus) is indicated. If delirious speech occurs, Si Wu Tang (Four Substance Decoction) combined with Sheng Mai San (Generate the Pulse Powder) plus Suan Zao Ren (Ziziphi Spinosae Semen) is indicated. If the scab is thin like bran, with lethargy and poor appetite, this is spleen-stomach deficiency. A large dose of Bao Yuan Tang (Protect Primordial Qi Decoction) combined with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), plus Chuan Shan Jia (Pangolin Scale), is used to prevent the risk of carbuncles. Some patients, after crust formation, develop fever, cough, hoarseness, expectoration, and epistaxis; this is toxin-fire attacking Metal (Lungs), emerging from upper orifices. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) plus Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Men Dong (Ophiopogonis Radix), and Niu Bang Zi (Arctii Fructus) is indicated. Some patients, after scab detachment, have incessant spontaneous sweating, pale scars, and cold hands and feet; this is qi deficiency. Shi Quan Da Bu Tang (Ten Substance Great Tonifying Decoction) is indicated. If there is body fever, incessant spontaneous sweating of hands and feet, and purple-red scars, it is residual heat in the stomach reaching the four extremities. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated. In summer heat, Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction) is used. After scab detachment, if the patient can eat but has constipation, fever, and thirst, this is accumulated heat in the stomach steaming upward; one must guard against mouth ulcers and dental issues. Qing Wei San (Clear Stomach Powder) is indicated. Some patients, after scab detachment, experience afternoon tidal fever, facial flushing, irritability, confused speech, and lethargy; this is fire arising from deficiency. Bao Yuan Tang (Protect Primordial Qi Decoction) plus Dang Gui (Angelicae Sinensis Radix) and Bai Shao (Paeoniae Radix Alba) is indicated. Some patients, after crust formation, develop recurrent purple macules and papules; this is excessive residual toxins. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) plus Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Lian Qiao (Forsythiae Fructus), Niu Bang Zi (Arctii Fructus), and Ren Zhong Huang (Human Midsection Yellow) is indicated. If after taking medicine diarrhea worsens or wheezing and distension occur, the condition is incurable. For any white-colored smallpox scars, priority must be given to regulating and tonifying middle qi. If the color gradually becomes ruddy and vibrant after medication, it is auspicious; if the color does not change, it is dangerous, and death from dysentery may occur even two or three years later. Reckless use of purgatives brings disaster instantly.