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Xi Taishun stated: The manifestation of toxin from smallpox is mostly seen in the syndrome of the outer crusts (the stage when pustules form and crust over). When pus and fluid ulcerate, how can it be considered sufficient? Although it is said to become foul-smelling, the vital energy has already been established. It must manifest as carbuncles and sores to be a stable omen. If it occurs on the four limbs, it damages the hands and feet; if it occurs on the hard part of the top of the head, it is auspicious. Internally administer Xiaofeng Huadu Decoction (Wind-Dispersing and Toxin-Resolving Decoction); externally, chew raw soybeans and apply the paste to the affected area. This is a method of finding safety within danger, with virtually no failure.

Shao Ci'an stated: Whenever there is a delay in duration before eruption, and the lesions are not round and smooth during crusting, and just as they are flattening out, carbuncles and swellings appear again. People naturally know this is residual toxin, but do not know which meridian it belongs to, and thus should differentiate it. If there is Qi rebellion with panting and urgency, chest fullness, and abdominal distension, the residual toxin is in the Lung Meridian. If there are thick and sticky phlegm and saliva, teeth grinding, incessant diarrhea, and bad breath, the residual toxin is in the Spleen and Stomach meridians. If there is night sweating, unrelenting fever, and thirst, the residual toxin is in the Heart. If there are frequent fright dreams, the residual toxin is in the Liver. If the ears are still hot, the residual toxin is in the Kidney. If the eyes cannot open, the body remains swollen without subsiding, internal heat is not cleared, and there is depression and unhappiness, the residual toxin is present in all meridians.

The *Xinfa* states: After smallpox, when residual toxin manifests, if it is as small as a plum, it is called "toxin" (Du); if it is as large as a peach, it is called "carbuncle" (Yong). If a single one appears, the toxin is in the muscles, belonging to a favorable syndrome that is easy to treat; if multiple areas erupt consecutively, it is like a small boat carrying heavy weight, belonging to a dangerous syndrome. If it knots between bone joints, or appears in pairs, the toxin is already abundant; after ulceration, if blood and Qi seep out and cannot coalesce, it has already become an unfavorable syndrome.

Chen Shigong stated: Carbuncles following smallpox are simply smallpox toxin. Due to insufficient filling of the pustules with fluid, the toxin flows into the Spleen and Lung meridians, causing diffuse swelling on the hands, feet, chest, and back, as large as plums or peaches. This mostly occurs after the scabs have formed. If the body is cool and there is no thirst, it is auspicious. At the initial stage, chewing raw soybeans and applying them externally will cause it to resolve spontaneously; once suppurated, apply Taiyi Plaster, and when the pus is ripe, puncture it with a needle. For those with deficient Yuan Qi, Baoyuan Decoction (Protective Qi Decoction) should be used primarily to support the Spleen and strengthen the Stomach. (From *Zhengzong*)

Hu Gongbi stated: Carbuncles following smallpox should primarily be treated with Da Liaoqiao Yin (Large Liaoqiao Drink). If there is constipation, add wine-fried Rhubarb to mildly promote bowel movement; if there are wind-sores after rash, add Honeysuckle Flower.

Dou Hanqing stated: Those occurring on the face, neck, chest, and hypochondrium are difficult to treat; those occurring on the four limbs are easy to treat.

Cheng stated: Whenever there is fever after smallpox, it means the residual toxin is not yet exhausted. If one has not taken more detoxifying medicines to prevent the eruption of smallpox toxin, one should carefully undress and inspect, eliminating it as early as possible.

He also stated: Occurrence at critical and vital points, or in cases of depleted Qi and Blood, is dangerous.

He also stated: Smallpox toxin must never be incised with a knife.