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When smallpox lesions present as "Dao Ye" (inverted healing), the pustular fluid is clear and thin, the lesions are sunken and lack redness, the scab skin is wrinkled, and a normal crust fails to form. At this stage, Jiawei Baoyuan Decoction should be administered immediately to replenish Qi and Blood, allowing the smallpox to complete its course and heal.

[Note] "Dao Ye" refers to a condition where the pustular fluid is clear and insufficient, the base of the lesion is pale white without a surrounding red halo, and the body's lesions resemble bean shells. The lesion skin is wrinkled, appearing to scab but not truly forming one, ultimately failing to crust even when the healing phase arrives. This is caused by deficiency in both Qi and Blood, lacking the strength to carry and support the process. It is suitable for treatment with Jiawei Baoyuan Tang.

Jiawei Baoyuan Decoction
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix) [honey-fried], Gan Cao (Glycyrrhizae Radix et Rhizoma) [roasted], Quan Dang Gui (Angelicae Sinensis Radix) [wine-washed], Bai Shao (Paeoniae Radix Alba) [wine-stir-fried], Mu Xiang (Aucklandiae Radix) [baked], Bai Zhu (Atractylodis Macrocephalae Rhizoma) [soil-fried], Guan Gui (Cinnamomi Cortex).
Use Lao Mi (aged rice) as a guide drug, decoct with water, and take orally.

[Prescription Song] Jiawei Baoyuan treats Dao Ye, Ren Shen, Huang Qi, and Gan Cao cooperate; Dang Gui, Bai Shao, and Guang Mu Xiang combine; Bai Zhu and Guan Gui make the effect more swift.

Dou Ding (Smallpox Carbuncle) carries fierce toxicity and disrupts normal lesions; its color is purple-black and dull, and its form is hard and strong. If it appears and grows before other smallpox lesions, it hinders their development. First, prick it with a needle, then apply Sisheng Gao (Four Sages Plaster); this is beneficial.

[Note] The formation of Dou Ding results from fierce toxicity accumulating and lurking, becoming entrenched between muscles. It appears before the smallpox erupts and grows before the smallpox enlarges. Its color is purple-black, and its form is hard. Each of the five Zang organs has specific manifestations: Xin Ding (Heart Carbuncle) is red in color and arises on the zygomatic prominence, chest, and breast area; Gan Ding (Liver Carbuncle) is purple in color and arises on the left Taiyang region, left hypochondrium, eyelids, and bilateral buttock prominences; Pi Ding (Spleen Carbuncle) is initially yellow then turns black and arises on the cheeks, Zhongting, corners of the mouth, abdomen, hands, and feet; Fei Ding (Lung Carbuncle) is initially gray then turns black and arises on the right Taiyang region, right hypochondrium, neck, and laryngeal prominence; Shen Ding (Kidney Carbuncle) is black in color and arises on the chin, posterior neck, ear canal, back and waist-hip region, lumbar spine, and penis. Upon discovery, urgently pierce with a silver needle to drain toxic blood. After piercing, apply Sisheng Gao to the affected area. If treatment is delayed, it will cause the smallpox to fail to erupt when it should, fail to swell when it should, and fail to fill with pus when it should, leading to various complications.

Sisheng Gao
Lu Dou (Mung Bean Seed) [49 grains], Wan Dou (Pea Seed) [burned to ash retaining efficacy, 49 grains], Zhen Zhu (Pearl) [1 qian 1 fen], Tou Fa (Human Hair) [burned to ash, 1 qian 1 fen].
Grind the above into fine powder, mix with Mian Yan Zhi Shui (Cotton Carmine Water) to form a paste. Use a silver needle to open the lesion head, then apply the paste.