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Ding (pustular nodule) of smallpox must be picked with a needle; the lightness, heaviness, slowness, and speed must be appropriate. Breaking the top or injuring the muscle is strictly forbidden; when pus begins to form, pick it urgently without hesitation.
[Note] When using a needle to pick Ding (pustular nodule), hold the needle with two fingers, insert it level into the pustule, and sever the meridians within the pustule, causing surrounding pustules to erupt. However, during picking, the balance between light/heavy and fast/slow must be proper. Do not break the top of the pustule, nor pierce deeply to injure the muscle. One must wait until the third, fourth, fifth, or sixth day when pus begins to form and the pustule can "hold" the needle before picking. After the seventh day, this method is useless. Practitioners should memorize this carefully.

Boiling Needle Method
Raw Gancao (Radix Glycyrrhizae) [Glycyrrhizae Radix et Rhizoma], Gansui (Radix Kansui) [Kansui Radix], Chuanwu (Radix Aconiti Carminati) [Aconiti Radix Praeparata], Caowu (Rhizoma Aconiti Kusnezoffii) [Aconiti Kusnezoffii Rhizoma Praeparata] (equal parts).
Use one cup of water, place in a clay pot, and boil until the water is dry. Each time, boil four or five needles. After boiling, store them in a goose quill tube, sealed with yellow beeswax.

Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction) for exterior heat with no sweat; Xiaodu Yin (Detoxification Decoction) for interior heat with sweat; Qingdu Huoxue Tang (Clear Toxins and Invigorate Blood Decoction) for toxic steaming during pus formation; Lianqiao Fang (Forsythia Formula) for residual heat after scabbing.
[Note] In the case of smallpox, heat cannot be completely eliminated from beginning to end, because this heat is not excessive fever (Zhuangre), but rather a mild and harmonious heat. Cold causes contraction, while heat promotes dissemination. Therefore, if there is no initial heat, eruptions will be uneven; if there is no heat during the swelling stage, pus will not form; if there is no heat during the recovery stage, scabs will not form. From initial eruption to the swelling stage, the skin is dry, with fever and no sweat; this indicates heat in the exterior (Biao), treated primarily with Shengma Gegen Tang (Pueraria and Cinnamon Twig Decoction) plus Jingjie Sui (Schizonepeta Spike) and Fangfeng (Saposhnikovia Root). If there is steaming heat with sweat, this indicates heat in the interior (Li), treated primarily with Jiajian Xiaodu Yin (Modified Detoxification Decoction). During the pus-formation stage, if heat persists, this indicates toxic heat steaming, treated with Qingdu Huoxue Tang (Clear Toxins and Invigorate Blood Decoction). If constipation occurs, remove Renshen (Ginseng) and Huangqi (Astragalus), and add Jiuhuang Dahei (Wine-fried Rhubarb). After scabbing, if fever is intense, with heat in the chest, abdomen, hands, and feet, and difficulty in urination and defecation, this indicates excessive residual toxins, treated with Dalianqiao Yin (Large Forsythia Decoction).

Shengma Gegen Tang (See Treatment of Fever Syndrome)
Jiajian Xiaodu Yin (Modified Detoxification Decoction)
Shengma (Bupleuri Radix) [Bupleuri Radix], Niubangzi (Arctii Fructus) [Arctii Fructus] (stir-fried and ground), Shandougen (Sophorae Tonkinensis Radix) [Sophorae Tonkinensis Radix], Zicao (Lithospermi Radix) [Lithospermi Radix], Lianqiao (Forsythiae Fructus) [Forsythiae Fructus] (heart removed), Shengdihuang (Rehmanniae Radix) [Rehmanniae Radix], Chishao (Paeoniae Radix Rubra) [Paeoniae Radix Rubra], Chuanlianhuan (Coptidis Rhizoma) [Coptidis Rhizoma], Gancao (Glycyrrhizae Radix et Rhizoma) (raw).
Add Dengxincao (Junci Medulla) as a guide, decoct in water and take orally.
[Formula Song] Jiajian Xiaodu Yin works like magic, Shengma, Niubang, and Shandou root; Zicao, Lianqiao, Shengdi, and Shaoyao, Liangan and Gancao with Dengxin as guide.
Qingdu Huoxue Tang (See Treatment of Pus-Filling Syndrome)
Dalianqiao Yin (See Treatment of Scabbing Syndrome)