痘出围绕若环珠，毒瓦斯壅滞宜早图，清热解毒为妙剂，毒解浆生患自除。
【注】痘名环珠者，以出而围绕，形若环珠也。此毒瓦斯壅滞所致，宜早图治，以清热
解毒汤主之，使毒解浆生，其患自除矣。
\r环珠图\p03-b24a27.bmp\r
清热解毒汤（方见见点证治）
视之有点按无形，参差紫黯若浮萍，速用凉血攻毒剂，能使毒松色转红。
【注】浮萍者，视之有点，按之无形，参差不齐，痘色紫黯，状如浮萍也。此乃血瘀
毒炽，非急攻不可。速用凉血攻毒饮攻之，能使毒松色转红活，庶可望生。
\r浮萍图\p03-b24a28.bmp\r
凉血攻毒饮（方见见点证治）
痘形连贯颗碎密，上阔下细蟹爪形，起胀根松毒始解，清热解毒服有功。
【注】蟹爪者，痘形连贯，颗粒碎密，上阔下细，如蟹爪之状。急用清热解毒汤治之，
使连贯处起胀根松，其毒可解也。
\r蟹爪图\p03-b24a29.bmp\r
清热解毒汤（方见见点证治）
痘形歪斜复扁阔，无顶无盘名HT 沙，通圣归宗酌量用，顶起根松痘始佳。
【注】HT 沙者，痘形扁阔，歪斜不圆，无顶无盘，若HT 沙细小，宜先用松肌通圣散主
之。若色紫黯者，归宗汤主之。能顶起根松，始为佳境。
\r HT 沙图\p03-b24a30.bmp\r
松肌通圣散（方见蒙头证治）
归宗汤（方见发热证治）
After the eruption of smallpox, if it presents in a surrounding pattern resembling ring beads, this indicates stagnation and obstruction by toxic heat; treatment should be planned early. Employing heat-clearing and detoxification is an excellent method; once the toxin is resolved and pus forms, the illness will naturally subside.
[Note] The term "Ring Beads" for smallpox refers to eruptions that appear in a surrounding pattern, shaped like ring beads. This is caused by the stagnation and obstruction of toxic qi. Treatment should be planned early, primarily using Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction), so that when the toxin is resolved and pus forms, the illness will naturally disappear.
Upon observation, spots are visible but yield no resistance upon palpation; they are irregular in distribution, purple and dark in color, resembling duckweed. Cool-blood and attack-toxin agents should be used rapidly, which can loosen the toxin and turn the color red.
[Note] "Duckweed" refers to eruptions where spots are visible but feel flat upon pressure, appearing irregular with a purple-dark hue, resembling duckweed. This condition arises from blood stasis and intense toxicity, requiring urgent purgative action. Rapidly using Liangxue Gongdu Yin (Cool Blood and Attack Toxin Drink) can loosen the toxin and restore a vibrant red color, offering hope for survival.
The smallpox lesions are continuous, with fine and dense granules, wider at the top and narrower at the bottom, resembling crab claws. When swelling begins and the base becomes loose, the toxin starts to resolve; taking Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction) proves effective.
[Note] "Crab Claw" describes continuous lesions with fine, dense granules, wider superiorly and narrower inferiorly, similar to the shape of crab claws. Urgently treat with Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction) to induce swelling and loosen the base, thereby resolving the toxin.
The smallpox morphology is slanted and broadly flattened, lacking both a summit and a base, named HT Sha. Tongsheng Guizong San (Tongsheng Guizong Powder) should be used judiciously; only when the summit rises and the base loosens does the condition become favorable.
[Note] "HT Sha" refers to smallpox that is broad, flattened, slanted, and roundless, lacking a summit and base. If the HT Sha is small, Songji Tongsheng San (Muscle-Loosening Tongsheng Powder) should be used first as the primary formula. If the color is purple and dark, Guizong Tang (Guizong Decoction) should be used. A favorable outcome is achieved only when the summit rises and the base loosens.