一痘感暑毒，靥后，头发珠子，因用香薷饮合犀角地黄汤加荆、防，服而愈。
一痘后遍身生疮，忽自愈，而喘胀搐搦。此同倒陷论，先用升发，使再作，后用犀角解毒汤加人参而愈。
亦有用百解散，发为丹肿者。
一痘遍身脓疮，久而肌瘦潮热。此毒已外泄，宜固正气为主，补中益气汤加苡、芍、茯、防、银花、石斛，
外治水银膏。
一女十七，痘后脓疥，逢时即发，苦参四两，归、芍、芎、防、荆芥、白芷、牛蒡、枸杞、连翘、蔓荆、
薄、蒺、蒌、丹、胡麻、首乌各一两，黄米糊丸，尽剂而愈。
一女痘顺，十二朝成脓疥，身热烦躁，此毒壅失解也。幸正不容邪，以归、芍、翘、蒡、芷、防、苡、银
花治愈。若失于解散，多有损其肢目者矣。
徐仲光治一痘，清浆结 ，四肢发疔数处，能食便调，见其脾胃实强，以内托解毒散治之，溃出疔根，用
生肌散敷愈。
一痘清浆结疤，便泄减食，疔发二十余处。因脾胃虚弱，正不胜邪，毒反内攻，解毒无效，十四日顶陷而死。
愚按∶解毒中兼补托药，未必无效。
一痘浆足，发疔数处，壮热烦渴，便秘能食，此有余之毒未尽。以四顺清凉饮，治之而愈。
万密斋治朱大尹子痘，至起发时，项后手背，有二痘变黑者，摸之则痛，此痘也。急取胭脂数帖，水浸取
汁涂之，尽汁而止，次日红润起发。
汪氏子痘起发时，有变黑者，以朱公子事语之，教取胭脂汁涂之。不听，后一身尽成黑痘而塌，复出一层
又塌，如此者三而卒。
汪氏子八岁，痘起发时，有黑枯者，此痘疔也。用四圣散，胭脂汁调，银针拨开疮头涂之，即转红活，亦
不蔓延。数日后，应收不收。问之，不便七日矣，知其肠内燥结，取猪肉烂煮，和汁与食，肠润便通，旋收靥。
郑氏子症同，以前法治之而愈。此病皮肉不活，根脚不肿者死。若起发有水，顶平而黑，内服凉血解毒，加烧
人矢，外用胭脂涂法。若便秘，得之里热，内服四物汤、三黄汤，外用胆导。若泄泻，此寒虚也，用保元汤加
木香、桂。如尽干枯，烦躁闷乱者，不治。
A patient with smallpox contracted summer-heat toxin. After the scabs fell off, pearl-like pustules appeared on the hair. Therefore, Xiangru Yin (Elsholtzia Decoction) was combined with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction), plus Jingjie (Schizonepeta Herb) and Fangfeng (Saposhnikovia Root), which cured the condition upon administration.
Another patient developed widespread sores after smallpox, which suddenly healed spontaneously, followed by wheezing, abdominal distension, convulsions, and spasms. This is similar to the "inverted collapse" pattern; initially, lifting and dispersing methods were used to induce re-emergence of the eruption, followed by Xijiao Jiedu Tang (Rhino Horn Detoxification Decoction) added with Renshen (Ginseng Root), resulting in recovery.
There are also cases where using Baijie San (Hundred-Resolution Powder) caused the toxin to manifest externally as erysipelas-like swelling.
Another patient had pus-filled sores all over the body due to smallpox, leading to emaciation and tidal fever over time. This indicates that the toxin has been excreted externally; treatment should focus on consolidating healthy qi. Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) was administered with Yiyiren (Coix Seed), Shaoyao (Peony Root), Fuling (Poria), Fangfeng (Saposhnikovia Root), Yinhua (Honeysuckle Flower), and Shihu (Dendrobium Stem). Externally, a mercury-based ointment was applied.
A seventeen-year-old female suffered from purulent scabies following smallpox, which flared up periodically. The prescription consisted of Kushen (Sophora Root) 4 liang, and Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Xiong (Ligusticum Rhizome), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Herb), Baizhi (Angelica Dahurica Root), Niubangzi (Arctium Fruit), Gouqi (Goji Berry), Lianqiao (Forsythia Fruit), Manjingzi (Vernonia Seed), Bohe (Mint Leaf), Jili (Tribulus Fruit), Lou (Trichosanthes Fruit), Danpi (Moutan Cortex), Huma (Sesame Seed), and Shouwu (Polygonum Multiflorum Root) each at 1 liang. These were made into pills using yellow millet paste. Recovery occurred after completing one course.
Another female with a favorable course of smallpox developed purulent scabies on the twelfth day, accompanied by fever and irritability. This resulted from toxin stagnation failing to resolve. Fortunately, the healthy qi was strong enough to resist the pathogen. Treatment with Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Lianqiao (Forsythia Fruit), Niubangzi (Arctium Fruit), Baizhi (Angelica Dahurica Root), Fangfeng (Saposhnikovia Root), Yiyiren (Coix Seed), and Yinhua (Honeysuckle Flower) led to cure. Had dispersal and detoxification been neglected, damage to limbs and eyes would likely have occurred.
Xu Zhongguang treated a smallpox patient whose pustular fluid had dried and formed scabs, with several ding (carbuncles/furuncles) appearing on the four limbs. The patient could eat normally and had regular bowel movements. Observing strong spleen and stomach function, Xu treated him with Neituo Jiedu San (Internal Support and Detoxification Powder). After the carbuncles ruptured and expelled their roots, Shengji San (Generate Flesh Powder) was applied topically for healing.
In another case, a smallpox patient’s pustular fluid dried and formed scabs, but diarrhea and loss of appetite ensued, with over twenty carbuncles erupting. Due to weak spleen and stomach, healthy qi failed to overcome the pathogen, causing the toxin to attack internally. Pure detoxification proved ineffective, and the patient died on the fourteenth day with collapsed pustule tops.
I remark: Incorporating tonifying and supporting herbs into detoxification formulas may well be effective.
In yet another case, a smallpox patient with full pustules developed several carbuncles, presenting with high fever, thirst, constipation, but preserved appetite. This indicated residual excess toxin. Sishun Qingliang Yin (Four-Orientations Cooling and Clearing Decoction) was used successfully.
Wan Muzhai treated the son of Prefect Zhu. During the eruption stage, two spots on the back of the neck and the dorsum of the hand turned black and were painful to touch, indicating ding (carbuncles) within the smallpox. Urgently, several pieces of rouge (Zhiyan) were soaked in water to extract juice, which was applied until exhausted. By the next day, the lesions became ruddy and began to rise properly.
The son of the Wang family developed blackened spots during the eruption stage. His family recounted the incident involving the son of Lord Zhu and instructed him to apply rouge juice. He refused. Subsequently, his entire body turned black and collapsed. This cycle of emerging and collapsing repeated three times before he died.
The eight-year-old son of the Wang family had blackened, withered spots during the eruption stage, identified as ding (carbuncles). Sixian San (Six-Saints Powder) was mixed with rouge juice and applied after puncturing the lesion heads with a silver needle. The lesions immediately turned red and active without spreading. Several days later, the lesions should have crusted but did not. Upon inquiry, it was found that the child had not defecated for seven days, indicating dryness and accumulation in the intestines. Well-cooked pork meat and its broth were given to moisten the intestines and promote bowel movement, after which the lesions quickly crusted over.
The son of the Zheng family presented with identical symptoms and was cured using the aforementioned method. For this condition, if the skin and flesh are not vibrant and the base is not swollen, death ensues. If fluid is present during the eruption stage with flat, black tops, internal administration of blood-cooling and detoxifying herbs, along with burned human excrement derivatives (Ren Zhong Huang/Bai), and external application of rouge juice is indicated. If constipated, due to interior heat, internal administration of Siwu Tang (Four-Substance Decoction) and Sanhuang Tang (Three-Yellows Decoction) is used, with external bile enema. If diarrheic, indicating cold deficiency, Baoyuan Tang (Preserve Origin Decoction) added with Muxiang (Aucklandia Root) and Gui (Cinnamon Bark) is prescribed. If the lesions become completely dry and withered, accompanied by restlessness and confusion, the condition is incurable.