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Acupuncture and bloodletting. If there is heat in the blood, still use *Danpi* (Moutan Cortex), *Dihuang* (Rehmanniae Radix), *Zicao* (Arnebiae Herba), *Lianqiao* (Forsythiae Fructus), *Lingyangjiao* (Saigae Tataricae Cornu), pig tail, chicken comb, and *Jimeng San* (Chicken Crowing Powder) as drugs to release the exterior, and *Zhutai Gao* (Pig Tail Ointment) as drugs to purge the interior.

Baoyuan Tang (Preserve the Origin Decoction): Consists of *Renshen* (Ginseng Radix), *Huangqi* (Astragali Radix), and Zhi Gancao (Prepared Licorice Root). Add *Chuanxiong* (Chuanxiong Rhizoma) and *Danggui* (Angelicae Sinensis Radix), named Xiong Gui Baoyuan Tang. For deficiency-cold, add *Rougui* (Cinnamomi Cortex); for high crown (failure of pustules to rise), add *Lurong* (Cervi Cornu Degelatinatum); for qi stagnation with righteous qi deficiency, add Guang Chenpi (Tangerine Peel) and Houpo (Magnolia Bark); for diarrhea, add *Muxiang* (Aucklandiae Radix) and *Rougu* (Myristicae Semen); for weak constitution, add Kanqi (Umbilical Cord) and Heche (Placenta Hominis); for vomiting and rebellious qi, add *Dingxiang* (Caryophylli Flos) and Houpo. Shengu Lurong Tang (Ginseng, Angelica, and Deer Horn Decoction): Consists of *Renshen*, *Danggui*, *Lurong*, *Huangqi*, Longyanrou (Longan Aril), and Zhi Gancao. Muxiang San (Aucklandia Powder): Consists of *Renshen*, *Muxiang*, *Dingxiang*, Guixin (Cinnamon Twig), Dafupi (Arecae Pericarpium), Qingpi (Green Tangerine Peel), Hezi (Chebulae Fructus), Banxia (Pinelliae Rhizoma), Gancao (Licorice Root), Qianhu (Peucedani Radix), and Chifuling (Poria with Red Coir). Yigong San (Extraordinary Merit Powder): Consists of *Renshen*, *Muxiang*, Guanguui (Official Cinnamon), Guang Chenpi, *Danggui*, *Fuling* (Poria), *Dingxiang*, *Fuzi* (Aconiti Lateralis Radix Praeparata), *Rougu*, Houpo, Banxia, and Baizhu (Atractylodis Macrocephalae Rhizoma). Doukou Wan (Cardamom Pill): Consists of *Rougu*, Kufan (Alumen Exsiccatum), Hezi, Longgu (Fossilia Ossis Mastodi et Gastrodiae), Chishizhi (Halloysit Rubrum), *Muxiang*, and Sharen (Amomi Fructus). Baizhu San (Atractylodes Powder): Si Jun Zi Tang (Four Gentlemen Decoction) plus Huoxiang (Agastaches Herba) and *Muxiang*.

On the 7th, 8th, or 9th day, frequent use of cooling drugs causes the color of the pox-heat to recede, preventing the pus from penetrating fully. There may be only half-filled pus, with the crown resembling a bamboo hat shape, unable to fill out. Nowadays, people often use Sangchong Jiang (Mulberry Insect Juice, raw) and Jiguan Xue (Chicken Comb Blood, raw), mixed with wine and taken orally. If after the eruption begins, the lesions become dull and stagnant shortly thereafter, one must use tonification and expulsion methods.

Wu’s formula for promoting eruption uses old human teeth ground into an extremely fine powder, with a small amount of Shexiang (Musk), taken at 2–3 fen per dose, named Heiling Dan (Black Spirit Pill).

Shangtian Chong (Sky-high Insect) is a drug that disperses wind from the exterior; Shan Jia (Pangolin Scale) is a drug that attacks wind in the meridians and collaterals. A single ingredient ground into powder, taken with wine, is called Dusheng San (Unique Victory Powder).

All insect and ant drugs have attacking properties. Those without blood move qi; those with blood move blood. Those that fly ascend; those that walk on the ground descend. As long as the pus is sufficient, hoarseness is not a concern. However, sudden asthma with rising phlegm is strictly contraindicated. (Xu Lingtai says: When the pox in the throat is full, the voice will also be hoarse.) Weng Zhongren says: Hoarseness due to throat trauma is not a concern if the pus flows fully. This is because pox pus is refined by heat and must ascend to reach the head and face. The Lung is located highest; when heat steams upward and presses, the Lung is damaged first, causing the voice to be unclear. If there is rapid breathing, holding the abdomen, and raising the chest, this indicates fire-toxin returning to the Lung, which is incurable. For fire-toxin returning to the Lung, pediatricians often use Zhu Zi (Pearl) and Niuhuang (Calculus Bovis), but three consecutive doses are mostly ineffective. I follow Sun Simiao’s Weijing Tang (Eupatorium Decoction) or Zhang Zhongjing’s Tingli Dazao Tang (Descurainia Seed and Jujube Decoction), which occasionally work. When Lung qi is obstructed, using bitter-cold drugs to purge downward goes beyond the disease site, hence ineffectiveness. (Xu Lingtai says: This is truly a brilliant discussion, must be referenced.)

Medical texts state that chills before the 6th or 7th day belong to qi deficiency; grinding teeth before the 6th or 7th day belongs to stomach heat; grinding teeth after the 6th or 7th day belongs to blood deficiency. This is also a fixed conclusion.

Itching, collapse, and grinding teeth on the 8th or 9th day, with no pus formation, or gray-white, dry, or shriveled lesions, are extremely dangerous. Rapid warm tonification can offer hope for survival. Weng Zhongren says: Collapse with grinding teeth is treatable if the stool is solid and the voice is clear. Clear voice indicates no heat obstruction above. Solid stool indicates that fu-yang has not completely leaked, so warm tonification is effective. Use Muxiang San or Yigong San.

For favorable pox on the 8th or 9th day, with pale yellow pus, all toxins are transformed, indicating near completion. Careful protection and nursing are required. Scratching causing pus flow and bleeding, if righteous qi leaks greatly, toxins sink from deficiency, often leading to incurable conditions. At this time, instruct the accompanying mother not to slacken, ensuring scabs dry and muscles remain intact, achieving full success. If pox is broken but voice is not hoarse, toxins have not sunk, so it is harmless. (Xu Lingtai says: This is a secret method.) Wu’s formula uses Shaoyao Tang: Fried Baishao (White Peony Root), Yiren (Coicis Semen), *Fuling*, Digupi (Phellodendri Cortex), Jinyinhua (Lonicerae Japonicae Flos), Baihe (Lilii Bulbus), Shanyao (Dioscoreae Rhizoma), and Jianlian (Nelumbinis Plumula).

On the 11th or 12th day, as scabs gradually form, excellent symptoms inevitably include cough or evening fever. Secular pediatricians claim toxins are not yet exhausted and indiscriminately administer bitter-cold drugs, often damaging the spleen and stomach, leading to loss of appetite and developing into pox-labor childhood weakness. I have argued that pox toxins emerge from the Kidney marrow, governed by the Liver (tendons), Heart (blood vessels), Spleen (muscles), and Lung (skin and hair), releasing toxins from inside out. During scar formation, true qi returns inward; the Lung governs skin and hair, meaning transmission has not occurred. The Lung is high and pure; prior swelling and scabbing caused extreme depletion of steaming pressure qi, leading to leakage and cough. Moreover, using damp-draining downward drugs to form scabs dries the upper jiao; if toxins remain latent, how can scabs form? This is certain. Furthermore, children have excess yang and insufficient yin. From eruption to scabbing, body fluids are greatly damaged, indicating yin deficiency. Thus, evening fever during yin hours is exactly what the *Neijing* calls "yin deficiency generating internal heat." A girl from the Wu family in Xijiao, aged four, had a favorable case. After treatment until pus was full and scabs formed, she suddenly became irritable, with night fever and insomnia, but calm in the morning. Doctors used Baoyuan Tang and Qian Yi’s Wuwei Yigong San plus Shaoyao, worsening the fever and irritability. Another doctor said: Toxins are not exhausted, this is due to mistaken tonification, and prescribed Sangchong Jiang and cooling-resolving drugs. After taking them, irritability worsened, and diarrhea appeared. Invited to diagnose, observing the pus and scab appearance, asking about daily habits, at noon, I used Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). (Xu Lingtai says: This is the method of nourishing yin.) One dose brought peace. These two points are often ignored by people, so I distinguish them here. If cough occurs after ten days, the general principle is sweet-cold drugs to generate fluids and nourish the stomach: Zhejiang (Sugarcane Juice), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Ludoupi (Vigna Radiata Testa), Digupi, Gancao, Yuzhu (Polygonati Odorati Rhizoma), and Tian Xingren (Sweet Apricot Kernel).

To resolve residual toxins, the primary goal is not to damage stomach qi. If using Huangqin (Scutellariae Radix) and Lianqiao (Forsythiae Fructus), they must be wine-processed; Dr. Zhai and Dr. Nie analyzed this in detail. Peaceful and unremarkable, never causing failure, such as Sandou Yin (Three Beans Drink). Regarding Jinyinhua alone, Materia Medica states it resolves toxicity without being cold, but I have seen that those with weak spleen and stomach suffer diarrhea if taken in large amounts. Wu’s Liaoqiao Yinzi (Forsythia Decoction) also aims for peacefulness.

Pox toxins and carbuncles are 70-80% heat syndromes and 20-30% deficiency-cold syndromes; even bone exposure and corruption can heal. However, surgery strictly forbids using fire-refined ascending drugs. Diagnosis follows the same principles as treating carbuncles, requiring differentiation of yin and yang.

Pox gangrene with excessive dampness generates heat; strong constitutions use bitter-cold descending drugs, as bitterness removes dampness. If swallowing is blocked and eating ceases, or cheeks and jaws perforate, it is difficult to treat.

Adults getting pox, whose desires are already active, initially present with knee pain, lower back soreness, and throat obstruction/pain closing up. Bitter-acid-cold drugs will definitely be ineffective. Use sweet-salty-cold to nourish water and control fire, assisted by detoxifying herbs. After six or seven days, pain gradually eases. Dr. Nie has Shenmai Qingbu Fang (Ginseng and Ophiopogon Clearing and Tonifying Formula); I often use Qian Yi’s Liuwei Dihuang Tang plus Guijiao (Tortoise Shell Glue), Xuanshen (Scrophulariae Radix), and Qiushi (Natrii Uras), achieving many successes. If pus fails to rise and frequent spitting of sticky saliva occurs, it is ominous.

Any malignant pox is critical in an instant. Various stifling syndromes last only three to five days. Eruption followed by shrinking is the most rapid danger, always within seven days. Additionally, Mengtou (Head-covering), Suohou (Throat-locking), Xuanjing (Hanging Mirror), Chan Yao (Waist-wrapping), Zhike (Spider Nest), Canzhong (Silkworm Seed), etc., are the Ten Evil Syndromes. Yuan’s Eighteen Evil Syndromes are rarely mentioned today. Such pox are untreatable, merely inviting resentment. There are also Tangsha Jiaban (Sugar-grain mixed spots) with a critical period around ten days. Even if roots and branches look good, if distributed in young children within the year, nine or eight storms will be incurable. Half-pus toxin sinking changes will surely kill around the 11th, 12th, or 4th day. If able to eat, one in ten might survive. Beyond eighty or ninety days without pus, internal toxins do not transform, leading to choking, hoarseness, itching, phlegm flooding, anorexia, and open eyes. Clauses cannot cover all; the critical period is swift. Sometimes, suddenly connected patches of pox split and leak water, looking like pine resin or peach gum exposed, accumulating rapidly, while internal symptoms gradually stabilize, turning from凶 (ominous) to ji (auspicious). More commonly, within ten days, dry plates dry up like scorched pot rice, devoid of vitality. Suddenly, cracks appear at the chin and other places, flowing foul water, gradually rising to the forehead, swelling high and thick like paste on the face, named Facou (Stinking Eruption). Once toxins drain, tonification and expulsion should be used immediately; delay leads to qi collapse. (Xu Lingtai says: This is a secret method.)