（收靥门参看）
〔万〕痘疮所贵者，坚实不破，圆净成痂也，其有溃烂者，火胜也。经曰∶热胜
则肉腐。火之为用，猛虐峻暴，近之则燥痒不宁，迫之则焦痛难忍，灼之则糜烂成疮，故败物者莫如火也。火生
于空，非虚不燃，乘之以风，其焰益烈，痘疮溃烂，由肌肉素虚，邪风侵袭，风者，善行数变，行诸脉俞，散
于荣卫之间，一旦毒发于里，风应于表，风火相扇，肌肉愤 ，皮肤决裂，而疮坏矣。如脓成而溃，则毒已
化，但粘衣渍席，不能干较，古方以败草散主之，诚良法也。脓浆未成，其毒未化，痒破溃烂者，则卫气暴泄，
津液不荣，譬诸草木剥削其皮，枯萎而死矣。经曰∶根于中者，命曰神机，神去则机息，根于外者，命曰气立，
气止则化绝，此之谓也。
〔薛〕闻人氏云∶痘 烂之证，因当发散而不发散，则毒瓦斯闭塞，以致喘促闷乱。不当发散而误发散，则
毒随阳气暴出于外，遍身皮肤溃烂。治宜调脾胃，进饮食，大便调和，荣卫健旺，毒瓦斯自解，而无目赤咽痛，口疮
吐衄等证。窃谓，前证若发表过甚，大便自利，急用理中丸、豆蔻丸（俱痘泻利）以救其里。亦有痘疹如蚊
所啮而色黑，乃危证也，若大小便秘结烦躁，用山栀子汤（痘夹 ）、 猪尾血调脑子治之，自利不食者
不可用。盖毒发于表而妄汗之，则腠理开泄，荣卫益虚，转增疮烂，由是风邪乘虚
变证者有之。若毒根于里而妄下之，则内气愈虚，毒不能出而反入焉，由是土不胜水，变黑归肾，身体振寒，
两耳尻冷，眼合肚胀，其疮黑陷，十无一生，治者审之。
疮出太盛，脓汁淋漓，不可着席，疼痛者干黄土罗末敷之，甚者白龙散（痒塌）帛裹扑之，或败草散（收靥）
贴之。丹溪云∶疮湿者，用泻湿，乃肌表间湿，宜用风药白芷、防风之类。闻人氏用麦麸衬卧。暑月热，甚
当藉之以芭蕉叶为佳。或疮已出定，大便不通，而脓汁不干者，此热毒合下证也，宜牛黄丹利之。若疮口湿，
及脓血杂流者，百花膏（收靥）、生肌散、金华散、绵茧散（收靥）、魏氏白螺散、乳香韶粉散俱可
用。若靥后复生，乃余毒失于解利，留滞于肌肉之间而然也，宜消毒散（出太密）。或结痂久而不落，亦宜百
花膏。若痘烂无脓，吐利不止，或二便下血，乳食不化者，不治之证也。
牛黄丹 治疮子出定，大便不通，疮中脓水不干。
牛黄 大黄末（生用） 珍珠末 粉霜（各一两）
上研匀，炼蜜丸，如黍米大。每服十粒，人参汤下。量儿大小加减。
生肌散 治疳蚀不敛，并痘后脓血杂流不收等疮。
地骨皮 黄连 五倍子 甘草 黄柏（各等分）
上为细末。干掺疮上。
金华散 治痘证后肥疮、疳疮疥癣，能收水、凉肌、解毒。
黄丹（水飞过，火 红，一两） 黄柏 黄连（各五钱） 黄芩 大黄（各三钱） 轻粉（一钱）
麝香（一分）
上为细末。疮湿，干掺，燥，用腊猪油熬化，调搽。
白螺散 专治疮痘不收。
白螺蛳壳（不拘多少，古墙上取）
上，去土，洗净，火炼红，取出，存性，为极细末。疮口湿处，干掺为妙。
乳香韶粉散
即韶粉散加乳香末三钱。（韶粉散方见落痂证治）
又方
荔枝壳（微烧，存性） 草纸（烧灰，存性） 败茅（多年者）
三味，共为细末。或搽，或掺，自能收水结痂。
又方
黄豆壳烧白灰，为末，掺之。如痘风癣，以痘壳煎汤洗。
秘传茶叶方 痘烂遍身、无皮，脓水流出，粘拈衣被。茶叶，要多拣去粗梗，入滚水一渫，即捞起，
再拣去梗，湿铺床上，用草纸隔一层，令儿睡上，一夜则脓皆干。
荞麦粉法（见收靥证治）
蝉花散 治烂痘生蛆虫，及夏月诸虫咬伤，臭恶不可近者。服之，虫皆化而为水，苍蝇亦不敢近。
蝉蜕（洗净，焙） 青黛（澄去灰土。各五钱） 北细辛（二钱半） 蛇蜕（一两，烧、存性）
上为细末。每服三钱，酒调下。仍以生寒水石细末，掺之。
(See also the section on Scab Formation)
[Wan Quan] The most desirable outcome for smallpox lesions is that they remain firm, unbroken, round, and clean until scabs form. Lesions that ulcerate are due to an excess of Fire pathogen. The classics state: "When heat prevails, flesh rots." The function of fire is fierce and violent; proximity causes dryness, itching, and restlessness; pressure causes burning pain that is unbearable; scorching leads to erosion and sore formation. Thus, nothing destroys matter more than fire. Fire arises from emptiness and cannot burn without a void; when driven by wind, its flames intensify. Smallpox ulceration occurs because the muscles are inherently deficient, allowing evil wind pathogens to invade. Wind is characterized by rapid movement and change, traveling through the meridians and acupoints, and dispersing between the Ying (Nutritive) and Wei (Defensive) levels. Once the toxin erupts internally, the wind responds externally. Wind and fire fan each other, causing muscle swelling and skin rupture, leading to the destruction of the sores. If pus forms and then ruptures, it indicates that the toxin has transformed; however, the discharge may still stick to clothes and bedding, making it difficult to dry. The ancient formula Baicao San (Decoction of Decayed Grass) is the primary treatment, which is indeed an excellent method. If the pus has not yet formed, and the toxin has not transformed, itching and scratching lead to ulceration. This represents a sudden leakage of Wei Qi and a failure of body fluids to nourish the skin, akin to trees losing their bark and withering to death. The classics state: "Those rooted within are called Shen Ji (Spirit Mechanism); when the spirit departs, the mechanism ceases. Those rooted outside are called Qi Li (Qi Establishment); when the qi stops, transformation ends." This refers to the aforementioned situation.
[Xue Ji] Wenren Shi stated: In cases of smallpox ulceration, if dispersing the exterior was indicated but neglected, the toxic vapors become blocked, leading to panting, shortness of breath, chest oppression, and confusion. If dispersing was not indicated but mistakenly used, the toxins follow the Yang Qi and erupt violently to the exterior, causing widespread skin ulceration. Treatment should focus on regulating the Spleen and Stomach, promoting appetite, ensuring smooth bowel movements, and strengthening Ying and Wei, so that the toxic vapors resolve naturally, preventing symptoms such as red eyes, sore throat, mouth ulcers, vomiting, and epistaxis. I believe that if the aforementioned condition results from excessive exterior-releasing measures leading to spontaneous diarrhea, one should urgently use Lizhong Wan (Regulate the Middle Pill) or Doukou Wan (Cardamom Pill) [both indicated for smallpox with diarrhea] to rescue the interior. There are also cases where smallpox lesions resemble mosquito bites and appear black, which is a critical condition. If accompanied by constipation of both stool and urine, irritability, and restlessness, Shanzhizi Tang (Gardenia Decoction) [for smallpox with macules] mixed with pig tail blood and brain can be used. However, it is contraindicated in patients with spontaneous diarrhea and inability to eat. This is because releasing the exterior via sweating when the toxin is at the surface opens the pores, further depleting Ying and Wei, exacerbating the ulceration, and allowing wind pathogens to enter due to deficiency, causing complications. Conversely, if the toxin is rooted internally and purgatives are wrongly used, the internal Qi becomes even weaker, the toxin cannot exit and instead sinks inward. Consequently, Earth fails to control Water, the color turns black, and the disease returns to the Kidney. Symptoms include tremors and aversion to cold, cold ears and coccyx, closed eyes, abdominal distension, and black, depressed lesions. Few survive; physicians must exercise caution.
If lesions are too numerous, with dripping pus, preventing contact with mats, and causing pain, apply fine powder of dry yellow earth. For severe cases, apply Bailong San (White Dragon Powder) [indicated for itchy collapse] wrapped in cloth, or Baicao San [indicated for scab formation]. Danxi stated: For moist sores, use damp-draining methods. This refers to dampness on the skin surface, suitable for aromatic wind-dispersing herbs like Bai Zhi (Angelicae Dahuricae Radix) and Fang Feng (Saposhnikoviae Radix). Wenren Shi recommended using wheat bran as a mattress liner. During hot summer months, using banana leaves is particularly beneficial. If lesions have erupted but defecation is obstructed and pus does not dry, this indicates heat-toxin combined with a downward-indicating syndrome; Niuhuang Dan (Calculus Bovis Pill) should be used to promote evacuation. For moist sore openings and mixed pus-blood discharge, Baihua Gao (Hundred Flowers Ointment), Shengji San (Generate Flesh Powder), Jinhua San (Golden Splendor Powder), Mianjian San (Silkworm Cocoon Powder), Wei's Bailuo San (White Snail Shell Powder), and Ruxiang Shaofen San (Frankincense and Kaolin Powder) are all applicable. Recurrence after scabbing is due to residual toxins failing to clear, lingering in the muscles; Xiaodu San (Detoxification Powder) [from the section on dense eruptions] is appropriate. If scabs persist for a long time without falling off, Baihua Gao is also suitable. Smallpox ulceration without pus, accompanied by persistent vomiting and diarrhea, hematochezia/melena, and undigested food in vomit/stool, constitutes an untreatable condition.
Niuhuang Dan (Calculus Bovis Pill): Treats smallpox lesions that have erupted, with obstructed defecation and non-drying pus/water in sores.
Calculus Bovis (Niu Huang), Rhubarb Powder (Da Huang Mo, raw), Pearl Powder (Zhen Zhu Mo), Frost Powder (Fen Shuang) (each 1 liang).
Grind uniformly, mix with refined honey, and pill to the size of millet seeds. Take 10 pills per dose, washed down with Ginseng decoction. Adjust dosage according to the child's age and size.
Shengji San (Generate Flesh Powder): Treats gan erosion that fails to heal, and post-smallpox sores with mixed pus-blood discharge that do not close.
Groundcherry Root Bark (Di Gu Pi), Coptis Rhizome (Huang Lian), Chinese Gall (Wu Bei Zi), Licorice Root (Gan Cao), Phellodendron Bark (Huang Bo) (equal parts).
Grind into fine powder. Apply dry powder directly to the sores.
Jinhua San (Golden Splendor Powder): Treats post-smallpox impetigo, gan sores, tinea, and scabies; drains dampness, cools the skin, and detoxifies.
Lead Monoxide (Huang Dan, water-washed, calcined until red, 1 liang), Phellodendron Bark (Huang Bo), Coptis Rhizome (Huang Lian) (each 5 qian), Scutellaria Root (Huang Qin), Rhubarb (Da Huang) (each 3 qian), Calomel (Qing Fen, 1 qian), Musk (She Xiang, 1 fen).
Grind into fine powder. For moist sores, apply dry powder; for dry sores, melt rendered pork lard and mix with the powder for application.
Bailuo San (White Snail Shell Powder): Specifically treats sores and smallpox that fail to close.
White River Snail Shells (Bai Luo Si Ke) (any amount, taken from old walls).
Remove dirt, wash clean, calcine until red, remove from fire, preserve the nature/properties, and grind into extremely fine powder. Apply dry powder to moist sore openings for best results.
Ruxiang Shaofen San (Frankincense and Kaolin Powder)
This is Shaofen San plus 3 qian of Frankincense Powder (Ru Xiang Mo). (Shaofen San formula is found in the section on Scab Falling).
Another Prescription:
Lychee Shell (Li Zhi Qiao, slightly burned, preserved properties), Paper Straw (Cao Zhi, burned to ash, preserved properties), Old Imperata Rhizome (Bai Mao Gen, aged) (three ingredients).
Grind together into fine powder. Apply or sprinkle; it naturally dries exudate and promotes scabbing.
Another Prescription:
Burn soybean shells to white ash, grind into powder, and sprinkle. For smallpox wind-tinea, wash with decoction of smallpox shells.
Secretly Transmitted Tea Leaf Method: For widespread smallpox ulceration without skin, with oozing pus sticking to clothes and bedding. Select tea leaves, removing coarse stems. Blanch in boiling water once, immediately remove, pick out remaining stems, spread wet on the bed, place a layer of paper straw over it, and let the child sleep on it overnight. The pus will dry completely.
Buckwheat Flour Method (see section on Scab Formation).
Chan Hua San (Cicada Flower Powder): Treats maggots in ulcerated smallpox and insect bites in summer that are foul-smelling and repulsive. Upon ingestion, maggots dissolve into water, and flies dare not approach.
Cicada Slough (Chan Tui, washed and dried), Indigo Naturalis (Qing Dai, settled to remove dust) (each 5 qian), Asarum (Xi Xin, 2.5 qian), Snake Slough (She Tui, 1 liang, burned, preserved properties).
Grind into fine powder. Take 3 qian per dose, mixed with wine. Additionally, apply fine powder of Calcitum (Han Shui Shi) topically.