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In the context of smallpox (Xiaochuan), if a pimple appears purple-black, dry, hard, suddenly swollen, and particularly prominent, without a red halo around it, or with pain or no pain, this is called "Dou Ding" (Smallpox Carbuncle). Dou Ding can block other toxic eruptions; if a carbuncle appears before the eruption is complete, other pimples cannot emerge; if it appears after the eruption is complete, other pimples cannot swell; if it appears during the stage of pus formation, other pimples will inevitably collapse. Therefore, when the eruption first appears, if one sees a purple-black, particularly prominent spot and fears it may become a carbuncle, one should immediately pierce it with a silver needle, suck out the black blood, and then apply Baling San (Carbuncle-Extracting Powder) to the area. The next day, check again; if it becomes hard and swollen again, pierce it once more and apply the previous medicine until the lesion turns red and vibrant, at which point treatment can cease. If the needle cannot penetrate and there is a palpable nodule upon touch, a carbuncle has indeed formed. One must use a needle to incise from the four sides, extract it with small forceps; its shape resembles a nail, about half an inch long. After extracting the carbuncle, fill the wound completely with the previous powder to ensure safety. Additionally, if smallpox lesions on the hands, feet, and limbs are dark, hard, and extremely painful, or if there are no external lesions but internal nodules causing pain, these are also Dou Ding. It is suitable to cauterize them with burning moxa for immediate cure. Cauterization with a lamp flame is also effective. If not treated urgently, the lesions will sink deep, penetrating tendons and marrow until bones are exposed and rotting, which is very terrifying. Furthermore, if there are black spots on the Tian Ting (forehead center), there must be carbuncles in the Xin Wo (heart pit) and on the tongue; if there are black spots on the Di Jiao (jaw corners), there must be carbuncles in the scrotum; if there are black spots on the Liang Quan (cheekbones), there must be carbuncles in both axillae; if there are black spots on the Zhun Tou (nose tip), there must be carbuncles in the four limbs. This allows for accurate judgment through observation, which must not be neglected. A certain woman had smallpox; the lesions were sparse, bright, and moist, seemingly a favorable condition, but the fever did not subside. Subsequently, the previously bright and moist lesions gradually became dark, and she felt irritable and uneasy. Upon careful observation of her face, a lesion at the Di Jiao was found to be purple-black and nearly scorched. Examination of her genital area revealed a Dou Ding resembling a black bean. Using a silver needle to pierce it and forceps to extract the Dou Ding, followed by application of Baling San, her fever subsided, all symptoms became moist and swollen, and she recovered.

Baling San (Carbuncle-Extracting Powder): Ming Xionghuang (Realgar) 2 qian, Yanzhi Mo (Carmine powder) 5 qian (if unavailable, Yanzhi Gao/Carmine paste may be used). Grind together into a fine powder. Whenever encountering Dou Ding or Zei Dou (rogue smallpox), pierce it and apply Beijing You Yanzhi (Beijing oil-based carmine); it stops oozing immediately with miraculous efficacy.

Another prescription: Ming Xionghuang (Realgar) 1 qian, Zicao (Radix Arnebiae / Lithospermi Radix) 3 qian. Grind together into a fine powder. Mix thoroughly with juice from the top-grade carmine. Pierce the lesion with a silver needle and rub the mixture on; it is highly effective, similar to using oil carmine.

Another prescription: Pierce the carbuncle to release purple blood. Boil Pugongying (Herba Taraxaci) into a paste, soak it in water for one day and night until cold and fire-heat dissipates, then apply it.

Another prescription: Mix Machixian (Herba Portulacae) with a small amount of Zhu Guisui (Porcine Marrow), pound into a融 paste, and apply around the four sides of the carbuncle. Pain stops instantly within moments, and the root of the carbuncle is extracted within a few days; repeatedly tested and verified.

Another prescription: Slice a head of Dasuan (Allium sativum) to a thickness of 3 fen and place it on the Dou Ding. Place a ball of Moxa (Ai Ye Folium) the size of a bean on the garlic and moxibustion. Perform moxibustion five times, then replace the garlic and continue. If swelling and pain persist after purple blood flows out, moxibustion is especially indicated. For painful areas, moxa until pain ceases; for painless areas, moxa until pain arises. The toxin disperses with the fire.