涸浆之候，即空壳之别名，痘形虽圆绽而内实空虚，少顷则涸极而色亦变矣。然此
固为气血两虚，殊不知又系火灼金枯之故，盖火炎上，而枭毒攻冲则血热不能化浆矣。
金承燥而肾水枯竭，则气陷而成内虚矣。故一见个机宜急黄连、生地、犀角、紫草以清
火毒，继以参 归地，培补阴阳，杜燥势于未萌，续真元于未竭，乃克有济。若稍一迟
缓，定难疗治矣。如能饮食则化源未绝，再加滋补，十可一生。
夫气乃血之标，血乃气之本。一身之间，荣卫相生，阴阳交互，各循其政，不可
须臾离也。其痘起发三、四、五、六日之际，有面目先肿光亮者，是因阴血不足，不
能载毒而出，阳乘阴分而毒不能宣发。然血既不足，犹根本已去，乃致虚动作，毒瓦斯弥
漫，妄行肉分矣。一有此症，则毒愈不能宣发，必七日之后，传经既足，即气退毒陷，
阴阳各失其政，尚何可治之有哉！故治者，不可不预调气血以保重之，然痘既发足而面
肿，痘不甚肿者，急须大补气血，升发痘毒，庶或可生。若痘未肿而面先肿者，乃纯
阳无阴之症，切忌参 补气，宜只以四物加人乳好酒和服，使痘与面皆肿。所谓养阴补
阳之义也，宜兼脉候辨之。
夫脓成而色黄者，中央土之正色也。况浆之化源，由浆胃自宜黄润光华，故痘浆既
重乎饱满，而尤贵乎脓之黄活，此顺理也。若阴阳离其正气，枭毒肆其残虐，则囊房销
灼而脓浆之澄灌于中者，腻滞牢贴。如物之枯萎而黄，乃气血不荣于内，是以死涩而不
活动，干腊而不明黄，以手抵之，凝结板定，名为板黄，明湿润之气全无，化源之机
已绝矣。尚何可治之有哉！
“涸浆”的症状，也就是“空壳”的别称。痘疹形态虽然圆润绽开，但内部实际上空虚，不久之后就会干涸至极，颜色也会随之改变。然而这固然属于气血两虚，殊不知又是由于火邪灼烧、肺金枯槁的缘故。盖因火性炎上，而枭毒（强烈的毒邪）攻冲导致血热，不能化生为脓浆；肺金承受燥气，肾水枯竭，导致气机下陷而形成内虚。因此一旦见到这种征兆，应当急用黄连、生地、犀角、紫草来清解火毒，随后用人参、当归、地黄来培补阴阳，在燥势未萌之前杜绝其根源，在未枯竭之前续接真元，这样才能有所救治。如果稍有迟缓，就 definitely 难以治疗了。如果患者还能进食，说明化源（脾胃生化之源）没有断绝，再加上滋补，十人中或许能救活一人。
气是血的标表，血是气的根本。在人体一身之中，营卫相互滋生，阴阳交互运行，各自遵循其规律，片刻也不能分离。在痘疹起发后的三、四、五、六天之际，如果出现面目先肿且光亮的情况，这是因为阴血不足，不能承载毒邪外透，阳气乘袭阴分，导致毒邪不能宣发。既然血液已经不足，犹如根本已去，就会导致虚阳妄动，毒瓦斯弥漫，乱行于肌肉腠理之间。一旦出现这种症状，毒邪就更不能宣发，必然等到七日之后，传经已满，此时气退毒陷，阴阳各自失去其正常职能，还有什么可治疗的呢！所以治疗者，不可不预先调理气血以保全正气。然而，如果痘疹已经发出饱满而面部肿胀，痘疹本身肿胀不严重的，必须急用大剂药物补益气血，升发痘毒，或许还有生机。如果痘疹尚未肿胀而面部先肿，这是纯阳无阴的病症，切忌使用人参补气，适宜只用四物汤加入人乳、好酒调和服用，使痘疹与面部都肿胀起来。这就是所谓“养阴补阳”的含义，应当兼察脉象来辨别。
脓液形成后呈现黄色，这是中央土行的正色。况且脓浆的化生源头，由胃气所主，自然应该黄润而有光泽。所以痘浆既重视饱满，尤其珍贵在于脓液的黄活润泽，这是顺应常理。如果阴阳背离了正气，枭毒肆意残虐，那么囊房被消灼，其中灌注的脓浆变得腻滞牢贴。就像物体枯萎而发黄一样，这是气血不能在内部荣养，所以死涩而不活动，干枯如腊而不明黄，用手触摸，凝结板定，名为“板黄”，完全没有明湿润泽之气，化生的源头机制已经断绝了。这还有什么可治疗的呢！
The manifestation of "He Jiang" (Dried Pustule), also known as the alias "Kong Ke" (Empty Shell), refers to a pustule that appears round and opened but is actually empty inside. Shortly thereafter, it becomes extremely dried up, and its color changes as well. Although this is indeed due to deficiency of both Qi and Blood, it is unknown that it is also caused by Fire scorching and Lung Metal drying up. Since Fire flares upward, and Xiao Du (intense toxic pathogen) attacks and rushes, causing blood heat that cannot transform into pus. Lung Metal receives dryness while Kidney Water dries up, leading to sinking of Qi and resulting in internal deficiency. Therefore, upon seeing such signs, one should urgently use Huang Lian (Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix), Xi Jiao (Rhinocerotis Cornu), and Zi Cao (Arnebiae Radix et Rhizoma) to clear Fire toxicity. Subsequently, use Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Di Huang (Rehmanniae Radix Praeparata) to nourish and tonify Yin and Yang, preventing dryness before it arises, and continuing True Yuan (Original Qi) before it is exhausted, so that there may be hope for recovery. If even slightly delayed, it will certainly be difficult to treat. If the patient can still eat, the source of transformation (Spleen and Stomach's digestive function) is not yet severed; adding further nourishment might save one out of ten.
Qi is the marker of Blood, and Blood is the root of Qi. Within the body, Ying (Nutritive Qi) and Wei (Defensive Qi) generate each other, Yin and Yang interact, each following its own governance, and they cannot be separated for even a moment. During the third, fourth, fifth, or sixth day after the eruption of smallpox/variolous lesions, if swelling appears first on the face and eyes with a shiny appearance, it is because Yin Blood is insufficient to carry the toxin out, allowing Yang to invade the Yin aspect, preventing the toxin from being vented. Since Blood is already deficient, like the root having been removed, it leads to vacuous movements, with toxic vapors spreading wildly and running disorderly through the muscle layers. Once such symptoms occur, the toxin becomes even harder to vent. It must wait until after the seventh day, when the transmission through meridians is complete, at which point Qi retreats and toxin sinks, Yin and Yang lose their respective functions, leaving nothing left to treat! Thus, the practitioner must not fail to pre-adjust Qi and Blood to protect the vital essence. However, if the lesions have fully erupted and are swollen, but the facial swelling is not severe, urgent large-dose tonification of Qi and Blood to raise and vent the lesion toxin is necessary, perhaps offering a chance of survival. If the lesions have not yet swollen but the face swells first, this is a condition of Pure Yang without Yin. One must strictly avoid using Ren Shen (Ginseng Radix et Rhizoma) to tonify Qi. Instead, it is appropriate to use only Si Wu Tang (Four Substance Decoction) mixed with human milk and good wine, causing both the lesions and the face to swell. This embodies the meaning of "Nourishing Yin to Supplement Yang," and pulse diagnosis should be combined for differentiation.
When pus forms and turns yellow, this is the correct color of Central Earth. Moreover, since the source of pus transformation comes from the Stomach, it naturally should be yellow, moist, and lustrous. Therefore, regarding pustules, fullness is valued, but especially prized is the yellow, active, and moist nature of the pus, which follows natural principles. If Yin and Yang depart from righteous Qi, and Xiao Du (intense toxic pathogen) acts cruelly, then the pouches are scorched away, and the pus infused within becomes greasy, stagnant, and firmly adherent. Like a withered object turning yellow, this indicates that Qi and Blood fail to nourish internally, resulting in lifelessness, stiffness, lack of activity, dryness like wax, and dull yellow color. Upon touch, it feels consolidated and board-like, named "Ban Huang" (Board-like Yellow). There is completely no bright, moist, or lustrous Qi, and the mechanism of transformation source has already ceased. What is there left to treat!