痘熟浑如果熟形，外无妖色内多津，脓浆饱满迦苍腊，可许如期结靥成。
待到成浆却要浆，切防清水及空囊，囊空无水邪犹伏，清水非浆痒莫当。
浆由气血毒由脓，毒化浆中气血功，充灌不知培气血，犹无米面整炊笼。
痘疮只说待脓成，那晓成脓未足凭，饱满坚牢诚可喜，湿淫软薄又堪惊。
失气原来足太阴，肠中贲响足阳明，相同泄泻休轻视，谷气消亡大限临。
遍身疮痘欲成浆，只要其人脾胃强，食少便坚中气足，便清能食却无妨。
痘疮皮嫩色娇红，待得成脓痒又攻，预此务须先补托，破时必贵痘重脓。
痘疮正色喜红鲜，到得脓时又不然，曰白曰苍皆正色。若犹红嫩转为愆。
正面诸疮不可伤，略伤一处便非祥，临时作痒浑无忌，破陷干平目下亡。
额上疮如沸水浇，容浴破烂不坚牢，渐延面颊都如是，泄尽元阳毒未消。
准头唇上与眉心，耳畔诸疮不可轻，脓未得成先黑暗，莫将干靥误时人。
手足诸疮要饱浆，充肥苍腊喜脾强，淡清塞谷多灰白，纵得干收有后殃。
痘出八九日来，已结干红痂 。如或少生不顺，至此方作脓窠。既至行浆饱满，还
须次第收成。若遇身发重热，停浆不易结痂，此为阳亢阴虚，引以清凉收敛。浆足气
促，恐因痰拥而然，忽尔发惊，乃或小便秘结。再见气虚而塌陷，倒靥而黑焦，一则温
补可与，一遇攻发可活。若夫泄泻安宁，是已大虚少毒。肺寒则下利脓粘，脏毒必然便
血。挫喉声哑，浆行饱满亦无妨；塌痒切牙，便实声清犹可治。靥来痂硬，变症终
无， 脱如麸，须愁余毒蒸发。若致太过，溃烂难行，收拾身热。若见燎浆可畏，空遗
痘壳不成痂，只为浆清热重，腹胀喘呼而塌靥，皆因毒入内攻。出来不贯黄浆，痂 犹
如血赤。若曾解毒于先，此症断之极美。至有口唇肿硬，是因胃气败绝。若逢目睛涕
白，总为肝热倍常。喘急发于泻后，乃以气虚而断，便泄继以渴烦，岂为实热而然。泄
泻而烦渴不止，理必可以升提。好饮而发渴愈甚，势必难以援救。气虚寒战，痘疮无恙
即温经，浆足难收，便实热蒸须解利。进清凉以助结痂，叱补益而防过适。故痂落之
余，渐进情凉，毒已去尽，宜疏补益，是以升麻和解，进于未点之初。解毒诸方，用于
将靥之际。
夫痘成痂 ，虽云生意已成其八九，然余毒变迁，犹未得为结痂而可喜，眼合腹
胀，犹蹈危机，虚浮不退，尚惟凶咎。痂或成而反致失声，前 恐为黑靥，肿未消而眼
已先开，眼开疑是内攻，阳气极而狂叫喘呼。肠兮伤而凄凄不宁。风冷入胃，则利下
脓粘；热渗膀胱，则小便尿血。热毒逗遛不化，结痂而壮热憎寒，经络各遗余毒，日晡
而往来潮热。发在午前为实症，烦渴腮红。申过方作是阴虚，便溏减食。撮唇弄舌，心
经热甚何疑。扶肚HT 胸，肺胃毒冲有准；身热燎人便秘，须防暴急惊风。悠悠潮热便
溏，久变慢脾风候验。丧明于眼合羞明，辨口疳于唇焦龈黑。实热下注大肠，必有秘结
之祸；虚寒客留脏内，乃成泄泻之 。喘渴须分虚实，验症切勿差讹，欲分痂落之余，
再审瘢痕之色。桃红光泽，荣卫俱安，黑紫干焦，尚留风热。粉白为气血之虚，周过也
应深逝，走马状牙疳之烈，月亦见长驱，遍体赤斑，乃是失于解利，浑身青紫，恐为风
寒所吹，余毒未消，不特为疽为疖。见风太早，尤防复发疮痍。
痘疮成脓之后，鲜明肥泽，饱满坚实，以手拭之，而疮头微焦硬者，此欲靥也，然
大小前后最宜，渐次收靥，既不失于太急，又不失于太缓。其已靥者，痂壳周圆而无凹
凸，及干净黄润而无淫湿破溅者。此为正靥。其先天之毒，已泄于外，先天之元，仍
归于中，是否极泰来之象也。然俗谓几日发
热，几日出形，几日起发，几日作浆，几日收靥，此大概言之。夫痘有疏密，毒有浅
深，人有虚实。如疮疏而毒微人实而能食，自然易出易靥，即疮稠密而毒盛，其人能食
而中气实，气血和而无诸犯，亦可刻期根据限。假如其人中气既虚，饮食既少，内有所
伤，外有所感，气候乖变而难靥者，岂可同日语哉！
痘疮收靥之时，毒邪已解，然要先后有次，疾徐得中。如收太急者，只恐浆微血
少，枭毒未尽，煎熬津液，以致速枯，轻为余毒，甚至夭枉，宜微利之，以彻其毒。如
收太迟者，是中气已虚，脾胃已弱，不能收渗淫湿耳，宜内用参芩补脾，投败草散以视
之。
夫脓后结痂，理之常也。有痘疮过期不收，遍身溃烂者，此与斑烂不同，其因有
六，有大便秘结，内外热极，表里俱实，热气蒸郁，毒瓦斯散漫而阳气大盛，无阴气以敛
之不收者，治宜清凉，或下之。有因泄泻里虚，脾胃亏弱，津液损少，肌肉分虚而元气
外散，表里不固，是以阴气太盛，无阳气以敛之不收者，宜用温补。有因渴饮冷水过
多，以致水溃于脾，湿淫肌肉而不收者，治宜渗湿。有因天寒，失于盖覆，疮受冻冷而
血凝毒滞不收者，治宜温和。有因天热过求温暖，使疮被热蒸而不收者，治宜清凉。有
因食少气虚而不收者，宜用补脾。如是以治未溃者，即成痂 ，已溃者，亦渐成痂，方
为佳兆。若痂皮俱不结者，则成倒靥而危矣。然大抵痘之成就，犹谷之秋成，盖五谷
得阳气以成熟，非凉风至，则不能实也。天地严肃之气一加，则万物秀而实矣。故非阳
和则苗不秀，非严肃则秀不实。痘之脓而不焦，犹苗之秀而不实，治之者，或解以成清
凉之义，或下以成肃谷之令可也。然亦有脓后，气血虚耗，是以不靥，其症虽似实热，
此血气虚甚之假热也。不可与前同视，宜用十全大补汤数剂。如自后而反神倦恶寒者，
此邪气退而正气将复，故乃遂见虚象，是《经》所谓∶正气夺则虚也。仍用前药，则
自愈也。若溃烂脓汁淋漓，不可着席而粘惹疼痛者，宜败草散，席立衬卧，更以绢袋盛
于身上扑之。若面上欲成瘢痕者，宜减瘢散，和百花膏敷之。
夫人中为任督交会之衢，督乃阳脉，自人中而上。任乃阴脉，自人中而下。故有以
泰卦象之，人中而上，分为三部，人中以下，亦为三部，发际之上，阳之上也。两眉
之间，阳之中也。山根以下，阳之下也。自口至两乳间，阴之上也。自心蔽骨至阴际，
阴之中也。自阴而下，阴之下也。凡自准头至印堂，与颏至鸠尾相应，印堂至发际，与
鸠尾至膝相应，发际以上，与则膝以下相应，故观靥痂但视面上收到之处，则知身上
收到之处，否此者，不合格也。故最宜于人中上下，左右口唇两傍，先出先靥者，吉。
盖以其得阴阳相济之理也，自头面而及手足者为顺；自手足而及头面者为逆。额角先靥
者，谓之孤阳不生，足下先靥者，谓之孤阴不长，皆凶兆也。盖造化之理，生于阳者，
则阴成之。主于阴者，则阳成之。头自发际以上，阳气独盛，谓之孤阳，足自膝盖以
下，阴气所聚，谓之寡阴。凡诸疮皆靥之后，惟此二处难收者，乃造化自然之理，不
可作倒靥论也。
痘疮成熟时，外形如同果实成熟一般，外部没有异常色泽，内部津液充盈，脓浆饱满且呈苍白色，这样就可以期望如期结痂愈合。
到了成浆阶段却需要浆液充足，务必防止出现清水样液体及空瘪的痘囊。痘囊空虚无水则邪气潜伏，清水并非真正的脓浆，此时瘙痒难以忍受。
浆液的生成源于气血，毒邪转化为脓液依靠的是气血的功效。如果不懂得通过培补气血来充灌痘疮，就如同没有米面却要蒸饭一样徒劳。
人们只说等待脓液形成，哪里知道脓液形成后并不足以完全凭信。虽然饱满坚牢确实令人欣喜，但如果湿邪过盛导致痘体软薄又令人惊恐。
失气（放屁）原本与足太阴脾经有关，肠中雷鸣声与足阳明胃经相关，即使是普通的泄泻也不可轻视，因为谷气消亡意味着生命大限临近。
遍身疮痘想要成浆，关键在于患者的脾胃功能强健。如果食量减少但大便干结，说明中气充足；如果大便清稀但能进食，则无妨。
痘疮皮嫩色红娇嫩，等到成脓时会感到瘙痒加剧。在此时必须预先采用补托法治疗，破溃时必然依赖厚重的脓液支撑。
痘疮的正色喜欢红鲜，到了化脓阶段就不一样了，发白或发苍都是正色。如果仍然红嫩则是过失（病态）。
面部正面的诸处疮口不可损伤，稍微损伤一处便是不祥之兆。如果临时瘙痒毫无顾忌，导致破陷、干枯、平塌，患者眼下就会死亡。
额头上的疮如沸水浇淋，面容洗浴后破烂不坚牢，逐渐蔓延至面颊都如此，这是元阳泄尽而毒邪未消的表现。
鼻准头、嘴唇上方以及眉心，耳畔的诸处疮口不可轻视。如果脓液尚未形成就先变黑暗，不要将这种干靥误认为是正常的结痂而延误时机。
手足各处的疮要浆液饱满，充实肥厚呈苍白色是脾气强健的表现。如果淡清稀薄、塞满谷物般的灰白色，即使得到干燥收敛也会有后患。
痘出八九天以后，已经结成干红痂。如果稍有不顺，到这时才形成脓窠。既然已经到了行浆饱满的阶段，还需要按次序收成。如果遇到身体发热严重，停浆不易结痂，这是阳亢阴虚，需用清凉收敛之法。浆足但气促，恐怕是因为痰浊壅滞所致，忽然发生惊厥，可能是小便便秘结。再见到气虚而塌陷，倒靥且黑焦，一则可用温补法，一遇攻发则可救活。如果是泄泻安宁，说明已经大虚少毒。肺寒则下利脓粘，脏毒必然便血。咽喉挫伤声音嘶哑，只要浆行饱满也无妨；塌陷瘙痒咬牙，只要大便实、声音清晰仍可治疗。结痂坚硬，变症最终不会发生；脱屑如麸皮，须担忧余毒蒸发。如果太过分，溃烂难治，收拾身热。如果见到燎浆可畏，空留痘壳不成痂，只是因为浆清热重，腹胀喘呼而塌靥，都是因为毒入内攻。出来不贯黄浆，痂犹如血赤。如果先前曾解毒，此症断定为极美。至于口唇肿硬，是因胃气败绝。如果逢到目睛涕白，总为肝热倍常。喘急发于泻后，乃以气虚而断，便泄继以渴烦，岂为实热而然。泄泻而烦渴不止，理必可以升提。好饮而发渴愈甚，势必难以援救。气虚寒战，痘疮无恙即温经，浆足难收，便实热蒸须解利。进清凉以助结痂，叱补益而防过适。故痂落之余，渐进情凉，毒已去尽，宜疏补益，是以升麻和解，进于未点之初。解毒诸方，用于将靥之际。
痘疮结成痂皮，虽然说生机已成八九，然而余毒变迁，还不能因为结痂就高兴，眼睛闭合腹部胀大，仍蹈危机，虚浮不退，尚属凶咎。痂皮虽成反而导致失声，前恐为黑靥，肿胀未消而眼睛已先睁开，眼开疑是内攻，阳气极而狂叫喘呼。肠兮伤而凄凄不宁。风冷入胃，则利下脓粘；热渗膀胱，则小便尿血。热毒逗留不化，结痂而壮热憎寒，经络各遗余毒，日晡而往来潮热。发在午前为实症，烦渴腮红。申过方作是阴虚，便溏减食。撮唇弄舌，心经热甚何疑。扶肚HT 胸，肺胃毒冲有准；身热燎人便秘，须防暴急惊风。悠悠潮热便溏，久变慢脾风候验。丧明于眼合羞明，辨口疳于唇焦龈黑。实热下注大肠，必有秘结之祸；虚寒客留脏内，乃成泄泻之 。喘渴须分虚实，验症切勿差讹，欲分痂落之余，再审瘢痕之色。桃红光泽，荣卫俱安，黑紫干焦，尚留风热。粉白为气血之虚，周过也应深逝，走马状牙疳之烈，月亦见长驱，遍体赤斑，乃是失于解利，浑身青紫，恐为风寒所吹，余毒未消，不特为疽为疖。见风太早，尤防复发疮痍。
痘疮成脓之后，鲜明肥泽，饱满坚实，以手拭之，而疮头微焦硬者，此欲靥也，然大小前后最宜，渐次收靥，既不失于太急，又不失于太缓。其已靥者，痂壳周圆而无凹凸，及干净黄润而无淫湿破溅者。此为正靥。其先天之毒，已泄于外，先天之元，仍归于中，是否极泰来之象也。然俗谓几日发热，几日出形，几日日起发，几日作浆，几日收靥，此大概言之。夫痘有疏密，毒有浅深，人有虚实。如疮疏而毒微人实而能食，自然易出易靥，即疮稠密而毒盛，其人能食而中气实，气血和而无诸犯，亦可刻期根据限。假如其人中气既虚，饮食既少，内有所伤，外有所感，气候乖变而难靥者，岂可同日语哉！
痘疮收靥之时，毒邪已解，然要先后有次，疾徐得中。如收太急者，只恐浆微血少，枭毒未尽，煎熬津液，以致速枯，轻为余毒，甚至夭枉，宜微利之，以彻其毒。如收太迟者，是中气已虚，脾胃已弱，不能收渗淫湿耳，宜内用参芩补脾，投败草散以视之。
夫脓后结痂，理之常也。有痘疮过期不收，遍身溃烂者，此与斑烂不同，其因有六，有大便秘结，内外热极，表里俱实，热气蒸郁，毒瓦斯散漫而阳气大盛，无阴气以敛之不收者，治宜清凉，或下之。有因泄泻里虚，脾胃亏弱，津液损少，肌肉分虚而元气外散，表里不固，是以阴气太盛，无阳气以敛之不收者，宜用温补。有因渴饮冷水过多，以致水溃于脾，湿淫肌肉而不收者，治宜渗湿。有因天寒，失于盖覆，疮受冻冷而血凝毒滞不收者，治宜温和。有因天热过求温暖，使疮被热蒸而不收者，治宜清凉。有因食少气虚而不收者，宜用补脾。如是以治未溃者，即成痂 ，已溃者，亦渐成痂，方为佳兆。若痂皮俱不结者，则成倒靥而危矣。然大抵痘之成就，犹谷之秋成，盖五谷得阳气以成熟，非凉风至，则不能实也。天地严肃之气一加，则万物秀而实矣。故非阳和则苗不秀，非严肃则秀不实。痘之脓而不焦，犹苗之秀而不实，治之者，或解以成清凉之义，或下以成肃谷之令可也。然亦有脓后，气血虚耗，是以不靥，其症虽似实热，此血气虚甚之假热也。不可与前同视，宜用十全大补汤数剂。如自后而反神倦恶寒者，此邪气退而正气将复，故乃遂见虚象，是《经》所谓∶正气夺则虚也。仍用前药，则自愈也。若溃烂脓汁淋漓，不可着席而粘惹疼痛者，宜败草散，席立衬卧，更以绢袋盛于身上扑之。若面上欲成瘢痕者，宜减瘢散，和百花膏敷之。
夫人中为任督交会之衢，督乃阳脉，自人中而上。任乃阴脉，自人中而下。故有以泰卦象之，人中而上，分为三部，人中以下，亦为三部，发际之上，阳之上也。两眉之间，阳之中也。山根以下，阳之下也。自口至两乳间，阴之上也。自心蔽骨至阴际，阴之中也。自阴而下，阴之下也。凡自准头至印堂，与颏至鸠尾相应，印堂至发际，与鸠尾至膝相应，发际以上，与则膝以下相应，故观靥痂但视面上收到之处，则知身上收到之处，否此者，不合格也。故最宜于人中上下，左右口唇两傍，先出先靥者，吉。盖以其得阴阳相济之理也，自头面而及手足者为顺；自手足而及头面者为逆。额角先靥者，谓之孤阳不生，足下先靥者，谓之孤阴不长，皆凶兆也。盖造化之理，生于阳者，则阴成之。主于阴者，则阳成之。头自发际以上，阳气独盛，谓之孤阳，足自膝盖以下，阴气所聚，谓之寡阴。凡诸疮皆靥之后，惟此二处难收者，乃造化自然之理，不可作倒靥论也。
When the smallpox pustules are mature, their appearance resembles that of a ripe fruit. There is no abnormal discoloration externally, and internally there is abundant fluid. The pus is full and white-grayish in color; under these conditions, one may expect scabbing to form on schedule.
When reaching the stage of pus formation, it is crucial to ensure sufficient pus. One must strictly guard against clear watery discharge and empty blisters. Empty blisters without fluid indicate that pathogenic factors remain latent. Clear fluid is not true pus, and the accompanying itching is unbearable.
The formation of pus originates from Qi and Blood, while the transformation of toxins into pus relies on the efficacy of Qi and Blood. If one does not understand how to tonify Qi and Blood to fill the pustules, it is like attempting to steam rice without rice or flour.
People often say to wait for pus formation, but they do not realize that pus formation alone is not entirely reliable. Although fullness and firmness are indeed gratifying, excessive dampness leading to soft and thin pustules is alarming.
Loss of gas (flatulence) is originally related to the Foot-Taiyin Spleen Meridian, while rumbling in the intestines relates to the Foot-Yangming Stomach Meridian. Even ordinary diarrhea should not be taken lightly, as the depletion of Grain Qi signals the approach of death.
For the whole-body sores to form pus, the key lies in the strength of the patient's Spleen and Stomach. If food intake is reduced but stool is hard, it indicates sufficient Middle Qi. If stool is loose but appetite remains, there is no cause for concern.
The skin of the smallpox sores is tender with a bright red color. As pus forms, itching intensifies. At this stage, preemptive tonification and support (Bu Tuo) therapy is essential. Upon rupture, the presence of substantial pus is critical for support.
The normal color of smallpox sores prefers bright red. However, at the pus stage, this changes: whitish or grayish colors are considered normal. If the color remains tender red, it is pathological.
Sores on the front of the face must not be injured. Injury to even one spot is an inauspicious sign. If itching becomes uncontrollable, leading to rupture, depression, dryness, or flattening, death will occur shortly.
Sores on the forehead resemble boiling water being poured over them. After bathing, the facial skin becomes broken and unstable. If this spreads to the cheeks, it indicates the exhaustion of Primordial Yang and the persistence of toxins.
Sores on the nose tip, above the lips, between the eyebrows, and around the ears must not be neglected. If they turn dark before pus forms, do not mistake this dry scabbing for normal healing, which would delay treatment.
Pustules on the hands and feet require full pus. Full, plump, and grayish-white characteristics indicate strong Spleen Qi. Pale, thin, grayish-white lesions resembling packed grain suggest that even if dry scabs form, adverse consequences will follow.
Nine to ten days after eruption, dry red scabs have formed. If there is any irregularity, pus pits may form at this stage. Since the stage of full pus has been reached, recovery must proceed sequentially. If severe fever occurs, preventing scabbing, this indicates Hyperactive Yang and Yin Deficiency, requiring cooling and astringent therapies. Full pus with shortness of breath suggests phlegm obstruction; sudden convulsions may indicate constipation. Further signs of Qi deficiency with depression, inverted scabbing, and blackened/scorched appearance can be treated with warming tonification or attacking methods to save the patient. If diarrhea is calm, it indicates severe deficiency with little toxin. Cold in the Lungs leads to purulent diarrhea; Zang-Toxin causes bloody stools. Throat trauma with hoarseness is acceptable if pus is full. Depression with teeth grinding is treatable if stool is solid and voice is clear. Hard scabs prevent complications; desquamation like bran requires vigilance against residual toxins. Excessive cases lead to difficult-to-treat ulceration. Fever must be managed. "Liao-pao" (burning blisters) are feared; empty shells failing to scab result from excessive heat clearing in the pus. Abdominal distension, wheezing, and collapsed scabs indicate internal toxin attack. Failure to produce yellow pus results in blood-red scabs. Prior detoxification yields excellent prognosis. Swollen/hard lips indicate failure of Stomach Qi. White eye discharge indicates excessive Liver Heat. Wheezing after diarrhea indicates Qi deficiency; diarrhea followed by thirst/irritability is not excess heat. Persistent diarrhea with thirst requires lifting strategies. Drinking increases thirst, indicating poor prognosis. Qi deficiency with chills requires warming meridians if sores are safe; full pus with difficulty recovering and solid stool with steaming heat requires resolving/diuresis. Cooling aids scabbing; tonification must be guarded against excess. After scab falling, gradually cool; once toxins are gone, gently tonify. Shengma (Cimicifugae Rhizoma) harmonizes early. Detoxifying formulas are used near scabbing.
Although scabbing indicates eight or nine parts of life remaining, residual toxins may change. Closed eyes and abdominal distension still pose crises. Persistent floating edema is ominous. Loss of voice despite scabbing suggests black scabs. Eyes opening before swelling subsides suggests internal attack. Extreme Yang leads to screaming and wheezing. Intestinal injury causes unrest. Wind-cold entering the Stomach causes purulent diarrhea; Heat seeping into the Bladder causes hematuria. Lingering heat/toxins causing high fever/chills after scabbing indicate residual toxins in meridians. Evening tidal fever occurs. Morning onset with irritability/thirst/red cheeks indicates Excess. Afternoon onset with loose stool/reduced appetite indicates Yin Deficiency. Lip curling/tongue playing indicates Heart Heat. Holding belly/chest indicates Lung/Stomach toxin. High fever, constipation, and risk of acute convulsions. Chronic low-grade fever with loose stool may become Slow-Spleen Wind. Blindness/light sensitivity indicates Eye issues; mouth ulcers/black gums indicate Lip/Gum issues. Excess heat sinking to Large Intestine causes constipation; Deficient-Cold in Zang organs causes diarrhea. Thirst/wheezing must distinguish Excess/Deficiency. Scab color analysis follows: Peach-red/glossy indicates healthy Ying-Wei; Black-purple/dry indicates lingering Wind-Heat. Powder-white indicates Qi/Blood deficiency; deep scars imply severe past illness. Rapidly progressing gangrenous stomatitis or widespread red spots indicate failure to resolve/diurese. Whole-body cyanosis suggests Wind-Cold invasion. Residual toxins may cause carbuncles/furuncles. Early wind exposure risks recurrence.
After smallpox matures into pus, appearing bright, plump, firm, and slightly scorched/hard upon touch, scabbing is imminent. Sequential scabbing (front/back, large/small) is ideal—not too fast, not too slow. Normal scabs are round, smooth, clean, yellow-moist, without excessive wetness or rupture. This indicates external release of congenital toxin and return of congenital Yuan Qi to the center, symbolizing extreme turning to prosperity. Folk sayings about days for fever, eruption, rising, pus, and scabbing are generalizations. Pustule density, toxin depth, and person's deficiency/excess vary. Sparse sores/mild toxin/strong constitution/eating well = easy eruption/scabbing. Dense sores/heavy toxin/eating well/Middle Qi strong/Qi-Blood harmonious/no violations = predictable timeline. Weak Middle Qi/poor diet/internal injury/external pathogen/climate deviation = difficult scabbing, cannot compare to others.
During scabbing, toxins are resolved, but order and pace matter. Too fast: scanty pus/blood, unexhausted toxins, boiling fluids, rapid drying, residual toxins, or death. Mild purgation clears toxins. Too slow: weak Middle Qi/Spleen-Stomach, inability to absorb dampness. Use Ginseng/Atractylodes/Kudzu root (Shen, Bai Zhu, Ge Gen) to tonify Spleen; use Baicao San (Grass-Destroying Powder) to observe.
Scabbing after pus is normal. Sores failing to scab after time limit with body-wide ulceration differ from macular eruptions. Six causes exist:
1. Constipation, extreme internal/external heat, exterior-interior excess, steaming heat, scattered toxins, strong Yang lacking Yin to restrain → Cool or purge.
2. Diarrhea, interior deficiency, weak Spleen-Stomach, damaged fluids, empty muscles, scattered Yuan Qi, insecure exterior-interior, strong Yin lacking Yang to restrain → Warm tonification.
3. Excessive cold water drinking, water flooding Spleen, dampness invading muscles → Leach dampness.
4. Cold weather, lack of covering, frostbite, coagulated blood/stagnant toxins → Warm harmony.
5. Hot weather, seeking warmth, heat steaming sores → Cooling.
6. Poor diet, Qi deficiency → Tonify Spleen.
Treating un-ulcerated sores leads to scabbing; treating ulcerated ones leads to gradual scabbing—good omens. Failure to scab leads to inverted scabbing and danger. Smallpox completion resembles autumn harvest: grains need Yang Qi to mature; without cool wind, they don't fill. Heaven-Earth solemn Qi makes things flourish and fill. Without Yang harmony, shoots don't flourish; without solemnity, flourishing doesn't fill. Pus without scabbing is like shoots without filling. Treaters may use cooling resolution or purging to enforce solemnity. However, post-pus Qi-Blood depletion causes non-scabbing. Symptoms mimic excess heat but are false heat from severe deficiency. Do not treat as previous cases; use Shiquan Dabu Decoction (Ten Significant Tonifying Decoction). Later fatigue/chills indicate pathogen retreat and Zheng Qi recovery, showing deficiency. This matches the Classic: "When Zheng Qi is depleted, deficiency appears." Continue previous medicine for self-healing. Ulcerated weeping pus sticking to mats causes pain; use Baicao San, place mat underneath, sprinkle silk bag contents on body. Facial scar prevention: use Jianban San (Scar-Reducing Powder) mixed with Baihua Gao (Hundred Flowers Ointment).
Ren and Du meridians intersect at Renzhong (GV26). Du is Yang, ascending from Renzhong. Ren is Yin, descending from Renzhong. Tai Hexagram represents this: upper three lines above Renzhong (Yang), lower three below (Yin). Hairline above is Upper Yang; between eyebrows is Middle Yang; below Shan Gen (bridge of nose) is Lower Yang. Mouth to breasts is Upper Yin; Xian Gu (xiphoid) to genitals is Middle Yin; below genitals is Lower Yin. Nose tip to Yintang corresponds to chin to Ji Wei (CV10); Yintang to hairline corresponds to Ji Wei to knees; above hairline corresponds to below knees. Observing facial scabbing reveals body scabbing progress. Deviation is abnormal. Auspicious: Renzhong area, lip sides erupting/scabbing first (Yin-Yang harmony). Head-to-foot progression is Smooth; foot-to-head is Reverse. Forehead-first scabbing is "Solitary Yang not growing"; foot-first is "Solitary Yin not lengthening"—both ominous. Creation logic: Yang born, Yin completes; Yin master, Yang completes. Head above hairline is Solitary Yang; feet below knees is Solitary Yin. These two areas are naturally hardest to scab after other sores heal; do not diagnose as inverted scabbing.