夫内之心肝脾肺肾，应乎外之耳目口鼻，所以好视者伤肝，好言者伤心，好听者
伤肾，好闻者伤肺，而痘之所恃者，血以养之，气以扩之，则斯能鼎峻充灌。然五官不
驰情于外，则元气自旋运于内，五官逐情于物，则元气耗散于中，故鼻乃肺之窍，肺之
所主者皮毛，所纳者卫气，痘赖肺气以终始，鼻封则气不逐于外，而气有所归矣。肝
之所主者筋，所纳者血。夫眼乃肝之窍，痘赖肝血以滋荣，眼蛤则气不驰于外而血有所
养矣，故痘必欲其封蛤也。若痘出阳明，与脾则经正，而阴阳相辅，虽鼻不封而气自
至。眼不蛤而血自荣。倘经于心肺而痘不封蛤，则经心者，椒皮铁叶，经肺者，HT 蚨连
薄，其势则然也。三四日而封蛤者，则易充易靥；六七日而封蛤者，则难足难痂。封而
不蛤，则阴不能以滋阳，蛤而不封，则阳不能以卫阴。然封者，十之四五，蛤者，十之
七八，但其间又有微焉。鼻封而窍外干者，死。如封有涕者，美之征也。眼蛤而沿眶如
涂煤者，死。若蛤而生泪者，吉之兆也。至若如脓之浊，流溢无拘者，又是毒火内灼，
津液外脱之象，此极恶之症，不可以为吉论也。
《经》曰，热胜则肿，大抵毒之盛者必肿，毒微者不肿。凡痘疮出尽，应期起发而
痘以渐长，头面以渐肿者，此毒火发越，聚于三阳之分，欲作脓血，以渐肿大，疮尖而
圆，磊落红活，因痘肿而乃皮肉 肿者，此正候也，亦顺候也。如疮本磊落，毒瓦斯轻
浅，根不密，此所以起发之时，不甚壅肿者，此毒轻候也，更顺候也。如疮本模糊，
起发不肿者，此毒伏于内而不发泄，是又不可以毒轻为论也。若一发多起。无复题粒，
皮色鲜红，疮本成串，粘聚平塌者，并疮色灰白，成饼如锡面者，并疮焦紫而无脓浆
者，不分肉痘。一齐 肿，并皆凶兆也。更有痘未起发而头面预肿，皮光色艳，如瓠瓜
之状者，此毒恶之气，上侵清虚之府。夫五脏精华，皆聚于头面而泥丸宫者，又元辰真
人出入之处也。恶毒上侵，则五精俱丧，元辰亦亡，丧精亡神，其后必痒塌而死矣。此
兼皮毒之气，名大头瘟者是也。惟初起之时，急以羌活救苦汤服之。若腮颊预肿者，
此名蛤蟆瘟也。并宜兼疫气而治，亦以前汤为主，然系多凶少吉者也。即应期肿胀者，
亦必直至浆干痂结，而毒化肿消为妙，兼在肿胀之时，切忌瘙痒，盖正面之中，不可少
有破损，苟生痒破，则沙崩之势，渐不可为，必毒瓦斯内陷，真气外泄，肿消而死矣。
惟得破者复灌，消者复肿，饮食如常，二便自调者，则或变凶为吉，然尤宜用十全大补
汤以助之。如疮色灰白面肿如锡饼者，此又宜着其脏腑何如，若饮食无减，二便如常，
无他苦者，犹可斡旋。若不能食，吐利并作，或生瘙痒者，死之必也。夫浮肿者，譬
诸夫谷种，谷种必胀，而元气萌达，于是苗而秀，秀而实矣。况痘发于脾土，土必虚，
则草木华茂，故痘必欲其浮肿也。浮肿者，乃毒火游于至阜之间，阴阳交相克侮。盖脾
主肌肉，故肌肉之浮肿，由毒瓦斯之洋溢也。若气血充盛者，自能逐毒出表，直入窠囊，
为溃为脓，所以痘肿而肉亦肿也，顺也。血气不足者，虽已载毒达表，无力直透窠囊为
隐为伏，散漫皮肤，所以肉肿痘不肿也，逆也。治者一见其机，便为大补气血之中，重
用角刺、天虫、穿山甲之类，则毒有所归自无妄肿之患矣。
张按前古哲之论，可谓备而悉者矣。但于大补气血之中，而重用天虫、甲并攻托之
药，不无仍借有形药力之猛，而逐无形变现之虚。若遇大虚，根本不固者，正气无力主
持，势必任药攻逐之性，奔溃无根据，浮肿之患，不能保其必无也。梦寐求之，始得至
理。凡于发热见点之时，按其脉之阴阳虚实而施治。如脉洪而属阴虚也，则于补阴药
中，加以鼓舞之药。如脉微而属阳虚也，则于补阳药中，加以鼓舞之药。阴阳既和，痘
点自了出，排列匀净，磊落粗肥，断无团聚，细密歪斜，不正之形焉，有日后散漫皮
肤之患。至于势将起胀行浆，亦必按其脉之阴阳虚实，或从阳，或从阴，预为调理，仍
加鼓舞之味，则正旺足以制邪，邪无虚可凑而顺正矣。盖痘所赖者气血，欲补其气，必
重脾元，况土德能化毒也。欲补其血，必为滋水，盖滋水兼得养血也。然脾土之益，亦
赖真火以生之，真阴之长，更赖真阴以煦之，故张深悟其旨，凡遇气虚之痘，古人用
参饮加肉桂，名为保元汤《博爱心鉴》一书，已备言其功矣。若阳虚脾元不足之痘，
更宜参苓白术姜桂，恐其燥槁，少佐酒炒当归，投之则起胀灌脓，便得捷效。至于阴虚
不足，水亏金燥之症，古人未有专方，余用熟地为君，山药为臣，少佐肉桂，三味煎
浓，另煎人参冲服，但用人参，勿用黄 ，则行浆成实，应奏神功。要知真阴者，乃肾
水而非肝心之血也。真阳者，乃命火而非脾肺之气也。是以肾水，重熟地而不用芎，补
命火乃肉桂而非 术，故张于重痘灌脓之时，但用地药参桂数味，与水火有情，方得必性纯而力峻，
不兼以天虫甲片，与气血非类，一睛能荷正以祛邪，既有熟地滋水之专功， 更得肉桂走窜化脓之神力，山
药养胃，人参驾驱，气血得力，自可化毒成功，脓浆腐熟随手饱满。盖脓浆之来，虽由于肝血，实资于真水。脓浆之收
，虽赖于脾土，实藉于真火耳。然发表时用桂者，能走血分，无微不达也。将靥时尚有可用者，余毒尽化于表而无
留伏之虑也。俟至气变纯阳，脓发腐熟，方投解毒清凉，如盛暑炎灼而忽凉风一至，更见其神矣。其用桂不用附者，何也？附能直达阴分，非若桂之走窜，达表更能上行，直达血分动而还者也。用攻托之药者，以力制毒也。用煦濡鼓舞之功者，以德化毒也。制则由乎勉强，中多反复化则由乎自然，终始无移，心求至理，敢补所遗。
【论封蛤 / 论浮肿】
内在的心、肝、脾、肺、肾，对应外在的耳、目、口、鼻。因此，过度用眼会损伤肝脏，过度言语会损伤心脏，过度听音会损伤肾脏，过度嗅闻气味会损伤肺部。而痘疹（天花）所依赖的，是以血液来滋养它，以气机来扩充它，这样才能使痘疹饱满隆起。如果五官不向外追逐情欲，元气自然会在体内运转；如果五官被外物牵引情感，元气就会在体内耗散。所以，鼻子是肺的窍道，肺所主管的是皮毛，所容纳的是卫气（行于脉外、具有护卫肌表作用的气），痘疹依赖肺气来完成其发生发展的全过程。如果鼻塞不通（封），气机就不向外发散，从而有所归聚。肝所主管的是筋，所容纳的是血。眼睛是肝的窍道，痘疹依赖肝血来滋润荣华。如果眼睑闭合（蛤），气机就不向外驰散，血液就能得到涵养。所以，痘疹必然希望出现“封蛤”的现象。如果痘疹发于阳明经，与脾经正气相合，阴阳相互辅助，即使鼻子没有闭塞，气机也会自然到达；眼睛没有闭合，血液也会自然荣华。倘若病经于心肺而痘疹没有“封蛤”，那么经过心脏的，痘形像椒皮铁叶一样坚硬；经过肺部的，痘形像枯叶薄纸一样脆弱，其势态就是如此。发病后三四天就出现“封蛤”的，容易充灌饱满且容易结痂；六七天才出现“封蛤”的，则难以饱满且难以结痂。“封”而不“蛤”，阴气不能滋养阳气；“蛤”而不“封”，阳气不能护卫阴气。然而，“封”的情况占十分之四五，“蛤”的情况占十分之七八，但其中又有细微差别。如果鼻子闭塞但鼻孔外部干燥的，主死。如果闭塞但有鼻涕流出的，是美好的征兆。如果眼睑闭合但眼眶周围像涂了黑炭一样的，主死。如果眼睑闭合且有眼泪流出的，是吉祥的预兆。至于像脓液那样浑浊、流淌不受拘束的，这是毒火在内灼烧、津液在外脱失的象征，这是极其凶恶的病症，不能认为是吉兆。
《黄帝内经》说：“热盛则肿。”大抵毒性旺盛的必然会肿胀，毒性轻微的不会肿胀。凡是痘疮出齐，到了应期开始起发，痘疹逐渐长大，头面部逐渐肿胀的，这是毒火发散，聚集在三阳经的部位，想要化脓成血，逐渐肿大，疮顶圆润，磊落红活，因为痘肿而导致皮肉也肿胀的，这是正常的征候，也是顺证。如果疮本来磊落分明，毒气轻浅，根基不紧密，所以在起发的时候，不太壅滞肿胀的，这是毒轻的征候，更是顺证。如果疮本来模糊不清，起发时不肿胀的，这是毒伏在内部而不能发泄，这又不能说是毒轻。如果一发出来就密集成片，不再有颗粒感，皮色鲜红，疮本连成串，粘聚平塌的，以及疮色灰白，结成饼状像锡面一样的，以及疮焦紫而没有脓浆的，不分肉痘，一齐肿胀，都是凶兆。更有痘疹尚未起发，头面部预先肿胀，皮肤光亮颜色鲜艳，像瓠瓜形状的，这是恶毒之气，向上侵犯清虚的头面部位。五脏的精华，都汇聚于头面和泥丸宫（脑），这也是元辰真人出入的地方。恶毒上侵，则五脏精气都丧失，元辰也随之消亡，丧精亡神，其后必然因瘙痒塌陷而死。这兼有皮毒之气，名叫大头瘟的就是这种。只有在初起之时，急忙服用羌活救苦汤。如果腮颊预先肿胀的，这名叫蛤蟆瘟。并宜兼治疫气，也以之前的方剂为主，但这属于多凶少吉的病证。即使是按时肿胀的，也必须直到浆干痂结，毒化解、肿消退才算妙处。兼且在肿胀之时，切忌瘙痒，因为面部正中，不可稍有破损，如果产生瘙痒抓破，则沙崩之势，渐渐无法挽回，必然导致毒瓦斯内陷，真气外泄，肿消而死。只有那些破损后又灌脓，消退后又肿胀，饮食如常，大小便自然调畅的，才能变凶为吉，此时尤其适宜用十全大补汤来辅助。如果疮色灰白而面肿像锡饼一样的，这又应当考察脏腑情况如何，如果饮食没有减少，二便如常，没有其他痛苦的，还可以挽救。如果不能进食，呕吐腹泻同时发作，或者产生瘙痒的，必定死亡。
关于浮肿，譬如谷种，谷种必然膨胀，元气萌动通达，于是抽苗开花，开花结果。何况痘疹发于脾土，土气必然虚弱，则草木茂盛，所以痘疹必然希望其浮肿。浮肿，是毒火游走于至阜（高地/体表）之间，阴阳相互克制侮逆。脾主管肌肉，所以肌肉的浮肿，是由毒气的洋溢造成的。如果气血充盛的，自然能驱逐毒邪出于体表，直接入于窠囊，化为溃烂成脓，所以痘肿而肉也肿，这是顺证。如果血气不足的，虽然已经载毒达表，但没有力量直接透入窠囊成为隐蔽潜伏的状态，而是散漫在皮肤表面，所以肉肿而痘不肿，这是逆证。治疗者一见此机转，便在大力补益气血之中，重用皂角刺、僵蚕、穿山甲之类的药物，则毒邪有所归依，自然没有妄肿的祸患。
张氏按语：前代古哲的论述，可谓详尽完备了。但在大补气血之中，重用僵蚕、穿山甲等攻托的药物，不免仍然借助有形药力的猛烈，去驱逐无形变现的虚邪。如果遇到大虚、根本不稳固的患者，正气无力主持，势必任由药物攻逐的性质，奔溃无根据，浮肿的祸患，不能保证一定不发生。我梦寐以求，才得到至理。凡是在发热见点的时候，按照脉象的阴阳虚实来施治。如果脉洪大而属阴虚的，则在补阴药中，加入鼓舞的药。如果脉微细而属阳虚的，则在补阳药中，加入鼓舞的药。阴阳既已调和，痘点自然顺利发出，排列匀净，磊落粗肥，断不会有团聚、细密歪斜、不正的形状，也就没有日后散漫皮肤的祸患。至于势将起胀行浆的时候，也必须按照脉象的阴阳虚实，或从阳治，或从阴治，预先调理，仍加鼓舞的味道，则正气旺盛足以制约邪气，邪气没有虚可乘而顺应正气。大概痘疹所依赖的是气血，想要补气，必须重在脾元，何况土德能化解毒邪。想要补血，必须滋补肾水，因为滋水兼得养血的功效。然而脾土的益处，也赖真火来生它，真阴的增长，更赖真阴来温煦它。所以张氏深悟其旨意，凡遇到气虚的痘疹，古人用人参饮加肉桂，名为保元汤，《博爱心鉴》一书，已经详尽说明了它的功效。如果是阳虚脾元不足的痘疹，更适宜用人参、茯苓、白术加姜、桂，恐怕其燥槁，稍佐酒炒当归，投服则起胀灌脓，便能获得捷效。至于阴虚不足、水亏金燥的病症，古人没有专用方剂，我用熟地黄为君药，山药为臣药，稍佐肉桂，三味煎浓，另煎人参冲服，只用人参，不用黄芪，则行浆成实，应奏神功。要知道真阴，是肾水而不是肝心之血。真阳，是命门之火而不是脾肺之气。所以补肾水，重用熟地而不用川芎；补命火乃用肉桂而非白术。所以张氏在重症灌脓之时，只用生地、熟地、人参、肉桂几味药，与水火有情，方能本性纯而力峻，不兼用僵蚕、穿山甲片，因为这些与气血非同类。一旦睛明能荷正以祛邪，既有熟地滋水的专功，更得肉桂走窜化脓的神力，山药养胃，人参驾驭，气血得力，自然可化毒成功，脓浆腐熟随手饱满。大概脓浆的到来，虽然由于肝血，实则资源于真水。脓浆的收敛，虽然赖于脾土，实则藉助于真火。然而发表时用桂枝，能走血分，无微不达。将结痂时还有可用的，余毒尽化于表而无留伏的顾虑。等到气变纯阳，脓发腐熟，方才投予解毒清凉药，如同盛暑炎灼而忽凉风一至，更显神奇。为什么用桂而不用附子？附子能直达阴分，不像桂枝走窜，达表更能上行，直达血分动而还。用攻托的药物，是用力量制毒。用煦濡鼓舞的功效，是用德行化毒。制毒则由乎勉强，中间多有反复；化毒则由乎自然，终始无移。用心寻求至理，敢补所遗漏之处。
[On Sealing and Closing / On Edema]
The internal Heart, Liver, Spleen, Lung, and Kidney correspond to the external ears, eyes, mouth, and nose. Therefore, excessive use of vision damages the Liver (Gan), excessive speech damages the Heart (Xin), excessive listening damages the Kidney (Shen), and excessive smelling damages the Lung (Fei). What the variola (smallpox) relies upon is nourishment by blood and expansion by Qi, so that it can become full and prominent. If the five orifices do not chase desires outwardly, Yuan Qi (Original Qi) will naturally circulate internally; if the five orifices are led by external objects emotionally, Yuan Qi will dissipate internally. Thus, the nose is the orifice of the Lung; the Lung governs the skin and hair and houses Wei Qi (Defensive Qi). The variola relies on Lung Qi for its beginning and end. If the nose is blocked (Feng), Qi does not scatter outward but finds a归宿 (return/gathering). The Liver governs the sinews and houses Blood. The eye is the orifice of the Liver; the variola relies on Liver Blood to moisten and prosper. If the eyelids close (Ge), Qi does not scatter outward, and Blood is nourished. Therefore, the variola must desire the state of "Sealing and Closing." If the variola emerges in the Yangming channel, harmonizing with the Spleen channel's righteousness, Yin and Yang assist each other; even if the nose is not blocked, Qi arrives naturally; even if the eyes do not close, Blood prospers naturally. However, if the path goes through the Heart and Lung but the variola does not seal and close, those passing through the Heart resemble pepper skin and iron leaves (hard/stubborn); those passing through the Lung resemble dry leaves and thin paper (fragile). Such is their momentum. Those that seal and close on the third or fourth day are easy to fill and easy to scab over; those that seal and close on the sixth or seventh day are difficult to fill and difficult to scab. "Sealing" without "Closing" means Yin cannot nourish Yang; "Closing" without "Sealing" means Yang cannot protect Yin. However, "Sealing" accounts for four or five out of ten cases, and "Closing" accounts for seven or eight out of ten cases, yet there are subtle distinctions within. If the nose is blocked but the nostrils externally are dry, death ensues. If there is mucus when blocked, it is a good omen. If the eyelids close but the orbital rim looks like blackened charcoal, death ensues. If the eyelids close and tears flow, it is an auspicious sign. As for turbidity like pus, flowing freely without restraint, this is a manifestation of toxic fire burning internally and body fluids escaping externally; this is an extremely malignant symptom and cannot be considered auspicious.
The Classics state: "Excess heat causes swelling." Generally, severe toxicity必然 leads to swelling, while mild toxicity does not. When all pox have erupted and reached the expected stage of rising, as the pox gradually grow and the head and face gradually swell, this indicates toxic fire dispersing and gathering in the three Yang regions, intending to form pus and blood, swelling gradually. With round, distinct, red, and vibrant pustules, where the swelling of the pox causes the skin and flesh to swell, this is the normal pattern and also a favorable course. If the lesions were originally distinct, the toxic qi was light and shallow, and the roots were not dense, so during the rising phase, there is little congestion or swelling; this is a sign of light toxicity and an even more favorable course. If the lesions were originally indistinct and did not swell during the rising phase, this indicates toxicity hidden internally without being expressed; this cannot be judged as light toxicity. If eruption occurs densely in clusters, losing individual grain-like definition, with bright red skin color, lesions connected in strings, adherent and flat; or if the lesion color is grayish-white, forming cakes like tin surfaces; or if the lesions are scorched purple without pus; these mixed flesh-pox cases, swelling all at once, are all ominous signs. Furthermore, if the head and face swell prematurely before the pox rise, with smooth, shiny, and bright skin resembling a gourd, this is evil toxic qi invading the clear and empty upper orifices. The essence of the five Zang organs gathers in the head and face and the Niwan Palace (brain), which is also the passage for the Yuan Chen True Person. Evil toxicity invading upward causes the loss of the five essences and the demise of Yuan Chen; losing essence and spirit, death inevitably follows from itching and collapsing. This involves skin toxicity qi, known as Da Tou Wen (Big Head Plague). At the initial stage, one must urgently administer Qiang Huo Jiu Ku Tang (Notopterygium Decoction for Saving from Bitterness). If the cheeks and jawline swell prematurely, this is called Ha Ma Wen (Toad Plague). It should be treated concurrently with epidemic qi, primarily using the aforementioned decoction, though this condition is mostly ominous with few auspicious outcomes. Even if swelling occurs on schedule, it is only excellent until the pus dries and scabs form, with toxin resolved and swelling subsided. During the swelling phase, one must strictly avoid itching, as any damage to the central face is unacceptable. If itching leads to rupture, the situation becomes uncontrollable, leading to internal sinking of toxic qi and external leakage of true Qi, resulting in death after swelling subsides. Only those whose ruptures refill with pus, whose subsidence reverses to swelling, who maintain normal diet, and whose urination and defecation are self-regulated can turn misfortune into fortune; at this time, it is especially appropriate to use Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) to assist. If the lesion color is grayish-white and the face swells like a tin cake, one must examine the state of the Zang-Fu organs. If diet is unchanged, excretions are normal, and there is no other suffering, recovery is still possible. If unable to eat, vomiting and diarrhea occur simultaneously, or itching arises, death is certain.
Regarding edema, consider a grain seed: the seed must swell, allowing Yuan Qi to sprout and reach forth, then shoot up, bloom, and bear fruit. Moreover, since the variola originates in the Spleen Earth, and Earth is necessarily deficient, vegetation flourishes; thus, the variola must desire edema. Edema is toxic fire wandering between the high grounds (body surface), with Yin and Yang mutually overcoming and insulting. The Spleen governs muscles; therefore, muscle edema is caused by the overflow of toxic qi. If Qi and Blood are abundant, they naturally drive the toxin out to the exterior, directly entering the nest/cavity, becoming ulcerated and purulent; thus, both pox and flesh swell, which is a favorable course. If Qi and Blood are insufficient, although they carry the toxin to the surface, they lack the strength to penetrate directly into the nest, causing it to scatter across the skin; thus, flesh swells but pox do not, which is an unfavorable course. Upon seeing this mechanism, the practitioner should heavily employ Zao Ci (Gleditsia Sinensis Spine), Jiang Can (Bombyx Batryticatus), and Chuan Shan Jia (Pangolin Scale) amidst heavy tonification of Qi and Blood, so that the toxin has a destination and avoids reckless swelling.
Commentary by Zhang: The discussions of ancient sages can be said to be thorough and detailed. However, in the midst of greatly tonifying Qi and Blood, heavily employing Jiang Can and Chuan Shan Jia as attacking and supporting drugs, one inevitably relies on the fierce power of tangible medicines to drive away intangible, manifesting deficiency. If encountering severe deficiency with an unrooted foundation, Zheng Qi (Upright Qi) lacks the strength to hold command, inevitably yielding to the attacking nature of the drugs, leading to collapse without basis; the hazard of edema cannot be guaranteed against. I sought this truth in dreams and finally attained the supreme principle. Whenever fever begins and spots appear, treatment should be administered according to the pulse's Yin-Yang and Deficiency-Excess. If the pulse is surging and belongs to Yin deficiency, add stimulating/driving herbs to Yin-tonifying medicines. If the pulse is faint and belongs to Yang deficiency, add stimulating/driving herbs to Yang-tonifying medicines. Once Yin and Yang are harmonized, the variola spots will emerge smoothly, arranged evenly, distinct and plump, definitely avoiding clustering, fine density, or crooked irregular shapes, thereby preventing future scattering across the skin. When approaching the swelling and pus-filling stages, one must again assess the pulse's Yin-Yang and Deficiency-Excess, treating either from Yang or Yin, preparing in advance, and still adding stimulating flavors, so that strong Zheng Qi can control Xie Qi (Pathogenic Qi), leaving no deficiency for Xie Qi to exploit, thus aligning with Zheng Qi. Essentially, what the variola relies upon is Qi and Blood. To tonify Qi, one must focus on the Spleen Yuan; moreover, Earth virtue can transform toxins. To tonify Blood, one must nourish Water (Kidney), as nourishing Water also benefits Blood generation. However, the benefit of Spleen Earth also relies on True Fire to generate it, and the growth of True Yin relies on True Yin to warm it. Thus, Zhang deeply understood this purport. Whenever encountering Qi-deficient variola, ancients used Renshen Yin (Ginseng Drink) plus Rou Gui (Cinnamon Bark), named Bao Yuan Tang (Protect Origin Decoction); the book *Bo Ai Xin Jian* has already fully described its merits. For variola with Yang deficiency and insufficient Spleen Yuan, it is better to use Renshen Ling Zhu Tang (Ginseng, Poria, and Atractylodes Macrocephala Powder) with Ginger and Cinnamon. Fearing dryness, slightly add Jiuhuang Dang Gui (Wine-fried Angelica Sinensis); administering this yields rapid effects in raising swelling and filling pus. For Yin deficiency insufficiency and Water-depletion with Metal-dryness symptoms, ancients had no specific formula. I use Shu Di Huang (Prepared Rehmannia Root) as Sovereign, Shan Yao (Dioscorea Opposita) as Minister, with a small addition of Rou Gui (Cinnamon Bark). Decoct these three strongly, and separately decoct Renshen (Ginseng) to mix in. Use only Renshen, not Huang Qi (Astragalus), so that pus fills and matures, achieving miraculous results. Know that True Yin is Kidney Water, not Liver-Heart Blood. True Yang is Ming Men Fire, not Spleen-Lung Qi. Therefore, to tonify Kidney Water, heavily use Shu Di Huang and do not use Xiong Diao (Chuanxiong); to tonify Ming Men Fire, use Rou Gui, not Bai Zhu (Atractylodes). Thus, Zhang, during the critical stage of pus filling, uses only Di Huang (Rehmannia), Renshen, and Rou Gui. These interact favorably with Water and Fire, ensuring pure nature and potent force. Not combining Jiang Can and Chuan Shan Jia, which are not of the same category as Qi and Blood, allows clarity to uphold Zheng Qi and dispel Xie Qi. With Shu Di Huang's dedicated function of nourishing Water and Rou Gui's divine power of moving and transforming pus, Shan Yao nourishes the Stomach, and Renshen drives the process; Qi and Blood gain strength, naturally transforming toxin and succeeding. Pus formation, though originating from Liver Blood, actually draws support from True Water. Pus contraction, though relying on Spleen Earth, actually depends on True Fire. When releasing the exterior, using Gui Zhi (Cinnamon Twig) can enter the Blood level, reaching every minute detail. Before scabbing, it is still usable, as residual toxins are entirely transformed at the surface without lingering concerns. Wait until Qi transforms to pure Yang, pus erupts and ripens, then administer detoxifying and cooling formulas; this is like a cool breeze arriving suddenly in intense summer heat, appearing even more miraculous. Why use Gui Zhi instead of Fu Zi (Aconite)? Fu Zi reaches the Yin level directly, unlike Gui Zhi which moves and penetrates, reaching the surface and ascending further, directly entering the Blood level and returning dynamically. Using attacking/supporting drugs controls toxin by force. Using warming/moistening and stimulating functions transforms toxin by virtue. Control is forced and often recurrent; transformation is natural and consistent throughout. Seeking the supreme principle with heart, I dare to supplement what was omitted.