〔丹〕痒塌者，于形色脉上分虚实，实则脉有力气壮，虚则脉无力气馁，实痒则势 ，虚痒则气怯。
虚痒，以实表之剂加凉血药；实痒，以大黄寒凉之药少许与之，下其结粪。痘疮痒塌不掩。
白术（一钱半） 黄 （炙，半钱） 当归 陈皮（各五分） 甘草（炙些） 水煎温服。
予治一子七岁，痘将出未出之际，腹泄数行，其泄色黑，不发根窠，三日后痒塌，抓即黑色，口渴，
其根窠如水疥状，不红泽，不起发，食少，脉浮数有力，按之虚。遂用参、 、归、术、陈皮、肉豆蔻
为君，炙甘草、诃子、桂为佐使，水煎熟，好酒些少，咽下，痒立止，食立进。根窠红泽而起发，二服
全愈。
〔丹〕轻者，用淡蜜水调滑石末，以鸡羽润疮上。
〔陈〕痘痒难任，搔之成疮，或脓或血出者，败草散治之。切不可用牛粪灰贴，则臭秽 瘢多矣。
屋烂草（屋上烂草也，如无，墙头上烂草亦可用。此草经霜雪雨露而感天地之气，善解疮毒）
上一味为末，每研碎筛末，若浑身疮破烂，脓水不绝，粘贴衣裳，难以坐睡，可用二三升摊于床褥上，令
儿坐卧，其效如神。
小儿痘疮痒难任，误搔成疮，及疮痂欲落不落。用上好白蜜一味，涂于疮上，其痂易落，可无紫黑瘢痕。
（世传痘靥落后，痘毒不尽，变成癞癣，其痒难任，用陈年腊脂油敷，神妙。）
又方 用羊 骨髓，炼一二沸，入轻粉少许，研成白膏，瓷合盛之，涂疮效。
【丹波元坚】痘疮出现瘙痒且伴有塌陷的情况，需要依据面色、形态和脉象来辨别虚实。实证表现为脉象有力、气息壮盛；虚证表现为脉象无力、气息怯弱。实证引起的瘙痒则病势较盛，虚证引起的瘙痒则气机怯弱。
对于虚证引起的瘙痒，使用固护体表的方剂并加入凉血药物；对于实证引起的瘙痒，给予少量大黄等寒凉药物，以通下其体内结聚的粪便。痘疮瘙痒且塌陷时不可掩盖（指不可因痒而抓破或遮盖伤口）。
白术（一钱半） 黄芪（炙，半钱） 当归 陈皮（各五分） 甘草（炙，适量） 加水煎煮，温服。
我治疗过一个七岁男孩，在痘疹即将发出但尚未完全发出的阶段，腹泻数次，排泄物颜色发黑，痘根没有隆起。三天后出现瘙痒和塌陷，抓挠后变为黑色，口渴，痘根形状像水疱，不红润光泽，不能起发，食欲减退，脉象浮数有力，但重按则感觉虚弱。于是用人参、黄芪、当归、白术、陈皮、肉豆蔻作为主药，炙甘草、诃子、桂枝作为辅佐药，加水煎熟，加入少许好酒送服，瘙痒立即停止，食欲立即恢复。痘根变得红润光泽并开始起发，服用两剂后痊愈。
【丹波元坚】症状较轻者，用淡蜂蜜水调和滑石粉末，用鸡毛蘸取涂抹在疮面上。
【陈氏】痘疮瘙痒难忍，抓挠后形成疮口，流出脓液或血液的，用败草散治疗。切不可使用牛粪灰贴敷，否则会导致气味臭秽且留下较多瘢痕。
屋烂草（即屋顶上的腐烂草，如果没有，墙头上的烂草也可以使用。这种草经过霜雪雨露滋润，感应了天地之气，善于解除疮毒）
以上一味药研成细末，每次取适量研碎筛细。如果全身疮面破烂，脓水不断，粘连衣物，难以坐卧，可用二三升铺在床褥上，让孩子坐在上面，效果神奇。
小儿痘疮瘙痒难忍，误抓导致成疮，以及疮痂欲落未落之时。用上好的白蜜一味，涂抹在疮面上，其痂皮容易脱落，可不留紫黑色的瘢痕。
（世间流传：痘靥脱落后，痘毒未尽，变成癞癣，瘙痒难忍，用陈年的腊猪脂油敷涂，神妙有效。）
[Dan Bo Yuan Jian] Itchiness and collapse of smallpox lesions should be differentiated as excess or deficiency based on the complexion, morphology, and pulse. In excess patterns, the pulse is forceful and the qi is robust; in deficiency patterns, the pulse is weak and the qi is timid. Excess itchiness presents with a vigorous pathological trend, while deficiency itchiness presents with timid qi.
For deficiency-induced itchiness, use a formula that consolidates the exterior combined with blood-cooling herbs; for excess-induced itchiness, administer a small amount of cold and cool herbs such as *Rhei Radix et Rhizoma* (Dahuang) to purge accumulated feces. Smallpox lesions with itchiness and collapse should not be covered/obscured.
*Psoraleae Fructus* (Baizhu, 1 qian 5 fen), *Astragali Radix* (Huangqi, roasted, 0.5 qian), *Angelicae Sinensis Radix* (Danggui), *Citri Reticulatae Pericarpium* (Chenpi, each 0.5 fen), *Glycyrrhizae Radix et Rhizoma* (Gancao, roasted, appropriate amount). Decoct in water and take warm.
I treated a seven-year-old boy who, at the stage when smallpox was about to erupt but had not yet fully emerged, suffered several episodes of diarrhea with black-colored stool. The lesion bases did not elevate. Three days later, he developed itchiness and collapse; scratching turned the lesions black. He experienced thirst. The lesion bases resembled vesicles, were not red and lustrous, failed to elevate, and he had poor appetite. His pulse was floating, rapid, and forceful, but empty upon deep pressure. I used *Ginseng Radix* (Renshen), *Astragali Radix* (Huangqi), *Angelicae Sinensis Radix* (Danggui), *Atractylodis Macrocephalae Rhizoma* (Baizhu), *Citri Reticulatae Pericarpium* (Chenpi), and *Myristicae Semen* (Roudoukou) as the principal herbs, with roasted *Glycyrrhizae Radix et Rhizoma* (Zhi Gancao), *Terminalia Chebula Retusa* (Hezi), and *Cinnamomi Ramulus* (Guizhi) as assisting and guiding herbs. After decocting in water, a small amount of good wine was added for administration. The itchiness stopped immediately, and appetite returned immediately. The lesion bases became red and lustrous and began to elevate. He recovered completely after two doses.
[Dan Bo Yuan Jian] For mild cases, mix fine powder of *Talcum* (Huashi) with light honey water, and apply it to the lesions using a chicken feather.
[Chen Shi] When smallpox itchiness is unbearable, leading to sores from scratching with pus or blood discharge, treat with Baicao San (Decoction of Defective Grass). Do not apply ash from cow dung under any circumstances, as this will cause foul odor and excessive scarring.
Wu Lan Cao (Rotting grass found on roofs; if unavailable, rotting grass on walls can also be used. This grass has been nourished by frost, snow, rain, and dew, absorbing the qi of heaven and earth, and is effective in resolving toxin accumulation in sores).
Take the above single herb, grind into fine powder. If the entire body is covered with broken sores with continuous pus discharge, sticking to clothes and making sitting or sleeping difficult, spread two or three sheng of the powder on the bed mattress, allowing the child to sit and lie on it. The effect is miraculous.
For children with unbearable smallpox itchiness, accidental scratching causing sores, and scabs that are reluctant to fall off: apply pure white honey to the lesions. This facilitates easy shedding of scabs and prevents purple-black scars.
(Tradition holds: After the smallpox crusts fall off, if the toxin remains incomplete, it may transform into leprosy-like tinea with unbearable itchiness. Applying aged rendered lard is miraculously effective.)
Another prescription: Use sheep bone marrow, boil for one or two boils, add a small amount of *Calomelas* (Qingfen), grind into a white paste, store in a porcelain container, and apply to the lesions for efficacy.