条文：111
气血虚寒不振扬，灰白陷顶少脓浆，速用参归鹿茸剂，鸡冠血酒更堪尝。
[注]
痘至灌浆时，其色淡白，根无红晕，而顶陷者，是谓白陷，
虚极则转为灰陷，由气虚委而不，血虚浆不能充，故一陷而不可遏也，
治宜大补气血为主，宜参归鹿茸汤，临服入鸡冠血酒，
日进二三服，但得顶起浆行方免无恙。
(参归鹿茸汤) 方见灌浆证治。
(鸡冠血酒) 用大雄鸡一只，先将白酒一杯炖温，次刺鸡冠血数点，
滴入杯中和匀，仍炖温调煎药内服。
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条文：112
紫陷黑陷皆毒盛，平塌昏黯根不松，此属气血被火郁，解毒急宜用归宗。
【注】
痘出稠密，颗粒碎小，根紧昏黯，顶凹下而紫者，谓之紫陷，
甚而转为黑色，则为黑陷，
皆由毒火郁闭，气不宣通故也，
治宜清热解毒，以归宗汤主之。
（归宗汤）方见发热证治。
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条文：113
浆未充足痘板黄，顶塌成片皮硬僵，气滞血凝难灌溉，皆缘毒热侵脾乡，
速服清毒活血剂，毒化痘起转安康。
【注】
板黄者，谓灌脓时浆未得半，忽然黄色突起，干燥坚硬，
盖因枭毒肆害脾乡，故气滞血凝，难以灌溉也，须用清毒活血汤治之，
倘得痘起尚可望生，若头面颈项眼眶唇上，及周身黄者，则不治也。
(清毒活血汤) 当归 白芍药酒炒 生地黄 紫草茸酒炒 黄芩 黄连酒炒
牛蒡子炒 南山查 连翘去心 人参 黄耆生 桔梗 木通引用灯心水煎服。
(方歌)
清毒活血汤最灵，归芍生地紫草茸，芩连牛蒡山查翘，参耆桔梗合木通。
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条文：111
气血虚弱寒冷，不能振奋升发，痘疹呈现灰色或白色且顶部凹陷，脓浆稀少，应迅速使用人参、当归、鹿茸组成的方剂，并饮用鸡冠血酒以辅助治疗。
[注]
痘疹发展到灌浆期时，如果颜色淡白，根部没有红晕，且顶部凹陷，这称为“白陷”。
如果虚损到了极点，就会转变为“灰陷”，这是由于气虚导致萎靡不振，血虚导致脓浆无法充盈，所以一旦凹陷就无法遏制。
治疗应当以大补气血为主，适宜使用参归鹿茸汤，服药前加入鸡冠血酒，
每天服用两到三次，只要看到痘顶隆起、脓浆运行，才能避免危险，恢复健康。
（参归鹿茸汤）方剂见“灌浆证治”章节。
（鸡冠血酒）取一只大公鸡，先将一杯白酒炖温，然后刺取鸡冠上的几滴血，
滴入杯中搅拌均匀，再次炖温后调入煎好的药液中内服。
条文：112
紫陷和黑陷都是毒邪炽盛的表现，痘疹平塌、色泽昏暗、根部不松动，
这属于气血被火邪郁闭所致，解毒急迫时应当使用归宗汤。
【注】
痘疹出得稠密，颗粒细碎细小，根部紧绷、色泽昏暗，顶部凹陷且呈紫色，这称为“紫陷”，
严重时转为黑色，则称为“黑陷”，
这都是由于毒火郁结闭塞，气机不能宣通所致，
治疗应当清热解毒，以归宗汤为主方。
（归宗汤）方剂见“发热证治”章节。
条文：113
脓浆尚未充足，痘疹呈现板黄状，顶部塌陷成片，皮肤僵硬，
这是气滞血凝，难以灌溉滋养，皆因毒热侵犯脾脏区域，
应迅速服用清毒活血的方剂，待毒邪化解、痘疹隆起，即可转危为安。
【注】
所谓“板黄”，是指在灌浆时脓浆未达到一半，突然突起黄色，干燥坚硬，
这是因为枭毒肆虐伤害脾脏，导致气滞血凝，难以灌溉滋养，必须使用清毒活血汤治疗，
倘若痘疹能够隆起，还有希望存活，如果头面、颈部、眼眶、嘴唇周围以及全身都出现黄色，则是不可治愈的死症。
（清毒活血汤）组成：当归、白芍药（酒炒）、生地黄、紫草茸（酒炒）、黄芩、黄连（酒炒）、牛蒡子（炒）、南山查（山楂）、连翘（去心）、人参、黄芪（生用）、桔梗、木通。引用灯心草水煎服。
（方歌）
清毒活血汤最灵验，当归、白芍、生地、紫草茸，
黄芩、黄连、牛蒡子、山楂、连翘，人参、黄芪、桔梗配合木通。
Clause 111
When Qi and Blood are deficient and cold, failing to rise and flourish, the smallpox lesions appear gray or white with depressed tops and scanty pus. One should promptly administer a decoction containing Ginseng Radix (Renshen), Angelicae Sinensis Radix (Danggui), and Antler Cornu Cervi Pantotrichum (Lurong), and drink Cock Comb Blood Wine (Jiguanxue Jiu) as an adjunct therapy.
[Note]
During the pustule-filling stage of smallpox, if the color is pale white, the base lacks a red halo, and the top is depressed, this is termed "White Depression" (Bai Xian).
If the deficiency reaches an extreme, it transforms into "Gray Depression" (Hui Xian). This occurs because Qi deficiency leads to lethargy and failure to support, while Blood deficiency fails to fill the pus; thus, once depressed, it cannot be controlled.
Treatment should focus on greatly tonifying Qi and Blood. The appropriate formula is Renshen-Gui-Lurong Decoction (Shenguilurong Tang). Before administration, add Cock Comb Blood Wine.
Take two to three doses daily. Only when the lesion tops rise and pus flows can danger be avoided and health restored.
(Shenguilurong Tang) See the section on "Pustule-Filling Syndrome Treatment."
(Cock Comb Blood Wine) Take one large rooster. First, warm a cup of white wine. Then, prick a few drops of blood from the cock's comb, drip them into the cup, mix well, re-warm, and blend into the prepared herbal decoction for oral administration.
Clause 112
Purple Depression and Black Depression both indicate excessive pathogenic toxin. The lesions are flat, dull in color, and the bases are tight and not loose.
This belongs to Qi and Blood being constrained by Fire toxin. For urgent detoxification, Guizong Decoction (Guizong Tang) should be used.
[Note]
When smallpox eruptions are dense, with small, fragmented particles, tight bases, dull colors, depressed tops, and purple hue, this is called "Purple Depression" (Zi Xian).
If it worsens and turns black, it is called "Black Depression" (Hei Xian).
Both result from the constraint and closure of toxic fire, preventing the free circulation of Qi.
Treatment should prioritize clearing heat and detoxifying, using Guizong Decoction as the primary formula.
(Guizong Tang) See the section on "Fever Syndrome Treatment."
Clause 113
When the pus is insufficient and the lesions appear as "Board Yellow," with collapsed tops forming patches and stiff skin,
this indicates stagnation of Qi and coagulation of Blood, making nourishment difficult. It is caused by toxic heat invading the Spleen region.
One must quickly take detoxifying and blood-invigorating agents. Once the toxin resolves and the lesions rise, recovery and peace will ensue.
[Note]
"Board Yellow" refers to the condition during pus-filling where the pus has not reached half volume, yet yellow patches suddenly protrude, becoming dry and hard.
This is due to fierce toxins ravaging the Spleen region, causing Qi stagnation and Blood coagulation, thereby hindering nourishment. Qingdu Huoxue Decoction (Qingdu Huoxue Tang) must be used.
If the lesions rise, survival is still possible. However, if yellow discoloration appears on the head, face, neck, eye sockets, lips, and throughout the body, it is incurable.
(Qingdu Huoxue Tang) Composition: Danggui (Angelicae Sinensis Radix), Baishao Yao (Paeoniae Radix Alba, stir-fried with wine), Sheng Dihuang (Rehmanniae Radix), Zicao Rong (Arnebiae Radix et Rhizoma, stir-fried with wine), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma, stir-fried with wine), Niubangzi (Arctii Fructus, stir-fried), Nanshan Zha (Crataegi Fructus), Lianqiao Forsythiae Fructus, removed heart), Renshen (Ginseng Radix), Huangqi (Astragali Radix, raw), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis). Use Dengxincao (Junci Medulla) water as a guide for decoction and administration.
(Verse Formula)
Qingdu Huoxue Tang is most effective,
Containing Danggui, Baishao, Shengdi, and Zicao Rong.
Huangqin, Huanglian, Niubangzi, Shan Zha, and Lianqiao,
Combined with Renshen, Huangqi, Jiegeng, and Mutong.