（共十五首，又一十六方）
收靥难拘日数文，但凭稀密实虚分。缓收循序多坚稳，太急须防余毒熏。
痘疮收靥，不可以日数拘也。大抵痘稀元气实者，易出易靥，痘密元气虚者，难出难靥。只要循序缓收，
倘收太急，乃毒熬煎，血气枯焦，非正收也，必发痈毒怪证，甚则丧躯，微则残形矣。
人中上下别阴阳，收靥先于此处良。若
是足颅先靥黑，多凶少吉早提防。
人中者，督任二脉交会之衢。痘疹先从此处出壮收靥，为阴阳和畅；若于额颅手足心先靥，乃邪气攻心，莫
救。
收靥从来贵整齐，臭腥烦烂便跷蹊。其间顺逆宜详审，慎勿逡巡当局迷。
痘疮收靥，贵于整齐。干如螺靥者，上也；顶破脓出，结如鸡屎者，次也；破烂无痂者，下也。凡遇此等
收靥，便须询察曾犯何逆？如血气本实，误投补药；以邪得补反溃正气，如火烁烂，宜天水散解之，则邪火退而
收靥齐矣。
如初饮冷水，浸淫脾胃，以致收靥不齐，以除湿汤渗之，则内渗其湿，外燥其表；令好收靥。
若头面溃烂，其气腥臭，及遍身手足和皮脱去，宜分顺逆。果脓成毒化，饮食如常，更无他苦者，顺也；
脓水未成，是名倒靥，未可量。
痘到收时脓自干，封藏收敛壳团乐。莫教腐烂和皮脱，此个还将倒陷看。
痘疮成脓之后，结为螺靥，此毒从外解；若不能结痂，反成腐烂，和皮脱去，此倒陷毒瓦斯入内也。
但逢倒陷毒深潜，复肿翻生始不嫌。头面肿消空未补，剥肤灾近易先占。
凡痘倒陷，系中气不足，急用温中托里汤托之。服药后，破者复加肿灌，无痘处又复出一层，谓之补空，俗
云翻生痘是也。此正气不亏，邪气不留，虽过期延日，不为害也。如头面不肿，空处不补，即易所谓剥床，
以肤切近灾矣，安可为哉！
靥时自利忽然侵，顺逆中间仔细寻。脓血痂皮为顺候，不分水谷定归阴。
收靥之时，忽然泻痢，若脓血痂皮之物，此脾强肾弱为顺候，痢尽自愈，不可强治；若不分水谷，此肾强
脾弱为逆候，用炒米汤送豆蔻丸，痢止则吉，不止则凶，豆蔻丸方见前。
过期不靥事跷蹊，臭烂浑身靥不齐。粘席粘衣何所治？白龙败草指群迷。
凡痘成脓之后，过期不靥，浑身溃烂，以致粘席粘衣，用白龙散、败草散衬贴铺床最佳。
收靥迟延须急治，劳君察证毋拘执。纵意违师徒自伤，临危施济终难及。
凡痘当靥不靥，须要详审，不可忽略。如冬寒之时，盖覆少薄，被寒风郁遏不能靥者，宜桂枝解毒汤疏解之。
如夏月衣被太浓，热气熏蒸不能靥者，宜去其衣被，少令清凉，用甘露解毒汤清之。
倘一向大便秘结，里热太甚，不能靥者，宜当归解毒汤微利之，胆导法尤妙。
如泄泻气虚不能靥者，此只收靥不齐，欲呼坐浆干也，不须妄治。如元气素弱，以致难靥，宜参归化毒汤解之。
脓水将干结靥时，休教愚昧失支持。不知禁忌多翻变，却是为山一篑辞。
世俗于痘收靥之时，即杀鸡食之，或姜椒之类，谓其和暖，殊不知鸡属巽，能动风，辛能助火。脾胃强者无
害，弱者反助火邪，以致发痈伤胃，口舌生疮，则至坏病者有之矣。又或宜温而过热，宜凉而过寒，皆为犯禁，
亦能生变，切宜慎之！
一向浑身凉且和，靥时忽热事如何？微微发热干脓水，太甚焦枯病转多。
痘疮始终要有微热，不可尽去。若收靥之时，反大热作渴烦躁，此毒在内，更防陷伏，急用生津凉血葛根
汤以清之。
破疮复灌依然烂，及至收成功愈慢。淋漓脓血苦难当，大补汤丸君莫惮。
凡痘疮犯着皮嫩易破，本不治之证，但破损之后，重复肿灌，此正气尚强，毒不能入而发于外，亦当根据期收
靥。设不能靥，乃正气被邪气剥削，虽能逐邪出外，不能逼邪成痂也，急宜大补汤温之，不可因循，反生灾变。
数个顽疮不肯收，犯时鲜血却长流。如
逢此证休轻易，破膜伤筋命必休。
痘疮破损，灌肿作痛，不能干水，一名疳蚀疮，一名阳疮。犯着即出血不止，乃难治之证，内服大补汤（方
见前），外以绵茧散敷之。若逡巡不治，以致灌伤筋骨，穿膜破空，夭人生命者多矣。
灌疮满面血脓多，败面伤睛奈若何！却在良医施妙手，调和中外起沉 。
如面疮破烂，反复肿灌，脓血浸淫，却防坏眼残形，宜升麻解毒汤清之。
痘疮抓破状多般，出血成坑水更干。瘙痒焦疼微小事，伤筋溃肉使形残。
其痘疮抓破之证非一∶有破而出血者，阳疮也，宜当归凉血散解之；有破而无水便干枯者，此陷伏也，要
疮复灌，肉复肿者为佳，内服托里回生散；有破而成坑者，此内陷也。内服托里回生散，外用白龙散（方见前）敷
之。若不详审以上三症治之。微则残形，甚则伤命。
收靥根据期更着痂，或时战栗或言邪。三元正气将回复，不必延医不必嗟。
凡痘欲收靥之时，痂皮圆静，但时或战栗，语言妄谈，此为正气将复，不能自持，不必忧疑，须臾自定。
（共十五首，又一十六方）
痘疮收靥（结痂愈合）的难易不能仅凭日数来判断，主要根据痘疹的稀疏密集以及患者元气的虚实来区分。如果收靥过程缓慢且循序渐进，病情多稳固；但如果收靥过急，必须防止余毒熏蒸体内。
痘疮收靥，不可以拘泥于固定的天数。大抵而言，痘疹稀疏、元气充实的患者，容易出痘也容易收靥；痘疹密集、元气虚弱的患者，难出也难收靥。只要按照顺序缓慢收靥即可。倘若收靥太急，那是毒火煎熬，导致血气枯焦，这不是正常的收靥，必然会发生痈肿毒气和怪异病症，严重的会丧命，轻微的也会毁容。
人中穴上下可以辨别阴阳，观察收靥情况此处最为良好。如果是额头和颅顶先出现黑斑并结痂，大多凶险少吉，需早加提防。
人中穴是督脉和任脉交汇的地方。痘疹如果先从人中处出壮并收靥，说明阴阳调和通畅；如果在额头、颅顶或手足心先结痂，这是邪气攻心的表现，无法救治。
收靥向来以整齐为贵，如果有臭腥味、烦乱溃烂就是异常。其中的顺证和逆证应当详细审察，切勿犹豫不决而在局中迷惑。
痘疮收靥，贵在整齐。干燥如螺壳状结痂的，是上等的；顶部破裂脓液流出，结痂如鸡屎状的，是次等的；破烂没有结痂的，是最下等的。凡是遇到这种情况，就必须询问考察是否犯了什么逆证？比如血气本来充实，却误用了补药；因为邪气得补反而溃败正气，如同火烧般糜烂，适宜用天水散来解除，那么邪火退去而收靥就会整齐了。
如果是初饮冷水，湿气浸淫脾胃，导致收靥不齐，可以用除湿汤渗利湿邪，这样内渗其湿，外燥其表，使收靥恢复正常。
如果头面部溃烂，气味腥臭，以及遍身手足连皮脱落，应当分辨顺逆。如果脓液已成、毒已化解，饮食正常，更没有其他痛苦的，是顺证；如果脓水未成，这名叫倒靥（痘毒内陷），难以估量预后。
痘疮到了收靥的时候脓液自然干燥，封藏收敛形成壳团令人欣慰。不要让痘疮腐烂和皮肤脱落，这种情况还要看作是倒陷（痘毒内陷）。
凡是遇到倒陷，毒邪深潜，重新肿胀翻生才不嫌弃。如果头面肿胀消退但空缺处未得到填补，剥肤之灾临近，容易预先占断。
凡是痘疮倒陷，属于中气不足，急忙使用温中托里汤来托举毒邪。服药后，破损处再次肿胀灌注，没有痘的地方又长出一层，叫做“补空”，俗称翻生痘。这是正气不亏，邪气不留，虽然过期延日，也不为害。如果头面不肿，空缺处不补，就是《易经》所说的“剥床”，肌肤切近灾难了，怎么可以呢！
收靥时自发性腹泻突然侵袭，要在顺逆中间仔细寻找。如果泻下物中有脓血痂皮等物，这是脾强肾弱，属于顺候，痢疾尽除则自愈，不可强行治疗；如果泻下物不分水谷，这是肾强脾弱，属于逆候，用炒米汤送服豆蔻丸，痢止则吉，不止则凶，豆蔻丸的方子见前文。
超过期限不结痂事情异常，浑身臭烂结痂不齐。粘席粘衣该如何治疗？白龙散和败草散指引众人走出迷途。
凡是痘疮成脓之后，超过期限不结痂，浑身溃烂，以致粘住席子和衣服，用白龙散、败草散衬贴铺床最佳。
收靥迟延必须紧急治疗，劳烦您察看病证不要固执。纵意违背师徒教导会自我伤害，临危施救终究难以赶上。
凡是痘疮该结痂而不结痂，须要详细审察，不可忽略。比如冬天寒冷之时，盖被太少，被寒风郁遏不能结痂的，适宜用桂枝解毒汤疏解。如果是夏天衣被太厚，热气熏蒸不能结痂的，适宜去掉衣被，稍微令其清凉，用甘露解毒汤清解。
如果一直大便秘结，里热太甚，不能结痂的，适宜用当归解毒汤轻微通利，胆导法尤其奇妙。
如果是泄泻气虚不能结痂的，这只是收靥不齐，想要呼叫坐浆干（一种疗法或状态），不需要胡乱治疗。如果元气素来虚弱，导致难结痂的，适宜用参归化毒汤解之。
脓水将干结痂时，不要让愚昧之人失去支持。不知道禁忌多生变故，却是功亏一篑。
世俗人在痘疮收靥之时，就杀鸡吃，或者吃姜椒之类，认为它们暖和，殊不知鸡属巽卦，能动风，辛辣能助火。脾胃强的无害，脾胃弱的反而助火邪，以致发生痈肿伤胃，口舌生疮，从而导致坏病的有之。又或者宜温而过热，宜凉而过寒，都是犯禁，也能生变，务必谨慎！
一向浑身凉爽平和，收靥时忽然发热是怎么回事？微微发热烘干脓水尚可，太甚则焦枯病转多。
痘疮始终要有微热，不可完全去除。如果收靥之时，反而大热作渴烦躁，这是毒邪在内，更要防备陷伏，急忙用生津凉血葛根汤来清解。
破溃的疮口重新灌注依然糜烂，等到收成功效更慢。淋漓脓血苦难忍受，大补汤丸你不要害怕。
凡是痘疮犯着皮嫩易破，本是不治之证，但破损之后，重新肿胀灌注，这是正气尚强，毒邪不能入内而发于外，也应当按期收靥。设若不能收靥，乃是正气被邪气剥削，虽然能逐邪出外，但不能逼邪成痂，急忙宜用大补汤温补，不可因循拖延，反生灾变。
数个顽固疮口不肯收口，触犯时鲜血却长流。如果遇到此证不要轻易对待，破膜伤筋性命必休。
痘疮破损，肿胀作痛，不能干水，一名疳蚀疮，一名阳疮。触犯即出血不止，乃难治之证，内服大补汤（方子见前），外用绵茧散敷之。如果犹豫不治，以致灌伤筋骨，穿膜破空，夭折人生命的很多了。
灌脓疮满面血脓多，败面伤睛怎么办！却在良医施妙手，调和中外起沉疴。
如果面疮破烂，反复肿胀灌注，脓血浸淫，却防备坏眼残形，适宜用升麻解毒汤清解。
痘疮抓破状貌多种，出血成坑水更干。瘙痒焦疼虽是小事，伤筋溃肉使形体残缺。
其痘疮抓破的证候不一：有破而出血的，是阳疮，适宜用当归凉血散解之；有破而无水便干枯的，这是陷伏，要疮口重新灌注，肌肉重新肿胀的为佳，内服托里回生散；有破而成坑的，这是内陷。内服托里回生散，外用白龙散（方子见前）敷之。如果不详细审察以上三种症状治疗，轻微则残形，严重则伤命。
(Comprising fifteen verses and another sixteen prescriptions)
The difficulty of *shouye* (scabbing/healing) of smallpox cannot be restricted by the number of days; it must be distinguished based on the sparsity or density of the lesions and the deficiency or excess of Yuan Qi (Original Qi). Slow, orderly scabbing tends to be firm and stable; if scabbing is too rapid, one must guard against residual toxins steaming internally.
The healing process of smallpox lesions should not be confined to a fixed number of days. Generally speaking, patients with sparse lesions and solid Original Qi find it easy to erupt and heal; those with dense lesions and deficient Original Qi find it difficult to both. As long as the healing proceeds slowly and in order, it is acceptable. If healing occurs too hastily, it indicates that toxic heat is boiling and burning, causing blood and Qi to wither and dry up. This is not normal healing; it will inevitably lead to carbuncles, toxic eruptions, and bizarre syndromes. In severe cases, it may cause death; in mild cases, it may result in disfigurement.
The area above and below the Renzhong (GV26, Philtrum) can distinguish Yin and Yang; observing the healing process at this location is beneficial. If blackening and scabbing occur first on the forehead and skull, the prognosis is mostly ominous with little auspiciousness, requiring early vigilance.
Renzhong (GV26) is the intersection of the Du Mai (Governing Vessel) and Ren Mai (Conception Vessel). If smallpox lesions erupt vigorously and heal first from this area, it indicates harmonious flow of Yin and Yang. If scabbing occurs first on the forehead, skull, palms, or soles, it signifies pathogenic qi attacking the Heart, which is incurable.
Healing is always prized for its neatness; foul odor, restlessness, and ulceration indicate abnormality. One must carefully examine the favorable (Shun) and unfavorable (Ni) patterns and must not hesitate or become confused within the situation.
In smallpox healing, neatness is paramount. Lesions drying into shell-like scabs are superior; those where the apex breaks, pus oozes out, and forms scabs resembling chicken droppings are secondary; those that remain ulcerated without forming scabs are inferior. Whenever such conditions are encountered, one must inquire whether any unfavorable factors were involved. For instance, if the patient's Blood and Qi were originally solid but tonifying herbs were mistakenly administered, the pathogen, aided by the tonification, would instead damage healthy Qi, causing ulceration like fire burning. In such cases, Tianshui San (Sky Water Powder) should be used to resolve it, allowing the pathogenic fire to recede and healing to proceed neatly.
If cold water was consumed initially, causing dampness to infiltrate the Spleen and Stomach and leading to uneven healing, Shishi Tang (Damp-Draining Decoction) should be used to percolate the dampness. This will drain dampness internally and dry the exterior, restoring proper healing.
If the face and head are ulcerated with a foul smell, and the skin peels off all over the body and limbs, one must differentiate between favorable and unfavorable patterns. If pus has formed and toxins have transformed, and the patient eats and drinks normally without other distress, it is a favorable pattern. If pus and fluid have not formed, it is called *daoye* (inverted healing/toxin sinking), and the outcome is unpredictable.
When smallpox reaches the stage of healing, pus naturally dries, sealing and converging into crusts, which is comforting. One must prevent rotting and skin shedding; such conditions should be viewed as *daoxian* (toxin sinking/internal collapse).
Whenever *daoxian* occurs, toxins sink deeply. Re-swelling and regeneration are not to be despised. If the face and head swell down but empty areas are not filled, disaster approaches like "peeling the bed," affecting the skin closely. How can this be tolerated?
All cases of inverted healing stem from insufficiency of Middle Qi. Urgently use Wenzhong Tuoli Tang (Warm the Middle and Support the Interior Decoction) to support and expel toxins. After taking the medicine, broken areas re-swollen and filled, and new eruptions appear in previously clear areas, this is called "filling the void," commonly known as "regenerating smallpox." This indicates healthy Qi is intact and pathogens are retained; although it prolongs the disease, it causes no harm. If the face does not swell and voids are not filled, it corresponds to the I Ching's concept of "peeling the bed," where disaster touches the skin. Such cases are dire!
During healing, sudden onset of diarrhea requires careful examination of favorable versus unfavorable signs. If the stool contains pus, blood, and scab material, it indicates strong Spleen and weak Kidney, which is a favorable sign; the dysentery will cease spontaneously, and forced treatment is unnecessary. If the stool is undigested food and water, it indicates strong Kidney and weak Spleen, an unfavorable sign. Administer Doukou Wan (Cardamom Pill) delivered with fried rice soup. If diarrhea stops, it is auspicious; if not, it is ominous. The formula for Doukou Wan is seen earlier.
Failure to heal past the expected time is anomalous; foul rotting all over the body and uneven scabbing occur. When lesions stick to mats and clothes, how to treat? Bailong San (White Dragon Powder) and Baicao San (Decayed Grass Powder) guide the lost.
After smallpox pustules form, failure to heal past the deadline with whole-body ulceration sticking to bedding is best treated by lining the bed with Bailong San and Baicao San.
Delayed healing requires urgent treatment; observe the syndrome carefully without rigidity. Ignoring teachings harms oneself; rescue at the critical moment is often too late.
When smallpox should heal but does not, detailed examination is required, never neglectful. In winter cold, if thin coverings allow wind-cold to constrain eruption and healing, Guizhi Jiedu Tang (Cinnamon Twig Detoxification Decoction) should be used to release and resolve. In summer, if thick clothing causes heat steaming preventing healing, remove layers to cool slightly, then use Ganlu Jiedu Tang (Sweet Dew Detoxification Decoction) to clear heat.
If constipation persists with excessive interior heat preventing healing, Danggui Jiedu Tang (Angelica Detoxification Decoction) should be used for mild purgation; anal suppositories are particularly effective.
If diarrhea and Qi deficiency prevent healing, resulting only in uneven scabbing and desire for "sitting paste" (a specific remedy/state), do not treat recklessly. If original Qi is chronically weak causing delayed healing, Shen Gui Huadu Tang (Ginseng and Angelica Toxin-Resolving Decoction) should be used.
When pus dries and scabs form, do not let ignorance undermine support. Ignoring taboos leads to changes; this is like abandoning a mountain project at the last basket.
Secular practices during smallpox healing involve killing chickens or eating ginger and pepper, believing them warming. However, chicken belongs to Xun (Wind), stirring Wind; pungency aids Fire. Those with strong Spleen/Stomach suffer no harm, but the weak see Fire exacerbated, leading to carbuncles, stomach injury, and mouth ulcers, causing ruin. Whether overheating when warmth is indicated or overcooling when cooling is indicated violates taboos and causes complications. Be extremely cautious!
Usually the body is cool and harmonious; why sudden fever during healing? Slight fever dries pus adequately; excessive fever causes withering and more diseases.
Smallpox should maintain slight heat throughout; it should not disappear completely. If during healing there is high fever, thirst, and irritability, toxins are internal, risking sinking. Urgently use Gegen Tang (Kudzu Decoction) with properties to generate fluids and cool blood to clear heat.
Broken sores refilling with pus remain ulcerated; healing becomes slower. Profuse pus and blood are hard to bear; do not fear using Dabu Tang/Wan (Great Tonification Decoction/Pill).
Smallpox lesions with tender skin prone to breaking are inherently difficult to treat. However, if they break and then re-swollen, it indicates strong Healthy Qi expelling toxins outward. Healing should still proceed according to schedule. If healing fails, it means Healthy Qi is depleted by pathogens; although pathogens are pushed out, they cannot be forced into scabs. Urgently use Dabu Tang to warm and tonify; do not delay, lest disasters arise.
Stubborn sores refusing to heal bleed fresh blood upon touch. Do not treat lightly; membrane and tendon damage implies fatal consequences.
Damaged smallpox lesions swelling and painful, unable to dry, are called Ganshi Chuang (Corrosive Ulcer) or Yang Chuang (Yang Ulcer). Touching them causes uncontrolled bleeding, a difficult-to-treat condition. Internally administer Dabu Tang (formula seen earlier); externally apply Mianjian San (Silkworm Cocoon Powder). Delaying treatment leads to tendon and bone damage, perforation of membranes, and many deaths.
Pustular sores covering the face with much blood and pus; ruined face and damaged eyes—what to do? Only skilled physicians can harmonize interior and exterior to save critical cases.
For facial sores that are ulcerated, repeatedly swelling and weeping pus and blood, guarding against eye damage and disfigurement, use Shengma Jiedu Tang (Cimicifuga Detoxification Decoction) to clear heat.
Scratched smallpox presents various states: bleeding into pits with dry fluid. Itching and burning pain seem minor, but tendon damage and flesh erosion cause deformity.
Scratched smallpox manifests differently:
1. Breaking with bleeding is Yang Chuang (Yang Ulcer); treat with Danggui Liangxue San (Angelica Cooling Blood Powder).
2. Breaking without fluid, becoming dry, indicates sinking; favorable if sores refill and flesh swells again; internally use Tuoli Huisheng San (Support Interior Revive Life Powder).
3. Breaking into pits indicates internal sinking; internally use Tuoli Huisheng San; externally apply Bailong San (formula seen earlier).
Failure to examine and treat these three symptoms carefully results in deformity or death.
Healing proceeds on schedule with scab formation; occasional tremors or delirious speech occur. The Three Primordial Qi (Yuan Qi) is recovering; there is no need to summon a doctor or sigh.
When smallpox is about to heal, scabs are round and quiet. Occasional tremors and delirious speech indicate recovering Healthy Qi struggling to maintain control. There is no need to worry; it will settle spontaneously shortly.