痘疔须用针挑拨，轻重徐急贵合宜，破顶伤肌俱深忌，上浆急挑莫迟疑。
【注】凡用针挑痘疔时，以二指拿针，平平入痘，拨断痘中筋络，众痘即发。但挑时
轻重、疾徐之间，贵乎得宜，不可挑破痘顶，
亦不可重入伤肌。须待三、四、五、六日上浆之际，痘能含针，方可挑拨，过七日则无
用矣。治者宜详识之。
\r挑痘疔图\p03-b24a45.bmp\r
煮针法
甘草（生） 甘遂 川乌 草乌（各等分）
用水一盅，入砂罐内，以水干为度。每次可煮四五针，煮完入鹅翎筒内，黄蜡塞口收之。
表热无汗升麻汤，里热有汗消毒良，行浆毒蒸清毒剂，结后余热连翘方。
【注】痘之一证，始终不可尽除其热，盖热非壮热，乃和缓之热也。以寒则收缩，热
则宣发，故初不热，则出不齐，胀不热，则浆不行；收不热，则痂不结。自初出以至起
胀时，皮肤干燥，发热无汗，此热在表也，升麻葛根汤加荆芥穗、防风主之。蒸热有汗，此
热在里也，加减消毒饮主之。至行浆时，热不减者，此为毒热熏蒸，宜用清毒活血汤。便
秘者去人参、黄 ，加酒炒大黄。至结痂后发热壮盛，胸腹、手足俱热，二便秘涩者，此
为余毒过盛，宜用大连翘饮治之。
升麻葛根汤（方见发热证治）
加减消毒饮
升麻 牛蒡子（炒、研） 山豆根 紫草 连翘（去心） 生地黄 赤芍 川黄连 甘草（生）
引用灯心，水煎服。
【方歌】加减消毒饮如神，升麻牛蒡山豆根，紫草连翘生地芍，黄连甘草引灯心。
清毒活血汤（方见灌浆证治）
大连翘饮（方见收靥证治）
痘疔必须用针挑拨，轻重缓急贵在适宜，破顶伤肌都是大忌，上浆时急挑莫迟疑。
【注】凡是用针挑痘疔时，用两个手指拿住针，平平稳稳地刺入痘中，拨断痘中的筋络，周围的痘就会发出来。但是挑的时候，轻重、快慢之间，贵在得当，不可挑破痘的顶部，也不可重刺伤及肌肉。必须等到第三、四、五、六天开始上浆的时候，痘能含住针，才可以挑拨，过了第七天就没有用了。治疗者应当详细记住这一点。
煮针法
甘草（生） 甘遂 川乌 草乌（各等分）
用水一盅，放入砂罐内，烧到水干为止。每次可以煮四五根针，煮完后放入鹅毛管筒内，用黄蜡塞口收藏。
表热无汗升麻汤，里热有汗消毒良，行浆毒蒸清毒剂，结后余热连翘方。
【注】痘疹这一病症，从头到尾不能完全清除其热，因为这种热不是壮热，而是和缓的热。如果寒则收缩，热则宣发，所以初起不发热，痘就出不齐；胀期不发热，浆就不行；收期不发热，痂就不结。从初出到起胀时，皮肤干燥，发热无汗，这是热在表，用升麻葛根汤加荆芥穗、防风主治。蒸热有汗，这是热在里，用加减消毒饮主治。到了行浆时，热不退的，这是毒热熏蒸，宜用清毒活血汤。便秘的去掉人参、黄芪，加酒炒大黄。到了结痂后发热壮盛，胸腹、手足都热，大小便涩滞的，这是余毒过盛，宜用大连翘饮治疗。
升麻葛根汤（方见发热证治）
加减消毒饮
升麻 牛蒡子（炒、研） 山豆根 紫草 连翘（去心） 生地黄 赤芍 川黄连 甘草（生）
引用灯心，水煎服。
【方歌】加减消毒饮如神，升麻牛蒡山豆根，紫草连翘生地芍，黄连甘草引灯心。
清毒活血汤（方见灌浆证治）
大连翘饮（方见收靥证治）
Ding (pustular nodule) of smallpox must be picked with a needle; the lightness, heaviness, slowness, and speed must be appropriate. Breaking the top or injuring the muscle is strictly forbidden; when pus begins to form, pick it urgently without hesitation.
[Note] When using a needle to pick Ding (pustular nodule), hold the needle with two fingers, insert it level into the pustule, and sever the meridians within the pustule, causing surrounding pustules to erupt. However, during picking, the balance between light/heavy and fast/slow must be proper. Do not break the top of the pustule, nor pierce deeply to injure the muscle. One must wait until the third, fourth, fifth, or sixth day when pus begins to form and the pustule can "hold" the needle before picking. After the seventh day, this method is useless. Practitioners should memorize this carefully.
Boiling Needle Method
Raw Gancao (Radix Glycyrrhizae) [Glycyrrhizae Radix et Rhizoma], Gansui (Radix Kansui) [Kansui Radix], Chuanwu (Radix Aconiti Carminati) [Aconiti Radix Praeparata], Caowu (Rhizoma Aconiti Kusnezoffii) [Aconiti Kusnezoffii Rhizoma Praeparata] (equal parts).
Use one cup of water, place in a clay pot, and boil until the water is dry. Each time, boil four or five needles. After boiling, store them in a goose quill tube, sealed with yellow beeswax.
Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction) for exterior heat with no sweat; Xiaodu Yin (Detoxification Decoction) for interior heat with sweat; Qingdu Huoxue Tang (Clear Toxins and Invigorate Blood Decoction) for toxic steaming during pus formation; Lianqiao Fang (Forsythia Formula) for residual heat after scabbing.
[Note] In the case of smallpox, heat cannot be completely eliminated from beginning to end, because this heat is not excessive fever (Zhuangre), but rather a mild and harmonious heat. Cold causes contraction, while heat promotes dissemination. Therefore, if there is no initial heat, eruptions will be uneven; if there is no heat during the swelling stage, pus will not form; if there is no heat during the recovery stage, scabs will not form. From initial eruption to the swelling stage, the skin is dry, with fever and no sweat; this indicates heat in the exterior (Biao), treated primarily with Shengma Gegen Tang (Pueraria and Cinnamon Twig Decoction) plus Jingjie Sui (Schizonepeta Spike) and Fangfeng (Saposhnikovia Root). If there is steaming heat with sweat, this indicates heat in the interior (Li), treated primarily with Jiajian Xiaodu Yin (Modified Detoxification Decoction). During the pus-formation stage, if heat persists, this indicates toxic heat steaming, treated with Qingdu Huoxue Tang (Clear Toxins and Invigorate Blood Decoction). If constipation occurs, remove Renshen (Ginseng) and Huangqi (Astragalus), and add Jiuhuang Dahei (Wine-fried Rhubarb). After scabbing, if fever is intense, with heat in the chest, abdomen, hands, and feet, and difficulty in urination and defecation, this indicates excessive residual toxins, treated with Dalianqiao Yin (Large Forsythia Decoction).
Shengma Gegen Tang (See Treatment of Fever Syndrome)
Jiajian Xiaodu Yin (Modified Detoxification Decoction)
Shengma (Bupleuri Radix) [Bupleuri Radix], Niubangzi (Arctii Fructus) [Arctii Fructus] (stir-fried and ground), Shandougen (Sophorae Tonkinensis Radix) [Sophorae Tonkinensis Radix], Zicao (Lithospermi Radix) [Lithospermi Radix], Lianqiao (Forsythiae Fructus) [Forsythiae Fructus] (heart removed), Shengdihuang (Rehmanniae Radix) [Rehmanniae Radix], Chishao (Paeoniae Radix Rubra) [Paeoniae Radix Rubra], Chuanlianhuan (Coptidis Rhizoma) [Coptidis Rhizoma], Gancao (Glycyrrhizae Radix et Rhizoma) (raw).
Add Dengxincao (Junci Medulla) as a guide, decoct in water and take orally.
[Formula Song] Jiajian Xiaodu Yin works like magic, Shengma, Niubang, and Shandou root; Zicao, Lianqiao, Shengdi, and Shaoyao, Liangan and Gancao with Dengxin as guide.
Qingdu Huoxue Tang (See Treatment of Pus-Filling Syndrome)
Dalianqiao Yin (See Treatment of Scabbing Syndrome)