附倒靥。
徐仲光治一血热痘，初失凉解，至五六日，方进芩、连、归、地、翘、红，才起胀。灌浆至半浆，又不服
药，九朝，变黑归肾，面唇腰脚皮肉俱黑，仍用前药加金汁及人牙散。势少缓，又用黄连、生地、红曲各一
钱，木香三分，灯心一钱。次日加犀角、连翘，黑色俱散，唇眼俱清，前方连进四剂而愈。
万密斋治吴氏子，磊落红活，顺痘也。其儿脾胃素弱，起发略迟，或谓其气虚，妄投陈氏木香散一剂，痘
转平不起。又投陈氏异功散一剂，再延视，不可为矣。
李氏子四岁出痘，十日后，痘顶平陷，根窠红紫，昏睡不食，不可救也，次日死。
吴氏女痘将脓，面上有干靥者，犯倒陷逆症，乃用参、 、甘草节、归、地、赤芍、银花、牛蒡、连翘、
麻黄酒蜜拌炒黑、红花子、山甲末，水煎服。且告之曰∶服后若先干者，复起作脓。未干者，壮红饱满，空处
再出小痘，上也。不作脓，不补空，或痈肿，次也。否则不可为矣。连进三服，已干者不肿，未干者饱脓，空
中补出不多，手足发痈。后以十全大补汤加银花、连翘，调理而安。
雷邑丞孙，五岁出痘，衣以浓锦，围以浓被，日夜向火，任其饮酒，未七日而靥，面目至腰，溃烂平塌，
无作痂者。曰∶此非至是倒靥也。亟用疏理解毒之药，减去衣被，勿近火饮酒，方保无事。以黄 、白芷排脓
托里，防风、蝉蜕以疏表，青皮、桔梗以疏里，牛蒡、甘草以解毒、一服溃疮复胀，大便脓涎，此毒瓦斯中外无
留矣。戒勿再药，恐生他病也。
董氏女年十九，腊月半出痘，至岁中不能收靥，精神已昏，饮食俱废。视之，僵卧如死人，其脉洪实调匀。
此本倒靥逆症，幸脉洪实，不疾不徐，今舍症从脉治之。若得坏疮复起，新疮复出，人事清爽，饮食如常，则
无事矣。乃用升阳降火汤加黄 、当归、木香、青皮，连进三剂。初三日，复出一层新痘，旧者尽干。初五日
出尽，周匝一身，乃渐苏醒，能言，求饭食。根据期起发，至十三日靥后，以十全大补汤调理。谓痘倒靥必归肾，
今幸愈，尤当防目疾，宜预解之。不听，半月后，左目痛不能开，果丧明。（此案不的，大抵前案中升发太多，
故目受其病。余见倒靥后起者甚多，不必皆伤目也。）
柴氏妇二十七岁，痘甚密，脓成时，鼻准先干。曰∶此症凶也，不可治。问故，曰∶起发未透，脓浆未熟，
不当靥也。况收靥自有次第，形色亦殊，先自口唇两旁收起，漏浆堆脓，面疮皆然，自项以下，则成 壳。今
痘未熟而靥，乃倒陷也。自鼻先收，失其序也。不漏浆者，干枯也。后竟死。
【关于痘疮倒靥（痘疹塌陷）的论述】
徐仲光治疗一例血热型痘疮患者，初期未能及时使用清凉解表之法，直到第五六天，才给予黄芩、黄连、当归、地黄、连翘、红曲等药物，痘疹才开始起发肿胀。灌浆阶段进行到一半时，患者又停止服药。到了第九天，痘色变黑并内陷归肾，面部、嘴唇、腰部及脚部的皮肤肌肉全部变黑。此时仍沿用之前的方药，加入金汁和人牙散。病情稍见缓和后，又使用黄连、生地黄、红曲各一钱，木香三分，灯心草一钱。次日加入犀角和连翘，黑色逐渐消散，嘴唇和眼睛恢复清明，前方连续服用四剂后痊愈。
万密斋治疗吴姓人家的儿子，痘疹磊落红润活泼，属于顺症。但该患儿脾胃素来虚弱，痘疹起发略微迟缓。有人说是气虚，便盲目投予陈氏木香散一剂，导致痘疹转为平塌不起。又投予陈氏异功散一剂，再次延请医生诊治时，已无法救治了。
李家的儿子四岁出痘，十日后，痘顶平陷，根部周围颜色红紫，患儿昏睡不食，已不可救，次日死亡。
吴姓女孩痘疮即将化脓，面上已有干燥结痂者，犯了倒陷逆症。于是用人参、[此处原文缺字，推测为黄芪或类似补气药]、甘草节、当归、地黄、赤芍、金银花、牛蒡子、连翘、麻黄（用酒蜜拌炒至黑）、红花子、穿山甲末，水煎服。并且告诫家属说：服药后如果已经干燥的痘疹重新起发化脓；未干燥的变得壮实红润饱满，空隙处再长出小痘，这是上佳表现。如果不化脓，不填补空隙，或者出现痈肿，则是中等表现。否则就不可救了。连续服用三剂，已经干燥的没有肿胀，未干燥的充满脓液，空隙中补出的不多，手足部位发生痈肿。后来用十全大补汤加入金银花、连翘，调理后安然无恙。
雷邑丞的儿子，五岁出痘，穿着厚重的锦缎衣服，围着厚被子，日夜靠近火源，任由其饮酒，不到七天就结痂，面目直至腰部溃烂平塌，没有形成痂皮的。医生说：这并非正常的倒靥。急需使用疏理解毒的药物，减少衣被，不要靠近火源和饮酒，才能保无事。用黄芪、白芷排脓托里，防风、蝉蜕以疏解表邪，青皮、桔梗以疏通里气，牛蒡子、甘草以解毒。服用一剂后，溃烂的疮口重新肿胀，大便排出脓液和涎沫，这说明毒气在体内内外都已清除干净。告诫不要再用药，恐怕会生出其他疾病。
董姓女孩十九岁，腊月半开始出痘，到年中还不能收靥结痂，精神已经昏沉，饮食俱废。诊视发现，她僵卧如死人，但脉象洪实调匀。这本来是倒靥逆症，幸好脉象洪实，不快不慢，现在舍弃症状而从脉象治疗。如果能使得坏死的疮口重新起发，新的疮口再次长出，人事清醒，饮食恢复正常，那就没事了。于是用升阳降火汤加入黄芪、当归、木香、青皮，连续服用三剂。初三日，重新长出一层新痘，旧的完全干燥。初五日全部出齐，遍布全身，这才渐渐苏醒，能说话，要求吃饭。按照周期起发，到十三日结痂后，用十全大补汤调理。说道痘疮倒靥必然归肾，如今侥幸痊愈，尤其应当预防眼疾，宜预先解除隐患。患者不听，半月后，左眼疼痛不能睁开，果然失明。（此案并不确切，大抵是前面的案中升发药物太多，所以眼睛受病。我见过倒靥后起发的很多，不一定都会伤目。）
柴姓妇人二十七岁，痘疮非常密集，脓成之时，鼻头先干燥。医生说：此症凶险，不可治。问原因，医生说：痘疹起发不透，脓浆未熟，本不该结痂。况且收靥自有次序，形色也不同，先从口唇两旁收起，漏浆堆脓，面部疮疡都是这样，从颈部以下，则结成壳状。现在痘未成熟就结痂，这是倒陷。从鼻子先收，失去了次序。不漏浆的，就是干枯。后来竟然死了。
Regarding the inversion of smallpox crusts (inverted scabs).
Xu Zhongguang treated a patient with blood-heat type smallpox. Initially, cooling and resolving methods were not used in time. By the fifth or sixth day, herbs such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix (Dihuang), Forsythiae Fructum (Lianqiao), and Pericarpium Papaveris Rubrum (Hongqu) were administered, allowing the pustules to begin rising and swelling. When the filling stage reached half-way, the patient stopped taking medicine. On the ninth day, the color turned black and inverted towards the Kidney; the skin and flesh of the face, lips, waist, and feet all turned black. The previous prescription was continued, adding Golden Juice (Jinzhi) and Human Tooth Powder (Renya). The condition slightly eased, after which Coptidis Rhizoma, Rehmanniae Radix, and Pericarpium Papaveris Rubrum were each used in 1 qian, Aucklandiae Radix (Muxiang) in 3 fen, and Juncus Effusus (Dengxincao) in 1 qian. The next day, Rhinoceros Horn (Xijiao) and Forsythiae Fructum were added. The blackness gradually dispersed, and the lips and eyes cleared. After four consecutive doses of the previous formula, the patient recovered.
Wan Mizhai treated the son of the Wu family. His smallpox lesions were distinct, red, and lively, indicating a favorable course. However, the child had always had weak Spleen and Stomach, and the eruption rose slightly late. Someone suggested it was Qi deficiency and blindly administered one dose of Chen's Muxiang San, causing the lesions to become flat and fail to rise. Another dose of Chen's Yigong San was given. When consulted again, the case was deemed incurable.
The Li family's son developed smallpox at age four. Ten days later, the tops of the lesions were flat and depressed, with red-purple roots. He was lethargic and refused food; the case was incurable, and he died the next day.
The daughter of the Wu family was about to suppurate, but some crusts on her face had already dried, presenting an inverted adverse syndrome. Treatment consisted of Ginseng Radix (Renshen), [missing character, likely Astragali Radix], Glycyrrhizae Radix et Rhizoma (Gancao) tips, Angelicae Sinensis Radix, Rehmanniae Radix, Paeoniae Radix Rubra (Chishao), Lonicerae Japonicae Flos (Yinjinhua), Arctii Fructus (Niubangzi), Forsythiae Fructum, Ephedrae Herba (stir-fried with wine and honey until black), Carthami Flos (Honghua), and powder of Pangolin Scales (Shanjia). Decocted in water. The physician advised: "After ingestion, if the already dried lesions re-rise and suppurate; if the non-dried ones become robust, red, and full, and new small lesions appear in empty spaces, this is the best outcome. If they do not suppurate, do not fill the gaps, or if abscesses form, this is a medium outcome. Otherwise, it is incurable." After three consecutive doses, the already dried lesions did not swell, the non-dried ones filled with pus, few appeared in the gaps, and abscesses developed on the hands and feet. Subsequently, Shiquan Dabu Tang (Decoction for Complete Great Tonification) with added Lonicerae Japonicae Flos and Forsythiae Fructum was used for regulation, leading to recovery.
The grandson of Magistrate Lei developed smallpox at age five. He wore thick brocade clothes, was wrapped in heavy quilts, stayed near fire day and night, and was allowed to drink alcohol. Within seven days, crusts formed, but the face down to the waist became ulcerated and flat, with no scabs forming. The physician said: "This is not normal inverted scabbing. Urgently use herbs to disperse, resolve, and detoxify. Reduce clothing and bedding, avoid fire and alcohol, and safety can be ensured." Astragali Radix and Angelicae Dahuricae Radix (Baizhi) were used to drain pus and support the interior; Saposhnikoviae Radix (Fangfeng) and Bombyx Batryticatus (Chantui) to disperse the exterior; Citri Reticulatae Pericarpium (Qingpi) and Platycodonis Radix (Jiegeng) to regulate the interior; Arctii Fructus and Glycyrrhizae Radix et Rhizoma to detoxify. After one dose, the ulcerated sores swelled again, and pus and mucus were passed in stool, indicating that toxic qi had been cleared from both inside and outside. The physician warned against further medication to prevent other diseases.
Miss Dong, aged nineteen, began developing smallpox in mid-winter but could not crust over by mid-year. Her spirit was confused, and she ate nothing. Examination showed her lying stiffly like a corpse, yet her pulse was surging, solid, and regular. This was originally an inverted adverse syndrome, but fortunately, the pulse was surging and solid, neither rapid nor slow. Therefore, treatment was based on the pulse rather than the symptoms. If the necrotic sores could re-rise and new sores emerge, with clarity of mind and normal appetite, there would be no danger. Thus, Shengyang Jianghuo Tang (Decoction to Raise Yang and Descend Fire) with added Astragali Radix, Angelicae Sinensis Radix, Aucklandiae Radix, and Citri Reticulatae Pericarpium was administered for three consecutive doses. On the third day, a new layer of smallpox emerged, and the old ones dried completely. By the fifth day, all had erupted, covering the body, and she gradually regained consciousness, could speak, and requested food. Following the cycle of eruption, after crusting on the thirteenth day, Shiquan Dabu Tang was used for regulation. It was stated that inverted smallpox inevitably affects the Kidneys. Although cured, eye diseases should be prevented proactively. She did not listen. Half a month later, her left eye hurt and could not open, resulting in blindness. (This case is not entirely accurate; generally, excessive dispersing and raising agents in previous cases caused eye damage. I have seen many cases of inverted scabs recovering without eye injury.)
Mrs. Chai, aged twenty-seven, had very dense smallpox. When pus formed, the tip of her nose dried first. The physician said: "This is a ominous sign, incurable." Asked why, he replied: "The eruption was not thorough, and the pus was not ripe; crusting should not have occurred. Moreover, crusting follows a specific order and appearance. It usually starts from the sides of the mouth, leaking pus and accumulating suppuration, with facial lesions behaving similarly, while those below the neck form shells. Now, the immature smallpox has crusted, which is inversion. Crusting starting from the nose disrupts the order. The lack of leakage indicates dryness and withering." She eventually died.