痘虽肥满，内是干枯，全无血水，乃空仓也。其痘硬者，名铁壳空仓，症至如是，其必
死矣。此等之症，其气虽盛，其血必亏。或又以前失于解毒，致毒火内炽，其血愈涸，浆汁
乃血之所化，血枯故是空仓。一儿出痘甚多，体性又弱，医人不明气血之理，只谓保元汤乃
治痘至稳之剂，人参用至数钱，其痘竟无浆汗。请余往视，余曰∶此空仓也，汝试以针刺之
。剔破之痘，俱无血水。其家人大惊。余曰∶无妨，此气有余而血不足也。人参可以不用，
乃用川芎、炙 、白芷、牛蒡、肉桂各八分，归身、鹿茸各二钱，大生地三钱，白芍一钱，
穿山甲四分，连进二服，浆脚来矣。乃去牛蒡，而又以补血为君，补气为臣，其浆乃足而愈。
其痘不甚起胀，四弦起而中略陷，痘有乱纹于顶上，形若茱萸，名茱萸痘。其后必空浆
倒陷而死。此毒盛而中气又虚，故痘顶有纹而不尖圆也。一儿出痘如此，诸医皆云难治，请
余视之，见痘中间多有黑眼。余曰∶以毒凝而气不能升，其毒将入脏腑，急为解毒行气，犹
为可救。盖此时只六日也。乃用生 、牛蒡、连翘各一钱，赤芍八分，升麻、白芷各六分，
黄芩五分，黄连二分，甘草二分，川芎一分，蝉蜕二个，外以杨柳煎水洗之，连服数剂，其
痘渐圆净，纹与黑眼俱无。其后，以补气为君，补血为臣治之，竟愈。余治此症甚多，其先
必须解毒行气，茱萸纹乃可除也。
痘疹虽然长得肥满，但内部却是干枯的，完全没有血液和浆液，这就是“空仓痘”。如果痘疹质地坚硬，称为“铁壳空仓”，病情发展到这种程度，必然导致死亡。这类病症，虽然气机看似旺盛，但血液必定亏虚。又或因之前未能及时解毒，导致毒火在体内炽盛，使得血液更加枯竭。浆汁是由血液化生而来的，血液干枯所以形成空仓痘。有一个孩子出痘数量很多，体质又虚弱，医生不明白气血的道理，只认为保元汤是治疗痘疹最稳妥的方剂，将人参用到几钱之多，结果孩子的痘疹竟然没有浆液也没有汗液。请我去诊治，我说：“这是空仓痘，你试着用针刺破它。”挑破后的痘疹，里面都没有血水。他的家人非常惊恐。我说：“不要紧，这是气有余而血不足。人参可以不用，改用川芎、炙黄芪、白芷、牛蒡子、肉桂各八分，当归身、鹿茸各二钱，大生地三钱，白芍一钱，穿山甲四分，连续服用两剂，浆液就长出来了。”随后去掉牛蒡子，又以补血为主药，补气为辅药，浆液充足后病就好了。
如果痘疹起胀不明显，四周隆起而中间略微凹陷，痘顶有乱纹，形状像茱萸，称为“茱萸痘”。其后必然出现空浆倒陷而死。这是因为毒邪盛而中气又虚，所以痘顶有纹路而不尖圆。有一个孩子出痘如此，众位医生都说难治，请我去看，见痘疹中间多有黑眼（黑色中心）。我说：“因为毒邪凝结而气不能升发，毒邪将要侵入脏腑，必须紧急解毒行气，还可以救治。此时距离发病才六天。”于是用生黄芪、牛蒡子、连翘各一钱，赤芍八分，升麻、白芷各六分，黄芩五分，黄连二分，甘草二分，川芎一分，蝉蜕两个，外用杨柳枝煎水洗患处，连续服用数剂，痘疹逐渐变得圆润干净，纹路和黑眼都消失了。之后，以补气为主药，补血为辅药来治疗，最终痊愈。我治疗这类病症很多，起初必须先解毒行气，茱萸状的纹路才能消除。
Although the variola (smallpox) lesions appear plump, they are internally dry and completely lack blood and fluid; this is termed "Empty Granary" (Kong Cang). If the lesions are hard, it is called "Iron Shell Empty Granary"; when the condition reaches this stage, death is inevitable. In such cases, although Qi appears abundant, Blood must be deficient. Furthermore, if prior treatment failed to resolve toxicity, causing toxic fire to blaze internally, the Blood becomes even more depleted. Since pus/fluid is transformed from Blood, the depletion of Blood results in the "Empty Granaries." A child with a severe outbreak of variola, who was also constitutionally weak, was treated by a physician who did not understand the principles of Qi and Blood. The physician assumed that Baoyuan Tang (Preserve Origin Decoction) was the most stable formula for treating variola and used Ren Shen (Ginseng Root) up to several qian. Consequently, the child's lesions produced no pus or sweat. I was invited to examine the patient and stated: "This is 'Empty Granary.' Try pricking the lesions with a needle." Upon piercing the lesions, there was no blood or fluid. The family was greatly alarmed. I said: "Do not worry; this indicates excess Qi and insufficient Blood. Ren Shen (Ginseng Root) should not be used. Instead, use Chuan Xiong (Sichuan Lovage Rhizome), Zhi Huang Qi (Honey-fried Astragalus Root), Bai Zhi (Angelica Dahurica Root), Niu Bang Zi (Arctium Fruit), and Rou Gui (Cinnamon Bark), each 8 fen; Dang Gui Shen (Angelica Sinensis Root Body) and Lu Rong (Deer Antler Velvet), each 2 qian; Da Sheng Di (Rehmannia Root), 3 qian; Bai Shao (White Peony Root), 1 qian; and Shan Jia Chuan (Pangolin Scales), 4 fen. After administering two doses, the pus began to form." Subsequently, Niu Bang Zi (Arctium Fruit) was removed, and the treatment focused on nourishing Blood as the sovereign herb and tonifying Qi as the minister herb. With sufficient pus formation, the patient recovered.
If the lesions do not swell significantly, with the periphery raised but the center slightly depressed, and if chaotic patterns appear on the apex resembling cornel fruit (Zhu Yu), it is named "Cornel Variola" (Zhu Yu Dou). This condition inevitably leads to empty pus and inversion, resulting in death. This occurs because the pathogenic factor is excessive while the Middle Qi is deficient, causing the lesion apex to have patterns rather than being sharp and round. A child presented with such symptoms, and all physicians deemed it difficult to treat. Upon examination, I observed many black centers (Hei Yan) within the lesions. I stated: "Due to coagulated toxicity preventing Qi from ascending, the toxicity is about to invade the Zang-Fu organs. Urgent resolution of toxicity and promotion of Qi circulation can still save the patient. It has only been six days since onset." Therefore, I prescribed Sheng Huang Qi (Astragalus Root), Niu Bang Zi (Arctium Fruit), and Lian Qiao (Forsythia Fruit), each 1 qian; Chi Shao (Red Peony Root), 8 fen; Sheng Ma (Cimicifuga Rhizome) and Bai Zhi (Angelica Dahurica Root), each 6 fen; Huang Qin (Scutellaria Root), 5 fen; Huang Lian (Coptis Rhizome), 2 fen; Gan Cao (Licorice Root), 2 fen; Chuan Xiong (Sichuan Lovage Rhizome), 1 fen; and Chan Tui (Cicada Slough), two pieces. Externally, the area was washed with decoction made from Yang Liu (Willow Branch). After several doses, the lesions gradually became round and clean, and the patterns and black centers disappeared. Thereafter, treatment focused on tonifying Qi as the sovereign herb and nourishing Blood as the minister herb, leading to complete recovery. I have treated many such cases; initially, resolving toxicity and promoting Qi circulation is essential to eliminate the cornel-like patterns.