痘有夹凡疮而出者，则肉分空虚，痘集必密，且血气为疮所夺，势必干枯黑陷。痘
多不能起发成浆，或热毒结聚而为疔者有矣，须急连服内托，大为凉血补血以济之
外，以珍珠细末胭脂涂敷疮处，恐疮黑蔓延，痘亦变黑也。
夫痘初出时，腹中常宜宽舒者，为里无邪也。若腹胀者，是毒瓦斯聚于肠胃，不能发
出，或少发出，而反伏入也。甚者，气喘发厥，疮无血色，或变紫黑，多致不救，治法
则当升发解利，使毒瓦斯上下中表分消。大便秘而脾热生胀者，泻之小便，赤而胃热，生
胀者利之。若腹胀泻渴，气促体倦，手足并冷，发哕自利而腹胀者，此脾胃虚寒也，宜
温补之。身热脉数，大便不通，烦燥作喘，大渴面赤，谵语不安而腹胀者，此热毒壅遏
也，当急下而兼表暴之。若因热毒，正发为冷所遏，是以阴阳不和，冷热相搏，毒不发
泄，以致腹中虚鸣，二便自利，其脉则微手足俱冷，饮食不进者，则加暖剂以攻托之。
若因乳食停滞而腹胀者，则于升发解利药中，加消食之剂兼所伤之物，审其寒而施治
之。若出太盛而面黄，大便色黑，烦燥喘渴腹胀者，此有瘀血在里也，宜于清热凉血剂
中，加桃仁红色之类，以消之。至若目闭神昏，口气臭甚者，则血气以离毒已内溃，不
可治矣。
痘疹伴有普通疮疡一同发出的，会导致肌肉腠理空虚，痘疹必然密集，且气血被疮疡所耗夺，势必导致痘疹干枯、颜色发黑并内陷。痘疹大多不能起发成浆，或者因热毒结聚而形成疔疮的情况也有，必须紧急连续服用内托法药物，大力凉血补血以救助，并在疮处涂抹珍珠细末和胭脂，防止疮色变黑蔓延，导致痘疹也变为黑色。
痘疹刚发出时，腹部通常应当宽舒，这是因为体内没有邪气。如果出现腹胀，是毒瓦斯聚集在肠胃，不能透发出来，或者稍微发出一点，反而伏入体内。严重的会出现气喘、昏厥，疮色无血色，或变成紫黑色，多导致无法救治，治疗方法应当升发解利，使毒瓦斯从上下中表各个部位分消。大便秘结而脾热引起腹胀的，通过小便泻下；小便赤涩而胃热引起腹胀的，通过利尿解决。如果腹胀腹泻口渴，气短体倦，手脚都冷，呃逆自利且腹胀的，这是脾胃虚寒，适宜温补。身体发热脉数，大便不通，烦躁气喘，大渴面红，胡言乱语不安且腹胀的，这是热毒壅遏，应当紧急攻下兼以发散表邪。如果因为热毒，正当发作时被寒气遏制，导致阴阳不和，冷热相搏，毒气不能发泄，以致腹中虚鸣，二便自利，脉象微弱手脚俱冷，饮食不进的，则加入温暖剂来攻托。如果因为乳食停滞而腹胀的，则在升发解利的药物中，加入消食的药物以及针对所伤食物的处理，审察其寒热性质施治。如果痘疹出得太盛而面色黄，大便颜色黑，烦躁气喘口渴腹胀的，这是里有瘀血，适宜在清热凉血的药剂中，加入桃仁红色之类，以消除瘀血。至于眼睛闭合神志昏迷，口气臭秽严重的，则是气血已经离开毒邪向内溃败，不可治愈了。
When smallpox erupts concurrently with ordinary sores (ordinary skin eruptions), the flesh and pores become empty, causing the smallpox lesions to inevitably cluster densely. Furthermore, as Qi and Blood are depleted by the sores, the lesions will inevitably dry up, turn black, and sink inward. The smallpox often fails to rise and fill with pus, or heat-toxin may aggregate to form carbuncles (ding). It is necessary to urgently administer internal support formulas continuously, vigorously cooling blood and nourishing blood to assist, while applying fine pearl powder mixed with rouge to the sore areas to prevent the sores from turning black and spreading, which would cause the smallpox to also turn black.
When smallpox first begins to emerge, the abdomen should generally be comfortable and loose, indicating that there is no pathogenic factor in the interior. If abdominal distension occurs, it signifies that toxic vapors have gathered in the intestines and stomach, preventing eruption, or allowing only a slight emergence before retreating inward. In severe cases, wheezing and syncope occur, the lesions lack color, or they turn purple-black, often leading to untreatable conditions. The treatment method should involve ascending and releasing to resolve obstruction, allowing toxic vapors to dissipate through the upper, lower, middle, and exterior aspects. If constipation accompanies spleen-heat-induced distension, purgation via urine is indicated; if scanty red urine accompanies stomach-heat-induced distension, diuresis is indicated. If abdominal distension is accompanied by diarrhea, thirst, shortness of breath, fatigue, cold hands and feet, hiccups, spontaneous diarrhea, and distension, this indicates Spleen and Stomach deficiency-cold, requiring warming and tonification. If fever, rapid pulse, constipation, irritability, wheezing, extreme thirst, red face, delirium, restlessness, and abdominal distension occur, this indicates heat-toxin congestion, requiring urgent purgation combined with dispersing the exterior. If heat-toxin, while actively erupting, is suppressed by cold, leading to disharmony of Yin and Yang, clashing of cold and heat, and failure of toxin to vent, resulting in abdominal borborygmus, spontaneous urination and defecation, faint pulse, cold extremities, and loss of appetite, warming agents should be added to attack and support. If abdominal distension is caused by food stagnation, digestive-resolving agents and treatments specific to the ingested substance should be added to ascending and releasing formulas, after assessing the cold or heat nature for treatment. If excessive eruption leads to a yellowish complexion, black stool, irritability, wheezing, thirst, and abdominal distension, this indicates blood stasis in the interior; peach kernels and red-colored substances should be added to heat-clearing and blood-cooling formulas to resolve it. As for closed eyes, unconsciousness, and severely foul breath, these indicate that Qi and Blood have separated from the toxin and collapsed internally, rendering the condition untreatable.