收靥之后，痂亦先手渐脱，其疤鲜明光润，既无赤黑，又无凹凸，容颜依旧者，此
乃大顺者矣。若靥后痂落，五官麻诀，四肢伤残，毛发尽脱，形容大改者，此险中得生
者也。面痘黑污者，须用灭瘢散，临睡蜜水调搽，至晓以水涤去，自然白莹光润，更宜
爱护，不得早见风日。如瘢突起着，此热毒未尽，宜用解毒防风汤。如下成凹者，此脾
胃虚而不能长养肌肉也，宜用人参白术散加黄 主之。若痂不脱者，以百花膏润之，令
其速脱，迟则深入肌肉而成瘢疤。若久不脱者，是肺主皮毛，脾主肌肉，二经血虚作热
也，宜内用补血凉荣之剂，外用麻油和蜜涂抹，痂得油润自脱也。不可强为剥去，致伤
皮肤，成疮溃烂，或变痘癞。
凡痘面浑身疮瘢黑暗者，未可便谓无事，犹思日前未甚作脓而到靥归肾也，宜细
别之。如身壮热，少食大渴，烦闷昏睡，便利或秘者，此真倒靥归肾也。若身温暖爽
快，二便饮食调匀者，此乃疮瘢本色无虑也。如瘢白色者，是气血虚也，急用大补气
血。如收靥既迟，痂亦难落，其人昏昏喜睡，无他苦者，此因邪气虽退，正气尚衰，
脾胃虚弱耳。宜用保元安神，缓缓调理，气血平复，则自清爽。然痂皮初落，肌肉新
嫩，不宜澡洗，增减衣服，盖表气已虚，六淫易袭，兼疮毒久困，里气必虚，肠胃必
弱，不宜饮冷，及伤饥饱。痘中做病，日后难疗，与其疾若一生，莫若谨慎百日。凡痘
痕赤而作痒者，是血虚而有热也，宜用丹皮、会皮之类。若赤而作痛者，是余毒也，
宜用连翘、鼠粘之类。若白者，是气虚而血衰也者，宜固元气为本。若白而作痒兼渴
者，是气血俱虚也，尤宜大补气血。若发热而大便调和者是脾胃虚热也。若发热而大便
秘结者，是肠胃实热也。若乳食减少，四肢倦怠者，是中气虚也。然治之而即愈，兼之
痘痕渐转红活者，吉。如色不转者，虽经年后，多变泻痢而死，然补气血，久而不效
者，莫若更补气血之根。气之根，肾中之真阳也。血之根，肾中之真阴也。于此根上补
起，未有不发虚气血。
凡痘痂既脱，复有瘢痕凸起，重作脓窠，依旧结一层 子者，是必收靥太聚，毒
气未尽，或因误服温补之药，多淡肥甘之物，饮酒恣辛，不忌煎 ，或因见风太早，
荣卫郁而不通，皆能复成此症。然此毒邪外散，决无大苦，只恐肌肉空虚，久为疮癞
也。复有痂虽脱去，或于面上，或于手足成片结硬，其疮差别虽焦，中蓄脓浆者，此是
痘子原出之初，其处太密，糊涂成丹，无分颗粒，所以毒壅于里，不能大泄，故靥独
迟，今血气少，复化成毒脓耳，宜用灭瘢散，和蜜涂之，待脓收痴起自愈。更有手足
腕膝之处，疮窠连串，作一大块脓化作水，停蓄于中，恰如囊袋，皮不破水不去，日久
只如是者，此乃里面肌肉已好，只是疮皮剩于外者而作也，宜用针之决去其水自干脱矣。
痘疹结痂脱落之后，如果痂皮先从手部开始逐渐脱落，留下的疤痕颜色鲜明、光泽润泽，既没有红黑色，也没有凹凸不平，面容恢复如初，这是非常顺遂的佳兆。如果结痂脱落后，五官出现麻木或功能缺失，四肢伤残，毛发全部脱落，容貌发生巨大改变，这是在危险中侥幸存活的情况。面部痘疮留下黑污色疤痕的，必须使用灭瘢散，睡前用蜂蜜水调和后涂抹，第二天早晨用水洗净，疤痕自然会变得洁白莹润、光泽润泽；此后更应小心爱护，避免过早接触风日。如果疤痕凸起，这是因为热毒尚未清除干净，适宜使用解毒防风汤。如果疤痕凹陷，这是因为脾胃虚弱，不能滋养肌肉，适宜用人参白术散加黄芪来主治。如果痂皮不脱落，用百花膏滋润它，使其快速脱落，拖延久了就会深入肌肉形成永久性瘢痕。如果长期不脱落，是因为肺主皮毛、脾主肌肉，这两经的血虚导致内热，适宜内服补血凉血的药剂，外用麻油和蜂蜜涂抹，痂皮得到油润自然就会脱落。不可强行剥去，以免损伤皮肤，造成疮疡溃烂，或者变成痘癞（一种严重的皮肤病）。
凡是痘疹痊愈后，全身疮疤颜色黑暗的人，不可以立刻认为没有问题，虽然想着前几天化脓不多而到了收靥期归于肾经，但需要仔细辨别。如果身体高热，食欲减退且极度口渴，烦躁闷乱、昏睡，大小便或通利或秘结，这是真正的“倒靥归肾”（痘毒内陷肾脏的危重证候）。如果身体温暖舒适，二便和饮食都调匀正常，这是疮疤的本色，无需担忧。如果疤痕呈白色，是气血虚弱，急需大补气血。如果收靥时间过迟，痂皮也难以脱落，患者昏昏欲睡喜欢睡觉，没有其他痛苦，这是因为邪气虽然退去，但正气仍然衰弱，脾胃虚弱所致。适宜用保元安神的方法，缓缓调理，待气血平复，自然清爽。然而痂皮刚脱落时，肌肉新嫩，不宜洗澡清洗，也不宜随意增减衣服，因为表气已经虚弱，六淫（风、寒、暑、湿、燥、火）容易侵袭，加上疮毒久困体内，里气必然虚弱，肠胃必定柔弱，不宜喝冷饮，也不宜饥饱失常。在痘病期间生病，日后难以治疗，与其让疾病伴随一生，不如谨慎调养百日。凡是痘痕发红且发痒的，是血虚而有热，适宜用牡丹皮、地骨皮之类的药物。如果发红且疼痛，是余毒未清，适宜用连翘、牛蒡子之类的药物。如果疤痕发白，是气虚而血衰，应当以固护元气为根本。如果发白且发痒兼有口渴，是气血俱虚，尤其应当大补气血。如果发热而大便调和，是脾胃虚热。如果发热而大便秘结，是肠胃实热。如果乳食减少，四肢倦怠，是中气虚弱。然而治疗后立即痊愈，并且痘痕逐渐转为红润鲜活，是吉兆。如果颜色不转变，即使经过多年，也多变泻痢而死；但如果补益气血，长时间无效，不如转而补益气血的根本。气的根本，是肾中的真阳；血的根本，是肾中的真阴。从这些根本上进行补益，没有不能发出虚损的气血的。
凡是痘痂已经脱落，却又出现瘢痕凸起，重新化作脓窠，依旧结出一层痂子的，这一定是因为收靥太急聚，毒气未尽，或者因为误服温补的药物，多吃淡薄肥甘的食物，饮酒纵情吃辛辣，不忌煎炸油腻，或者因为见风太早，营卫之气郁滞不通，都能再次造成这种病症。然而这种毒邪向外发散，决不会有太大的痛苦，只恐怕肌肉空虚，长久成为疮癞。又有痂皮虽然脱落，但在面部，或在手足成片结成硬块，其疮形虽然焦枯，中间蓄积脓浆的，这是因为痘子最初发出时，该处太密集，糊涂成丹，不分颗粒，所以毒气壅塞在内部，不能大大宣泄，因此收靥特别迟，现在血气少，又化成毒脓罢了，适宜使用灭瘢散，和蜜一起涂抹，等待脓液收敛、痂皮起落自然痊愈。更有在手足腕膝之处，疮窠连串，作一大块脓化作水，停蓄在中间，恰如囊袋，皮不破水不去，日子久了只是这样的，这是里面的肌肉已经好了，只是疮皮剩在外面而造成的，适宜用针挑破排出积水，自然干燥脱落。
After the scabs have fallen off, if they gradually detach starting from the hands, and the resulting scars are bright, smooth, and lustrous, without any redness or blackness, nor any concavities or convexities, with the facial appearance restored to normal, this is a highly favorable outcome. If after the scabs fall, the five organs exhibit numbness or dysfunction, the four limbs are disabled, hair falls out completely, and the physical appearance is drastically altered, this indicates survival amidst critical danger. For dark and dirty scars on the face, Miecan San (Scar-Removing Powder) must be used; mix it with honey water before sleep and apply it, then wash it off with water at dawn, so that it will naturally become white, bright, and lustrous. Further care should be taken to avoid exposure to wind and sunlight too early. If the scars protrude, it indicates that heat-toxin has not been fully cleared; Jiedu Fangfeng Tang (Detoxifying and Saposhnikovia Decoction) is appropriate. If the scars are depressed, it indicates Spleen and Stomach deficiency failing to nourish muscles; Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) added with Huangqi (Astragali Radix) should be used. If the scabs do not detach, apply Baihua Gao (Hundred Flowers Ointment) to moisten them for rapid detachment; delay may cause them to penetrate deep into the muscle and form permanent keloids. If they remain for a long time, it is due to Blood deficiency generating heat in the Lung (which governs skin and hair) and Spleen (which governs muscles); internally, use formulas to tonify Blood and cool Ying (Nutritive Qi), and externally, apply Sesame Oil and Honey. The scabs will detach naturally when moistened. Do not forcibly peel them off, as this may damage the skin, causing ulcers or transforming into acne-like lesions (Dou Lai).
For cases where the entire body's scar marks are dark after smallpox recovery, one should not immediately assume there is no issue, even if recalling that pus formation was insufficient previously and the resolution phase seemed to relate to the Kidney. Careful differentiation is required. If there is high fever, poor appetite, extreme thirst, restlessness, confusion, drowsiness, and irregular bowel movements (either loose or constipated), this is true "Dao Ye Gui Shen" (Inverted Resolution Retreating to the Kidney), a critical condition. If the body feels warm and comfortable, and bowel movements and diet are regular, this is merely the natural color of the scars, requiring no worry. If the scars are white, it indicates Qi and Blood deficiency; urgently use major Qi and Blood tonics. If resolution is delayed and scabs are hard to fall, and the person is lethargic and sleepy without other suffering, it is because although pathogenic factors have receded, Zheng Qi (Upright Qi) remains weak due to Spleen and Stomach deficiency. Use Baoyuan Anshen (Protect Vitality and Calm Spirit) methods, regulating slowly; once Qi and Blood stabilize, clarity will return. However, when scabs first fall, the new muscle tissue is tender; bathing is inappropriate, and clothing adjustments should be cautious because Biao Qi (Defensive Qi) is weak, making the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) prone to attack. Additionally, internal Qi is weakened by lingering toxin, and the Intestines and Stomach are fragile; cold drinks and irregular eating habits should be avoided. Illness during the smallpox course is difficult to treat later; rather than enduring lifelong illness, it is better to exercise caution for one hundred days. Red and itchy scars indicate Blood deficiency with Heat; use Mudanpi (Moutan Cortex) and Digupi (Cortex Lycii). Red and painful scars indicate residual toxin; use Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus). White scars indicate Qi deficiency and Blood decline; focus on consolidating Yuan Qi (Original Qi). White, itchy, and thirsty scars indicate dual Qi and Blood deficiency; major tonification of Qi and Blood is especially indicated. Fever with normal stools indicates Spleen-Stomach Deficient Heat; fever with constipation indicates Intestine-Stomach Excess Heat. Reduced milk/food intake and limb fatigue indicate Middle Qi deficiency. If treatment leads to immediate recovery and scars turn red and vibrant, it is auspicious. If the color does not change, diarrhea and dysentery leading to death may occur even years later. If Qi and Blood tonification fails over a long period, one should instead tonify the root of Qi and Blood. The root of Qi is True Yang in the Kidney; the root of Blood is True Yin in the Kidney. Tonifying from these roots will invariably restore deficient Qi and Blood.
If scars protrude again after falling, forming new pustules and re-scabbing, it is likely due to overly rapid resolution leaving incomplete toxin, or misusing warming and tonifying herbs, consuming excessive bland, fatty, and sweet foods, drinking alcohol, indulging in spicy foods, ignoring fried/greasy items, or early exposure to wind causing stagnation of Ying and Wei (Nutritive and Defensive Qi). All these can cause recurrence. However, since this pathogenic toxin disperses outward, severe suffering is unlikely, though muscle emptiness may lead to chronic ulcerative conditions. Another scenario involves scabs falling but hard,成片 (patchy) formations appearing on the face, hands, or feet; although the surface is scorched, pus accumulates inside. This occurs because the initial eruption was too dense, merging into a mass without distinct granules, trapping toxin internally preventing thorough expulsion, thus delaying resolution. Now, with diminished Qi and Blood, toxic pus reforms. Apply Miecan San mixed with honey; wait for pus to resolve and scabs to fall for natural healing. In cases where wrist and knee lesions form connected chains, creating large masses of liquid pus like sacs, where the skin remains intact and fluid persists for a long time, this indicates the underlying muscle has healed, but only the outer scar skin remains. Puncture with a needle to drain the fluid, allowing it to dry and detach naturally.