条文：116
痘疔须用针挑拨，转重徐急贵合宜，破顶伤肌俱深忌，上浆急挑莫迟疑。
[注]
凡用针挑痘疔时，以二指拏针，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。
(煮针法) 甘草生 甘遂 川岛 草乌各等分 用水一钟，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
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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，
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，去人参黄耆，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。
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痘中杂证
条文：116
治疗痘疔必须使用针具进行挑拨，操作时轻重缓急要适宜，切忌挑破痘顶或深入损伤肌肉，待痘浆充盈时应立即挑拨，不可迟疑。
[注]
凡是使用针具挑治痘疔时，用两指捏住针柄，将针平直刺入痘中，挑断痘内的筋络，这样其他痘疹就会发出。但在挑治时，轻、重、快、慢之间贵在得当，不可挑破痘的顶部，也不可用力过深伤及肌肉。必须等到第三、四、五、六天痘液开始化浆的时候，痘体能够含住针尖，才可以进行挑拨，过了第七天就没有作用了，医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，用水一钟（约200毫升），放入砂罐内，以水烧干为限度，每次可以煮四五根针，煮完后放入鹅毛管筒内，用黄蜡封口收藏。
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]
痘疮这一病症，从头到尾不能完全清除其热邪。因为这种热不是壮热（高热），而是和缓的热。寒则导致收缩，热则导致宣发。发热且无汗，说明热邪在体表，主方用升麻葛根汤加荆芥穗、防风；蒸热且有汗，说明热邪在体内，主方用加减消毒饮。到了行浆期（痘液充盈阶段）热势不减的，这是毒热熏蒸所致，宜用清毒活血汤；若伴有便秘者，去掉人参、黄芪，加入酒炒大黄。到了结痂后发热壮盛，胸腹手足都热，大小便不通畅的，这是余毒过盛，宜用大连翘饮治疗。
（升麻葛根汤）方剂见“发热证治”章节。
（加减消毒饮）组成：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）。引用灯心草煎水服用。
（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）方剂见“灌浆证治”章节。
（大连翘饮）方剂见“收靥证治”章节。
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痘疮中的杂症
Clause 116
To treat Dou Ding (pox carbuncle), needle picking must be used. The manipulation should be neither too heavy nor too light, neither too fast nor too slow, but appropriate. It is strictly forbidden to pierce the top of the pox or penetrate deeply to damage the muscle. When the pus fills the pox, it must be picked immediately without hesitation.
[Note]
When using a needle to pick Dou Ding (pox carbuncle), hold the needle with two fingers and insert it horizontally into the pox. Break the meridians and collaterals within the pox so that other poxes will erupt. However, during the picking process, the degree of lightness, heaviness, speed, and slowness must be appropriate. Do not pierce the top of the pox, nor insert the needle heavily to damage the muscle. One must wait until the third, fourth, fifth, or sixth day when the pox begins to fill with pus (Xing Jiang stage). Only when the pox can hold the needle tip can the picking be performed. After the seventh day, this method is useless. Practitioners should memorize this carefully.
(Boiling Needle Method) Equal parts of Gancao Sheng (Raw Glycyrrhizae Radix et Rhizoma), Gansui (Kansui Radix), Chuanwu (Aconiti Radix), and Caowu (Aconiti Kusnezoffii Radix). Use one zhong (approx. 200 ml) of water, place in a clay pot, and boil until the water is dry. Each time, four or five needles can be boiled. After boiling, store them in a goose feather tube and seal the mouth with yellow beeswax.
Shengma Gegen Tang (Bupleurum and Kudzu Decoction) for exterior heat with no sweat; Xiaojian Xiaodu Yin (Modified Detoxification Decoction) is good for interior heat with sweat; Qingdu Huoxue Tang (Detoxifying and Blood-Activating Decoction) for toxic steaming during the pus-filling stage; Lianqiao Fang (Forsythia Formula) for residual heat after scabbing.
[Note]
In the case of smallpox/pox diseases, the heat cannot be completely eliminated from beginning to end. This is because the heat is not Zhuang Re (high fever), but rather a mild heat. Cold causes contraction, while heat causes dissemination. Fever with no sweat indicates heat in the Exterior (Biao); the primary formula is Shengma Gegen Tang (Puerariae Radix and Bupleuri Decoction) plus Jingjie Sui (Schizonepetae Spica) and Fangfeng (Saposhnikoviae Radix). Steaming heat with sweat indicates heat in the Interior (Li); the primary formula is Xiaojian Xiaodu Yin (Modified Detoxification Decoction). If the heat does not subside during the Xing Jiang (pus-filling) stage, this is due to toxic heat steaming. Qingdu Huoxue Tang (Detoxifying and Blood-Activating Decoction) should be used. If constipation is present, remove Renshen (Ginseng Radix) and Huangqi (Astragali Radix), and add Jiuchao Dahuang (Rhubarb Radix stir-fried with wine). After scabbing, if there is high fever, heat in the chest, abdomen, hands, and feet, and difficulty in urination and defecation, this is due to excessive residual toxins. Dalianqiao Yin (Large Forsythia Decoction) should be used for treatment.
(Shengma Gegen Tang [Puerariae Radix and Bupleuri Decoction]) See the section on "Treatment of Fever Symptoms".
(Xiaojian Xiaodu Yin [Modified Detoxification Decoction]) Composition: Shengma (Cimicifugae Rhizoma), Niubangzi Chao Yan (Arctii Fructus, fried and ground), Shandougen (Sophorae Tonkinensis Radix), Zicao (Lithospermi Radix), Lianqiao Qu Xin (Forsythiae Fructus, heart removed), Sheng Dihuang (Rehmanniae Radix Recens), Chi Shao (Paeoniae Radix Rubra), Chuan Huanglian (Coptidis Rhizoma), Gancao Sheng (Glycyrrhizae Radix et Rhizoma). Decoct with Dengxin Cao (Junci Medulla) as a guiding herb.
(Folk Song/Formula Verse)
Xiaojian Xiaodu Yin works like magic,
Shengma, Niubang, and Shandougen are key.
Zicao, Lianqiao, Shengdi, and Chi Shao,
Huanglian and Gancao, with Dengxin as the guide.
(Qingdu Huoxue Tang [Detoxifying and Blood-Activating Decoction]) See the section on "Treatment of Pus-Filling Symptoms".
(Dalianqiao Yin [Large Forsythia Decoction]) See the section on "Treatment of Scabbing Symptoms".
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Miscellaneous syndromes in pox diseases