痘里夹瘿生颈项，形如桃李瓜枣状，证兼身热多渴烦，痰气凝结致此恙。
【注】此证结于颈项，或生耳后腋下，形如桃李枣瓜，身热烦渴，由痰气凝结所致。痘
初起即发瘿者，治宜托里、消痰、解毒，如木通、桔梗、生地、甘草、蝉蜕、芍药、荆
芥等药，缺一不可；若芩连等药，及耗烁之剂，俱不可用。若痘发在三四日而作瘿者，则
毒随痘泄，毒随痘灌，自可挽全而无害，宜服三消散。倘斯时红肿将脓一溃，则元气泄，
而痘浆必不能充灌；乘未溃时，急用黄 卫元汤补之。若痘至七八日，灌浆时而发瘿者，
冲和饮子主之。若痘疮苍蜡色而作瘿者，宜消毒兼保元气；溃后宜生肌玉红膏贴之。
三消散
当归 赤芍 天花粉 甘草 牛蒡子（炒，研） 白茯苓 生地黄 红花 蝉蜕（去足翅）
木通 半夏（制，各八分）
水二盅，灯心二十根，煎六分服。
【方歌】三消痘发三四日，痰凝结瘿须当治，归芍天花甘蒡苓，生地红蝉通夏制。
黄 卫元汤
黄 人参 当归 桔梗 红花 甘草（炙） 白芍（酒炒） 防风（各一钱）
水煎，不拘时服。
【方歌】黄 卫元瘿肿起，已溃未溃急补之，人参归桔红花草，防风芍药服无时。
冲和饮子
麦门冬（去心） 人参 桔梗 当归 黄
柴胡 白芍（酒炒） 白茯苓 天花粉 荆芥 防风 连翘（去心） 白术（土炒，各七分）
水煎服。
【方歌】冲和饮子麦门冬，参桔归 柴芍苓，花粉荆防翘白术，痘发七天痰气凝。
生肌玉红膏（见溃疡门）
痘疮中夹杂瘿肿生于颈项部位，形状像桃李、瓜果或枣子一样，症状伴有身体发热、口渴烦躁，这是由于痰气凝结导致的病症。
【注】这种证候结聚在颈项部，或者生在耳后、腋下，形状像桃李、枣瓜，伴有身体发热、心烦口渴，是由痰气凝结所致。如果在痘疮初起时就出现瘿肿，治疗应当采用托里透脓、消除痰浊、解毒的方法，如使用木通、桔梗、生地黄、甘草、蝉蜕、芍药、荆芥等药物，这些药物缺一不可；如果用到黄芩、黄连等药物，以及耗伤阴液的制剂，都不可使用。如果痘疮发于三四天之后才出现瘿肿，那么毒邪会随着痘疮的发出而排泄，随着痘浆的灌注而化解，自然可以保全生命而无危害，适宜服用三消散汤。倘若此时红肿即将化脓溃破，那么元气就会泄露，导致痘浆必然不能充盈灌注；趁尚未溃破之时，紧急使用黄芪卫元汤来补益正气。如果痘疮到了七八天，正在灌浆阶段时却发生瘿肿，则以冲和饮子为主治方剂。如果痘疮呈现苍蜡色并发生瘿肿，适宜采用解毒兼以保护正气的治疗方法；溃破后适宜贴敷生肌玉红膏。
三消散汤
当归、赤芍、天花粉、甘草、牛蒡子（炒熟，研碎）、白茯苓、生地黄、红花、蝉蜕（去掉足和翅膀）、木通、半夏（制过，以上各八分）
用水两盅，灯心草二十根，煎煮至六分，服用。
【方歌】三消痘发三四日，痰凝结瘿须当治，归芍天花甘蒡苓，生地红蝉通夏制。
黄芪卫元汤
黄芪、人参、当归、桔梗、红花、甘草（炙烤）、白芍（酒炒）、防风（以上各一钱）
用水煎煮，不拘泥时间服用。
【方歌】黄芪卫元瘿肿起，已溃未溃急补之，人参归桔红花草，防风芍药服无时。
冲和饮子
麦门冬（去掉心）、人参、桔梗、当归、黄芪、柴胡、白芍（酒炒）、白茯苓、天花粉、荆芥、防风、连翘（去掉心）、白术（土炒，以上各七分）
用水煎煮服用。
【方歌】冲和饮子麦门冬，参桔归芪柴芍苓，花粉荆防翘白术，痘发七天痰气凝。
生肌玉红膏（见溃疡门）
Diphtheria-like nodules (Ying, 瘿) appearing within smallpox lesions occur on the neck and nape, resembling the shape of peaches, plums, melons, or dates. The presentation includes fever, excessive thirst, and irritability, caused by the condensation of phlegm and Qi stagnation.
[Note] This condition manifests as nodules in the neck region, or behind the ears and in the axillae, with shapes resembling peaches, plums, dates, or melons, accompanied by fever, irritability, and thirst. It is caused by the condensation of phlegm and Qi stagnation. If nodules appear at the initial stage of smallpox, treatment should focus on supporting the interior (Tuo Li, 托里), resolving phlegm, and detoxifying. Herbs such as Tong Cao (Akebiae Caulis), Jie Geng (Platycodonis Radix), Sheng Di Huang (Rehmanniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chan Tui (Cicadae Periostracum), Shao Yao (Paeoniae Radix), and Jing Jie (Schizonepetae Herba) are indicated; none of these can be omitted. Decoctions containing Huang Qin (Scutellariae Radix) and Lian Lian (Coptidis Rhizoma), as well as formulas that consume Yin fluids, must not be used. If nodules develop three to four days after the onset of smallpox, the pathogenic toxin will be excreted along with the eruption and resolved as the pustules fill, naturally preserving life without harm; San Xiao San (Three-Reduction Powder) is appropriate. However, if redness and swelling are about to suppurate and ulcerate at this time, vital Qi will leak, and the pus in the smallpox lesions will fail to fill adequately. Before ulceration occurs, use Huang Qi Wei Yuan Tang (Astragalus Defense-Yuan Decoction) urgently to tonify. If nodules appear during the seven-to-eight-day stage when pustules are filling, Chong He Yin Zi (Harmonizing Decoction) is the primary formula. If the smallpox lesions present with a pale waxy color accompanied by nodules, detoxification combined with protecting vital Qi is suitable; after ulceration, Sheng Ji Yu Hong Gao (Vital-Flesh Jade-Red Ointment) should be applied externally.
San Xiao San (Three-Reduction Powder)
Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra), Tian Hua Fen (Trichosanthis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Niu Bang Zi (Arctii Fructus, stir-fried and crushed), Bai Fu Ling (Poria), Sheng Di Huang (Rehmanniae Radix), Hong Hua (Carthami Flos), Chan Tui (Cicadae Periostracum, feet and wings removed), Mu Tong (Akebiae Caulis), Ban Xia (Pinelliae Rhizoma, processed). Each ingredient: 8 fen.
Decoct two cups of water with twenty stalks of Deng Xin Cao (Junci Medulla) until reduced to six parts; take orally.
[Prescription Song] Smallpox erupts on the third or fourth day, phlegm-condensed nodules require treatment; Dang Gui, Chi Shao, Tian Hua Fen, Gan Cao, Niu Bang Zi, Bai Fu Ling, Sheng Di Huang, Hong Hua, Chan Tui, Mu Tong, and processed Ban Xia.
Huang Qi Wei Yuan Tang (Astragalus Defense-Yuan Decoction)
Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Jie Geng (Platycodonis Radix), Hong Hua (Carthami Flos), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Jiu Chao Bai Shao (Paeoniae Radix Alba, wine-fried), Fang Feng (Saposhnikoviae Radix). Each ingredient: 1 qian.
Decoct in water; take at any time.
[Prescription Song] Huang Qi Wei Yuan treats rising nodules, urgent tonification whether ulcerated or not; Ren Shen, Dang Gui, Jie Geng, Hong Hua, Gan Cao, Fang Feng, and Shao Yao taken without restriction.
Chong He Yin Zi (Harmonizing Decoction)
Qu Xin Mai Men Dong (Ophiopogonis Radix, heart removed), Ren Shen (Ginseng Radix), Jie Geng (Platycodonis Radix), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Chai Hu (Bupleuri Radix), Jiu Chao Bai Shao (Paeoniae Radix Alba, wine-fried), Bai Fu Ling (Poria), Tian Hua Fen (Trichosanthis Radix), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Qu Xin Lian Qiao (Forsythiae Fructus, heart removed), Tu Chao Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried). Each ingredient: 7 fen.
Decoct in water and take orally.
[Prescription Song] Chong He Yin Zi contains Mai Men Dong, Ren Shen, Jie Geng, Dang Gui, Huang Qi, Chai Hu, Bai Shao, Bai Fu Ling, Tian Hua Fen, Jing Jie, Fang Feng, Lian Qiao, and Bai Zhu; on the seventh day of smallpox, phlegm and Qi become condensed.
Sheng Ji Yu Hong Gao (Vital-Flesh Jade-Red Ointment) (See Section on Ulcers)