一凡痘十日十一二日。痘渐收靥。自上而下为顺。自下而上为逆。其遍身皆
靥。虽数颗不靥。尚能杀人。犹蛇蜕皮。虽一节被伤。不能退者。是亦死也。
一十日至十一日。当靥不靥。其身不壮热。闷乱不宁。卧则哽气。烦渴切牙。异功散加
木香、当归。以救阴阳表里。若以蜜水西瓜、红柿等冷物食之。速死。
一凡当靥不靥。泄泻寒战。切牙抓破。此虚寒也。宜异功散。
一凡过服热药。以致热毒猖狂。血气弥盛。痘烂不靥者。内服小柴胡汤、猪尾膏解之。
外用败草散敷之。
一凡痘不收靥。气急上痰。声哑目闭无神者。死。靥后瘢红。吉。白无血色。毒瓦斯滞内
也。恐生余症。
一治痘疮抓搔。成脓血淋漓。宜
败草散
用盖房多年烂草。或盖墙烂草亦可。其草经霜露。感天地阴阳之气。并解疮毒。其功不
能尽述
取草不拘多少。晒干或焙干为末。干贴疮上。或浑身疮破。脓水不绝。粘贴衣裳。难以坐
卧。可用二三升摊于席上。令儿坐卧。其效如神。仍服木香散。加丁香、官桂二味。同煎服
之。
硝胆膏
硝胆膏疗口不收。疮瘢臭烂血脓流。宜研诸胆芒硝细。患处涂之病自瘳。
猪尾膏
龙脑半字研细。旋滴猪心血为丸。辰砂为衣。紫草汤化下。
一治痘疹抓破稀烂。用茧孔内入上蜜。新瓦上焙干。烧灰存性为末。如湿。干掺、如干
香油调搽效。
一小儿三岁者。发热七日。疮出倒靥黑色。唇口冰冷。危症也。祈福求神。无所不至。
偶逢一士曰。此疾有药可起。以少许俾服之。移时即红活如常。不吝赀求方。其法。用狗
蝇七枚。擂细。和醋酒少许调服。蝇夏月极多易得。冬月藏于耳中。不可不知。此蝇夏月狗
身上飞者是也。
一痘疮属虚寒者。直可延至十数日后方死。属毒盛转色者。不过七八日。盖痘是胎毒自
内出
外。一二三日方出齐。毒瓦斯尚在内。出至六日。则当尽出于外。七八九日藏脓而结痂矣。若
毒瓦斯盛。不能尽出。过六日毒反内入脏腑。故须六日以前。毒瓦斯皆出之时。急服凉血解毒之
药。以驱出之。六日以后。医无及矣。故其死最急。若虚弱毒瓦斯少者。只是气血不足。不能
贯脓成就。故绵延日久而后死。此虚实轻重之分也。
一、凡是痘疮发病到第十天或十一二天时，痘疹逐渐结痂脱落。痘疹从头部向下部发展结痂为顺证；若从下部向上部逆向发展则为逆证。即使全身大部分都已结痂，只要有几颗未结痂，仍然可能致死。这就像蛇蜕皮一样，虽然只有一节受损无法蜕下，也会导致死亡。
二、到了第十天至第十一天，应当结痂时却不结痂，患者身体没有壮热，但感到烦闷混乱、不得安宁，躺下时呼吸急促（哽气），烦躁口渴且咬紧牙关。此时应使用异功散加入木香、当归，以挽救阴阳表里的失衡。如果食用蜂蜜水、西瓜、红柿等生冷食物，会迅速导致死亡。
三、凡是到了该结痂的时候却不结痂，伴有腹泻、寒战、咬牙抓挠破皮肤等症状的，属于虚寒证。适宜使用异功散治疗。
四、凡是过度服用热性药物，导致热毒猖獗，气血过于旺盛，痘疮溃烂不能结痂的，内服小柴胡汤和猪尾膏来解毒。外用败草散敷贴患处。
五、凡是痘疮不结痂，出现气急、喉间痰鸣、声音嘶哑、眼睛闭合无神气的，预后不良，主死。结痂后留下的瘢痕呈红色，为吉兆；若瘢痕白色无血色，说明毒瓦斯滞留体内，恐怕会产生其他后遗症。
六、治疗痘疮被抓挠搔破，化成脓血淋漓不止的情况，适宜使用败草散。
败草散：
取盖房子多年腐烂的草，或者盖墙腐烂的草也可以。这些草经过霜露，感应了天地阴阳之气，具有解除疮毒的功效，其作用难以详尽描述。
取草不拘多少，晒干或焙干后研成粉末，直接干撒在疮口上。如果浑身疮口破损，脓水不绝，粘贴在衣裳上，难以坐卧，可以用二三升药粉摊在席子上，让孩子坐在上面睡觉。疗效神奇。同时仍要服用木香散，加入丁香、官桂两味药，一同煎服。
硝胆膏：
硝胆膏治疗口唇不收敛，疮瘢臭烂流血流脓。宜将各种动物胆汁与芒硝细细研磨，涂抹于患处，病自然痊愈。
猪尾膏：
将龙脑（冰片）半字量研细，随即滴入猪心血制成丸剂，用辰砂（朱砂）作为衣层，用紫草汤送服。
七、治疗痘疹被抓破稀烂的情况，用蚕茧孔内装入上等蜂蜜，放在新瓦上焙干，烧成灰保留药性后研成粉末。如果疮面湿润，就干掺药粉；如果干燥，就用香油调匀后搽涂，效果显著。
八、有一个三岁的小孩，发热七天，痘疮发出后倒靥（凹陷），颜色发黑，嘴唇口角冰冷，这是危重病症。家人祈福求神，无所不用其极。偶然遇到一位读书人说：“这个病有药可以救起。”给小孩服用少许药物，过了一会儿脸色就红润鲜活如常。家属不惜钱财求取方子。其方法是：用狗身上的苍蝇七只，擂碎，加少许醋和酒调匀后服用。这种苍蝇在夏季极多且容易得到，冬季则藏在耳朵里，这一点不可不知道。这里指的是夏季在狗身上飞的那种苍蝇。
九、痘疮属于虚寒证的，往往可以拖延到十几天后才死亡；属于毒邪炽盛导致变色的，不过七八天就会死亡。因为痘疮是胎毒从体内向外发出的过程，第一二三天才出齐，此时毒瓦斯还在体内；发到第六天，则应该全部透出体外；第七八九天则是化脓并结痂的时候。如果毒瓦斯太盛，不能完全透出，过了第六天毒反而内陷入脏腑，所以必须在第六天以前，毒瓦斯全部透出的时候，紧急服用凉血解毒的药物，将其驱除出去。如果过了第六天，医生就无能为力了，所以这类死亡最为急迫。如果是虚弱体质、毒瓦斯较少的人，只是气血不足，不能化脓成就痘疮，所以会绵延日久后才死亡。这就是虚实轻重的区别。
1. Generally, when the smallpox reaches the tenth day or eleven to twelve days, the pustules gradually scab over and fall off. Scabbing from the head downwards is considered a favorable progression (Shun); scabbing from the bottom upwards is considered an unfavorable progression (Ni). Even if the entire body has scabbed over, if a few spots remain unscabbed, it can still be fatal. This is analogous to a snake shedding its skin: even if only one segment fails to shed due to injury, the snake will die.
2. By the tenth to eleventh day, if scabbing should occur but does not, and the patient lacks high fever but experiences mental restlessness and agitation, gasping when lying down, irritability, thirst, and teeth grinding, Yi Gong San (Extraordinary Efficacy Powder) with added Muxiang (Aucklandiae Radix) and Danggui (Angelicae Sinensis Radix) should be used to rescue the imbalance of Yin-Yang and interior-exterior. If cold foods such as honey water, watermelon, or red persimmons are consumed, death will ensue rapidly.
3. In cases where scabbing should occur but does not, accompanied by diarrhea, chills, teeth grinding, and scratching until the skin is broken, this indicates a deficiency-cold syndrome. Yi Gong Tang (Extraordinary Efficacy Decoction) is appropriate for treatment.
4. In cases where excessive use of hot-natured medicines leads to rampant heat-toxin and hyperactive Qi-Blood, causing pustules to ulcerate without scabbing, Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Zhu Wei Gao (Pig Tail Ointment) should be taken internally to resolve the toxin. Baicao San (Decayed Grass Powder) should be applied externally to the affected areas.
5. In cases where smallpox does not scab over, accompanied by rapid breathing, phlegm in the throat, hoarseness, closed eyes, and lack of spirit, the prognosis is fatal. Red scars after scabbing indicate a good omen; white, bloodless scars indicate that toxic vapors are stagnating internally, which may lead to residual complications.
6. For treating smallpox lesions scratched open, resulting in dripping pus and blood, Baicao San (Decayed Grass Powder) is suitable.
Baicao San:
Use rotten grass from roofs that have been there for many years, or rotten grass from walls. These grasses, having been exposed to frost and dew, have absorbed the Yin-Yang Qi of Heaven and Earth, possessing the power to detoxify sores. Their efficacy cannot be fully described.
Take an unspecified amount of grass, dry it in the sun or bake it until dry, then grind it into powder. Apply the dry powder directly to the sores. If the whole body is covered with broken sores with incessant pus flow, sticking to clothes and making sitting or lying difficult, spread two or three sheng (a unit of volume) of the powder on a mat and let the child sit or lie on it. The effect is miraculous. Continue to administer Muxiang San (Aucklandia Powder) with Dingxiang (Caryophylli Flos) and Guigui (Cinnamomi Cortex) added, decocted together for oral administration.
Xiao Dan Gao (Nitre and Gall Ointment):
Xiao Dan Gao treats lips that fail to close, foul-smelling and rotting scar tissue with flowing blood and pus. Grind various animal gallbladders with Mangxiao (Natrii Sulfas) finely and apply to the affected area; the disease will heal spontaneously.
Zhu Wei Gao (Pig Tail Ointment):
Grind Longnao (Borneolum Syntheticum) finely (half zi quantity), mix with fresh pig heart blood to form pills, coat with Chen Sha (Cinnabar), and swallow using Zicao Tang (Arnebiae seu Lithospermi Radix Decoction).
7. For treating scratched and ulcerated smallpox/rash, place premium honey inside silkworm cocoons, bake them on new tiles until dry, burn them to ash while preserving their medicinal nature, and grind into powder. If the wound is wet, sprinkle the dry powder; if dry, mix with sesame oil and apply. This is effective.
8. A three-year-old child suffered from fever for seven days, with inverted black smallpox lesions, cold lips and mouth, indicating a critical condition. The family prayed to gods and spirits exhaustively. They encountered a scholar who said, "This disease can be cured with medicine." After administering a small amount, the child's complexion returned to normal redness and vitality shortly thereafter. Desiring the prescription regardless of cost, the method is as follows: Take seven houseflies found on dogs, crush them finely, mix with a little vinegar and wine, and administer orally. These flies are abundant and easy to obtain in summer; in winter, they hide in ears. One must know this refers specifically to the flies found on dogs in summer.
9. Smallpox cases belonging to deficiency-cold syndromes may persist for ten-plus days before death; those belonging to severe toxin transformation with color changes usually result in death within seven to eight days. This is because smallpox represents fetal toxin emerging from the interior to the exterior. It typically erupts completely by the second or third day, at which point the toxic vapors are still largely internal. By the sixth day, they should have all emerged outward. By the seventh, eighth, and ninth days, pus forms and scabs develop. If the toxic vapors are too strong to emerge completely, after the sixth day, the toxin may re-enter the Zang-Fu organs. Therefore, before the sixth day, when the toxic vapors are all emerging, urgent administration of Blood-cooling and Toxin-resolving medicines is required to drive them out. After the sixth day, medical intervention is futile, leading to rapid death. In contrast, weak patients with less toxic vapor suffer only from insufficient Qi-Blood failing to generate pus and complete the lesion process, resulting in a prolonged course before death. This distinguishes the severity between deficiency/excess conditions.