（诸痘中有独大者，或黑、或白，其根结硬，即是痘疔，如疔疮样，直抵筋骨，宜挑破，以四圣散点之。凡
黑陷中有微尖顶如苦楮样者，疔也，无此状者，谓之黑陷，非疔也）
〔万〕痘疔者，热毒蓄积，气血腐坏而成也，状有数种，乃疫毒之气，最为恶候，宜谨察之。有肌肉微肿，状
如堆粟，不分颗粒者，此气滞血凝，毒瓦斯郁结也。有初出红点，渐变黑色，其硬如石者，此肌肉已败，气血中虚，
不能载毒而出，反致陷伏也。有中心黑陷，四畔突起戴浆者，此血随毒走，气不为用也。有中心戴浆，四
畔干陷焦黑者，此气附毒出，血不为使也。有头戴白浆，自破溃烂者，此气血不充，皮肤败坏也。有为水泡溶溶易
破者，此火湿并行，气虚不能敛束也。有为血泡色紫
易破者，此血热妄行，不能自附于气也。有疮头针孔，浆水自出者，此卫气已败，其液外脱也。此数证者，于五六
日间候之，但见一证，即不可治。〔薛〕痘疔，又谓之贼痘，或三五枚，或五七枚，间杂于诸痘之间，其色紫
黯，作痛不宁，以致诸证蜂起，不能灌脓，甚至不救，乃热毒势甚并结也，用仙方活命饮（疮疡）。如二便秘
涩，量加大黄。遍身拘急，加麻黄。外必用线针挑破，出黑血，或吮出毒血，以泄其毒，余痘才得灌脓，否则其
毒无从而解，必致不起。如未应，急用隔蒜灸，若毒瓦斯盛者，或不知痛者，不用蒜隔，就着肉灼艾灸之，若灸后，
疮头红肿发 ，用针挑破出毒血，灼艾尤好，虽此法未出方书，予屡用屡验者，世多用至宝丹之类，亦
不可恃。别见起发证治，宜参考。
凡痘疮起发之时，但见干燥，其根焦黑者，即内服夺命丹（见形），外用四圣散涂之。如原有疮疹，或灌疮未
愈，或疮将较瘢嫩者，至痘出之时，其处痘本攒聚，形色黑溃，急以针刺破之，吮去毒血，外以四圣散涂之，内
服加味四圣汤（见形）调无价散（倒靥）并夺命丹主之。如疮焦黑，浑身皆是者，看大便何如，若大便秘者，内服承气
汤（便闷）调无价散，外用水杨汤浴法（起发）。大便利者，内服十全大补汤（汗）陈氏木香散（泻）调无
价散合夺命丹，外用水杨汤浴法。
四圣散
绿豆（四十九粒） 豌豆（四十九粒。各烧、存性） 珍珠（一分） 油头发（烧过，一分）
上为细末。胭脂水调，先以簪子拨开黑疮，以此涂之。
二圣散 治痘疔，挑破，以此点之。
雄黄（二钱） 紫草（三钱）
上，研末。用油胭脂调。
敷方 痂后痘疔溃烂成坑，内见筋骨，以此敷之。
赤石脂 腻粉 黄柏 杭粉（炒） 血竭 伏龙肝（各一钱） 飞丹（炒，八分） 发灰（五分）
乳香 没药（各三分） 冰片（三厘） 蜜陀僧（飞过，二钱）
有臭气，加阿魏三四分。
上为细末。绵纸筛过敷之，外用膏药贴。内服人参败毒散加穿山甲、蝉蜕、连翘。
拔毒膏 治痘疔。
雄黄（研）
上，用胭脂重浸水，令浓，调雄黄点疔痘上。立时红活，亦神法也，盖雄黄能拔毒，胭脂能活血也。
飞龙夺命丹 治痘疔、痘毒、痘痈，或麻木呕吐，重者昏愦切牙。
真蟾酥（干者，酒化） 轻粉（各一钱） 枯白矾 寒水石 铜绿 乳香 没药 麝香（各二钱）
朱砂（六钱） 蜗牛（四十二个，另研、如无亦可）
上，各为末。入蟾酥、蜗牛，或加酒少许，糊丸绿豆大。每服一丸，温酒或葱汤送下。重者，外用隔蒜
法灸，甚者，多灸或着肉灸。
卷帘疔〔袁〕痘六七朝，舌望上卷，喉锁，烦渴紧痛，饮食难进，不知者妄用刀割舌下青筋，倏时致死，
岂知疔毒结坐于舌根，疔甚者如黑豆，次者似葡萄，犯此证候，要把银钩钩破患处，尽净恶血，随以苦茶漱口，
尽吐其毒血，而以后方投之。歌口∶晡仙妙制龙宫丹，冰片硼砂青黛间，薄荷荆芥僵蚕炒，还觅黄连法制
难，按合研匀为细末，慢吹喉内卷帘翻。按∶此疔人多不晓，夭杀儿童，若患此者痘，定经于心，急宜清解，
若补助之药，不宜服也，有方用蛤蜊汁和玉露滴者，
亦可。
燕窝疔 痘形五六日，而腋下硬肿，两手坦垂，不能活动转舒，烦躁谵语，眼碧脸赤，恶渴吐沫，不知者以
为结痈而然，岂知痘毒结坐于腋下，名曰燕窝疔，急用银针挑去其根，尽除恶血，随将燕窝打水澄清者
洗净，而以珍珠末和油胭脂涂其患处，内服消毒饮。歌曰∶燕窝疔欲燕窝除，挑破须将澄去泥，洗净尽除其
毒血，油胭脂和米珍珠，涂沫其中时刻候，管教毒尽痘离离。又曰∶消毒饮是鼠粘先，甘草通茯生地全，红
花犀芍连翘合，灯草浓煎毒尽捐。余历详察此痘左腋潜注，则右体之痘沉伏而失色，右腋潜注，则左体之
痘叛逆而无元，是准格也，若曰疔左而左痘坏则误矣，有方以蜒蝣和核桃肉吞者，虽暂获效，终之无济。
火珠疔 痘值六七日而鼻窍中阗塞喷火，气息甚难，恶渴烦躁，面赤眼红，痰紧，饮食不餐，热烙，名曰火
珠疔，外要钩破，随将药点入眼角，再服泻金汤，则愈矣。歌曰∶鼻中阗塞火珠疔，速要钩穿眼上行，黄连
膏和梅花片，点滴其中左右经，再服泻金汤二剂，自然毒尽得安宁。泻金汤歌曰∶乌犀桔梗鼠粘行，芍药
甘稍伏火青，生地红花通紫草，合煎服后自消疔。按∶此痘疔患于小儿们，人昧
以为息肉阗塞，不知挑剔，屡致枉死，惯治者允宜详验眼翻气急，手足乱撒候，则是矣，或以田螺水滴入者，未善。
忘汲疔 痘值六七之期，两眼沿倏然结座，疔毒封蛤肿胀，热极而面色紫，烦渴，则以治鼻疔法治之，挑破
处速以瓦葱捣烂 之，盖此处不可以钩穿者也。歌曰∶眼沿生疔眼必瞎，自有仙家神治法，瓦葱细捣 封牢，莫
待风枭再作恶。昔穆修治此疔，专用山慈菇和蜣螂肉捣烂 上，取疔根，亦捷法也。
豢虎疔 痘期里正要会脓结蜡，而耳孔内结成疔毒，盖肾地宜无痘毒，而疔独辏结于此者，则枭炎炽而癸元已
耗矣，急宜锥破，随用鹅管石、女真子、薄荷共研为极细末，吹于患处，再用马兰根洗净，寸断塞耳。歌曰∶豢虎
由来两耳中，少阳临证制吹筒，鹅管石和女真子，薄荷三味并相攻，再把马兰根洗净，随将寸断
塞其中，不须时刻相回挽，自然疔里见奇功。
按∶此方鹅管石宜改玄精石，以玄精而写鹅管，此亦传易隐射之失也，内还有冰片、女真子，亦是女真，
抄曰子者，亦传讹也。
注命疔痘期里两足掌心，痘毒辏结成疔，硬肿恶痛，或如钱样，或如大黑豆，
或如胡椒粒，紫筋直注透足股盘处，其毒甚矣，速锄取其根，尽净其血，随用田螺水调和冰片点三次，把慎火草、绿豆、
浸胀，捣烂 于患处，内服化毒丹。歌曰∶痘里如生注命疔，花栏决定不为轻，银针挑尽其中毒，寻个田螺
吐水清，调和冰片胭脂点，再觅龙鳞草要真（即慎火草又名火丹草），脱皮绿豆浸渍胀，共捣将来 一层，内把
化毒丹来服，不怕疔生足掌心。俗人多以足下疔不加意，岂知疔虽生于下，而绾
刺于上，竟犯脾心二经，时刻不可挨，故曰注命。
骊含疔 痘值五六朝，身发恶热躁，谵语，两眼翻厥，肚腹膨胀，小便闭塞，恶痛叫号不宁，盖因枭毒澄聚于膀胱，
而于阳茎窍里辏结鸩疔，名骊含疔，语云∶痘疔结此，时刻要死，急用银朱、冰片、蟾酥、牛黄、麝香研匀极细末，将
黄连、细茶浓煎，候冷，取半匙调药，把细软稻心蘸药，通纳其窍中，再用油菜子 捋其茎，内服木通败毒散。歌曰∶
骊含生疔疔如刀，十个疔来九不饶，胡僧仙授攻医法，继后骊含命始逃，牛黄冰片蟾酥麝，和合银朱一样HT ，
茶连数沸
煎浓冷，稻草心将蘸药膏，根据方按法相为用，何畏疔锥日夜号。昔云间一僧，用细银丝通窍内，随以清水漱口净，翕之，
以尽其毒血，外用珍珠片脑，调服亦验。
透肠疔 痘六七朝之内，腹中饱闷，绞痛难忍，大便闭结，烦渴，遂于粪门旁
阖辏坐疔毒，肿硬紫锥，名曰透肠疔，毒彻于阳明故耳，速针锥其毒，大用金银花、防风、煎汤，候冷洗净，
随将轻粉、珍珠、片脑、白蔹末，灯心蘸涂于上，内服黄连解毒汤。歌曰∶透肠疔毒命随倾，治得全时漏必成，
此方奇效人谁得，惟是晡仙用自珍，片脑珍珠与轻粉，分两般般无重轻，要将白蔹先为末，澄过干时后并行，
毒收还黄时干结，溃烂来时极可憎。此疔，有剔后用苎根捣烂、 者，有用桑杪捣烂和麝敷者，俱有明效，
总不如野绿豆末和红花末、干掺，甚美。
（在各类痘疹中，若有单独特别大的，颜色或黑或白，根部结聚坚硬，这就是痘疔，形状像疔疮一样，深达筋骨，应当挑破，用四圣散点涂。凡是黑陷证中，有微小尖顶像苦楮树果实形状的，是疔；没有这种形状的，称为黑陷，不是疔。）
〔万全论述〕痘疔，是由于热毒蓄积，导致气血腐坏而形成的。其形态有多种，属于疫毒之气，是最为凶险的证候，应当仔细诊察。有的肌肉微肿，形状像堆积的粟米，分不清颗粒，这是气滞血凝，毒瓦斯郁结所致。有的初起为红点，逐渐变为黑色，坚硬如石头，这是肌肉已经败坏，气血中虚，不能载毒外出，反而导致毒邪内陷伏留。有的中心黑陷，四周突起并带有脓浆，这是血随毒走，气机失于统摄所致。有的中心带浆，四周干枯下陷焦黑，这是气依附毒邪外出，血失于濡养所致。有的顶部带白浆，自行破裂溃烂，这是气血不充盛，皮肤败坏所致。有的形成水泡，溶溶易破，这是火湿并行，气虚不能收敛固束所致。有的形成血泡，颜色紫暗易破，这是血热妄行，不能依附于气所致。有的疮头呈针孔状，浆水自行流出，这是卫气已败，津液外脱所致。这几种证候，在发病五至六天时要密切观察，只要见到其中一种证候，就认为难以治愈。
〔薛己论述〕痘疔，又叫做贼痘，数量有三五枚，或五七枚，夹杂在普通痘疹之间，颜色紫暗，疼痛不安，导致其他症状蜂拥而起，不能灌浆化脓，甚至导致死亡，这是因为热毒势盛且结聚所致。使用仙方活命饮治疗。如果大小便秘涩，酌情加大黄。全身拘急痉挛，加麻黄。外部必须用线针挑破，放出黑血，或用嘴吸出毒血，以泄解毒邪，其余的痘疹才能灌浆化脓，否则毒邪无法解除，必然导致死亡。如果上述方法无效，急忙使用隔蒜灸法。如果毒瓦斯旺盛，或者患者不知疼痛，不用大蒜间隔，直接在肉上灼烧艾灸。如果灸后，疮头红肿发热，用针挑破放出毒血，再施以艾灸效果更好。虽然这种方法未见于方书，但我屡用屡验。世人多依赖至宝丹之类的药物，也不可过分倚仗。详见起发证治篇，宜参考。
凡痘疮起发之时，只要见到干燥，根部焦黑的，立即内服夺命丹，外用四圣散涂抹。如果原有疮疹，或灌浆疮未愈，或疮将愈合但皮嫩者，到痘出之时，该处痘疹聚集，形色黑溃，急忙用针刺破，吸去毒血，外用四圣散涂抹，内服加味四圣汤调和无价散和夺命丹主治。如果疮面焦黑，浑身皆是，查看大便情况，若大便秘结，内服承气汤调和无价散，外用水杨汤浴法。大便通畅者，内服十全大补汤和陈氏木香散调和无价散合夺命丹，外用水杨汤浴法。
四圣散
绿豆（四十九粒） 豌豆（四十九粒。各烧存性） 珍珠（一分） 油头发（烧过，一分）
以上研为细末。用胭脂水调匀，先用簪子拨开黑疮，以此药粉涂之。
二圣散 治疗痘疔，挑破后，以此药点涂。
雄黄（二钱） 紫草（三钱）
以上研末。用油胭脂调匀。
敷方 痂后痘疔溃烂成坑，内部可见筋骨，以此药敷贴。
赤石脂 腻粉 黄柏 杭粉（炒） 血竭 伏龙肝（各一钱） 飞丹（炒，八分） 发灰（五分）
乳香 没药（各三分） 冰片（三厘） 蜜陀僧（飞过，二钱）
有臭气，加阿魏三四分。
以上研为细末。用绵纸筛过后敷贴，外用膏药贴敷。内服人参败毒散加穿山甲、蝉蜕、连翘。
拔毒膏 治疗痘疔。
雄黄（研细）
以上用胭脂重浸的水，使其浓稠，调雄黄点涂于疔痘上。立时变红活，也是神效之法，因为雄黄能拔毒，胭脂能活血。
飞龙夺命丹 治疗痘疔、痘毒、痘痈，或麻木呕吐，重者昏愦咬牙。
真蟾酥（干者，酒化开） 轻粉（各一钱） 枯白矾 寒水石 铜绿 乳香 没药 麝香（各二钱）
朱砂（六钱） 蜗牛（四十二个，另研，如无亦可）
以上各研为末。加入蟾酥、蜗牛，或加少许酒，糊丸如绿豆大。每服一丸，温酒或葱汤送下。重者，外用隔蒜灸法，甚者，多灸或直接着肉灸。
卷帘疔〔袁氏论述〕痘疹六七天后，舌头向上卷曲，喉部锁紧，烦渴紧迫疼痛，饮食难进。不知情的人妄用刀割舌下青筋，瞬间致死。哪里知道疔毒结聚在舌根，重的像黑豆，轻的像葡萄。患此证候，要用银钩钩破患处，排尽恶血，随即用苦茶漱口，吐尽毒血，然后投以下方。歌诀曰：晡仙妙制龙宫丹，冰片硼砂青黛间，薄荷荆芥僵蚕炒，还觅黄连法制难，按合研匀为细末，慢吹喉内卷帘翻。按语：此疔人多不晓，残杀儿童。若患此痘，病位定在心经，急需清解，补助类药物不宜服用。有方用蛤蜊汁和玉露滴入，也可。
燕窝疔 痘形出现五六日后，腋下硬肿，双手坦垂，不能活动舒展，烦躁谵语，眼碧脸赤，恶渴吐沫。不知情的人以为是结痈所致，哪里知道痘毒结聚在腋下，名叫燕窝疔。急忙用银针挑去其根，排尽恶血，随即取燕窝加水澄清洗净，用珍珠末和油胭脂涂于患处，内服消毒饮。歌诀曰：燕窝疔欲燕窝除，挑破须将澄去泥，洗净尽除其毒血，油胭脂和米珍珠，涂沫其中时刻候，管教毒尽痘离离。又曰：消毒饮是鼠粘先，甘草通茯生地全，红花犀芍连翘合，灯草浓煎毒尽捐。我详细考察此痘，左腋潜注，则右体之痘沉伏而失色；右腋潜注，则左体之痘叛逆而无元气，这是规律。如果说疔在左而左痘坏则是错误的。有方用蜒蚰和核桃肉吞服，虽暂获效，最终无济于事。
火珠疔 痘疹值六七日，鼻窍中堵塞喷火，气息非常困难，恶渴烦躁，面赤眼红，痰紧，饮食不进，热烙感，名叫火珠疔。外部要钩破，随即用药点入眼角，再服泻金汤，则痊愈。歌诀曰：鼻中阗塞火珠疔，速要钩穿眼上行，黄连膏和梅花片，点滴其中左右经，再服泻金汤二剂，自然毒尽得安宁。泻金汤歌诀曰：乌犀桔梗鼠粘行，芍药甘稍伏火青，生地红花通紫草，合煎服后自消疔。按语：此痘疔患于小儿，人昧然以为息肉堵塞，不知挑剔，屡次导致枉死。惯治者应当详验眼翻气急、手足乱撒等征候，这才是正确的。或以田螺水滴入，尚不完善。
忘汲疔 痘疹值六七日期，两眼眼睑突然结座，疔毒封蛤肿胀，热极而面色紫，烦渴，则以治鼻疔的方法治疗，挑破处速以瓦葱捣烂敷之，盖此处不可以钩穿。歌诀曰：眼沿生疔眼必瞎，自有仙家神治法，瓦葱细捣封牢，莫待风枭再作恶。昔年穆修治疗此疔，专用山慈菇和蜣螂肉捣烂敷上，取疔根，也是捷法。
豢虎疔 痘期里正要会脓结蜡，而耳孔内结成疔毒。肾地适宜无痘毒，而疔独辏结于此，则枭炎炽盛而癸元已耗损。急忙宜锥破，随即用鹅管石、女真子、薄荷共研为极细末，吹于患处，再用马兰根洗净，寸断塞耳。歌诀曰：豢虎由来两耳中，少阳临证制吹筒，鹅管石和女真子，薄荷三味并相攻，再把马兰根洗净，随将寸断塞其中，不须时刻相回挽，自然疔里见奇功。
按语：此方鹅管石宜改玄精石，以玄精而写鹅管，这也是传易隐射之失。内还有冰片、女真子，亦是女真，抄曰子者，也是传讹。
注命疔 痘期里两足掌心，痘毒辏结成疔，硬肿恶痛，或如钱币样，或如大黑豆，或如胡椒粒，紫筋直注透足股盘处，其毒甚矣。速锄取其根，排尽血液，随即用田螺水调和冰片点三次，把慎火草、绿豆浸胀，捣烂敷于患处，内服化毒丹。歌诀曰：痘里如生注命疔，花栏决定不为轻，银针挑尽其中毒，寻个田螺吐水清，调和冰片胭脂点，再觅龙鳞草要真（即慎火草又名火丹草），脱皮绿豆浸渍胀，共捣将来一层，内把化毒丹来服，不怕疔生足掌心。俗人多以足下疔不加意，岂知疔虽生于下，而绾刺于上，竟犯脾心二经，时刻不可挨，故曰注命。
骊含疔 痘值五六朝，身发恶热躁，谵语，两眼翻厥，肚腹膨胀，小便闭塞，恶痛叫号不宁。盖因枭毒澄聚于膀胱，而于阳茎窍里辏结鸩疔，名叫骊含疔。俗语说：痘疔结在此处，时刻要死。急忙用银朱、冰片、蟾酥、牛黄、麝香研匀极细末，将黄连、细茶浓煎，候冷，取半匙调药，用细软稻心蘸药，通纳其窍中，再用油菜子捋其茎，内服木通败毒散。歌诀曰：骊含生疔疔如刀，十个疔来九不饶，胡僧仙授攻医法，继后骊含命始逃，牛黄冰片蟾酥麝，和合银朱一样HT ，茶连数沸煎浓冷，稻草心将蘸药膏，根据方按法相为用，何畏疔锥日夜号。昔云间一僧，用细银丝通窍内，随即用清水漱口净，翕之，以尽其毒血，外用珍珠片脑，调服亦验。
透肠疔 痘六七朝之内，腹中饱闷，绞痛难忍，大便闭结，烦渴，遂于粪门旁阖辏坐疔毒，肿硬紫锥，名叫透肠疔，毒彻于阳明故耳。速针锥其毒，大用金银花、防风，煎汤，候冷洗净，随即用轻粉、珍珠、片脑、白蔹末，灯心蘸涂于上，内服黄连解毒汤。歌诀曰：透肠疔毒命随倾，治得全时漏必成，此方奇效人谁得，惟是晡仙用自珍，片脑珍珠与轻粉，分两般般无重轻，要将白蔹先为末，澄过干时后并行，毒收还黄时干结，溃烂来时极可憎。此疔，有剔后用苎根捣烂敷者，有用桑杪捣烂和麝敷者，俱有明效，总不如野绿豆末和红花末、干掺，甚美。
(In various types of smallpox, if there is one that is uniquely large, or black, or white, with a root that is knotted and hard, this is *Dou Ding* (Smallpox Carbuncle), resembling a carbuncle, penetrating directly to the bones and sinews. It should be pricked open and treated with *Sisheng San* (Four Sages Powder). In cases of black depression, if there is a slight pointed top resembling the fruit of the Chinese Toosendan tree (*Kuzhu*), it is a Ding; without this appearance, it is called black depression, not a Ding.)
[Wan Quan stated] *Dou Ding* (Smallpox Carbuncle) is formed by the accumulation of heat-toxin, leading to the corruption of Qi and Blood. Its manifestations are varied; it is caused by epidemic toxic Qi and is the most malignant prognosis, requiring careful observation. Some present with slightly swollen muscles, resembling piled millet grains, without distinct particles; this is due to Qi stagnation and Blood congealment, with toxic vapors郁结 (stagnating). Some begin as red spots that gradually turn black and become hard as stone; this indicates muscle failure, deficiency of Qi and Blood in the center, inability to carry the toxin out, resulting in sinking and伏留 (retention). Some have a black depression in the center with protruding edges carrying pus; this is Blood following the toxin while Qi fails to control it. Some have pus in the center with dry, sunken, scorched-black edges; this is Qi attaching to the toxin to exit, while Blood fails to nourish. Some have white pus on the head that spontaneously ruptures and ulcerates; this is insufficient Qi and Blood, leading to skin failure. Some form blisters that are soft and easily broken; this is Fire and Dampness acting together, with Qi deficiency failing to consolidate. Some form blood blisters that are purple and easily broken; this is reckless movement of Heat in the Blood, unable to attach to Qi. Some have needle-hole-like sore heads with spontaneous discharge of serum; this is defeat of Wei Qi (Defensive Qi) and external loss of fluids. Among these syndromes, observe during the fifth to sixth days; seeing any one of them indicates a difficult-to-treat condition.
[Xue Ji stated] *Dou Ding* (Smallpox Carbuncle), also called "Thief Pox," consists of three to five or five to seven lesions interspersed among other pox. They are purple-dark, painful and restless, causing other symptoms to arise like swarms, preventing suppuration, and even leading to death, due to intense and clustered heat-toxin. Use *Xianfang Huoming Yin* (Immortal Life-Extending Decoction). If constipation occurs, add *Dahuang* (Rhubarb Root) according to the situation. If general stiffness and spasms occur, add *Mahuang* (Ephedra Herb). Externally, one must prick open with a thread needle to release black blood, or suck out toxic blood to vent the toxin, so that remaining pox can suppurate; otherwise, the toxin cannot resolve, inevitably leading to death. If ineffective, urgently apply *Gesu Jiu* (Garlic-Separated Moxibustion). If toxic vapors are abundant or pain sensation is lost, do not use garlic separation; apply moxa directly to the flesh. If after moxibustion the sore head becomes red, swollen, and hot, prick it to release toxic blood, then moxibustion is especially good. Although this method is not found in medical texts, I have used it repeatedly with success. The world often relies on pills like *Zhibao Dan* (Precious Treasure Pill), but one should not depend solely on them. Refer to the chapter on Promoting Eruption for treatment principles.
When smallpox is erupting, if dryness and scorched-black roots are seen, immediately administer *Du Ming Dan* (Life-Seizing Pill) internally, and apply *Sisheng San* (Four Sages Powder) externally. If there were pre-existing rashes, or unhealed pustules, or tender skin where scars are forming, when new pox appear, they gather at those sites with black, ulcerated colors. Prick them urgently with a needle, suck out toxic blood, apply *Sisheng San* externally, and treat internally with *Jiawei Sisheng Tang* (Modified Four Sages Decoction) combined with *Wujia San* (Priceless Powder) and *Du Ming Dan*. If sores are scorched-black all over the body, check the stool. If constipated, take *Chengqi Tang* (Purgative Decoction) mixed with *Wujia San*, and bathe externally with *Shuiyang Tang* (Water-Willow Decoction). If bowel movements are free, take *Shiquan Dabu Tang* (Comprehensive Great Tonifying Decoction) and *Chen's Muxiang San* (Aucklandia Powder) mixed with *Wujia San* and *Du Ming Dan*, and bathe externally with *Shuiyang Tang*.
**Sisheng San (Four Sages Powder)**
*Lv Dou* (Mung Bean, 49 grains)
*Wan Dou* (Pea, 49 grains. Both burnt to retain character)
*Zhenzhu* (Pearl, 1 fen)
*You Toufa* (Oily Hair, burnt, 1 fen)
Grind into fine powder. Mix with *Yanzhi Shui* (Alkermes Water). First, use an hairpin to part the black sore, then apply this powder.
**Ersheng San (Two Sages Powder)** Treats *Dou Ding*; apply after pricking open.
*Xionghuang* (Realgar, 2 qian)
*Zicao* (Arnebia Root, 3 qian)
Grind into powder. Mix with oily alkermes.
**Application Formula** For post-scab *Dou Ding* ulcerations forming pits exposing bone/sinew.
*Chishizhi* (Red Halloysite)
*Nifen* (Calomel)
*Huangbai* (Phellodendron Bark)
*Hang Fen* (Starch, stir-fried)
*Xuejie* (Dragon's Blood)
*Fulonggan* (Household Hearth Earth) (Each 1 qian)
*Feidan* (Cinnabar, stir-fried, 8 fen)
*Fa Hui* (Hair Ash, 5 fen)
*Ruxiang* (Frankincense)
*Moyao* (Myrrh) (Each 3 fen)
*Bingpian* (Borneol, 3 li)
*Miduoseng* (Lead Monoxide, purified, 2 qian)
If foul odor exists, add *Awei* (Asafoetida) 3-4 fen.
Grind into fine powder. Sieve through cotton paper and apply; cover with plaster. Internally, take *Renshen Baidu San* (Ginseng Detoxification Powder) plus *Chuanshanjia* (Pangolin Scales), *Chantui* (Cicada Slough), and *Lianqiao* (Forsythia Fruit).
**Badu Gao (Toxin-Pulling Ointment)** Treats *Dou Ding*.
*Xionghuang* (Realgar, ground)
Soak in concentrated Alkermes water, mix Realgar, and dot onto the Ding lesion. It turns red and lively immediately; this is a divine method because Realgar pulls toxins and Alkermes invigorates Blood.
**Feilong Duoming Dan (Flying Dragon Life-Seizing Pill)** Treats *Dou Ding*, Pox Toxin, Pox Abscess, numbness/vomiting, or severe cases with coma and teeth-grinding.
*Zhen Chansu* (True Toad Venom, dried, dissolved in wine)
*Qingfen* (Calomel) (Each 1 qian)
*Ku Baifan* (Calcined Alum)
*Han Shuishishi* (Cold Water Stone)
*Tonglv* (Verdigris)
*Ruxiang* (Frankincense)
*Moyao* (Myrrh)
*Shexiang* (Musk) (Each 2 qian)
*Zhusha* (Cinnabar, 6 qian)
*Wo Niu* (Snail, 42 pieces, ground separately; optional if unavailable)
Grind each into powder. Add Toad Venom and Snail, or a little wine, to make pills the size of mung beans. Take one pill per dose, washed down with warm wine or green onion soup. For severe cases, apply Garlic-Separated Moxibustion externally; for extreme cases, frequent or direct-meat moxibustion.
**Juanlian Ding (Rolling-Curtain Ding)** [Yuan stated] On the 6th-7th day of pox, the tongue rolls upward, throat locks,烦渴 (restlessness/thirst) and tight pain occur, making eating difficult. Ignorant people cut the blue veins under the tongue with a knife, causing sudden death. They do not know the Ding toxin clusters at the tongue root; severe cases look like black beans, mild ones like grapes. For this syndrome, use a silver hook to break the affected area, drain all evil blood, rinse mouth with bitter tea, spit out toxic blood, then administer the following formula. Verse: *Buxian* makes *Longgong Dan* excellently, mixed with Borneol, Borax, Indigo; Stir-fry Mint, Schizonepeta, and Silkworm, Hard to process Coptis finely; Grind evenly into powder, slowly blow into throat to unroll the curtain. Note: Few understand this Ding, killing children. If pox involves this, the pathogen is in the Heart Meridian; urgent clearing/resolving is needed, tonics are contraindicated. Using Clam Juice with *Yulu Di* (Jade Dew Drops) is also acceptable.
**Yanwo Ding (Swallow's Nest Ding)** On days 5-6 of pox, armpits become hard and swollen, arms hang limp and immobile, restlessness, delirium, blue eyes/red face, aversion to thirst with foaming saliva. Ignorant people think it is an abscess formation. They do not know Pox Toxin clusters in the armpit, named Yanwo Ding. Urgently use a silver needle to remove the root, drain all evil blood. Then wash Swallow's Nest with clarified water, mix Pearl Powder with oily Alkermes, and apply to the site. Internally take *Xiaodu Yin* (Detoxifying Decoction). Verse: To cure Yanwo Ding, use Swallow's Nest; clear mud before breaking; Wash clean all toxic blood, Mix rice Pearl with oily Alkermes, Apply and wait moment by moment, Guarantee toxin gone and pox separate. Also: *Xiaodu Yin* starts with Burdock, Licorice, Atractylodes, Rehmannia complete; Red Flower, Rhinoceros Horn, Peony, Forsythia combine, Boil Rush grass thick to donate all toxin. I have carefully observed: Left armpit infiltration causes right-side pox to sink and lose color; Right armpit infiltration causes left-side pox to rebel and lose Yuan Qi; this is the rule. Saying "Left Ding means Left Pox fails" is wrong. Using Slug and Walnut meat orally gives temporary effect but ultimately fails.
**Huozhu Ding (Fire Pearl Ding)** On days 6-7 of pox, nasal passages are blocked with fire-spraying, breathing is very difficult, aversion to thirst/restlessness, red face/eyes, tight phlegm, no appetite, burning heat. Named Huozhu Ding. Externally hook/break it, then dot medicine into the eye corners. Then take *Xiejintang* (Draining Metal Decoction) to heal. Verse: Nasal blockage Fire Pearl Ding, Quickly hook through to eye travel; Coptis Ointment and Plum Blossom Borneol, Dot inside left and right channels; Take Xiejintang two doses more, Naturally toxin gone and peace returns. *Xiejintang* Verse: Black Rhinoceros, Platycodon, Burdock move; Peony, Licorice, Licorice Root subdue Fire Green; Rehmannia, Red Flower, Rush, Arnebia combine, After decoction and taking, Ding naturally消 (dissolves). Note: This Ding affects children; people mistakenly think it is polyp blockage, not knowing to prick/explore, causing many wrongful deaths. Experienced practitioners should verify eye-flipping, breath-hitching, and chaotic hand-waving signs. Using Snail water is not ideal.
**Wangji Ding (Forget-Drawing Ding)** On days 6-7 of pox, eyelids suddenly knot, Ding toxin seals/swells like a clam, extreme heat with purple face, restlessness/thirst. Treat using methods for Nasal Ding. Prick open and quickly mash *Wacong* (Tile Onion/Garlic chive) to apply here, as hooks cannot be used. Verse: Ding on eyelid leads to blindness, Immortal family has divine treatment method; Mash Tile Onion fine and seal firmly, Do not wait for Wind Owl to cause evil again. Formerly Mu Xiu treated this Ding using *Shancigu* (Fritillaria Bulb) and *Qianglang* (Dung Beetle) meat mashed and applied, extracting the Ding root; also a swift method.
**Huanhu Ding (Taming-Tiger Ding)** During the period of meeting pus and forming wax, Ding toxin forms in the ear canal. The Kidney region should have no Pox Toxin, but Ding clusters here, indicating fierce inflammation and depletion of Gui Yuan (Kidney Essence). Urgently pierce with an awl. Then grind *Guanguan Shi* (Tube Stone), *Nvzhenzi* (Eucommia Seed), and *Bohe* (Mint) into extremely fine powder, blow into the affected area. Then wash *Malangen* (Kalimeris Root), cut into inches, and stuff in the ear. Verse: Taming Tiger originates in both ears, Shaoyang syndrome controls blowing tube; Tube Stone and Eucommia Seed, Mint three flavors attack together; Wash Kalimeris Root clean, Cut into inches stuff inside; No need to hesitate moments, Naturally Ding sees miraculous merit. Note: This formula's Guanguan Shi should be changed to *Xuanjing Shi* (Black Crystal); writing Guanguan instead of Xuanjing is a transmission error. Bingpian and Nvzhenzi are also Nvzhen; copying as 'Zi' is also an error.
**Zhuming Ding (Life-Injecting Ding)** During the period, on both soles/palms, Pox Toxin clusters into Ding, hard/swollen/painful, like a coin, large black bean, or pepper grain. Purple veins inject directly through to the thigh/knee joint. The toxin is severe. Quickly dig out the root, drain all blood. Then mix *Tianluo Shui* (Snail Water) with Bingpian (Borneol) and dot three times. Soak *Shenhuaocao* (Scutellaria Barbata) and Lv Dou (Mung Beans), mash and apply to the site. Internally take *Huadu Dan* (Toxin-Transforming Pill). Verse: If Zhuming Ding grows in Pox, Flower fence decides not light; Silver needle picks all toxin, Find snail spit clear water; Mix Borneol and Alkermes dot, Seek Dragon Scale Grass true (i.e., Shenhuaocao also Huodanca); Peel Mung Bean soak swell, Mash together layer, Internally take Huadu Dan, Fear not Ding growing sole palm. Common people ignore foot Ding, not knowing although born below, it connects/stabs above, offending Spleen and Heart meridians, cannot endure moment, hence called Zhuming.
**Lihan Ding (Black-Horse-Holding Ding)** On days 5-6, body emits惡热 (evil heat) and restlessness, delirium, eyes rolling/upside-down, abdominal distension, urinary obstruction, severe pain/crying restless. Because Xiao Toxin gathers in Bladder, and Zhen Ding clusters in Yang organ orifice, named Lihan Ding. Proverb: Ding clustering here means death in moments. Urgently grind *Yinzhu* (Silver Cinnabar), Bingpian, Chansu, Niuhuang (Calculus Bovis), Shexiang into fine powder. Decoct Huanglian (Coptis) and strong Tea thick, cool, take half spoon to mix medicine. Dip soft Rice Straw Heart in medicine, insert into orifice. Then rub penis with Rapeseed Oil. Internally take *Mutong Baidu San* (Akebia Detoxification Powder). Verse: Lihan generates Ding like knife, Ten Dings nine do not spare; Monk immortal teaches attacking method, Afterwards Lihan life escapes; Calmus, Borneol, Toad Venom Musk, Mixed with Silver Cinnabar same HT, Tea/Coptis boil thick cool, Rice straw heart dip medicine paste, Follow method use together, Why fear Ding awl day/night cry. Formerly a monk from Yunjian used thin silver wire to pass through orifice, rinsed mouth clean, sucked to exhaust toxic blood; externally Pearl/Borneol mixed/taken also effective.
**Touchang Ding (Penetrating-Intestine Ding)** Within days 6-7, abdomen full/stuffy, unbearable colic, constipation, restlessness/thirst. Then Ding toxin sits/clusters beside anus, swollen/hard/purple cone, named Touchang Ding, toxin penetrates Yangming. Quickly needle/awl the toxin. Use large amounts of *Jinyinhua* (Honeysuckle Flower) and *Fangfeng* (Saposhnikovia Root), decoct, cool, wash clean. Then mix *Qingfen*, Pearl, Bingpian, *Bai Lian* (Ampelopsis Rhizome) powder, dip Rush Heart to apply. Internally take *Huanglian Jiedu Tang* (Coptis Detoxification Decoction). Verse: Touchang Ding toxin life tilts, If cured completely fistula forms; Who gets this miracle effect, Only Buxian treasures self; Borneol, Pearl, Calomel, Weights neither heavy nor light; Must first make Bai Lian powder, Clarify dry then proceed together; Toxin收了 (collected) yellow time dry knots, Ulceration comes extremely hateful. For this Ding, some use Ramie Root mashed after picking, some use Mulberry tip mashed with Musk applied; both effective. Total不如 (not as good as) Wild Mung Bean Powder and Red Flower Powder, dry sprinkling, very beautiful.