伏者，毒蓄于里而不出也。陷者，毒出而复陷入也。此皆恶候。伏唯一证，陷有数种，伏候于见形之时，其人疮出，
热不少减，烦渴闷躁，此有伏毒未得尽出也。陷则见形之后，其血渐干而变黑者，谓之黑陷。浆水未成破损痒塌者，
谓之倒陷。脓成复化为水，不肯结痂者，谓之倒靥，亦陷类也。其疮黑色，皆谓之黑陷，凡
疹黑色，皆不治之，以肾为水，其黑色，乃肾之真脏色见也，粗工不知变黑归肾之理，妄谓肾不可实，欲泻肾而使之
虚，不知人之一身，大言阴与阳，小言心与肾，即方家所谓真水真火也，疮疹之火发于中，赖此一点真水、以制其
充，苟欲泻之，则火无所制，本先拨矣，岂治之要哉。然谓归肾者，以肾主骨髓，又主闭藏也，盖疮疹秽毒，由骨
髓达于筋肉皮毛之间，乃自内而外，其毒得泄，今既陷伏，则自外而复入于内，藏于骨髓，谓之归肾也。又初出形之时，
春气发生之令也，出形而黑，是春行冬令矣。起壮之时，夏气长养之令也，起发而黑，是夏行冬令矣。养浆之时，
秋气成实之令也，脓干而黑，是秋行冬令矣。故皆谓之逆。结 之时，冬气闭藏之令也，此肾之正候，若不着痂，脓
水浸润，此冬行春夏之令，亦谓之逆。惟知造化之机，可以语归肾之说，其色黑者，火化也，观物之干者其色黑，出
于火者色亦黑，岂可谓之水乎。经曰∶火发而熏昧。知此，可以语黑陷矣。
凡疮伏而不出者，双解散主之（初热）。 点色白或黑色，其人必不能食乳，大便自利，或呕或厥，此胃虚弱
而不能副荣卫故也，宜用温中之剂，令其胃暖，荣卫复行，则当自出矣，宜理中汤（痘吐利）丁香煮散（痘吐逆）之类。
如倒陷者，看其大腑何如，如大小便秘，四顺清凉饮（发热）合夺命丹（见形）主之。泄利气弱者，十全大补汤
（汗）合夺命丹主之。并外用胡荽酒、水杨汤（俱起发）。丹溪先生云∶痘疮倒陷，因真气虚而毒瓦斯不能尽出者，用
黄、人参、紫草酒制治之。若将成就之际却淡色者，属血虚，用当归、川芎之类，或加红花、紫草。属热毒者，
用升麻、芩、连、梗、翘之类，甚者用犀角屑，大解痘毒。〔薛〕窃谓前证若热毒方出，忽被风寒闭塞肌窍，血脉不行，
身体作痛，或四肢微厥， 点不长，或变青紫黑色者，此为倒靥。若胃气虚弱，不能补接荣卫，出而复没者，谓之陷
伏。误用解毒之药，必致陷塌。若喜热饮食，手足并冷者，乃脾胃亏损，阳气虚寒之证，宜用辛热之剂补之。喜冷冻饮料
食，手足并热，乃阳气实热之证，宜用苦寒之剂泻之。外感风寒者，温散之。毒入腹者，分利之。阳气虚者，温补之。
外寒触犯者，熏解之。自昔谓白陷不可救，盖痘色白者，必变为灰惨，灰惨者，必至于平伏倒塌，故谓之白陷，此固由
气虚所致，然血不华色，血亦本虚，治法须兼气血为当，血活气行，白可变而为红，自不至于陷塌矣。若单补气，则气
愈燥热，势必陷伏，故白陷抓破，皮薄干燥而极痒者，由失于补血，致气盛极而燥也，愈用补气之药，速死之兆也。
故凡见痘色白者，无分先后，皆以补中益气汤合四物汤治之，内有热者，加解毒药，或利小便，若待白陷已成，而后
治之，难为力矣。痘有紫黑陷，灰白陷。紫黑陷者，乃血热干滞，而气亦不能以营运，有余之证也，急治之，犹
多可活。灰白之陷，乃元气衰败，故不能起发，而血亦不得通贯，不足之证也，多难救治。
如将起发，疮亦有水，但色黑黯者，以十全大补汤（汗）调无价散主之，或以快 汤（见形）、夺命丹（见形）
合而服之。
如倒靥者，亦视其大便何如。大便秘，宜利之，三黄丸、四顺清凉饮（俱发热）。泄利者，宜补之，轻则十全
大补汤，甚则陈氏木香散（泻），并外用败草散（收靥）主之。
〔庞安常〕郁金散 痘始有白泡，忽搐入腹，渐作紫黑色，无脓，日夜叫，烦乱者。
郁金（一枚） 甘草（一分）
水半碗，煮干，去甘草，切片，焙干，为细末。入脑子半钱同研一钱匕，用生猪血五七滴，新汲
水调下。不过二服，甚者毒瓦斯从手足心出如痈状，乃瘥，此是五死一生候也。
四圣散 黑陷倒靥，不起发，不红活，小便不利。
紫草 黄 甘草 木通
上，水煎服。热甚色紫，倍加紫草、芩、连、红花。大便秘，加枳壳。如常，加糯米。
参 内托散（见痒塌）
无价散
用人、猫、猪、犬、粪，腊月内烧为灰，沙糖水调服。
南金散 治痘已出而复 ，其势甚危，诸药不效者，万无一失。
紫背荷叶（霜后搭水紫背者） 白僵蚕（洗去丝，炒干）
上为末。等分。每服看大小，大者一钱，小者五分，研芫荽汁和酒下，米饮亦可。
治此证多有用龙脑、人牙者，卒难措办，惟此无毒，而效且速，但紫背者，甚难得，可于盐铺内寻之。
橄榄饮 治倒靥。
橄榄从中截断，水服少许，服之立发。
白花蛇散 治痘疹黑陷倒靥。
白花蛇（连骨，一两，火炙干勿焦） 丁香（二十个）
共为末。每服五分，或二分，热酒送下。如黑陷者移时转红，甚效。
《罗浮方》治塌陷痘。歌曰∶乌蛇全蝎与僵蚕，带肉穿山甲与缠，四样净该均一两，绵 官桂倍加焉，白酒煮浓
随意服，见多陷痘得回全。愚每用此，全活甚众，但僵蚕须要去丝，清水洗去锻石，再晒干，乌蛇须用
尾极好，穿山甲先酒洗，焙干用。
〔袁氏〕治倒靥。歌曰∶倒靥原为痘后难，只因气血两相残，参 归地并蝉蜕，连绵进服靥自还。又曰∶倒
靥血不止，名为回阳泉，若犯胸胁地，十来九不全，速觅胭脂胚，血竭加一钱，烧之俱存性，点上血收干。予见痘后
倒靥，人多妄用浴法，枉杀人男女。若痘后结痂浓垒，不能脱起，或半脱而半在，或四围脱而中心锥痛者，准用后方。
生蜜 苏合油
二味调匀。用银簪敷于靥盘沿处，其痛即止，而靥自速脱，并无呛血刨肉之患，如无苏合油，只以线鸡油
代之，甚妙。
伏，是指毒邪蕴结在体内而不能透发出来。陷，是指毒邪虽然透出体表，随后又陷入体内。这两种情况都属于危重的证候。伏证只有一种表现，而陷证则有几种不同的类型。伏证的征象出现在痘疹显现形态的时候，患者身上发出痘疹，但发热并没有明显减轻，反而出现心烦、口渴、胸闷、烦躁不安，这是毒邪未能完全透发的表现。陷证则是在痘疹显现形态之后，痘疮中的血液逐渐干枯并变成黑色，这称为“黑陷”。痘浆尚未形成就破损、瘙痒塌陷的，称为“倒陷”。脓液已经形成却又化为水样液体，不肯结痂的，称为“倒靥”，这也属于陷证的范畴。凡是痘疮颜色发黑的，都称为黑陷。凡是疹色发黑的，都是无法治愈的，因为肾属水，其对应的颜色是黑色，这是肾脏真脏色外露的表现。粗劣的医生不懂得“变黑归肾”的道理，错误地认为肾不可用补法（实），想要通过泻下使肾气虚弱，却不知道人体一身之大者在于阴与阳，细微处在于心与肾，也就是方士所说的真水和真火。痘疹的火毒发于体内，依赖这一点点真水来制约过盛的火势，如果试图泻去真水，那么火势就失去了制约，根本就会动摇，这哪里是治疗的要领呢？然而说毒邪“归肾”，是因为肾主骨髓，又主闭藏。痘疹的秽浊毒邪，是由骨髓通达到筋肉皮毛之间，这是由内向外，毒邪得以宣泄；现在既然陷入伏留，则是从外重新进入体内，藏匿于骨髓之中，所以称之为“归肾”。
另外，在痘疹初出形态的时候，正值春季生发之气的主令，此时出形却发黑，相当于春天施行冬天的命令。在痘疹起壮（隆起）的时候，正值夏季长养之气的主令，此时起发却发黑，相当于夏天施行冬天的命令。在养浆（化脓成熟）的时候，正值秋季成实之气的主令，此时脓干却发黑，相当于秋天施行冬天的命令。所以这些都称为逆证。在结痂的时候，正值冬季闭藏之气的主令，这是肾脏的正常征象，如果不结痂，脓水浸润，这是冬天施行春夏的命令，也称为逆证。只有懂得自然造化机理的人，才可以谈论“归肾”的说法。那些颜色发黑的，属于火化的结果，观察物体被烧干后颜色发黑，从火中出来的东西颜色也是黑的，怎么能说是水呢？《内经》说：“火气发作会熏灼昏暗。”懂得这个道理，就可以谈论黑陷了。
凡是痘毒伏留不能透发的，以双解散为主治方剂（适用于初热阶段）。痘点颜色发白或发黑，患者必定不能吃奶，大便自利（腹泻），或者呕吐或者四肢厥冷，这是因为胃气虚弱，不能配合荣卫运行所致，适宜使用温中的药剂，使胃气温暖，荣卫恢复运行，痘疹自然就会透发，适宜用理中汤（适用于痘疹呕吐泄利）、丁香煮散（适用于痘疹呕吐逆乱）之类的方剂。如果是倒陷的情况，要看患者的大便情况如何，如果大小便秘结，以四顺清凉饮（适用于发热）合夺命丹（适用于见形阶段）为主治。如果泄利且气虚弱的，以十全大补汤（适用于汗后）合夺命丹为主治。并外用胡荽酒、水杨汤（均适用于起发阶段）。丹溪先生说：痘疮倒陷，是因为真气虚弱而毒瓦斯不能完全透出，用黄芪、人参、紫草（酒制）来治疗。如果痘疮即将成就时颜色却淡白，属于血虚，用当归、川芎之类的药物，或者加红花、紫草。属于热毒的，用升麻、黄芩、黄连、桔梗、连翘之类的药物，严重的用水牛角屑，大力解除痘毒。〔薛己〕私下认为前面的证候，如果是热毒刚刚发出，忽然被风寒闭塞肌窍，血脉不通，身体疼痛，或者四肢轻微厥冷，痘点不长，或者变为青紫黑色的，这叫倒靥。如果胃气虚弱，不能补充接引荣卫，痘疹透出后又隐没的，叫作陷伏。误用解毒的药物，必然导致塌陷。如果喜欢热饮食，手足都冷的，是脾胃亏损，阳气虚寒的证候，适宜用辛热的药剂来补益。喜欢冷冻饮料食物，手足都热的，是阳气实热的证候，适宜用苦寒的药剂来泻除。外感风寒的，用温散的方法。毒入腹部的，用分利的方法。阳气虚的，用温补的方法。外寒触犯的，用熏解的方法。自古以来说白陷不可救，大概痘色白的，一定会变为灰惨色，灰惨色的，一定会至于平伏倒塌，所以叫作白陷，这固然由气虚引起，但是血不荣华于面色，血也本虚，治疗方法必须兼顾气血才恰当，血活气行，白色可以变为红色，自然不至于陷塌了。如果单补气，那么气会更加燥热，势必陷伏，所以白陷被抓破，皮薄干燥而且极痒的，是由于失于补血，导致气盛极而燥，越用补气的药，是速死的征兆。所以凡是见到痘色白的，无论先后，都用补中益气汤合四物汤治疗，里面有热的，加解毒药，或者利小便，如果等到白陷已成，然后再治疗，就很难起作用了。痘疹有紫黑陷和灰白陷。紫黑陷的，是血热干涩阻滞，而气也不能营运，属于有余的证候，紧急治疗，大多还可以存活。灰白的陷，是元气衰败，所以不能起发，而血也不能贯通，属于不足的证候，大多难以救治。
如果将要起发，痘疮也有水，但颜色黑黯的，用十全大补汤（适用于汗后）调无价散主治，或者用快斑汤（适用于见形阶段）、夺命丹（适用于见形阶段）合起来服用。
如果是倒靥的情况，也要看其大便如何。大便秘结的，适宜通利，用三黄丸、四顺清凉饮（均适用于发热）。泄利的，适宜补益，轻的用十全大补汤，重的用陈氏木香散（适用于泻痢），并外用败草散（适用于收靥）主治。
〔庞安常〕郁金散：用于痘疹起初有白泡，忽然抽搐陷入腹部，渐渐变成紫黑色，没有脓液，日夜啼叫，烦乱不安的。
郁金（一枚） 甘草（一分）
用水半碗，煮至水干，去掉甘草，切片，焙干，研为细末。加入脑子半钱一起研匀，每次取一钱匕，用生猪血五七滴，新汲水调服。不超过两服，严重的毒瓦斯会从手足心排出，像痈肿一样，这才是痊愈，这是五死一生的危重证候。
四圣散：用于黑陷倒靥，不起发，不红活，小便不利的。
紫草 黄芪 甘草 木通
以上药物，用水煎服。热甚颜色紫的，加倍加入紫草、黄芩、黄连、红花。大便秘结的，加枳壳。如常的，加糯米。
参苓内托散（参见痒塌章节）
无价散
用人粪、猫粪、猪粪、犬粪，在腊月内烧成灰，用沙糖水调服。
南金散：治疗痘疹已出而又回陷，其势非常危险，其他药物无效的，万无一失。
紫背荷叶（霜后搭水呈紫背色的） 白僵蚕（洗去丝，炒干）
以上研为末。等分。每服根据年龄大小，大的服一钱，小的服五分，研碎芜荽汁和酒送下，米饮也可以。
治疗这个证候多有用龙脑、人牙的，突然很难准备，只有这个无毒，而且疗效快，只是紫背叶很难得，可以在盐铺里寻找。
橄榄饮：治疗倒靥。
橄榄从中截断，用水服少许，服用后立即发出。
白花蛇散：治疗痘疹黑陷倒靥。
白花蛇（连骨，一两，火炙干不要焦） 丁香（二十个）
共研为末。每服五分，或二分，热酒送下。如果是黑陷，过一会儿转红，效果很好。
《罗浮方》治疗塌陷痘。歌诀说：乌蛇、全蝎与僵蚕，带肉穿山甲与缠（指某种药材或配伍，此处依原文保留），四样净该均一两，绵花官桂倍加焉，白酒煮浓随意服，见多陷痘得回全。我每次使用这个方子，保全了很多生命，但是僵蚕必须去丝，清水洗去锻石，再晒干，乌蛇必须用尾部极好的，穿山甲先用酒洗，焙干使用。
〔袁氏〕治疗倒靥。歌诀说：倒靥原为痘后难，只因气血两相残，参、芪、归、地并蝉蜕，连绵进服靥自还。又说：倒靥血不止，名为回阳泉，若犯胸胁地，十来九不全，速觅胭脂胚，血竭加一钱，烧之俱存性，点上血收干。我看见痘后倒靥，很多人妄用浴法，枉杀男女。如果痘后结痂浓垒，不能脱起，或者半脱而半在，或者四围脱而中心锥痛的，准用后方。
生蜜 苏合油
这两味调匀。用银簪敷在痘盘边缘处，疼痛立即停止，而痘痂自然快速脱落，并没有呛血刨肉的祸患，如果没有苏合油，只用线鸡油代替，也非常妙。
Fu (entrapment) refers to the pathogenic toxin accumulating internally without being able to erupt. Xian (sinking) refers to the toxin having erupted but subsequently sinking back into the body. Both are ominous signs. Fu presents as a single syndrome, whereas Xian has several variations. The signs of Fu appear when the rash manifests; the patient develops lesions, yet the fever does not significantly subside, accompanied by irritability, thirst, chest stuffiness, and restlessness. This indicates that the toxic heat has not been fully expelled. Xian occurs after the rash has manifested; if the blood within the lesions gradually dries up and turns black, it is called "Black Sinking" (Hei Xian). If the pustular fluid fails to form before rupturing, causing itching and collapse, it is called "Reverse Sinking" (Dao Xian). If pus forms but reverts to water-like fluid and refuses to scab over, it is called "Reverse Crusting" (Dao Ye), which also falls under the category of sinking syndromes. Any lesion turning black is termed Black Sinking. Rashes turning black are generally considered incurable because the Kidney corresponds to Water, and its associated color is black; this represents the appearance of the true organ color of the Kidney. Incompetent physicians fail to understand the principle of "black turning归属于 the Kidney." They erroneously believe that the Kidney should not be tonified (filled) and attempt to drain the Kidney to induce deficiency. They do not realize that the human body, in broad terms, is governed by Yin and Yang, and in specific terms, by the Heart and Kidney—what practitioners refer to as True Water and True Fire. The fire-toxin of the chickenpox/smallpox erupts from within, relying on this trace of True Water to restrain excessive fire. If one attempts to drain this True Water, the fire loses its restraint, and the root foundation is shaken; this is certainly not the key to treatment. However, saying the toxin "returns to the Kidney" is because the Kidney governs bone marrow and closure/storage. The filth and toxin of the rash travel from the bone marrow to the muscles, skin, and hair, moving from inside out so that the toxin can be vented. Now, having sunk and become entrapped, the toxin moves from outside back inside, hiding in the bone marrow; thus, it is called "returning to the Kidney."
Furthermore, when the rash first appears, it coincides with the Spring season's command of growth and emergence. If the lesions turn black upon emergence, it is like Winter's command operating in Spring. When the rash rises and swells, it coincides with Summer's command of nourishment and development. If it turns black upon rising, it is like Winter's command operating in Summer. During the stage of maturing the pustules, it coincides with Autumn's command of ripening and solidification. If the dried pus turns black, it is like Winter's command operating in Autumn. Therefore, all these are termed "Rebellious" (Ni) patterns. At the stage of scabbing, it coincides with Winter's command of closure and storage; this is the normal sign of the Kidney. If no scab forms and pus infiltrates, it is like Spring/Summer commands operating in Winter, also termed Rebellious. Only those who understand the mechanisms of natural creation can discuss the theory of "returning to the Kidney." Colors that are black result from Fire transformation; observing objects burned dry reveals they turn black, and things emerging from fire are also black—how can these be said to belong to Water? The Classic states: "When Fire erupts, it causes obscuration and dimness." Understanding this allows one to discuss Black Sinking.
For cases where the toxin is entrapped and cannot erupt, Shuangjie San (Double Resolution Decoction) is the primary formula (for the initial heat stage). If the spots are white or black, the patient will likely refuse milk, suffer from spontaneous diarrhea, vomiting, or cold limbs. This is due to Stomach Qi deficiency failing to support Ying and Wei circulation. It is appropriate to use warming formulas for the Middle Jiao to warm the Stomach, allowing Ying and Wei to resume circulation, after which the rash will naturally erupt. Suitable formulas include Lizhong Tang (Regulate the Middle Decoction, for vomiting/diarrhea in smallpox) and Dingxiang Zhusan (Clove Boiled Powder, for vomiting/reversal in smallpox). For Reverse Sinking, examine the bowels. If there is constipation of both urine and stool, Sixun Qingliang Yin (Four-Obedience Cooling Drink) combined with Duoming Dan (Life-Restoring Pill) is indicated. If there is diarrhea with weak Qi, Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) combined with Duoming Dan is indicated. Externally, apply Huyijiu (Coriander Wine) and Shuiyangtang (Water Poplar Decoction) (both for the eruption stage). Mr. Danxi stated: Reverse sinking of smallpox is caused by deficiency of True Qi preventing complete expulsion of toxins; treat with Huangqi (Astragali Radix), Renshen (Ginseng Radix), and Zicao (Arnebiae Radix et Rhizoma processed with wine). If the lesions appear pale just before completion, it belongs to Blood deficiency; use Danggui (Angelicae Sinensis Radix) and Chuanxiong (Ligustici Chuanxiong Rhizoma), possibly adding Honghua (Carthami Flos) and Zicao. If it belongs to Heat-Toxin, use Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Lianlian (Coptidis Rhizoma), Jiegeng (Platycodonis Radix), and Qiaoyu (Forsythiae Fructus). For severe cases, use Xijiaoxie (Rhinocerotis Cornu Fragment) to strongly resolve the smallpox toxin. [Xue Ji] privately opines that regarding the aforementioned conditions: if Heat-Toxin is just erupting but suddenly blocked by Wind-Cold closing the muscle pores, causing blood stasis, body pain, slight cold limbs, failure of spots to grow, or turning cyanotic/purple/black, this is Dao Ye (Reverse Crusting). If Stomach Qi is weak and cannot supplement Ying and Wei, causing the rash to emerge and then disappear, this is called Xian Fu (Sinking Entrapment). Misusing detoxifying herbs will inevitably lead to collapse. If the patient prefers hot drinks and has cold hands and feet, it is a syndrome of Spleen-Stomach damage with Yang Qi deficiency and Cold; treat with acrid-hot tonifying agents. If the patient prefers cold drinks and has hot hands and feet, it is a syndrome of excess Heat in Yang Qi; treat with bitter-cold draining agents. For external Wind-Cold, use warming dispersants. For toxin entering the abdomen, use separating and draining methods. For Yang Qi deficiency, use warming tonics. For external Cold invasion, use fumigation and resolution. Since ancient times, it has been said that White Sinking is incurable. Generally, white spots will turn gray and miserable; gray and miserable spots will eventually flatten and collapse, hence called White Sinking. This is indeed caused by Qi deficiency, but since Blood fails to provide luster, Blood is also fundamentally deficient. Treatment must address both Qi and Blood. When Blood circulates and Qi moves, white can turn red, preventing sinking and collapse. If only Qi is tonified, Qi becomes excessively dry and hot, inevitably leading to sinking. Thus, if white spots are scratched open, becoming thin-skinned, dry, and extremely itchy, it is due to neglecting Blood tonification, resulting in extreme Qi excess and dryness. Using more Qi-tonifying herbs is a sign of imminent death. Therefore, whenever white spots are seen, regardless of timing, treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) combined with Siwu Tang (Four Substances Decoction). If there is internal heat, add detoxifying herbs or promote urination. If one waits until White Sinking is established before treating, it is difficult to effect a cure. Smallpox presents with Purple-Black Sinking and Gray-White Sinking. Purple-Black Sinking is due to Blood Heat causing dryness and stagnation, with Qi unable to circulate; this is an Excess pattern. If treated urgently, survival is likely. Gray-White Sinking is due to collapse of Yuan Qi, preventing eruption and blood penetration; this is a Deficiency pattern, and rescue is often difficult.
If the rash is about to erupt but contains fluid that is dark black, treat with Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) mixed with Wuji San (Priceless Powder), or administer Kuaiban Tang (Rapid Eruption Decoction) and Duoming Dan together.
For Reverse Crusting, again examine the bowels. If constipated, use purgatives such as Sanhuang Wan (Three Yellows Pill) or Sixun Qingliang Yin (for fever). If diarrheic, use tonics: mild cases with Shiquan Dabu Tang, severe cases with Chen's Muxiang San (Chen's Costus Powder), externally applying Baicao San (Decayed Grass Powder).
[Pang Anchang] Yujin San (Curcuma Powder): For smallpox starting with white blisters, suddenly convulsing into the abdomen, gradually turning purple-black, lacking pus, with day-and-night crying and agitation.
Yujin (Curcumae Radix, 1 piece)
Gancao (Licorice Root, 1 fen)
Boil in half a bowl of water until dry. Remove Gancao, slice, bake dry, and grind to fine powder. Add Naozi (Borneolum Syntheticum, half qian), mix well. Take 1 qianbi per dose, mixed with 5-7 drops of fresh pig blood, administered with fresh well-water. Within two doses, severe cases will expel toxin from the palms and soles resembling carbuncles, indicating recovery. This is a critical prognosis (five deaths, one life).
Sixiang San (Four Sages Powder): For Black Sinking, Reverse Crusting, failure to erupt, lack of redness/vitality, and difficulty urinating.
Zicao (Arnebiae Radix et Rhizoma)
Huangqi (Astragali Radix)
Gancao (Licorice Root)
Mutong (Akebiae Caulis)
Decoct in water and drink. If heat is severe and color is purple, double Zicao, add Huangqin (Scutellariae Radix), Lianlian (Coptidis Rhizoma), and Honghua (Carthami Flos). If constipated, add Zhike (Aurantii Fructus). If normal, add Nuomi (Oryza Sativa Glutinosa).
Shenling Neituo San (Ginseng and Atractylodes Internal Support Powder) (See Itching/Collapse section)
Wuji San (Priceless Powder)
Use human, cat, pig, and dog feces, burned to ash in the twelfth lunar month. Mix with rock sugar water and take.
Nanjin San: Treats smallpox that has erupted but receded, a critical condition unresponsive to other drugs, ensuring safety.
Zibei Heye (Purple-backed Lotus Leaf, harvested after frost with purple backs)
Baijiangcan (Bombyx Batryticatus, washed free of silk, stir-fried dry)
Grind to powder. Equal parts. Dosage depends on age: adults 1 qian, children 0.5 qian. Grind with Yuanxi juice (Coriander juice) and wine, or rice water.
Treating this condition often involves Longnao (Borneolum) and Renya (Human Teeth), which are hard to obtain. This formula is non-toxic and fast-acting. Purple-backed leaves are rare; check salt shops.
Ganlan Yin (Olive Drink): Treats Reverse Crusting.
Cut olive in half. Take a small amount boiled in water. It promotes immediate eruption.
Baihuashe San (White-Banded Snake Powder): Treats smallpox/rash Black Sinking and Reverse Crusting.
Baihuashe (Bungarus multicinctus, including bones, 1 liang, fire-dried but not charred)
Dingxiang (Caryophylli Flos, 20 pieces)
Grind to powder. Take 0.5 qian or 0.2 qian, washed down with hot wine. If Black Sinking, the color turns red after a while; very effective.
*Luofu Fang* treats collapsed smallpox. Verse:
"Wushe (Black Snake), Quanxie (Scorpion), and Jiangcan (Silkworm),
Along with Shanjiarou (Pangolin Scales with meat) and Chan (Mantis Egg-case).
Each of these four pure ingredients weighs one liang,
Add twice as much Guanrou (Cinnamomi Cortex).
Boil in strong white wine and take as desired.
Many collapsed smallpox cases are restored to wholeness."
I have used this frequently, saving many lives. Note: Jiangcan must be free of silk, washed clean of lime, and sun-dried. Wushe must use the excellent tail portion. Shanjiarou must be washed in wine and baked dry.
[Yuan Shi] Treating Reverse Crusting. Verse:
"Reverse crusting is difficult post-smallpox,
Due to mutual depletion of Qi and Blood.
Renshen (Ginseng), Huangqi (Astragalus), Danggui (Angelica), Dihuang (Rehmannia), and Chantui (Cicada Slough)
Taken continuously, the crusts will return naturally."
Another verse:
"If bleeding persists from reverse crusting, it is named 'Returning Yang Spring.'
If it affects the chest and flanks, nine out of ten die.
Quickly find Yanzhipei (Red Earth/Pigment), add one qian of Xuemei (Dragon's Blood).
Burn them retaining their nature, apply to stop bleeding and dry the wound."
I have seen many wrongly use bathing methods for post-smallpox reverse crusting, causing unnecessary deaths. If scabs are thick and cannot detach, or detach partially leaving central piercing pain, or detach around the edges but leave the center, use the following formula:
Shengmi (Raw Honey)
Suheyou (Styrax Oil)
Mix evenly. Apply along the edge of the scab base using a silver hairpin. Pain stops immediately, and the scab detaches quickly without risk of hemorrhage or flesh tearing. If Suheyou is unavailable, substitute with Chicken Oil (from a hen fed thread/wire?), which is also excellent.