痘疮结痂自当根据期脱落，其有应落下落，及延绵日久者，此亦不可不察而治之，以防他变也。
一、结痂至半月、一月，粘肉不落或发痒者，此必表散太过，伤其津液，以致腠理虚涩，无力
脱卸故也，
宜用人参固肌汤，或以真酥油、麻油润之。如久而不脱，宜六物煎加黄 、肉桂、蝉蜕主之。切不
可勉强剥去，恐伤皮肤，一时难愈。
一、遍身结痂虽完，若余热未退，蕴蓄肌表，或身热，或烦渴而痂不落者，宜凉血养营煎，或
解毒防风汤，酌宜用之。如热甚者，宜大连翘饮加地骨皮主之。外宜用滑石为末，以蜂蜜调匀，鸡
翎扫润痂上即落。
一、痘瘢突起作痒不止者，此热毒未尽也，宜解毒防风汤主之。
一、痘瘢发痒，剥去痂皮，或血出，或后成脓如疮疥者，此血热气虚也，宜四君子汤，或四物
汤加红花、紫草、牛蒡子治之。
一、收靥迟而痂不落，昏昏欲睡，此邪气已退，正气未复，脾胃虚弱也，宜五福饮，或调元汤
，缓缓调治之。若余火未清者，宜酸枣仁汤。
一、痘痂既落，中气暴虚，多有不能食者，宜五味异功散，或养中煎以调之。
一、收靥落痂之后，若余热不退，谵语昏沉者，用辰砂六一散，以小柴胡汤调服之。若大便秘
胀者，宜当归丸利之。热甚者，用大连翘饮最妙。
一、原痘不灌脓，干如豆壳，虽痂落而疤白，或有余热不退者，虽过一日亦要死，宜速用八珍、
十全之类调补之。或毒盛者，仍须先用消毒饮。
一、痘痂既落之后，血气未复，极当调护，切不宜澡浴及食饮生冷，伤饥过饱，损伤脏气，致
生他病，为终生之患也。慎之，慎之！
痘疮结痂应当根据病程自然脱落，那些该脱落而未脱落，以及拖延日久不落的，这也是不可不仔细考察并治疗，以防发生其他变证。
一、结痂到半个月、一个月，粘连肌肉不脱落或发痒的，这必定是发散太过，损伤了津液，导致腠理（皮肤纹理及汗孔）虚涩，没有力量脱卸的缘故，适宜用人参固肌汤，或者用真酥油、麻油滋润它。如果久了还不脱落，适宜用六物煎加黄柏、肉桂、蝉蜕来主治。切不可勉强剥去，恐怕损伤皮肤，一时难以愈合。
一、遍身结痂虽然完成，如果余热未退，蕴蓄在肌表，或者身体发热，或者烦躁口渴而痂皮不落的，适宜用凉血养营煎，或者解毒防风汤，酌情选用。如果热势严重的，适宜用大连翘饮加地骨皮来主治。外用适宜用滑石研为粉末，用蜂蜜调匀，用鸡毛扫润痂上，痂皮即脱落。
一、痘瘢突起作痒不止的，这是热毒未尽的缘故，适宜用解毒防风汤来主治。
一、痘瘢发痒，剥去痂皮后，或者出血，或者后来化脓像疮疥一样的，这是血热兼气虚的缘故，适宜用四君子汤，或者四物汤加红花、紫草、牛蒡子来治疗。
一、收靥（结痂脱落过程）迟缓而痂皮不落，昏昏欲睡的，这是邪气已退，正气未复，脾胃虚弱的原因，适宜用五福饮，或者调元汤，缓缓调理治疗。如果余火未清的，适宜用酸枣仁汤。
一、痘痂既已落下，中气突然虚弱，多有不能进食的，适宜用五味异功散，或者养中煎来调理。
一、收靥落痂之后，如果余热不退，出现胡言乱语、昏沉嗜睡的，用辰砂六一散，用小柴胡汤调服。如果大便秘结胀满的，适宜用当归丸通利它。热势严重的，用大连翘饮最妙。
一、原痘不灌脓，干燥如豆壳，虽然痂落了但疤痕发白，或者有残余热势不退的，即使过了一天也可能会死，适宜速用八珍汤、十全大补汤之类调补。如果毒邪盛的，仍须先用消毒饮。
一、痘痂既已落下之后，血气尚未恢复，极应当调养护理，切不宜洗澡沐浴以及饮食生冷，避免饥饿过度或过饱，以免损伤脏气，导致产生其他疾病，成为终身的祸患。谨慎啊，谨慎啊！
Scabbing from smallpox should naturally fall off according to the course of the disease. Those that should fall off but do not, or those that linger for a long time, must be carefully examined and treated to prevent other complications.
1. If scabs adhere to the flesh after half a month or a month without falling off, or if itching occurs, this is necessarily due to excessive dispersing (sweating), which has damaged body fluids (Jin-Ye), leading to deficiency and dryness in the Cou-Li (skin texture and pores), resulting in a lack of strength to shed them. It is appropriate to use Renshen Guji Tang (Ginseng Muscle-Securing Decoction) or to moisten with genuine butter oil or sesame oil. If they remain for a long time without shedding, Liuwu Jian (Six-Ingredient Decoction) added with Huangbai (Phellodendron Bark), Rougui (Cinnamon Bark), and Chantui (Cicada Slough) should be used as the main treatment. Do not forcibly peel them off, lest skin damage occur, making healing difficult in a short time.
2. Although scabs cover the whole body, if residual heat remains unsubsided and accumulates in the muscle surface, causing fever or irritability and thirst while the scabs do not fall, Liangxue Yangying Jian (Cool Blood and Nourish Ying Decoction) or Jiedu Fangfeng Tang (Detoxify and Saposhnikovia Decoction) should be used酌情ly. If the heat is severe, Dalianqiao Yin (Large Forsythia Drink) added with Digupi (Dogwood Root Bark) should be used. Externally, Talcum (Huashi) powder mixed evenly with honey can be applied; sweeping it onto the scabs with a chicken feather will cause them to fall off.
3. If pockmarks protrude and itch incessantly, this indicates that heat toxins are not yet exhausted. Jiedu Fangfeng Tang (Detoxify and Saposhnikovia Decoction) should be used as the main treatment.
4. If pockmarks itch, and after peeling off the scabs there is bleeding or subsequent suppuration resembling sores or scabies, this is due to blood heat combined with Qi deficiency. Sijunzi Tang (Four Gentlemen Decoction) or Siwu Tang (Four Substances Decoction) added with Honghua (Safflower), Zicao (Arnebia Root), and Niubangzi (Burdock Fruit) should be used for treatment.
5. If the recovery phase (shouye) is delayed and scabs do not fall, accompanied by drowsiness and desire to sleep, this indicates that pathogenic factors have receded, Zhengqi (Upright Qi) has not yet recovered, and the Spleen and Stomach are weak. Wufu Yin (Five Blessings Drink) or Tianyuan Tang (Origin-Regulating Decoction) should be used for gradual regulation and treatment. If residual fire is not cleared, Suanzaoren Tang (Zizyphus Seed Decoction) is appropriate.
6. After scabs have fallen, sudden deficiency of Middle Qi often results in an inability to eat. Wuyi Yigong San (Five-Ingredient Extra-Effort Powder) or Yangzhong Jian (Nourish Middle Decoction) should be used to regulate.
7. After the recovery phase and scab shedding, if residual heat does not subside and delirium or lethargy occurs, Chen Sha Liu Yi San (Cinnabar Six-to-One Powder) should be taken with Xiaochaihu Tang (Minor Bupleurum Decoction). If constipation and abdominal distension occur, Danggui Wan (Angelica Pill) should be used to promote bowel movement. For severe heat, Dalianqiao Yin (Large Forsythia Drink) is most excellent.
8. If original pustules did not fill with pus and remained dry like bean shells, resulting in white scars even after scab shedding, or if residual heat persists, death may occur even after one day. Immediate supplementation with Bazhen Tang (Eight-Treasure Decoction) or Shiquan Daybu Tang (Ten Complete Great Tonifying Decoction) is required. If toxins are abundant, Xiaodu Yin (Detoxify Poison Drink) must be used first.
9. After scabs have fallen and blood and Qi have not yet recovered, careful nursing and regulation are extremely important. One must strictly avoid bathing, consuming raw or cold foods/drinks, extreme hunger, or overeating, to prevent damage to Zang-Fu Qi and the onset of other diseases that could become lifelong afflictions. Be cautious, be cautious!