痘出围绕若环珠，毒瓦斯壅滞宜早图，清热解毒为妙剂，毒解浆生患自除。
【注】痘名环珠者，以出而围绕，形若环珠也。此毒瓦斯壅滞所致，宜早图治，以清热
解毒汤主之，使毒解浆生，其患自除矣。
\r环珠图\p03-b24a27.bmp\r
清热解毒汤（方见见点证治）
视之有点按无形，参差紫黯若浮萍，速用凉血攻毒剂，能使毒松色转红。
【注】浮萍者，视之有点，按之无形，参差不齐，痘色紫黯，状如浮萍也。此乃血瘀
毒炽，非急攻不可。速用凉血攻毒饮攻之，能使毒松色转红活，庶可望生。
\r浮萍图\p03-b24a28.bmp\r
凉血攻毒饮（方见见点证治）
痘形连贯颗碎密，上阔下细蟹爪形，起胀根松毒始解，清热解毒服有功。
【注】蟹爪者，痘形连贯，颗粒碎密，上阔下细，如蟹爪之状。急用清热解毒汤治之，
使连贯处起胀根松，其毒可解也。
\r蟹爪图\p03-b24a29.bmp\r
清热解毒汤（方见见点证治）
痘形歪斜复扁阔，无顶无盘名HT 沙，通圣归宗酌量用，顶起根松痘始佳。
【注】HT 沙者，痘形扁阔，歪斜不圆，无顶无盘，若HT 沙细小，宜先用松肌通圣散主
之。若色紫黯者，归宗汤主之。能顶起根松，始为佳境。
\r HT 沙图\p03-b24a30.bmp\r
松肌通圣散（方见蒙头证治）
归宗汤（方见发热证治）
痘疹出后，若呈现围绕状如环珠，此为毒气壅滞所致，应当尽早谋划治疗。采用清热解毒作为妙方，待毒邪解除、脓浆生成，病患自然痊愈。
【注】痘疹名为“环珠”，是因为痘疹发出后呈围绕状，形状如同环珠。这是由毒气壅滞所导致，应当尽早规划治疗，以清热解毒汤为主方，使毒邪解除、脓浆生成，其病患自然消除。
观察痘疹，视之有斑点，按压却无实体感，参差不齐且颜色紫暗，状如浮萍。应迅速使用凉血攻毒的药剂，能使毒邪松动、痘色转为红润。
【注】所谓“浮萍”，是指视之有斑点，按压无形，参差不齐，痘色紫暗，形状像浮萍。这是由于血瘀毒炽盛，非紧急攻下不可。迅速使用凉血攻毒饮进行攻治，能使毒邪松动、痘色转红活，这样才有望存活。
痘形连贯，颗粒细碎密集，上部宽下部细，呈蟹爪形状。起胀时根部松软，毒邪始得解除，服用清热解毒汤功效显著。
【注】所谓“蟹爪”，是指痘形连贯，颗粒细碎密集，上部宽下部细，如同蟹爪的形状。急用清热解毒汤治疗，使连贯之处起胀且根部松软，其毒邪便可解除。
痘形歪斜且复盖扁阔，没有顶部也没有底盘，命名为HT沙。通圣归宗汤酌情选用，待顶部隆起、根部松软，痘疹才算良好。
【注】所谓“HT沙”，是指痘形扁阔，歪斜不圆，没有顶部和底盘，若HT沙细小，宜先用松肌通圣散为主方。如果颜色紫暗，则用归宗汤为主方。能够顶起且根部松软，才是佳境。
After the eruption of smallpox, if it presents in a surrounding pattern resembling ring beads, this indicates stagnation and obstruction by toxic heat; treatment should be planned early. Employing heat-clearing and detoxification is an excellent method; once the toxin is resolved and pus forms, the illness will naturally subside.
[Note] The term "Ring Beads" for smallpox refers to eruptions that appear in a surrounding pattern, shaped like ring beads. This is caused by the stagnation and obstruction of toxic qi. Treatment should be planned early, primarily using Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction), so that when the toxin is resolved and pus forms, the illness will naturally disappear.
Upon observation, spots are visible but yield no resistance upon palpation; they are irregular in distribution, purple and dark in color, resembling duckweed. Cool-blood and attack-toxin agents should be used rapidly, which can loosen the toxin and turn the color red.
[Note] "Duckweed" refers to eruptions where spots are visible but feel flat upon pressure, appearing irregular with a purple-dark hue, resembling duckweed. This condition arises from blood stasis and intense toxicity, requiring urgent purgative action. Rapidly using Liangxue Gongdu Yin (Cool Blood and Attack Toxin Drink) can loosen the toxin and restore a vibrant red color, offering hope for survival.
The smallpox lesions are continuous, with fine and dense granules, wider at the top and narrower at the bottom, resembling crab claws. When swelling begins and the base becomes loose, the toxin starts to resolve; taking Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction) proves effective.
[Note] "Crab Claw" describes continuous lesions with fine, dense granules, wider superiorly and narrower inferiorly, similar to the shape of crab claws. Urgently treat with Qingre Jiedu Tang (Heat-Clearing and Detoxifying Decoction) to induce swelling and loosen the base, thereby resolving the toxin.
The smallpox morphology is slanted and broadly flattened, lacking both a summit and a base, named HT Sha. Tongsheng Guizong San (Tongsheng Guizong Powder) should be used judiciously; only when the summit rises and the base loosens does the condition become favorable.
[Note] "HT Sha" refers to smallpox that is broad, flattened, slanted, and roundless, lacking a summit and base. If the HT Sha is small, Songji Tongsheng San (Muscle-Loosening Tongsheng Powder) should be used first as the primary formula. If the color is purple and dark, Guizong Tang (Guizong Decoction) should be used. A favorable outcome is achieved only when the summit rises and the base loosens.