痘中有紫黑干硬暴胀独大，脚无红晕，或疼或不疼者，即痘疔也。痘疔能闭诸毒，未齐
有疔，则诸痘不能出现；既齐有疔，则诸痘不能起胀；行浆时有疔，则诸痘必致倒陷。故初
出时，见有紫黑独大之点，恐其成疔，即宜以银针刺破，吸尽黑血，然后以拔疔散敷之。次
日复看，若再硬胀，仍然刺破，以前药敷之，必转红活，方可已也。若针挑不动，手捻有核
，则成疔矣。须用针从四旁刳开，以小钳钳出，其形如钉，有半寸许长。拔去其疔，仍以前
药敷满疮口，乃可无虞。又手足四肢有痘，惨暗坚硬而甚痛，或外无痘而内有核作痛者，亦
痘疔也。宜以艾火烧之即愈。或以灯火烙之亦效。若不急治，则其痘深陷，穿筋透髓而烂见
骨，甚可畏也。又天庭有黑点，心窝、舌上必有疔；地角有黑点，阴囊必有疔；两颧有黑点
，两腋必有疔；准头有黑点，四肢必有疔。此观显可知其稳，又不可不详也。一妇人出痘，
稀疏朗润，似为顺症，但热不退，已而明润者渐觉惨暗，其人亦烦闷不安。详观面部，见地
角一痘，紫黑将焦，察其阴中有痘疔，形如黑豆一颗，此乃疔也。用银针剔破，钳出痘疔，
以拔疔散敷之，其热遂退，诸症悉皆润泽起胀而愈。
拔疔散∶明雄二钱，胭脂末五钱（无则胭脂膏亦可），共为细末，凡遇痘疔、贼痘，刺
出
又方∶京城油胭脂敷之，立能止涌，其效如神。
又方∶明雄一钱，紫草三钱，共为细末，多用顶上胭脂汁调匀，用银针挑破，擦之神效
，与油胭脂同。
又方∶将疔挑破出紫血，蒲公英熬膏，放水中一日一夜冷透火气，敷之。
又方∶马齿苋交猪骨髓少许，捣融，敷于四围，顷刻止痛，不数日能拔疔根，屡试屡验
又方∶大蒜头，切三分浓安痘疔上，用艾一团如豆大在蒜上灸之，每五次，换蒜再灸，
若紫血出后肿痛不止，尤当用灸，痛者灸至不痛，不痛者灸至痛，其毒随火而散。
痘疹中若出现紫黑色、干燥坚硬、突然肿胀且特别突出的痘点，周围没有红晕，或者疼痛或不疼痛的，这就是“痘疔”。痘疔能够闭塞其他痘毒，如果痘疹尚未出齐时出现疔疮，那么其他的痘疹就不能发出；如果痘疹已经出齐后出现疔疮，那么其他的痘疹就不能起胀；在行浆阶段出现疔疮，那么其他的痘疹必然会导致倒陷（即痘疹塌陷）。所以在痘疹刚出来时，看到有紫黑色且特别突出的痘点，担心它形成疔疮，就应当立即用银针刺破，吸尽黑色的瘀血，然后用拔疔散敷在上面。第二天再看，如果再次变得坚硬肿胀，仍然刺破，用之前的药粉敷上，直到痘疹转为红润鲜活，才可以停止治疗。如果针挑不动，用手触摸感觉里面有硬核，那就确实形成了疔疮。必须用针从四周切开，用小钳子夹出来，其形状像钉子，长约半寸。拔出疔疮后，仍然用之前的药粉填满疮口，这样就没有危险了。另外，手足四肢出现痘疹，颜色惨暗坚硬而且非常疼痛，或者外面没有痘疹但内部有硬核并疼痛的，也是痘疔。适宜用艾火烧灼即可痊愈。或者用灯火烙烫也有效。如果不紧急治疗，那么痘疹会深陷，穿透筋脉骨髓而腐烂见骨，非常可怕。另外，天庭部位有黑点，心窝、舌头上必定有疔；地角部位有黑点，阴囊必定有疔；两颧部位有黑点，两腋窝必定有疔；准头（鼻尖）部位有黑点，四肢必定有疔。这是通过观察表面现象就可以准确判断的，又不可不详细考察。有一位妇女出痘，痘疹稀疏明亮润泽，看似顺症，但是发热不退，随后原本明润的痘疹逐渐变得惨暗，人也烦闷不安。仔细观察面部，发现地角处有一颗痘疹，紫黑将焦，检查其阴部发现有痘疔，形状像一颗黑豆，这就是疔疮。用银针剔破，夹出痘疔，用拔疔散敷上，她的热势随即消退，所有症状都变得润泽起胀而痊愈。
拔疔散：明雄黄二钱，胭脂末五钱（如果没有胭脂末，胭脂膏也可以），共同研成细末，凡是遇到痘疔、贼痘，刺破后用京城产的油胭脂敷上，立刻能止住涌出，效果如神。
又一方：明雄黄一钱，紫草三钱，共同研成细末，多用顶部的胭脂汁调匀，用银针挑破患处，涂抹上去效果神奇，与使用油胭脂相同。
又一方：将疔疮挑破流出紫血，用蒲公英熬制成膏，放在水中浸泡一天一夜使其冷透火气，然后敷在上面。
又一方：马齿苋混合少许猪骨髓，捣烂融合，敷在疔疮四周，片刻就能止痛，几天内就能拔出疔根，多次尝试都验证有效。
又一方：大蒜头，切成三分厚的片安放在痘疔上，用一团如豆子大小的艾绒在蒜上灸治，每灸五次，更换大蒜再灸，如果紫血流出后肿痛不止，尤其应当使用灸法，痛的灸到不痛，不痛的灸到痛，毒素随着火力而消散。
In the context of smallpox (Xiaochuan), if a pimple appears purple-black, dry, hard, suddenly swollen, and particularly prominent, without a red halo around it, or with pain or no pain, this is called "Dou Ding" (Smallpox Carbuncle). Dou Ding can block other toxic eruptions; if a carbuncle appears before the eruption is complete, other pimples cannot emerge; if it appears after the eruption is complete, other pimples cannot swell; if it appears during the stage of pus formation, other pimples will inevitably collapse. Therefore, when the eruption first appears, if one sees a purple-black, particularly prominent spot and fears it may become a carbuncle, one should immediately pierce it with a silver needle, suck out the black blood, and then apply Baling San (Carbuncle-Extracting Powder) to the area. The next day, check again; if it becomes hard and swollen again, pierce it once more and apply the previous medicine until the lesion turns red and vibrant, at which point treatment can cease. If the needle cannot penetrate and there is a palpable nodule upon touch, a carbuncle has indeed formed. One must use a needle to incise from the four sides, extract it with small forceps; its shape resembles a nail, about half an inch long. After extracting the carbuncle, fill the wound completely with the previous powder to ensure safety. Additionally, if smallpox lesions on the hands, feet, and limbs are dark, hard, and extremely painful, or if there are no external lesions but internal nodules causing pain, these are also Dou Ding. It is suitable to cauterize them with burning moxa for immediate cure. Cauterization with a lamp flame is also effective. If not treated urgently, the lesions will sink deep, penetrating tendons and marrow until bones are exposed and rotting, which is very terrifying. Furthermore, if there are black spots on the Tian Ting (forehead center), there must be carbuncles in the Xin Wo (heart pit) and on the tongue; if there are black spots on the Di Jiao (jaw corners), there must be carbuncles in the scrotum; if there are black spots on the Liang Quan (cheekbones), there must be carbuncles in both axillae; if there are black spots on the Zhun Tou (nose tip), there must be carbuncles in the four limbs. This allows for accurate judgment through observation, which must not be neglected. A certain woman had smallpox; the lesions were sparse, bright, and moist, seemingly a favorable condition, but the fever did not subside. Subsequently, the previously bright and moist lesions gradually became dark, and she felt irritable and uneasy. Upon careful observation of her face, a lesion at the Di Jiao was found to be purple-black and nearly scorched. Examination of her genital area revealed a Dou Ding resembling a black bean. Using a silver needle to pierce it and forceps to extract the Dou Ding, followed by application of Baling San, her fever subsided, all symptoms became moist and swollen, and she recovered.
Baling San (Carbuncle-Extracting Powder): Ming Xionghuang (Realgar) 2 qian, Yanzhi Mo (Carmine powder) 5 qian (if unavailable, Yanzhi Gao/Carmine paste may be used). Grind together into a fine powder. Whenever encountering Dou Ding or Zei Dou (rogue smallpox), pierce it and apply Beijing You Yanzhi (Beijing oil-based carmine); it stops oozing immediately with miraculous efficacy.
Another prescription: Ming Xionghuang (Realgar) 1 qian, Zicao (Radix Arnebiae / Lithospermi Radix) 3 qian. Grind together into a fine powder. Mix thoroughly with juice from the top-grade carmine. Pierce the lesion with a silver needle and rub the mixture on; it is highly effective, similar to using oil carmine.
Another prescription: Pierce the carbuncle to release purple blood. Boil Pugongying (Herba Taraxaci) into a paste, soak it in water for one day and night until cold and fire-heat dissipates, then apply it.
Another prescription: Mix Machixian (Herba Portulacae) with a small amount of Zhu Guisui (Porcine Marrow), pound into a融 paste, and apply around the four sides of the carbuncle. Pain stops instantly within moments, and the root of the carbuncle is extracted within a few days; repeatedly tested and verified.
Another prescription: Slice a head of Dasuan (Allium sativum) to a thickness of 3 fen and place it on the Dou Ding. Place a ball of Moxa (Ai Ye Folium) the size of a bean on the garlic and moxibustion. Perform moxibustion five times, then replace the garlic and continue. If swelling and pain persist after purple blood flows out, moxibustion is especially indicated. For painful areas, moxa until pain ceases; for painless areas, moxa until pain arises. The toxin disperses with the fire.