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The term "Sha" (Sand spots) refers to spots on the body resembling sand; when scraped with hemp, they appear clustered like cinnabar, hence the name. This condition arises from wind-cold-damp pathogenic factors or mountain miasma invading between the skin and muscle. The skin is the exterior correspondence of the Lung; the muscle is the exterior correspondence of the Spleen. The Lung governs Qi, while the Spleen governs the abdomen. If pathogens invade internally affecting the Lung, Qi rebellion occurs, manifesting as a cyan face and cold limbs; if invading the Spleen, it causes colicky abdominal pain. Therefore, superficial cases are treated by scraping, while deeper cases are treated by acupuncture, allowing pathogenic factors to exit externally, thereby stopping the pain. If the pathogen is severe and timely rescue and acupuncture are neglected, the pathogen will interfere with the Zang organs, causing stagnation of Qi mechanism, rendering it incurable. In recent times, this is called "Ban Sha" (Spotted Sand), and acupuncture at Baihui (GV20) is indicated. Acupuncture at Baihui to induce bleeding is named "Opening the Door," which is the method for treating macules and rashes, thus applied here. However, if it is not macule eruption due to excessive heat, Baihui need not be selected. Yu Tianmin stated in *Yixue Zhengzhuan* (Correct Transmission of Medicine): To treat Sha syndrome, one may first apply hot water soaked cloth to the arm and scrape with ramie; for severe cases, prick the ten fingers to bleed, or use an sesame oil lamp to illuminate the chest and back, cauterizing any red spots found. The theory of spots has existed for a long time, and cauterization methods have been practiced. Recent practitioners consider it a new "Ban Sha" due to lack of scholarly engagement! If heat pathogens remain in the skin, or cold pathogens transform into heat forming spots, sudden invasion leading directly inward would present with cyan face and cold limbs, without any spots. Without urgent acupuncture, sudden death would occur, leaving no time for lamp illumination and cauterization!

Discussions on smallpox and rashes have numbered over a hundred schools from ancient to modern times. However, without studying classics such as *Lingshu* (Spiritual Pivot) and *Sujing* (Basic Questions), one cannot understand the origin, exit, and entry of Zang-Fu organs and Qi-Blood. Thus, one only knows the manifestations of favorable (Shun), dangerous (Xian), and adverse (Ni) syndromes, but not their causes. Without knowing the causes, rescue methods cannot be applied. Humans form their bodies by inheriting Yin-Yang and Water-Fire Qi. Where there is righteous Qi, there must be pathogenic excess, which is the natural law of heaven and earth. (Excess Qi also exists in heaven and earth.) The toxic vapor of smallpox sprouts at the beginning of life. The beginning of life is akin to Taiji; at three months, the fetus takes shape, starting with the two Kidneys, akin to Taiji dividing into Two Yi (Yin and Yang). Thus, the root of smallpox lies in the Kidney. The Kidney is a Water organ, storing Essence and transforming Blood, and is the source of generating Qi. Shaoyang Qi is the generating Yang within Water, ascending to combine with the Pericardium. Therefore, the eruption of smallpox follows the righteous Qi of Shaoyang upward to reach the Pericardium. (Kidney Qi interacting with the Pericardium must ascend through the Middle Jiao. Pathogens in the Yangming channel cause vomiting and rebellion; excessive Yangming heat causes mania. Thus, convulsions before smallpox eruption are treatable. If pathogens erupt in the skin and muscle corresponding to Liver, Spleen, and Lung, and toxic pathogens do not resolve, internal injury to the Liver causes convulsions, injury to the Spleen causes diarrhea, injury to the Lung causes panting. Thus, convulsions after smallpox eruption are untreatable.) The Heart governs Blood, and the Pericardium governs Vessels. Therefore, toxins move from channels to vessels, from vessels to collaterals, from collaterals to Sun collaterals, and finally emerge in the skin; this is a favorable course. Smallpox is fire-toxin within Essence and Blood; thus, moving through the Blood level allows it to suppurate and scab. If it moves through the Qi level, it becomes vesicles with white shells. Channels and collaterals belong to the Blood level; skin and interstices belong to the Qi level. Hair follicles correspond to the Lung; muscles correspond to the Spleen. Within skin and muscle, blood that nourishes flesh and warms the body is governed by the Liver and also belongs to the Qi level. Therefore, favorable smallpox emerges from channels into the skin, appearing successively, uneven in size, with converging bases and clear boundaries, because the boundary skin and muscle are unharmed by toxic pathogens. The blood color is lustrous, roots red and tops white; Qi leads the formation of pus, as Qi moves outside vessels and Blood transforms with Qi. Adverse syndromes occur when toxins move into the Qi level of the skin, erupting all at once like miliaria, commonly called "Lung Channel Smallpox." If toxins move into the Qi level and stagnate in interstices, lips swell, eyes puff, flesh floats first while pustules flatten, commonly called "Spleen Channel Smallpox." If toxins move into the Qi level and stagnate between the blood nourishing flesh, the skin is thin, delicately red, and shiny like a lamp. These three types lack blood to form pus and are ultimately incurable. This is because toxins follow Qi into the skin and muscle corresponding to Lung, Spleen, and Liver, actually not being toxin of Lung, Spleen, or Liver channels. Another type is smallpox accompanied by rashes, where toxins separately move through Qi and Blood levels, making them treatable. If purely moving through the Qi level, even skilled physicians cannot cook without rice (cannot cure). Dangerous syndromes involve excessive fire-toxin, either blocking the Kidney or accumulating in the Pericardium. (Toxin blocking the Kidney causes lower back and abdominal pain, chattering teeth, and potentially purple/black depressed spots; toxin accumulating in the Pericardium causes high fever, irritability, bloody stool, and coma.) This depends on skilled physicians applying effective methods: release the exterior for exterior excess, drain the interior for interior excess, clear and resolve rapidly for excessive heat-toxin, and promote eruption first if it fails to rise. These are critical conditions where life and death hang in the balance, requiring no delay. Syndromes vary in severity, and prescriptions vary in urgency. If cured by mild decoctions, the original condition was not fatal, and medication might not even be needed; if mild decoctions lead to incurability, it is the physician's fault. For rescuing adverse syndromes, *Bingji San* (Ice Skin Powder) exists in medical texts to treat simultaneous eruption and induce retraction. I consider this prescription too plain and shallow to save major adverse cases. My disciple Jin Ximing obtained a *Jiuni Tang* (Rescue Adverse Decoction) in Danyang. I obtained a pill prescription from Mr. Qiu Hanchong. Based on these three prescriptions, I adjusted and combined them into one formula named *Wulei Jiuni Dan* (Five-Class Rescue Adverse Elixir), which shows miraculous effects for adverse and dangerous syndromes. Regarding exterior-interior, Qi-blood, cold-heat, and deficiency-excess, attending physicians should treat accordingly with decoctions.