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The etiology of smallpox and chickenpox lies in the infant's ingestion of blood turbidity from the mother's five zang organs while in the womb, which remains latent in the Mingmen (Gate of Life); or it may be triggered by epidemic qi, fright, falls, dietary injuries, thereby manifesting with symptoms resembling Taiyang disease (Taiyang syndrome). The clinical manifestations include dry face and red cheeks, red eyelids, frequent yawning with lethargy, alternating chills and fever, coughing and sneezing, cool feet, cool ears and coccyx, excessive sleepiness or startle during sleep, and red vascular patterns behind the ears. These are the signs of the disease. Each of the five zang organs corresponds to a specific manifestation: the Liver governs water blisters, the Lungs govern pus-filled pustules, the Heart governs macules, the Spleen governs papules, and if the pathogen returns to the Kidneys, it turns black. This is because the Foot-Taiyang Bladder meridian originates below the right kidney, scalding the left kidney; the cold water of the Foot-Taiyang Bladder flows up along the spine, reaching the head and forehead, and reversely transmits to the Hand-Taiyang Small Intestine meridian. Consequently, Bing Fire (Small Intestine/Heart fire) cannot transmit properly, reversing upward to the face, thus producing these symptoms. This occurs due to the restriction of Bing-Ding Fire by Ren-Gui Water.

Generally, if all lesions erupt simultaneously at the onset, the condition is severe. If sores and rashes appear together, the severity is moderate. Scarcity indicates mildness; slight redness inside and out indicates mildness; black exterior with red interior indicates slightly severe; white exterior with black interior indicates extremely severe; and black dots like needle holes at the lesion apex indicate critical intensity. Cyanosis with dryness, purple depression, coma, incessant sweating, irritability, fever, thirst, abdominal distension, crying with wheezing, and obstruction of urination and defecation indicate a critical state.

In the typical course of smallpox/chickenpox, there is steaming fever for one day, followed by slight cooling and eruption. By the third day, eruptions appear on the soles of the feet. They gradually enlarge like pearls, forming full, pus-filled pits, and eventually turn into a grayish-wax color. Counting from the initial redness, crusting should occur by the seventh day; this describes the general rule. Individuals vary in deficiency and excess, and diseases differ in depth. If the Spleen and Stomach are robust and Qi and Blood are harmonious, recovery occurs according to schedule. However, improper treatment damaging the Spleen and Stomach, or inappropriate exposure to cold and heat, will inevitably lead to protracted illness. Generally, if the disease pattern is standard without other complications, medication is unnecessary; this is an adage of the sages. Zheng stated: For impending sores or smallpox, fever precedes eruption. Mild cases take three days, moderate five, and severe no more than seven; this is a rough guideline. On the first day, the pathogen is in the Taiyang meridian transmitting to the Bladder; on the second day, Yangming to the Stomach; on the third day, Shaoyang to the Gallbladder; on the fourth day, Taiyin to the Spleen; on the fifth day, Taiyin to the Kidney; on the sixth day, Jueyin to the Liver; on the seventh day, it returns to the channel. After traversing the five zang and six fu organs, the cycle stops at seven days. Additionally, in cases of Shanghan (Cold Damage) persisting beyond seven days, whether after sweating or not, or after vomiting/purging where heat persists, this indicates abundant toxic qi that has not erupted. Heat toxin enters the Stomach and manifests on the skin. Lesions resembling mosquito bites: red ones have nine survivors out of ten; black ones have only one survivor out of ten. Jaundice due to Stomach heat, resembling orange color, accompanied by diarrhea, indicates death. Eruptions presenting as hidden rashes or white blisters also result from uneliminated heat toxin from Shanghan, often transforming into such conditions. Therefore, diaphoretic (sweat-inducing) medicines must not be used when treating eruptive diseases.