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Cough is a common manifestation of variola (smallpox) and exanthematous diseases. Its pathogenesis involves cold and heat, as well as excess and deficiency. If coughing begins from the initial eruption of the rash and persists without resolution, this indicates that Lung Qi fails to consolidate; treatment should focus on consolidating and moistening. If coughing is accompanied by fever, difficult defecation, dark red urine, or hemoptysis leading to the desiccation and elevation of lung lobes, this signifies intense heat toxin; treatment should employ clearing and draining methods. If coughing is accompanied by loose stools, clear urine, absence of high fever, and no thirst, this constitutes a deficiency syndrome; treatment should utilize tonification. If one did not previously cough but now develops coughing along with symptoms such as clear nasal discharge, this is due to external contraction of wind-cold; treatment should employ dispersing and diffusing methods. Additionally, coughing accompanied by pain in both hypochondriac regions indicates residual toxins lingering within, causing dysfunction in the ascending and descending of Yin and Yang energies. The *Classic* states: "The left and right are the pathways of Yin and Yang," referring to the hypochondriac regions; treatment should prioritize resolving toxins and regulating Qi. However, in cases of dual deficiency of Qi and Blood with unsmooth circulation of Yin and Yang, treatment should focus on nourishing and regulating Qi and Blood, after which the suffering will naturally cease.

Post-variolous vomiting and diarrhea of roundworms indicate that heat toxin has penetrated inward, and the worms are driven out by the steaming heat. Heat in the Stomach causes vomiting of worms, while heat in the Intestines causes diarrhea of worms. For diarrhea of worms, use Huangqin Tang (Scutellaria Decoction) added with Tao Ren (Peach Kernel) and Ai Ye (Mugwort Leaf); for vomiting of worms, use Huangqin Banxia Tang (Scutellaria and Pinellia Decoction) added with Wu Mei (Mume Fruit) and Chuan Jiao (Sichuan Pepper). Furthermore, individuals who do not typically vomit or pass worms may vomit upon smelling food odor and feel hungry soon after eating; this occurs because long-standing Stomach deficiency leaves the worms without food, causing them to react to food odors with vomiting and leading to rapid hunger post-prandially. If vomiting of worms is accompanied by cold extremities, it is termed "Hui Jue" (Roundworm Syncope); treatment for all such cases should utilize Lizhong Tang (Regulate the Middle Decoction) added with Wu Mei and Chuan Jiao. One must absolutely avoid using drugs like Shijunzi (Quisqualis Seed) or Binglang (Areca Nut), as the parasites have not yet caused severe damage, but the body's righteous Qi is already exhausted. There are also cases where, although there is no vomiting or diarrhea of worms, internal erosion of Zang-Fu organs occurs, known as "Hu Huo" (Fox-Huo Syndrome). Patients exhibit somnolence, taciturnity, and anorexia. If ulcers appear on the upper lip, it indicates worm erosion of the anus; if ulcers appear on the lower lip, it indicates worm erosion of the viscera. The voice becomes hoarse, and the patient experiences restlessness above and below, hence the name Hu Huo. This results from prolonged deficiency of water and grain essences, leaving worms without sustenance, thus eroding viscera and anus internally while manifesting as ulcers on lips and mouth externally. This condition is extremely malignant, particularly common after measles. Treatment should primarily utilize Huote Wan (Resolve Malice Pill). In cases of constipation, Taoren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) added with Huaizi (Sophora Seed) should be used to promote bowel movement. If the condition progresses to lip sloughing, nasal collapse, tooth loss, and aphonia, it is incurable. Cases involving only ulceration and rotting of the gingiva occur after the exanthem subsides, due to phlegm-fluid infiltration and erosion, forming Gan Shi Chuang (Gan Erosion Ulcer); these should be treated with topical application of Mianjian San (Silkworm Cocoon Powder). If foul breath and bleeding occur, it is termed "Zou Ma Gan Chuang" (Running Horse Gan Ulcer), caused by heat in the Yangming channel; internal treatment requires Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), and external treatment requires topical application of Mamingsan. If the condition advances to swollen and edematous lips, perforation of the nose and cheeks, throat ulceration with necrotic tissue, and inability to ingest food, it is incurable. Any ulcers on the lips that are red are named "Chi Kou Chuang" (Red Mouth Ulcer), indicating heat in the Heart and Spleen channels. Those that are white are named "Bai Kou Chuang" (White Mouth Ulcer), also known as "E Kou Chuang" (Goose Mouth Ulcer), indicating heat in the Heart and Lung channels. Both types are treated internally with Xixin San (Heart-Cleansing Powder). In cases of constipation, Sixun Yin (Four-Obedience Drink) is used to promote purgation. However, in cases where the pulse is faint and weak, and the Spleen Yuan and Middle Qi are deficient and cold, failing to secure the Lower Jiao, causing Yin fire to float upward resulting in mouth ulcers, treatment with Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction) will lead to recovery.