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Hoarseness or aphonia after smallpox presents with two main patterns. When throat pain prevents speech, it is due to toxic pathogens accumulating in the throat, where phlegm obstruction causes pain leading to inability to speak; treatment should focus on clearing heat and resolving phlegm, benefiting the throat, and detoxifying (Qingre Huatan, Liyan Jiedu). In cases of aphonia due to heart heat, it is because pathogenic heat in the heart has not been fully cleared, and kidney deficiency fails to ascend clear yang; although vocalization is possible, coherent speech is absent. Treatment should focus on clearing heat and nourishing the heart, and yin-nourishing and tonifying the kidney, to achieve the intersection of water and fire (Kan-Li Ji-Ji).

Sudden chills and fever resembling malaria occurring at regular intervals after smallpox are caused by spleen deficiency and qi weakness, improper nursing, and secondary contraction of wind-cold. Since the spleen governs the muscles, symptoms manifest regularly. Initial treatment should use Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to disperse new exterior wind-cold pathogens, followed by Tiaoyuan Tang (Regulating Origin Decoction) with modifications as the main treatment. In cases of dual deficiency of qi and blood after smallpox, qi deficiency generates external cold, and blood deficiency generates internal heat, presenting as malaria-like but not true malaria. Dispersing methods are strictly contraindicated; instead, substantial tonification of qi and blood is required, after which the chills and fever will resolve spontaneously.

Pain in bone joints, commonly known as "smallpox wind" (Doufeng), requires differentiation between qi-blood deficiency and excess. It involves both toxin and wind. For deficiency patterns, formulas tonifying qi and blood are used with slight additions of wind-dispelling herbs; for excess patterns, cooling formulas are used with slight additions of wind-dispelling herbs. Treating wind addresses wind, detoxification addresses toxins, but nourishing blood remains primary, allowing wind-toxins to transform internally. If treatment fails, substantial nourishment of the liver and kidney is necessary, as joints belong to the domain of the liver and kidney.

Non-timed convulsions and spasms after smallpox present with two patterns. One pattern arises from residual toxins remaining in the heart, causing extreme heat to generate wind, with wind and fire battling; patients exhibit phlegm in the throat, upward staring eyes, red face, thirst, preference for cool environments, and treatment focuses on clearing the heart and purging the liver (Qingxin Xiegan). Another pattern results from overeating after illness while the stomach is weak and unable to digest food, causing food stagnation to transform into heat and trigger convulsions; patients exhibit tidal fever, abdominal fullness, irritability, sour-smelling stools, alternating constipation and diarrhea, vomiting, and abdominal pain. Treatment should focus on promoting digestion and assisting stomach nourishment, promoting grain qi transformation. Additionally, limb contracture and difficulty in flexion and extension result from blood consumption and qi deficiency failing to nourish the sinews; Shiquan Dabu Tang (Complete Great Tonifying Decoction) is indicated. Mistaking this for a wind-pattern is strictly contraindicated, as it would further consume yin-blood. Post-smallpox confusion, failure to recognize people, and constant delirium resembling possession indicate heat-toxin transferring to the pericardium collateral (Xinbaoluo); treatment focuses on clearing the heart and regulating origin. Cases without fever or delirium, but characterized by sudden drowsiness and vertigo-like states, occur in patients with poor appetite and inherent weak righteous qi who suffered severe smallpox. With proper nursing and resolution of toxins, recovery follows. As evil qi resolves and righteous qi regenerates, indicating a turn from adversity to prosperity, Tiaoyuan Tang should be administered lightly and in small amounts until spontaneous awakening. Disturbing the patient, shaking, calling, or inducing crying disperses the spirit and often leads to untreatable conditions. Cold hands and feet, termed Jue-Ni (Reversal Cold), if occurring during the peak eruption of smallpox, are almost invariably fatal. However, in post-recovery states with prolonged qi-blood deficiency and severe spleen-stomach exhaustion, Tiaoyuan Tang with modifications is appropriate.