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After fever has persisted for three days, if the smallpox lesions first appear in the lower part of the face, those appearing on both cheeks (Yi) are considered superior, while those on both malar regions are considered medium. If they first appear on the forehead, it indicates that the pathogenic toxin has invaded the Yang region, which is classified as inferior-inferior. When the lesions resemble morning stars and are dense, even if other areas are sparse, it is difficult to treat. Conversely, when the lesions resembling morning stars are sparse, smooth, and lustrous, even if other areas are dense, there is a chance for recovery. The essence of the five Zang organs flows upward to the head and face. Therefore, when the essence of the five Zang organs is sufficient, although there may be many lesions, they will clearly form distinct pustules, standing high and moist; thus, their abundance causes no harm. If the essence is insufficient, the pathogenic toxin dominates, causing溃散 (disintegration) into patches like bran, resulting in an incurable condition.

Diagram of the infant's face \ps98a21.bmp\

Qian (Heaven) and Dui (Lake) belong to Metal, representing the Lung (Fei). They are controlled by the Heart Fire (Xin Huo) of the South Li (Fire) trigram, and are nourished by the Spleen Earth (Pi Tu) of the Southwest Kun (Earth) and Northeast Gen (Mountain) trigrams. Kan (Water) belongs to Water, representing the Kidney (Shen). It is controlled by the Spleen Earth (Pi Tu) of the Southwest Kun and Northeast Gen trigrams, and is nourished by the Lung Metal (Fei Jin) of the Northwest Qian and West Dui trigrams. Kun (Earth) and Gen (Mountain) belong to Earth, representing the Spleen (Pi). They are controlled by the Liver Wood (Gan Mu) of the East Zhen (Thunder) and Southeast Xun (Wind) trigrams, and are nourished by the Heart Fire (Xin Huo) of the South Li trigram. Zhen (Thunder) and Xun (Wind) belong to Wood, representing the Liver (Gan). They are controlled by the Lung Metal (Fei Jin) of the Northwest Qian and West Dui trigrams, and are nourished by the Kidney Water (Shen Shui) of the North Kan trigram. Li (Fire) belongs to Fire, representing the Heart (Xin). It is controlled by the Kidney Water (Shen Shui) of the North Kan trigram, and is nourished by the Liver Wood (Gan Mu) of the East Zhen and Southeast Xun trigrams.

Since Qian and Dui belong to Metal, Metal controls Wood. Since Wood is controlled, it becomes weak and cannot generate Fire; therefore, Metal is not counter-controlled by Wood, which predicts a favorable outcome. Both Zhen and Xun belong to Wood, but why is Xun heavier and Zhen lighter? This is because Xun is close to Li Fire. Fire generates Earth, and Earth controls Kidney Water, leading to the exhaustion of the Primordial Spirit (Yuan Shen). Thus, seeing lesions in this area first is ominous. If lesions first appear in the Li Palace, excessive Fire will inevitably damage Water; if not damaged, Fire will reverse and attack upwards, making it a critical condition. However, if the lesions appear moist and spirited, indicating the intersection of Water and Fire, the omen turns from bad to good. If lesions first appear in the Li Palace and later in the Kan Palace, but the Kan Palace lesions are lustrous while the Li Palace lesions are dull, this indicates that the Heart Fire of the South is overcome and controlled by the Kidney Water of the Kan center. Without fire under the cauldron, how can the contents cook? Therefore, the pus cannot mature, leading to death, which is ominous. Other cases can be inferred by analogy. One should also consider the density of lesions in various areas and their color to make a judgment, ensuring accuracy.