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Yang Dou (pox-like rash resembling smallpox) is like brothers and sisters in one family; if there are several younger sisters, or if an elder brother contracts smallpox and it spreads to the younger brother, resulting in only a few spots appearing on his body, this is not his own genuine smallpox, but what is referred to as "Yang Dou." If pox lesions appear first at the "biao" (superficial level or specific peripheral sites), this is transmitted from the internal meridian positions, and it cannot be viewed in the same light as those acquired through contact transmission. It is erroneous for people to regard all such cases as Yang Dou. When an elder brother infects a younger brother, an uncle infects a nephew, an elder sister infects a younger sister, or a male infects a female, the originator of the infection possesses righteous qi that is not deviant; conversely, it is a "ni" (reverse/abnormal) pattern. Can one fail to distinguish between favorable and reverse patterns of Yang Dou?

Generally, it is auspicious if sores and rashes manifest in only one type. Even if mixed forms occur, they require detailed analysis. For instance, if pustules appear first followed by maculopapular rashes, this indicates the generating relationship between the Spleen and Lung, which is a favorable ("shun") pattern. If rashes appear first followed by macules/purpura, this indicates the generating relationship between the Heart and Spleen, which is also favorable. If vesicles appear first followed by rashes, this indicates the Liver overcoming the Spleen, which is an unfavorable ("ni") pattern. If pustules appear first followed by macules/purpura, this indicates the Heart overcoming the Lung, which is unfavorable. If pustules appear first followed by vesicles, and the quantity is small, it signifies that Metal and Wood are both obtained, making it difficult to be fatal, which is favorable. If the quantity is large, it signifies Metal overcoming Wood, or Wood exploiting the decline of Metal, which is unfavorable. If vesicles appear first followed by macules/purpura, and the quantity is large, it signifies Fire exploiting the decline of Wood, which is unfavorable. If the quantity is small, it signifies the child being weak while the mother is prosperous, which is favorable. Manifesting pustules in Spring, black depression in Summer, macules/purpura in Autumn, and rashes in Winter are all unfavorable patterns. However, once sores and rashes have erupted, their favorable or unfavorable nature can be categorized into three types: temporal favorable/unfavorable, where favorable conditions exist in Spring and Summer due to the rising of Yang Qi, while unfavorable conditions prevail in Autumn and Winter due to the hiding of Yang Qi; deficiency-excess favorable/unfavorable, where constipation with ability to eat indicates Excess and Favorable, whereas free bowel movements and inability to eat indicate Deficiency and Unfavorable; and exit/entry favorable/unfavorable, where the eruption of sores and rashes is Favorable, while involution (inward collapse) and depression are Unfavorable. This is a brief overview. Furthermore, if rashes appear first and are accompanied by eruptions resembling chickenpox, it is definitely genuine smallpox. Because the rashes consume Ying Blood (nutritive blood), the color appears white like chickenpox. However, by dispersing the rashes and subsequently nourishing the Ying Blood, the rashes will dissipate and the smallpox will form naturally. One must not mistake them for chickenpox, as rashes never accompany chickenpox.