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For severe cases of chickenpox (Shuidou), the symptoms resemble those of Cold Damage (Shanghan). The body fever persists for two to three days before the eruption appears, and its morphology differs from that of smallpox (Zhengdou). If the vesicle wall is not thin, the base is elevated with an areola, the head gradually becomes red and swollen, then turns white and yellow, contains pus, and heals slowly, it is called "Large Pox" (Da Dou). This represents a Interior Syndrome (Li Zheng) originating from the Zang organs. Conversely, if the vesicle wall is thin like water, the apex is bright like a pearl, or it dries into a crust immediately upon rupture, erupts without order, has a diffuse base without distinct borders, appears white or pale red, feels cool, and contains serous fluid, it is called "Skin Sore" (Fu Chuang), also known as Chickenpox (Shuidou). This represents an Exterior Syndrome (Biao Zheng) originating from the Fu organs. It resembles measles (Zhenzi) but is milder; thus, fever is accompanied by immediate eruption, which subsides quickly after appearing, making it easy to erupt and easy to crust over. Initially, excessive diaphoresis (inducing sweating) should be avoided; excessive sweating may transform the condition into a severe sore. Finally, excessive drying of dampness should be avoided, as it may hinder crusting. Only mild agents should be used to resolve the pathogen. If there are no other distressing symptoms, medication is unnecessary, and life will not be endangered. However, medical texts state: "In cases where chickenpox is mixed with black color and fails to erupt, or is entirely black, ten out of ten die." Although such entries exist in books, this type of pox has practically never been seen. These are likely malignant forms of true smallpox that cause death, which people mistakenly identify as chickenpox.

Macules/Purpura (Ban) often occur in epidemics caused by Heavenly Qi (Tianxing Shiqi). Patients suffer from persistent high fever and constipation. This indicates heat retention in the Stomach. Since the Stomach governs the muscles, the retained heat manifests as macules/purpura, constituting an Interior Syndrome due to Stomach heat. This must not be treated identically to measles; using dispersing agents recklessly can worsen the condition critically. The appropriate treatment is Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction), modified by removing Ginseng and adding Xuan Shen (Scrophulariae Radix) and Sheng Di Huang (Rehmanniae Radix). One must strictly avoid Five Acrids (Wu Xin: garlic, chives, leeks, scallions, and asafoetida) and glutinous rice, as these foods aid Stomach fire. For constipation, San Huang Wan (Three Yellow Pill) should be used to promote bowel movement. Red macules/purpura indicate a prognosis of ten deaths to one survival. Black macules/purpura indicate a similar fatal prognosis. Furthermore, there are cases where Yin-cold lies hidden internally, forcing rootless and unanchored floating fire to rise to the muscle surface, causing macular eruptions. This is a syndrome of extreme deficiency of Stomach Qi. Administering cold-natured medicines in such cases will lead to immediate danger; this must be clearly understood.

All essential principles regarding medication throughout the course of treating smallpox are detailed in the section "Flexible Application of Medications" within the "Supplementary Volume" (Buyi Men); please refer to that section.