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In the entire course of smallpox (Dou Chuang), tranquility is most prized. However, the causes of restlessness (Fan Zao) differ significantly throughout the stages. If restlessness occurs at the initial stage, it is caused by heat-toxin attacking internally and scorching the Zang-Fu organs; thus, as the rash emerges and heat resolves, the condition will resolve spontaneously. During the stage of swelling and pus formation, if fever and restlessness recur, this indicates the steaming process for pus formation; it must continue until the pustules are full, pain ceases, and fever subsides. After pus formation, toxins should be fully resolved, Zang-Fu functions harmonious, and spirit refreshed, making tranquility especially appropriate. If sudden restlessness and insomnia occur, one must examine the appearance of the pustules. If there is abundant but clear, thin pus that is not yet full, this indicates toxin remaining inside, unable to fully emerge; treatment should employ methods to support the interior and assist pus formation. If pus is formed and full, and dryness results from fever leading to scabbing and hardening, this is a normal progression; treatment should clear heat and nourish Yin. If the pustules are too dense, causing blood and heart deficiency after pus formation, leading to empty restlessness and insomnia, this is due to Yin failing to contain Yang; treatment should clear the Heart and nourish Blood. Although this condition appears mild but is actually severe, if it persists despite medication, both the Heart and Spleen meridians will be damaged by heat-toxin. Consequently, restlessness leads to thirst, thirst leads to diarrhea, and diarrhea leads to teeth chattering and shivering, immediately bringing about the dangers of itching, collapse, and internal invasion of toxins.

According to theory: The Taiyin Spleen Meridian governs flatus (Shi Qi). The Foot-Yangming Stomach Meridian governs abdominal distension. Abdominal borborygmi accompanied by flatus indicates Spleen failure and the downward escape of Grain Qi. Intestinal rumbling indicates Stomach failure and the sinking of Middle Qi. For patients with smallpox, these symptoms are inappropriate; along with diarrhea, they are considered fatal signs. Thus, it is said: intestinal rumbling and flatus indicate the depletion of the vital Qi of the intestines and stomach. Treatment greatly benefits from tonifying the Middle Jiao, assisted by lifting methods.

The head is the convergence point of all Yang meridians; due to the upward steaming of toxic vapors, it feels warm. The six meridians of the feet belong to Water, Earth, and Wood elements. Specifically, the Three Yang Meridians of the Foot: Taiyang Bladder Meridian belongs to Water, Yangming Stomach Meridian belongs to Earth, Shaoyang Gallbladder Meridian belongs to Wood. The Three Yin Meridians of the Foot: Taiyin Spleen Meridian belongs to Earth, Shaoyin Kidney Meridian belongs to Water, Jueyin Liver Meridian belongs to Wood. When Water is cold, it freezes; when Earth is cold, it cracks; when Wood is cold, its branches and leaves wither. Coldness in the feet indicates the extinction of Yang Qi. Therefore, coldness extending above the knees is considered incurable. However, there are cases where Fire is constrained in the upper body causing cold feet. In excess patterns, clearing the upper Heat allows Fire to descend naturally; in deficiency patterns of the lower Jiao, warming the lower region allows Fire to return to its source, warming the feet. One cannot rigidly adhere to the previous assertion that such cases are incurable.