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Grasses that bloom in the morning wither by evening, while pines and cypresses, due to their toughness, do not shed their leaves even in winter. This is because plants differ in hardness and brittleness; hard ones are difficult to damage, while brittle ones are easily injured. How much more so for humans? Their constitution varies in density (thickness/substance), and their Qi (vital energy) differs in strength! The toxin of smallpox/variolae (痘疮) prefers "mature/old" (lao) and dislikes "tender/young" (nen). Regarding color: if the lesion appears tenderly red like wax, this indicates the maturity/tenderness of the color. Regarding shape: if it is firm and compact or hollow and floating, this indicates the maturity/tenderness of the shape. Regarding pus: if it is thick and turbid or clear and light, this indicates the maturity/tenderness of the pus. Regarding scabs: if they are hard and thick or soft and thin, this indicates the maturity/tenderness of the scabs. However, the cause of maturity versus tenderness is governed by Wei Qi (Defensive Qi, a type of vital energy that circulates on the body surface and provides defense). The Classic states: "Wei Qi serves to warm the muscles, fill the skin, thicken the interstices (Couli), and control the opening and closing [of pores]." Therefore, when Wei Qi is strong, the muscle tissue is firm, the skin is thick, the interstices are dense, and the opening and closing functions are regulated. Thus, it can restrain and bind the toxin, preventing it from running rampant. Consequently, the lesions appear dark and waxy, the shape is tight and solid, the pus is thick and turbid, and the scabs are thick and hard. Naturally, they mature easily and crust over easily. Even if exposed to pathogenic wind or foul toxins, they cannot be harmed. Conversely, if Wei Qi is weak, the muscle tissue is brittle, the skin is thin, the interstices are loose, and the opening and closing functions are lost. Thus, it cannot withstand the toxin, allowing the toxin to act wildly. Consequently, the lesions appear tender and bright red, the shape is hollow and floating, the pus is clear and pale, and the scabs are tender and sparse. They break easily and crust over prematurely. Without waiting for external pathogenic winds or foul air, the lesions may already deteriorate. Hence, the maturity or tenderness of the lesions is determined by the state of Qi. As for redness, although it is the nature of Blood, Blood presents its color only when agitated by Fire. Without Fire, even if red, it must be pale. Those who identify redness as Heat in Blood refer specifically to deep red. As for the "tender" redness mentioned above, it arises because Qi is inherently deficient, leading to concurrent Blood deficiency. With very little Blood remaining, it is driven by rootless Fire, wandering within the skin. Because the vesicle cavity is not dense, although red, it appears tender, unlike white which signifies maturity.

All things remain still when they achieve balance, but become active when balance is lost. The Classic states: "When Yang Qi is still, it nourishes the Spirit; when soft, it nourishes the sinews." It also states: "When Yin Qi is still, the Spirit is stored; when dry/hot, it dissipates." Therefore, breathing should be even, speech should be minimal, sleep should be stable, and wakefulness should be peaceful. Seeking food when hungry, drinking sparingly when thirsty, groaning when touching the lesions, and crying out when desires are frustrated—these are signs of sufficient Qi and clear Spirit, resembling normal health, termed "Stillness" and auspicious. Stretching indicates bodily pain; muttering to oneself indicates unclear Spirit; panting indicates internal Heat; borborygmus (bowel sounds) indicates diarrhea; restlessness in sitting or lying indicates Heart vexation; incessant crying and calling indicate severe pain; head shaking indicates Wind; fingers wanting to scratch indicate itching; difficulty swallowing indicates sore throat; grinding teeth indicates Heat in the Heart and Liver. Severe cases involving confusion, agitation, delirium, dizziness, head shaking, neck twisting, flailing hands and feet, upward rolling of the eyes, chills with teeth grinding—all these are signs of death. However, if a patient was previously still but suddenly becomes agitated, with changes in lesion appearance but no other obvious symptoms, this is likely triggered by a virulent pathogen (Li Qi). On the other hand, closed eyes, faint breathing, stiff limbs, locked jaw, necrotic lesions, and unrousable coma are signs that True Qi is about to collapse and the Soul is about to depart; these must not be diagnosed as "Stillness."