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In cases of variola (smallpox) with Qi deficiency, some patients suffer from spleen and stomach injury due to improper dietary management involving cold or raw foods, leading to diarrhea. Consequently, body fluids sink downward while deficient fire flares upward, inevitably causing thirst. Additionally, with sinking of primordial Qi and upward rushing of deficient Yang, the Qi in the lower jiao fails to continue, inevitably causing panting and thirst. This differs from excess-type panting. However, symptoms arising after diarrhea are caused by sudden loss of body fluids leading to thirst, and Qi deficiency leading to panting. How could there be thirst due to excess heat and panting due to Qi stagnation arising after diarrhea? Therefore, for treating thirst, Shenling Baizhu Muxiang San (Ginseng, Poria, Atractylodes Macrocephala, and Amomum Powder) is appropriate. If diarrhea persists, Yigong San (Extra Efficacy Powder) should be administered. For treating panting, Renshen Dingchuan Tang (Ginseng Panting-Calming Decoction) is suitable. If panting, thirst, and persistent diarrhea occur simultaneously, Muxiang Yigong San (Amomum Extra Efficacy Powder) should be used. If the condition progresses to mental confusion, restlessness, and abdominal distension, it indicates that the toxin has attacked internally. With eyes closed and muttering to oneself, this is already termed "Shi Zhi" (Loss of Spirit). To still consider this an excess pattern is extremely absurd!

Disease patterns must prioritize primordial Qi. When primordial Qi is substantial, toxins are easily expelled and transformed. Thus, practitioners treating variola must protect primordial Qi before it becomes weak, preventing it from dissipating into an excess pattern. What are the treatment methods? First, strengthen the couli (interstices) and consolidate the muscle surface; second, regulate diet and preserve Spleen Earth. If the muscle surface is solid, there is no need to worry about external sinking complications; if Spleen Earth is substantial, there is no need to fear internal sinking complications. Furthermore, with the tonifying efficacy of Renshen (Ginseng), the head (and upright Qi) will naturally become substantial. When the rash erupts, it will naturally progress to pustule formation without generating complicated symptoms, leading to a smooth scabbing process. One must strictly prohibit cold-natured purgative agents such as Dahuang (Rhei Radix et Rhizoma), Huashi (Talcum), Cheqiancao (Plantaginis Herba), Shengdi (Rehmanniae Radix), Niuzbangzi (Arctii Fructus), Zicao (Lithospermi Radix), and Zhike (Aurantii Fructus Immaturus), lest they purge and moisten downward, thereby damaging the spleen and stomach. Once the spleen and stomach are injured, primordial Qi sinks downward, leading to Qi collapse and internal attack resulting in death. Moreover, one must strictly prohibit slippery and dispersing agents such as Niuzbangzi, Renya (Human Tooth), Chantui (Cicadae Periostracum), Mahuang (Ephedrae Herba), Gange (Puerariae Radix), Shengma (Cimicifugae Rhizoma), Zicao, Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), and Jingjie (Schizonepetae Spica), lest excessive dispersion leads to exterior deficiency. If the exterior becomes deficient, primordial Qi dissipates outward, leading to collapse, itching, exfoliation, and death. Whose fault is this!