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Smallpox originates from the five zang organs (solid organs), which belong to Yin; therefore, it should first appear on the head and face, with a sparse eruption being auspicious. Measles originates from the six fu organs (hollow organs), which belong to Yang; therefore, it should appear more abundantly on the head and face, with pale granules indicating recovery. Smallpox is considered optimal when it erupts successively over three or four stages, whereas measles is considered miraculous when it erupts all at once and then quickly subsides. When illuminated by fire, if the entire body resembles a coating of cinnabar, this is a sign that the rash is about to emerge. The morphology is fine and dense, with bright red spots appearing, resembling dense smallpox, but unlike smallpox which gradually enlarges, these rashes appear and disappear simultaneously. They form distinct granular sores, unlike macules where the skin turns red in patches like mosquito bites. However, the color of measles and smallpox cannot be discussed identically. Smallpox most abhors a complex, bright redness, while measles prefers a uniform thorough redness. This is because measles emanates from the Heart; red is the true color of Fire. If the color is pale white, it indicates insufficiency of Heart Blood, and one should primarily administer Yangxue Huaban Tang (Blood-Nourishing Macule-Transforming Decoction). If the color is too bright red or slightly purple, it indicates Heat in the Blood. In cases of excessive eruption, Daying Tang (Great Blue Decoction) should be used for all such conditions. If the color is black, it signifies a fatal condition. If there is no epistaxis (nosebleed), the pathogenic factor resolves through nasal discharge, which is actually an auspicious sign.

The emergence of measles resembles both smallpox and macules, which needs no further elaboration. Furthermore, during fever caused by transformation and evaporation, red spots are commonly seen. This occurs because the couli (pores/skin texture) are open and the muscles are tender, with Heat in the Blood manifesting as boiling heat visible on the muscle surface. Although this resembles measles, the treatment method should only focus on harmonizing Qi and Blood, without the need to release the exterior. When convulsions due to wind (Jingfeng) subside, red spots may also appear; this indicates that Qi and Blood have harmonized and the pathogenic factor is dissipating, serving as a sign of recovery. If the skin itches extremely, and scratching results in swollen, purulent lumps resembling cloud patterns, this is Wind-Heat combined with Dampness, manifesting as erysipelas or urticaria, neither of which falls under the category of measles. Generally, fever followed immediately by eruption indicates measles, while fever followed by difficulty in eruption indicates smallpox, revealing the depth of the toxin. Historically, the eruption of measles was standardized within six shichen (twelve-hour periods); emerging in the morning and receding by evening, appearing at dusk and disappearing by dawn. Why do current cases take two or three days of fever before eruption, or even four to five days, and require two to three or three to four days to resolve? This is because ancients lived simply and moderately, possessing light internal toxicity; thus, even when contracting seasonal toxins, they were easily transmitted and resolved. Modern people consume rich, greasy, fried foods, suffer from irregular climate adaptation, have thin innate vitality, and harbor deeper toxins. Therefore, upon slight contact, the condition becomes deep and latent. Thus, the measles are the same, but the individuals differ. If residual heat persists after measles, transforming into sha-lao (sha-tuberculosis), considering that the initial eruption severely injures the Blood, and prolonged residual heat exhausts the remaining Yin, how can one control the hyperactive Yang without vigorously nourishing Water (Kidney Yin)?