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Blood pox (Xuedou) refers to a condition where Qi deficiency occurs first, preventing Qi from reaching the surface. Consequently, within five days before eruption, blood carries toxic pathogens inward, causing intense heat and fire in the Zang-Fu organs leading to internal attack. This is akin to the kernel rotting when the fruit rots; it is considered incurable in worldly medicine. Sunken pox (Xiandou) refers to a situation where Qi reaches but is insufficient, failing to sustain subsequent pus formation. Thus, after seven days, blood becomes rebellious and fails to adhere, preventing toxins from transforming into pus for external shedding. This is like good water lacking an epidermis. However, although Qi arrival is insufficient, if blood adhesion is strong and support is adequate, even if success is lost by one basketful at nine ren's height (a metaphor for near-complete failure), recovery is still possible.

A sunken apex indicates Yang deficiency and Yin excess. Generally, the five types of sinking occurring around the seventh day are due to insufficient Qi failing to constrain blood, resulting in blood overpowering toxins and hindering pus formation. Baoyuan Tang (Preserve the Origin Decoction) should be used, added with Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Glutinous Rice (Nuomi) to warm the Stomach and assist Qi. Washing with a decoction of Populus euphratica leaves (Shuiyang) can lead to sufficient pus by the eleventh or twelfth day. If the blood and Qi appear lustrous and there is a tendency to rise, over-treatment should be avoided to prevent excessive force from harming the entire body. If the blood appears dead like ash, pus is insufficient, or although blood adheres, it lacks nourishment and is accompanied by internal symptoms, life cannot be guaranteed.

Inverted sinking occurs when the pox has formed a complete circle, is full and plump, and is in the stage of pus formation, but suddenly, due to diarrhea, internal deficiency causes Qi to sink. Consequently, toxins also sink along with the Qi and Blood. This is a sign of separation between Qi and Blood dynamics, indicating both internal and external deficiency, hence the transition from fullness to sinking. If blood does not scatter but adheres clearly, the power of Defensive Qi (Wei Qi) remains, suggesting there is still hope for rescue. If blood disregards this and toxins invade internally, disaster arises from within, making rescue difficult. Furthermore, the harsh use of dispersing and detoxifying agents may damage Yuan Qi; thus, when the medicinal effect wanes, Qi, Blood, and toxin trends may sink and lie latent.

Internal ulceration occurring within seven days of eruption indicates rotting of the Stomach. This is typically caused by Wind-Cold invasion, which solidifies the Cou Li (pores/skin texture), blocking the separation of Yin and Yang. Consequently, Qi cannot constrain Blood, and Blood cannot carry toxins outward. Toxins then attack internally within the Zang-Fu organs, where toxic fire blazes, leading to ulceration and pus formation. The diagnostic sign is that the lips, mouth, and tongue turn white. Therefore, wise practitioners, upon observing signs such as rough breathing, high fever, acute abdominal pain, and body tremors during the pre-eruption phase when Wind-Cold obstruction is present, should urgently prevent this complication. Using formulas like Shengma Tang (Cimicifugae Rhizoma Decoction) to disperse Cold pathogens and open the Cou Li allows toxins to exit via sweating, thereby avoiding such conditions.