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When variola (smallpox) and rubeola (measles) erupt, if the body heat is mild and spreads outward, the condition will inevitably be mild; if there is internal distress, confusion, irritability, and stagnation of pathogenic factors within, the condition will inevitably be severe. This is the natural progression of the disease's momentum. Therefore, the color of the lesions should be valued for being moist and lustrous, while dullness is disliked; brightness is valued, while dryness and roughness are disliked; a pale red hue is valued, while blackish stagnation is disliked; a round and clean shape is valued, while fragmentation is disliked; elevation is valued, while flatness is disliked; sparsity is valued, while density is disliked; the skin texture should be firm and solid, while vacuity and thinness are disliked. When the base of the pustule tightens, it helps distinguish between Yin and Yang aspects of the eruption. The appearance of spots should be active and flexible; edema is strictly contraindicated. The eruption should be uneven in timing (staggered), blood should return to its proper attachment, and fewer eruptions behind the ears, on the neck, chest, and heart area compared to other parts are preferable. Smoothness and luster without stagnation on the brow ridge, zygomatic arches, and forehead are ideal. If all eruptions appear simultaneously upon onset, the condition must be severe. Cases where sores are accompanied by rashes are considered half-mild and half-severe. Eruptions that are sparse with slight redness inside and out indicate a mild condition. Black exterior with red interior indicates slightly severe. White exterior with black interior indicates extremely severe. Black dots at the apex of the sores, resembling needle holes, indicate intense heat and extreme severity. Cyanosis, dryness, purple depression, lethargy, sweating, irritability, fever, thirst, abdominal distension, crying, panting, and constipation of both urine and feces indicate a critical state. Generally, if the color of the sores is lustrous and vibrant red, it indicates harmonious and vigorous Qi and Blood. If the color is dreary and dark, it indicates decline of Qi and Blood. When Qi is vigorous, Blood follows its command; when Qi declines, Blood is imprisoned by it. Without Qi, toxins cannot be contained; without Blood, toxins cannot be resolved. Indeed, the toxin of smallpox requires Qi and Blood to complete its course from beginning to end. However, a red color indicates the toxin is just beginning to emerge; white indicates the toxin has not yet resolved; yellow indicates the toxin is about to resolve; greasy yellow indicates the toxin is completely resolved. Grayish-white indicates Blood decline and Qi stagnation; scorched brown indicates exhaustion of Qi and Blood; scorched purple indicates fierce accumulation of evil toxins; black indicates toxin stagnation and drying of Blood. A change from red to white, or white to yellow, signifies survival. A change from red to purple, or purple to black, is an omen of death. There are also cases where Blood struggles with the toxin, forming a hollow shell; although appearing round and full, it is actually an empty, flaccid blister with withered white color. In cases where both Qi and Blood have separated, and the fire of the pathogen floats freely, although a red halo remains, Qi deficiency fails to sustain it, and Blood deficiency fails to transform it, leading to gradual withering and drying. These conditions require careful differentiation and should not be taken lightly.