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When fever occurs, if the head and face are uniformly red like rouge, death will occur within six days. During the initial stage of fever, if a fire is used to illuminate the area between the heart and the navel, or the skin and flesh all over the body, and there are patchy red areas, it is incurable. When fevering, if the body is not very hot, but the abdomen is distended, eyes are closed, there is mania, extreme thirst, and dry, cracked lips and tongue, this indicates that the root of the toxin is in the interior, which is ominous. When fevering, if the head is warm but the feet are cold, accompanied by stupor, dullness, and thirst for drinking, it is ominous. When fevering, if a woman's menstruation does not stop, it is ominous. If the body is as hot as fire, eyes are red, lips and mouth are purple-black and cracked, and the tongue is dry with prickles, it is incurable. When fevering, if rubbing the face causes the color to turn white upon rubbing and then red again immediately after stopping, this is called "blood circulation," and even if the condition is severe, survival is possible. If rubbing does not make it white, and lifting the hand does not make it red, this is called "blood exhaustion," and even if the condition is mild, death will occur. During the initial fever, if there is severe abdominal pain or lower back pain as if beaten by a stick, it is incurable. During the initial fever, if fresh blood flows continuously from the seven orifices and the two excretions, regardless of the stage, death will occur. When fevering, if purple-black spots appear immediately, it is incurable. In the early stage of fever, if the chest is elevated and the face is swollen/protruding, it is incurable. During the initial fever, if the tip of the tongue is slightly black, or there is hoarseness, choking sensation, and coma, it is incurable. During the initial fever, if there is abdominal pain accompanied by purulent bloody diarrhea, it is incurable. When fevering, if a woman miscarries and bleeding does not stop, or if the fetus has not miscarried but high fever persists, both are ominous. Before the eruption of smallpox/variolae, if the base color along the lesions appears black, it is ominous. During the initial fever, if vomiting and diarrhea contain roundworms (Ascaris), it is incurable. On the first day of fever, if red spots appear densely like silkworm eggs, are dark purple and dry, and do not feel raised when touched, death will occur. If the eruption is desired but does not emerge, passing five days or seven weeks will be difficult.

For releasing the exterior, physicians often use a stabilized formula; ancients specifically advocated Ge Gen Tang (Pueraria Decoction). If one can adapt flexibly and know how to add or subtract, why establish multiple formulas as rigid guidelines? Jie Biao Sheng Ma Tang (Exterior-Releasing Cimicifuga Decoction) is excellent; even if red macules are seen, what harm is there in taking it? Contemporary physicians are inflexible and lack adaptability, refusing to try it once variolae take shape. Before variolae/rash form, fever occurs; how to distinguish auspicious/inauspicious and severity? Mild heat with little toxin suggests auspiciousness; severe heat with much toxin suggests inauspiciousness. Abdominal pain during fever, intermittent and unbearable, indicates toxin/warm pathogen invading the Zang-Fu organs. If dispersing and unblocking reduces pain, beware of collapse/internalization which may change severely.
Fever with lower back pain is most surprising, indicating transmission from Bladder to Kidney becoming malignant evil. Urgently disperse and drain water-dampness in Yin; do not wait until disaster strikes to sigh.
Fever with delirium as if seeing ghosts, unclear consciousness, toxin in the interior. Dispersing evil and reaching the exterior is a divine prescription; cooling medicines calming the Heart prevent variolae from erupting.
Body feels steaming hot with cold extremities, often accompanied by vomiting/diarrhea due to Spleen deficiency and weakness. Tonifying the Middle and releasing the exterior should be done together; when exterior and interior are harmonious, toxin is penetrated and discharged.
Fever with slight sweating all over the body indicates harmony of Yin and Yang, a joyful state. Heat decreases through sweat, toxin exits; however, profuse sweating with burning body is another disaster.
High fever with aversion to wind/cold resembling malaria, struggle between pathogenic and righteous Qi, deficiency of Ying and Wei. Do not wrongly suspect chills; mistakenly using large warming substances on the body as medicine. At the beginning of fever, teeth grinding occurs, indicating heat obstruction in Heart and Liver, a lamentable situation. Early differentiation of syndrome and application of methods are crucial; do not blame falling flowers towards the east wind.