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The head is the convergence point of all Yang meridians, and the face is the manifestation of the Heart's splendor. Smallpox (Xiaochu) is a Yang toxin governed by the Heart; therefore, sparse lesions on the head and face indicate a mild condition, dense lesions indicate a severe condition, pre-swelling of the head and face indicates a critical condition, and lesions that are broken, suppurating, and foul-smelling indicate a dire prognosis. Thus, in ancient times, the severity of smallpox was judged primarily by the head. Moreover, within the body, the Heart is the monarch, and externally, the head is the chief. Diseases such as True Heart Pain (Zhen Xintong) and True Headache (Zhen Toutong) are considered incurable, demonstrating that the head and face must not be lightly offended. The *Classic* states: "The head is the mansion of clarity and spirit; if the head hangs low and the eyes are sunken, the spirit is about to be seized." Therefore, when prognosticating life and death, nothing is more important than observing the head. It is also said that the Twelve Primary Meridians and the three hundred and sixty-five collaterals all ascend to the face and open into the orifices. The Liver opens into the eyes, the Lungs into the nose, the Spleen into the mouth, and the Heart and Kidneys open into the ears. The face has seven orifices and internally corresponds to the Heart. Thus, if dense lesions cause the closure of the seven orifices and disfigurement of the face, it is a bad omen, indicating that the Qi of the Zang-Fu organs and meridians is diseased. When smallpox first appears, it typically marks other areas before gradually ascending to the head; this progression applies to its eruption, suppuration, and crusting (Shouye). If the head and face are uniquely sparse, or if the two zygomatic arches and cheeks appear first and gradually spread to the forehead corners, these are all auspicious signs. However, if lesions appear first between the head and forehead, crust over first, dry up first, or break first, this is called "toxin invading the Yang position." If the lesions are densely packed without gaps, with subcutaneous edema and rough, raised skin texture, these are all ominous signs. If lesions on the entire body crust over first, while those on the head and feet crust late, or if pus breaks spontaneously due to heat, or piles up and aggregates, do not be surprised. This follows the transformation of Heaven and Earth: solitary Yang cannot generate, solitary Yin cannot grow; Yang changes and Yin combines, mutually supporting each other. The head is the convergence of all Yang; without Yin to assist it, maturation is difficult. Treatment should nourish Yin to assist Yang, after which crusting will occur naturally. If the eyes are closed, the head shakes, scabs fall off, and the breath is foul, the Heart meridian pulse has ceased. Similarly, head swelling without corresponding lesion swelling is incurable.

The face is where all Yang meridians gather. Since smallpox is a Yang toxin, upon initial eruption, like fire tending toward dryness, it must first appear on the face. However, different locations have vastly different prognoses. The forehead belongs to the Heart and the Li Fire position; Fire nature is urgent and fierce, so it must not be lightly offended. If toxin erupts from the Heart, it first appears at the ruler's position; if dangerous, the twelve officials (Zang-Fu organs) will all be endangered. If vesicles, pustules, and crusting begin first on the forehead, it is inauspicious. The left cheek belongs to the Liver and the Zhen Wood position; the right cheek belongs to the Lungs and the Dui Metal position. In these two areas, regardless of order, if they are red, sparse, clear, firm, and thick, it is auspicious. If they are blurred into clumps, floating, tender, easily broken, ulcerated, and swollen, it is inauspicious. If they are black, depressed, dry, cold, and hard like wood blocks, it is incurable. The Liver stores the Hun (Ethereal Soul), and the Lungs store the Po (Corporeal Soul). If both Liver and Lungs fail, both souls depart. Thus, if both cheeks become cold or woody-hard, death ensues. If the tip of the nose (Zhuntou) erupts and crusts first, it is inauspicious. The nose belongs to the Spleen, which governs Earth; the four Zang organs receive orders from the Spleen. If toxin erupts from the Spleen, the four Zang organs follow and fail. If the cheeks resemble rouge or orange peel redness but do not elevate, it is unfavorable. The chin belongs to the Kidney and the Kan Water position. If lesions here erupt first, become robust first, and crust first, it is auspicious. Smallpox emerging from the Kidney is auspicious; entering the Kidney is inauspicious. The Three Yin and Three Yang meridians all converge here, so when Yin and Yang harmonize, eruption occurs naturally. However, the ears are also Kidney orifices, and other signs should not appear first. This is because location and orifice differ, and since the Heart also opens into the ears, Ministerial Fire and Sovereign Fire are active. Their burning intensity, even if suppressed, causes harm. If the area around the lips and the cheeks erupt, rise, and crust first, it is highly auspicious. The Yangming meridians surround the mouth and lips, governed by the Stomach and Large Intestine, which accumulate and transform, possessing abundant Qi and Blood. The lips and mouth are the Water Star, and the chin and cheeks belong to Kidney Water. Fire is controlled by Water, preventing it from running rampant, hence it is auspicious. Although the hands and feet belong to the Spleen and are the root of all Yang, they are servants of the body, like low-ranking soldiers, unlike the head and face which are the chief and must not be offended. Furthermore, residing at the four extremities, they are inferior to the chest and diaphragm where the Heart and Lungs reside, the abode of Spirit. Thus, even if dense, they pose little danger. If they erupt, suppurate, and crust first, this indicates excessive Yang Fire; treatment should use detoxification to suppress Yang and support Yin. If they erupt and crust slightly late, this conforms to the seasonal timing. If too delayed, this indicates Spleen and Stomach deficiency, unable to circulate Qi and Blood to the extremities. Treatment should strongly tonify the Spleen Yuan to prevent complications such as water blisters, itching, and collapse.