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After the eruption of smallpox, if sweating or purging is incorrectly induced, and medicines such as Shengma Tang (Cimicifugae Decoction) and Dahuang (Rhei Radix et Rhizoma) are mistakenly taken, dietary restrictions are ignored, leading to overeating or starvation, consumption of raw and cold foods, excessive alcohol intake, reliance on witchcraft rather than medicine, sexual activity, exposure to foul odors, and contraction of wind-cold.

The patient refuses food and experiences excessive thirst (thirst with drinking but refusal to eat can be treated with Yihuang San [Yi Huang Powder] and Baizhu San [Atractylodis Macrocephalae Powder]). Teeth gnashing and jaw clenching occur (indicating either deficiency or excess, which can cause the lesions to sink inward). Aversion to cold, fatigue, and lethargy lead to the sinking of lesions, indicating Spleen deficiency. Restlessness and body heat (head shaking suggests impending wind-stroke). Vomiting and diarrhea (undigested food expulsion, and pus-blood in stool after smallpox). Lesions turn black and sink inward (absence of pus and blood inside, formation of black blisters, or initial lesions turning into black holes indicate death). Difficulty in urination and defecation (can be treated with Sanhuang Wan [Three Yellows Pill]). Abscesses and swelling blockages (smallpox toxin transforming into sores, bad breath, erosion of lips, mouth, nose, and tooth loss indicate death). Panting, urgency, profuse phlegm, hoarseness, and Qi obstruction (symptoms occurring during eruption or after smallpox usually indicate death). Swallowing medicine or food accompanied by borborygmus indicates death.
All the above are critical conditions, fearful from beginning to end. Apart from these, there are no hindrances. If internal factors violate two rules: if diet remains normal, even if the condition is severe, medical treatment can lead to survival. If diet decreases to half of the usual amount, death ensues. If diet remains normal but internal factors violate three or four rules, death also ensues.

Smallpox lesions exhibit four colors: wax-yellow, red, white, and black, which are primary indicators of auspiciousness or inauspiciousness, requiring careful differentiation. Why? Wax-yellow is greenish-yellow, the correct color of the Central Earth. Smallpox presenting a wax-yellow color is an auspicious omen. Red represents the image of Southern Fire and the Heart. Excessive Fire results in redness, an inauspicious path. One should resolve Heart heat, using formulas like Liangxue Xijiao Dihuang Tang (Cool Blood, Rhinoceros Horn, and Rehmannia Decoction). White represents the image of Western Metal and the Lung. Lung Qi deficiency results in whiteness; severe deficiency leads to sinking and hiding. Smallpox presenting white and sinking is an inauspicious path. One should greatly tonify Qi and Blood, using formulas like Baoyuan Tang (Protect the Origin Decoction) added with Shengjiang (Fresh Ginger), Rougui (Cinnamon Bark), and Fuzi (Prepared Aconite Root). Black represents the image of Northern Water and the Kidney. Kidney Water is insufficient to control Fire evil; extreme Fire transforms into black resembling Water. Commonly said as "black transformation returns to the Kidney." Smallpox presenting black and sinking is an inauspicious omen. One should resolve toxicity. For prolonged constipation, Baixiang Wan (Baixiang Pill) or Xiao Chengqi Tang (Minor Order the Qi Decoction) should be used to purge. For severe deficiency, Baoyuan Tang added with Guizhi (Cinnamon Twig) and Chuanxiong (Ligusticum Rhizome), following the heat to treat it, are examples.
Wang's *Libian* states: The five colors are the essence of the Five Elements. When regular, they are bright and clear; when declining, they are dim and dark. The prosperity or withering of the Zang organs can be seen here. Therefore, for smallpox toxin emerging from the Zang organs, brightness is favorable, while darkness is unfavorable. Brightness indicates robust Qi and Blood. Dimness indicates deficient Qi and Blood. When Qi position is robust, Blood follows its command; when Qi position declines, Blood is imprisoned. Without Qi, Blood cannot收 (collect/resolve) the toxin; without Blood, Qi cannot transform the toxin. Indeed, smallpox toxin requires Qi and Blood to achieve success from start to finish. Moreover, red indicates the toxin is just emerging. White indicates the toxin has not dispersed. Yellow indicates the toxin is about to resolve. Dry yellow indicates the toxin is completely resolved. Gray-white indicates Blood deficiency and Qi stagnation. Black indicates toxin stagnation and Blood dryness. Scorched and exhausted indicates depletion of Qi and Blood. Changes from red to white, or white to yellow, are auspicious. Changes from red to purple, or purple to black, are inauspicious omens. Furthermore, the toxin emerges from the Five Zang organs, not just one. Predecessors stated that each Zang organ governs a specific color, which is true, but they did not record treatment methods for each Zang. Qian Yi and Chen Zhongwen's discussion on "black transformation returning to the Kidney" is overly theoretical.
Chunfu harmonizes the five colors with the five Zang organs, which is the most appropriate principle. However, *Libian* states that the toxin emerges from the Five Zang organs, not just one; precisely because if the disease in one of the Zang organs is severe, the manifestation of that specific Zang will appear prominently. It also states that Qian Yi and Chen Zhongwen's theory of "black transformation returning to the Kidney" is overly theoretical, implying *Libian* lacks detailed differentiation. In fact, any blackening is due to extreme Fire, causing Kidney Water to weaken and fail to control Fire, hence the black color. How can the responsibility not fall on the Kidney? It is acceptable to say it does not record formulas for the five Zang, but calling it a fallacy shows *Libian* fails to think deeply. I have always combined the five Zang to formulate prescriptions, with no failure in efficacy. Therefore, I record these methods in the differentiation of the four colors to complete the full discussion. Physicians should examine this carefully.