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1. After the pustules have been swelling for three days, if the base of each pustule is ruddy and red, filled with pus, and yellowish like beeswax, with normal urination and defecation, and no reduction in appetite, this is an auspicious sign; no purgative medicine is needed. If the color is red, purple, or black, accompanied by hoarseness, death ensues.

2. When the pustules are maturing into pus, if they contain only clear fluid, with thin white skin resembling a water blister, and the patient scratches them all over the body until death occurs within three to four days.

3. When the pustules are maturing into pus, if the pustules are dry and shriveled with no blood or fluid inside, this is called "Empty Pustule Disease" (Kong Chuang Dou), which indicates a fatal prognosis.

4. When the pustules are maturing into pus, if there is incessant vomiting and diarrhea, or bleeding from both urine and stool, indigestion of milk and food, and the pustules are ulcerated without pus, this indicates a fatal prognosis.

5. When the pustules are maturing into pus, if there is obstruction of urination and defecation, closed eyes, hoarseness, abdominal distension, and blackening of the muscles, death ensues.

Generally, on the tenth day, or the eleventh and twelfth days after onset, when the pustules begin to scab over (Shou Ye), progression from top to bottom is considered favorable (Shun), while progression from bottom to top is unfavorable (Ni). Even if the entire body has scabbed over, if a few spots fail to scab, it can still be fatal, similar to a snake shedding its skin: if one segment fails to shed due to injury, the snake dies.

On the eleventh or twelfth day, if the pustules gradually scab over starting from the mouth, lips, head, and face down to the feet, this is favorable, and medication is not required. If other symptoms appear, treatment should then be discussed.

If the pustules fail to scab over when they should, accompanied by diarrhea, chills, teeth grinding, and scratching until broken, this is a deficiency-cold syndrome; administer Yi Gong San (Isolated Efficacy Powder).

If triggered by foul pathogens or cold invasion, resulting in black sunken pustules that fail to scab, decoct Yi Gong San (Isolated Efficacy Powder) and mix with Wu Jia San (Priceless Powder) for administration. For external itching, fumigate with Qu Hui San (Remove Filth Powder) externally.

If excessive use of hot medicines leads to rampant heat-toxin and hyperactive Qi and Blood, causing pustules to ulcerate and fail to scab, internally administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Zhu Wei Gao (Pig Tail Paste) to resolve the toxin, and apply Bai Cao San (Defeat Grass Powder) externally.

If the pustules were previously fully erupted and matured with sufficient pus, and the detoxification was already cleared, but during the scabbing stage, external pathogenic factors cause the lesions to sink and stagnate, becoming ulcerated, itchy, collapsed, and failing to scab, simply administering Yi Gong San (Isolated Efficacy Powder) will lead to self-healing. Although the sores may not rise, there is no need to worry.

If all pustules have scabbed over except for a few that are foul-smelling and ulcerated, deeply depressed, and failing to close, apply Xiao Dan Gao (Nitre Gall Ointment).

If the pustules fail to scab over, accompanied by rapid breathing, phlegm rising, hoarseness, closed eyes, and lack of spirit, death ensues. Red scars after scabbing are auspicious. White or bloody-colored scars indicate that toxins have returned inward, raising concern for residual complications.

After the pustules have scabbed over, Qi and Blood are greatly deficient, and the muscles are tender and unable to withstand wind and cold. One must strictly avoid exposure to wind and cold. Negligence in cooling off can lead to mild cases of internal attack by residual toxins, or severe cases of wind-stroke paralysis, which is critical. Beware, beware.

If the scabs are dry and itchy, reluctant to fall off, or if the scabs have fallen but the color is dark, or if the surface is convex or concave, or if the sore has healed but the scab remains, apply an appropriate amount of Bai Sha Mi (White Sand Honey) to the sores. This facilitates easy removal of scabs, prevents purple-black scarring, avoids odor, and is highly effective.

During the period between scabbing and healing, when the Five Zang organs are unstable, muscles are weak, and Qi and Blood have not yet stabilized, sudden exposure to wind and cold at the skin and interstices causes stagnation of body fluids, leading to Gan Shi Chuang (Gan Eroding Sores). Treat with Xiong Huang San (Realgar Powder) and Mian Jian (Cocoon) etc. If prolonged and unhealed, it may erode bone and damage tendons, harming the person.

For children, smallpox/rash requires twelve days from eruption to scabbing to ensure safety. Raw water should not be given from start to finish; boiled warm water is acceptable. If raw water is mistakenly given, after scabbing, the scabs may fall late, or abscesses may form on the body. If punctured, these become Gan Shi Chuang (Gan Eroding Sores) with continuous pus discharge, potentially leading to yellow face and white lips, making cure difficult. Why? The Spleen and Stomach belong to Earth and govern the muscles externally. Excessive drinking damages the Spleen and Stomach with dampness, which binds to the muscles. When Spleen/Stomach and muscles are weak, fluid flow decreases, Ying and Wei Qi become stagnant, and Qi and Blood cannot circulate freely, condensing and not dispersing. Thus, scabs fall late and abscesses form.

The Yellow Emperor asked: What is the Yin-Yang distinction in drinking? Those who prefer cold drinks do not feel the cold even of ice and snow; those who prefer hot drinks do not feel the heat even of boiling water. Qibo replied: In cases of Yang excess and Yin deficiency, drinking cold does not feel cold; in cases of Yin excess and Yang deficiency, drinking hot does not feel hot. How to treat? Therefore, for Yang excess, tonify Yin deficiency using Mu Xiang San (Aucklandia Powder) added with Ding Xiang (Clove) and Rou Gui (Cinnamon Bark); for Yin excess, tonify Yang deficiency using Yi Gong San (Isolated Efficacy Powder) added with Mu Xiang (Aucklandia) and Dang Gui (Angelica Sinensis), adding one qian per liang of herbs. Yi Gong San (Isolated Efficacy Powder) dispels wind-cold-damp bi, harmonizes Yin and Yang, nourishes Qi and Blood, facilitating eruption and scabbing of rashes, preventing itching and collapse. Mu Xiang San (Aucklandia Powder) is warm and neutral, harmonizing interior and exterior, promoting fluid circulation, clearing the upper and solidifying the lower, assisting Yin and Yang. It effectively treats pediatric abdominal distension, diarrhea, and thirst, with miraculous efficacy, too numerous to detail. Generally, all things in heaven and earth sprout in spring and grow in summer due to the steaming of Yang Qi. In rash diseases, if the Zang-Fu organs are harmonious, Qi and Blood are substantial, leading to easy eruption and scabbing, primarily because the exterior is kept warm and the interior lacks cold qi.