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The Lung governs Qi. If Qi is insufficient, it leads to the following three syndromes: spontaneous sweating (Zihan), inability to vocalize (Shengbuchu), and sunken crust tops (Chuangding xianta). All these are suitable for treatment with Shiqi San (Ten Miracles Powder). (If spontaneous sweating is severe, double the amount of Huangqin [Scutellariae Radix]; if unable to vocalize, double the amount of Jiegeng [Platycodonis Radix].)

The Heart governs Blood. If Blood is insufficient, it leads to the following three syndromes: ash-gray or white color (Huibaise), non-red roots (Genge buhong), and lack of luster (Bu guangze). All these are suitable for treatment with Xionggui Tang (Peony and Angelica Decoction) added with Shaoyao (Paeoniae Radix), Zicao (Arnebiae Radix et Rhizoma), and Honghua (Carthami Flos), which yields excellent results.

[Qian Yi] Regarding variola and rubeola, one must carefully distinguish their severity. If they erupt all at once upon onset, the condition is necessarily severe. Variola mixed with rubeola indicates a moderate severity. Sparse eruption indicates mildness. Plump, red, and lustrous both inside and out indicates mildness. Black outside and white inside indicates slightly severe. White outside and black inside indicates very severe. Crust heads that are black inside like needle holes indicate intense heat. Cyan, dry, black, and sunken crusts, accompanied by drowsiness with incessant sweating, restlessness, thirst, abdominal distension, crying and wheezing, and obstruction of urination and defecation, indicate a critical and difficult condition.

During variola and rubeola, the nursing mother must observe dietary restrictions. The infant must not be allowed to become hungry or exposed to wind-cold; otherwise, the pathogen will return to the Kidney, turning the crusts black, making them difficult to treat. [Hai Zang] In cases where extreme heat reversely combines with water transformation (Hanxiang), it can also lead to blackening. One should primarily use cooling herbs. This must not be overlooked; pulse diagnosis can differentiate it. In cases where the eruption color appears normal but there is pre-existing internal heat, the head may reverse into depression, with colors appearing grayish-blue or black-like, featuring needle-hole depressions in the center. One should urgently use cooling herbs to disperse it. For constipation, use substances like Dahuang (Rhei Radix et Rhizoma) and Qianniu (Pharbitidis Semen); for loose stools, use Jinhuawan (Golden Flower Pill).

[Chen Zhongwen] Mild cases erupt in three stages. Sizes vary. They are sparse on the face and head. None appear around the eyes. Roots are red. Plump and lustrous.

Severe cases erupt simultaneously. Dense as silkworm eggs. Fever and abdominal distension. Ash-gray or white crusts. Dense without gaps. Incessant diarrhea and thirst. Warm head and cold feet.

Causes of mild turning severe: Sexual intercourse. Failure to observe dietary taboos. Previous diarrhea. Drinking cold water. Taking cooling medicines.

Methods for severe turning mild: Avoid wind and cold. Maintain warmth. Formed stools. No dryness or thirst. Avoid raw and cold foods. Avoid contact with outsiders.

Regarding "drinking cold water and taking cooling medicines" mentioned above, if there is excess-heat internally, no need to avoid them.

On the second or third day, variola begins to appear. Newly erupted ones resemble millet grains, or broomcorn millet grains, or mung beans. Those resembling water beads, bright and clear, are auspicious and require no medication.

On the fourth or fifth day, variola varies in size. Red and vibrant roots with bright clarity indicate mildness. Dense, sunken tops, ash-gray or white color, with diarrhea and thirst indicate severity.

On the sixth or seventh day, plump, red, and lustrous variola indicates mildness. Warm body but rapid breathing, dry mouth, abdominal distension, and cold toes indicate severity.

On the eighth or ninth day, fully grown, plump, waxy-colored variola indicates mildness. Chills, confusion, abdominal distension, vexation and thirst, rapid breathing, and teeth grinding indicate the most severe condition.

On the tenth or eleventh day, variola should scab over, with crusts falling off indicating recovery. Fever, confusion, abdominal distension, diarrhea, chills, and teeth grinding indicate severity.

[Weng Shi] Song for Mild Variola: Heat is mild, spirit is clear, pustules are small and sparse; roots are red and vibrant, unevenly distributed; limbs are warm without chills or fever; milk and food intake are normal; thirst and diarrhea are absent; Taiyang area and cheeks are smooth; hands and feet are piled up, round like pearls; fewer lesions on waist, neck, and heart region; only requires care, no medicine needed.

Song for Severe Variola: Onset of heat with eruption on the first day; dense and bright red, reduced appetite; diarrhea, vexation, thirst, abundant on head and face; red pustules mixed with rashes, obstructed urination and defecation; flat and broad, ash-gray lacking brightness; carbuncles and sores weeping fluid; such severe conditions require prevention; do not wait until the moment arises to make mistakes.

[Wan Quan] The ancients said: Mild can turn severe, severe can turn mild. "Mild" refers to sparse eruptions, plump and red inside and out. People see its mildness and quickly develop an attitude of negligence, failing to avoid wind-cold, failing to regulate diet, failing to observe precautions, and failing to select appropriate doctors or shamans. Consequently, contracting wind-cold generates external heat; damaging diet generates internal heat. Heat steams and steeps, causing pustules to flip out densely, or leading to blindness after variola, abscesses, abdominal distension, vexation, vomiting, and diarrhea. Violating taboos causes itching and ulceration. Medical error involves tonifying what should not be toned or purging what should not be purged; shamanic deception involves sprinkling cursed water to damage the exterior and forcing drinking to damage the interior. Often this turns into serious illness, yet it is attributed to fate, how foolish! "Severe" refers to dense eruptions, black outside and red inside, white outside and black inside. If one maintains a sense of caution, regulates temperature, observes diet strictly, adheres to taboos, and selects proper medical help, natural healing becomes easy, transforming into mildness. Is this not human effort surpassing destiny?

Differentiating Recovery Without Medication:
Sparse pustule bases, red and spreading roots, no diarrhea or thirst, normal milk/food intake, warm limbs, no high fever.
For the above six signs, medication is unnecessary. Only proper care is required. Keep the room warm, exclude foul odors, avoid seeing outsiders, abstain from sexual activity, and keep away from menstruating women and those with axillary odor. Burning Dahuang (Rhei Radix et Rhizoma) and Cangzhu (Atractylodis Rhizoma) is recommended to repel evil qi. Do not burn Chenxiang (Aquilariae Lignum Resinatum), Tanxiang (Santalum Album Lignum), Jiangzhenxiang (Dipterocarpus Turbinatus Resina), Ruxiang (Olibanum), Bingpian (Borneolum Syntheticum), or Shexiang (Moschus). Hanging Huisu (Coriandri Fructus) inside curtains, soaking it in wine to spray beds and curtains, or burning Muxiang (Aucklandiae Radix) is excellent. The toxin of variola fears foul odors most. Do not believe monks or Daoists who claim to cleanse impurity through scriptures; they have no power and may introduce foul odors themselves. Do not rely on them for cleansing without prevention. Beware, beware.

Differentiating Five Incurable Syndromes:
Itching and collapse, chills with teeth grinding, incessant thirst. Purple-black pustules, panting and restless thirst. Ash-gray or white sunken tops, abdominal distension. Warm head and cold feet, confused and desiring water. Rapid breathing, diarrhea, and thirst.