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[Wang] Predecessors stated that children's deficiency and excess conditions vary, so one cannot rigidly adhere to a fixed number of days. Some may develop rashes after three days of fever, some after six or seven days, and even some after ten-plus days; the criterion for completion is when red spots appear on the feet. After the rash is complete, blood blisters form. These blood blisters persist for seven days and should then form pustular crusts. If red spots are still interspersed within the blood blisters, one cannot rigidly adhere to the number of days; instead, wait until all red spots transform into blood blisters to consider it complete. Blood blisters forming pustular crusts after seven days indicates harmonious Ying (Nutritive) and Wei (Defensive) Qi, with no external pathogenic invasions internally or externally, allowing the process to proceed as scheduled. Moreover, during the initial formation of blood blisters, if weather conditions such as cold, heat, dryness, dampness, or wind are irregular, causing delays or accelerations in the rash progression, one cannot rigidly adhere to the number of days. The standard remains the day when all red spots become blood blisters. If, after seven days of blood blister formation, the patient has Qi deficiency and some red spots have not yet turned into blood blisters, it is because the toxic factors are too vigorous to consolidate. In this case, Zhuiwei Gao (Pig Tail Ointment) should be applied immediately to facilitate scabbing at any time.

[Wan] Popular belief holds that there are specific days for fever, rash emergence, eruption, pus formation, and crusting. This is merely a generalization. Rashes vary in density, toxins vary in severity, and patients vary in deficiency or excess. How can one rigidly apply a fixed timeline? For instance, if the rash is naturally sparse, the toxin is mild, the patient's Middle Jiao Qi is substantial, and they can eat, the rash will emerge and crust easily without needing ten days. Conversely, if the rash is dense, the toxin is severe, but the patient's Middle Jiao Qi is substantial, they can eat, and their Ying and Wei Qi are harmonized without internal or external injuries, they may crust by the twelfth or thirteenth day. However, if the patient has deficient Middle Jiao Qi, poor appetite, previous internal/external injuries, or encounters abnormal climate changes leading to difficulty in crusting, how can one insist on a fixed timeline?

Wenren Shi said: Those with robust constitution do not fear extreme heat in summer or extreme cold in winter. Those with weak constitution easily succumb to cold or heat; in cold rainy weather, they contract cold-dampness leading to loose stools; in slightly warm weather, latent heat accumulates leading to heatstroke. Thus, those who understand seasonal changes can distinguish the rise and fall of Yin-Yang and cold-heat. The Classic states: Those with Yang excess endure winter but not summer; those with Yin excess endure summer but not winter. This reflects different constitutions. From Lixia (Start of Summer), the climate becomes purely Yang, and things flourish. Physicians should "avoid heat when using hot remedies" (Yong Re Yuan Re); for example, when using herbs like Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction), one must add Zhimu (Anemarrhenae Rhizoma), Shengma (Cimicifugae Rhizoma), and Shigao (Gypsum Fibrosum). At Lidong (Start of Winter), the climate aligns with pure Yin. Physicians should "avoid cold when using cold remedies" (Yong Han Yuan Han); when using cooling formulas, stop once the disease is addressed, without necessarily finishing the dose. Furthermore, in warm winters, the deficient feel comfortable while the excess get sick; in cool summers, the excess feel comfortable while the deficient get sick. Warm winters and cool summers are unseasonal energies that arrive violently and depart quickly; management depends on proper care. If extremely cold, keep covered warmly to avoid cold trapping the toxin inside; if extremely hot, avoid heavy covering to prevent external heat from combining with toxin, causing restlessness and ulceration. During storms or heavy rain, secure curtains, add coverings, and burn Huibi Xiang (Stale-Air-Dispersing Incense) to dispel aberrant qi. Sleeping areas should be draft-free but bright, never dark. Keep lights on at night and have family members watch over to ensure food availability or provide massage for itching/pain, as others may not be attentive enough.

Wenren Shi said: Wood withers with Guizhi (Cinnamomi Ramulus), Realgar turns black with Fuliang (Lead White), and citrus rots with dried meat. Things repel each other thus. Pox fears foul and mixed airs similarly. Avoid: sexual vapors, menstrual blood odor, fox-like underarm odor, drunken/fishy odors, realgar/mosquito coil fumes, moldy/damp air, burnt oil/hair fumes, feces/urine splashes, frying oil/eggs fumes, all fishy/offensive smells, Five Pungent Spices, and odors from travelers. Guard doors strictly; forbid strangers entry; do not sweep rooms, disturb drains, open latrines, or burn strong incenses like Nao (Borneol) or Shexiang (Moschus). Zhang Zhongjing said: When pox is about to emerge, burn Cangzhu (Atractylodis Rhizoma) and Zhu Jia (Porcinis Unguis). Hang Huyuan (Coriandri Fructus) around the bed, spray with wine, or burn Rushiang (Boswelliae Resina) for best results, as fragrance speeds Ying and Wei circulation, helping toxin emerge. Failure to follow precautions leads to disaster: eruptions fail to emerge, existing ones become necrotic patches, severe cases turn black and sunken with rotting odor, pain like knife wounds, leading to death from suffocation. Even survivors may have permanent black scars or eczema. One must beware. Upon initial eruption, abstain from sex, burn Huibi Xiang continuously, and heat hard stones with water. If contamination occurs causing color change or itching, use Yinchen Xun Fa (Artemisiae Scopariae Fumigation Method).

Huibi Xiang (for Pus Formation Stage) Yinchen Xun Fa (for Eruption Stage)

[Yuan] Formula for Pox Turning Purple upon Contamination
If pox turns purple and sudden asthma arises, seek loofah skin, powder it, mix with honey, and apply. Drink Gancu Dihuang Tang (Licorice and Rehmannia Decoction); one dose promotes eruption. If irritability/thirst appears (days 4-5), grind Xijiao (Rhinocerotis Cornu) in water. If days 7-8, empty-shell pox contaminated is fatal. For half-pus contamination, verify carefully. (Loofah skin must be harvested before veins form, dried, and only skin/stem powdered.)

Formula for Pox Turning Gray-White upon Contamination
If pox turns gray-white and unbearable itch arises, use Fuzi (Aconiti Lateralis Radix Preparata) tightly wrapped in yellow cloth; more yields greater effect. Supporting herbs are prepared previously. Examine the base: if original redness exists, it can be saved; if no true root, do not treat.

Formula for Pox Contaminated by Menstrual Blood
When pox is erupting and menstruation coincides, lack of cleanliness causes abnormal changes. Use Honghua (Carthami Flos) decoction monthly, regardless of parts. Young shoots decocted with wine restore normalcy quickly.

Formula for Pox Itching due to Musk Contamination
Musk contact causes unbearable itching with black specks. Immediately decoct Shengma (Cimicifugae Rhizoma) and Cang'er Cao (Xanthii Fructus) for slow bathing. Internally, support Wei Qi with Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Chenzhi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix), Shengdi (Rehmanniae Radix), Fangfeng (Saposhnikoviae Radix), Chan Tui (Cicadae Periostracum), Honghua (Carthami Flos), and Chi Dou (Phaseoli Semen Rubrum - specifically wild variety, coarse and flat, reddish; substitute with domestic red soybean if unavailable).

Formula for Pox Contaminated by Corpse Aura
Corpse contamination causes eye deviation and sinking pox with foaming. Quickly burn Yuan Sui (Coriandri Fructus) and Zao Ai (Ziziphi Jujubae Fructus with Artemisia) in a tube to fumigate. Externally, use Chen Sha (Cinnabar) boiled with ginger wine to sip frequently. Although corpse aura does not kill the pox directly, this treatment restores beauty. (I treat this by giving Yuan Sui, Chen Sha, and Ginger Wine internally, and burning the medicine externally. Chen Sha is heavy and sedating, good for raising pox, but should not be taken in large amounts.)

Formula for Pox Contaminated by Ke Wu (Alien Intrusion)
Ke Wu intrusion resembles fright, with crying and blue face. Use finely knotted loofah with flowers, dew-harvested, steamed, and baked to powder. Mix with honey according to age. Loofah is worth its weight in gold here.

Formula for Pox Shrinking due to Animal Fright
On days 5-6, during pus formation, if frightened by cats/dogs, pox shrinks, turns slanted, or sinks due to Heart losing mastery and Qi/Blood failing to support. Urgently administer Wulong San (Black Dragon Powder).

Wulong San Formula
Wulong San treats fright in pox caused by pigs, cats, dogs, horses. Use Yuanzhi (Polygalae Radix) and Changpu (Acori Tatarinowii Rhizoma), washed Chan Tui (Cicadae Periostracum). Boil with wine, remove Yuanzhi and Changpu, leave Chan Tui, powder it, and take with brown sugar and wine.
(Net Yuanzhi 1 liang, fine Changpu 1 liang, boil in wine, remove herbs, powder Chan Tui, take medicinal wine, then give Jiming San for full recovery.)

Qian Yi said: For all rashes, nurses must guard their diet and prevent hunger/cold exposure. Wenren Shi said: A person fasting one day gets hungry; touching cold/wind causes illness. Especially for infants with pox relying on grain Qi internally and avoiding wind/cold externally, deficiency of grain Qi and invasion of wind/cold cause great harm. Infants need mothers with sufficient diet and draft-free housing. Older children need careful supervision by experienced adults. Balance is key; overfeeding or overheating to avoid hunger/cold is harmful. Families must know this.

Chen Shi said: For pox fever with persistent dry mouth/thirst, do NOT give water, honey, persimmon, watermelon, or oranges. (Unless pulse is excess indicating internal heat, then cold is not forbidden.) Between crusting stages, if crusting fails, abdomen distends, thirst persists, do NOT give water/honey/cold foods. If head is warm but toes cold, or diarrhea/thirst/shortness of breath occur, do NOT give them. On days 12-13, after scabs fall, scars are dark/uneven, flesh tender. Do NOT bathe. Avoid roasted, fried, spicy, pungent, or toxic foods to prevent heat-toxin from affecting eyes (causing cataracts/opacities). Hai Zang said: People often spoil children with excessive love, believing folk customs over medicine. By the time illness is serious, they worry. They rub and soothe indiscriminately. Does this love not harm? Does this pity not abandon? Early treatment is missed, treatment is incomplete, death ensues, labor is vain, and doctors are blamed. Alas, their plan is flawed!