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Diseases such as smallpox and chickenpox manifest with visible physical signs, seemingly rendering pulse diagnosis unnecessary. Furthermore, the occurrence of these diseases is governed by the prevailing annual climate (Sui Qi), suggesting that pulse diagnosis might also be deemed superfluous. However, the *Classic of Internal Medicine* states: "The subtlety lies in the pulse; it must not be neglected. To examine it requires a systematic approach, beginning with the differentiation of Yin and Yang." Thus, pulse diagnosis is indispensable. Ancient sages have said: "If the pulse is calm and the body cool in cases of smallpox/chickenpox, life is preserved; if the pulse is restless and the body hot, death ensues." This demonstrates that pulse diagnosis is indeed applied in the treatment of rashes and eruptions.

Generally speaking, children's pulses often present as tight and rapid. The pulse associated with toxic sores or eruptions frequently appears floating, large, and rapid. The *Treatise on Cold Damage Disorders* (*Shanghan Lun*) states: "Floating indicates wind invasion or deficiency; large indicates excessive Qi. When wind and deficiency Qi contend, urticaria (skin rashes) will inevitably form." It further states: "A rapid pulse that does not follow regular intervals gives rise to malignant sores."

For children over seven years old, five beats per respiration cycle constitute a normal pulse; for those under seven, six beats per cycle are considered normal. Exceeding this frequency indicates "excessive rapidity," signifying an excess of pathogenic factors. Falling short indicates "slowness," signifying a deficiency of healthy Qi. A floating and rapid pulse indicates exterior heat; a floating and slow pulse indicates the decline of Yang Qi. A deep and tight pulse indicates interior heat; a deep and thin pulse indicates the depletion of primordial Qi.

Smallpox and chickenpox are Yang diseases. Their pulses should ideally exhibit a洪 (surging/full) and solid quality upon both superficial (floating) and deep (sinking) palpation. If the pulse is weak and forceless, it represents a Yin pulse appearing in a Yang disease, which is ominous. Any pulse found to be floating without a root, light and fleeting like fat floating on soup; or rapid and frantic, coming continuously like a sparrow pecking; or thin and dissipating, lingering like a spider's thread; or slow and nearly absent, dripping like water from a leaking roof; or deep and intermittent, appearing suddenly like a fish leaping—all are considered death omens.

In severe cases of smallpox, prognosis can be determined by pulse examination: a洪 (surging) and solid pulse is auspicious, whereas a floating, rapid, deficient, and small pulse is inauspicious.

Zhu Danxi once treated a sixteen-year-old male patient who presented with fever, confusion, blindness, and deafness. His pulses in both hands were broad (Huo) and slightly rapid. He diagnosed this as damage due to overexertion. At that time, smallpox was prevalent in the village. Although the patient was unconscious, he could swallow medicine when offered and sip porridge when fed. Zhu advised administering a large dose of strong decoction containing Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), Cang Zhu (Atractylodes Lancea Rhizome), and Chen Pi (Citrus Reticulata Pericarp). After more than twenty doses, the rash began to erupt. After another twenty doses, pus formed, and the skin became extensively ulcerated. Someone asked, "This consumption-like condition is terrifying; why not use Chen's complete formula?" Zhu replied, "This is merely deficiency without cold. Simply adhere to the previous prescription, and after dozens more doses, he will recover." Later inquiry revealed the cause: fearing the onset of smallpox four or five days prior, the patient had engaged in strenuous firewood gathering, resulting in profuse sweating over several days. This case illustrates diagnosing deficiency through the broad pulse and treating eruptions based on pulse findings.