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The key principles for treating smallpox and measles are no different from those for treating carbuncles and sores. It is essential to differentiate the exterior and interior, deficiency and excess, cold and heat. If the exterior is deficient and diaphoretic (sweat-inducing) formulas are used, mild cases may result in ulceration of the rash, while severe cases may fail to erupt and lead to death. If the interior is excess and tonifying/detoxifying formulas are used, mild cases may result in internal retention of toxin, while severe cases may lead to panting, abdominal distension, and death. If the interior is deficient and draining/advancing formulas are used, mild cases may fail to suppurate and form scabs, while severe cases may fail to crust over or shed prematurely, leading to death. How can treatment methods not be cautious?

If there is redness, fever, pain, thirst, ability to eat, and constipation, this indicates that both the constitutional qi and pathogenic qi are in an excess state. Even in severe winter, Si Shun Qing Liang Yin (Four-Obedience Cooling Decoction) must be used to nourish yin. If there is blackening and sinking of lesions, inability to eat, vomiting, diarrhea, chattering teeth due to cold, and cold extremities, this indicates failure of Spleen Earth being invaded by Cold Water. Even in peak summer, Liu Jun Zi Tang (Six-Gentlemen Decoction) with Gan Jiang (Dried Ginger) and Fu Zi (Prepared Aconite), or Chen Shi Yi Gong San (Mr. Chen’s Extraordinary Power Powder), must be used to restore yang. This is the method of "abandoning the season to follow the syndrome" described in the Nei Jing (Inner Canon).

If eruption is delayed, color is not vibrant or fresh, suppuration does not occur, and scabs do not form, accompanied by fever, thirst, poor appetite, and lack of desire to eat, this indicates Spleen and Stomach deficiency. Shen Si Sheng San (Ginseng Four-Saints Powder) should be used to tonify. If eruption occurs but color is pale, suppuration is incomplete, scabs do not shed, or if there is itching, collapse, thirst for hot drinks, abdominal pain, anorexia, vomiting, and diarrhea, this indicates Spleen and Stomach deficiency-cold. Chen Shi Mu Xiang San (Mr. Chen’s Costus Powder) should be used to warm.

Those who die between the fourth and fifth days have excessive toxins and deficient true qi unable to erupt. Those who die between the sixth and seventh days have deficient yuan qi unable to suppurate. Those who die after ten days have expelled pathogens but failed Spleen and Stomach function, leading to internal collapse of yuan qi. Practitioners who can only predict death without understanding that it stems from blood and qi deficiency, and who fail to reverse-engineer the cause and provide preventive regulation and tonification, miss the opportunity for survival. Eruption, suppuration, and scabbing all rely on the nourishment of the Spleen and Stomach; one must not recklessly administer attacking or reducing formulas, which would lead to premature death.

For adults suffering from this disease, the treatment method is entirely different. In the past, Danxi treated an elderly patient who initially suffered from smallpox with confusion and unconsciousness. He urgently administered forty-plus doses of major tonifying formulas, resulting in the eruption of lesions and recovery. This illustrates the principle.