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When the smallpox lesions are tight, small, and full, they are named "Pearl Smallpox" (Zhenzhu Dou), which tends to mature easily and heal quickly. When they are tall, large, and plump, they are named "Large Smallpox" (Da Dou), which matures early but heals slowly.

When the lesions are raised around the periphery but depressed in the center, they are named "Dogwood Smallpox" (Zhuyu Dou); when they are flat and not protruding, they are named "Steamed Cake Smallpox" (Zhengbing Dou). These cases may be either auspicious or inauspicious; sparse lesions indicate a mild condition, while dense lesions indicate a severe one.

From the onset of fever until the swelling stage, the pathogenic toxin emerges from the interior to the exterior, representing a Yang syndrome manifestation. The pulse should be floating, large, and rapid (Shu), and should not be deep, fine, and slow (Chi). After the pustule formation and healing stages, the toxin has been resolved externally, representing a Yin syndrome manifestation. The pulse should be harmonious and moderate (Hehuan), and should not be surging and rapid. It is also said: For smallpox pulses, harmony and moderation are paramount. The pulse must not be overly restless and rapid, nor should it appear minute and weak. Therefore, it is stated: Those with a quiet pulse and cool body will survive; those with a restless pulse and hot body will die. Furthermore, a Yang disease presenting with a Yin pulse indicates death. Generally speaking, the stomach Qi (Wei Qi) is the root of the pulse in all four seasons. Stomach Qi is characterized by a harmonious and moderate quality present in the seasonal pulses. Slippery, rapid, floating, and surging pulses represent excess (Tai Guo); excess indicates an Excess syndrome (Shi Zheng), where pathogenic factors are strong. Wiry, slow, minute, and weak pulses represent deficiency (Bu Ji); deficiency indicates a Deficiency syndrome (Xu Zheng), where healthy Qi is weak. If a pulse exhibits excess or deficiency without the moderating influence of Stomach Qi, these are all signs of impending death. Thus, it is said that a person without Stomach Qi will die.

During epidemics of infectious smallpox and measles, before the rash erupts, one can predict auspiciousness or inauspiciousness by observing the patient's complexion, form, temperament, and nature. First, observe the complexion: If the face is red and white, bright, and moist, remaining unchanged from usual, it is auspicious. If suddenly appearing overly crimson and delicate, or pale and lusterless, changing abruptly from the norm, it is inauspicious. For instance, green lines on the forehead, red veins in the eyes, black aura around the mouth, and dusty marks on the ears are all omens of great inauspiciousness. Second, observe the form: If the spirit is clear and refreshing, movements are free, and speech is clear and loud, it indicates health and auspiciousness. If the spirit is weak, movements are sluggish, and speech is low and different from usual, it is inauspicious. Additionally, those originally possessing features of longevity are auspicious. However, features of premature death include a cracked skull or separated cranial sutures, a thin neck and slender legs, a faint voice and lackluster eyes, or glaring eyes revealing exposed spirit, intermittent crying, absence of joy or affection accompanied by self-talk and laughter, precocious intelligence, and floating flesh with tender bones; all these are inauspicious omens. Third, observe the temperament and nature: Before the onset of fever, if the child suddenly displays excessive joy, clinging affectionately to parents unwilling to part, or reacts to strange sights and sounds with absurd talk, these are all ominous signs.