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Smallpox should ideally erupt alone; if it erupts simultaneously with measles, it is termed "Jia Zhen" (Measles-Complicated Smallpox). Generally, the eruption of both smallpox and measles is influenced by seasonal pathogenic factors (Shi Qi); when both appear together, their toxicity must be severe. The *Xin Jian* states: "Jia Zhen" refers to the "Liang Gan Zheng" (Two-Factor Syndrome affecting both exterior and interior) of smallpox, which is a highly unfavorable prognosis. If smallpox is originally sparse but complicated by measles, it is named "Ma Jia Dou" (Measles Complicating Smallpox), and the condition is relatively mild; if smallpox is originally dense and further complicated by measles, mixing indistinguishably in fine fragments, the condition is ominous. Urgent treatment should prioritize dispersing the exterior with acrid-cool formulas, followed by supporting the interior. Only when the measles toxin gradually subsides and the smallpox lesions can be seen crusting and falling off is the case treatable. If smallpox and measles remain mixed without any reduction in toxicity, the case is undoubtedly critical.

1. The method for treating Jia Zhen first requires examining the density of the smallpox and the severity of the measles. If the measles are mild with slight heat, treatment should focus primarily on the smallpox; if the smallpox resolves favorably, the measles need not be a concern. If the measles are numerous with severe heat, urgent resolution of the measles toxin is required; only after the measles have dispersed can the smallpox be preserved.

1. When smallpox first erupts, if there are fine, dense eruptions resembling silkworm eggs within, this indicates Jia Zhen. If smallpox is sparse and measles are numerous, priority should be given to resolving the measles toxin. In cases where exterior pathogens are unresolved, external heat is severe, internal fire is not excessive, and measles are present, suitable formulas include Shu Xie Yin (Dispersing Pathogen Decoction), Sheng Ma Ge Gen Tang (Cimicifugae et Puerariae Decoction), Jing Fang Bai Du San (Schizonepetae et Saposhnikoviae Detoxifying Powder), or Shi Wei Qiang Huo San (Ten-Ingredient Notopterygii Powder). In cases where both exterior and interior are hot, toxicity is abundant, and measles are present, use Chai Ge Jian (Bupleuri et Puerariae Decoction), Jie Du Fang Feng Tang (Detoxifying Saposhnikoviae Decoction), or Shi San Wei Qiang Huo San (Thirteen-Ingredient Notopterygii Powder). In cases where internal heat-toxicity is abundant and measles are present, use Liu Wei Xiao Du Yin (Six-Ingredient Detoxifying Decoction) or combine it with Huang Lian Jie Du Tang (Coptidis Detoxifying Decoction). In cases where Yangming Fire is excessive, presenting with much heat, thirst, irritability, and measles, use Bai Hu Tang (White Tiger Decoction), Hua Ban Tang (Transforming Maculae Decoction), or Ge Gen Mai Men Dong San (Puerariae et Ophiopogonis Powder). If the above treatments are applied correctly, resulting in the dispersion of measles and eruption of smallpox, the case is treatable and can then be regulated according to symptoms. If the measles do not disperse and the toxin does not resolve, the case is difficult to treat.

1. When both smallpox and measles are numerous, toxicity must be extremely abundant. Even if the treatment method is correct and the measles toxin is resolved, the vital qi and blood will inevitably suffer severe injury, making recovery difficult. In such cases, one must primarily focus on nourishing and protecting the spleen and stomach, and harmonizing vital qi and blood, so that assistance may be achieved.

1. If measles reappear after the smallpox has crusted and healed (Shou Ye), this is a sign that residual toxins are being dispersed; no treatment is necessary.