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After the exterior-releasing treatment for variola/rubella (Zhen Chuang), when red rashes appear on the skin, one must strictly avoid wind-cold and raw/cold foods. If violated, the skin pores will become closed and tight, causing toxic factors to stagnate, leading to a purple-blue discoloration of the whole body, with toxins attacking inwardly, resulting in restlessness, abdominal pain, asthma, and confusion, thereby triggering various critical syndromes. If the rash attempts to emerge but fails to do so, danger and death are imminent; both physicians and patients must exercise utmost caution.

1. The management of Zhen Chuang relies entirely on proper regulation and treatment. Taboos include chicken, fish, fried/grilled foods, salt, vinegar, and "Five Pungent Spices" (Wu Xin, referring to pungent vegetables like garlic, scallions, etc.). These may only be consumed after forty-nine days (seven sevens) have passed. A bland diet is recommended; one must not indulge the palate, lest other diseases arise. Misconsumption of chicken or fish may cause lifelong rough, bumpy skin resembling gooseflesh. During epidemic outbreaks of Zhen, misconsumption may trigger recurrence. Misconsumption of pork often leads to diarrhea during the months corresponding to previous Zhen episodes. Misconsumption of salt or vinegar causes coughing, which recurs annually during those same months. Misconsumption of Five Pungent Spices induces frequent fright-heat. These are matters that families dealing with smallpox/rubella must heed.

Sores and rashes do not erupt without heat. When Zhen Zi (childhood exanthem) is about to erupt, there is invariably generalized fever, restlessness, dizziness, or bodily stiffness/spasms. Once erupted, the body cools down, and all symptoms resolve. This type, where the rash subsides immediately, is extremely mild. If heat persists strongly after eruption, it indicates abundant toxins; Da Qing Tang (Great Blue Decoction) should be used to resolve toxins. For difficult/dysuric urination, Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxins) combined with Bai Hu Tang (White Tiger Decoction), or Da Lian Qiao Yin (Large Forsythia Drink), should be used to clear interior heat. For constipation, Liang Ge San (Cool the Diaphragm Powder) from *Ju Fang* (Prescriptions of the Imperial Medical Bureau) added with Niu Bang Zi (Arctii Fructus) is indicated.

Zhen syndromes frequently involve coughing, reflecting the pattern of sudden eruption and sudden internalization. However, as long as Zhen toxins exist, profuse coughing is necessary to disperse them. Therefore, within ten days post-eruption, some coughing is expected. One must not treat the cough merely because it is frequent; this requires caution. Zhen syndromes relate to the Lung and Spleen/Stomach. If the Lung is affected by Fire Evil, coughing increases, causing the rash to suddenly appear on the face/head and spread to the limbs. If the Large Intestine is affected by Fire Evil, it connects upward to the Spleen/Stomach, causing diarrhea. If diarrhea occurs too early, coughing decreases and transforms into asthma/wheezing, as both asthma and cough belong to the Lung. Cough represents excess (Shi), while asthma represents deficiency (Xu). Cough indicates outward dispersion of toxins; asthma indicates inward contraction. Inward contraction manifests as closed eyes with excessive phlegm, chest fullness, abdominal distension, pale complexion, and incomplete toxin expulsion, indicating a critical condition. Thus, Zhen favors cough over asthma, and most of all, avoids diarrhea.