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Jingyue said: Variola (smallpox) and exanthema (measles/rash) are originally not the same disease. Although variola presents with many variations and syndromes, exanthema is slightly easier to resolve; however, severe cases of exanthema can be equally ominous and critical, which is most fearsome. This is because the toxins of exanthema and variola are essentially the same. It is just that ancient physicians valued variola but neglected exanthema, rarely discussing it in detail, leaving later generations without a standard to follow, which I deeply regret. Since obtaining the printed work by Mr. Wan from Luotian, seeing its profound medical principles and refined treatment methods, my concerns have been alleviated. Now, following his teachings completely, I narrate this in detail here. Although there are slight revisions and adjustments, they merely correct ambiguous points and elaborate on previously unspecified details. May those who suffer from exanthema in the future find a guide through their confusion, thereby acknowledging the significant merit of Mr. Wan.

Exanthema is a mild form of variola, primarily involving symptoms of the Spleen and Lung meridians. Internally, it corresponds to the Hand and Foot Taiyin meridians, and externally, it combines with the skin and muscles. These are caused by the aberrant and unhealthy qi of heaven and earth, hence called "exanthema." However, its names vary: in Suzhou and Songjiang, it is called "Shazi" (Sand Rash); in Zhejiang, "Cuzi" (Vinegar Seed Rash); in Jiangxi and Huguang, "Ma" (Hemp/Rash); in Shanxi and Shaanxi, "Fuchuang" (Skin Sore), "Kangchuang" (Bran Sore), or "Chichuang" (Red Sore); and in Zhili, "Zhenzi" (Rash Child). Though the names differ, the clinical manifestations are identical. However, if exanthema appears before variola, variola will inevitably reappear after the initial rash; only when exanthema appears after variola does it signify a conclusion (recovery).

Mr. Wan stated: Exanthema appearing in spring and summer is a favorable prognosis (Shun), while appearing in autumn and winter is unfavorable (Ni). Because it originates from the Spleen and Lung meridians, once exposed to wind-cold, it becomes difficult to erupt and is prone to complicated syndromes, making autumn and winter unsuitable seasons for its occurrence. The aberrant qi of nature causes sores and rashes in humans. Yet, ancient physicians always emphasized variola over exanthema, never distinguishing what exanthema actually was. How can two distinct conditions be lumped into one? It seems that at that time, valuing variola over exanthema led to its omission, causing later generations to miss the essential methods, resulting in harm frequently. Now, recording the four generations of family transmission along with my own insights below, these methods applied to diseases will certainly be accurate. If I dare conceal even a slightest detail, may Heaven witness it.