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Qian Yi stated: Whenever the pox and rashes erupt completely all at once upon their first appearance, the condition must be severe. When sores and rashes appear together, it is a case of half-light and half-severe. When they appear sparsely, the condition is mild. When the sores are plump and red externally and internally, the condition is mild; when black externally and red internally, it is a slightly severe condition; when white externally and black internally, it is a very severe condition. When there are black spots like needle holes inside the tips of the sores, the disease momentum is violent. Cases presenting with cyanosis, dryness, purple depression, lethargy/coma, unceasing discharge of fluid, restlessness, fever, thirst, abdominal distension, crying and wheezing, and obstruction of both large and small bowel movements, are critical and distressed conditions.

During the eruption of pox and rashes, the nursing mother must be cautious about her diet. If due to hunger and exposure to wind-cold, the pathogenic qi returns to the Kidney causing the pox to turn black, it is difficult to treat. If there is high fever, one should promote urination; if there is slight fever, detoxification is appropriate. If the pox presents as black-purple, dry, and depressed, Baixiang Wan (Hundred-Prosperity Pill) should be used to purge. If not black, purging must strictly be avoided. Generally speaking regarding the severity according to seasons: Pox and rashes belong to Yang. Eruption in spring and summer is favorable (Shun), while in autumn and winter it is unfavorable (Ni). In winter, Kidney Qi is prosperous, and combined with strong cold, diseases often return to the Kidney turning black. Additionally, one must distinguish: pus blisters in spring, black depression in summer, rashes in autumn, and pox in winter are all unfavorable. Black pox is hardly curable regardless of the season, with only one in ten surviving. The symptoms include chills, teeth grinding, or yellowish swelling of the body, and purple discoloration. In such cases, Baixiang Wan should be urgently administered to purge. If after purging, aversion to cold persists, the body becomes cold with sweating, and the ears become hot instead, this is a death sign due to excessive Kidney Qi. After purging, if the body becomes hot and the patient desires water, it is treatable; this indicates Spleen Earth overcoming Kidney Water, cold dissipating, and transforming into warmth.

Erupting pus blisters first and then rashes is favorable; erupting rashes later is unfavorable. Erupting water blisters first and then rashes is unfavorable. Erupting pus blisters first and then many water blisters is favorable, few is unfavorable. Many water blisters first and then rashes is unfavorable, few is favorable. Rashes first and then pus blisters is favorable. Whenever pox and rashes present in only one type of morphology, the prognosis is good.

Zhang Yuansu (Jiegu) stated: If pox and rashes erupt densely like needle heads immediately, indicating a severe situation, one should lightly release the exterior and cool the interior using Lianqiao Shengma Tang (Forsythia and Cimicifuga Decoction). If already erupted, dense and severe, with slight wheezing and desire for water, indicating heat signs, remove wind-dispelling herbs and slightly purge. If eruption is slow but stool and urine are normal, knowing the pathogen is in the exterior not the interior, use mild diaphoresis with Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction). If the pox is cyanotic, dry, black, and depressed, without significant body heat, and with astringent stool and urine, the heat is internal and boiling; purge using Dahuang Tang (Rhubarb Decoction) combined with Xuanfeng San (Wind-Releasing Powder). If the body surface has high heat and exterior signs have not resolved, do not purge. If rashes have erupted showing slight heat and difficulty in urination, promote urination. After eruption, if residual toxins remain undissipated and recurrent fever and sores occur, use Cha Fen (Tea Powder) to administer Jiedu Wan (Detoxification Pill). If the voice remains normal after pox eruption, it means the form is diseased but the Qi is not. If the voice is absent before pox eruption, it means the form is not diseased but the Qi is. If pox erupts but the voice is absent, both form and Qi are diseased; one should clear Lung Qi, using Bafeng Tang (Eight-Winds Decoction), or Liangge San (Cool the Epigastrium Powder) with Nuxi (Mirabilite) and Huanglian (Coptis Rhizome) removed.