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[Diagram of Spots Appearing on the Face]

After three days of fever, if the smallpox spots first appear in the lower part of the face, appearing on the upper parts of both cheeks (Yi) is considered "Upper" grade; appearing on both cheekbones (Jia) is "Middle" grade. If they first appear on the forehead, it indicates that the pathogenic toxin has invaded the Yang region (the head belongs to Yang), which is the lowest and most ominous grade. If the spots reported like morning stars are dense, although sparse in other areas, it is difficult to treat; if the spots reported like morning stars are sparse, smooth, and lustrous, although dense in other areas, there is still a chance for recovery. However, the essence of the five Zang organs flows upward to the head and face. Therefore, when the essence of the five Zang organs is sufficient, even if the spots are numerous, they will be distinct, elevated, and moist/lustrous, causing no harm even if numerous. If the essence is insufficient, the pathogenic toxin will run rampant and merge into patches, resembling bran, leading to an incurable condition.

The chest and nipples serve as the Guan (Gate/Pass) of the Heart; the area around the umbilicus serves as the Guan of the Spleen; the external genitalia (Yang Qiu) serve as the Guan of the Kidney. The Sha Men (Killing Gate) of White Emperor is located at the Taiyang acupoint on the right side of the Qi Wo (depression below the throat); the Sha Men of Green Emperor is located at the Taiyang acupoint on the left side of the eye socket. The Cheekbone Eminence (Quan Fu), chest, and nipples form the Axis of the Heart; the left Taiyang acupoint, left hypochondrium, eyelids, and buttock eminences form the Axis of the Liver; the right Taiyang acupoint, right hypochondrium, neck, and Qi Tu (prominence of the thyroid/trachea) form the Axis of the Lung; the cheeks, Zhongting (middle court), corners of the mouth, abdomen, hands, and feet form the Axis of the Spleen; the chin (Di Ge), back of the neck, ear fossae, back, waist/hips, lumbar spine, and external genitalia form the Axis of the Kidney.

Xinhui: Located one cun above Shangxing on the vertex, approximately one cun wide, where the Du Mai (Conception Vessel of the Back) emerges. Toxicity arising here is extremely ominous. Fangguang: Belongs to the Lung sector; few spots indicate auspiciousness. Shenting: Belongs to the Lung sector, located five fen above the anterior hairline, the convergence point of the Du Mai, Foot-Taiyang Bladder Meridian, and Foot-Yangming Stomach Meridian; excessive spots here are inadvisable. Tianting: Belongs to the Lung sector; if the spot markers appear here first and are numerous, it indicates toxin invading the Yang region, which is ominous. Qionglong: Refers to the high points of the Five Yue (Five Mountains). If spots appear here first, they are Yang; however, if numerous and fine, it is ominous. Fenggan: Located behind the brain; carbuncles should not arise here. Yintang: Belongs to the Lung sector; if spots resemble clouds covering the area, it indicates extreme ominousness. Sizhu: The pivot of the Liver, located in the depression at the brow end, where the Qi of the Foot-Taiyang Bladder Meridian emerges; corresponds to Shangqiu; excessive density is strictly forbidden. Tiancang: Belongs to the Lung sector, located above the Taiyang acupoint; fullness and plumpness indicate no pathological changes in the five meridians. Caixia: Located above the outer ends of the eyebrows; clarity and brightness are beautiful; belongs to the Lung sector. Fanxia: Located above the outer ends of the eyebrows; clarity and brightness are beautiful; belongs to the Lung sector. Xuanwu: At the level of the upper ear; belongs to the Kidney sector. Shanlin: Toxicity nodules should not form here. Baihui: Smallpox toxin should not arise here. Hairline: If toxicity nodules form here, resulting in red eyes, dry tongue, and dry mouth, it is ominous. Jingming: Located at the inner canthus near the lacrimal punctum, convergence of the Hand-Taiyang Small Intestine Meridian and Hand-Yangming Large Intestine Meridian; belongs to the Liver sector. Yangchi: A place of dual Yang; excessive density and fineness appearing early are strictly forbidden. Left Taiyang: The Killing Gate of the Liver; excessive density is strictly forbidden. Right Taiyang: The Killing Gate of the Lung; early appearance with excessive density is extremely ominous. Leitang: Refers to the eye socket, the Killing Gate of the Liver; if spots are the size of pepper seeds, it is ominous. Yuwei: Belongs to the Lung sector, above the corner of the eye; excessive density is extremely ominous. Jiaogu: Belongs to the Kidney sector, one cun in front of the ear; spots resembling moving silkworms indicate ominousness. Tinghui: Belongs to the Kidney sector, in the depression in front of the tragus, one cun below the Shangguan acupoint in the pulsating depression, where the Qi of the Hand-Taiyang Small Intestine Meridian emerges; toxicity should not arise here. Erkong: The pivot of the Kidney; a carbuncle here is named Huanhu (Rearing Tiger) and requires rapid puncture treatment. Xuanbi: Also known as Rui Bi, belongs to the Spleen sector; sparse and clear spots are an auspicious sign. Jinggu: The seven orifices are referred to as Jinggu; if spots appear here first, it is Yin and indicates ominousness. Wuyue: Refers to the two cheekbones, nose, forehead, and Di Ge (chin); sparse, clear, and beautiful spots are auspicious. Quanfu: The Axis of the Heart; spots resembling colorful flower ornaments are auspicious; those resembling purple duckweed or moving silkworms are ominous. Quanshi: Belongs to the Heart sector; observing whether the upper part is filled and the lower part is turbulent determines if it is treatable. Bizhun: Belongs to the Stomach sector; toxicity should not arise here. Songyue: Belongs to the Stomach sector; if spots resemble pomegranates, and spots on the four limbs resemble peach blossoms, it is an auspicious sign. Nianshou: Belongs to the Stomach sector; if purple blisters rise here on the seventh day, and are hard like wood or tin sheets, it is extremely ominous. Dige: Belongs to the Kidney sector; should not appear first. Bizhu: Belongs to the Stomach sector; spots resembling the beauty of peach blossoms are auspicious; those gray-black like coal dust are extremely ominous. Yingxiang: Located in the oblique crease five fen beside the nostril, convergence of the Hand-Yangming Large Intestine Meridian and Foot-Yangming Stomach Meridian; toxicity should not arise here. Shicang: Located beside the two nostrils; also refers to the area near the nasolabial fold between the two cheeks, belonging to the Spleen sector; spots resembling nests indicate vomiting and are ominous. Renzhong: Belongs to the Spleen sector, the Hall of Life; spots should not appear here; if spots resemble a chariot wheel, it is ominous. Saijing: Belongs to the Spleen sector; smallpox toxin should not arise here; corresponds to Zu Lougu. Saitian: Belongs to the Spleen sector; should not be dense. Yichi: Belongs to the Spleen sector; if spots resemble plum blossoms, the Spleen Earth is injured leading to diarrhea and counterflow, indicating ominousness. Chengjiang: Located in the depression five fen below the lip in front of the chin, convergence of the Foot-Yangming Stomach Meridian and Lung Meridian (Note: Text says Lung, typically Ren Mai/Stomach); toxicity here is ominous. Qishu: The pivot of the Lung, located near the throat under the chin; numerous spots are ominous. Houtu: Located in the depression one cun below the Adam's apple, convergence of the Yin Wei Mai and Ren Mai, the pivot of the Lung governing life and death; dense spots here are ominous. Qiwo: The Killing Gate of the Lung; emergence of spots here is extremely ominous. The acupoint is in the depression below the prominence; if resembling three stars hanging down, death is certain. Beizuo: Observing the upper filling and lower turbulence indicates a difficult-to-treat case. Xingsuo: If spots resemble coiled snakes, the toxin is abundant and difficult to cure sharply; belongs to the Lung sector. Rupan: The pivot of the Heart; if spots resemble intersecting ramparts, it causes irritability and curling up in bed. Danzhong: Also known as Xiongfus, located between the two breasts, one cun six fen below Yutang, where meridian Qi emerges, the pivot of the Heart; presence of spots causes irritability and is ominous. Zhongwan: Four cun above the umbilicus, belonging to the stomach membrane, governed by the Hand-Taiyang Small Intestine Meridian and Hand-Shaoyang Sanjiao Meridian, convergence of the Ren Mai, and jurisdiction of the Spleen's Guan; spots resembling bee stings are ominous. Qifeng: The Guan of the Spleen; should not have many spots, otherwise Spleen deficiency leads to diarrhea and counterflow, indicating ominousness. Qilu: The Guan of the Spleen; if spots resemble spinning pearls, it inevitably leads to diarrhea and counterflow, indicating ominousness. Feishu: One and a half cun lateral to the lower border of the third thoracic vertebra, where the Qi of the Foot-Taiyang Bladder Meridian emerges. However, the positions of the Five Shu Points should not have many spots; if they all emerge here, it is named Xuanjing and indicates ominousness. Xinshu: One and a half cun lateral to the lower border of the fifth thoracic vertebra. Ganshu: One and a half cun lateral to the lower border of the ninth thoracic vertebra. Pishu: One and a half cun lateral to the lower border of the eleventh thoracic vertebra. Weishu: One and a half cun lateral to the lower border of the twelfth thoracic vertebra. Shenshu: One and a half cun lateral to the lower border of the fourteenth thoracic vertebra; should not have many spots. Jianyu: Carbuncles forming here are treatable. Shangmen: The Five Guan constitute the Shangmen; numerous spots cause irritability. Jingtian: Above the umbilicus; toxin accumulation in the Dantian leads to intestinal constriction and difficulty defecating. Xuanmen: Male glans, female vulva; belongs to Water but Fire does not generate; if a carbuncle arises here, it is extremely ominous. Fengqiu: The high points of the five meridians; few spots indicate peace and smoothness. Quchi: In the depression at the bend of the elbow; carbuncles should not occur here, requiring rapid treatment, otherwise chronic disease may result. Sanli: Two cun below Dubi on the side of the knee; if carbuncles form here, life is not threatened, but one must guard against ulceration damaging tendons and bones. Tunfu: The Axis of the Liver; carbuncles forming here are treatable. Yangqiu: The Guan of the Kidney; presence of toxin is ominous. Shangqiu: In the slight depression anterior to the medial malleolus, traversed by the Foot-Taiyin Spleen Meridian; corresponds to Sizhu. Gongsun: On the foot, traversed by the Foot-Jueyin Liver Meridian (Note: Text says Liver, typically Spleen). Yongquan: In the depression of the center of the sole; firm masses here indicate toxin penetrating the foot, difficult to treat. Taichong: Two cun posterior to the proximal interphalangeal joint of the great toe, in the depression. Taixi: In the depression of the pulsating vessel behind the medial malleolus. Taibai: On the foot. Yinling: On the foot. Weizhong: In the popliteal crease. Lougu: On the sole, corresponding to Saijing; if toxic carbuncles arise here, they are absolutely incurable.