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On the first day, when fever appears, Su San (Perilla Powder) should be used; on the second day, it is still appropriate to follow the original prescription. On the third day, detoxification should only be performed once the pockmarks begin to emerge; on the fourth day, if purple-black mottled spots appear, Zi Hei Hua Ban Tang (Purple-Black Mottled Spot Decoction) is indicated. On the fifth day, when the rashes erupt in large numbers, if there is internal heat, Zi Ge Tang (Puerariae Radix Decoction) should be used. On the sixth day, one must comprehensively observe the coloration; Tuo Li San (Support the Interior Powder) is the most appropriate method. If there are depressed lesions internally, modifying the base formula is indeed a good approach. On the seventh day, when the pustules are filling with pus, those with deficiency should all use Da Bu Tang (Great Tonifying Decoction). The eruption of smallpox begins on the eighth day; regulating according to the principles is truly remarkable. One must employ flexible methods in mind; missing a single day renders all effort vain. On the ninth day, when the pus is properly discharging, one only fears that Qi and Blood may be incomplete. Combining Si Wu Tang (Four Substances Decoction) with Ba Zhen Tang (Eight Treasures Decoction), carefully observe to determine Yin and Yang. On the tenth day, special attention must be paid; do not neglect cases involving Huo Luan (Cholera-like syndrome). Daily care continues through the eleventh day; do not abandon Si Wu Tang (Four Substances Decoction). One must also fear symptoms such as teeth grinding and coughing due to Qi stagnation; several doses of the base formula will harmonize the body. By the twelfth day, if the pus is complete but the apex has not filled, diarrhea, deficiency-cold, and chills may arise. Yi Gong San (Yi Gong Powder) is truly stable and appropriate; following this prescription for regulation ensures no error. When the smallpox is fully erupted and stable after twelve days, mental effort should be applied flexibly. First, examine the scar color to determine if heat has been cleared; the key points in San Du Fang (Detoxification Powder) must be mastered. Apply daily care day by day; adjusting for excess or deficiency is the optimal strategy. For Qi deficiency, regulating Qi is primary; for Blood deficiency, generating Blood is the constant principle. Medicines should not be rigidly fixed to formulas but used flexibly; this secret transmission is the art of living methods. If these secrets are not followed, effort is wasted and the infant is harmed.

Whenever fever persists for three days, if there are rashes with severe facial pain, or alternating chills and fever, or convulsions, twitching, and teeth grinding, redness of the sclera, tight and urgent skin, or absence of sweating, this indicates that the toxin is trapped inside and the pathogenic factor is vigorous. When the rash erupts, do not lightly use Shi Jie San (Ten Releases Powder) to suppress its momentum. Whenever the initial eruption lacks various toxic signs, but vomiting and diarrhea persist without cessation, and eating is impossible, Zhong He Tang (Harmonizing Middle Decoction) is suitable. Whenever initial fever prevents closing the eyes, accompanied by mania, extreme thirst, high body heat, or heat at the tip of the tongue, this indicates the root of the toxin is internal. If blood flows from the mouth or from the two bowels, this is a Syndrome of the Heart Channel. It is suitable to use Da Jie Fa (Major Release Method/Decoction) to vent it; delaying by one day makes treatment difficult. If the area around the mouth is dense on the second or third day, or if Ding Du (Ding Toxin) manifests as郁结 (stagnant) spots within the skin欲出不出 (wanting to emerge but unable to), treat with Zi Cao Tou Ji Tang (Arnebia Skin-Penetrating Decoction) and Xiao Feng San (Eliminate Wind Powder). If they erupt on the same day, failing to use these two formulas will result in collapse, scorching, and death. If the rash has erupted for seven or eight days but has not covered the whole body, and the pus is not full, this indicates the toxin is not circulating freely. Use Qi Zhen Tang (Seven True Decoction) plus three slices of Chuan Shan Jia (Pangolin Scale) to assist in forming pus. If the patient does not sleep or feel pain, it means the toxin is not being contained; Ya Tuo San (Tooth Support Powder) should be used to contain it. If the time limit passes, it becomes difficult to treat. If there are black depressions, Ba Ding Dan (Ding-Toxin Removing Pill) should be used to pierce and apply locally. Whenever smallpox initially presents with fever due to weak Stomach Qi, leading to edema from diarrhea and toxin sinking, use a large dose of San (Powder) or Si Jun Zi Tang (Four Gentlemen Decoction) added with Rou Dou Kou (Nutmeg), followed by Shi Chang San (Intestine-Solidifying Powder); once diarrhea stops, resume Bao Yuan Tang (Protect Origin Decoction) added with Xiong Gui (Ligusticum and Angelica) to aid Qi and Blood. Whenever smallpox undergoes three rounds of pus-filling, but the apex remains depressed and does not rise, carefully inspect the Nian Shou (Area between nose and upper lip). If it can rise but does not, worry is warranted; if the rash on the hands does not rise, the toxin is internal, urgently administer one dose of Sheng Tian San (Ascend to Heaven Powder); if it still does not rise, check the Tian Ting (Forehead area); if it rises, another half dose of Sheng Tian San can achieve full success. Quack doctors do not recognize pock colors; they only see the brightness of the whole body and consider it a favorable progression, unaware that the key lies entirely in the sufficiency of pus in Nian Shou, Tian Ting, and behind the ears. Within nine days of smallpox, if Tian Ting, Yin Tang, Li Gong, and Kan Gong do not rise, treat with Sheng Tian San. If this medicine fails to produce results after one hour, administer another dose; if it still does not rise, rescue is impossible, and it is a fatal syndrome. After the smallpox crusts fall off, if the lips and mouth do not peel, urgently treat with Qing Xue Tui Xin Tang (Clear Blood and Retreat Heart Decoction). If untreated, it will definitely transform into Zou Ma Ya Gan (Running Horse Gum Rot), a difficult-to-treat condition. After the smallpox crusts fall off, if the shells are thin and ash-dry, Qi and Blood are exhausted. Urgently use Da Li Jie Du Tang (Great Strength Detoxification Decoction) for one dose, followed by Si Jun Zi Tang (Four Gentlemen Decoction). After smallpox, if the shells are thin and peeling, accompanied by throat trauma and delirious speech, urgently treat with Du Huo Xiao Tan Yin (Angelica Pubescens Phlegm-Resolving Drink). If there are chills and teeth grinding after smallpox, urgently use Xiang Su San (Cyperus and Perilla Powder) to dispel evil Qi; if the toxin attacks the Heart, it becomes difficult to treat. If after smallpox one cannot eat, only drinking soup is possible, this is a Syndrome of the Heart Channel. If the toxin attacks the throat, Guan Kai San (Open Gate Powder) must be taken; do not overdo it, merely slightly clearing the heat of the Heart Channel. If after smallpox one can eat but also has diarrhea, this is Disharmony of Yin and Yang with residual internal toxin; Bu Yin Tang (Tonify Yin Decoction) must be taken to resolve the toxin. If after smallpox dysentery persists for a long time, this is Toxic Yin-Yang Disharmony and Spleen-Stomach Disharmony; Xiao Ji San (Accumulation-Resolving Powder) can be used to turn sorrow into joy; otherwise, use Zhi Li Tang (Stop Dysentery Decoction). If after smallpox there are carbuncles, this is residual toxin manifesting externally; urgently use Bai Du San (Eliminate Toxin Powder) to cool the Qi and Blood, taking three to five doses consecutively for natural resolution. If smallpox erupts on both cheeks, or if string-like toxins resembling silkworm eggs appear on the chest, Tian Tang, and Yin Tang, indistinguishable as individual grains and hidden in the skin, they are hardest to rise; or if there is purple-black color on the tongue, or pock-dings, or one dot, or two dots like the character 'Lu', or three dots like 'Pin', or four dots like 'Qi', or five dots like 'Plum Blossom', or large purple-red blisters on the head, face, and limbs, with the whole body's pocks appearing bright red—these shapes are all untreatable. In the early stage, urgently use Huan Dou Fang (Change Pock Formula) to change them; if effective, follow up with Shi Jie San (Ten Releases Powder). Whenever smallpox presents with fever and vomiting, lower back pain and heat for one day, with cheek spots like needle shoots rising only the next day, while appetite remains normal, this is an auspicious sign; regarding lower back pain as ominous is wrong, but seeing vomiting as auspicious is correct; many cases have combined superficial and deep signs on the first day. As long as the apex rises with yellow moisture, it is auspicious.