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The initial erupting pustules stand pointed; though numerous and slow in emergence, do not worry. If they erupt all at once with scorched heads and withered appearance, even if prolonged, survival is unlikely.

Furthermore, observe the color to assess the flourishing or withering of Qi and Blood. When spots first appear, prognosis can be known by inspecting their hue: if the bases are red and成片 (in patches), moist and lively, it is treatable; if black as coal, the blood is dead, undoubtedly fatal. (Shao Gong)

Pearl Shape: The shape resembles a pearl, white at the apex and red at the base, which can be referenced in medical texts. If distinct, uniform, and bright/lustrous, the pus will circulate on the seventh day and expand fully by the ninth.

Dogwood Shape: The shape resembles dogwood fruit, indicating excess in the Blood level. Administering Jiedu Tang (Detoxification Decoction) in advance can eliminate the pathogen. If the apex is depressed, dark/black, and dull, refer to Shao Gong's treatise for guidance.

Chess Piece Shape: The shape resembles a chess piece with a flat top, thick skin, and dull/dark color. This is due to Qi stagnation and weak Yuan Yang (Primary Yang). Treatment with Tiaoyang Tang (Regulation and Nourishment Decoction) offers hope.

Mung Bean Shape: The shape resembles a mung bean, with a hard apex and greenish hue. Both Qi and Blood are robust, and the pus is sufficient. However, there is fear that it may fail to crust over during the recovery phase. This is an orally transmitted secret formula, not recorded here.

White Bean Shape: The shape resembles a white bean, with the thinnest skin. It produces clear, watery pus and appears flaccid. This type of smallpox is caused by deficiency of Qi and Blood. Regulating Qi and nourishing Blood will suffice to generate adequate pus.

Those with superior insight, seeing these shapes and colors, possess keen vision and integrated wisdom. They can infer three corners from one corner, know ten things from hearing one, and can save eight or nine out of ten patients.

Crow Spot: The appearance of Crow Spots indicates many malignant conditions. The eruption is dim, hidden, and chaotic like a flying shuttle. With a black, depressed center and purple surroundings, death occurs within six days, like waking from a dream.

Purple Sand Spot: The affliction of Purple Sand Spots is never mild. The pustule apex resembles measles. Due to Qi deficiency and盛 (excess) toxin, timely detoxification is appropriate. Administering Qingdi Tang (Clear Earth Decoction) is effective.

Cloud Head Spot: The shape resembling floating duckweed is favorable, similar to a mole/beauty mark. If methods for detoxification and breaking blood stasis are incorrect, death occurs within six days, morning or evening.

Flea Bite Spot: The shape resembles flea bites covering the body, yet looks like mosquito bites. For treatment of Qi deficiency and Blood stagnation, remove Poria (Fuling) from the Tiaoyang Tang (Regulation and Nourishment Decoction).

Lipstick Spot: The shape lies on the skin surface, like rouge applied to flesh. Although there is Heat in the Blood and excess Qi, slight administration of detoxifying herbs ensures no harm.

Dry Skin Shape: The dry skin sore is slightly red, accompanied with withered blackness attacked by Heat. With little Qi and withered Blood, the sore toxin lurks internally. Urgent application of Qingdi Tang (Clear Earth Decoction) is required.

Purple Duckweed Spot: The shape resembles a purple lotus. Upon eruption, the blood color is hidden without distinct bases, only because Fire Toxin connects and blazes with the sores. Within seven days, the Five Poisons torment the body.

White Duckweed Spot: The white duckweed sore has a brittle shell and thin skin, lacking pus, gray in color, with significant Blood deficiency. Both regulating Qi and nourishing Blood should be used to avoid endangering the infant on the ninth day.

Red Duckweed Spot: The red duckweed sore erupts uniformly, shaped like peach blossoms adhering to the flesh. Scratching causes bleeding like dripping. Herbs that remove toxin, cool the Heart, and defeat fire are suitable.

Lotus Flesh Shape: The red shape of lotus flesh indicates the smallpox has erupted uniformly. Five days after full eruption, the skin swells. If it collapses without pus, it is difficult to treat; on the ninth day, one returns from the Yellow Springs (underworld) like a dream.

(Regarding malignant shapes and colors, caution is still advisable. At the time of clinical practice, one must not be rash. Among ten people, two or three can still be saved. If dealing with the ignorant or stubborn, who either demand remuneration beforehand, delay treatment through往返 (back-and-forth) procrastination, or fear that saving them might damage their reputation if unsuccessful—thus abandoning them without rescue—such individuals are unworthy. Even if pediatricians possessed these many secrets, they would not achieve success with such patients. My secret methods are unknown to one in a hundred practitioners nationwide. Because I made a vow before Heaven: I do not transmit to those who love profit, to the ignorant, or to those who violate righteousness. The reason for these three non-transmissions is that I fear knowing this method, they would take advantage of others' peril, even frightening parents of patients with favorable prognoses, forcing them to pawn clothes, kowtow, and pray for rescue. Those holding this secret method only seek profit, lacking any heart to protect infants. Therefore, not only will their use be ineffective, but they will surely suffer heavenly retribution. Be cautious.)