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Taiji generates the Two Modes (Yin and Yang); in human society, there are husbands and wives. Male-female intercourse cannot occur without desire, nor can it be activated without Fire (Mingmen Fire). Indulgence in lust causes Fire-Toxin to remain between Essence and Blood, thereby forming the toxin of infantile smallpox and measles. However, although both smallpox and measles are fetal toxins with the same origin, their manifestations differ. At the beginning of pregnancy, Zang organs form before Fu organs; Fu organs belong to Yang, while Zang organs belong to Yin. Smallpox arises from within the interior, emerging from deep within the muscles, thus it is difficult; measles emerges from the exterior, appearing between the skin, thus it is easy. Smallpox belongs to Yin; Yin governs stillness. It has form and contains pus, the granules remain stationary, and they conform to even numbers. Measles belongs to Yang; Yang governs movement. It has form but no pus, appearing and disappearing intermittently, seen three times a day, erupting nine times over three days, conforming to odd numbers. The differences in their clinical presentations are as follows: for smallpox, neither vomiting nor purging should be used from start to finish; the ability to eat is auspicious. If vomiting or purging occurs, it is because the Fire-Toxin is extremely abundant and attacking upward; inability to eat indicates that the Fire-Toxin is depressed and obstructed, a condition resistant to treatment. For measles, simultaneous vomiting and purging are auspicious, while inability to eat is favorable. Vomiting and purging allow the Fire-Toxin to drain out; inability to eat leaves the interior empty, allowing the Fire-Toxin to circulate freely. Smallpox requires tonifying Qi and generating Blood, using formulas that tonify and support to seek internal solidity. Measles requires nourishing Yin and controlling Yang, using formulas that release and disperse while avoiding internal stagnation. Smallpox presents as smooth/normal, deficiency-cold, excess-heat, or blood-heat. Measles is always excess-heat. Treatment for the Fire-Toxin of measles should employ cooling methods, avoiding acrid-warm herbs. For smallpox, extensive eruption on the head and face is an adverse sign; for measles, extensive eruption on the head and face is a favorable sign. In both cases, the living quarters should be sealed tightly, and clothing and bedding should be thickly layered to maintain warmth. This keeps the Couli (pores) open and facilitates eruption. Strict adherence to taboos is also required. If attacked by external Wind-Cold or if taboos are violated, mild conditions can become severe, and stability can turn into danger. Although measles has fewer days of duration than smallpox, claiming that smallpox is severe and measles is light ignores the rapid transformation of measles, which can change in an instant, making its critical state more dangerous than that of smallpox.

(Also known as Heavenly Blister or Hundred-Year Blister)
When observing smallpox and prescribing treatments, one must understand the classification into Smooth, Adverse, and Critical categories. For Smooth patterns, only careful regulation is needed; medication is unnecessary. If diaphoresis is applied when inappropriate, it leads to ulceration and difficulty in healing; if tonification is applied when unnecessary, it aids the toxin and causes carbuncles. If cooling herbs are used before the rash erupts, the cold causes stagnation; if warm tonics are recklessly used before the toxin resolves, the heat prevents suppuration, worsening other symptoms. Is this not the fault of the medicine? Conversely, if one neglects caution for mild smallpox and violates taboos, leading to severity, this is indeed not due to medicinal error! For Adverse patterns, medication is often ineffective. However, from the perspective of benevolent medicine, one should still prescribe and attempt treatment; saving even one out of ten would be boundless merit. Critical patterns rely entirely on appropriate medication and careful nursing. If parents protect the patient according to proper rules, the condition becomes Smooth; otherwise, it becomes Adverse. Initially, this often coincides with years of excessive Fire Qi and circulating Heat-Toxin, triggering the smallpox toxin. The initial presentation resembles Taiyang disease (Exogenous Cold Damage). Symptoms include fever, restlessness, red face, red lips, headache, body pain, sneezing, yawning, cough, and phlegm. Causes may include external contraction of Wind-Cold, food injury leading to vomiting/diarrhea, seasonal epidemic transmission, or fright/fall injuries. Generally, the toxin of smallpox and measles lies dormant in the Kidney Meridian. Once the smallpox toxin erupts, the Kidney Meridian itself should show no symptoms. Therefore, one must pre-test for coldness at the earlobes, the sacrum (tailbone), and the feet (indicating the Kidney Meridian is symptom-free; if these areas are hot accompanied by lower back pain, the prognosis is ominous, indicating extreme Fire-Toxin failing to exit via the Kidneys). Other signs include coldness at the middle finger, coldness at the nasal tip, vein patterns behind the ears (pale red, few/light; deep red, many/heavy), eye fatigue, and red streaks on the cheekbones. These are all precursors to eruption.