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Xu Zhongguang's son had two or three pustules appearing under the eyelids on both sides. By the fifth day, he experienced restlessness, fever, and restless sleep. The pustules were flat-topped and broad, with red roots showing vitality. This indicated that the child had contracted the pestilential qi of smallpox, with the toxin manifesting externally first. If these were normal smallpox lesions, given their scarcity, they would necessarily be pointed and protruding without the aforementioned prodromal symptoms. Two doses of Shengma Gegen Tang (Cinnamon Twig and Kudzu Root Decoction) were administered, after which the smallpox indeed erupted again, evenly distributed, bright, red, and blooming, with all previous symptoms subsiding.

Another infant presented with a single spot on the lips before any fever appeared. Another infant, also without fever initially, had one spot on the left cheek and one on the right forehead; these spots were flat-topped and broad. On the fifth day, fever arose, followed by a full eruption of smallpox that was even, clear, red, and favorable. The pus filled adequately, and scabs formed. However, the initial spots (Bao Dou) ulcerated and failed to heal, taking fourteen days to recover.

A girl first showed smallpox spots at Chengjiang (CV24). The spots were flat-topped and broad. Fever appeared on the fourth day, followed by a secondary eruption that was sparse, clear, red, and favorable. However, the initial spots swelled and extended to the submental region. Recovery occurred after suppuration and detoxification.

An infant first showed a single spot on the glabella (Meixin). By the sixth day, it became progressively flat and sunken, resembling the size of a Go stone, grayish-white and lifeless, accompanied by itching, rupture, irritability, and fever. A subsequent eruption was even, clear, red, and favorable. However, the glabella corresponds to the Ministerial Fire of the Gate of Life (Mingmen). Since the smallpox toxin originated here, the Ministerial Fire was injured. Although eruptions elsewhere were favorable, there was a risk of "Solitary Yin failing to transform." When the pus collapsed and scabs formed, the limbs became cold, accompanied by wheezing, abdominal distension, and convulsions. The child died on the ninth day.

Another infant showed spots on the waist before maturation. Another showed spots on the neck before fever. Yet others showed spots in the epigastrium or throat. All erupted fully between the fifth and sixth days, appearing even, clear, red, and favorable. Only the primary spots (Mu Dou) were flat, grayish-white, and lifeless. Although the pus filled, sudden collapse of the pus, wheezing, and abdominal distension led to death.

An infant initially showed spots at Shan Gen (the root of the nose). The child was coarse and fat. Everyone believed the smallpox would be sparse. By the third day, high fever and delirium occurred. The primary spots sank, while faint traces appeared on the cheeks and chin. Xu stated that Shan Gen belongs to the Spleen. Despite the coarse appearance resembling a steamed bun, this indicated toxin attacking the Spleen and Stomach. Renya San (Human Tooth Powder) combined with Qianghuo San Yu Tang (Notopterygium Decoction for Dispelling Depression) was used. The smallpox erupted densely, and sunken spots rose. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was then administered. Pus filled and scabs formed, but the lesions were dry, red, and lacked moisture. Cracks bled from the lips and mouth, accompanied by abdominal distension, constipation, and dysuria. Nourishing and clearing agents were used; upon bowel movement, the child slept peacefully. Later, gingival ulcers developed, treated with Qingwei Jiedu Tang (Clear Stomach and Detoxify Decoction) plus Qiaqiao (Forsythia Fruit).

Wan Mizhai treated the son of Prefect Zhu, aged nine, who presented with fever and vomiting. He diagnosed: "Smallpox." He noted that since it had already erupted, the marks remained. He corrected another opinion that these were chickenpox scars, stating they were not typical smallpox scars. Another suggested food stagnation. Wan explained: "Smallpox fever resembles Taiyang disease or food stagnation. In Taiyang disease, the face is red and hands/feet are slightly warm; in food stagnation, the face is yellow and hands/feet are hot; in smallpox, boys have a yellow face and cool extremities, girls have a red face and dry cheeks, and feet are cool. Now, the young master has body heat, a yellow face, and cool feet, indicating smallpox. The Classics state smallpox is fetal toxin, with each Zang organ having specific signs. Fever, yawning, palpitations belong to the Heart. Neck stiffness, irritability belong to the Liver. Cough, sneezing belong to the Lung. Vomiting, diarrhea, drowsiness belong to the Spleen. Cool ears, body, and feet belong to the Kidney. Currently, the Spleen and Stomach are weak, allowing toxin to invade due to deficiency, hence manifesting in the Spleen. Only vomiting is seen now, with fever for three days. Let us wait until tomorrow." The next day, using lamplight, faint red spots were seen under the skin, and Bao Dou appeared on the lips. It was a favorable case. Asked about medication, the response was: "Smallpox without pathology does not require medicine; simply regulate warmth/cold and diet. Peace will come by the thirteenth day." This proved correct. (Commentary by Xu Lingtai: These are words of gold and jade.)

Suo Xiwen's son, aged thirteen, presented with fever, abdominal pain, irritability, and thirst. Treatment for food stagnation worsened the condition. Wan diagnosed: "Smallpox. Abdominal pain indicates internal attack by smallpox Qi. Irritability and thirst indicate Spirit unrest and dryness of fluids. The method must be to resolve toxicity and support the interior; delay is not an option." The family did not believe him. Five days later, smallpox erupted en masse, failed to rise, dried up, and collapsed internally, leading to death. (Commentary by Xu Lingtai: Pediatricians often use exterior-releasing methods as routine, causing many failures.)

Hu Yuanxi sought advice from Wan regarding his son's impending smallpox. Wan observed: "The five mountains (facial features) are upright, the three passes are bright and moist, bones are firm, flesh solid, spirit handsome, and breath clear. Smallpox will surely be sparse." (This is the method for verifying smallpox in children.) Later, fever and convulsions occurred. Wan said: "This is a good omen." Chen Sha San (Cinnabar Powder) was administered, stopping convulsions and allowing eruption. Wan added: "When smallpox swells, head and face swelling is universal. Here, particles are tight and small, so significant swelling will not occur. Peace by the twelfth day." This came true.

Wan's son, Bangxiao, aged four, presented with fever, sudden fright, and cessation of breathing. His mother wept bitterly. Wan diagnosed: "Smallpox." He pinched Hegu (LI4), restoring consciousness, and prescribed Daochi San (Guide Out Red Powder) and Xieqing San (Drain Green Powder). One dose stopped convulsions. Smallpox erupted densely. Fortunately, no other complications arose; scabs formed by the thirteenth day, followed by rash eruption and recovery.

Li's son had three or four smallpox spots that failed to rise and disappeared. There was no fever, complexion was dull, and spirit was fatigued. Wan predicted a severe course. Someone argued: "Two or three spots have already resolved." Wan replied: "Incorrect. Regardless of severity, smallpox must suppurate and scab. The previous spots were 'test spots' (Shi Dou); their resolution indicates a adverse pattern with heat hidden inside. In a few days, high fever will arise, and smallpox will erupt en masse, covering the entire body. Use Ginseng, Astragalus, Ligusticum, Angelica, and licorice tips to nourish Qi and Blood; Schizonepeta, Saposhnikovia, Akebia, Citrus peel, Arctium, Forsythia, Honeysuckle, Scutellaria (wine-processed), Gardenia, and Platycodon to resolve toxicity. Prepare a large decoction, one dose daily. After the thirteenth day, if the body ulcerates and scabbing is delayed, switch to Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction), remove Cinnamon Twig, add Angelica Dahurica and Saposhnikovia. Apply Baicao San (Decayed Grass Powder) externally. Peace achieved after ten-plus days."

Wang's son, aged two, presented with fever and one or two red spots. Blue veins were visible on the forehead, and the face was red and shiny. This was a dangerous smallpox case. The initial spots are called test spots; insufficient middle Qi causes toxin to hide, delaying eruption. Tiaoyuan Tang (Regulate Origin Decoction) plus Saposhnikovia and Costus Root was administered. Subsequently, smallpox erupted rapidly. Fortunately, no other symptoms appeared; peace was achieved by the thirteenth day.

Chen Wenzhong recorded: The son of Controller Zhao of Huaidong, aged fifteen, had high fever and respiratory distress. Physicians diagnosed food stagnation and gave Yinggan Wan (Miracle Pill), causing two diarrheal episodes, yet high fever persisted. Another physician diagnosed Taiyang disease and gave Xiaochaihu Tang (Minor Bupleurum Decoction) with Aurantium, reducing high fever but causing dry mouth and cold feet. I stated: "Initial high fever and respiratory distress are symptoms of smallpox. Dry mouth and cold feet result from Yinggan Wan purging and causing interior deficiency. Lack of fever results from Bupleurum resolving exterior heat. If wheezing and thirst develop, Spleen and Lung deficiency will be incurable." Muxiang San (Costus Powder) plus Cardamom and Cassia Bark (0.5 qian each) was given. Five doses over two days. On the third day, sores appeared; on the fourth day, suppuration began. Mild thirst was treated with Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) and another dose of Muxiang San. Scabs fell off by the thirteenth day, and recovery ensued.

Fei Jianzhong treated the grandson of Grand Secretary Han, aged one year. Suddenly, the body felt hot like burning iron, coma ensued, resembling fright but showing smallpox signs. This belonged to the "Fire Seed" pattern, untreatable by mild methods. Approximately 1 qian of Rhubarb, along with Gypsum and Coptis, aided by clearing and penetrating exterior agents, were given for two doses. Smallpox appeared, and severity halved. By the third day, eruptions were sparse and clear. From onset to end, no major complications occurred, and recovery ensued. Without early intervention, unpredictable changes might have occurred.

Li Jie used three to five freshly laid eggs soaked in a latrine pit for five to seven days, then cooked and fed. Eating one egg every few days prevented smallpox entirely. This formula was obtained by Commander Xu from a Zhejiang native.

Shunliu Dan (Smooth Flow Pill) treats dangerous and adverse smallpox patterns. Radix Angelicae Sinensis (Danggui), Rhizoma Chuanxiong (Chuanxiong), Radix Cimicifugae (Shengma), and Radix Glycyrrhizae (Gancao) are each used in 6 liang quantities, coarsely powdered. On the eighth day of the twelfth lunar month, seven large bowls of east-flowing clear water are collected. The herb residue is removed, and the liquid is placed in a new clay pot. Four liang of pure Cinnabar (Zhusha) is placed in a fine silk bag, tied shut, and suspended in the herbal liquid, approximately one finger-width above the pot bottom. Slow fire from mulberry wood is used to boil until the liquid evaporates. The remaining material is ground into fine powder and stored in a porcelain jar. Half a jin of glutinous rice is washed and drained. Clean yellow earth mixed with salt brine is used to coat the rice balls. These are roasted in charcoal fire until red-hot, then quickly removed. Once cooled, they are cracked open, and yellow grains are selected, ground into fine powder, and stored separately in a porcelain jar. For a child exactly one year old, use one fen of Cinnabar-rice powder and one fen of plain rice powder (dosage increases with age, do not err). Mix with one tea spoon of white honey, half a cup of rice soup, and three spoons of strong wine. Stir well and feed slowly with a tea spoon. Unerupted cases will not erupt; spotted cases will be sparse; sunken cases will rise immediately. One batch can save hundreds. Preparation must occur in a quiet room with incense burned. Do not allow chickens, dogs, eunuchs, mourners, disabled persons, or those with infectious diseases to witness the process. Cherish and guard this carefully.