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Xu Zhongguang treated a child with smallpox. The lesions initially appeared on the lower cheek, corresponding to the Kidney region. The lesions were flat and depressed, indicating Qi deficiency; the spirit was lacking, indicating Blood deficiency. The six pulses were deep and weak. On the sixth day, the color remained dull and did not rise. The legs were painful, and there was loose stool, presenting signs of Qi stagnation and Blood stasis. This is a syndrome of Qi deficiency and Spleen weakness. It is appropriate to greatly tonify Middle Qi using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Chan Tui (Cicada Slough), Rou Gui (Cinnamon Bark), and Qiang Huo (Notopterygii Rhizoma et Radix). After two doses, the lesions began to swell. Subsequently, Baoyuan Tang (Preserve the Origin Decoction) added with Chen Pi (Citri Reticulatae Pericarpium) and Rou Gui (Cinnamon Bark) was used for regulation. By the eighth day, diarrhea persisted, so Mu Xiang (Aucklandiae Radix), He Zi (Terminalia Chebulae Fructus), and Rou Dou Kou (Myristicae Semen) were added, and the patient recovered.

Another child presented with swollen smallpox lesions that were flat at the apex and pale white in color, accompanied by thirst, diarrhea, cold limbs, and a preference for hot drinks. The Classics state: "When Yin Cold is extreme, one does not feel heat even when drinking boiling water." It also states: "In cases of severe Cold where warming treatment fails to produce warmth, it indicates the absence of Fire (Mingmen Fire)." Treatment should involve benefiting the source of Fire to dissipate Yin shadows. Chenpi San (Tangerine Peel Powder), Yigong San (Extraordinary Efficacy Powder), and Bawei Wan (Eight-Ingredient Pill) were used, and the patient recovered.

A third child had smallpox for six days. The lesions were dense, flat, and dark/stagnant in color, resembling clouds obscuring the forehead or locks binding the neck and chest. Although the appearance indicated an adverse prognosis, the four limbs were red, vibrant, and protruding; the lips were red and moist; activity and rest were peaceful; diet was normal; and urination and defecation were regulated. Although the toxin was abundant and Qi/Blood were deficient, fortunately, the Spleen and Stomach were still strong. Therefore, nourishment combined with consolidation was appropriate. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Zicao (Arnebiae Radix seu Lithospermi Radix), Chan Tui (Cicada Slough), and Niu Bang Zi (Arctii Fructus) was administered. All adverse lesions flattened, the pus broke and leaked, scabs formed, and several ding abscesses appeared before recovery. (This is also a syndrome of Qi deficiency and Blood Heat; the medication was highly appropriate.)

Fei Yangheng treated a child who vomited due to internal injury. The next day, smallpox appeared very densely, but showed no rising trend throughout the day. A method to loosen the muscle layer and penetrate the exterior was used, but two doses yielded no effect. The following day, Baoyuan Tang (Preserve the Origin Decoction) added with a small amount of Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamon Bark) was given, but two doses again yielded no effect. On the third day, Ren Shen (Ginseng Radix et Rhizoma) was increased to 3 qian. By the fourth and fifth days, the lesions slightly rose, but ultimately the apex remained depressed and the sac wall thin. On the seventh day, Ren Shen (Ginseng Radix et Rhizoma) was increased to 5 qian, along with half a cup of Lurong Gao (Deer Antler Paste), yet there was still no vigorous rising momentum. Some argued that the pathogen became more vigorous due to tonification. Fei replied: "If this were true, there would be vexation, heat, dryness, thirst, and a rough, old-looking, alum-red complexion. Now the skin is thin and white, the head is warm, and the feet are cold; the syndrome can be deduced from this." Consequently, Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix) were each prescribed at 1 liang, along with more than half a cup of Lurong Gao (Deer Antler Paste). After one dose, the lesions immediately protruded like pearls, with red roots and white tops. Within less than a day, the fluid became thick and purulent. The subsequent recovery required no further effort, demonstrating a verification of 'using tonification as purgation.' Such syndromes are rare nowadays. (These two sentences refer to establishing Middle Qi.)