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When fever occurs, the body does not have high heat, and the waist, abdomen, feet, and knees do not pain. After three days, red spots appear, which are hard and obstructive to touch; this is a favorable prognosis (a condition with good outcome), and no medicine is needed.

During fever, the whole body feels warm, and there are occasional convulsions; the smallpox toxin emerges from the Heart Meridian, which is also a favorable prognosis, treatable and curable.

Note: In recent years, there have been frequent cases of convulsions before smallpox eruption leading to fatal outcomes; it is better not to call it favorable.

At the initial stage of fever, severe abdominal pain occurs, and the waist feels as if beaten by a staff; when the pustules dry up after reporting their shape, if the previous pain still does not cease, death is inevitable and untreatable.

If abdominal pain occurs first and then stops, medicines that tonify Qi and Blood can be used to save the patient.

On the first day of initial fever, if red spots appear all over the body, dense like silkworm eggs, but smooth to touch without obstruction, death is inevitable and untreatable.

At the initial stage of fever, if the head and face are uniformly red like rouge, death will occur on the sixth day.

At the initial stage of fever, if lighting a red paper wick dipped in oil and shining it on the scalp over the heart reveals redness like a patch of rouge inside the skin and flesh, or if the whole body forms clumps of redness, death will occur after eight or nine days.

The course of smallpox begins with the appearance of spots. Counting from the appearance of spots, the period lasts seven days. Within these seven days, it is like a flower bud beginning to bloom; its vital energy increases daily to emerge. After seven days, the energy condenses and the flower fades. Therefore, those taking medicine should take it continuously day and night within the seven-day period, without indulgence. The hardship endured for seven days ensures a lifetime of health. People do not understand this and only seek indulgence; after seven days, taking medicine is of no benefit. I once said that the smallpox toxin residing in Qi and Blood is like bran in rice. Only when Qi and Blood are sufficient and move swiftly and urgently, like sifting rice without stopping, will the bran not mix with the rice but rise and gather into a lump. When Qi and Blood are sufficient and circulate throughout the body, the toxin will not stagnate in the Ying and Wei levels but will naturally condense to form sores. Thus, smallpox suppurates on time without rotting muscle or damaging flesh; it merely stores the red toxic qi of the skin and flesh in the follicles. Those that become foul and rotten after a long time are all altered conditions, not the original state. Nowadays, the world uses food to "trigger" smallpox, unaware that this is originally unhelpful. It is only appropriate to take medicines that tonify Qi and Blood to assist the momentum of circulation and expulsion.

After three days of fever, if the heat subsides and the body becomes cool, with pustules of varying sizes emerging in three batches, pale red with a luster like water droplets, no medicine is needed. Whenever smallpox spots appear, if sparse, the toxin is light, and one must not treat rashly; if dense, the toxin is severe, yet they should be distinct, clear in size, and non-adherent. Slightly administer formulas that support the interior and resolve toxicity, such as Kuaiban Tang (Rapid Spot-Dispersing Decoction) and Xiaodu Yin (Toxin-Resolving Drink), to facilitate easy eruption and crusting. If eruption is too dense, adherent and blurred, the toxin is particularly severe; the interior-supporting and toxin-resolving formulas should be taken in larger quantities to prevent complications like itching, collapse, black depression, or sinking. Furthermore, observe external signs; treat if treatable, do not treat if not. When smallpox spots erupt, if the skin and flesh are normal, and the roots and tips are bright and moist, the toxin is light, and one must not treat rashly. If the skin and flesh are dull black or red-swollen, and the roots and tips are dry, purple-black, or grayish-white, the toxin is severe; combine Xiaodu Yin (Toxin-Resolving Drink) and Duoming Dan (Life-Snatching Pill).

Kuaiban Tang (Rapid Spot-Dispersing Decoction)
Ren Shen (Ginseng Radix et Rhizoma, 5 fen), Dang Gui (Angelicae Sinensis Radix), Fang Feng (Saposhnikoviae Radix), Mu Tong (Akebiae Caulis, each 1 qian), Gan Cao (Licorice Root, 3 fen), Mu Xiang (Aucklandiae Radix), Zi Cao (Arnebiae Radix seu Lithospermi Radix), Chan Tui (Cicadae Periostracum, each 2 fen).
Crush finely. Add one cup of water, decoct to七分 (70%), remove dregs, and take warm at any time.

Xiaodu Yin (Toxin-Resolving Drink)
Niu Bang Zi (Arctii Fructus), Lian Qiao (Forsythiae Fructus), Gan Cao (Licorice Root), Lv Sheng Ma (Green Cimicifugae Rhizoma), Shan Dou Gen (Sophorae Tonkinensis Radix), Zi Cao (Arnebiae Radix seu Lithospermi Radix, equal parts).
Crush finely. Add one cup of water, decoct to七分 (70%), remove dregs, and take warm at any time.

Duoming Dan (Life-Snatching Pill)
Ma Huang (Ephedrae Herba), Sheng Ma (Cimicifugae Rhizoma, each half liang), Shan Dou Gen (Sophorae Tonkinensis Radix), Hong Hua Zi (Carthami Flos), Da Li Zi (Arctii Fructus), Lian Qiao (Forsythiae Fructus, each 2.5 qian), Chan Tui (Cicadae Periostracum), Zi Cao (Arnebiae Radix seu Lithospermi Radix, each 1.5 qian), Ren Zhong Huang (Human Excrement Extract, 3 qian).
Grind into fine powder. Form pills with wine and honey, coat with Chen Sha (Cinnabar). Take with decoction of Bo He Ye (Menthae Haplocalycis Folium).

In the eruption of smallpox, the most important sign is moist lips and tongue, red and fresh as usual, indicating light toxin. If lips are scorched and cracked, and the tongue is dry with prickles, it indicates excessive fire toxin and internal-external stagnation; immediate resolution is required using Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) plus Da Li Zi (Arctii Fructus).

Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) [Indicated for restlessness]