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The Lung governs Qi. If Qi is insufficient, it leads to the following three syndromes: spontaneous sweating (Zi Han) and inability to produce sound. The pustule apex is depressed and collapsed, failing to become plump. All are suitable for treatment with Shiqi San (Ten Wonders Powder). (If spontaneous sweating is severe, double the amount of Huangqin [Scutellariae Radix]; if inability to produce sound occurs, double the amount of Jiegeng [Platycodonis Radix]).

The Heart governs Blood. If Blood is insufficient, it leads to the following three syndromes: ash-white coloration, non-redness at the root base, and lack of luster. All are suitable for treatment with Xionggui Tang (Angelica and Ligusticum Decoction) added with Shaoyao (Paeoniae Radix), Zicao (Arnebiae Radix), and Honghua (Carthami Flos), which yields excellent results.

[Qian Yi] Regarding variola and rubeola, one must carefully distinguish their severity. If they erupt all at once upon onset, the condition is necessarily severe. Variola mixed with rubeola indicates a moderate severity. Sparse eruption indicates mildness. Plump and red both inside and out indicates mildness. Black outside and white inside indicates slightly severe. White outside and black inside indicates very severe. Pustules with black centers like needle holes indicate intense heat toxin. Cyanosis, dryness, black depression, lethargy with incessant sweating, irritability, heat, thirst, abdominal distension, crying, wheezing, and obstruction of urination and defecation indicate a critical and difficult state.
For all variola and rubeola, the wet nurse must be cautious with diet and lifestyle; the infant must not be allowed to go hungry or be exposed to wind-cold. Otherwise, the pathogen will return to the Kidney, turning black, and will be difficult to treat. [Hai Zang] Alternatively, extreme heat may paradoxically generate water transformation (cold signs), also leading to blackening. One should use cooling medicines. This must not be overlooked; pulse diagnosis can differentiate it. There may be cases where the eruption color is normal, but internal heat exists chronically, causing the head to depress, with colors appearing grayish-blue or black, and central needle-like depressions. One should urgently use cooling medicines to disperse them. For constipation, use Da Huang (Rhei Radix et Rhizoma) and Qianniu (Pharbitidis Semen); for loose stools, use Jinhua Wan (Golden Flower Pill).

[Chen Zhongwen] Mild cases erupt in three stages. Sizes vary. Scarce on the head and face. Absent around the eyes. Root bases are red. Plump and lustrous.
Severe cases erupt simultaneously. Dense as silkworm eggs. Fever and abdominal distension. Ash-white color. Dense without gaps. Incessant diarrhea and thirst. Warm head and cold feet.
Causes of mild becoming severe: Sexual activity. Failure to observe dietary taboos. Previous diarrhea. Drinking cold water. Taking cooling medicines.
Causes of severe becoming mild: Avoiding wind-cold. Maintaining warmth. Formed stools. No dryness or thirst. Avoiding raw and cold foods. Avoiding outsiders.
Regarding the above, if drinking cold water or taking cooling medicines, there is no need to avoid them if there is excess heat internally.

On the second and third days, variola begins to appear, just emerging like millet seeds, or like broomcorn millet seeds, or like mung beans. Those resembling water droplets, bright and clear, are auspicious and require no medicine.
On the fourth and fifth days, variola varies in size. Red and vibrant root bases with bright clarity indicate mildness. Dense, depressed apices, ash-white color, diarrhea, and thirst indicate severity.
On the sixth and seventh days, plump, red, and lustrous variola indicates mildness. Warm body but rapid breathing, dry mouth, abdominal distension, and cold toes indicate severity.
On the eighth and ninth days, fully grown, plump, and waxy-yellow variola indicates mildness. Chills, confusion, abdominal distension, irritability, thirst, rapid breathing, and teeth grinding indicate the most severe condition.
On the tenth and eleventh days, variola should crust over, scabs fall off, and healing occurs. Fever, confusion, abdominal distension, diarrhea, chills, and teeth grinding indicate severity.

[Weng Shi] Song for Mild Variola: Heat is mild, spirit is clear, pustules are small and sparse, root bases are red and vibrant with irregular distribution, limbs are warm without chills or fever, nursing and eating are normal, no thirst or diarrhea, Taiyang area and cheeks are smooth and moist, hands and feet are round and piled like pearls, fewer lesions on waist and neck. Only care is needed, no medical intervention required.
Song for Severe Variola: Erupts immediately after one day of initial heat, dense and fresh red, reduced appetite, diarrhea, irritability, thirst, abundant on head and face, red pustules mixed with rubeola, obstructed urination and defecation, flat and wide ash-white lacking luster, carbuncles and pus sores weeping moisture. Such severe conditions require prevention; do not wait until the crisis for negligence.

[Wan Quan] The ancients said: Mild becomes severe, severe becomes mild. "Mild" refers to sparse eruptions, plump and red inside and out. People see its mildness and become negligent, failing to avoid wind-cold, regulate diet, observe taboos, or choose proper healers. Thus, contracting wind-cold generates external heat; damaging diet generates internal heat. Heat steams upward, causing either dense eruption of pustules, blindness or carbuncles post-variola, abdominal distension, irritability, vomiting, or diarrhea. Violating taboos causes itching and ulceration. Medical error involves tonifying what should not be tonified or purging what should not be purged. Shamanistic deception involves sprinkling cursed water, damaging the exterior, or forcing water intake, damaging the interior. Often this turns into serious disease, attributed to fate, how foolish! "Severe" refers to dense eruptions, black outside/red inside, or white outside/black inside. By maintaining caution, regulating temperature, being careful with diet, strictly observing taboos, and choosing proper healers, it naturally erupts and crusted easily, transforming into mildness. Is this not humans overcoming heaven?

Differentiating Self-Healing Without Medicine
Sparse pustule bases, red and spreading root bases, no diarrhea or thirst, normal nursing and eating, warm limbs, no high fever.
For the above six syndromes, no medicine is needed. Only proper care is suitable. Keep the room warm, exclude foul odors, avoid seeing outsiders, abstain from sexual activity, and keep away from menstruating women and those with axillary odor. Burning Da Huang (Rhei Radix et Rhizoma) and Cangzhu (Atractylodis Rhizoma) is recommended to dispel evil qi. Burning Chenxiang (Aquilariae Lignum Resinatum), Tanxiang (Santalum Album Lignum), Jiangzhengxiang (Daemonorops Draconis Resina), Ruxiang (Olibanum), Bingpian (Borneolum Syntheticum), and Shexiang (Moschus) should be avoided. Inside the curtains, hanging Huyu (Coriandri Fructus) is suitable, or soaking Huyu in wine and spraying beds/curtains, along with burning Muxiang (Aucklandiae Radix), is excellent. The toxin of variola fears foul odors most. Do not believe monks or Daoists who claim to cleanse impurity through scriptures; they have no power and may themselves introduce foul odors. Do not rely on them for cleansing without prevention. Beware, beware.

Differentiating Five Incurable Syndromes
Itching and collapse, chills and teeth grinding, incessant thirst. Purple-black variola, panting, thirst, and restlessness. Ash-white depressed apices, abdominal distension. Warm head and cold feet, confusion and drinking water. Rapid breathing, diarrhea, and thirst.