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The eruption of smallpox (or chickenpox) should be sparse; if sparse, the toxin is less severe. It should not be dense; if dense, the toxin is profound. This is a confirmed theory from ancient and modern times. The distinction between sparse and dense has its respective preferences and taboos. For instance, the head and face should be sparse, as the head is the "chief" and must not be invaded; the neck should be sparse, as the "pipe and lock" (throat/airway) must not be blocked; the chest and back should be sparse, as they are where the Shu (Back-Shu points) and Mu (Front-Mu points) of the Zang-Fu organs are attached. As for the hands and feet, density is not taboo.

To call it "sparse" does not merely mean few in number; if arranged distinctly and evenly in size and cleanliness, it can also be called sparse. To call it "dense" does not necessarily mean numerous; if clustered and adhering, layer upon layer, even if only in a few places, it can still be called dense.

There are several types of sparse eruptions that indicate a ominous prognosis. First, when the eruption first appears, only two or three red spots are seen, and the fever subsides immediately, which seems sparse. However, if high fever persists, lips and mouth become dry and cracked, urination and defecation are obstructed, and there is restlessness and irritability, or if there is no body heat but increased thirst and irritability, this is because the toxin is deep and repressed internally, unable to emerge quickly. Day by day, more emerge, becoming increasingly dense. This is the first type. Second, if one or two spots appear initially with blackened, necrotic tips, or three or four grains cluster together, appearing only in a few places while others do not erupt, accompanied by lethargy, anorexia, irritability, thirst, and difficult urination/defecation, this indicates toxin hidden internally. If delirium occurs, death may ensue before the eruption rises; if it does rise, abscesses and toxins will likely develop later. This is the second type. Third, although the eruption is truly sparse, negligence arises due to laxity in observing taboos, failure to avoid wind-cold, dietary injury, or inappropriate use of decoctions and pills, leading to unpredictable changes. This is the third type.

Conversely, there are cases of dense eruptions with a auspicious prognosis. This occurs when treatment is early, care is strict, there is no internal disease, and all lesions mature successfully.

I often observe that morning-blooming grass withers by evening, while pine and cypress remain resilient through winter. Plants differ in hardness and brittleness; hard ones are difficult to damage, while brittle ones are easily injured. How much more so for humans, whose constitution varies in thickness/thinness and Qi in strength/weakness? The toxin of sores and pox prefers "mature/old" (Lao) and dislikes "tender/young" (Nen). "Cangla" (dark waxy) versus "Jiaohong" (delicate red) refers to color maturity. "Jinshi" (tight/solid) versus "Xufu" (empty/fluctuant) refers to form maturity. "Nongzhuo" (thick/turbid) versus "Qingdan" (clear/light) refers to pus maturity. "Jianong" (hard/thick) versus "Ruanbo" (soft/thin) refers to scab maturity.

The reason for maturity lies in Wei Qi (Defensive Qi). The Classics state: "Wei Qi warms the muscles, fills the skin, thickens the interstices, and controls the opening and closing." Therefore, strong Wei Qi results in firm muscles, thick skin, dense interstices, and proper regulation of opening/closing. It thus restrains and binds the toxin, preventing it from running rampant. Consequently, the color is dark-waxy, the form is tight-solid, the pus is thick-turbid, and the scab is hard-thick. Naturally, it becomes robust and heals easily. Even if attacked by evil winds and foul toxins, it cannot be harmed.

If Wei Qi is weak, muscles are brittle, skin is thin, interstices are loose, and opening/closing is disordered. It cannot withstand the toxin, allowing the toxin to act wildly. Thus, the color is delicate-red, the form is empty-fluctuant, the pus is clear-light, and the scab is soft-thin. It breaks easily and fails to heal. Without waiting for evil winds or foul air, it deteriorates prematurely. Observing the maturity of sores reveals that Qi must be nourished.