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Diseases such as smallpox and chickenpox manifest with visible physical signs, seemingly rendering pulse diagnosis unnecessary. Furthermore, the occurrence of these diseases is governed by the annual climate qi (seasonal climatic influence), suggesting that pulse diagnosis might also be deemed superfluous. However, the *Classic of Internal Medicine* (*Huangdi Neijing*) states: "The subtlety of medicine lies in the pulse; it must not be neglected. The principle of examination has its discipline, beginning with the differentiation of Yin and Yang." Thus, pulse diagnosis is indispensable. Ancient sages have said: "In smallpox and chickenpox, if the pulse is calm and the body cool, life is preserved; if the pulse is restless and the body hot, death ensues." This demonstrates that pulse diagnosis is indeed employed in treating these eruptions.

Generally speaking, children's pulses often present as tight and rapid. Pulses associated with toxin eruptions are frequently floating, large, and rapid. The *Treatise on Cold Damage* (*Shanghan Lun*) states: "Floating indicates wind pathogen or deficiency; large indicates strong Qi. When wind and deficiency contend, urticaria-like rashes will inevitably form." It further states: "If the rapid pulse appears irregularly, malignant sores will arise."

For children above seven years old, five beats per respiration constitute a normal pulse. For children below seven years old, six beats per respiration constitute a normal pulse. Exceeding this frequency indicates "excessive rapidity," signifying excess of pathogenic factors. Falling short indicates "slowness," signifying deficiency of healthy Qi. A floating and rapid pulse indicates exterior heat; a floating and slow pulse indicates decline of Yang Qi. A deep and tight pulse indicates interior heat; a deep and thin pulse indicates depletion of Yuan Qi (Original Qi).

Smallpox and chickenpox are Yang diseases. Their pulses should ideally exhibit a洪 (Hong/Full) and substantial quality upon both superficial (floating) and deep (sinking) palpation. If the pulse is weak and forceless, it represents a Yin pulse appearing in a Yang disease, which is an ominous sign. Any pulse that is floating without root, light and fleeting like fat floating on soup; or rapid and urgent, continuous like a sparrow pecking; or thin and dissipating, lingering like a spider's silk; or slow and nearly absent, dripping like water from a leaking roof; or deep and intermittent, like a fish jumping—all are considered death pulses.

In severe cases of smallpox, prognosis based on pulse is favorable if the pulse is Hong and substantial, but unfavorable if it is floating, rapid, deficient, and small. Zhu Danxi once treated a sixteen-year-old male who presented with fever, coma, blindness, and deafness. His pulses were both broad (Huo) and large, slightly rapid. He diagnosed this as damage due to overexertion. At that time, smallpox was prevalent in the village. Although the patient was unconscious, he could swallow medicine and porridge when offered. Zhu advised using a heavy decoction of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Cangzhu (Atractylodis Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). After more than twenty doses, the eruption began to appear. After another twenty doses, pus formed, and the skin became extensively ulcerated. Someone asked, "This deficiency condition is terrifying; why not use Chen's complete formula?" Zhu replied, "This is merely deficiency without cold. Stick to the previous prescription, and after dozens more doses, he will recover." Later inquiry revealed that four or five days prior, fearing the onset of smallpox, the patient had engaged in strenuous firewood gathering, sweating profusely for several consecutive days. This case illustrates diagnosing deficiency through the broad pulse and treating smallpox based on pulse findings.