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The eruption of smallpox and chickenpox presents differences according to the Taiyang, Yangming, Shaoyang (the Three Yang meridians), and Taiyin, Shaoyin, Jueyin (the Three Yin meridians). These must be carefully differentiated to avoid misdiagnosis.

If it is a Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang meridian), characterized by aversion to cold, fever, scanty dark urine with dysuria, and slow or difficult eruption, Jingjie Gancao Fangfeng Tang (Schizonepeta, Licorice, and Saposhnikovia Decoction) is indicated.

If it is a Shaoyang disease (a syndrome caused by pathogenic invasion of the Shaoyang meridian), characterized by alternating chills and fever, and slow or difficult eruption, Lianqiao Fangfeng Tang (Forsythia and Saposhnikovia Decoction) is indicated.

If it is a Yangming disease (a syndrome caused by pathogenic invasion of the Yangming meridian), characterized by high fever, red eyes, constipation with dry stools, eruptions covering the muscles but erupting slowly, Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) [for initial heat] added with Zicao (Arnebiae Radix seu Lithospermi Radix) is indicated.

If it is a Taiyin disease (a syndrome caused by pathogenic invasion of the Taiyin spleen meridian), characterized by spontaneous diarrhea and cold extremities, Fuzi Lizhong Tang (Aconite and Atractylodes Macrocephala Decoction) [for diarrhea] or Muxiang San (Costus Powder) [for diarrhea] is indicated.

If it is a Shaoyin disease (a syndrome caused by pathogenic invasion of the Shaoyin kidney meridian), characterized by black sinking of eruptions and dryness of the mouth and tongue, Siwu Tang (Four Substances Decoction) added with Zicao (Arnebiae Radix seu Lithospermi Radix) and Honghua (Carthami Flos) is indicated.

If it is a Jueyin disease (a syndrome caused by pathogenic invasion of the Jueyin liver meridian), characterized by retraction of the testicles, curling of the tongue, and frequent episodes of cold limbs and reversal, Dayigong San (Great Yi Gong Powder) [for slow eruption] added with Fangfeng (Saposhnikovia Root) and Qingpi (Citrus Reticulata Pericarpium Viride) is indicated.

For diseases of the Three Yin meridians, the treatment principle is to rescue the interior deficiency; therefore, warm tonifying agents are indicated to assist the treatment.

(Generally, eruptions appearing in spring and summer are considered favorable because these seasons correspond to the time of pure yang qi. The ancient methods of treatment are similar to those for Shanghan [Cold Damage].)

Symptoms such as heat in the lower legs and shins, redness of both cheeks, constipation, dysuria, unquenchable thirst, rapid breathing, and a surging and rapid pulse—these seven syndromes should not be treated with hot medicines.

When eruptions first appear, if they are dense like silkworm eggs or sparse like bran, surface-clearing methods should be used, indicating Lianqiao Shengma Tang (Forsythia and Cimicifuga Decoction) [for the manifestation stage]. If convulsions occur before the eruptions emerge, this indicates an concurrent external contraction of wind-cold pathogens. It is appropriate to administer Jiedu Wan (Detoxification Pill) [for smallpox convulsions] with tea water, as well as Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) [for hemorrhage]. If eruptions are slow to emerge but bowel movements and urination are normal, the pathogen is known to be at the exterior; mild diaphoresis should be induced, indicating Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) [for initial heat]. If eruptions are blue, dry, black, and sunken, with little body heat and obstructed urination and defecation, heat is accumulated internally. Da Huang Tang (Rhubarb Decoction) should be decocted to administer Xuanfeng San (Wind-Dispersing Powder) [for fever]. If there is significant exterior heat, purgatives should not be used. For severe black sinking, Baixiang Wan (Baixiang Pill) [for black sinking] is indicated. If eruptions have emerged, are dense, accompanied by slight wheezing, and thirst with desire to drink, mild purgation is indicated, using Danggui Wan (Angelica Sinensis Pill) and Pangshi Dihuang Gao (Pang's Rehmannia Paste) [for the manifestation stage], and externally applying Huangbai Gao (Phellodendron Paste) [for the manifestation stage] to the face. In midsummer when summer heat is intense, coinciding with severe eruptions, irritability, thirst, and solid stools indicate Yulu San (Jade Dew Powder) [for vomiting and diarrhea] and Ganlu Yinzi (Sweet Dew Drink) [for sore throat]. If coma, loss of consciousness, frequent convulsions, inverted healing, and black sinking occur, Zhuxin Longnao Gao (Pig Heart and Borneol Paste) [for black sinking] is indicated.