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(Regarding the application of formulas) The primary treatment is Guashuang Zixue Dan (Melon Frost Purple Snow Pill) with added ingredients. In critical cases, particularly "Men Dou" (stifled smallpox), "Zi Men" (purple stifled type) is the most urgent. The symptoms typically manifest as excessive toxin and fire closure. Initially, administer approximately one qian of Guashuang Zixue Dan, using a large dose of aromatic penetrating agents. Subsequently, administer three to five pills of Ju Fang Miaoxiang Wan (Wonderful Fragrance Pill from the Bureau Formulary) as a potent agent to open and unblock. Next, administer Fei Shi Bisheng Tang (Fei's Invincible Decoction) in a large dose for cooling and detoxifying attack. Externally, needle the Shaoshang (LU11), Quchi (LI11), and Weizhong (BL40) acupoints to drain blood toxins. This approach may save one or two out of ten patients. However, stifled smallpox often involves complicated conditions: food stagnation causing "Shi Bi" (food closure), phlegm turbidity causing "Tan Bi" (phlegm closure), and blood stasis causing "Xue Bi" (blood closure). Many cases involve closure due to complications, leading to stifling. In such emergencies, rapidly administer Feima Jindan (Flying Horse Golden Pill, Shen Yueting's verified prescription from Chuanxin Fang) to induce vomiting and diarrhea, thereby opening the qi channels and blood pathways. Once the complicating pathogen is resolved, assess the severity of the disease and prescribe medication accordingly. For mild cases, only blood-invigorating and detoxifying methods are needed, such as Nie Shi Qingdu Huoxue Tang (Nie's Toxin-Clearing Blood-Invigorating Decoction), Wu Shi Liangxue Jiedu Tang (Wu's Cooling-Blood Detoxifying Decoction), or a small dose of Qingwen Baidu Yin (Clear Plague and Eliminate Toxin Decoction). For severe cases, cooling-blood and attacking-toxin methods are essential, such as Qingliang Gongdu San (Cooling Attack-Toxin Powder, Wang Jinshan's Ancient Formula Selection), Fei Shi Bisheng Tang, or Qinghuo Jiedu Tang (Fire-Clearing Detoxifying Decoction, from Jiupian Suoyan). Only when warm toxin is complicated by parasites causing stifling should one first use Jiaomei Wan (Pepper and Plum Pill) to lure the medicine into the parasite's mouth, followed by Zicao Chengqi Tang (Lithospermum Da-Huang Decoction, from Zhang Shi Yitong) to purge downwards. Furthermore, in cases where true yuan (vital energy) is extremely deficient causing stifling, urgently rescue with Shenguilu Rong Tang (Ginseng, Angelica, and Deer Antler Decoction, from Doumen Fangzhi) or Shenrong Sheng Tang (Ginseng and Deer Antler Ascending Decoction, from Zhang Shi Yitong); however, this is seen in less than one in a hundred warm-heat diseases. If the stifling is slow, it is called "Qingxing Mendou" (mild-type stifled smallpox). If caused by internal obstruction of fire toxin, use Nie Shi Qingjie San (Nie's Clearing-Unblocking Powder) for cooling and penetrating; if constrained externally by wind-cold, use Nie Shi Sujie San (Nie's Eucalyptus Unblocking Powder) for dispersing and unblocking. The manifestations of eruptive smallpox syndromes are listed below:

Manifestations of favorable syndrome: On the first or second day, eruptions appear like millet grains, pale red and moist. Two or three spots initially appear around the mouth, nose, and Nianshou area. By the second or third day, the bases are round, full, and long. By the fourth or fifth day, they are large, round, glossy, and vary in size. By the sixth or seventh day, they are red, vibrant, bright, clean, and full. By the seventh or eighth day, spirit is complete and color is moist. By the ninth or tenth day, the pus is full, the base resolves, and there are no other symptoms. By the eleventh or twelfth day, the pus is full and begins to dry/converge. By the thirteenth or fourteenth day, the pus matures and forms scabs. By the fifteenth or sixteenth day, the scabs fall off, leaving clear marks.

Manifestations of adverse and critical syndromes: Black soot-like discoloration of the nostrils, epistaxis, sore throat, hoarseness, restlessness, mania, tongue protrusion with black prickles, cracked lips, dry skin, swollen eyelids, thirst with preference for cold drinks, foul breath, hot tears with bleeding, profuse watery diarrhea, purulent urine mixed with blood. Smallpox lesions resemble ink sprinkled on vermilion, bursting and bubbling up.

Manifestations of purple depression and black depression: Dense eruptions with red-purple halos, depressed tops, and even dry, withered edges. There may be black umbilici with central depression. Symptoms include coarse breathing, fever, coma, restlessness, and confusion. In severe cases, blood syncope resembling death, mental confusion, and convulsions occur.

Manifestations of mild-type stifled smallpox: Fever for three days, eruptions desire to emerge but do not, eruption shadows are red-purple, voice is loud, breathing is coarse, palms and soles are hot,惊悸 (startle/convulsion), restlessness, or heavy voice, nasal congestion, and runny nose.

Manifestations of severe-type stifled smallpox with excessive toxin and fire closure: Upon fever onset, points appear like cinnabar. Body heat feels like burning iron. Eruptions gradually become dry, scorched, purple, and black. Restlessness, mental confusion, cracked lips, and foul odor occur, or swelling of lips and mouth.

Manifestations of stifled smallpox complicated by food stagnation: At initial onset, high fever, coma, abdominal pain, delirium, tongue prickles like thorns, coarse breathing, constipation, screaming, and mental confusion.

Manifestations of stifled smallpox complicated by phlegm: During fever, inability to lift head and neck, coughing with phlegm, rapid breathing, closed eyes, coma, dizziness, falling, mental confusion, and convulsions.

Manifestations of stifled smallpox complicated by blood stasis: Upon fever and appearance of spots, delirium and coma occur immediately. Symptoms include wheezing, distension, epistaxis,烦闷 (restlessness/oppression), agitation, chest bi (pain/blockage), and purple-dark tongue color.

Manifestations of stifled smallpox complicated by parasites: Upon fever, immediate restlessness and vomiting. Saliva flows constantly under the tongue, or sometimes silence with preference for spitting, or agitation and unrest, or abdominal pain with uncertainty, or frequent screaming. Blue-green veins under the tongue, or black-and-white fine dots on the lower lip.

Manifestations of severe-type stifled smallpox with extreme deficiency of true yuan: Fever for two or three days, eruptions desire to emerge but have not. When spots first appear, they are small and white like millet. No significant body heat. Weak qi and lack of strength. Closed eyes without spirit. Face and lips appear unusually fresh, moist, delicate, and radiant beyond normal.