毒微天时和者吉，毒甚天时不和凶，毒微不和顺中险，毒甚时和逆或更。
[注]
毒微吉矣，然必逢天时之和，始为顺而吉也，
毒甚凶矣，然必遇天时不和，则始为逆而凶也，
毒微者顺也，若值天时不和，恐顺中化险也，
毒甚者逆也，若值天时之和，或逆中转险也，
此以胎毒之轻重，天时之和不和，定痘之顺逆险也。
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险逆时和无病吉，不知有病定然凶，由此故识种痘善，人事能回天命亨。
[注]
凡痘险逆之证，固不善矣，
若逢天时之和，儿又无病，险者可以变顺，逆者可以化险，故曰吉也，
若逢天时不和，儿又有病，则险者变逆，逆者更逆，故曰凶也，
由此观之，可识种痘之善，以得其天时之和，儿素无病，
其中即有毒之重者，而人事克尽，亦能挽回天命而致亨也。
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发热和缓微微汗，饮食如常二便调，睡卧安然神气爽，此为顺证不须疗。
[注]
发热和缓，身不甚热，毒轻也，
微微汗，身微微有汗表和也，
饮食二便如常，里和也，
神气清爽，睡卧安然，精神气血大和，故为顺证，不须治疗也。
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发热三日热不远，烦渴咬牙面赤红，惊啼战栗乳食少，夜不安眠险证明。
[注]
发热三日见点者，常候也，
若见点热不退者，毒盛也，
更兼烦躁口渴，频频咬牙，面色红赤，惊悸多啼，身体战栗，
乳食甚少，不能安眠等证，
此是毒盛，伏郁难出，其为险证明矣，急宜随证施治，庶或从险化顺也。
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If the pathogenic toxin is slight and the heavenly timing (environmental/seasonal conditions) is harmonious, the prognosis is auspicious; if the toxin is severe and the heavenly timing is disharmonious, the prognosis is ominous. If the toxin is slight but the heavenly timing is disharmonious, it represents a danger within a favorable course; if the toxin is severe but the heavenly timing is harmonious, it may represent a worsening of an unfavorable course.
[Note]
A slight toxin is auspicious, yet it must coincide with harmonious heavenly timing to be considered favorable and auspicious.
A severe toxin is ominous, yet it becomes truly unfavorable and ominous only when encountering disharmonious heavenly timing.
A slight toxin indicates a favorable course; however, if the heavenly timing is disharmonious, there is fear that the favorable course will transform into a dangerous one.
A severe toxin indicates an unfavorable course; if the heavenly timing is harmonious, it might transform into a dangerous state within the unfavorable course.
This determines the favorable (Shun), unfavorable (Ni), and dangerous (Xian) prognoses of smallpox based on the severity of fetal toxin and the harmony or disharmony of heavenly timing.
In cases of dangerous or unfavorable courses, if heavenly timing is harmonious and the child has no other illness, the prognosis is auspicious; failing to recognize the existing illness leads to certain ominous outcomes. From this, we can appreciate the benefits of variolation: human effort can reverse destiny and bring about prosperity (recovery).
[Note]
Cases of dangerous or unfavorable smallpox are inherently undesirable.
However, if heavenly timing is harmonious and the child has no other illness, dangerous cases can become favorable, and unfavorable cases can become merely dangerous (less severe); thus, it is said to be auspicious.
If heavenly timing is disharmonious and the child also has other illnesses, dangerous cases will become unfavorable, and unfavorable cases will become even more so; thus, it is said to be ominous.
From this observation, one can understand the advantage of variolation: by securing harmonious heavenly timing and ensuring the child was previously healthy, even if the toxin load is heavy, complete human effort (medical intervention) can reverse destiny and lead to recovery.
Fever is mild with slight sweating, diet remains normal, bowel movements and urination are regulated, sleep is peaceful, and spirit/qi is refreshed; this is a favorable course requiring no treatment.
[Note]
Mild fever without excessive heat indicates light toxin.
Slight sweating indicates harmonious exterior (surface) qi.
Normal diet and excretion indicate harmonious interior (visceral) qi.
Refreshed spirit and peaceful sleep indicate great harmony of spirit, qi, and blood; therefore, it is termed a favorable course requiring no treatment.
After three days of fever, if the heat persists, accompanied by irritability, thirst, teeth grinding, red face, startled crying, tremors, reduced milk intake, and insomnia at night, these are signs of a dangerous course.
[Note]
The appearance of spots after three days of fever is a common pattern.
If the heat does not subside after spots appear, it indicates abundant toxin.
Combined with irritability, thirst, frequent teeth grinding, red complexion, palpitations and frequent crying, body tremors,
very little milk intake, and inability to sleep peacefully,
these symptoms indicate abundant toxin that is stagnant and difficult to erupt; this clearly demonstrates a dangerous course. Urgent treatment according to symptoms is required, so that the condition may possibly transform from dangerous to favorable.