顺证七朝浆自行，先起先灌次第明，由红转白渐肥泽，九日苍蜡显痂形。
[注]
灌浆顺证者，因气盈血附，其毒易化，
至七朝不期行而自行也，先起先灌，
次第明者，谓痘先起胀者，当先灌浆，自头面以及周身也，由红转白，
渐肥泽者，谓痘先见红点，由红转白，血变成浆，渐惭肥满而光泽也，
至九日浆老，则苍如黄蜡色，而显结痂之形矣。
%
灌浆浆清不按期，行迟收早总非宜，亮软根艳并水泡，不杂他证险可医。
[注]
痘当灌浆之时，浆清不浓，及不按期而浆行迟者，皆气血虚也，
浆行收早者，是毒热盛也，
软薄者，谓痘皮不能坚实，恐其易于损破，则气泄而浆虽成也，
根艳者，谓痘根赤艳，热在血分，毒未尽化也，
水泡者，水泡夹杂于痘中，盖因脾虚多湿也，此皆险证，
若不夹杂他证，虽险亦可医也。
%
紫黑灰白浆不行，□烂痒塌痘壳空，稠密无浆目不闭，已闭行浆复开凶。
[注]
痘至行浆之时，其色紫黑或灰白，而浆不行者，
非枭毒内蕴，锢滞气血，即虚弱不能领载其毒也，
□烂者，谓浆未成而腐烂也，
痒塌者，谓行浆时作痒塌也，
痘壳空者，谓壳空而无浆也，
稠密无浆者，谓稠密不分颗粒，而复干枯无浆也，
目不闭者，谓痘出太稠密，而眼目不封也，
目已闭复开凶者，谓起胀时其目已闭，行浆时目忽复开也，
此皆灌浆逆证，必主凶也。
%
**Smooth Syndrome (Shun Zheng):** On the seventh day, the pus fills naturally. The pustules that appeared first fill with pus first, following a clear sequence. The color gradually changes from red to white, becoming plump and lustrous. By the ninth day, the pus matures, appearing pale yellow like beeswax, and scabs begin to form.
[Note]
The smooth syndrome of pus-filling occurs because Qi and Blood are abundant, allowing the pathogenic toxin to be easily resolved. Thus, by the seventh day, pus-filling occurs spontaneously without needing to wait. "First appearance, first filling" means that pustules that initially swelled should fill with pus first, progressing from the head and face to the entire body. "Clear sequence" refers to this orderly progression. "Changing from red to white, gradually becoming plump and lustrous" means that after the initial red spots appear, they turn white as blood transforms into pus, becoming progressively fuller and shinier. By the ninth day, when the pus is mature, it takes on a pale yellow hue resembling beeswax, revealing the formation of scabs.
**Dangerous Syndrome (Xian Zheng):** If the pus is thin and does not follow the schedule, or if pus-filling is delayed or healing concludes too early, these are inappropriate. Signs such as soft and thin pustule walls, bright red roots, and the presence of water blisters indicate a dangerous syndrome; however, if no other complications are mixed in, it may still be treatable.
[Note]
During the pus-filling stage, if the pus is thin and not thick, or if pus-filling is delayed beyond the expected time, these are signs of Qi and Blood deficiency. If the healing process concludes too early after pus-filling, it indicates excessive heat and toxicity. "Soft and thin" refers to pustule walls that lack firmness, fearing they may rupture easily, leading to the leakage of Qi even if pus has formed. "Bright red roots" refers to the intense redness at the base of the pustules, indicating heat in the Blood level and incomplete resolution of the toxin. "Water blisters" refer to vesicles interspersed among the pustules, caused by Spleen deficiency and dampness. These are all dangerous syndromes. However, if they do not mix with other pathological conditions, although dangerous, they can still be treated.
**Adverse Syndrome (Ni Zheng):** Pustules are purple-black or grayish-white with no pus formation; rotting, itching, collapsing, and empty pustule shells; dense pustules without pus causing the eyes to remain open; or eyes that were closed during swelling suddenly reopen during pus-filling—all indicate an ominous prognosis.
[Note]
When the pustules reach the stage of pus-filling, if the color is purple-black or grayish-white and pus does not form, it is either due to the internal accumulation of severe toxins obstructing Qi and Blood, or due to weakness preventing the body from carrying the toxin. "Rotting" refers to decay occurring before pus is fully formed. "Itching and collapsing" refers to the sensation of itching and sinking/collapsing during pus-filling. "Empty pustule shells" refers to hollow shells lacking pus. "Dense without pus" refers to densely packed pustules that are indistinct and dry without pus. "Eyes not closing" refers to the eyes failing to seal due to the extreme density of the eruption. "Eyes reopening after closure" refers to a situation where the eyes were closed during the swelling phase but suddenly reopen during the pus-filling phase. All these constitute adverse syndromes of pus-filling and inevitably portend a fatal outcome.