发热三朝始见点，热减身和不渴烦，颗粒稀疏渐次出，色润红活顶尖圆。
[注]
发热三朝之后始见点者，
此痘如期而出也，热减身和者，毒已宣发透彻也，
不渴不烦者，无里热壅滞也，
颗粒稀疏者，不稠密联系也，
渐次出者，先自头面惭至周身而出也，
色润红者，痘色红活滋润也，
顶尖圆者，痘形顶尖而体圆也，此皆见点顺证。
%
痘已见形身仍热，稠密联系不润红，稀疏淡隐精神少，痘顺兼杂病险名。
[注]
痘已见形，身仍发热者，此毒气未尽透也，
稠密者，痘出稠密不少也，
联系者，颗粒粘连不分也，
不润红者，痘色虽红而黯滞也，
稀疏淡隐者，痘虽稀疏而色浅淡，隐于皮肤不透出也，
精神少者，精神倦怠也，此皆见点险证，
痘顺兼杂病者，谓痘出虽属顺证，而或兼杂病，亦属险名也。
%
发热一朝即见形，一齐涌出不分明，密如蚕种平塌隐，紫黑干枯逆证凶。
[注]
发热一朝或半朝即见点者，此毒火太迅，不循次第也，
一齐涌出者，此毒火太盛，不受领载也，
点不分明者，颗粒不分也，
密如蚕种者，密如蚕之种也，
平塌者，平塌不起也，
隐者，痘已出复隐也，
紫黑者，痘色或紫或黑也，
干枯者，痘干枯不润也，此皆见点逆证。
%
Three days after the onset of fever, the pustules begin to appear; the fever subsides, the body feels harmonious, and there is no thirst or restlessness. The pustules are sparse, emerge sequentially, have a moist and ruddy luster, and possess a rounded apex.
[Note]
When the pustules appear only after three days of fever, this indicates that the eruption occurs as scheduled. The subsiding fever and harmonious body condition signify that the pathogenic toxins have been thoroughly disseminated. The absence of thirst and restlessness indicates no internal heat stagnation. The sparsity of the pustules means they are not dense or clustered. Emerging sequentially implies they first appear on the head and face and gradually spread to the entire body. A moist and ruddy color indicates the pustules are vibrant and hydrated. A rounded apex means the shape is pointed at the top but round in body. These are all considered favorable signs (Shun Zheng) during the initial appearance stage.
If the pustules have taken shape but the body remains febrile, if they are dense, clustered, and lack moisture and ruddiness, or if they are sparse, pale, hidden, and accompanied by lethargy, these are dangerous signs (Xian Zheng). Even if the eruption itself follows a favorable pattern, the presence of concurrent diseases renders it dangerous.
[Note]
Fever persisting after the pustules have appeared indicates that the pathogenic qi has not yet fully penetrated to the surface. "Dense" refers to a high quantity of eruptions. "Clustered" means the pustules adhere to one another without clear separation. "Lacking moisture and ruddiness" describes a red but dull and stagnant color. "Sparse, pale, and hidden" refers to eruptions that are few in number, light in color, and remain concealed beneath the skin without fully emerging. "Lethargy" indicates mental fatigue and weakness. These constitute dangerous signs during the initial appearance stage. The term "favorable eruption with concurrent disease" means that although the primary eruption follows a favorable course, the addition of other pathological conditions classifies it as dangerous.
If the eruption appears within one day, or even half a day, of the fever's onset, erupting all at once without distinct boundaries, densely packed like silkworm eggs, flat and depressed, or receding, with colors turning purple or black and becoming dry and withered, these are unfavorable signs (Ni Zheng), indicating a ominous prognosis.
[Note]
Appearance of pustules within one day or half a day of fever onset indicates that the toxic fire is too rapid and does not follow the normal sequence. Erupting all at once signifies that the toxic fire is excessively strong and cannot be contained or carried by the body's defensive mechanisms. Indistinct points mean the individual pustules are not clearly separated. "Dense like silkworm eggs" refers to extreme crowding. "Flat and depressed" means the lesions do not rise above the skin level. "Receding" indicates that the pustules emerged but then disappeared. "Purple or black" refers to discoloration of the lesions. "Dry and withered" means the pustules lack moisture. These are all considered unfavorable signs during the initial appearance stage.