面为诸阳聚会之所，其部位各有所属，欲识痘出之吉凶，
须按部位验之，则立判矣，
如额属心位，自印堂以上，发际以下，至日月两角，
若先见点，先作浆，先结靥者，皆恶候也，以心为君主，义不受邪，
先见于是位者，乃毒发于心，故非吉兆也，
左颊属肝，右颊属肺，
若两颊先见红点，磊落分明者吉，如相聚成块地界不清，肉体肿硬者凶，
盖肝藏魂，肺藏魄枭毒侵犯，则魂魄将离，安望其有生意乎？
颏下属肾，自承浆以至两颐，先见点先灌先靥者吉，
诚以此位虽系肾部，而三阴三阳之脉皆聚于此，
先发先灌先靥者，乃阴阳和畅，故可治也，
至若鼻属脾藏，位在中央，所最忌者，准头先出与先靥也，
盖脾土荣养于四藏，若毒发于脾，是脾败矣，
脾败则四藏亦随之而败，即缠绵时日，亦不过苟延性命而已，
夫耳为肾窍，又少阳相火之脉行耳前后，
故凡耳轮先见红点者，乃火毒燔灼，难以扑灭，非吉象也，
最可喜者，口唇四围先出先灌先靥也，以阳明之脉侠口环唇，胃与大肠主之，
多气多血之处，无物不受，故主吉也，
此藏府部位之要，须详察于平时，庶能权宜于临证也。
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痘疮贯顶号蒙头，毒参阳位最可忧，形尖松肌通圣治，红肿如瓜药枉投。
[注]
头为诸阳之会，遍身稀疏而头独稠密者，名曰蒙头，此毒参阳位也，
若痘形稍尖圆者，当以松肌通圣散治之，
设头红肿如瓜，是为不治之证，即投药饵，终属无济。
(松肌通圣散) 荆芥 羌活 牛蒡子炒研 防风 紫草 红花 青皮 当归
赤芍 紫花地丁 蜂房 山查 木通 引加芦□芫荽水煎服。
(方歌)
松肌通圣药最灵，荆芥羌蒡共防风，紫草红花青归芍，地丁蜂房查木通。
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The face is the gathering place of all Yang meridians, and each part of the face corresponds to specific internal organs. To determine the auspiciousness or inauspiciousness of smallpox (variola) eruption, one must verify according to the location, which allows for an immediate judgment.
For instance, the forehead belongs to the Heart position, ranging from above Yintang (Ex-HN26) to below the hairline, extending to the lateral corners of the eyes near Riyue (GB24). If pustules appear first on the forehead, form pus first, and scab first, these are all ominous signs. Since the Heart is the monarch organ and theoretically does not accept pathogenic factors, the emergence of toxins at this location indicates that the toxin originates from the Heart; thus, it is not a good omen.
The left cheek belongs to the Liver, and the right cheek belongs to the Lung. If red spots appear first on both cheeks, with distinct and clear boundaries, it is auspicious. If they cluster together into masses with unclear boundaries, accompanied by swelling and hardness of the flesh, it is inauspicious. This is because the Liver stores the Hun (Ethereal Soul) and the Lung stores the Po (Corporeal Soul); if malignant toxins invade, the Hun and Po will scatter, making it impossible to hope for vitality.
The chin belongs to the Kidney position, ranging from Chengjiang (CV24) to both jawlines. If lesions appear first, suppurate first, and scab first, it is auspicious. Indeed, although this area belongs to the Kidney region, the meridians of the Three Yin and Three Yang converge here. Early appearance, suppuration, and scabbing indicate harmonious and smooth flow of Yin and Yang Qi, so it is treatable.
As for the nose, it belongs to the Spleen, located in the center of the face. The most taboo is for lesions to appear first or scab first on the tip of the nose (Zhuntou). This is because Spleen Earth nourishes the other four Zang organs; if toxins erupt in the Spleen, it indicates Spleen failure. Once the Spleen fails, the other four Zang organs will also fail subsequently. Even if time drags on, it merely prolongs life temporarily.
The ears are the orifices of the Kidneys, and the meridians of Shaoyang Ministerial Fire run along the front and back of the ears. Therefore, if red spots appear first on the ear helix, it indicates blazing fire-toxins that are difficult to extinguish, which is not an auspicious sign.
What is most gratifying is when lesions appear, suppurate, and scab first around the mouth and lips. This is because the Yangming meridians flank the mouth and encircle the lips, governed by the Stomach and Large Intestine. This is a place abundant in Qi and Blood, capable of bearing any condition, hence it signifies auspiciousness.
These key correspondences between Zang-Fu organs and facial locations must be carefully studied in daily practice, so as to apply flexible judgment during clinical treatment.
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When pox covers the entire head, it is called "Meng Tou" (Head-Covering). Toxin involving Yang positions is most worrying. If the shape is sharp like pine needles, Tong Sheng San (Universal Sage Decoction) modified for loosening the muscle layer should be used; if swollen and red like a melon, medication is futile.
[Note]
The head is the meeting point of all Yang meridians. When pox is sparse over the body but dense exclusively on the head, it is named "Meng Tou." This represents toxin invading Yang positions.
If the pox shape is slightly pointed and round, it should be treated with Song Ji Tong Sheng San (Decoction for Loosening Muscles and Universal Salvation).
If the head becomes swollen and red like a melon, it is a case of untreatable disease; even administering medicine will ultimately be of no help.
(Song Ji Tong Sheng San / Decoction for Loosening Muscles and Universal Salvation): Jingjie (Schizonepetae Spica), Qianghuo (Notopterygii Rhizoma et Radix), Niubangzi (Arctii Fructus, stir-fried and ground), Fangfeng (Saposhnikoviae Radix), Zicao (Lithospermi Radix), Honghua (Carthami Flos), Qingpi (Aurantii Fructus Immaturus), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Zihua Diding (Violaris Herba), Fengfang (Vespa Nidus), Shanzha (Crataegi Fructus), Mutong (Akebiae Caulis). Add Luzhu (Reed Rhizome) and Yuansui (Coriandri Fructus) water for decoction and administration.
(Prescription Verse)
Song Ji Tong Sheng's efficacy is most spiritual,
Jingjie, Qianghuo, Niubang, and Fangfeng unite.
Zicao, Honghua, Qingpi, Danggui, and Chishao join,
Diding, Fengfang, Shanzha, and Mutong complete the line.
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