发热时身无大热腰腹脚膝不痛，过三日才见红点，又坚硬碍指，此为吉证，不须服药。
发热时浑身温热，不时发惊，痘自心经出也，乃为吉证，可治而愈。
按∶近年，屡有痘前惊而终凶者，好事不如无，未可言吉。
发热之初，腹中大痛，腰如被杖，及至报痘干燥，而前痛犹不止者，死不治。
先腹痛，后止，可用助血气药救之。
初发热一日，遍身即现红点稠密如蚕种，摸过不碍手者，死不治。
初发热时，头面一片红如胭脂者，六日后死。
初发热时，用红纸捻蘸油点火，照心头皮肉里，红如一片胭脂，或遍身皆有成
块红者，八九日后死。
痘疮之期，始于见点，从见点而数之，期止七日，七日之内，如花之始蕾而发
也，其气日盛以出，七日之后，气敛而花谢矣，故服药者当于七日之内，日夜连服，
毋或姑息，苦之以七日，所以全之于百年，人不知此，而惟务姑息，七日之外，服
无益矣。予尝谓痘毒之在血气，譬若糠 之在米也，惟血气充足，运转迅急，若筛
米然运转不停、则糠 不混于米，而腾起浮聚，自作一团，血气充足周流，则毒不
滞于荣卫之中，而自然收敛以成疮，故痘疮及时贯脓，未尝烂肌损肉，只是将皮肉
红色毒瓦斯，收贮窠囊而已，其有日久才发臭烂者，此皆变证，而非本然如此也，今
举世以食物发痘，而不知其本无益也，惟服补气血药，以助其营运推出之势可也。
发热三日之后，热退身凉，大小不等，作三次出，淡红色如水珠光泽者，不须
服药。凡痘子出现，疏则毒轻，不可妄治，密则毒甚，却要磊落大小分明，不相
粘连，略与托里解毒之剂快斑汤、消毒饮、主之，使之易发易靥。如出太密，粘连
模糊，其毒尤甚，托里解毒之剂，宜多饮之，以防痒塌黑陷之变，更察外证，可
治则治，不可则勿治。凡痘子出形，皮肉如常，根苗明润，此毒轻也，不可妄治，
如皮肉昏黑或赤肿，根苗干枯青紫或灰白者，此毒甚也，以消毒饮、夺命丹、合服。
快 汤
人参（五分） 当归 防风 木通（各一钱） 甘草（三分） 木香 紫草 蝉蜕（各二分）
上锉细。水一盏，煎七分，去滓温服，不拘时。
消毒饮
牛蒡子 连翘 甘草 绿升麻 山豆根 紫草（各等分）
上，锉细。水一盏，煎七分，去滓温服，不拘时。
夺命丹
麻黄 升麻（各半两） 山豆根 红花子 大力子 连翘（各二钱半） 蝉蜕 紫草（各一钱半） 人中黄（三钱）
上，研细末。酒蜜和丸，辰砂为衣。薄荷叶煎汤下。
凡痘子之出，最要唇润舌润，红鲜如常，其毒则轻，如唇焦破裂，舌燥有芒，
为毒火太甚，表里郁遏，急宜解之，黄连解毒汤加大力子。
黄连解毒汤（烦躁）
When fever occurs, the body does not have significant heat, and there is no pain in the waist, abdomen, feet, and knees. After three days, red spots appear, which are hard and obstructive to touch; this is a favorable prognosis (Ji Zheng), and medication is unnecessary.
During fever, the whole body feels warm, with occasional惊悸 (palpitations/startle) and convulsions; this indicates that the smallpox toxin is emerging from the Heart Meridian, constituting a favorable prognosis, which is treatable and curable.
Note: In recent years, there have been frequent cases of惊悸 before the eruption of smallpox leading to fatal outcomes. It is better not to claim it as auspicious.
At the beginning of fever, if there is severe abdominal pain and the waist feels as if beaten by a stick, and even after the pustules dry up, the previous pain persists, death is inevitable and untreatable.
If abdominal pain occurs first and then stops, herbs that tonify Qi and Blood can be used to save the patient.
On the first day of fever, if red spots appear all over the body, dense like silkworm eggs, but smooth to the touch without obstruction, death is inevitable and untreatable.
At the onset of fever, if the head and face are uniformly red like rouge, death will occur on the sixth day.
At the onset of fever, if a red paper twist dipped in oil is lit and shone upon the skin and flesh of the heart region, revealing a patch of red like rouge, or if the entire body forms clumps of redness, death will occur after eight or nine days.
The course of smallpox begins with the appearance of spots (Jian Dian). Counting from this point, the period lasts seven days. Within these seven days, it is like a flower bud beginning to bloom; its vital energy increases daily to push outward. After seven days, the energy contracts, and the flower fades. Therefore, medication should be administered continuously day and night within the seven-day period, without indulgence. The hardship endured for seven days ensures health for a lifetime. People do not understand this and only seek indulgence; taking medicine after the seventh day is of no benefit. I once said that the smallpox toxin residing in Qi and Blood is like chaff mixed with rice. Only when Qi and Blood are sufficient and circulate rapidly, like sifting rice without stopping, will the chaff not mix with the rice but float and gather into a lump. When Qi and Blood are sufficient and flow throughout the body, the toxin will not stagnate in Ying and Wei but will naturally contract to form sores. Thus, smallpox suppurates in time without rotting muscles or damaging flesh; it merely stores the red toxic vapor of the skin and flesh in the follicles. Cases where putrefaction occurs only after a long time are complications, not the natural state. Nowadays, the world believes that food induces smallpox, not realizing this is originally unhelpful. Only by taking herbs that tonify Qi and Blood to assist the momentum of circulation and expulsion can one succeed.
After three days of fever, if the heat subsides and the body becomes cool, with pustules of varying sizes appearing in three waves, pale red and glossy like water droplets, medication is unnecessary. Whenever smallpox spots appear, if they are sparse, the toxin is mild, and rash treatment should be avoided. If dense, the toxin is severe, yet they must be distinct, clearly sized, and non-adherent. Slightly administer formulas that support the interior and resolve toxicity, such as Kuaiban Tang (Rapid Spot-Dispersing Decoction) and Xiaodu Yin (Toxin-Resolving Drink), to facilitate easy eruption and crusting. If eruption is too dense, adherent, and blurred, the toxin is particularly severe; the interior-supporting and toxin-resolving decoctions should be taken in larger quantities to prevent complications such as itching, collapse, or black depression. Observe external signs; treat if treatable, otherwise do not treat. Whenever smallpox takes shape, if the skin and flesh are normal, and the roots and tips are bright and moist, the toxin is mild, and rash treatment should be avoided. If the skin and flesh are dull black or reddish-swollen, and the roots and tips are dry, purple-black, or grayish-white, the toxin is severe; combine Xiaodu Yin (Toxin-Resolving Drink) and Duoming Dan (Life-Snatching Pill).
Kuaiban Tang (Rapid Spot-Dispersing Decoction)
Ren Shen (Ginseng Radix et Rhizoma, 5 fen) Dang Gui (Angelicae Sinensis Radix) Fang Feng (Saposhnikoviae Radix) Mu Tong (Akebiae Caulis, each 1 qian) Gan Cao (Licorice Root, 3 fen) Mu Xiang (Aucklandiae Radix) Zi Cao (Arnebiae Radix seu Rhizoma Chan Tui (Cicadae Periostracum, each 2 fen)
Finely chop. Decoct with one cup of water until reduced to 0.7 cups. Strain and take warm, at any time.
Xiaodu Yin (Toxin-Resolving Drink)
Niu Bang Zi (Arctii Fructus) Lian Qiao (Forsythiae Fructus) Gan Cao (Licorice Root) Lv Sheng Ma (Green Cimicifugae Rhizoma) Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma) Zi Cao (Arnebiae Radix seu Rhizoma, equal parts)
Finely chop. Decoct with one cup of water until reduced to 0.7 cups. Strain and take warm, at any time.
Duoming Dan (Life-Snatching Pill)
Ma Huang (Ephedrae Herba) Sheng Ma (Cimicifugae Rhizoma, each half liang) Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma) Hong Hua Zi (Carthami Flos) Da Li Zi (Arctii Fructus) Lian Qiao (Forsythiae Fructus, each 2.5 qian) Chan Tui (Cicadae Periostracum) Zi Cao (Arnebiae Radix seu Rhizoma, each 1.5 qian) Ren Zhong Huang (Indinis Excrementum, 3 qian)
Grind into fine powder. Mix with wine and honey to form pills, coat with Chen Sha (Cinnabar). Take with Mint Leaf Decoction.
In the eruption of smallpox, the most critical factor is that the lips and tongue are moist, red, and fresh as usual, indicating mild toxin. If the lips are scorched and cracked, and the tongue is dry with prickles, it indicates excessive fire toxin and internal/external stagnation, requiring urgent resolution using Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) plus Da Li Zi (Arctii Fructus).
Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) [Indicated for irritability]