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1. After the pox begins to erupt, small ones gradually enlarge, flat ones gradually rise, and depressed ones gradually elevate, with a slight redness on the exterior and clear fluid contained within. When reaching the stage of suppuration (formation of pus), it is required that each lesion suppurates completely, with a reddish and vibrant base, a round shape, and a lustrous appearance. At this time, the pathogenic toxin transforms into fluid; the color changes from mountain green to waxy gray. Upon palpation, the skin feels hard, the pus is thick and turbid, the containment is intact and secure without any breakage, and diet and bowel/bladder functions are normal. This is an auspicious sign of high grade, requiring no medication.

2. In cases of dense pox, from eruption to fluid formation, they gradually enlarge and inevitably merge with one another. Although connected, as long as the bases are distinct, all depressed areas fully elevate, and penetration occurs everywhere, the toxin resolves through the fluid, and upon pus formation, the toxin is naturally eliminated without retention. This is also an auspicious sign.

3. When the pox first appears, some may have flat tops, some central depression, or be white in color. As long as the patient can eat, and bowel/bladder functions are normal, and treatment has been appropriate, by the time of suppuration, depressed areas slightly elevate, flat areas slightly protrude, and pale areas become reddish and vibrant. If the blood and water within the follicles transform entirely into pus, the toxin is considered resolved. Furthermore, if there are no external symptoms of pain or itching, and no internal symptoms of vomiting or diarrhea, indicating no pathology in both the exterior and interior, one should simply await the crusting stage (shou ye) and must not administer decoctions recklessly.

4. During suppuration, if the lesions appear red, purple, or black, accompanied by external ulceration and hoarseness, death is certain.

5. If during suppuration the lesions contain only clear water, with thin, white skin resembling blisters, the patient will likely die after scratching them open within three to four days.

6. If pus fails to form, resulting in dryness, charring, and blackening, or if there is a complete absence of blood and water, and the lesions remain depressed, death ensues immediately.

7. If the head and face swell significantly, sores are all scratched open, emitting an unbearable foul odor, accompanied by cold feet, death is certain.

8. During suppuration, if vomiting and diarrhea persist unceasingly, or if there is blood in stool and urine, food remains undigested, and sores rot without forming pus, death is certain.

9. During suppuration, if urination and defecation are obstructed, abdominal distension occurs, flesh turns black with macules appearing, delirium and wheezing arise, or there is severe shivering and teeth grinding, death is certain.

10. During the stage of fluid regression (hui jiang), the lesions should gradually turn dark and contract. If instead they remain tender and fail to contract, this indicates deficiency of both Qi and Blood, preventing the fluid from drying. Itching will inevitably occur, leading to death from scratching.

11. If the pus and fluid have not yet formed but suddenly dry up and contract, or turn cyanotic, purple, charred, or black, death is certain.

12. If sudden itching occurs, and the front of the body is scratched open, with skin peeling and flesh drying out, death is certain.

13. If all pox have fluid but the forehead (Tian Ting) does not elevate, or if the forehead resembles skin broken by boiling water, with foul odor extending to both cheeks, and after fluid loss becomes dry, resembling scabs but not truly scabbing, death is certain.