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Wan said: Form is the manifestation of Qi's fullness, and color is the brilliance of Blood. In all methods of observing smallpox (or variola), apart from these two, there are no other approaches. Therefore, the desirable form is pointed, round, and fully elevated; if the pustule skin is thick, hard, and flat/depressed, it indicates a ominous prognosis. The desirable color is bright, lustrous, and moist, with a vibrant red base (root); if the color is pale, dull, or dark black, it indicates an ominous prognosis. However, even if the form is elevated, changes may occur due to unclear/lusterless color and non-vibrant roots. If the pustule color is glossy and the root is vibrant red, even if the form is flat, it is treatable. Nevertheless, among colors, vibrant red is most prized, but distinctions exist between "circular red," "halo red," and "spread red." "Circular red" refers to a thin line of pale red tightly attached below the root, without signs of spreading or collapsing, which is an auspicious omen. "Halo red" refers to blood adhering to the pustule, yet the color at the heel/root is faint and not gathered, which is a dangerous omen. "Spread red" refers to the pustule color blending indistinguishably with the surrounding flesh, lying flat and scattered, which is an ominous omen. By observing in this manner, life and death can be predicted. The root is the foundation of Blood, and pus is formed from Blood. Therefore, before the sixth day, one focuses on the root; without a root, pus formation will certainly not occur. After the sixth day, one focuses on the color of the pus; without pus, scabbing will certainly not occur. This is an inevitable trend.

First, observe whether the lips and tip of the tongue are vibrant and red, lacking dry white patches; this is auspicious.
Second, observe whether the roots are red, round, and vibrant, with distinct white background; this is auspicious.
Third, observe if the areas of the heart pit (epigastrium) and forehead have sparse lesions; this is the most favorable condition.
Fourth, observe if the tops of the pustules are protruding, neither scorched nor purple; this is auspicious.
Fifth, observe if there is no black depression, and the inside of the pustule top is dark yellow like wax, while the outside is moist and yellow like oil; this is auspicious.

One: In all methods of observing smallpox, one must examine the location and the quantity. Generally, fewer lesions indicate less toxin and an auspicious outcome, while more lesions indicate severe toxin and an ominous outcome. From the head and face above, to the throat next, to the chest and abdomen in front, to the waist and back behind, and to the limbs below—these five areas—if only two or three areas are sparse, and the head and face show no critical signs, it is an auspicious sign. If all five areas are densely covered over the whole body, then even if the particles are distinct, it is feared that Qi and Blood cannot supply sufficiently, making complete pus formation difficult. Or, after pus formation, crusting may fail to occur; or after crusting, shedding may fail to happen. This represents the pathogen being strong while the healthy Qi is weak, external excess masking internal deficiency, like a small boat carrying a heavy load beyond its capacity, rarely failing to capsize. This is why the quantity must be carefully examined; do not assume that abundance is always auspicious.