旧以饮乳婴儿，脏腑娇嫩，服药但宜酿乳，与能食童子可以服药，治有不同。然年壮与年幼者，又有不
同。若年壮外实皮浓，痘毒难以快出，或被风寒相搏，则身痛甚，宜透肌散主之；或劳役汗多，气弱发热，耳目
皆昏，脉
大者，当用补中益气汤去升、柴，自始至终服之。有虚无寒，不可用丁香、姜、附，反致热耗元气。又有男子
破阳已多，女子通经以后，乃患痘者，尤宜谨慎。常服保元汤以固脾胃；八物汤调理气血。肾虚者，肾气丸以滋
水，使肾气旺而毒不下陷也。
孕妇胎动生摘瓜；
孕妇以命门系胎，痘毒又发自命门，自初热至收靥，全以安胎饮加黄芩、白术为主。天寒有表证者，间用五
积散去麻黄、半夏、浓朴、姜、桂，换白术、赤获苓、赤芍，加柴胡、黄芩、阿胶、人参、糯米等分，水煎服。
身热咳嗽者，暂用参苏饮；烦躁者，古芩术汤加白芍、麦门冬，或小活血散；痘稠密者，鼠粘汤；痘出太盛
或便秘者，犀角地黄汤、紫草饮；痘出不快者，消毒饮；痘出后血虚者，古芎归汤加芍药；气虚者，保元汤加
芍药；气血俱虚者，内托十宣散去桂倍归、芍，加乌梅、香附；热盛恐堕胎者，罩胎散；胎动者，安胎饮连进，
或单砂仁炒为末，酒调服，服后觉胎热则安。凡胎前患痘，倘用峻药动胎，去血泄气者，孕妇必死，如生摘
瓜，必动其蒂也。患麻亦与痘同。若无孕妇人，麻痘初热，煎熬血海，必然经来，小柴胡汤加生地主之。产后
麻痘，但忌芍药，以黄 代之。
三日出齐至胫股，
三日放标至足三阴为出齐，正宜观形色以察气血强弱。形尖圆光泽者顺。或顶起而色惨不明者，保元汤
加官桂助阳，芍药敛阴，糯米温中。若一日出齐，干红紫 者死。
上胀下无亦可取。
上身先有起胀，而下体还未出，或出未尽者，无妨。
淡白顶软气全虚，
淡白顶不坚实，不碍指者，气虚也，内托十宣散去防风、白芍。自汗，倍黄 ；声不出，倍桔梗。
白光带红决不愈；
痘白色薄，根全无红色，或根带一点红，三五日后，如绿豆样者，决不能贯脓而死。
淡红摸过又转白，血衰气滞宜大补。
根窠不红或略红，手摸过即转白者，气血虚也，十全大补汤；或但淡红不转白者，血虚也，小活血散。
口角有粒如疥形，将来变黑归肾腑；
口角此时有粒如疥，不日必变焦黑归肾而死。
鼻有余疮妨睡息，
痘出后，有余疮塞鼻中，不得卧者，用木笔花为末，入麝少许，葱白蘸药入鼻中数次即通。
紫 刺黑无生路。
痘稠密中有紫 ，刺开血红，乃血协热毒，化斑汤救之；血黑者死。又有白 者，乃气协热毒，仍以化斑汤
解之。
起胀（三朝）毒尽浮于表，最怕中虚入里了；
痘出三日后，当潮起胀，先报者先起，后报者后起，至五六日毒尽发于表，宜内托不致内攻。观痘气血壮
弱，变毒深浅，全在此关。诸虚证见，而痘形色反者皆死。
虽然气血有盈亏，平陷仍分痘多少。
气盈血亏，则顶虽平而色光润，痘多者亦自无害。血盈气亏，则顶平而色又干枯，恐变陷伏，不论痘多少，
俱内托十宣散救之。
四日血 已分明，
四日，水 当成血 ，淡红色润根活，个数分明者顺。
不喜胸背颧尚平；
额上红者，终不起胀。颧脸一身之主，若颧上先胀者，四肢必顺；颧上不胀，必遍体皆然。若手足、下
身、肚腹等处皆胀，惟胸背不起胀则不宜。
上胀下缓固无害，
上体已胀，下体缓慢者，无害；若下体已胀，上体缓慢者，逆。
陆续出者反长生。
有出不快，直待起胀时陆续出，如粟米于
痘空隙，圆净者亦吉。
五日顶尖欲碍指，
五日，顶尖满起，如鼓丁碍指，光活明润者顺。
额项皮红擦破死；
痘起满顶红紫，连皮肉红，或绕项红，后必擦破而死。
贼痘软大气血衰，
报痘虽稀，根窠全白无血，三四日便起胀，痘大按之虚软者，此名贼痘，气血大衰也，保元汤加紫草救
之。额上见之尤凶，必贯脓时变成水 擦破而死。
毒陷腹上多青紫。
毒入胃，则腹上痘多青红紫色，外证口角流涎者必死。
六日圆满光明美，
六日，气血荣盛，发扬于外，顶形尖圆，肥满红活者顺。
血热紫红尚不起；
火盛血热，色红紫不起胀者，内托十宣散去桂，加紫草、红花；热盛加黄芩。痘紫黑陷者，独圣散。
中陷黑白皆气虚，
有中黑陷而外白起，或外黑赤而内白陷者，气虚而血热也，宜兔血丸。如原不起顶，灰白陷者，气虚也，
宜单人参汤，或保元汤加川芎助阳，当归和血，木香行滞。如顶陷浆滞不行，或风寒久克者，水杨汤沃之。惟
腹胀不食，神昏者死。
水 变样一定死。
顶陷灰白紫黑，必变为水 ，发痒而死。
贯脓三朝胃气升，自肌从渐至充盈；
痘以胃气为本，胃气升腾，化毒成脓，自肌肉上贯起，渐至顶尖，充满光润者顺。
切忌寒凉与疏泄，伤脾损胃浆难成。
贯脓，九窍俱宜封闭，极忌寒凉解毒及疏发淡渗之剂，伤脾损胃，清气下陷，不能贯脓，或吐利不止，或二
便下血，声哑腹胀，乳食不化，寒战切牙，痘烂无脓，肌肉黑者，不治。
七日浆行 里黄，淡红软大非真浆；
浆行， 里肥满黄光，或苍蜡色，或黄绿色者吉。色淡者虚。血虚，四物汤去地黄，加红花少许；气虚，
保元汤加桂米。若淡红疏大如脓者，必变焦黑，其间紫者，血热；灰白，气虚。如前法治。
水 皮薄有根活，
纯是清水，皮白而薄，与水 相似者死。若略有清水，或根窠起胀，血红而活，犹有生意者，内托十宣散倍
、当归，又将人乳汁和酒各半温服。又有痘中生水 ，乃气盛津液有余，随毫孔生出，小如圆眼核者，保元
汤加山楂、白术；大如鸡卵者死。
皮破流脓去湿方；
有湿，痘内如水渍。皮未破者，宜温中药内加防风、白芷，以泻肌表间湿气；如皮破流脓不干者，用白螺
壳火 为末，干糁，或用苦参、滑石、蚌粉、轻粉、白芷等分为末，干糁疮口。余详前斑烂条。
中空干燥血枯朽，火盛天水义悠长。
中空干燥、全无脓水，血分枯朽剥极，宜小活血散加当归。火盛者，六一散加荆芥、干葛，升麻，轻清
之剂以散其火。服后犹无脓水者死。
八日浆成喜饱满，不满只是气血缓；
八日，血气大振，毒浆已满，将欲收敛之时，圆满光润者吉。其有化浆不满者，乃气血因寒少缓也，宜
保元汤加姜、桂、糯米，助其成浆。
满而又陷或不齐，
痘暂满而又陷者，内托十宣散去防风、白芷，倍用人参、黄 ，水、酒各半煎服，人弱不食者，入人乳。
痘皆贯脓，中间几颗不贯者，终变虚寒痒塌，宜内托十宣散，或托里温中汤，倍加补药。
不齐有热亦难贯。
当结脓窠不结，此由毒瓦斯内外灌注，血热相搏，必复入心，急宜猪尾膏凉心血，使阴气感之，随时结痂回
浆，自面至项，或至胸不回，靥而住者死。
九日回浆喜自颧，
头面上先回浆，四肢方才起胀者吉。如七日前，唇上有痘几颗，脓黄熟，乃毒攻胃，胃烂必死。
背先肚上无浆涎；
肚上未收，背上先收者，必外驳碎内，非真实有浆涎脓液完结也。
摸过皮皴难收靥，
凡贯脓肥满，庶易结靥。虽胀满光泽可观，然摸过软而皮皴，纵横如橙子皮者，中虽有脓，不甚满足，
必不能收靥。
脓清收者亦徒然。
脓清，或半脓半水者，必变痒塌而死。若四肢脉络处，发痈毒者，可生。
收靥三日如果熟，
如果熟蒂落，气收血平，光色如敛。黄黑色光者轻，黄灰者重。
虚寒有脓难结壳；
有脓，红者轻；无脓，白者重。寒战切牙者，死。
收成大半热宜清，
收靥将半，或见作渴、惊狂等证，乃气血不能收敛，宜清解其内，免毒遗于脏腑，以生余证。
口眼流脓防齿目。
口角流涎带血者，必患牙疳齿落；眼角出脓太甚者，必损双目，俱宜清解内毒，以预防之。有浆回眼肿
不能开者，以水润湿绢帕，拭去脓屎，略用指攀开睑皮，透一点风，不致有翳攻睛。
十日苍蜡似葡萄，按之坚硬不灰焦；
十日收靥脓满回绿，痘羸苍蜡色，或似紫红葡萄色者，佳。自上而下，按之坚硬，全无灰陷焦黑者生；自
下而上，倒靥者死。
靥快有痈疔可保，
靥亦忌快。快而发痈、疔者生；快而失声者死。
靥慢有黑反可调。
当靥不靥，谓之慢。凡痘不收靥、气急痰上、声哑、目闭无神者死。间有黑者反吉，保元汤加苓、术，助
其收敛结痂。
慢亦有热触秽者，无阴以敛生微潮；
有内外热极，毒瓦斯散漫而无阴气以敛者，宣风散加犀角磨汁以解之，或调砂糖水吃，即结痂矣。但七日
前最忌砂糖。有触秽胃寒，黑陷不收靥者，异功散，调四屎散最妙。有毒盛不结痂者，猪尾膏换猪心血为丸服。
靥不能齐因饮过，
原因初出之时，烦渴引饮太过，以致靥不能齐者，六一散以解其标；若不因饮水者，保元汤加苓、术主之。
将靥全白泻难熬；
将靥时全白色，如豆壳者，仍因初时饮水过多，故靥不能齐，亦曰倒靥。大便秘则通大便；小便秘则通小
便，连翘散、小柴胡汤加枳壳、四顺清凉饮。如泄泻者，危。
伤冷疮陷伤热烂，
凡痘疮解毒已清，至收靥时，或因触冒以致陷伏、斑烂、痒塌、不靥者，异功散。如寒战切牙，手足颤掉，
及腹胀，足冷过膝者危。亦宜此救之。凡痘过服寒热表药，以致痘烂不结痂者，小柴胡汤、猪乳膏，麦门冬煎
汤下，外用败草散敷之。有臭烂深坑不收口者，用猪胆汁调芒硝末敷。如遍身臭烂如饼搭不可近，目中无神者死。
阴囊靥起命三朝。
阴囊及足上先靥起者，死。
十一（日）浆老痂已结，
或有杂证一二，保元汤随证加减。忌用峻寒、峻热，恐致内损之患。
脚根紫者还是热；
将成熟之际，脚根色红紫者属热，用凉药
解其毒，升麻葛根汤，或犀角地黄汤加酒炒芩、连、连翘之类，盖犀角、升麻，善解热毒。
气衰顶陷浆湿干，
收靥注屎，尖圆结实，佳。如顶陷若茱萸，浆湿盈盈不敛者危，保元汤加苓、术以救之。如痂结剥干不润，
内无血者亦危，八物汤加黄 救之。
遍身靥尽留一节。
遍身皆靥，惟数颗不靥，亦能杀人，犹蛇蜕皮，虽一节被伤不能退者亦死。若原贯脓充满，毒瓦斯尽出，不生
异证者，无妨。
十二（日）痂落从头妙，
从头上至胸膈、手、腹、腰、足，节节缓缓靥下者妙。
痂未易落色宜耀；
痂难脱，外见热证，疮色红紫，因原贯脓不满，浑身臭烂，脓血不干，所以难脱。根脚未散，饮食壮健者，
连翘饮。身上痂不落者，加地骨皮；头面痂不落者，加白芷。外剪去头发，以乌 油搽之。若见诸虚证，及有潮
热者，必危。
靥瘢迭凸红色佳，若无血色还堪吊；
靥后瘢红者吉，白无血色者，过后亦死。须养脾胃气血药以预防之。痂落瘢黯，或凹或凸者，用韶粉一两，
轻粉一字，研匀，猪油调涂瘢上。
痂落不宜早见风，好事瘢痕需药疗。
痂剥之后，见风太早，以致成瘢痕者，用密陀僧为末水调；或炒白蒺藜为末，鸡子清调敷；或马齿苋绞汁，
熬膏涂之；或用人精调鹰屎白敷之，其痕自灭。如欲不作瘢痕者，须于才结痂后，即以真酥润之，用手抓破，或
剥去又润之。稍迟则干硬深入肌肉，经久方脱，遂成瘢痕。凡痘后肌肉尚嫩，不可洗浴，亦不宜食炙爆、五辛、
五味，并有毒之物，恐热毒熏于肝膈，眼目多生翳障。必过百日，乃可万全。
瘥证无非是余毒，毒盛痘再发如初∶
痘疹愈而再发者亦轻，因愈后失于解利，毒瓦斯未净，治宜保元汤，加解毒药，量体增减。
余毒仍当分虚实，虚证坐立仗人扶。
瘥后杂证，热多虚少。但亦有禀弱，及服凉药，以致愈后坐立振摇，须人扶策，宜双和散、保元汤。
吐泻热渴补脾胃，
中气暴虚不食者，参苓白术散、胃爱散；虚热口渴不食者，四君子汤加陈皮、山楂、黄连。吐泻，理中
汤、丸，益黄散，异功散，久不止者危。身热自汗者，补中益气汤；壮热经日者，二参汤。
饮食调和渐自如；
轻者，但以饮食调和，久则气血自复。纯阳之体，痘毒之余，慎不可服峻药。
实证能食何须药，能食便秘当预图。
痘愈能食便调者，脾实无害。惟胃中蕴热，善消谷食，大便秘硬，将来必口齿、咽喉、吐衄、惊风之证，
或发为疮疽痈毒，宜量体清解。如曾服热药过多者，必用三黄丸利之；便秘口渴身热者，大黄散；胃热呕吐，
口舌生疮，下部亦有疮，而下利脓血，单黄连汤；烦渴溺少者，五苓散；作烦渴者，单黄连汤，或灯心一把，
鳖甲二两，水煎服。湿热齿痛或肿者，甘露饮；口牙出血者，五福化毒丹；咽痛者，抱龙丸，或甘桔汤加牛蒡
子、麦门冬竹叶。肝热多怒，叫不得眠者，柴胡清肝汤。下血疼痛者，薤白汤，三黄熟艾汤。心痛不可忍者，
过去认为，喝奶的婴儿脏腑娇嫩，服药只宜将药物酿入乳汁中喂服；这与能吃饭的儿童直接服药不同，治疗方法有所区别。然而，身体强壮者与年幼者之间，又有不同之处。如果身体壮实、皮肤厚实的人，痘毒难以迅速发出，或者被风寒邪气相搏结，导致身体疼痛剧烈，适宜用透肌散主治；或者是因劳累过度汗出过多，气虚发热，耳目昏花，脉象大的，应当使用补中益气汤去掉升麻、柴胡，从开始到结束一直服用。对于只有虚证没有寒证的情况，不可使用丁香、干姜、附子，否则反而会导致热盛耗伤元气。还有男子房事过度，女子月经来潮之后，才患痘病的人，尤其需要谨慎。平时常服保元汤以巩固脾胃；用八物汤调理气血。肾虚者，用肾气丸滋补肾水，使肾气旺盛而痘毒不向下陷入。
孕妇胎动不安如同生摘瓜果；
孕妇依靠命门之气维系胎儿，痘毒又发自命门，从初热期到收靥期，全以安胎饮加黄芩、白术为主方。天气寒冷且有表证的，偶尔使用五积汤去掉麻黄、半夏、厚朴、生姜、肉桂，换用白术、赤茯苓、赤芍药，加入柴胡、黄芩、阿胶、人参、糯米各等分，水煎服。身热咳嗽的，暂时使用参苏饮；烦躁的，用古芩术汤加白芍药、麦门冬，或小活血散；痘疹稠密的，用鼠粘汤；痘出得太盛或便秘的，用犀角地黄汤、紫草饮；痘出不快的，用消毒饮；痘出后血虚的，用古芎归汤加芍药；气虚的，用保元汤加芍药；气血都虚的，用内托十宣散去桂枝加倍当归、芍药，加乌梅、香附；热盛担心堕胎的，用罩胎散；胎动的，连续服用安胎饮，或者单用砂仁炒为粉末，酒调服，服后感觉胎热则安定。凡是胎前患痘，如果使用峻烈药物动胎，导致失血泄气的，孕妇必死，就像生摘瓜果，必然损伤瓜蒂一样。患麻疹也与痘病相同。如果没有怀孕的人，麻疹痘病初热期，煎熬血海，必然导致月经来潮，用小柴胡汤加生地黄主治。产后患麻疹痘病，只忌用芍药，用黄芪代替。
痘疹三日出齐至小腿大腿，
三日痘疹发至足部三阴经为出齐，正适宜观察形色以察知气血强弱。形状尖圆光泽的为顺证。或者顶起但颜色惨白不明亮的，用保元汤加官桂助阳，芍药敛阴，糯米温中。如果一日就出齐，干燥红紫色的为死证。
上身先胀起下身无痘也可取。
上身先有起胀，而下体还未出痘，或出痘未尽的，无妨。
淡白色顶软气全虚，
颜色淡白顶上不坚实，按之不碍手指的，是气虚，用内托十宣散去防风、白芍药。自汗的，加倍黄芪；声音不出，加倍桔梗。
白光带红决不能愈；
痘色白薄，根部完全没有红色，或根部带一点红，三五日后，像绿豆大小的，决不能化脓而死。
淡红色摸过又转白，血衰气滞宜大补。
根部不红或略红，手摸过即转白的，是气血虚，用十全大补汤；或者只是淡红不转白的，是血虚，用小活血散。
口角有粒如疥形，将来变黑归肾腑；
口角此时有颗粒像疥疮，不久必定变焦黑归肾而死。
鼻有余疮妨碍睡眠呼吸，
痘出后，有余疮堵塞鼻子中，不能卧睡的，用木笔花为粉末，加入少许麝香，葱白蘸药液多次放入鼻中即可通畅。
紫黑色刺破无生路。
痘疹稠密中有紫色，刺破后血色鲜红的，是血与热毒相协，用化斑汤救治；血色黑的为死证。又有白色的，是气与热毒相协，仍然用化斑汤解除。
起胀（三天）毒尽浮于表，最怕中虚入里了；
痘出三天后，应当潮涌起胀，先报出的先起，后报出的后起，到五六天毒气全部发于体表，适宜内托以防内攻。观察痘疹气血强弱，变化毒气深浅，全在此关键时期。诸虚证出现，而痘疹形色相反的皆死。
虽然气血有盈亏，平陷仍分痘多少。
气盈血亏，则顶虽平但色泽光润，痘多的也自然无害。血盈气亏，则顶平且色泽干枯，恐怕变为陷伏，不论痘多少，都用内托十宣散救治。
四天血泡已分明，
四天，水泡应当变成血泡，淡红色润泽根部活络，个数分明的为顺证。
不喜欢胸背颧骨尚平；
额上红的，最终不起胀。颧骨脸面是一身之主，如果颧上先胀起的，四肢必顺；颧上不胀，必遍体皆然。如果手足、下身、肚腹等处都胀，惟独胸背不起胀则不宜。
上胀下缓固无害，
上体已胀，下体缓慢的，无害；若下体已胀，上体缓慢的，为逆证。
陆续出者反长生。
有出得不快，直待起胀时陆续出，像粟米在痘空隙间，圆净的也是吉兆。
五天顶尖欲碍指，
五天，痘顶尖满起，像鼓钉碍手，光活明润的为顺证。
额项皮红擦破死；
痘起满顶红紫，连皮肉红，或绕颈红，后来必擦破而死。
贼痘软大气血衰，
报痘虽稀，根部全白无血，三四日便起胀，痘大按之虚软的，此名贼痘，是大衰的表现，用保元汤加紫草救治。额上见到的尤其凶险，必在贯脓时变成水泡擦破而死。
毒陷腹上多青紫。
毒入胃，则腹部痘多青红紫色，外证口角流涎的必死。
六日圆满光明美，
六天，气血荣盛，发扬于外，顶形尖圆，肥满红活的为顺证。
血热紫红尚不起；
火盛血热，色红紫不起胀的，用内托十宣散去桂枝，加紫草、红花；热盛加黄芩。痘紫黑陷的，用独圣散。
中陷黑白皆气虚，
有中黑陷而外白起，或外黑赤而内白陷的，是气虚而血热，宜用兔血丸。如原不起顶，灰白陷的，是气虚，宜单人参汤，或保元汤加川芎助阳，当归和血，木香行滞。如顶陷浆滞不行，或风寒久克制的，用水杨汤沃之。惟独腹胀不食，神昏的必死。
贯脓三天胃气升，自肌从渐至充盈；
痘以胃气为本，胃气升腾，化毒成脓，自肌肉上贯起，渐至顶尖，充满光润的为顺证。
切忌寒凉与疏泄，伤脾损胃浆难成。
贯脓期，九窍俱宜封闭，极忌寒凉解毒及疏发淡渗之剂，以免伤脾损胃，清气下陷，不能贯脓，或吐利不止，或二便下血，声哑腹胀，乳食不化，寒战切牙，痘烂无脓，肌肉黑的，不治。
七天浆行里面黄，淡红软大非真浆；
浆行，里面肥满黄光，或苍蜡色，或黄绿色的为吉。色淡的为虚。血虚，用四物汤去地黄，加红花少许；气虚，用保元汤加桂枝糯米。若淡红疏大像脓的，必变焦黑，其间紫的，血热；灰白的，气虚。如前法治。
水泡皮薄有根活，
纯是清水，皮白而薄，与水泡相似的必死。若略有清水，或根部起胀，血红而活，犹有生意的，用内托十宣散倍用人参、当归，又将人乳汁和酒各半温服。又有痘中生水泡，乃气盛津液有余，随毛孔生出，小如圆眼核的，用保元汤加山楂、白术；大如鸡卵的必死。
皮破流脓去湿方；
有湿，痘内如水渍。皮未破的，宜在温中药内加防风、白芷，以泻肌表间湿气；如皮破流脓不干者，用白螺壳煅烧为粉末，干撒，或用苦参、滑石、蚌粉、轻粉、白芷等分为粉末，干撒疮口。其余详见前斑烂条。
中空干燥血枯朽，火盛天水义悠长。
中空干燥、全无脓水，血分枯朽剥极，宜用小活血散加当归。火盛的，用六一散加荆芥、干葛、升麻，轻清之剂以散其火。服后犹无脓水的必死。
八天浆成喜饱满，不满只是气血缓；
八天，血气大振，毒浆已满，将欲收敛之时，圆满光润的为吉。其有化浆不满的，乃气血因寒少缓，宜用保元汤加姜、桂、糯米，助其成浆。
满而又陷或不齐，
痘暂满而又陷的，用内托十宣散去防风、白芷，倍用人参、黄芪，水、酒各半煎服，人弱不食的，入人乳。痘皆贯脓，中间几颗不贯的，终变虚寒痒塌，宜用内托十宣散，或托里温中汤，倍加补药。
不齐有热亦难贯。
当结脓窠不结，此由毒瓦斯内外灌注，血热相搏，必复入心，急宜用猪尾膏凉心血，使阴气感之，随时结痂回浆，自面至项，或至胸不回，靥而住的必死。
九天回浆喜自颧，
头面上先回浆，四肢方才起胀的为吉。如七日前，唇上有痘几颗，脓黄熟，乃毒攻胃，胃烂必死。
背先肚上无浆涎；
肚上未收，背上先收的，必外驳碎内，非真实有浆涎脓液完结也。
摸过皮皴难收靥，
凡贯脓肥满，庶易结靥。虽胀满光泽可观，然摸过软而皮皱，纵横如橙子皮的，中虽有脓，不甚满足，必不能收靥。
脓清收者亦徒然。
脓清，或半脓半水的，必变痒塌而死。若四肢脉络处，发痈毒的，可生。
收靥三天如果熟，
如果熟蒂落，气收血平，光色如敛。黄黑色光的轻，黄灰的重。
虚寒有脓难结壳；
有脓，红的轻；无脓，白的重。寒战切牙的，死。
收成大半热宜清，
收靥将半，或见作渴、惊狂等证，乃气血不能收敛，宜清解其内，免毒遗于脏腑，以生余证。
口眼流脓防齿目。
口角流涎带血的，必患牙疳齿落；眼角出脓太甚的，必损双目，俱宜清解内毒，以预防之。有浆回眼肿不能开的，以水润湿绢帕，拭去脓屎，略用指攀开睑皮，透一点风，不致有翳攻睛。
十天苍蜡似葡萄，按之坚硬不灰焦；
十天收靥脓满回绿，痘羸苍蜡色，或似紫红葡萄色的，佳。自上而下，按之坚硬，全无灰陷焦黑的生；自下而上，倒靥的死。
靥慢有黑反可调。
当靥不靥，谓之慢。凡痘不收靥、气急痰上、声哑、目闭无神的死。间有黑的反吉，用保元汤加茯苓、白术，助其收敛结痂。
慢亦有热触秽者，无阴以敛生微潮；
有内外热极，毒瓦斯散漫而无阴气以敛的，用宣风散加犀角磨汁以解之，或调砂糖水吃，即结痂矣。但七日前最忌砂糖。有触秽胃寒，黑陷不收靥的，用异功散，调四屎散最妙。有毒盛不结痂的，用猪尾膏换猪心血为丸服。
靥不能齐因饮过，
原因初出之时，烦渴引饮太过，以致靥不能齐的，用六一散以解其标；若不因饮水的，用保元汤加苓、术主治。
将靥全白泻难熬；
将靥时全白色，如豆壳的，仍因初时饮水过多，故靥不能齐，亦曰倒靥。大便秘则通大便；小便秘则通小便，用连翘散、小柴胡汤加枳壳、四顺清凉饮。如泄泻的，危。
伤冷疮陷伤热烂，
凡痘疮解毒已清，至收靥时，或因触冒以致陷伏、斑烂、痒塌、不靥的，用异功散。如寒战切牙，手足颤掉，及腹胀，足冷过膝的危。亦宜此救之。凡痘过服寒热表药，以致痘烂不结痂的，用小柴胡汤、猪乳膏，麦门冬煎汤下，外用败草散敷之。有臭烂深坑不收口的，用猪胆汁调芒硝末敷。如遍身臭烂如饼搭不可近，目中无神的死。
十一（天）浆老痂已结，
或有杂证一二，用保元汤随证加减。忌用峻寒、峻热，恐致内损之患。
脚根紫者还是热；
将成熟之际，脚根色红紫的属热，用凉药解其毒，用升麻葛根汤，或犀角地黄汤加酒炒芩、连、连翘之类，盖犀角、升麻，善解热毒。
气衰顶陷浆湿干，
收靥注屎，尖圆结实，佳。如顶陷若茱萸，浆湿盈盈不敛的危，用保元汤加苓、术以救之。如痂结剥干不润，内无血的亦危，用八物汤加黄芪救之。
遍身靥尽留一节。
遍身皆靥，惟数颗不靥，亦能杀人，犹蛇蜕皮，虽一节被伤不能退的亦死。若原贯脓充满，毒瓦斯尽出，不生异证的，无妨。
十二（天）痂落从头妙，
从头上至胸膈、手、腹、腰、足，节节缓缓靥下的妙。
痂未易落色宜耀；
痂难脱，外见热证，疮色红紫，因原贯脓不满，浑身臭烂，脓血不干，所以难脱。根脚未散，饮食壮健的，用连翘饮。身上痂不落的，加地骨皮；头面痂不落的，加白芷。外剪去头发，以乌油搽之。若见诸虚证，及有潮热的，必危。
靥瘢迭凸红色佳，若无血色还堪吊；
靥后瘢红的吉，白无血色的，过后亦死。须养脾胃气血药以预防之。痂落瘢黯，或凹或凸的，用韶粉一两，轻粉一字，研匀，猪油调涂瘢上。
痂落不宜早见风，好事瘢痕需药疗。
痂剥之后，见风太早，以致成瘢痕的，用密陀僧为末水调；或炒白蒺藜为末，鸡子清调敷；或马齿苋绞汁，熬膏涂之；或用人精调鹰屎白敷之，其痕自灭。如欲不作瘢痕的，须于才结痂后，即以真酥润之，用手抓破，或剥去又润之。稍迟则干硬深入肌肉，经久方脱，遂成瘢痕。凡痘后肌肉尚嫩，不可洗浴，亦不宜食炙爆、五辛、五味，并有毒之物，恐热毒熏于肝膈，眼目多生翳障。必过百日，乃可万全。
瘥证无非是余毒，毒盛痘再发如初∶
痘疹愈而再发的也轻，因愈后失于解利，毒瓦斯未净，治宜用保元汤，加解毒药，量体增减。
余毒仍当分虚实，虚证坐立仗人扶。
瘥后杂证，热多虚少。但亦有禀弱，及服凉药，以致愈后坐立振摇，须人扶策，宜用双和散、保元汤。
吐泻热渴补脾胃，
中气暴虚不食的，用参苓白术散、胃爱散；虚热口渴不食的，用四君子汤加陈皮、山楂、黄连。吐泻，用理中汤、丸，益黄散，异功散，久不止的危。身热自汗的，用补中益气汤；壮热经日的，用二参汤。
饮食调和渐自如；
轻的，但以饮食调和，久则气血自复。纯阳之体，痘毒之余，慎不可服峻药。
实证能食何须药，能食便秘当预图。
痘愈能食便调的，脾实无害。惟胃中蕴热，善消谷食，大便秘硬，将来必口齿、咽喉、吐衄、惊风之证，或发为疮疽痈毒，宜量体清解。如曾服热药过多的，必用三黄丸利之；便秘口渴身热的，用大黄散；胃热呕吐，口舌生疮，下部亦有疮，而下利脓血的，用单黄连汤；烦渴溺少的，用五苓散；作烦渴的，用单黄连汤，或灯心一把，鳖甲二两，水煎服。湿热齿痛或肿的，用甘露饮；口牙出血的，用五福化毒丹；咽痛的，用抱龙丸，或甘桔汤加牛蒡子、麦门冬竹叶。肝热多怒，叫不得眠的，用柴胡清肝汤。下血疼痛的，用薤白汤，三黄熟艾汤。心痛不可忍的，
In the past, it was believed that infants drinking milk have delicate internal organs and viscera; for them, medication should only be brewed into the milk for administration. This differs from children who can eat solid food and take medicine directly, with treatment methods varying accordingly. However, there are further differences between those in their prime and the young. If a person is physically robust with thick skin, the smallpox toxin may struggle to emerge quickly. If affected by wind-cold pathogens clashing, causing severe body pain, Touji San (Skin-Penetrating Powder) is indicated. Alternatively, if excessive sweating due to overexertion leads to Qi deficiency fever, with blurred vision and hearing, and a large pulse, Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) without Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) should be used continuously from start to finish. In cases of pure deficiency without cold, Dingxiang (Caryophylli Flos), Jiang (Zingiberis Rhizoma), and Fuzi (Aconiti Lateralis Radix Praeparata) must not be used, as they will exacerbate heat and consume Yuan Qi (Original Qi). Furthermore, men who have exhausted their Yang through excessive sexual activity, or women after menstruation, who contract smallpox, require particular caution. Regularly consuming Baoyuan Tang (Preserve the Origin Decoction) consolidates the Spleen and Stomach; Bawu Tang (Eight-Ingredient Decoction) regulates Qi and Blood. For Kidney deficiency, Shenqi Wan (Kidney Qi Pill) nourishes Kidney Water, ensuring strong Kidney Qi prevents the toxin from sinking downward.
For pregnant women, fetal movement resembles picking melons while still attached to the vine;
The pregnant woman relies on Mingmen (Gate of Life) Qi to sustain the fetus. Since the smallpox toxin also originates from Mingmen, from the initial fever stage until scabbing, An Tai Yin (Fetus-Calming Infusion) with Huangqin (Scutellariae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) serves as the main formula. In cold weather with exterior symptoms, Wuji Zhi Tang (Five Accumulations Decoction) may occasionally be used, excluding Mahuang (Ephedrae Herba), Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Shengjiang (Zingiberis Rhizoma Recens), and Rougui (Cinnamomi Cortex), substituting them with Baizhu, Chifuling (Poria Cocos with Red Host), and Chi Shao (Paeoniae Radix Rubra), adding Chaihu, Huangqin, Ejiao (Asini Corii Colla), Renshen (Ginseng Radix), and Nuomijian (Oryza Sativa Glutinosa) in equal parts, decocted in water and taken orally. For fever and cough, Shen Su Yin (Ginseng and Perilla Infusion) is temporarily used; for irritability, Gu Qinshu Tang (Ancient Scutellaria and Atractylodes Decoction) with Baishao (Paeoniae Radix Alba) and Maidong (Ophiopogonis Radix), or Xiaohuoxue San (Minor Blood-Invigorating Powder) is employed. For dense eruptions, Niuniu Tang (Arctii Decoction); for excessively profuse eruptions or constipation, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and Zicao Yin (Arnebiae Root Infusion); for slow eruption, Xiaodu Yin (Detoxifying Infusion); for blood deficiency after eruption, Gu Xiong Gui Tang (Ancient Ligusticum and Angelica Decoction) with Shaoyao; for Qi deficiency, Baoyuan Tang with Shaoyao; for combined Qi and Blood deficiency, Neituo Shixuan San (Internal Support Ten-Accumulation Powder) without Guizhi, doubling Danggui (Angelicae Sinensis Radix) and Shaoyao, adding Wu Mei (Mume Fructus) and Xiangfu (Cyperi Rhizoma); for intense heat fearing miscarriage, Zao Tai San (Fetus-Covering Powder); for fetal movement, continuous use of An Tai Yin, or single-cardamom powder mixed with wine. After ingestion, if fetal heat subsides, stability is achieved. Any smallpox contracted during pregnancy treated with harsh drugs that disturb the fetus, cause blood loss, or deplete Qi will result in maternal death, akin to plucking a melon prematurely, severing the stem. Measles follow similar principles. For non-pregnant women, during the initial fever of measles/smallpox, which boils the Blood Sea and inevitably triggers menstruation, Xiao Chaihu Tang (Minor Bupleurum Decoction) with Shengdihuang (Rehmanniae Radix Recens) is indicated. Postpartum measles/smallpox contraindicates Shaoyao, substituting it with Huangqi (Astragali Radix).
By the third day, eruptions reach the calves and thighs;
By the third day, eruptions reaching the three Yin meridians of the foot indicate complete emergence. It is crucial to observe color and shape to assess Qi and Blood strength. Sharp, round, and lusterous shapes are favorable. If raised but pale and dull, Baoyuan Tang with Guigui (Cassiae Ramulus) to assist Yang, Shaoyao to astringe Yin, and Nuomijian to warm the middle is used. If fully erupted in one day with dry red-purple color, it is fatal.
Upper body swelling without lower body involvement can still be acceptable.
If the upper body begins to swell before the lower body erupts, or if eruption is incomplete, it is not concerning.
Pale white and soft apex indicates total Qi deficiency;
Pale white color with a soft, non-resilient apex that yields to pressure indicates Qi deficiency. Neituo Shixuan San without Fangfeng (Saposhnikoviae Radix) and Baishao is used. For spontaneous sweating, double Huangqi; for inability to speak, double Jiegeng (Platycodonis Radix).
Pure white with red base implies incurability;
If the pustule is thin and white with no redness at the base, or only a slight hint of red, and remains bean-sized after three to five days without suppuration, it is fatal.
Pale red turning white upon touch indicates blood decline and Qi stagnation requiring major tonification.
If the base is not red or slightly red, and turns white immediately upon touch, it indicates Qi and Blood deficiency; Shiquan Dabu Tang (Ten-Accumulation Great Tonifying Decoction) is used. If merely pale red without turning white, it indicates Blood deficiency; Xiaohuoxue San is used.
Sores like scabs at the mouth corners will turn black and affect the Kidneys;
Sores appearing at the mouth corners resembling scabs will inevitably turn dark black, affecting the Kidneys, leading to death.
Residual sores in the nose hinder sleep and breathing;
After eruption, residual sores blocking the nose preventing sleep can be treated by grinding Mutbihua (Stemonae Radix) into powder, adding a little Shexiang (Moschus), dipping Congbai (Allii Fistulosi Bulbus) into the medicine, and inserting it into the nose several times until clear.
Purple-black lesions offer no hope.
Dense eruptions with purple color, where bleeding is bright red upon pricking, indicate Blood cooperating with Heat-Toxin; Huaban Tang (Transform Maculae Decoction) saves the patient. Black blood indicates death. White lesions indicate Qi cooperating with Heat-Toxin, also treated with Huaban Tang.
Swelling phase (Day 3): Toxins float to the surface; fear of interior invasion due to middle deficiency;
Three days after eruption, swelling should surge. Those reported first swell first, later ones later. By days five to six, toxins fully manifest on the surface. Internal support prevents internal attack. Observing Qi/Blood strength and toxin depth is critical here. Deficiency signs with contradictory eruption colors indicate death.
Although Qi and Blood have surplus and deficit, flat depression depends on eruption quantity.
Qi surplus and Blood deficit: Apex is flat but lusterous; numerous eruptions are harmless. Blood surplus and Qi deficit: Apex is flat and dry/withered; risk of collapse/inversion regardless of quantity. Neituo Shixuan San is used for rescue.
Day 4: Blood blisters clearly formed;
On day four, fluid blisters should become blood blisters. Pale red, moist, with active roots and distinct counts are favorable.
Dislike flat forehead, chest, back, and cheekbones;
Redness on the forehead ultimately fails to swell. Cheekbones govern the face; if cheekbones swell first, limbs follow smoothly. If cheekbones do not swell, the whole body suffers. Swelling in hands, feet, lower body, and abdomen is fine, but lack of swelling in chest and back is unfavorable.
Upper swelling with lower slowness is harmless;
Upper body swollen with lower body slow is harmless; lower body swollen with upper body slow is adverse.
Gradual eruption promotes survival.
Slow eruption continuing into the swelling phase, appearing like millet grains in gaps, round and clean, is auspicious.
Day 5: Apex touches fingers;
On day five, apexes are full and raised, hard to touch like drum nails. Lusterous and moist is favorable.
Forehead and neck redness, if broken, is fatal;
Full red-purple swelling on head and neck, involving skin and flesh, or redness around the neck, will eventually break and cause death.
Thief Pustules: Soft and large indicate severe Qi/Blood decline;
Sparse eruptions with completely white bases lacking blood, swelling early (days 3-4), large and soft to touch, are called "Thief Pustules," indicating severe Qi/Blood decline. Baoyuan Tang with Zicao (Arnebiae Radix) rescues. Forehead involvement is particularly ominous, likely becoming fluid-filled and breaking during suppuration.
Toxin sinking causes green-purple spots on abdomen.
Toxin entering the Stomach causes green-red-purple eruptions on the abdomen. Saliva flowing from mouth corners externally indicates death.
Day 6: Full, bright, and beautiful;
On day six, Qi and Blood flourish outward. Sharp, round, plump, red, and active apexes are favorable.
Blood heat with purple-red color fails to rise;
Excessive fire and blood heat causing purple-red color without swelling: Neituo Shixuan Tang without Guizhi, adding Zicao and Honghua (Carthami Flos); add Huangqin for intense heat. Purple-black inverted eruptions: Dusheng San (Single Sage Powder).
Central inversion with black/white indicates Qi deficiency;
Black inversion inside with white outside rising, or black/red outside with white inside sinking, indicates Qi deficiency with Blood heat; Tuxue Wan (Rabbit Blood Pill) is suitable. If originally flat, gray-white sinking indicates Qi deficiency; Danren Shen Tang (Single Ginseng Decoction) or Baoyuan Tang with Chuanxiong (Ligustici Chuanxiong Rhizoma) to assist Yang, Danggui to harmonize Blood, and Muxiang (Aucklandiae Radix) to move stagnation. If apex sinks and pus stagnates, or prolonged wind-cold suppression, Shuiyang Tang (Water Willow Decoction) is applied. Abdominal distension, anorexia, and coma indicate death.
Fluid blister changes guarantee death.
Sunken apex, gray-white, or purple-black, transforming into fluid blisters with itching, leads to death.
Suppuration Day 3: Stomach Qi rises, filling gradually from muscle;
Smallpox relies on Stomach Qi. Rising Stomach Qi transforms toxin into pus, ascending from muscles to apex, filling lusterously is favorable.
Avoid cold/cooling and purgatives; damaging Spleen/Stomach hinders pus formation.
During suppuration, orifices should be sealed. Cold-cooling detoxifiers and diuretics are strictly forbidden as they damage Spleen/Stomach, sink Clear Qi, prevent pus formation, or cause vomiting/diarrhea, bloody stools/urine, hoarseness, abdominal distension, indigestion, chills, teeth grinding, rotting pustules without pus, and black muscles—these are untreatable.
Day 7: Pus flows yellow inside; pale red/soft/large is not true pus;
Pus flow showing plump yellow luster, waxy, or yellow-green is auspicious. Pale color indicates deficiency. Blood deficiency: Siwu Tang (Four Substances Decoction) without Dihuang, adding Honghua; Qi deficiency: Baoyuan Tang with Guizhi and Nuomijian. Pale red, loose, large like pus will turn black; purple indicates Blood heat; gray-white indicates Qi deficiency. Treat as above.
Fluid blisters with thin skin and active root survive;
Pure clear fluid, white thin skin resembling fluid blisters is fatal. Slight clear fluid or raised red-active base indicates life; Neituo Shixuan Tang doubled with Renshen and Danggui, plus human milk and wine warmed and taken orally. Fluid blisters arising from pores due to excess Qi/fluids, small as grape seeds, treated with Baoyuan Tang adding Shanzha (Crataegi Fructus) and Baizhu; large as chicken eggs is fatal.
Broken skin draining pus requires dampness-draining formulas;
Dampness makes pustules waterlogged. Unbroken skin: Warm middle herbs with Fangfeng and Baizhi (Angelicae Dahuricae Radix) to drain surface dampness. Broken skin with non-drying pus: Bai Luoke (Concha Melani) calcined to powder, dusted dry; or Kushen (Sophorae Flavescentis Radix), Huashi (Talcum), Bangfen (Concha Margaritiferae), Qingfen (Calomelas), Baizhi in equal parts, dusted dry. See macula section for details.
Hollow dryness indicates blood exhaustion; fire excess requires long-term cooling;
Hollow, dry, no pus indicates blood exhaustion/extreme peeling; Xiaohuoxue San with Danggui. Fire excess: Liuyi San (Six-to-One Powder) with Jingjie (Schizonepetae Spica), Gegen (Puerariae Lobatae Radix), Shengma to scatter fire with light/clear agents. No pus after administration indicates death.
Day 8: Pus formed, favoring fullness; lack of fullness is Qi/Blood slowness;
On day eight, Qi/Blood surges, toxin/pus fills, approaching convergence. Full and lusterous is auspicious. Incomplete pus formation due to cold slowing Qi/Blood: Baoyuan Tang with Shengjiang, Guizhi, Nuomijian to aid pus formation.
Full then sinking or uneven;
Temporarily full then sinking: Neituo Shixuan San without Fangfeng and Baizhi, doubling Renshen and Huangqi, decocted half-water/half-wine. Weak/non-eating patients: add human milk. Eruptions suppurating except a few in center: eventually turn void-cold, itchy, collapsed; use Neituo Shixuan San or Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction) with increased tonics.
Unevenness with heat hinders suppuration.
Failure to form pus crusts due to toxin infusion and Blood heat clashing, re-entering Heart: Urgently use Zhuwei Gao (Pig Tail Ointment) to cool Heart Blood, inducing Yin Qi to scab/resuppurate. Failure to resolve from face/neck/chest indicates death.
Day 9: Pus receding favors starting from cheeks;
Head/face receding first, limbs swelling later is auspicious. Yellow-mature pus on lips before day seven indicates toxin attacking Stomach, Stomach rotting, fatal.
Back receding before abdomen lacks pus/saliva;
Abdomen not resolved, back resolved first, indicates external fragmentation/internal lack of true pus completion.
Touching wrinkled skin hinders scabbing;
Full suppuration facilitates scabbing. Even if swollen/lusterous, soft/wrinkled skin like orange peel indicates insufficient pus, hindering scabbing.
Clear pus resolution is futile.
Clear pus or half-pus/half-fluid turns itchy/collapsed, fatal. Abscesses on limb meridians may survive.
Scabbing Day 3 like ripe fruit;
Like ripe fruit falling, Qi settles, Blood calms, color收敛 (converges). Yellow-black luster is mild; yellow-gray is severe.
Void-cold with pus struggles to form crust;
With pus, red is mild; without pus, white is severe. Chills/teeth grinding indicates death.
Halfway resolution with heat requires clearing;
Halfway scabbing with thirst/manic behavior indicates failure of Qi/Blood to converge; clear internally to prevent toxin lingering in viscera causing residual syndromes.
Mouth/eyes draining pus warns of teeth/eyes;
Saliva/blood from mouth corners predicts gum disease/tooth loss; excessive pus from eyes predicts blindness. Clear internal toxin to prevent. Swollen eyes preventing opening after pus return: wipe with wet silk, gently open eyelid to let air in, preventing corneal opacity.
Day 10: Waxy like grapes, hard to touch, not gray/scorched;
Day ten scabbing: pus full, returning green, emaciated waxy color or purple-red grape-like is good. Top-down, hard to touch, no gray-sunken/scorched areas indicates life; bottom-up, inverted scabbing indicates death.
Fast scabbing with carbuncles/furuncles can be saved;
Fast scabbing is also avoided. Fast scabbing with carbuncles/furuncles survives; fast scabbing with voice loss dies.
Slow scabbing with blackness can be regulated.
Failure to scab is "slow." Non-scabbing, rapid breathing/phlegm, hoarseness, closed spiritless eyes die. Occasional blackness is auspicious; Baoyuan Tang with Fuling (Poria) and Baizhu aids convergence.
Slowness with heat/turbidity, lack of Yin to收敛 causes slight tidal fever;
Extreme internal/external heat, scattered toxin without Yin to收敛: Xuanfeng San with Xijiao (Rhinoceri Cornu) juice to resolve, or sugar water to scab. Sugar forbidden before day seven. Turbidity/Cold Stomach, black-sunken non-scabbing: Yigong San with Sisi San is best. Excessive toxin preventing scabbing: Zhuwei Gao replaced with Pig Heart Blood pills.
Incomplete scabbing due to excessive drinking;
Initial excessive thirst/drinking causing incomplete scabbing: Liuyi San resolves the branch; if not due to drinking, Baoyuan Tang with Fuling and Baizhu treats the root.
Complete whiteness before scabbing with diarrhea is hard to endure;
Complete whiteness like bean shells before scabbing, due to initial excessive drinking, also called inverted scabbing. Constipation: unblock bowels/bladder; Lianqiao Yin, Xiao Chaihu Tang with Zhike (Aurantii Fructus), Sishun Qingliang Yin. Diarrhea is critical.
Cold injury causes sunken sores; Heat injury causes rotting;
After toxin cleared, during scabbing, exposure causing inversion/maculitis/itch-collapse/non-scabbing: Yigong San. Chills/teeth grinding, trembling limbs, abdominal distension, cold feet above knees: critical, treat similarly. Overuse of cold/hot exterior drugs causing rotting/non-scabbing: Xiao Chaihu Tang, Zhu Ru Gao (Pig Milk Ointment), Mai Dong (Ophiopogonis) decoction internally; Baicao San (Decayed Grass Powder) externally. Deep smelly pits not closing: Pig bile mixed with Mangxiao (Natrii Sulfas) applied. Whole-body smelly rot like cakes, spiritless eyes: death.
Scabbing on scrotum/feet within three days indicates death;
Scabbing on scrotum/feet first indicates death.
Eleventh (day): Old pus, crusts formed;
Miscellaneous syndromes: Baoyuan Tang modified. Avoid harsh cold/hot drugs to prevent internal damage.
Purple heels indicate remaining heat;
Near maturity, red-purple heels indicate heat; cool drugs resolve toxin. Shengma Gegen Tang or Xijiao Dihuang Tang with Jiu Chao Huangqin/Helianlianqiao. Xijiao/Shengma excel at resolving heat-toxin.
Qi decline, sunken apex, wet/dry pus;
Scabbing stool, sharp/round/solid is good. Sunken like cornel, wet overflowing non-converging pus: critical, Baoyuan Tang with Fuling/Baizhu. Crust peeled dry/unmoistured, no internal blood: critical, Bawu Tang with Huangqi.
Whole body scabbed leaving one segment;
Whole body scabbed except a few segments can kill, like snake shedding skin where one injured segment prevents molting. Original full suppuration, toxin fully expelled, no abnormal syndromes: harmless.
Twelfth (day): Crusts falling from head is wonderful;
Top-down gradual scabbing through chest, hands, abdomen, waist, feet is ideal.
Crusts hard to fall, color should shine;
Hard-to-fall crusts with exterior heat, red-purple sores, due to incomplete suppuration, whole-body rot, non-drying pus/blood. Roots not dispersed, strong appetite: Lianqiao Yin. Body crusts not falling: add Digupi (Lycii Cortex). Head/face crusts not falling: add Baizhi. Cut hair, apply Wu You (likely a typo for specific oil, context implies topical application). Void syndromes or tidal fever: critical.
Scars convex/red are good; pale/colorless are dire;
Red scars after scabbing are auspicious; white/colorless lead to death later. Nourish Spleen/Stomach Qi/Blood to prevent. Dark/scaly or concave/convex scars: Shaofen (Alumen) 1 liang, Qingfen 1 zi, ground, mixed with pig fat, applied.
Crusts falling too early exposed to wind causes scars; remedies needed.
Early wind exposure after crust removal causes scars: Mituoseng (Lead Monoxide) powder with water; or fried Bajili (Tribuli Fructus) powder with egg white; or Machixian (Portulacae Herba) juice paste; or Human Essence mixed with Eagle Droppings White applied, scars vanish. To prevent scars, apply real butter immediately after scabbing, scratch/peel and reapply. Delay leads to hard/deep penetration, eventual scarring. Post-smallpox tender skin: avoid bathing, roasted/spicy/five pungents/toxic foods to prevent liver/diaphragm heat-toxin steaming eye opacities. Wait 100 days for safety.
Recovery syndromes are residual toxin; heavy toxin causes recurrence like initial stage;
Recurrence after recovery is mild, due to unresolved toxin from inadequate post-recovery treatment. Baoyuan Tang with detoxifiers, adjusted by constitution.
Residual toxin divided by deficiency/excess; deficiency requires support to sit/stand;
Post-recovery miscellaneous syndromes: mostly heat, less deficiency. Weak constitution or cold drug use causing shaking needing support: Shuanghe San, Baoyuan Tang.
Vomiting/diarrhea, heat/thirst tonify Spleen/Stomach;
Sudden central Qi deficiency/anorexia: Shenling Baizhu San, Wei Ai San. Deficient heat/thirst/anorexia: Sijunzi Tang with Chenpi (Citri Reticulatae Pericarpium), Shanzha (Crataegi Fructus), Huanglian (Coptidis Rhizoma). Vomiting/diarrhea: Lizhong Tang/Wan, Yihuang San, Yigong San. Persistent: critical. Fever/spontaneous sweating: Buzhong Yiqi Tang. Persistent high fever: Ershen Tang.
Diet harmony gradually restores normalcy;
Mild cases: diet harmony restores Qi/Blood. Pure Yang constitution, post-toxin residue: avoid harsh drugs.
Excess syndrome eating well needs no medicine; constipation requires planning;
Post-smallpox eating well, regular bowels: Spleen excess harmless. Stomach heat digesting food well, hard constipation: future oral/throat issues, hematemesis, convulsions, or carbuncles likely. Clear according to constitution. Previous hot drug excess: Sanhuang Wan (Three Yellows Pill) purges. Constipation/thirst/fever: Dahuang San. Stomach heat/vomiting/mouth ulcers/lower sores/dysentery: Single Huanglian Tang. Thirst/scanty urine: Wuling San. Irritability/thirst: Single Huanglian Tang or Dengxin (Junci Medulla) with Biejia (Testudinis Carapax et Plastrum) decocted. Damp-heat tooth pain/swelling: Ganlu Yin. Bleeding gums: Wufu Huadu Dan. Sore throat: Baolong Wan or Ganjie Tang with Niubangzi (Arctii Fructus), Maidong, Zhuye (Bambusae Folium). Liver heat/anger/insomnia: Chaihu Qinggan Tang. Lower bleeding/pain: Xiebai Tang, Sanhuang Shuai Ai Tang. Unbearable heart pain: