毒微天时和者吉，毒甚天时不和凶，毒微不和顺中险，毒甚时和逆或更。
[注]
毒微吉矣，然必逢天时之和，始为顺而吉也，
毒甚凶矣，然必遇天时不和，则始为逆而凶也，
毒微者顺也，若值天时不和，恐顺中化险也，
毒甚者逆也，若值天时之和，或逆中转险也，
此以胎毒之轻重，天时之和不和，定痘之顺逆险也。
%
险逆时和无病吉，不知有病定然凶，由此故识种痘善，人事能回天命亨。
[注]
凡痘险逆之证，固不善矣，
若逢天时之和，儿又无病，险者可以变顺，逆者可以化险，故曰吉也，
若逢天时不和，儿又有病，则险者变逆，逆者更逆，故曰凶也，
由此观之，可识种痘之善，以得其天时之和，儿素无病，
其中即有毒之重者，而人事克尽，亦能挽回天命而致亨也。
%
发热和缓微微汗，饮食如常二便调，睡卧安然神气爽，此为顺证不须疗。
[注]
发热和缓，身不甚热，毒轻也，
微微汗，身微微有汗表和也，
饮食二便如常，里和也，
神气清爽，睡卧安然，精神气血大和，故为顺证，不须治疗也。
%
发热三日热不远，烦渴咬牙面赤红，惊啼战栗乳食少，夜不安眠险证明。
[注]
发热三日见点者，常候也，
若见点热不退者，毒盛也，
更兼烦躁口渴，频频咬牙，面色红赤，惊悸多啼，身体战栗，
乳食甚少，不能安眠等证，
此是毒盛，伏郁难出，其为险证明矣，急宜随证施治，庶或从险化顺也。
%
毒邪轻微且天时调和者，预后吉祥；毒邪深重且天时不调者，预后凶险。毒邪轻微但天时不调，属顺证中潜伏危险；毒邪深重但天时调和，属逆证中可能转为更严重的危象。
[注]
毒邪轻微本为吉兆，然而必须恰逢天时调和，才算是顺证而吉祥。
毒邪深重本为凶兆，然而必须遭遇天时不调，才算是逆证而凶险。
毒邪轻微属于顺证，若正值天时不调，恐怕在顺证中转化为险证。
毒邪深重属于逆证，若正值天时调和，或许在逆证中转化为险证（或指病情复杂化）。
这是根据胎毒的轻重、天时的调和与否，来判定痘疹（天花）的顺、逆、险三种预后情况。
险证或逆证若逢天时调和且患儿无其他疾病，预后吉祥；不知已有病情的存在，则必然凶险。由此可以认识种痘技术的优越性，通过尽人事（医疗干预）能够挽回天命，使病情亨通好转。
[注]
凡是痘疹出现险证或逆证的状况，固然不好。
若逢天时调和，患儿又没有其他疾病，险证可以变为顺证，逆证可以化为险证（即不再恶化），所以说吉祥。
若逢天时不调，患儿又有其他疾病，则险证会变为逆证，逆证会更加严重，所以说凶险。
由此看来，可以认识到种痘的好处：获得天时的调和，患儿平素没有疾病，即使其中毒邪较重，只要人事（治疗护理）竭尽全力，也能挽回天命而致亨通。
发热和缓，微微出汗，饮食如常，大小便调畅，睡眠安稳，神气清爽，此为顺证，不需要治疗。
[注]
发热和缓，身体不特别热，说明毒邪轻浅。
微微出汗，身体有微汗，说明表气调和。
饮食和二便如常，说明里气调和。
神气清爽，睡眠安稳，说明精神气血大调和，所以称为顺证，不需要治疗。
发热三天后热度不退，烦躁口渴，咬牙，面色红赤，惊叫啼哭，战栗，吃奶少，夜间不能安眠，这是险证的证明。
[注]
发热三天后出点（皮疹显现），是常规征候。
若出点后热度不退，说明毒邪炽盛。
再加上烦躁口渴，频频咬牙，面色红赤，惊悸多啼，身体战栗，
吃奶很少，不能安眠等症状，
这是毒邪炽盛，伏郁难以透发，这确实是险证的证明，应当紧急根据症状进行治疗，或许能从险证转化为顺证。
If the pathogenic toxin is slight and the heavenly timing (environmental/seasonal conditions) is harmonious, the prognosis is auspicious; if the toxin is severe and the heavenly timing is disharmonious, the prognosis is ominous. If the toxin is slight but the heavenly timing is disharmonious, it represents a danger within a favorable course; if the toxin is severe but the heavenly timing is harmonious, it may represent a worsening of an unfavorable course.
[Note]
A slight toxin is auspicious, yet it must coincide with harmonious heavenly timing to be considered favorable and auspicious.
A severe toxin is ominous, yet it becomes truly unfavorable and ominous only when encountering disharmonious heavenly timing.
A slight toxin indicates a favorable course; however, if the heavenly timing is disharmonious, there is fear that the favorable course will transform into a dangerous one.
A severe toxin indicates an unfavorable course; if the heavenly timing is harmonious, it might transform into a dangerous state within the unfavorable course.
This determines the favorable (Shun), unfavorable (Ni), and dangerous (Xian) prognoses of smallpox based on the severity of fetal toxin and the harmony or disharmony of heavenly timing.
In cases of dangerous or unfavorable courses, if heavenly timing is harmonious and the child has no other illness, the prognosis is auspicious; failing to recognize the existing illness leads to certain ominous outcomes. From this, we can appreciate the benefits of variolation: human effort can reverse destiny and bring about prosperity (recovery).
[Note]
Cases of dangerous or unfavorable smallpox are inherently undesirable.
However, if heavenly timing is harmonious and the child has no other illness, dangerous cases can become favorable, and unfavorable cases can become merely dangerous (less severe); thus, it is said to be auspicious.
If heavenly timing is disharmonious and the child also has other illnesses, dangerous cases will become unfavorable, and unfavorable cases will become even more so; thus, it is said to be ominous.
From this observation, one can understand the advantage of variolation: by securing harmonious heavenly timing and ensuring the child was previously healthy, even if the toxin load is heavy, complete human effort (medical intervention) can reverse destiny and lead to recovery.
Fever is mild with slight sweating, diet remains normal, bowel movements and urination are regulated, sleep is peaceful, and spirit/qi is refreshed; this is a favorable course requiring no treatment.
[Note]
Mild fever without excessive heat indicates light toxin.
Slight sweating indicates harmonious exterior (surface) qi.
Normal diet and excretion indicate harmonious interior (visceral) qi.
Refreshed spirit and peaceful sleep indicate great harmony of spirit, qi, and blood; therefore, it is termed a favorable course requiring no treatment.
After three days of fever, if the heat persists, accompanied by irritability, thirst, teeth grinding, red face, startled crying, tremors, reduced milk intake, and insomnia at night, these are signs of a dangerous course.
[Note]
The appearance of spots after three days of fever is a common pattern.
If the heat does not subside after spots appear, it indicates abundant toxin.
Combined with irritability, thirst, frequent teeth grinding, red complexion, palpitations and frequent crying, body tremors,
very little milk intake, and inability to sleep peacefully,
these symptoms indicate abundant toxin that is stagnant and difficult to erupt; this clearly demonstrates a dangerous course. Urgent treatment according to symptoms is required, so that the condition may possibly transform from dangerous to favorable.