痘形见点喜尖圆，恶隐蚊迹痱粟蚕，起胀惭绽充肥顺，顶平不突板实难，
生浆敛束形完固，緛嫩皮薄痒塌缠，结痂如螺先后落，最忌麸薄溃烂粘。
[注]
痘形气之为也，气胜毒，则毒为气驭其毒解矣，故顺也。
毒胜气，则气为毒蚀，其气竭矣，故逆也，
气毒相平，则势界于险，惟在医者调治得宜，使险变顺也，
如始出之形顶尖而根圆，此气胜毒，为顺也，
若隐如蚊咬，或如热痱，寒粟蚕种，此毒胜气，为逆也，
起胀之形，渐绽充肥，此气胜毒，为顺也，
若顶平不突，板实不绽，此毒胜气，为逆也，
出浆之形，根红敛束，痘壳完固，此气胜毒，为顺也，
若壳软皮簿，则必痒塌，此毒胜气，为逆也，
结痂之形，痂如螺壳，先结先落，后结后落，此气胜毒，为顺也，
若痂薄如麸，溃烂粘聚，此毒胜气为逆也，此痘形顺逆之大略也。
%
痘色桃花渐渐红，淡白桔紫晦多凶，起胀顶白根红润，顶灰根散或深红，
生浆由白而黄厚，最忌灰干与薄清，靥喜苍粟恶麸白，疤喜红满恶白平．
[注]
痘色血之为也，血胜毒，则毒为血载，其毒化矣，故顺也，
毒胜血，则血为毒滞，其血涸矣，故逆也，
血毒相平，则势界于险，亦在医者之调治得宜也，
始出之色如桃花，而渐加滋润，此血胜毒，为顺也，
若初出之即淡白干紫晦而不亮，此毒胜血，为逆也，
起胀之色，顶渐放白，根红光润，此血胜毒，为顺也，
若顶色灰滞，根血散漫，或地角深红，此毒胜血，为逆也，
生浆之色，白而渐黄，苍而淳厚，此血胜毒，为顺也，
若灰干不润，或浆薄清稀，此毒胜血，为逆也，
结痂之色，苍如粟壳，此血胜毒，为顺也，
若痂色麸白，此毒胜血，为逆也，
疤痕之色，红润凸起为顺，
若淡白黑紫，平凹无突起之状，皆为不顺之色，医者详之。
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痘疹形态在见点阶段，以尖圆为喜，厌恶像蚊子叮咬的痕迹、热痱子、寒栗或蚕种那样隐没的形态。起胀阶段，逐渐绽开、充盈肥满为顺证；若顶部平坦不突起、板硬坚实难以绽开则为难治（逆证）。生浆阶段，收敛束紧、形态完整坚固为顺证；若皮肤细嫩变薄、发痒塌陷则纠缠难愈。结痂阶段，痂壳如螺壳般先后脱落为顺证；最忌讳的是痂壳薄如麦麸、溃烂粘连。
[注]
痘疹的形态是由“气”所主导的。如果气盛而毒弱，那么毒邪就会被气所驾驭并化解，所以是顺证。
如果毒盛而气弱，那么气就会被毒邪侵蚀，导致气力衰竭，所以是逆证。
如果气和毒势均力敌，那么病情就处于危险境地，这完全取决于医生调理治疗是否得当，使险境转变为顺境。
例如刚开始出痘时，形态顶尖而根部圆润，这是气胜毒的表现，属于顺证。
如果痘形隐没如同蚊子叮咬，或者像热痱子、寒栗、蚕种一样，这是毒胜气的表现，属于逆证。
起胀阶段的形态，逐渐绽开且充盈肥满，这是气胜毒的表现，属于顺证。
如果顶部平坦不突起，板硬坚实而不绽开，这是毒胜气的表现，属于逆证。
出浆阶段的形态，根部红润、收敛束紧，痘壳完整坚固，这是气胜毒的表现，属于顺证。
如果痘壳软、皮薄，那么必然会出现发痒塌陷，这是毒胜气的表现，属于逆证。
结痂阶段的形态，痂壳如螺壳一般，先结的先落，后结的后落，这是气胜毒的表现，属于顺证。
如果痂壳薄如麦麸，溃烂且粘聚不散，这是毒胜气的表现，属于逆证。以上是痘疹形态顺逆的大致情况。
痘疹的颜色像桃花一样渐渐变红为吉，淡白色、桔红色、紫色晦暗无光的多主凶险。起胀阶段，顶部发白、根部红润为顺证；若顶部灰暗、根部散漫或颜色深红则为逆证。生浆阶段，颜色由白转黄且厚润为顺证；最忌讳的是灰色干枯或浆液稀薄清冷。收靥阶段，喜欢苍色如粟壳，厌恶白色如麦麸；留疤阶段，喜欢红润饱满，厌恶白色平坦凹陷。
[注]
痘疹的颜色是由“血”所主导的。如果血盛而毒弱，那么毒邪就被血液承载并化解，所以是顺证。
如果毒盛而血弱，那么血液就会被毒邪阻滞，导致血液枯竭，所以是逆证。
如果血和毒势均力敌，那么病情也处于危险境地，同样取决于医生调理治疗是否得当。
刚出痘时的颜色如桃花，并且逐渐增加滋润感，这是血胜毒的表现，属于顺证。
如果初出时即呈淡白色、干枯紫色、晦暗而无光泽，这是毒胜血的表现，属于逆证。
起胀阶段的颜色，顶部逐渐放白，根部红光润泽，这是血胜毒的表现，属于顺证。
如果顶部颜色灰暗滞涩，根部血色散漫，或者基底颜色深红，这是毒胜血的表现，属于逆证。
生浆阶段的颜色，白色逐渐转黄，苍色而醇厚浓厚，这是血胜毒的表现，属于顺证。
如果颜色灰干不润泽，或者浆液稀薄清冷，这是毒胜血的表现，属于逆证。
结痂阶段的颜色，苍色如粟壳，这是血胜毒的表现，属于顺证。
如果痂色白如麦麸，这是毒胜血的表现，属于逆证。
疤痕的颜色，红润凸起为顺证。
如果呈现淡白色、黑色或紫色，平坦凹陷没有突起的状态，都是不顺的颜色，医生需详细辨别。
The morphology of smallpox (Variola) at the spot-emergence stage is favored when it is pointed and round; it is dreaded when it hides like mosquito bites, heat pricks, cold shivers, or silkworm eggs. During the swelling stage, gradual expansion and plumpness indicate a favorable course (Shun); flat tops without protrusion and hard, solid textures that fail to expand indicate a difficult/unfavorable course (Ni). During the pus-formation stage, convergence with tight boundaries and complete, solid forms indicate a favorable course; tender, thin skin accompanied by itching and collapse indicates a lingering/unfavorable course. During the scabbing stage, scabs resembling snail shells falling off in sequence (first-formed first-fallen, last-formed last-fallen) indicate a favorable course; the most taboo is thin scabs like bran, accompanied by ulceration and adhesion.
[Note]
The morphology of smallpox is governed by Qi (Vital Energy). When Qi is strong and Pathogenic Toxin (Du) is weak, the toxin is controlled and resolved by Qi, thus indicating a favorable course.
When Pathogenic Toxin is strong and Qi is weak, Qi is eroded by the toxin, leading to exhaustion of Qi, thus indicating an unfavorable course.
When Qi and Pathogenic Toxin are balanced, the condition is precarious; it depends on the physician's appropriate regulation and treatment to transform danger into safety.
For example, if the initial form has a pointed tip and a round base, this signifies Qi overcoming Pathogenic Toxin, which is a favorable course.
If the form is hidden like mosquito bites, or resembles heat pricks, cold shivers, or silkworm eggs, this signifies Pathogenic Toxin overcoming Qi, which is an unfavorable course.
During the swelling stage, gradual expansion and plumpness signify Qi overcoming Pathogenic Toxin, which is a favorable course.
If the top is flat and non-protruding, and the texture is hard and solid without expanding, this signifies Pathogenic Toxin overcoming Qi, which is an unfavorable course.
During the pus-formation stage, a red root, convergent boundaries, and a complete, solid pustule shell signify Qi overcoming Pathogenic Toxin, which is a favorable course.
If the shell is soft and the skin thin, itching and collapse will inevitably occur; this signifies Pathogenic Toxin overcoming Qi, which is an unfavorable course.
During the scabbing stage, scabs like snail shells falling off in order signify Qi overcoming Pathogenic Toxin, which is a favorable course.
If the scabs are thin like bran, with ulceration and aggregation, this signifies Pathogenic Toxin overcoming Qi, which is an unfavorable course. This summarizes the general principles of favorable and unfavorable morphologies in smallpox.
The color of smallpox spots gradually turning red like peach blossoms is auspicious; pale white, orange-red, or dull purple colors often portend misfortune. During the swelling stage, a white top and red root indicate a favorable course; a grayish top, scattered root, or deep red base indicate an unfavorable course. During pus formation, a transition from white to yellow and thickness indicates a favorable course; grayish dryness or thin, clear fluid is most dreaded. During the crusting stage, a苍 (dark/greenish-black) color like millet husks is favored, while white like bran is dreaded; for scars, red fullness is favored, while white flatness is dreaded.
[Note]
The color of smallpox is governed by Blood. When Blood is strong and Pathogenic Toxin is weak, the toxin is carried and transformed by Blood, thus indicating a favorable course.
When Pathogenic Toxin is strong and Blood is weak, Blood is stagnated by the toxin, leading to depletion of Blood, thus indicating an unfavorable course.
When Blood and Pathogenic Toxin are balanced, the condition is precarious; it also depends on the physician's appropriate regulation and treatment.
The initial color like peach blossoms, becoming increasingly moist, signifies Blood overcoming Pathogenic Toxin, which is a favorable course.
If the initial color is pale white, dry purple, and dull/lusterless, this signifies Pathogenic Toxin overcoming Blood, which is an unfavorable course.
During the swelling stage, the top gradually whitens and the root becomes red and lustrous, signifying Blood overcoming Pathogenic Toxin, which is a favorable course.
If the top color is gray and stagnant, the root blood is scattered, or the base is deep red, this signifies Pathogenic Toxin overcoming Blood, which is an unfavorable course.
During pus formation, the color changes from white to yellow, becoming dark and thick/rich, signifying Blood overcoming Pathogenic Toxin, which is a favorable course.
If the color is gray and dry without moisture, or the pus is thin and clear, this signifies Pathogenic Toxin overcoming Blood, which is an unfavorable course.
During scabbing, a dark color like millet husks signifies Blood overcoming Pathogenic Toxin, which is a favorable course.
If the scab color is white like bran, this signifies Pathogenic Toxin overcoming Blood, which is an unfavorable course.
For scars, redness and elevation indicate a favorable course.
Pale white, black, or purple colors, along with flat, depressed surfaces without elevation, are all unfavorable colors; physicians must examine these carefully.