唇口与五脏相通气血盛衰受毒深浅观此可知吉凶也未出宜红活如常不宜燥裂干红如见黄
白紫赤而不润泽或气粗热盛舌白至唇口湿处而为胃烂者皆不可治如唇上痘出相连诸痘未浆而
此痘已先黄熟则其毒内攻已成使毒难成浆尤为不治之证间有气血下陷毒攻唇口糜烂成疳疳虽
成若得黄白脓水出者尚可治也又有黄色如干酱其肉臭烂一日烂一分则二日烂一寸名走马疳者
世无可治之方也若痘未褪谢连唇口结干红渣滓颊红唇紫此乃欲成肺痈之候治宜解毒清肺以解
毒汤加陈皮归芍桔梗黄连甚则大连翘饮随症加减
津液不能制火宜大补元气保元气加麦门冬五味子甚则加参苓白术散阴虚火动渴难治
气虚而血上行盐腌皮肉抓破倒塌宜保元汤倍 助表加芍制血或加何首乌有食毒而发中气
者宜解之
痘气非热不发其出非热不损未出之前宜大热以发其毒却乃头温足冷不能发其毒反致攻内
此当热而不热也毒既出宜表里和平长养气血助毒成浆乃反热煎熬气血往来不宁不能拘收其毒
毒无出路甚则气滞血失之患作矣是皆逆候也但观气粗面赤耳尻反热耳 之间平时冷处今皆热
可见热盛也治法在前宜无比散升麻汤解毒汤在后以保元汤加桂助气血以逐毒也初发寒热为实
因血气与毒火相攻气血旺而不受邪触故也已出而发则为虚矣七日前后独热者痘蒸气血与毒俱
盛之过也七日前后独寒者为气血虚损而毒瓦斯内郁太盛难治矣十四日独热者为余毒易治
唇口与五脏相通，气血的盛衰以及受毒的深浅，通过观察此处即可知晓吉凶。痘疹未出时，颜色宜红润鲜活如常；不宜干燥皲裂、干枯发红。若见到黄色、白色、紫色、赤色且不润泽，或者气息粗重、热势亢盛，舌苔白直至唇口湿润处出现胃烂现象的，都属于不可治疗的证候。如果嘴唇上先出现痘疮，连缀在一起，其他痘疹尚未灌浆，而此处的痘已先变黄成熟，说明毒邪内攻，已成使毒难以化浆的局面，尤为不治之证。间或有因气血下陷、毒邪攻冲唇口导致糜烂成疳的，虽然已成疳，但若能有黄白色的脓水排出，尚可治疗。又有黄色如干酱状，肌肉臭烂，一天腐烂一分，两天腐烂一寸，名为“走马疳”的，世间没有可治的方法。如果痘疹未退谢，连及唇口结成干红渣滓，面颊红、唇紫，这是将要形成肺痈的征象，治疗应当解毒清肺，使用解毒汤加陈皮、当归、芍药、桔梗、黄连，严重时用大连翘饮，随症状加减。
津液不能制约火邪，宜大补元气，保元汤加麦门冬、五味子，严重时加参苓白术散。阴虚火动，口渴难治。
气虚而血上行，皮肤像盐腌过一样，抓破后倒塌，宜用保元汤加倍用量以助表，加芍药以制血，或加何首乌。有食毒引发中气者，宜解其毒。
痘气的发出，非热则不发；痘疹的损伤，非热则不损。在痘疹未出之前，宜用大热之法以发散其毒。如果反而头温足冷，不能发散其毒，反致毒邪攻入体内，这是当热而不热的情况。毒既已发出，宜表里平和，长养气血，帮助毒邪成浆，却反而热势煎熬气血，往来不宁，不能收敛其毒，毒无出路，甚至导致气滞血失的祸患，这些都是逆证的征候。只要观察气息粗重、面色赤红、耳朵和尾骶部反而发热，耳屏之间平时是冷的地方现在都热了，可见热势亢盛。治疗方法在前文已有提及，宜用无比散、升麻汤、解毒汤；在后文则以保元汤加桂枝以助气血以驱逐毒邪。初发寒热为实证，是因为血气与毒火相互攻伐，气血旺盛而不受邪气触碰所致。痘疹发出之后发热则为虚证。发病七日前后唯独发热的，是痘蒸腾、气血与毒火俱盛的过失。发病七日前后唯独发冷的，是气血虚损而毒瓦斯内郁太盛，难以治疗。发病十四日唯独发热的，是余毒作祟，容易治疗。
The lips and mouth are connected with the five zang organs; the prosperity or decline of Qi and Blood, as well as the depth of toxin invasion, can be determined by observing this area to know auspiciousness or inauspiciousness. Before the eruption, the color should be ruddy, vibrant, and normal; it should not be dry, cracked, or dried red. If yellow, white, purple, or crimson colors are seen without moisture, or if there is coarse breathing and excessive heat, with a white tongue coating extending to the moist parts of the lips and mouth causing stomach rot, these are all untreatable conditions. If pustules appear on the lips first, connecting together, while other pustules have not yet filled with fluid, and this particular pustule has already turned yellow and matured, it indicates that the toxin has attacked inwardly, making it difficult for the toxin to form pus, which is particularly an untreatable condition. Occasionally, due to sinking of Qi and Blood and toxin attacking the lips and mouth, erosion leading to gan (necrotic sores) occurs; although gan has formed, if yellow-white pus can discharge, it is still treatable. There is also a condition where the color is yellow like dried soy sauce paste, with foul-smelling necrotic flesh, rotting one fen per day and one cun per two days, named "Zou Ma Gan" (Running Horse Gangrene), for which there is no known cure in the world. If the pustules have not yet faded and crusts of dry red dregs form around the lips and mouth, with red cheeks and purple lips, this is a sign that Fei Yong (Lung Abscess) is about to form. Treatment should focus on clearing heat and detoxifying the lungs using Jiedu Tang (Detoxification Decoction) added with Chenpi (Tangerine Peel), Danggui (Angelica Sinensis), Shaoyao (Peony Root), Jiegeng (Platycodon Root), and Huanglian (Coptis Rhizome). In severe cases, Da Lianqiao Yin (Large Forsythia Decoction) should be used, modified according to symptoms.
When Body Fluids cannot control Fire, it is appropriate to greatly tonify Yuan Qi (Original Qi); Baoyuan Tang (Preserve Origin Decoction) added with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry) should be used. In severe cases, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) may be added. Yin deficiency with hyperactive Fire causing thirst is difficult to treat.
When Qi is deficient and Blood ascends, the skin resembles salted meat; if scratched and broken, it collapses. Baoyuan Tang (Preserve Origin Decoction) should be used with increased dosage to support the exterior, plus Shaoyao (Peony Root) to regulate Blood, or Heshouwu (Polygonum Multiflorum) may be added. If food toxicity triggers Middle Qi issues, it should be resolved.
The eruption of Dou Qi (Pox Qi) does not occur without Heat; the damage to the pox does not happen without Heat. Before eruption, strong Heat methods should be used to vent the toxin. However, if the head is warm but the feet are cold, failing to vent the toxin, it instead causes the toxin to attack inwardly; this is a case where Heat was indicated but not applied. Once the toxin has erupted, the interior and exterior should be peaceful, nourishing Qi and Blood to help the toxin form pus. Instead, excessive Heat boils and torments Qi and Blood, causing restlessness and preventing the containment of the toxin, leaving no outlet for the toxin, potentially leading to Qi stagnation and Blood loss. These are all adverse signs. Observing coarse breathing, reddish face, and reversed heat in the ears and sacrum—areas that are usually cool becoming hot—indicates excessive Heat. The treatment method was mentioned earlier: use Wubi San (Incomparable Powder), Shengma Tang (Ephedra Decoction), and Jiedu Tang (Detoxification Decoction). Later, Baoyuan Tang (Preserve Origin Decoction) added with Guizhi (Cinnamon Twig) should be used to assist Qi and Blood in expelling the toxin. Initial chills and fever indicate excess syndrome, caused by the conflict between Qi/Blood and toxin-fire; when Qi and Blood are vigorous, they resist pathogenic influence. Fever after eruption indicates deficiency syndrome. Isolated heat around the seventh day before and after eruption is due to excessive steaming of the pox, with both Qi/Blood and toxin-fire being overly prosperous. Isolated cold around the seventh day before and after eruption indicates Qi and Blood deficiency with excessive internal depression of toxin-qi, which is difficult to treat. Isolated heat at the fourteenth day indicates residual toxin, which is easy to treat.