夫痘疮属阳。春夏为顺。秋冬为逆。春痧夏 。秋脓胞。四季疹者为顺。如春脓 。夏黑陷。秋
冬疹者皆为逆。逆者不必用药。总是仙丹。岂能返于生命乎。又云。先痘后夹疹者为顺。先疹后夹
者顺。先痘后水泡者多则顺。少则逆。先水泡后夹 少者顺。多者逆。先水泡后夹疹者逆。疮已黑。
忽泄出脓血痂皮者顺。水谷乳食不化者逆。大抵顺者吉。而逆者凶。有顺时令而内兼险恶坏症者亦死。
有逆时令而痘色形症轻稀者生。如此之度婴幼生之有赖。
夫痘之初出。先分部位。部位者。天庭地阁。乃额上承浆是也。如那一部位稠者毒之甚。稀者毒
之轻。无者即本经无毒也。如头顶额背脊腰委中者太阳经也。如面鼻腮颊属手足阳明经。咽喉手背肺
经也。胸膈舌心部也。胁肋阴器肝胆部也。四肢脾部也。轻则尖圆饱满。苍黄肤糙。能食。气体壮无
他症者吉也。重则空陷痒 。密串丹浮。肉肿。痘不胀。目闭声哑不食者。纵有千金难买大限。妙药
何功。又云痘从头面胸背先灰者。八九日为顺。从脚膝腰腿者为逆。如此直指。应验神矣。
夫痘之色者宜光泽于外。则知五内及肤里无蓄滞之毒为吉。混黑灰色干红焦顶下泽于外者。乃脏
腑壅滞之毒。不能疏泄于外为凶。不可治之。
痘之形症如一二日间作二三次旋。旋而出耳下鼻边颔下三五。窠红活滋润微微体然。或往来寒热。
旋出旋
长。至五七日内。皮肤糙。浆满。色苍蜡尖圆者吉也。如一二日内。发热间即一齐发出。如蚊蚤叮斑
者香搐焦顶干红。蛇皮蚕壳。紫胀痒 。或肿而忽消。或忽然而肿。肉痘不胀者凶也。
痘疮属于阳证。在春夏季节出现为顺证，在秋冬季节出现为逆证。春季出痧疹、夏季出黑陷、秋季出脓疱、四季皆见疹子者，属于顺证。如果是春季出脓疱、夏季黑陷、秋季和冬季出疹子，都属于逆证。对于逆证，即使不用药，即便是仙丹妙药，又怎能挽回生命呢？又说，先出痘疮后夹杂疹子的为顺证，先出疹子后夹杂痘疮的也为顺证；先出痘疮后出水泡，水泡多的为顺证，少的为逆证；先出水泡后夹杂疹子，数量少的为顺证，多的为逆证；先出水泡后夹杂疹子的为逆证。痘疮已经变黑，忽然泄出脓血痂皮的为顺证；饮食水谷乳食不消化的为逆证。大抵顺证吉利，而逆证凶险。有顺应时令但内部兼有险恶坏症的也会死亡；有违背时令但痘色形态症状轻微稀疏的也能存活。这样的判断方法，是婴幼儿生存所依赖的。
痘疮刚发出时，首先要分辨部位。所谓部位，是指天庭（额头）和地阁（下巴承浆穴处）。如果某一部位痘疮稠密，说明毒气很重；稀疏则说明毒气很轻；没有痘疮即说明本经无毒。例如头顶、额部、背部、腰部、委中穴处，属于太阳经；面部、鼻部、腮部、颊部，属于手足阳明经；咽喉、手背，属于肺经；胸膈、舌部、心部，属于心经；胁肋、阴器，属于肝胆部；四肢，属于脾部。病情轻的表现为痘尖圆饱满，颜色苍黄，皮肤粗糙，能进食，身体壮实无其他症状，这是吉兆。病情重的表现为痘空陷、瘙痒、密集串连、如丹砂浮起、肌肉肿胀、痘不胀大、眼睛闭合、声音嘶哑、不能进食，即使有千金难买的长寿命数，妙药又有什么功效呢？又说，痘疮从头面胸背先变灰暗的，在第八九日出现为顺证；从脚膝腰腿先出现的为逆证。如此直接的指征，应验起来神奇无比。
痘疮的颜色应该外表光泽，这样就知道五脏及肌肤里没有蓄积滞留的毒气，这是吉兆。如果混杂黑灰色，干燥焦顶，下部润泽于外，这是脏腑壅滞的毒气，不能疏泄于外，这是凶兆，不可治疗。
痘疮的形态症状，如果在第一二天内发作两三次，随即发出，耳下、鼻边、颔下只有三五颗，痘窠红活滋润，微微隆起，或者伴有往来寒热，随即发出随即生长，到第五七天内，皮肤粗糙，浆液充满，颜色像苍蜡一样，痘尖圆，这是吉兆。如果在第一二天内，发热间歇间就一齐发出，像蚊蚤叮咬的斑点一样，香搐（抽搐）、焦顶干红，像蛇皮蚕壳，紫色肿胀瘙痒，或者肿了忽然消退，或者忽然肿胀，肉痘不胀大的，这是凶兆。
The smallpox (douchuang) belongs to the Yang syndrome. Its appearance in spring and summer is a favorable course (shun), while its appearance in autumn and winter is an unfavorable course (ni). The emergence of sand-rash (shasha) in spring, black depression (hei xian) in summer, pustules (nong pao) in autumn, and rashes throughout the four seasons are considered favorable courses. Conversely, if pustules appear in spring, black depression in summer, and rashes in autumn and winter, these are all unfavorable courses. For unfavorable courses, even without medication, how could immortal pills restore life? It is also said that smallpox appearing first followed by mixed rash is a favorable course; rash appearing first followed by mixed smallpox is also a favorable course. If smallpox appears first followed by blisters, a large number indicates a favorable course, while a small number indicates an unfavorable course. If blisters appear first followed by mixed rash, a small number is favorable, and a large number is unfavorable. If blisters appear first followed by mixed rash, it is an unfavorable course. If the sores have turned black but suddenly discharge pus, blood, and scabs, it is a favorable course; if food and milk cannot be digested, it is an unfavorable course. Generally, favorable courses indicate auspiciousness, while unfavorable courses indicate ominous signs. There are cases where the timing follows the seasons but internal dangerous complications lead to death; there are also cases where the timing opposes the seasons but the color, shape, and symptoms of the smallpox are mild and sparse, leading to survival. Such judgment methods are relied upon for the survival of infants and young children.
When smallpox first emerges, one must first distinguish the locations. These locations refer to the Heavenly Court (Tianting, forehead) and the Earthly Pavilion (Dige, Chengjiang point at the chin). If the sores are dense in a certain location, the toxin is severe; if sparse, the toxin is light; if absent, the respective meridian has no toxin. For instance, the top of the head, forehead, back, waist, and Weizhong (BL40) belong to the Taiyang Meridian; the face, nose, cheeks, and jaw belong to the Hand and Foot Yangming Meridians; the throat and dorsum of the hand belong to the Lung Meridian; the chest and diaphragm, tongue, and heart area belong to the Heart; the hypochondrium and genitalia belong to the Liver and Gallbladder; the four limbs belong to the Spleen. Mild cases present with pointed, round, and full sores, grayish-yellow color, rough skin, ability to eat, robust physique, and no other symptoms, which is auspicious. Severe cases present with hollow, depressed, itchy, densely clustered, floating red sores, swollen flesh, non-distended sores, closed eyes, hoarse voice, and inability to eat; even with a lifespan hard to buy for a thousand gold, what use are miraculous medicines? It is also said that if smallpox turns gray first on the head, face, chest, and back, appearing around the eighth or ninth day is a favorable course; if it appears first on the feet, knees, waist, and legs, it is an unfavorable course. Such direct indications are amazingly accurate.
The color of the smallpox should be lustrous on the outside, indicating that there is no accumulated toxic stagnation in the five zang organs and beneath the skin, which is auspicious. If the color is mixed with black and gray, dry with a scorched apex, and moist only at the base on the outside, this indicates toxic stagnation in the zang-fu organs that cannot be vented outward, which is ominous and incurable.
Regarding the morphology and symptoms of smallpox: if eruptions occur two or three times within one or two days, emerging successively, with only three to five sores behind the ears, beside the nose, and under the chin, having red, vibrant, moist pits, slightly raised, or accompanied by alternating chills and fever, emerging and growing successively, and by the fifth to seventh day, the skin becomes rough, the blisters fill with fluid, the color resembles gray wax, and the tips are round, this is auspicious. However, if within one or two days, during intermittent fever, they all erupt at once like mosquito or flea bites, with convulsions, dry red scorched tops, resembling snake skin or silkworm shells, purple and swollen with itching, or swelling then suddenly subsiding, or sudden swelling, with fleshy sores that do not distend, this is ominous.