凡痘疮紧小充实者，名曰珍珠痘，此则易壮易靥。高硕饱满者，名曰大痘，此则早壮而迟收。
四围起而中心陷者，名茱萸痘；平扁不突者，名曰蒸饼痘，此则有凶有吉，稀者轻，密者重。
痘自发热以至起胀，毒从内出，阳之候也，脉宜浮大而数，不宜沉细而迟。自灌脓收靥以后，
毒已外解，阴之候也，脉宜和缓，不宜洪数。又曰∶痘疮之脉，中和为贵，不可过于躁疾，或见微
小。故曰∶脉静身凉者生，脉躁身热者死。又阳病得阴脉者死。大抵四时以胃气为本，胃气者，以
四时之脉而皆兼和缓，即胃气也。盖滑、数、浮、洪为太过，太过为实，实者邪气实也。弦、迟、
微、弱为不及，不及为虚，虚者正气虚也。设以太过不及之脉，而中无和缓之气，是皆死候之脉，
故曰人无胃气则死。
凡天行痘疹之时，有于未出之先，察其形色情性，可以预知吉凶也。一观其色∶如面颜红白明
润，与平日同而无变者吉，如忽见红赤而太娇，或 白而无彩，顿然改变异于平时者凶。又如额有青
纹，目有赤脉，口有
黑气，耳有尘痕者，皆大凶之兆。二观其形∶凡精神畅爽，动止便利，语言清亮者，无病而吉也；
如精神衰弱，动止迟留，言语低微异如平时者凶。又原具寿相者吉。如有天相，则儿头破颅解，项
小脚细，声微目无精彩，或睛光露神，啼声断续，无喜无情而自语自笑，聪意太早，肉浮骨嫩者，
皆不吉之兆。三观情性∶几未发热时；忽生喜心，若与父母爱恋不忍舍者，及闻见怪异言语妄诞者，
皆凶兆也。
凡是痘疮形态紧缩、细小且充实的，称为“珍珠痘”，这种痘疹容易成熟并结痂愈合。形态高耸硕大且饱满的，称为“大痘”，这种痘疹容易早期成熟但后期收靂（结痂脱落）较慢。
痘疮四周隆起而中心凹陷的，称为“茱萸痘”；平坦扁平不突出的，称为“蒸饼痘”，这两种情况吉凶不定，稀疏的为轻症，密集的为重症。
痘疮从发热到起胀阶段，毒邪由内向外透发，属于阳证的表现，脉象应当浮大而数（快），不宜出现沉细而迟（慢）的脉象。从灌脓到收靂阶段以后，毒邪已经向外解除，属于阴证的表现，脉象应当和缓，不宜出现洪大数急的脉象。又说：痘疮的脉象，以中和为贵，不可过于躁动疾速，或者出现微小无力的脉象。所以说：脉象安静、身体凉爽的预后良好（生），脉象躁动、身体发热的预后不良（死）。另外，阳证出现阴脉的预后不良（死）。大致来说，四季的脉象都以胃气为本底，所谓胃气，就是在四季脉象中都兼带有和缓之象，这就是胃气。滑、数、浮、洪属于太过，太过代表实证，实证是邪气盛实。弦、迟、微、弱属于不及，不及代表虚证，虚证是正气虚弱。如果脉象出现太过或不及，且中间没有和缓的胃气，这些都是死证的脉象，所以说人如果没有胃气就会死亡。
凡是遇到时行痘疹流行的时候，在痘疹尚未发出之前，通过观察其形色情性，就可以预先判断吉凶。一是观察其颜色：如面部红润白皙明润，与平时相同而没有变化的，预后良好；如果忽然见到红赤得过于娇艳，或者苍白而无神采，突然改变异于平时的，预后不良。又如额头有青纹，眼睛有赤脉，口唇周围有黑气，耳朵上有尘垢痕迹的，都是大凶的征兆。二是观察其形态：凡是精神畅达清爽，动作举止便利，语言清晰响亮的，是无病且吉利的表现；如果精神衰弱，动作举止迟缓停留，言语低微异于平时的，预后不良。另外，原本具备长寿相貌特征的吉利。如果有夭折之相，则表现为婴儿头颅破裂颅骨解离，颈部细小脚部纤细，声音微弱眼神无光彩，或者眼珠光亮显露神气，啼哭声断断续续，没有喜悦之情而自言自语自笑，聪明意趣太早显现，肌肉浮肿骨骼娇嫩的，都是不吉利的征兆。三是观察其情性：在还未发热的时候，忽然产生欢喜之心，好像对父母爱恋不忍分离，以及听到看见怪异言语妄诞荒谬的，都是凶兆。
When the smallpox lesions are tight, small, and full, they are named "Pearl Smallpox" (Zhenzhu Dou), which tends to mature easily and heal quickly. When they are tall, large, and plump, they are named "Large Smallpox" (Da Dou), which matures early but heals slowly.
When the lesions are raised around the periphery but depressed in the center, they are named "Dogwood Smallpox" (Zhuyu Dou); when they are flat and not protruding, they are named "Steamed Cake Smallpox" (Zhengbing Dou). These cases may be either auspicious or inauspicious; sparse lesions indicate a mild condition, while dense lesions indicate a severe one.
From the onset of fever until the swelling stage, the pathogenic toxin emerges from the interior to the exterior, representing a Yang syndrome manifestation. The pulse should be floating, large, and rapid (Shu), and should not be deep, fine, and slow (Chi). After the pustule formation and healing stages, the toxin has been resolved externally, representing a Yin syndrome manifestation. The pulse should be harmonious and moderate (Hehuan), and should not be surging and rapid. It is also said: For smallpox pulses, harmony and moderation are paramount. The pulse must not be overly restless and rapid, nor should it appear minute and weak. Therefore, it is stated: Those with a quiet pulse and cool body will survive; those with a restless pulse and hot body will die. Furthermore, a Yang disease presenting with a Yin pulse indicates death. Generally speaking, the stomach Qi (Wei Qi) is the root of the pulse in all four seasons. Stomach Qi is characterized by a harmonious and moderate quality present in the seasonal pulses. Slippery, rapid, floating, and surging pulses represent excess (Tai Guo); excess indicates an Excess syndrome (Shi Zheng), where pathogenic factors are strong. Wiry, slow, minute, and weak pulses represent deficiency (Bu Ji); deficiency indicates a Deficiency syndrome (Xu Zheng), where healthy Qi is weak. If a pulse exhibits excess or deficiency without the moderating influence of Stomach Qi, these are all signs of impending death. Thus, it is said that a person without Stomach Qi will die.
During epidemics of infectious smallpox and measles, before the rash erupts, one can predict auspiciousness or inauspiciousness by observing the patient's complexion, form, temperament, and nature. First, observe the complexion: If the face is red and white, bright, and moist, remaining unchanged from usual, it is auspicious. If suddenly appearing overly crimson and delicate, or pale and lusterless, changing abruptly from the norm, it is inauspicious. For instance, green lines on the forehead, red veins in the eyes, black aura around the mouth, and dusty marks on the ears are all omens of great inauspiciousness. Second, observe the form: If the spirit is clear and refreshing, movements are free, and speech is clear and loud, it indicates health and auspiciousness. If the spirit is weak, movements are sluggish, and speech is low and different from usual, it is inauspicious. Additionally, those originally possessing features of longevity are auspicious. However, features of premature death include a cracked skull or separated cranial sutures, a thin neck and slender legs, a faint voice and lackluster eyes, or glaring eyes revealing exposed spirit, intermittent crying, absence of joy or affection accompanied by self-talk and laughter, precocious intelligence, and floating flesh with tender bones; all these are inauspicious omens. Third, observe the temperament and nature: Before the onset of fever, if the child suddenly displays excessive joy, clinging affectionately to parents unwilling to part, or reacts to strange sights and sounds with absurd talk, these are all ominous signs.