痘疹发热，大抵初时与伤寒相似。然伤寒之邪从表入里，故见各经之证，痘疹之毒则从里出表，
故见五脏之证。如呵欠闷顿，肝证也；乍凉乍热，手足稍冷，多睡，脾证也；面燥腮赤，咳嗽喷嚏，
肺证也；惊悸，心证也； 凉耳冷，肾证也。又观心窝有红色，耳后有红筋，目中含泪，成身热，
手指皆热，惟中指独冷，乃知是痘证也，盒饭察其虚实，随证治之。
五指稍头冷，惊来不可当。若逢中指热，必定是伤寒；中指独自冷，麻痘证相传。女右男分左，
分明好细看。
两耳红筋痘必轻，紫筋起处重沉沉，急须用药相攻治，十个难求三五生。
凡初看痘法，以纸捻蘸油照其颗粒，次以手摸面颊，如红色随手转白，随白转红，谓之血活，
生意在矣。若揩下不白，举之不红，是谓血枯，纵疏亦危。又看目睛神光，口唇舌尖，红活如常，
无燥白之色，乃为吉兆，自可无忧。此观痘疹之大治。
凡看痘之法，一见发热，即当先察其脉。盖凡痘疮将出者，未见形迹，必先发热，既见发热，
脉必滑数。
但微见滑数有神而不失和缓之气者，其痘必轻而少；若滑数加倍而犹带和缓者，其痘必多而重，尚
亦无害；若滑数之甚，义兼弦躁，或芤急无神而全无和缓之气者，其痘必甚而危，故余于初熟时，
便能断其吉凶，人多惊服而不知所窥在脉也。凡诊此之法，但全握小儿之手，而单以拇指诊之，亦
最易也。看疹之法，此为第一，而今医多不知之，亦以古人之未之及耳。
痘疹发热，大体在初期与伤寒相似。然而，伤寒的病邪是从体表侵入体内，所以表现出各条经络的证候；痘疹的毒邪则是从体内透发至体表，所以表现出五脏的证候。例如：呵欠、困倦，是肝（肝脏）的证候；忽冷忽热，手足稍冷，嗜睡，是脾（脾脏）的证候；面部干燥、腮部发红，咳嗽、打喷嚏，是肺（肺脏）的证候；惊恐、心悸，是心（心脏）的证候；耳朵发凉、寒冷，是肾（肾脏）的证候。另外，观察心窝处有红色，耳后有红色筋络，眼睛含着泪水，全身发热，手指都热，唯独中指单独发冷，由此可以知道这是痘疹的证候。应当仔细辨别其虚证或实证，根据具体证候进行治疗。
五个手指梢头发冷，惊风发作时难以抵挡。如果中指发热，必定是伤寒；如果唯独中指发冷，则是麻疹或痘疹的征象。女性看右手，男性看左手，分辨得清清楚楚，需要仔细观察。
两耳有红色筋络，痘疹病情必然较轻；如果有紫色筋络浮现，病情则沉重深沉。必须紧急用药攻逐治疗，十个人中很难救活三五个。
凡是初诊痘疹的方法，用点燃的纸捻蘸油照亮观察痘疹颗粒，接着用手触摸面颊，如果红色随按压转白，松开后转红，这叫做“血活”，说明生机尚存。如果擦拭后不白，抬起后不红，这叫做“血枯”，即使治疗宽松也处于危险境地。另外观察眼睛的神气光彩，口唇和舌尖，颜色红润鲜活如常，没有干燥白色的色泽，这才是吉兆，自然可以无忧。这是观察痘疹的大致治法。
凡是诊察痘疹的方法，一见到发热，就应当先诊察脉象。大概痘疮将要发出的时候，尚未出现皮疹痕迹，必须先发热；既然已经见到发热，脉象必定滑数（流利快速）。但是，如果脉象只是轻微滑数且神气充足，不失和缓之气，那么痘疹必然轻微且数量少；如果滑数加倍但仍然带有和缓之气，那么痘疹必然多而且重，但也尚无大害；如果滑数非常严重，又兼见弦急躁动，或者芤急（浮大中空）无神且完全没有和缓之气，那么痘疹必然严重而危险。所以我能在痘疹初熟阶段，就能判断其吉凶，人们对此感到惊讶佩服，却不知关键在于脉象。凡是诊察这种脉象的方法，只要完全握住小儿的手，单用拇指进行诊察，也是最容易做到的。观察疹病的方法，这是第一要诀，但现在的医生大多不知道这一点，也是因为古人未曾提及的缘故。
Fever associated with smallpox and measles is generally similar to Shanghan (Cold Damage) in the early stages. However, the pathogenic factor of Shanghan enters from the exterior into the interior, thus presenting syndromes of the various meridians; whereas the toxin of smallpox and measles emerges from the interior to the exterior, thus presenting syndromes of the five Zang organs. For instance: yawning and drowsiness indicate a Liver syndrome; alternating chills and fever, slightly cold hands and feet, and excessive sleepiness indicate a Spleen syndrome; dry face, red cheeks, coughing, and sneezing indicate a Lung syndrome; fright and palpitations indicate a Heart syndrome; cold ears and coldness indicate a Kidney syndrome. Furthermore, observing redness at the epigastrium, red veins behind the ears, tears in the eyes, generalized body heat, heat in all fingers but coldness specifically in the middle finger, allows one to ascertain that this is a smallpox/measles condition. One must carefully distinguish between deficiency and excess patterns and treat according to the specific manifestations.
Coldness at the tips of all five fingers indicates severe fright convulsions that are difficult to withstand. If the middle finger is warm, it is certainly Shanghan; if only the middle finger is cold, it is transmitted as a sign of mumps/smallpox or measles. For females, observe the right hand; for males, the left hand. The distinction should be clear and requires careful observation.
Red veins on both ears suggest that the smallpox will be mild; where purple veins appear, the condition is heavy and profound. Urgent treatment with attacking medications is required; among ten cases, it is rare to save three or five.
The method for initially examining smallpox involves using a lit paper wick dipped in oil to illuminate the pustules/granules, followed by touching the cheeks with the hand. If the redness turns white upon pressure and returns to red upon release, this is called "active blood," indicating that vitality remains. If wiping does not make it white and lifting does not make it red, this is called "exhausted blood"; even with lenient treatment, the prognosis is critical. Additionally, observe the spirit and luster of the eyeballs, as well as the lips and tip of the tongue. If they are red and vibrant as usual, without dry or pale white discoloration, this is an auspicious omen, and there is no cause for worry. This constitutes the general approach to observing smallpox and measles.
Regarding the method of examining smallpox, once fever appears, the pulse must be inspected first. Generally, before the rash manifests visibly, fever must precede it; once fever is observed, the pulse will necessarily be slippery and rapid (Hua Shu). However, if the pulse is merely slightly slippery and rapid with sufficient spirit and retains a harmonious and relaxed quality, the smallpox will likely be mild and sparse. If the slipperiness and rapidity double but still retain a harmonious quality, the smallpox will be numerous and severe, yet still not immediately dangerous. If the slipperiness and rapidity are extreme, accompanied by wiry and restless qualities, or if the pulse is hollow and urgent (Kou Ji) without spirit and completely lacks a harmonious quality, the smallpox will be severe and critical. Therefore, I can determine the auspiciousness or inauspiciousness during the initial maturation stage of the rash. People are often amazed and convinced by my judgments but do not realize that the key lies in the pulse. The method for diagnosing this is simply to hold the child's hand firmly and use only the thumb to palpate, which is also the easiest approach. This is the primary method for examining rashes, yet many contemporary physicians are unaware of it, largely because ancient texts did not emphasize it.