血之体本红，血得其畅，则红而活、荣而润，敷布洋溢，是疹之佳境也。○淡红有美有疵，色淡而润，此色之上者
也；若淡而不荣，或娇而艳、干而滞，血之最热者。○深红者，较淡红为稍重，亦血热之象。凉其血即转淡红。○色艳
如胭脂，此血热之极，较深红为更恶。必大用凉血，始转深红。再凉其血，而淡红矣。○紫赤类鸡冠花而更艳，较艳红
为火更盛。不急凉之，必至变黑。须服清瘟败毒饮加紫草、桃仁。○细碎宛如粟米，红者谓之红砂；白者，谓之白砂。
疹后多有此证，乃余毒尽透最美之境。愈后蜕皮。若初病未认是疫，后十日半月而出者。烦躁作渴，大热不退，毒发于
颔者，死不可救。
疫毒发斑，毒之散者也。疫毒发疮，毒之聚者也。初起之时，恶寒发热，红肿硬痛，此毒之发扬者。但寒不热，平
扁不起，此毒之内伏者。或发于要地，发于无名，发于头面，发于四肢，种种形状，总是疮证。何以知其是疫毒所聚？
寻常疮脉，洪大而数；疫毒之脉，沉细而数。寻常疮证，头或不痛；疫毒，则头痛如劈，沉不能举，是其验也。稽其证，
有目红面赤而青惨者，有忽汗忽呕者，有昏愦如迷者，有身热肢冷者，有腹痛不已者、有大吐干呕者，有大泄如注者，
有谵语不止者，有妄闻妄见者，有大渴思水者，有烦躁如狂者，有喊叫时作、若惊若惕者。病态多端，大率类是。误认
寻常疮证，温托妄施，断不能救。
雄按∶暑、湿、热、疫诸病，皆能外发痈疮。然病患不自知其证发之由。外科亦但见其外露之疮，因而误事者，最
多。人亦仅知其死于外证也。噫！
血液的本色是红色，当血液运行通畅时，疹色呈现红润、鲜活、光泽且滋润的状态，弥漫分布，这是疹病中最好的表现。○淡红色的疹子有优劣之分：颜色淡而润泽的，属于上佳之色；如果颜色淡却无光泽，或者娇嫩艳丽但干燥滞涩，则属于血热极盛的表现。○深红色的疹子，比淡红色稍重一些，也是血热的征象。通过凉血治疗即可转为淡红色。○颜色鲜艳如胭脂一般，这是血热到了极点，比深红色更为凶险。必须大剂量使用凉血药物，才能先转为深红色，再进一步凉血，最终转为淡红色。○细碎如同粟米大小，红色的称为“红砂”；白色的称为“白砂”。出疹后常出现这种情况，这是余毒完全透发的最美境界。痊愈后会蜕皮。如果是初起时未识别为疫病，而在发病十几天或半个月后才出疹的，若伴有烦躁口渴、高热不退，毒邪发于下颌部位的，属于死证，无法救治。
疫毒引起的发斑，是毒邪散漫的表现；疫毒引起的发疮，是毒邪凝聚的表现。疾病初起时，若见恶寒发热，局部红肿硬痛，这是毒邪向外发散的表现；若只见恶寒而不发热，疮形平扁不起，这是毒邪内伏的表现。无论发于要害部位、无名之处、头面还是四肢，形态各异，总归属于疮证。如何判断这是疫毒凝聚所致？寻常疮证的脉象洪大而数；疫毒之脉则沉细而数。寻常疮证头部可能不痛；而疫毒则头痛剧烈如劈裂，沉重不能抬起，这是其验证依据。考察其症状，有的目红面赤且面色青惨，有的忽而出汗忽而呕吐，有的神志昏乱如昏迷，有的身热但四肢厥冷，有的腹痛不止，有的剧烈干呕，有的腹泻如水注，有的胡言乱语不停，有的幻听幻视，有的极度口渴想喝水，有的烦躁狂乱，有的不时喊叫，似惊似惧。病症表现多种多样，大体类似如此。若误认为是寻常疮证，妄用温补托毒之法，必定无法救治。
王士雄按语：暑、湿、热、疫等诸病，都能导致外发痈疮。然而患者自己并不清楚发病的原因。外科医生也往往只看到外露的疮疡，因而误事的情况最多。人们也只知其死于外在的疮证罢了。唉！
The natural color of blood is red. When blood flow is smooth, the rash appears bright red, vibrant, lustrous, and moist, spreading abundantly; this represents the optimal condition for a rash. ○ A pale red color has both favorable and unfavorable aspects: if the color is pale yet moist, it is considered superior; however, if it is pale without luster, or delicate and overly bright but dry and stagnant, it indicates extreme heat in the blood. ○ A deep red color is slightly more severe than pale red and also signifies blood heat. Cooling the blood will cause it to revert to pale red. ○ A color as vivid as rouge indicates extreme blood heat, which is worse than deep red. Large doses of blood-cooling herbs are required to first turn it deep red, and further cooling will eventually restore it to pale red. ○ Small, millet-grain-sized spots that are red are called "Red Sand" (Hong Sha); those that are white are called "White Sand" (Bai Sha). This condition often occurs after the rash has erupted, representing the most favorable state where residual toxins are fully expelled. The skin will peel off after recovery. If the disease was not recognized as an epidemic at the onset, and the rash appears only ten days or half a month later, accompanied by irritability, thirst, persistent high fever, and toxins manifesting on the jaw, it is a fatal condition that cannot be saved.
Epidemic toxin causing macules (Ban) represents the dispersion of toxins; epidemic toxin causing sores (Chuang) represents the aggregation of toxins. At the initial stage, if there is aversion to cold and fever with local redness, swelling, hardness, and pain, this indicates the toxins are being expelled outward. If there is aversion to cold without fever, and the sores are flat and do not rise, this indicates the toxins are lying latent internally. Whether they appear in critical areas, nameless places, on the head and face, or on the limbs, despite various shapes, they all belong to sore syndromes. How can one determine that this is caused by aggregated epidemic toxins? The pulse of ordinary sores is surging (Hong), large, and rapid; whereas the pulse of epidemic toxins is deep (Chen), fine, and rapid. In ordinary sore syndromes, the head may not hurt; but with epidemic toxins, the headache is severe as if split open, heavy, and unable to lift the head, which serves as verification. Examining the symptoms, some present with red eyes and a red face with a cyan hue, some experience alternating sweating and vomiting, some are confused and comatose, some have body heat but cold limbs, some suffer from unceasing abdominal pain, some have violent dry heaving, some have profuse watery diarrhea, some speak deliriously without stopping, some hear and see hallucinations, some have extreme thirst desiring water, some are irritable and manic, and some shout intermittently, appearing frightened and alarmed. The pathological manifestations are diverse but generally similar. Misidentifying these as ordinary sore syndromes and recklessly applying warming and supporting methods will certainly lead to death.
Wang Shixiong notes: Various diseases such as summerheat, dampness, heat, and epidemics can all externally manifest as carbuncles and sores. However, patients are often unaware of the cause of their condition. Surgeons, seeing only the external sores, frequently make errors. People generally only know that the patient died from external signs. Alas!