聂九吾曰∶发热至三四日报痘，形如粟米，口鼻腮耳年寿之间，先发数点淡红
润泽者最吉，不必服药。若身热一二日即出痘，先发与天庭、司空、印堂等处者，或
一齐出而稠密者，或干枯而紫黑者，或成片不分颗粒者，皆血气凝滞而毒瓦斯肆行，最
为可忧，急宜活血养气而送毒，用调元化毒汤。（生绵黄 、人参、白芍、当归、牛蒡子、连翘、
黄芩、黄连、防风、荆芥、桔梗、前胡、木通、紫草茸、红花、生地、甘草、蝉衣、楂肉煎服。腹痛者去参 加
炒枳壳；大便久秘者去参 加酒炒大黄微利之，大便通仍除之；若气血与毒瓦斯俱旺，而脉洪数者，归芍减三分
之一去参 。此方以参 养气，归、芍、红花、生地活血，翘、蒡、芩、连、荆、防、前、桔、紫、蝉、通草
解毒，加枳、楂疏气。）
若痘出不快者，其证不同，最宜分别。痘色红紫干枯，或密如蚕种，或一片不
分颗粒，身热大便秘而出不快者，此毒瓦斯郁滞，血气不流行也。用调元化毒汤去参
，加小川芎清之。痘色淡白，饮食减少，身凉手足冷，小便清，大便滑而出不快者，
此气血怯弱，不能载毒出外也。用温中益气汤以托之。有鼻塞声重，咳嗽恶寒而出
不快者，风寒蔽之也。宜加减参苏饮发散之。（苏叶、人参、陈皮、小川芎、羌活、防风、荆芥、
桔梗、白芷、甘草，冬加麻黄五分煎，带热服，但不可出汗。）或因邪秽所触，伏陷而出不快者，其
痘必痒，宜用平和汤解之。（人参、当归、桔梗、白芍、紫苏、黄 、防风、白芷、甘草、官桂、沉香、檀
香、乳香、藿香温服。）痘正出时，有忽然传风，眼直视，牙关紧者，此调护不谨而为风邪
所袭也。且勿轻用驱风峻药，宜姜附汤。（白附子、老生姜各二钱，煎浓汤灌下一二酒杯，出微汗即
愈。）痘正出时，身微温而不热不寒者为佳；
或热轻和缓亦无妨。惟大热者可忧。若出齐发热尤可忧。其痘必稠密，必红紫，必
干枯，仍用调元化毒汤去参 。看痘出齐与否，以脚心为验，脚心有痘则出齐矣。若
痘稀少者不必拘此，以身不热为出齐。肉食不可太早，必待痘出齐而身不热，方可
食猪肉；若热未退而食肉以助火邪，必成大患。鸡肉首尾俱不可食，惟起胀时怯弱
者可食以助行浆，壮盛者亦忌之。诸鱼皆腥，牛羊皆膻，痘家最忌，并宜禁绝。报
痘时头面稀少，顶尖碍手，根窠红润，前心后心，皆无其色，如水珠光泽者上吉。报
痘先花后果，花如朱砂梅之色，是其花也。痘如嫩黄色，后成老黄色，顶尖小小红点
者，是顺证也。（不可一概而论，此正是知花大法也。）先花后痘，六日红是其花也。（九日成功，亦是
此种顺痘也。）报痘烦躁不宁，腰腹痛不止，口气大臭，出紫点者死。报痘色白皮薄而光，
根窠全无红色，或带一线红，三五日即长如绿豆大，此痘不能贯浆，久后即是一
包清水，擦破即死。（不可因好看，妄与药治，切记。）报痘全然不起，顶如汤包，抑或如灯草烧
者，十日后痒塌而死。报痘起红斑如锦纹者，六日死。报痘遍身如蛇皮者死。报痘
遍身起黑斑如痣状，肌肉成黑颜料者，指日而死。报痘过暖，毒瓦斯收入心经者，半
日死。报痘形不现，过凉，凉极则里不能外发，必闭，五日死。（天时严寒，或验发痘证，将
薄被单同宜保护，以免外寒袭侵，而报痘时切不可轻投苦寒，冰凝气血，不能外发，其害非浅。）报痘不分根
窠，其色如灰，其痘又如鱼子之小者，又痒又痛，八日死。报痘有父母平日不谨慎，
遗火毒于婴儿，临时先一发，其色黄，头如疮，后焦枯，头面身忽然全无如平日好
时者，内归五经，串到即死也。报痘婴儿先天本不足，后天又不足，先后二天大亏，
父母又不滋补婴儿，任其 羸，出痘临时无药治矣。（不在痘之多少，俱因气血亏损，不能载毒
外出耳。）报痘夹麻痧者，万难收功也。报痘喉痘阻闭者，气不流行，饮食不下者，三
日死。报痘证出五脏之上，外而皮肉并无者，一刻死。（此痘孰能知是肚内五脏上而出痘，师
曰∶有此证得，小儿无病，忽然肢体发寒又有汗，头项发上有水珠，其色紫胀欲破者是。破则无救，以此辨之，
则知五内发痘矣。）报痘，凡小婴儿，平日不可过与酒糖煎炒等味。若平时过与，到报痘
时，邪入合邪，正气微弱，就难以胜肝脾二火，肾水纵有些，又何能制二经之火，此
时相克昼夜必死。（为父母者须防之于未萌，不可不知。）报痘之时，如四围淡白，色如枯涩，属
血虚；如痘顶白色，俱收晕而顶陷者属气虚。急宜芎、归、肉桂、木香之类，加人
乳和好酒服之。诸痘未出之先，有大痘一粒，如金黄色，又一黑痘如黄痘大者；黄
者名曰贼痘，黑者名曰痘疔。一起之时，急用银针刺破，以口含清滚汤吸出秽血，用
紫草膏或油胭脂，加血余灰、珍珠末调敷疮口，诸痘自然起发也。报痘初出之时，多
有咽喉肿痛声哑之证，乃内毒壅塞气道而起，可用甘桔汤加元参、牛蒡子治之也。
喜泰顺曰∶夫痘疮之发也，身热和缓，达于外者必轻，闷乱烦躁，彰于外者必重，
势之所必然也。故颜色贵润泽而嫌昏暗，颗粒贵圆净而嫌破碎；痘贵高耸而嫌平塌，皮
贵结实而嫌虚薄，粒贵稀疏而嫌稠密。根窠收紧，痘分阴阳。见点活动，更忌浮肿，
出要参差，血宜归附。耳后头项心胸少于他处为佳，眉棱两太阳额前光泽不滞为妙。
若一发便出尽者，重也；痘夹疹者，半轻半重也；里外微红者，轻也；外红里黑者，
重也；疮上黑点如针孔者，热极也；青干紫陷、烦红焦黑，昏睡汗出，腹胀喘啼，大
小便秘者， 也。善治者于其形色而辨之，于其轻重而分之，则轻者可以高枕获安，而
重者亦可以扶危而奏绩矣。
又曰∶热缓神清痘大兮，根窠红活出参差，四肢温暖无寒热，乳食如常渴泻除，
更兼腰项当心少，但宜调治不须医。
又曰∶初热一日即便出，稠密 红减饮食，泄泻烦渴头面多，红斑夹疹二便塞，
平塌灰白欠光明，疔毒脓疮水流湿，若此重证须预防，莫待临期叹疏失。
又曰∶先看面上诸经络，生死吉凶自灵通。左脸肝兮右脸肺，脾为年寿及人中；
心属印堂方广额，肾为颧骨耳尻风。此是阴阳部位属，痘嫌枯滞及鲜红。假如年寿
部先发，人中腮脚亦相同，淡红磊落如朱润，过期七日自然安。若越印堂方广出，心
家热毒解方颐，颧骨耳目似麻子，重极须知命必终。
又曰∶发热三日，气体如常；见点红活，无分部位。出来遂觉粗肥，稀疏可必，
初出如还琐碎，稠密堪知。带热敷疮，陆续出来，尖圆高耸，颜色光润，虽甚密犹
为可救；一齐拥出 红皮薄，即稀疏未必全生。细细白头如痱，干枯定作内攻；形
绯绯红点如丹，焦萎定成悴憔。势粗肥光顶点子不肥，终白陷头尖嫩薄；茱萸纹起
定空浆，肌嫩则皮薄娇红。黄瘦则痘成褐色，人黑皮粗，疮色必然惨暗。是故婴儿
之肌肉不同，未可一例而断。只要锭凸有神，不喜烦红干燥，色泽神安。见点如珠
如粟，毛焦皮燥敷疮，或紫或焦，是故带热齐出，既恐密似针头，纵然陆续出来，尤
忌形如蚕种，如麸如痱如疹如疥，根窠不立，脚地俱无，犯此数端，皆云莫救。夹
斑如同蚊咬，恶裂甚似蛇伤，乃或螺蛳云电，差为可救。未热先敷数点，俗名报痘。
若还热久而不敷，便作疔看。先发块而后发疮，块名痴毒而必生；先发疮而后发块，
块名鬼肿以难医。避痘避于隐僻，眼泡唇口必多凶；闷痘闷于要害，舌喉肩背而不
吉。顺不憎多，逆嫌一粒冷疔；先见诸痘，不敢彰形。贼痘若生，诸痘不能灌汁；辨
认若真，急宜挑破。是以里证未平，痘虽出而毒犹在内；透肌发散，尤宜解毒为良。
便调人静，身虽热而毒已在表，补兼发散，仍以安表为先。设使内外证平，此后不须
混治，再看精神勇怯，详审表补如何。
又曰∶三日、四日，痘出当齐，点至
足心，势方安定。犹有陆续不出之状，或隐隐于皮肤之间，不见不起者，古名不快。
若非壅遏之因，必有气血不振之过。是以四日以前痘毒方出，身表宜凉；四日后毒
已出定，身表宜温。凉则气血和平，痘色必然润泽；温则腠理开通，其毒易于成浆。
至此而身不微热，虽未至于冰伏，而痘疮断乎弗长，医者当审其故而投之以药，或
为风寒吹袭，或为呕吐泄泻，或为秽浊触犯。故身不热而痘不起，已成冰硬之形；赤
色若还不起，变败可期。红润依然如故，若见气急而腹胀，黄泉在迩。失声而凄凄，阳数无多。
愈天池曰∶痘未见点，预卜其为吉为凶，惟于神情证象而求之，脉理而参之。然
非极美极恶者，未见镜其将来也。放点则有形可察，有色可详，顺险逆三途昭然而
睹矣。盖形成于气色，根乎血气，正则拘领其毒，毒有所拘，痘虽密而得定其位，不
模糊，不细碎，颗粒分明而脚必周净，毒有所领，毒易于达外，痘虽密顶绽突而苍
老，此气得其正，而形其无间也。血正则荣载其毒，毒有所载，痘虽密，而能安其
位，根有盘助。囊浓其藏而饶涵泳，毒受其荣，痘不燥涩，形虽密淡而不白，红而
不娇，此血得其正，色无咎也。反此则气血反受毒制可知。有表里俱虚而出不快者，
有表里俱实而毒壅滞者，有气血虚馁皮薄而色白者，有毒火炽盛而形恶色恶者。千形万态，总由此出。
放点于发热三日之后，身凉神爽，颗粒分明，淡红苍老，其余可知为顺，不必
服药。放点一日，烈热干泡，带火而出，不论稀密，色一紫艳或 红，其他可知，此
枭毒烈火，及早图之，不致日后内溃。急以攻毒清火，带清肌透发，不可以初见而
玩忽之。放点有身不见热，神情困倦，偶因四傍痘气相感而出见痘，色淡皮薄，此
腠理不密，肌肉不固，不能约束而然也。不宜疏散，防日后有痒塌之患，以调中汤主
之。放点有先因吐泻困倦，头温足冷，适感时行而出，色淡囊薄而淹滞不起者，此
气虚不振，不能透发，宜以升发中即兼治本，免日后有倒陷之患。放点有热如火炽，
紫艳 红，神情躁乱，累日不松而不起者，急宜攻毒凉血，清火疏肌以透之。放点有
仅数粒，色不甚红，亦不甚白，身体温和，神情清爽不暗者，目之为顺。其囊窠累日
不见粗壮，痘色不见光肥，浮沉其间，名为等伴痘。先见数点者，报痘也。四五日
后，身必忽然大热，神即昏溃，大队枭毒一时涌出，其痘稠密紫暗，大都不起，明
者即与挑破，吮松其毒，以药胭脂贴之，内服猪尾膏、通天散活血疏透，来势猖狂，必
荡涤庶可救也。放点有毒火雄烈，气血不能约束，一齐涌出，火热如焚，急宜解毒
凉血清火。放点热如火灼，干燥如烟，神情躁乱，不论稀密，宜攻毒凉血，清肌散
火，缓则毒即内攻无及矣。放点痘色干滞矾红，身宜壮热而反凉者，以毒火遏郁于
内，非真凉也。急宜散火疏肌，活血透发，俟火透而后清凉，不宜遽与清火。放点痘
甚稀疏，却间蚤斑，或间紫黯，有若紫背浮萍，或犯贯珠，神情悉闷及诸般痛楚之
类，多因恶毒盘居于内，表里故不相符，不可因其稀而致忽也。即当攻其伏毒，松肌
活血。放点有唇裂 肿，甚有焦黑如煤，或口中秽气不堪，或舌起芒刺，此毒火犯胃，
急宜重以清火凉血解毒，重必攻之。放点皮毛刺痛，衣衾苦动，此毒壅于肺，急宜
重以攻毒，松肌透发，失治至行浆时，脓根不起，必致躁痒以毙。放点筋抽脉惕，叫
喊而已，此伏毒于肝，宜疏肝，毒重必宜攻，有切牙者，亦如之。放点谵语狂烦，如
见鬼祟，此毒火迷心，宜凉血清火，兼之身热如烙，或诸般痛楚者，尤宜攻毒。放
点骨节烦痛，更有腰如被杖，此毒在于肾，大都不起，攻毒刻不容缓。放点拳毛倒竖，
目胞下有血丝如线绊于其处，或腹痛不已，身热如火，肢冷如冰，此毒伏于脾，急宜
攻毒清肌透发。放点小水有如腌鱼汁，如鲜血，如红花膏，此毒火下注小肠，急宜
攻毒凉血，鼻衄成流者亦然。放点大便欲解或解时疾首蹙额，所解如漆如胶，有若
瘀血，有若羊粪者，此毒注于大肠，急宜攻毒，因势而利导之。放点大便暴注如倾，
有纯解清水而躁乱者，此火扰大肠，宜分利凉大肠，五脏伏火伏毒，惟下利者稍轻，
以肠为传送之地也。虽壅滞艰塞，终得因势利导。放点颗粒稀疏，囊窠饱满而色有
矾红，有紫艳，有晦色，此毒火在于血分也。宜解血分之毒，清血中之火。放点有
归附甚浓，而囊窠不松，或平或陷，此血至而气不至也。宜宽气道，松肌疏透，兼
他证凶暴者，必下之。放点有孔壳圆满，而盘助干滞，此气至而血不至也。宜清营活
血，兼他证猖狂者，必攻之。放点有外感未愈，或风，或寒，或风热，或轻或重，有
累日不起，有起而不快，此为表实，审其邪而疏解之，令毒有出路。放点有饮食未
聂九吾说：发热到三四天才出痘，形状像粟米一样，在口、鼻、腮、耳以及年寿（鼻准）之间，先发出几点淡红色且润泽的，是最吉利的，不需要服药。如果身体发热一两天就出痘，先在天庭、司空、印堂等处发出的，或者一齐出来且稠密的，或者干枯呈紫黑色的，或者成片不分颗粒的，都是血气凝滞而毒瓦斯肆意横行，最为令人担忧，应当紧急使用活血养气的方法来疏导毒邪，使用调元化毒汤。（药物组成：生绵黄芪、人参、白芍、当归、牛蒡子、连翘、黄芩、黄连、防风、荆芥、桔梗、前胡、木通、紫草茸、红花、生地、甘草、蝉蜕、山楂肉，煎服。腹痛者去掉人参，加入炒枳壳；大便长期秘结者去掉人参，加入酒炒大黄轻微通便，大便通畅后仍去掉大黄；如果气血与毒瓦斯都旺盛，且脉象洪数者，将当归、白芍减去三分之一，去掉人参。此方用人参来养气，用当归、白芍、红花、生地来活血，用连翘、牛蒡子、黄芩、黄连、荆芥、防风、前胡、桔梗、紫草、蝉蜕、木通来解毒，加入枳实、山楂来疏理气机。）
如果痘出不快，其证候各不相同，最宜仔细分辨。痘色红紫干枯，或密如蚕种，或一片不分颗粒，身体发热且大便秘结而出痘不快，这是毒瓦斯郁滞，血气不流通。使用调元化毒汤去掉人参，加入小川芎来清解。痘色淡白，饮食减少，身体发凉手足冷，小便清长，大便滑泄而出痘不快，这是气血怯弱，不能载毒外出。使用温中益气汤来托举毒邪。有鼻塞声重，咳嗽恶寒而出痘不快，这是风寒遮蔽所致。适宜用加减参苏饮来发散。（药物组成：苏叶、人参、陈皮、小川芎、羌活、防风、荆芥、桔梗、白芷、甘草，冬季加麻黄五分煎服，趁热服用，但不可令出汗。）或因邪秽所触，伏陷不出而致出痘不快，其痘必然瘙痒，适宜用平和汤来解之。（药物组成：人参、当归、桔梗、白芍、紫苏、黄芪、防风、白芷、甘草、官桂、沉香、檀香、乳香、藿香，温服。）痘正在发出时，有忽然出现中风症状，眼睛直视，牙关紧闭的，这是护理不慎而被风邪侵袭。切勿轻易使用驱风的峻烈药物，适宜用姜附汤。（药物组成：白附子、老生姜各二钱，煎浓汤灌下一二酒杯，出微汗即愈。）痘正在发出时，身体微温而不热不寒为最佳；或者热势轻和缓也无妨。只有大热的才令人担忧。如果痘出齐了还发热尤其令人担忧。其痘必然稠密，必然红紫，必然干枯，仍然使用调元化毒汤去掉人参。看痘是否出齐，以脚心为验证标准，脚心有痘则算出齐了。如果痘稀少者不必拘泥于此，以身不热为出齐。肉食不可吃得太早，必须等到痘出齐且身不热，才可以吃猪肉；如果热未退而吃肉以助火邪，必成大患。鸡肉从头到尾都不可吃，只有在起胀阶段体质怯弱的可以吃以助行浆，壮盛者也忌食。各种鱼皆腥，牛羊皆膻，痘家最忌讳，都应禁绝。报痘（初现痘点）时头面稀少，顶尖碍手，根窠红润，前心后心都没有这种颜色，如水珠光泽的是上吉。报痘先花后果，花像朱砂梅的颜色，这就是“花”。痘像嫩黄色，后来变成老黄色，顶尖有小小红点的，是顺证。（不可一概而论，这正是知晓“花”的大法。）先花后痘，六天变红就是“花”。（九天成功，也是这种顺痘。）报痘烦躁不宁，腰腹痛不止，口气大臭，出紫点的会死。报痘色白皮薄而光亮，根窠全无红色，或带一线红，三五天长如绿豆大，这种痘不能贯浆，久后变成一包清水，擦破即死。（不可因为好看，胡乱用药治疗，切记。）报痘全然不起，顶如汤包，或者像灯草烧过的样子，十日后痒塌而死。报痘起红斑如锦纹的，六日死。报痘遍身如蛇皮的死。报痘遍身起黑斑如痣状，肌肉成黑颜料样的，指日可待死亡。报痘过暖，毒瓦斯收入心经的，半日死。报痘形不现，过凉，凉极则里不能外发，必闭，五日死。（天时严寒，或验发痘证，将薄被单一同保护，以免外寒袭侵，而报痘时切不可轻投苦寒药，冰凝气血，不能外发，其害非浅。）报痘不分根窠，其色如灰，其痘又如鱼子之小的，又痒又痛，八日死。报痘有父母平日不谨慎，遗火毒于婴儿，临时先发，其色黄，头如疮，后焦枯，头面身忽然全无如平日好时的，内归五经，串到即死也。报痘婴儿先天本不足，后天又不足，先后二天大亏，父母又不滋补婴儿，任其羸弱，出痘临时无药治矣。（不在于痘的多少，都因气血亏损，不能载毒外出耳。）报痘夹麻痧的，万难收功也。报痘喉痘阻闭的，气不流行，饮食不下者，三日死。报痘证出五脏之上，外而皮肉并无的，一刻死。（此痘谁能知道是肚内五脏上而出痘，老师说：有此证得，小儿无病，忽然肢体发寒又有汗，头项发上有水珠，其色紫胀欲破的是。破则无救，以此辨之，则知五内发痘矣。）报痘，凡小婴儿，平日不可过与酒糖煎炒等味。若平时过与，到报痘时，邪入合邪，正气微弱，就难以胜肝脾二火，肾水纵有些，又何能制二经之火，此时相克昼夜必死。（为父母者须防之于未萌，不可不知。）报痘之时，如四围淡白，色如枯涩，属血虚；如痘顶白色，俱收晕而顶陷者属气虚。急宜芎、归、肉桂、木香之类，加人乳和好酒服之。诸痘未出之先，有大痘一粒，如金黄色，又一黑痘如黄痘大者；黄者名曰贼痘，黑者名曰痘疔。一起之时，急用银针刺破，以口含清滚汤吸出秽血，用紫草膏或油胭脂，加血余灰、珍珠末调敷疮口，诸痘自然起发也。报痘初出之时，多有咽喉肿痛声哑之证，乃内毒壅塞气道而起，可用甘桔汤加元参、牛蒡子治之也。
喜泰顺说：夫痘疮之发也，身热和缓，达于外者必轻，闷乱烦躁，彰于外者必重，势之所必然也。故颜色贵润泽而嫌昏暗，颗粒贵圆净而嫌破碎；痘贵高耸而嫌平塌，皮贵结实而嫌虚薄，粒贵稀疏而嫌稠密。根窠收紧，痘分阴阳。见点活动，更忌浮肿，出要参差，血宜归附。耳后头项心胸少于他处为佳，眉棱两太阳额前光泽不滞为妙。若一发便出尽者，重也；痘夹疹者，半轻半重也；里外微红者，轻也；外红里黑者，重也；疮上黑点如针孔者，热极也；青干紫陷、烦红焦黑，昏睡汗出，腹胀喘啼，大小便秘者，逆也。善治者于其形色而辨之，于其轻重而分之，则轻者可以高枕获安，而重者亦可以扶危而奏绩矣。
又说：热缓神清痘大兮，根窠红活出参差，四肢温暖无寒热，乳食如常渴泻除，更兼腰项当心少，但宜调治不须医。
又说：初热一日即便出，稠密 红减饮食，泄泻烦渴头面多，红斑夹疹二便塞，平塌灰白欠光明，疔毒脓疮水流湿，若此重证须预防，莫待临期叹疏失。
又说：先看面上诸经络，生死吉凶自灵通。左脸肝兮右脸肺，脾为年寿及人中；心属印堂方广额，肾为颧骨耳尻风。此是阴阳部位属，痘嫌枯滞及鲜红。假如年寿部先发，人中腮脚亦相同，淡红磊落如朱润，过期七日自然安。若越印堂方广出，心家热毒解方颐，颧骨耳目似麻子，重极须知命必终。
又说：发热三日，气体如常；见点红活，无分部位。出来遂觉粗肥，稀疏可必，初出如还琐碎，稠密堪知。带热敷疮，陆续出来，尖圆高耸，颜色光润，虽甚密犹为可救；一齐拥出 红皮薄，即稀疏未必全生。细细白头如痱，干枯定作内攻；形绯绯红点如丹，焦萎定成悴憔。势粗肥光顶点子不肥，终白陷头尖嫩薄；茱萸纹起定空浆，肌嫩则皮薄娇红。黄瘦则痘成褐色，人黑皮粗，疮色必然惨暗。是故婴儿之肌肉不同，未可一例而断。只要锭凸有神，不喜烦红干燥，色泽神安。见点如珠如粟，毛焦皮燥敷疮，或紫或焦，是故带热齐出，既恐密似针头，纵然陆续出来，尤忌形如蚕种，如麸如痱如疹如疥，根窠不立，脚地俱无，犯此数端，皆云莫救。夹斑如同蚊咬，恶裂甚似蛇伤，乃或螺蛳云电，差为可救。未热先敷数点，俗名报痘。若还热久而不敷，便作疔看。先发块而后发疮，块名痴毒而必生；先发疮而后发块，块名鬼肿以难医。避痘避于隐僻，眼泡唇口必多凶；闷痘闷于要害，舌喉肩背而不吉。顺不憎多，逆嫌一粒冷疔；先见诸痘，不敢彰形。贼痘若生，诸痘不能灌汁；辨认若真，急宜挑破。是以里证未平，痘虽出而毒犹在内；透肌发散，尤宜解毒为良。便调人静，身虽热而毒已在表，补兼发散，仍以安表为先。设使内外证平，此后不须混治，再看精神勇怯，详审表补如何。
又说：三日、四日，痘出当齐，点至足心，势方安定。犹有陆续不出之状，或隐隐于皮肤之间，不见不起者，古名不快。若非壅遏之因，必有气血不振之过。是以四日以前痘毒方出，身表宜凉；四日后毒已出定，身表宜温。凉则气血和平，痘色必然润泽；温则腠理开通，其毒易于成浆。至此而身不微热，虽未至于冰伏，而痘疮断乎弗长，医者当审其故而投之以药，或为风寒吹袭，或为呕吐泄泻，或为秽浊触犯。故身不热而痘不起，已成冰硬之形；赤色若还不起，变败可期。红润依然如故，若见气急而腹胀，黄泉在迩。失声而凄凄，阳数无多。
愈天池说：痘未见点，预卜其为吉为凶，惟于神情证象而求之，脉理而参之。然非极美极恶者，未见镜其将来也。放点则有形可察，有色可详，顺险逆三途昭然而睹矣。盖形成于气色，根乎血气，正则拘领其毒，毒有所拘，痘虽密而得定其位，不模糊，不细碎，颗粒分明而脚必周净，毒有所领，毒易于达外，痘虽密顶绽突而苍老，此气得其正，而形其无间也。血正则荣载其毒，毒有所载，痘虽密，而能安其位，根有盘助。囊浓其藏而饶涵泳，毒受其荣，痘不燥涩，形虽密淡而不白，红而不娇，此血得其正，色无咎也。反此则气血反受毒制可知。有表里俱虚而出不快者，有表里俱实而毒壅滞者，有气血虚馁皮薄而色白者，有毒火炽盛而形恶色恶者。千形万态，总由此出。
放点于发热三日之后，身凉神爽，颗粒分明，淡红苍老，其余可知为顺，不必服药。放点一日，烈热干泡，带火而出，不论稀密，色一紫艳或 红，其他可知，此枭毒烈火，及早图之，不致日后内溃。急以攻毒清火，带清肌透发，不可以初见而玩忽之。放点有身不见热，神情困倦，偶因四傍痘气相感而出见痘，色淡皮薄，此腠理不密，肌肉不固，不能约束而然也。不宜疏散，防日后有痒塌之患，以调中汤主之。放点有先因吐泻困倦，头温足冷，适感时行而出，色淡囊薄而淹滞不起者，此气虚不振，不能透发，宜以升发中即兼治本，免日后有倒陷之患。放点有热如火炽，紫艳 红，神情躁乱，累日不松而不起者，急宜攻毒凉血，清火疏肌以透之。放点有仅数粒，色不甚红，亦不甚白，身体温和，神情清爽不暗者，目之为顺。其囊窠累日不见粗壮，痘色不见光肥，浮沉其间，名为等伴痘。先见数点者，报痘也。四五日后，身必忽然大热，神即昏溃，大队枭毒一时涌出，其痘稠密紫暗，大都不起，明者即与挑破，吮松其毒，以药胭脂贴之，内服猪尾膏、通天散活血疏透，来势猖狂，必荡涤庶可救也。放点有毒火雄烈，气血不能约束，一齐涌出，火热如焚，急宜解毒凉血清火。放点热如火灼，干燥如烟，神情躁乱，不论稀密，宜攻毒凉血，清肌散火，缓则毒即内攻无及矣。放点痘色干滞矾红，身宜壮热而反凉者，以毒火遏郁于内，非真凉也。急宜散火疏肌，活血透发，俟火透而后清凉，不宜遽与清火。放点痘甚稀疏，却间蚤斑，或间紫黯，有若紫背浮萍，或犯贯珠，神情悉闷及诸般痛楚之类，多因恶毒盘居于内，表里故不相符，不可因其稀而致忽也。即当攻其伏毒，松肌活血。放点有唇裂 肿，甚有焦黑如煤，或口中秽气不堪，或舌起芒刺，此毒火犯胃，急宜重以清火凉血解毒，重必攻之。放点皮毛刺痛，衣衾苦动，此毒壅于肺，急宜重以攻毒，松肌透发，失治至行浆时，脓根不起，必致躁痒以毙。放点筋抽脉惕，叫喊而已，此伏毒于肝，宜疏肝，毒重必宜攻，有切牙者，亦如之。放点谵语狂烦，如见鬼祟，此毒火迷心，宜凉血清火，兼之身热如烙，或诸般痛楚者，尤宜攻毒。放点骨节烦痛，更有腰如被杖，此毒在于肾，大都不起，攻毒刻不容缓。放点拳毛倒竖，目胞下有血丝如线绊于其处，或腹痛不已，身热如火，肢冷如冰，此毒伏于脾，急宜攻毒清肌透发。放点小水有如腌鱼汁，如鲜血，如红花膏，此毒火下注小肠，急宜攻毒凉血，鼻衄成流者亦然。放点大便欲解或解时疾首蹙额，所解如漆如胶，有若瘀血，有若羊粪者，此毒注于大肠，急宜攻毒，因势而利导之。放点大便暴注如倾，有纯解清水而躁乱者，此火扰大肠，宜分利凉大肠，五脏伏火伏毒，惟下利者稍轻，以肠为传送之地也。虽壅滞艰塞，终得因势利导。放点颗粒稀疏，囊窠饱满而色有矾红，有紫艳，有晦色，此毒火在于血分也。宜解血分之毒，清血中之火。放点有归附甚浓，而囊窠不松，或平或陷，此血至而气不至也。宜宽气道，松肌疏透，兼他证凶暴者，必下之。放点有孔壳圆满，而盘助干滞，此气至而血不至也。宜清营活血，兼他证猖狂者，必攻之。放点有外感未愈，或风，或寒，或风热，或轻或重，有累日不起，有起而不快，此为表实，审其邪而疏解之，令毒有出路。放点有饮食未
Nie Jiwu stated: When fever lasts for three to four days before the eruption of smallpox, and the lesions resemble millet grains, if a few pale red and moist spots appear first in the areas of the mouth, nose, cheeks, ears, and Nianshou (tip of the nose), this is the most auspicious sign, and no medication is required. If the rash appears within one or two days of fever onset, starting at Tianting, Sikong, Yintang, or other areas; or if they erupt all at once and are dense; or if they are dry, shriveled, and purple-black; or if they merge into patches without distinct granules, these indicate stagnation of blood and Qi with rampant toxin. These are most concerning. Urgent treatment should focus on invigorating blood and nourishing Qi to guide out the toxins, using Yuanhua Huadu Decoction (Decoction for Restoring Origin and Transforming Toxins). (Ingredients: Sheng Mian Huang [Astragali Radix], Renshen [Ginseng Radix et Rhizoma], Baishao [Paeoniae Radix Alba], Danggui [Angelicae Sinensis Radix], Niubangzi [Arctii Fructus], Lianqiao [Forsythiae Fructus], Huangqin [Scutellariae Radix], Huanglian [Coptidis Rhizoma], Fangfeng [Saposhnikoviae Radix], Jingjie [Schizonepetae Spica], Jiegeng [Platycodonis Radix], Qianhu [Peucedani Radix], Mutong [Akebiae Caulis], Zicao Rong [Lithospermi Radix], Honghua [Carthami Flos], Shengdi [Rehmanniae Radix], Gancao [Glycyrrhizae Radix et Rhizoma], Chan Yi [Bombyx Batryticatus], Zha Rou [Crataegi Fructus]. Decoct and take orally. For abdominal pain, remove Renshen and add Chao Zhike [Fructus Aurantii Preparatus]; for chronic constipation, remove Renshen and add Jiu Chao Dahuang [Rhei Radix et Rhizoma] to induce mild purgation, removing it once bowel movements normalize; if both Qi/Blood and toxins are vigorous with a surging and rapid pulse, reduce Danggui and Baishao by one-third and remove Renshen. This formula uses Renshen to nourish Qi, Danggui, Baishao, Honghua, and Shengdi to invigorate blood, Lianqiao, Niubangzi, Huangqin, Huanglian, Jingjie, Fangfeng, Qianhu, Jiegeng, Zicao, Chan Yi, and Mutong to resolve toxins, and Zhishi and Zharen to regulate Qi.)
If the eruption is slow, the patterns vary greatly and must be distinguished carefully. If the rash is red-purple, dry, and shriveled, or dense like silkworm eggs, or merged into patches without distinct granules, accompanied by fever and constipation with slow eruption, this indicates stagnation of toxins and non-circulation of blood and Qi. Use Yuanhua Huadu Decoction without Renshen, adding Xiao Chuanxiong [Chuanxiong Rhizoma] to clear heat. If the rash is pale white, appetite is reduced, body temperature is low with cold extremities, urination is clear, and stool is loose with slow eruption, this indicates deficiency and weakness of Qi and Blood, unable to carry toxins outward. Use Wenzhong Yiqi Decoction (Decoction for Warming the Middle and Boosting Qi) to support and expel. If there is nasal congestion, heavy voice, cough, aversion to wind/cold, and slow eruption, this is due to obstruction by Wind-Cold. Use Jiashen Su Yin Decoction (Modified Ginseng and Perilla Decoction) to disperse. (Ingredients: Suye [Perillae Folium], Renshen [Ginseng Radix et Rhizoma], Chenpi [Citri Reticulatae Pericarpium], Xiao Chuanxiong [Chuanxiong Rhizoma], Qianghuo [Notopterygii Rhizoma et Radix], Fangfeng [Saposhnikoviae Radix], Jingjie [Schizonepetae Spica], Jiegeng [Platycodonis Radix], Baizhi [Angelicae Dahuricae Radix], Gancao [Glycyrrhizae Radix et Rhizoma]. In winter, add Mahuang [Ephedrae Herba] 5 fen, decoct, and take warm, but do not induce sweating.) If triggered by foul pathogens causing latent sinking and slow eruption, the rash will likely itch. Use Heping Tang (Peaceful Decoction) to resolve. (Ingredients: Renshen [Ginseng Radix et Rhizoma], Danggui [Angelicae Sinensis Radix], Jiegeng [Platycodonis Radix], Baishao [Paeoniae Radix Alba], Zisu [Perillae Folium], Huangqi [Astragali Radix], Fangfeng [Saposhnikoviae Radix], Baizhi [Angelicae Dahuricae Radix], Gancao [Glycyrrhizae Radix et Rhizoma], Guanzi Gui [Cinnamomi Cortex], Chenxiang [Aquilariae Lignum Resinatum], Tanxiang [Santalum Album Lignum], Xuxiang [Olibanum], Huoxiang [Agastaches Herba]. Take warm.) During eruption, if sudden wind-stroke symptoms occur, such as staring eyes and locked jaw, this is due to careless nursing allowing Wind pathogen invasion. Do not lightly use harsh wind-dispelling drugs; use Jiangfu Tang (Ginger and Aconite Decoction) instead. (Ingredients: Baifuzi [Typhonii Rhizoma], Laoshengjiang [Zingiberis Rhizoma Recens] each 2 qian. Decoct strongly, administer 1-2 wine cups. Recovery occurs with slight sweating.) During eruption, mild warmth without extreme heat or cold is ideal; mild, gentle heat is also acceptable. Only high fever is concerning. Fever persisting after complete eruption is particularly worrying. The rash will be dense, red-purple, and dry/shriveled. Continue using Yuanhua Huadu Decoction without Renshen. To determine if eruption is complete, check the soles of the feet; if lesions appear there, eruption is complete. For sparse eruptions, completion is marked by absence of fever. Meat should not be consumed too early; only eat pork after complete eruption and resolution of fever. Eating meat while fever persists aids fire-pathogens and causes severe complications. Chicken is forbidden throughout; only allowed during the swelling phase for weak patients to aid pus formation, but avoided in robust patients. All fish are pungent/fishy, beef and mutton are gamey; these are taboo for smallpox patients and must be strictly avoided. At the initial spotting stage ("Baodou"), if head and face have few spots, tips are sharp/tactile, bases are red/moist, and chest/back lack color, shining like water droplets, this is highly auspicious. "Hua" (flower) precedes "Dou" (pox); Hua resembles Cinnabar Plum color. Pox resembling tender yellow turning old yellow with small red tips at the apex is a favorable pattern. (This is the general rule for identifying "Hua".) If Hua turns red on the sixth day, it is favorable. (Success on the ninth day also indicates this favorable type.) Signs of death include restlessness, unceasing waist/abdominal pain, foul breath, and purple spots. Death also occurs if spots are white, thin-skinned, shiny, with no red base or only a faint red line, growing to mung bean size in 3-5 days without filling with pus, eventually becoming clear fluid; rupturing leads to death. (Do not treat based on appearance alone.) Complete failure to rise, with tops like boiled dumplings or burnt rush, leads to death from itching and collapse after ten days. Red rashes like brocade patterns lead to death on the sixth day. Snake-skin-like full-body eruption is fatal. Black spots like moles with blackened muscle pigment predict imminent death. Over-warming causes toxins to enter the Heart Meridian, leading to death within half a day. Over-cooling prevents internal toxins from reaching the exterior, causing closure and death within five days. (In severe cold, protect with light bedding to prevent external cold invasion; never use bitter-cold herbs that freeze Qi/Blood and block eruption.) Gray-colored, grain-sized spots with itching/pain lead to death on the eighth day. If parents neglected care, transmitting fire-toxin to the infant, appearing first as yellow sores then drying up, followed by sudden disappearance of all signs, toxins entering the Five Zang organs leads to immediate death. Congenital and acquired deficiencies in infants, combined with poor parental nourishment, lead to depletion where no medicine can save them upon eruption. (Death results from Qi/Blood deficiency failing to expel toxins, regardless of spot count.) Complications with measles/rash are difficult to cure. Throat pox blocking airways and preventing eating/drinking leads to death in three days. Eruptions originating internally from the Five Zang without external skin manifestations lead to death instantly. (Identification: Child suddenly develops chills, sweating, water-like bumps on head/neck that are purple/swollen/wanting to burst. Rupture means no rescue. This confirms internal Zang eruption.) Infants should not consume alcohol, sugar, fried foods daily. Excessive consumption leads to pathogenic combination, weak Zheng Qi, inability to control Liver/Spleen Fire despite Kidney Water, resulting in mutual destruction and death within a day. (Parents must prevent this beforehand.) During spotting, pale/dry surroundings indicate Blood Deficiency; white tops with retracted halos and sunken centers indicate Qi Deficiency. Urgently use Xiong, Danggui, Rougui, Muxiang with human milk and good wine. Before eruption, a large golden-yellow spot is called "Zeidou" (Thief Pox), and a black spot of similar size is "Douding" (Pox Carbuncle). Prick immediately with silver needle, suck out foul blood with hot water, apply Zicao Gao or Oil Rouge mixed with Xueyu Hui and Zhenzhu Mo. Other spots will naturally rise. Initial eruption often includes sore throat, hoarseness due to internal toxin blocking airways; treat with Ganjie Tang plus Yuanshen and Niubangzi.
Xi Taishun said: Mild fever reaching the exterior indicates mild disease; internal oppression, confusion, and irritability manifesting externally indicate severe disease. Color should be moist/lustrous, avoiding dullness; granules should be round/clean, avoiding fragmentation; elevation should be high, avoiding flatness; skin should be firm, avoiding thinness; spacing should be sparse, avoiding density. Tight bases distinguish Yin/Yang. Active spotting avoids edema; eruption should be uneven; blood should return/adhere. Fewer spots behind ears, neck, chest, heart are good; luster on brow ridges, Taiyang, forehead without stagnation is excellent. Immediate full eruption is severe; pox with rash is moderately severe; mild redness inside/outside is mild; red outside/black inside is severe. Black needle-hole points indicate extreme heat; cyan/dry/purple/sunken, irritable red/scorched black, drowsiness/sweating, abdominal distension/wheezing/crying, constipation indicate adverse patterns. Skilled practitioners distinguish severity by form/color, ensuring mild cases recover safely and severe cases are stabilized.
Verse 1: Mild heat, clear spirit, large pox; red/vibrant bases, uneven distribution; warm limbs, no chills/fever; normal milk/food intake, thirst/diarrhea resolved; less involvement of waist/neck/chest; regulation suffices, no need for aggressive treatment.
Verse 2: Early eruption on first day of heat; dense, red, reduced appetite; diarrhea, irritability/thirst, abundant on head/face; red macules with rash, blocked bowels/bladder; flat, gray/white, lacking luster; carbuncles/toxins, wet pus flow; prevent such severe cases, do not lament negligence later.
Verse 3: Inspect facial meridians for life/death/auspiciousness. Left cheek=Liver, Right cheek=Lung; Spleen=Nianshou/Renzhong; Heart=Yintang/Forehead; Kidney=Cheekbones/Ears/Nape. These are Yin/Yang zones. Pox dislikes dry/stagnant or bright red. If Nianshou erupts first, same for Renzhong/Cheeks/Feet; pale red, distinct, moist like cinnabar, safe after seven days. If crossing Yintang/Forehead, Heart fire-toxin resolves only at chin; cheekbones/ears/eyes resemble measles, extremely severe, death inevitable.
Verse 4: Fever for three days, normal Qi/Breath; red/vibrant spotting, location irrelevant. Appearance becomes coarse/plump; sparsity ensures survival. Initial fragmentation suggests density. Gradual eruption with heat application, tips round/high, lustrous color; even if dense, salvageable. Simultaneous eruption with red/thin skin, even if sparse, may not survive. Fine white heads like prickly heat, dry/shriveled, certain internal attack; crimson red dots like cinnabar, scorched/withered, certain decline. Coarse/plump but tips not plump, finally white/sunken, tips tender/thin; Cornel patterns indicate empty pus; tender muscle/thin skin, delicate red. Yellow/thin pox turns brown; dark skin/coarse texture, pox color gloomy. Infant muscles vary, cannot generalize. Look for convex vitality, dislike irritable red/dryness, prefer lustrous calm spirit. Spotting like pearls/millet, dry hair/skin, application of poultice, purple/scorched, simultaneous eruption with heat; fear density like needle heads. Even gradual eruption, avoid silkworm egg shapes, bran/prickly heat/rash/scabies forms, unstable bases, no footprints; violation of these implies hopeless cases. Macules like mosquito bites, severe cracking like snake wounds, or snail/cloud/lightning patterns, slightly salvageable. Pre-fever spotting, commonly "Baodou". Persistent fever without spreading treated as carbuncle. Blocks first, sores second: Blocks named "Chidu" (Stupid Toxin), must survive. Sores first, blocks second: Blocks named "Guizhong" (Ghost Swelling), hard to cure. Avoid pox in secluded places, eye lids/lips/mouth prone to凶 (misfortune). Stifled pox in vital areas, tongue/throat/shoulders/back unfavorable. Favorable: does not hate quantity. Adverse: fears single cold carbuncle. Early visible pox, dare not show form. Thief Pox arises, other pox fail to fill; true identification requires immediate pricking. Interior patterns unsettled, pox erupted but toxin internal; muscle-releasing dispersion, detoxification is best. Bowel regulation, calm person, body hot but toxin external; tonification plus dispersion, stabilizing exterior is priority. If interior/exterior patterns balanced, no mixed treatment; observe spirit courage, detail exterior/tonification strategy.
Verse 5: Days 3-4, pox should be complete, reaching soles, momentum stabilizes. Continued non-eruption or hidden/subtle lesions, ancient name "Bu Kuai" (Not Fast). If not due to obstruction, must be Qi/Blood weakness. Before Day 4, toxin emerging, body surface should be cool; After Day 4, toxin fixed, body surface should be warm. Cool harmonizes Qi/Blood, pox lustrous; Warm opens pores, toxin fills easily. If body lacks mild heat here, though not frozen, pox definitely won't grow. Physician must investigate cause: Wind-Cold, vomiting/diarrhea, or foul contact. No heat/non-rising pox becomes ice-hard; red non-rising pox predicts deterioration. Red/lustrous unchanged, but with shortness of breath/abdominal distension, death near. Loss of voice/sorrow, Yang numbers few.
Yu Tianchi said: Predicting auspicious/inauspicious before spotting relies on spirit/expression/pulse. Unless extremely good/bad, future is unclear. Once spotted, form/color visible, favorable/dangerous/adverse paths clear. Form depends on Qi/Color, rooted in Blood/Qi. Regular Qi controls toxin; toxin controlled, pox stable despite density, not blurry/fragmented, distinct granules, clean bases. Led toxin reaches exterior easily, dense but top bursts/aged, Qi regular, form seamless. Regular Blood carries toxin; toxin carried, pox stable despite density, roots supported. Bags thick/nourishing, toxin receives nourishment, pox not dry/astringent, dense but pale-not-white, red-not-delicate, Blood regular, color blameless. Reverse indicates Qi/Blood controlled by toxin. Exterior/Interior deficiency causes slow eruption; Exterior/Interior excess causes toxin stagnation; Qi/Blood deficiency causes thin skin/white color; Toxin-Fire excess causes ugly form/color. Thousands of forms stem from this.
Spotting after 3 days fever, cool body, clear spirit, distinct granules, pale-red aged, others known favorable, no meds needed. Spotting Day 1, fierce heat/dry blisters, fire-associated eruption, any density, purple-bright or red, others known, this is fierce toxin/fire, plan early to prevent internal ulceration. Urgently attack toxin/clear fire, clear muscle/promote eruption, do not neglect initial sight. Spotting with no fever, tired spirit, accidental eruption due to surrounding Qi influence, pale/thin skin, pores not tight, muscle not solid, unable to constrain. Do not disperse, prevent itching/collapse later, use Tiaozhong Tang. Spotting preceded by vomiting/diarrhea/tiredness, warm head/cold feet, seasonal infection, pale/thin bags, stagnant/non-rising, Qi deficiency unable to promote, use rising methods treating root, prevent inversion/collapse. Spotting fiery heat, purple-bright/red, irritable spirit, days unresolved/non-rising, urgently attack toxin/cool blood, clear fire/disperse muscle. Spotting few grains, not very red/white, warm body, clear spirit, termed favorable. Bags not thick over days, pox not lustrous/plump, floating, termed "Dengban Dou" (Equal Companion Pox). First few spots, "Baodou". Days 4-5, sudden high fever, confused spirit, mass fierce toxin erupts, dense/purple-dark, mostly non-rising, wise ones prick, suck toxin, apply medicinal rouge, internal Zhuwei Gao/Tiantong San to invigorate blood/disperse, rampant momentum requires cleansing to save. Spotting fierce toxin-fire, Qi/Blood unable to constrain, simultaneous eruption, burning heat, urgently detoxify/cool blood/clear fire. Spotting scorching heat, dry/smoke-like, irritable spirit, any density, attack toxin/cool blood, clear muscle/disburse fire, delay allows internal attack. Spotting dry/stagnant alum-red, body should be hot but is cool, toxin-fire suppressed internally, not true cool. Urgently disburse fire/disperse muscle, invigorate blood/promote eruption, wait for fire penetration then cool, do not abruptly clear fire. Spotting sparse, interspersed flea spots or purple-dark, like purple-backed duckweed or string pearls, spirit oppressed/painful, mostly evil toxin residing internal, exterior/internal mismatch, do not neglect due to sparsity. Attack latent toxin, loosen muscle/invigorate blood. Spotting cracked lips/swelling, scorched black like coal, foul mouth odor, tongue prickles, toxin-fire invading Stomach, urgently heavy clear fire/cool blood/detoxify, heavy must attack. Spotting skin/hair stinging, clothes disturbing, toxin congested in Lung, urgently heavy attack toxin, loosen muscle/promote eruption, neglect leads to pus-phase failure, agitation/itching death. Spotting tendon twitching/pulse palpitation, screaming only, latent toxin in Liver, soothe Liver, heavy toxin must attack, grinding teeth same. Spotting delirium/maniacal, seeing ghosts, toxin-fire confusing Heart, cool blood/clear fire, plus burning heat/pain, especially attack toxin. Spotting joint pain, waist like beaten, toxin in Kidney, mostly non-rising, attack toxin urgent. Spotting hair standing erect, blood lines under eyelids, unceasing abdominal pain, burning heat/ice-cold limbs, toxin latent in Spleen, urgently attack toxin/clear muscle/promote eruption. Spotting urine like pickled fish juice, fresh blood, safflower paste, toxin-fire descending Small Intestine, urgently attack toxin/cool blood, epistaxis same. Spotting desire to defecate or grimacing during, stool like lacquer/glue/clots/sheep dung, toxin noted in Large Intestine, urgently attack toxin, guide by momentum. Spotting violent diarrhea like pouring, pure clear water/restless, fire disturbing Large Intestine, separate/drain/cool Large Intestine. Five Zang latent fire/toxin, only diarrhea slightly lighter, intestine as transport ground. Though obstructed, ultimately guided by momentum. Spotting sparse granules, full bags, alum-red/purple-bright/dull colors, toxin-fire in Blood level. Resolve Blood-level toxin, clear Blood-level fire. Spotting strong adherence, but bags not loose/flat/sunken, Blood arrived, Qi not arrived. Widen Qi pathway, loosen muscle/disperse, combine with other violent symptoms, must purge. Spotting perfect shell, but bases dry/stagnant, Qi arrived, Blood not arrived. Clear Ying/invigorate blood, combine with rampant symptoms, must attack. Spotting unresolved exterior, Wind/Cold/Wind-Heat, mild/severe, days non-rising or slow rising, Exterior Excess, examine pathogen/disperse, give toxin exit. Spotting diet un...