痘色桃花渐渐红，淡白枯紫晦多凶，起胀顶白根红润，顶灰根散或深红。生浆由白
而黄浓，最忌灰干与薄清，靥喜苍栗恶麸白，疤喜红满恶白平。
【注】痘色，血之为也。血胜毒，则毒为血载，其毒化矣，故顺也；毒胜血，则血为
毒滞，其血涸矣，故逆也。血毒相平，则势界于险，亦在医者之调治得宜也。始出之色
如桃花，而渐加滋润，此血胜毒，为顺也；若初出即淡白干紫，晦而不亮，此毒胜血，为
逆也。起胀之色，顶渐放白，根红光润，此血胜毒，为顺也；若顶色灰滞，根血散漫，或
地脚深红，此毒胜血，为逆也。生浆之色，白而渐黄，苍而淳浓，此血胜毒，为顺也；若
灰干不润，或浆薄清稀，此毒胜血，为逆也。结痂之色，苍如栗壳，此血胜毒，为顺也；若
痂色麸白，此毒胜血，为逆也。疤痕之色，红润凸起，为顺；若淡白黑紫，平凹无突起之
状，皆为不顺之色，医者详之。
苍淳娇艳老嫩色，浓实浮虚老嫩形，浓浊稀清浆老嫩，浓薄痂之老嫩明。
【注】痘之一证，自始至终，喜老恶嫩。如苍淳娇艳，此色之老嫩也；肥实浮虚，此
形之老嫩也；浓浊稀清，此浆之老嫩也；薄软浓坚，此痂之老嫩也。总之，老者多顺，易
于成功；嫩多险逆，难于施治也。
头项胸背痘疏吉，手足虽密不为凶，疏兼阳热须防变，密若磊落不必惊。
【注】头面清阳元首，颈项管龠咽喉，胸背乃脏腑所附，惟稀疏则吉也。至于手足无
甚关系，虽多不为凶也。疏固是顺，若见阳证谵妄，大渴大热，唇舌燥裂，烦躁不宁，大
小便秘等证，此毒壅遏不出，虽疏未为吉也。密固是逆，若铺排磊落，大小匀净，精神、寝
食、二便如常，虽密亦不须惊也。
痘疹的颜色若像桃花一样逐渐变红，是顺证；若颜色淡白、干枯或紫暗晦涩，多为凶兆。在起胀阶段，痘顶发白而根部红润为顺；若痘顶灰暗、根部散漫，或者根基深红，则为逆证。灌浆过程中，浆液由白色转为黄色浓稠状为顺；最忌讳的是浆液灰干或稀薄清冷。结痂（靥）阶段，喜欢颜色如栗子壳般苍老，厌恶颜色如麦麸般苍白；留疤阶段，喜欢疤痕红润饱满，厌恶疤痕淡白平坦。
【注】痘疹的颜色，反映的是血液的状态。如果血气强盛能制约毒邪，那么毒邪就被血液承载并化解，这是顺证；如果毒邪强盛导致血液被阻滞枯竭，这是逆证。如果血与毒势均力敌，病情就处于危险边缘，这也取决于医生调理治疗是否得当。初期发出的痘色像桃花，并且逐渐变得滋润，这是血胜毒的表现，属于顺证；如果刚发出就是淡白、干枯或紫暗，晦暗不亮，这是毒胜血的表现，属于逆证。起胀时的颜色，痘顶逐渐变白，根部红光润泽，这是血胜毒，属于顺证；如果痘顶颜色灰暗滞涩，根部血色散漫，或者基底深红，这是毒胜血，属于逆证。生浆时的颜色，由白渐黄，色泽苍老且浓稠，这是血胜毒，属于顺证；如果灰暗干燥不润，或者浆液稀薄清冷，这是毒胜血，属于逆证。结痂时的颜色，苍老得像栗子壳，这是血胜毒，属于顺证；如果痂皮颜色像麦麸一样白，这是毒胜血，属于逆证。疤痕的颜色，红润凸起为顺；如果淡白黑紫，平坦凹陷没有突起的样子，都是不顺的颜色，医生要仔细辨别。
痘疹颜色苍老淳厚或娇艳嫩弱，形态充实厚重或浮浅虚弱，浆液浓浊或稀清，痂皮厚薄，都能明确分辨出痘证的“老”与“嫩”。
【注】痘疹这一病症，从开始到结束，都喜好“老”而厌恶“嫩”。比如颜色苍老淳厚或娇艳嫩弱，这是颜色的老嫩之分；形态肥实或浮虚，这是形态的老嫩之分；浆液浓浊或稀清，这是浆液的老嫩之分；痂皮薄软或浓坚，这是痂皮的老嫩之分。总之，“老”的痘证大多顺遂，容易治愈；“嫩”的痘证多险恶逆乱，难以施治。
头面、颈部、胸部和背部的痘疹稀疏为吉；手部和足部虽然密集也不为凶。但是，如果痘疹稀疏却伴有阳热证候，必须防止病情变化；如果痘疹密集但排列磊落分明，也不必惊慌。
【注】头面部是清阳之府，颈项连接咽喉，胸背部依附脏腑，这些部位的痘疹只有稀疏才是吉利的。至于手部和足部关系不大，即使多也不算凶险。痘疹稀疏固然是顺证，但如果出现谵语妄言、大渴、大热、嘴唇舌头干燥开裂、烦躁不安、大小便不通等阳热证候，这说明毒邪壅塞无法透出，虽然痘疹稀疏也不算吉利。痘疹密集固然是逆证，但如果分布均匀整齐，精神、睡眠、饮食和二便都正常，虽然密集也不需要惊慌。
The color of the smallpox/rash lesions gradually turning red like peach blossoms indicates a favorable prognosis; pale white, withered, or dark purple and dull colors often indicate an ominous prognosis. During the swelling stage (Qi Zhang), a white apex with a ruddy root is favorable; a grayish apex, scattered root, or deep red base indicates an unfavorable prognosis. During the pus formation stage, the fluid turning from white to thick yellow is favorable; grayish dryness or thin, clear fluid is most taboo. For scabbing (Ye), a color resembling chestnut shells is preferred, while a wheat-bran-like white color is avoided; for scar formation, ruddy and full scars are favorable, whereas pale and flat scars are unfavorable.
[Note] The color of the lesions reflects the state of the blood. If blood qi is strong enough to overcome the toxin, the toxin is carried by the blood and resolved, indicating a favorable course; if the toxin overwhelms the blood, causing blood stagnation and depletion, it indicates an unfavorable course. If blood and toxin are in equilibrium, the condition is precarious, depending on the physician's appropriate regulation and treatment. Lesions appearing initially like peach blossoms and becoming increasingly moist indicate that blood overcomes the toxin, which is favorable. Lesions appearing initially as pale white, dry, or dark purple, dull and lacking luster, indicate that the toxin overcomes the blood, which is unfavorable. During the swelling stage, a whitening apex and ruddy, moist root indicate blood overcoming the toxin, which is favorable; a grayish, stagnant apex, scattered root blood, or deep red base indicate the toxin overcoming the blood, which is unfavorable. During pus formation, a transition from white to yellow, appearing mature and thick, indicates blood overcoming the toxin, which is favorable; grayish, dry, unmoistened, or thin, clear fluid indicates the toxin overcoming the blood, which is unfavorable. At the scabbing stage, a color mature like chestnut shells indicates blood overcoming the toxin, which is favorable; a scab color like wheat bran indicates the toxin overcoming the blood, which is unfavorable. Ruddy, raised scars are favorable; pale white, black-purple, flat, and depressed scars without elevation are all unfavorable signs, requiring careful observation by the physician.
Mature and rich versus delicate and tender colors, substantial and floating forms, thick and turbid versus thin and clear pus, and thick versus thin scabs clearly distinguish between "mature" (Lao) and "tender" (Nen) presentations of the disease.
[Note] In the case of smallpox/rash, from beginning to end, maturity (Lao) is preferred over tenderness (Nen). Mature and rich versus delicate and tender colors refer to the maturity of the hue; substantial/fat versus floating/empty forms refer to the maturity of the shape; thick/turbid versus thin/clear pus refers to the maturity of the fluid; thin/soft versus thick/firm scabs refer to the maturity of the crust. In summary, mature cases are mostly favorable and easy to cure; tender cases are mostly dangerous and unfavorable, making treatment difficult.
Sparse lesions on the head, neck, chest, and back are auspicious; dense lesions on the hands and feet are not necessarily ominous. However, sparse lesions accompanied by Yang heat syndromes require vigilance against transformation; dense but well-arranged lesions need not cause alarm.
[Note] The head and face are the residence of clear Yang, the neck connects to the throat, and the chest and back are attached to the Zang-Fu organs; thus, sparsity in these areas is auspicious. The hands and feet have less significance, so density there is not ominous. Sparsity is generally favorable, but if accompanied by Yang syndrome symptoms such as delirium, extreme thirst, high fever, dry and cracked lips and tongue, restlessness, and constipation of both bowels and bladder, it indicates toxin obstruction preventing expulsion; even if sparse, it is not auspicious. Density is generally unfavorable, but if evenly distributed and neat, with normal spirit, sleep, diet, and excretion, even if dense, there is no need for alarm.