夫痘之来也，随火而至，是以常多迫血妄行，血亦随火而动。若阳络伤，则从上焦
而出，为衄为呕。若阴络伤，则从下焦而出，为溲为便。若阴阳俱伤，则上下俱失，
或从疮间而出者有焉。然失血后，而多睡不醒者，何也？盖心为血之主，血失则心之神
昏，而失其虚灵之性矣，诸失血惟鼻出者，可治，其余皆绝症也。
（碎锦）
一痘潮热三四日而后出者，是血气充足，毒少难于感动，如灼火难燎，其痘必稀
而易愈。有始热半日一日即出者，由血气怯弱，毒多易于感动，如烈火易焚，其痘必密
而难痊。初出三五相连而细者，必密。单见形而肥者，必稀。一热一二日而见点，眼眶
不肿，二便如常，胫不软唇不浮，两颊不模糊肌肉不浮肿者，吉。一痘出稀疏，表里便
凉，则毒必轻，兼大小磊落分明，不相粘连者，则托里解毒之剂，宜略饮之，以助其起
发。灌脓收靥，如出太密，粘连模糊，则难出而其毒犹盛，则托里解毒之剂，宜多饮
之。以防其陷伏痒塌黑靥之变。若遍身虽是模糊，独面上喉颈胸背之处，稀朗分珠者，
可治也。一凡痘疹一色者，善。若二色三色相合而作者，凶。一先吐而痘见即止者，
吉。有大吐而变凶者，胃败不能逐毒也。一目光精彩，神映了然，口唇红活，而无燥白
色者，吉。一痘作二三次出，至三日后手足心方始出齐，头面背稀少，摸之坚硬，根窠
红晕，大小不一，肥满光泽，痘肉红白分明，势如笋出土形，朝暮易眼者吉。一凡先
于骨处见点而稀者，必吉。若于软肉无骨处，先见点而密者，必凶。但忌头额者，以
毒盛而妄参阳位也。一凉而复热，热而复凉，连棉数日，然后从口角颧骨之处三两成
对报点至三四五日出齐者，顺之兆也。一看天道太阳方广，二看颈项，三看胸背，四看
谷道之所，五看地阁，六看肚脐，七看两手脉处，如数地俱稀少者，吉。
痘疹的发作，是随着火邪而至的，因此常常导致血液逼迫而妄行，血液也随着火势而动荡。如果阳络受损，血液就会从上焦排出，表现为鼻衄或呕吐。如果阴络受损，血液就会从下焦排出，表现为尿血或便血。如果阴阳二络都受损，则上下都会出血，或者从疮口间渗出的情况也有。然而，在失血之后，如果出现多睡不醒的症状，是什么原因呢？这是因为心主宰血液，血液丢失后，心的神志就会昏昧，从而失去了其虚灵的特性。在所有失血症状中，只有鼻出血是可以治疗的，其余的都是绝症。
（碎锦篇）
痘疹在潮热三四天之后才发出的，说明气血充足，毒邪较少难以被触动，就像灼热的火难以点燃物体一样，这样的痘疹必然稀疏且容易痊愈。有开始发热半天或一天就发出的，是由于气血怯弱，毒邪较多容易被触动，就像烈火容易焚烧物体一样，这样的痘疹必然密集且难以痊愈。初发出时三五颗相连且细小的，必然密集。单独看见形态而饱满肥大的，必然稀疏。发热一两天就见到痘点，眼眶不肿胀，大小便正常，小腿不软弱，嘴唇不浮肿，两颊不模糊，肌肉不浮肿的，为吉兆。痘疹发出稀疏，表里都凉爽，说明毒邪一定轻浅，兼见痘粒大小磊落分明，互不粘连的，适宜稍微服用托里解毒的药物，以帮助痘疹起发。灌浆收靥阶段，如果出得太密，粘连模糊，说明难发出且毒邪仍然旺盛，适宜多服用托里解毒的药物，以防止出现陷伏、瘙痒塌陷、黑靥等变证。如果遍身虽然模糊，唯独面部、咽喉、颈部、胸部和背部稀疏明朗、颗粒分明的，是可以治疗的。凡是痘疹颜色单一的，为善证。如果是两种或三种颜色混合出现的，为凶证。先呕吐而后痘点出现随即停止的，为吉兆。有大吐现象并导致病情转凶的，是胃气败坏不能驱逐毒邪所致。目光有神采，神气清晰明了，口唇红润鲜活，而没有干燥白色的，为吉兆。痘疹分二三次发出，到第三天后手足心才完全出齐，头面背部稀少，摸起来坚硬，根脚红晕，大小不一，饱满光泽，痘肉红白分明，态势像竹笋出土形状，早晚变化明显的为吉兆。凡是先在骨骼部位见到痘点且稀疏的，必然吉利。如果在软肉无骨处，先见到痘点且密集的，必然凶险。但忌讳在额头部位出现，因为那里毒邪旺盛且妄犯阳气高位。凉后又发热，发热后又转凉，连绵数日，然后从口角颧骨处两三成对地报点至三四五天出齐的，是顺症的征兆。一看天道太阳方广（指额头宽阔），二看颈项，三看胸背，四看肛门所在，五看下颌，六看肚脐，七看两手脉处，如果上述几个部位痘点都稀疏的，为吉兆。
The eruption of smallpox arrives following the path of fire; therefore, it often forces blood to move recklessly, with blood agitated by the heat. If the Yang collaterals are damaged, blood exits from the Upper Jiao (Upper Burner), manifesting as epistaxis or vomiting. If the Yin collaterals are damaged, blood exits from the Lower Jiao (Lower Burner), manifesting as hematuria or bloody stools. If both Yin and Yang collaterals are damaged, bleeding occurs in both upper and lower regions, or there may be seepage from between the pustules. However, why does excessive sleepiness and inability to wake occur after blood loss? This is because the Heart governs blood; when blood is lost, the Spirit of the Heart becomes confused, losing its ethereal clarity. Among all types of blood loss, only epistaxis is treatable; the rest are considered terminal conditions.
(Sui Jin Section)
When smallpox erupts after three to four days of tidal fever, it indicates sufficient Qi and Blood, with mild toxin that is difficult to stir, similar to how a hot fire is hard to ignite fuel; such eruptions will be sparse and easy to heal. When eruptions appear within half a day to one day of initial fever, it is due to weak Qi and Blood, with abundant toxin easily stirred, like a fierce fire burning readily; such eruptions will be dense and difficult to cure. Initial eruptions appearing in clusters of three to five, small and fine, indicate density. Single spots appearing plump and full indicate sparsity. Fever lasting one to two days before spots appear, with non-swollen eye sockets, normal urination and defecation, non-weak calves, non-puffy lips, non-blurred cheeks, and non-edematous muscles, is auspicious. Sparse eruptions with coolness in both exterior and interior indicate light toxin; if the pustules are distinct in size and clear without adhesion, it is appropriate to slightly administer formulas for supporting the Interior and resolving toxicity to aid eruption. During the filling and scabbing stages, if eruptions are too dense, adherent and blurred, indicating difficulty in emergence and persistent strong toxin, it is appropriate to administer larger doses of formulas for supporting the Interior and resolving toxicity to prevent complications such as sinking, pruritus, collapse, or black scabs. If the body is generally blurred but the face, throat, neck, chest, and back are sparse, clear, and distinct like pearls, it is treatable. Uniform color in rashes is favorable; mixed colors (two or three) appearing together are ominous. Vomiting followed by the appearance of spots which then stops is auspicious. Severe vomiting leading to deterioration indicates failure of Stomach Qi to expel toxin. Bright eyes with clear spirit, red and lively lips without dry whiteness, are auspicious. Eruptions appearing in two or three waves, fully emerging on the palms and soles by the third day, sparse on the head, face, and back, feeling firm to touch, with red halos at the base, varying sizes, plump and glossy, distinct red and white flesh, resembling bamboo shoots emerging from soil, and changing rapidly day and night, are auspicious. Spots appearing first on bony areas and being sparse are always auspicious. Spots appearing first on fleshy, non-bony areas and being dense are always ominous. Eruptions on the forehead are contraindicated, as this area is prone to excessive toxin invading the high Yang position. Alternating coolness and heat over several days, followed by spots appearing in pairs from the corners of the mouth and cheekbones, completing by the third to fifth day, is a sign of smooth progression. Observe: 1. The breadth of the forehead (Heavenly Sun); 2. The neck; 3. The chest and back; 4. The anus; 5. The chin (Earth Pavilion); 6. The umbilicus; 7. The pulse sites on both hands. If spots are sparse in these locations, it is auspicious.