痘疮以正面为主，盖五脏之精华，皆上着于头面也。故身上疮痒而抓破者，不为大
害，惟正面不可犯动一处，苟于眉目鼻面之间，抓破一处者，此肺热也，急用甘桔牛蒡
之类，以解之。其痒即止者，乃佳兆也。如痒不已，则浸淫渐开，其气泄而其痒愈甚，
必至满面抓破而死。更有起发养浆之时，额上疮如火烧，汤浇之状，溃烂破坏，无复完
肤，或两颊之傍，亦如是样，不待抓搔而自破烂者，必渐渐溃破壳焦，水去似靥非靥，
其沙崩之势，莫之能御，必至阳气脱而死，更有痘疮作浆之初，未易收靥，面上诸疮未
尽成脓，而忽鼻准头疮，先干如橘子色者，或眉心疮自干黑者，或两耳上疮自收者，或
唇上疮自焦黑者，或两颊疮干蹈如饼者，此皆名为倒靥，乃死之候。不可认为正收也。
夫人之身，诸阳脉上行头面，诸阴脉自头胸而还，故头面属阳，而痘疹亦属阳，以
类相从，是以起发以至收靥，皆自头面而始。盖升生浮长，阳之性也。凡痘疮起发，
头面以渐肿大，则得升生浮长之性，不须忧恐，只要痘子磊落红活，光壮肥泽，则自成
脓之后，毒化结痂，而肿亦渐消矣。如疮粘连通片，模糊成饼者，只要红活润泽，咽喉
疏利，胸膈宽快，饮食无节，而亦无变也。若色灰白或青黄，干燥者皆死。其有头面肿
而不闭目者，毒浅而轻，若闭目者，毒深而重。疮熟而肿消目开者，为吉，未成脓而即
肿消，目开者，此为陷也，不治。更有未见点而头面预肿看，则毒散漫于皮毛，必不能
透肌而出矣。亦有将起发而头面预肿者，则气浮越而肉腠，必不能起顶而脓矣。此染时
行疫 之气，名大头瘟，其毒最酷，一见其机，急用清解透托，以图万一也。
痘疮以头面部为主，因为五脏的精华都上注于头面。所以身上疮疡发痒而抓破的，不构成大害，唯独头面部不可触碰损伤一处，如果在眉毛、眼睛、鼻子和面部之间抓破一处，这是肺热所致，应立即使用甘草、桔梗、牛蒡子之类的药物来解表清热。如果瘙痒随即停止，这是吉兆。如果瘙痒不止，则病情会浸淫扩散，正气泄失而瘙痒更加严重，必然导致满面抓破而死。更有在起发养浆的时候，额头上的疮像火烧、汤浇一样，溃烂破坏，没有完好的皮肤，或者两颊旁边也是这样，不待抓挠而自己破烂的，必然渐渐溃破结痂焦黑，水分流失似痂非痂，其崩塌之势无法抵御，必然导致阳气脱绝而死。更有痘疮开始化浆之初，不容易收靥（结痂），面上各种疮还没有完全成脓，忽然鼻准头（鼻尖）的疮先干燥呈橘子色，或者眉心处的疮自己干燥变黑，或者两耳上方的疮自己收敛，或者嘴唇上的疮自己焦黑，或者两颊的疮干燥塌陷像饼一样，这些都叫做倒靥，是死亡的征兆。不能认为是正常的收靛。
人的身体，诸阳经脉上行至头面，诸阴经脉从头部胸部返回，所以头面属阳，而痘疹也属阳，同类相从，因此从起发到收靥，都是从头面开始的。因为升发生长浮长，是阳的特性。凡是痘疮起发，头面逐渐肿大，就得到了升发生长浮长的特性，不必担忧恐惧，只要痘粒磊落红活，光泽壮实肥润，那么自成脓之后，毒气化解结痂，肿胀也会渐渐消退。如果疮疡粘连成片，模糊成饼状，只要颜色红活润泽，咽喉通畅，胸膈宽快，饮食有节制，也不会发生变故。如果颜色灰白或青黄，干燥的都会死亡。那些头面肿胀但不闭眼的，毒邪浅而病轻；如果闭眼的，毒邪深而病重。疮熟而肿胀消退眼睛睁开的，为吉利；未成脓就肿胀消退且眼睛睁开的，这叫内陷，无法治疗。更有尚未见到痘点而头面预先肿大的，看诊时则毒邪散漫于皮毛，必然不能透达肌肉而出。也有即将起发而头面预先肿大的，则气机浮越而肌肉腠理疏松，必然不能起顶化脓。这是感染了时行疫疠之气，名叫大头瘟，其毒性最猛烈，一见其征兆，立即使用清解透托的方法，以图万一之生机。
Smallpox primarily manifests on the face, as the essence of the five Zang organs ascends to the head and face. Therefore, if sores on the body itch and are scratched open, it does not cause major harm; however, the facial area must not be touched or damaged in any spot. If a scratch occurs between the eyebrows, eyes, nose, or cheeks, this indicates Lung Heat (Lung Re: Pathogenic heat affecting the Lung system). One should urgently use herbs such as Gancao (Licorice Root), Jiegeng (Platycodon Root), and Niubangzi (Arctii Fructus) to resolve it. If the itching stops immediately, it is a favorable omen. If the itching persists, the condition will spread progressively, Qi (Vital Energy) will leak, and the itching will intensify, inevitably leading to death from extensive scratching of the entire face. Furthermore, during the stage of eruption and pus formation, the sores on the forehead may appear as if scalded by fire or boiling water, ulcerating and destroying the skin until no intact skin remains. The same may occur on the sides of the cheeks. Without being scratched, they break open spontaneously. They will gradually ulcerate and form dry, blackened crusts. As fluids dissipate, the appearance resembles scabs but is not true scabbing. This collapsing momentum cannot be controlled, inevitably leading to death from the exhaustion of Yang Qi (Yang Qi: The active, warming, and defensive energy of the body). Additionally, at the initial stage of pus formation, when scabbing is difficult, if the sores on the face have not yet fully suppurred, but suddenly the tip of the nose dries first with an orange-like color, or the sores at the glabella dry and turn black spontaneously, or the sores above the ears retract spontaneously, or the sores on the lips become dry and black, or the sores on the cheeks dry and flatten like a cake, these are all termed "Dao Ye" (Inverted Scabbing), which is a sign of death. It must not be mistaken for normal scabbing.
In the human body, all Yang meridians ascend to the head and face, while all Yin meridians return from the head and chest. Thus, the head and face belong to Yang, and smallpox also belongs to Yang. Like attracts like; therefore, from eruption to scabbing, the process begins at the head and face. Ascending, generating, floating, and lengthening are the nature of Yang. When smallpox erupts, if the head and face swell gradually, it aligns with the nature of ascending and generating, so there is no need for fear. As long as the pustules are distinct, red, and vibrant, with luster, robustness, and moisture, after they naturally form pus, the toxin will transform and scab over, and the swelling will gradually subside. If the sores adhere and merge into patches, appearing blurred and cake-like, as long as they are red, vibrant, and moist, the throat is clear, the chest and diaphragm feel comfortable, and diet is regulated, complications will not arise. However, if the color is grayish-white or greenish-yellow and dry, death ensues. If the head and face are swollen but the eyes remain open, the toxin is shallow and the disease is mild. If the eyes are closed, the toxin is deep and the disease is severe. If the sores mature, swelling subsides, and the eyes open, it is auspicious. If swelling subsides and eyes open before pus formation, this is termed "Xian" (Collapse/Depression), which is incurable. Furthermore, if the head and face swell prematurely before spots appear, the toxin is scattered in the skin and hair follicles and cannot penetrate the muscles to emerge. If the head and face swell prematurely just before eruption, Qi floats upward and muscle pores relax, preventing the pustules from rising and forming pus. This results from infection with epidemic pathogenic Qi (Epidemic Qi: Pathogenic factors capable of causing epidemics), named "Da Tou Wen" (Great Head Plague). Its toxicity is most fierce. Upon recognizing the signs, one must urgently employ clearing, resolving, penetrating, and supporting methods to seek a slim chance of survival.