夫浆势虽已充满，忽下鲜血者，是毒归大肠，大肠为肺表，必危在十五朝。如将收
靥时，忽作惊悸者，是毒滞于心而磨耗真元，必危在十四朝。如方收靥时，忽然声哑
者，是毒归于肺，必危在十三朝。如方收靥时忽发症肿硬块，紫黑渐加者，必危在十六
朝，如当靥不靥，泄泻不渴，寒战切牙者，是属虚寒也。急进异攻散以救之。然诸危
症，亦有似是而实非者，宜兼诸候而并参之。
（碎锦）
凡痘靥自上而下者，顺。从脚上循腰以上者，逆，必回至心窝便死。若早能提起元
气，使回浆自上而下为妙。惟有先从阴颈上先收者，此又为佳候，不在自下之例。从一
痘至血化毒解，脓如苍蜡之色，从口鼻两旁，人中上下面部收起，渐至胸腹而下，以
至两腿，始乃额与脚背，一齐结靥，内症全无，饮食如故，神爽身轻者，井手足心，或
手指尖，及阴上先收者，吉。一痘色苍蜡而有微热者，乃烧瘢之候不必忧治。一痘鼻梁
上先焦者，虽凶不死。一凡痘回至颈，切忌过用黄 ，盖痘欲回而 复托之，则升降不
定，毒必攻内而死。一靥后忌食五辛，恐热毒熏于肝膈，眼生翳障耳。一心痘系危证，
气血大虚，多服补剂，渐有脓色而将收靥，虽有热者，当于补剂中加凉药。若谓将靥，
宜补剂而竟与凉药，更用下利，令其速靥，是令其速毙也。盖虚者复虚，毒反内攻而
死，此必然之理也，又已然之验也。
浆液虽然已经充满，如果突然流出鲜血，这是毒邪归入大肠。大肠与肺相表里，病情必定在十五天内危及生命。如果在痘疹即将收靥（结痂脱落）时，突然出现惊悸症状，这是毒邪滞留于心，耗损真元，病情必定在十四天内危及生命。如果在刚刚准备收靥时，突然声音嘶哑，这是毒邪归于肺，病情必定在十三天内危及生命。如果在刚刚准备收靥时，突然发作症肿硬块，颜色变为紫黑并逐渐加重，病情必定在十六天内危及生命。如果到了该收靥的时候却不收靥，伴有腹泻但不口渴，寒战且咬牙，这属于虚寒证。应当紧急服用异攻散来救治。然而，各种危重病症中，也有看似如此实则不同的情况，应当结合其他症状综合参详判断。
（碎锦篇）
凡是痘疹的结痂从头部向下发展，为顺证。从脚部向上蔓延至腰部以上，为逆证，必然回传至心窝处导致死亡。如果能及早提振元气，使浆液回流、结痂过程恢复自上而下的顺序，最为巧妙。只有先从阴器部位开始收靥的，这又是吉兆，不属于自下而上的逆例。从第一颗痘发出到血液化解毒素解除，脓液呈现苍蜡色，从口鼻两旁、人中上下及面部开始收靥，逐渐向胸腹部下方发展，直至双腿，最后额头和脚背同时结痂，内部症状完全消失，饮食如常，精神清爽身体轻便，这是吉兆。如果手足心、手指尖或阴部先收靥，也是吉兆。如果一颗痘疹颜色呈苍蜡色且有微热，这是形成瘢痕的征兆，不必担忧治疗。如果一颗痘疹鼻梁上先焦枯，虽然凶险但不会死亡。凡痘疹回退至颈部时，切忌过度使用黄芪等托毒药物，因为痘疹欲回退却强行托举，会导致气机升降不定，毒邪必定内攻致死。痘疹结痂后忌食五辛（葱、蒜、韭、薤、兴渠），恐怕热毒熏蒸肝膈，导致眼部生翳障。心痘属于危重证候，气血大虚，多服补益药剂，逐渐出现脓色并将要收靥，即使有热象，也应当在补剂中加入凉药。如果说将要收靥，应当用补剂却竟然给予凉药，甚至使用泻下利导的方法令其快速收靥，这是促使患者快速死亡的做法。因为虚弱的体质再次受损，毒邪反而内攻致死，这是必然的道理，也是有据可查的验证。
Although the pustules are full, if fresh blood suddenly appears, it indicates that the toxin has returned to the Large Intestine (Da Chang). Since the Large Intestine is the exterior counterpart of the Lung (Fei), the condition will be critical within fifteen days. If palpitations and fright occur suddenly when the lesions are about to scab over (Shou Ye), it indicates that the toxin is stagnant in the Heart (Xin) and consuming the True Yuan (Zhen Yuan); the condition will be critical within fourteen days. If hoarseness occurs suddenly just as the lesions are about to scab over, it indicates that the toxin has returned to the Lung; the condition will be critical within thirteen days. If hard, purple-black swellings appear suddenly just as the lesions are about to scab over and gradually worsen, the condition will be critical within sixteen days. If the lesions fail to scab over when they should, accompanied by diarrhea without thirst, chills, and teeth grinding, this belongs to Deficiency-Cold (Xu Han). Yi Gong San (Yigong Powder) should be administered urgently to rescue the patient. However, among various critical conditions, there are those that seem similar but are actually different; one must consider all symptoms together for judgment.
(Sui Jin Chapter)
When the scabs of smallpox lesions descend from the head downwards, it is a favorable progression (Shun). When they ascend from the feet up to the waist and above, it is an unfavorable progression (Ni), which inevitably returns to the heart pit leading to death. If the Primordial Qi (Yuan Qi) can be lifted early on, allowing the pus to return and the scabbing process to resume its downward direction, this is optimal. Only when the scabbing begins first at the genitalia is this considered an excellent sign, falling outside the category of unfavorable downward progression. From the emergence of the first lesion until the blood transforms and the toxin resolves, with pus resembling the color of pale wax, the scabbing starts from both sides of the mouth and nose, above and below the philtrum, and the face, gradually extending down to the chest and abdomen, then to both legs, finally with the forehead and dorsum of the feet scabbing over simultaneously. With no internal symptoms remaining, normal diet, refreshing spirit, and light body, this is auspicious. Scabbing first at the palms/soles or fingertips, or at the genitals, is also auspicious. If a single lesion is pale wax-colored with slight heat, it is a sign of scar formation; there is no need to worry or treat. If a single lesion scorches first on the nasal bridge, although ominous, it will not lead to death. When lesions recede to the neck, one must strictly avoid overusing Astragali Radix (Huangqi) to support the eruption. Forcing support while the lesions wish to recede causes unstable ascending and descending movements, leading the toxin to attack internally and cause death. After scabbing, pungent spices (Wu Xin: garlic, onion, leek, chives, Chinese chive) are forbidden to prevent heat-toxin from steaming the Liver and Diaphragm, causing eye opacities. Heart-pox is a critical condition characterized by severe deficiency of Qi and Blood. Taking many tonics leads to pus formation and impending scabbing; even if heat signs exist, cooling herbs should be added to the tonic formula. If one assumes that because scabbing is imminent, tonics should be used but instead gives cooling herbs, or uses purgatives to force rapid scabbing, this hastens death. Because the deficient becomes more deficient, the toxin counter-attacks internally leading to death; this is an inevitable principle and a verified experience.