头疼 初热而发者,常也。
目闭 在初出者,不治。八九日无事,十三四日大内。
咳嗽 痘疹而咳嗽者,常也。但不宜过,且忌音哑仵呛。
心胸疼痛 凶症。
气急在初热者,凶。八九日微喘,无事,但急不宜过。若十三日急促气喘者,死。
声哑 初起不治。惟喉中有痘,外痘长,内亦肥大而然,兼之外痘红活润泽而无
枯暗之色者,吉。痂落后者,凶。若兼气急
者,始终不治。
喉痛 初起难治。八九日可终治,痂后是余毒耳。乱语初起为重,痂落为凶。若
失志者,不治。
呻吟 凶症。如灌脓疼痛而呻吟,不甚者,不妨。
哕声 凶症。初起毒火上冲,可治。脓后胃弱痂后余毒,再兼音哑不食,乃胃气
败绝也,不治。
努气 凶症。是丹田无根之气上乘胸次也。
肚疼 初热常事,若疼不止,腰难伸直,痘发不出及色惨暗者,凶。痂后是余毒,如
痛极难忍者,大凶。
十指冷 凶症。
腰痛 初起微微者,常也。若痛甚难立,并痛而不止者,不治,盖此是肾经后致。
手摇 凶症。
足摇 凶症。但在作脓痛时并灌脓,虚时略动者,无妨。
眼出血 不治。
足冷 凶也。若至过膝者,不治。
鼻衄 无事,但宜甚耳。
尿血 不治。
口吐血 因呛伤胃脘,微出少许者,可治。若甚者及黑者,不治。
便血 鲜血而少,且兼即止者,并倒靥之后而使痂皮脓血者,皆可治。如甚而黑
者,不治。
挫喉 初热者,凶。若灌脓时而浆足者,无妨。
寒战 七日前为热,七日后为寒,又当兼痘症参断吉凶。
切牙 起胀时凶。
蛔虫 初起吐出一二条者,无事。多者为凶,十三、四日吐出者,即死。从便出
而多者亦凶。
吐脓痰 无事。若见腥臭者,宜防肺痈,则必胸中疼痛,唇白面惨为验耳。
吐臭痰 不治。及呕恶臭气者,凶。
惊搐 初起无事,乃痘从心经出也,反为佳候。若在脓后靥后者,乃气血已竭,
神无所根据。大凶。
手足痛 初出为凶,八九日后无事。
手心痛 热症。
耳出血 不治。
吐清水 无事。但甚者,则大泄元气而属虚寒。
泄白粪 寒也。
红粪 热也。
泄青粪 寒也。
泄黑粪 脏腑坏也,不治。
不食 初起不妨,贯浆时及痂后者,凶。
能食 始终为吉。堆痂后而倍者,余毒。
十指痛 凶症。
头冷 不治。
唇干 凡此及唇裂者,凶。
胸高 胸突如盏者,凶。
吐黄水 肚不疼者,无事。肚疼者,为凶。
头痛:在初起发热时出现,属于正常现象。
目闭:在痘疹初出时出现,预后不良。若在发病八九日时没有异常,到十三四日时病情加重(内陷),则危险。
咳嗽:患痘疹时伴有咳嗽,属于常见现象。但不宜过于剧烈,且忌讳声音嘶哑和呛咳。
心胸疼痛:属于凶险病症。
气急:在初起发热时出现,属凶兆。若至八九日仅有轻微喘息,无大碍,但急促不宜过度。若至十三日出现急促气喘,则为死证。
声哑:初起时出现难以治愈。只有当喉中有痘疹,外部痘疹长出,内部痘疹也肥大所致,兼见外部痘疹红活润泽而无枯暗之色者,为吉兆。痂皮脱落后出现声哑,属凶兆。若兼有气急,则始终无法治愈。
喉痛:初起时难治。至八九日尚可治疗,痂皮脱落后的喉痛则是余毒所致。胡言乱语初起时为重证,痂皮脱落时出现为凶兆。若出现神志丧失,则无法治愈。
呻吟:属凶兆。若是化脓期因疼痛而呻吟,程度不严重者,不妨碍预后。
呃逆(哕声):属凶兆。初起时因毒火上冲,尚可治疗。化脓后胃气虚弱或痂后余毒未清,再兼声音嘶哑、不能进食,则是胃气败绝,无法治愈。
努气(用力屏气/气上冲):属凶兆。这是丹田无根之气上乘于胸膈所致。
肚疼:初起发热时腹痛是常事。若疼痛不止,腰部僵硬难以伸直,痘疹发不出来及颜色惨暗者,属凶兆。痂皮脱落后的腹痛是余毒所致,如疼痛极度难以忍受,则为大凶。
十指冷:属凶兆。
腰痛:初起时轻微疼痛,属常事。若疼痛剧烈难以站立,并持续疼痛不止者,无法治愈,这是因为肾经受损所致。
手摇:属凶兆。
足摇:属凶兆。但在化脓疼痛期间及灌脓时,因虚弱而略有颤动者,无妨。
眼出血:无法治愈。
足冷:属凶兆。若寒冷超过膝盖,则无法治愈。
鼻衄(流鼻血):无大碍,但出血量多为宜(注:此处原文“但宜甚耳”在痘疹语境下通常指气血外泄以解毒,或指若不出血反危,结合上下文“无事”,理解为少量或适量出血无妨,或依字面直译为“但出血较多也无妨/需关注”,鉴于中医痘疹理论中鼻衄有时为热随血解,故译为“无大碍,但需注意出血情况”或保留原意“无大碍,但出血多亦无妨”)。*修正:根据冯氏锦囊语境,鼻衄在痘疹中若不过度,可视为邪有出路,故曰“无事”。*
尿血:无法治愈。
口吐血:因呛咳损伤胃脘,仅吐出少许者,可治。若出血量大及血色黑者,无法治愈。
便血:血色鲜红且量少,并能立即停止者,以及痘疹倒靥之后排出带脓血的粪便者,均可治愈。若出血严重及血色黑者,无法治愈。
挫喉(咽喉肿胀闭塞感):初起发热时出现,属凶兆。若化脓时浆液充足,则无妨。
寒战:七日前表现为发热,七日后表现为恶寒,应当结合痘疹症状综合判断吉凶。
切牙(磨牙):在痘疹起胀阶段出现,属凶兆。
蛔虫:初起时吐出一两条,无大碍。吐出多条者属凶兆,十三四日吐出蛔虫者,即死。从大便排出多条者亦属凶兆。
吐脓痰:无大碍。若见到腥臭气味者,应预防肺痈,其验证标准为必然伴有胸痛、嘴唇白、面色惨淡。
吐臭痰:无法治愈。呕吐出恶臭气味者,属凶兆。
惊搐(惊厥抽搐):初起时无大碍,这是痘毒从心经外出,反而是佳兆。若在化脓后或收靥后出现,则是气血已竭,神无所依,大凶。
手足痛:初出时出现属凶兆,八九日后无大碍。
手心痛:属热证。
耳出血:无法治愈。
吐清水:无大碍。但若严重,则会大伤元气,属于虚寒证。
泄白粪:属寒证。
红粪(便血或红色粪便):属热证。
泄青粪:属寒证。
泄黑粪:脏腑败坏,无法治愈。
不食:初起时不妨碍,但在贯浆期及痂皮脱落期出现,属凶兆。
能食:始终为吉兆。若痂皮脱落后食欲倍增,则是余毒未清。
十指痛:属凶兆。
头冷:无法治愈。
唇干:凡此症及唇裂者,属凶兆。
胸高(胸部隆起):胸部突起如盏状者,属凶兆。
吐黄水:腹部不疼痛者,无大碍。若伴有腹痛,则属凶兆。
Headache: Appearing during the initial fever is a normal occurrence.
Eye closure: Incurable if appearing when the pustules first emerge. If there are no issues on the 8th or 9th day, but severe internal collapse occurs on the 13th or 14th day, it is dangerous.
Cough: Cough accompanying smallpox/rash is common. However, it should not be excessive, and hoarseness with choking is contraindicated.
Pain in chest and heart: A ominous sign.
Shortness of breath/Asthma: Ominous if occurring during the initial fever. Mild wheezing on the 8th or 9th day is harmless, provided it does not become too急促 (rapid/severe). If急促气喘 (rapid panting) occurs on the 13th day, it indicates death.
Hoarseness: Incurable if appearing at the onset. It is auspicious only if caused by pustules within the throat and hypertrophy of internal tissues corresponding to external pustules that are red, vibrant, and moist without withered or dark colors. Hoarseness after scab falling is ominous. If accompanied by shortness of breath, it remains incurable throughout.
Sore throat: Difficult to treat initially. Treatable by the 8th or 9th day; sore throat after scab falling is due to residual toxins. Delirium is severe initially and ominous after scab falling. Loss of consciousness is incurable.
Groaning/Moaning: An ominous sign. However, groaning due to pain during the suppuration phase is acceptable if not severe.
Hiccups/Belching: An ominous sign. Initially, due to toxic fire rushing upward, it is treatable. After suppuration, if stomach qi is weak, or after scab falling with residual toxins, combined with hoarseness and anorexia, it indicates failure of stomach qi and is incurable.
Straining/Qi rushing up: An ominous sign. This refers to rootless qi from the Dantian rushing up to the chest.
Abdominal pain: Abdominal pain during initial fever is common. If pain persists, the waist is stiff and difficult to straighten, pustules fail to erupt, and color is pale/dark, it is ominous. Abdominal pain after scab falling is due to residual toxins; if extremely painful and unbearable, it is severely ominous.
Coldness of ten fingers: An ominous sign.
Lower back pain: Slight pain at onset is common. If pain is severe, making standing difficult, and persists incessantly, it is incurable, as this results from damage to the Kidney meridian.
Shaking of hands: An ominous sign.
Shaking of feet: An ominous sign. However, slight trembling during the pain of suppuration or while filling with pus, due to deficiency, is acceptable.
Bleeding from eyes: Incurable.
Coldness of feet: Ominous. If coldness extends above the knees, it is incurable.
Epistaxis (Nosebleed): Harmless, though excessive bleeding requires attention.
Blood in urine: Incurable.
Vomiting blood from mouth: Caused by injury to the stomach region due to choking; if only a small amount is vomited, it is treatable. If severe or black, it is incurable.
Blood in stool: Fresh blood that is scant and stops immediately is treatable. Also, pus and blood discharged after the inversion of scabs is treatable. If severe and black, it is incurable.
Throat obstruction/swelling: Ominous during initial fever. Harmless if sufficient fluid/pus is present during the suppuration phase.
Chills: Fever before the 7th day and chills after the 7th day require assessment based on rash symptoms to determine prognosis.
Teeth grinding: Ominous during the swelling phase.
Roundworms: Vomiting one or two worms initially is harmless. Many worms is ominous. Vomiting worms on the 13th or 14th day indicates death. Passing many worms via stool is also ominous.
Expectorating purulent sputum: Harmless. If foul-smelling, watch out for Lung Abscess (Fei Yong), verified by chest pain, white lips, and pale face.
Expectorating foul sputum: Incurable. Vomiting foul odor is ominous.
Convulsions/Startle: Harmless initially, as it indicates toxin exiting through the Heart meridian, which is actually a good sign. If occurring after suppuration or scabbing, it indicates exhaustion of Qi and Blood with spirit having no foundation, which is severely ominous.
Pain in hands and feet: Ominous upon eruption, harmless after the 8th or 9th day.
Pain in palm of hand: Indicates Heat syndrome.
Bleeding from ears: Incurable.
Vomiting clear water: Harmless. However, if severe, it damages Yuan Qi significantly and indicates Deficiency-Cold.
White diarrhea: Indicates Cold.
Red stool: Indicates Heat.
Green diarrhea: Indicates Cold.
Black diarrhea: Indicates destruction of Zang-Fu organs, incurable.
Anorexia: Acceptable initially. Ominous during the fluid-filling phase and after scab falling.
Appetite: Auspicious throughout. Excessive appetite after scab falling indicates residual toxins.
Pain in ten fingers: An ominous sign.
Coldness of head: Incurable.
Dry lips: Lips dryness and cracking are ominous signs.
High chest/Chest protrusion: Chest protruding like a cup is ominous.
Vomiting yellow fluid: Harmless if abdomen is not painful. Ominous if accompanied by abdominal pain.