一痘当靥而遍身未见稠脓，惟口唇上下痘先黄熟者，是毒瓦斯内攻于脾也。并诸痘未
靥而口唇先腐烂，及唇白到舌者，并皆不治。一痘至收靥，口中无物而空嚼不止者，
死。一面部肚腹未靥而脚先靥者，不治。盖阴胜于阳也。一遍身臭烂而不可近，痰雍气
促，目闭无神者，死。一发痒抓破而不见脓血，皮倦如豆谷干者，不治。一将靥而寒战
切牙，手足摇动，噤口目闭，腹胀足冷过膝者，不治。一遍身难靥尚存数粒不靥者，犹
有杀人如蛇蜕皮一节被伤，退不全者，终死。故不可不慎。若至项下，或至胸前而任
定不靥，服药不效者，胸为受气之所，是气血亏尽也，不治。一痘皮薄而软，色白如梅
花片子，靥薄易落，疤白血枯者，此为假靥，必十一二日，毒瓦斯内攻而死，急进温补
气血。如有泄泻喘渴，腹胀寒战切牙者，不治。一两腮干硬，按之如石者，及泄泻不
止，遍身渍烂，而声哑足冷者，死。一呛水夫声，或干呕不止，痂皮不脱不思饮食，昏
愦闷乱者死。一牙龈腐烂，臭不可近者，是谓胃烂也，不治。一凡病后弄知者凶。一痘
后伤风伤食，而即瘦脱者，不治。盖脾主肌肉，是土崩脾败也。
阴阳界限在人中，任督分来上下通，宜向此中渐收靥，阴阳相济得和衷。
阴阳相济得相成，阴寡阳孤势不行，不信但观头与足，痘疮难靥理分明。
莫言收靥已无邪，不疾不徐方始佳，太骤只防余毒壅，太迟溃烂不成痂。
疮臭须知有几般，时人莫把混同谈，方脓见此为凶兆，靥目当知作吉看。
待到浑身脓水干，时人忽略息心潜，不知禁忌多翻变，一篑功亏九仞山。
收靥休将日数拘，几曾根据闵不差殊，但凭本痘分疏密，且向其人论实虚。
但到收时脓自干，收藏敛束贵周圆，莫教溃烂痂皮嫩，至此还将倒靥看。
收靥原来贵整齐，臭腥溃烂是凶时，过期见此还为顺，人及而然作逆推。
当痘疮应当结痂时，如果遍身都没有看到稠密的脓液，只有口唇上下的痘先变黄成熟，这是毒气内攻于脾脏的表现。并且所有痘疮未结痂而口唇先腐烂，以及嘴唇白到舌头的情况，都属于不治之症。
痘疮到了收靥（结痂）阶段，口中没有实物却空嚼不止的，死亡。
面部和肚腹的痘还未结痂，而脚部的痘先结痂的，不治。这是因为阴气胜过阳气。
遍身痘疮臭烂得让人无法靠近，痰多壅塞、气息急促，眼睛闭合且无神气的，死亡。
痘疮发痒被抓破后不见脓血，皮肤松弛干枯像豆谷一样干瘪的，不治。
即将结痂时出现寒战、咬牙，手足摇动，牙关紧闭、眼睛闭合，腹胀且脚冷超过膝盖的，不治。
遍身痘疮难以结痂，还剩下几粒不结痂的，这就像蛇蜕皮时有一节被损伤，退得不完全，最终会死亡。所以不可不谨慎。
如果痘疮至颈部以下，或至胸前部位任其定住而不结痂，服药无效的，胸部是受气之所，说明气血已经亏耗尽，属于不治之症。
痘皮薄而软，颜色白如梅花片，结痂薄易脱落，留下的疤痕白色、血液枯竭的，这叫“假靥”，必然在十一二日内因毒气内攻而死，急需进服温补气血的药物。
两侧腮部干燥坚硬，按起来像石头一样，以及泄泻不止，遍身浸渍腐烂，声音嘶哑、脚冷的，死亡。
呛水发出声音，或干呕不止，痂皮不脱落、不想饮食，神志昏乱闷躁的，死亡。
牙龈腐烂，气味臭不可近闻的，这叫“胃烂”，不治。
凡是病后出现弄舌（伸舌玩弄）情况的，凶险。
痘疮后伤风或伤食，随即身体消瘦脱力的，不治。这是因为脾主肌肉，这是土崩脾败的表现。
阴阳界限位于人中穴，任脉与督脉分自上下相通，适宜在此处逐渐收靥，使阴阳相互济助达到和谐。
阴阳相互济助才能相成，阴少阳孤则势难运行，不信只看头与足，痘疮难结痂的道理就很分明。
不要说收靥阶段已经没有邪气，不快不慢才是最佳状态，太急只防备余毒壅滞，太迟则溃烂不能结成痂皮。
疮疡臭气需要知道有几种，世人不要把各种情况混同谈论，正在化脓时见此为凶兆，结痂时应知作为吉兆看待。
等到浑身脓水干涸时，世人往往忽略而松懈心神，不知道禁忌多有变化，一筐土的功夫差一点就会像九仞高的山功亏一篑。
收靥不要拘泥于日数，何曾根据标准不差丝毫，只需根据本痘的疏密分布，并且针对病人的虚实情况进行论治。
到了收靥的时候脓自然干涸，收藏敛束贵在周全圆满，不要让溃烂嫩痂受损，至此还要观察是否有倒靥（痘疮塌陷）的情况。
收靥原本贵在整齐，臭腥溃烂是凶险之时，过期见此情况还算顺证，人若不及此时发生则推定为逆证。
When the smallpox pustules should be scabbing over, if no dense pus is seen all over the body, but only those around the mouth and lips turn yellow and mature first, this indicates that the toxic qi has attacked the Spleen internally. Furthermore, cases where all pustules have not yet scabbed over while the lips are rotting first, or where the lips are white extending to the tongue, are all considered incurable.
If at the stage of scabbing over, the patient chews emptily without anything in the mouth, death ensues.
If the pustules on the face and abdomen have not yet scabbed over, but those on the feet scab first, it is incurable. This is because Yin prevails over Yang.
If the pustules all over the body are foul and putrid to the point of being unbearable, accompanied by phlegm obstruction, shortness of breath, closed eyes, and lack of spirit, death ensues.
If the pustules itch, are scratched open, reveal no pus or blood, and the skin becomes flaccid and dry like shriveled beans or grains, it is incurable.
Just before scabbing over, if there are rigors, teeth grinding, trembling of hands and feet, locked jaw with closed eyes, abdominal distension, and coldness of the feet extending above the knees, it is incurable.
If most pustules fail to scab over, leaving a few remaining unscabbed, this is akin to a snake shedding its skin where one segment is damaged and does not shed completely; ultimately, death will occur. Therefore, caution is essential.
If the pustules reach below the neck or to the chest and remain stationary without scabbing, and medication proves ineffective, since the chest is the residence of Qi, this indicates that both Qi and Blood are exhausted, making it incurable.
If the pustule skin is thin and soft, white as plum blossom petals, scabs thinly and falls off easily, leaving white scars with dried blood, this is called "false scabbing" (Jia Ye). Within eleven or twelve days, toxic qi will attack internally leading to death; urgent administration of decoctions to warm and tonify Qi and Blood is required.
However, if accompanied by diarrhea, wheezing and thirst, abdominal distension, and rigors with teeth grinding, it is incurable.
If both cheeks are dry and hard, feeling like stone upon pressure, along with incessant diarrhea, generalized maceration and rotting, hoarseness, and cold feet, death ensues.
If there is choking sound when drinking water, or incessant dry retching, failure of scabs to detach, loss of appetite, and mental confusion or restlessness, death ensues.
If the gums rot and emit an odor too foul to bear, this is termed "rotten Stomach," which is incurable.
Any case showing tongue protrusion and playfulness after illness is ominous.
If after smallpox, wind-cold or food stagnation leads to immediate emaciation and debility, it is incurable. This is because the Spleen governs muscles, indicating a collapse of Earth and failure of the Spleen.
The boundary between Yin and Yang lies at the Renzhong (GV26) acupoint, with the Ren and Du meridians connecting from above and below. It is appropriate for scabbing to gradually occur here, allowing Yin and Yang to assist each other to achieve harmony.
Yin and Yang assisting each other leads to mutual completion; if Yin is deficient and Yang isolated, the vital force cannot circulate. If you do not believe this, observe the head and feet; the principle of difficult scabbing in smallpox becomes clear.
Do not say that no pathogenic factors remain during the scabbing phase; neither too fast nor too slow is ideal. Too rapid risks accumulation of residual toxins; too slow leads to ulceration preventing scab formation.
One must know the different types of foul odors from sores; laypeople often confuse them. Seeing this during suppuration is an evil omen, whereas seeing it during scabbing should be regarded as auspicious.
When the pus dries up all over the body, people often neglect this stage and relax their vigilance. Not knowing that taboos frequently change, one may fail at the last step, just as a nine-ren-high mountain fails due to a basket of earth left unfinished.
Do not rigidly adhere to specific days for scabbing; standards vary. Instead, assess the density of the original pustules and discuss the deficiency or excess constitution of the patient.
At the time of scabbing, pus naturally dries; retention and gathering should be complete and round. Do not allow ulceration or damage to tender scabs; at this stage, also check for inverted scabbing (Dao Ye).
Scabbing is originally prized for its neatness; foul smell and ulceration indicate a perilous time. If these signs appear after the expected period, it may still be considered a favorable progression; if they appear prematurely, they are deduced as adverse reversals.