夫诸阳之会，在于头，心之华，在于面，痘为阳毒，而心主之，是以痘疮头面少
者轻，头面稠密者重，头面预肿者危，头面疮破烂腥臭者，凶。故古疮之轻重，莫如头
也。况人之一身，内则心为君主，外则头为元首，病有真心痛真头痛，为不可治者，以
见不可轻犯也，《经》曰∶头者，精明之府，头倾视深，神将夺矣。故占人之生死，亦莫
如头也。又曰∶十二经脉，三百六十五络，皆上走于面而走空窍，肝开窍于目，肺开窍
于鼻，脾开窍于口，心肾开窍于耳。面有七窍，内应于心，故疮密稠，七窍闭塞败面
者，凶，以脏腑经络之气皆病也。故痘疮初出，先从他处见标，渐登于头，其起发灌脓
收靥皆然，而头面独稀者，或两颧、两颐先见，渐及额角者，皆佳兆也。若于头额之间
先出现，先戴浆，先干收，先破损，谓之毒参阳位，且其疮稠密无缝，肉下浮肿，皮上
溅起粗肤者，此皆凶兆。若疮遍身先收，而头足两处迟收，或脓热自破者，堆结聚
者，不须怪之，盖天地之化，孤阳不生，孤阴不长，阳变阴合，彼此相成。头者，诸阳
之会，无阴相济，所以难成，治宜养阴济阳，则自收矣。若目闭摇头，痂落气秽者，
是心脉已绝，及头肿痘不肿者，俱为不治。
夫面者，诸阳所聚。痘为阳毒，故初出之时，似火就燥，必先于面，然部位不同吉
凶迥异。如额属心离火之位，火性急烈，不可轻犯，若毒发于心，则先见于位君，危则
十二官皆危。凡出现泡浆干收，先从额上起者，凶。左颊属肝，震木之位，右颊属肺，
兑金之位，其二处不论先后，但宜 红疏朗，磊落坚浓者，吉。若模糊成块浮嫩易
破，溃烂肉肿者，凶。若黑陷干冷，硬如木块者，不治。盖肝藏魂，肺藏魄。肝肺俱
败，魂魄皆离，故凡病两腮冷，或木硬者，死。准头先出先靥者，凶。盖鼻属脾而脾属
土，四脏皆禀命于脾，令毒发于脾，则四脏相随而亦败矣。两颐如胭脂之色，或如橘皮
之红者，不抬。更下颏属肾，坎水之位，此处先出先壮先靥者，吉。盖痘疹出于肾则
吉，入于肾则凶。且三阴三阳之脉，皆聚于此，故阴阳和而自出也。然耳亦肾窍，而诸
候不宜先者，盖位与窍不同，且心又开窍耳，则君相二火用事，燔灼之势，虽加扑灭
也。口唇四围，两颐先出，先起先靥者，大吉。盖阳明之脉，挟口环唇，胃与大肠主
之，积陈受朽，气血俱多，唇口又为水星，颏颐又属肾水，火为水制，自然不能肆疟，
故为吉也。若夫手足虽属于脾，为诸阳之本，然为身所役使，如卒伍卑贱之职，非若
头面元首，不可犯也。况居四末，菲若胸膈心肺之居，神明之舍也。故虽稠密，无大害
耳，但先起先脓先收者，此阳火太旺，宜用解毒，抑阳扶阴。如略迟起迟收者，此应候
也。如迟太过者，此脾胃虚弱，不能营运气血，达于手足耳。宜用大补脾元，以杜水泡
痒塌之患。
头部是诸阳经交汇之处，面部是心气外荣的表现。痘疮属于阳毒，由心所主，因此痘疮在头面部位稀疏的病情较轻，头面部位稠密的病情较重，头面预先肿胀的病情危险，头面疮疡破溃流脓且气味腥臭的，预后凶险。所以古代判断痘疮轻重，没有比观察头面更重要的了。况且人的身体，内部以心为君主，外部以头为元首，疾病中有真心痛和真头痛，属于不可治疗的病症，以此可见头面部位不可轻易侵犯。《黄帝内经》说：头是精明之府，如果头低垂、眼窝深陷，说明神气即将被剥夺。所以古人占测生死，也没有比观察头面更重要的了。又说：十二经脉，三百六十五络脉，都上行至面部并通达五官九窍，肝开窍于目，肺开窍于鼻，脾开窍于口，心肾开窍于耳。面部有七窍，内应于心，所以如果痘疮稠密导致七窍闭塞、面容败坏，属于凶兆，这是因为脏腑经络之气都已受病。所以痘疮初出时，先从其他部位出现标志，逐渐蔓延到头面，其起发、灌脓、收靥（结痂）都是如此，而头面部位唯独稀疏的，或者两颧、两颊先出现，逐渐波及额角部位的，都是佳兆。如果在头额之间先出现，先戴浆（化脓），先干燥结痂，先破损，这叫做毒邪侵犯阳位，而且如果疮疡稠密无缝，皮下浮肿，皮肤表面溅起粗糙肤质的，这些都是凶兆。如果全身疮疡先收靂，而头足两处收靲迟缓，或者脓液过热自行破溃，堆积凝结的，不必奇怪，因为天地造化之道，孤阳不能生长，孤阴不能发育，阳变阴合，彼此相成。头是诸阳之会，如果没有阴气来济助，所以难以成熟，治疗应当滋养阴气以济助阳气，自然就能收靲。如果出现眼睛闭合、摇头、痂皮脱落且气息秽浊的，这是心脉已绝，以及头肿而痘不肿的，都属于不治之症。
面部是诸阳经汇聚的地方。痘疮是阳毒，所以在初出之时，像火趋向干燥物体一样，必定先在面部出现，然而不同部位的吉凶截然不同。比如额头属于心离火之位，火性急烈，不可轻犯，如果毒邪发于心，则首先见于君位，危险时十二官（五脏六腑）都会危险。凡是出现水泡、化脓、干燥结痂，先从额头开始的，属凶。左颊属于肝，震木之位，右颊属于肺，兑金之位，这两个部位不论先后，只要红疏朗、磊落坚浓的，属吉。如果模糊成块、浮嫩易破，溃烂肉肿的，属凶。如果黑陷干燥寒冷，硬如木块的，属不治。因为肝藏魂，肺藏魄。肝肺都败坏，魂魄都离散，所以凡是病见两腮冷或木硬的，死亡。准头（鼻尖）先出先结痂的，属凶。因为鼻属脾而脾属土，四脏都禀命于脾，如果毒邪发于脾，则四脏相随而也都败坏。两颊像胭脂色，或者像橘皮红的，不抬举（指不起发）。下巴属于肾，坎水之位，这个部位先出、先壮实、先结痂的，属吉。因为痘疹出于肾则吉，入于肾则凶。而且三阴三阳之脉，都汇聚于此，所以阴阳调和而自然发出。然而耳朵也是肾窍，而其他征候不宜先出现的，因为位置与窍穴不同，且心也开窍于耳，则君火相火用事，燔灼之势，虽然加以扑灭也无益。口唇四周，两颊先出、先起发、先结痂的，大吉。因为阳明经脉，挟口环唇，胃与大肠主之，积陈受朽，气血俱多，唇口又是水星，下巴两颊又属肾水，火被水制约，自然不能肆虐，所以为吉。至于手足虽然属于脾，为诸阳之本，但为身体所役使，如同卒伍卑贱的职位，不像头面是元首，不可侵犯。况且居于四肢末端，菲薄不如胸膈心肺所在的神明之舍。所以即使稠密，也没有大害，只是先起发、先化脓、先收靲的，这是阳火太旺，宜用解毒，抑阳扶阴。如略迟起发、迟收靲的，这是顺应时令。如果延迟太过，这是脾胃虚弱，不能营运气血，达于手足。宜用大补脾元，以防止水泡、瘙痒、塌陷的祸患。
The head is the convergence point of all Yang meridians, and the face is the manifestation of the Heart's splendor. Smallpox (Xiaochu) is a Yang toxin governed by the Heart; therefore, sparse lesions on the head and face indicate a mild condition, dense lesions indicate a severe condition, pre-swelling of the head and face indicates a critical condition, and lesions that are broken, suppurating, and foul-smelling indicate a dire prognosis. Thus, in ancient times, the severity of smallpox was judged primarily by the head. Moreover, within the body, the Heart is the monarch, and externally, the head is the chief. Diseases such as True Heart Pain (Zhen Xintong) and True Headache (Zhen Toutong) are considered incurable, demonstrating that the head and face must not be lightly offended. The *Classic* states: "The head is the mansion of clarity and spirit; if the head hangs low and the eyes are sunken, the spirit is about to be seized." Therefore, when prognosticating life and death, nothing is more important than observing the head. It is also said that the Twelve Primary Meridians and the three hundred and sixty-five collaterals all ascend to the face and open into the orifices. The Liver opens into the eyes, the Lungs into the nose, the Spleen into the mouth, and the Heart and Kidneys open into the ears. The face has seven orifices and internally corresponds to the Heart. Thus, if dense lesions cause the closure of the seven orifices and disfigurement of the face, it is a bad omen, indicating that the Qi of the Zang-Fu organs and meridians is diseased. When smallpox first appears, it typically marks other areas before gradually ascending to the head; this progression applies to its eruption, suppuration, and crusting (Shouye). If the head and face are uniquely sparse, or if the two zygomatic arches and cheeks appear first and gradually spread to the forehead corners, these are all auspicious signs. However, if lesions appear first between the head and forehead, crust over first, dry up first, or break first, this is called "toxin invading the Yang position." If the lesions are densely packed without gaps, with subcutaneous edema and rough, raised skin texture, these are all ominous signs. If lesions on the entire body crust over first, while those on the head and feet crust late, or if pus breaks spontaneously due to heat, or piles up and aggregates, do not be surprised. This follows the transformation of Heaven and Earth: solitary Yang cannot generate, solitary Yin cannot grow; Yang changes and Yin combines, mutually supporting each other. The head is the convergence of all Yang; without Yin to assist it, maturation is difficult. Treatment should nourish Yin to assist Yang, after which crusting will occur naturally. If the eyes are closed, the head shakes, scabs fall off, and the breath is foul, the Heart meridian pulse has ceased. Similarly, head swelling without corresponding lesion swelling is incurable.
The face is where all Yang meridians gather. Since smallpox is a Yang toxin, upon initial eruption, like fire tending toward dryness, it must first appear on the face. However, different locations have vastly different prognoses. The forehead belongs to the Heart and the Li Fire position; Fire nature is urgent and fierce, so it must not be lightly offended. If toxin erupts from the Heart, it first appears at the ruler's position; if dangerous, the twelve officials (Zang-Fu organs) will all be endangered. If vesicles, pustules, and crusting begin first on the forehead, it is inauspicious. The left cheek belongs to the Liver and the Zhen Wood position; the right cheek belongs to the Lungs and the Dui Metal position. In these two areas, regardless of order, if they are red, sparse, clear, firm, and thick, it is auspicious. If they are blurred into clumps, floating, tender, easily broken, ulcerated, and swollen, it is inauspicious. If they are black, depressed, dry, cold, and hard like wood blocks, it is incurable. The Liver stores the Hun (Ethereal Soul), and the Lungs store the Po (Corporeal Soul). If both Liver and Lungs fail, both souls depart. Thus, if both cheeks become cold or woody-hard, death ensues. If the tip of the nose (Zhuntou) erupts and crusts first, it is inauspicious. The nose belongs to the Spleen, which governs Earth; the four Zang organs receive orders from the Spleen. If toxin erupts from the Spleen, the four Zang organs follow and fail. If the cheeks resemble rouge or orange peel redness but do not elevate, it is unfavorable. The chin belongs to the Kidney and the Kan Water position. If lesions here erupt first, become robust first, and crust first, it is auspicious. Smallpox emerging from the Kidney is auspicious; entering the Kidney is inauspicious. The Three Yin and Three Yang meridians all converge here, so when Yin and Yang harmonize, eruption occurs naturally. However, the ears are also Kidney orifices, and other signs should not appear first. This is because location and orifice differ, and since the Heart also opens into the ears, Ministerial Fire and Sovereign Fire are active. Their burning intensity, even if suppressed, causes harm. If the area around the lips and the cheeks erupt, rise, and crust first, it is highly auspicious. The Yangming meridians surround the mouth and lips, governed by the Stomach and Large Intestine, which accumulate and transform, possessing abundant Qi and Blood. The lips and mouth are the Water Star, and the chin and cheeks belong to Kidney Water. Fire is controlled by Water, preventing it from running rampant, hence it is auspicious. Although the hands and feet belong to the Spleen and are the root of all Yang, they are servants of the body, like low-ranking soldiers, unlike the head and face which are the chief and must not be offended. Furthermore, residing at the four extremities, they are inferior to the chest and diaphragm where the Heart and Lungs reside, the abode of Spirit. Thus, even if dense, they pose little danger. If they erupt, suppurate, and crust first, this indicates excessive Yang Fire; treatment should use detoxification to suppress Yang and support Yin. If they erupt and crust slightly late, this conforms to the seasonal timing. If too delayed, this indicates Spleen and Stomach deficiency, unable to circulate Qi and Blood to the extremities. Treatment should strongly tonify the Spleen Yuan to prevent complications such as water blisters, itching, and collapse.