夫形乃气之充，色乃血之华。形以尖圆，皮浓为吉，皮薄半塌为凶，色以光润红
活为吉，惨黯昏黑为凶。然痘之红活又有红圈、 红、铺红之别，圈红者，一线淡红，
紧附根下而无走散之势，吉之兆也。 红者，血虽似附而根脚血色隐隐出部，险之兆
也。铺红者，病色与肉相平，红铺散漫，凶之兆也。故根窠者，血之晕，脓者血之腐，
六日以前，专看根窠，若无根窠，必不灌脓，六日以后，专看脓色，若无脓色，必难
收靥，此必然之势，不可不详也。
夫包血而成圆者，天之象也，毒出血从气交，则圆必周净，以见气之制毒，得其官
也。附气而成晕者，血之形也，地之象也，
毒出气从血会，则晕必光明，以见血之制毒，得其识矣，此是气血和就，并行祛毒，
邪正自分，痘可不治而自愈，故曰∶真气胜于毒则顺，毒火胜于真则逆，其歪斜陷伏如
麸如 者，皆责之气，晕色浓淡，滋润干枯者，皆责之血。
夫有虚弱痘症，精神倦怠，面青 白者，是气不充，则精神倦怠，血不荣，则面
青白，治则补气不补血者何也？气有神而无形，补之则易充，血有形而无神，补血
之药难收速效，况气阳而血阴，阴从阳。血从气者理也。能使气盛而充，则血自随而亦
旺也。且气虚之症最易发泻，而补血之剂，性能润燥滑下，多用恐致溏泻，补血之效未
得，而气虚之害益深，然有白陷不荣，不得已而用归芍补血之剂，并有痘点繁红，不得
已而用红花紫草，生地活血凉血之药，并宜酒炒，以抑其润下之性，借酒力而行之达
表，则补血凉血之中，犹可升发，达表之妙，庶无润肠溏泻之患矣。惟在真血热者，
则不拘于酒炒，拼扶阴血大虚者，亦不可拘以阴从阳长而独补其气，恐卫分独盛，得以
自专其捩作，而为空壳之患，况补阳气之药，必有碍于阴血之宜。而反愈致其枯涸矣。
形体是气充盈的表现，色泽是血荣华的外显。形体以尖圆、皮厚为吉兆，皮薄且半塌陷为凶兆；色泽以光亮润泽、红润鲜活为吉兆，惨淡晦暗、昏黑为凶兆。然而痘疹的红活又有红圈、红晕、铺红三种区别：红圈者，是一线淡红色，紧贴根部而无扩散之势，这是吉兆；红晕者，血液虽然看似附着，但根脚处血色隐隐透出痘体之外，这是险兆；铺红者，病色与周围肌肉平齐，红色散漫无聚，这是凶兆。所以，痘疮的根窠（痘疮底部的红晕），是血液形成的晕圈；脓液，是血液腐败而成的。六日以前，专门观察根窠，如果没有根窠，必然无法灌脓；六日以后，专门观察脓色，如果没有脓色，必然难以收靥（结痂愈合），这是必然的趋势，不可不详细考察。
由血液包裹而成圆形的，是天之象；毒邪随血外出，从气交合，则圆形必定周正洁净，以此显示气能制约毒邪，得其官守。依附于气而形成晕圈的，是血之形，也是地之象；毒邪随气外出，从血会合，则晕圈必定光明，以此显示血能制约毒邪，得其识见。这是气血调和成就，并行祛除毒邪，邪气与正气自然分明，痘疹可以不治而自愈。所以说：真气胜过毒邪则为顺证，毒火胜过真气则为逆证。那些歪斜陷伏、如麸皮如米粒大小的，都归咎于气的问题；晕色的浓淡、滋润或干枯，都归咎于血的问题。
如果有虚弱型的痘症，精神倦怠，面色青白，这是气不充盈，所以精神倦怠；血不荣养，所以面色青白。治疗时采用补气而不补血的方法，为什么呢？气有神妙作用而无固定形体，补益它就容易充盈；血有固定形体而无神妙作用，补血药物难以收到速效。况且气属阳而血属阴，阴随阳行，血随气走的道理。能使气旺盛而充盈，那么血自然会随之也旺盛。而且气虚的病症最容易引发腹泻，而补血药剂的性能滋润滑利下行，多用恐怕会导致溏泻，补血的疗效尚未得到，而气虚的危害却更加深重。然而，如果有痘疮白陷不荣的情况，不得已而使用当归、芍药等补血药剂；也有痘点繁红的情况，不得已而使用红花、紫草、生地等活血凉血的药物，这些都应该用酒炒制，以抑制其润下之性，借助酒力使其通达体表，那么在补血凉血之中，还可以起到升发、达表的作用，这样才没有润肠导致溏泻的祸患。只有真正属于血热的情况，就不拘泥于酒炒；对于极度阴虚血虚的患者，也不可拘泥于“阴从阳长”的理论而单独补其气，恐怕卫分之气独盛，得以独自专权作乱，从而造成空壳（痘疮无脓）的祸患。况且补阳气的药物，必然会对阴血适宜的状态产生妨碍，反而更加导致枯涸。
The physical form is the manifestation of Qi (Vital Energy) being filled, and the complexion is the splendor of Blood. A sharp and round shape with thick skin is auspicious, while thin skin with partial collapse is inauspicious. A lustrous, moist, red, and vibrant complexion is auspicious, whereas a dull, dark, and lifeless one is inauspicious. However, the redness and vitality of smallpox lesions vary into three types: red halo, red晕 (halo/radius), and spreading redness. The "red halo" presents as a faint red line tightly attached to the base without any tendency to spread, which is an omen of good prognosis. The "red晕" indicates that although the blood seems attached, the color at the root subtly emerges beyond the lesion, which is an omen of danger. The "spreading redness" means the pathological color is level with the surrounding flesh, with redness scattered and diffuse, which is an omen of bad prognosis. Therefore, the *genke* (base/areola of the pustule) is the halo formed by blood, and pus is the corruption of blood. Before the sixth day, one must specifically observe the *genke*; if there is no *genke*, pus formation will inevitably fail. After the sixth day, one must specifically observe the color of the pus; if there is no pus color, healing and scabbing (*shouye*) will be difficult. This is an inevitable trend and must be examined in detail.
The round shape formed by enclosing blood represents the image of Heaven; when toxins exit via blood and interact with Qi, the roundness must be complete and clean, demonstrating that Qi controls the toxin and fulfills its function. The halo shape adhering to Qi represents the form of Blood and the image of Earth; when toxins exit via Qi and converge with Blood, the halo must be bright, demonstrating that Blood controls the toxin and achieves understanding. This signifies the harmony of Qi and Blood, jointly expelling toxins, with evil and righteous energies clearly distinguished, allowing smallpox to heal spontaneously without treatment. Thus it is said: When True Qi surpasses the toxin, the course is favorable (Shun); when toxin-fire surpasses True Qi, the course is unfavorable (Ni). Lesions that are crooked, depressed, or sunken, resembling bran or millet grains, are attributed to Qi disorders. Variations in the depth of the halo's color, whether moist or dry, are attributed to Blood disorders.
In cases of deficiency-type smallpox characterized by mental fatigue and a cyan-white complexion, the fatigue results from Qi insufficiency, and the cyan-white complexion results from Blood failing to nourish. Why does treatment focus on tonifying Qi rather than Blood? Qi possesses spiritual efficacy but lacks fixed form, so tonifying it leads to easy replenishment. Blood has fixed form but lacks spiritual efficacy, so blood-tonifying herbs rarely yield rapid results. Moreover, Qi is Yang and Blood is Yin; Yin follows Yang, and Blood follows Qi. If Qi becomes abundant and full, Blood will naturally follow and flourish. Furthermore, conditions of Qi deficiency are prone to diarrhea. Blood-tonifying agents have lubricating and downward-moving properties; excessive use may cause loose stools. Without achieving the effect of blood tonification, the harm of Qi deficiency would deepen. However, in cases of white, depressed, and non-nourishing lesions, Guizhi Tang (Cinnamon Twig Decoction) [Note: Text says Gui/Shao, likely Danggui/Baishao] blood-tonifying formulas may be used out of necessity. In cases of profusely red lesions, Honghua (Carthami Flos, Safflower), Zicao (Arnebiae Radix et Rhizoma, Arnebia Root), and Shengdi Huang (Rehmanniae Radix, Rehmannia Root) for invigorating blood and cooling blood may be used out of necessity. These should all be stir-fried with wine to suppress their lubricating and downward properties, utilizing the power of wine to reach the exterior. Thus, within blood tonification and cooling, ascending and reaching-the-exterior effects can still be achieved, avoiding the risk of intestinal lubrication and loose stools. Only in cases of true Blood Heat is the wine-frying method not restricted. For patients with severe Yin and Blood deficiency, one cannot rigidly adhere to the principle of "Yin grows from Yang" and solely tonify Qi, lest Wei Qi (Defensive Qi) become excessively strong and act autonomously, leading to the hazard of empty shells (pustules lacking content). Moreover, Qi-warming herbs would inevitably hinder the suitability of Yin Blood, further causing desiccation.