凡痘发热温和，或乍凉乍热，数日见点，粗肥颜色红活，按之碍手，肉内有根核
者，吉。如热不多时一齐涌出，或头额先见，按之无根者，凶。有肌肉微肿，状如堆
粟不分颗粒者，此气滞血凝，毒瓦斯郁结也。有初出红点渐变黑色，其硬如石者，此肌肉
已败，气血中虚，不能载毒而出，反致陷伏也。有中心黑陷，四畔突起戴浆者，此血随
毒走，气不为用也。有中心载浆，四畔干陷焦黑者，此气附毒出，血不为使也。有头戴
白浆，自破溃烂者，此气血不充皮肤败坏也。有为水泡溶溶易破者，此火湿并行，气
虚不能敛束也。有为血泡，色紫易破者，此血热妄行，不能自附于气也。有疮头针孔，
浆水自出者，此卫气已败，其液外脱也。并为不治。
卫气者，昼则行阳，夜则行阴，行阳则寤，行阴则寐，人之常也。凡疮疹发热，便
昏肿者，盖心主热而脾主困，夫心受气于脾，故发热昏睡，此常候也。但起卧不时
者，内有热也。必多陷伏之变。如合面而卧者，是里热也。总之，疮疹始终安寝者，
吉。盖气血强盛，荣卫流行则邪出于表而不在里，故乃神安，神安则志定，是以得安寝
也。若气血衰弱，荣卫滞涩，则邪在里而不在表，故乃内热，盖心恶热，热则神不安，
神不安则志不宁，是以烦燥闷乱，谵妄而不得眠也。更有痘后而毒伏于中，是以神丧气
脱，僵卧如尸，呼之不应，饮食不知者，是为死痘，又不可作安寝论也。
凡是痘疹发热温和，或者忽冷忽热，经过几天后出痘点，痘粒粗大丰满、颜色红活润泽，按压时有碍手感，且痘根在肌肉内有坚实核感的，属于吉兆。如果发热时间不长就一齐涌出，或者头额部位先出现痘点，按压时没有根基的，属于凶兆。有的痘疹肌肉轻微肿胀，形状像堆积的粟米而分不出颗粒，这是气机阻滞、血液凝涩，毒邪郁结所致。有的初起为红点，逐渐变为黑色，质地坚硬如石头，这是肌肉已经败坏，气血虚弱，不能托举毒邪外出，反而导致毒邪内陷伏留。有的痘中心黑陷，四周边缘突起并带有脓浆，这是血液随着毒邪走散，气机失去统摄作用。有的痘中心充满脓浆，四周边缘干枯下陷、焦黑，这是气依附于毒邪外发，但血液不能随之运行。有的痘头顶着白浆，自行破裂溃烂，这是气血不充盈，皮肤败坏所致。有的变成水泡，溶溶易破，这是火邪与湿邪并行，气虚不能收敛固摄。有的变成血泡，颜色紫暗易破，这是血热妄行，血液不能依附于气。有的疮头呈针孔状，浆水自行流出，这是卫气已经败坏，体液外脱。以上这些情况都属于难以治愈的病症。
卫气，白天运行于阳分，夜晚运行于阴分，运行于阳分则清醒，运行于阴分则睡眠，这是人体的常态。凡是疮疹发热，同时出现昏沉肿胀的，大概是因为心主热而脾主困倦，心受脾气的影响，所以出现发热昏睡，这是常见的征候。但是起卧不安时的，说明体内有热。必然会出现多发的内陷伏留之变。如果是脸朝下趴着睡的，是里有热邪。总之，疮疹从头到尾都能安稳睡眠的，属于吉兆。这是因为气血强盛，营卫之气流通顺畅，那么邪气出于体表而不留在体内，所以神志安宁，神志安宁则意志安定，因此能够安稳睡眠。如果气血衰弱，营卫之气滞涩不畅，那么邪气留在体内而不在于体表，所以产生内热，因为心厌恶热邪，热邪扰动则神志不安，神志不安则意志不宁，因此烦躁闷乱，胡言乱语而不能入睡。更有痘疹之后毒邪潜伏在中焦，导致神气丧失、元气脱失，僵卧如同尸体，呼叫不应，不知饮食，这称为死痘，又不可当作安稳睡眠来论述。
When the smallpox (or variola) presents with mild fever, or alternating chills and fever, and after several days the spots appear, if they are coarse, plump, red and vibrant in color, feel rough to the touch, and have a solid root within the flesh, it is auspicious. If the fever lasts only briefly before all spots erupt simultaneously, or if they first appear on the forehead and feel rootless upon palpation, it is ominous. If there is slight swelling of the muscles, resembling piled millet grains without distinct individual spots, this indicates Qi stagnation and Blood coagulation, with toxic factors郁结 (accumulating). If the initial red spots gradually turn black and become hard as stone, this signifies that the muscle tissue has already deteriorated; due to deficiency of Qi and Blood, the body cannot carry the toxin out, leading instead to sinking and伏留 (retention). If the center of the spot is black and sunken while the surrounding edges protrude and contain pus, this indicates that Blood follows the toxin but Qi fails to exert its controlling function. If the center contains pus while the surrounding edges are dry, sunken, and scorched black, this indicates that Qi attaches to the toxin to emerge, but Blood fails to follow as its guide. If the top of the sore bears white pus and ruptures spontaneously into ulceration, this is due to insufficient Qi and Blood and deterioration of the skin. If it forms blisters that are fluid-filled and easily broken, this indicates concurrent Fire and Dampness, with Qi deficiency failing to consolidate and bind. If it forms blood blisters that are purple and easily broken, this indicates reckless movement of Heat in the Blood, which cannot adhere to Qi. If the sore head resembles a needle hole with serum oozing out, this signifies that Wei Qi (Defensive Qi) has failed and body fluids are escaping externally. All these conditions are considered untreatable.
Wei Qi (Defensive Qi) circulates in the Yang aspects during the day and in the Yin aspects at night; circulation in Yang leads to wakefulness, while circulation in Yin leads to sleep, which is the normal state of humans. When sores and rashes present with fever accompanied by lethargy and swelling, it is generally because the Heart governs Heat and the Spleen governs heaviness/stagnation; since the Heart receives Qi from the Spleen, fever and drowsiness occur, which is a common presentation. However, if the patient tosses and turns restlessly, it indicates internal Heat, which inevitably leads to variations of sinking and retention. Sleeping face down indicates interior Heat. In general, if the patient sleeps peacefully throughout the course of the sores and rashes, it is auspicious. This is because strong Qi and Blood allow Ying (Nutritive) and Wei (Defensive) Qi to flow smoothly, causing the pathogenic factor to exit via the exterior rather than remaining in the interior; thus, the Spirit (Shen) is calm. When the Spirit is calm, the will is settled, allowing for peaceful sleep. Conversely, if Qi and Blood are weak and Ying and Wei Qi are stagnant and sluggish, the pathogen remains in the interior rather than the exterior, generating internal Heat. Since the Heart dislikes Heat, Heat disturbs the Spirit, making it restless; when the Spirit is restless, the will is unsettled, leading to irritability, confusion, delirium, and insomnia. Furthermore, if after the eruption of smallpox, toxins remain latent in the middle Jiao, causing the loss of Spirit and depletion of Qi, resulting in rigid lying like a corpse, unresponsiveness to calls, and ignorance of food and drink, this is termed "dead smallpox" and should not be discussed under the category of peaceful sleep.