初发悠悠身热。最宜气息和平。饮食甘而便溺如常。手足温而面容不改。兼之睡卧安宁。便
见证来之顺。四肢清而面色 白。饮食少而精神倦怠。此证当作虚看。痘出决然不振。再见便溏
乳。急当补气为宜。若还热甚气粗。定须解毒何疑。谵语狂言烦躁。均为内热。喘满气粗便秘。
须知毒壅。毒盛则头面赤热。气虚则手足寒清。呕吐为火气上炎。溏泻为毒瓦斯下迫。腹胀口张喘
急。啼声不绝嗄频。须防失血。面青札眼摇头。狂乱忽生吐乳。发惊先兆。是以热盛者。只宜清
凉发散。不可峻用苦寒。发散则毒外出而热自解。苦寒则毒反伏而出愈难。故发散之剂。轻则升、
葛以疏其热。而烦躁壮实者。非此何以定其标。重则麻黄以开其壅。而喘急胀满者。非此何以救
其危。未萌先泻。有热证莫作虚看。已泄而渴。无热证便从虚治。止热泄以清凉。重加发散。治
虚溏以温补。仍用开提。内虚误用寒凉。助其作泻。实热妄投补剂。转增烦剧。安静能食。勿谓
便实可下。泄泻烦渴。休言热证宜凉。气弱而少食者。不任其毒。神强而能食者。不失其常。
尝谓痘初见点。便观颜色荣枯。一来便觉粗肥。稀疏可必。始发若还琐屑。繁密堪知。带热
敷疮。陆续出来犹可救。一齐涌出。 经皮薄总难生。细细白头如痱 。干枯必作内攻形。稠稠
红点似丹朱。不久定成焦萎势。粗肥馒顶。点子不红终白陷。头尖皮薄。茱萸纹起定空疮。白嫩
则皮薄娇红。黄瘦则痘成褐色。若人苍黑皮粗。疮色必然惨暗。婴儿肌肉不同。未可一例而断。
只宜绽凸有神。不喜娇红平塌。色泽神安。见点如珠如粟。毛焦皮燥。敷疮或紫或焦。带热
出来。最恐密似针头。纵然续出。尤忌形如蚕种。如麸如 。如疹如疥。根窠不立。脚地俱无。
犯此数端。总皆不救。夹斑如同蚊咬。最为恶烈。乃或螺蛳云电。差为可治。未热先敷数点。俗
名报痘。若还热久不敷。便作疔看。先发块而后发疮。块为风毒所发。先发疮而后发块。块名鬼
肿难医。避痘避于隐僻。眼胞唇内多凶。闷痘闷于要处。喉舌胸背皆危。顺不憎多。逆嫌一点。
冷疔先见。诸疮何敢彰形。贼痘若生。诸痘焉能灌汁。辨认若真。急须挑破。里证未平。痘虽出
而毒犹在里。解毒为务。便调人静。身虽热而毒已透表。安表为先。设使内外证平。此际不须过
治。再看精神勇怯。审详表里如何。
三日四日。痘出当齐。点至足心。势方安定。犹是陆续不齐。尚隐皮肤之内。若非风寒壅遏。
定属气虚不振。是以四日以前。痘毒方出。身表宜凉。四日以后。毒出已定。身表宜温。凉则气
血和平。痘色必然润泽。温则腠理开通。其势易以成浆。故至此而身不微热。色不鲜泽。虽不至
于冰伏。痘疮断乎不长。五六日来。血包已成。候当肥大而粗。顶宜发光而白。故根红而顶白者。
已具行浆之势。若还赤色过头。虽见娇红可爱。绵延六日依然。到头空壳虚花。皮薄而光亮如灯。
内含似水。顶尖而根脚不红。行浆不实。热毒盛而未解。则为紫为黑。壅而不起。则为陷为塌。
滞而不荣。则为干枯为青灰。怯而不振。则为不快为停浆。或有肉先肿而痘反不起者。浆则滞而
不行。面已浮而痘反退伏者。毒则壅而不通。故身不热而痘不起。已成冰硬之形。赤色若还不变。
温之可兴。气血弱而疮不振。遂成不快之状。红润依然如旧。补之可生。紫色干枯。切忌温中带
补。只宜活血松肌。毒势壅滞。烈药虽然可发。透肌尤是良方。溏泄惟于温补。泻甚佐以升提。
六日七日之期。气血敷化之际。顺候浆行半足。虚疮才发微光。毒重而壅遏者。顶滞干红。
气盛而 发者。饱满光泽。头面行浆而四肢未起。切莫慌张。腿 发泡而脸额焦枯。且休欢喜。
既以惧其发呛。且又虑其喘急。饮食不多。恐致脏虚而内陷。水浆频进。须防泄泻而变危。热盛
烦渴。到此休为实论。再加溏泄。此时只作虚看。黑紫干枯。急须攻发其热。气虚塌陷。盒饭温
补其虚。发呛愁其失声。喘急恐其腹胀。疮或白而少神。根虽红而难治。尖不起而离根。脚虽赤
而无济。色淡白而塌阔。此内必无浆汁。皮薄泽而娇红。有浆亦是清稀。犯此四端。总属气虚。
八九日间。必然发痒。若还壮热燎人。不痒定行干燥。紫色干枯。不须着眼。中凝血迹。或可幸
成。浆既行而半足。时则未当收敛。忽尔一齐紫黑。倒 莫认结痂。若还攻发得宜。傍生血点再
行浆。如见气急腹胀。不久失音死在迩。
痘出八九日来。已结干红痂 。（音被）如或少生不顺。
至此方得灌浆。若遇身重发热。停浆不易结痂。此则阳亢阴虚。应以清凉收敛。浆足气促。恐因
痰涌而然。忽尔发惊。毋乃二便秘结。再见气虚塌陷。必然倒 黑焦。一则温补可兴。一则攻发
可活。泄泻安宁。大虚少毒。脾寒则下白脓。脏毒必然便血。唑喉声哑。浆行饱满亦无妨。塌痒
切牙。便实声清犹可活。靥来痂硬。变证终无 脱如麸。须愁余毒。蒸发或致太过。则溃烂难收。
身热若见燎人。则燎浆发泡。空遗痘壳不成痂。只为浆清热重。腹胀喘呼而塌陷。皆因毒入内攻。
出来不灌黄浆。痂 犹如血赤。若曾解毒于先。此证断之极美。胃气绝则唇口肿硬。肝热盛则目
睛吊白。喘急发于泻后。总属气虚。便泻继以烦渴。谅非实热。泄泻而烦渴不止。理必升提。好
饮而发渴愈甚。势难救援。气虚寒战。痘疮无恙即温经。浆足难收。便实热蒸须解利。进清凉以
助结痂。叱补法而防过益。
痘成痂 。八九功成。余毒变迁。终非吉兆。是故眼合腹胀。犹蹈危机。虚浮不退。尚罹凶
咎。痂虽成而反致失声。犹为黑 。肿未退而眼已先开。恐毒内攻。阳气极而狂叫喘呼。肠胃伤
而便溺脓血。热毒逗遛不化。结痂而壮热憎寒。经络余毒未尽。日晡则往来寒热。发在午前为实证。
烦渴腮红。申后方热是阴虚。便调形瘦。他如摄唇弄舌。心经蓄热无疑。撷肚抬胸。肺胃毒冲有
准。身热便秘。恐成暴急惊风。潮热便溏。防变慢脾风搐。验失明于眼合羞明。辨口疳于唇焦龈
黑。实热结于大肠。必然便秘。虚寒客于胃府。乃成泄泻。喘渴须分虚实。泄泻当辨寒热。欲观
痂落之余。再审瘢痕之色。桃红光泽。营卫俱安。灰紫干焦。尚留风热。粉白为气血之虚。皮粘
为脾胃之疾。遍体赤斑。乃是失于解利。浑身青紫。恐为风寒所客。余毒未消。不特为疽为疖。
见风太早。须防发疮发痍。匪人切勿胡传。此本先贤真诀。
初起时身体微微发热，最适宜气息平和。饮食香甜，大小便正常，手足温暖，面色如常，加上睡眠安稳，大便通畅，这属于痘疹发病顺证。如果四肢发凉，面色苍白，饮食减少，精神倦怠，这种证候应当当作虚证来看待。痘疹发出后必然不振作，如果再出现大便稀溏、呕吐乳食的情况，急当以补气为宜。如果热势很重，呼吸粗重，必须解毒，无需怀疑。说胡话、狂言乱语、烦躁不安，都是内热的表现；气喘胸满、呼吸粗重、大便秘结，须知是毒邪壅滞。毒盛则头面部赤热，气虚则手足寒冷清冷。呕吐是因为火气上炎，腹泻是因为毒瓦斯下迫。腹部胀满、口张喘急，啼哭声不止且声音嘶哑频繁，须防失血。面色青紫、眨眼摇头，突然发生狂乱并吐乳，这是惊风的先兆。因此，热盛者，只宜用清凉发散的方法，不可峻烈地使用苦寒药物。发散则毒邪外出而热自解，苦寒则毒邪反而潜伏而出痘更难。所以散发的药剂，轻症用升麻、葛根来疏散热邪，而对于烦躁壮实的患者，不用这些药怎么能平息其标证？重症用麻黄来开通壅滞，而对于喘急胀满的患者，不用这些药怎么能挽救其危局？在未出痘前若有泄泻，有热证不要当作虚证看；已经泄泻且口渴，无热证就从虚证治疗。止住热性泄泻要用清凉法，并重加发散；治疗虚性溏泄要用温补法，仍用开提之法。内虚误用寒凉，会助长泄泻；实热妄投补剂，会加重烦闷剧烈。安静能进食的，不要认为大便结实就可以攻下；泄泻烦渴的，不要说热证适宜用凉药。气弱而少食的，不能耐受毒邪；神强而能食的，不失常态。
曾经说痘疹初见红点，就观察颜色的荣枯。一来就觉得形体粗壮肥大的，稀疏可以肯定；刚开始如果细碎琐屑，繁密可以知道。带热出来的疮痘，陆续出来还可以救治；一齐涌出的，皮薄总难存活。细细白头像痱子一样，干枯必定呈现内攻的形态。稠密的红点像丹砂朱红，不久定成焦萎之势。粗肥馒头顶，点子不红最终白陷；头尖皮薄，出现茱萸纹起，必定是空疮。白嫩则皮薄娇红，黄瘦则痘成褐色。如果人肤色苍黑皮肤粗糙，疮色必然惨暗。婴儿肌肉不同，不可一概而论。只宜绽凸有神，不喜欢娇红平塌。色泽有神安定，见点如珠如粟；毛发焦枯皮肤干燥，敷疮或紫或焦。带热出来，最怕密集似针头，纵然后续再出，尤其忌讳形状像蚕种，如麸皮如糠秕，如疹如疥，根窠不立，脚地俱无。犯此数端，总皆无法救治。夹斑如同蚊咬，最为恶烈，或者是螺蛳云电状，稍微可治。未发热前先出几颗，俗名报痘。如果热久不出，就当作疔疮看。先发块而后发疮，块为风毒所发；先发疮而后发块，块名叫鬼肿，难医。避痘要避开隐僻之处，眼胞唇内多凶险。闷痘闷在要处，喉舌胸背都危险。顺证不嫌多，逆证嫌一点。冷疔先见，诸疮不敢显形；贼痘若生，诸痘焉能灌汁。辨认若真，急须挑破。里证未平，痘虽出而毒犹在里，以解毒为务。便调人静，身虽热而毒已透表，以安表为先。假如内外证候平稳，此时不需要过度治疗。再看精神勇怯，审详表里如何。
第三日第四日，痘出应当齐整，直至足心，势方才安定。如果还是陆续不齐，尚隐于皮肤之内，如果不是风寒壅遏，定属气虚不振。因此四日以前，痘毒方出，体表宜凉；四日以后，毒出已定，体表宜温。凉则气血和平，痘色必然润泽；温则腠理开通，其势容易成浆。所以到此阶段，如果身不微热，色不鲜泽，虽然不至于冰伏，痘疮断乎不长。五六日来，血包已成，候应当肥大而粗，顶宜发光而白。所以根红而顶白的，已具行浆之势。如果红色过头，虽然见娇红可爱，绵延六日依然，到头空壳虚花，皮薄而光亮如灯，内含似水。顶尖而根脚不红，行浆不实。热毒盛而未解，则为紫为黑；壅而不起，则为陷为塌；滞而不荣，则为干枯为青灰；怯而不振，则为不快为停浆。或者有肉先肿而痘反不起的，浆则滞而不行；面已浮而痘反退伏的，毒则壅而不通。所以身不热而痘不起，已成冰硬之形，赤色若还不变，温之可兴。气血弱而疮不振，遂成不快之状，红润依然如旧，补之可生。紫色干枯，切忌温中带补，只宜活血松肌。毒势壅滞，烈药虽然可发，透肌尤是良方。溏泄惟于温补，泻甚佐以升提。
第六第七日，是气血敷化之际。顺候浆行半足，虚疮才发微光。毒重而壅遏的，顶滞干红；气盛而发的，饱满光泽。头面行浆而四肢未起，切莫慌张；腿脚发泡而脸额焦枯，且休欢喜。既怕其发呛，又虑其喘急。饮食不多，恐致脏虚而内陷；水浆频进，须防泄泻而变危。热盛烦渴，到此休为实论；再加溏泄，此时只作虚看。黑紫干枯，急须攻发其热；气虚塌陷，盒饭（应为“合当”）温补其虚。发呛愁其失声，喘急恐其腹胀。疮或白而少神，根虽红而难治；尖不起而离根，脚虽赤而无济；色淡白而塌阔，此内必无浆汁；皮薄泽而娇红，有浆亦是清稀。犯此四端，总属气虚。
第八第九日间，必然发痒。如果壮热燎人，不痒定行干燥。紫色干枯，不须着眼，中凝血迹，或可幸成。浆既行而半足，时则未当收敛，忽尔一齐紫黑，倒（音同“到”）莫认结痂。如果攻发得宜，傍生血点再行浆。如见气急腹胀，不久失音死在迩（近）。
痘出八九日来，已结干红痂。（音被）如或少生不顺，至此方得灌浆。如果遇身重发热，停浆不易结痂，此则阳亢阴虚，应以清凉收敛。浆足气促，恐因痰涌而然。忽尔发惊，毋乃二便秘结。再见气虚塌陷，必然倒黑焦。一则温补可兴，一则攻发可活。泄泻安宁，大虚少毒。脾寒则下白脓，脏毒必然便血。唑喉声哑，浆行饱满亦无妨；塌痒切牙，便实声清犹可活。靥来痂硬，变证终无脱如麸，须愁余毒。蒸发或致太过，则溃烂难收。身热若见燎人，则燎浆发泡，空遗痘壳不成痂，只为浆清热重。腹胀喘呼而塌陷，皆因毒入内攻。出来不灌黄浆，痂犹如血赤。若曾解毒于先，此证断之极美。胃气绝则唇口肿硬，肝热盛则目睛吊白。喘急发于泻后，总属气虚；便泻继以烦渴，谅非实热。泄泻而烦渴不止，理必升提；好饮而发渴愈甚，势难救援。气虚寒战，痘疮无恙即温经；浆足难收，便实热蒸须解利。进清凉以助结痂，叱补法而防过益。
痘成痂，八九功成。余毒变迁，终非吉兆。是故眼合腹胀，犹蹈危机；虚浮不退，尚罹凶咎。痂虽成而反致失声，犹为黑痂。肿未退而眼已先开，恐毒内攻。阳气极而狂叫喘呼，肠胃伤而便溺脓血。热毒逗遛不化，结痂而壮热憎寒；经络余毒未尽，日晡则往来寒热。发在午前为实证，烦渴腮红；申后方热是阴虚。便调形瘦。他如摄唇弄舌，心经蓄热无疑；撷肚抬胸，肺胃毒冲有准。身热便秘，恐成暴急惊风；潮热便溏，防变慢脾风搐。验失明于眼合羞明，辨口疳于唇焦龈黑。实热结于大肠，必然便秘；虚寒客于胃府，乃成泄泻。喘渴须分虚实，泄泻当辨寒热。欲观痂落之余，再审瘢痕之色。桃红光泽，营卫俱安；灰紫干焦，尚留风热；粉白为气血之虚；皮粘为脾胃之疾。遍体赤斑，乃是失于解利；浑身青紫，恐为风寒所客。余毒未消，不特为疽为疖。见风太早，须防发疮发痍。匪人切勿胡传，此本先贤真诀。
At the initial stage, when the body has a slight fever, it is most appropriate for the breath to be peaceful, diet to be sweet and palatable, urination and defecation to be normal, hands and feet to be warm, facial complexion to remain unchanged, accompanied by peaceful sleep. This indicates that the eruption of smallpox is proceeding smoothly. If the four limbs are cold, the facial complexion is pale, food intake is reduced, and spirit is listless, this syndrome should be viewed as deficiency; the erupted lesions will certainly fail to thrive. If loose stools and vomiting of milk occur, urgent supplementation of Qi is indicated. If the heat is severe and breathing is coarse, detoxification is absolutely necessary, leaving no room for doubt. Delirium, manic speech, and irritability all indicate internal heat. Wheezing, chest fullness, coarse breathing, and constipation indicate toxin stagnation. When toxins are abundant, the head and face become red and hot; when Qi is deficient, the hands and feet become cold and clear. Vomiting is due to fire qi ascending; loose stools are due to toxic vapors pressing downward. Abdominal distension, open mouth, rapid breathing, incessant crying with frequent hoarseness, require vigilance against hemorrhage. Cyanotic complexion, blinking, head shaking, sudden mania, and vomiting milk are precursors to convulsions. Therefore, in cases of excess heat, only cooling and dispersing methods should be used; harsh bitter-cold drugs must not be employed vigorously. Dispersing allows toxins to exit outward, resolving heat naturally; bitter-cold drugs cause toxins to retreat inward, making eruption more difficult. Thus, for mild cases, Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix) are used to disperse heat; for irritable and robust patients, how else can the branch symptoms be settled? For severe cases, Mahuang (Ephedrae Herba) is used to open stagnation; for those with wheezing and abdominal distension, how else can the critical condition be saved? If diarrhea occurs before eruption, do not mistake heat syndromes for deficiency. If diarrhea has occurred with thirst, treat as deficiency if there is no heat syndrome. To stop heat-type diarrhea, use cooling methods combined with heavy dispersing; to treat deficiency-type loose stools, use warming and tonifying methods combined with lifting. Mistakenly using cold-cooling agents for internal deficiency promotes diarrhea; recklessly administering tonics for excess heat exacerbates irritability and severity. Patients who are calm and able to eat should not be assumed to have solid stool requiring purgation; patients with diarrhea and irritability/thirst should not be assumed to have heat syndromes suitable for cooling. Those with weak Qi and poor appetite cannot tolerate the toxin; those with strong spirit and good appetite retain their normal state.
I have said that when smallpox spots first appear, observe the luster or withering of the color. If they appear large and plump immediately, sparsity is certain; if they start fine and scattered, density is known. Lesions appearing with heat, emerging successively, can still be rescued; those erupting all at once with thin skin are unlikely to survive. Fine white heads like miliaria, becoming dry and withered, indicate internal attack. Dense red spots like cinnabar will inevitably become scorched and withered. Coarse, plump, mushroom-topped spots that are not red but eventually turn white and sunken, or those with pointed tops, thin skin, and "cornel" wrinkles, will result in empty pustules. White and tender skin implies thin, delicate redness; yellow and emaciated bodies result in brownish pustules. In individuals with dark skin and rough texture, lesion colors will inevitably be dull and dark. Infants have different muscle structures, so generalizations do not apply. Lesions should ideally protrude with spirit, avoiding delicate redness and flatness. Lustrous color and calm spirit, with spots like pearls or millet grains, are good signs. Dry hair and skin, with lesions turning purple or scorched while emerging with heat, are feared to be dense like needleheads. Even if subsequent eruptions occur, shapes resembling silkworm eggs, bran, or wheat chaff, rashes, or scabies, with no root base or foundation, are incurable. Clad spots resembling mosquito bites are extremely malignant; spiral-shell cloud patterns are slightly more treatable. A few spots appearing before fever, commonly called "reporting smallpox," are acceptable. If fever persists without eruption, treat as carbuncles. Blocks appearing before lesions indicate wind-toxin; lesions appearing before blocks, called "ghost swelling," are difficult to cure. Avoid secluded places for smallpox; the eyelids and inside of the lips are ominous sites. Muffled smallpox in vital areas (throat, tongue, chest, back) is dangerous. Smooth courses tolerate many lesions; adverse courses fear even one. Cold carbuncles appearing first prevent other lesions from showing; thief smallpox prevents other lesions from filling with fluid. If identification is accurate, puncture urgently. If interior syndromes are unbalanced, despite eruption, toxins remain interior; prioritize detoxification. If stool is regulated and the person is calm, despite fever, toxins have penetrated the exterior; prioritize stabilizing the exterior. If interior and exterior syndromes are balanced, avoid over-treatment. Assess spirit and courage, and examine interior/exterior conditions.
By the third and fourth days, eruptions should be uniform, reaching the soles of the feet, indicating stability. If eruptions are still uneven and hidden within the skin, it is either wind-cold stagnation or Qi deficiency. Before the fourth day, toxins are just emerging; the body surface should be kept cool. After the fourth day, toxins have emerged; the body surface should be kept warm. Cooling harmonizes Qi and blood, ensuring lustrous lesion color; warming opens the pores, facilitating pus formation. If, at this stage, there is no slight fever and the color is not fresh/lustrous, although not frozen, the lesions will certainly not grow. By the fifth and sixth days, blood sacs form; they should be large and coarse, with bright white tops. Red roots and white tops indicate readiness for pus formation. Excessive redness, though attractive, lasting six days, results in hollow, flower-like emptiness with thin, shiny skin containing water-like fluid. Pointed tops with non-red bases indicate incomplete pus formation. Unresolved intense heat/toxins lead to purple/black colors; stagnation without rising leads to sinking/collapse; stagnation without nourishment leads to dryness/grey-blue; weakness without vigor leads to slow/retarded pus formation. Flesh swelling without lesion elevation indicates stagnant pus; facial edema with receding lesions indicates blocked toxins. No fever with non-elevating lesions indicates ice-hard forms; if redness remains unchanged, warming may revive them. Weak Qi and blood causing non-thriving lesions, yet remaining rosy, can be revived with tonification. Purple/dry lesions contraindicate warming-tonifying; activate blood and loosen muscles instead. Stagnant toxins may require potent herbs to erupt, but penetrating the muscle is superior. Loose stools require warming-tonifying; severe diarrhea requires lifting agents.
On the sixth and seventh days, during Qi and blood transformation, smooth courses show half-filled pus, while deficient lesions emit faint light. Heavy toxins with stagnation show dry/red tops; abundant Qi shows full/glossy lesions. Head/face pus formation with non-raised limbs requires no panic; leg blistering with scorched face/forehead requires no joy. Fear choking and wheezing. Poor food intake risks organ deficiency and internal collapse; frequent fluids risk diarrhea and danger. Severe heat/irritability/thirst should not be treated as excess here; combined with loose stools, treat as deficiency. Black/purple/dry lesions require urgent heat-dispelling; Qi-deficient/sunken lesions require warming-tonifying. Choking fears voice loss; wheezing fears abdominal distension. White lesions lacking spirit, even with red roots, are hard to treat; tips not rising from roots, even with red bases, are futile. Pale/white/sunken/broad lesions lack pus; thin/shiny/delicate-red lesions have thin pus. These four conditions indicate Qi deficiency.
By the eighth and ninth days, itching is inevitable. High fever without itching leads to dryness. Purple/dry lesions need no attention; clotted blood traces may rarely succeed. Half-filled pus is not yet time for scabbing. Sudden all-purple/black should not be mistaken for scabbing. Proper dispersing generates blood points and further pus. Rapid breathing/abdominal distension predicts imminent death by voice loss.
After eight/nine days, dry red scabs form. If growth is irregular, pus formation occurs now. Heavy fever with body heaviness hinders scabbing, indicating Yang excess/Yin deficiency; use cooling/astringents. Full pus with shortness of breath suggests phlegm surge. Sudden convulsions suggest constipation of both bowels/bladder. Qi deficiency/sinking leads to black/scorched lesions; warming-tonifying revives them, dispersing saves them. Stable diarrhea indicates major deficiency/minor toxin. Spleen cold causes white pus; organ toxicity causes bloody stool. Hoarseness with full pus is tolerable; collapsing/itching/grinding teeth with solid stool/clear voice is livable. Hard scabs indicate no further changes; beware residual toxins. Over-evaporation causes ulceration. Burning fever causes blister rupture, leaving empty shells due to excessive heat clearing. Abdominal distension/wheezing/collapse indicates internal toxin attack. Lack of yellow pus results in blood-red scabs. Prior detoxification yields excellent prognosis. Stomach Qi exhaustion causes lip/mouth swelling; Liver heat causes upward-gazing white eyes. Wheezing after diarrhea indicates Qi deficiency; diarrhea followed by thirst is not excess heat. Persistent diarrhea/thirst requires lifting; excessive drinking worsening thirst is hopeless. Qi deficiency/chills with intact lesions require warming meridians; full pus/hard recovery with solid stool/heat requires draining. Cooling aids scabbing; avoid over-tonifying.
Scabs complete by the eighth/ninth day. Residual toxin variations are never auspicious. Closed eyes/abdominal distension indicate crisis; persistent edema indicates disaster. Voice loss despite scabs indicates black lesions. Swelling persisting with early eye-opening fears internal toxin attack. Extreme Yang causes manic screaming/wheezing; intestinal damage causes pus/blood in urine/stool. Lingering heat/toxins cause high fever/chills despite scabs; residual meridian toxins cause alternating chills/fever at dusk. Morning fever/red cheeks indicate excess; afternoon fever indicates Yin deficiency. Thin body with regulated stool. Lip-smacking/tongue-playing indicates Heart heat; belly-grabbing/chest-lifting indicates Lung/Stomach toxin. Fever/constipation risks acute convulsions; tidal fever/loose stools risks slow spleen wind spasms. Blindness with light-aversion; mouth ulcers with burnt lips/black gums. Excess heat in Large Intestine causes constipation; deficiency-cold in Stomach causes diarrhea. Distinguish excess/deficiency in wheezing/thirst; distinguish cold/heat in diarrhea. Observe post-scab fall and scar color. Peach-red/lustrous indicates safe Ying/Wei; grey-purple/dry indicates residual wind-heat; pink-white indicates Qi/Blood deficiency; sticky skin indicates Spleen/Stomach disease. Whole-body red spots indicate failed drainage; whole-body cyanosis indicates wind-cold invasion. Residual toxins cause carbuncles/furuncles. Early wind exposure risks new sores. Do not spread falsely; this is the true secret of sages.