痘未出而声哑嗾喉者不治。已出五日内见者亦不治。
痘未壮而先抓破无气血者不治。
痰涎壅盛气急者不治。
痘未出已出而神昏气促，躁乱不宁者不治。
腹痛而泻脓血者不治。
肌肉黎黑如被杖者不治。
浆水米粒不入口，或饮食呛喉者不治。
眼中神光不明，珠色转绿转赤者不治。
闭目昏睡，舌卷囊缩者不治。
头温足冷，闷乱饮水者不治。
吐泻不止，药食不停不化，直下及肛门如竹筒者不治。
胃热发黄，身如橘色，下利者不治。
痘初出即青晦焦黑者不治。
密如蚕种，全不起发，平片花搭者不治。
痘疮痒 ，寒战不止者不治。
旧有疮疡走漏气血，而敷药不效者不治。故曰∶不怕五心有痘，只怕原疮泄漏。原疮即是未痘
之先有疮，泄去脓血，最为凶也。若果五心稀少，而饮食如常者，亦不妨事。
痘后伤风伤食，肌肉瘦脱者不治。
上除此之外，虽有杂证险证，及痘之稠密，但略有润泽兴起之意，须仗医之高妙，患家之心托
弗惑，细心调理，自有可收全功者。
怪痘者，乃逆痘中之尤甚者，形证不一，不可不辨。
一、痘初出时，面胸手足已见红点，却不起发，不成脓浆，随即收敛，若加气促声哑闷乱者即
死，此名内陷证也。此证若无烦喘闷乱等候者，名曰试痘。过五七日后，必复发热而痘出者，其痘
必重。
一、痘疮初出，如蚊蚤所咬，三日后反不见者，名反关痘，五日死。
一、痘子出现，三两成丛，根脚坚硬成块者，此名痘母，六七日死。
一、痘子将出，身上有红肿结硬处，似瘤非瘤，似痈非痈者，亦名痘母，三五日死。以上二证，
俱宜真人解毒汤救之。
一、痘初出便成血泡，或水泡，随即破坏者，此名烂痘，二三日死。
一、痘出后，遍身都是空壳不作脓水者，此名空痘，八九日死。
一、痘当出现起发之时，中有干黑者，此名鬼痘，宜用胭脂水涂之，勿使蔓延。若不能急治，
则乍起乍 ，当靥不靥，或多作番次而出，绵延日久而死。
一、痘出起发之时，中有痛甚如刀剜，叫哭不停者，此名痘疔，五六日死。
一、痘当起发之时，枯燥不润， 伏不起，皮肤皱揭者，此名干痘，五六日加烦满喘急而死。
一、痘于起发之时，皮嫩易破，摸之温手者，此名温痘，六七日痒 而死。
一、痘起发之时，疮色娇艳，皮薄光润，鲜红可爱者，此名嫩痘，八九日后不能成痂，必痒
而死。
一、痘于起发养浆之时，疮头有孔，浆水漏者，此名漏疮，五六日后痒 而死。
一、贼痘者，是诸痘未浆而此痘先熟也。又名假云泛。多在太阳、喉口、心胸等处，三日见者
六日死，四日见者七日死，五六日见者十一、二日必死也。
一、痘出虽稀，根窠全白无血色，三四日后虽亦起胀，然按之虚突，此亦名为贼痘，气血太虚，
至灌浆时，必变成水泡，大如葡萄，皮薄若纸，抓破即死。
一、脓水将成之时，其疮自破，有孔而深者，此名倒陷。
一、将靥之时不能成痂，皮脱骨黑者，此亦名倒陷，俱不治。
一、痘于收靥之时不能成痂，皮肉溃烂，脓水淋漓者，此名痘癞，能食则生，不能食则死。凡
以上者，皆不治之证。
痘疹尚未发出，但声音嘶哑、喉间有痰鸣声的，属于不治之证。痘疹已经发出五日内出现这种情况的，也属于不治之证。
痰涎壅盛、呼吸急促的，属于不治之证。
痘疹未发出或已发出，但神志昏迷、气息短促、烦躁混乱不安的，属于不治之证。
腹痛并排泄脓血的，属于不治之证。
肌肉颜色黑如被杖击过的，属于不治之证。
呕吐腹泻不止，药物和食物不停留体内且不消化，直接泻出肛门如同竹筒般的，属于不治之证。
胃热导致发黄，身体像橘子色一样黄，并伴有下利的，属于不治之证。
痘疹刚发出就呈现青暗晦涩、焦黑色的，属于不治之证。
痘疹密集如蚕种，完全不起发，平塌成片花搭分布的，属于不治之证。
原本就有疮疡溃漏气血，而外敷药物无效的，属于不治之证。所以说：不怕五心（手心、脚心、心口）有痘，只怕原有的疮疡泄漏。原疮是指痘疹未发之前已有的疮疡，泄去脓血，最为凶险。如果确实是五心部位痘疹稀少，而饮食正常的，也不妨事。
除此之外，虽然还有各种杂证、险证，以及痘疹稠密的情况，但只要略有润泽兴起的意思，必须依靠医生的高超医术，患者家属心志坚定不疑惑，细心调理，自然能够取得全功。
其一，痘疹初出时，面部、胸部、手、足已经见到红点，却不起发，不成脓浆，随即收敛，如果加上气促、声音嘶哑、烦闷混乱的，立即死亡，这名叫内陷证。此证如果没有烦喘、闷乱等表现，名叫试痘。过了五七日后，必定再次发热而痘疹发出的，其痘疹必然严重。
其二，痘疮初出，像被蚊子跳蚤咬过一样，三日后反而看不见的，名叫反关痘，五日死。
其三，痘子出现，两三颗成丛聚集，根脚坚硬成块的，这名叫痘母，六七日死。
其四，痘子将要发出时，身上有红肿结硬处，似瘤非瘤，似痈非痈的，也名叫痘母，三五日死。以上两种证候，都适宜用真人解毒汤来救治。
其五，痘疹初出便形成血泡，或水泡，随即破坏的，这名叫烂痘，二三日死。
其六，痘疹发出后，遍身都是空壳不作脓水的，这名叫空痘，八九日死。
其七，痘疹应当出现起发之时，中间有干黑的，这名叫鬼痘，适宜用胭脂水涂抹它，不要使其蔓延。如果不能紧急治疗，则忽起忽落，当结痂时不结痂，或多次反复而出，绵延日久而死。
其八，痘疹发出起发之时，中间疼痛剧烈如刀剜，叫哭不停的，这名叫痘疔，五六日死。
其九，痘疹应当起发之时，枯燥不滋润，潜伏不起，皮肤皱裂揭开的，这名叫干痘，五六日后加上烦满喘急而死。
其十，痘疹在起发之时，皮嫩易破，摸上去温手的，这名叫温痘，六七日后因瘙痒而死。
其十一，痘疹起发之时，疮色娇艳，皮薄光润，鲜红可爱的，这名叫嫩痘，八九日后不能结成痂皮，必因瘙痒而死。
其十二，痘疹在起发养浆之时，疮头有孔，浆水漏出的，这名叫漏疮，五六日后因瘙痒而死。
其十三，贼痘，是诸种痘疹还未化浆而此痘先成熟的。又名假云泛。多在太阳穴、喉口、心胸等处，三日见到的六日死，四日见到的七日死，五六日见到的十一、二日必死。
其十四，痘疹发出虽然稀疏，根窠全白无血色，三四日后虽然也起胀，然而按之虚突，这也名叫贼痘，气血太虚，到了灌浆时，必定变成水泡，大如葡萄，皮薄若纸，抓破即死。
其十五，脓水将成之时，其疮自行破裂，有孔而深的，这名叫倒陷。
其十六，将要结痂之时不能结成痂皮，皮脱落骨发黑的，这也名叫倒陷，都不治。
其十七，痘疹在收靥之时不能结成痂皮，皮肉溃烂，脓水淋漓的，这名叫痘癞，能进食则生，不能进食则死。凡以上这些，都是不治之证。
If the smallpox has not yet erupted but the voice is hoarse and there is rattling in the throat, it is incurable. If this occurs within five days after eruption, it is also incurable.
If the smallpox has not yet become vigorous but is scratched open first, showing no Qi and Blood sufficiency, it is incurable.
If phlegm and saliva are abundant and obstructing, accompanied by rapid breathing, it is incurable.
If the smallpox has not erupted or has already erupted, but the spirit is confused, breath is short, and there is restlessness and agitation, it is incurable.
If there is abdominal pain accompanied by purulent bloody diarrhea, it is incurable.
If the muscles are dark black as if beaten with a staff, it is incurable.
If one cannot take even a mouthful of porridge or rice water, or if food and drink choke the throat, it is incurable.
If the spirit in the eyes is dim, and the color of the eyeballs turns green or red, it is incurable.
If the patient sleeps with closed eyes in a coma, with the tongue curled up and the scrotum retracted, it is incurable.
If the head is warm while the feet are cold, accompanied by stifled confusion and thirst for drinking, it is incurable.
If vomiting and diarrhea persist without cease, and medicines and food pass through without digestion, exiting the anus directly like a bamboo tube, it is incurable.
If stomach heat causes jaundice, the body is orange-yellow, accompanied by diarrhea, it is incurable.
If the smallpox appears initially as cyan, dull, scorched, and black, it is incurable.
If the lesions are dense like silkworm eggs, completely failing to erupt, flat and patchy, it is incurable.
If the sores itch and chills persist without ceasing, it is incurable.
If there was a pre-existing ulcer leaking Qi and Blood, and topical applications were ineffective, it is incurable. Thus it is said: "Do not fear smallpox on the Five Centers (palms, soles, and chest); fear the leakage of the original ulcer." The original ulcer refers to sores present before the eruption of smallpox; leaking pus and blood from them is extremely ominous. However, if the smallpox on the Five Centers is sparse and dietary intake is normal, it is not a matter of concern.
If wind-cold or food stagnation injures the patient after smallpox recovery, leading to emaciation and muscle wasting, it is incurable.
Apart from the above, although there may be miscellaneous dangerous syndromes and dense eruptions, as long as there is a sign of moistening and rising, relying on the physician's superior skill, the family's unwavering trust, and careful nursing, full recovery can be achieved.
Strange smallpox represents the most severe form of adverse smallpox. Its forms and syndromes vary and must be distinguished.
First, when smallpox initially erupts, red spots appear on the face, chest, hands, and feet, but they fail to erupt, do not form pus, and immediately retract. If accompanied by rapid breathing, hoarseness, and mental confusion, death ensues immediately. This is called the Internal Collapse Syndrome. If this syndrome lacks signs of irritability, panting, and confusion, it is called Trial Smallpox. After five to seven days, fever will return and the rash will re-emerge; such cases are severe.
Second, smallpox initially appears resembling mosquito or flea bites, but disappears after three days. This is called Reverse Guan Smallpox, resulting in death within five days.
Third, smallpox papules appear in clusters of two or three, with hard, nodular bases. This is called Smallpox Mother, resulting in death within six to seven days.
Fourth, before eruption, there are red, swollen, hard nodules on the body that resemble tumors but are not, or abscesses but are not. This is also called Smallpox Mother, resulting in death within three to five days. Both of the above conditions should be treated with Zhenren Jiedu Tang (Genuine Human Detoxification Decoction).
Fifth, smallpox initially forms blood blisters or water blisters that rupture immediately. This is called Rotten Smallpox, resulting in death within two to three days.
Sixth, after eruption, the entire body consists of empty shells without pus formation. This is called Empty Smallpox, resulting in death within eight to nine days.
Seventh, during the eruption and rising phase, some lesions turn dry and black. This is called Ghost Smallpox. It should be applied with Carminative Water to prevent spreading. If not treated urgently, the lesions will rise and fall intermittently, fail to crust when expected, or erupt repeatedly over a prolonged period, leading to death.
Eighth, during the eruption and rising phase, some lesions are extremely painful as if carved by a knife, causing continuous crying and screaming. This is called Smallpox Carbuncle, resulting in death within five to six days.
Ninth, during the rising phase, the lesions are dry and unmoistened, lie flat without rising, and the skin wrinkles and peels. This is called Dry Smallpox, leading to death within five to six days due to increasing irritability, fullness, and wheezing.
Tenth, during the rising phase, the skin is tender and easily broken, feeling warm to the touch. This is called Warm Smallpox, resulting in death within six to seven days due to itching.
Eleventh, during the rising phase, the sores have a delicate, charming color, thin and smooth skin, and are bright red and attractive. This is called Tender Smallpox. By the eighth or ninth day, scabs fail to form, and death ensues due to itching.
Twelfth, during the rising and pitting phase, holes appear on the pustule heads, and fluid leaks out. This is called Leaking Sore, resulting in death within five to six days due to itching.
Thirteenth, Thief Smallpox refers to lesions that mature prematurely before other lesions have formed pus. Also known as False Cloud Flooding. It often occurs at the Taiyang acupoint, throat, mouth, heart, and chest areas. If seen on the third day, death occurs on the sixth; if seen on the fourth, death on the seventh; if seen on the fifth or sixth, death on the eleventh or twelfth day.
Fourteenth, although the eruption is sparse, the bases are entirely white without blood color. After three to four days, they may swell, but feel hollow upon pressure. This is also called Thief Smallpox, indicating extreme deficiency of Qi and Blood. During the pitting stage, they will inevitably turn into blisters the size of grapes, with paper-thin skin; scratching them leads to death.
Fifteenth, when pus is about to form, the sore ruptures spontaneously with a deep hole. This is called Inverted Collapse.
Sixteenth, during the crusting phase, scabs fail to form, the skin falls off, and the bone turns black. This is also called Inverted Collapse, and is incurable.
Seventeenth, during the crusting phase, scabs fail to form, the skin and flesh ulcerate, and pus flows profusely. This is called Smallpox Leprosy. Survival is possible if the patient can eat; death ensues if they cannot. All the above conditions are considered incurable.