一、见点之时，头面稀少，胸前背上皆无，根窠红润，顶突碍手，如珠光泽，此为上吉，不必
服药。
一、发热三日或四五日，热稍退，乃于口鼻、腮颐、地阁、颈项之间，或四肢，先放数点，大
小不一，淡红润色，痘与肉色红白分明者吉。
一、痘作二三次出，三日后手足心方才出齐，出齐后，头面胸背稀少，尖圆紧实，饮食二便如
常者吉。如无他证，不宜妄行用药。
一、痘之初出，三五相连者必密，单见者必稀。
一、痘疮上身多，下体少者吉，反是者险。
一、发热至五六日，痘应出不出，以灯照之，只在皮肤中有红点，但其色脉和平，别无逆证，忽
然眩冒大汗出者，毒瓦斯痘疮一齐从汗而出者，此名冒痘，再无壅遏之患，乃吉兆也。一、痘疮变化
莫测，有等身无大热，亦见报痘，但不灌脓结痂，或出而复没者，此名试痘，不可误作轻看。再过
数日，忽然大热，必然复出，宜审治之。
一、发热一日便出者凶。或一齐涌出，如蚕种密布者决死。
一、大热未退而见红点数粒，先见于太阳、额角、发际、天庭，或山根以上等处，此阳毒乘虚
上侵阳位也，大非吉兆。再加目红唇裂，痰鸣色紫，或白者尤甚，又或有三五粒聚于一块者，此名
铜钱痘，皆不吉之兆，急宜凉血解毒，以防其危。
一、痘疮初出紫色红片者，名紫云痘，四日死。
一、痘疮初出当顶红者，六七日死。盖痘欲淡红如线，附于根下，不欲当顶红也。
一、痘已出一遍，又出一遍，心腹疼痛不止，口气臭，色紫黑者决死。
一、痘疮皮薄，色白而光，根窠全无红色，或根带一点红，三五日后乃如绿豆样，此痘决不能
成脓，只成一胞清水，擦破即死。
一、色红带艳，皮肉尽红者，必不成脓，痒 而死。
一、报痘之时，全不起顶，有如汤泡及灯草火烧者，十余日后，必痒 而死。
一、报痘之时，有黑斑如痣状，或肌肉有成块黑者即死。
一、报痘时，若口鼻及耳有紫红色，或血出不止者决死。
一、报痘之时，应出不出，或起红斑如蚊迹者，六日后必死。
一、报痘之时，腰腹痛，或狂言烦躁、大渴、吐泻、不食者，俱不治。
一、报痘之后，痘已齐而身热不退，反甚者死。
一、痘齐之后，毒已外达，则内当安静，而反见烦躁闷乱，谵妄不止者，此邪气盛极，神机无
主也，必死。
一、在痘疹显现初期，若头面部稀疏，胸前和背部均无分布，痘疮根部红润，顶部突起且触感明显，光泽如珠，这是上等的吉兆，不需要服药。
二、发热三到四天或四到五天，热度稍退后，在口鼻、腮颊、下巴、颈项之间，或者四肢，先发出几颗痘疹，大小不一，颜色淡红润泽，痘疹与周围皮肤的红白界限分明，这是吉兆。
三、痘疹分两三次发出，三天后手足心才出齐，出齐后头面胸背稀疏，痘形尖圆紧实，饮食和二便正常，这是吉兆。如果没有其他病症，不宜随意用药。
四、痘疹刚发出时，三五颗连在一起的必然密集，单独出现的必然稀疏。
五、痘疹上身多、下身少的是吉兆，反之则危险。
六、发热到第五六天，痘疹应该出却未出，用灯照看，只见皮肤中有红点，但神色脉象平和，没有其他逆证，突然头晕冒汗大量出汗的，是毒气随痘疹一起从汗液排出的表现，这叫做“冒痘”，不再有壅滞遏阻的祸患，是吉兆。
七、痘疹变化莫测，有的人身体没有大热，也见了痘疹，但不化脓结痂，或者出了又隐没的，这叫做“试痘”，不可误当作轻症看待。再过几天，突然发大热，必然再次复出，应当仔细诊治。
八、发热一天就出痘的是凶兆。如果一齐涌出，像蚕种密布一样，必定死亡。
九、大热未退而见到几粒红点，首先出现在太阳穴、额角、发际、天庭，或者山根以上等处，这是阳毒乘虚侵入阳位，非常不是吉兆。再加上眼睛红、嘴唇裂、痰鸣声重、面色紫暗，或者发白的更严重，或者有三五粒聚成一团的，这叫做“铜钱痘”，都是不吉利的征兆，急需凉血解毒，以防危险。
十一、痘疹初出顶部发红的，六七天死亡。因为痘疹希望颜色淡红如线，附着在根部下方，不希望顶部发红。
十二、痘疹已经出一遍，又出一遍，心腹疼痛不止，口气臭秽，面色紫黑的，必定死亡。
十三、痘疹皮薄，颜色白而光亮，根部完全没有红色，或者根部带一点红，三五天后像绿豆样，这种痘疹决不能化脓，只形成一胞清水，擦破就会死。
十四、颜色红艳，皮肉全部变红的，必然不能化脓，因瘙痒而死。
十五、出痘时，完全不起顶，像水泡及灯草火烧过的样子，十多天后，必然因瘙痒而死。
十六、出痘时，有黑斑像痣状，或者肌肉有成块黑色的，立即死亡。
十七、出痘时，如果口鼻及耳朵出现紫红色，或者出血不止的，必定死亡。
十八、出痘时，应该出却不出，或者起红斑像蚊子叮咬痕迹的，六天后必定死亡。
十九、出痘时，腰腹痛，或者胡言乱语烦躁不安、极度口渴、呕吐腹泻、不能进食的，都属不治之症。
二十一、痘疹出齐之后，毒邪已外达，体内应当安静，反而出现烦躁闷乱、胡言乱语不止的，这是邪气极盛，神机失去主宰，必定死亡。
1. During the initial appearance of smallpox lesions, if they are sparse on the head and face, absent from the chest and back, with a ruddy base, prominent tops that are palpable, and lustrous like pearls, this is an auspicious sign of the highest order; medication is not required.
2. After fever persists for three to five days and subsides slightly, a few lesions may appear first around the mouth, nose, cheeks, chin, neck, or limbs. These lesions vary in size, have a pale red luster, and show a clear distinction between the lesion color and the surrounding skin (red vs. white). This is an auspicious sign.
3. If lesions erupt in two or three waves, completing their emergence on the palms and soles only after three days, and subsequently remain sparse on the head, face, chest, and back, with sharp, round, firm shapes, while diet and excretion remain normal, this is an auspicious sign. In the absence of other symptoms, arbitrary use of medication should be avoided.
4. When smallpox lesions first emerge, those appearing in clusters of three to five will necessarily be dense, whereas those appearing singly will necessarily be sparse.
5. Smallpox lesions being more abundant on the upper body and fewer on the lower body is auspicious; the reverse indicates danger.
6. By the fifth or sixth day of fever, if lesions should have emerged but have not, inspection by lamp reveals only red spots within the skin. If the complexion and pulse are harmonious and no adverse signs are present, sudden dizziness accompanied by profuse sweating indicates that the toxic heat and lesions are expelling together through sweat. This is termed "Mao Dou" (Emerging via Sweat), indicating no risk of stagnation or obstruction, which is an auspicious omen.
7. The transformation of smallpox is unpredictable. Some patients exhibit no high fever yet show early lesions ("Bao Dou"), but these fail to suppurate or scab over, or appear and then disappear. This is termed "Shi Dou" (Test Lesions) and must not be mistaken for a mild condition. After a few more days, a sudden high fever will likely occur, followed by reappearance of lesions; careful treatment is required.
8. Lesions appearing on the first day of fever indicate a ominous prognosis. If they all erupt simultaneously, densely distributed like silkworm eggs, death is certain.
9. If several red spots appear before the major fever subsides, initially manifesting at the Taiyang acupoint, temple corners, hairline, Tianting point, or above the Shangen point, this indicates Yang toxin invading Yang regions due to deficiency, which is highly inauspicious. If accompanied by red eyes, cracked lips, phlegm rattling, purple complexion, or even whiter complexions, or if three to five lesions cluster together, this is termed "Tong Qian Dou" (Copper Coin Lesions). All are inauspicious signs requiring urgent blood-cooling and detoxification to prevent crisis.
10. Lesions appearing initially as purple-red patches are named "Zi Yun Dou" (Purple Cloud Lesions); death occurs four days later.
11. Lesions appearing initially with redness on the apex die within six to seven days. Ideally, lesions should be pale red like threads and attached below the root, not red on the apex.
12. If lesions erupt twice, accompanied by unceasing abdominal pain, foul breath, and a purple-black complexion, death is certain.
13. Lesions with thin skin, white and lustrous color, lacking any redness at the base, or showing only a trace of red, resembling mung beans after three to five days, will never suppurate. They form only a blister of clear fluid; rupture leads to death.
14. Lesions that are bright red and cause the skin and flesh to turn entirely red will never suppurate; death results from itching.
15. At the onset of lesions, if they completely fail to elevate, resembling water blisters or burns from moxa sticks, death by itching will occur after more than ten days.
16. At the onset of lesions, the presence of black spots resembling moles, or patches of black muscle tissue, indicates immediate death.
17. At the onset of lesions, if the mouth, nose, or ears turn purple-red, or if bleeding does not stop, death is certain.
18. At the onset of lesions, if they fail to emerge as expected, or if red macules resembling mosquito bites appear, death will occur after six days.
19. At the onset of lesions, if accompanied by waist and abdominal pain, delirious speech, restlessness, extreme thirst, vomiting and diarrhea, or inability to eat, the condition is incurable.
20. After lesions have fully erupted, if fever persists or worsens, death ensues.
21. After lesions have fully erupted, toxins having reached the exterior, the interior should be calm. If instead there is restlessness, confusion, and incessant delirium, this indicates extreme pathogenic qi and loss of Shen (Spirit) control; death is certain.