初出顶陷连肉红,过至九日一场空。又如血点带红紫,斑证只在六日中,发斑黑者在朝夕,斑
青顷刻去
匆匆。无脓痒 期二日,不冶腰疼及挺胸。报痕似痱如蚕种,舌卷囊缩命不充。紫泡刺出黑血者,
饮食嗾喉证俱凶。难疗面肿痘不肿,青色黑陷及无脓,二便流利下肠垢,更加吐泻出蛔虫,头温足
冷好饮水,痘先惊后药难攻。气促泄泻渴不止,目无神者数当穷。声哑失音叫与哭,痘色纵好也
难终。有种气急亦难治,庶几灌好是伤风,见此宜服参苏饮,起死回生须见功。
一、初发热时,身无大热,或热或退,神清气爽,唇鼻滋润,腰腹不疼,自始至终皆饮食如常,
大便稠实,小便清利,而无杂证者吉,不必服药。
一、初热时,先发惊搐一二次而随止者,此痘出心经也,乃为吉兆,不必治之。若甚惊不止,
日发三五次,或连日不止,痘出多而密者,乃凶兆也。
一、初发热时,吐泻不甚而随止者吉。
一、正发热时,或得大汗一身,汗随止而脉见稍平者吉。
一、初发热时,用红纸倏蘸麻油点照之,如心窝或遍身有成瑰红者,八九日后决死。
一、发热一日,即遍身齐出,或稠密如蚕种,摸之不碍手者决死。
一、发热时,腹中大痛,腰如被仗,乃至报痘而痛犹不止者决死。
一、发热时,头面上有一片红如胭脂者,八九日以后决死。
一、发热时,口鼻或大小便俱失血者快死。
一、发热时,妄见妄语,昏不知人者死。
一、发热时,腹胀而痛,大叫不止者死。
一、正发热三日之内,其热勿退而反烦躁闷乱,坐卧不安,此外虽清凉内却热也。若见手足冷,
腹胀气喘
者即死。以上诸证,俱不必治。
【死证日数歌】(第十四首)
痘疹初出时,若见头顶凹陷且连及周围皮肤发红,病情发展至第九天则一场空亡(死亡)。又如痘疹中出现血点并带有红紫色,此类斑证仅在第六天内就会致死。痘色发黑的,在早晚之间即可致死;痘色发青的,顷刻间便匆匆离去(死亡)。若无脓液且伴有瘙痒,期限仅为两天;若不治疗,会出现腰痛及挺胸(僵直)的症状。报痕(痘疹形态)似痱子或如蚕种,若出现舌体卷缩、阴囊收缩,则生命元气衰竭。若刺破紫泡流出黑血,且伴有饮食困难、咽喉梗阻等症状,均属凶险之证。面部肿胀而痘疹不隆起,痘色青黑内陷且无脓液,大小便通畅但排出肠道垢秽物,再加上呕吐腹泻并吐出蛔虫,头温足冷且喜好饮水,痘疹先出现惊厥而后用药难以攻治。气促、腹泻、口渴不止,眼神无神者,寿命将尽。声音嘶哑、失音、呼叫哭泣,即使痘色良好也难以保全性命。有一种气急症状也难以治疗,如果是误诊为伤风而用灌服法,见到上述症状应服用参苏饮,方能起死回生见效。
一、在初发热阶段,身体没有大热,或热或退,精神清爽,嘴唇和鼻子滋润,腰腹部不疼痛,自始至终饮食如常,大便稠实,小便清利,且没有其他杂症者,为吉兆,不必服药。
一、在初热阶段,先发惊厥抽搐一两次随即停止的,这是痘毒出于心经的表现,属于吉兆,不必治疗。如果惊厥严重不止,每天发作三五次,或连续多日不止,且痘疹发出多而密集者,则是凶兆。
一、在正发热阶段,如果突然大汗一身,汗止后脉搏稍显平和的,为吉兆。
一、在初发热阶段,用红纸迅速蘸取麻油点照患处,如果心窝处或遍身出现成片的玫瑰红色,八九日后必定死亡。
一、发热一天,痘疹就遍身齐出,或稠密如蚕种,摸起来不碍手的,必定死亡。
一、发热时,腹中剧烈疼痛,腰部像被杖打一样,直到出痘阶段疼痛仍不止的,必定死亡。
一、发热时,头面部有一片红如胭脂色的,八九日以后必定死亡。
一、发热时,口鼻或大小便全部出血的,即将死亡。
一、在正发热三天之内,热度不退反而烦躁闷乱,坐卧不安,这是外表看似清凉内部却热的表现。如果见到手足冰冷、腹胀气喘的,立即死亡。以上各种证候,都不必治疗。
[Song on Fatal Signs and Days] (14th)
When the pustules first appear, if the crown of the head is sunken and connected to surrounding red skin, death occurs by the ninth day. If blood spots with a reddish-purple hue appear, such macular eruptions are fatal within six days. Pustules that turn black may cause death within hours; those that turn green lead to immediate demise. If there is no pus accompanied by itching, the duration is limited to two days; without treatment, lower back pain and rigid extension of the trunk occur. The rash resembles miliaria or silkworm eggs; if the tongue curls and the scrotum retracts, vital energy is depleted. If puncturing purple blisters yields black blood, accompanied by difficulty in eating/drinking and throat obstruction, these are ominous signs. Facial swelling with non-elevated pustules, green-black depressed pustules without pus, free passage of urine and stool but excretion of intestinal filth, combined with vomiting, diarrhea, and expulsion of roundworms, warm head with cold feet, and preference for drinking water, along with convulsions preceding medication which is difficult to administer, indicate severe conditions. Shortness of breath, diarrhea, unquenchable thirst, and lack of spirit in the eyes indicate impending death. Hoarseness, loss of voice, crying, and screaming indicate that even if the pustule color is good, survival is unlikely. Some cases of rapid breathing are also difficult to treat; if mistakenly diagnosed as wind-cold and treated with drenching methods, seeing these signs requires administering Shen Su Yin (Ginseng and Perilla Decoction) to revive the patient.
1. During the initial fever stage, if there is no high fever, or the fever fluctuates, with clear spirit, moist lips and nose, no lower back or abdominal pain, normal diet throughout, solid stools, clear urination, and no other mixed symptoms, this is auspicious; no medicine is needed.
2. At the onset of heat, if convulsions occur once or twice and then stop, this indicates the eruption originates from the Heart Meridian, which is an auspicious sign; no treatment is required. However, if convulsions are severe and persistent, occurring three to five times daily or continuously over several days, with numerous and dense pustules, this is an ominous sign.
3. During the initial fever, if vomiting and diarrhea are mild and cease quickly, this is auspicious.
4. During the main fever stage, if sudden profuse sweating occurs, and after sweating stops the pulse becomes slightly calm, this is auspicious.
5. During the initial fever, if a piece of red paper dipped in sesame oil is used to illuminate the area, and rose-red patches appear on the chest or all over the body, death will occur after eight or nine days.
6. If one day after fever onset, pustules appear all over the body densely like silkworm eggs and feel smooth to the touch, death is certain.
7. During fever, if there is severe abdominal pain and lower back pain as if beaten by a staff, persisting until the eruption phase, death is certain.
8. During fever, if a patch of red like rouge appears on the head and face, death will occur after eight or nine days.
9. During fever, if bleeding occurs from the mouth, nose, or both urine and stool, death is imminent.
10. During fever, if delirium, incoherent speech, and unconsciousness occur, death ensues.
11. During fever, if abdominal distension and pain occur with incessant screaming, death ensues.
12. Within three days of the main fever, if the fever does not subside but instead causes irritability, restlessness, and inability to sit or lie comfortably, indicating internal heat despite external coolness. If cold extremities, abdominal distension, and wheezing are observed, death follows immediately. For all the above conditions, no treatment is necessary.