紫云灌顶∶其痘遍身俱好,但头顶紫干,陷伏不起者是也。不治。彤云绕顶∶
其痘遍身俱好,但头顶一片红赤者,此乃热毒聚于膀胱也。须清利之。督元至栏∶
气会足心之下,名涌泉穴,若于此中见痘,则痘已全而获最美。一云∶凡于此处先红
先灌者,大非佳兆,宜急保元。乌纱覆顶∶其痘必咽喉哑塞,喘促气粗,是血衰
气败而元阳脱也。不治。梨花漫顶∶此因气血虚寒,不能振发光泽耳,急用保元
汤加天雄,犹或可救。云掩天庭∶一名覆釜,一名蒙头。其痘遍身磊落光泽,惟额
上一片血泡如云者是也。此乃心家客热识甚耳,宜急用犀角之类服之。紫萍铺额∶
其证则热甚咽痛而闷乱发狂,治宜急用清利解毒为主。乌纱落额∶其证额上一片
黑气罩定,是元阳气血并绝也。不治。灰扑印堂∶此证是心家少血也,若兼腹胀
嗌干之候者,宜补气血为主而兼托里,宜保元汤加芎桂红花主之。如至于鼻者,则
又名中流砥柱,又名毒滞迎香,是又属于肺也。红纱拂面∶此宜凉血解毒为主,如
痘多而连肉红者不治。杨花扑面∶此宜内托散加天雄主之。赤珠绕唇∶此乃脾
经极热也,宜急清火解毒。乌饭沾唇∶此证必声哑神昏,目睛不转,四肢厥冷,三
朝七日乃死。霞锦穿胸∶此因火毒识盛,不治之证也。紫云布胸∶此乃血凝气滞,
毒来攻胸也。其证必切牙战掉,口唇焦裂,甚或顷刻而死。黑棋排胸∶此心火亢极,
其脏色见,三朝决死,火性迅速也。柳絮飞胸∶此乃血气枯弱也,宜保元汤加芎
归、桂附主之。桃花映背∶其痘遍身红活,光绽圆满,但背上深红稠密,治宜清
火凉心解毒为主。紫萍浮背∶其痘背上稠密,红紫连片者是也。不治。毒拥三
仓∶一名缦胸。其痘胸前成片,此五脏之募系焉,气会聚焉,心胞络注焉,决无生
理。花钿斜堆∶其痘两鬓独多,若至紫赤者,尤宜清热化毒。黑砂落背,此证
尤为不治。枭炎蔽聪∶一名锁音,其痘在耳独多者是也,耳为肾窍,忌先见先靥,
如耳热黑色,防变黑归肾为凶。雪铺鱼背∶此五脏血已枯尽也。不治。赤鳞穿
腹∶此乃胃家热甚,故大便秘坚,小便淋涩,治宜和解。三阴凑毒∶足大拇是太
冲穴属厥阴,足心是涌泉穴属少阴,足股傍是商邱穴属太阴,若毒凑者凶。白梨
堕腹∶此系气血皆败也,半月之间,必发惊而死。葡萄落地∶其痘臀尻间红紫一
片若葡萄者,不治。烂粟居臀∶其痘遍身俱好,惟臀上一片如粟壳臭烂者是也。宜
急为补托下元,或有可生。榴花散野∶凡诸痘俱好,惟四肢红赤,唇口崩裂者,是
心脾肺三经热甚也,治宜凉血清火解毒为主。荷钱透水∶一名托腮,其痘独两腮
稠密是也。若至焦紫神黯者凶。杨花堕枝∶其痘独四肢灰白者是也。此因气凝血
滞耳。宜八珍汤加附子主之。枭聚两颐∶一名胭脂扑面,一名橘壳脸。其痘两脸紫
赤独多者是也。此因肝肺热甚,宜急清热解毒。
紫云灌顶:全身痘疹均正常,唯独头顶部位呈现紫色、干枯、凹陷且不起发,这就是“紫云灌顶”。属于不治之症。
彤云绕顶:全身痘疹均正常,唯独头顶有一片红赤,这是热毒聚集在膀胱经所致。必须采用清热利湿的方法治疗。
督元至栏:气会穴位于足心下方,名为涌泉穴。如果在此处见到痘疹,说明痘疹已经出齐且形态最美。另一种说法是:凡是此处先发红或先灌浆的,都是极不吉利的征兆,应当紧急使用保元汤来固护元气。
乌纱覆顶:痘疹必然导致咽喉哑塞、气喘急促、呼吸粗重,这是血衰气败、元阳脱失的表现。属于不治之症。
梨花漫顶:这是由于气血虚寒,不能振奋并显现光泽所致。紧急使用保元汤加入天雄(附子的一种),或许还可以救治。
云掩天庭:又名“覆釜”,又名“蒙头”。全身痘疹磊落有光泽,唯独额头上一片血泡如同云朵,这就是此证。这是心经有客热且程度严重,应当紧急服用犀角类药物。
紫萍铺额:症状表现为热势极盛、咽喉疼痛、烦闷混乱甚至发狂,治疗应当紧急以清热利湿解毒为主。
乌纱落额:症状表现为额头上一片黑气笼罩固定,这是元阳和气血均已断绝的表现。属于不治之症。
灰扑印堂:此证是心经血液不足。如果兼有腹胀、咽干的症状,应当以补益气血为主,兼用托里透脓之法,宜用保元汤加川芎、桂枝、红花为主方治疗。如果痘疹发展到鼻部,则又名为“中流砥柱”,又名“毒滞迎香”,这又归属于肺经病变。
红纱拂面:治疗应当以凉血解毒为主。如果痘疹多且连成片呈红色,则属不治之症。
乌饭沾唇:此证必然声音嘶哑、神志昏迷、眼球转动不灵、四肢厥冷,通常在发病后第三日或第七日死亡。
紫云布胸:这是血液凝滞、气机阻滞,毒邪攻冲胸部所致。症状必然咬牙颤抖、口唇焦裂,严重时顷刻间就会死亡。
黑棋排胸:这是心火亢盛至极,脏器的本色显露出来,通常在第三日决定生死,因为火性迅速猛烈。
柳絮飞胸:这是气血枯弱所致,宜用保元汤加川芎、当归、桂枝、附子为主方治疗。
桃花映背:全身痘疹红活、光亮绽开、圆满饱满,唯独背部深红且稠密,治疗应当以清火、凉心、解毒为主。
紫萍浮背:痘疹在背部稠密,红紫连成一片,这就是此证。属于不治之症。
毒拥三仓:又名“缦胸”。痘疹在胸前成片出现,这里是五脏募穴所在,气机汇聚之处,也是心包络注输之地,绝无生还之理。
花钿斜堆:痘疹在两鬓部位独多,如果发展到紫红色,尤其应当清热化毒。
黑砂落背:此证尤为不治之症。
枭炎蔽聪:又名“锁音”,痘疹在耳部独多。耳为肾之窍,忌讳痘疹先在耳部出现或先结痂脱落。如果耳朵发热变黑,要防止变为“黑归肾”的凶险证候。
赤鳞穿腹:这是胃家热势极盛,所以大便秘结坚硬,小便淋沥涩痛,治疗应当采用和解之法。
三阴凑毒:足大趾部位是太冲穴,属厥阴肝经;足心是涌泉穴,属少阴肾经;大腿外侧是商丘穴,属太阴脾经。如果毒邪汇聚于此,则为凶兆。
白梨堕腹:这是气血皆已败坏的表现,半月之内,必然因惊风发作而死。
葡萄落地:痘疹在臀部之间红紫一片,如同葡萄,属于不治之症。
烂粟居臀:全身痘疹均正常,唯独臀部有一片如粟壳般臭烂,这就是此证。应当紧急进行补益托毒、温补下元的治疗,或许还有生机。
榴花散野:所有痘疹均正常,唯独四肢红赤,唇口崩裂,这是心、脾、肺三经热势极盛的表现,治疗应当以凉血、清火、解毒为主。
荷钱透水:又名“托腮”,痘疹唯独在两腮部位稠密。如果发展到焦紫、神色黯淡,则为凶兆。
Ziyun Guanding (Purple Cloud Pouring Over the Crown): The pustules on the rest of the body are normal, but the crown of the head is purple, dry, sunken, and fails to erupt. This is Ziyun Guanding. It is an intractable condition.
Tongyun Raoding (Red Cloud Surrounding the Crown): The pustules on the rest of the body are normal, but there is a patch of redness on the crown of the head. This indicates heat-toxin accumulating in the Bladder channel. It requires clearing heat and promoting diuresis.
Duzhi Zhilan: The Qihui point is located below the sole of the foot, named Yongquan (KI 1). If pustules appear here, it signifies that the eruption is complete and presents with the most auspicious appearance. Another view states: if redness or suppuration appears first at this location, it is a very ominous sign; one should urgently use Baoyuan Tang (Preserve the Origin Decoction) to protect the Yuan Qi (Original Qi).
Wusha Futop (Black Veil Covering the Crown): The patient inevitably suffers from hoarseness and obstruction in the throat, panting, and coarse breathing. This indicates depletion of blood and Qi, and loss of Yuan Yang (Primal Yang). It is an intractable condition.
Lihua Mantop (Pear Blossoms Spreading Over the Crown): This is caused by deficiency-cold of Qi and Blood, which fails to stimulate luster. Urgently using Baoyuan Tang (Preserve the Origin Decoction) added with Tianxiong (Aconiti Lateralis Radix Praeparata, a type of prepared Aconite root) may still be curable.
Yunyan Tianting (Clouds Obscuring the Forehead): Also known as "Fufu" (Covered Cauldron) or "Mengtou" (Veiled Head). The pustules on the rest of the body are distinct and lustrous, except for a patch of blood blisters on the forehead resembling clouds. This indicates severe guest-heat in the Heart. One should urgently administer Rhinoceros Horn (Xijiao, now substituted with Water Buffalo Horn Shuiniu Jiao in practice) preparations.
Ziping Fu'e (Purple Duckweed Paving the Forehead): The symptoms include extreme heat, sore throat, mental confusion, and mania. Treatment should urgently focus on clearing heat, promoting diuresis, and detoxifying.
Wusha Luo'e (Black Veil Falling on the Forehead): A patch of black qi covers the forehead firmly. This indicates the extinction of both Yuan Yang and Qi and Blood. It is an intractable condition.
Hui Pu Yintang (Ash Dusting the Glabella): This condition indicates insufficient Blood in the Heart. If accompanied by abdominal distension and dry throat, treatment should primarily tonify Qi and Blood while simultaneously supporting the interior to expel toxins. Use Baoyuan Tang (Preserve the Origin Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma), Guizhi (Cinnamomi Ramulus), and Honghua (Carthami Flos) as the main formula. If the eruption extends to the nose, it is also called "Zhongliudizhu" (Pillar in the Midstream) or "Du Zhi Yingxiang" (Toxin Stagnating at Yingxiang), indicating involvement of the Lung.
Hongsha Fumian (Red Silk Brushing the Face): Treatment should primarily cool the blood and detoxify. If the pustules are numerous and merge into red patches, it is an intractable condition.
Yanghua Pumian (Poplar Catkins Facing the Face): Treatment should use Neituo San (Internal Support Powder) added with Tianxiong (Aconiti Lateralis Radix Praeparata).
Chizhu Zaochun (Red Pearls Surrounding the Lips): This indicates extreme heat in the Spleen channel. Urgent fire-clearing and detoxification are required.
Wufan Zhan Chun (Black Rice Staining the Lips): The patient inevitably exhibits hoarseness, coma, immobility of the eyeballs, and cold limbs. Death typically occurs on the third or seventh day after onset.
Xiajin Chuexiong (Rosy Brocade Piercing the Chest): This is due to excessive fire-toxin and is an intractable condition.
Ziyun Buxiong (Purple Clouds Spreading on the Chest): This indicates blood stasis and Qi stagnation, with toxin attacking the chest. Symptoms inevitably include teeth grinding and tremors, scorched and cracked lips, and death may occur within moments.
Heiqi Paixiong (Black Chess Pieces Arranged on the Chest): This indicates extreme hyperactivity of Heart Fire, with the color of the organ manifesting externally. Death is determined by the third day due to the rapid nature of Fire.
Liuxu Feixiong (Willow Catkins Flying on the Chest): This indicates exhaustion of Qi and Blood. Use Baoyuan Tang (Preserve the Origin Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Guizhi (Cinnamomi Ramulus), and Fuzi (Aconiti Lateralis Radix Praeparata) as the main formula.
Taohua Yingbei (Peach Blossoms Reflecting on the Back): The pustules on the rest of the body are red, vibrant, bright, blooming, and full, but the back shows deep red, dense eruptions. Treatment should focus on clearing fire, cooling the Heart, and detoxifying.
Ziping Fu Bei (Purple Duckweed Floating on the Back): The pustules on the back are dense and form continuous red-purple patches. This is an intractable condition.
Duyong Sancang (Toxin Congesting the Three Granaries): Also known as "Manxiong". Pustules appear in patches on the chest. This area is where the Mu points of the five Zang organs gather, where Qi converges, and where the Pericardium channel pours. There is no hope for survival.
Huadian Xie Dui (Flower Ornaments Slanting in Piles): Pustules are particularly abundant on the temples. If they turn purple-red, clearing heat and resolving toxin is especially indicated.
Heisha Luobei (Black Sand Falling on the Back): This condition is particularly intractable.
Xia Yan Bi Cong (Owl Flame Obscuring Hearing): Also known as "Suoyin" (Locked Voice). Pustules are particularly abundant in the ears. The ear is the orifice of the Kidney; it is contraindicated for eruptions to appear first or crust over first in the ears. If the ears become hot and black, guard against transformation into "Black Returning to the Kidney," which is ominous.
Xuepu Yu Bei (Snow Paving the Fish Back): This indicates that the Blood of the five Zang organs has been completely exhausted. It is an intractable condition.
Chilin Chuanfu (Red Scales Piercing the Abdomen): This indicates extreme heat in the Stomach, resulting in hard constipation and scanty, painful urination. Treatment should employ harmonizing methods.
Sanyin Coudu (Three Yin Channels Gathering Toxin): The big toe area is Taichong (LR 3), belonging to the Jueyin Liver channel; the sole is Yongquan (KI 1), belonging to the Shaoyin Kidney channel; the lateral thigh is Shangqiu (SP 5), belonging to the Taiyin Spleen channel. If toxin gathers here, it is ominous.
Baili Duofu (White Pear Falling into the Abdomen): This indicates exhaustion of both Qi and Blood. Within half a month, convulsions will arise leading to death.
Putao Luodi (Grapes Hitting the Ground): Red-purple patches resembling grapes appear between the buttocks. This is an intractable condition.
Lansu Ju Tun (Rotten Millet Dwelling in the Buttocks): The pustules on the rest of the body are normal, except for a patch on the buttocks resembling rotten millet husks with a foul odor. Urgent tonification and support, along with warming and supplementing the Lower Yuan, may offer a chance of survival.
Liuhua San Ye (Pomegranate Flowers Scattering in the Wild): All pustules are normal, except for red limbs and bursting/cracking of lips and mouth. This indicates extreme heat in the Heart, Spleen, and Lung channels. Treatment should primarily cool the blood, clear fire, and detoxify.
Heqian Tou Shui (Lotus Coins Penetrating Water): Also known as "Tuosai". Pustules are particularly dense on the cheeks. If they turn scorched purple and the spirit becomes dim, it is ominous.
Yanghua Duo Zhi (Poplar Catkins Falling from Branches): Pustules are exclusively gray-white on the four limbs. This is due to Qi stagnation and blood coagulation. Use Bazhen Tang (Eight Treasures Decoction) added with Fuzi (Aconiti Lateralis Radix Praeparata) as the main formula.
Xiao Ju Liang Yi (Owls Gathering on Both Cheeks): Also known as "Yanzhi Fuman" (Rouge Brushing the Face) or "Juke Lian" (Orange Peel Face). Pustules are predominantly purple-red on both cheeks. This is due to extreme heat in the Liver and Lung. Urgent clearing of heat and detoxification is required.