顺证七朝浆自行，先起先灌次第明，由红转白渐肥泽，九日苍蜡显痂形。
【注】灌浆顺证者，因气盈血附，其毒易化，至七朝不期行而自行也。先起先灌，次
第明者，谓痘先起胀者，当先灌浆，自头面以及周身也。由红转白，渐肥泽者，谓痘先
见红点，由红转白，血变成浆，渐渐肥满而光泽也。至九日浆老，则苍如黄蜡色，而显
结痂之形矣。
灌浆浆清不按期，行迟收早总非宜，亮软根艳并水泡，不杂他证险可医。
【注】痘当灌浆之时，浆清不浓，及不按期而浆行迟者，皆气血虚也。浆行收早者，是
毒热盛也。软薄者，谓痘皮不能坚实，恐其易于损破，则气泄而浆难成也。根艳者，谓
痘根赤艳，热在血分，毒未尽化也。水泡者，水泡夹杂于痘中，盖因脾虚多湿也。此皆险
证；若不夹杂他证，虽险亦可医也。
紫黑灰白浆不行， 烂痒塌痘壳空，稠密无浆目不闭，已闭行浆复开凶。
【注】痘至行浆之时，其色紫黑或灰白，而浆不行者，非枭毒内蕴，锢滞气血，即虚
弱不能领载其毒也。 烂者，谓浆未成而腐烂也。痒塌者，谓行浆时作痒塌也。痘壳空
者，谓壳空而无浆也。稠密无浆者，谓稠密不分颗粒，而复干枯无浆也。目不闭者，谓
痘出太稠密，而眼目不封也。目已闭复开凶者，谓起胀时其目已闭，行浆时目忽复开也。
此皆灌浆逆证，必主凶也。
顺证：第七天浆液自然充盈，先出痘先灌浆，次序分明；颜色由红转白，逐渐饱满润泽；到第九天浆液成熟，呈现如黄蜡般的苍色，显现结痂的形态。
【注】所谓灌浆顺证，是因为气血充足，毒邪容易化解，到了第七天无需期待而自然行浆。先起胀的先灌浆，次序分明，是指痘疹先起胀者，应当先灌浆，从头面蔓延至全身。由红转白、逐渐饱满润泽，是指痘疹先出现红点，由红转白，血液转化为浆液，渐渐变得丰满而有光泽。到了第九天浆液老熟，颜色像黄蜡一样苍黄，从而显现出结痂的形状。
险证：浆液清稀且不按期而行，行浆迟缓或收束过早都不适宜；若见痘体软薄、根盘红艳并伴有水泡，且不夹杂其他病证，则属于险证但尚可医治。
【注】痘疹在灌浆的时候，浆液清稀不浓稠，以及不按期而行浆迟缓的，都是气血虚弱的表现。行浆后收束过早的，是毒热亢盛的表现。软薄，是指痘皮不能坚实，恐怕容易破损，导致气泄而浆液难以形成。根艳，是指痘根赤红鲜艳，说明热在血分，毒邪尚未完全化解。水泡，是指水泡夹杂在痘疹中，这是因为脾虚湿气重的缘故。这些都属于险证；如果不夹杂其他病证，虽然危险也可以医治。
逆证：痘色紫黑或灰白，浆液不行；痘体腐烂、瘙痒塌陷、痘壳空虚；浆液稠密无浆且眼睛无法闭合，或者眼睛已闭后又重新张开，均为凶兆。
【注】痘疹到了行浆的时候，如果颜色紫黑或灰白，而浆液不行的，不是枭毒（烈性毒邪）内蕴，阻滞气血，就是身体虚弱不能承载毒邪。烂，是指浆液未成而已经腐烂。痒塌，是指行浆时出现瘙痒和塌陷。痘壳空，是指痘壳空虚而没有浆液。稠密无浆，是指痘疹稠密不分颗粒，反而干枯没有浆液。目不闭，是指痘疹出得太稠密，导致眼睛无法封合。目已闭复开凶，是指起胀时眼睛已经闭上，行浆时眼睛忽然又张开。这些都是灌浆逆证，必定主凶。
Shun Zheng (Smooth Course): On the seventh day, the pus fills naturally; those that erupted first fill with pus first, following a clear sequence. The color transitions from red to white, gradually becoming plump and lustrous. By the ninth day, the pus matures, appearing yellowish like beeswax, and the scabbing form becomes visible.
[Note] A Shun Zheng in the pus-filling stage occurs because Qi and Blood are sufficient, allowing the pathogenic toxin to be easily resolved. Pus filling occurs naturally by the seventh day without needing external intervention. "Those that erupted first fill first" refers to the principle that pustules which first undergo swelling should first fill with pus, spreading from the head and face to the entire body. "Transitioning from red to white, gradually becoming plump and lustrous" means the pustules initially appear as red spots, turning white as blood transforms into pus, becoming increasingly full and shiny. By the ninth day, when the pus is mature, it takes on a yellowish hue resembling beeswax, indicating the formation of scabs.
Xian Zheng (Dangerous Course): If the pus is thin and does not follow the schedule, or if pus filling is delayed or healing concludes too early, these are inappropriate. If the pustules are soft and thin, the base is bright red, accompanied by vesicles, but without mixed complications, it constitutes a Xian Zheng (dangerous course) which is still treatable.
[Note] During the pus-filling stage, if the pus is thin and not dense, or if pus filling is delayed beyond the expected time, this indicates a deficiency of Qi and Blood. If healing concludes too early after pus filling, it indicates excessive heat and toxicity. "Soft and thin" refers to pustule skins that lack firmness, fearing they may rupture easily, leading to leakage of Qi and failure of pus formation. "Bright red base" refers to the intense redness at the base of the pustules, indicating heat in the Blood level and incomplete resolution of toxins. "Vesicles" refer to blisters interspersed among the pustules, caused by Spleen deficiency and dampness. These are all considered dangerous courses; however, if no other complications are mixed in, even dangerous cases can be treated.
Ni Zheng (Rebellious Course): If the pustules are purple-black or grayish-white with no pus formation; if they rot, itch, collapse, or have empty shells; if they are dense, dry, lack pus, and the eyes cannot close; or if the eyes were closed during swelling but reopen during pus filling, these are ominous signs.
[Note] When reaching the pus-filling stage, if the color is purple-black or grayish-white and pus does not form, it is either due to the accumulation of fierce toxins obstructing Qi and Blood, or due to weakness failing to carry the toxins. "Rotting" refers to decay occurring before pus forms. "Itching and collapsing" refers to itching and sinking during pus filling. "Empty shell" refers to an empty pustule shell lacking pus. "Dense and dry without pus" refers to densely packed pustules that are indistinct, dry, and devoid of pus. "Eyes not closing" refers to such density of eruption that the eyelids cannot seal. "Eyes reopening after closing" refers to the eyes being closed during the swelling phase but suddenly opening again during the pus-filling phase. These are all Ni Zheng (rebellious courses) in pus filling, invariably indicating a fatal prognosis.