顺 饮食如常，气调血和，毒解浆回，老色收敛，次转黄蜡色，渐变酱褐色。结靥从口唇、人
中起，
头面周身，未至腿足，紫黑色坚浓之痂。惟宜节饮食，慎风寒。
险 气血已竭，未易收靥，停浆不敛，身重发热（补脾利水解毒。）凡曾经泄泻后，所见诸证
皆作虚治（十全大补、异功、木香参酌。）泄泻而烦渴不止，大用升提。浆足难收，大便结实，
略宜疏通。或风冷入胃，下利脓粘，热渗膀胱，小便尿血，并宜清利。痘后发热，午前是阳盛，
宜清热；午后是阴虚，宜滋阴。大热便实，恐变急惊，微热便溏，恐变慢惊。
主方 当归 芍药（酒炒） 白术 茯苓 山药 苡仁 桔梗（等分） 甘草（减半）
莲肉（七个）
口渴加麦冬、五味；虚加人参，不敛加木通。水煎服。
逆 气滞而血凝，毒留而浆薄。不能回水结靥，则为干枯外剥。
顺 疤痕绽凸，色见桃红，光泽鲜明，神气清爽。
险 疤痕淡红而不绽，宜补气血。如全白者，急用大补，则数月犹危。从发热至此，身常温热
（不热为水伏证。）如大热疤紫干焦，大宜清凉解热。如稠密危痘，赖能饮食，外收结靥，成片
落者，切勿剥伤。见风太早，变成疮疡，年年生发。若痂后身弱，立则战摇等证，宜后方。
主方 人参 白术 茯苓 当归 川芎 白芍 熟地 黄 知母 麦冬（等分） 甘草
（减半）水煎服。
小便涩加木通；大便泻加肉果。痂当落不落乃火盛也，柴苓汤调辰砂六一散，外以蜜水调滑
石末敷之。
逆 痂若竹衣，大便脓血，若发慢惊，目无神而面青。或发牙疳；或生痈毒，后另有条。
顺证：饮食正常，气机调畅，血液调和，毒邪解除，痘浆回缩，痂色老练收敛，随后转为黄蜡色，逐渐变为酱褐色。结痂从口唇、人中处开始，蔓延至头面及全身，但尚未到达腿足部位，形成紫黑色、坚硬厚实的痂皮。此时只宜节制饮食，小心防范风寒。
险证：气血已经耗竭，难以收靥（结痂），痘浆停滞不能收敛，身体沉重且发热（治疗原则为补脾、利水、解毒）。凡是曾经发生泄泻之后，所出现的各种症状都应按虚证治疗（参考十全大补汤、异功散、木香散等方剂斟酌使用）。若泄泻伴随烦渴不止，需大力使用升提之法。若痘浆充足却难以收靥，大便干结，则略微予以疏通。若是风冷侵入胃腑，导致下利脓粘；或是热邪渗入膀胱，导致小便尿血，均宜采用清利之法。痘疹后期发热，午前发热属阳气盛，宜清热；午后发热属阴虚，宜滋阴。高热伴大便干实，恐转变为急惊风；低热伴大便溏薄，恐转变为慢惊风。
主方：当归、芍药（酒炒）、白术、茯苓、山药、苡仁、桔梗（各等分）、甘草（减半用量）、莲肉（七个）。口渴者加麦冬、五味子；体虚者加人参；不敛者加木通。水煎服。
逆证：气机阻滞而血液凝滞，毒邪留恋而痘浆稀薄。不能回水结痂，则表现为干枯并外剥脱。
险证：疤痕淡红而不绽开，宜补益气血。如果颜色全白，急需使用大补之法，否则数月内仍有危险。从发热至此阶段，身体通常保持温热（若不热则为水伏证）。若出现大热、疤痕紫黑干枯焦灼，宜大用清凉解热之法。若是稠密危重的痘疹，若能进食，外部已收靂成片脱落，切勿强行剥伤。过早见风，会转变为疮疡，年年复发。若结痂后身体虚弱，站立时颤抖摇晃等症状，宜用后方治疗。
主方：人参、白术、茯苓、当归、川芎、白芍、熟地黄、黄芪、知母、麦冬（各等分）、甘草（减半用量）。水煎服。小便涩痛加木通；大便泄泻加肉豆蔻。痂皮当落不落是因为火盛，用柴苓汤调服辰砂六一散，外用蜂蜜水调滑石末敷贴。
Shun (Favorable) Pattern: Dietary intake remains normal, Qi mechanism is regulated, blood is harmonious, pathogenic toxins are resolved, and the pustular fluid retracts. The scab color matures and converges, subsequently turning into a yellow wax color, gradually changing to a sauce-brown hue. Scabbing begins at the lips and philtrum, spreading to the head, face, and entire body, but has not yet reached the legs and feet, forming purple-black, hard, and thick scabs. At this stage, one should only regulate diet and carefully guard against wind and cold.
Xian (Dangerous) Pattern: Qi and blood have been exhausted, making it difficult for scabbing to occur; the pustular fluid stagnates and fails to converge, accompanied by heavy sensation in the body and fever (Treatment principle: Tonify Spleen, promote urination, resolve toxins). For any symptoms appearing after previous diarrhea, they should all be treated as deficiency patterns (Reference Shiquan Dabu Decoction, Yigong San, or Muxiang San for consideration). If diarrhea is accompanied by incessant irritability and thirst, strong lifting methods should be employed. If there is sufficient pustular fluid but difficulty in scabbing, with solid stool, slight unblocking is appropriate. If wind-cold enters the Stomach causing dysentery with pus and mucus, or if heat penetrates the Bladder causing hematuria, clear and promote urination methods are suitable. Fever after smallpox/chickenpox occurring before noon indicates Yang excess, requiring clearing heat; fever after noon indicates Yin deficiency, requiring nourishing Yin. High fever with solid stool fears transformation into acute convulsions (Ji Jing Feng); mild fever with loose stool fears transformation into chronic convulsions (Man Jing Feng).
Main Formula: Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba, stir-fried with wine), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), Yiren (Coicis Semen), Jiegeng (Platycodonis Radix) in equal parts; Gancao (Glycyrrhizae Radix et Rhizoma) in half dose; Lianrou (Nelumbinis Semen) seven pieces. Add Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus) for thirst; add Renshen (Ginseng Radix et Rhizoma) for deficiency; add Mutong (Akebiae Caulis) for failure to converge. Decoct in water and take orally.
Ni (Adverse) Pattern: Qi stagnation leads to blood coagulation; toxin retention results in thin pustular fluid. Inability to retract fluid and form scabs leads to dryness and external peeling.
Shun (Favorable) Pattern: Scars open and protrude, showing a peach-red color, with bright luster and refreshing spirit.
Xian (Dangerous) Pattern: Scars are pale red and do not open; tonifying Qi and Blood is indicated. If the color is entirely white, urgent use of major tonification is required, otherwise danger persists for months. From fever to this stage, the body is usually warm (lack of heat indicates Water Retention pattern). If there is high fever with purple, dry, and scorched scars, significant cooling and heat-clearing are necessary. For dense, critical cases, if the patient can eat and external scabs fall off in patches, do not forcibly peel them. Exposure to wind too early transforms into sores/ulcers that recur annually. If weakness follows scabbing, with trembling upon standing, etc., use the following formula.
Main Formula: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shudi (Rehmanniae Radix Preparata), Huangqi (Astragali Radix), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix) in equal parts; Gancao (Glycyrrhizae Radix et Rhizoma) in half dose. Decoct in water and take orally. Add Mutong (Akebiae Caulis) for astringent urination; add Rouguou (Myristicae Semen) for diarrhea. Scabs that fail to fall when they should indicate Fire excess; treat with Chailing San adjusted with Chen Sha Liuyi San, and externally apply滑石 (Talcum) powder mixed with honey water.
Ni (Adverse) Pattern: Scabs resemble bamboo husk, accompanied by pus and blood in stool; if chronic convulsions develop, eyes lack spirit and complexion is cyanotic. Or dental gangrene occurs; or carbuncles/toxins arise, discussed in separate sections later.