〔万〕诸疮皆属心火,心之华在面,疮痘之候,但以面之部位占之,思过半矣,
且痘疹阳毒,诸阳皆聚于面,吉凶善恶,尤易见也。额属心火,如印堂以上,发际
以下,横两日月角位先见红点,先作浆,先结靥者,此恶候也,盖心为君主,毒发
于心,故先见于其位,君危,则十二官皆危,其死速矣。左脸属肝木,右脸属肺金,
如两脸先见红点磊落者吉,如相聚作块,其肉硬肿者死,盖肝藏魂,肺藏魄,生意
既绝,魂魄将离,故不治也。颏属肾,承浆横抵两颐,先见红点,先发,先靥者吉,
此位虽属肾,然三阴三阳之脉皆聚于此,阴阳和,故可治也。鼻属脾土,若准头先
出,先靥者凶,盖脾属土,四脏禀命于脾,毒发于脾,土败则四脏相随而败,故绵
延日久,后毙也。肾之窍在耳,又云∶心开窍于耳,心肾皆少阴君火也,又少阳相
火之脉,行耳之前后,凡在耳叶先见红点者凶,盖君相二火用事,燔灼之势,难可
扑灭也。惟口唇四围,先出、先起、先靥者大吉,盖阳明之脉侠口环唇,胃与大肠
主之,无物不受故也。
痘家有八门、五枢、三关、两煞、五轴之分。心为赤帝门(附心,胞络)两颧为心
枢。肝为青阳门(附,胆)两眼眶为肝枢。脾为黄央门(附,胃)两腮颐为脾枢。肺
为肃杀门,喉突为肺枢。肾为玄武门,两耳垂为肾枢。胸膛乳阜心之关。
脐封脾之关。阳球肾之关。白帝煞门座于气窝右太阳。青帝煞门座于眼眶左
太阳。颧阜胸乳心之轴。左太阳左胁眼胞两臀肝之轴。右太阳右胁项颈气突
肺之轴。腮颊中庭口角肚腹手足脾之轴。地阁后颈耳窖背俞腰脊阳球肾之轴。
袁氏阅痘,重门、栏、辅、轴四字,门犯则验栏,栏犯则验辅,辅犯则验轴,至轴
而变态尽矣。门凡八,栏辅各十有八,轴凡一百五十四,各分经络而验之。天庭
穹窿之地名赤帝门。胸膛名炎车门。两手掌心名正离门(不属心而属阳明阳明透彻则鼻先形
而掌心次之阳明迅暴则掌心先。形而鼻次之标于鼻 顺标于掌者逆)眉心一带统上下寸
地号五将门。眼下丝竹泪堂名青阳门。气窝天突穴名肃杀门。两耳窍圈为玄武门。脐封之处
脾经所注名黄帝门。八门与前稍异,至栏、辅、轴,抑又异矣,图诀繁俚,无关
治疗,故今不取。
【万全论述】各种疮疡都归属于心火。心的外在荣华表现在面部,痘疹的征候,只要观察面部的部位就能推断出大半了。况且痘疹属于阳毒,所有的阳气都汇聚于面部,吉凶善恶,尤其容易显现。
额头归属于心火,如印堂以上、发际以下,横向两旁的日月角位置先出现红点,先化脓成浆,先结痂脱落,这是恶候。因为心是君主之官,毒邪发于心,所以首先出现在其对应的部位。君主危急,则十二脏腑都危急,死亡迅速。
左脸颊归属于肝木,右脸颊归属于肺金。如果双颊先出现红点且分布磊落(清晰分散)为吉;如果红点聚集形成块状,肌肉硬肿,则为死证。因为肝藏魂,肺藏魄,生机既已断绝,魂魄即将离散,所以无法救治。
下巴归属于肾,承浆穴横向抵至两侧下颌角,如果先出现红点,先发出来,先结痂者为吉。这个部位虽然归属于肾,但是足三阴经和手三阳经的经脉都汇聚于此,阴阳调和,所以可以治疗。
鼻子归属于脾土,如果鼻准头(鼻尖)先出痘,先结痂者为凶。因为脾属土,其他四脏都禀受脾的命令,毒邪发于脾,土气败坏则四脏随之败坏,所以病程绵延日久,最后死亡。
肾的窍穴在耳朵,又有说法认为心开窍于耳。心和肾都属于少阴君火,此外少阳相火的经脉,行走在耳朵的前后。凡是在耳叶上先出现红点的为凶。因为君火和相火当令,燔灼烧灼的态势,难以扑灭。
只有口唇四周,先出痘、先起疱、先结痂的为大吉。因为阳明经脉夹口环唇,由胃和大肠主司,没有东西不能容纳接受。
痘家(专治痘疹的医家或理论体系)有八门、五枢、三关、两煞、五轴的分类。心为赤帝门(附带心包络),两颧骨为心枢。肝为青阳门(附带胆),两眼眶为肝枢。脾为黄央门(附带胃),两腮颊和下颌角为脾枢。肺为肃杀门,喉结突起处为肺枢。肾为玄武门,两耳垂为肾枢。胸膛和乳头部位是心的关卡。肚脐封处是脾的关卡。外生殖器(阳球)是肾的关卡。
白帝煞门位于右侧太阳穴和气窝处。青帝煞门位于左侧太阳穴和眼眶处。颧骨隆起处、胸膛、乳头是心的轴线。左侧太阳穴、左侧胁肋、眼睑、双侧臀部是肝的轴线。右侧太阳穴、右侧胁肋、项颈、气突(喉结)是肺的轴线。腮颊、中庭、口角、肚腹、手足是脾的轴线。地阁(下巴)、后颈、耳窖(耳后凹陷处)、背俞、腰脊、阳球是肾的轴线。
袁氏阅读痘疹诊法,重视“门”、“栏”、“辅”、“轴”四个字。门位发病则验证栏位,栏位发病则验证辅位,辅位发病则验证轴位,到了轴位,病情的变化就穷尽了。门共有八个,栏和辅各十八个,轴共有一百五十四个,分别根据经络来验证。
天庭高耸之地名为赤帝门。胸膛名为炎车门。两手掌心名为正离门(不归属于心而归属于阳明经,阳明经透彻则鼻子先显形而掌心随后显形;阳明经迅急暴烈则掌心先显形而鼻子随后显形,显于鼻子为顺,显于掌心为逆)。眉心一带统管上下寸许之地号称为五将门。眼下丝竹空穴、泪堂处名为青阳门。气窝天突穴名为肃杀门。两耳窍圈为玄武门。肚脐封处为脾经所注,名为黄帝门。这八门与前文所述稍有不同,至于栏、辅、轴,更是差异巨大。图诀繁杂俚俗,与治疗无关,所以现在不采用。
[Wan Quan's Discussion] All sores and ulcers are attributed to Heart Fire. The external flourishing of the Heart manifests on the face. Regarding the signs of smallpox and measles, one can deduce most of the prognosis by observing the facial regions. Moreover, smallpox and measles belong to Yang Toxicity; all Yang Qi gathers in the face, making auspicious or ominous outcomes particularly visible.
The forehead belongs to Heart Fire. If red spots appear first at the positions between Yin Tang (Yintang, EX-HN3) above and the hairline below, extending horizontally to the Sun Yue Jiao (Sun Yue Jiao, a point near the temple), followed by suppuration and then scabbing, this is an ominous sign. Since the Heart is the Sovereign Monarch, if toxicity erupts from the Heart, it appears first in its corresponding region. If the Sovereign is endangered, the twelve organs are all endangered, leading to rapid death.
The left cheek belongs to Liver Wood, and the right cheek belongs to Lung Metal. If red spots appear first on both cheeks and are distinct and scattered, it is auspicious. If they cluster into masses with hard and swollen flesh, it indicates death. This is because the Liver stores the Hun (Ethereal Soul) and the Lung stores the Po (Corporeal Soul); when vitality is extinguished, the souls are about to depart, rendering it untreatable.
The chin belongs to the Kidney. Cheng Jiang (Chengjiang, CV24) extends horizontally to the bilateral mandibular angles. If red spots appear first here, erupt first, and scab first, it is auspicious. Although this region belongs to the Kidney, the meridians of the Three Yin and Three Yang all converge here; thus, Yin and Yang are harmonious, making it treatable.
The nose belongs to Spleen Earth. If the tip of the nose (Zhun Tou) shows lesions first and scabs first, it is inauspicious. Because the Spleen belongs to Earth, and the other four Zang organs receive their commands from the Spleen, if toxicity erupts from the Spleen and Earth fails, the four organs will follow in failure. Consequently, the disease lingers for a long time before causing death.
The opening of the Kidney is in the ears. It is also said that the Heart opens into the ears. Both the Heart and Kidney belong to Shaoyin Jun Huo (Ministerial Fire). Additionally, the meridians of Shaoyang Xiang Huo (Ministerial Fire) run anterior and posterior to the ears. If red spots appear first on the earlobe, it is inauspicious. This is because both Jun Huo and Xiang Huo are active, creating a blazing intensity that is difficult to extinguish.
Only the area surrounding the lips, where lesions appear, rise, and scab first, is highly auspicious. This is because the Yangming Meridians flank the mouth and encircle the lips, governed by the Stomach and Large Intestine, which accept everything without rejection.
In the study of smallpox, there are classifications of Eight Gates (Ba Men), Five Pivots (Wu Shu), Three Passes (San Guan), Two Sha (Two Evil Spirits), and Five Axes (Wu Zhou). The Heart is the Chi Di Gate (Red Emperor Gate) (accompanied by the Pericardium Luo); the bilateral zygomatic bones are the Heart Pivot. The Liver is the Qing Yang Gate (Green Yang Gate) (accompanied by the Gallbladder); the bilateral eye sockets are the Liver Pivot. The Spleen is the Huang Yang Gate (Yellow Center Gate) (accompanied by the Stomach); the bilateral cheeks and mandibular angles are the Spleen Pivot. The Lung is the Su Sha Gate (Austere Killing Gate); the prominent throat (Adam's apple) is the Lung Pivot. The Kidney is the Xuan Wu Gate (Black Tortoise Gate); the bilateral earlobes are the Kidney Pivot. The chest and nipple area constitute the Heart Pass. The umbilicus constitutes the Spleen Pass. The genitalia (Yang Qiu) constitute the Kidney Pass.
The Bai Di Sha Gate (White Emperor Evil Gate) is located at the right temporalis region and the suprasternal fossa. The Qing Di Sha Gate (Green Emperor Evil Gate) is located at the left temporalis region and the eye socket. The zygomatic prominence, chest, and nipples form the Heart Axis. The left temporalis, left hypochondrium, eyelids, and bilateral buttocks form the Liver Axis. The right temporalis, right hypochondrium, neck, and throat protrusion form the Lung Axis. The cheeks, Zhong Ting (Middle Court), corners of the mouth, abdomen, hands, and feet form the Spleen Axis. The chin (Di Ge), back of the neck, post-auricular fossa, back Shu points, lumbar spine, and genitalia form the Kidney Axis.
Yuan’s method of reading smallpox emphasizes the characters "Gate," "Lan" (Barrier), "Fu" (Assistant), and "Zhou" (Axis). If the Gate is affected, verify the Lan; if the Lan is affected, verify the Fu; if the Fu is affected, verify the Zhou. By the time the Zhou is reached, all variations of the disease have manifested. There are eight Gates, eighteen Lans, eighteen Fus, and 154 Zous, each verified according to their respective meridians.
The high ground of the Tian Ting (Heavenly Court/Forehead) is named the Chi Di Gate. The chest is named the Yan Che Gate (Flame Chariot Gate). The centers of both palms are named the Zheng Li Gate (Correct Li Gate) (not belonging to the Heart but to the Yangming Meridian; if Yangming is thorough, the nose forms first and the palm second; if Yangming is swift and violent, the palm forms first and the nose second. Manifestation on the nose is favorable; manifestation on the palm is unfavorable). The area around the Mei Xin (Glabella), spanning upper and lower cun, is called the Wu Jiang Gate (Five Generals Gate). The areas under the eyes at Si Zhu Kong (Sizhukong, GB23) and the tear trough are named the Qing Yang Gate. The Qi Wo (Suprasternal Fossa) and Tiantu (Tiantu, CV22) acupoint is named the Su Sha Gate. The circular openings of both ears are the Xuan Wu Gate. The area of the umbilicus, where the Spleen Meridian pours qi, is named the Huang Di Gate (Yellow Emperor Gate). These eight gates differ slightly from the previous ones. As for the Lan, Fu, and Zhou, the differences are even greater. The diagrams and rhymes are complex and vulgar, irrelevant to treatment, and thus are not adopted here.