痘以饱满为形，红活为色。顶陷不起是气虚，色不鲜明是血虚，宜培补气血为主。真阳
虚者、乃无红晕，甚至通身皆白，身凉不温，宜大补元煎，阳回身温，转白为红矣。又有一
种遍身血泡者，此非血多，乃气少不能统血，故血妄行，急当大补元煎，阳气充满，血泡变
白而成功矣。庸医不明此理，谬言血热，误用寒凉，变症日增。形与色，外象也。必要饮食
有味，二便如常，知其无内病，可以不服药。若二便不调，饮食不下，烦躁闷乱，夜中不宁
，形色虽好，亦甚可忧，必当察其病情何如，小心用药，挽回方妙。形色不佳，多半是气体
虚寒，手足厥冷，头重神疲，便清泄泻等症，必当大补元煎，兼用附、桂。若泄泻不止，并
当添入龙骨、粟壳等药以收涩之，方可回生。
痘以红为贵，有圈红、巽红、铺红之别。圈红者、一线红圈紧附痘根，最为佳兆。巽红
者，痘根血色隐隐散漫，亦气不收之故，速宜大补气血。铺红者，一片平铺，无痘之处亦红
，所谓地界不分，若兼不恶寒，口渴而渴，小便臊而短，大便燥而结，内热有据，宜白虎地
黄汤以利之。热退身凉，即宜平补，不可多剂。又有一种锡光痘，身凉不温，色白不红，此
乃阳虚，阴象也，宜大补气血，附、桂同施，气足阳回，痘根红而浆稠痂结矣。又有一种根
无红盘，顶含黑水者，乃阳气大虚，阴气凝结，亦宜大补元煎，兼用附、桂，黑水化而为脓
矣。痘有五泡，曰水泡、脓泡、灰泡、血泡、紫泡。痘有五陷，曰白陷、灰陷、血陷、紫陷
、黑陷。水泡者，皮薄而明。《经》言气热生水，要知清浆皆水。何以不成脓？火少故也。
必当姜、桂、附子等药，大剂陡进，水必成脓。若误用凉药作泻后，转为白陷。脓泡失治，
则破流脓水。灰泡失治，转为灰陷。二症亦宜参、熟、附、桂，大剂多进。若有小颗粒发出
，谓之子救母，生意在焉。血泡者，乃气虚，非血热，亦宜大补元阳，否则变为白陷。紫泡
者，其症有二∶紫中带青者，亦因气虚不能摄血、阴血凝结而成，其人必身倦，恶寒，舌苔
白，饮食不多，大小便清白，速宜大补元阳，否则变为紫陷；又有一种紫黑焦枯者，乃纯阳
无阴之症，其人必口干恶热，小便短，大便结，此实火也，宜清凉解毒，白虎地黄汤酌加大
黄以行之，但得灌浆，尚可望生，失治转为黑陷。又有一种小儿因服凉药，腹中作痛，呕吐
泻利，将成慢惊，头面大热，唇焦舌黑，亦似实火，此乃火不归元之故。实火者，二便臊闭
。虚火者，泻利不止。全在细心体察，方得其真。《经》云∶有者求之，无者求之，实者责
之，虚者责之。盖言万病皆当体察寒热虚实。医治痘症，可概云实火肆用苦寒克削，以毙人
性命耶。
痘疹以形态饱满为“形”，色泽红活为“色”。痘顶凹陷不起是气虚的表现，色泽不鲜明是血虚的表现，治疗应以培补气血为主。若是真阳虚衰者，则没有红晕，甚至全身发白，身体冰凉不温暖，宜用大补元煎，待阳气回复、身体转温后，颜色由白转红。又有一种全身布满血泡的情况，这并非血多，而是气少不能统摄血液，导致血液妄行，应当急用大补元煎，待阳气充满，血泡变白（化脓）而痊愈。庸医不明白这个道理，错误地说是血热，误用寒凉药物，导致变证日益增多。
形态与色泽是外在表现。如果饮食有味，大小便正常，可以判断体内无病，可以不服药。如果大小便不调，饮食不下，烦躁闷乱，夜间不安宁，即使形色看起来很好，也非常令人担忧，必须仔细考察病情如何，小心用药，才能挽回生机。
形色不佳，多半是气体虚寒，伴有手足厥冷、头重神疲、大便清稀泄泻等症状，必须使用大补元煎，并兼用附子、桂枝。如果泄泻不止，还应当加入龙骨、粟壳等药物以收敛固涩，才可以起死回生。
痘疹以红色为贵，有圈红、巽红、铺红的区别。圈红是指一线红圈紧紧附着在痘根上，是最为吉祥的征兆。巽红是指痘根血色隐隐约约散漫开来，这也是气不能收敛的缘故，应当迅速培补气血。铺红是指一片平铺，没有长痘的地方也发红，所谓的地界不分，如果同时伴有不怕冷、口渴且想喝水、小便臊臭短少、大便干燥结块，说明内有实热依据，宜用白虎地黄汤来利导清热。热退身凉后，就应当改为平补，不可多服。
又有一种锡光痘，身体冰凉不温暖，颜色白而不红，这是阳虚，属于阴象，宜大补气血，同时使用附子、桂枝，待气足阳回，痘根变红且浆液稠厚结痂。又有一种痘根没有红盘，顶部含有黑水的，这是阳气大虚，阴气凝结，也宜用大补元煎，兼用附子、桂枝，使黑水化为脓液。
痘疹有五泡，分别是水泡、脓泡、灰泡、血泡、紫泡。痘疹有五陷，分别是白陷、灰陷、血陷、紫陷、黑陷。水泡的特点是皮薄而透明。《内经》说气热生水，要知道清浆都是水。为什么不能化成脓？是因为火（阳气）少的缘故。必须用姜、桂、附子等药，大剂量突然进服，水必然化成脓。如果误用凉药导致腹泻，就会转为白陷。脓泡失治，则会破裂流出脓水。灰泡失治，会转为灰陷。这两种症状也宜用人参、熟地黄、附子、桂枝，大剂量多次进服。如果有小颗粒发出，称为“子救母”，生机就在其中。
血泡是由于气虚，不是血热，也宜大补元阳，否则变为白陷。紫泡的症状有两种：紫中带青的，也是因为气虚不能摄血，阴血凝结而成，患者一定身体疲倦，怕冷，舌苔白，饮食不多，大小便清白，应当迅速大补元阳，否则变为紫陷；又有一种紫黑焦枯的，是纯阳无阴的症状，患者一定口干怕热，小便短少，大便结块，这是实火，宜用清凉解毒的方法，白虎地黄汤酌情加大黄以通下，只要能够灌浆，还有一线生机，失治则转为黑陷。
又有一种小儿因为服用凉药，腹中疼痛，呕吐泻利，将要形成慢惊风，头面大热，嘴唇焦裂舌头黑，也像是实火，这是火不归元的缘故。实火的特点是二便臊闭不通。虚火的特点是泻利不止。全在于细心体察，才能得其真相。《内经》说：“有的症状要探究其成因，没有的症状也要探究其机理，实证要责之于邪实，虚证要责之于正虚。”这是说万病都应当体察寒热虚实。治疗痘症，怎么能一概认为实火就可以肆意使用苦寒克削的药物，从而害人性命呢？
Smallpox (or variola) is characterized by "form" (shape) being full and plump, and "color" being red and vibrant. A depressed and non-elevated pustule head indicates Qi deficiency (deficiency of vital energy), while a lack of brightness in color indicates Blood deficiency (deficiency of nutritive blood). Treatment should primarily focus on nourishing and tonifying Qi and Blood. In cases of true Yang deficiency, there is no red halo, and the entire body may appear white, with the body feeling cold and not warm. The Da Bu Yuan Jian (Great Tonification Decoction for the Source) should be used; once Yang returns and the body warms up, the color will turn from white to red.
There is another condition where the entire body is covered with blood blisters. This is not due to excess Blood, but rather insufficient Qi failing to control the Blood, causing it to flow recklessly. One must urgently use Da Bu Yuan Jian. Once Qi and Yang are filled, the blood blisters will turn white (suppurate) and the patient will recover. Quack doctors, misunderstanding this principle, erroneously claim it is Blood Heat and mistakenly use cold and cooling herbs, leading to an increase in complications day by day.
Form and color are external manifestations. If the patient has an appetite for food and bowel and urinary functions are normal, one can ascertain that there is no internal disease, and medication may be withheld. However, if bowel and urinary functions are irregular, food cannot be taken, and the patient experiences irritability, confusion, and restlessness at night, even if the form and color appear good, it is a matter of great concern. One must carefully examine the condition and administer medication cautiously to save life.
Poor form and color are mostly due to Qi deficiency and Cold, accompanied by cold extremities, heavy head, mental fatigue, clear stools, and diarrhea. Da Bu Yuan Jian must be used, combined with Fuzi (Prepared Aconite Root) and Guizhi (Cinnamon Twig). If diarrhea persists, Longgu (Fossilized Bones) and Susuke (Poppy Shell) should be added to astringe and stop the discharge, which can then restore life.
Redness is prized in smallpox, categorized into Quan Hong (Ring Red), Xun Hong (Scattered Red), and Pu Hong (Spread Red). Quan Hong refers to a distinct ring of redness tightly adhering to the base of the pustule, which is the most auspicious sign. Xun Hong refers to the blood color at the base appearing faint and scattered, also due to Qi's inability to consolidate; rapid tonification of Qi and Blood is required. Pu Hong refers to a flat spread of redness extending to areas without pustules, indicating indistinct boundaries. If accompanied by aversion to cold, thirst with desire to drink, foul-smelling and scanty urine, and dry, constipated stool, it indicates internal heat. Bai Hu Di Huang Tang (White Tiger and Rehmannia Decoction) should be used to clear heat and promote urination. Once heat subsides and the body cools, mild tonification should be adopted, avoiding excessive doses.
Another type is Xi Guang Dou (Tin-Light Pustules), where the body is cold and not warm, and the color is white without redness. This is Yang deficiency, representing Yin manifestation. It requires massive tonification of Qi and Blood, using Fuzi and Guizhi together. When Qi is sufficient and Yang returns, the pustule base turns red, and the pus becomes thick, forming scabs. Another type features a base without a red disk and a top containing black fluid. This indicates severe Yang deficiency and congealing of Yin. Da Bu Yuan Jian combined with Fuzi and Guizhi is appropriate, transforming the black fluid into pus.
There are five types of blisters: Water Blister, Pus Blister, Ash Blister, Blood Blister, and Purple Blister. There are five types of depressions/collapses: White Collapse, Ash Collapse, Blood Collapse, Purple Collapse, and Black Collapse. Water blisters have thin, transparent skins. The Classics state that Qi heat generates water, knowing that clear serum is water. Why does it not become pus? Because Fire (Yang) is insufficient. Large doses of Jiang (Ginger), Gui (Cinnamon), and Fuzi (Aconite) must be administered abruptly; the water will then transform into pus. If cooling herbs are mistakenly used, causing diarrhea, it transforms into White Collapse. Neglecting Pus Blisters leads to rupture and discharge of pus. Neglecting Ash Blisters leads to Ash Collapse. Both conditions require large doses of Renshen (Ginseng), Shudi (Prepared Rehmannia Root), Fuzi, and Guizhi. If small granules emerge, it is called "the child saving the mother," indicating that vitality remains.
Blood blisters result from Qi deficiency, not Blood Heat. They also require massive tonification of Yuan Yang (Original Yang); otherwise, they transform into White Collapse. Purple blisters present two syndromes: Those with purple mixed with cyan are due to Qi deficiency failing to control Blood, causing Yin Blood to congeal. The patient必定 exhibits fatigue, aversion to cold, white tongue coating, poor appetite, and clear urine and stool. Rapid tonification of Yuan Yang is necessary, or it transforms into Purple Collapse. Another type is purple-black and scorched/dry, representing a syndrome of pure Yang without Yin. The patient必定 exhibits dry mouth, aversion to heat, scanty urine, and constipation. This is Excess Fire. Cooling and detoxification methods are indicated; Bai Hu Di Huang Tang with added Dahuang (Rhubarb) to promote purgation is suitable. As long as suppuration occurs, survival is possible; neglect leads to Black Collapse.
Furthermore, some children, after taking cooling herbs, experience abdominal pain, vomiting, and diarrhea, progressing toward slow convulsions. They exhibit high fever on the head and face, cracked lips, and a black tongue, resembling Excess Fire. This is actually Fire failing to return to its source (Mingmen). Excess Fire is characterized by foul, obstructed urine and stool. Deficient Fire is characterized by incessant diarrhea. Careful observation is essential to discern the truth. The Classics say: "For existing symptoms, seek their cause; for absent symptoms, seek their mechanism. For Excess, blame the pathogen; for Deficiency, blame the constitution." This means all diseases must be examined regarding Cold, Heat, Excess, and Deficiency. Can treatment of smallpox simply assume Excess Fire and indiscriminately use bitter-cold, draining herbs, thereby costing lives?