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One may engage in the practice of variolation (smallpox treatment). For instance, in the Upper Yuan period, the One White star; in the Middle Yuan period, the Four Green star; and in the Lower Yuan period, the Seven Red star, each governs for sixty years, which is called the Great Movement (Da Yun). Among them, the One White star governs the beginning of the Upper Yuan as a Water movement; the Two Black star governs the middle of the Upper Yuan as an Earth movement; the Three Jade star governs the end of the Upper Yuan as a Wood movement; the Four Green star governs the beginning of the Middle Yuan as a Wood movement; the Five Yellow star governs the middle of the Middle Yuan as an Earth movement; the Six White star governs the end of the Middle Yuan as a Metal movement; the Seven Red star governs the beginning of the Lower Yuan as a Metal movement; the Eight White star governs the middle of the Lower Yuan as an Earth movement; and the Nine Purple star governs the end of the Lower Yuan as a Fire movement. They proceed in order and shift sequentially, each governing for twenty years, which is called the Small Movement (Xiao Yun). The Great Movement controls its authority, while the Small Movement executes its decrees. This is the fundamental principle of the Luo Shu (a traditional Chinese numerical diagram). The ancients used the innate Five Elements theory of the He Tu (another traditional Chinese numerical diagram) to discuss the substance, and the Five Elements theory of the Luo Shu to discuss the function, which was indeed well-founded. Regarding the annual Qi (vital energy), there are differences in the Five Movements and Six Qi (two aspects of traditional Chinese medical meteorology). For example, Jia and Ji years correspond to Earth movements, favoring warmth and disliking cold; Yi and Geng years correspond to Metal movements, favoring coolness and disliking dryness; Bing and Xin years correspond to Water movements, desiring warmth but fearing cold; Ding and Ren years correspond to Wood movements, loving unobstructed flow but disliking stagnation; Wu and Gui years correspond to Fire movements, suitable for coolness but detesting heat. This is the succession of the Five Movements. As for the Six Qi: in Zi and Wu years, Shaoyin Junhuo (Ministerial Fire, corresponding to the Heart and Pericardium) governs the Heaven (controlling the climate of the first half of the year); Mao and You years have Zaojin (Dry Metal) governing the Earth (controlling the climate of the second half of the year), whereas in Mao and You years it is reversed (referring to different configurations); in Chou and Wei years, Taiyin Shitu (Damp Earth) governs the Heaven, and Taiyang Hanshui (Cold Water) governs the Earth, whereas in Chen and Xu years it is reversed; in Yin and Shen years, Shaoyang Xianghuo (Ministerial Fire) governs the Heaven, and Jueyin Fengmu (Wind Wood) governs the Earth, whereas in Si and Hai years it is reversed. This is the circulation of the Six Qi. Within a year, there are also the Main Qi (fixed climatic patterns) corresponding to the monthly commands, and the Guest Qi (variable abnormal climates) superimposed upon them; all must be distinguished and treated accordingly. Qibo said: When Jueyin governs the Heaven, its transformation manifests as Wind; when Shaoyin governs the Heaven, its transformation manifests as Fire; when Yangming governs the Heaven, its transformation manifests as Dryness; when Taiyang governs the Heaven, its transformation manifests as Cold. The Classics state: If one does not know the addition of the annual Qi, the prosperity and decline of Qi, and the origin of deficiency and excess, one cannot serve as a physician. Generally, the Heaven-governing Qi exercises the orders of Heaven, occupying the superior position, thus governing the first half of the year; the Earth-governing Qi manages the transformations of the Earth, occupying the inferior position, thus governing the second half of the year; the Annual Movement governs the Qi of generation and transformation between Heaven and Earth, occupying the central position, thus governing the entire year. The principles of Yun-Qi (Five Movements and Six Qi) are detailed here comprehensively. How can they not be examined? The toxins of smallpox originate internally from the Zang-Fu organs and externally correspond to the Qi movements. As Heaven moves, humans follow, without the slightest error. Therefore, for those treating smallpox, understanding the Qi movements is urgent. However, Qian Yi's use of cooling methods and Chen Wenzhong's use of warming and tonifying methods were not biases of these two individuals, but rather suited to the specific Qi movements of their respective times. Just like the book *Jiu Pian Suo Yan*, its elucidations contain profound truths, and its arguments are extremely detailed and clear. Although it mainly focuses on clearing fire and detoxifying, it also includes tonifying methods. It particularly emphasizes the use of Rhubarb because at that time, during the Lower Yuan Jiazi cycle, the Nine Purple Fire movement lasted for twenty years, so seven or eight out of ten cases required purging, while only two or three out of ten required tonification. Later readers of this book, unaware of the reason, might attempt to apply a single method universally. Could the shifting Qi movements really be so uniform? Now, we are in the Upper Yuan Jiazi cycle, where the Qi movement belongs to Water. If one recklessly uses bitter-cold herbs without realizing that this could cause hidden worries for those using Baochi Wan (a formula for infant care), what then? I have reviewed all books on smallpox treatment, none surpassing Mr. Wang Yutai's pediatric compilation. However, it is included among many other works, making the collection vast and overly complex with various formulas and theories, which might hinder learners from easy reference. Therefore, I have specially extracted the essence and summarized the key points, savoring the subtleties and absorbing the brilliance, adapting to the times, balancing ancient and modern practices, not rigidly adhering to methods but following their principles, not sticking to formulas but aligning with their logic. Readers of this compilation must comprehend the principles of tonification, purgation, warming, and cooling, and apply flexible variations within them. Those who cling to partial views and fixed methods cannot discuss the Great Dao and the art of weighing circumstances. As for the emphasis on Qi movements in smallpox and rashes, the ancients have discussed this in detail; it is not my original insight. Thus, I place this at the beginning of the book to present it to the world, wondering if this is appropriate. Hence this preface. Written in the first month of winter in the Xinsi year of the Kangxi reign by Li Pudong, styled Baimeshan, from Guyue.

[Tan Jinzhang's *Cheng Shu Dou Zhen*] Three volumes. Extant.
[Zhang Yanyan's *Zhong Dou Xin Shu*] Twelve volumes. Extant.
Preface: To create something unprecedented in history, to distill unique insights, and to refresh the perceptions of Traditional Chinese Medicine (Qihuang), one can truly be called "new." In the field of smallpox treatment, there are numerous renowned experts, and the methods are abundant. Yet, those who stick to narrow perspectives are constrained by limited views and fail to achieve flexibility; those who follow old tracks are bound by conventional methods and do not know how to adapt. They merely repeat old chapters, perpetuating the same traditions. Considering old chapters, no medical texts in the world previously mentioned variolation. Does this mean that treatments for smallpox should be transmitted to the world, while the technique of variolation should not be shared? Perhaps the secrets were kept private and not written down, and the skills hoarded rather than made public. I now reveal what others have withheld and transmit what others have not shared. If the book is not new, what else could be called new? Some say: Smallpox is the most dangerous condition. During epidemics, people are terrified and try to avoid it as much as possible. How can one gather infants and inoculate them without warning, effectively giving disease to healthy children? Would benevolent people bear this? I reply: Not so. Smallpox toxin is innate, rooted in the fetal constitution since the moment of yin-yang interaction. Once triggered by shifts in the Five Movements and seasonal epidemic Qi, it invariably erupts. If one waits until eruption to treat it, the epidemic spreads, symptoms become complicated, and if handled by incompetent physicians who cannot distinguish exterior-interior, deficiency-excess, or understand warming-cooling and harmonizing methods, death may result instead of recovery. Blaming heaven for such disasters is unjust. This is why I deeply lament the importance of preventing disaster before it arises and ensuring safety before danger occurs. By using good seedlings to induce the innate toxin during healthy periods, the toxin will not act violently, and symptoms will naturally be mild. Can human effort usurp the power of creation? No, it is merely a way to seek auspiciousness and avoid calamity, ensuring safety, and a benevolent method for caring for children. My ancestors learned from Master Nie Jiuwu, and the family tradition of variolation has continued for generations. I studied my father's writings, observed nearly ten thousand cases of smallpox, and spent decades thinking hard about treatment methods. I learned from the ancients but did not blindly follow them; I read books but did not accept everything uncritically. I differentiated syndromes, prescribed medicines according to diseases, transformed severe cases into mild ones, adverse ones into favorable ones, and critical ones into safe ones. Even in untreatable cases, I attempted treatment. Now, aged and weary, lacking the desire to travel widely, I record my lifelong learning in this book. I dare not claim to have created something unprecedented, but rather share my unique insights with the world to supplement methods for child care and refresh the perceptions of Traditional Chinese Medicine. Hence, I titled it *Zhong Dou Xin Shu*. Written in the mid-spring of the Xin-you year, sixth year of the Qianlong reign, by Zhang Yan, courtesy name Xunyu, from Ninyang, Tingshan Tingjun.

[ Zhu Xijia's *Dou Zhen Ding Lun* ] Not seen.
[ Anonymous *Dou Ke Zheng Zong* ] Not seen.
Li Dou stated: For newborns, variolation is essential. Otherwise, there are two treatment methods. One is lifting and supporting with tonification to promote pus formation, initiated by Nie Jiuwu's *Huoyou Xinfa* and detailed in Zhu Xijia's *Dou Zhen Ding Lun*. The other is purging downward to eliminate toxins, starting with *Jiu Pian Suo Yan* and expanded in *Dou Ke Zheng Zong*. Since smallpox toxin originates from the congenital state, it tends to manifest outwardly and should not be resolved inwardly. Using standard methods favors Nie's approach. However, if caused by epidemic infection, the disease relates to plague, making the purgative method of *Zheng Zong* more suitable. This explains why Zhang Zhongjing's Shanghan treatment and Wu Keyi's Wenbing theory coexist without contradiction. Recent physicians tend to overuse purgatives, while a few traditionalists criticize them based on Nie's teachings, unaware that both are biased viewpoints. (From *Yangzhou Huafang Lu*)

[Wu Jianniu's *Yi Chuan Xi Dou Jing Yan Liang Fang*] One volume. Extant.
[ Anonymous *Dou Zhen Chuan Xin Lu*] Nineteen volumes, including *Ciyou Chuanxin Caisha Zhongdou Fa*. Not seen.
Note: Listed above in compiled bibliographies, Cheng Yongpei's *Luli Zhai Yishu*.

[Shu Zhao's *Dou Zhen Zhen Quan*] One volume. Extant.