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When administering variolation, the primary consideration is mild and harmonious weather. The first, second, third, eighth, ninth, and twelfth lunar months are superior; severe cold and intense heat are both unsuitable. If absolutely necessary, the fourth, seventh, eleventh, and twelfth months may still be used for inoculation. However, the fifth and sixth months must strictly be avoided. Furthermore, if spring should be warm but turns cool, this logic applies analogously to summer, autumn, and winter. Whenever there is abnormal qi of the seasons (atypical climate), inoculation must not be performed.

After an infant reaches one hundred days of age, if their physical form and vital qi are substantial, spirit is robust, and they have no internal injury from phlegm-heat, food stagnation, or fright, nor external contraction of wind-cold, summer-heat, dampness, dryness, or fire, and possess no sores, leprosy-like conditions, scrofula (tuberculous lymphadenitis), or congenital toxins, they can be inoculated at the appropriate time.

Additionally, if a child’s face is ruddy with luster, eyes are bright and clear, and the Yin Tang (space between eyebrows), Shan Gen (root of nose), Nian Shou (bridge of nose), areas under the eyes, and corners of the mouth show no bluish-dark discoloration, and the two eyes possess spiritual brilliance, these are signs of a healthy child suitable for inoculation; otherwise, it is contraindicated.

Why did cowpox originate from cattle? Former sages sought to understand its cause. They observed small greenish-blue vesicles near the udder of cows, which resembled humanpox. From this, they deduced that cattle suffering from pox would have a mild condition, and transmitting it to humans would surely be harmless. Thus, following ancient acupuncture methods, they took the fluid from cowpox and inoculated it into the arms of humans, inserting the seed via needle puncture at specific acupoints. Within ten days, several pustules indeed appeared at the puncture sites. From initial fluid accumulation to full suppuration, and finally to crusting and falling off, there was no damage and no recurrence. This is likely because cattle are earth-associated animals, while the human spleen belongs to the Earth element. Using earth to guide earth, and through resonance of similar qi, efficacy is achieved. However, selecting high-quality, fresh fluid is essential.

Following the puncture inoculation, fever does not occur. For the first one or two days, the puncture site often resembles a mosquito bite. By the third or fourth day, the shape begins to appear, with the pox tip emerging and blood traces shedding. From the fifth to sixth days, it resembles small vesicles, surrounding fluid accumulates, and by the sixth to seventh days, the fluid is sufficient for suppuration, accompanied by slight itching. On the eighth and ninth days, suppuration is complete, slight pain occurs in the axillae, resembling small nodules, and slight heat is felt on the forehead and palms. This indicates the emergence of systemic pox. As the toxin manifests, fire moves, relying on primordial yang (Yuan Yang) for transformation. By the ninth and tenth days, red halos around the feet dissipate, slight heat subsides, the fluid turns yellow-wax colored, and the hardened center of the pox becomes grayish and forms crusts. After half a month, the crusts fall off leaving scars. These scars are lustrous and thick, with curled edges resembling small mushrooms. Upon close inspection, a few small vesicles remain in the center. When this condition is fully established, success can be declared.