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Smallpox (Xiaochuan) must wait for three days; if the eruption does not appear or appears slowly, only mild diaphoresis (releasing the exterior through sweating) should be employed. If after diaphoresis the eruption still does not appear, it is appropriate to administer two doses per day. Only if the eruption fails to appear thereafter should vigorous diaphoresis be used. Although few spots may be seen, if the pulse is harmonious and peaceful, this indicates that the smallpox is naturally sparse; one must not recklessly use exterior-releasing methods. Exterior-releasing methods are thus constrained, let alone diaphoresis and purgation. Therefore, although smallpox symptoms resemble Taiyang disease (a syndrome caused by pathogenic factors invading the Taiyang channel), treatment should only employ gentle and balanced methods, without the rationale of diaphoresis or purgation. Moreover, even in Taiyang disease, if the exterior syndrome is unresolved, purgation is contraindicated; how much more so for smallpox, which must proceed to swelling and pustulation before resolution? Why do some claim that upon initial onset, purgation and detoxification are indicated? This is erroneous. Thus, during the initial fever with cold feet, headache, and rapid pulse—where differentiation from Taiyang disease is difficult—only mild muscle-relieving and slight exterior-releasing methods should be used. If there are internal injuries such as food stagnation, only mild digestion-promoting and chest-widening herbs should be given. If smallpox is mistakenly treated with Ephedrae Herba (Mahuang, 麻黄) preparations to induce sweating and purgation, Yang Qi will all exit to the muscular surface, inevitably leading to ulcerated lesions and visceral deficiency. Deficiency results in abdominal pain and spontaneous diarrhea, or chills and shivering. In severe cases, the interior lacks Yang Qi, leading to Yin epilepsy (Yin Xian), with many deaths. Furthermore, if large doses of Rhizoma et Radix Rhei (Dahuang, 大黄) are mistakenly used for purgation, toxic pathogens will sink into the deficiency and become latent, causing abdominal distension or panting and urgency, resulting in death. However, there are situations where diaphoresis or purgation is necessary to seize the disease. For example, before eruption, if heavy exposure to wind-cold constricts the skin and closes the pores (Couli, interstices), hindering eruption, diaphoresis is mandatory to harmonize Ying and Wei (Nutritive and Defensive Qi), allowing the eruption to emerge easily and toxins to dissipate. Without diaphoresis, toxins cannot exit outward but remain latent inside, creating the disaster of "locking the door and leaving the thief inside." Similarly, if high fever persists, worsening with irritability, thirst, delirium, coma, and urinary/fecal obstruction, toxins are accumulated in the intestines and stomach, binding with grain qi. Urgent purgation is required to cleanse waste and unblock the Zang-Fu organs. Without purgation, filth and toxins simmer within, posing the risk of "nurturing a tiger and leaving trouble behind." The *Book* states: "The head and tail [beginning and end] stages should not be purged." Some interpret "head" as the Upper Jiao and "tail" as the Lower Jiao, suggesting treatment of the upper should focus on dissipation and the lower on guidance, without purgation. Others argue that when smallpox has not yet manifested on the surface, the pulse and symptoms show exterior signs but lack interior pathology; purgation would prevent the evil from extending outward, hence the prohibition against purging at the beginning. When smallpox has manifested externally without any interior symptoms, lacking an internal root, and the stool is not severely dry, purgation causes toxic pathogens to counterflow and sink, deplete essence and blood even after crusting, hence the prohibition against purging at the end. Although theories differ, the principle is consistent. For favorable smallpox initially erupting without exterior-interior pathogenic invasion, nature should be allowed to take its course, with only supportive care needed for full recovery. If wind-cold blocks the exterior, only muscle-relieving methods should be used to allow natural eruption. Alas, seeing just a few spots, disregarding the severity of the latent toxin, while skin heat is not fully penetrated and pores are not loose, fearing non-eruption, practitioners use harsh diaphoretic drugs. With no outlet for toxins, the effect multiplies tenfold; ten lesions merge into one, termed "ban lan" (maculopapular rash). Viscera and seven orifices are affected; severe cases are incurable, while mild cases may suffer from sore throat, hoarseness, eye diseases, or nasal congestion.