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There are two syndromes in smallpox: blood-heat and Qi-deficiency. For the blood-heat syndrome, people naturally know to use cooling-blood methods. For the Qi-deficiency syndrome, people naturally know to use tonifying-Qi methods. However, it is not well known that rashes (Zhen) first disturb the Yang aspect and then return to the Yin meridians, whereas smallpox (Dou) directly transmits from the Yin meridians to the Yang aspect. Therefore, for the initial stage of the blood-heat syndrome, although cooling-blood treatment is appropriate, if cold-natured agents are applied immediately, the pathogenic toxin will be frozen in the Kidney and become difficult to erupt. Thus, one must first use cooling, ascending, lifting, and dispersing herbs to allow the toxin to emerge from the Yin meridians and transmit to the Yang aspect, before treating with cooling-blood and clearing-heat agents. Regarding the Qi-deficiency syndrome, even if it manifests clearly, although tonifying Qi is indicated, one must wait until the toxin is about to resolve before tonifying the true Qi to control it. Therefore, when red spots first appear, tonifying Qi agents should not be added abruptly; even if the color slightly turns white, they should not be used hastily, because white indicates the toxin has not yet resolved. If tonics are administered at this time, the received tonification will intensify the pathogenic force, thereby exacerbating the trend of dryness and withering. Hence, when the color is slightly yellowish, large doses of Ginseng Radix et Rhizoma (Renshen, 人参) can yield miraculous effects. However, if the condition is vigorous and the color remains white, administering tonics lightly will hinder the mechanism of pus formation and eruption. Only in cases where Qi weakness prevents eruption should the Qi be mildly supplemented; once the Qi harmonizes, eruption will occur rapidly. Even when using Qi-tonifying herbs, surface-expelling and supporting methods should be combined. Generally, in cases of Qi weakness preventing eruption, it is merely a lack of Qi, not an excessive toxin that is difficult to release or rampant and unwilling to erupt. A slight assistance is like rain nourishing seedlings after a long drought; it supports the righteous Qi so that righteousness benefits, and assists in eliminating evil so that evil is subdued, allowing righteous and evil forces to distinguish themselves. If the rash has turned white but no yellow pus is visible, it indicates that Blood has carried the toxin and Qi has constrained it; the toxin is mixed with Qi and Blood, but due to their deficiency, they cannot transform and transport the toxin out. The pathogenic toxin is too strong and has lingered for a long time, so Qi and Blood cannot instantly dissolve the toxin within the lesion. Although the color is white without yellow pus, the toxin is currently at its peak. Administering tonics at this stage is akin to "providing grain to thieves"; supporting righteousness allows the toxin to receive sustenance, while attacking evil allows the toxin to avoid the sharp edge, ultimately damaging the true Qi. In such cases, gradual support is required until the toxin's锐气 (sharp energy) is slightly dampened, the pathogenic toxin slightly resolves, and the color turns slightly yellow, before administering strong tonification. In cases where fluid deficiency and Metal-dryness prevent natural pus formation, it is especially important to first nourish Blood and regulate Ying (Nutritive Qi). Since toxin resolution relies on pus, and pus formation depends on Blood, even if Blood becomes abundant momentarily, failing to investigate whether the deficiency is of Qi or Blood and indiscriminately using Ginseng Radix et Rhizoma (Renshen, 人参) will make dry and withered conditions even drier. Once Blood has nourished and promoted circulation, and pus flows freely, Ginseng Radix et Rhizoma (Renshen, 人参) and other supporting tonics should be continued directly without interruption. The *Classic of Internal Medicine* states: "Treating during the peak of excess will inevitably damage; treating according to decline ensures great success." This is Zhang Jingyue's humble opinion. Only when the pulse is weak, or when there are many pustules indicating Qi and Blood insufficiency, is preemptive warming and tonification most suitable to facilitate whitening and pus formation. If one waits until extreme deficiency and various complications arise before attempting tonification, it will be too late.