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The nose is the external orifice of the Lung. In the "Water Miao" variolation method, the vaccine material is inserted into the nose; its qi first transmits to the Lung. The Lung governs the skin and hair (pí máo), and Lung qi transmits to the Heart. The Heart governs the blood vessels (xuè mài), and Heart qi transmits to the Spleen. The Spleen governs the muscles (jī ròu), and Spleen qi transmits to the Liver. The Liver governs the sinews (jīn), and Liver qi transmits to the Kidney. The Kidney governs the bones (gǔ). The smallpox toxin resides within the bone marrow. Upon sensing the qi of the vaccine material, it erupts. Its toxicity then extends from the bone marrow to the sinews, resolving the toxin stored in the Kidney. It then extends from the sinews to the muscles, resolving the toxin stored in the Liver. It then extends from the muscles to the blood vessels, resolving the toxin stored in the Spleen. It then extends from the blood vessels to the skin and hair, resolving the toxin stored in the Heart. Finally, it extends from the skin and hair to the pustules (kē lì), resolving the toxin stored in the Lung. The toxins of the Five Zang organs are resolved layer by layer. Only then does the toxin transform into pus, forming crusts that eventually fall off. This is the sequence of transmission during variolation, which must not be ignored.

In the "Dry Miao" variolation method, a silver tube approximately five to six cun long, with a curved neck, is used. The smallpox scabs are ground into an extremely fine powder and placed at the end of the tube. According to the principle of "left for males, right for females," the powder is blown into the nostril. Fever also occurs on the seventh day. Currently, this method is widely used because it is simple, convenient, and avoids the risk of the vaccine qi leaking due to falling out. However, there is concern that future practitioners may use it improperly: blowing lightly prevents rapid entry, while blowing heavily makes it too fierce and difficult to bear. Moreover, excessive runny nose may cause the vaccine material to exit with the mucus, often resulting in failure. To establish a standard for posterity, one should adopt a method that is mild, stable, and foolproof. This is why only the "Water Miao" method is selected.

When children develop smallpox, at the time when the pustules are full and mature, their smallpox qi is abundant. One might take their close-fitting garments and have uninfected children wear them. After wearing them for two or three days without removing them at night, fever begins on the ninth or eleventh day. This is called "garment transmission." However, the qi transmitted this way is likely too weak to penetrate effectively, often resulting in no fever and no eruption. Since this method is ineffective, it should not be used.

Select children who have had a smooth course of smallpox. Use cotton swabs to collect their pustule fluid. Following the "left for males, right for females" rule, insert it into the nose of uninfected children to induce smallpox. However, obtaining the pustule fluid without the family's knowledge involves rupturing the pustules and stealing the material for vaccination. This causes the child's true qi to be drained and the toxin unable to resolve. Such acts are cruel and unethical. Those with shared moral principles should detest and reject this behavior utterly; how could anyone imitate it?