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Smallpox (Variola) concerns life and death; it cannot be treated by those who are not proficient in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and the *Shanghan Lun* (Treatise on Cold Damage). Once a specialized school emerges, the scope of vision becomes narrow, and understanding is limited. Following the stream while losing sight of the source, this medical art eventually perishes. For instance, the initial use of Jianzhong Tang (Cinnamon Twig and Reishi Decoction for warming the middle and tonifying deficiency) led to the current situation of "inverted suspension" (a state of critical and difficult-to-treat illness).

Investigating the reasons for its exacerbation: seeing that at the onset of smallpox, there is heat in the blood, physicians are startled into regarding it as toxic fire. They then severely employ bitter-cold herbs to forcibly suppress it. At that time, when the fire is vigorous and eager to emerge, although suppressed by ice-like coldness, it remains in a stalemate, preventing immediate death upon ingestion. Physicians then believe that using these familiar drugs causes no harm. Consequently, the mechanism of Qi becomes depressed, the red halo deepens, irritability and heat increase, and everyone further believes it is due to severe blood heat and toxicity. They recklessly use cold-natured herbs, passing errors from one to another. This is the first drawback.

When encountering truly critical cases, they use alarmist language, declaring them incurable, yet continue to prescribe daily. The particular harm lies in the correspondence between their harsh methods and words. When delivering the final rites, families do not blame the physician's harsh technique but instead praise their diagnostic acumen. Physicians become even more arrogant, abandoning alternative strategies, making decisions with increasing precision, and gaining fame. This is the second drawback.

Families prefer theories of clearing heat and resolving toxicity. Women chatter, believing that purging food stagnation and descending toxic fire is the primary step. If one does not cater to their wishes, even if slight coughing or acne-like lesions remain after recovery, it is attributed to insufficient detoxification, blaming the previous physician. Or, after more than ten days, when all other methods are exhausted, Ginseng Radix et Rhizoma (Renshen, 人参) is reluctantly added to heat-clearing and attacking formulas, like patching a leak in the middle of a river. Only wheezing and chest distension are seen, and the heart remains warm after death. Ignorant people regret the error of using tonics, viewing them as poison. Contemporary physicians, deeply versed in worldly ways, strive to maintain social harmony. This is the third drawback.

Rigidly applying standard prescriptions is common throughout the country. Any deviation lacks support. Formulas become standardized through mutual recommendation; success claims credit, while failure avoids blame. This uniformity marks the beginning of the current medical practice. Those eager to propagate this "Way" do not realize their techniques are erroneous. Moreover, with hereditary traditions and lineages preserved in just a few pages of prescription books, their insight is short-sighted, unable to grasp spiritual flexibility. This is the fourth drawback.

With these drawbacks interlinked, infants, innocent and unaware, suffer this great calamity. With utmost sincerity, I reveal my heart to parents: In mild smallpox (Shun Dou), there are essentially no fatal cases, yet mismedication can cause death. In critical smallpox (Xian Dou), there is a path to survival, yet mismedication ensures death. In adverse smallpox (Ni Dou), there are still methods to seek life, yet mismedication accelerates death. Rather than mismedicate, it is better not to medicate.

In recent years, smallpox has been prevalent, with wailing heard in every household. Among mild cases, three out of ten die; among critical cases, seven out of ten die. Those who fortunately recover either have very sparse eruptions, belong to poor families unable to afford doctors, or have stubborn children who refuse to swallow medicine, vomiting it up immediately if forced. It seems as if divine help is required. Finding a case cured by medication is less than one in a hundred.

Once, a young physician's daughter died of smallpox. He wept bitterly. I smiled and said to him, "You should quote the *Zuo Zhuan* to justify yourself," and recited, "I have killed many of your sons; how could I avoid such retribution?" Alas! Do I enjoy slandering diseases? I merely wish to turn the tide slightly and open a ray of hope for infants. If one understands the teaching that "not taking medicine constitutes medium-level treatment" (Bu Fu Yao Wei Zhong Yi), more than half would survive. How much more so for those who are proficient in the *Neijing* and *Shanghan Lun*?