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The toxin of smallpox (dòu) should originate from the diet of the pregnant woman. It has been seen in *Wu Shi Dou Ke* (Wu's Smallpox Manual) discussing that the toxin resides in the Spleen Meridian, stating that the qi and flavor of food belong to Dampness (Shī), and Dampness originally stems from the Spleen; pregnancy relies on Spleen Qi for nourishment. If the mother's Spleen Qi has Damp-Heat (Shī Rè), it invades the fetus's Spleen Meridian, just like a bean seed in soil: when the time is not right, it remains silent and motionless; only when Yang Qi (Yáng Qì) drums outwardly and sprouts generate internally can it then grow into a shoot, bloom, and bear fruit. Moreover, objects rot in water, become infested in wood, burn in fire, metal is hard and cannot contain things, only Earth (Tǔ) can receive things for a long time, and can also plant vegetation and produce fruits. According to this discussion, it is most insightful. Its statement that the smallpox toxin resides in the Spleen merely indicates that the Qi of the Taiyin Meridian (Tàiyīn Jīng) is not yet pure; the word "toxin" should not be taken too literally. From this, we know that the ancients' methods for protecting infants, such as wiping the mouth and using formulas like Zhu Mi (Cinnabar and Honey) to purge foul feces, were not without insight. The theory of the Gate of Life (Míng Mén) storing toxins thus needs no further confirmation.

Smallpox is originally a heavenly sore. Initially, it invariably occurs due to sudden warming of the weather, where Qi leaks outwards, and Damp-Heat steams up to form smallpox. This is similar to adults suffering from Spring-Warmth disease (Chūn Wēn), both presenting the same phenomenon of moving from interior to exterior. Therefore, Warm Diseases (Wēn Bìng) prohibit sweating and purging methods, and smallpox sores also prohibit sweating and purging. In cases of smallpox, if severe, the smallpox Qi steams and scatters far and wide. Weather connects through the nose, interacting like a bellows, inducing the eruption. Thus, although the manifestations are similar, they vary according to each person's constitutional Qi. The treatment method focuses on harmonizing Yin and Yang (Yīn Yáng), with promoting ascending and diffusing being particularly crucial. Generally, all sores belong to Fire (Huǒ); when Fire is constrained, it must be dispersed. Furthermore, since Qi enters through the nose, pathogenic factors located superiorly are especially suitable for guiding them outward via dispersion. If the toxin is deep and heavy, it will likely travel directly to the Membrane Source (Mó Yuán), disturbing the Triple Burner (Sān Jiāo), clashing with pre-existing Damp-Heat, obstructing Qi mechanism. In such cases, one should follow Yu Jiayan's method for treating epidemics: "The Upper Jiao is like mist; raise and expel it, accompanied by detoxification; the Middle Jiao is like fermentation vat; loosen and expel it, accompanied by detoxification; the Lower Jiao is like a drain; drain and expel it, accompanied by detoxification." This constitutes proper regulation without error. When Ying (Nutritive) and Wei (Defensive) Qi circulate freely, the smallpox eruption will proceed smoothly. One must first clear the path for the pathogen, then allow the Yuan Qi (Primal Qi) to recover and regulate itself; whether expanding or contracting, the key lies in acting as if doing nothing (following nature). Although smallpox originates from fetal Damp-Heat, the toxins are generally not very heavy. Only when foul and evil Qi penetrates while the internal Qi is deficient will the smallpox eruption be dense. Nowadays, variolation is prevalent, but if the selected vaccine material is poor, it easily leads to dangerous conditions, which is evident proof. Therefore, for heavy toxins, one must differentiate by the Three Jiaos to expel the pathogen, while simultaneously caring for Middle Qi to support the righteous Qi; merely treating the smallpox upon seeing it, and rushing to clear heat and resolve toxicity, inevitably leads to failure. Regarding the principle of first considering the annual Qi and not violating the Harmony of Heaven, the reasoning is extremely flexible and subtle. *Neijing · Zhizhen Yao Da Lun* details the treatment methods for Si Tian (Heavenly Ruler), Zai Quan (Earthly Sovereign), Jian Qi (Intermediary Qi), Zhu Ke (Host and Guest), and Sheng Fu (Overcoming and Retaliating) patterns, making it difficult to adhere rigidly to one approach. It does not mean that in Zi and Wu years (Fire-Dryness), treatments must all use clearing and moistening methods, nor that in Chou and Wei years (Damp-Cold), treatments must all use warming and tonifying methods. If one can treat diseases based on their specific conditions within the contexts of Yin-Yang, Exterior-Interior, Deficiency-Excess, Cold-Heat, Root-Accident, and Priority, then one will align perfectly with the Dao of Annual Qi and Heavenly Harmony.