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The six pulses are the basis for determining the deficiency and excess of the Zang-Fu organs, the signs of the strength and weakness of Qi and Blood, and the verification of the flourishing and declining of Water and Fire. Therefore, treating all diseases must rely on pulse diagnosis to prescribe medication without error; treating smallpox is particularly effective when treatment is administered based on pulse diagnosis. Generally, the eruption of smallpox relies entirely on Righteous Qi (Zheng Qi) to fill and support the toxin to reach the exterior. The suppuration of smallpox relies entirely on Qi to warm it and Blood to moisten it. This is not merely a function of Qi and Blood, but also requires True Water and True Fire as the root of Blood, so that the power of warming and moistening is sufficient to accomplish the virtue of Qi and Blood. The crusting (shou ye) of smallpox relies both on the function of Earth (Spleen/Stomach) to transform toxins and embodies the principle of storage and return. Thus, Qi and Blood are considered the branch (biao), while Water, Fire, and Earth are the root (ben). Moreover, various sores, swellings, and toxic lesions are caused either by disharmony of Qi and Blood or by sudden contraction of external heat, without fixed limits of transmission through meridians. Therefore, they can linger for years, resolving internally through harmonizing Qi and Blood, or preventing pus and blood formation through detoxification and cooling. In contrast, smallpox is acquired from birth, rooted in the Kidney, originating in the Heart, and transmitting to the Liver, Lungs, and Spleen. It follows fixed timelines: within fourteen days, it progresses gradually from the head and face downward, showing spots, swelling, filling with fluid, and crusting before ending. How could there be internal resolution? How could there be failure to form pus? Therefore, one must regulate Qi and Blood, send the toxin out to the exterior, and fill/support to form pus. Thus, the toxin is transformed externally, and Yuan Qi (Original Qi) is restored internally. Even if external pathogens invade, there is little to worry about. Hence, those treating smallpox must, before the seventh day, when the condition is like a flower bud beginning to bloom and its momentum daily increasing with Qi rising above, assist Qi and Blood to fill the head and face with fluid. When Qi intersects in the middle, assist Qi and Blood to fill the chest and back. When Qi intersects below, assist Qi and Blood to fill the legs and feet. By borrowing the operation of toxic fire, filling and forming fluid becomes easy. With this medicinal power substituting for the function of Qi and Blood filling, after pus forms, Qi and Blood remain uninjured, and spirit remains unchanged. If one does not tonify Qi and Blood but recklessly uses detoxifying and cooling methods, delaying time, after the seventh day, the Qi of the "flower" will contract and fade. As Qi declines and descends daily, attempting to raise and lift Qi and Blood to reach the head and face for fluid formation is too late! Furthermore, as Qi and Blood decline daily, filling becomes difficult, toxic fire cannot be digested, severe cases attack the Zang-Fu internally, and mild cases generate various syndromes. Infants in ancient times had abundant innate endowment, so ancient formulas only focused on releasing the exterior and clearing heat, aiming for easy eruption and resolution, because Qi and Blood were sufficient, requiring no hesitation. Unfortunately, infants in recent times have thin constitutions. Although called "children of pure Yang," it is well known that Yin is insufficient and the endowed Yang is also weak. During the manifestation of this heavenly disease, many suffer from dual deficiency of Yin and Yang, making eruption and suppuration difficult. If initially one only focuses on releasing the exterior, those with deficient exterior cannot constrain the eruption, allowing toxins to surge out uncontrollably. Consequently, Qi and Blood filling will be incomplete, leading to difficulties in forming fluid and crusting. Those with interior deficiency will have further weakened Middle Qi, lacking the strength to carry toxins into shape. Ignorant practitioners use heavy toxic drugs for rapid attack, which is akin to cooking rice without grain; this leads either to transformation into deficiency causing internal collapse, or to bursting rupture resembling silkworm molting or snake skin shedding. Regarding suppuration, if one only seeks clearing and resolving, those with Yang deficiency will have their interior frozen by cold, and those with Yin deficiency will become dry at the exterior. Water and Fire fail to circulate, hindering无形 transformation, making it difficult for Qi and Blood to achieve tangible results. Moreover, children with thin constitutions cannot tolerate illness. Once fever occurs, Yuan Qi is damaged internally within a few days. Adding exterior-releasing and supporting measures causes Qi and Blood to be secretly consumed. For sparse smallpox, although deficient, life is not endangered; for dense smallpox, further damage cuts off vitality. Therefore, Zhang Tongqiu sought the ultimate truth: whenever the six pulses are surging (hong) and forceful, follow ancient methods to release the muscle layer (jie ji); if the six pulses are deep (chen) and faint (wei) with no force, use mild warming of the Middle Jiao to support the interior, ensuring Middle Qi is not exhausted, thereby inspiring Qi and Blood to forcefully expel toxins, causing swelling and fluid formation to arrive spontaneously. If the six pulses are wiry (xian) and rapid (shu) with no force, focus on strengthening Water (nourishing Yin) while assisting Fire (aiding Yang), ensuring sufficient moistening power, allowing natural eruption. Thus, it is evident that smallpox is the branch, and Qi and Blood are the root. The book states: Recognize the branch and root, treat only the root, and treating thousands will result in no harm. This is what is meant.