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Smallpox and chickenpox originally had no method of artificial inoculation; one typically contracts them only once in a lifetime. Their fiery intensity is as severe as that of cruel officials, and their wind-like sharpness is as swift as a blade. They cause harm by invading the hollow orifices and attacking the solid tissues deep within, reaching areas where hair does not grow. Upon recovery, when the lesions scab and fall off, the body returns to its original state, yet this is merely the whims of nature (Zaohua).

This chapter refers to eye diseases caused by smallpox and chickenpox. Smallpox and chickenpox are inherently difficult-to-cure sores. Terms such as "Tianhua" (Heavenly Flower) and "Da Xiao Guo Zi" (Big and Little Fruit Seeds) are euphemisms. The toxicity is extremely heavy; contracting it results in a condition often more violent than ordinary diseases.

Generally, from the time of endowment, various pathogenic factors accumulate deeply within the Zang-Fu organs. When the epidemic of smallpox and chickenpox occurs, infection with its Qi disturbs the pure and harmonious regions of the Six Channels and Hundred Meridians, disrupting the source of growth and nurturing.

Therefore, if the toxin attacks inward, the rash will deteriorate; if the toxin rises upward, the eyes will suffer disaster. Moreover, the Liver and Gallbladder are the offices of strategy and decision-making; evil and righteous Qi cannot coexist. The eyes are the residence of clarity and emptiness; how can turbid filth be allowed to fumigate them? Thus, whether eye disease appears immediately upon the eruption of the rash or only during the resolution phase, there are underlying reasons: either extreme exhaustion is unbearable, or the internal accumulation of toxin is too heavy. Alternatively, the Yuan Qi has not recovered, yet rich and greasy foods are overconsumed; or food supply is interrupted, accompanied by double the usual worry and bitterness. Although the causes of onset are diverse, the resulting symptoms converge into one category: some present with tearing and red, ulcerated eyelids; some with corneal opacity resembling congealed fat (Ningzhi) or yellow fluid rising (Huangye Shangchong); some with flower-white opacities or clustered star-shaped nebulae (Juxing); some with star-moon corneal erosion. Subsequently, protruding, necrotic, ice-fleck-like, or crab-pupil-like opacities may appear. Some transform into strabismus due to wind, or involve twitching and traction. Generally, one must think carefully and distinguish clearly, prescribing medication according to the meridians based on each individual's severity and deficiency/excess patterns. Although this condition is dangerous, there are methods to manage it. If one is ignorant and stubborn, relying on the ability to inoculate, and boldly ruining healthy children for no reason, it is akin to killing without a blade. There are also village women and foolish men who claim that inoculation is safer than natural epidemic infection, largely out of a naive hope that the inoculator will take responsibility and the "inoculation mother" will offer protection. How could an inoculator possibly possess a "Soul-Returning Pill"! Treatment methods: Regardless of the quality of the smallpox/chickenpox, if tears, photophobia, and slight redness are observed in the eyes, immediately use Huangdan (Lead Oxide), Qingfen (Calomel), and Weilingxian (Symplocos Root) ground into powder and blown into the ear. If symptoms do not recede, apply Yinzhu (Cinnabar) or Yanzhixue (Throat Fat Snow), Feixiong Dan (Flying Male Arsenic Pill). If still ineffective, regulate with Huoxue San (Blood-Invigorating Powder) or Shengjie San (Ascending and Resolving Powder); otherwise, use Xiaodu Yin (Toxin-Clearing Decoction) or Huadu Tang (Toxin-Transforming Decoction), or temporarily remove Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala). Although a complete cure may not be guaranteed, the disease can be suppressed and alleviated, transforming a severe condition into a mild one. However, this condition has specialized treatments. Works such as *Huoyou Xinfa* (Essential Methods for Pediatric Care) and *Youyou Jicheng* (Compendium of Infant Care) should be studied diligently in spare time, which will undoubtedly provide minor assistance in treating eye diseases.

My two full brothers each had eight sons, and my cousin's descendants doubled that number. Blessed by Heaven, none died of smallpox. My cousin Zhu had two sons who were already childhood age, handsome and intelligent. Worried that having too many children would result in pockmarked faces, he selected a famous expert skilled in attenuating smallpox and set up an altar for specific inoculation. The vaccine took hold, but the child died immediately. Had they left it to nature and not been confused by demonic talk, perhaps things would not have ended this way. Eventually, they had no heirs. Alas! Medicine is a benevolent art; those who perform inoculation—are they makers of arrows intended to kill?