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Zhou Mei, aged twenty-three, was three or four months pregnant when she accidentally suffered from fright. Shortly after returning to her natal home for a visit, she experienced a miscarriage (half-birth). A few days later, she developed fever. Two days after the fever started, many pox appeared. By the fourth or fifth day, they were fully erupted, extremely dense, pale in color, and accompanied by vomiting. Observing her weak constitution and the fact that the pox erupted heavily after a miscarriage, physicians dared not administer treatment. Zhou Yue said, "How can one sit and wait for death?" He then used Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala), and Chen Pi (Tangerine Peel) to harmonize the Stomach Qi and stop vomiting, which made the pox color slightly redder and more vibrant. Delighted, Zhou Yue said, "This can be cured with warming and tonifying." He prescribed a large dose of Ren Shen (Ginseng), Lu Rong (Deer Antler), Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Zhi Gan Cao (Honey-fried Licorice), Ding Xiang (Clove), Rou Gui (Cinnamon Bark), and Mu Xiang (Aucklandia). The patient felt the pox color turn redder and more vibrant. If medication was withheld for half a day, the color would fade again. Therefore, two large doses had to be administered within a day and night. When the pus formation stage arrived, lochia had not completely ceased. Zhou Yue said, "This is like a leaking vessel (referring to leakage of Qi and Blood)." He modified the previous formula by removing Guan Gui (Cinnamon Twig) and Mu Xiang, and added Chao Hei Gan Jiang (Charred Dried Ginger), Mi Chao Sheng Ma (Honey-fried Cimicifuga), and Chai Hu (Bupleurum), each 1 qian 2 fen, along with E Jiao (Donkey-hide Gelatin) and Ai Ye (Mugwort Leaf), each 8 fen. After two doses, the lochia stopped. The modified formula (excluding those five herbs) was frequently administered. The pustules filled up, and scabbing occurred after more than twenty days. In total, over forty prescriptions were taken. Each prescription used 3 qian of Ren Shen (Ginseng) and Lu Rong (Deer Antler), and 1 qian of Ding Xiang (Clove) and Rou Gui (Cinnamon Bark). Other herbs were weighed accordingly. How could such ordinary standard methods suffice? After the pox, she suffered from swollen eyes with severe nebula. She took Qing Du Bo Yi Tang (Clear Toxin Remove Nebula Decoction) for dozens of doses until recovered.

Zhou's cousin's grandson, aged ten, contracted smallpox. The eruption was extremely dense, especially on the neck and nape, commonly known as "Locking the Neck." There were also several cases of sudden swelling and dark pox scattered elsewhere. Initially, the pox appeared purple-black. Physicians declared it incurable. Zhou Yue examined him; it had been over six days since eruption, yet there was still no pus. Perhaps one might still wish to resolve the toxin. Zhou Yue said, "Life depends only on the filling of pus. At this stage, what toxin remains to be resolved?" The child was delicate and refused medicine but liked drinking wine. (The ability to drink wine indicates it is not a adverse condition.) Zhou Yue said, "Drinking wine is appropriate at this time." He prepared a large dose of Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), and Lu Rong (Deer Antler) decoction, concentrated it, mixed it equally with good wine, and instructed frequent sipping. From Shen hour to Chen hour, one dose was consumed. The pox on the head and face were more than half filled with pus. At Wu hour, he suddenly had loose stools twice. Recognizing internal deficiency and Spleen weakness, Zhou Yue administered Shen Zhu San (Ginseng and Atractylodes Powder), mixed with 2-3 qian in thin porridge, stopping the diarrhea. Another dose of Ren Shen, Dang Gui, and Lu Rong decoction was given, and the pustules became fully filled. After scabbing, residual toxins were strong, causing constipation. Da Lian Qiao Yin (Large Forsythia Decoction) was used with Jiu Chao Da Huang (Wine-fried Rhubarb) 1 qian 2 fen. After several doses, the condition stabilized.

A three-year-old toddler contracted smallpox. During the scabbing phase, diarrhea persisted despite various treatments. Zhou Yue gave dozens of pills of Qi Wei Dou Kou Wan (Seven-Ingredient Cardamom Pill), but it failed to stop the diarrhea. The pills passed through the stool unchanged, indicating severe deficiency and slipping. Zhou Yue used the same formula, instructing the parents to soak the pills in rice water until soft, grind them into a paste, and mix with a little porridge for the child to eat. The diarrhea stopped, the pox scabbed, and the child recovered. (The method of administration was exquisite.)

A six-year-old girl contracted smallpox. Her symptoms were weak. She had taken many tonics beforehand. After scabbing, sudden persistent diarrhea occurred. Yi Gong San (Benefit the Work Powder) plus He Zi (Chebula Fruit) and Dou Kou (Cardamom) failed. The physician intended to use Qi Wei Dou Kou Wan. Zhou Yue asked, "This girl has always taken tonics; why is she now so deficient and slipping?" Upon examining her defecation, he noted she strained frequently, and the stool was scanty and yellow. This must be due to toxic qi flowing and depositing. He prescribed Jia Wei Si Ling San (Modified Four Poria Powder). One dose stopped the diarrhea. Later, due to dry and hard stools, Bin Lang (Areca Seed), Qing Pi (Green Tangerine Peel), and Chao Zhi Ke (Stir-fried Aurantium) were added. Several doses brought stability.

Xu Lingtai said: Among medical methods lost today, none are more so than those for smallpox. The origin of smallpox lies in the Zang-Fu organs, bones, and vessels, and manifests according to the times (Heavenly timing). What is meant by originating in the Zang-Fu, bones, and vessels is that at the beginning of human conception, when Yin and Yang Qi interact to form shape, movement begins with Fire. There must be residues that have not melted, lying dormant in the Zang-Fu, bones, and vessels. This is the root of smallpox. However, without external induction, it remains latent. When the cold, heat, Yin, and Yang Qi of Heaven and Earth accumulate malicious energy, corresponding to the Zang-Fu and Qi-Blood of the body, the toxin emerges. This is manifestation according to Heavenly timing. Since Heavenly timing varies with the Five Movements and Six Qi, and differences in root/branch and overcoming/recovery exist, and since individuals have different constitutions and inductions vary by time, treatment must understand the principles of creation to remedy these conditions. This is an extremely refined art. Why use cold-cooling to disperse and poisonous drugs to劫 (rob/seize)? The source of smallpox is nothing other than Qi and Blood. As the *Nei Jing* states: "When Fire is depressed, disperse it." If encountering hot weather where Fire easily erupts, clearing and resolving is appropriate. But in winter and spring, if Qi is constrained by Cold, eruption fails. If eruption occurs but Essence and Blood are insufficient, there is no pus. If pus forms but Essence and Blood do not follow, scabbing fails. Thus, warming-dispersing and tonifying-nourishing methods are indispensable. How can one generally use cold-cooling? Using poisonous drugs like Earthworms, Mulberry Insects, and Scorpions causes even greater harm. "Using poison to attack poison" applies only when toxic qi sinks inward and cannot be pushed out temporarily, borrowing their power to penetrate and erupt. These are critical cases, rare among thousands. Treating them as common medicines makes non-toxic cases increase toxicity. Patients die without resentment because they know he predicts death accurately. Who knows that taking his medicine leads inevitably to death? Only with high insight can one use medicine so effectively. Thus, life and death depend entirely on Qi and Blood. When clearing Fire and resolving toxin is needed, do so. When nourishing Qi and Blood is needed, use warming-supporting and tonifying methods. This preserves integrity. Alas! Erroneous theories spread since the late Ming Dynasty, becoming worse today. They simply use a few cold herbs, fix formulas by day, and if ineffective, add poisonous drugs. For a disease of extreme change and subtlety, establishing fixed and coarse methods makes laypeople think smallpox treatment is easiest, unaware it kills the most. Also: Vaccination (Variolation) is a immortal transmission with nine benefits. Things usually desire aggregation, but smallpox does not. Forcing eruption before time prevents toxin aggregation—Benefit 1. Things desire abundance, but smallpox desires scarcity. Forced eruption results in fewer pox—Benefit 2. Things desire size, but smallpox desires smallness. Forced eruption results in smaller pox—Benefit 3. Avoiding the malicious qi of seasonal smallpox—Benefit 4. Selecting mild days of Heaven and Earth—Benefit 5. Selecting times when children have no other illnesses—Benefit 6. Taking vaccine material from vaccinated sources, using non-toxic good seeds—Benefit 7. Natural smallpox requires full pus formation to prevent toxin sinking; vaccinated pox with 50%+ pus formation is harmless—Benefit 8. Natural smallpox takes twelve days to scab, sometimes a month; vaccinated pox returns in nine days—Benefit 9. Those who die after vaccination should not regret, as natural eruption would certainly be fatal—Benefit 9 (implied continuation). Dangerous pox or toxin generation after vaccination is due to physicians' inability to treat properly. If vaccinators also know treatment methods, perfection is achieved.

Zhu Yingwo treated a six-year-old boy with fever for two days. Upon initial reporting of spots, they collapsed. Examination showed spots lacked distinct shape. Parents believed the child would surely die. Zhu promised recovery in seven days. The child's complexion was pale and spiritless, indicating Qi deficiency and lack of vigor, hence no eruption. A heavy dose of Ma Huang (Ephedra) was given. Immediately after, ginger, green onion, and wine were used to crush and rub Hu Sui (Coriander). It was February. The child was covered and sat over fire. By dusk, Ren Shen (Ginseng) was administered to tonify. At midnight, the spots were clearly visible, forming sharp, round points. Over 1 liang of Ren Shen was consumed, and the child recovered.

For a child with eye opening after smallpox suffering from star-shaped nebula inside, Hangzhou rouge was soaked in water. The bottom was placed on the water surface. A new brush dipped in water on paper was used to apply to the eye three times a day. Recovery occurred in three days.