种痘发热以前，小儿面部上忽出颗粒似痘，名曰信苖，此痘之将发，毒气之标也
，色红而暖，听之自消，若红紫坚硬，有如鱼目者，急以银针挑破，上以二圣散则无
虞。
（二圣散）明雄黄 紫草 共碾为细末，用油臙脂调上。
下苗后宜令亲切之入左右看守，恐他人用心不慎也，若视为泛常，看守疏忽，恐
小儿恶其苗塞鼻中，不时捏出，使苖气一泄，种多不验，所以种而不发者亦有之也，
然或小儿五内壮实，不受苗气，艰于传进不发者亦有之，更有胎毒深邃，潜藏内蓄，
虽苖气传至，不能引出不发者亦有之，俱当俟逾十一日为度，过此不发，然后察天时
和顺，再为补种之亦可。
种痘以七日为期，五藏传遍始发热者常也，或有至九日十一日而发者，如传送迟
慢之故，亦无足虑，若发热于五日以前，此时苗气尚末传至，其毒何由而发，必因种
后适逢天行时气，小儿感染而成，是乃自出之痘，非关苗气引出者，种痘者不可不知
，要当于未种之时，预为申明其说焉。
种痘乃引毒达表，乘儿安宁无病之时，事属顺吉，又何言治，然恐痘家过于溺爱
，起居不谨，饮食不节，此病所由生也，故治法亦所不免，当悉照治正痘之法治之可
也。
御纂医宗金鉴卷一
【方歌】手之三阳手外头，手之三阴胸内手，足之三阳头外足，
足之三阴足内走。
【注】手之三阳手外头者，谓手阳明大肠经，从手次指内侧之
端，上行手臂外之上行（音杭），至头鼻孔两旁也；手
少阳三焦经，从手四指外侧之端，上行手臂外之中行，
至头耳前动脉也；手太阳小肠，经从手小指外侧之端，
上行手臂外之下行，至头耳中珠子也。手之三阴胸内手
者，谓手太阴肺经，从胸乳上循行臑内，下行肘臂内之
上行，至手大指内侧之端也；手厥阴心包络经，从腋下
乳外，循行臑内，下行肘臂内之中行，至手中指之端也
；手少阴心经，从腋筋间循行臑外，外行肘臂内之下行
，至手小指内侧之端也。足之三阳头外足者，谓足阳明
胃经，从头目下循颊颈乳中，下行腹外股膝跗之前行，
至足二指之端也；足少阳胆，经从头目外眦，循行绕耳
颅巅，下行胁跨膝跗之中行，至足四指外侧之端也；足
太阳膀胱经，从头目内眦，循行额巅项背，外行臀腘〔
月专〕踝之后行，至足小指外侧之端也。足之三阴足内
走者，谓足厥阴肝经，从足大指外侧之端，循行前行上
内踝上腘〔月专〕，膝之中行，内行阴器腹胁之外行，
上至乳下也；足太阴脾经，从足大指内侧之端，循内联
踝膝里股内之中行，上行腹中至季胁也；足少阴肾经，
从足心循内联踝足跟内侧之后行，上腹内至胸也。诸阳
行外，诸阴行里，四肢背腹皆如此也。
在接种牛痘发热之前，小儿面部突然长出类似痘疹的颗粒，称为“信苗”，这是痘毒即将发出的征兆，属于毒气的外在表现。如果颜色红润且温暖，通常可自行消退；若颜色红紫、质地坚硬，状如鱼眼，则需立即用银针挑破，并外敷二圣散，即可无虞。
（二圣散）由明雄黄和紫草组成，共研为细末，用油胭脂调和后涂抹患处。
下种牛痘后，应安排亲近之人左右看守，防止他人用心不慎。如果视为平常事而看守疏忽，恐怕小儿厌恶鼻中堵塞的痘苗，不时将其捏出，导致苗气泄失，接种多无效验，因此出现种痘而不发痘的情况也有发生。然而，有的小儿五脏元气壮实，不受苗气影响，难以传变引发痘疹的也有；更有胎毒深重，潜藏体内蓄积，虽然苗气已传入，但不能引出痘毒而发痘的也有。这些都应当等待超过十一日作为观察期限，过了这个时间仍不发作，然后选择气候温和顺遂之时，再进行补种也可以。
种痘以七日为期，五脏传遍后才开始发热是常理。有的延至九日或十一日才发热，如同传送迟慢的缘故，也不必担忧。若在五日以前就发热，此时苗气尚未传至，痘毒从何而来？必定是因为接种后恰逢流行时气，小儿感染所致，这是自然长出的痘疹，与苗气引出无关。种痘者不可不知晓这一点，应当在未种痘之前，预先向家属阐明这一道理。
种痘是将毒邪引出体表，应在小儿安宁无病之时进行，事情属顺吉之象，无需特别治疗。但担心痘家过于溺爱孩子，起居不谨慎，饮食不节制，从而导致疾病发生，所以治疗方法也不可避免，应当完全按照治疗正痘的方法来施治。
【方歌】手之三阳经行于手外侧到头，手之三阴经行于胸内侧到手，足之三阳经行于头外侧到足，足之三阴经行于足内侧走。
【注】所谓“手之三阳手外头”，是指手阳明大肠经，从手食指内侧端，沿手臂外侧上行至头部鼻孔两旁；手少阳三焦经，从手无名指外侧端，沿手臂外侧中行上行至头部耳前动脉处；手太阳小肠经，从手小指外侧端，沿手臂外侧下行至头部耳中珠穴处。所谓“手之三阴胸内手”，是指手太阴肺经，从胸部乳上沿臂内侧下行至肘臂内侧上行端，止于手大拇指内侧端；手厥阴心包络经，从腋下乳外，沿臂内侧下行至肘臂内侧中行，止于手中指端；手少阴心经，从腋筋间沿臂外侧下行至肘臂内侧下行端，止于手小指内侧端。所谓“足之三阳头外足”，是指足阳明胃经，从头目下沿颊颈乳中下行至腹外股膝跗前行，止于足第二趾端；足少阳胆经，从头目外眦，沿绕耳颅巅下行至胁跨膝跗中行，止于足第四趾外侧端；足太阳膀胱经，从头目内眦，沿额巅项背下行，经臀腘踝后侧下行，止于足小指外侧端。所谓“足之三阴足内走”，是指足厥阴肝经，从足大趾外侧端，沿前行上内踝上腘窝膝中行，内行阴器腹胁外侧上行至乳下；足太阴脾经，从足大趾内侧端，沿内联踝膝里股内中行上行至腹中至季胁；足少阴肾经，从足心沿内联踝足跟内侧后侧上行至腹内至胸。诸阳经行于体表，诸阴经行于体内，四肢背腹皆如此规律。
Before the onset of fever following variolation, smallpox-like granules suddenly appear on the infant's face, known as "Xin Miao" (Sign Seedlings), which is a precursor to the eruption of smallpox and represents the superficial manifestation of toxic qi. If the lesions are red and warm, they will typically resolve spontaneously; however, if they are red-purple, hard, and resemble fish eyes, they should be promptly punctured with a silver needle and treated externally with Er Sheng San (Two Sage Powder) to ensure safety.
(Er Sheng San) Consists of Ming Xiong Huang (Realgar) and Zi Cao (Arnebiae Radix et Rhizoma), ground together into a fine powder, mixed with oil-based Yan Zhi (Vermilion/Oil Rouge), and applied topically.
After inoculation, close relatives should be assigned to watch over the child constantly to prevent negligence by others. If treated casually with lax supervision, the child may dislike the blockage in the nose caused by the seedling and frequently pick it out, causing the leakage of seedling qi. This results in poor efficacy, leading to cases where inoculation fails to produce smallpox. However, there are also cases where the child's internal organs are robust and resistant to the seedling qi, making transmission and eruption difficult; furthermore, there are cases where deep-seated congenital toxins are latent and accumulated internally, such that even though the seedling qi has transmitted, it cannot draw out the toxin to cause eruption. In all these instances, one should wait until after the eleventh day as a standard observation period. If no eruption occurs beyond this time, re-inoculation can be performed when the weather is mild and favorable.
The standard period for variolation is seven days; fever appearing after the qi has circulated through the five zang organs is the norm. Some may take nine or eleven days to erupt, similar to slow transmission, which is not a cause for concern. If fever appears before the fifth day, at which time the seedling qi has not yet transmitted, how could the toxin erupt? This must be due to infection from epidemic seasonal pathogens occurring shortly after inoculation. These are naturally occurring smallpox cases, unrelated to the seedling qi being drawn out. Variolators must be aware of this and clarify this principle to families before inoculation.
Variolation aims to guide toxins to the exterior. It should be performed when the child is calm and free of illness, representing a smooth and auspicious procedure requiring no specific treatment. However, parents often spoil their children, leading to irregular daily routines and unregulated diet, which can cause disease. Therefore, treatment methods cannot be entirely avoided; one should follow the same protocols used for treating natural smallpox.
[Formula Song] The Three Yang meridians of the Hand run from the lateral aspect of the hand to the head; the Three Yin meridians of the Hand run from the chest interior to the hand; the Three Yang meridians of the Foot run from the head exterior to the foot; the Three Yin meridians of the Foot run along the medial aspect of the foot.
[Annotation] "The Three Yang meridians of the Hand run from the lateral aspect of the hand to the head" refers to: The Large Intestine Meridian of Hand-Yangming starts from the radial side of the index finger, ascends along the lateral aspect of the arm to the head, ending beside the nostrils; the Sanjiao Meridian of Hand-Shaoyang starts from the ulnar side of the ring finger, ascends along the middle of the lateral aspect of the arm to the head, ending anterior to the ear at the temporal artery; the Small Intestine Meridian of Hand-Taiyang starts from the ulnar side of the little finger, ascends along the lower part of the lateral aspect of the arm to the head, ending in the ear. "The Three Yin meridians of the Hand run from the chest interior to the hand" refers to: The Lung Meridian of Hand-Taiyin originates in the chest/upper abdomen, descends along the medial aspect of the arm, ending at the radial side of the thumb; the Pericardium Meridian of Hand-Jueyin originates in the chest, descends along the medial aspect of the arm, ending at the tip of the middle finger; the Heart Meridian of Hand-Shaoyin originates in the axilla, descends along the medial aspect of the arm, ending at the ulnar side of the little finger. "The Three Yang meridians of the Foot run from the head exterior to the foot" refers to: The Stomach Meridian of Foot-Yangming starts from the head, descends along the face, neck, and chest, running down the anterior aspect of the leg to the second toe; the Gallbladder Meridian of Foot-Shaoyang starts from the outer canthus, winds around the ear and vertex, descends along the lateral aspect of the body and leg to the lateral side of the fourth toe; the Bladder Meridian of Foot-Taiyang starts from the inner canthus, runs over the vertex, down the back, along the posterior aspect of the leg to the lateral side of the little toe. "The Three Yin meridians of the Foot run along the medial aspect of the foot" refers to: The Liver Meridian of Foot-Jueyin starts from the dorsal aspect of the big toe, ascends along the medial malleolus and popliteal fossa, curves around the genitalia and abdomen to the hypochondrium, ascending to below the breast; the Spleen Meridian of Foot-Taiyin starts from the medial side of the big toe, ascends along the medial aspect of the leg to the abdomen and hypochondrium; the Kidney Meridian of Foot-Shaoyin starts from the sole of the foot, ascends along the medial malleolus and heel, entering the abdomen and chest. All Yang meridians run on the exterior, and all Yin meridians run on the interior; this pattern applies to the limbs, back, and abdomen.