痘之毒，当由妊妇饮食中得来，曾见《伍氏痘科》论毒藏脾经，云饮食气味属湿，湿本从脾，胎孕赖脾气生养，母
脾气有湿热，袭于子之脾经，犹豆种土中，非时则寂然不动，必待阳气外鼓，萌芽内生，然后苗而秀，秀而实矣。且物
入水则腐，入木则蠢，入火则焚，金坚不容物，惟土受物则可久，又能植物，又能生实也。按此论最为有识，其云痘毒
藏脾，只是太阴经气有未纯处，毒字亦勿太泥。即此知古人保婴用拭口法及朱蜜等方逐下秽粪，亦非不见到者。命门藏
毒之说，从此无容印定矣。
痘本天疮，其始也，无不因天时骤暖，气从外泄，湿热乃蒸而为痘，譬如大人病春温，同一自内达外之象，所以温
病禁汗下，痘疮亦禁汗下。病痘者，多则痘气熏蒸，飘泊远近，天气通于鼻，橐龠相感，引动而出，故证候相同，而亦
各随其人之体气为变动。治法以和其阴阳为主，而升发尤为吃紧。盖诸疮属火，火郁则发，况气从鼻入，在上者尤宜引
而越之。若毒厉深重，必直行膜原，扰动三焦，与素有之湿热，两相搏激，阻遏气机，则当如喻嘉言论疫之法，“上焦如
雾，升而逐之，兼以解毒；中焦如沤，疏而逐之，兼以解毒；下焦如渎，决而逐之，兼以解毒”，乃为调剂无误。荣卫得
通，痘出自顺。务宜先达其邪，而后听其元气之收发，拓之、敛之，贵在行所无事而已。盖痘虽本胎中湿热，然为毒皆
不甚重，惟秽恶之气，乘内气不实而潜入者，痘发乃密。今种痘之法盛行，而选苗不善，易涉险候，其明验也。故毒重
者，须分别三焦以逐其邪，即宜照顾中气以扶其正；但云见痘治痘，急于清解，无惑乎舆尸而归矣。至于必先岁气，无
伐天和，道理极变通，极精微，《内经·至真要大论》详列司天在泉、间气、主客、胜复之治法，最难执一，非子午火燥，
治皆清润，丑未湿寒，治皆温补之谓也。苟能于阴阳、表里、虚实、寒热、标本、先后之间，因病施治，即于岁气天和
之道，无不合矣。
痘毒，应当是由孕妇饮食中得来的。曾见《伍氏痘科》论述毒气藏于脾经，说饮食的气味属于湿邪，而湿邪本源于脾；胎孕依赖脾气来生养，如果母体的脾气有湿热，侵袭到胎儿的脾经，就像豆种在土中一样，不是时候就寂静不动，必须等待阳气向外鼓动，萌芽从内生发，然后才能长出苗、开花、结果。况且物体入水则腐烂，入木则生虫，入火则焚烧，金坚硬不容纳异物，只有土能容纳万物且持久，又能种植植物、产生果实。按照这种论述最有见识，它说痘毒藏于脾，只是太阴经的气血不够纯正之处，“毒”字也不必过于拘泥。由此可知，古人保护婴儿使用的拭口法以及朱蜜等方剂用来排出污秽粪便，也不是没有道理的。关于命门藏毒的说法，从此就没有必要再确定了。
痘疮本是天行疮疡，起初，无不因为天气突然变暖，气机从外泄出，湿热蒸腾而形成痘疮，譬如成年人患春温病，都是同样的由内达外的征象，所以温病禁止使用发汗和攻下法，痘疮也禁止使用发汗和攻下法。患痘疮的人，多则痘气熏蒸，飘泊远近，天气通过鼻子与人相通，如风箱般相互感应，引动痘毒发出，所以证候相同，但也各自随着个人的体质气息而变化。治疗方法以调和阴阳为主，而升发透疹尤为关键。大概各种疮疡都属于火，火郁结则需要发散，何况气从鼻入，病位在上者尤其适宜引导其向外发散。如果毒气深重，必然直走膜原，扰动三焦，与素有的湿热相互搏结激荡，阻遏气机，那么就应当像喻嘉言论述治疗疫病的方法那样：“上焦如雾，用升散法驱逐邪气，兼用解毒药；中焦如沤，用疏利法驱逐邪气，兼用解毒药；下焦如渎，用决泄法驱逐邪气，兼用解毒药”，这才是调理得当无误。营卫得以通畅，痘疮自然顺遂。务必先通达邪气，然后听任元气的恢复与调节，开拓或收敛，贵在看似无所作为（顺应自然）罢了。大概痘疮虽然本源于胎中的湿热，但作为毒邪都不算太重，只有秽恶之气，乘体内正气不实而潜入时，痘疮才会发得密集。如今种痘之法盛行，但如果选用的痘苗不好，容易涉及险恶证候，这是明显的验证。所以毒重者，必须分别三焦来驱逐邪气，同时也应当顾护中气以扶持正气；如果只是见到痘疮就治痘疮，急于清热解表，难怪会失败而归了。至于必须先考虑岁气，不破坏天和之道，道理极其变通精微，《内经·至真要大论》详细列出了司天、在泉、间气、主客、胜复的治疗法则，最难固执一端，并不是指子午年火燥，治疗都用清润法，丑未年湿寒，治疗都用温补法的意思。如果能够于阴阳、表里、虚实、寒热、标本、先后之间，因病施治，那么对于岁气天和之道，就没有不合的了。
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.