Abstract: Studying the understanding and treatment experience of ancient physicians on the etiology and pathogenesis of variola has important guiding significance for the use of traditional Chinese medicine theories and methods to prevent and treat monkeypox. By reviewing the understanding of physicians from the Western Jin Dynasty to the Qing Dynasty on the etiology, pathogenesis, diagnosis, differentiation, treatment and prevention of variola, this study aims to explore the origin and development of variola diagnosis and treatment, in order to provide ideas and methods for clinical research on the prevention and treatment of monkeypox disease.