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The external application of the four methods—rolling (Yun), fumigation (Xun), moxibustion (Jiu), and inversion (Dao)—is applicable to chronic injuries but not to acute injuries. In cases of acute injury, blood has not yet returned to its proper channels; there is a fear of the danger of stasis attacking the heart. The herbs are stir-fried in a pot until hot, treated with she vinegar (She Cu); after a short while, while still hot, they are wrapped in cloth, applied to the injured area for movement, and replaced when cold, continuing until sweat oozes from the site like oil.

For the fumigation method: whenever chronic injury exists between the skin and fascia, even if medicines promoting qi circulation cannot eradicate the root cause, one should first administer Gua Pi San (Melon Peel Powder). Subsequently, use three herbs: Luode Da Cao (Patrinia Herb), Chen Xiao Mai (Aged Wheat), and Ai Ye (Mugwort Leaf). Decoct them together in river water in a pot, bring to a vigorous boil, and pour into a small-mouthed vat. Place a board horizontally across the top; the patient sits on the board. Cover the body with a single blanket. For the Gua Pi San preparation: heat charcoal until red-hot on the ground, treat with she vinegar, spread straw upon it, lay a single blanket as a mat, and have the patient lie upon it. Cover with thick blankets to keep warm, inducing profuse sweating like rain. Afterward, administer Sheng Jin San (Winning Gold Powder) to achieve peace. This method must not be used for individuals with Qi deficiency constitution.

Regarding the inversion method: if the patient can speak but cannot eat, and no other treatment is effective, one may resort to expelling foul matter by vomiting. First, administer Liu She San (Sulfur and Musk Powder). Have the patient lie on a blanket; two people on each side pull and shake the blanket, causing the patient to roll and turn repeatedly to vomit foul matter. Subsequently, administer Meng Chong San (Leech Powder) and further regulate the condition for recovery.

For the navel moxibustion method: if the bladder is injured resulting in urinary retention, grind fresh Snail (Tian Luo) and Musk (She Xiang) into a paste. First place this paste in the umbilicus, then cover the navel with Fei Yan (Refined Salt) to the thickness of a copper coin. Apply moxa fire on the salt for two or three moxa cones (Zhuang); urination will then resume. Remove the musk afterward.

For the bloat-resolving warming compress method: when blood stasis accumulates forming a mass (Pi), located either in the hypochondrium or abdomen, oral medication may fail to dissolve it. Use refined flour (Fei Mian) to draw a circle around the mass according to its size, preventing foul matter from escaping. Fill the interior of the circle with Piao Xiao (Mirabilite). To prevent slipping at the edges, bind it with a strap. Place twenty to thirty layers of paper underneath. Heat an iron warmer and apply it to the area. When a rustling sound is heard from the affected site, it indicates the resolution of the mass.

These rolling, fumigation, moxibustion, and inversion methods are employed out of necessity when patients are unable to take oral medications effectively, and should not be used lightly. If applied excessively to individuals with weak Yuan Qi (Original Qi), it may lead to breathlessness and syncope (Jue Ni). Physicians must exercise caution.