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[Verse] Mild pain indicates a superficial location in the muscle and skin; severe pain indicates a deep location between the bone and sinew. Pain from deficiency worsens with hunger, without abdominal distension or obstruction, and is relieved by massage temporarily. Pain from excess worsens after eating, accompanied by significant distension and obstruction, is aggravated by touch, and is unbearable. Cold-type pain prefers warmth with no change in skin color; heat-type pain presents as burning redness and feels better with cold. Pain from pus formation shows swelling that rebounds immediately upon pressure. Pain from blood stasis is dull and persists even after ulceration. Wind-type pain and Qi-type pain both feature wandering migration; careful observation is needed to distinguish wind-stabbing from Qi-stabbing.

[Annotation] Pain arises from blockage, yet manifests in various forms: mild, severe, deficiency, excess, cold, heat, pus, blood stasis, wind, and Qi types. Mild pain occurs in the muscle and skin, indicating a shallow depth. Severe pain penetrates to the bone and sinew, indicating a deep depth. Deficiency pain intensifies when hungry, without distension or closure, favors massage, and provides temporary relief. Excess pain intensifies after meals, presenting with distension and closure, fears touch, and is intolerable. Cold pain is fixed in location, with unchanged skin color, and benefits from warmth. Heat pain features burning redness of the skin and comfort with cold. Pus pain involves chills and high fever, with local swelling that rebounds upon pressure. Pain from coagulated blood stasis begins with dull pain, slight heat and distension, turns purple with mild pain before ulceration, and ceases to hurt after ulceration. Wind pain moves rapidly. Qi pain wanders without fixed location and is unbearable stabbing pain. Such are the characteristics of various pains; they must be distinguished in detail.

[Verse] For carbuncles and sores not yet formed into abscesses, resolution or support methods are appropriate; once formed, one must distinguish the presence of pus. Hardness upon palpation indicates no pus; lack of heat indicates no pus, while heat indicates pus. Complete softness indicates mature pus; half-soft and half-hard indicates incomplete pus formation. Immediate rebound upon pressure indicates pus; no rebound indicates no pus, signifying extreme exhaustion of Qi and Blood. Rapid rebound upon deep pressure indicates thin yellow fluid; slow rebound upon deep pressure indicates foul, necrotic pus. Firmness with severe pain indicates internal blood; emptiness without pain indicates internal Qi. Pain upon light pressure indicates shallow pus; pain only upon heavy pressure indicates deep pus. Thin, raised skin indicates shallow pus; non-elevated skin indicates thick pus. Thick yellow and white pus should appear first, followed sequentially by peach-blossom colored pus and red watery discharge. Obese individuals tend to have more pus, while thin individuals have less; deviations from this pattern suggest ominous changes. Thick yellow pus indicates strong Zheng Qi (Upright Qi), while thin white pus indicates deficient Zheng Qi. Pus resembling flour paste or sewage is termed "failed paste" and is incurable. Pus discharged after sweating may still be curable; if pus is discharged but fever persists, treatment is futile.

[Annotation] In diagnosing carbuncles, sores, and ulcers, if the condition has not yet formed an abscess, employ internal resolution methods; if it has formed, employ internal support methods, distinguishing the presence, depth, and nature of the pus. Hardness on palpation signifies no pus. Lack of heat signifies no pus; heat signifies pus. Complete softness signifies mature pus. Half-soft and half-hard signifies incomplete pus formation. Immediate rebound upon pressure signifies pus; no rebound signifies no pus, due to extreme Qi and Blood deficiency. Rapid rebound upon deep pressure signifies thin yellow fluid. Slow rebound upon deep pressure signifies foul, necrotic pus. Firmness with severe pain signifies internal blood. Emptiness without pain signifies internal Qi. Pain upon light pressure signifies shallow pus. Pain upon heavy pressure signifies deep pus. Thin, raised skin signifies shallow pus. Unchanged skin color and lack of elevation signify thick pus. Generally, for carbuncles and sores, thick yellow-white pus should appear first, followed by peach-blossom pus, and then pale red water. Obese individuals suitably produce more pus; thin individuals suitably produce less. If an obese person produces little pus, it means the flesh has not rotted; if a thin person produces much pus, it means the flesh is decaying. Neither is auspicious. Furthermore, those with strong Zheng Qi often produce thick yellow pus; those with weak Zheng Qi often produce thin white pus; those with mixed deficiency and excess often produce thick white pus. Pus resembling flour paste or sewage is called "failed paste," representing an incurable condition where life cannot be saved. Only if pus is discharged after sweating can recovery occur; if pus is discharged but high fever persists, treatment is ineffective. The emergence of pus in carbuncles is analogous to sweating in Shanghan (Cold Damage) disease. Just as persistent high fever after sweating indicates deterioration of Shanghan, persistent high fever after pus discharge indicates deterioration of the carbuncle.