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The human body is characterized by unobstructed blood vessels and meridians, circulating like rivers and seas without any blockage. However, if pathogenic toxins suddenly invade the five Zang organs or six Fu organs, or if wind-dampness penetrates the skin and muscle layers (Ji-Cou), blood circulation will be impeded, leading to the onset of disease. The manifestations of toxin development are myriad; toxins may affect the Zang organs, the Fu organs, the Yang aspects, the Yin aspects, the Qi level, or the Blood level. There are numerous causes, too many to list. When manifesting in the Yang aspect, symptoms include redness, swelling, elevation, and severe pain. When manifesting in the Yin aspect, symptoms present as low, flat, grayish-white lesions, with variations such as being lighter during the day and heavier at night, or vice versa; their presentations are quite inconsistent. At the initial stage of the disease, some cases are cured with herbal remedies, while others remain unresponsive to prolonged treatment. If left unchecked for a long time, various adverse outcomes arise, such as the formation of calluses or non-healing wounds. In our school, when faced with such difficulties where conventional physicians are at a loss, we employ four unique herbs and thirteen miraculous formulas to resolve these issues. Physicians who can treat the world's rare diseases have never lightly transmitted these secrets to outsiders. Those who obtain them can reap substantial profits and benefit all living beings. These precious medicines are so valuable that even a king sitting on the throne would not exchange them for them. My descendants must observe this rule generation after generation; this is my earnest instruction!

Furthermore, according to Volume 7 of Huang Chenghao's *Zhe Gong Man Lu* (Casual Records of Broken Limbs), under the section on swellings and toxins: "For those suffering from toxic sores, it is common to administer the Thirteen Formulas or Xian Fang Huo Ming Yin (Immortal Formula for Saving Life) to eliminate toxins. However, elderly and weak individuals cannot tolerate this strong action, so Xue Lizhai substituted Tuo Li Bai Du San (Support Interior and Eliminate Toxin Powder)." Additionally, *Yi Yao Bian* records: "A person suffered from malaria that did not heal for a long time; after administering Jin Gong Wan (Golden Centipede Pill), the malaria ceased." Huang was a Jinshi degree holder in the Bingchen year of the Wanli era in the Ming Dynasty, and *Zhe Gong Man Lu* was completed in the Yihai year of the Chongzhen era. Thus, the origin of the External Surgery Thirteen Formulas likely did not begin in the Qing Dynasty.

I await writing the general outline of the treatise, clearly distinguishing Yin and Yang, interior and exterior. For carbuncles and sores, distinguish between red and white at the site of eruption; for boils and folliculitis, discern dark and light signs upon onset. Fill your belly with benevolence to leave kindness for the common people; invest your heart with compassion into the medical profession (Qing-Nang). For poisoning throughout the hundred bones, differentiate between surface and interior; penetrate the three barriers directly to understand Yin and Yang. Pass down the miraculous art of restoring life like water from the cauldron; let the miraculous formulas for saving lives shine in the Shu region. Behold the beauty of the Apricot Grove (symbolizing the medical field); know that the Orange Well has fragrant spring water. Do not let the ignorant people fail my medical grace; look forward to the enduring joy of heaven and earth.