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Vomiting (Ou, 呕吐) refers to the act of producing sound without expelling matter; this is a disorder of Qi (vital energy). Expulsion (Tu, 吐) refers to expelling matter without producing sound; this is a disorder of Blood. When sores and ulcers present with swelling and pain, if there are sounds of vomiting or expulsion, one must examine the pulse. If the pulse is surging (Hong, 洪), rapid (Shu, 数), full (Shi, 实), and large, or if there is constipation accompanied by a preference for cold drinks, it is appropriate to reduce fire and clear the middle jiao, treating with formulas such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity). If the patient prefers hot drinks and fears cold while experiencing vomiting, and bowel movements are normal, Yangwei Tiaozhong Tang (Stomach-Nourishing and Middle-Regulating Decoction) should be used. If the pulse is faint and fine, accompanied by borborygmus, abdominal pain, diarrhea, and vomiting, Tuoli Wenzhong Tang (Supporting Interior and Warming the Middle Decoction) combined with Ershen Wan (Two Divine Pills) should be used, followed by Xiangsha Liujunzi Tang (Aucklandia and Amomum Six-Gentlemen Decoction); dietary intake will immediately improve, and Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) may also be used. In cases where patients with unruptured sores experience vomiting and nausea, it is due to severe toxin attacking internally and originally deficient Stomach Qi, hence these symptoms arise; treat with Liujunzi Tang (Six-Gentlemen Decoction) added with Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus), Banxia (Pinelliae Rhizoma), and Shengjiang (Zingiberis Rhizoma Recens). If sores have ruptured yet vomiting and nausea persist, or if there is anorexia, chest and epigastric fullness, borborygmus, abdominal pain, loose stools, continuous vomiting, persistent hiccups (Yue, 哕), inability to sleep, and intermittent confusion, Tuoli Wenzhong Tang should be used. The Neijing states: "When cold invades the interior, treat with pungent-hot substances, assisted by bitter-warm substances." Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) can warm the interior and exterior and emit Yang Qi from the interior to the exterior, thus serving as the sovereign drug. Qianghuo (Notopterygii Rhizoma et Radix), being bitter, pungent, and warm, can penetrate the joints.

Thirst (Ke, 渴) results from the consumption and depletion of body fluids, occurring when heat is extreme; it arises from the blazing of Heart Fire. If thirst occurs before the rupture of sores, it indicates that sore toxins are flourishing and invading the Heart and Lungs; the pulse will necessarily be surging, rapid, full, and large. It is appropriate to reduce fire and clear the Metal element (Lungs), treating with internal-draining agents containing Qin (Scutellariae Radix) and Lian (Coptidis Rhizoma). If the chi position of the pulse is surging and large but forceless, it is appropriate to nourish Yin and reduce fire, treating with herbs that greatly tonify Qi and Blood, or urgently using Danshen Tang (Ginseng Decoction), which is excellent. After the rupture of sores, if thirst persists due to severe deficiency of Qi and Blood—which occurs in eight or nine out of ten cases—treat with modified Huangqi Jianzhong Tang (Astragalus Building the Middle Decoction) combined with Bawei Wan (Eight-Ingredient Pill). For abscesses and carbuncles that have erupted, whether ruptured or not, modified Bawei Wan can be used with great efficacy. If there are no sores, but the Lung pulse is surging and rapid with severe thirst, an abscess or carbuncle will inevitably develop; this is the sign.