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Discussions on sores and ulcers are numerous; one must understand their depth. If the differentiation method is correct, it is as precise as a craftsman using compasses and squares, how could one discard it? Generally, there are three manifestations of sores and carbuncles: those that are elevated and soft originate in the blood vessels (xue mai); those that are swollen, depressed, and hard originate in the tendons and bones (jin gu); those where the skin and flesh colors are indistinguishable originate in the bone marrow (gu sui). Another method involves palpating the base of the swelling: if the base is firm, hard, and large, the disease is deep; if the base is small and superficial, the disease is shallow. The rare appearance of the "Seven Evils" (qi e, ominous signs indicating severe condition) suggests a deep-seated yu (carbuncle with yin characteristics); the frequent appearance of the "Five Goods" (wu shan, favorable signs) suggests a shallow yi (abscess with yang characteristics). Generally, superficial conditions are easy to treat, while deep and hard conditions are difficult to cure. The methods for seeking recovery cannot escape this principle.

When a sore or swelling has formed, one must differentiate whether pus is present to know the maturity of the sore, the urgency of its form, and the depth and quantity of the pus. One should observe whether puncture is appropriate to avoid danger. How can one apply puncture uniformly? If the area is swollen and painful upon pressure, the pus is deep; if slight pressure causes pain, the pus is shallow. If pressure does not cause significant pain, the pus has not yet formed. If the area rebounds immediately after pressure, there is pus; if it does not rebound, there is no pus (this view is incorrect; there must be fluid accumulation). If the entire body swells, becoming soft without pain, it is a blood tumor (xue liu). If the swelling increases daily but is not very hot, with occasional pulling pain, it is a qi tumor (qi liu). Recently, there have been cases of chancre poison (yang mei jie du, referring to syphilitic lesions), characterized by painful swelling, long-standing non-ulceration, or ulceration that fails to heal. There are also cases of wandering damp-phlegm (shi tan liu zhu) that do not resolve over time; although they eventually ulcerate, they discharge foul-smelling fluid continuously, leading to depletion of qi and blood and potentially death. Generally, sores with shiny, thin, and soft skin indicate the presence of pus; those with thick, hard flesh and low heat indicate that pus has not yet formed. These should be treated with formulas that support the interior and expel pus (tuo li pai nong).

The occurrence of yi and ju (sores and carbuncles) has no fixed location; distinguishing between life and death is essential. For lesions occurring in areas not associated with meridian intersections or joints, nor at the Shu-Mu points of the zang-fu organs, acupuncture and moxibustion treatments are detailed in specialized surgical texts. By verifying through pulse diagnosis, examining symptoms, observing the location, and assessing deficiency and excess, treatment according to principles can lead to survival even in the "Nine Deaths" (jiu si, highly dangerous locations). However, if patients conceal their condition, fail to seek early treatment, encounter incompetent physicians who misdiagnose, violate taboos, and neglect care, survival may be difficult even if the lesion occurs in a non-lethal location. The nine critical locations are: 1. Futu (the bulge on the anterior thigh), 2. Fei (the calf muscle), 3. Back (bei), 4. Five Zang Shu points (wu zang shu, back-Shu points of the five zang organs), 5. Brain (nao), 6. Mustache area (zi), 7. Temples (bin), 8. Chin/Jaw (yi). These nine places are critical joint areas; lesions arising here are difficult to prognosticate and require careful study and understanding.