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In all cases of toxic sores, first observe the apex: if it is elevated, it indicates abundant Qi. If the base is constricted, it indicates abundant Blood. Furthermore, observe the surrounding erythema; clear and distinct boundaries indicate robust Yuan Qi (Original Qi) and that the pathogenic factor has not dispersed. High and swollen lesions belong to Yang syndromes, implying no deep-seated toxicity; treatment should employ the "Supporting the Interior" method to accelerate suppuration, avoiding internal resolution methods, as doing so would hinder ulceration. Diffuse, flat, and collapsed swelling indicates inherent deficiency of Yuan Qi; urgent warm tonification is required to urge the toxin outward, while sweating and purging methods are contraindicated to prevent complications.

If at the onset the apex is flat, the base is scattered, the color is dark with slight swelling, there is no heat or pain, and the body feels fatigued, this is a "Rebellious" (Ni) sign. If the abscess has formed but remains hard, purple in color, fails to suppurate or slough, accompanied by dry mouth and irritability, this is also a "Rebellious" sign. If after ulceration the skin rots, the interior remains hard without draining, swelling persists, pain does not diminish, and mental restlessness occurs, this is a "Rebellious" sign. If after ulceration the pus is clear and thin, although necrotic tissue sheds, new flesh does not grow, and the complexion is ruined with a foul odor, this is a fatal sign. If at the onset Yuan Qi is not deficient and both symptoms and pulse are Excess, treatment should proceed smoothly. One must not hesitate in critical moments due to fear; one should stop medication once the disease is addressed, as stated: "If the medicine does not cause dizziness/discomfort, the severe disease will not heal." For those with chronic diseases and deficient Yuan Qi, even if residual or complicated symptoms remain, one must first consolidate the root before harmonizing, dispersing, or resolving them. This is known as "When momentum is weak, defend; when the root is established, the Way arises." The Classics state: Deficiency of the Du Meridian causes sores to emerge from the vertex; deficiency of the Bladder Meridian causes them from the back; deficiency of the Stomach Meridian causes them from the beard area. Thus, it is known that various sores arise from deficiency. Treatment relies on hot/warm herbs to disperse them. Even for Yang syndromes with heat and pain, warm herbs slightly balanced with cool agents are appropriate for stability.

Regarding various symptoms of pre-ulcerative swellings, regardless of whether it is early or late stage, if redness, swelling, irritability, preference for cold, constipation, thirst, and a surging, full, rapid pulse are present, this is called "Five Excesses." This indicates pathogens inside; treatment should involve purgation and drainage, such as Neishu Huanglian Tang (Coptis Decoction for Internal Draining), to cut off the source. If the body is cool, limbs cold, diarrhea with borborygmus, vomiting, poor appetite, and a fine pulse are present, this is called "Five Deficiencies." This indicates insufficiency of Yuan Qi; treatment should involve nourishment and tonification, such as Tuoli Xiaodu San (Interior-Supporting and Toxin-Resolving Powder) or Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), to cultivate the root. For Five Excesses, even in severe cold, strong bitter-cold herbs must be used to drain Yang and save Yin. For Five Deficiencies, even in intense heat, strong acrid-hot herbs must be used to scatter Yin and restore Yang. The Classics state: "Use cold remedies avoiding cold times; use hot remedies avoiding hot times; reverse this if there are false signs." Although this may violate seasonal norms, one must follow the syndrome. It is also said: "Treating disease requires examining defecation/urination," referring to determining the appropriateness of purgation at the current time.