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For sores and ulcers (sores and ulcers), if the pathogenic toxins have formed pus, it is appropriate to use the method of supporting the interior (supporting the interior) to hasten the maturation of pus. When the pus has formed, one should examine its ripeness, depth, and shallowness before puncturing with a needle. If the swelling is high and soft, and pressing it causes pain localized under the finger, the pus is deep. If pressing leaves an indentation that does not rebound, the pus has not yet formed. If pressing causes immediate rebound, the pus has formed. Using a needle when pus has not yet generated will cause the leakage of Qi and blood, making it difficult for pus to form. If ripe pus is not drained by puncturing, the ulceration will deepen, and the wound will be difficult to heal. If the sore is deep but the puncture is shallow, internal pus will not drain, while external blood may leak out. If the sore is shallow but the puncture is deep, although internal pus may drain, healthy flesh will be injured. If the patient's Yuan Qi (vital energy) is weak, tonification must be performed first before puncturing; once the pus drains, various symptoms will naturally recede. If pain persists or there is irritability and vomiting after pus drainage, this is due to damage to Stomach Qi, requiring urgent tonification. For back sores with intense heat toxins and dark central flesh, internally use methods to support the interior and strengthen the Spleen and Stomach; externally apply Wujin Gao (Gold Ointment) to the dark areas. The red areas will gradually rise, and the dark areas will gradually lower. By the sixth or seventh day, a boundary between red and dark will appear with natural cracks, resembling knife marks, and the dark flesh will gradually slough off. At this point, sharp scissors should be used to slowly remove the necrotic tissue, ideally ensuring the patient feels no pain and sees no fresh blood. Even if cracks appear, if pus flow is not smooth, or if pain persists despite pus drainage, it indicates internal blockage; needles should be used within the cracks to guide drainage. For lesions between the shoulder blades where flesh rots and pus drains but swelling and pain persist, this is due to toxic sinews blocking the pus channel internally, requiring especially careful guidance of drainage. If Yuan Qi is weak and astringent/draining drugs are mistakenly taken, causing lack of pain at the site or impending death of flesh, urgent warming and tonification of the Spleen and Stomach are needed, and recovery is possible. Subsequently, purely tonifying medicines are necessary for healing. If knives and needles are used recklessly to cut flesh and cause bleeding, Qi will lose its anchor, Qi and blood will become more deficient, and Yuan Qi will be further damaged, making it impossible to promote flesh regeneration and wound closure.

Vomiting in sores and ulcers should not be treated solely based on the assumption of internal toxin attack, nor should detoxifying drugs be used indiscriminately. If heat is severe and pain is intense, indicating excess pathogenic factors, Xianfang Huoming Yin (Immortal Life Elixir Decoction) should be used to resolve the toxicity. If pain occurs during pus formation, indicating deficiency of Stomach Qi, Tuoli Xiaodu San (Support Interior and Detoxify Powder) should be used to tonify. If there is distending pain when pus is ripe, indicating Qi and blood deficiency, Tuoli San (Support Interior Powder) should be used first, followed by needle drainage. For vomiting caused by food stagnation, Tuoli Yizhong Tang (Support Interior and Benefit Middle Decoction) is indicated. For vomiting due to middle jiao deficiency and cold-dampness, Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction) is indicated. For vomiting due to Liver Wood overacting on Spleen Earth, Tuoli Yiqing Tang (Support Interior and Suppress Green Decoction) is indicated. For vomiting due to phlegm retention in the stomach region, Tuoli Qingzhong Tang (Support Interior and Clear Middle Decoction) is indicated. For vomiting due to Spleen deficiency itself, Tuoli Yihuang Tang (Support Interior and Enrich Yellow Decoction) is indicated. For vomiting due to constraint injuring the Spleen, Tuoli Yueju Tang (Support Interior and Resolve Depression Decoction) is indicated. If the root cause is not investigated in detail and toxic-draining drugs are used recklessly, swellings will not suppurate, and ulcers will not heal. Danxi stated: Vomiting during the swelling stage should be treated as toxin attacking the Heart; vomiting during the ulcer stage should be treated as Yin deficiency requiring tonification. However, he did not realize this was a general statement, referring to the meaning in *Neijing* that all painful, itching sores belong to Heart Fire. Moreover, nowadays, vomiting due to internal heat toxin attack is rare, while vomiting due to Spleen-Stomach deficiency-cold is common. How can one rigidly adhere to the words of past sages to treat current cases? Scholar Zhang Dehong suffered from a carbuncle on the back, with slight swelling and redness, and poor appetite. I used Liujunzi Tang (Six Gentlemen Decoction) and similar formulas; after pus formed and ruptured, I used formulas to greatly tonify Yang Qi, leading to flesh regeneration. This was because his Stomach Qi was exhausted, not due to the sore toxin. He said: "Indeed, it started after smelling foul odors while using the toilet early in the morning." This confirms the theory of Stomach deficiency. Use supportive tonification. A man had an abscess on his abdomen, which was swollen, hard, and unruptured, indicating weak Yang Qi; vomiting and poor appetite indicated deficient-cold of Stomach Qi; the treatment method should be to warm and tonify the Spleen and Stomach. [Text gap/fragment] ...if vomiting is caused by contracting cold pathogens or foul odors, even in the swelling stage, one should still assist the Stomach and strengthen Qi. That person did not believe this, continued taking draining/astringent drugs, and indeed died.