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At the initial stage, with alternating chills and fever, swelling in one area of the head and face, accompanied by redness, heat, and pain, is easy to treat. If it has progressed to high swelling with fever and pain, but the patient's voice remains clear and liquids/medicines are easily swallowed, it is a mild condition.

After ulceration, if the pus is thick, the indurated swelling gradually subsides, pain decreases, diet progressively improves, and body temperature is normal, it is auspicious. After ulceration, if the discharge gradually stops, swelling recedes, muscles relax, spirit and complexion are calm, and sleep is peaceful, it is a favorable course.

At the initial stage, with severe chills and slight fever, swelling involving the head, face, ears, and neck, where the skin is shiny like crystal and not hot locally, is dangerous. If it progresses to diffuse swelling without a head, trismus (lockjaw), inability to take in liquids or food, and loss of voice, it is an adverse condition. After ulceration, if the discharge is thin and watery, foul-smelling, pain and swelling persist, and the body swells like a corpse, death ensues. If after ulceration, foul water drips continuously, the swollen area is insensible to pain, hands and feet are cold, and delirium occurs frequently, death ensues.

With alternating chills and fever, dizziness, body pain, and floating-tight pulse throughout all six positions, the pathogen is in the exterior; sweating dispersal method should be used. With red and swollen head and face, dry mouth and throat, and constipation with hard stool, the pathogen is in the interior; purgation should be used. With exterior chills and fever, internal dry mouth, and strong wiry pulse, both exterior and interior are excess; release the exterior and attack the interior simultaneously. If both exterior and interior pathogens are resolved but swelling and pain persist, it is due to blood stasis coagulation; scarification to remove evil blood should be used. After scarification, if swelling and pain persist, suppuration is imminent; promoting suppuration and strengthening the spleen should be used. If swelling and pain increase daily with distending pain, pus has formed; urgent needle drainage is required, combined with tonifying and promoting methods for the spleen and stomach. After ulceration, if swelling and pain do not decrease, and pus is thin and fishy/foul, the spleen and stomach are weak; warming the middle and strengthening the spleen should be further employed. In years of famine when epidemic toxins spread contagiously, attacking and dispersing methods are contraindicated; harmonizing methods and nourishing healthy qi should be preferred.

A man presented with swelling and pain in the ear and neck, with chills and fever, and a floating-rapid pulse. One dose of Jingfang Baidu San (Jing-Jie and Fang-Feng Decoction to Overcome Toxicity) was administered; chills subsided but fever remained. Then, Liaoqiao Xiaodu Yin (Forsythia Decoction to Eliminate Toxins) was given; bowel movements occurred three times, internal heat suddenly subsided, but residual swelling persisted. The original formula had Da Huang (Rhubarb Rhizome) removed and Chuan Xiong (Szechwan Lovage Rhizome) added; several doses resulted in recovery.

A man first developed chills and fever. The next day, his entire head and face swelled. Two days later, he had trismus and could not take in liquids or food. His pulse was surging-rapid and forceful, indicating both exterior and interior excess. He also had throat obstruction making swallowing difficult. First, acupuncture needles were used in the throat area to release evil blood for about the time it takes to eat a meal, slightly opening the jaw. Then, Fangfeng Tongsheng San (Saposhnikovia Universal Benefit Powder) was administered slowly; bowel movements occurred three or four times. Evil blood was removed via scarification from the swollen areas, and Jinhuang San (Golden Yellow Powder) was applied externally. The next day, the swelling trend subsided slightly. Two doses of Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins) were given; facial swelling gradually subsided. However, hardness and swelling below both ears persisted, indicating impending suppuration. Several doses of Tuoli Xiaodu San (Support Interior Decoction to Eliminate Toxins) were given. Once the pus matured, it was drained by needle. Subsequently, Shiquan Dabu Tang (Complete Great Tonifying Decoction) with Rou Gui (Cinnamon Bark) removed and Chen Pi (Tangerine Peel) added was taken for over ten doses, leading to wound contraction and healing.

A man presented with swelling and pain at the gum roots, which then spread to the cheeks and neck, accompanied by sudden chills and fever. This was damp-heat in the Yangming channel attacking upwards. One dose of Jingfang Baidu San (Jing-Jie and Fang-Feng Decoction to Overcome Toxicity) with Shi Gao (Gypsum Fibrosum) was given; chills and fever subsided suddenly, but cheek swelling persisted. Acupuncture needles were used on the swollen gum root area to release toxic blood. Bingpeng San (Ice and Borax Powder) was applied topically, Zhenjun Miaotie San (Miraculous Paste of the True Lord) was applied externally, and Niubangzi Tang (Arctostaphylis Decoction) was taken internally; several doses resulted in recovery.

A man presented with red and swollen ears and face in winter, with fever, dry mouth, surging-solid pulse, and constipation. This is a syndrome of heat accumulation in the Three Yang channels. Treatment must set aside seasonal considerations and focus on symptoms. One dose of Wuli Dahuang Tang (Five Benefits Rhubarb Decoction) was given; two bowel movements occurred, redness and swelling slightly subsided, and internal heat slightly dispersed. Two doses of Shengma Jiedu Tang (Cimicifuga Detoxification Decoction) were given; swelling also subsided and the disease healed. This illustrates the principle of "using cold remedies while avoiding cold seasons" (adapting treatment to pathology rather than rigidly following seasonal restrictions).

A woman presented with facial swelling and sore throat in winter, trismus making it hard to open the mouth, and a surging-rapid, forceful pulse. Additionally, the room felt hot as if roasted due to the stove fire. One dose of Huanglian Jiedu Tang (Coptis Detoxification Decoction) with Xuan Shen (Scrophularia Root) was given. The next day, swelling subsided and the throat cleared. Two more doses cured the disease.

A man presented with hard swelling in the temples after excessive labor, with unchanged skin color. I stated: This is a syndrome of Qi and Blood injury with stagnation of damp-phlegm, different from external epidemic toxin invasion. His pulse was fine-rapid and powerless, indicating an internal injury damage syndrome. Treatment should nourish Qi and Blood, regulate meridians, and follow the principles of treating chronic fatigue and repairing damage. He desired internal resolution and self-administered Xianfang Huoming Yin (Immortal Formula for Preserving Life) twice; the swelling did not subside, damaging the spleen and stomach. Another doctor was consulted who used purgative methods, further damaging the zang-fu organs. Days later, he could not eat, suffered continuous diarrhea, the swelling became harder, and phlegm-saliva increased. When asked again, I declined to treat, stating: In therapy, diseases have primary and secondary aspects, and treatments require flexibility. At the onset, unchanged skin color indicates insufficient Blood; hardness without heat indicates weak Spleen and Stomach; fine-rapid powerless pulse indicates decline of Healthy Qi. How can one use drugs for excess conditions to attack a deficiency disease? Later, warm middle-tonifying supplements were forcibly administered, which failed, and he died.