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At the initial stage, there is no headache, no pain in the sinews and bones, no astringent or strangury-like urination, and dry, fine sores indicate a mild condition. If sores appear sparsely on the head and face, with no sores at the corners of the mouth, and although there are many on the neck, chest, and back but none around the anus, it is acceptable; however, if initially chancre (hard chancre) appears, followed by fish-mouth (a manifestation of syphilitic chancre), and subsequently bone and joint pain occurs, the outbreak of sores is an inauspicious sign. If the sores are red-purple, hard, and numerous on the hands and feet, resembling blisters caused by scalding hot water, the harm is not slight.

If the onset begins with astringent and strangury-like urination, then spreads to cause pain in the sinews and bones, and later sores erupt, one should also employ purgative and diuretic methods. If there are no external chancres and no internal bone/joint pain, but only a contraction of epidemic qi, mild dispersal is sufficient. If chancre arises from unclean sexual intercourse, causing obstructed and difficult urination, one should use promoting drainage and diuresis methods. For itching and numerous sores in the upper body, eliminate wind and clear heat; for severe pain and itching in the lower body, prioritize draining dampness. For red-purple, intense toxicity with elevated sores, cool blood and resolve toxicity; for pale-white, mild toxicity with flat sores, combine purgation with draining dampness. For dry and rough skin on hands and feet, resembling goose-palm wind (tinea manuum), fumigate and wash with decoction of cypress leaves and two alums (alum and ferrous sulfate), which will lead to recovery. For loss of hair and eyebrows, known as oil wind (alopecia), there is no need to elaborate; taking Shenyang Zhen Dan early can treat sparse hair loss. For speckled poplar-flake tinea and patchy leprosy-like sores, take Huanji Wan, with efficacy as swift as sweeping.

A man suffered from this disease for over two months. He self-administered detoxifying and cooling agents without effect, and bone/joint pain persisted. This indicated exterior and interior coldness with deep-seated toxin difficult to expel; thus, acrid-hot herbs were needed to induce sweating. Wanning Dan was decocted with green onion and wine, taken orally, followed by bathing and covering to induce sweat: first, cold sweat poured like rain, then hot sweat, reducing pain by more than half. He then took Guiling Tang for over a month until the sore condition stabilized. Subsequently, he took Bixie Tang combined with Buzhong Yiqi Tang, and after another two months, he fully recovered.

Another man had white turbid urine with pain, followed by the eruption of chancres that swelled and ulcerated, with mild bone/joint pain. I stated, "This is impending syphilis." He did not believe me and consulted other physicians who used fumigation therapy. Although the chancres improved slightly, his bone/joint pain worsened, and his head felt distended and about to burst. He returned for treatment. At that time, his face was covered with red spots, indicating trapped fire qi difficult to vent. First, he took Liuhuang Jiedu Tang for two doses to purge fire toxin, then Chan Su Wan to induce sweating, allowing the toxin to emerge through the muscle surface. Afterward, the red spots gradually turned into sores, and bone/joint and head pain gradually decreased. He took Jiawei Yi Liang Tang for two months until all sores erupted, and bone pain ceased. He then took Jiedu Tianjiang San for 100 days until the sores receded, and another 100 days until he normalized.

A woman contracted the disease from her husband, suffering extreme bone/joint pain and severe chills in the evening. She took Renshen Baidu San for four doses, after which the chills subsided; however, pain persisted. She underwent sweating induction with Wanning Dan twice, resulting in the eruption of bean-sized spots. Her face, head, and back were completely covered, indicating intense toxicity. She took Fangfeng Tongsheng San for two doses to promote bowel and urinary movement, with Mang Xiao and Da Huang removed and Zao Jiao Zhen and Jin Yin Hua added. After more than ten doses, the sores enlarged, small ones like coins, large ones like cups, emitting foul odors and ulcerating, making sitting and standing unbearable. Externally, Shizhen San was applied to the ulcers to form scabs, repeated as they ulcerated. Internally, she took Jiawei Yi Liang Tang. After over two months, the sores gradually dried up; mild cases healed and shed, while severe cases took another six months to recover.

A student suffered from this disease for over a month and sought rapid cure. I said, "This disease differs from others; rapid cure will leave residual toxins for later." I declined treatment. Another physician claimed, "Complete recovery in half a month, with no future complications." Delighted, the patient applied mercury and danfan (chrome alum) to the palms and soles. The sores indeed healed within half a month. However, bone pain ensued, unresponsive to various medicines. Half a year later, internal toxins emerged as ulcers, causing unbearable pain spreading throughout the legs with no unaffected area. Two years later, his legs and feet became permanently bent, resulting in lifelong disability, accompanied by deafness and lack of coordination. Another man contracted sores from visiting prostitutes, experiencing bone/joint pain. I advised that lifting and dispersing methods were suitable. He desired internal resolution and consulted another doctor who prescribed seven pills, burning one pill on charcoal and inhaling the smoke per dose. After three doses, he suffered epistaxis and died that night. A prostitute suffering from this disease sought rapid cure via fumigation; three days later, she vomited several basins of fresh blood and died. These cases illustrate those who seek rapid cures and bring about their own demise, with no one to blame but themselves.