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Sores and ulcers include carbuncles (Yong), gangrenes (Ju), and boils (Jie). The severity varies, and the depth of the lesion differs; some occur in a single meridian, while others involve two meridians. Treatment should focus on identifying the cause within one or two relevant meridians, rather than seeking causes in other unrelated meridians. Prescribing medications as Li Dongyuan did is correct. Furthermore, there are cases complicated by wind, dampness, phlegm, qi stagnation, blood stasis, yin deficiency, and other syndromes. Since the root causes of the diseases differ, treatment must be targeted at specific etiologies.

The symptom of "Yu Mao" (depression and dizziness/coma) in sores and ulcers, commonly referred to as coma, can be cured by inducing sweating.

If swelling occurs but is soft and painless, it is a Blood Tumor (Xue Liu). If the swelling is deficient in nature and yellowish, it is due to water retention. If swelling increases gradually without significant heat, accompanied by occasional pulling pain, it is Qi Stagnation with slight swelling, which will eventually suppurate after a long time. Various conditions such as strangury (Long), tumors (Liu), warts (You), and skin tags (Zhui) often spontaneously ulcerate internally when patients reach old age. Treating them in youth can prevent future worries.

When pain from a carbuncle or gangrene ceases, the body feels calm, appetite returns, and both pulse and symptoms indicate slowness (Huan), it indicates that the root should be treated. Therefore, mild and harmonious medicines (Wang Dao herbs) can be used for gradual treatment without adverse consequences. However, if the pulse is excess (Shi), accompanied by swelling, irritability, aversion to cold and fever, and all signs indicate an excess syndrome, only potent purgatives like Mangxiao (Natrii Sulfas) and Huanglian (Coptidis Rhizoma) [Note: Text says Huang, likely Dahuang/Rhei Radix] can eliminate the pathogen. Using mild medicines in this case is incorrect.

If a sore or ulcer forms a lump but does not suppurate, or if it suppurates with thin and clear pus, or if there is diarrhea with borborygmus, inability to eat, frequent vomiting, or cold hands and feet, these pulse and symptom patterns indicate deficiency. Only strong tonifying medicines can resolve this; using purgatives like Mangxiao and Huang would be inappropriate. Therefore, when treating such conditions, one must differentiate between exterior/interior and deficiency/excess, and treat according to circumstances to ensure complete safety.

Li Dongyuan stated that sores and ulcers have external and internal origins, and their treatments differ in cold and warmth. For externally acquired pathogens, the method should be to support the interior with warm agents. Conversely using cold agents would drive the pathogen from the skin and hair into the bone marrow. For internally acquired diseases, the method should be to dredge and drain with cold agents. Conversely using warm agents to support the interior would cause the disease from the bone marrow to penetrate outward to the skin and hair. This inevitably leads to simultaneous ulceration of the interior and exterior, merging into one large sore, assisting the pathogen to become toxic, causing hundreds of times more suffering. Mild cases become critical, and severe cases result in death.

Regarding male and female carbuncles and gangrenes, *Waike Jingyao* states that the treatment methods are no different. Zhu Danxi said: Women's temperaments are stubborn and fixed; compared to men, the difficulty of treatment is more than tenfold. Even when supplementation is indicated, one must consider their stubborn temperament. I once saw a woman who had been widowed early, enjoyed drinking and eating rich food, was fat and tall, and had a deep, vicious character. At sixty-six, she developed a back carbuncle near the spine. The physician made horizontal and vertical incisions to drain blood, mixed it with Wuxiang Shixuan San (Five-Aromatic Ten-Acun Powder), and administered it with wine for over a month. The physician failed to account for her depression from widowhood, toxicity from alcohol and meat, stagnation from her stubborn nature, and the seasonal heat. Consequently, the sore collapsed flat, lingering for two or three months without healing.