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In ancient times, the size of bian stones (bian shi, a stone tool for draining blood) was made according to the suitability for the disease. The *Neijing* (Classic of Internal Medicine) states that needles, bian stones, and lancets are essentially the same. Currently, following the *Shengji Zonglu* (General Records of Holy Relief) · "Treatise on Erysipelas": the method is to cut with a sickle to induce bleeding, indicating that the condition is urgent and cannot be delayed. Bian Que said: For diseases in the blood vessels, treat them with bian stones. This cites *Suwen* (Basic Questions): "When blood is excessive, it should be drained." It also cites the chapter on "Qi, Blood, Form, and Will" (referring to *Suwen*: "Those whose form is at ease and spirit is joyful, their diseases arise internally; treat them with bian stones"). Generally, bian stones originated from the East, because the people of the East often suffered from sores and ulcers, so the method suitable for them was bian stones; the use of bian stones has its own indications, not limited to erysipelas. Whenever swelling rises, with red color and wandering boundaries, one should urgently use a sickle to cut. First, apply raw oil on the red area, then cut with a sickle; the key lies in draining the toxin. However, this method should not be used lightly, and caution must be taken against cutting too deeply. The *Neijing* says: "Pierce the skin without injuring the flesh," because each of the nine needles has its appropriate application. Although the bian-lancing method can treat sores and carbuncles, it should not be used rashly.

Sores and swellings arising externally are caused by the accumulation and knotting of heat-toxin qi internally. Generally, external swelling may have a head or be diffuse; the skin may be thick or thin; the toxin qi may be deep or shallow. Some cases are suitable for warm medicine patches, some for cool medicine patches; some allow changing the medicine when dry, some require wet changes. Due to differences in depth, the medicines used differ, thus distinguishing them is essential. If a sore/swelling is newly formed and appears to have a head, warm medicine should be applied immediately to draw out the heat, following the principle that "fire tends to dryness"; on the surrounding red areas, crushed cool medicine should be applied to suppress the heat trend and drive away evil pathogens, akin to extinguishing fire. Raw cool medicines possess strong momentum and potent nature/flavor; if practitioners do not understand the principles of materia medica and universally use herbal pastes, which have weak efficacy, trying to subdue such vigorous pathogens would indeed be difficult! Moreover, incompetent physicians who fail to assess the favorable or unfavorable course of the disease may use cold medicines indiscriminately, applying patches to chase the pathogen, causing the evil toxin to re-enter the interior and affect the Liver and Heart, leading to death in eight or nine out of ten cases. Generally, the method of application aims to dissipate swelling and toxicity, unblock blood vessels, and determine retention or expulsion based on cold/heat and favorable/unfavorable conditions. One must not rigidly adhere to fixed formulas without flexibility; how else can one disperse stagnation and promote suppuration? For swellings with thick skin, old soft cloth or paper flowers coated with medicine can be used as patches, changed when dry; for swellings with thin skin, gauze or thin paper coated with medicine should be used, changed before the medicine dries. After pus rupture, patches promoting muscle regeneration and warming the tissues should be applied, focusing on removing foul decay, discharging bad fluids, eliminating dead tissue, and generating healthy flesh, relying entirely on the power of warm ointments. Cold water-mixed powders should never be used for application. Blood vessels prefer warmth and dislike cold; if cold qi penetrates too deeply, blood stasis will occur, making recovery difficult.