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The manifestations of sores and carbuncles involve distinctions between favorable (Shan) and unfavorable (E) signs, as well as smooth (Cong) and adverse (Ni) courses, which must not fail to be differentiated. Historically, physicians treating sores have generally cited the Five Favorable and Seven Unfavorable signs, yet they did not realize that these specifically refer to the syndromes discussed for sores and carbuncles located within the internal organs of the intestines and stomach. For back carbuncles (Fabei) and neck carbuncles (Naoju), there are distinct favorable and unfavorable signs, which are recorded below.

The so-called Seven Unfavorable Signs: Restlessness accompanied by frequent coughing, abdominal pain with extreme thirst, or uncontrolled diarrhea and dysentery, or urination resembling strangury (Lin syndrome), is the First Unfavorable Sign; after pus and blood have been discharged, swelling becomes even more severe, the pus has a败坏 (decayed) color and foul odor, and the pain is unbearable to touch, is the Second Unfavorable Sign; gaze is abnormal, the black pupil is tight and small, the white sclera is greenish-red, and the pupil looks upward, is the Third Unfavorable Sign; panting, rough breathing, shortness of breath, mental confusion, and drowsiness, is the Fourth Unfavorable Sign; inability to move shoulders and back, heaviness in the four limbs, is the Fifth Unfavorable Sign; inability to take food, vomiting after taking medicine, and loss of taste for food, is the Sixth Unfavorable Sign; hoarseness, deterioration of complexion, cyanotic and red lips and nose, and edema of the face, eyes, and four limbs, is the Seventh Unfavorable Sign.

The so-called Five Favorable Signs: calm breathing and movement, knowing the taste of food, is the First Favorable Sign; regular and balanced bowel movements and urination, is the Second Favorable Sign; after pus ulcerates and swelling subsides, the discharge is fresh and odorless, is the Third Favorable Sign; bright spirit and clear voice, is the Fourth Favorable Sign; peaceful body qi, is the Fifth Favorable Sign.

In disease, some cases present symptoms consistent with the Seven Unfavorable Signs, yet the skin is tight and appears normal like a favorable case; some cases present symptoms consistent with the Five Favorable Signs, yet the skin is loose and weak like an unfavorable case. Such situations, can they be understood by those with shallow knowledge? It is commonly believed that if all Five Favorable signs appear, favorability cannot be exceeded; if all Seven Unfavorable signs appear, unfavorability reaches its extreme. In my opinion, when suffering from sores and carbuncles, if one or two favorable signs suddenly appear among the Five Favorable, it indicates that the sore may turn around; if one or two unfavorable signs suddenly appear among the Seven Unfavorable, deep caution is required. Generally speaking, regarding pulse diagnosis, pulses that are surging, slippery, coarse, or scattered are difficult to treat; pulses that are fine, choppy, slow, or delayed are easy to cure. These favorable and unfavorable signs can also be known through pulse diagnosis. Back carbuncles (Fabei), neck carbuncles (Naoju), and [missing text] are referred to as the Five Adverse conditions. The remaining symptoms such as heat, thirst, dysentery, and vomiting are likely due to toxic vapors entering the interior and damaging the zang-fu organs; treatment should follow the specific syndrome.