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The manifestations of sores and ulcers are diverse. To distinguish their depth, one must employ the correct methods. If one is not familiar with the relevant theories and prescriptions beforehand, yet blindly performs incisions or punctures, it is like a master craftsman abandoning the ink line and measuring tools; how can one adhere to standards? As the ancients said, "Too much leads to confusion, too little leads to certainty." Briefly speaking, sores and carbuncles can be generally categorized into three types: those that are elevated and soft originate in the blood vessels; those that are depressed, swollen, and hard originate in the tendons; those where the bone, flesh, and skin color are indistinguishable originate in the bone marrow. It is also said: When treating sores and carbuncles, press and shake them with the hand. If the base of the swelling is firm and large, the disease is deep; if the base is small and superficial, the disease is shallow. Furthermore, verify by observing the patient's condition when the sore first appears: if they initially experience high fever with aversion to cold, limb stiffness and headache, mental restlessness, irritability, and a desire for cold drinks, the sore or carbuncle is likely deep. If, although suffering from a sore or carbuncle, the patient's daily activities are peaceful and diet remains normal, the disease is superficial. When an evil sore first forms, its head resembles millet grains, with slight pain or itching. If mistakenly broken, one will immediately sense the pathology penetrating deeper. One should quickly administer Xijiao Tang (Rhinoceros Horn Decoction), Loulu Tang (Caulis Euphorbiae Lathyri Decoction), Tongqi Wan (Qi-Regulating Pill), etc., to promote unblocking and smooth flow, and simultaneously use Yuduo Tang (Toxin-Bathing Decoction) for soaking. For superficial cases, apply plasters to seek healing. From this, we deduce that distinguishing depth is the primary step in determining the course of the disease.

For diseases of sores and swellings, if the toxic qi has already consolidated, internal resolution methods cannot be discussed; instead, one must distinguish the ripeness and depth of the pus, and must not make rash incisions, lest improper handling lead to danger. Whenever a sore or carbuncle is swollen and painful only upon deep pressure, the pus is deep; painful upon light pressure, the pus is shallow; with little pain upon pressure, pus has not yet formed. If depression after pressure rebounds immediately, there is pus; if it does not rebound, there is no pus; if it does not rebound, it is likely fluid accumulation. If the swelling is entirely soft and painless, it is a Blood Tumor (Xueliu); if the swelling grows day by day without significant heat, accompanied by occasional pulling pain, it is a Qi Tumor (Qiliu); if Qi stagnation causes slight swelling that persists for a long time and later turns to pus, this is caused by Cold and Heat pathogens. Accumulated over a long period, extreme Yin generates Yang, and Cold transforms into Heat. Upon rupture, it will likely produce abundant pus; therefore, one should take Neisai San (Internal-Sealing Powder) early to expel it. Various tumors, warts, and excrescences will naturally ulcerate internally in old age. If treated during youth, one can avoid future worries. Additionally, when treating carbuncles, if covering the area with the hand reveals intense heat, the pus is mature and the area becomes soft; if the superficial skin peels up, the pus is shallow; if the swelling is not very hot, pus has not yet formed; if suffering from scrofula (Luoli) with nodules, accompanied by alternating chills and fever, thirst, and persistence without resolution, and the person's complexion is sallow due to steaming by Heat, pus has formed. Regarding internal sores and carbuncles of the Zang-Fu organs and intestines/stomach, the pathology is hidden and invisible, eyes cannot see it, and hands cannot reach it, making treatment extremely difficult. However, one can diagnose and distinguish it by palpating the pulse. For patients with Stomach-Wall Carbuncle (Weiwuan Yong), one should monitor the Stomach Pulse. The pulse at the Renying acupoint corresponds to the Stomach channel. If the pulse is deep and fine, Qi rebellion is severe; if severe, Heat gathers at the stomach opening and fails to circulate, leading to a carbuncle in the stomach wall. If the pulse is surging and rapid, pus has formed. If the pulse is slow and tight, although pus has not formed, blood stasis exists; urgent treatment is required. Otherwise, pathogenic toxins will attack inward, rotting the intestines and stomach, rendering the condition incurable. The treatise on Lung Abscess states: In the initial stage, it can be saved; once pus forms, death ensues. Caution is essential. If coughing up pus resembling rice porridge persists for a long time, it is untreatable; if vomiting pus stops the symptoms, self-healing occurs. The treatise on Intestinal Abscess states: Some develop sores around the umbilicus with pus draining from the sore, or some drain from the umbilicus itself. Only those who pass pus and blood in the stool will heal spontaneously.