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Muscles are governed by the Spleen and Stomach. Wound contraction (healing of ulcers) is related to Blood and Qi. If the Spleen and Stomach are strengthened and Blood and Qi are abundant, then yesterday's necrotic tissue will regenerate today, and pus formed in the morning will heal by evening. How could it lead to a prolonged course lasting years, with foul decay and even rectal prolapse, causing immense suffering? Therefore, it is said: In the initial swelling stage, one should aim to dissipate stagnation; after ulceration, one should support the expulsion of residual toxic pathogens. Once toxins are exhausted, contraction should be promoted. The method for contraction lies primarily in vigorously tonifying Blood and Qi and purely nourishing the Spleen and Stomach, rather than indiscriminately applying topical flesh-regenerating medicines. When toxin load is high, ulceration occurs naturally; when toxins are cleared, healing follows spontaneously, like water filling a channel. One must not force results or seek rapid efficacy through artificial means. If residual toxins remain and one recklessly applies flesh-regenerating drugs, it blocks the dispersion of toxic vapors, potentially causing the lesion to spread and become putrid, resulting in severe harm. Only when pain subsides, swelling flattens, and the color turns ruddy and vibrant should internal tonification and external application be used, leading to healing within days. Students of medicine must exercise caution.

All pains arise from the stasis and obstruction of Qi and Blood. Cold, heat, deficiency, excess, as well as pus, blood stasis, and wind pathogens can all cause pain, and these must be differentiated. Redness accompanied by pain indicates Heat. Whiteness accompanied by soreness indicates Cold. Absence of distension or fullness, with temporary relief upon massage, indicates Deficiency. Distension combined with fullness and aversion to touch indicates Excess. Pain resembling tendon traction or chicken-pecking, accompanied by aversion to both cold and heat, indicates Pus. Pain resembling muscle tearing or qi drawing, with slight distension, indicates Blood Stasis. Migratory pain indicates Wind. Pain characterized by stabbing and distension indicates Qi Stagnation. Given such variations in pain, the method for relieving pain must be adapted to the specific case. For pain caused by Heat-Toxin, use cold-cooling herbs to subdue the heat, and the pain will cease. For pain caused by Cold pathogen, use warm-heating methods to harmonize the cold, and the pain will resolve. For pain due to deficiency, tonify the deficiency; for pain due to excess, purge the excess; for pain due to dryness, moisten it; for pain due to obstruction, unblock it; for pain due to closure of pus and blood, open it; for pain due to foul flesh erosion, resolve it; for pain due to disharmony of Yin and Yang, regulate it; for pain due to blocked and stagnant meridians, promote flow. Adapting to circumstances is the highest therapeutic principle.

Itching, although attributed to Wind, has various causes. Itching at the initial onset of Wind is due to the struggle between Wind and Heat, where severe scratching leads to pain. Itching after ulceration is caused by pus maceration and exposure to wind, presenting as raised papules. Itching during the impending healing phase occurs because initial muscle stasis prevented Qi and Blood flow; now, as Qi and Blood gradually harmonize to nourish new tissue, the sensation resembles insects crawling under the skin. Other forms, such as skin itching, stem from Blood dryness generating Wind; persistent tinea and scabies belong to excessive Wind infestation and worm erosion. Although syndromes differ, treatments have subtle distinctions, and they should not be treated as a single category.