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When sores and pox have erupted, if the lesions sink inward or recede (sores/pox erupt and then disappear), medical texts merely call this "receding" (Dao Ye). However, they fail to realize that when internal deficiency prevents the complete expulsion of toxins, it is called "sinking inward" (Xian Fu); whereas when external wind-cold forces the condition, or evil qi assaults it, preventing eruption, it is called "receding" (Dao Ye). Nevertheless, these conditions arise with different origins, processes, and severities. If treated uniformly with medication, many perish as a result. Generally, after sores and pox have begun to appear, the emergence of macules marks the beginning, the filling of blood vessels (indicating congestion and fullness of the lesions) marks the middle stage, and the formation of pustules and scabs marks the end. These three stages differ in depth; how can one fail to distinguish them?

In cases where the eruption begins with macules, the zang-fu organs are steaming and accumulating heat, with toxic heat blazing both internally and externally. After several days of fever, the heat intensifies, and the accumulated macular toxin disperses through the muscle pores and emerges on the skin. In such scenarios, some cases involve sinking inward, while others involve receding. When macules first appear, if affected by external wind-cold, the muscle pores close again, causing blood to coagulate and stagnate without flowing freely. This inevitably leads to body pain and slight coldness in the four limbs. If the vital energy and blood are abundant and contend with wind-cold at the muscle-skin level, it will inevitably cause constipation and difficulty in urination. If the macules do not grow, turn black, or if green-purple wheals appear on the body, this is termed "receding" (Dao Ye). At this stage, one should warm the muscles and disperse wind-cold, using herbs such as *Lithospermi Radix* (Zicao), *Bombyx Batryticatus* (Chantui), *Citri Reticulatae Pericarpium* (Chenpi), *Vitis Vinifera* (Putao), human teeth (Renchì), *Bombyx Batryticatus* (Jiangcan), and *Nelumbinis Nelumbo* (Heye) to warm and disperse cold pathogens. Once the cold is dispersed, the heat will circulate again, allowing the macules to emerge properly.

If there is stomach deficiency failing to support the Ying and Wei (nutritive and defensive energies), the eruptions may appear and then vanish. Consequently, the macules may appear white or black. This is caused by internal deficiency, meaning there is no blood and qi to respond to the eruption. Such patients typically cannot eat or drink milk. They may experience spontaneous diarrhea, clear urine (not red), fatigue, vomiting, and slight coldness in the four limbs. This occurs because the internal stomach qi is deficient and cannot naturally expel the pathogen, resulting in "sinking inward" (Xian Fu). In this case, warm and acrid medicines should be used to warm the stomach and restore the warmth of Ying and Wei, allowing natural eruption. Formulas such as *Lizhong Tang* (Regulate the Middle Decoction), *Huoxue San* (Invigorate Blood Powder), and *Renchì San* (Human Teeth Powder) can be used for warming. In cases of severe vomiting and diarrhea, *Ginger* (Shengjiang), *Aconiti Lateralis Radix Praeparata* (Fuzi), *Sulfur* (Liuhuang), and *Cinnamomi Cortex* (Rougui) may also be employed. This treats sinking inward caused by internal self-deficiency.

Regarding the middle stage characterized by filled blood vessels: after red macules have emerged, the presence of spots all the way to the feet indicates complete eruption, meaning the toxin of the macules and papules has been fully expelled. From the initial appearance of macules like bean-sized bumps rising above the skin surface, the state of "filled blood vessels" refers to the condition before the formation of pus-filled pustules and scabs. Seven days after the blood vessel filling stage, pus-filled pustules and scabs should form. At this time, if affected by external wind-cold leading to receding, or if stomach qi deficiency causes vomiting and diarrhea leading to sinking inward, the previously mentioned methods can be applied.

During the blood vessel filling stage, the toxic heat is at its peak, with yang-heat filling the interior and exterior, lacking yin to restrain it. By the seventh day of eruption, pus-filled pustules and scabs should form, leading to recovery. If, after seven days, the lesions remain only bean-sized and do not form pustules upon pricking, it is due to toxic heat penetrating internally and externally, with blood-heat contending. This likely means the pathogen has re-entered the Heart. The pox condition becomes critical and life-threatening. Urgently use *Zhutai Gao* (Pig Tail Ointment) to cool heart-blood and induce yin energy, which will facilitate immediate scabbing and recovery. Ancients used cooling-heart medicines like *Cinnabar* (Zhusha), *Borneolum Syntheticum* (Nao), *Moschus* (She), and *Sanguis Porcinus* (Zhuxue) to treat sores and pox. This was intended for cases where, after toxin release, heart-heat and toxic heat were exceptionally high. It is not for treating internal weakness causing sinking inward, nor for receding caused by cold invading the muscle pores.

Both sinking inward and receding are deficiency-cold syndromes. Sinking inward results from weak stomach qi unable to expel the pathogen, requiring warming treatment. Receding results from external wind-cold invading the muscle pores, requiring dispersal treatment. Therefore, *Zhutai Gao* is not indicated for receding. *Zhutai Gao* treats excessive heart-heat preventing natural contraction and scabbing; it is not a spleen-cooling medicine. As stated in *Su Wen*: Sores and ulcers with dryness and pain do not all originate from the Heart. If, after the blood vessel filling stage, the color turns purple-black without forming pustules or scabs, and toxic heat penetrates internally and externally returning to the Heart, the condition is critical. Once the blood vessel filling stage forms pustules, and pustules form scabs—like thick, dense scabs—if illness arises without external cold invasion, it is due to exposure negligence. Treatment is no different from that used during the macule stage.

Observe that if a child reduces food intake for several days, it indicates stomach deficiency with intense heat and qi consumption, leading to macule formation. During pustule formation, blood is weak at the scabbing stage. Slightly increasing nourishment to regulate Ying and Wei, and assisting with appropriate cold or warm medicines, is ideal. Post-illness administration of resolving and purgative medicines should not be delayed.

For sores and pox that have not fully penetrated, presenting with mental restlessness, mania, agitation, panting, delirious speech, or hallucinations (seeing ghosts), use *Longnao Gao* (Camphor Ointment). For cases involving black toxic qi, use *Duoming Gao* (Life-Seizing Ointment). For black sinking, use *Baixiang Wan* (Hundred Auspicious Pills), *Langen San* (Blue Root Powder), *Sisheng San* (Four Sages Powder), and *Renchì San*. For severe toxicity with black discoloration, use *Shanzhi Tang* (Gardenia Decoction) and *Xuandu Gao* (Toxin-Releasing Ointment). *Liang Fang* uses *Naobao Zhuxue Jiu* (Brain and Pig Blood Wine) for toxic heat entering the zang-organs without exiting. *Huo Ren Shu* addresses malignant signs of black pox using *Wubi San*, *Beijin San*, and *Zhusha San*. For pox reversing inward, use *Disheng Wan*, *Jiusheng San*, *Daimao San*, and *Huaban San*. For pox receding, use *Huashe San*, *Mahuang Tang*, *Shishengchong San*, water ground from *Canarii Fructus* (Ganlan He), and *Niubang San*. For black pox named "Ghost Pox," *Renchì Zhuxue San* is applicable. For receding caused by intense heat and toxic qi, this is not an internal deficiency treatment. For receding accompanied by vomiting, diarrhea, and anorexia due to spleen-stomach deficiency, or if doctors misidentify pre-eruption macules and fear using cooling medicines, causing internal suppression, use *Wei'ai San* as the primary treatment. If sweating occurs after administration, do not use *Kongxin San*; if no sweat occurs, administer *Kongxin San*, followed by *Qianghuo San* for optimal results.