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Qi's *Jingyi* states: The manifestations of sores and ulcers are manifold. To distinguish their depth, one must employ the correct method. Briefly speaking, sores and ulcers can be generally categorized into three types: those that are swollen, elevated, and soft originate in the blood vessels; those that are flat, depressed, and hard originate in the muscles and bones; those where the skin and muscle color remain unchanged originate in the bone marrow. It further states: When treating sores and ulcers, pressing and shaking the swelling with the hand reveals that a firm root and large area indicate deep pathology, while a small root and superficial position indicate shallow pathology. One must also examine the patient: if upon the initial appearance of the sore, there is immediate high fever (*Zhuangre*), aversion to cold, limb stiffness and headache, mental restlessness, irritability, and a desire for cold drinks, the sore or ulcer is necessarily deep. Conversely, if the patient suffers from a sore or ulcer but maintains normal daily activities and diet, the lesion is superficial. When an malignant sore first appears, presenting as a head like millet grain, with slight pain or itching, accidental rupture leads to spread, indicating a tendency toward deeper involvement. In such cases, one should quickly administer *Xijiao Shengma Tang* (Rhino Horn and Cimicifuga Decoction), as well as *Loulu Tang* (Euphorbia Lomata Decoction) and Qi-tonifying medicines, aiming for unblocking and free flow, while simultaneously using *Yudu Tang* (Poison-Bathing Decoction) to promote suppuration. For superficial lesions, applying plasters suffices for recovery. From this, we deduce that the variation between shallow and deep constitutes the sequence of disease progression. It also states: Aversion to cold with high fever indicates deep pathology. Unchanged flesh color suggests internal origin.

Zeng states: Regarding all carbuncles and ulcers, if the pulse is floating, rapid, full, and tight, accompanied by swelling and pain, fever, thirst, and normal appetite, this indicates disharmony of the Six Fu-organs, with toxicity manifesting externally as a carbuncle (*Yong*). Although the condition is acute, administration of cooling agents often ensures survival. If the pulse is deep, fine, hidden, and tight, with initial symptoms being subtle or lacking a visible head, no fever but internal dryness, heavy body with painful discomfort, low mood, chest and diaphragm stuffiness, and loss of taste, this indicates disharmony of the Five Zang-organs, with toxicity accumulating internally as an ulcer (*Ju*). One should urgently administer *Wuxiang Lianqiao Tang* (Five Spices and Forsythia Decoction), or *Shenxian Jiefa Lafan Wan* (Immortal Interception Method Wax-Adorned Pill), and prepared licorice decoction to prevent the toxic qi from penetrating inward and causing internal attack complications. Moxibustion with garlic partition on the affected area is particularly suitable. Applying toxic drugs may obstruct the interstices (*Couli*); administering cooling drugs may deplete true qi. Thus, the distinction between favorable and unfavorable signs depends on the physician's skill. Symptoms such as belching with obstruction, coughing and rebellious qi, cold body with spontaneous sweating, fixed gaze with deafness, mental confusion with palpitations, and incoherent speech are all signs of extreme depth and malignancy. If three of the "Five Favorable Signs" appear, recovery is possible; if four of the "Seven Unfavorable Signs" appear, the condition is critical. The simultaneous presence of all Five Favorable Signs represents the peak of favorability; the simultaneous presence of all Seven Unfavorable Signs represents the peak of malignancy.

Li states: An ulcer initially appearing as a single bean-sized nodule, with fever, swelling, elevation, hot pain, and redness, indicates external manifestation. Although the condition is vigorous, proper treatment can ensure survival. However, if there is no fever at onset, general fatigue, no change in the affected area, and no swelling or pain after several days, it indicates that the internal organs have already deteriorated. Even with the medicinal skills of Lu Yi (Bian Que) or Bian Que, nothing can be done.

Lizhai states: The aforementioned conditions may arise because the original qi is deficient and unable to expel the pathogen; because cold medications were applied topically preventing expulsion; because excessive purgation damaged the qi and blood preventing expulsion; or because internal accumulation of heat-toxin was not addressed with draining and supporting methods. Careful examination and treatment often lead to survival.