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The *Shengqi Tongtian Lun* (Treatise on the Connection between Vital Qi and Heaven) states: Excessive consumption of rich and sweet foods is sufficient to cause large ding sores; it also states that when Ying Qi (Nutritive Qi) fails to flow smoothly and rebels within the muscle tissue, carbuncles and swellings arise.

The *Yinyang Yingxiang Dalun* (Great Treatise on Yin-Yang Correspondences to Phenomena) states: Dampness from the earth, when contracted by the human body, damages the skin, flesh, sinews, and vessels.

The *Miyao Jingweilun* (Essential Microcosmic Treatise on Pulse Diagnosis) states: Various swellings, spasms of sinews, and bone pain are caused by the swelling of Cold Qi and changes due to the Eight Winds.

The *Zhihen Dayalun* (Great Treatise on the True Essentials) states: All pain, itching, sores, and ulcers belong to Heart Fire.

Liu Wansu in the *Yuanbingshi* (Manual of Original Causes of Diseases) explains: "All pain, itching, sores, and ulcers belong to Heart Fire." This is because when a person approaches fire, slight heat causes itching, severe heat causes pain, and close proximity burns the skin to form sores; these are all manifestations of the function of Fire.

Some experience itching and pain as if lightly pricked by needles, similar to flying sparks burning the skin. Itching is considered a "beautiful disease" (indicating smooth Yang Qi circulation); thus, Fire dominates in summer when all things flourish and appear vibrant. If moxibustion or hot water immersion exacerbates itching, it is due to mild heat. If itching subsides afterward, it is because heat relaxes the skin, opens the Couli (pores and interstices), allows Yang Qi to vent, and dissipates the heat.

If cold water washing fails to relieve summer-induced skin itching, it is because Cold constricts and closes the Couli, causing Yang Qi to stagnate and internal heat to accumulate.

Itching relieved by scratching occurs because scratching induces a "Fire transformation"; mild scratching may worsen itching, but vigorous scratching relieves it by inducing a "Metal transformation" (spicy sensation), which disperses. When Metal transformation appears, the Fire force divides and resolves.

Some claim pain indicates excess and itching indicates deficiency, not meaning deficiency is Cold, but rather referring to the degree of heat.

One might question: If sores and ulcers all belong to Fire/Heat, why do some discharge pus? This is like grains, meats, fruits, and vegetables rotting and turning into liquid when heat reaches its extreme. Rotting is a manifestation of Water transformation. According to Five Element theory, when things reach an extreme, the element that controls them counteracts them. Thus, when Fire/Heat is extreme, it assumes Water characteristics. For example, salt preserves food because its salty-cold Water nature restrains Fire/Heat, preventing excess, thus maintaining stability. This applies to all things.

A Yong (Carbuncle) is superficial and broad. The Classics state: Heat overcoming Blood results in Yong. The *Sanyin Fang* states: Yong means obstruction (Qi and Blood stagnation). A Ju (Deep-seated abscess) is deep and malignant. The *Sanyin Fang* states: Ju means blockage. A Ji (Furuncle) is limited like a joint/nodule.

Yang refers to small sores with heads.

Zhen refers to floating, small urticaria/rashes.

Liu (Tumor/Nodule) includes Qi Chi Liu (Red Nodule/Erysipelas), caused by Heat overcoming Qi; red is the color of Fire.

Jiehe (Scrofula/Knots) occurs when Fire/Heat is excessive and stagnates, becoming hard like a fruit pit. It does not necessarily require ulceration; if Heat dissipates, it resolves spontaneously.