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Generally, when Qi and Blood are disordered and meridians are obstructed, compounded by the contraction of the Six Evils (Six Pathogenic Factors) and Seven Emotions, toxic vapors will follow wind-heat to scatter and flow. This syndrome arises from excessive Wind generating Heat; when Heat reaches its extreme and Qi becomes hyperactive, Qi scatters in all directions due to the extremity of Heat. It is urgent to dispel Wind and settle Heat, so that Wind will naturally subside. If the Original Qi is robust and it is an initial onset, moxibustion should be applied rapidly for seven moxa cones, medicine should be applied around the lesion, and Liuxi Yin (Flowing Qi Decoction) should be taken internally; there will be no case that does not heal. However, if the pathogen flows into the legs and feet, death is inevitable.

Ancient prescriptions in *Tu Jing* treat malignant sores and carbuncles, or pain extending to the groin and thigh region, with urgent spasms pulling into the lower abdomen, unbearable to endure, which can kill within one night. Use the seedlings and leaves of Fennel (*Foeniculi Vulgaris Fructus*, though here referring to foliage/roots contextually often implying *Anisi Stellati Fructus* but text says 'seedling/leaf', strictly translating as Fennel seedling/leaf juice), crush and extract the juice, take one sheng, three to four times a day. Apply the dregs topically. In winter, the root may also be used. This is a foreign prescription, effective in reviving the dying since the Yongjia era. (From *Zhunsheng*)

Wang Kentang stated: In carbuncles and ulcers, if the eyes deviate upward, the black pupil is tight and small, and the white sclera is blue-red, this indicates Liver Fire mixed with evil pathogens. (From *Zhunsheng*)
Jiang Shiji stated: It is suitable to treat with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) formula, adding Gardenia (*Gardeniae Fructus*), Ophiopogon (*Ophiopogonis Radix*), and Schisandra (*Schisandrae Chinensis Fructus*). (From *Shuoyue*)

When sores and ulcers develop spasms, it is due to deficiency and loss of Qi and Blood, external pathogens clashing, or internal deficiency with stagnant fire. The symptoms include locked jaw, stiffness and rigidity of the four limbs, opisthotonos (arching of the back), and limb convulsions. Those who have sweat but do not fear cold are called "Rou Jing" (Yin Spasm). Wind disperses Qi, hence sweating occurs. Those who have no sweat and fear cold are called "Gang Jing" (Yang Spasm). Cold congeals Blood, hence no sweat occurs. All these result from excessive blood loss, leaving tendons without nourishment. Therefore, after excessive sweating or purgation in Cold Damage diseases, or in patients with chronic ulcers and postpartum women, this condition is frequently seen; it is a critical, deteriorating syndrome. If Qi and Blood are greatly tonified, many will recover. If treated as a Wind disorder, it will accelerate the danger.

Wang Kentang stated: Coldness and numbness of the four limbs indicate deficiency-cold of Stomach Qi. (From *Zhunsheng*)
Cheng stated: Where lies the distinction between Cold Jue and Heat Jue? In Cold Jue, the coldness of the four limbs extends beyond the elbows and knees, the fingernails turn cyan, the pulse is deep, fine, and weak, and cold signs appear on the exterior. In Heat Jue caused by extreme heat, Fire resembles Water; although there is Jue (cold extremities), the fingernails remain warm, unlike Cold Jue where coldness exceeds elbows and knees. The pulse in Heat Jue is deep, solid, large, and forceful, which serves as the basis for differentiation. In Cold Jue, the sore must be grayish-white and sunken; in Heat Jue, the sore must be purple-dark and dry/withered.