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Wherever the ulcer opening presents with a black halo and lacks blood color, it is due to the excessive use of cooling herbs. It is advisable to apply Chonghe Gao (Harmonizing Ointment) augmented with Rougui (Cinnamon Bark) and Danggui (Angelica Sinensis) to warm and revitalize stagnant dead blood, whereupon the black halo will naturally recede. If the discoloration persists, continue applying Chonghe Gao externally.

When an ulcer first erupts, and the flesh color is indistinct while the meridians are initially obstructed, it is appropriate to employ exterior-releasing methods combined with formulas that support the interior (tonifying qi and expelling toxins), thereby facilitating the unblocking of meridians and dispersing toxic pathogens. This guides the toxins outward, constituting a favorable progression. The *Neijing* states: "Sweating cures ulcers." The subtlety lies in ensuring the smooth circulation of Ying (Nutritive Qi) and Wei (Defensive Qi). However, some mediocre practitioners, ignorant of this principle yet arrogant, forcibly resort to internal purgation. They fail to understand that a floating pulse indicates pathology at the exterior, inadvertently causing the entrapment of evil toxins within. This parallels the error in treating Taiyang disease (Exterior Syndrome) by mistakenly using purgatives when sweating is indicated. Such errors result in a condition where the exterior appears mild like miliary rash, while the interior becomes distended like a melon, accompanied by aversion to cold and high fever, indicating that the pathogen has attacked inward. In such cases, only urgent application of garlic moxibustion can reconnect Yang Qi and guide toxins outward, followed by large doses of interior-supporting formulas; survival may still be possible. It is commonly observed that patients with sores and scabies using fumigating or burning thread-like medicaments often suffer from internal penetration of these agents, bringing about self-inflicted harm and death.

In cases of carbuncles and sores where the face is red, despite the presence of latent intense heat, internal purgation is strictly prohibited. This is because Yang Qi is constrained and the pathogen resides in the meridians; thus, exterior-releasing methods should be used to dispel it. Hence it is said: "What is constrained by fire must be dispersed." Even if constipation occurs, one should primarily focus on releasing the exterior to dissipate Yang-fire, adding only a small amount of moistening and drying-relieving herbs. If wind-pulse or wind-symptoms are present, only exterior-releasing wind-dispelling herbs should be used to achieve unblocking and free flow. If there is merely dryness and constipation, moistening is appropriate, but purgation remains contraindicated.

For patients suffering from carbuncles and sores who exhibit diarrhea, sweating, anorexia, or insomnia at night, internal syndromes should be treated first. Once the internal condition resolves, the external lesions will heal more easily. This exemplifies the principle of "treating the branch in acute situations." External applications, such as plaster rings and surrounding medicines, should continue to be used according to established protocols without omission.

Li Dongyuan stated: Carbuncles and gangrene have distinctions between internal and external origins, and their treatments differ between cold and warm approaches. For those caused by external factors, the method should involve supporting the interior with warm properties. Conversely, using cold herbs would draw the pathogen from the skin and hair follicles into the bone marrow. For those caused by internal factors, the method should involve draining and promoting movement with cold properties. Conversely, using warm tonics to support the interior would drive the disease from the bone marrow up to the skin and hair follicles. Such scenarios inevitably lead to simultaneous ulceration of both interior and exterior, merging into a single wound, assisting the evil to become highly toxic, resulting in hundredfold suffering. Mild cases become critical, and severe cases result in death.