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Ulcerative exudation of fluid: In all skin diseases, it is due to an excess of dampness. For instance, in conditions such as scabies (Scabies), pemphigus (Pemphigus), and impetigo (Impetigo), there is extreme itching, presence of fluid but no pus, which indicates that damp-heat pathogenic factors are overflowing into the muscle-cou li (interstitial spaces of skin and muscles). The exuded fluid is yellow, turbid, and sticky; its toxicity is intense, making it prone to spreading and infiltrating. Not only does the patient develop papules and itching upon contact with this fluid, but others who come into contact with it are also easily infected. Individuals with internal dampness who contract this pathogenic qi will suffer from the same disease; thus, wet scabies and pemphigus belong to the category of epidemic diseases. It is not without reason that laypeople shrink back in fear when seeing these conditions; this represents the proliferation of water-toxin in ulcerative sores.

Furthermore, in conditions such as migratory wind (Migratory Erythema), damp infiltration, damp tinea, auricular eczema, swallow-nest sore, yin sores, scrotal wind, and saddle-sores, after the purulent toxin has been discharged and residual swelling remains, fluid must necessarily emerge externally before the swelling gradually subsides. At this stage, the fluid is non-sticky, appearing either pale yellow or clear like spring water, slowly oozing from the wound. Recovery can only occur when the fluid ceases and thick pus reappears. This phase is inevitable in cases where the condition is severe and deep-seated. However, this process lasts a short time, at most four to five days, after which new tissue gradually fills the wound. This is a favorable progression (Shun) of ulcers, where fluid discharge poses no harm.

Conversely, if an ulcer has existed for some time yet the pus remains clear and thin, or only yellow fluid or clear water flows continuously for a prolonged period, it indicates that the patient’s righteous Qi (Zheng Qi) is deficient and nourishing capacity is weak. Treatment should focus on strengthening the Stomach and Spleen to assist the source of transformation and generation, hoping that fluid discharge will cease and pus will appear, allowing muscles to fill in. Otherwise, excessive fluid loss will further damage the righteous Qi, which is an unfavorable outcome. Generally, in ordinary ulcerative diseases, discharging pus is considered favorable, while discharging fluid is considered unfavorable, for this reason.

There are also ulcerative conditions on the feet caused by accumulated dampness and stagnant heat, suddenly presenting with redness and swelling. The condition is firm and severe, with bright red, shiny skin that indents upon pressure and does not rebound immediately. If damp-fire is abundant, putrefaction occurs easily; this is known as Yang-type major toxicity, commonly called "Water Ding" (Water Carbuncle). Before putrefaction sets in, it is appropriate to use a Pi needle (Bian Zhen) to puncture the shiny area eight to nine times or more than ten times. Such excess syndromes may also occur on the arms and dorsum of hands, but are most common on the dorsal aspect of the feet and shins, hence the colloquial names "Hand Back-Boil" and "Foot Back-Boil." In cases complicated by damp tinea pedis (Athlete's Foot) with frequent recurrences, acupuncture is also indicated. (In the Wu region, this disease is colloquially called "Flowing Fire," characterized by simultaneous excess of dampness and heat, prone to rotting, i.e., referred to as "flowing water.") The course is prolonged; the fluid color is initially pale yellow, turning deep yellow or greenish-blue over time, extremely sticky, resembling egg white. Once this fluid is drained, treatment becomes easier. This constitutes another type of internal ulceration resulting in fluid accumulation.

However, if Ding-toxin (Carbuncle toxin) does not localize, presenting with fluid but no pus, or in cases of brain carbuncle and back carbuncle where pus fails to form, showing only faint yellow fluid, the swelling will be large and hard, and the toxin is prone to sinking inward. These are dangerous syndromes. Unless treated properly to resolve the major toxicity and promote suppuration and penetration, there is a grave risk to life. Similarly, in stubborn sores associated with scrofula (Scrofula), intermittent pus and fluid discharge occur; seeing pus is favorable, while seeing fluid is unfavorable. Pus discharge offers hope for success, whereas fluid discharge makes recovery difficult. In advanced stages of stone abscess (Stone Abscess), loss of luster (Loss of Luster Syndrome), breast fibroadenoma (Breast Lump), or breast cancer (Breast Cancer) after rupture, intermittent fluid and blood discharge, as well as the foul slough of deteriorating conditions—characterized by turbid bloody water, dull color, and offensive odor—are virtually untreatable. These represent the most malignant prognostic signs of fluid discharge in ulcerative diseases.