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External sores are not without cold syndromes. When the weather is cold, the water and marshes become hard in the abdomen, human blood becomes stagnant and sluggish, remaining stationary and obstructed, forming sores; this is according to natural principles and nothing surprising. However, the coldness in sore diseases is merely Qi of Yang stagnation invading the collaterals, which cannot be compared to the true cold of the Zang-Fu organs. Therefore, for treating cold agents, one only needs to warm the meridians, promote circulation in the collaterals, and unblock them with a simple gesture, leaving no room for further effort; there is certainly no need to use great warming and heating methods that require the strength of nine oxen and two tigers. Based on my observations of external sores suitable for warming and nourishing, there are approximately only two types of syndromes.

One type is brain carbuncle (Nao Ju) and back carbuncle (Bei Ju), where cold affects the meridians. The external appearance often shows redness, swelling, and heat, but since the disease occurs at the back of the head, the location belongs to Yin, and it involves the Taiyang Cold Water meridian. External signs must include aversion to cold and wind, and the tongue must be pale white without luster. If damp-phlegm is abundant, the coating will likely be thick and greasy white, and the tip and edges will definitely not be red or crimson. The pulse must be fine, choppy, and powerless. Even if occasionally muddy and large, it is due to severe toxin and swelling. However, it definitely cannot be surging, rapid, slippery, and solid. There may also be cases where pressure feels forceful, which is a sign of condensed toxin that has not transformed, indicating a particularly severe condition. If treated correctly, the toxin can be resolved, the syndrome slightly relaxed, and the pulse becomes powerless. The neck and back will definitely feel stiff and difficult to move, which is definitive evidence of cold pathogen. According to treatment principles, one must warm the meridians and transform stagnation, and necessarily lift the Great Qi (lifting the Great Qi refers to herbs like Chuanxiong Rhizoma [Chuanxiong] and Notopterygii Rhizoma et Radix [Qianghuo], which can penetrate the skin and hair, allowing the toxin to be resolved).

There are also cases of short legs unable to extend, with severe pain upon movement, while the skin and muscles have not yet swollen. At this time, warming the meridians to dissipate cold, unblocking the meridians and promoting collateral circulation is used, and several doses will surely be effective. If delayed for several days, internal firm swelling forms, and the disease symptoms become prominent, with the root deepening. However, if the pulse remains fine and choppy, and the tongue coating remains white and greasy, using warming transformation methods is still timely. If more days pass, the cold pathogen transforms into heat, the swelling becomes harder, the momentum larger, the pulse gradually turns rapid, and the tongue gradually turns red, while pus is about to form internally, medication requires careful consideration. Superficial observers might think this syndrome benefits from warming and unblocking, but if one continues to use a batch of rigid and dry drugs at this stage, it will hasten ulceration, rarely resulting in prolonged difficulty in healing, gradually becoming a chronic sore labor, making the medical process burdensome and the patient's life perilous.

Furthermore, crane knee (He Xi Feng), ankle abscess (Huai Ju) present with cold-damp syndromes or deficiency-cold syndromes; waist abscess (Yao Ju) and Shenshu abscess (Shenshu Ju) mostly present with deficiency-cold syndromes, all of which can be warmed and nourished, and severe cases can even be warmed and tonified. Flowing phlegm (Liu Tan) and flowing injection (Liu Zhu) have cold-damp syndromes and also deficiency-cold syndromes; bone trough wind (Gu Cao Feng) has cold-phlegm syndromes, all of which can be treated by considering the timing and incorporating warming transformation methods. However, hot medicines must not be excessive; excess leads to cold transforming into heat, assisting in pus formation, which is the fault of the medicine, not a change in the disease.

As for stubborn conditions such as phlegm nodules (Tan He), spreading tubercles (Chuan Lao), breast carbuncle (Ru Ju), breast cancer (Ru Yan), loss of prosperity (Shi Rong), and stone carbuncle (Shi Ju), their initial hardness is abnormal, possibly an image of Yin-cold condensation. However, the source of these diseases always carries depressed fire, and they mostly occur in individuals with Yin deficiency. Harmonizing blood and nourishing Yin is still feared to be insufficient. Yet, theorists often claim this is a cold-condensation excess syndrome, and I use warming medicines to harmonize it, as if the light of Li (Fire) illuminates everything, melting ice and snow. Wang Hongxu's Yanghe Decoction (Yanghe Tang) was said by him to treat almost every disease, but recent users often see its drawbacks rather than benefits. One must not blindly follow without clear differentiation. My research companion Pan Fuchen's wife, in the winter of Bingchen year, felt a nodule in her left breast. In the first month of Disi year, she self-administered sixteen doses of Yanghe Decoction. It grew day by day. By mid-March, she sought my medical attention. The condition was protruding high, extending seven or eight inches around to the armpit, unable to be held by the hand, and already incurable. Her temperament was peaceful, her circumstances smooth, with no signs of depression or constraint, yet the stubborn breast cancer progressed rapidly to this extreme. If not for Yanghe Decoction, it would not have reached this state. By July, it gradually swelled and ruptured, leading to a tragic death, which is truly pitiable.