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Carbuncles and sores typically present with pain, while the absence of pain is an occasional occurrence. In cases of superficial skin diseases or sores caused by summer-heat, there are instances without pain; however, these are not serious conditions, and the lack of pain poses no harm. Conversely, if swelling is rampant, with masses that are both hard and large, yet accompanied by a sensation of numbness and insensitivity—neither painful nor itchy—one must ask: unless potent toxic substances have been used to suppress neural function and cause anesthesia, how could such a state arise? Therefore, conditions characterized by stubborn swelling and numbness are invariably more harmful than those presenting with severe pain.

For instance, in aggressive ding sores (hard boils), the lesion initially appears as small as a millet grain, followed immediately by induration and swelling, spreading rapidly within moments. The patient may only perceive a dullness and lack of agility in the skin, without experiencing any pain. This presentation is common in ding sores located on the supraorbital ridge, face, forehead, skull, preauricular area, lips, and mandible. If left untreated for even a short period (less than half a day), the pathogenic toxin may penetrate inward, leading to chest fullness, nausea, and mental confusion. Without urgent administration of large doses of clearing and resolving formulas, the prognosis is often fatal. This constitutes one category of emergency conditions characterized by numbness and lack of pain.

Another category involves chronic, stubborn diseases. Initially, hard nodules form, adhering to tendons and bones, without pain or itching. Although the duration is long, the clinical picture remains unchanged, and the overlying muscle and skin color remain normal. Some cases persist for years without alteration. Patients often disregard these symptoms, assuming they have coexisted peacefully for a long time and pose no threat. However, upon accidental stimulation, the mass may enlarge significantly, suddenly triggering a pulling pain. At this stage, a major disease has developed, and changes occur rapidly. Such peculiar transformations are characteristic of shi ju (stone abscesses) and ru yan (breast cancer), but at this point, the condition is incurable. This represents another category of chronic conditions characterized by numbness and lack of pain.

Furthermore, there are cutaneous sores that have ulcerated for a prolonged period. These lesions may occasionally contract slightly or gradually expand, recurring frequently across seasons. Discharge persists indefinitely, and both pain and itching sensations disappear. This occurs because prolonged ulceration leads to necrosis of the muscular nerves, resulting in darkened skin pigmentation and dryness of body fluids, resembling dead wood. Consequently, the area becomes rigid and insensitive; scratching elicits no response. While this may appear to be a habitual state without immediate danger, the essence and blood (body fluids and nutrients) have been depleted, and recovery is delayed indefinitely. This scenario is typical of chronic ulcers that have failed to heal due to inadequate management, leading to complicated conditions. It is frequently observed among poor individuals engaged in strenuous labor. Additionally, improper treatment of syphilitic chancres or condylomata can lead to similar outcomes. In all these cases, prolonged decay and inappropriate conditioning result in stagnation of Qi and Blood, causing the surrounding non-ulcerated skin to become numb and stiff. Even if subsequent treatment is appropriate and healing is achieved, the muscles may lose sensitivity to pain and itch, feeling alien to the patient. Moreover, the skin may exhibit mottled discoloration and feel woody-hard upon palpation. This is due to the irreversible loss of local neural function. Ultimately, these represent chronic, deteriorating ulcers that deviate from standard therapeutic norms.