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Wind, fire, summer-heat, dampness, dryness, and cold are the climatic changes of nature. Humans live within the intersection of heaven and earth qi; those with strong constitutions are not harmed by pathogenic factors, while those with weak constitutions retain these factors, leading to disease. This is the result of the mutual overacting of the Five Movements and Six Qi, which explains why exogenous diseases are particularly numerous. Those who study internal medicine know without exception that seasonal diseases (Shi Bing) constitute a major category, and how could external sores be any different? Indeed, due to climatic deviations and the predominance of seasonal pathogens, when they invade the meridians and zang-fu organs, they form internal diseases; when they invade the muscle interstices and sinews, they manifest as external sores. Although the pathways differ, the principles are identical. How can one treat external sores without adapting to the changing seasons, addressing the root cause first, and controlling the primary aspect?

Let us briefly discuss various sores related to the Six Qi: sores on the head and face, parotitis (Fa Yi), epidemic toxins, abscesses on the cheeks, zygomatic area, jaw, and buccal regions, and swellings in the dental alveolus and jawbone are all caused by the excess of Wind. Sudden swelling of various Ding sores, large Yang-type carbuncles, gan lesions in the throat, mouth, and tongue, and various conditions such as everted flower-like growths are all caused by the excess of Fire. During the muggy heat of late summer and the fierce sun of autumn, amidst the three qi of summer-heat, dampness, and heat, sores are particularly common, indicating an excess of Heat. During times when metal melts and stone scorches, the flesh-and-blood body accumulates toxins, forming carbuncles, generating pus, and causing putrefaction, which is very easy to happen. Moreover, when earthly qi is humid and heavenly qi is hot, dampness and heat mutually steam, leaving eyes full of sores, occurring in every house; this is inevitable. Only when Dryness prevails, and the climate becomes condensed and austere, are sores rare. However, individuals with depleted fluids and consumed yin often suffer from rough, peeling skin and wind generated by blood dryness; this is another case of dermatological diseases caused by the excess of Dryness. As for the excess of Cold, leading to qi stagnation and blood coagulation, there are also large deep-seated abscesses attached to bone joints, and brain/back abscesses caused by cold invading the meridians. These should be treated with warming the meridians and unblocking collaterals to transform cold pathogens. Linwu Shanshan's "Yang He Decoction" (Cordyceps and Deer Antler Decoction) was designed precisely for such syndromes and fits them perfectly. It is a pity that his work "Waike Quansheng Ji" (Complete Life Collection for Surgery) instead uses it to generally treat breast abscesses, breast cancer (Ru Yan), and scrofula (Luo Li); these conditions usually involve latent damp-heat in the Liver and Gallbladder meridians. Writing rashly causes immense harm. In summary, whenever treating sores where the Six Excesses are the cause, one must first eliminate the external pathogenic factors, giving hope for the resolution of the carbuncle. Therefore, in major sore syndromes where seasonal pathogens flow through the body, lingering fever and chills may persist for days before the sore appears. If cold does not cease and heat does not clear, not only will existing carbuncles fail to recede, but new ones will continue to emerge, entangling endlessly. Without a profound understanding of internal medicine principles to vent and resolve pathogens in the meridians, one cannot grasp the management of sore syndromes. One must wait until external pathogens are fully resolved, body heat clears, tongue coating becomes non-turbid, appetite improves, and the sore heals spontaneously without specific treatment. If specialists rely solely on external treatments, even mild cases may undergo unpredictable transformations. This is the most common scenario in sore patients, who absolutely cannot be treated merely for their external sores. After pus erupts, toxins have been discharged, and the cessation of fever is a favorable sign. Essentially, pus discharge in external sores is akin to sweating in Shang Han (Cold Damage) syndrome; if fever persists after sweating, it is a deteriorated Shang Han condition. Similarly, if fever persists after pus discharge, it is a deteriorated sore condition. At this juncture, correcting imbalances and adjusting according to symptoms relies primarily on internal medicine principles, subtleties of which cannot be fully captured by words alone.