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Commentary states: Sores and ulcers belong to the category of Fire. One must distinguish between internal and external causes to treat their root. The *Neijing* (Inner Canon) says: "Changes resulting from rich and sweet foods are sufficient to produce large ding sores on the body." Their origin is internal, manifesting externally. This description resembles a deficiency pattern, indicating that internal stagnation manifests outwardly, though it is unclear through which pathway it emerges; in fact, all emerge from areas of deficiency. If the Taiyang channel is deficient, it emerges from the back; if the Shaoyang channel is deficient, it emerges from the temples; if the Yangming channel is deficient, it emerges from the beard area; if the Du vessel is deficient, it emerges from the head. Furthermore, the classic states: "The dampness of the earth, when encountered, harms the skin and sinews of humans." If external pathogenic factors are abundant, they may travel inward. If the pulse is deep and solid, one should first unblock the interior to cut off the source. If the pulse is floating and large, one should first support the interior, fearing injury to the vital qi within. There are cases where both interior and exterior are affected by pathogens; the pathogenic factor is severe, obstructing the meridians, thus causing carbuncles and swellings. The classic states: "When Ying (Nutritive) Qi does not flow smoothly and reverses into the muscle tissue, abscesses and gangrene arise." This occurs due to failure in supporting the interior, failure in unblocking, and failure in harmonizing Ying and Wei (Defensive) Qi. The general principle for treating sores requires understanding three methods: supporting the interior, unblocking, and promoting Ying-Wei circulation. Supporting the interior treats diseases moving from outside to inside; unblocking treats diseases moving from inside to outside; promoting Ying-Wei circulation treats diseases in the middle state. For "inside-to-outside" patterns, the pulse is deep and solid, with fever and irritability, but no obvious redness or pain externally, indicating the pathogen is deep within; thus, one first unblocks to cut off the source. For "outside-to-inside" patterns, the pulse is floating and rapid, swelling is external, and signs/symptoms are apparent externally, suggesting fear that the pathogen is extreme and moving inward; thus, one first supports the interior. For "middle of inside and outside" patterns, there are no exterior aversion-to-cold or fever symptoms, and the internal zang-fu organs are unobstructed; knowing the pathogen is in the meridians, one should harmonize Ying and Wei Qi. After applying these three methods, even if not fully recovered, complications will certainly be avoided, and the pathogen will be significantly reduced, facilitating recovery. Thus, the classic states: "All pain, itching, and sores belong to Heart Fire." It also says: "Those who understand the essence can conclude with one word; those who do not understand the essence wander endlessly."

Acupuncture and Moxibustion Method states: For sores and ulcers suitable for moxibustion or acupuncture, one must distinguish the meridian involved, the abundance or scarcity of blood and qi, and the proximity of acupoints. If emerging from the back, select five points from the Taiyang channel, choosing according to symptoms, either needling or moxibusting to drain the pathogen.
Generally, the Taiyang channel has abundant blood and scarce qi.
Zhiyin (BL66), Tonggu (BL65), Shugu (BL64), Kunlun (BL60), Weizhong (BL40).
If emerging from the temples, select from five points of the Shaoyang channel.
The Shaoyang channel has scarce blood and abundant qi.
Qiaoyin (GB45), Xiaxi (GB43), Linqi (GB41), Yangfu (GB38), Yanglingquan (GB34).
If emerging from the beard area, select from five points of the Yangming channel.
The Yangming channel has abundant blood and abundant qi.
Lidui (ST45), Neiting (ST44), Xangu (ST43), Chongyang (ST42), Jiexi (ST41).
If emerging from the head, initially there is unbearable headache, indicating impending sore formation. The brain is the sea of marrow; one should moxa or needle Juegu (GB39) to drain the pathogen. Marrow is the residence; therefore, if the pulse is floating, select points from the Taiyang channel as previously described; if the pulse is long, select from the Yangming channel as previously described; if the pulse is wiry, select from the Shaoyang channel as previously described. Commentary states: Each meridian has Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. Jing-Well points govern epigastric fullness and green-colored sores; Ying-Spring points govern body heat and red-colored sores; Shu-Stream points govern heavy body and joint pain, and yellow-colored sores; Jing-River points govern cough and chills/fever, and white-colored sores; He-Sea points govern rebellious qi and diarrhea, and black-colored sores. Depending on the meridian pathology presenting these signs, one may use moxibustion or acupuncture to drain the pathogen. The classic states: "Accumulation of pathogenic factors internally leads to swelling and heat; bi-shi (stone lancets) should be used." The *Neijing* states: "For stagnant pi-qi, needles should be used to open and discharge it; for conditions where qi overcomes and blood gathers, stone lancets should be used to drain it." Wang Bing's commentary notes: "Stone refers to bi-shi, which can rupture large abscesses and drain pus." Today, drainage needles are used instead. Whenever a sore feels slightly swollen, hard, with unchanged skin color and blood hue, and a deep pulse without pain, external moxibustion should be applied to guide the pathogen out until cessation. If pus is already present, moxibustion is contraindicated; needling is required. Superficial lesions should not be moxa-ed. The classic states: "Depressed lesions are treated with moxibustion." If the exterior feels slightly numb and hard without pain, urgent moxibustion is indicated, signifying deep pathogen penetration; superficial lesions must not be moxa-ed, exercise caution.

For various sores accompanied by vomiting, this indicates dampness invading the Stomach; increase the dosage of Baizhu (Atractylodis Rhizoma) in the prescription.

Neishu Huanglian Tang (Internal Draining Coptis Decoction): Treats vomiting, hiccups, rebellious heart qi, fever, irritability, deep and solid pulse, swollen and hard numb distension with unchanged skin/flesh color, deep-rooted and large, internal pathology, and constipation. Urgent purgation and draining are required.
Huanglian (Coptidis Rhizoma), Shaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Huangqin (Scutellariae Radix), Shanzhizi (Gardeniae Fructus), Bohe (Menthae Haplocalycis Herba), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 liang), Lianqiao (Forsythiae Fructus) (2 liang).
Except for Binglang and Muxiang which are ground into fine powder, the remaining herbs are chopped. Take 1 liang per dose, add 1.5 cups of water, decoct to 1 cup. Take 1-2 doses initially. Subsequently, add 1 qian of Dahuang (Rhei Radix et Rhizoma) per dose, and 2 qian upon further administration, stopping when bowels move freely. If heat signs exist, continue only with Huanglian Tang. For dry stool, add Dahuang. If no heat signs are felt, decoct less Mo Yao (Boswelliae Resina) within the Neituo Fujian San (Support Interior Re-decoction Powder), taking it frequently. If truly no heat and bowel/bladder functions are normal, take only Fujian San. If slight heat appears, resume Huanglian Tang. For constipation, add Dahuang. This ensures both interior and exterior are unblocked, Ying and Wei Qi are harmonized, and meridians are no longer obstructed.

Treating swelling on the exterior with shallow roots and superficial signs, typically with a floating pulse and pain in skin/flesh. When pathogens are strong, they invade internally; urgent internal support is needed to save the interior.
Take Neituo Fujian San (Support Interior Re-decoction Powder).
Digupi (Lycii Cortex), Huangqi (Astragali Radix), Shaoyao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Renshen (Ginseng Radix), Liugui (Salicis Ramulus, mild flavor), Gancao (Glycyrrhizae Radix et Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Danggui (Angelicae Sinensis Radix) (each 1 liang), Fangfeng (Saposhnikoviae Radix) (2 liang).
Chop the herbs. First decoct Cangzhu (Atractylodis Rhizoma) 1 jin in 5 sheng of water until reduced to 3 sheng, remove dregs, add the previous 12 herbs, decoct again to 3-4 cups, strain clear liquid, divide into 3-4 doses, consume throughout the day. Additionally, decoct the Cangzhu dregs in water, remove dregs, and decoct the 12 herb dregs again as before. This dispels dampness and dissipates郁热 (stagnant heat), harmonizing Stomach Qi. If unresolved, prepare half a dose. If constipation and irritability occur, take less Huanglian Tang. If mild diarrhea and irritability have passed, resume half a dose of Fujian San. This promotes circulation of Ying and Wei Qi, preventing internal invasion by pathogens.

For various sores where zang-fu functions are restored but pain is unbearable, take Danggui Huangqi Tang (Angelica and Astragalus Decoction), with modifications below.
Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Dihuang (Rehmanniae Radix), Digupi (Lycii Cortex), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba) (equal parts).
Chop the herbs. Take 1 liang per dose, add 1 bowl of water, decoct to 1/5 volume, remove dregs, take warm. If feverish, add Huangqin (Scutellariae Radix). If irritable heat prevents lying down, add Zhizi (Gardeniae Fructus). If vomiting occurs due to dampness invading the Stomach, double the Baizhu (Atractylodis Rhizoma).

Ointment Formula:
Good Sesame Oil (ban jin / half jin), Danggui (Angelicae Sinensis Radix) (ban liang / half liang), Xingren (Pruni Armeniaci Semen) (49 kernels, peeled), Tao Zhi (Persicae Ramulus) and Liu Zhi (Salicis Ramulus) (each 49 strips, 4 fingers long).
Wrap the herbs in a new cotton cloth, tie to one branch, immerse in oil. Stir with the other branch in an iron vessel. Once decocted, add Huandan (Minii Oxidum Rubrum) 3 liang, boil together. Test by dropping into water; it should form beads that do not disperse.

Jin Yinsi Chuang (Metal Thread Sore), also known as Hongsi Liu (Red Thread Tumor), resembles a thread or rope of varying thickness, corresponding to the Dan Du (Erysipelas) mentioned in classics. It is less extensive than typical Dan Du. It may appear on the head or hands; if it descends to the Heart, death ensues; ascending from below follows similar logic. Treatment involves lancing the sore head along the meridian to bleed, then chewing Ping Cao Gen (Potamogeton Root) and applying it topically for immediate cure.

Treating fainting and salivary flooding after falling from height, caused by fright and terror. Ku Zhang San (Quercus Inflorescence Powder).
Ku Zhang (Quercus Inflorescence) (any amount).
Grind into fine powder, mix with hot wine and take. Also treats postpartum retained blood or blood stasis.

Treating Ding Sore (Hard Carbuncle), Deming San (Life-Seizing Powder).
Wutou Jian (Aconiti Radix Lateralis Preparata apex), Fuzi Di (Aconiti Radix Preparata base), Xie Shao (Bombyx Batryticatus tip), Xionghuang (Realgar), Wugong (Scolopendra) (one pair), Shafen (Antimonii Sulfuretum Praeparatum), Fen Shuang (Calomelas), Qingfen (Calomelas), Shexiang (Moschus), Ruxiang (Boswelliae Resina) (each 1 qian), Xinshi (Arsenici Trioxidum) (2.5 qian), Naozi (Borneolum Syntheticum) (small amount).
Grind into fine powder. First lance the sore to drain foul blood. Insert a grass stem wrapped in paper into the sore, aiming for depth.

Treoring difficult-to-resolve sores that fail to suppurate and cause persistent pain. Muxiang San (Aucklandia Powder).
Digupi (Lycii Cortex) (1 liang, cleaned), Muxiang (Aucklandiae Radix) (ban liang / half liang), Chuanshanjia (Manis Squama) (2.5 qian, roasted yellow), Shexiang (Moschus) (1 zi).
Grind into fine powder, take 3 qian mixed with wine. Also effective for infantile pox-related abscesses, taken with rice water.

Treating Ding Sore poison entering the abdomen, causing stupor and anorexia. Zihua Diding (Viola Yedoensis), Chanqiao (Cicada Slough), Guanzhong (Polyporus) (each ban liang / half liang), Dingxiang (Caryophylli Flos), Ruxiang (Boswelliae Resina) (each 1 qian).
Grind into fine powder, take 2 qian mixed with warm wine.

Treating malignant sores with necrotic flesh and promoting pus discharge. Baidingxiang (Turdus Merula Excrement processed), Qingfen (Calomelas), Fen Shuang (Calomelas), Xionghuang (Realgar), Shexiang (Moschus) (each 1 qian), Badou (Crotonis Fructus) (3 seeds, oil removed).
Grind together finely, mix with fresh rice paste to form pellets.

Treating severe pain in various sores with discoloration to purple/black, diffuse swelling, named "Bone-Attacking Abscess Miracle," Sansheng San (Three-Life Powder).
Lufengfang (Vespa Nest), Shetui Pi (Ophichthus Skin), Toufa (Human Hair) (washed, equal parts).
Char the three ingredients until carbonized but retaining properties, grind fine, take 3 qian mixed with wine.

Treating Heat transferring from Bladder to Small Intestine, ascending to cause oral ulceration (Kou Mi), common in heavy drinkers. Use Daochi San (Guide Out Red Powder) and Wuling San (Five-Ling Powder), each ban liang (half liang), decocted and taken.

Treating Shaoyin Oral Ulcers, Banxia San (Pinellia Powder). If voice is lost, it indicates Wind-Cold obstructing Yang Qi.
Banxia (Pinelliae Rhizoma Preparata) (1 liang), Gui (Cinnamomi Ramulus) (1 zi), Caowutou (Aconiti Radix) (1 zi).
Decoct together in 1 cup of water, divide into two doses. Highly effective.

Treating Taiyin Oral Ulcers, Ganfan San (Licorice-Alum Powder).
Sheng Gancao (Glycyrrhizae Radix et Rhizoma) (1 cun), Baifan (Alumen) (size of a chestnut).
Hold in mouth to dissolve and swallow saliva.

Treating Red Oral Ulcers, Ruxiang San (Frankincense Powder).
Ruxiang (Boswelliae Resina), Moyao (Myrrhae Resina) (each 1 qian), Baifan (Alumen, purified) (ban qian / half qian), Tonglv (Chalcanthite) (small amount).
Grind into fine powder, apply topically.

For sores turning purple/black with pain, Huichang Jinyinhua Tang (Return Carbuncle Honeysuckle Decoction).
Jinyinhua (Lonicerae Japonicae Flos, with stems) (2 liang), Huangqi (Astragali Radix) (4 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang).
Chop the three herbs, place in a bottle with 1 sheng of wine, seal tightly, boil in a water bath for 2-3 hours, remove dregs, cool, and take warm.

For sores that have ruptured or are severely swollen but unruptured, Danggui San (Angelica Powder) is primary.
Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Gualou (Trichosanthis Fructus), Muxiang (Aucklandiae Radix), Huanglian (Coptidis Rhizoma) (equal parts).
Grind into coarse powder, decoct 1 liang. If painful with constipation, add Dahuang (Rhei Radix et Rhizoma) 3 qian.

Ruxiang San (Frankincense Powder): Treating large, painful sore openings.
Hanshuishi (Calcites) (burned, 1 liang), Huashi (Talcum) (1 liang), Ruxiang (Boswelliae Resina), Moyao (Myrrhae Resina) (each 5 fen), Naozi (Borneolum Syntheticum) (small amount).
Grind each separately, mix uniformly, sprinkle sparingly on the sore opening.

Xionghuang San (Realgar Powder): Treating sores with malignant flesh that cannot be removed.
Xionghuang (Realgar) (1 qian, ground), Badou (Crotonis Fructus) (1 seed, peeled and ground).
Grind these two together into a paste, add small amounts of Ruxiang (Boswelliae Resina) and Moyao (Myrrhae Resina), grind fine again, apply sparingly; malignant flesh will naturally detach.

Muxiang San (Aucklandia Powder): Treating sores that fail to close for a long time.
Muxiang (Aucklandiae Radix), Binglang (Arecae Semen) (each 1 qian), Huanglian (Coptidis Rhizoma) (2 qian).
Grind into fine powder, apply topically. If painful, add Danggui (Angelicae Sinensis Radix) 1 qian and apply; it will self-converge.

Another Formula:
Shujiao (Zanthoxyli Pericarpium, de-stemmed, stir-fried until black, 1 qian, ground separately), Dingfen (Cerussa), Fenghua Hui (Weathered Ash) (5 qian), Baifan (Alumen, purified) (2.5 qian), Ruxiang (Boswelliae Resina), Moyao (Myrrhae Resina) (each 1 qian).
Grind into fine powder, apply to sore opening.

Zhentousui (Needle Head Year): Treating sores with hard, numb swelling.
Chansu (Toad Venom), Shexiang (Moschus) (each 1 qian).
Grind extremely fine, mix with infant milk to form a paste, store in a porcelain container (dry storage is acceptable). Apply a small amount mixed with saliva to the swollen area, cover with ointment; toxins will exit, preventing severe sores, or making existing ones mild.

Treating White Oral Ulcers, Moyao San (Myrrh Powder).
Moyao (Myrrhae Resina), Ruxiang (Boswelliae Resina), Xionghuang (Realgar) (each 1 qian), Qingfen (Calomelas) (ban qian / half qian), Badoushuang (Crotonis Fructus Pulvis) (small amount).
Grind into fine powder, apply dry.