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According to the "Rites of Zhou" (Zhou Li), under the Minister of State (Tian Guan Zai Zai), physicians have long been divided into Ji Yi (Internal Medicine Physicians) and Yang Yi (Surgical Physicians). There were eight Zhong Shi (Middle-grade Scholars) for Internal Medicine and eight Xia Shi (Lower-grade Scholars) for Surgery. The emphasis on internal medicine over surgery has existed since ancient times; however, one cannot effectively treat external diseases without mastering internal medicine. If a patient cannot be saved by an Internal Medicine Physician, their parents' remains can still be preserved and buried intact. In contrast, Surgical Physicians often fail in this regard, leading to rotting bones and muscles, exposing viscera before death. Therefore, among all diseases, surgical sores are the most tragic, yet they are disregarded by the world. Why is this? Among contemporary Surgical Physicians, those who understand meridians, are proficient in prescriptions, do not crave profit, and solely focus on saving lives are fewer than one in a thousand or ten thousand. Their disregard is justified, but does this not also reflect their own disregard for life?

Since childhood, I studied Qi Huang's arts (Traditional Chinese Medicine). In my early twenties, I treated my sister's Ru Yong (Acute Mastitis) and Yu Weng's Fu Gu Ju (Deep Abscess), restoring flesh to bone and achieving remarkable recoveries. These experiences were not inherited from a master; I believed surgery was relatively straightforward. I sought intelligent and ambitious individuals to guide me in becoming a true Surgical Physician, but found none. Thus, I collected the formulas and theories of famous physicians from previous generations, integrated them with my unique insights, and compiled this book. Compared to specialized books circulating in the world that depict human figures, print prescriptions, and boast of secret transmissions, this work differs by tens of thousands of times. By studying it thoroughly and understanding it profoundly, one could achieve fame in the world.

After returning to my hometown due to convenient official duties, I was entitled to receive my salary according to regulations. Accepting it made me uneasy, while refusing it seemed eccentric. Therefore, I entrusted the manuscript to printers. After the deadline passed, the work was completed, and books covering various specialties and symptom-based treatments were roughly prepared. Who allowed me to draw a salary in court while leisurely editing and publishing this work? Is this not a gift from the Sage Emperor?

Written at She Lan Xuan in Jintan during the Qixi Festival of the year Wushen (1608), amidst light rain and cool weather, by Wang Kentang.

The origins of Yong Ju (general term for superficial suppurative infections) are fivefold: 1. Abnormal seasonal climates (Tian Xing Shi Qi); 2. Internal stagnation of the Seven Emotions (Qi Qing); 3. External pathogenic invasion due to physical weakness; 4. Conflict between body heat and wind-cold; 5. Heat toxins from consuming roasted/fried foods, strong alcohol, or cinnabar/stone elixirs. In summary, these fall within the scope of the Three Causes (Nei Yin, Wai Yin, Bu Nei Wai Yin).

Regarding external causes, there are four types of Yong Ju related to Yun Qi (Five Movements and Six Qi):
First, Fire-Heat assisting the Heart leads to sores. Classics state: "When Shao Yin prevails, ulcers and rashes appear." Also: "When Shao Yin governs the year, heat descends, Lung Qi rises, and severe cases result in sores." Also: "During Shao Yin's governance, in the first Qi period, cold begins, Yang Qi is stagnant, summer heat approaches, causing internal and external sores." Also: "When Shao Yang prevails, sores appear." Also: "During Shao Yang's governance, wind-heat spreads, Tai Yin dampness flows horizontally, cold arrives, people suffer from cold in the middle, manifesting externally as sores. In the first Qi period, the climate is warm, causing sores in the skin and interstices. In the second Qi period, fire is suppressed, causing heat stagnation above and sores in the middle. In the third Qi period, summer heat arrives, causing pustules." Also: "During Tai Yang's governance, in the first Qi period, the climate is very warm, causing sores in the skin and interstices. These are normal transformations, representing mild disease." Also: "When Shao Yin governs, excessive heat causes severe sores." Also: "When Shao Yin governs, if guest Qi wins, severe sores occur." Also: "In Shao Yin's return disease, symptoms include aphasia, paralysis, rashes, carbuncles, furuncles, acne, and hemorrhoids." Also: "Excessive fire is called He Xi, causing bleeding from sores." Also: "When fire is stagnant and erupts, people suffer from sores and swelling. This represents severe pathological changes."

Second, Cold Evil injuring the Heart causes sores. Classics state: "During Tai Yang's governance, in the third Qi period, cold qi moves, people suffer from cold, developing internal heat, carbuncles, and diarrhea." Also: "When Tai Yang governs, excessive cold alters blood internally, causing sores, rooted in the Heart." Also: "During Tai Yang's governance, in the fourth Qi period, cold rain falls, causing sores and swelling."

Third, Dryness Evil injuring the Liver causes sores. Classics state: "When Wood is deficient, it is called Wei He, resembling Metal Qi. Symptoms include limb lesions, carbuncles, and sores, caused by evil injuring the Liver." Also: "When Tai Yang governs, excessive dryness causes sores, acne, and carbuncles, rooted in the Liver."

Fourth, Dampness Evil causes sores. Classics state: "When Tai Yin governs, dampness affects objects, severely causing back sores." Also: "When Tai Yin wins, fire stagnates internally, causing internal sores that spread externally. These four points constitute 'Tian Xing Shi Qi'."

In *Su Wen: Mai Yao Jing Wei Lun*, the Yellow Emperor asked: "How do various swellings, tendon spasms, and bone pain arise?" Qi Bo replied: "These are swellings caused by cold and variations of the Eight Winds." The Emperor asked: "How to treat?" Qi Bo replied: "These are seasonal diseases; treating them with opposing elements brings recovery."

*Ling Shu: Yong Ju Pian* states: "Blood vessels, Ying, and Wei circulate continuously, corresponding to stars above and meridians below. When cold evil lodges in meridians, blood becomes sluggish and obstructed. Wei Qi gathers there and cannot return, causing swelling. Cold transforms into heat; excessive heat rots flesh, turning it into pus. If pus is not drained, tendons rot, damaging bones. Bone damage depletes marrow. If not excreted through bone openings, blood becomes empty, failing to nourish tendons, bones, and muscles. Meridians leak, fuming into the Five Viscera, leading to death."

*Sheng Qi Tong Tian Lun* states: "Sweating from labor exposed to wind causes cold to press in, forming acne-like lesions when stagnant. If Yang Qi's opening and closing functions fail, cold enters, causing severe curvature. If Ying Qi does not flow smoothly and reverses in muscle tissue, swelling occurs." This explains how cold evil enters through sweat pores or faulty Yang Qi regulation, lingering to cause swelling. This corresponds to "external invasion due to weakness" and "heat conflicting with wind-cold." Treatments include Shi Xuan San, Wu Xiang Tang from *Jing Yao*, and Cang Zhu Fu Jian San by Jie Gu (Zhang Yuansu), which are exterior-releasing agents.

Regarding internal causes, Chen Wuyue stated: "Yong Ju and Luo Li (scrofula), regardless of deficiency/excess or cold/heat, are formed by Qi stagnation." Classics say: "Qi stagnates in meridians, moving sluggishly with blood, obstructing and forming Yong Ju." This implies formation due to emotional stagnation (joy, anger, worry, thought) rather than just heat. Treatments use Yuan Zhi Jiu and Du Sheng San, applying the theory of the Five Emotions overcoming each other (e.g., anger overcoming thought).

Regarding non-internal/non-external causes, classics mention "changes from rich food causing large Ding," akin to replacing contents in an empty vessel. Eastern regions, rich in fish and salt, have people who eat fish and salty foods. Fish generates internal heat; salt damages blood. Thus, people have dark skin and loose pores, prone to Yong Ju. Consumption of elixirs and strong alcohol also falls into this category. Li Dongyuan stated: "Rich food changes involve excessive flavors, causing Ying Qi to reverse in muscle tissue. Ying Qi is Stomach Qi. Food enters the stomach, goes to the Spleen, then to the Lungs, which govern all vessels, extending to skin/hair, intestines, and finally the Viscera, forming the pulse at the Qi Kou. Wealthy people lack moderation, consuming strong alcohol, fatty mutton, and heavy flavors. These dense, yang substances should enter orifices and follow Yang pathways but instead enter Yin pathways, causing excessive dampness. The child enriches the mother, making fire vigorous. Excessive heat-dampness attacks the Kidney. If sexual activity is not regulated, True Water is damaged. Lack of water allows dampness to rise, causing sores on the back and head, known as severe Da Ding. Sores appearing in Lung/Stomach areas are less toxic; others are even less so. Wherever heat-damp toxin stops, ulceration occurs. Hence, 'rich food changes cause large Ding.' Combined with 'holding emptiness' (weakness), treatment must drain Ying Qi. From a root-branch perspective, the initial pathology is the root. Bitter-cold herbs must be primary to relieve pain. Examples include Dongyuan treating Yuan Haowen and Danxi treating an old woman's brain carbuncle, both using San Huang and Da Huang processed with wine, or Pai Nong San and Dang Gui San. Exhaustion from sexual activity causing essence/Qi deficiency also belongs here; treatment should tonify deficiency and support interior expulsion, avoiding Wu Xiang herbs that consume True Yin and aid evil heat. Medications include Nei Gu Huang Bai Tang and Shen Xiao Tuo Li San. Classics state: 'Stagnant heat in Five Viscera causes sores in Six Bowels.' 'Six Bowels disharmony leads to accumulation and sores.' 'All pain, itching, and sores belong to the Heart.' Lung overcoming Liver causes sores; Kidney transferring cold to Liver causes swelling and shortness of breath; Spleen transferring cold to Liver causes swelling and tendon spasms. These are visceral changes, belonging to internal causes."

Dongyuan cited *Sheng Qi Tong Tian Lun*: "Ying Qi reversal in muscle tissue causes swelling." And *Gao Liang Zhi Bian*: "Rich food causes large Ding, entering easily like an empty vessel." And *Yin Yang Ying Xiang Lun*: "Earth's dampness harms skin, flesh, tendons, and vessels." This indicates external dampness obstructs Ying Qi. Ying and Wei are managed by Ying Qi, which is Stomach Qi and Luck Qi. Ying Qi is the root; if the root reverses and is damaged by dampness, sores form. Rich food similarly causes Ying Qi reversal and stagnation in meridians. This pathogen is neither in the exterior nor interior, but in the mid-way of meridians. All *Nei Jing* passages attribute this to Ying Qi reversal. Most discussions on sores mention two heats clashing, turning into pus. Some mention only heat turning to pus; others mention dampness generating sores, cold transforming to heat to form pus. These are sources of sores. One should use channel-guiding herbs for affected areas, differentiate Yin/Yang syndromes, and prioritize draining Ying Qi as the root. Root reversal aids fire; heat-dampness combines to rot flesh into pus-blood, which is secondary. Analogy: Summer is hottest, yet things do not rot; rotting occurs in autumn when dampness dominates. On the body, fever shows heat but does not rot flesh. Clear understanding of root and branch subdues evil. Knowing one thing to understand a hundred qualifies one as a Superior Physician (Shang Gong).