初起核高肿痛，色红软活，微作寒热，肩项不强者易。已成根不坚硬，内无小核相丛，脾健气血不衰者易。
已溃脓稠，肉色红活，核肿渐消，肩项自便、渐敛者顺。溃后易消易敛，气体平和，胸膈宽利，饮食知味
者顺。
未成形体消瘦，寒热往来，结核顽硬，痰嗽相兼者险。已成核坚，连续如珠，大小不等，项强筋急、脉虚
者险。
已溃脓水清稀，肌肉消铄，自汗盗汗，寒热不睡者逆。溃
后阴虚烦躁，作渴泄秘，男子骨蒸，女人经闭俱逆。
初起肿痛，憎寒壮热，四肢拘急，项强头 者，表散之。肿硬发热，便秘口干，胸膈不利，恶心脉实者，
宜利之。膏粱浓味，醇酒积热，湿痰凝结而成，化痰、降火、清中。忧思过度，郁怒伤肝，筋缩结核者，宜养
血、开郁、疏肝。房欲劳伤，阴虚晡热，自汗咳嗽，形消瘦者，滋肾健脾。失利忘名，怀抱郁结，积想在
心，所如不得，乖隔阴阳，虚嗷岁月；所得此者，精血俱伤，先养正气，次治标病。坚而不溃，腐而溃之，溃
而不敛，补而敛之，皆活法也。
一男人项核肿痛，拘急恶寒，用荆防败毒散二剂，表症悉退，余核不消；用散肿溃坚汤加川芎、香附、贝
母十余服，其核渐消。外以琥珀膏贴之，月余而安。
一男人仲冬渡江，暴发雾气，又值惊恐，次日寒热交作，头、面、耳、项俱肿，先以藿香正气散二服，寒
热亦止，面肿渐消；惟项间坚肿不退，红 作痛，此毒聚必欲作脓，仍用正气散加芎、归、皂刺数服，候脓熟
针之，肿痛顿退，又以十全大补汤，脾健肌生完口。
一妇人孀居六载，子幼未立，忧郁成核半年；又兼经水不调，寒热交作，形体消瘦，脉亦弦数，此劳伤气
血，肝火妄动而成斯疾也。所谓损者益之，不可用追蚀之药损而复损。先用逍遥散加香附、牡丹皮、贝母和其
血脉，和其肝气，使寒热尽退；次用益气养荣汤，服至月余，气血渐复，经事渐调，元气渐醒。外用火针核上，
点破四孔，用黄线药插入五、六次，候至孔
大，换用冰蛳散搽于核上封之，至十三日外，其核自落，外搽红膏生肌收敛，内换人参养荣汤加香附、木香三
十余服，其口自完。此妇慎起居、回七情、戒口味、尽调理，故可得愈，否则必不能矣。
一室女年十七，因父择婿不遂，耽至二旬，怀抱日久，项生数核，坚硬如石，此肝经凝结筋缩之病也。又
兼经水断绝，寒热如疟，咳嗽脉数，惟不颧红，此阴虚火动，已成痨瘵症也。非药能愈，视其形状，喜无败色。
予曰∶欲治此病，先治其心犹可。父问曰∶何药治心？予曰∶非药也。《易》云∶天地氤氲，万物化醇，男女
媾精，万物化生，此天地男女生成化育之道也。斯病独起于孤阴，寡阳不生不化，所谓逆理之病，此女大失配，
谓当至而不至，渐成失度之疾，其病不生而自生，非己作也，由时变也。故药不能挽回，必得阴阳和而雨泽降，
夫妇和而家道成。斯时之后，用药方可。彼父始悟，随即择嫁，三月后，复请视之，前症稍定，先用逍遥散加
香附、青皮、山栀、丹皮、贝母十余剂开郁疏肝，寒热渐止；次以人参养荣汤加丹皮、红花通其血脉，使心血
易生，容颜稍泽∶又用益气养荣汤倍参、术培助脾胃，增进饮食；间用归脾汤加麦冬、五味、远志、沙参收敛
神气，宽慰性情。又制参术地黄膏，服至半年，精神顿复，经事亦通，惟核不能全退，用火针点破一核，琥珀
膏贴之，渐腐为脓；又两月而得收敛。余肿三核，渐针渐溃渐敛，首尾纯用补脾开郁药，调理一年，始得全愈。
一男子年近三十，项生数核，面白神劳，皮粗脉数，此元气受伤之症也。先当补养气血，待根本壮实后治
其疮，随用养荣健脾药十余剂未效，彼以为缓，又信方士所惑，图内消之，自服斑蝥、巴、麝之药，连泻十数
行后，致小便淋漓不已，虚热更增，饮食减少。又复请视，形色内败，不堪调理，辞而不治。彼后
方悔，虽请内医，强投扶助降火之药，终不应而死。
一妇壮年性急，夫荡不为家，左项生核半载，渐至鸡卵大，坚硬如石，皮外红丝缠绕，左右脉俱弦数。弦
属肝火妄动，数乃脾热之甚。先用栀子清肝汤平伐肝木，五服后而脉始平。又以清肝解郁汤数服散其郁结，次
用益气养荣汤调其气血，间服散肿溃坚汤软其坚肿，外以琥珀膏贴之，调理百日而元气乃复。坚硬已消八、九
，止存小核未尽，彼以为愈，止不服药。后又一载，值夫赌讼未胜，暴急惊恐，前肿复作，两手脉诊细而多
数，此阴血亏损，阳火乘之，非前有余症也。又兼胸膈不利，饮食无味，经水先期过多，形容憔悴不泽，此神
伤于思虑则肉脱，意伤于忧愁则肢废，魂伤于悲哀则筋挛，魄伤于喜乐则皮槁，志伤于暴怒则腰脊不能俯仰，
以上俱七情内损症也。法当滋养气血，调和脾胃，益肾清心，开郁散滞，庶保无虞。彼不肯信，仍前欲服散肿
溃坚之药，欲灸肿上，图内消之。予曰∶此非前比，今则不敢治也。请客医自制前药，亦灸患上，并灸肘尖，
此为真气虚而益虚，邪气实而益实。后果反加发热自汗，咳嗽项强，四肢不收，灸疮无脓，血水不绝，肿亦炽
盛，此脏腑已损之候，必不久居也。又月余传为气急声哑，痰血交出而殁。予尝见庸医不辨虚实，患家不信，
正理偏费，服药往往多致不救者十有八、九，凡医者、患者俱当省而慎戒之。
初起时，肿块高突、疼痛且肿胀，颜色红活、质地柔软而活动自如，伴有轻微的恶寒发热，肩部及颈部感觉不灵活但尚可活动的，属于易治之证。
已经成形的，根部不坚硬，内部没有多个小核聚集在一起，脾气健运、气血未衰的，属于易治之证。
已经溃破流脓，脓液稠厚，肌肉颜色红活，核肿逐渐消退，肩颈活动自如、疮口逐渐愈合的，属于顺证。
溃破后容易消散、容易愈合，身体气息平和，胸膈宽畅舒适，饮食有味道的，属于顺证。
尚未形成明显形体，身体消瘦，寒热往来交替，结核顽固坚硬，兼有痰多咳嗽的，属于险证。
已经成形的，核块坚硬，连续排列如串珠状，大小不一，颈部僵硬、筋脉拘急、脉象虚弱的，属于险证。
已经溃破，脓水清稀，肌肉消损消瘦，自汗盗汗，寒热交作、无法安睡的，属于逆证。
溃破后出现阴虚烦躁，口渴、便秘，男子出现骨蒸潮热，女子出现月经闭止的，均属于逆证。
初起时肿痛，憎恶寒冷且高热，四肢拘挛紧急，颈部僵硬、头痛的，应当采用解表发散的方法治疗。
肿胀坚硬、发热，大便秘结、口干，胸膈不适，恶心、脉象实有力的，应当采用通利攻下的方法治疗。
因食用膏粱厚味、浓烈酒食导致积热，湿痰凝结而成的，应当采用化痰、降火、清中焦的方法治疗。
因忧思过度，郁怒伤肝，导致筋脉收缩、结成结核的，应当采用养血、开郁、疏肝的方法治疗。
因房事劳伤，导致阴虚午后发热，自汗咳嗽，身体消瘦的，应当采用滋肾健脾的方法治疗。
因名利得失导致忧虑郁结，积想在心，愿望不得实现，导致阴阳乖隔，长年累月患病；这类患者精血俱伤，应当先调养正气，其次再治疗标病。
肿块坚硬而不溃破的，促使它溃破；溃破后不愈合的，用补益法使其愈合，这些都是灵活变通的治疗方法。
一个男子颈部核块肿痛，拘挛紧急且怕冷，服用荆防败毒散两剂后，表症全部消退，但剩余核块未消；又服用加川芎、香附、贝母的散肿溃坚汤十余服，核块逐渐消退。外用琥珀膏贴敷，一个月左右痊愈。
一个男子在仲冬时节渡江，突然遭遇雾气侵袭，又正值惊恐之时，第二天寒热交作，头、面、耳、颈部全部肿胀。先用藿香正气散服用两剂，寒热停止，面部肿胀逐渐消退；只有颈部坚硬肿胀不退，发红疼痛，这是毒气聚集必然要化脓，仍然用正气散加川芎、当归、皂角刺服用数剂，等待脓液成熟后针刺排脓，肿痛立刻减退，随后又用十全大补汤，待脾气健运、肌肉生长完全后疮口愈合。
一个妇人守寡六年，儿子年幼未成家，因忧郁结成核块半年；又兼月经不调，寒热交作，身体消瘦，脉象弦数，这是劳损伤及气血，肝火妄动而导致的疾病。所谓“损者益之”，不可使用追蚀腐蚀的药物造成再次损伤。先用逍遥散加香附、牡丹皮、贝母调和血脉，疏理肝气，使寒热全部退去；接着用益气养荣汤，服用一个多月，气血逐渐恢复，月经逐渐调顺，元气逐渐苏醒。外用火针在核块上刺破四个孔，插入黄线药五到六次，等待孔洞变大，换用冰蛳散涂抹于核块上并封固，十三天后，核块自行脱落，外用红膏生肌收敛，内服改用人参养荣汤加香附、木香三十余服，疮口自然愈合。这位妇人注意起居、调节七情、节制口味、坚持调理，所以能够痊愈，否则必定不能治愈。
一个十七岁的少女，因为父亲选择女婿不满意，拖延到二十岁，怀抱郁结日久，颈部生出数个核块，坚硬如石，这是肝经凝结、筋脉收缩的疾病。又兼月经断绝，寒热如疟疾般发作，咳嗽、脉数，只是颧骨不红，这是阴虚火动，已经形成痨瘵症。不是药物能治愈的，观察其神色，喜欢面色无败坏之色。我说：“想要治疗这个病，先治其心还可以。”父亲问：“什么药治心？”我说：“不是药物。《易经》说：天地氤氲，万物化醇，男女媾精，万物化生，这是天地男女生成化育的道理。此病独起于孤阴，寡阳不生不化，所谓违背常理的病，此女大失婚配时机，谓应当到来而未到来，逐渐形成失度的疾病，其病不生而自生，非自己造作，由时势变化所致。所以药物不能挽回，必须得阴阳和谐而雨泽降临，夫妇和睦而家道成就。在这之后，用药才可以。”那位父亲这才醒悟，随即为她择嫁，三个月后，再次请我诊治，前症稍定，先用逍遥散加香附、青皮、山栀、丹皮、贝母十余剂开郁疏肝，寒热逐渐停止；接着用人参养荣汤加丹皮、红花通其血脉，使心血易于生成，容颜稍显润泽；又用益气养荣汤倍加人参、白术培助脾胃，增进饮食；间或用归脾汤加麦冬、五味子、远志、沙参收敛神气，宽慰性情。又制作参术地黄膏，服用半年，精神顿时恢复，月经也通畅，只是核块不能完全消退，用火针点破一个核块，贴琥珀膏，逐渐腐烂化为脓；又两个月后得以收敛。其余三个肿核，逐渐针刺、逐渐溃破、逐渐愈合，从头到尾纯用补脾开郁的药物，调理一年，才完全痊愈。
一个男子年近三十，颈部生出数个核块，面色白、神情疲惫，皮肤粗糙、脉数，这是元气受伤的病症。应当先补养气血，待根本壮实后再治疗疮疡，随即服用养荣健脾药十余剂未见效，他认为太慢，又听信方士迷惑，企图内消，自行服用斑蝥、巴豆、麝香的药物，连续腹泻十多次后，导致小便淋漓不尽，虚热更增，饮食减少。再次请我诊治，形色内部败坏，不堪调理，推辞不予治疗。他后来后悔，虽然请内科医生，强行投用扶助降火的药物，最终无效而死。
一个妇人在壮年时期性格急躁，丈夫放荡不为家计，左侧颈部生核半年，逐渐长至鸡蛋大小，坚硬如石，皮肤外红丝缠绕，左右脉象都弦数。弦属肝火妄动，数乃脾热严重。先用栀子清肝汤平伐肝木，服用五剂后脉象才平复。又以清肝解郁汤数服疏散其郁结，接着用益气养荣汤调其气血，间服散肿溃坚汤软化其坚肿，外用琥珀膏贴敷，调理百日元气才恢复。坚硬已消除八九，只存小核未尽，她以为痊愈，只不服药。后来又过一年，正值丈夫赌博诉讼未胜，暴急惊恐，前肿复发，两手脉诊细而多数，这是阴血亏损，阳火乘虚而入，不是之前的有余症。又兼胸膈不适，饮食无味，月经先期过多，形容憔悴无光泽，这是神伤于思虑则肌肉脱削，意伤于忧愁则肢体废用，魂伤于悲哀则筋脉挛缩，魄伤于喜乐则皮肤枯槁，志伤于暴怒则腰脊不能俯仰，以上都是七情内损的病症。治法应当滋养气血，调和脾胃，益肾清心，开郁散滞，庶几可以保全无忧。她不肯相信，仍想服用散肿溃坚的药，想要灸肿处，企图内消。我说：“这不同于之前，现在不敢治疗了。”请客医自制前药，也灸患处，并灸肘尖，此为真气虚而更虚，邪气实而更实。后果反而加重发热自汗，咳嗽项强，四肢不收，灸疮无脓，血水不绝，肿胀也炽盛，这是脏腑已受损的迹象，必定不久于世。又过一个多月传变为气急声哑，痰血交出而死亡。我曾见庸医不辨虚实，患家不信正理，偏费服药往往多致不救的十有八九，凡医者、患者都应当反省并谨慎戒除。
In the initial stage, if the nodule is elevated, painful, and swollen, with a red, soft, and mobile texture, accompanied by slight chills and fever, and the shoulder and neck are stiff but still movable, it is easy to treat.
If the condition has progressed to formation, where the base is not hard, there are no clusters of small nodules inside, the spleen function is robust, and qi and blood are not depleted, it is easy to treat.
If already ulcerated, with thick pus, red and vibrant flesh, gradual reduction of swelling, free movement of shoulders and neck, and gradual healing of the wound, it is a favorable prognosis (Shun).
If after ulceration, the swelling dissipates easily, the wound heals easily, the body's qi is peaceful, the chest and diaphragm feel open and comfortable, and appetite is good, it is a favorable prognosis (Shun).
If the body has not yet formed a distinct shape, the patient is emaciated, experiencing alternating chills and fever, with stubborn and hard tubercles, accompanied by phlegm and cough, it is a dangerous condition (Xian).
If the condition has progressed, with hard nodules arranged continuously like beads, varying in size, stiff neck, tight sinews, and a weak pulse, it is a dangerous condition (Xian).
If already ulcerated, with thin and watery pus, wasting of muscle tissue, spontaneous sweating, night sweats, alternating chills and fever, and insomnia, it is an adverse prognosis (Ni).
If after ulceration, yin deficiency causes irritability, thirst, and constipation; men experience bone-steaming tidal fever; women experience amenorrhea; all these are adverse prognoses (Ni).
In the initial stage, if there is swelling and pain, aversion to cold with high fever, stiffness and urgency of the four limbs, stiff neck, and headache, treatment should involve releasing the exterior (Biao San).
If there is hard swelling and fever, constipation, dry mouth, discomfort in the chest and diaphragm, nausea, and a forceful pulse, treatment should involve purging and draining (Li).
If caused by accumulation of heat from rich foods, strong wines, and condensation of damp-phlegm, treatment should involve resolving phlegm, descending fire, and clearing the middle jiao.
If caused by excessive worry and anger injuring the liver, leading to tendon contraction and nodule formation, treatment should involve nourishing blood, relieving depression, and soothing the liver.
If caused by sexual exhaustion leading to yin deficiency, afternoon tidal fever, spontaneous sweating, cough, and emaciation, treatment should involve nourishing the kidney and strengthening the spleen.
If caused by obsession with fame and gain, emotional stagnation, unfulfilled desires, leading to yin-yang disharmony over many years; such patients have damaged essence and blood, so one must first nourish healthy qi, then treat the manifest disease.
For hard nodules that do not ulcerate, promote ulceration; for ulcerated wounds that do not heal, use tonification to promote healing; these are flexible therapeutic methods.
A man had swollen and painful nodules in the neck, with stiffness and aversion to cold. After two doses of Jingfang Baidu San (Coptis and Saposhnikovia Decoction), the exterior symptoms resolved, but the remaining nodules did not disappear. After more than ten doses of Sanzhong Kuijian Tang (Swelling-Reducing and Hardness-Resolving Decoction) added with Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), and Fritillariae Bulbus (Beimu), the nodules gradually subsided. Applied Hupo Gao (Amber Ointment) externally, he recovered within a month.
A man crossed a river in mid-winter, suddenly exposed to fog, and was frightened. The next day, he had alternating chills and fever, with swelling of the head, face, ears, and neck. After two doses of Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi), the chills and fever stopped, and facial swelling subsided. However, the hard swelling in the neck persisted, turning red and painful, indicating toxin accumulation likely to suppurate. He was given Zhengqi San again with added Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Gleditsiae Spina (Zaocili) for several doses. Once the pus matured, it was punctured, and the swelling and pain immediately receded. Then, Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) was used until spleen function improved and muscle regeneration completed the healing.
A widow of six years, with a young son, developed nodules due to depression over half a year. She also had irregular menstruation, alternating chills and fever, emaciation, and a wiry-rapid pulse. This was damage to qi and blood from labor, with hyperactive liver fire. As stated, "for deficiency, tonify"; corrosive drugs should not be used to cause further damage. First, Xiaoyao San (Free and Easy Wanderer Powder) with added Cyperi Rhizoma (Xiangfu), Moutan Cortex (Mudanpi), and Fritillariae Bulbus (Beimu) was used to harmonize blood vessels and liver qi, eliminating chills and fever. Next, Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction) was taken for over a month, restoring qi and blood, regulating menstruation, and reviving primal qi. Externally, fire needles were used to pierce four holes in the nodule, inserting yellow thread medicine five or six times. When the holes enlarged, Bing Si San (Ice Snail Powder) was applied and covered. Thirteen days later, the nodule fell off naturally. Hong Gao (Red Ointment) was applied externally to generate flesh and close the wound. Internally, Renshen Yangrong Tang (Ginseng Nourishing Decoction) with added Cyperi Rhizoma (Xiangfu) and Aucklandiae Radix (Muxiang) was taken for over thirty doses, and the wound healed naturally. This woman followed advice on daily routine, emotional regulation, dietary restraint, and continuous care, thus achieving recovery; otherwise, it would have been impossible.
A seventeen-year-old maiden, whose father failed to find a suitable husband for her, delaying marriage until age twenty, developed multiple hard, stone-like nodules in the neck due to long-term emotional stagnation. This is a disease of liver meridian condensation and tendon contraction. She also had amenorrhea, malaria-like chills and fever, cough, and rapid pulse, though without malarial flush. This indicates yin deficiency with fire hyperactivity, progressing into consumption disease (Lao Zhai). Medication alone cannot cure this. Observing her complexion showed no signs of decay. I said, "To treat this, treating the mind first is possible." The father asked, "What medicine treats the mind?" I replied, "Not medicine. The *I Ching* states: Heaven and earth interact, transforming all things into purity; male and female unite, generating all life. This is the way of creation. This disease arises from isolated yin and scarce yang, unable to generate or transform. It is a disease against nature, resulting from missed marital timing, gradually becoming a disorder of excess/deficiency imbalance. The disease arises spontaneously, not by personal fault, but by temporal change. Therefore, medicine cannot reverse it; only when yin and yang harmonize and rain falls, and when husband and wife are harmonious and family order is established, can medication be effective." The father finally understood, arranged her marriage, and three months later, upon re-examination, symptoms had stabilized. First, Xiaoyao San with added Cyperi Rhizoma (Xiangfu), Citri Reticulatae Pericarpium (Qingpi), Gardeniae Fructus (Zhizi), Moutan Cortex (Danpi), and Fritillariae Bulbus (Beimu) for over ten doses to relieve depression and soothe the liver, stopping chills and fever. Then, Renshen Yangrong Tang with added Moutan Cortex (Danpi) and Carthami Flos (Honghua) to unblock blood vessels, facilitating heart blood generation and improving complexion. Next, Yiqi Yangrong Tang with doubled Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) to support spleen and stomach and increase appetite. Intermittently, Guipi Tang (Restore the Spleen Decoction) with added Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), Polygalae Radix (Yuanzhi), and Glehniae Radix (Shashen) to gather spirit and comfort temperament. Also, Shen Zhu Dihuang Gao (Ginseng, Atractylodes, and Rehmannia Paste) was taken for half a year, restoring spirit and menstruation. Only the nodules did not fully resolve. One nodule was pierced with fire needles and covered with Amber Ointment, gradually suppurating. Two months later, it healed. The remaining three nodules were gradually needled, ulcerated, and healed. Throughout, purely spleen-tonifying and depression-relieving medicines were used for one year until full recovery.
A man near thirty had multiple nodules in the neck, pale complexion, fatigued spirit, rough skin, and rapid pulse, indicating injury to primal qi. He should first tonify qi and blood, then treat the sore once the root is strong. He took over ten doses of Yangrong Jianpi medicines without effect. Thinking it too slow, he believed a quack's advice to seek internal resolution, self-administering Mylabris (Banmao), Croton Seed (Badou), and Moschus (Shexiang). After more than ten episodes of diarrhea, he suffered continuous dribbling urine, increased deficient heat, and reduced appetite. Upon re-examination, his internal state was ruined and untreatable; I declined treatment. He later regretted this. Although internal physicians were consulted, forced administration of tonifying and fire-descending medicines failed, and he died.
A woman in her prime, with a quick temper and a dissolute husband, developed a nodule on the left side of her neck for half a year, growing to the size of a chicken egg, hard as stone, with red veins winding on the skin. Both pulses were wiry and rapid. Wiry indicates hyperactive liver fire; rapid indicates severe spleen heat. First, Zhizi Qinggan Tang (Gardenia Clearing Liver Fire Decoction) was used to subdue liver wood. After five doses, the pulse normalized. Then, Qinggan Jieyu Tang (Clearing Liver and Resolving Depression Decoction) was taken for several doses to disperse stagnation. Next, Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction) regulated qi and blood. Intermittently, Sanzhong Kuijian Tang (Swelling-Reducing and Hardness-Resolving Decoction) softened the hardness. Externally, Hupo Gao (Amber Ointment) was applied. After one hundred days of regulation, primal qi recovered. Eight or nine-tenths of the hardness disappeared, leaving only small nodules. Believing herself cured, she stopped medication. A year later, due to her husband's gambling losses and litigation, she experienced sudden fright and anger, causing recurrence. Pulses were fine and numerous, indicating blood deficiency with hyperactive yang fire, not the previous excess syndrome. She also had chest discomfort, loss of taste, early and heavy menstruation, and haggard appearance. This shows spirit injured by worry leads to muscle wasting; intention injured by sorrow leads to limb paralysis; soul injured by grief leads to tendon contraction; corporeal soul injured by joy leads to withered skin; will injured by rage leads to inability to bend or straighten the waist and spine. All these are internal damages from the seven emotions. Treatment should nourish qi and blood, harmonize spleen and stomach, benefit kidney and clear heart, relieve depression, and scatter stagnation, ensuring safety. She refused to believe, insisting on taking Sanzhong Kuijian Tang and moxibustion on the swelling to achieve internal resolution. I said, "This is different now; I dare not treat it." She invited another doctor who prepared the same medicine and performed moxibustion on the lesion and the elbow tip. This further depleted true qi and strengthened pathogenic qi. Subsequently, fever, spontaneous sweating, cough, stiff neck, flaccid limbs, non-suppurating moxa sores, continuous bloody discharge, and intense swelling occurred. This indicated organ damage, predicting imminent death. Over a month later, she developed shortness of breath, hoarseness, expectoration of blood and phlegm, and died. I have often seen incompetent doctors failing to distinguish deficiency and excess, and patients refusing correct principles, relying on improper medications, leading to failure in eight or nine out of ten cases. Both doctors and patients should reflect and exercise caution.