Toxic heat located in the exterior should be dispersed; toxic heat located in the interior should be purged. This is an unchangeable principle. Currently, with the heat of sores and pox located in the exterior, yet using methods to drain or redirect towards the interior, this constitutes a failure to distinguish between exterior and interior. Therefore, some individuals scrutinize every word and character carefully. Toxic heat in the exterior should be dispersed; toxic heat in the interior should be purged. These sores and pox involve heat-toxin in the exterior, yet people often recklessly apply purgatives, causing deficiency in the interior and leading to premature death and injury frequently. They fail to realize that in *Shanghan* (Cold Damage), where the body is hot, if the pathogen is in the exterior, it must not be purged. Thus, the *Huoren Shu* (Book of Living People) discusses sores and pox: when there is body heat but cold ears and coldness at the sacrum accompanied by coughing, if laxative drugs are used indiscriminately, the toxin enters the interior, killing people even more severely than blades. Sores and pox certainly have cases suitable for purging, and there are specific indications for purging, which are detailed elsewhere.

When sores and pox erupt excessively with a yellowish complexion, black stool, irritability, panting, dryness, thirst, or abdominal distension, this indicates blood stasis in the interior. The appropriate formula is Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). It is also used for epistaxis and hematemesis during the course of sores and pox, where the toxin is not fully cleared and residual blood stasis remains. However, for those with excessive eruption and dryness/thirst, Gancao San (Licorice Powder) should be taken; it can also be taken for those whose lesions have not yet erupted. For severe irritability and panting, Mahuang Tang (Ephedra Decoction) is indicated. For sore throat and cough, adding Moschus (She Xiang) is particularly effective. For delayed eruption, Zicao Yinzi (Arnebia Drink) is beneficial.

In *Shanghan*, males may present with a yellowish face, while females may have a reddish face, increased aversion to cold, a sensation of no heat in the mouth, yawning, sudden mental fog, and neck stiffness. In contrast, sores and pox present with red, dry cheeks, frequent sneezing, palpitations, drowsiness, fatigue, and cold limbs. *Shanghan* requires dispersal, whereas sores and pox require warming. There are differences in balanced qi flow versus facial and cheek redness. Furthermore, various heat syndromes can steam into sores and pox. Although the progression varies, treatment must follow the specific syndrome, avoiding rigid adherence to a single perspective.

A skilled healer aims to prevent disease before it arises; an unskilled healer treats disease after it has manifested. Past discussions on Shengma Tang (Cimicifuga Decoction) suggest it can occasionally be taken if not carefully distinguished. This is because before the pox erupts and spots appear, internal resolution is possible, hence its use. However, once spots have appeared, it must not be taken due to its strongly cold nature. Taking Shengma Tang after eruption leads to situations where only after the rash fully emerges and scabs form does one take remedies to clear residual toxins. Often, people do not understand this; taking it after spots appear cools the skin and prevents proper eruption, causing significant harm. Using Huixie Jiu (Coriander Wine), however, states it can be taken whether erupted or not. Coriander repels all evil qi. Externally, for protection, Huixie Jiu involves placing wine-soaked coriander around the bed curtains to ward off evil qi, which is highly suitable for sores and pox, unlike Shengma Tang. Thus, taking Shengma Tang before careful distinction can eliminate accumulated heat and resolve toxins preemptively. Once spots appear, mild and harmonizing formulas should be used to nourish the body. Shengma and Gegen have strongly cold properties; taking them after eruption causes cold weakness, delayed eruption, cold invasion, or sinking/obscuration. Children with robust constitution might tolerate it, but those with weak constitution suffer greatly. This must be known. Medical texts state some sores and pox can be purged, others cannot. Since constitutions differ and appropriate formulas vary, how can one stick to one bias without flexibility? Moreover, in northern winters, wind-cold and ice are fierce; in southern New Year's Eve, weather is mild, flowers bloom, and all things flourish according to season, free from extreme heat or cold hazards. Observing this, since constitutions differ, treatments differ. One must adapt to circumstances. Whether purging is indicated or not depends on specific signs; thus, rigid adherence is a flaw in physicians.