It is believed in Chinese medicine that "Bayberry Sore" is mainly caused by infection of essence transformation, in which the toxin takes the advantage of deficiency of the liver and kidney to invade the interior during ejaculation in sexual contact with the patient with syphilis, or by infection of qi transformation, in which the toxin transmits inwards via the lung and spleen meridians in contact with the dirty toxin, or by infection of toxin in the fetus due to transmission of the toxin from the body of the mother. Once infected by pathogenic factors, the toxins can be accumulated in the internal organs and manifested externally on the skin to cause this disease.

According to the theory of traditional Chinese medicine, there are some patterns of syndrome that lead to syphilis.
1. Syndrome of Dampness and Heat in the Liver Meridian
2. Syndrome of Mixture of Phlegm and Blood Stasis
3. Syndrome of Dampness Accumulation due to Spleen Deficiency
4. Syndrome of Qi and Blood Deficiency