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Carbuncles and sores (superficial purulent infections) are merely caused by heat pathogen overcoming the blood level. Among the six Yang meridians and six Yin meridians, some have abundant Qi and scarce Blood, some have scarce Qi and abundant Blood, and some have abundant Qi and abundant Blood; they cannot be generalized. As for carbuncles and sores occurring in vital areas near deficient or thin regions, this has been discussed by past sages. However, discussions on classification by meridian have not been heard of. Among all meridians, only when carbuncles and sores occur in the Shaoyang (Gallbladder/San Jiao) and Jueyin (Liver/Pericardium) meridians should prevention be considered, because these two meridians have abundant Qi and scarce Blood, making muscle growth difficult. If ulcers remain unhealed for a long time, they will inevitably become fatal conditions. Hasty use of drugs to expel toxins and promote bowel movements to attack the Blood of the Yin aspect will bring disaster swiftly. When Yang stagnates in Yin, the pulse is floating, surging, wiry, and rapid; when Yin stagnates in Yang, the pulse is deep, fine, weak, and choppy. Stagnation of Yang is treated with cold-natured drugs, and stagnation of Yin is treated with hot-natured drugs. After middle age, one should not develop carbuncles and sores. Once pain and swelling appear, referring to the pulse and symptoms, if weakness is observed, tonifying Qi and Blood can ensure a favorable outcome. Using common heat-clearing, toxin-extracting, and Qi-regulating drugs would cause the disaster of deficiency upon deficiency, which is as clear as pointing at one's palm. The internal support method (a technique using tonification to push toxins outward), Hejian treated external swelling where the root base was shallow and the signs were superficial, with pulses often floating, indicating the disease was in the skin and flesh. Unless Qi is abundant, the toxin will inevitably invade internally; urgent internal support is needed to rescue the interior. Fupian San (Decoction for Repeated Decoction) is suitable to warm and disperse stagnant Qi, harmonizing the Stomach Qi. If the condition persists, half a dose can be decocted and drunk again. If there is constipation and irritability, a small amount of Huanglian Tang (Coptis Decoction) can be taken. If there is mild diarrhea and the irritability has subsided, give half an ounce of Fupian San. This allows Ying (Nutritive) and Wei (Defensive) Qi to circulate together, preventing the pathogen from damaging the interior. However, laypeople often use Paiong Neibu Shixuan San (Ten-Vitality Powder for Draining Pus and Internal Tonification). Using this for such minor sores in winter is acceptable. But using it for ulcers in summer, the warming and dispersing properties of Guizhi (Cinnamon Twig) and Houpo (Magnolia Bark), assisted by Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica), I fear that despite the presence of Renshen (Ginseng) and Huangqi (Astragalus), reliance on them may be futile. A seventy-year-old woman, physically robust, irritable, and fond of alcohol, developed a carbuncle on her head. After five days, her pulse was urgent and choppy. Urgently, Dahuang (Rhubarb) was wine-steamed, finely sliced, stir-fried with wine into powder. Then, Ren Shen (Ginseng) was sprinkled with wine and stir-fried, added with Shengjiang (Fresh Ginger), decocted, and one qian (approx. 3-5g) was mixed and administered. Two hours later, another dose was given. She slept, sweated on her upper body, and upon waking, the illness had vanished. This illustrates the intent of the internal support method. Another man, fifty years old, robust and dark-skinned, developed red swelling on his back and pain under his scapula. His pulse was floating, rapid, surging, and tight, and he vomited after eating. It was mid-winter. Mahuang Guizhi Tang (Ephedra and Cinnamon Twig Decoction) was prescribed with Jiuhuangbai (Wine-processed Phellodendron), Sheng Fuzi (Raw Aconite), Gualouzi (Trichosanthes Seed), Gancaojie (Licorice Joint), Qianghuo (Notopterygium Root), Qingpi (Green Tangerina Peel), Renshen (Ginseng), Huangqin (Scutellaria Root), Banxia (Pinellia Rhizome), and Shengjiang (Fresh Ginger). Six doses led to resolution. This is indeed the internal support method, not the Neituo San (Internal Support Powder) from Jingyao, nor drugs like Rushi (Frankincense) and Ludou (Mung Bean). Presumably, this formula was designed specifically for those who developed sores after taking Dan Shi (mineral pills). For those not caused by mineral pills, its necessity is doubtful.

Intestinal abscess (purulent disease of the intestine): Phlegm accumulation and dead blood flow into the Large Intestine. Taoren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) plus Lianqiao (Forsythia) and Qinjiao (Gentiana Macrophylla). Difficult to treat if it breaks near the anus and is exposed to wind.

Breast abscess (acute purulent infection of the breast): The breast is traversed by the Yangming (Stomach/Large Intestine) meridians, and the nipple belongs to the Jueyin (Liver/Pericardium) meridians. Nursing mothers who do not know how to regulate themselves may suffer from reversed emotions due to anger, blocked Qi due to depression, and damp-heat generated by rich foods. This causes the Qi of the Jueyin meridian to stagnate, so the ducts do not open and milk cannot exit; the Blood of the Yangming meridian boils, causing severe heat and pus formation. There are also cases where an infant has phlegm stagnation in the diaphragm and hot breath, sleeping with the nipple in their mouth, blowing hot air into the breast, leading to nodules. At the initial stage, one must endure pain, massage until slightly soft, and suck to ensure milk flows freely, allowing natural resolution. If neglected, it will become a boil or furuncle. Treatment: Disperse Jueyin stagnation with Qingpi (Green Tangerina Peel); clear Yangming heat with finely ground Shigao (Gypsum); move turbid blood with Gancao jie (Licorice Joint); reduce swelling and guide out toxins with Gualouzi (Trichosanthes Seed), optionally adding Moyao (Myrrh), Qing Juye (Green Orange Leaf), Zaojiaoci (Gleditsia Spine), Jinyinhua (Honeysuckle), and Danggui (Angelica Sinensis). Whether as decoction or powder, with modifications as needed, always assist with a small amount of wine. Applying moxibustion (two or three cones) on the swelling yields especially quick results. Needles and knives should not be used rashly, as this leads to critical danger. If one feels wronged by the husband or parents-in-law, accumulating sorrow and anger day and night, Spleen Qi becomes obstructed, Liver Qi rebels horizontally, forming hidden nodules like large chess pieces, painless and itchless. Decades later, it becomes a sunken sore named Naiyan (Breast Rock/Cancer), because the sore shape is concave like a rock cave. It is incurable. If at the very beginning, the root of the disease can be resolved, calming the mind and spirit, and then applying treatment, recovery is possible.

Formula for Breast Abscess.
Qingpi (Green Tangerina Peel), Gualou (Trichosanthes Fruit), Juye (Orange Leaf), Lianqiao (Forsythia), Taoren (Peach Kernel), Zaojiaoci (Gleditsia Spine), Gancao jie (Licorice Joint). (If ulcerated, add more Renshen [Ginseng] and Huangqi [Astragalus]).
Decoct with water. Take with wine.

Breast Abscess and Milk Stasis Swelling.
Shigao (Gypsum), Huapi (Birch Bark, burnt), Gualouzi (Trichosanthes Seed), Gancao jie (Licorice Joint), Qingpi (Green Tangerina Peel).
Decoct with water and take.

Treating Nodules in the Breast.
Nanxing (Arisaema Rhizome), Beimu (Fritillaria Bulb), Gancao jie (Licorice Joint), Gualou (Trichosanthes Fruit, each 1 liang), Lianqiao (Forsythia, 0.5 liang).
Decoct with water. Take with wine.

Another Formula.
Renshen (Ginseng), Huangqi (Astragalus), Chuanxiong (Ligusticum), Danggui (Angelica Sinensis), Qingpi (Green Tangerina Peel), Lianqiao (Forsythia), Gualou (Trichosanthes Fruit), Baishao (White Peony Root), Gancao jie (Licorice Joint).
For early-stage Breast Cancer (Naiyan) with slight ulceration, add Chaihu (Bupleurum) and Chuanxiong (Ligusticum). Decoct with water. Take with wine.

Hard and Painful Breast.
Moyao (Myrrh, 1 qian), Gancao (Licorice, 3 qian), Danggui (Angelica Sinensis, 3 qian).
Prepare as one dose, decoct with water, add a little wine, and drink hot.

Blowing Milk (Milk Stasis).
Jinyinhua (Honeysuckle), Da Qiaomai (Buckwheat Herb), Zi Gengteng (Polygonum Vine, equal parts).
Decoct with vinegar. Wash the affected area for immediate resolution. If the latter two are unavailable, only Jinyinhua (Honeysuckle) can be used.

Ulcerated Breast Nodule: Slight ulceration requires strong tonification.
Renshen (Ginseng), Huangqi (Astragalus), Baizhu (Atractylodes Macrocephala), Danggui (Angelica Sinensis), Chuanxiong (Ligusticum), Lianqiao (Forsythia), Baishao (White Peony Root), Gancao jie (Licorice Joint).
Decoct with water and take.

Parosteal Abscess (Deep Abscess).
Heat in the finest aspects of the Blood level. At the first sign, use Qingpi (Green Tangerina Peel) and Gancao jie (Licorice Joint). After ulceration, nourish the Blood. For initial leg swelling, use Renshen (Ginseng), Huanglian (Coptis), and Fuling (Poria, each 2 qian), plus 48 Gualouzi (Trichosanthes Seeds), prepared as two doses, added with Zhuli (Bamboo Sap), and drunk hot.

Treating Persistent Pain at the Huantiao Acupoint to Prevent Parosteal Carbuncle.
Use Cangzhu (Atractylodes Lancea) to assist the pungency of Huangbai (Phellodendron), move Qi with Qingpi (Green Tangerina Peel). Add Guizhi (Cinnamon Twig) in winter, Tiaohuangqin (Scutellaria) in summer, and Niuxi (Achyranthes Root) for the deficient. Use Gancao jie (Licorice Joint) as the guiding herb. Decoct in large quantities. Add Jiangzhi (Ginger Juice) for spiciness, drink before meals. If the disease is deep, ten or more doses of Cangzhu, Huangbai, and Guizhi may fail to induce sweating. Add a small amount of Mahuang (Ephedra). If still ineffective after two or three doses, the abscess may be forming. Dig a pit, heat it with fire until red, pour urine on it, sit naked on it, surround the lower body with blankets to create intense steam, opening the pores, promoting Qi and Blood circulation, leading to cure.

Tiewei San (Iron Encirclement Powder) for Treating Carbuncles, Sores, and Swelling.
Ruxiang (Frankincense), Moyao (Myrrh, 0.5 liang), Dahuang (Rhubarb), Huangbai (Phellodendron), Huanglian (Coptis), Nanxing (Arisaema Rhizome), Banxia (Pinellia Rhizome), Fangfeng (Saposhnikovia Root), Zaojiaoci (Gleditsia Spine), Mubiezi (Strychnos Seed), Gualou (Trichosanthes Fruit), Gancao jie (Licorice Joint), Caowu (Aconitum Kusnezoffii), Ejiao (Donkey-hide Gelatin).
Grind into powder, mix with vinegar to form a paste. Boil in a stone vessel until black. Apply with a goose feather.

Encircling Medicine for Various Carbuncles and Sores to Dissolve Swelling.
Ruxiang (Frankincense), Moyao (Myrrh), Dahuang (Rhubarb), Lianqiao (Forsythia), Huangqin (Scutellaria Root), Huanglian (Coptis), Huangbai (Phellodendron), Nanxing (Arisaema Rhizome), Banxia (Pinellia Rhizome), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Root), Gualou (Trichosanthes Fruit), Ejiao (Donkey-hide Gelatin).
Grind into fine powder, decoct with good vinegar until black and paste-like. Use hot for cold patterns, cold for heat patterns.

Encircling Medicine Tiejinglan.
Beimu (Fritillaria Bulb), Nanxing (Arisaema Rhizome, each 7 qian), Lianqiao (Forsythia), Wubeizi (Chinese Gall), Jingshuang Furongye (Hibiscus Leaves after frost, each 1 liang).
Grind into fine powder. Mix with water and apply around the swollen area, leaving only one hole in the center to drain toxic vapors.

Method to Extract Pus Through the Skin.
Lvti (Donkey Hoof, finely sliced, 1 liang), Qiaomaimian (Buckwheat Flour, 1 liang), Baixian (White Salt, 0.5 liang), Caowu (Aconitum Kusnezoffii, peeled, 4 qian).
Grind into powder, mix with water to make cakes. Slowly roast until slightly yellow, remove fire toxicity, grind into powder, mix with vinegar to form a paste. Spread on white paper and apply to the affected area. Water will exude from pores, and swelling will subside.

Qima Yong (Cross-Horse Abscess, Perineal Abscess).
Use 4 liang of thick Licorice with nodes. With one bowl of running water, process the Licorice by quenching and roasting until water is gone, grind into powder. Add a little Zaojiaotan (Gleditsia Charcoal). Divide into four doses. Take with decoction for effect.

Another Formula.
Gancaojie (Licorice Joint), Baizhi (Angelica Dahurica), Huanglian (Coptis). For ulcerated lesions, add Longgu (Fossil Bone), Kufan (Alum), and Chishizhi (Red Halloysite).

Paste for Carbuncles and Furuncles.
Caowu (Aconitum Kusnezoffii), Huanglian (Coptis), Zijingpi (Bauhinia Bark), Baizhi (Angelica Dahurica), Dahuang (Rhubarb), Furongpi (Hibiscus Bark), Poxiao (Mirabilite), Nuomi (Glutinous Rice, equal parts).
Grind into powder. Mix with honey water and apply. If the sore is severe, mix Xionghuang (Realgar) powder with honey to encircle the sore, then apply the previous powder around it.

Case: A person had a furuncle at the anus that did not heal for a long time, with three needle-sized openings, producing pus upon exertion.
Huangqi (Astragalus), Tiaohuangqin (Scutellaria Root), Lianqiao (Forsythia), Qinjiao (Gentiana Macrophylla).
Grind into powder. Make pills with Shenqu (Medicated Leaven) paste.

Extracting Necrotic Bone: Occurs in chronic carbuncles and fistulas.
Take the tibia of a black-bone hen, fill it with high-quality Yihuang (Realgar), seal with salt mud, roast over fire until red-hot. Remove from ground, eliminate fire toxicity, remove mud, grind the bone into fine powder. Make pills the size of millet grains using rice paste. Insert into the sinus tract using a paper wick, and apply a plaster.

Biandu (Inguinal Abscess).
Shanzhizi (Gardenia Fruit), Dahuang (Rhubarb), Ruxiang (Frankincense), Moyao (Myrrh), Danggui (Angelica Sinensis, 5 fen), Gualouren (Trichosanthes Seed, 3 qian), Daizheshi (Haematite, 1 qian).
Prepare as one dose and decoct.

Another Formula.
Mubiezi (Strychnos Seed), Dahuang (Rhubarb), Gualou (Trichosanthes Fruit), Taoren (Peach Kernel), Caolongdan (Gentiana Scabra).
Chop coarsely. Decoct strongly, leave exposed to stars and moon overnight, take warm in the early morning for immediate cure.

Another Formula: Baijiangcan (Silkworm) and Huaihua (Sophora Flower) ground into powder, taken with wine. One variation adds Jiudahuang (Wine-processed Rhubarb).

Appendix Formulas.
Xiaodu Yin (Detoxification Drink) for early-stage Biandu, effective within 3-4 days.
Zaojiaoci (Gleditsia Spine), Jinyinhua (Honeysuckle), Fangfeng (Saposhnikovia Root), Danggui (Angelica Sinensis), Dahuang (Rhubarb), Gancao jie (Licorice Joint), Gualouren (Trichosanthes Seed, equal parts).
Chop coarsely. Decoct with half water and half wine. Take warm before meals. Frequently pull the hair on the vertex.

Neituo Fupian San (Internal Support Repeated Decoction Powder) from "Jiyao" for strengthening the stomach and supporting the interior in carbuncles and sores.
Digupi (Groundcherry Root Bark), Huangqin (Scutellaria Root), Fuling (Poria), Baishao (White Peony Root), Renshen (Ginseng), Huangqi (Astragalus), Baizhu (Atractylodes Macrocephala), Guizhi (Cinnamon Twig), Gancao (Licorice), Fangji (Stephania Root), Danggui (Angelica Sinensis, each 1 liang), Fangfeng (Saposhnikovia Root).
Chop coarsely. First, decoct 1 jin of Cangzhu (Atractylodes Lancea) in 5 sheng of water until reduced to 3 sheng. Remove Cangzhu. Add the previous twelve herbs. Decoct again until 3-4 zhan (cups). Take the clear juice, divided into 3-4 doses, drinking throughout the day. Also decoct the Cangzhu dregs, and according to the previous method, decoct the dregs of the twelve herbs, dividing them for drinking.

Neishu Huanglian Tang (Internal Draining Coptis Decoction) for sores with hard, swollen skin, fever, vomiting, constipation, and surging-full pulse.
Huanglian (Coptis), Shaoyao (Peony Root), Danggui (Angelica Sinensis), Binglang (Betel Nut), Muxiang (Aucklandia Root), Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), Bohe (Mint), Jiegeng (Platycodon Root), Gancao (Licorice, each 1 liang), Lianqiao (Forsythia, 2 liang), Dahuang (Rhubarb, 2.5 liang).
Chop coarsely. Each dose 1 liang, decoct with ginger.