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To treat wandering red carbuncle (Chi Dan).
Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Danpi (Moutan Cortex), Tianhuafen (Trichosanthis Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Niuzibang (Arctii Fructus, stir-fried and pounded), Xuanshen (Scrophulariae Radix), Chishao (Paeoniae Radix Rubra), Qianghuo (Notopterygii Rhizoma et Radix), Jinyinhua (Lonicerae Japonicae Flos) in equal parts. Decoct in water and take orally.

Lv dou (Vigna radiata Seed, 5 qian), Dahuang (Rhei Radix et Rhizoma, 2 qian), grind together into fine powder. Use fresh Bohe (Menthae Haplocalycis Herba) juice, mix with honey, and apply externally.
Another prescription:
Apply juice of Pingping Cao (Spirodela Polyrrhiza), or juice of Bajiao Gen (Musa Basjoo Root), or juice of Niu Bang Gen (Arctii Radix).

The *Classic* states: Where pathogenic factors gather, healthy qi must be deficient; if they remain and do not depart, the disease becomes excess. It also states: When Ying Qi (Nutritive Qi) does not flow smoothly and reverses within the muscle tissue, abscesses and swellings arise. (When Ying Qi reverses, blood stagnates; when blood stagnates, heat gathers to form swelling, hence called abscess and swelling.) Where heat passes, it generates pus. (When heat is excessive, Yang Qi is internally constrained, causing sudden edema; Ying Qi also reverses within the muscle tissue, gathering to form the swelling of an abscess.) It also states: Cold damages the form (body structure), Heat damages Qi (functional energy); damage to Qi causes pain, damage to form causes swelling. (Heat damaging Qi means heat binds in the muscle layers causing pain; Cold damaging form means cold presses on the skin causing hardness and coagulation, leading to swelling.) If pain precedes swelling, Qi was injured first, and then the form was injured. If swelling precedes pain, the form was injured first, and then Qi was injured. Therefore, conditions with both form changes and pain indicate Yang injury; conditions with pain but no obvious form change indicate Yin injury. Furthermore, sweating followed by bathing in cold water can cause heat to be constrained within the skin, dampness to coagulate, resulting in severe acne/furuncles or mild prickly heat. There are also cases where Yang Qi is not secure, allowing pathogenic factors to sink into the "Sunken Meridians" (meridians depleted by cold). This refers to cold pathogens sinking into deficient meridians, accumulating cold in the center, causing blood stasis and coagulation, which attacks internally over time, accumulates in the muscle tissue, and manifests as scrofula (Luo Li). The *Classic* further states: Changes from rich food and fat can cause large carbuncles on the feet. It also states: Disharmony of the Five Zang Organs leads to blockage of the Nine Orifices; disharmony of the Six Fu Organs leads to retention and knotting, forming abscesses. Generally, high and soft swellings originate in the Blood vessels; low and hard ones originate in the Sinew vessels; those with unchanged skin color originate in the Bone Marrow. Thus, it is essential to differentiate the deficiency and excess of Qi and Blood, and the depth of Heat-Toxin. One must not simply see a swelling and assume it is Excess Heat-Toxin, immediately administering purgatives under the mistaken belief that toxins are expelled through purging. In fact, Yang-type lesions present with redness and swelling protruding upwards; Yin-type lesions present with bluish-white color and depression; Ju (deep abscesses) attach to bones and sinews and rely primarily on Qi and Blood. As the *Classic* says: Qi provides warmth and nourishment; Blood provides moistening. If Yuan Qi (Primal Qi) is damaged and cannot warm and moisten, the lesion will sink and fail to suppurate; how can one prevent internal attack?
Human sores and swellings arise from internal heat and external deficiency, allowing Wind-Dampness to invade. The Lung governs the skin and hair; the Spleen governs the muscles. When Qi is deficient, the pores open, inviting Wind-Dampness. Moreover, Spleen Qi dampness combined with internal heat generates sores. Swelling occurs when toxic factors of biased cold and heat lodge in the meridians, causing blood to become sluggish and blocked, leading to congestion and swelling. When Wind Pathogen acts internally, there is no head or root. When Qi and Blood contend, there is a head and a root. When congestion is severe and heat corrupts blood, pus forms. Minor toxins can be resolved and healed naturally by Qi and Blood without worry. Major and severe toxins may overwhelm Qi and Blood, requiring medicinal assistance to support Qi and Blood in circulating and expelling the root of the toxin.
Diseases of Yong (superficial abscess) and Ju (deep abscess) often occur in people who consume rich foods, roasted items, and indulge in desires. Deficient pathogens and Heat-Toxin boil and damage Qi and Blood. "Yong" means obstruction, specifically obstruction in the Yang collaterals. Large and elevated lesions belong to Yang, with floating and rapid pulses, thus mostly arising from the Six Fu Organs. "Ju" means hindrance, specifically hindrance in the Yin meridians. Flat and inward-developing lesions belong to Yin, with deep and rapid pulses, thus mostly arising from the Five Zang Organs. "Jie" (boil) refers to small, knotted swellings like a pimple. "Chuang" (sore/ulcer) is the general term for toxin. The *Classic* states: All pain, itching, and sores belong to Heart Fire. Among all sores, Back Ju and Ding (carbuncle) are the most urgent. Next are Brain Ju, Intestinal Abscess, and Throat Abscess, which are also urgent. Conditions like Scrofula, Xuan Yong (perineal abscess), and Hemorrhoid Fistula can be treated slowly. Although conditions like Scabies, Feng Chuang (wind sore), and Gan Chuang (chancre) belong to the category of sores, their severity and urgency differ greatly. Treatment should always observe deficiency/excess and cold/heat, applying heavy or light treatments accordingly, matching symptoms to medicines, and maintaining correct sequence. Even minor boils should be treated quickly at onset; do not delay, lest they become major ailments. Treatment methods should be divided into early, middle, and late stages. Early stage: Clear heat, resolve toxin, unblock meridians to aim for resolution. Middle stage: Drain pus and promote expulsion to aim for clearing residual toxin. Late stage: Tonify, promote expulsion, and warm to aim for easy healing. This is the general principle. But what are the Five Goods and Seven Evils?
Five Goods: Rest and movement are calm, appetite is normal (Good 1). Bowel and bladder functions are regular (Good 2). Pus drains, swelling subsides, color is bright and odorless (Good 3). Spirit is bright, voice is clear (Good 4). Body and Qi are harmonious (Good 5).
Seven Evils: Irritability, cough, severe abdominal pain, extreme thirst, uncontrolled diarrhea, urine resembling strangury (Evil 1). Massive discharge of pus and blood, severe pain, foul odor (Evil 2). Rapid breathing, shortness of breath, mental confusion, lethargy (Evil 3). Surface ulceration turns black first, long-term depression, blue face, dark lips, dirty stool (Evil 4). Stiff shoulders and neck, heavy limbs (Evil 5). Inability to eat, vomiting after taking medicine, loss of taste (Evil 6). Hoarse voice, sallow complexion, blue-black lips and nose, edema of face, eyes, and limbs (Evil 7).
Beyond the Seven Evils, there are also bad signs: belching and chest fullness, coughing with cold body, spontaneous sweating at any time, staring eyes and deafness, mental confusion and palpitations, disordered speech. These are all evil signs. However, if three of the Five Goods appear, recovery is possible; if four of the Seven Evils appear, death is certain.
Yong and Ju are formed by damp-heat and rebellious Qi in those consuming rich foods, often affecting obese, fair-skinned individuals whose Qi resides on the surface while Middle Qi is necessarily deficient. At onset, urgently cool blood, invigorate blood, dissipate knots, and resolve toxin. Administer large doses continuously, attacking from inside and out, ensuring resolution. Even if the势头 is severe and toxin strong, preventing complete immediate resolution, eliminating 70-80% is necessary to avoid later complications like mouth ulcers and internal attack. Even if it suppurates, major harm can be prevented. If treatment is delayed, Heat-Toxin sinks internally, membranes are destroyed, leading to critical danger. Books state: The five types of Fa (emerging) Yong/Ju refer to Back Fa, Brain Fa, Temple Fa, Eyebrow Fa, and Cheek Fa. However, anywhere Qi and Blood stagnate slightly, disease can emerge there, not just these five locations. Back Fa involves Wind-Heat of the Five Zang and Evil-Toxin of the Six Fu penetrating between sinews and bones, emerging within collaterals. Though small on the surface, it can be fist-sized internally; do not neglect! High, red, swollen onset is easy to treat; flat, depressed, Yin-type is difficult. Brain, Eyebrow, Temple, Beard, and Cheek Fa differ in location but share the mechanism of latent Yang stagnation and upward congestion of evil toxin along meridians. Those with robust Qi and Blood suffer less toxicity; those with deficient Qi and Blood often face danger. "Toxin" here refers to the imbalance and stagnation of Qi and Blood. Practitioners must rely on pulse diagnosis to correct Yin/Yang and Qi/Blood imbalances, resolving stagnation and stabilizing critical cases. Mistaking toxin for a tangible object and using cold/purgative herbs will worsen Yin-stagnant toxins and make Yang-excess toxins hard to drain and heal, as the disease stems from Qi/Blood disharmony; adding more disharmony increases illness.
Yong and Ju begin with irregular emotions, improper diet and lifestyle, or reactions to minerals/herbs. Imbalance of Cold/Heat/Dryness/Dampness and Yin/Yang leads to accumulation. Stagnant Ying and Wei Qi rot and溃 (break down). Mild cases arise in Six Fu (Yang, superficial, Yong); severe cases arise in Five Zang (Yin, deep, Ju). Superficial are Jie (boils), solid are Yong, deep are Ju. External manifestations include Back Ju, Brain Ju, Beard/Eyebrow Ju. Internal manifestations include Liver Abscess, Lung Abscess, Intestinal Abscess. External signs are easy to identify; internal signs are hard to clarify. Taiyang Meridian deficiency emerges from the back; Shaoyang Meridian deficiency from the temples; Yangming Meridian deficiency from the beard; Du Mai deficiency from the brain.
Sores on throat/tongue are Heart Toxin; on skin/hair are Lung Toxin; on muscles are Spleen Toxin; on bone marrow are Kidney Toxin. Lower body sores are Yin Toxin; upper body sores are Yang Toxin. External are Six Fu Toxin; internal are Five Zang Toxin. Internal rupture is called "Huai"; external ulceration is called "Kui". Upward progression is "Cong" (favorable); downward progression is "Ni" (unfavorable). Upper sores develop fast; lower sores develop slow. Six Fu involvement is easier to treat; Five Zang involvement is harder to cure. Near-bone sores are often cold; near-skin sores are often hot. Near-bone sores lingering become "Blood Worms" (chronic infection); near-skin sores lingering become "Lou" (fistulas). Worms cause more itching than pain, or itch then pain. Fistulas cause more pain than itching, or neither. Internal deficiency with external excess causes more pain than itching. Unstoppable bleeding leads to death; suppuration leads to survival. Difficulties in growth, drainage, and healing indicate severe Qi/Blood deficiency, requiring warming and tonifying to promote expulsion. Zhu Danxi said: After Yong/Ju ulcerates, tonify Qi and Blood, regulate Spleen/Stomach—this is crucial. Otherwise, deficiency symptoms return months later, transforming into other diseases.
Zhu Danxi said: Yong/Ju arises from Yin-Yang stagnation. Qi is Yang; Blood is Yin. Blood flows in vessels; Qi flows outside. They circulate together. Cold/Damp binding causes stagnation and slowness (insufficiency); Heat/Fire binding causes boiling and rushing (excess). Qi constrained by pathogen makes fluids thick, forming Phlegm/Fluids, which seep into vessels over time, disturbing Blood (Yin stagnating in Yang). Blood constrained by pathogen blocks channels, overflowing or clotting, seeping out of vessels over time, disturbing Qi (Yang stagnating in Yin). All diseases stem from this, not just Yong/Ju. Thus, early Yong/Swelling with pain and swelling is treatable; non-painful, non-swollen, depressed lesions are untreatable.
Back Ju has five sources: 1. Epidemic influence, 2. Emaciation and Qi stagnation, 3. Anger, 4. Kidney Qi deficiency, 5. Drinking cold alcohol/eating roasted food/taking elixirs. Treat by supporting the Root (Ben Yuan) primarily, promoting expulsion secondarily. Cooling clears heat but damages Stomach Qi. Mild sweating/purging traps exterior/interior, damaging Qi/Blood and causing internal Heat-Toxin attack, which is harmful. Elderly, post-illness, and postpartum patients require warming and tonifying; avoid internal expulsion formulas like Lv Dou San.
First, upon onset of Yong/Ju, moxibustion should be applied immediately, with external medication around the wound, leaving the center open for toxin exit. Small sores are fully covered. Once ulcerated, apply plaster. Touch the swelling: heat indicates pus; no heat indicates no pus.
Second, once ulcerated, wash daily with Pig Trotter Soup; reduce frequency to once every three days near healing.
Third, near healing, use plasters. If toxin remains, do not rush to use flesh-generating agents.
Fourth, nearing safety, tonify Qi and Blood for easy muscle growth. Cooling agents hinder closure.
Fifth, after Back Ju heals, sudden thirst untreated leads to death in 80-90%. Pre-existing thirst with Ju is very hard to treat; therefore, take Bawei Wan (Eight-Ingredient Pill) frequently. It prevents thirst and greatly nourishes Qi/Blood for muscle growth.
Sixth, vomiting in Yong/Ju has two causes: 1. Failure to promote expulsion early, latent heat in Heart; 2. Spleen Qi abnormality, latent heat in Spleen/Heart. Heart heat causes irritability, fever, swelling/pain. Spleen abnormality causes no fever/irritability but vomiting at foul odors. Hence, aromatic herbs are used because Qi/Blood moves with fragrance and rebels against stench. Sores arise from Ying Qi reversal in muscle tissue,郁结 (knotting) into pus; fragrance promotes circulation. Sores are naturally fishy/foul; exposure to bad smells worsens them. If toxin enters Stomach, vomiting occurs. Ancients used aromatics rationally. Food should also be fragrant to benefit Spleen Earth and preserve True Yuan.
Seventh, for wounds not closing due to muscle injury, use Liu Jun Zi Tang (Six Gentlemen Decoction) to tonify Spleen/Stomach. For Qi deficiency with aversion to cold, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify Spleen/Lung. For Blood deficiency with fever, use Si Wu Tang plus Ren Shen (Angelica Decoction with Ginseng) to nourish Liver/Spleen. For excessive pus, use Ba Zhen Tang (Eight Treasures Decoction) or Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) to nourish Qi/Blood. The *Classic* states: Spleen governs muscles. If previous remedies fail, use Si Jun Zi plus Dang Gui (Astragalus/Ginseng/Atractylodes/Poria/Codonopsis + Angelica) to tonify Spleen/Stomach. If still ineffective, Lower Yuan Yang is deficient; urgently use Bawei Wan to strengthen Fire to generate Earth. If pulse is rapid with thirst, it is difficult to treat (True Qi deficient, Evil Qi excess).
Sa Yong (Cheek Abscess) involves the Foot Yangming Stomach Collateral. Brain Ju (abscess on head/neck/throat) was historically considered incurable. 20-30% are due to Damp-Heat rising; 80-90% are Yin Fire rising. Proper regulation may save life. Bi Yong (Arm Abscess): Anterior arm is Hand Yangming; Posterior arm is Hand Taiyang; Lateral arm is Hand Shaoyin; Medial arm is Hand Jueyin. Total mechanism: Meridian Heat constraint, external Wind invasion, Qi/Blood disharmony. Differentiate meridians, use channel-specific herbs as guides to move Qi/Blood for cure.
Neck/cheek nodules lasting long indicate severe Qi/Blood deficiency; do not attack. Tun Yong (Buttock Abscess) is Bladder Damp-Heat steaming or congenital Yin deficiency. Hard to elevate/drain here; internal promotion is key. Ye Yong (Axillary Abscess) involves Foot Shaoyang, Hand Shaoyin, Hand Jueyin. Often congenital or Liver Fire blazing. Ear Stone Yong (hard, painless, non-suppurating) requires nourishing Liver Blood, Kidney Water, and warming tonification. In youth with solid pulse, add slight Liver-clearing herbs, but avoid Qi-moving/Blood-breaking drugs. Xie Yong (Flank Abscess) involves Foot Jueyin/Shaoyang and Ministerial Fire. Liver/Gallbladder Qi imbalance causes Wind-Fire internal conflict, Ying reversal, Blood stagnation, Heat gathering into pus. All Gu Yong/Ju (bone-abscesses) originate in Kidney (Kidney governs bone). Treat by warming/nourishing Kidney Qi; bone receives Yang harmony, swelling/hardness melts. Taking Bawei Wan prevents bone Ju. Fu Yong (Abdominal Abscess) below umbilicus or 2 cun lateral belongs to Spleen Channel. Near flank belongs to Gallbladder Channel. Caused by Spleen Yin deficiency, Qi stagnation, Blood congealing injuring Spleen. Tui Yong (Leg Abscess): Medial side is Liver/Spleen; Lateral side is Gallbladder/Stomach. Flat/hard is Qi deficiency (use Nei Bu Huang Qi Tang type). Acute/swollen/painful is Damp-Heat (use Nei Tuo Chai Hu Tang type), external garlic application. Fu Gu Yong (Bone-Clinging Abscess) at Huantiao point is extreme Heat in Blood level. Onset: Gan Cao Jie, Qing Pi, Cang Zhu, Huang Bai, Qin Pi, Niu Xi. Post-ulceration: Greatly nourish Qi/Blood. Fei Yong/Fei Wei (Lung Abscess/Withered Lung) from chronic cough, Spleen/Lung Qi deficiency, spicy/rich food heat, Wind-Cold invading deficiency, or excessive sweating losing fluids. Symptoms: Void-fire coughing foul pus, dyspnea, hidden chest pain, mild limb edema. Shou Zu Jia Ju (Toe/Finger Nail Carbuncle) is Tuo Jue (gangrene). From sexual exhaustion damaging Kidney Water, anger injuring Liver/Spleen. Remote location, scarce Qi/Blood, hard for medicine to reach. Easily leads to tendon decay/bone shedding. Prioritize tonifying/promoting Qi/Blood. Black color is untreatable. Chang Yong (Intestinal Abscess) from rich food heat. Symptoms: Skin like fish scales, tight abdomen, soft on pressure, periumbilical sores, lower abdominal pain on pressure, frequent urination like strangury, abdominal distension, aversion to cold, fever, spontaneous sweat. Pulse deep-tight without pus: Urgently resolve toxin. Pulse surging-rapid with pus: Urgently drain pus. Lower abdominal pain with urinary retention: Pus obstruction. Do not panic; panic breaks intestines. Move slowly, drink thin gruel, take Ba Zhen Tang to secure Yuan Qi, rest quietly.
Nang Yong (Scrotal Abscess): Book says "Yong entering scrotum leads to death." Liver Channel Damp-Heat. Onset: swelling/pain, red/scanty urine. Treat with clearing/diuresis/resolving toxin. Pus formed but urine difficult: Toxin not dispersed, use metal needle/diuretics. Pain after pus drains: Qi/Blood deficiency, tonify. If Qi/Blood intact but scrotum fully ulcerated/testes exposed: Not fatal. Children: Mother’s anger affects child; mother and child take Liver-clearing meds. Xia Gan (Chancre) on penis, eroding deeply, chronic. Internal drying-dampness/resolving toxin; external fumigation/powder. Mostly Liver Channel Damp-Heat, purge Liver/drain Dampness. Bian Du (Groin Swelling) between lower abdomen and inner thighs. Children: Liver Fire/Gan Gan. Adults: Frustrated desire, stale essence clashing with blood, lodging in channels. Treat by opening depression, dispersing Qi, clearing draining Heat-Toxin, promoting Essence/Blood flow. Unclean intercourse causing淫火 (libido fire) toxin: First induce sweating, then promote urination. Xuan Yong (Perineal Abscess) before/after anus. Starts like pine cone, grows like lotus seed, painful/red/swollen like peach after weeks, hard to heal. Treat with 1 liang Gan Cao (Licorice) decocted in wine to drink, resolving toxin. Mostly Yin deficiency, affecting weak people. Strictly avoid cold/purgative herbs. Severe Liver/Kidney deficiency; heavily nourish Yin/tonify strongly, abstain from sex, urge quick healing, else becomes chronic fistula/tuberculosis root. Wei Yong (Stomach Abscess): Stomach is sea of water/grain, abundant Qi/Blood/Heat. Internal heat combines, forming abscess. Stomach pulse deep-thin; Ren Ying pulse (on neck) very strong. Right Guan pulse should be surging but is deep-thin, indicating reversed Stomach Qi. Ren Ying point (larynx side) corresponds to Left Cun. Strong Ren Ying + weak Right Guan = Heat congested at stomach gate, unable to fill pulse. Misdiagnosing strong Ren Ying as Taiyang Cold Damage and fasting leads to death. Ding (Carbuncle): *Classic* says "Rich food changes." Rich food consumers have dense skin/flesh, internal stagnant heat, prone to Ding. Ancient texts list 13 types, 36 locations. Origin: Visceral accumulated Heat-Toxin, pathogen combats meridians, blood coagulates/toxin stagnates, pours into pores. Appears on hands/feet/head/face according to viscera locations. Shape like millet grain, painful/itchy, spreading numbness, dizziness/chills-fever, vomiting, heavy limbs, palpitations/vision blur. *Classic* mentions 5 colors corresponding to 5 Zang, but purple-black and yellow blisters are common. Itch then pain, chills then fever. Internal dispersing/resolving/expelling agents; external application...