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[Verse] The method of internal resolution possesses the miraculous efficacy of releasing the exterior. It is most effective when both the pulse and symptoms indicate excess patterns. When both pulse and symptoms indicate deficiency patterns, tonification should be combined. For cases involving thirst and constipation, prompt unblocking and purging are essential. The primary approach involves clearing heat and detoxifying while invigorating qi and blood. One must further observe which meridian the lesion belongs to, adding guiding herbs (Yin Jing Yao) according to the main treatment. Once the toxin is eliminated, the flesh will naturally heal.

[Annotation] The classics state: "Releasing the exterior does not distance itself from hot [natured] substances." It also states: "Sweating will cure the sores." Therefore, it is said that internal resolution with exterior release has miraculous effects. This method can only be used when both the pulse and symptoms indicate excess patterns. If both pulse and symptoms indicate deficiency patterns, tonification should be combined. In cases of thirst and constipation, urgent unblocking and promoting movement are required; one must not indiscriminately apply exterior-releasing formulas. Carbuncles and ulcers are caused by the coagulation of qi and blood and excessive fire-toxin. Therefore, the main treatment is clearing heat, detoxifying, and invigorating qi and blood. One should carefully examine which meridian the location belongs to and use guiding herbs for treatment, so that swelling and pain will naturally subside, and the flesh will naturally level out.

[Verse] When a sore has formed but fails to protrude and produces no pus, or is hard, non-red, or painless, or when there is little thin pus and the wound fails to close, one must greatly tonify qi and blood and harmonize Ying and Wei (Nutritive and Defensive levels). Assist with agents that dispel toxins and move stagnation. For cold conditions, add warm and hot agents to ward off wind-cold. When swelling subsides, pus emerges, and necrotic tissue falls off, with new flesh growing and the wound closing, this demonstrates the merit of internal support (Nei Tuo).

[Annotation] Whenever a swelling has formed but cannot protrude, nor easily dissipate pus, or is hard and swollen without redness yet painful, or painless, with little thin pus and an unclosed wound, these are all signs of qi and blood deficiency. One should take great tonification of qi and blood and harmonization of Ying and Wei as the sovereign (Jun) strategy, with toxin-dispelling as the assistant (Zuo) strategy. Add acrid and aromatic substances to move depression and stagnation, and add warm and hot substances to resist wind and cold. Wait until pus is discharged, swelling subsides, and necrotic tissue is completely removed; once qi and blood are sufficient, new flesh will naturally grow.

[Verse] For carbuncles and ulcers before suppuration, moxibustion is best; taking internal support formulas ensures peace and health. If fever, aversion to cold, and body stiffness occur, and there is no sweating, the exterior-releasing method yields the longest-lasting benefit. If there is hardness, dry mouth, and obstruction of urination and defecation, purgative methods naturally cool the toxic heat. If there is intense redness and pain, high heat, irritability, and thirst, but normal bowel movements, clearing-heat methods bring auspicious results. If internal pus does not emerge and necrotic tissue blocks the opening, surgical incision is appropriate. If soft and flat without pus or necrosis, administer warm-tonifying agents to generate yang. After ulceration, if new flesh appears pale like frostbite, double the warm and hot agents for auspicious outcomes. For massive sweating leading to collapse of yang, use Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction); for spontaneous sweating and cold limbs, use Sini Tang (Frigid Extremities Decoction). For spleen deficiency after ulceration with muscle wasting, thin pus, and sallow-white complexion; for insomnia, fever, loose wounds, poor appetite, thirst, and loose stools, administer clear-and-tonify spleen formulas. Matching the prescription to the syndrome ensures safety.

[Annotation] In treating carbuncles and ulcers, regardless of yin or yang, exterior or interior, or duration, moxibustion is suitable whenever pus has not yet formed. For redness, swelling, fever, and floating pulse, use internal-supporting medications. If the pulse is tight, with fever, aversion to cold, and generalized stiffness without sweat, use exterior-releasing medications. For hardness, dry mouth, and turbid/obstructed urination and defecation, use purgative/laxative medications to drain the toxin. For intense heat, deep pain, irritability, desire for cold drinks, dry mouth and tongue, but normal bowels, use clearing-heat medications. If internal pus does not emerge and necrotic tissue blocks the wound, perform surgical incision. If soft and flat without pus or necrosis, this indicates yang deficiency; use warm-tonifying agents to generate yang. If new flesh grows slowly after ulceration and appears pale like frostbite, this indicates cold flesh and muscles; double the warm and hot agents. For incessant massive sweating, indicating collapse of yang, use Guizhi Fuzi (Cinnamon Twig and Aconite) etc. For spontaneous sweating and cold limbs, use Sini Tang (Frigid Extremities Decoction). If after ulceration there is muscle wasting, thin pus, and sallow-white complexion, this is spleen deficiency; insomnia and fever indicate deficient fire flaming upward; loose and enlarged wounds indicate sinking qi failing to secure; poor appetite, thirst, and loose stools indicate spleen deficiency with heat. All these cases are suitable for administering clear-and-tonify spleen medications.