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[Song] Among the twelve meridians, only the Yangming (Yang Brightness) meridian is abundant in both Qi and Blood. The Taiyang (Greater Yang) and Jueyin (Terminal Yin) meridians have less Qi [Note: Contextually implies relative Qi deficiency or specific pattern; literal translation "less Qi"]. Shaoyang (Lesser Yang), Taiyin (Greater Yin), and Shaoyin (Lesser Yin) meridians often have less Blood. When Blood is deficient, regulate Qi to nourish Ying (Nutritive) Blood. When Qi is deficient, breaking Blood should be avoided; instead, tonify Qi. If both Qi and Blood are充盈 (abundant), therapeutic efficacy is easily achieved. The Jueyin and Shaoyang meridians contain excessive Xianghuo (Ministerial Fire); if carbuncles and sores occur in these meridians, they are the most difficult to heal and pacify.

[Annotation] In the human body's twelve meridians, there are distinctions in the abundance of Qi and Blood. Abundance facilitates recovery, while deficiency makes healing difficult. Surgeons who understand this can predict the onset, progression, and difficulty of carbuncles, sores, and ulcers, thereby employing appropriate methods of medication for dissipation or tonification. For instance, the Hand-Yangming Large Intestine meridian and Foot-Yangming Stomach meridian typically possess abundant Qi and Blood. The Hand-Taiyang Small Intestine, Foot-Taiyang Bladder, Hand-Jueyin Pericardium, and Foot-Jueyin Liver meridians typically possess abundant Blood but less Qi. The Hand-Shaoyang Sanjiao (Triple Burner), Foot-Shaoyang Gallbladder, Hand-Shaoyin Heart, Foot-Shaoyin Kidney, Hand-Taiyin Lung, and Foot-Taiyin Spleen meridians typically possess abundant Qi but less Blood. The general principle is: where Blood is abundant, break stasis; where Qi is abundant, move Qi. Where Qi is deficient, lesions are difficult to elevate (rise), requiring supportive and tonifying methods; where Blood is deficient, wounds are difficult to close, requiring nourishing methods. If both Qi and Blood are abundant, elevation and closure are easy. Only the four meridians of Hand-Foot Jueyin and Hand-Foot Shaoyang have doubled Ministerial Fire. If carbuncles and sores arise in these four meridians, muscle growth is difficult, and wound closure is hard. Overuse of harsh drugs to expel toxins and drain will damage Qi and consume Blood, making success unlikely. Thus, understanding the Qi and Blood status of each meridian prevents the misuse of sweating or purging therapies.

[Song] Carbuncles and sores originate from Fire-Toxin, causing obstruction in meridians and coagulation of Qi and Blood. External causes include invasion by Six Excesses (Six Evils) and Eight Winds; internal causes involve excess of Six Desires and Seven Emotions; improper diet and lifestyle constitute neither-internal-nor-external causes; carrying loads or falling injures the body form; rich food leads to disharmony of Ying and Wei, while poor food leads to exhaustion of Qi and Blood. Sores arising between sinews and bones belong to the Yin aspect; those between flesh and vessels belonging to the Yang aspect are called Carbuncles (Yong); lesions outside the skin but inside the flesh are called Ulcers (Yang); boils on the skin surface are generally called Chuang-Jie. Yang-excess presents with red, swollen, hot, painful symptoms, which are easy to treat; Yin-excess presents with dark, depressed, non-painful symptoms, which are difficult to treat; Half-Yin-Half-Yang presents with slight swelling, mild pain, slight heat, and pale redness. Five Good signs indicate favorable prognosis; Seven Evil signs indicate adverse prognosis. Observing three Goods or Four Evils clarifies survival or death. Clinically, one must carefully inspect complexion and pulse, applying warming, cooling, tonifying, sweating, or purging methods as appropriate. Mastering the treatment of Cold Damage and miscellaneous diseases is proficient; mastering the treatment of carbuncles and toxic swellings demonstrates exquisite skill.

[Annotation] The Classic states: "All pain, itching, and sores belong to Heart Fire." Hence, it is said that carbuncles and sores originate from Fire-Toxin. They arise due to deficiency of Ying and Wei, coagulation of Qi and Blood, and obstruction of meridians. There are three categories of causes: external, internal, and neither-internal-nor-external. External causes stem from Wind in Spring, Heat/Summerheat in Summer, Dampness in Late Summer, Dryness in Autumn, and Cold in Winter. Arriving in their proper season, they are Righteous Qi; arriving out of season or excessively, they become Pathogenic Excesses. All diseases caused by the Six Excesses are external. Also included are invasions by the Eight Winds: Gangfeng (Rigid Wind) from North at Winter Solstice; Xiongfeng (Auspicious/Bad Wind - *Note: 'Xiong' usually means bad/malevolent here*) from Northeast at Start of Spring; Ying'erfeng (Infant Wind) from East at Spring Equinox; Ruofeng (Weak Wind) from Southeast at Start of Summer; Daweifeng (Great Weak Wind) from South at Summer Solstice; Mofeng (Plotting Wind) from Southwest at Start of Autumn; Gangfeng (Rigid Wind) from West at Autumn Equinox; Zhefeng (Folding Wind) from Northwest at Start of Winter. Arriving in season, they nurture all things; arriving out of season, they harm all things. Human exposure leads to internal severe disease and external carbuncles/swellings. These Eight Winds are also external causes. Internal causes arise from hearing obscene sounds, viewing lewd sights, smelling foul odors, craving flavors, mental overexertion, and delusional thoughts, which damage Shen (Spirit) and Qi. Joy over-injures the Heart, Anger over-injures the Liver, Pondering over-injures the Spleen, Grief over-injures the Lung, Fear over-injures the Kidney, prolonged sorrow knots Qi, sudden fright shrinks Qi. These Seven Emotions are internal causes. Neither-internal-nor-external causes include irregular diet and lifestyle. Excessive alcohol generates Fire and consumes Yin fluids; excessive tea generates Dampness and fluid retention; excessive pungent spices (Five Pungents) damages Qi and Blood; irregular meals injure the Spleen and Stomach. Daytime overwork, carrying heavy loads, falls, and sprains injure the body form; nighttime lack of rest and forced sexual activity exhaust Jing (Essence) and Qi. Rich foods cause Ying-Wei disharmony and internal Fire-Toxin binding; poor foods cause Spleen-Stomach Qi deficiency and Qi-Blood depletion. The human body has five layers: Skin, Vessels, Flesh, Sinews, Bones. Lesions between sinews and bones are Ju (Deep Sores/Yin); between flesh and vessels are Yong (Carbuncles/Yang); outside skin but inside flesh are Yangdu (Ulcer Toxins); on the skin surface are Chuangjie (Boils). Yang-excess Yong/Ju starts with red, swollen, hot, painful lesions, easy to suppurate and heal (Favorable). Yin-excess starts with dark, depressed, hard, painless lesions, difficult to suppurate and heal (Adverse). Half-Yin-Half-Yang presents with diffuse swelling, mild pain/heat/color, representing a dangerous condition. Proper treatment can turn danger into favor; otherwise, it becomes adverse. Five Good signs indicate favorable prognosis; Seven Evil signs indicate adverse prognosis. Seeing three Goods suggests survival; seeing four Evils suggests death. Clinicians must examine complexion and pulse, applying warming, cooling, tonifying, sweating, or purging treatments appropriately. Treating external carbuncles is akin to treating internal Cold Damage. One who masters Cold Damage can treat miscellaneous diseases easily; one who masters carbuncles treats all sores with precision, primarily by distinguishing Exterior/Interior, Yin/Yang, Deficiency/Excess, and Cold/Heat.