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[Verse] For carbuncles and sores (acute suppurative diseases of the skin and subcutaneous tissues) presenting with redness, swelling, and wandering migration; for erysipelas (a rapidly spreading form of erythema), red-thread ding (an acute infection characterized by a red line along lymphatic vessels), and conditions of epidemic toxins causing severe blood stasis and congestion,
the bian stone therapy is most appropriate. It involves only puncturing the skin without damaging the flesh; using the sharp edge of a porcelain shard against the affected area requires light touch.
When toxic blood is expelled through the punctures, the swelling subsides and redness dissipates, yielding miraculous effects.

[Annotation] For any carbuncle or sore that is red, swollen, and migratory, as well as erysipelas, spreading red-thread ding,
and conditions of epidemic toxins with severe blood stasis and congestion, the bian stone method should be employed. However, one must avoid puncturing too deeply,
as stated in the *Neijing* (Classic of Internal Medicine): "Puncture the skin without injuring the flesh." The method involves crushing fine porcelain to select a piece with a sharp edge, splitting the head of a chopstick, clamping and binding the porcelain shard within it. Using two fingers to gently press the end of the chopstick, hold the porcelain shard opposite the lesion at a distance of about one cun. Then, use another heavy chopstick to frequently tap the head of the first chopstick, causing toxic blood to flow out upon puncture. If the swelling has not completely subsided the next day, perform the bian therapy again as needed,
stopping when the swelling disappears and redness dissipates.

[Verse] For carbuncles and sores in their initial stage within seven days, moxibustion is most suitable for resolving stagnation and extracting toxins. For painless lesions, moxa until pain is felt;
for painful lesions, moxa until pain ceases. The method involves covering the lesion with wet paper; apply moxa first where the paper dries, without delay.
Methods include garlic-interposed moxibustion, yellow wax moxibustion, prepared aconite moxibustion, fermented soybean cake moxibustion, and larva moxibustion.

[Annotation] For carbuncles and sores in the early stage, before the seventh day, moxibustion is indispensable for resolving stagnation and extracting toxins. Painless lesions are treated until pain is perceived; painful lesions are treated until pain subsides. This is because areas affected by toxin do not hurt, while healthy tissue does.
One must continue moxibustion until pain is felt, ensuring the fire energy reaches the healthy tissue. Where the skin and flesh are intact, it hurts; where the toxin resides, it does not. One must continue until pain ceases, ensuring the fire energy penetrates the toxin.
The method involves soaking paper with water and covering the lesion completely. Observe where the paper dries first and apply moxa there. Moxibustion is most effective when applied early: if applied on the second or third day, eight or nine out of ten cases may heal; if applied on the fourth or fifth day, six or seven out of ten may heal; if applied on the sixth or seventh day, four or five out of ten may heal. The earlier, the better. Various methods exist: garlic-interposed moxibustion, direct moxibustion on flesh, yellow wax moxibustion, prepared aconite cake moxibustion, fermented soybean cake moxibustion, and larva moxibustion.
One zhu (cone of moxa) up to one hundred zhu, stopping when effective. The size of the moxa cone depends on the severity of the lesion. However, there are contraindications for moxibustion. For example, carbuncles at Shenshu (BL23) should not be moxed, as it may deplete kidney fluids. Fingers should not be moxed due to thin skin and flesh, risking skin cracking and tissue protrusion. The head is the meeting point of all Yang meridians, and classical texts prohibit moxibustion there; erroneous application may force toxins inward, causing phlegm and wheezing to surge upward and increasing swelling. However, for pure Yin sinking syndromes, moxibustion is mandatory to restore Yang. For half-Yin half-Yang syndromes, moxibustion should still be avoided.
Method: Garlic-Interposed Moxibustion
Slice fresh garlic, approximately three qian thick, place it on the carbuncle, and apply large moxa cones. Replace the garlic slice after three zhu. For diffuse swelling without a head, cover with wet paper, identify the first drying spots, place garlic slices there, and moxa simultaneously at two or three such spots. If there is a single white grain like millet surrounded by redness and swelling the size of a coin, apply moxa directly on the white grain. For large lesions with long duration, mash garlic, spread it on the wound, place moxa on top of the garlic. Replace the garlic when it burns down. Effectiveness is indicated by intense pain sensation. For carbuncles, flowing deposits, and crane-knee wind (deformity of the knee joint), apply twenty to thirty zhu daily. For yin sores of carbuncles, a larger number of moxa cones is required; administer Huxin San (Heart-Protecting Powder) beforehand to prevent fire qi from invading internally. For pediatric patients, place garlic on an adult's arm, ignite moxa until the garlic warms, then transfer to the child's lesion, following the previous method. The classic states: When cold pathogens lodge in the collaterals, blood becomes viscous and stagnant. Stagnation causes Wei Qi to gather and obstruct, generating heat. Unchecked high heat causes flesh to rot into pus. Toxins originate from fire but combine with external cold; thus, moxa and garlic are used to open stagnation and move deep-seated toxins to the surface.
Method Two: Yellow Wax Moxibustion
For carbuncles, back carbuncles, malignant sores, and stubborn sores, first make a circle with wet dough around the base of the swelling, about one cun high, adhering tightly to the skin like a well mouth, preventing leakage. Wrap several layers of cloth outside the circle to protect the skin from heat. Inside the circle, spread wax shavings three to four fen thick. Suspend mulberry charcoal fire in a copper sieve above the wax to melt it until boiling. Add more wax shavings until the circle is full. For painless skin (shallow toxin), moxa until pain is felt; for painful skin (deep toxin), moxa until pain is lost. Remove the heat source, spray a little cold water on the wax, wait for it to cool, then remove the wax. If the bottom of the wax is blue-black, this indicates toxin expulsion. For diffuse swelling without a head, test with wet paper and moxa where it dries first. Early-stage lesions resolve in one or two applications; established lesions ulcerate in two or three. For chronic ulcers that fail to heal with hard surrounding tissue, apply moxa directly on the ulcer opening; the melted wax enters the hole, deeper being better. Stubborn necrotic pus will dissolve, and healing will be rapid.
Method Three: Prepared Aconite Cake Moxibustion
Grind raw Chuan Aconite root into powder, mix with yellow wine to form cakes about three qian thick. Place on the lesion and apply moxa cones. Apply several zhu daily, keeping it mildly warm, avoiding pain. Replace the cake when dry. Continue until the ulcer bed appears red and vibrant. This method is highly effective for ulcers with deficiency of both Qi and Blood, inability to heal, or obstruction of Qi and Blood circulation due to Wind-Cold invasion.
Method Four: Fermented Soybean Cake Moxibustion
For carbuncles and back carbuncles, whether ulcerated or not, grind Jiangxi light fermented soybeans into powder. Form cakes three fen thick using yellow wine, sized according to the lesion. Place on the affected area and moxa. Replace when dry. If an ulcer opening exists, do not cover it; place soybean cakes around the opening, arrange moxa on top, and apply mild heat without breaking the flesh. Replace immediately if hot pain becomes urgent. Apply three times daily. Healing occurs when sweat exudes from the ulcer opening.
Method Five: Larva Moxibustion
For gan fistulas and malignant sores unresponsive to other drugs, take larvae (larvae of scarab beetles), cut off both ends, place on the ulcer, and apply moxa. Replace after seven zhu. Use no more than seven larvae. This method is invariably effective.
Formula: Ophiopogon and Coix Seed Drink
Indications: This formula treats yin sores of carbuncles where moxibustion was indicated but was excessive, or where yang sores were erroneously moxed, leading to fire-toxin entering the interior. Symptoms include swelling of the head and neck, coma, surging phlegm, and panting. Administer urgently to clear and resolve fire-toxin effectively.
Composition: Radix Ophiopogonis (heart removed) and Coix Seed (each three qian).
Boil in two zhong of water until one zhong remains. Take slowly while warm.
[Verse] Equal parts Ophiopogon and Coix Seed,
Treats head and neck swelling after moxibustion.
Coma, surging phlegm, and wheezing cease,
Slowly decocted and taken warm, its efficacy is supreme.