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[Prescription Verse] Itching at the initial stage of carbuncle and ulcer is caused by wind-heat; itching after ulceration may be due to pus maceration or exposure to wind; itching during the healing phase indicates the growth of new flesh, signifying sufficient Qi and blood. If the itching feels like insects crawling, it indicates that Qi and blood are abundant.

[Note] Itching belongs to wind pathogenic factors, but has various causes. In the initial stage of a swelling ulcer (swollen lesion), skin itching is due to the struggle between wind and heat. Itching after ulceration is mild if caused by pus maceration, but severe if caused by the wound exposed to wind, resulting in raised bumps resembling millet grains. After scratching, clear fluid discharge indicates Spleen dampness, while blood discharge indicates Spleen dryness. Itching when the wound is about to heal occurs because muscle stagnation prevented Qi and blood from reaching the area initially; as healing approaches, Qi and blood gradually fill the area to nourish new flesh, causing itching. However, only itching that feels like insects crawling signifies a favorable prognosis. Other itches caused by scabies and tinea all belong to excessive wind pathogenic factors and should not be confused with this condition.

[Prescription Verse] The true "halo" (erythema) should be distinguished from ordinary redness and swelling; its shape around the wound resembles red veins. This results from sharp toxins accumulating in the Zang-Fu organs. Two or three halos can be cured, but five halos are difficult to treat and damage the body.

[Note] Commonly, redness and swelling are mistaken for halos, but they are not true halos. True halos appear beside the wound, resembling red veins, formed by sharp toxins accumulated within the Zang-Fu organs. Two or three halos are treatable, while five halos are difficult to cure.

[Prescription Verse] Carbuncles, ulcers, and sores initially resemble millet grains; numbness, itching, burning, and pain indicate severe toxicity. Regardless of Yin or Yang syndrome, moxibustion is most suitable. After moxibustion, wash with decoction and protect with plaster. Internally use herbs to disperse and unblock; externally apply poultices to bind the surroundings. For mild cases, use Shen Deng (Divine Lamp) irradiation with three branches. For flat lesions, urgently tonify deficiency; for high swellings, avoid excessive purgation. If internal heat and toxin are abundant, use detoxifying agents. For constipation of both bowels and bladder, promote unblocking; smooth flow of Zang-Fu organs is auspicious. If the sore remains hard after ten days, puncture first with a Pi needle (scalpel). If pus is scant after half a month, use the medicinal cylinder suction method. If pus is viscous, it is a favorable sign; if purple blood or thin water, it is unfavorable. After twenty-one days, even with thin pus, it is difficult to treat. If ulcerated sores have necrotic tissue that does not shed, cut open the aperture to allow pus drainage. Wash frequently, avoid wind. Remove necrosis with spiritual medicines; use flesh-regenerating powder when nearing healing. Maintain diligence, do not be lazy. Avoid cold-cold herbs when pus is discharging. Winter: warm room; Summer: bright window. When muscles level out and wounds close, manage carefully. If new flesh grows like pearls but skin does not close, neglect leads to death.

[Note] Carbuncles and ulcers start like millet grains; numbness, itching, burning, and pain indicate severe toxicity. Before seven days, when the condition is not yet fully formed, regardless of Yin or Yang syndrome, moxibustion should be applied first. For mild cases, toxins dissipate with fire; for severe cases, moxibustion draws out stagnant toxins and connects interior and exterior, which is an excellent method. After moxibustion, wash with decoction, then apply Taiyi Plaster to the top of the wound to prevent wind invasion. Internally administer dispersing and unblocking agents such as Shenshou Weisheng Decoction, Neishu Huanglian Decoction, or Chansu Pill. Externally apply poultices like Chonghe Ointment or Yulong Ointment to bind the perimeter. For mild cases, irradiate with Shen Deng using three branches. Once the condition is established, treat according to symptoms. Flat lesions require tonics to supplement deficiency and expel toxins outward. High swellings should not be aggressively purged to avoid damaging Yuan Qi and hindering ulceration and healing. Internal heat requires adjunctive detoxification to prevent toxin proliferation. Constipation requires urgent unblocking agents to ensure smooth Zang-Fu function, which is a good omen. If the sore remains hard after ten days, puncture with a Pi needle. If pus is scant after fifteen days, urgently use the medicinal cylinder suction method. Viscous pus and blood indicate a favorable course; thin purple blood or watery discharge indicates an unfavorable course. Beyond twenty-one days, even with thin pus, treatment is difficult. If necrotic tissue persists after ulceration, cut open one inch at the center to unblock pus drainage. After removing pus and necrosis, place a square plate under the wound. Pour pig trotter decoction over soft cloth to wash the wound surface and enter the cavity, gently wiping clean internal pus so that decayed matter and old pus exit with the liquid, until clean. Fold soft cloth seven or eight layers thick, not too dry, keep warm with the liquid, cover the wound, press gently for a moment, and replace when cool. Repeat washing and pressing four or five times to unblock Qi and blood, making the patient feel refreshed. Wash daily, avoiding wind and cold. Apply Huang Ling Yao (Yellow Spiritual Medicine) to necrotic areas. When necrosis sheds and red flesh appears, melt Yuhong Gao (Jade Red Ointment) on the palm and apply inside the wound after washing, covering externally with Taiyi Plaster. New flesh will grow rapidly within a few days, and the wound will begin to close. Sprinkle Shengji San (Flesh-Generating Powder) or Zhenzhu San (Pearl Powder). Maintain careful care without delay. Avoid cold-cold herbs after pus discharge. Winter: stay in warm rooms to prevent cold. Summer: stay in bright windows to avoid wind and summer heat. When muscles level and wounds close, exercise extra caution. Even if new flesh grows like pearls and skin closes, negligence in care may lead to collapse and sudden changes, endangering life.