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[Prescription Verse] Tou Nao Ju (Brain-Penetrating Carbuncle) arises anterior to the Baihui point, resembling an egg in shape, with pain and firmness. If soft, diffuse, with thin pus and a sunken appearance, it indicates deficiency; if red, swollen, hard, with thick pus and a pointed apex, it indicates excess.

[Note] This condition arises anterior to the Baihui point, near the fontanelle, resulting from fire-toxin accumulating in the Du Meridian. Initially like a millet grain, it gradually enlarges to the size of an egg, becoming hard and painful. If the ulcer apex is sunken, the base is diffuse, and the color is dark, it belongs to deficiency; if the color is red, swelling is hard, the apex is high, and the pus is thick, it belongs to excess. Rapid ulceration is a favorable sign (Shun), while delayed ulceration or penetration into the brain marrow is an unfavorable sign (Ni). The internal and external treatments for swelling and ulceration follow the guidelines for Baihui Ju.

[Prescription Verse] Qin Nao Ju (Brain-Infiltrating Carbuncle) arises beside the Tou Nao Ju, caused by damp-fire attacking, belonging to the Taiyang Bladder Meridian. The acupoint name Wuchu indicates its location. Redness indicates a favorable prognosis, purple discoloration indicates an unfavorable one; careful examination is required.

[Note] This carbuncle arises lateral and inferior to the Tou Nao Ju, caused by damp-fire of the Taiyang Bladder Meridian, located at the Wuchu acupoint. If red, swollen, elevated, burning hot, and painful, with pus resembling "gray wax" (yellowish-white and turbid), it indicates excess of both Qi and Blood, which is favorable and easy to treat. If purple, sunken, without pus, and with a diffuse base, it indicates deficiency of both Qi and Blood, which is unfavorable and difficult to treat. In the initial stage, Jing Fang Bai Du San should be taken to induce sweating. Subsequently, Nei Shu Huang Lian Tang should be taken to purge heat. As it approaches ulceration, Tuo Li Tou Nong Tang should be taken. After ulceration, Tuo Li Pai Nong Tang should be taken. Externally, Hu Po Gao should be applied to the ulcer, and Chong He Gao should be applied around the periphery. Other internal and external treatments follow the guidelines in the "Carbuncle and Ulceration Section."

Formula: Tuo Li Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction)
Ingredients: Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Chuan Shan Jia (Pangolin Scales, stir-fried and ground), Bai Zhi (Angelicae Dahuricae Radix) [each 1 qian]; Sheng Ma (Cimicifugae Rhizoma), Gan Cao Jie (Licorice Root Node) [each 0.5 qian]; Dang Gui (Angelicae Sinensis Radix) [2 qian]; Sheng Huang Qi (Astragali Radix) [3 qian]; Zao Jiao Ci (Gleditsiae Sinensis Spina) [1.5 qian]; Qing Pi (Citri Reticulatae Pericarpium Viride, stir-fried) [0.5 qian].
Administration: Add three zhong of water, decoct to obtain one zhong. For lesions in the upper body, drink one zhong of boiled wine first, then take this medicine hot. For lesions in the lower body, take the medicine first, then drink wine. For lesions in the middle body, mix half a zhong of wine into the decoction and take hot.

[Prescription Verse] Tuo Li Tou Nong Tang treats carbuncles and sores; it is suitable for use when pus has formed but not yet ulcerated. It contains Ren Shen, Bai Zhu, Chuan Shan Jia, Bai Zhi, Sheng Ma, Gan Cao, Dang Gui, Huang Qi, Zao Jiao Ci, and Qing Pi.

Alternative Formula: Jing Fang Bai Du San (See Neck/Brain Carbuncle section)
Nei Shu Huang Lian Tang, Chong He Gao (See Swelling/Ulceration Section)
Tuo Li Pai Nong Tang (See Fish-Tail Toxin of the Neck section)
Hu Po Gao (See Hairline Sores section)