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Attribute: Whenever encountering a person suffering from internal carbuncle (internal abscess), give them five raw soybeans. If there is no bean flavor when chewed in the mouth, this is the sign of the disease.

[Prescription Verse] Shoulder carbuncle and abscess occur exactly in the center of the shoulder; the carbuncle is hard with black depression, while the abscess is red and swollen. Dry carbuncle is located before and after the shoulder, caused by accumulation of wind-dampness and heat, with blood stasis coagulation.
[Note] This carbuncle arises on the medial margin of the shoulder, belonging to the Sanjiao (Triple Burner) and Gallbladder meridians. If the lesion is red, vibrant, and high-swollen, it is named Ci Carbuncle; if it is hard and flat, it is called Shoulder Middle Carbuncle. The anterior margin of the shoulder belongs to the Large Intestine meridian, named Dry Carbuncle, also known as Ding Carbuncle. The posterior margin of the shoulder belongs to the Small Intestine meridian, named Over-shoulder Carbuncle. Regardless of the size of the lesion, it is named based on its origin. Generally, it is formed by the stagnation of damp-heat and wind-pathogens, or sometimes by the coagulation of blood stasis due to carrying heavy loads. If the swelling is high, red, and vibrant, with rapid suppuration and ulceration, it is a favorable prognosis (Shun); if it is flat, hard, without redness or heat, and suppurates slowly, it is dangerous; if pain and swelling extend to the arm and scapula, accompanied by trismus, chills, severe pain preventing eating, or soft ulceration with diarrhea, it is an unfavorable prognosis (Ni). Treatment methods: In the initial stage with exterior syndrome, Jingfang Baidu San (Jingjie, Fangfeng, and other herbs to expel pathogens) should be used to induce sweating; with interior syndrome, Neishu Huanglian Tang (Internal Draining Coptis Decoction) should be used to purge. After sweating or purging, if pain and swelling persist and pus is about to form, Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) is suitable; once the pus matures, incision and drainage are performed. As for guiding herbs, they are added according to the specific meridian during clinical practice. After ulceration, both internal and external treatments follow the regulations in the "Carbuncle and Ulcer" section.
Formulas: Jingfang Baidu San (See Occipital Brain Carbuncle)
Neishu Huanglian Tang (See Swelling and Ulcer Section)
Tuoli Tou Nong Tang (See Head Invasion Brain Carbuncle)

[Prescription Verse] Gu Liao Carbuncle arises behind the shoulder and outside the armpit, where the Small Intestine meridian's Jianzhen acupoint is affected by wind-fire coagulation. Shoulder Wind-Toxicity causes swelling at the upper end of the arm, formed by wind-dampness affecting the Large Intestine meridian's Jianyu acupoint.
[Note] Gu Liao Carbuncle arises below the posterior shoulder, slightly above the posterior-lateral aspect of the armpit, between the bone gaps. It belongs to the Small Intestine meridian's Jianzhen acupoint and is formed by wind-fire coagulation. Initially, it resembles millet grains, hard, painful, and swollen, with stiffness in the shoulder and arm, unable to lift. Initially, take Jingfang Baidu San; for those with dry and solid stool, take Shuangjie Guijin Wan (Double Resolution Golden Pill) for double resolution. Shoulder Wind-Toxicity arises at the tip of the shoulder and the bony prominence of the upper arm, belonging to the Large Intestine meridian's Jianyu acupoint. It is caused by pathogenic wind deeply invading the bone gaps, lingering with dampness, and transforming into heat. Initially, there is diffuse swelling and redness; large lesions are like peaches, small ones like apricots. Pain extends to the shoulder and arm, accompanied by stiffness. Initially, take Juantong Wuyou San (Pain-Relieving Worries-Free Powder) to induce sweating, which will eliminate the condition immediately. If swelling and pain deepen daily and cannot be completely eliminated, pus is about to form, and Tuoli Tou Nong Tang should be taken. For both conditions after ulceration, internal and external treatments follow the "Carbuncle and Ulcer" section.
Formula: Juantong Wuyou San
Composition: Strychnos nux-vomica (Fanned in sesame oil until floating) Angelica sinensis (Washed with wine)
Glycyrrhiza uralensis (Raw, two taels each) Ephedrae Herba (three taels)
Manis squama (Stir-fried with old soil) Aconiti Radix lateralis preparata (Boiled with black soybean wine, skin and tip removed)
Aconiti Kusnezoffii Radix (Boiled with ginger juice) Atractylodis Rhizoma (Soaked in rice water and stir-fried)
Pinelliae Tuber (Prepared, two taels each) Salvia miltiorrhiza (one tael)
Each processed into powder, mixed uniformly. Take 0.5 to 1 qian per dose, mixed with clear wine. Drink more alcohol until drunk, then cover with blankets to sweat and avoid wind. Adding four liang of Datura metel (Nao Yang Hua) to this formula also treats headache due to wind.
[Prescription Verse] Juantong Wuyou San treats Shoulder Wind-Toxicity, where wind invades bone gaps and coagulates with dampness; Strychnos nux-vomica, Angelica sinensis, Glycyrrhiza uralensis, Ephedrae Herba, Manis squama, Chuanxiong Rhizome, Aconiti Radix lateralis preparata, Atractylodis Rhizoma, Pinelliae Tuber, and Salvia miltiorrhiza.
Another Formula: Jingfang Baidu San (See Occipital Brain Carbuncle)
Shuangjie Guijin Wan (See Swelling and Ulcer Section)
Tuoli Tou Nong Tang (See Head Invasion Brain Carbuncle)