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[Verse] Bristle abscess (Binju) occurs in the Hand Shaoyang Sanjiao Meridian and Foot Shaoyang Gallbladder Meridian. The condition is formed by the condensation of desire-fire and anger. These two meridians have abundant Qi but deficient Blood; after ulceration, only a small amount of pus should be seen.

[Commentary] This condition manifests at the hairline, belonging to the Hand Shaoyang Sanjiao Meridian and the Foot Shaoyang Gallbladder Meridian. It arises from the reckless movement of Ministerial Fire (Xianghuo), external invasion of Wind-Heat, and internal fire generated by impatience, anger, and lust, leading to condensation of Qi and Blood. Both meridians are characterized by abundant Qi and deficient Blood, making it difficult for tissue to putrefy and ulcerate. Furthermore, the flesh at the hairline is thin, making acupuncture and moxibustion unsuitable; one should wait for natural ulceration. After ulceration, excessive pus discharge is undesirable, as it excessively depletes Blood and hinders wound healing. In the initial stage, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) is indicated to resolve the pathogen. When pus has formed, Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) is indicated to support the healthy Qi and expel toxins externally, with Erwei Baidu San (Two-Ingredient Toxin-Extracting Powder) applied topically. For treatment methods after ulceration, refer to the section on Ulcerated Carbuncles and Sores.

Formula: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction)
Composition: Chai Hu (Radix Bupleuri), Sheng Di Huang (Radix Rehmanniae Preparata) (each 1.5 qian); Dang Gui (Radix Angelicae Sinensis) (2 qian); Chi Shao (Radix Paeoniae Rubra) (1.5 qian); Chuan Xiong (Rhizoma Chuanxiong) (1 qian); Lian Qiao (Fructus Forsythiae) (decored, 2 qian); Niu Bang Zi (Fructus Arctii) (stir-fried and crushed, 1.5 qian); Huang Qin (Radix Scutellariae) (1 qian); Sheng Zhi Zi (Fructus Gardeniae) (crushed); Tian Hua Fen (Radix Trichosanthis); Gan Cao Jie (Ramulus Glycyrrhizae); Fang Feng (Radix Saposhnikoviae) (each 1 qian).
Preparation and Administration: Add two bowls of water, decoct until reduced to eight-tenths, and take far from meals.

[Verse] Chaihu Qinggan Tang treats conditions caused by anger, effectively promoting blood circulation, unblocking collaterals, and detoxifying. The formula uses raw Siwu Tang (Four Substances Decoction) ingredients combined with Chai Hu, Lian Qiao, Niu Bang Zi, Huang Qin, Zhi Zi, Tian Hua Fen, Gan Cao Jie, and Fang Feng.

Another Formula: Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), Erwei Baidu San (Two-Ingredient Toxin-Extracting Powder) (both see Section on Swollen Sores).

[Verse] Tian Ju (Heaven Abscess) is on the left, Rui Du (Sharp Toxin) is on the right. They belong to the Gallbladder Fu-organ and occur behind the ear. They are formed by郁火 (Stagnant Fire) due to excessive deliberation. The flesh here is thin, requiring urgent treatment.

[Commentary] These two conditions are named Tian Ju (Heaven Abscess) on the left and Rui Du (Sharp Toxin) on the right. Both occur behind the high bone, one inch and three fen behind the ear. "Tian" refers to dying before one's natural lifespan ends; "Rui" means sharp like a blade, indicating severe toxicity. Few patients recover from these conditions. Initially, they appear like millet grains, gradually swelling like a melon, becoming hard, flat, purple-dark, and lusterless, with pain doubling that of other sores. Although named differently, both left and right areas behind the ear belong to the Foot Shaoyang Gallbladder Meridian. They are caused by indecisiveness and condensation of stagnant fire. The skin and flesh here are thin, with abundant Qi and deficient Blood, ultimately constituting a dangerous condition requiring urgent treatment. Delay allows Heat-Qi to descend into Yuan Ye acupoint, damage the Ren Mai (Conception Vessel) anteriorly, and internally熏蒸 (mingle/burn) the Liver and Lungs, causing all malignant symptoms to appear, inevitably leading to death. Rapid swelling, redness, and ulceration indicate a favorable prognosis (Shun); hardness and black depression indicate an unfavorable prognosis (Ni). Even if the prescription matches the syndrome, only four or five out of ten cases may be cured. Initially, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) is taken to dissipate and resolve. As pus is about to form, Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) is taken. For deficiency patterns, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) is used to support and tonify. Topically, Wulong Gao (Black Dragon Ointment) is applied. Other internal and external treatments follow the Section on Swollen and Ulcerated Carbuncles and Sores.
(Yuan Ye is an acupoint name of the Gallbladder Meridian.)

Formulas: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) (see previous section on Bristle Abscess); Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder), Wulong Gao (Black Dragon Ointment) (both see Section on Swollen Sores); Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) (see Section on Ulcerated Sores).