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The *Lu Yan Fang* (Recorded Verified Prescriptions) states: Da Wu Bu Tang (Great Five Tonifying Decoction) treats malaria transforming from epidemic febrile diseases. The prescription is as follows:
Cortex Lycii Chinensis (Radicis Lycii) (one jin), Radix Ophiopogonis (Mendong, 麦门冬) (one sheng, remove the heart), Rhizoma Zingiberis Recens (Shengjiang, 生姜) (one jin), Radix Rehmanniae Preparata (Dihuang, 干地黄) (three liang), Radix Angelicae Sinensis (Danggui, 当归) (three liang), Radix Scutellariae (Huangqin, 黄芩) (three liang), Radix Ginseng (Renshen, 人参) (three liang), Radix Glycyrrhizae (Gancao, 甘草) (three liang), Poria (Fuling, 茯苓) (three liang), Folium Bambusae (Zhuye, 竹叶) (five liang), Cortex Polygalae (Yuanzhi, 远志) (three liang), Rhizoma Atractylodis Macrocephalae (Baizhu, 白术) (three liang), Radix Chuanxiong (Chuanxiong, 川芎) (two liang), Ramulus Cinnamomi (Guixin, 桂心) (five liang), Fructus Jujubae (Dazao, 大枣) (twenty pieces), Radix Platycodi (Jiegeng, 桔梗) (two liang), Radix Paeoniae Alba (Baishao, 芍药) (three liang), Rhizoma Pinelliae (Banxia, 半夏) (two liang, washed).

These eighteen substances are sliced and decocted in fifteen dou of water to obtain three sheng of liquid. Divide into four doses and consume within one day.

The *Liu Juanzi Fang* records: Huang Fu from Jiujiang asked Qibo: I have heard that the intestines and stomach receive food and drink, the Upper Jiao (Upper Burner) releases Qi to warm the muscles and flesh, nourish the bone joints, and open the interstices. The Qi produced by the Middle Jiao (Middle Burner) is like dew, flowing upward into the vessels and seeping into the Sun collateral vessels. When fluids and essence are harmonious, they transform into red blood. When blood is harmonious, the Sun collaterals fill first, then flow into the Luo collateral vessels; when the Luo collaterals are full, they flow into the Jing main vessels. Yin and Yang expand, and movement proceeds with respiration. Movement has its order, and circulation has its principles. It aligns with Heaven and Earth and does not cease. Pulse diagnosis regulates it; treating deficiency removes excess. Purging leads to insufficiency, while haste causes Qi stagnation. Removing deficiency and tonifying excess leads to surplus. When Qi and Blood are harmonized, form and spirit are maintained. I know the state of harmony or disharmony of Blood and Qi, but I do not know the origin of carbuncles and sores, the timing of their success or failure, and the proximity of death or life. How can this be measured? May I hear about it?

Qibo replied: The movement of Qi and Blood in the main vessels never stops, corresponding to the degrees of Heaven and the measures of Earth. Thus, if celestial bodies lose their regularity, eclipses occur; if earthly meridians lose their discipline, waters overflow, grass fails to grow, and grains fail to plant. In humans, when meridians are blocked, Qi and Blood cannot circulate freely. People separate and live in different places, yet Qi and Blood behave similarly. Let me explain the reason.

Blood vessels and Ying-Wei (Nutritive and Defensive) Qi flow continuously without rest, corresponding to stars above and earth below. When cold pathogen invades the meridians, Blood becomes stagnant. Stagnant Blood leads to blockage. Blockage causes Qi to gather there and prevents it from returning, resulting in swelling and abscesses. Cold transforms into heat. Excessive heat rots the flesh. Rotten flesh fails to suppurate. If pus is not discharged, tendons rot. Rotting tendons damage bones. Damaged bones cause marrow depletion. If not drained through bone cavities, the body boils dry and empties. Bones, tendons, and muscles lose their connection. Meridians fail and leak. Internal heat steams the Zang organs. Damage to the Zang organs leads to death.

It is also said: Huang Fu asked: You spoke of carbuncles and sores; how to distinguish them? Qibo answered: When Ying and Wei Qi remain stagnant in the vessels for a long time, Blood becomes stagnant and ceases to flow. Stagnant Blood causes Wei Qi to follow. Following Wei Qi encounters blockage and cannot move. High fever persists. Excessive heat rots the flesh, which turns to pus. If it does not penetrate the skin and marrow, and the marrow is not scorched and the Zang organs are not damaged, it is called a carbuncle (Yang sore).

Huang Fu asked: What is a sore (Yin sore)? Qibo said: When hot pathogen is abundant and deep, penetrating tendons and bones, leaving no healthy flesh, it is named a sore. The skin of a sore is hard, resembling the hide of an ox neck. The skin of a carbuncle is thin and glossy. These are their signs.

Huang Fu said: I understand what was said, but I do not know the names, origins, color diagnoses, morphological signs, treatment outcomes, and life-death periods of carbuncles and sores. I wish to hear everything.

Qibo said: The *Yong Ju Tu* (Map of Carbuncles and Sores) states: Red sores appearing on the forehead, if not drained, lead to death in ten-plus days. They can be needled on the fifth day. If pus is red and bloody, death ensues. If no pus has formed, it is treatable. At ages twenty-five, thirty-one, sixty, and ninety-five, the Hundred Spirits reside in the forehead. Do not allow bleeding; bleeding indicates death.

Avian sores appear as dozens of rashes. Swelling occurs on the fourth day, forming hard, painful nodules resembling contracture. Needling is possible on the tenth day. If internal onset causes tremors and aversion to cold, with teeth clenched as if in spasm, death occurs in ten days.

Zhu sores appear on the neck or below both ears. Without drainage, death occurs in sixteen days. Needling is possible on the sixth day. If black and suppurating with rot, death ensues; it is untreatable. At ages nineteen, twenty-three, thirty, thirty-five, thirty-nine, fifty-one, fifty-five, sixty-one, eighty-seven, and ninety-nine, the Spirit resides in the ears. Do not allow bleeding; bleeding indicates death.

Ding sores appear on both shoulders, caused by evil blood chasing and lingering internally and externally, blocking Ying and Wei Qi. Body swelling and pain occur in three days; severe cases present with trismus resembling opisthotonos. Needling is possible on the eleventh day. Untreated, death occurs in twenty days.

Bee sores appear on the back, originating at Xinshu (BL15) or Jianyu (SI15). Without drainage, death occurs in twenty days. Needling is possible on the eighth day. If red-black with green pus, death ensues; it is untreatable. At ages six, eighteen, twenty-four, forty, fifty-six, sixty-seven, seventy-two, and ninety-eight, the Spirit resides in the shoulders. Do not allow bleeding; bleeding indicates death.

Yin sores appear on the outer thigh or inner upper leg. Initially, the waist is stiff and cannot stop moving. Frequent drinking but inability to swallow much. Hardness and pain persist for five days. Such cases die within three years.

Ci sores originate at Feishu (BL13) or Ganshu (BL18). Without drainage, death occurs in twenty days. Needling is possible on the eighth day. If red with flesh resembling peppercorns on top, death ensues; it is untreatable. At ages nineteen, twenty-five, thirty-three, thirty-nine, fifty-seven, sixty, seventy-three, eighty-one, and ninety-seven, the Spirit resides in the back. Do not allow bleeding; bleeding indicates death.

Mai sores appear around the head (or neck), causing pain and body heat. Desire to move is absent; eating may be impossible. This stems from great fear, restlessness, and lack of tranquility. Upper Qi coughs and rebels. Qi cuts off. Onset pulls the ears; movement is restricted. Needling is possible on the twentieth day. Without needling, death occurs in eighty days.

Long sores appear on the back, originating at Weishu (BL21, 1.5 cun lateral to lower border of spinous process of 12th thoracic vertebra) or Shenshu (BL23, 1.5 cun lateral to lower border of spinous process of 2nd lumbar vertebra). Without drainage, death occurs in twenty days. Needling is possible on the ninth day. During needling, if upper is red and lower black, or green-black pus appears, death ensues. Bleeding pus indicates survival.

Shou sores involve fever. After eighty days of fever, high fever causes sweating, pulling heat from the head to the whole body, resembling leprosy-like heat, boiling uniformly. Superficial needling should be performed on slightly swollen skin areas. Without needling, invasion of the abdomen leads to death in twenty days.

Xia Rong sores appear in the hypochondrium or at the elbows. Without drainage, death occurs in twenty-five days. Needling is possible on the ninth day. If red and white mixed, and pus is mostly white without red, it is treatable. At ages one, sixteen, twenty-six, thirty-two, forty-eight, fifty-eight, sixty-four, eighty, and ninety-six, the Spirit resides in the hypochondrium. Do not allow bleeding; bleeding indicates death.

Xing sores appear as swelling, sometimes merging and moving. Trace the location and needle for immediate cure.

Yong sores appear in the thighs, originating from Taiyin or Fushu. Without drainage, death occurs in twenty-five days. Needling is possible on the tenth day. Yong sores with red-black pus indicate death; white pus is still treatable. At ages eleven, fifteen, twenty, thirty-one, thirty-three, forty-six, fifty-nine, sixty-three, seventy-five, and ninety-one, the Spirit resides in the sacrum/tailbone. Do not allow bleeding; bleeding indicates death.

Biao Shu sores involve fever and deafness. After sixty days, swelling resembles water containment. Needling is appropriate. Drain fluid; if blood appears, remove it. At ages fifty-seven, sixty-five, seventy-three, eighty-one, and ninety-seven, the Spirit resides in the back. Do not allow bleeding; bleeding indicates death.

KT sores appear on the dorsum pedis or sole. Without drainage, death occurs in thirty days. Needling is possible on the twelfth day. KT sores with red-white pus that do not reverse (die) usually have white, itchy tops. Black-red pus indicates death and untreatability; non-black is treatable. At ages thirteen, twenty-nine, thirty-five, sixty-one, seventy-three, and ninety-three, the Spirit resides in the feet. Do not allow bleeding; bleeding indicates death.

Chong sores appear in the lower abdomen, with pain, tremors, aversion to cold, and fever. Needling is possible on the fourth day. Changes occur by the sixth day, allowing needling. Without needling, death occurs in fifty days.

Dun sores appear on the tips of the ten fingers or toes. Without drainage, death occurs in eighteen days. Needling is possible on the fourth day. If black on the day of onset, and the carbuncle is not severe, before crossing joints, it is treatable.

Jie sores appear in the axilla, arms, or palms, with tremors, aversion to cold, fever, and dry throat. Excessive drinking causes vomiting. Heart vexation... or itching after sixty days with healing tendencies allows diaphoresis. Without diaphoresis, abdominal invasion leads to death.

Jin sores appear on the large tendons on both sides of the spine on the back, with cyan color. Needling is possible on the eighth day. If a carbuncle exists in the intestines, death occurs in ninety days.

Chen Gan sores appear on both arms. Pain prevents movement for three to four days. Body heat and redness occur on the fiftieth day. Needling is possible on the sixtieth day. If needling lung yields no blood, disease resolves in three to four days. Absence of pus indicates death.

Zao sores originate on the tips of the ten fingers/toes. If joints are crossed without color change, needling is possible within ten days. Delayed needling leads to erosion. If a carbuncle exists in the axilla, death occurs in three years.

Shu sores involve body swelling, hard nodules, and fever. Sitting, walking, flexion, and extension are impossible. Suppuration allows needling for immediate relief.

Bai sores appear on the upper arm or behind the elbow, with itching, eye pain, Jing injury, body heat, and excessive sweating. Death occurs at five or six sites. Xin Zhu sores in the thighs/shins lead to death in six days; suppuration leads to death in sixty days.

Hei sores involve swelling on the major bones of the back. Needling is possible on the eighth day. Delayed needling becomes Gu Ju (Bone Sore). Pus discharge is uncontrollable; expulsion of bone fragments leads to death in sixty days.

Shaoyang swelling/carbuncle in the hypochondrium/neck leads to death in eight days; blood-pus discharge leads to death in ten days.

Chuang sores begin with itching followed by pain. This is due to Cold Pathogen entering the Zang from Cold Damage, developing severely into Chuang Ju. Needling is possible on the ninth day. Without needling, death occurs in ninety days.

Taiyang swelling in the sacrum/lumbar region connects to Yangming. Carbuncle in the neck leads to death in ten days; blood-pus discharge leads to death in seventy days.

Taiyang swelling/carbuncle at the sole (Yangming/Shaoyang) leads to death in eight days; blood-pus discharge leads to death in eighty days.

Yangming swelling/carbuncle at the head/sacrum leads to death in six days; blood-pus discharge leads to death in sixty days.

Taiyang swelling/carbuncle in the thigh/foot leads to death in seventeen days; blood-pus discharge leads to death in one hundred days.

Taiyang/Taiyin swelling/carbuncle in the shoulder/calf leads to death in eight days; blood-pus discharge leads to death in four hundred days.

Shaoyang swelling/carbuncle in the foot/hypochondrium leads to death in eight days; blood-pus discharge leads to death in six hundred days.

Yangming swelling/carbuncle in the hand/axilla leads to death in one year; blood-pus discharge leads to death in two years.

Hei Ju in the axillary hollow leads to death. Hei Ju in the ear like rice grains is a major Ju leading to death. Hei Ju on the shoulder is not fatal and treatable. Hei Ju in the Clavicular fossa is named Fu Yong (Hidden Carbuncle), leading to death, untreatable. Hei Ju on the chest is treatable. Hei Ju above/below the elbow is not fatal and treatable. Chi Ju on the inner thigh: hard leads to death, soft is treatable. Chi Ju at the hip pivot: treatable within six days; untreated leads to death in one year. Chi Ju in the palm is treatable. Hip joint: black root/red tip leads to death. Chi Ju on the genitals is fatal and untreatable. Hei Ju on the intestines leads to death. Hei Ju on the knee patella: hard leads to death, soft is treatable. Hei Ju on the dorsum pedis: hard leads to death. Chronic sore on the sole with red color leads to death, untreatable.

Furthermore: Carbuncles and sores start subtly and are often not considered urgent, yet they are perilous. Quick treatment is essential. Delay makes rescue difficult, bringing disaster. Is this not painful? I record these thoughts to enlighten future scholars. Summarizing Huang Fu’s discussion on carbuncles and sores, regarding attachment, urgency, life-death periods, shapes, colors, and difficulty of treatment:

Superficial carbuncles in skin/flesh are shallow, high, and red. Application dissipates them; even without treatment, they may heal first.

Deep carbuncles in muscle/tendon are low, hard, and colored green, yellow, white, or black, or slightly red/hot. Urgent treatment is required; they may resolve halfway.

Carbuncles attached to bone may go unnoticed internally until damage occurs. This is severe.

Back carbuncles: thin skin indicates carbuncle; hard skin indicates sore. These show prodromal signs. Urgent treatment of large, hard-skin sores prevents disaster.

The *Tai Su Jing* states: Huangdi asked: Tell me fully about the forms and taboo days of carbuncles and sores. Qibo answered: Carbuncle in the pharynx is named Meng Ju (Fierce Sore). Untreated, it suppurates. If pus blocks the throat, death occurs in half a day. If suppurated, drain it, then hold pig fat in the mouth. Avoid cold food. Recovery in three days. (Note: Matches *Liu Juanzi Fang*’s eighteen extreme types.)

Neck carbuncle is named Tian Ju. Large, red-black. Untreated, heat enters Yuanye, damaging Ren Mai, steaming Liver/Lungs. Death in ten-plus days.

Excessive Yang Qi dissipating brain/nape is named Nao Shuo. Unhappy expression, neck pain like needle pricking, heart vexation leads to death. Untreated.

Shoulder/arm carbuncle is named Ci Yong. Red-black. Treat urgently. Sweating to feet does not harm Zang organs. Carbuncles appearing four or five times require counter-measures. (Note: *Liu Juanzi Fang* lacks these seven characters.)

Axillary red-hard carbuncle is named Zhu Ju. Treat with Bian stone (fine/long), frequent pricking, apply pig fat. Recovery in six days; do not bandage. Hard/non-suppurating becomes Ma Dao Xia Ying (Horse Knife Axillary Sore); treat urgently. (*Liu Juanzi Fang* uses "Mouse Fat").

Chest carbuncle is named Jing Ju. Like soybean. Appears in 3-4 days. Untreated, descends to abdomen. Death in seven days.

Sternum carbuncle is named Gan Ju. Like gourd fruit. Constant chills/fever. Treat urgently to resolve chills/fever. Untreated, death in ten years; pus discharges post-mortem.

Hypochondrial carbuncle is named Bai Ci. Disease of women. Long-term large abscess with meat like adzuki bean. Treatment: Decoct Forsythia root/bark (1 sheng each) in 1.6 dou water to 3 sheng. Force drink, sit on hot pot in thick clothes to sweat to feet. Recovery.

Thigh/shin carbuncle is named Gu Ting Ju. Little change in shape, but pus attaches to bone. Untreated, death in forty days.

Thigh [specific area] carbuncle is named Tuo Ju. Little shape change, pus grips bone. Untreated, death in thirty days.

Sacral carbuncle is named Dui Ju. Red, hard, large. Treat urgently. Untreated, death in forty days.

Thigh/genital carbuncle is named Chi Jue. Untreated, death in six days. Inside thighs, untreated, death in sixty days.

Knee carbuncle is named Ci Ju. Large, unchanging color, cold/heat, hard. Do not rupture; rupture leads to death. Wait for softness, then rupture for survival.

Joint-associated carbuncles are untreatable. Male genital onset: death in 100 days. Female genital onset: death in 40 days.

Shin carbuncle is named Tu Chi. Red to bone. Treat urgently; untreated harms people.

Ankle carbuncle is named Zou Huan. Color unchanged. Stone therapy on acupoints to stop cold; survival.

Foot upper/lower carbuncle is named Si Yin. Large, unchanging color. Untreated, death in 100 days.

Foot side carbuncle is named Li Ju. Small, starting like finger. Treat urgently. Remove blackness; if not dissipated, it grows. Untreated, death in 100 days.

Toe carbuncle is named Tuo Ju. Red-black is fatal/untreatable; non-red-black survives. If treatment fails, amputation saves life; otherwise death.

Body has five parts: Futu (1), Calf (2), Back (3), Five Zang Shu points (4), Nape (5). Carbuncles/sores in these five parts are fatal.

Yang Shangshan stated: Four causes of carbuncles: 1. Excessive anger/joy, conflict Qi gathering. 2. Irregular diet, ignoring cold/heat. 3. Deficient Yin Qi in Zang, Excess Yang Qi in Fu; excess Yang generates carbuncle. 4. Pathogen in Blood, stagnation generates carbuncle. Long-standing carbuncles destroying bone are named Ju.

Accumulated stones make mountains; accumulated Qi makes carbuncles. Not from heaven or earth, but from neglecting subtle fragility.

*Bing Yuan Lun* states: Carbuncles arise from Six Fu disharmony; Sores arise from Five Zang disharmony.

Swelling 1-2 cun is Boil (Jie); 2-5 cun is Carbuncle (Yong); 5 cun-1 chi is Carbuncle/Sore (Yong Ju). 1-3 chi involves whole-body suppuration, nine orifices draining. Qi/Blood stagnation from frustrated desires causes this.

High swelling indicates shallow origin; low swelling indicates deep origin. High fever easy to treat; low fever hard to treat.

In May, avoid unripe fruits, peaches, dates to prevent carbuncles/boils.

Sweat in food causes Ding sores/carbuncles/boils.

Sweat in food covered by copper vessels causes malignant sores/internal sores.

Raw carp with pork liver/lung causes sores.

Drunk overeating causes sores.

*Yi Men Fang* states: Back carbuncles should be high. High means superficial floating; even if suppurating, many recover. Low/deep swelling implies deep pus invading inward, leading to death.

*Fan Wang Fang* states: Classics say: Zang disharmony causes sores; Fu disharmony causes carbuncles. Urgent sores include: 1. Biao Ju (fatal in 2-3 days acute, 10+ days chronic). 2. Yong Ju (fatal in 10+ days acute, 1 month chronic). 3. Huan Ju (fatal in 1 year acute, years chronic). 4. Shui Ju (hands/feet, treatable for years). Dozens of sores exist. Carbuncles in slow areas don't kill; dangerous areas require immediate resolution. Small pus treatable; large pus disastrous. Dangerous spots: 1. Naohu (below Yuzhen); 2. Tongue base; 3. Uvula; 4. Neck segments; 5. Hu Mai; 6. Five Zang Shu; 7. Five Systems; 8. Breasts; 9. Xinqiuwei; 10. Yuji; 11. Intestinal curves; 12. Posterior small path; 13. Nine orifices; 14. Hypochondrium/abdomen; 15. Spirit residence. Forty-five spots must not be injured, especially sores. If carbuncle hits these, good doctor may save before large pus; large pus brings harm.

Carbuncle pulse:洪粗 (Surging/Rough) hard to treat; 微涩 (Fine/Choppy) easy to heal. Floating-rapid pulse with aversion to cold (instead of fever) indicates carbuncle.

Carbuncle starting at joints, treated by incompetent doctors leading to large pus, cannot be saved by ointments.