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The *Mai Jue* (Pulse Classic) states: When various pulse qualities are floating and rapid, fever should occur; if there is no fever but instead aversion to cold, with painful areas on the body, an abscess (Yong Ju) will certainly develop.

It further states: A slippery and rapid pulse indicates heat for the rapid quality and excess for the slippery quality. The slippery pulse governs Ying (Nutrient) Qi, and the rapid pulse governs Wei (Defensive) Qi. When Ying and Wei Qi meet and knot together, an abscess forms. It also states: If a rapid pulse appears intermittently, malignant sores will arise.

Zhu Danxi stated: Regarding symptoms of abscesses and carbuncles that involve pain, both cold and heat, deficiency and excess can cause pain. For pain caused by cold knotting, warm and hot agents should be used to dissipate it; for pain caused by heat knotting, clear the heat; for pain caused by dampness obstruction, dry the dampness; for pain caused by blockage, unblock and dredge; for pain caused by Qi stagnation (Fu Yu), open and disperse the depression; for pain caused by foul flesh, remove the necrotic tissue; for pain caused by disharmony between Yin and Yang, harmonize them. Do not indiscriminately use cooling medicines to congeal the blood. Moreover, blood vessels prefer warmth and dislike cold; if cold qi is depressed internally, the disease will be difficult to treat.

First, when a sore or ulcer initially develops, presenting with swelling, redness, pain, fever, constipation, and a deep and solid pulse, purgation is indicated. Formulas include Huanglian Neishu Tang (Coptis Internal Purging Decoction), Danggui Lianqiao Yin (Angelica and Forsythia Drink), Qingliang Yin (Cooling and Refreshing Drink), and Shenxian Jiuku Dan (Immortal's Pain-Relieving Pill).

Second, when a sore or ulcer initially develops with slight swelling, bodily stiffness and fatigue, and aversion to cold, Shixuan San (Ten Acupoints Powder) and Tuoli San (Supporting the Interior Powder) are indicated.

Third, when an abscess or carbuncle first appears, showing millet-like papules on the head, itching, or numbness, this indicates abundant pathogenic factors. Moxibustion with garlic partition (Ge Suan Jiu) may be used.

Fourth, when a sore or ulcer is swollen, elevated, painful, and the pulse is floating, supporting the interior to expel toxins is indicated. Formulas include Neituo Qianjin San (Inner Support Thousand Gold Powder) and Xianfang Huoming Yin (Immortal Formula Life-Saving Decoction).

Fifth, for swelling and pain in the neck and back without a visible head, Neituo Liqi Yin (Inner Support Moving Qi Decoction) is indicated.

Sixth, when an abscess or carbuncle is swollen, elevated, red, and painful, it belongs to the Yang pattern and is easy to treat. Cooling and detoxifying agents are indicated.

Seventh, when an abscess or carbuncle is flat and depressed, white in color, with stiffness and fatigue but little pain, it belongs to the Yin pattern and is difficult to treat. Tonifying and supporting the interior to expel toxins is indicated, such as Tuoli Wenzhong Tang (Supporting the Interior and Warming the Middle Decoction).

Eighth, when a sore or ulcer has not yet ruptured and toxic heat attacks the Zang-Fu organs, hot-natured medicines should not be used excessively. The treatment should focus on clearing damp-heat, supporting the interior, and detoxifying.

Ninth, at the initial stage of a sore or ulcer, encircling drugs (Gu Yao) should be applied to contain the swelling. After rupture, Wulong Gao (Black Dragon Ointment) and encircling drugs are indicated.

Tenth, when a sore or ulcer presents with fever, restlessness, and thirst, Huang [Qin] Zhuye Tang (Scutellaria and Bamboo Leaf Decoction) is indicated. *(Note: Original text "Huang" implies Scutellaria based on standard formula names).*

Eleventh, when a sore or ulcer persists without rupturing and pus does not emerge, internal support and strong tonification are indicated to promote spontaneous rupture of the pus. Lafan Wan (Beeswax and Alum Pill) is indicated.

Twelfth, when an ulcer presents with fever and vomiting, Jiedu Huxin San (Detoxifying Heart-Protecting Powder) is indicated.

Thirteenth, when a sore or ulcer initially develops with redness, swelling, bodily fatigue, and fever, mild diaphoresis should be induced to vent the toxic qi. Fangfeng Tongsheng San (Saposhnikovia Unblocking the Exterior Powder) or Jingfang Baidu San (Schizonepeta and Saposhnikovia Resolving Toxin Powder) are indicated.

Fourteenth, when pus is formed and hot in an abscess or carbuncle, it should be punctured quickly with a needle. Furthermore, supportive and tonifying therapy is essential; otherwise, the pus may invade deeply, making the condition difficult to treat.