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Liu Zhu (Flowing Abscess) is mostly caused by emotional depression, sudden rage, or spleen deficiency leading to dampness counterflowing into the muscle tissue. It may also result from loose cou li (skin pores and interstitial spaces), allowing cold pathogenic factors to lodge in the meridians; from sprains or falls; from postpartum blood stasis flowing into joints; or from residual pathogens of Shang Han (Cold Damage Disease) not yet fully resolved. All these occur because of insufficient healthy Qi, allowing pathogenic factors to take advantage of the deficiency. The general treatment principles are: for depression, use opening methods; for rage, use calming methods; for sprains and postpartum blood stasis, use dispersing methods; for spleen deficiency and loose cou li, use gradual tonification; for residual Shang Han pathogens, use harmonizing and resolving methods. The main strategy is to consolidate Yuan Qi (Original Qi), assisted by herbs addressing specific manifestations. If the sore remains cold after a long duration, moxibustion with fermented soybean cake or Aconite cake should be applied. If there are sinus tracts or residual blood stasis, using needle heads to remove necrotic tissue and applying锭zi (medicated plasters/pills) is particularly effective. If Blood and Qi are not supplemented, and if diet, daily routine, and Seven Emotions (Joy, Anger, Worry, Overthinking, Sorrow, Fear, Fright) are not managed carefully, the condition will not heal.

For cases caused by depression without pain, regulating the meridians and tonifying Blood and Qi is appropriate. For swelling, hardness, and pain, promoting Qi movement and invigorating Blood is indicated.
For ulcers that fail to heal, tonifying and benefiting Qi and Blood is primary.
For residual Shang Han pathogens, harmonizing and resolving is indicated.
For chest and diaphragm discomfort caused by sudden rage, regulating Qi is primary.
For spleen deficiency with damp-heat condensing in the muscle tissue, strengthening the spleen and removing dampness is primary.
For patients with blood stasis condensation due to sprains, activating Blood and Qi and regulating the meridians is indicated.
For invasion by cold pathogenic factors causing tendon spasms, bone pain, or generalized body pain, warming the meridians and nourishing Blood and Qi is indicated.

One patient suffered hypochondriac pain due to anger and was cured using Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Si Wu Tang (Four Substances Decoction), augmented with Qing Pi (Aurantii Fructus Immaturus), Jie Geng (Platycodonis Radix), and Zhi Ke (Aurantii Fructus).
Another patient suffered hypochondriac swelling and pain with chest/diaphragm discomfort and a deep, slow pulse. After taking Fang Mai Liu Qi Yin (Pulse-Based Qi-Flowing Drink) for several doses with slight improvement, they took Xiao Chai Hu Tang for twenty doses and recovered.
A female patient had shoulder swelling and generalized body pain due to a sprain. Pain ceased after two doses of Hei Wan Zi (Black Pills). Swelling subsided after two doses of Fang Mai Liu Qi Yin. She was finally cured using Er Chen Tang (Two-Cured Decoction) combined with Si Wu Tang, augmented with Xiang Fu (Cyperus Rhizome), Zhi Ke, and Jie Geng.
A female patient suffered tendon spasms and bone pain in the leg, unresponsive to other medicines, with a slow and tight pulse. Da Fang Feng Tang (Major Saposhnikovia Decoction) worked after two doses, bringing stability after another two doses.
One patient had Liu Zhu in the leg that ulcerated but failed to heal. Ren Shen Yang Rong Tang (Ginseng Nourishing荣 Decoction) was used, along with moxibustion using Aconite cake. A tonic paste was applied externally. Recovery occurred after two months.
One patient with inherent weak spleen Qi had a non-painful arm swelling with unchanged skin color and reduced appetite, persisting for half a year without suppuration. Liu Jun Zi Tang (Six Gentlemen Decoction) plus Xiong Gui (Ligusticum and Angelica) and Shao Yao (Peony) was administered for over twenty doses, improving appetite. Moxibustion with Fermented Soybean Cake was applied daily. Huang Qi (Astragali Radix) and Rou Gui (Cinnamon Bark) were added to the herbal formula for thirty doses until pus matured. After needle drainage, Shi Quan Da Bu Tang (Ten Great Tonics Decoction) and Aconite cake moxibustion led to healing within a month.
One patient had leg swelling, unchanged skin color, no pain, and a floating, slippery pulse. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Zhi Ke, and Mu Xiang (Aucklandiae Radix) was decocted and taken, accompanied by Aconite cake moxibustion. The patient believed "Qi disorders cannot be treated with tonification" and instead took Fang Mai Liu Qi Yin, becoming more deficient. Later, Liu Jun Zi Tang plus Xiong Gui was used for several doses, slightly improving appetite. Continued tonic therapy led to resolution after over a month.
One patient had arm swelling, tendon spasms, and bone pain, ulcerating only after over a year and failing to heal. The pulse was even more deficient. Nei Sai San (Internal Obstruction Powder) improved the condition slightly after one dose. Shi Quan Da Bu Tang and Aconite cake moxibustion led to recovery.
One patient with physical exhaustion and weak Qi had slight back/arm swelling. Yi Qi Yang Rong Tang (Benefit Qi and Nourish荣 Decoction) was taken intermittently with Hei Wan Zi. A cake made of Mu Xiang and Sheng Di Huang (Rehmanniae Radix) was applied topically with heat. Pus formed after a month, was drained by needle, and the patient recovered with continued medication.
One patient had an arm lesion hard for over a year, with poor appetite, morning chills, and evening fevers. Ba Zhen Tang (Eight Treasures Decoction) plus Chai Hu (Bupleuri Radix), Di Gu Pi (Lycii Cortex), and Mu Dan Pi (Moutan Cortex) stopped the fever/chills after a month. Yi Qi Yang Rong Tang and Aconite cake moxibustion followed. Pus formed after two months, was drained, and Ren Shen Yang Rong Tang was taken for half a year until recovery.
One patient with arm Liu Zhu expelled three pieces of necrotic bone but failed to heal, suffering fever, thirst, and a large, floating, choppy pulse indicating dual deficiency of Qi and Blood. Prolonged administration of Qi and Blood generating agents was necessary for preservation. The patient, believing fire toxins remained, used cooling herbs internally and externally, nearly dying from critical condition before seeking treatment. The patient appeared emaciated with a very deficient pulse. Liu Jun Zi Tang plus Xiong Gui was given for a month, improving appetite. Ba Zhen Tang plus Rou Gui was taken for over thirty doses, turning the sore red. Shi Quan Da Bu Tang and external Aconite cake moxibustion led to recovery after over a year.
An elderly patient with unresolved exterior pathogens from Shang Han developed Liu Zhu in the thigh with fever. Ren Shen Bai Du San (Ginseng Detoxifying Powder) stopped the fever after two doses. Xiang Fu cake and Xiao Chai Hu Tang combined with Er Chen Tang, Qiang Huo (Notopterygii Rhizoma et Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Zhi Ke reduced the swelling after several doses.
A female patient with irregular menstruation (once every two or three months), limb swelling, poor appetite, and afternoon fever was diagnosed with Spleen Earth Qi and Blood deficiency. Tonifying the spleen and nourishing Qi and Blood was prescribed. Improved diet would resolve edema, and充盈 Qi and Blood would regulate menstruation. Dismissing this as too slow, she used harsh purgatives to force menstruation, resulting in abdominal pain, continuous diarrhea, generalized edema, reduced appetite, and death during the Wood-dominant month (Spring).