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Fugu Ju (Periosteal Abscess) is a condition where toxic heat deeply adheres to the interstices of the bone, causing unceasing pain. It is further divided into three types: one is Huan Ju (Slow Abscess), two is Shi Ju (Stone Abscess), and three is Fugu Ju (in the narrow sense). All these conditions arise because the body's healthy Qi is deficient, allowing pathogenic "Zei Wind" (thieving wind) to invade, compounded by prolonged treatment failure and delay. The Classics state: "All diseases enter when there is deficiency." In the initial stage of Zei Wind invasion, there is pain, but the skin is not significantly hot; the pulse is deep and slow; there is slight aversion to wind, spontaneous sweating, a preference for warm compresses, and pain is slightly relieved by warmth. At this stage, it is appropriate to administer Yin Yue Pi Shui Tang (Yin-Yue Ma Huang Decoction) for treatment. However, typical Fugu Ju presents with ceaseless pain, or chills and fever without sweating. If left untreated for a long time, extreme Yin generates Yang, transforming cold into heat, which eventually leads to suppuration and ulceration.

Huan Ju (Slow Abscess) features a slow onset of heat, failing to ulcerate for months or even half a year. After prolonged delay, the color turns purple-black, and both skin and flesh rot, hence the name. Shi Ju (Stone Abscess) also involves alternating chills and fever, with pathogens lying deep in the bone marrow; it presents with swelling and pain that are hard as stone, hence the name. The treatment for both should prioritize tonifying and expelling toxins using formulas supplemented with Aconite Radix Preparata (Fuzi, 附子). Since Aconite is warm and hot in nature, it can dissipate cold-induced pain within the bones. When applied correctly in clinical practice, its efficacy is miraculous.

When a Chuang Yang (Sore and Ulcer) has formed pus, it indicates that flesh has rotted into pus due to toxic erosion and ulceration. If the pus is not drained promptly, the accumulated toxin may invade and destroy healthy tissue. Especially in joint areas such as the elbow and knee, this can lead to destruction of tendons and bones, resulting in disability. Some patients fear acupuncture/needle drainage, often leading to untreatable conditions. Or, if punctured, the pus does not drain freely. I now present Sai Zhen San (Needle-Competing Powder), which is highly effective for rapid pus drainage. The formula is recorded below for reference. Keep this secret.

In cases of Yong Ju (Carbuncle and Malignant Tumor) relying on toxicity, as well as Yangmei Jiedu (Chancre/Syphilitic Gumma), Xiahang Chuang (Chancroid), Biandu (Inguinal Bubo), and Ding Chuang (Malignant Furuncle), there is often necrotic tissue (Si Rou, 死肉) remaining that corrodes healthy flesh, causing unbearable pain. If not removed early, the decay worsens. This is described as being as vicious as wild wolves and tigers, and as toxic as snakes and scorpions, threatening life and potentially becoming incurable. One must assess the urgency and size of the necrotic tissue. Large necrotic pieces may be excised with needles or knives; smaller amounts can be treated with Furou Dingzi (Necrotic Flesh Pellets), powdered medicines, or plasters, aiming for a flat, level surface. Subsequently, apply medicines to promote granulation and tissue regeneration. Internally, administer Da Bu Tang Wan (Great Tonification Decoction/Pills) until recovery. Vulgar practitioners of the world only know superficial applications of granulation-promoting drugs as miraculous, unaware that retained necrotic tissue causes harm and exacerbates decay. If necrotic tissue is not completely removed, healing cannot occur. Study this carefully.