Library

Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (see Scrofula Section), Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment the Qi), Bawei Tang (Eight-Ingredient Decoction), Liujunzi Tang (Six-Gentleman Decoction), Tuoli Xiaodu San (Decoction to Support the Interior and Eliminate Toxins), Guijin Wan (Precious Metal Pill), Moxibustion methods (all see Volume 1).

Guankou Ju (Stork-Mouth Carbuncle) arises at the apex of the high bone of the sacrococcygeal region. It is also known as Rui Ju (Sharp Carbuncle). The *Ling Shu* states: arising in the sacral region, initially resembling a fish's ventriculus, and over time taking the shape of a stork's beak. This condition is caused by the accumulation and binding of damp-phlegm flowing through the Du Meridian (Governing Vessel). Symptoms include morning chills and evening fevers, worsening at night and improving during the day. Upon ulceration, thin pus or fresh blood may flow. It is treatable in young and strong individuals but difficult to cure in the elderly and weak.
For early-stage cases, Ziyin Chushi Tang (Nourish Yin and Dampness-Draining Decoction) is suitable for harmonization.
Ingredients: Chuanxiong Rhizome (Chuanxiong Radix), Danggui Radix (Angelicae Sinensis Radix), Baishao Radix (Paeoniae Radix Alba), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Chaihu Radix (Bupleuri Radix), Huangqin Cortex (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Zhimu Rhizoma (Anemarrhenae Rhizoma), Beimu Bulbus (Fritillariae Thunbergii Bulbus) (each 8 fen); Zexia Herba (Alismatis Rhizoma), Digupi Cortex (Lycii Cortex), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water and three slices of ginger. Decoct until eight fen remains. Take before meals.

Heqi Yangrong Tang (Harmonize Qi and Nourish Ying Decoction) is indicated when the abscess has formed but cannot resolve internally; it is suitable for supporting the interior to expel toxins.
Ingredients: Renshen Radix (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma), Huangqi Radix (Astragali Radix), Poria (Poria Cocos), Mudanpi Cortex (Moutan Cortex), Danggui Radix (Angelicae Sinensis Radix), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Chenxiang Lignum (Aquilariae Lignum Resinatum), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water. Decoct until eight fen remains. Take before meals.

Zishen Baoyuan Tang (Nourish Kidney and Protect Yuan Decoction) is indicated for deficiency of qi and blood with ulcers that fail to heal; it is suitable for tonification.
Ingredients: Renshen Radix (Ginseng Radix), Huangqi Radix (Astragali Radix), Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma), Poria (Poria Cocos), Danggui Radix (Angelicae Sinensis Radix - specifically the body), Duzhus Cortex (Eucommiae Cortex), Shanyurou Fructus (Corni Fructus), Mudanpi Cortex (Moutan Cortex), Shudihuang (Prepared Rehmanniae Radix) (each 1 qian); Rougui Cortex (Cinnamomi Cortex), Da Fuzizi (Aconiti Lateralis Radix Praeparata), Gancao Radix et Rhizoma (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Preparation: Use two zhong of water, three slices of ginger, two dates, and seven lotus seeds. Decoct and take before meals.

If the above conditions are neglected and develop into fistulas over time, Xiantian Dazao Wan (Primordial Great Creation Pill) (see Flowing-Note Section) should be taken, along with Hupo Lafan Wan (Amber Wax Alum Pill) (see Ulcerated Swelling Section). Over time, they will naturally converge and heal.

Zuama Yong (Sitting-Horse Abscess) arises slightly above the sacrococcygeal region. At the onset, moxa should be applied to the lateral end of the transverse bone below the knee. Treatment is the same as for Guankou Ju.

Tun Yong (Gluteal Abscess) arises in the center of the buttocks, located behind the lower abdomen. It belongs to yin within yin. Its location is distant and remote. Although it belongs to the Foot-Taiyang Bladder Meridian, which is rich in blood, qi circulation rarely reaches it, and blood flow is scarce, making healing most difficult. This condition is caused by the coagulation of damp-phlegm.
In the early stage, if there is a head, with redness, heat, heavy dragging sensation, fever, and dry mouth, use Guijin Wan to promote drainage and apply Ganzhu Gao externally. If there is no head and swelling is diffuse with unchanged skin color, use Ganzhu Dan to support the interior, and apply moxibustion with garlic slices. If the major symptoms have subsided but residual swelling remains, frequently apply hot scallion compresses and regulate with Chushi Erchen Tang. When the abscess is mature and suppuration is imminent, use Tuoli Qianghuo Tang. For severe pain, use Shenshou Weisheng San. After the major symptoms subside, use Tuoli Xiaodu San. If it does not resolve, nor suppurate nor heal, it indicates Spleen deficiency; use Liujunzi Tang plus Chuanxiong Rhizome (Chuanxiong Radix), Danggui Radix (Angelicae Sinensis Radix), and Huangqi Radix (Astragali Radix). If due to Spleen deficiency with downward pouring, simply decoct Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma) alone and drink it to resolve spontaneously; do not be confused by whether pus can be expelled. If it does not resolve, accompanied by thirst and dysuria, it indicates Yin deficiency; use Liuwei Dihuang Wan plus Wuweizi Fructus. For ulcers that fail to heal, wash with ginger decoction; for chronic cases, apply moxibustion with fermented soybean cakes.
This condition emerges from the interior to the exterior in eight or nine out of ten cases, while entering from the exterior via the six excess pathogens occurs only one or two times in a hundred. Therefore, treatment should focus on dispersing outward to prevent internal attack. Cases presenting with soft depression without pus, flat and scattered roots without pain, or even dry mouth, irritability, delirium, phlegm-wheezing, and coarse breathing, are caused by the mistaken use of cold-cooling herbs and lack of tonification. These are incurable. The text states: "Without the merit of nourishment and tonification, disaster often follows after scabbing." Thus, it is known that in surgery, cultivating and supplementing Yuan Qi (Original Qi) is the primary task.
There are cases where hemorrhoids were treated with cold-cooling applications and ingestions, leading to ulceration in the gluteal region. The pulse is large and rapid; symptoms include alternating chills and fever, thirst; the wound discharges clear and thin pus. These are signs of deficiency in the Three Yin Meridians and are incurable.