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Meridians: The midline of the spine belongs to the Du Mai (Governor Vessel). The second and third rows on each side of the spine also belong to the Foot-Taiyang Bladder Meridian.

Upper Back Carbuncle (Shang Fa Bei): Arises below the Tianzhu bone (Fengfu, GV16 area). Also known as Spleen Belly Carbuncle (Pi Du Yong). Its shape is broad and transverse like a belly. It belongs to the Foot-Taiyin Spleen Meridian. It is caused by accumulated heat from overconsumption of rich and sweet foods. If it presents with high swelling and bright coloration, and its base does not extend beyond the shoulders, it is a favorable condition (Shun). If the swelling is flat and hard, gradually enlarging and spreading to attack both shoulders, chest, and neck, it is critical. If it is blackish-purple, flat, and sunken, it is fatal. In the initial stage, it is appropriate to resolve the accumulated heat in the Spleen Meridian. Intermittently take Lafan Wan (Wax and Alum Pill) and Huxin San (Heart-Protecting Powder) to prevent internal invasion of toxins. Once pus has formed, the primary treatment must be to support the interior and promote pus discharge. Why? Because supporting the interior leads to survival, while attacking with toxic herbs leads to death.

Middle Back Carbuncle (Zhong Fa Bei): Arises opposite the heart on the back. Also known as Opposite Heart Carbuncle (Dui Xin Fa). It arises from reckless movement of Heart Fire and extreme heat. The swelling is not high or pointed, and the lesion is difficult to rise and discharge. This indicates toxin invading the "ruler's position," which is most dangerous for harming the person. If there is a red halo at the front (chest), it is untreatable. Treatment should focus on greatly reducing Heart Fire and urgently draining accumulated heat. The apex should be punctured with a needle, followed by cupping methods, ensuring that the toxic qi is unblocked internally and externally, discharging through various openings, thus preventing internal invasion. This constitutes a defensive strategy. Maintain this for fifteen days; if no internal complications arise and pus appears, relief is achieved. If after this period complications arise, hardness increases, and no pus forms, it is fatal. Within twenty-two days, early treatment can save three or four out of ten cases.

Lotus Seed Carbuncle (Lian Zi Fa): Protrudes like a lotus seed.
Honeycomb Carbuncle (Feng Ke Fa): Pores resemble a honeycomb.
These two conditions arise at the shoulder blade/humerus joint, or along the spine, or at Xinshu (BL15) and Xinbaoshu (BL44) acupoints. Mild cases present with elongated, high swelling, or unilateral back involvement. Severe cases present with oblique, flat swelling affecting both hypochondria, also known as Half-Body Carbuncle (Ban Shen Fa). Even more severe cases involve extensive growth and swelling/ulceration covering half the body, named Whole-Body Carbuncle (Jing Ti Fa).

Upper Hand-Da (Shang Da Shou): Arises at Feishu (BL13) acupoint, where the shoulder bone moves. Also known as Left-Right Stringing. The left side relates to the Liver, the right to the Lung. It arises from phlegm coagulation, Qi stagnation, and fire depression. Initially, use Gan Zhu Dan (Cyan Pearl Pill) to induce sweating. Next, use Xiaoyao San (Free and Easy Wanderer Powder) to clear heat, combined with Liu Yu Tang (Six Stagnations Decoction) to regulate. After ulceration, use Bazhen Tang (Eight Treasures Decoction) to tonify. The principle is to open stagnation and move obstruction. Avoid using harsh purgative or toxic drugs typical in surgery. Moxibustion at Huiyang (BL35) acupoint, fourteen moxa cones.

Middle Hand-Da (Zhong Da Shou): Arises near Gaohuang (BL43) acupoint. Belongs to the Foot-Taiyang Bladder Meridian. Treatment distinguishes between Yin/Yang and Deficiency/Excess, applying attack or tonification as appropriate. Moxibustion at Xinshu (BL15) acupoint, seven moxa cones, sized like mung beans.

Stringing Abscess (Chuan Ju): Arises in three or four locations between the back and hypochondrium. Skin color remains unchanged or shows slight redness. Pain radiates/tractions, and the interior is actually connected. Hence also known as Mouse Gathering (Lao Shu Zan) or Wandering Blood (You Zou Xue), which is Spleen Abscess. It is caused by accumulated resentment/anger.

Yin-Yang Two-Qi Abscess (Yin Yang Er Qi Ju): Its shape fluctuates between swelling and flattening, softness and hardness. Chills and fever occur intermittently, localized to one spot, unlike the migratory nature of Stringing Abscess. It is caused by internal depression of the Seven Emotions.

Alcohol-Toxin Carbuncle (Jiu Du Fa): Initially appears like a bean, then enlarges to fist size, hard as stone, numbness varies. Severe cases cause pain penetrating the five viscera, general stiffness, and difficulty in urination and defecation. After several days, puffiness occurs in the head, face, hands, and feet, accompanied by visceral diarrhea and dysentery.

Pearl-String Carbuncle (Lian Zhu Fa): Three to five lumps swell continuously, shaped like threaded pearls. Internal pain affects all joints, lower abdomen distends, urination stops, scrotum swells. Caused by excess alcohol and sexual indulgence.

Erysipelas Carbuncle (Dan Du Fa): Initially small red spots appear, spreading over a chi. Shape resembles burns/scalds. Caused by taking harsh, dry cinnabar/stone elixirs. Thirst is prominent. Treatment uses Lafan Wan (Wax and Alum Pill) and Guolao Gao (Licorice Paste), which are essential medicines. If skin becomes dark, spirit is confused, pulse is dry, abdomen distends, and vomiting occurs, it is untreatable.

Bird Abscess (Qin Ju): Initially purple spots resembling rashes appear in dozens, shaped like bruises from punches. If chills, fever, and trismus occur within seven days, it is untreatable.

Note on the above conditions: External manifestation leads to survival; internal sinking leads to death. Although the appearance may be terrifying, elderly and weak patients often survive. Conversely, although small, abnormal lesions can kill even strong and young patients. The general rule fears non-pure Yang patterns; treatment methods need not fear severe local conditions.

Phlegm-Deposit Carbuncle (Tan Zhu Fa): Shape like a cloth bag, hard as stone, neither red nor hot. Caused by latent phlegm accumulating over time.

Cucumber Carbuncle (Huang Gua Yong): Shape resembles a cucumber, about one cun high and one chi long. Also known as Meat Turtle (Rou Gui). Skin color unchanged, pain radiates to the heart, limbs are numb. Both of the above conditions are mostly untreatable.

Summer Heat Ulcer (Xia Yue Shu Yang): Generally, carbuncles and abscesses have fever at specific times, worsening at dusk and stopping in the morning. Those caused by summer heat have fever without specific timing, persisting day and night. However, summer heat symptoms must be present, such as dizziness, dry/bitter mouth, irritability, back heat, and limb fatigue. Externally, initially a red halo appears on the back, followed by swelling and pain. Treatment should use Baidu San (Resist Toxin Powder) added with Huo Xiang (Patchouli), Huang Lian (Coptis), Shi Gao (Gypsum), etc., to clear heat. Once summer heat resolves, swelling subsides naturally. For robust individuals, Huai Hua Mo (Sophora Flower Powder) mixed with honey into blocks, taken with yellow wine, is also effective.

Miasma Abscess (Zhang Ju): Caused by prolonged exposure to mountain miasma vapors. Initially presents as black swelling, color like boot leather, stubborn pain penetrating bone, hard as stone. By the fifth to seventh day, swelling increases, color turns green, shape like a punch bruise, chills like malaria. Wind symptoms must appear, such as head tremor, facial deviation, and cold extremities. Treatment requires urgent incision to drain three to five sheng of clear blood, followed by the discharge of yellow pus and white fluid. If the skin does not soften and pain/swelling persists until color fades, the condition improves. The key is urgently driving out pus and toxins externally, rendering it harmless.

Postpartum Carbuncle/Abscess (Chan Hou Yong Ju): Postpartum treatment should support deficiency, eliminate stasis, and greatly tonify blood and Qi. Regardless of other diseases, they should not be treated prematurely. Now, carbuncles arise from blood stasis coagulation. Use Shenghua Tang (Generate the New Decoction) added with Lian Qiao (Forsythia) 1 qian, Fen Hua (Trichosanthes Root) 1 qian, Gan Cao (Licorice) 8 fen. For nausea and irritability, add Ru Xiang (Frankincense) 1 qian and Lu Dou Fen (Mung Bean Powder) 3 qian, mixed and taken. Avoid using detoxifying purgatives.

Shenghua Tang (Generate the New Decoction)
Dang Gui (Angelicae Sinensis Radix) (8 qian)
Chuan Xiong (Ligusticum Chuanxiong Rhizoma) (4 qian)
Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (4 fen)
Jiang Tan (Zingiberis Rhizoma Carbonized) (4 fen)
Tao Ren (Persicae Semen, peeled, tip removed, ground to powder, 10 kernels)
Use half a bowl of water, decoct to six-tenths volume, add a little clean wine, mix, and take.