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Ganzhu Dan (Cinnabar Pearl Pill), Weisheng San (Health-Preserving Powder), Guijin Wan (Noble Gold Pill), Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder, a formula to tonify qi and blood and expel toxins), Jiadi Dihuang Wan (Modified Rehmannia Pill), Jiangzhu Gao (Crimson Pearl Ointment) (all formulas mentioned in the first volume). Huanglian Xiaodu Yin (Coptis Decoction for Detoxification) (see Head section). Chansu Wan (Toad Venom Pill), Chansu Tiao (Toad Venom Strip) (see Ding [Carbuncle] section). Futie Yao (External Application Paste) (refer to first volume for use). Jiu Fa (Moxibustion Method) (see Moxibustion section in the first volume).

A man suffered from a neck carbuncle for more than ten days. The condition was severe, with the root of the lesion extending to the ear and neck, presenting with redness, swelling, heat, and a floating, rapid pulse. After taking two doses of Huanglian Xiaodu Yin, the major symptoms subsided slightly. Subsequently, several doses of Tuoli Xiaodu San were administered, but the wound failed to suppurate and ulcerate. The pulse remained floating and weak, indicating damage to the primordial qi. The treatment could only promote the elevation of the abscess head but failed to generate pus. Therefore, Shiquan Dabu Tang (Ten Great Tonifying Decoction) was prescribed with added Jiegeng (Platycodon Root), Baizhi (Angelica Dahurica), and increased amounts of Renshen (Ginseng) and Huangqi (Astragalus) powders by three qian each. Externally, the Sangchai Hong Fa (Mulberry Wood Fire Roasting Method) was applied twice daily, morning and evening. Jiangzhu Gao was applied for several days. At this stage, the patient's head and face became severely swollen, eyes tightly shut, creating a terrifying appearance. Eventually, the tissue necrosed and ulcerated simultaneously, discharging several sheng of pus daily. Nearly half a month later, the patient developed five-palm heat, irritability, and loss of appetite due to insufficient tonic efficacy. Although the pathology changed, it did not preclude further treatment. One dose of Shengyu Tang (Holy to Save Decoction) was given without effect. A second dose was administered with the addition of Shu Fuzi (Prepared Aconite Root) by two qian, which finally took effect, resolving all previous symptoms. Then, Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) was prescribed with added Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry), doubling the dosage of Renshen and Baizhu (Atractylodes Macrocephala Rhizome) to three qian each. Over a month later, necrotic tissue and hair detached in sheets, leaving a messy state. To prevent delayed tonification, three qian of Renshen were added to his daily porridge, divided into several meals and cooked together. Gradually, the primordial qi recovered, and after four months of regulation, he healed.

Another man developed a lateral neck carbuncle. He underwent moxibustion with garlic slices for fifteen moxa cones, stopping when pain was felt. However, internal medication was neglected. Four days later, the area became purple, swollen, numb, and painful, accompanied by constipation and a solid pulse. Neishu Huanglian Tang (Internal Draining Coptis Decoction) with two qian of Xuanmingfen (Mirabilite) was used to unblock bowels and drain heat. Two doses of Xiaodu Jiuku Tang (Detoxifying and Suffering-Relieving Decoction) followed, but swelling persisted. This indicated that internal toxins were manifesting externally; thus, further draining was contraindicated. Tuoli Xiaodu San was switched to. By the twentieth day, due to the patient's obesity and tight external flesh, suppuration failed to occur. Needling for drainage was proposed, but the patient strongly resisted. Later, he experienced restlessness, confusion, and unconsciousness, signaling a complication. Immediately, a Beizhen (Be Needle, a surgical knife/needle) was used to create openings at both ears and the vertex. Necrotic tissue within the abscess was excised about one cun long, releasing approximately one bowl of pus and blood. Tonifying herbs for spleen and blood were administered. Pus flowed like a spring, with six to seven qian of medicine taken with food morning and evening until necrosis resolved and new tissue grew. More than forty days later, the patient gradually regained consciousness. If needling had been forbidden and strong tonics withheld, survival would have been rare.

A third man had a neck carbuncle for five to six days, initially with a flat, spreading base. Five days later, the lesion became hard, the base widened, and toxic factors spread over both shoulders to the anterior neck, causing chest and breast swelling, vomiting, nausea, alternating chills and fever, and anorexia, presenting a dire situation where herbal power alone was insufficient. Old medicines were washed off with scallion water. Ba Tong (Suction Cupping) was performed at two sites, extracting about one bowl of stasis blood. Silver needles were inserted obliquely into the base to penetrate multiple areas at the bottom of the lesion. Chansu Tiao strips were inserted into the holes to detoxify and promote suppuration. The area was covered with ointment. Warm herbs were applied to areas where toxicity dispersed. Day by day, the condition improved, and toxicity receded to the original site. Internal medications to support the interior, clear fire, and resolve phlegm were taken. Within three to four days, the major symptoms subsided, and internal pus drained freely. Shiquan Dabu Tang was then administered. For hard lesions that do not soften, apply this method; for necrotic but painless areas, extract them; for slow granulation, nourish them. With such regulation, healing occurred in three months.

A sixty-year-old woman, constitutionally weak, presented with a carbuncle head the size of millet. Fortunately, her body was not obese, suggesting that although the onset was adverse, it would likely ulcerate easily. She underwent garlic-slice moxibustion, followed by application of Chansu Bing (Toad Venom Cake) on the moxa site, and Xidu San (Poison-Sucking Powder) around the periphery to consolidate the base. Internally, Tuoli Xiaodu San was taken. After several doses, the lesion hardened, causing severe pain. Her pulse was fine, rapid, and weak, indicating internal deficiency preventing toxin resolution and suppuration, with pain as the primary symptom. Yiqi Yangrong Tang (Qi-Nourishing and Harmony-Decoction, effectively a tonifying formula) was prescribed with added Zaoci (Gleditsia Spine) and Baizhi. After three doses, swelling began to rise. Mulberry wood roasting was used, softening the hardness. Pus was thick but scant. Zaoci and Baizhi were removed from the prescription, and Xiangfu (Cyperus Rhizome) and doubled Renshen were added. After several more doses, pus discharged. Pain persisted post-ulceration. Three days later, nearly half the necrotic tissue detached. Rufang Dingchuang San (Frankincense Stabilizing Wound Powder) was given, relieving pain after one dose. The wound closed in dozens of days. Success depended on the physician's skill in assessing difficulty, timing of necrosis vs. granulation, and appropriate tonification.

A young, obese woman developed a neck carbuncle with a high apex and mobile base. She desired internal resolution. Herbal internal treatment failed, so needling was employed. A Be Needle was inserted vertically into the center to a depth of six or seven fen, stopping at soft tissue. Stasis blood was removed, Chansu Tiao inserted, and Chansu Wan administered. Profuse sweating ensued, leading to resolution. The next day, slight pus appeared, and swelling decreased. Anti-inflammatory and heat-clearing herbs were taken, resulting in recovery within ten days. Generally, to eliminate carbuncle toxins, one must first cut off the root, then drain toxic factors, ensuring they diminish daily to prevent internal invasion.

A man had a carbuncle behind the ear for nearly half a month. The base enlarged, the head exuded foul bloody fluid, surrounding skin was purple-black, sunken and devoid of pus. His complexion was pale, nose tip black (sign of spleen failure), hands cold, breathing short, and pulse scattered, large, and rootless. This indicated internal collapse. It was deemed untreatable. He died shortly after. Those suffering this condition, regardless of robust physique, will inevitably perish upon collapse.

A woman with a duikou carbuncle (posterior neck carbuncle) self-moxibusted for over twenty cones without pain. The moxa scars were black and flat. Pulse was fine, rapid, and weak, indicating internal deficiency. Relying solely on herbs would delay treatment. A Be Needle was inserted one cun deep at the apex. No pain or blood was observed, indicating stagnant toxin not yet manifesting. Chansu Tiao was inserted and covered with ointment, once daily. Seven days later, cracks formed around the perimeter, discharging pus. Internal tonics were taken. By the fourteenth day, the base detached. Jiangzhu Gao was applied. Half a month later, the wound flattened. Zhenzhu San (Pearl Powder) was sprinkled to regenerate skin, leading to cure. Without needle intervention and relying only on herbs, while death might be avoided, rapid recovery would be impossible.

A forty-year-old, very obese woman had a neck carbuncle for five to six days. The muscle was swollen but the wound surface was not (indicating depressed apex). She had dry mouth and irritability (internal pathogenic fire). The lesion was hard, purple, and dark (blood death and toxin stagnation preventing suppuration). The base was flat and spreading (internal qi failure unable to contain toxin). The six pulses were surging and large (toxic factors overpowering healthy qi). This was an excess condition destined for non-suppuration, sinking, internal invasion, and death. Treatment was declined. She subsequently died.