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Leju (Shoulder Carbuncle) arises in the anterior shoulder and above the axilla, specifically within the depression of the bone fissure where opening and closing occur. It is hard like a goose egg, with pain penetrating into the bone, caused by blood heat and qi stagnation in the Pericardium Meridian (Xinbao Jing).

[Note] This condition occurs anterior to the shoulder and above the axilla, in the hollow of the bone fissure. Initially, it resembles a peppercorn, gradually swelling and hardening to the size of a goose egg. Palpation causes pain that penetrates to the bone. This disease belongs to the Pericardium Meridian and is formed by blood heat and qi stagnation. When the condition reaches its term, it will ulcerate and discharge thick pus; if the swelling subsides, it is a favorable prognosis (Shun). If it does not ulcerate after more than a month, or if it ulcerates but discharges clear water while the swelling and hardness persist, it is an unfavorable prognosis (Ni). Initially, Shen Shou Wei Sheng Tang is suitable. If aversion to wind is excessive, add extra Cong Bai (Scallion Stem) to induce sweating, followed by Tuo Li Tou Nong Tang. If ulceration is delayed, Shi Quan Da Bu Tang is used. The internal and external treatment methods after ulceration follow the records in the Ulcerative Stage of Carbuncles and Sores section.

(The area from the shoulder to the elbow is called "Nao".)

(Attachment: Ou Bao Du / Lotus Root Bag Poison)
Yong (Carbuncle) appears around the shoulder and elbow with circumferential swelling, redness, millet-like papules, and stiffness. Ou Bao Du presents as a swelling resembling a duck or goose egg, involving the Hand Three Yin and Hand Three Yang meridians.

[Note] This condition is caused by the conglomeration of wind-warmth or wind-fire. It arises below the shoulder and above the elbow, with diffuse circumferential swelling, redness, and pain. Initially, it resembles a cluster of millet grains, or sometimes a single stiff nodule. It gradually becomes swollen, red, hot, and extremely painful upon suppuration. If there is no halo outside the redness and swelling, it is a favorable prognosis; two halos indicate a dangerous condition; three or four halos indicate an unfavorable prognosis. A solitary swelling arising on either the medial or lateral side, shaped like a peach or a duck/goose egg, is named Ou Bao Du. "Du" refers to a mild form of carbuncle. The internal and external treatments for Yong and Ou Bao Du follow the records in the Swollen Stage and Ulcerative Stage of Carbuncles and Sores sections. Regarding the location of this carbuncle toxin's onset: if it is on the medial side, it belongs to the Hand Three Yin Meridians; if on the lateral side, it belongs to the Hand Three Yang Meridians. Using guiding herbs according to the syndrome will surely yield effective results.