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Internal resolution through exterior-releasing dispersion possesses miraculous efficacy; it is most effective when both the pulse and symptoms indicate excess patterns. When both pulse and symptoms indicate deficiency patterns, tonification should be combined. In cases of thirst and constipation, prompt unblocking and purging are essential. Clear heat and detoxify, invigorate qi and blood, and further determine which meridian the affected area belongs to. Add channel-guiding herbs to the primary treatment formula; once the toxin is eliminated, the flesh will naturally heal.

[Note] Ancient texts state: "Exterior-releasing methods do not distance themselves from hot-natured substances." It also states: "Sweating leads to the healing of sores." Hence, it is said that internal resolution via exterior-releasing dispersion has miraculous effects. This method is applicable only when both pulse and symptoms indicate excess patterns. If pulse and symptoms indicate deficiency patterns, tonification should be employed concurrently. In cases of thirst and constipation, urgent unblocking and moving stagnation are required; one must not indiscriminately apply exterior-releasing formulas. Carbuncles and sores are caused by the coagulation of qi and blood and excessive fire-toxin. Therefore, the main treatment focuses on clearing heat, detoxifying, promoting qi circulation, and activating blood. One must carefully examine the location to determine the involved meridians and use channel-guiding herbs for treatment, so that swelling and pain will subside naturally, and the flesh will heal.

When a sore has formed but fails to protrude and produces no pus, appearing hard, non-red, or painless, with scanty thin pus and an unhealed wound, this indicates qi and blood deficiency. One should greatly tonify qi and blood to harmonize Ying (Nutritive) and Wei (Defensive) Qi, assisted by herbs that dispel toxins and move stagnation. For cold patterns, add warm-hot herbs to ward off wind-cold. Once swelling subsides, pus drains, and necrotic tissue falls away, new flesh grows and the wound closes, demonstrating the efficacy of internal support (Nei Tuo).

[Note] Whenever a swelling has formed but cannot protrude or suppurate, or appears hard and swollen without redness and pain, or presents with scanty thin pus and an unhealed wound, these are signs of qi and blood deficiency. The treatment should prioritize greatly tonifying qi and blood and harmonizing Ying and Defensive Qi as the sovereign herbs, with toxin-dispelling herbs as assistants. Add acrid-aromatic herbs to resolve stagnation and warm-hot herbs to resist wind-cold. Once pus drains, swelling subsides, and necrotic tissue is completely removed, and qi and blood are sufficient, new flesh will naturally grow.

For carbuncles and sores before suppuration, moxibustion is most beneficial, and taking internal support formulas ensures safety. If accompanied by fever, aversion to cold, and body stiffness without sweat, exterior-releasing methods yield the best results. If the area is swollen and hard, with dry mouth and constipation/urinary retention, purgative and draining herbs cool the toxic heat naturally. If pain and heat are severe with irritability, thirst, but normal bowel movements, clearing-heat herbs bring auspicious outcomes. If internal pus does not emerge and necrotic tissue blocks the wound, surgical incision is appropriate. If the area is soft and flat without pus or necrosis, it indicates yang deficiency, and warming-tonifying herbs should be used to generate yang. After ulceration, if new flesh grows slowly and appears pale like frostbite, increase the dosage of warm-hot herbs for good fortune. For profuse sweating leading to collapse of yang, use Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction); for spontaneous sweating and cold limbs, use Sini Tang (Four Reversal Decoction). For spleen deficiency after ulceration, characterized by emaciation, thin pus, sallow complexion, insomnia, fever, loose wounds, poor appetite, thirst, and loose stools, take clear-tonifying and spleen-supplementing formulas; matching the prescription to the syndrome guarantees safety.

[Note] In treating carbuncles and sores, regardless of yin/yang or exterior/interior differentiation, and regardless of duration, moxibustion is suitable as long as pus has not formed. For swelling with fever and floating pulse, internal support herbs are indicated. For tight pulse, fever, aversion to cold, and generalized stiffness without sweat, exterior-releasing herbs are indicated. For hardness, dry mouth, and obstructed urination and defecation, purgative herbs are used to drain toxicity. For deep-seated painful heat, irritability, preference for cold drinks, dry mouth and tongue, but normal stool, clearing-heat herbs are indicated. For internal pus retention blocked by necrotic tissue, surgical incision is required. For soft, flat areas without pus or necrosis, indicating yang deficiency, warming-tonifying herbs are used to generate yang. For slow new flesh growth after ulceration with a frost-like appearance, indicating cold flesh and muscle, warm-hot herbs should be doubled. For incessant sweating indicating collapse of yang, herbs such as Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) are used. For spontaneous sweating and cold extremities, Sini Tang (Four Reversal Decoction) is used. For post-ulceration muscle wasting, thin pus, sallow complexion, indicating spleen deficiency; insomnia and fever, indicating deficient fire flaming upward; loose and dilated wounds, indicating sinking qi and insecurity; poor appetite, thirst, and loose stools, indicating spleen deficiency with heat—all these require clear-tonifying and spleen-supplementing herbs.