Library

In the chest and abdomen of a human being, there are eleven Mu-Collector points (Mu points, sites where Zang-Fu organ Qi converges). The *Ling Shu* states: For those developing internal carbuncles (internal abscesses) or internal gangrenous sores, the flesh over the Mu point of the corresponding primary meridian must be swollen and puffy, and there must be intermittent dull pain at the Mu point. Swelling indicates a carbuncle, while dull pain indicates a gangrenous sore; this is the diagnostic criterion for internal carbuncles and internal gangrenous sores. Herein, treatment methods are provided for internal carbuncles but not for internal gangrenous sores. Why? Essentially, the etiology of internal carbuncles and internal gangrenous sores is identical; the distinction lies only in the depth of the lesion. A superficial lesion is a carbuncle, whereas a deep-seated one is a gangrenous sore. If, during clinical practice, the use of purgative and tonifying herbs is appropriate, efficacy can invariably be achieved. Regarding the eleven Mu points, why are there only nine types of internal carbuncles? This is because the Gallbladder resembles a membranous sac, lacking functions of excretion and reception; its bile is clear and pure, thus it does not generate internal carbuncles or gangrenous sores. Similarly, the Bladder is like a membranous sac containing only turbid urine; therefore, ancient and modern texts do not discuss internal carbuncles or gangrenous sores related to it, so I dare not record them in detail. Although Zhongji (CV3, Bladder Mu-Collector Point) is the Mu point of the Bladder, when people today present with swelling or dull pain at Zhongji, the symptoms manifest identically to Small Intestine Carbuncle, and the treatment should follow that for Small Intestine Carbuncle. Let future scholars pay attention to this.

Whenever encountering a person suffering from an internal carbuncle, have them chew five raw soybeans. If there is no bean odor in the mouth, this is a sign of the condition.

Shoulder gangrenous sores: Carbuncles arise in the center of the shoulder; gangrenous sores are hard, black, and sunken, while carbuncles are red and swollen. Dry gangrenous sores occur anterior to the shoulder, and trans-shoulder gangrenous sores occur posterior to the shoulder; these result from the accumulation of wind-dampness and heat, along with blood stasis coagulation.
[Note] This type of sore arises on the medial aspect of the shoulder, belonging to the Sanjiao and Gallbladder meridians. When red, vibrant, and highly swollen, it is also called Ci Yong (Cicada Carbuncle); if hard and flat, it is termed Jianzhong Ju (Shoulder-Center Gangrenous Sore). The anterior medial aspect of the shoulder belongs to the Large Intestine meridian and is named Gan Ju (Dry Gangrenous Sore), also known as Ding Ju (Ding Gangrenous Sore). The posterior medial aspect of the shoulder belongs to the Small Intestine meridian and is named Guoshan Ju (Trans-Shoulder Gangrenous Sore). Regardless of size, the name is derived from the site of origin. These generally arise from the constraint of damp-heat and wind pathogens, or from blood stasis coagulation due to carrying heavy loads. High swelling with redness and vitality, accompanied by rapid ulceration upon fever, indicates a favorable course (Shun); flat, hard lesions without redness or heat, with delayed ulceration, indicate a dangerous course (Xian); severe cases involve swelling and pain radiating to the arm and scapula, trismus with chills, severe pain preventing eating, or slow ulceration with diarrhea, indicating an unfavorable course (Ni). Treatment methods: In the initial stage, if exterior syndrome is present, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Overcome Toxicity) should be used to induce sweating; if interior syndrome is present, Neishu Huanglian Tang (Internal Draining Coptis Decoction) should be used to purge downward. After sweating and purging, if swelling and pain persist and pus is about to form, Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) should be used to promote pus discharge; once the pus is ripe, incision and drainage should be performed. As for guiding herbs, they should be selected according to the specific meridian involved during clinical practice. After ulceration, both internal and external treatments follow the protocols in the Chapter on Ulcerated Carbuncles and Sores.