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Only the Yangming meridians have abundant Qi and Blood; the Taiyang and Jueyin meridians have deficient Qi; the Shaoyang and Taiyin meridians usually have deficient Blood. When Blood is deficient, promote Qi to nourish Ying (Nutritive Qi); when Qi is deficient, break stasis and tonify Qi. When both Qi and Blood are abundant, therapeutic success is easily achieved. The Jueyin and Shaoyang meridians contain excessive Xianghuo (Ministerial Fire); if carbuncles or sores occur in these meridians, they are difficult to resolve.

[Note] The twelve meridians of the human body differ in the abundance of Qi and Blood. Abundance facilitates recovery, while deficiency makes healing difficult. Surgeons who understand this can anticipate the progression and difficulty of carbuncles and sores, thereby applying appropriate methods of drug elimination and tonification. For instance, the Hand-Yangming Large Intestine meridian and Foot-Yangming Stomach meridian often possess abundant Qi and Blood; the Hand-Taiyang Small Intestine meridian, Foot-Taiyang Bladder meridian, Hand-Jueyin Pericardium meridian, and Foot-Jueyin Liver meridian often possess abundant Blood but deficient Qi; the Hand-Shaoyang Sanjiao meridian, Foot-Shaoyang Gallbladder meridian, Hand-Shaoyin Heart meridian, Foot-Shaoyin Kidney meridian, Hand-Taiyin Lung meridian, and Foot-Taiyin Spleen meridian often possess abundant Qi but deficient Blood. The general principle is: for abundant Blood, break stasis; for abundant Qi, move Qi. When Qi is deficient, it is difficult to raise pus (Qi-fa), so use Tuo-bu (supporting and tonifying) methods; when Blood is deficient, it is difficult to contract wounds (shou-lian), so use nourishing methods. When both Qi and Blood are abundant, raising pus and wound contraction are easy. Only the four meridians of Hand-Foot Jueyin and Shaoyang have doubled Xianghuo (Ministerial Fire). If carbuncles or sores occur in these four meridians, muscle growth is difficult, and wound closure is hard. Overuse of harsh detoxifying drugs to deplete Qi and Blood will inevitably fail to achieve results. Therefore, understanding the abundance or deficiency of Qi and Blood in meridians prevents the misuse of sweating and purging methods.

Carbuncles and sores originate from Fire-Toxin, causing stagnation of Qi and Blood due to meridian obstruction. External causes include invasion by Six Excesses (Liu-Yin) and Eight Winds; internal causes involve Six Desires and Seven Emotions; improper diet and lifestyle fall under neither-internal-nor-external causes; carrying heavy loads or falls injure the body form; rich foods disrupt Ying and Wei (Defensive Qi), while coarse food leads to exhaustion of Qi and Blood. Ju (Deep Sores) arise in tendons and bones (Yin division); Yong (Superficial Abscesses) arise in flesh and vessels (Yang division); Yang (Ulcers) appear between skin and flesh; Chuang (Sores) and Jie (Boils) appear on the skin surface. Yang excess presents with swelling, redness, and pain, making it easy to treat; Yin excess presents with dark color, depression, and lack of pain, making it difficult to treat. Half-Yin Half-Yang presents with slight swelling, mild pain, and faint redness. Five Good prognoses indicate favorable conditions; Seven Bad prognoses indicate adverse conditions. Observing three good signs suggests survival; observing four bad signs suggests death. Clinicians must carefully examine complexion and pulse, applying warming, cooling, tonifying, sweating, or attacking methods as appropriate. Mastery of treating cold damage and miscellaneous diseases is relatively easier; precision in treating carbuncles and sores demonstrates true expertise.

[Note] The classic states: "All pain, itching, and sores belong to Heart Fire." Thus, carbuncles and sores originate from Fire-Toxin. They arise from deficiency of Ying and Wei, stagnation of Qi and Blood, and meridian obstruction. There are three categories of causes: external, internal, and neither-internal-nor-external. External causes include Wind of Spring, Heat/Summerheat of Summer, Dampness of Late Summer, Dryness of Autumn, and Cold of Winter. When arriving in season, they are righteous Qi; when off-season or excessive, they become pathogenic factors. All diseases caused by the Six Excesses are external. Also included are the Eight Winds: Great Rigid Wind from the North on Winter Solstice; Ominous Wind from Northeast on Start of Spring; Infant Wind from East on Spring Equinox; Weak Wind from Southeast on Start of Summer; Great Weak Wind from South on Summer Solstice; Strategy Wind from Southwest on Start of Autumn; Rigid Wind from West on Autumn Equinox; Breaking Wind from Northwest on Start of Winter. Seasonal winds nurture all things; unseasonal winds destroy them. Infection leads to internal severe disease and external carbuncles/swellings. These Eight Winds are also external causes. Internal causes stem from listening to obscene sounds, viewing lewd sights, smelling foul odors, craving flavors, excessive mental activity, and delusional thoughts, which damage Shen (Spirit). These Six Desires are internal. Additionally, excessive joy damages the Heart, anger damages the Liver, overthinking damages the Spleen, grief damages the Lung, fear damages the Kidney, prolonged worry knots Qi, and sudden fright shrinks Qi. These Seven Emotions are internal. Neither-internal-nor-external causes include irregular diet and lifestyle. Excessive alcohol generates Fire and consumes Yin fluids; excessive tea generates Dampness and fluid retention; excessive pungent spices damage Qi and Blood; irregular meals damage the Spleen and Stomach. Daytime overwork, lifting heavy weights, or falls injure the body; nighttime restlessness or excessive sexual activity damages Jing (Essence) and Qi. Rich diets cause Ying and Wei disharmony and internal Fire-Toxin binding; poor diets lead to insufficient Stomach Qi and Qi/Blood deficiency. The human body has five layers: Skin, Vessels, Flesh, Tendons, and Bones. Lesions in tendons/bones are Ju (Yin); lesions in flesh/vessels are Yong (Yang); lesions between skin and flesh are Yang-Du (Ulcer Toxin); lesions only on the skin are Chuang-Jie (Sores/Boils). Yang-excess Yong begins with swelling, redness, and pain, facilitating ulceration and healing (favorable/Yang syndrome). Yin-excess Ju begins with dark, non-red, depressed, hard, painless lesions, hindering ulceration and healing (adverse/Yin syndrome). Half-Yin Half-Yang presents with diffuse swelling, mild pain, slight heat, and faint redness, indicating a dangerous condition. Proper treatment can turn danger into favorability; otherwise, it becomes adverse. Five Good signs indicate favorable prognosis and ease of treatment; Seven Bad signs indicate adverse prognosis and difficulty. Seeing three good signs implies survival; seeing four bad signs implies death. Clinicians must examine complexion and pulse, applying warming, cooling, tonifying, sweating, or attacking methods appropriately. Treating external carbuncles is akin to treating internal cold damage; mastery of cold damage facilitates treatment of miscellaneous diseases, while precision in carbuncles demonstrates comprehensive skill, based on the ability to differentiate exterior/interior, Yin/Yang, deficiency/excess, and cold/heat.