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Nuchal Carbuncle (Naohou Fa) occurs in the Du Meridian (Governing Vessel). Heat accumulation at Fengfu (GV18) causes swelling and pain resembling millet grains. If the lesion is red and vibrant, easy to ulcerate, and discharges thick pus, it is a favorable prognosis; if purple and dark, difficult to ulcerate, and discharges bloody fluid, it is ominous.

[Note] This condition belongs to the Du Meridian (Governing Vessel), located at the Fengfu (GV18) acupoint below the occipital bone. It is formed by the confluence of accumulated internal heat and externally contracted wind pathogen. Initially, it resembles a millet grain, swelling with pain that radiates to the vertex, shoulders, and neck, accompanied by coarse breathing and nasal congestion. It gradually enlarges to the size of a plate or bowl. If red and vibrant, rapid ulceration with thick pus discharge indicates a favorable course; if purple and dark, difficulty in ulceration with exudation of serum and blood indicates an unfavorable course. For initial treatment, refer to the section on Yuzhen Abscess (Yuzhen Ju). All other internal and external treatments follow the section on Carbuncles, Ulcers, Swellings, and Ulcerations.

Brain Chisel (Naoshuo) appears at the back of the neck like a horizontal log. It arises from the depletion of Essence (Jing) and the ascent of toxic fire. If black as soot and hard as ox lips, with numbness and pain but clear fluid flowing before suppuration, it is critical. Immediately apply the Mulberry Wood Roasting Method or Moxibustion; if burning and stinging pain occurs, it belongs to the Yang meridians. Quickly administer Xianfang Huoming Yin (Immortal Formula for Saving Life). If Seven Evil signs appear, the prognosis is definitely poor.

[Note] This condition arises at the Fengfu (GV18) acupoint of the Du Meridian (Governing Vessel), caused by the depletion of Yin Essence allowing toxic fire to ascend. Initially, it resembles a pepper grain, hard and purple-dark. It gradually swells like a horizontal log, extending up to the vertex and down to Dazhui (GV14). The color resembles soot, and hardness resembles ox lips. Before suppuration, the skin may rot first, leaking clear fluid, with cold muscles. Mild cases present with numbness and pain; severe cases involve toxin sinking inward with complete loss of sensation. Urgently apply the Mulberry Wood Roasting Method or Moxa Cone Moxibustion, using pain sensation as the gauge. Quickly take Xianfang Huoming Yin (Immortal Formula for Saving Life) to relieve toxicity. After seven days, if new tissue does not grow or abundant pus does not form, take Shiquan Dabu Tang (Decoction for Complete Great Tonification). If tonifying herbs are ineffective, it is difficult to treat. If initially presenting with intense heat like burning and stinging pain, it is a Yang syndrome; quickly take Huanglian Xiaodu Yin (Coptis Decoction for Detoxification) and apply Waiyang Yulong Gao (Ointment for Restoring Yang and Jade Dragon) externally. If throughout the course only Five Good signs are seen, it is favorable; if Seven Evil signs are seen, it is unfavorable. All other internal and external treatments follow the section on Carbuncles, Ulcers, Swellings, and Ulcerations.

Mulberry Wood Roasting Method & Moxa Cone Moxibustion (See Volume 1)
Xianfang Huoming Yin (Immortal Formula for Saving Life) (See Section on Pre-ulcerative Lesions)
Shiquan Dabu Tang (Decoction for Complete Great Tonification) (See Section on Post-ulcerative Lesions)
Huanglian Xiaodu Yin (Coptis Decoction for Detoxification) (See Bailui Ju mentioned previously)
Waiyang Yulong Gao (Ointment for Restoring Yang and Jade Dragon) (See Section on Pre-ulcerative Lesions)