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Naoju (Brain Carbuncle) located at the center of the nape belongs to the Du Meridian (Governing Vessel); Pian Naoju (Lateral Brain Carbuncle) located on both sides belongs to the Foot-Taiyang Bladder Meridian. Yang-type (Zheng Naoju) and Yin-type (Pian Naoju) differ in difficulty, but their treatment principles are the same as the general methods for treating Yong (Carbuncle) and Ju (Abscess).

[Note] This type of Ju (deep-seated abscess with cold nature or chronic course) has central and lateral presentations. The central type belongs to the Du Meridian (Governing Vessel), invading the hairline, called Naoju (Brain Carbuncle), commonly known as "Dui Kou" (Facing Mouth); the lateral type belongs to the Foot-Taiyang Bladder Meridian, called Pian Naoju (Lateral Brain Carbuncle), commonly known as "Pian Dui Kou" (Lateral Facing Mouth). Zheng Naoju arises from hyperactive Yang and extreme heat; its symptoms include redness, swelling, and pain, with fresh red and vibrant color, a contracted base, and a pointed apex, with intermittent pain. Since the Du Meridian (Governing Vessel) is purely Yang, originating at the Weilu point and ascending through the vertex, carrying toxic pathogens upward, it tends to suppurate easily, slough off easily, and heal easily, mostly constituting a favorable prognosis (Shun Zheng). In contrast, Pian Naoju arises from a mixture of cold and heat; its symptoms present as diffuse swelling without a head, dark color, flat collapse, and hardness. However, the Foot-Taiyang Bladder Meridian is exteriorly Yang and interiorly Yin, running from the head down to the feet, where Yang descends and Yin coagulates, making it difficult to suppurate, slough off, and heal, mostly constituting an unfavorable prognosis (Ni Zheng). Furthermore, cases complicated by Wind-Dampness may have bases that spread widely and discharge laterally. Therefore, for favorable and unfavorable prognoses, the treatment method must distinguish between Yong (Carbuncle) and Ju (Abscess). Nao Yong (Brain Carbuncle) features thin skin that breaks easily; Nao Ju (Brain Abscess) features thick skin that is hard to break. If there are exterior syndrome manifestations at the onset, causing alternating chills and fever, Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity) is indicated; if there are interior syndrome manifestations, causing scorched purple lips, extreme thirst, and dry constipation, Neishu Huanglian Tang (Internal Purging Coptis Decoction) is indicated. If the lesion has already formed, treat according to the general methods for Yong (Carbuncle) and Ju (Abscess) in the chapters on Swelling Ulcer (Zhongyang Men) and Ulcerated Wound (Kuangyang Men).

Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity)
Ingredients: Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus Immaturus, stir-fried with bran), Fuling (Poria), each 1 qian; Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), each 0.5 qian.
Preparation and Administration: Add three slices of Shengjiang (Zingiberis Rhizoma Recens) and two cups of water, decoct until eight-tenths remain, take after meals. If chills are severe, add three stalks of Congbai (Allii Fistulosi Bulbus).

[Prescription Song] Jingfang Baidu San treats initial sores, relieving aversion to cold, high fever, and promoting sweating; containing Qianghuo, Duhuo, Qianhu, Chaihu, Jingjie, Fangfeng, Jiegeng, while Chuanxiong, Zhike, Renshen, Fuling, and Gancao strengthen the formula.

Neishu Huanglian Tang (Internal Purging Coptis Decoction) (See Chapter on Swelling Ulcer)