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In the treatment of sores and ulcers, if diarrhea occurs, it may be due to excessive use of cold-cooling purgatives damaging the Spleen Qi; or due to weak Spleen Qi causing indigestion; or due to Spleen deficiency with sinking Qi failing to raise the clear Yang; or due to decline of Mingmen Fire failing to warm the Earth (Spleen); or due to weakness of the Kidney Meridian failing to control excretion; or due to cold-deficiency of both Spleen and Kidney failing to perform their functions. The primary treatment methods are as follows: If cold-damage injures the Spleen and Stomach, use Liu Jun Zi Tang (Six Gentlemen Decoction) with Mu Xiang (Aucklandiae Radix) and Sha Ren (Amomi Fructus), administered with Er Shen Wan (Two Spirits Pill). If Spleen deficiency causes sinking Qi, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), administered with Er Shen Wan. If Mingmen Fire declines, use Ba Wei Wan (Eight-Ingredient Pill) ingredients, administered with Si Shen Wan (Four Spirits Pill). If Kidney deficiency causes incontinence, use Jiang Fu Tang (Ginger and Aconite Decoction) with Wu Zhu Yu (Evodiae Fructus) and Wu Wei Zi (Schisandrae Fructus). If Spleen-Kidney cold-deficiency exists, use Shen Fu Tang (Ginseng and Aconite Decoction) administered with Si Shen Wan. *Bing Ji* states: If the pulse is deep and fine, the body is immobile, vision is blurred, food and drink cannot be taken, and breath at the nose tip is weak, treat with Jiang Fu Tang. If the body feels heavy and limbs cannot be lifted, treat with Shen Fu Tang. Mr. Zhang Zhongjing said: For dysentery with borborygmus, warming is indicated. If the pulse is slow and tight with unceasing pain, warming is indicated. If there is anal pain, warming is indicated. If there is heart pain, rescue the interior, and Li Zhong Tang (Regulate the Middle Decoction), Fu Zi (Aconiti Lateralis Radix Praeparata), or Si Ni Tang (Frig Extremities Decoction) may be given. *Jing Yao* states: In carbuncles and ulcers, if vomiting and diarrhea occur and the Kidney pulse is weak, it is incurable. This elucidates the profound meaning of *Nei Jing*. For such difficult-to-treat conditions, if treated according to the aforementioned methods, many patients can survive.

Case Record
The wife of Imperial Physician Wang Pengfeng, over forty years old, suffered from a back carbuncle that failed to suppurate, accompanied by diarrhea and vomiting, poor appetite, and cold extremities. Her pulse was faint and barely perceptible, indicating Yang deficiency and cold. She was prescribed a major tonifying formula with Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), and Rou Gui (Cinnamomi Cortex). There was no response. Two additional doses of Fu Zi were added, but diarrhea worsened. Subsequently, a larger dose of Da Fu Zi (Prepared Aconite Root), Gan Jiang, and Rou Gui (each 3 qian), along with Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Fu Ling (Poria) (each 5 qian) was prepared as one dose. Only then did warmth return to the abdomen, vomiting and diarrhea ceased, hands and feet warmed, and the pulse recovered. Further major tonification led to ulceration, followed by Tuo Li (Supporting the Interior) formulas for healing. Ten years later, she died due to Spleen-Stomach cold-deficiency.

For sores and ulcers, if urination is dribbling, frequent, difficult, or accompanied by astringency in the urethra, this is a severe symptom of Kidney Meridian deficiency. Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) should be used to nourish Yin. If the lower legs and calves feel cold, Ba Wei Wan (Eight-Ingredient Pill) should be used to tonify Yang. If urination is frequent and yellow, Si Wu Tang (Four Substance Decoction) plus Mai Men Dong (Ophiopogonis Radix), Ren Shen, Bai Zhu, and Wu Wei Zi should be used to nourish Lung and Kidney. If urine is scanty, Bu Zhong Yi Qi Tang plus Shan Yao (Dioscoreae Rhizoma), Mai Men Dong, and Wu Wei Zi should be used to tonify Spleen and Lung. If heat binds in the Bladder causing difficulty in urination, Wu Lin San (Five Strangury Powder) should be used to clear heat. If Spleen Qi is dry and fails to transform fluids, Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Decoction) should be used to nourish Yin. If Bladder Yin is deficient and Yang cannot generate, Liu Wei Wan (Six-Ingredient Pill) should be used. If Bladder Yang is deficient and Yin cannot transform, Zi Shen Wan (Nourish Kidney Pill) should be used. Diseases of Kidney deficiency often transmit to these symptoms; without nourishing the source of transformation, recovery is impossible. Using Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma) will drain Yang and accelerate danger. For elderly men with impotence desiring sexual activity, leading to internal depletion of essence, pain in the urethra and difficulty urinating, Jia Jian Ba Wei Wan plus Che Qian Zi (Plantaginis Semen) and Niu Xi (Achyranthis Bidentatae Radix) should be used. If ineffective, add Fu Zi; many recover. If essence is exhausted yet further depleted, causing pulling pain during defecation and urination—where more pain leads to more urge to defecate/urinate and vice versa—using previous formulas with Fu Zi can also lead to recovery. Wang Tai Pu said: Without Yin, Yang cannot transform; without Yang, Yin cannot generate. One must nourish the source of transformation. If only diuretic drugs are used, True Yin is damaged, accelerating death.

Case Record
Wang Tang, an official, suffered from a back carbuncle that ulcerated, resulting in dribbling urination and occasional incontinence, thirst with desire to drink, irritability, fever, insomnia, redness of the wound, burning sensation, and occasional bowel/bladder incontinence. I stated: This is a severe Kidney deficiency symptom. Jia Jian Ba Wei Wan plus Mai Men Dong was prescribed, and he recovered after several doses.
Zhu Yangshan, Prefect, suffered from a back carbuncle with diffuse swelling, dark color, slight pain, thirst, and dozens of pustules. The left Chi pulse was surging and rapid but empty upon pressure, indicating Kidney deficiency and Qi deficiency. Fortunately, he had not used toxic-draining medicines, so his Yuan Qi was undamaged. Pus drained and necrotic tissue sloughed off within days, leading to recovery.
Lin Ruyu, Department Official, refused to wear cotton in winter, felt thirsty and drank cold water, believing himself robust, and discarded leftover cotton garments. His pulse was rapid and large but empty. I diagnosed Xu Huo (Deficient Fire). Huang Qin (Scutellariae Radix) and Lian Zi (Lotus Plumule) were used with Ren Shen, Bai Zhu, and Fu Ling. After more than twenty doses and half a jin of the previous pill, thirst decreased by 60-70%, and back heat subsided. In summer, a back carbuncle developed and healed using purely Tuo Li (Supporting Interior) agents.
Yuan Huaixue, Lord, suffered from fever and thirst due to a back carbuncle, with a rapid but empty pulse. Si Wu Tang plus Huang Bo, Zhi Mu, Xuan Shen (Scrophulariae Radix), Shan Zhi Zi (Gardeniae Fructus), Lian Qiao (Forsythiae Fructus), Wu Wei Zi, Mai Men Dong, and Yin Hua (Jasminis Flos) were used, gradually reducing the carbuncle. Bai Zhi (Angelicae Dahuricae Radix), Ren Shen, Dang Gui, and others were added to resolve necrotic tissue. Due to stopping medication and labor, fever and thirst returned. Ren Shen, Dang Gui, Bai Zhi, Zhi Gan Cao (Honey-fried Licorice Root), Shan Yao, Shan Zhu Yu (Corni Fructus), Fu Ling, Ze Xie (Alismatis Rhizoma), and Rou Gui were used for cure. Finally, Liu Wei Wan and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) were used for wound closure.