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In the initial stage, with aversion to cold, physical fatigue, a preference for wearing extra clothes and covering with quilts, and a floating, tight pulse indicating the pathogen is in the exterior, mild diaphoresis (inducing sweating) should be used to disperse the pathogen.
When the abscess has formed, presenting with internal heat, dry mouth, a desire for cold drinks, scanty and difficult urination, and constipation, purgation (draining downward) should be employed.
If the abscess apex is high, red, painful, accompanied by fever, and pain occurs at specific times, Ying-Supporting (Tuo-Li) methods combined with detoxification should be used.
If swelling is already high and painful, pus is mature but not yet ruptured, and distending pain is unbearable, immediate needle drainage is indicated.
After rupture, if induration persists, pus continues to drain profusely, and appetite is lost, deficiency supplementation and spleen strengthening are appropriate.

A male patient developed this condition; pain began after four or five days, followed by chills in the evening. The six pulses were floating and rapid. Two doses of Renshen Baidu San (Ginseng Detoxification Decoction) caused the chills and fever to subside abruptly, and the pain subsided slightly.
At that time, he was busy with official duties and wished to go out. Therefore, the affected apex was punctured with a needle to a depth of five or six fen, releasing purple blood. A Chan Su strip (Toad Venom Strip) was inserted under a plaster cover. After two doses of Huoxue Sanyu Tang (Blood-Invigorating and Stasis-Dispelling Decoction), purple blood was discharged the next day, allowing him to walk freely. He then took five or six doses of Ying-Supporting medicines and recovered.

Another male patient suffered from this for six or seven days, experiencing pain with fever, dry mouth, and dry stools. Tuo Li Xiao Du San (Support Interior and Disinfect Decoction) was administered with Tian Hua Fen (Trichosanthes Root) and Da Huang (Rhubarb). After two doses, bowel movements normalized and thirst ceased. The previous formula was continued with Jiao Zhen (Gleditsia Sinensis Spine) and Shan Jia (Pangolin Scale); after several doses, pus erupted. Subsequently, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) was used, leading to healing within half a month.

A third male patient had an abscess that remained hard and unruptured, due to prior misuse of cold-natured medicines. Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) was modified with Jiao Zhen (Gleditsia Sinensis Spine), Cang Zhu (Atractylodes Rhizome), and Mu Dan Pi (Moutan Cortex). After four doses, the hardness gradually softened. Tou Nong San (Pus-Revealing Powder) was given for two doses; once the pus matured, it was drained by needle. The previous formula was used with doubled amounts of Ren Shen (Ginseng), Bai Shao (White Peony Root), Dang Gui (Angelica Sinensis), and Bai Zhu (Atractylodes Macrocephala Rhizome), resulting in healing after more than a month.

A fourth male patient contracted this during the summer months, mistakenly believing it to be internal toxin. He applied crushed Lao Ya Teng (Uncaria rhynchophylla or similar vine) externally and drank over ten bowls of cold water daily for three days. This caused the sore toxin to sink inward; the lesion became flat and ice-cold, his jaw locked preventing speech, and the six pulses were deficient and fine as a thread. Refusing treatment, he died that night.

Another patient contracted this in winter. He applied Si Huang San (Four Yellows Powder) mixed with cold water externally and took internal detoxifying and cooling medicines. The toxin also sank inward, causing restlessness, dry mouth, nasal flaring, and rapid breathing. The lesion was flat, leaving only an empty hole at the original site with no pus or fluid. I stated: "The sore toxin has sunk inward; it is certainly incurable."
Other physicians were consulted and claimed there was no issue. I explained: "The buttocks are located behind the lower abdomen, where muscles are thick and dense. Once the toxin reaches this area, it must be supported internally to form pus; after rupture, healing is easiest. Now, with both external and internal use of cold-natured medicines, the toxin has entered inwardly; how can it possibly exit?" The other doctors insisted on administering internal resolving, detoxifying, and calming irritability medicines. Ultimately, these were ineffective, and he died after half a month.