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The patient exhibits red vessels in the eyes, penetrating vertically through the pupil. One vessel indicates death within one year; two vessels indicate death within two years. If the vessels extend downward, treatment can lead to recovery. The face suddenly shows a reddish hue resembling grease, extending from the forehead down to the nose. Black discoloration appears on the forehead, as large as a finger, and connects from above the nose to the shoulder. Additionally, there is hanging redness. Wang Ji's commentary states that red vessels belong to Fire, while the pupil belongs to Water. Red vessels penetrating the pupil indicate Fire counter-attacking Water. The face belongs to Yang; redness in the Yang region indicates Yang excess and Yin deficiency. Blackness on the forehead indicates Yang deficiency and Yin excess; thus, the condition is mostly critical.

1. Epidemic pathogenic factors (Tianxing); 2. Emaciation with Qi stagnation; 3. Anger; 4. Kidney Qi deficiency; 5. Consumption of alcohol, roasted/fried foods, and hot toxins from elixirs.
Generally, treating carbuncles and sores should not be uniformly regarded as Heat syndromes. The difficulty or ease of treatment depends on analyzing these five categories sequentially.

Excesses from rich and greasy foods easily produce large Ding (severe furuncles). Susceptibility is like holding an empty vessel. Rich and greasy flavors accumulate internal heat toxins, often transforming into large Ju (deep-seated abscesses). The toxin enters through weak areas. Large Ding and large Ju are characterized by deep roots internally. This explains that Ju arises from transformations due to internal heat caused by rich flavors.

Yang Qi, when refined, nourishes the Spirit; when soft, it nourishes the sinews. If opening and closing mechanisms fail, Cold pathogenic factors enter, leading to severe flexion deformities. Human body Yang Qi uses its essence to nourish the Spirit and its gentleness to nourish the sinews. When Yang Qi is at the body surface, improper opening and closing allow external Cold to invade. If it attacks the sinew collaterals, spasms cause flexion. If it penetrates the meridians, stasis forms ulcers. If it lingers between muscles and interstices, it is difficult to dissipate. This explains that ulcers arise from improper Yang Qi opening/closing, invasion by external Cold, and meridian stasis.

When Ying Qi does not follow its course and reverses within the muscle tissue, carbuncles and swellings arise. Ying generates Blood. If Ying Qi circulation is abnormal and obstructed/reversed in the muscle tissue, Blood stagnates and generates heat, accumulating into carbuncles and swellings. This explains that carbuncles arise from abnormal Ying Qi reversing in muscle tissue, causing Blood stagnation and heat accumulation.

Diseases of the Three Yang meridians manifest as chills and fever; below, they manifest as carbuncles and swellings. The Three Yang refer to the Hand-Yangming Large Intestine Meridian, Taiyang Small Intestine Meridian, and Foot-Taiyang Bladder Meridian. Diseases of these three Yang meridians manifest as chills and fever above, and as carbuncles and swellings below. This explains that lower-body carbuncles arise from the Three Yang meridians and should be differentiated by examining their pulses.

In the Eastern regions, lands of fish and salt, people eat fish and crave salt. They settle comfortably and enjoy their food. Fish generates internal heat; excessive salt damages Blood. Thus, people have dark skin and loose texture, prone to carbuncles and sores. This explains that carbuncles and sores arise from coastal living, consuming fish and salt, sedentary lifestyle, and lack of dietary moderation, leading to internal heat from fish and Blood damage from salt.

Various carbuncles and swellings, tendon spasms, and bone pain are swellings caused by Cold pathogenic factors and changes from the Eight Winds. The Classic states: "Cold injures the form; injury to the form causes swelling." The Eight Winds refer to winds from eight directions. *Ling Shu* states: Wind from the southeast is called Weak Wind, injuring the muscle layer; wind from the west is called Mou Wind, injuring the flesh; wind from the east is called Infant Wind, injuring the sinews; wind from the north is called Great Rigid Wind, injuring the bones. These cold-induced swellings and Eight Wind variations cause carbuncles, tendon spasms, and bone pain. This explains that carbuncles arise from Cold pathogens from four directions and excessive harm from the Eight Winds.

Kidney transferring Cold to the Spleen causes carbuncles and shortness of breath. If the Kidney is injured by Cold and transfers it to the Spleen, since the Spleen governs flesh and the space between muscles is where Wei Qi circulates, Kidney Cold transmitting to the Spleen causes Cold in the flesh and coagulation of Wei Qi. Thus, Kidney knotting leads to carbuncles, flesh knotting damages Blood, resulting in shortness of breath. This explains that carbuncles arise from Kidney Cold transmitting to the Spleen.

Spleen transferring Cold to the Liver causes carbuncles and tendon spasms. The Spleen governs flesh; the Liver governs sinews. Warm flesh allows relaxed sinews. Now, Spleen transmits Cold to the Liver; thus, Cold flesh causes Wei Qi aggregation forming carbuncles, and Cold sinews cause tension/spasms. This explains that carbuncles arise from Spleen Cold transmitting to the Liver.

Fullness in the Liver, Fullness in the Lung, and Fullness in the Kidney, all Excess patterns, result in Liver, Lung, and Kidney carbuncles. Fullness and Excess refer to pulse qi being full and excess. Due to organ Qi being pathological and excessively full, the pulse qi manifests accordingly. This explains that Liver, Lung, and Kidney carbuncles arise from excessive organ Qi and pathogenic fullness, and should be differentiated by observing full and excess pulse qi.