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For any carbuncle that fails to rise, employ the method of supporting and raising it. For those that fail to suppurate, employ tonification to induce suppuration, thereby preventing the pathogenic factor from attacking inward. Once pus has formed, timely needle drainage should be performed. Some patients refuse needling due to fear of pain, or hesitate for fear of damaging healthy tissue. They fail to realize that although the lesion may arise in areas with thin muscle, once pus is mature, the swelling can exceed one cun in height, and the skin thickness may reach several fen. The depth of needle insertion should not exceed two fen. If the lesion arises on the back, the swelling height must be three to four cun, and the needle insertion depth should only reach about one cun. Moreover, since the tissue at the affected site is already necrotic, what pain could there be? What concern for damage is warranted? Weak individuals, as well as patients suffering from deep-seated bone abscess (Fugu Ju), who wait for pus to drain spontaneously, will inevitably suffer massive ulceration that fails to heal, leading to exhaustion of Qi and Blood and death.

For pain accompanied by a rapid and excess pulse in the upper position, fire-clearing (Jiang Huo) is appropriate.
For pain accompanied by a rapid and deficient pulse in the upper position, nourishing Yin and clearing fire should be the primary approach.
For thirst accompanied by a rapid pulse in the Chi (Cun Cun) position, employ nourishing Yin and clearing fire, such as Si Wu Tang (Four Substances Decoction) added with Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma).
Generally, the cold, heat, deficiency, and excess patterns of carbuncles can all cause pain. Pain caused by heat toxin is treated with cold-natured medicines to subdue it; pain caused by cold pathogen is treated with warm-natured medicines to disperse it.
Pain due to wind is treated by dispelling wind; pain due to dampness by promoting dampness drainage; pain due to dryness by moistening; pain due to obstruction by unblocking; pain due to deficiency by tonifying; pain due to excess by purging.
Obstruction due to stagnant pus is opened; erosion by foul flesh is removed; disharmony of Yin and Yang is regulated; blockage and stagnation of meridians are smoothed. One must not indiscriminately use cold-natured medicines. This is because blood vessels prefer warmth and dislike cold; if cold qi enters the interior, blood coagulation and stasis occur, making recovery more difficult. It is also said: Generally, although carbuncles and sores present with pain, severe symptoms, restlessness, and thirst, if the pulse is forceful and dietary intake is adequate, prognosis is good. Once the pus drains, all symptoms recede. Many cases involve pain due to pus retention without external drainage; using toxic-resolving and cold medicines to attack this condition often leads to mishaps. If pus is present, urgent needle drainage is required; once pus exits, pain ceases. If heat toxin causes pain before pus formation, detoxifying medicines are used, which may result in tissue necrosis spanning over one chi. If no malignant signs are present, administering strong tonifying agents facilitates easy tissue regeneration without adverse effects.