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Any disease of carbuncle and ulcer (Yongju, a severe skin infection) is the most cruel compared to other diseases, and the Sages ranked it as the foremost among miscellaneous diseases. Since ancient times, although there has been a department of surgeons (Yangyi), as well as discussions such as *Gui Yi Fang*, later generations failed to investigate deeply, causing this medical art to fall into obscurity and deviate from the correct path. Nowadays, in the countryside, many are people of low status who specialize in this field. However, those who contract this disease are mostly wealthy individuals. *Neijing* states: "Generally speaking, carbuncles and sores often occur in people who consume rich and greasy foods." My family has practiced internal medicine (Dafangmai) for generations, and I have often seen that among those contracting this disease, only one or two out of ten survive. This is likely because few doctors are skilled enough to thoroughly study formulas and theories. Even if some read the books, they fail to explore profound and hidden principles. When facing patients, in haste, they merely consult prescriptions against symptoms and try various medicines indiscriminately. Moreover, those who can treat carbuncles and ulcers, master tonification and surgical excision, manage fractures, and treat dental and hemorrhoidal conditions are mostly vulgar people unversed in literature. Upon seeing lengthy texts, they become disgusted and discard them. Patients' families then use theoretical texts to question and challenge the doctors, leaving the physicians helpless like flying squirrels, confused and panicked. They hesitate when action is needed, delaying treatment for long periods, thus turning mild cases severe and severe cases fatal. It is also common for those suffering from ulcers to hide their condition, disliking others to call it carbuncle or ulcer, preferring to say it is merely a small boil. By the time the condition becomes critical, it leads to untreatable situations. Some families are suspicious and stingy about the high costs, refusing to hire competent doctors, and instead willingly entrust their lives to mediocre practitioners. Some doctors act with bad intentions, greedy for profit, unwilling to immediately administer effective attacking remedies, fearing that quick recovery would yield no gain, believing that greater disaster brings greater merit. Others rigidly adhere to one or two formulas without flexibility. Some apply treatments in the wrong order: using purgatives too late when they should be used first, or vice versa. It is frequently observed that at the onset of the disease, patients are made to take large amounts of *Paion Neibu Shixuan San* (Ten-Pure Powder for Draining Pus and Tonifying Internally), which aggravates the illness. This formula is intended for draining pus and tonifying internally after the abscess has ruptured, yet Hong Nei Han misunderstood its purpose and wrote prefaces and postscripts recklessly, misleading countless people in the world and future generations. Chen Wuyue said: "It should be used in the fourth section," which is correct. Some obtain one or two formulas, treating them as secret transmissions, fearing others will know them; many wealthy nobles refuse to believe in them unless they see the ingredients. Others, knowing that commonly used formulas have proven effective, change their names to claim them as secrets, or recklessly add herbs to confuse the public, resulting in ineffectiveness. Such people are great thieves harming living beings; what reason is there to converse with them! There are also those who spread hearsay, travel far to inquire about illnesses, pretending to be knowledgeable and capable, discussing heterodox views, claiming either deficiency or excess, presenting a single formula, and vigorously asserting its miraculous efficacy achieved somewhere else. These people are all flatterers. In reality, none have experienced diagnosing or treating a disease themselves, possessing no real skill. Patients' families lack judgment and are easily swayed, desiring quick results while wanting to save money, without consulting doctors, deciding whether to take the medicine or not, and suddenly inviting disaster before scattering away. The ancients said: "When poor, no noble person gives gold; when sick, idle people offer prescriptions." This is a universal ailment of the world, unreformed through dynasties.

The disease of carbuncle and ulcer is truly like bandits, disregarding laws, acting with unexpected ferocity. If treated too leniently, they kill and burn, which is undeniable. To treat such diseases, one cannot rely on etiquette and law alone; one must conveniently administer one or two crucial, clinically effective medicines to stabilize the Zang-Fu organs, and apply external acupuncture to vent toxic vapors. Once the condition stabilizes slightly, then carefully observe the formulas and theories, or instruct the doctor to meticulously examine and determine the diagnosis. Whether it is a carbuncle or an ulcer, deficiency or excess, cold or heat, heavy or light, one must prescribe medication according to the syndrome, maintaining the correct sequence. The patient need not be anxious or panicked; if the doctor firmly holds their ground and does not create confusing diagnoses, success is certain. Modern famous doctors such as Li Sizhi, Wu Qiyu, and senior expert Zeng Fu compiled essential keys from effective ancient formulas. Taking advantage of my leisure time, I collected various opinions, established main principles, arranged them in order, neither preceding nor following incorrectly. Redundant and verbose parts were removed, retaining concise language and complete meaning, with clear guidelines and items, orderly and unconfused. May readers understand it as clearly as pointing to their palm. Although I cannot achieve even a fraction of the Sages' wisdom, I hope that when facing illness, there will be a basis for decision-making, avoiding the folly of digging a well only when thirsty or forging weapons only when fighting!

Preface by Chen Ziming, courtesy name Liangfu, a physician from Baotang, in the early autumn of the Guihai year of Jingding.