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Wu stated: For all patients with sores and ulcers, it is appropriate to disperse and eliminate toxins from the body and cleanse away stale accumulation. It is suitable to use Shenxian Zhuidu Wan (Immortal Pill for Pursuing Toxin), Liuwei Che'ao San (Six-Ingredient Chiton Powder), Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction), or Qianjin Loulu Tang (Thousand-Gold Rhapontic Decoction). Furthermore, one must carefully distinguish the strength or weakness of the patient's constitution and adjust the prescription accordingly at the time. Generally speaking, the essential method for treating sores requires that the Zang-Fu organs be firm but not constipated, unobstructed but not incontinence, so that the True Qi is not depleted and pathogenic factors have no place to remain. If constipation occurs, Shenxiao Maren Wan (Miraculous Hemp Seed Pill) can be used. After a sore has ulcerated, if deficiency heat is still felt, Dahuang (Rhubarb Root) and Poxiao (Mirabilite) can be added to Wuxiang Tang. Moreover, when using warm-natured herbs to treat sores, Guizhi (Cinnamon Twig) should be used first to promote blood circulation and guide various other herbs; when using cold-natured herbs, Dihuang (Rehmannia Root) must be used to tonify deficiencies, benefit Qi, and fill the marrow. Recently, Ruixiang San (Frankincense Powder) has been commonly used. Ruixiang (Frankincense Resin) detoxifies, and Ludou (Mung Bean) clears heat; these are indeed good medicines.

My commentary: Large intestine constipation, if indeed caused by Blood dryness and with non-deficient Stomach Qi, is most suitable for the aforementioned prescriptions. However, if it is due to the exhaustion of Essence and Blood, Bazhen Tang (Eight-Treasure Decoction), Taoren (Peach Kernel), and Maren (Hemp Seed) should be used. Regarding fever after ulceration, if caused by Qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) with Huangqi (Astragalus Root) and Danggui (Angelica Sinensis Root) should be used; if caused by Blood deficiency, Siwu Tang (Four Substances Decoction) with Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria) should be used; if both Qi and Blood are deficient, Bazhen Tang with Huangqi should be used; if there is large intestine constipation and reddish urine, Siwu Tang with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit) should be used; if ineffective, Jiajian Bawei Wan (Modified Eight-Ingredient Pill) or Liuwang Wan (Six-Ingredient Pill) should be urgently employed; if fever occurs after purgation due to injury of Yuan Qi, Liujunzi Tang (Six Gentlemen Decoction) with Danggui should be used; if fever occurs due to Stomach Qi deficiency, Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) should be used. Generally, urination and defecation are governed by the Liver and Kidney. The Classics state: "The Kidney governs the five fluids and opens into the two lower orifices." If body fluids are moistening, defecation will be smooth; if body fluids are insufficient, it is necessarily due to Spleen Qi damage, and the source of transformation (Spleen/Stomach) should be cultivated.

Attached Treatment Case
The scholar Gu Dayou, nearly sixty years old, engaged in sexual intercourse when his back carbuncle initially appeared in mid-winter. The affected area was black and necrotic for about five cun, with a dark halo extending over a chi. The swelling was diffuse, hard, and solid, making his back feel as heavy as carrying a stone. He had fever, thirst, frequent urination, bilateral hearing loss, restlessness with exposed body, confused mental state, and a deep, fine pulse, more pronounced on the right hand. He had been constipated for twenty-seven days, having consumed over a hundred bowls of food, while his abdomen remained normal internally. The colleagues wished to induce bowel movement, but I said: "What is fortunate is this condition." I urgently prescribed a large dose of Liujunzi Tang (Six Gentlemen Decoction) with Shengjiang (Fresh Ginger), Fuzi (Prepared Aconite Root), and Rougui (Cinnamon Bark). After three doses, the sore began to hurt. Thereafter, he took the aforementioned medicine on an empty stomach. In the afternoon, he took Liuwei Wan (Six-Ingredient Pill) with Renshen (Ginseng Root), Huangqi, Danggui, and Baizhu for five doses. Then, Xianfang Huoming Yin (Immortal Life-Deciding Decoction) was taken for two doses. Pricking released a large amount of black blood and a small amount of stasis pus, and his back immediately became soft. He continued taking the previous medicine, and his bowels also became smooth. I went away for four days, during which his mental state became confused again, the sore remained black and sunken, pus and water flowed continuously, and he lost his appetite. I urgently administered Danggui and Baizhu, each 1 liang, Paofuzi (Prepared Aconite Root) 5 qian, and Shengjiang and Rougui, each 3 qian. He immediately asked for food and ate two ducks. Thereafter, he took two doses of the previous medicine daily. As the flesh rotted and pus discharged, he recovered.

Fu Yongcheng, whose family held the rank of Jin Yi Wei (Embroidered Uniform Guard), had a mother over seventy years old who developed a carbuncle on her waist with abnormal itching. Her pulse was floating and rapid, yet she paradoxically felt aversion to cold. I said: "This is a symptom of a carbuncle or deep abscess. Without ulceration, the condition is already weak; how can it heal? Moreover, since the bowels are unblocked, her Qi is exhausted, and treatment will be futile." His son pleaded, and reluctantly, I prescribed Liujunzi Tang with Huoxiang (Patchouli Herb) and Shenqu (Medicated Leaven). After several doses, her diet gradually improved, and her bowels finally moved. Strongly tonifying agents were then used. After ulceration, the pus was clear, and she felt thirsty. Ren Shen, Huangqi, Danggui, Maidong, Wuweizi, and Shudihuang (Prepared Rehmannia Root) were used to stop the thirst. Fu Yongcheng happily said: "My mother is safe!" I replied: "Contraction is still difficult, as I previously stated." He doubted me and hurriedly sought another physician, ultimately resulting in her death.