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The origin of carbuncles and ulcers lies in Qi dysfunction or Heat pathogen. From my limited perspective, there are also cases caused by a diet rich in fatty and sweet foods, excessive sexual activity, and the ingestion of mineral-based medicines (Jinshi). Therefore, the treatment methods involve using Mung Bean (Lüdou), Rhinoceros Horn (Xijiao), Alum (Fanshi), Guolao Gao (Licorice Paste), and Zhuodu Wan (Poison-Chasing Pill), clearly indicating their nature as detoxifying agents. The statements made by Hua Tuo in *Zhongzang Jing* (Middle Cabinet Classic) also advocate the use of herbs that disperse heat and eliminate toxins; this need not be doubted.

My commentary: For the aforementioned conditions caused by mineral-based medicines, if the patient's Yuan Qi (Original Qi) is robust, this method is indeed appropriate. However, if the condition arises from accumulated heat due to dietary excesses or Spleen and Kidney deficiency resulting from excessive sexual activity, one should nourish the source of transformation and metabolism, rather than rigidly adhering to previous methods.

The occurrence of carbuncles, sores, and swellings results from the accumulation of toxins within the Five Zang and Six Fu organs that fail to circulate freely; it is not solely due to the obstruction of Ying (Nutritive) and Wei (Defensive) Qi. Their manifestation has specific locations, and their management has specific correspondences. For instance, lesions appearing on the throat and tongue stem from Heart toxins; those on the skin and hair follicles stem from Lung toxins; those on muscles stem from Spleen toxins; those in the bone marrow stem from Kidney toxins; those appearing on the lower body stem from Yin toxins; those on the upper body stem from Yang toxins; those on the exterior stem from Fu organ toxins; and those on the interior stem from Zang organ toxins. Therefore, internal necrosis is termed "Huai" (Destruction), external ulceration is termed "Kui" (Ulceration), upward progression is considered "Cong" (Favorable/Compliant), and downward progression is considered "Ni" (Adverse/Opposing). Lesions on the upper body develop rapidly, while those on the lower body develop slowly. Infections involving the Fu organs are easier to treat, whereas those involving the Zang organs are difficult to cure. Furthermore, lesions close to bones often present with cold signs, while those close to the skin often present with heat signs. If lesions near bones do not heal for a long time, they may transform into "blood worms" (necrotic tissue or parasitic-like lesions); if lesions near the skin do not heal for a long time, they may transmit qi abnormalities forming fistulas. Fistula formation typically presents with more itching than pain, or no pain and no itching. Blood worm formation typically presents with more pain than itching, or initially itching followed by pain. Conditions characterized by internal deficiency and external excess present with more pain than itching. Uncontrolled bleeding often leads to death, while suppuration (drainage of pus) often indicates survival. Frequent vomiting and regurgitation, along with irregular eating habits, are all consequences of carbuncles and ulcers. The symptoms are manifold and require detailed diagnosis and treatment.

My commentary: The generation of worms in sores is due to Wind-Heat in the Liver channel; the formation of fistulas is due to weak Yuan Qi (Original Qi); bleeding is due to Spleen deficiency with Fire; and suppuration indicates robust Yuan Qi. As for symptoms such as vomiting and regurgitation, these are caused by Spleen and Stomach deficiency. One should regulate and tonify Yuan Qi to ensure safety and recovery.