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Any lesion that is red, painful, and has a base diameter of approximately one cun constitutes a carbuncle (Yong). If the pathogenic toxin has manifested for three to four days but pus has not yet formed, apply Yi Yang San (Suppressing Yang Powder) externally around the lesion. Internally, administer Xing Xiao Wan (Awakening and Eliminating Pill) taken with warm, aged yellow wine, three qian per dose; this will immediately cease pain, allow sleep at night, and cause the skin of the lesion to wrinkle on the following day. A subsequent dose will lead to complete resolution. If four or five days have passed and the lesion is about to suppurate, Xing Xiao Wan should still be administered to reduce swelling and induration in the surrounding areas, thereby alleviating pain and dispersing toxicity; this method transforms a large lesion into a smaller one. For lesions containing pus, apply Yao Tou Gao (Bite-Head Paste) to the apex, and administer Dai Dao San (Knife-Replacement Powder), three qian, with wine to facilitate penetration. Alternatively, puncture slightly with a needle to drain, then apply Dong Tian Gao (Cave Heaven Paste); healing will occur within a few days. For lesions several inches in diameter, or those located in dangerous areas such as the back, nape of the neck, waist, abdomen, chest, axilla, or scrotum, administer Wu Tong Wan (Five-Passage Pill), three qian, and Xing Xiao Wan, three qian, alternating morning and evening with Bai Du Tang (Toxin-Resolving Decoction). Continue until the skin wrinkles and pain ceases, then continue administration until recovery. If the lesion has ulcerated, immediately use Nei Tuo San (Interior-Supporting Powder) combined with Xing Xiao Wan, also administered alternately morning and evening.

First, if early-stage symptoms include fever, aversion to cold, and limb stiffness, San Xiao Yin (Scattering and Eliminating Infusion) is indicated. After the exterior syndrome resolves, treat according to the aforementioned methods.

Second, if exterior symptoms such as aversion to cold and fever suddenly appear after ulceration, Tuo Xie Yin (Evil-Expelling Infusion) is indicated. After the exterior syndrome resolves, follow the previous treatment protocols.

Third, if stool is dry and constipated despite several days without passage, moisten the intestines rather than purging. Run Chang Jian (Intestine-Moistening Decoction) is indicated. If an exterior syndrome exists, only resolve the exterior; once the exterior is resolved, the interior will naturally become unobstructed. If obstruction persists, administer Run Chang Jian.

Fourth, for major carbuncles, whether ulcerated or not, if there is fever without aversion to cold, this indicates heat prevailing over blood. Bai Du Tang combined with Si Wu Tang (Four Substances Decoction) is indicated.

Fifth, pregnant women suffering from carbuncles must not take Xing Xiao Wan because it contains Moschus (She Xiang). Instead, cure them with Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life) modified by removing Panax Notoginseng Radix et Rhizoma (Shan Jia). If the lesion has ulcerated but residual toxin remains, causing swelling and induration, treat with Nei Tuo San, removing Chuanxiong Rhizoma (Chuan Xiong) and adding Boswellia Carterii Resin (Ru Xiang) and Myrrha Resin (Mo Yao).

Sixth, Moschus in Xing Xiao Wan is expensive. For those too poor to afford it, Xian Fang Huo Ming Yin may be used as a substitute, although its efficacy is not as rapid as that of Xing Xiao Wan.