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I have never been versed in medicine. Whenever residing in remote rural areas, I respectfully followed the *Imperial Compilation of Medical Classic of Gold Mirror* (Yuzuan Yizong Jinjian) for treatment, with its *External Medicine Mind Method* (Waikexinfa) serving as a supplementary guide; I had already extracted the essentials and had them printed. However, fearing that beginners might find it difficult to enter the field, in the autumn of the Bing Shen year of the Qianlong reign (1776), I compiled the concise and easy-to-understand contents from Chen Yuren's *Orthodox Manual of External Medicine* (Waike Zhengzong), Qi Guangsheng's *Great Completion of External Medicine* (Waike Dacheng), and Wang Yutai's *Standard Rules for Surgeon* (Yangyi Zhunsheng) into a single volume. It consists of two volumes and is titled *Selected Essentials of External Medicine* (Waike Xuanya). This way, beginners can obtain a ladder to approach the path, and further study the mind methods of the *Gold Mirror*, thereby ascending the hall and entering the inner chamber. Not only does this embody the heart of saving lives, but it also attains half of the principles of health preservation. Therefore, I have it printed together, appended after the *External Medicine Mind Method*.

Respectfully recorded by Tang Hong of Qin Zhou, Kunshan.

Why do carbuncles, ulcers, and back eruptions arise? Why does such a condition appear on a healthy body?
Those who live in the world without disease are those whose Kidney Water ascends and Heart Fire descends, whose Essence is securely retained and Blood is abundant. The Health Preservation Chapter states: Do not agitate your Essence, do not overwork your Form, return your mind to quiet silence, and you can attain longevity. These are achievable only by those determined to cultivate their character and preserve life, who stay away from secular affairs, forget fame and profit, and eliminate greed and anger. How can modern people reach such a state? Generally speaking, stillness generates Water, while movement generates Fire. Water can generate all things, while Fire can overcome all things; thus, hundred diseases arise from Fire. Once Fire arises, the Seven Emotions and Six Desires follow suit and enter the body. After entering, the hundred diseases manifest. Those manifesting internally present as Wind, Consumption, Gu Poison, Diaphragm obstruction, Phlegm-wheezing, and Internal Injury; those manifesting externally form Carbuncles, Ulcers, Back Eruptions, Opposite-Heart Ding Sores. This describes the general overview. Thus, "Carbuncle" (Yong) means congestion; it belongs to Yang and the Six Fu Organs, with toxic heat surging outward. Its onset is sudden and the lesion is superficial. Therefore, it easily swells, suppurates, sloughs, and heals. Indeed, it does not damage sinews or bones and is an easy-to-treat condition. "Ulcer" (Ju) means obstruction; it belongs to Yin and the Five Zang Organs, with toxic heat attacking inward. Its onset is slow and the lesion is deep. Therefore, it damages sinews and erodes bones, making it a difficult-to-treat condition. Generally, if one is young and vigorous with strong Qi and Blood overcoming the toxin, the course is favorable; if one is old and weak with the toxin overpowering Qi and Blood, the course is dangerous.

Internally disturbed by the Seven Emotions affecting the Zang Organs, worry, sorrow, and anxiety always concern the heart.
The Seven Emotions are: Joy injures the Heart, Anger injures the Liver, Sorrow injures the Lungs, Pensive thought injures the Spleen, Grief harms the Hun and Po, Fear injures the Kidneys, and Shock injures the Gallbladder. The Six Desires are: ears listening to sounds, eyes observing colors, nose smelling fragrances, tongue craving flavors, the heart encompassing the earth, and the mind covering all directions.

Externally injured by the Six Excesses damaging Qi and Blood, Wind, Cold, Summerheat, Dampness, and Fire succeed each other.
The Six Excesses are: Wind, Cold, Summerheat, Dampness, Dryness, and Fire, all entering from the exterior. In robust individuals, encountering these pathogens without being affected occurs; in frail individuals, contracting them and developing symptoms immediately is common. There are also cases where infection does not immediately manifest, but the pathogen lodges within the Zang-Fu organs, meridians, collaterals, and joints, accumulating over time. Later, triggered by internal injury or external contraction, the pathogen activates. After manifestation, treatment should be based on evaluating Cold, Heat, Warmth, Coolness, and the struggle between Pathogenic factors and Righteous Qi.

Rich and greasy foods taken without restraint, labor and sexual indulgence leading to Yin deficiency.
"Gao Liang" refers to fine wine, rich meats, and roasted foods. People seek momentary pleasure, unaware of the daily consumption of Yin. Moreover, those suffering from these diseases rarely originate from coarse vegetables but mostly from rich diets. Who realizes that the flavor of rich food is short-lived, unlike the lasting benefit of coarse vegetables?

Thus, the Five Zang Organs often undergo abnormal changes, and naturally, the Six Fu Organs become unharmonious.
The Five Zang Organs correspond to the Five Elements: Metal, Wood, Water, Fire, and Earth. They mutually generate and mutually overcome. As stated, mutual generation leads to prosperity, while mutual overcoming leads to decline. If the Five Zang Organs are disharmonious, the Six Fu Organs will not circulate freely. The nine orifices become fatigued and obstructed, stagnation forms carbuncles. Generally, carbuncles and ulcers arise from Zang-Fu disharmony and the failure of orifices to ventilate and circulate. Treatment should be adapted: For pain caused by Cold pathogens, disperse with warm/hot herbs; for swelling and stiffness caused by Dampness, drain and guide downward; for spasms and cramps caused by Dryness, moisten and lubricate. For pain due to diarrhea, warm it; for pain due to constipation, unblock it; for pain due to deficiency, tonify it; for pain due to excess, purge it; for Yin-Yang disharmony, harmonize and adjust it; for blocked meridians, promote harmony; for pain due to pus distension, incise it; for necrotic flesh erosion, remove the dead tissue; for pain due to fatigue, allow rest; for pain due to injury, reconnect tissues. These are flexible methods, depending on the practitioner's discretion.

Eruptions on the heart area are often dangerous; the interaction of the Five Zang Organs can be understood.
The Five Zang Organs are Heart, Liver, Spleen, and Lung; four of them are connected to the back. Only the Kidney Meridian resides alone at the lower part. Its essence, fluids, Yuan Qi, and Yuan Shen irrigate and nourish the upper body. Thus, the fire of the four upper organs relies on the water of the Kidney to balance it. This is why the root of the Five Zang Organs is tied to the Kidney. Anyone developing carbuncles or ulcers first injures the Five Zang Organs before eruption. Furthermore, the back is governed by the Taiyang Bladder Meridian and the Du Mai (Governing Vessel). The Taiyang is the leader of the Six Meridians; the Du Mai is the commander of the Twelve Meridians. Since the Heart is the seat of the Sovereign, how can it tolerate toxic invasion? Eruptions here are dangerous and difficult to treat.

Eruptions below the heart tend to be favorable; the causes related to the Six Fu Organs can be evaluated.
Any sore arising below the Heart, except at the Shenshu acupoint, is considered mild. The Six Fu Organs include: Foot-Yangming Stomach Meridian, Hand-Taiyang Small Intestine Meridian, Foot-Taiyang Bladder Meridian, Hand-Jueyin Pericardium Meridian, Hand-Shaoyang Sanjiao Meridian, and Foot-Shaoyang Gallbladder Meridian. These six meridians belong to the Fu organs. Their form is lower, their Qi governs the exterior, and their pathology involves carbuncles. Thus, eruptions on these meridians are mild.

Toxin accumulation in the Spleen manifests on the shoulders and spine.
Caused by toxin accumulation from rich diet, presenting with high, bright swelling, with a base not exceeding the shoulders, this is a favorable sign. Initially, prioritize detoxification and protecting the Heart; subsequently, use internal support and clearing Heart heat. Occasionally use Larva and Alum Pill (Lafan Wan) or Heart Protection Powder (Huxin San) to prevent toxin attacking the Heart. If the swelling is flat and hard, gradually expanding to the shoulders, chest, and neck, with swelling but no pain, it is critical.

Heart Meridian Fire-Toxin attacks opposite the Heart.
Opposite-Heart eruption results from reckless Heart Fire moving upward due to extreme heat. Since the Heart is the sovereign, systemic heat gathers here, forming lesions. It easily harms the body and obstructs the Du Mai, causing severe damage. Additionally, the spine has many depressions, making eruption difficult. The sore shape sinks, swelling is not sharp. Treatment requires strongly descending Heart Fire and urgently dispersing accumulated heat. Use needle therapy on the apex to open pathways, followed by drawing-out methods to ensure internal and external ventilation of toxins, preventing internal attack. Maintain defense for fifteen days; if no internal changes occur and pus forms, it resolves. If changes develop, hardness increases, and no pus forms, death occurs around twenty-two days. Early treatment is crucial; three or four out of ten may survive.

Double eruptions on both left and right shoulders; Lung and Liver toxin accumulation is well-deserved.
Left shoulder involvement relates to the Liver; right shoulder involvement relates to the Lungs. Both occur at mobile points of the shoulder bones and are treatable. Initial treatment uses Ten Thousand Spirit Pill (Wanling Dan) to induce sweating and unblock interior/exterior. Follow with Liver-Clearing and Depression-Relieving Decoction (Qinggan Jieyu Tang) or Bupleurum Liver-Clearing Decoction (Chaihu Qinggan Tang). For Qi deficiency, use Four Gentlemen Decoction (Sijunzi Tang); for Blood deficiency, use Four Substance Decoction (Siwu Tang); after ulceration, use Eight Treasures Decoction (Bazhen Tang). Adjust accordingly. This condition originates from Phlegm stagnation, Qi stasis, and Fire depression, with disharmonious Qi and Blood. As stated, open stagnation, move stasis. Misusing external medicine detoxifying and draining Qi, or inappropriate tonifying/purging drugs, will lead to danger.

Lotus Seed and Beehive types fear toxin sinking.
Beehive and Lotus Seed eruptions often occur on the back, near the Heart and level with the spine. Mild cases show long, high swelling or half-back involvement; severe cases show slanting, flat collapse. Both hypochondriac regions are injured, holes resembling beehives, protrusions like lotus seeds. Though feared, they often present multiple risks yet allow survival. Frail elderly patients suffer more; standard care ensures stability. The main rule fears lack of Pure Yang; treatment method need not fear severe sore condition. Heart-Protection and Membrane-Protection Pills/Elixirs require careful adjustment. Adherence to formulas must be guided by medical wisdom. Refer to General Discussion for mechanisms; laws determine life and death.

Kidney Shu eruption on the waist is difficult to cure.
Kidney Shu eruptions occur between the muscles of both waists or in the center. Eruptions here are most critical because the internal Kidney is the root of life, storing Essence, Qi, and Spirit, governing congenital endowment, reproduction, and longevity. This disease results from excessive sexual activity, exhausting Qi and injuring Essence, leading to organ deficiency. Various Fires and Pathogens enter via deficiency, aggregating into sores. If the organ retains some True Yin to control Fire, the sore will be red, vibrant, swollen, and suppurative. Treat with Ginseng Nourishing Harmony Decoction (Renshen Yangrong Tang), adding Cornus Fruit (Shanzhuyu), Schisandra Berry (Wuweizi), Phellodendron Bark (Huangbai), Anemarrhena Rhizome (Zhimu), and Modified Eight Flavor Pill (Jiajian Bawei Wan) to restore the source. If the sore is purple-black, dry, hard, and non-suppurative, it indicates internal failure of True Yin, with no hope of survival.

Du Mai deficiency erupts from the neck, commonly called Opposite-Neck.
Opposite-Neck varies in position: central eruptions are governed by the Du Mai; lateral ones by the Taiyang Bladder. Both arise from Damp-Heat attacking upward and condensing. Du Mai eruptions are easier to treat because the Du Mai rises from below, pierces the spine, and travels upward; thus, toxins surge and swell high. Bladder eruptions, though lateral, are often difficult to treat because the Bladder meridian starts at the vertex, passes through the neck sides, and flows downward, intersecting with toxin flow downwards, resulting in flat sores. Also, Taiyang Bladder governs Cold Water, having cold and heavy qualities, making eruptions here hard to rise, lacking redness/vitality, hard to suppurate, and prone to flowing to shoulders/chest/neck. No pus after fifteen days indicates turning black and returning to Yin, usually untreatable. Treat primarily with Coptis Detoxification Drink (Huanglian Xiaodu Yin); others focus on descending Fire, resolving Phlegm, detoxifying, clearing Heart, and supporting the interior.

Unexpectedly, eruptions behind the ears are frequent; Tian Ju and Rui Du are not minor conditions.
Eruptions occurring 1.3 cun behind the ear are fatal and highly dangerous. Left side is Tian Ju (belonging to Liver Wood); right side is Rui Du (belonging to Lung Metal). Both arise from persistent thoughts and indecision, causing Fire to flare and stagnate repeatedly. Forms are often hard, heads hidden, turning black before ulceration, rotting before suppuration, foul-smelling, with rapid Qi depletion. Toxins often fail to express externally and attack inward after eruption, causing death. However, early stages are subtle and unnoticed; by the time noticed, toxins have entered. If red, vibrant, swollen, easy to suppurate and slough, there is no harm.

Another type, Gangrene of Extremities, arises on hands and feet, rooted in improper tonic practices.
Gangrene begins like millet grains, colored like dates, gradually enlarging. Sinews and bones stand out, turning pitch black, causing cutting pain, decay, and foul odor spreading to ankles, threatening life. This is self-inflicted, not fate. Ancients had methods where amputation could save life. Modern people refuse amputation for fame. Treatment details follow later.

Diffuse swelling is hard to treat; localized swelling is easier; methods in the General Discussion are reliable.
Diffuse swelling means flesh swells but the sore does not; localized swelling means the sore swells but the flesh does not. At initial stage, promotion and eruption are appropriate. After suppuration, internal resolution is contraindicated; use supporting drugs. If ineffective, toxin overpowers Qi and Blood, death in ten days. If erupted but not sloughing, with hard base or soft/diffuse base, urgently administer supporting drugs and strongly tonify Spleen/Stomach. If ineffective, death in twenty days. If ulcerated but color remains dull, failing to regenerate flesh and close, with large halo and unrelenting pain/swelling, indicating failed Stomach Qi, urgently apply strong tonification. If ineffective, it indicates Spleen collapse, death in over a month.

Different sores should be classified separately; do not lightly confuse this presentation.