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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) records: The Yellow Emperor asked Qibo, "How can one distinguish between a carbuncle (Yong) and a deep-seated abscess (Ju)?" Qibo replied, "When Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) stagnate within the meridians, blood flow becomes sluggish and obstructed. When blood flow is obstructed, Wei Qi becomes congested and blocked, failing to circulate freely, thus generating intense heat. Excessive heat causes flesh to rot and transform into pus. However, this pathogen cannot sink deeply into the bone marrow, nor does it erode or drain from the bone marrow; it remains within the blood vessels, causing blood to coagulate and accumulate. Internally, it arises in the chest, abdomen, and zang-fu organs; externally, it appears on the surface of skin, flesh, sinews, and bones. These two types of toxins have no fixed location of onset but possess standard names. The root cause of such stagnation begins with old blood failing to be expelled through sweating, and stale flesh failing to shed impurities. The steaming qi fails to reach the exterior, accumulating to form internal heat.

The formation of pus and fluid in Yong and Ju is neither descended from heaven nor emerged from earth, but accumulates gradually from minute origins. Those who wish to preserve life should seek medical treatment before injury occurs, prevent symptoms before they manifest, and regulate the condition before the disease forms. This is called detecting it in the morning and treating it by evening, thereby preventing the body from suffering from Yong and Ju, leading to the accumulation of pus and blood. Is this not far removed from the Great Dao? Once pus and fluid have formed, eight or nine out of ten patients will die. How can one not be cautious?

However, there are many causes for onset, varying in nature. Some become sores (Chuang), some boil-like lesions (Jie), some carbuncles (Yong), and some deep abscesses (Ju). Initially, the sensations may differ slightly, but one must harbor great fear, as if facing capital punishment. If treated promptly, Yong, Ju, Jie, and Chuang will certainly heal. [Text missing/corrupted here regarding specific early signs]. Ju arising in... [Text missing] ...is easy to cure with moxibustion... [Text missing]. All stem from internal... [Text missing] liquid draining its... [Text missing] excessive heat... [Text missing] turning yellow at times. How can one distinguish the depth and superficiality of this disease? Therefore, death results. Treating Yong and Ju is like treating sudden syncope (Bao Jue); there are sufficient... [Text missing] and onset varies in speed. Onset in the throat, tongue, face, brain, and nape, shoulders, back, upper chest, abdominal interior, large joints of limbs, and women's mastitis (Du Ru) belong to slower onset. If occurring in dangerous locations, detecting it in the morning and treating it by evening might lead to recovery. Suddenly encountering a good physician while oneself not understanding this analogy, recovery is merely luck.

However, the onset of Yong and Ju has two main categories: swelling that is high and soft indicates onset in the blood vessels; swelling that is low and hard indicates onset in the bone marrow. Superficial sores desire thick pus; deep sores desire thin pus. In Yong and Ju swelling, pain only upon firm pressure indicates shallow pus; indentation that does not rebound upon pressure indicates no pus, but rather edema.

If swelling increases daily without significant heat, accompanied by occasional pulling pain, it is a Qi Tumor (Qi Liu), caused by Qi knotting into swelling. If it persists for a long time without resolving, it may later become a Yong. This is due to cold qi... [Text missing] expelling... [Text missing] resolving... [Text missing]. Cases where fever should occur but are accompanied by aversion to cold indicate Yong or Ju.

The treatise states: Among the nobility (Zan Gui), cases of Yong and Ju often lead to critical distress; among the common people, occurrences are fewer and dangers less severe. Why? Humans receive Qi similarly, embodying Yin and Yang, and consume vinegar and salt alike, yet diseases differ. The answer is: Heroes and dignitaries have extraordinary desires. They do not tread on frozen cold in winter, nor suffer scorching heat in summer. They dine with ringing bells and bronze tripods, and ingest milk-stone (Ru Shi) preparations. This accumulates Yin and stagnates Yang, leading to obstruction and coagulation. Stagnant Qi damages the blood vessels, and Yong and Ju arise with the accumulation. Severe cases end within ten days; mild cases perish after a month. Thus, the common people are different. Why? Their vegetable food supply is insufficient, and their bodies are frequently struck by cold and heat. Although Wei Qi may have沉滞 (stagnation), physical labor allows toxins to be excreted with sweat. Sleep and regulation differ, hence paths of disease diverge. Comparing a life of ease to a life of toil, how can they be discussed on the same day?

Therefore, Chu Cheng, Minister of Works in the Jin Dynasty, treated widows and nuns. Although they lacked sexual exhaustion, they suffered from worry and thought. This demonstrates profound understanding of human nature. Examining pulse floating and sinking for acupuncture, and ensuring moxibustion/cauterization is regulated, truly requires no worry. If left to mediocre or ignorant practitioners, critical danger and death follow immediately. Encountering a good physician ensures complete recovery. However, if one follows routine practices arrogantly, consults ordinary folk, resigns oneself to fate, prays for self-healing, or violates various taboos, these are causes of death due to doubt and poor planning.

In ancient times, those with Yong forming large pus survived only one or two out of ten. For Ju on the finger, therapists amputated the distal segment. It is said Lu Chun had efficacy in finger amputation. Reflecting quietly, this is not a good method. Why? Treating Yong and Ju without precise identification, applying needles and moxa indiscriminately, using scalpels for cutting, makes the toxin more severe, making guaranteed efficacy difficult. Figures like Liu Juanzi and Bian Que, though famous in antiquity, did not fully comprehend the principles upon careful examination. Thus, ancients abandoned Yong with large pus (choosing conservative management or deeming it untreatable) and amputated Ju on fingers without hesitation. Abandoning pus means abandoning severe illness, which is not the work of a skilled artisan; amputating fingers harms the root... [Text missing] . Current treatment is different. Why? Regulating zang-fu to ensure unobstructed flow, harmonizing Ying and Wei to prevent congestion, mastering the source of Qi and Blood dispersion and gathering. Internally, tonifying deficiency and draining excess, regulating superficial and deep levels. Externally, irrigating with decoctions... [Text missing] to protect sinews and bones, ensuring superficial flesh does not necrose. Regarding care regulations, there are established standards. However... [Text missing] lies in the mind, beyond the capacity of the dull to fully articulate. Medicine is an art of intent. Adapting to the times, I briefly outline the general principles to establish the main framework."