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For carbuncles and sores (Yongju, 痈疽), where the head has slight swelling, pus often emerges. If the condition is not progressing smoothly, needle cauterization (Zhenlao, 针烙) is suitable. Before the pus matures, one must not fail to apply various medicinal plasters for treatment, in order to stabilize the patient's mind. Once the pus has formed, one should abandon medication and switch to needle cauterization. Since the pus has matured, this is the critical juncture determining life and death; one must not hesitate due to doubt or fear of pain. Within a short period, if the abscess is not ruptured by needle cauterization, the heat-toxin cannot be resolved, and the stagnant pus cannot be drained. If the timing for needling is missed, the pathogen may counter-attack internally. Once the internal righteous qi has collapsed, how can one hope for survival? Alas! Treating this disease with needle cauterization is actually quite manageable; succumbing to death due to hesitation is certainly not easy. This is a fatal affliction. Some conceal this disease, some fear pain and refuse needling; this indicates spiritual depletion and loss of consciousness, with death imminent, which is evident. Carbuncles have thin skin and are suitable for needling; sores have thick skin and are suitable for cauterization. Ancient methods did not use cauterization, only needling. "Cauterization" refers to fire, also called "Fan" (燔). Needle劫刺 (Jieci,劫刺 - coercive needling) is named so because it has the function of coercing the disease. Currently, using the cauterization method often leads to recovery and is very stable, superior to the Pi needle (Biren, 铍针) method. Originally, Pi needles were used, but for cauterization, fire needles should be employed, resembling fire rods. The needle tip should be ground smooth and sized like a jujube pit pill. It is heated over a lamp flame until fire ignites, then coated with oil and burned until red-hot. Cauterization must be performed close to the lower aspect of the lesion. If one cauterization does not penetrate, repeat until penetration is achieved. If the attack area is slightly broad, cauterize at several scattered points, ensuring penetration everywhere, so that Qi can diffuse freely and pus-water can easily exit without requiring pressing or squeezing. For excess conditions, twisted hair can be used as a guide; for deficiency conditions, paper can be used as a liner. One must strive for rapid recovery. If residual pus within the swelling and the root of the pus are not fully expelled, and the wound is hastily closed, recurrence is inevitable later; who can explain the details? All swellings that are generally soft and non-painful are suitable for needle cauterization. If occurring on the back, water cupping (Shuijiao, 水角) is necessary for cure.

Whenever treating carbuncles and sores on the back, if the swelling is high and hard, with thick, abundant, and red-colored pus, water cupping is suitable. If the swelling is depressed, the flesh color remains unchanged, and the texture is soft, slow, and the pus is thin, water cupping is not suitable. The method of water cupping: In a spacious and quiet room, away from drafts, on a flat and solid ground, dig a small pit. The opening should be slightly wider than the swelling, with a depth of less than one chi. [Text gap/ambiguity here regarding distance/position]. Or deviating from wisdom, knowing early that toxic vapors are hard inside, flesh turns to pus, leading to internal ulceration, truly lamentable. When a sore is already severe, applying fire attacks causes fire-toxin to clash, causing irritability and stuffiness; compounded by weakness and exhaustion, how can one not be cautious? Or, wealthy individuals encountering this disease, often store mercury to make water cups, which is particularly excellent. The method for mercury cupping: Select a firm and solid place above, dig a pit, the opening slightly wider than the swelling, depth about four or five cun. First, lay five or six layers of paper in the pit to line the mercury. All other preparations follow the previous method exactly. Use about one sheng of mercury; if unavailable, three or five he is sufficient.