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Xu Jianlao, Vice Minister of Works, in the early days of the third month of the Dingyou year (1577) of the Wanli era, went to congratulate the longevity of Madam Zang of Changxing. He developed chills and fever, and a toxic carbuncle (a severe skin infection) appeared on the hard area near the anus in his buttocks. It was red, swollen, and painful, making sitting and lying down difficult. Therefore, he returned to Jingxi to seek treatment from a surgeon. The surgeon punctured the lesion with a needle, inserted a medicinal thread into it, applied caustic medicine to induce rapid suppuration and drainage of pus and blood, and then applied flesh-regenerating medicine to the wound to facilitate healing. After receiving payment, Mr. Xu left. Within half a month, the adjacent hard area became red, swollen, and painful again, with alternating chills and fever, nearly forming an abscess. Because the previous doctor seemed to have achieved some effect, he was invited back. Upon arrival, the doctor used the same method as before, took payment, and left. The condition and doctors changed repeatedly; each time involving needle puncture and insertion of medicinal threads. In total, the patient underwent this treatment eight times, and there were eight different doctors involved, including Zhang, Lu, and Feng. Among them, a surgeon surnamed Chen received the most payments overall. This period lasted from March of the Dingyou year to August of the Wuxu year, spanning one and a half years.

At that time, I was summoned by Mr. Wu Shaoxi to Suzhou. Learning that Mr. Wu was bedridden, I hurriedly visited him at his bedside. Seeing me arrive, Mr. Wu was filled with both sorrow and joy. He detailed the history of his illness, the suffering caused by needles and knives, and the deep pain of lying prostrate for so long, which moved me to tears. Observing his complexion closely, it appeared blueish and gloomy. Palpating his pulse, it was soggy and weak. Touching his hands and feet, they were cold as ice. Asking about his diet, he reported eating only four-tenths of his usual amount. Investigating the medicines he had taken, they consisted mainly of Huaijiao (Fructus Acanthopanacis Senticosi), Huangbai (Cortex Phellodendri), and Shengdi (Radix Rehmanniae Preparata), which are herbs for cooling blood and detoxifying.

I was shocked and said to Mr. Wu: "This perianal carbuncle is not a fistula ani (anal fissure/fistula). Fistula ani should be treated with seton therapy, and applying Wuhui Gao (Five Ashes Ointment) can cure it. Now, the swelling and hardness are indefinite in location and far from the anus. Moreover, initially, there was no hard mass; the current hardness resulted from the stagnation caused by inserting caustic medicines. As the proverb says: 'Digging out flesh to create a sore,' does this not describe the situation? If your constitution were not robust and your Stomach Qi (digestive energy) not strong, how could you endure such exploitation at over sixty years old? Initially, one should only greatly tonify Qi and Blood. Even if there is pathogenic toxin, one should only use the method of expelling toxins by drawing out pus to achieve healing. For unformed pus, one should promote its dispersion and resolution, preventing further toxicity. This is the 'King's Way' of gentle treatment, which is vastly superior to needles and knives! Your treatments are like people trying to avoid their shadows: not realizing that stopping in the shade eliminates the shadow, but instead running frantically to escape it, causing the shadow to move faster and exhausting one's breath. This is self-destruction."

Mr. Wu initially did not accept my advice because I was not a surgeon. However, after listening to my analysis, he suddenly realized the truth. Seeing that my book *Xuanzhu Ji* contained two volumes on surgery, he further believed in my surgical expertise and accepted my treatment. I immediately prescribed Shiquan Dabu Tang (Complete Golden Pill to Tonify Great Deficiency Decoction). After four doses, his appetite increased, his hands and feet warmed up, and his previously stubborn constipation, which resisted all moistening and purgative methods, became smooth and easy, with no sensation of anal discomfort. The other surgeons continued to argue that tonification was incorrect. I strongly refuted them. Mr. Wu listened only to me. I prescribed a pill formula containing Hesouwu (Polygoni Multiflori Radix Praeparata, 4 liang), Renshen (Ginseng Radix et Rhizoma, 2 liang), Gouqizi (Lycii Fructus, 2 liang), Huangqi (Astragali Radix, 2 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Shudi (Rehmanniae Radix Preparata, 2 liang), Huaijiao (Fructus Acanthopanacis Senticosi, 1 liang), and Qinjiu (Gastrodiae Rhizoma, 1 liang), made into honey pills. Before finishing one dose, the swelling slightly discharged pus and completely healed, without any new hard masses forming nearby. This further confirmed that the previous hardness was caused by the toxicity of the inserted caustic medicines. Mr. Wu joked happily: "If not for Dr. Sun, the other surgeons would view my illness as a gold mine, and their demands would never end!" Haha!