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Qi stated: The manifestations of sores and carbuncles vary. Pain can be caused by cold, heat, deficiency, or excess conditions; therefore, methods for relieving pain are not limited to a single approach. People generally believe that costly herbs such as Ru Xiang (Frankincense) and Mo Yao (Myrrh) can stop pain, unaware that one must adapt treatment to the specific condition. For pain caused by heat-toxin, cooling herbs are used to subdue the heat, and the pain ceases naturally. For pain caused by cold pathogen, warming agents are applied to dispel the cold, and the pain is eliminated naturally. For pain due to wind, the wind is removed; for pain due to dampness, the dampness is guided out; for pain due to dryness, it is moistened; for pain due to obstruction, it is unblocked; for pain due to deficiency, it is tonified; for pain due to excess, it is purged. For pain caused by pus retention and blockage, the blockage is opened; for pain caused by foul tissue erosion and ulceration, the foul tissue is removed; for pain due to disharmony of Yin and Yang, harmony is restored; for pain due to blocked and stagnant meridians, flow is facilitated. Adapting to changing circumstances is the mark of an excellent physician; one must not rigidly adhere to fixed prescriptions without flexibility.

Li Zhai stated: Sores and ulcers arise from injuries caused by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The pain results from stagnation of Qi and Blood. If heat-toxin is internal, causing constipation and pain, Nei Shu Huang Lian Tang (Internal Purging Coptis Decoction) is used to guide the evacuation. If heat-toxin is vigorous, causing swelling and pain, Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) is administered. If there is no response, Xian Fang Huo Ming Yin (Immortal Formula for Preserving Life) is used to resolve the toxicity. If pain is caused by blood stasis and stagnation, Ru Xiang Ding Tong Wan (Frankincense Pain-Relieving Pill) is used to harmonize. If pain occurs during suppuration, Tuo Li Xiao Du San (Support Interior and Eliminate Toxin Powder) is used to drain the pus. If pain is due to pus distension, acupuncture or lancing is employed. If pain persists after the pus has drained, tonification is used. If pain is due to Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) with Dang Gui (Angelica Sinensis) is added. If pain is due to Blood deficiency, Si Wu Tang (Four Substances Decoction) with Ren Shen (Ginseng) is added. If pain is due to Kidney deficiency, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is used. For symptoms of dry mouth, thirst, and frequent urination, Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) is prescribed. These are all methods for relieving pain; one must be cautious about indiscriminately using cold-natured herbs. Moreover, Qi and Blood prefer warmth and dislike cold; if cold qi enters the interior, Blood will stagnate, resulting in a difficult-to-cure condition. Danxi stated: Pain persisting after pus drainage indicates deficiency, which should be treated with tonification. If affected by foul odors, harmonization is required; if constrained by Wind-Cold, warming dispersion is needed. If one exclusively uses Xue Jie (Dragon's Blood) and Er Cha (Chernomorite/Catechu) for flesh regeneration, and Ru Xiang and Mo Yao for pain relief, I know this will certainly be ineffective.

In cases where carbuncle toxins cause severe swelling, redness, and pain, although internal treatments have been described above, decoctions act slowly. When pain is acute and unbearable, external applications must be used. To achieve both pain relief and toxin dispersion, there is nothing more miraculous than Jiang Yong San (Carbuncle-Reducing Powder).