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Xue Ji stated: The syndrome of Liuzhu (flowing obstruction) is mostly caused by emotional depression, sudden rage, or spleen qi deficiency leading to the reversal of dampness in the muscle tissue. It may also result from loose interstices (skin pores and muscle gaps) allowing cold pathogens to lodge in the meridians, presence of damp-phlegm, sprains or falls, postpartum blood stasis flowing into joints, or residual pathogens from Shanghan (cold damage disease) not yet cleared. All these occur because of a deficiency in true qi, allowing pathogens to take advantage, resulting in qi stagnation and blood coagulation. However, for this syndrome, whether it arises in the limbs and joints, or in the chest, abdomen, waist, and buttocks; whether it forms a lump or diffuse swelling; whether it is painful or painless, one should appropriately use the Congyi method (applying hot scallion packs to the affected area) and Qiyi Yangying Tang (Qi-Nourishing Decoction) to consolidate the original qi. Thus, unformed abscesses will dissipate on their own, and formed ones will suppurate and heal, leading to complete recovery. If one does not tonify qi and blood, nor regulate diet, be cautious with daily life, and guard against the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), but instead exclusively uses cold and purgative drugs, it cannot be cured.

Furthermore, "Treatment Methods" states: In frequently treating this syndrome, if caused by sudden rage with chest and diaphragm discomfort, regulation of qi is primary. If caused by depression without pain, regulating the meridians and tonifying qi and blood are appropriate. For swollen, hard, and painful areas, moving qi and harmonizing blood is indicated. For ulcers that fail to heal, tonifying qi and blood is primary. For residual pathogens from Shanghan, harmonizing and resolving them is suitable. For spleen qi deficiency with damp-heat stagnating in muscle tissue, strengthening the spleen and removing dampness is primary. For injuries from sprains and falls with blood stasis stagnation, harmonizing qi and blood and regulating meridians is appropriate. For attacks by cold pathogens causing tendon spasms, bone pain, or generalized body pain, warming the meridians and nourishing qi and blood is indicated. If the condition persists without healing and the ulcer shows signs of "Yang deficiency" (lack of yang energy), moxibustion with fermented soybean cakes or aconite cakes is suitable to dispel cold pathogens and restore yang qi. Alternatively, Hupo Gao (Amber Plaster) can be applied externally. If there are internal sinus tracts or overgrown granulation tissue preventing healing, Zhitou San (Needle Head Powder) should be used to remove necrotic tissue for self-healing; Dingzi (pill-shaped medicine) is particularly effective.

"Yilin Jiyao" (Essentials of the Medical Forest) states: Guju (bone carbuncle) is a deteriorated stage of Liuzhu. If cooling medicines are used, they will internally injure the spleen and externally freeze the blood. The spleen governs muscles; when spleen qi is injured, appetite decreases, and muscles do not grow. Blood flows through vessels; when frozen, qi and blood become weak and stagnate further. It is appropriate to regulate the spleen; when the spleen is healthy, blood generates naturally, and qi circulates smoothly. There is also the pathogen known as Baihu Feishi (White Tiger Flying Corpse), which lingers for cycles or years until cold toxins and necrotic bones are expelled, after which it heals spontaneously. If the flesh attached to the bone rots, it can be cured; if the bone itself rots, it results in lifelong disability. If toxic swelling arises from the hands, feet, or head and face, accompanied by pain, spreading upwards to the neck and joints like linked beads, this is a Wind-Dampness Flowing Qi syndrome, treatable with Jiajian Xiaoyuming Tang (Modified Minor Rescue Decoction) and Duhuo Jisheng Tang (Angelica Pubescens and Taxillus Decoction). If both knees swell and hurt, or general joint pain occurs, this is Wind-Dampness Bi Syndrome, also known as Lijie Feng (Traveling Joint Wind), treatable with Fuzi Bawu Tang (Aconite Eight Substances Decoction). There are also nodules in the neck, armpits, beside the breasts, or soft flesh of the groin, called Shiyong (Stone Carbuncle), belonging to Cold Syndromes. In children, retained phlegm deviating from its path can cause nodules in the neck, buttocks, arms, chest, and back, also constituting Shiyong, all of which should be treated with warm compresses. All the above syndromes originate from the Kidney. The Kidney governs bones; Kidney deficiency leads to cold bones, causing disease. So-called Guju all arise from the Kidney, hence the root lies here. Therefore, large doses of Fuzi (Prepared Aconite Root) are used to tonify Kidney qi; when the Kidney is solid, bones have vital energy, and the carbuncle does not adhere to the bone.

A male patient had a slightly painful swelling on his buttock with a wiry-tight pulse. He was treated with Chuangke Liuqi Yin (Wound Specialist Flowing Qi Decoction) for four doses, and it resolved.

A female patient suffered from a swollen mass on her waist due to sudden rage, with chest diaphragm discomfort and intermittent wandering pain. She was treated with Fangmai Liuqi Yin (Pulse Diagnosis Flowing Qi Decoction) for several doses to stop the symptoms, followed by Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substances Decoction) plus Xiangfu (Cyperus Rhizome) and Beimu (Fritillaria Bulb). She recovered after more than a month.

Another female patient, constitutionally weak and irritable, experienced swelling and pain in her hypochondrium and arm, with chest fullness. After taking Liuqi Baidu Yao (Flowing Qi Detoxifying Medicine), she developed fever. She was treated with Siqu Tang (Seven Four Decoction) for several doses, relieving chest fullness and promoting qi flow. Then, Xiaochaihu Tang combined with Siwu Tang plus Chenpi (Tangerine Peel) and Xiangfu reduced the swelling and pain. Generally, women tend to be emotionally fixed and unable to relax, making them susceptible to injury by the Seven Emotions, leading to generalized pain, joint swelling, chest oppression, globus sensation (feeling of a plum pit in the throat), excessive phlegm, shortness of breath, nausea, or severe thirst and distress. Postpartum women often suffer from this. It is appropriate to take Siqu Tang first to regulate stagnant qi, followed by blood-nourishing herbs. If urinary turbidity is caused by worry and overthinking, swallowing Qingzhou Baiwanzi (Qingzhou White Pills) with this decoction has proven effective repeatedly.

An elderly patient had residual exterior pathogens from Shanghan, presenting with swelling and fever in the inner thigh. Renshen Baidou San (Ginseng and Imperata Powder) for two doses stopped the fever. Moxibustion with Xiangfu cakes was applied, followed by Xiaochaihu Tang combined with Erchen Tang (Two Aged Things Decoction), Qianghuo (Notopterygium Rhizome), Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Baizhu (Atractylodes Macrocephala Rhizome), and Zhike (Bitter Orange Fruit). It resolved after several doses.

A male patient had an ulcerated leg wound that failed to heal. He was treated with Renshen Yangying Tang (Ginseng Nourishing Qi and Blood Decoction) and Aconite Cakes, along with topical application of tonic paste. He healed after more than two months.

A male patient had a leg swelling with unchanged skin color and no pain, with a floating-slippery pulse. He was given Buzhong Yiqi Tang (Central-Boosting and Qi-Supplementing Decoction) added with Banxia (Pinellia Tuber), Fuling (Poria), Zhike, and Muxiang (Aucklandia Root), and the area was moxa-warmed with Xiangfu cakes. He believed that qi disorders should not be treated with tonification, so he took Fangmai Liuqi Yin, worsening his deficiency. Upon seeking further treatment, Liujunzi Tang (Six Gentlemen Decoction) added with Chuanxiong and Danggui for several doses improved his appetite. Continued tonification led to resolution after a month. The saying "qi disorders cannot be treated with tonification" is a vulgar theory. Although the disease presents as blockage, seemingly difficult to tonify, it is unknown that when defensive qi is deficient and fails to circulate, pathogens stagnate and cause disease. The Classics state: Those who are strong recover as qi moves; those who are weak suffer lingering disease. Without tonification, how can original qi move?

A female patient suffered from leg tendon spasms and bone pain, unresponsive to various medicines, with a slow-tight pulse. Dafangfeng Tang (Major防风 Decoction) for two doses rapidly alleviated symptoms, and she stabilized after another two doses. Another female patient with similar symptoms took two doses of the previous decoction, followed by Hei Wanzi (Black Pills), and recovered. If these cases were mismanaged, they would likely suppurate and become incurable.

A male patient had slight swelling on his shoulder blade, with physical exhaustion and weak qi. He took Qiyi Yangying Tang and Hei Wanzi, and applied Muxiang Shengdihuang Bing (Aucklandia and Rehmannia Cake) to the area with heat compression. Pus formed after a month. Incision and drainage were performed, and he continued the previous medication to heal.

A male patient had arm swelling, tendon spasms, and bone pain, which only suppurated after more than a year and failed to heal. His pulse was even weaker. One dose of Neisai San (Internal Obstruction Powder) brought slight improvement. He was then treated with Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) and moxibustion with Aconite Cakes, leading to recovery. "Jingyao" states: Long-standing accumulation generates yang from extreme yin, and cold transforms into heat. Thus, ulcers often become atrophic; early administration of Neisai San is recommended to expel pathogens.

A male patient expelled three pieces of necrotic bone from his arm wound, which still did not heal, accompanied by fever, thirst, and a large-slippery-pulse. This indicated dual deficiency of qi and blood, requiring abundant intake of qi- and blood-generating herbs for preservation. Confused by the belief that fire toxins were not fully cleared, he continued using cooling medicines internally and externally, nearly dying before seeking help. His appearance was emaciated, and his pulse extremely weak. First, Liujunzi Tang added with Chuanxiong and Danggui was given for a month, gradually improving his diet. Bazhen Tang (Eight Treasures Decoction) added with Rougui (Cinnamon Bark) for more than thirty doses turned the wound red. Finally, Shiquan Dabu Tang was taken, with external moxibustion using Aconite Cakes, leading to recovery within a year. (Note by Xue Ji)