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Chapter on Carbuncles and Ulcers (Yong Ju Pian): The Yellow Emperor said: When the blood and qi are already harmonized, the form and qi are maintained. I already know the balance and imbalance of blood and qi, but I do not yet know from where carbuncles and ulcers arise, their timing of success or failure, and the duration of life or death. How can they be measured? May I hear about it? Qibo said: The flow of meridians never ceases, corresponding to the degrees of heaven, and conforming to the laws of earth. Thus, if the celestial bodies lose their proper degrees, solar and lunar eclipses occur; if the earthly paths lose their regularity, water channels overflow, grass and trees fail to grow, and the five grains fail to multiply; if roads are blocked, people cannot travel, and villages and cities become separated and dispersed. The movement of blood and qi is similar. Let me explain the reason: Blood vessels, Ying (Nutrient) Qi, and Wei (Defensive) Qi circulate ceaselessly, responding above to the stars and below to the earthly measures. When cold pathogens lodge in the meridians, blood becomes stagnant. When blood stagnates, it does not flow freely. When it does not flow, Wei Qi gathers there and cannot return, thus forming a carbuncle or swelling. Cold qi transforms into heat. When heat prevails, flesh rots; when flesh rots, pus forms. If pus is not drained, tendons rot; when tendons rot, bones are damaged; when bones are damaged, marrow diminishes. If not at bone openings, pus cannot drain, blood becomes depleted and empty, tendons, bones, muscles, and flesh lose mutual nourishment, meridians deteriorate and leak, heat steams the five Zang organs, damage to the Zang organs leads to death.

The Yellow Emperor said: I wish to hear fully about the manifestations of carbuncles and ulcers, as well as the names of taboo days. Qibo said: A carbuncle arising in the throat is called Meng Ju (Fierce Carbuncle). If Meng Ju is not treated, it turns to pus. If pus is not drained, it blocks the throat, leading to death within half a day. For those who have turned to pus, draining it and applying pig fat ointment, taken cold, results in recovery in three days. A carbuncle arising in the neck is called Yao Ju (Premature Death Carbuncle). Its swelling is large with red-black color. If not treated urgently, heat qi descends into the Yuan Ye area, damages the Ren Mai anteriorly, and steams the Liver and Lungs internally. Steaming the Liver and Lungs leads to death in ten-plus days. Excessive expansion of Yang Qi, consuming brain marrow and remaining in the nape, is called Nao Shuo (Brain Melting). With a displeased expression, neck pain like needle pricking, and vexation, it is a fatal condition unamenable to treatment. A carbuncle arising in the shoulder and scapula region is called Ci Yong. Its appearance is red-black. It requires urgent treatment; this causes sweating down to the feet but does not harm the five Zang organs. For carbuncles arising for four or five days, they should be pierced with bi stone. A carbuncle arising in the axilla that is red and hard is called Mi Ju (Rice Carbuncle). It is treated with bi stones, which should be fine and long, pricked sparsely, coated with pig fat ointment, resulting in recovery in six days, without bandaging. Those carbuncles that are hard and do not ulcerate are called Ma Dao Jia Ying (Horse Knife with Pendant), requiring urgent treatment. A carbuncle arising in the chest is called Jing Ju (Well Carbuncle). Its shape resembles a soybean. It arises in three to four days. If not treated early, it descends into the abdomen; if untreated, death occurs in seven days. A carbuncle arising in the precordium is called Gan Ju (Sweet Carbuncle). It is green in color, shaped like a grain fruit, often suffering from chills and fever. Urgent treatment is required to remove chills and fever; otherwise, death occurs after ten years, with pus discharge post-mortem. A carbuncle arising in the hypochondrium is called Bai Ci. Bai Ci is a disease specific to women. Moxibustion treatment causes a large abscess with pus. Treatment reveals living flesh inside, sized like a adzuki bean. One part each of chopped Qian Cao Gen (Radix Rubiae) is boiled in 16 sheng of water until reduced to 3 sheng. The patient drinks it strongly, wears thick clothes, sits over a pot to induce sweating down to the feet, resulting in recovery. A carbuncle arising in the thigh and calf is called Gu Ting Ju. Its appearance changes little, but the abscess presses against the bone. If not treated urgently, death occurs in thirty days. A carbuncle arising in the sacrum is called Rui Ju. It is red, hard, and large. Urgent treatment is required; otherwise, death occurs in thirty days. A carbuncle arising in the inner thigh is called Chi Shi. If not treated urgently, death occurs in sixty days. If between both thighs, untreated, death occurs in ten days. A carbuncle arising in the knee is called Ci Yong. It is a large carbuncle with unchanged color, accompanied by chills and fever, feeling like hard stone. Do not pierce with bi stone; piercing leads to death. Wait until it softens, then pierce to survive. Carbuncles and ulcers arising at joints bilaterally are incurable. Those arising in Yang meridians lead to death in one hundred days; those in Yin meridians lead to death in thirty days. A carbuncle arising in the lower leg is called Tu Nie (Rabbit Bite). It is red down to the bone. Urgent treatment is required; otherwise, it harms the person. A carbuncle arising in the medial malleolus is called Zou Huan. It appears as a carbuncle with unchanged color. Frequent bi stone therapy at its Shu points stops chills and fever, ensuring survival. A carbuncle arising above and below the foot is called Si Yin. It is a large carbuncle requiring urgent treatment; death occurs in one hundred days. A carbuncle arising on the side of the foot is called Li Yong. It is not large, initially like a small finger. Upon onset, urgent treatment is required to remove blackened tissue; if it does not subside and increases, untreated death occurs in one hundred days. A carbuncle arising in the toe is called Tuo Yong. It is red-black, a fatal condition unamenable to treatment. If not red-black, it is not fatal. If it does not recede, urgent amputation is required; otherwise, death ensues.

The Yellow Emperor asked: Master, regarding carbuncles and ulcers, how are they distinguished? Qibo replied: When Ying Qi stagnates in the meridians, blood stagnates and does not flow. When blood does not flow, Wei Qi follows but cannot pass, becoming obstructed and unable to move, thus generating heat. Persistent high heat causes flesh to rot and turn to pus. However, it does not sink deeply; the bone marrow is not scorched, and the five Zang organs are not injured. Hence, it is called a Carbuncle (Yong). The Yellow Emperor asked: What is a Ju? Qibo replied: When heat qi is pure and abundant, sinking into the skin and muscles, drying up tendons and marrow, connecting internally to the five Zang organs, exhausting blood and qi, beneath the lesion, tendons, bones, and healthy flesh are entirely destroyed. Hence, it is named Ju. On Ju, the upper skin is withered and hard, resembling the skin of an ox's neck. On Yong, the upper skin is thin and lustrous. These are their signs.

Chapter on Jade Tablet (Yu Ban Pian): The Yellow Emperor said: Diseases arise from unpredictable emotions, irregular diet, deficiency of Yin Qi, excess of Yang Qi, and stagnation of Ying Qi, leading to carbuncles and ulcers. When Yin and Yang are blocked, two heats clash and transform into pus. Can small needles treat this? Qibo said: Treating a major condition with small needles yields little effect; treating a major condition with large needles causes much harm. Therefore, for cases where pus and blood have formed, only bi stones or Pi Feng (scalpels) can extract them. The Yellow Emperor asked: If there is much harm, can it not be completely cured? Qibo said: It depends on whether the pattern is Ni (Rebellious/Adverse) or Shun (Smooth/Favorable). If the eyes show blue whites and small pupils, this is the first Ni. Vomiting after taking medicine is the second Ni. Abdominal pain with severe thirst is the third Ni. Inconvenience in shoulders and neck is the fourth Ni. Hoarse voice and loss of complexion is the fifth Ni. Excluding these five, it is Shun.

Chapter on Cold and Heat Diseases (Han Re Bing Pian): The five Zang organs correspond to five body regions: Futu (Stomach Channel point ST32) is one, the calf (Fei) is two, the back is three, the Shu points of the five Zang organs are four, and the neck is five. Carbuncles and ulcers in these five regions indicate death. The harm of acupuncture: if needling hits the target but pathogenic factors are not expelled, essence leaks; if needling misses the target and the needle is withdrawn, pathogenic qi accumulates. Essence leakage worsens the disease and causes weakness; accumulation of pathogenic qi generates carbuncles and ulcers.

Chapter on Discussion of Vital Energy and Heavenly Connection (Sheng Qi Tong Tian Lun): Changes from rich food and alcohol can generate large Ding (boils), receiving pathogens as easily as holding an empty vessel. Sweating while exposed to dampness generates Acne and Prickly Heat. Labor sweat exposed to wind, with cold pressing upon it, causes rash; depression leads to acne. Ying Qi failing to follow normal pathways, reversing in muscle textures, generates carbuncles and swellings. Pathogens sinking into vessels cause fistulas, lingering in muscle layers; following full meals, tendons and vessels relax, intestinal damp-heat generates hemorrhoids.

Chapter on Discussion of Yin and Yang Differences (Yin Yang Bie Lun): Disease of the Three Yang meridians presents with chills and fever, and carbuncles/swellings in the lower body.

Chapter on Meridian Lengths (Mai Du Pian): Disharmony of the Six Fu organs leads to stagnation and knotting, forming carbuncles.

Chapter on Diverse Methods and Suitable Areas (Yi Fa Fang Yi Lun): In the Eastern region, people eat fish and prefer salty flavors; their diseases are all carbuncles and sores. Treatment suits bi stones. Thus, bi stones originated from the East.

Chapter on Qi Acupoints (Qi Xue Lun): Large gatherings of muscle are called Gu (Valleys); small gatherings are called Xi (Streams). Between muscle divisions, at the convergence of Xi and Gu, Ying and Wei Qi circulate, and Great Qi converges. Pathogenic overflow causes stagnation, vessel heat and tissue decay, Ying and Wei Qi stagnation, inevitably forming pus, internally consuming bone marrow, externally rupturing large collaterals. Lingering at joint crevices leads to deterioration; accumulated cold lodges, Ying and Wei Qi fail to reside, muscles and tendons curl and shrink, ribs and elbows cannot extend, internally causing Bone Bi, externally causing numbness. This is termed Deficiency. It is caused by great cold lodging in Xi and Gu.

Chapter on True Pathogens and Acupuncture Joint (Ci Jie Zhen Xie Pian): When Empty Pathogens invade, the body shivers and trembles, lanugo rises, and Cou Li open. If invading deeply, clashing with bone, it causes Bone Bi; clashing with tendons, tendon spasms; clashing within vessels, blood closure; blockage causes carbuncles. Empty Pathogens enter deeply; cold and heat clash, lingering internally. If cold prevails, bone pain and muscle wasting occur. If heat prevails, flesh rots and muscles decay into pus, internally damaging bone, causing Bone Erosion. Prior tendon disease with屈曲 (flexion) inability, where pathogenic qi resides and does not retreat, develops into Jin Liu (Tendon Slurry). Where Qi gathers, Wei Qi stays, unable to return; fluids linger, combining to form Chang Liu (Intestinal Slurry). Long-standing, forming over years, soft to touch. Where Qi gathers, fluids linger, pathogenic qi invades, condensation increases daily, clustering to form Xi Liu (Old Slurry), hard to touch. Where Qi gathers, deep in bone, Qi combines with bone, enlarging daily, forming Gu Ju (Bone Carbuncle). Where Qi gathers, in flesh, Zong Qi gathers, pathogenic qi stays, heat transforms to pus, no heat forms Rou Ju (Flesh Carbuncle). These various Qi have no fixed location but have fixed names.

Chapter on Disease Capabilities (Bing Neng Lun): The Yellow Emperor asked: Regarding stomach carbuncles, how should diagnosis proceed? Qibo answered: Diagnose by observing the Stomach pulse. It should be deep and fine. Deep and fine indicates Qi rebellion. Rebellion causes the Ren Ying pulse to be very vigorous, indicating heat. Ren Ying is the Stomach pulse. Rebellious and vigorous means heat gathers at the stomach opening without flowing, causing stomach carbuncle. The Emperor asked: Neck carbuncles are sometimes treated with bi stone, sometimes with acupuncture, both curing. What is the truth? Qibo said: Same name, different categories. For relaxed carbuncle Qi, acupuncture is suitable to open and remove. For excessive Qi and blood accumulation, bi stone drainage is suitable. This is "Same Disease, Different Treatment."

Chapter on Essential subtleties of Pulse Investigation (Mai Yao Jing Wei Lun): The Emperor asked: All carbuncles, swellings, tendon spasms, and bone pain, how do they arise? Qibo said: These are swellings of cold Qi and variations of Eight Winds. The Emperor asked: How to treat? Qibo said: These are seasonal diseases; treat using the controlling cycle for cure.

Chapter on Jue Syndrome (Jue Lun): Shaoyang Jue Ni (Rebellious Counterflow) causes joint dysfunction. Dysfunction means inability to walk or look back. Developing intestinal carbuncle is incurable; shock leads to death.

Chapter on Cold and Heat (Han Re Pian): The Emperor asked: Cold-heat Lu Li (scrofula) in neck and axilla, what Qi causes this? Qibo said: These are toxins of Shu Lu (mouse scrofula) cold-heat, lingering in vessels. The root lies in the Zang organs, the branch emerges in neck and axilla. Floating in vessels, not lodged in muscle, externalizing as pus and blood, is easy to remove. The Emperor asked: How to remove? Qibo said: Guide from root to branch to decline and eliminate cold-heat. Follow the pathway to treat, slow entry and exit to remove. Small as wheat grain, one puncture shows effect, three punctures cure. The Emperor asked: How to determine life and death? Qibo said: Observe the eyes. Red vessels crossing the pupil vertically: one vessel, death in one year; one and a half, death in one and a half years; two vessels, death in two years; two and a half, death in two and a half years; three vessels, death in three years. Red vessels not crossing the pupil are treatable.

Chapter on Comprehensive Evaluation of Deficiency and Excess (Tong Ping Xu Shi Lun): "Using few needles and stones" does not refer to carbuncles and ulcers. Carbuncles and ulcers cannot wait a moment.

Chapter on Great Theory of Qi Intersection and Change (Qi Jiao Bian Da Lun): Excessive Fire year, people suffer body heat and bone pain, developing spreading sores. Excessive Metal year, people suffer lower abdominal and hypochondriac pain, red painful eyes, Lung injury, deafness. Insufficient Wood year, rebound is hot summer fire. Dampness turns dry, causing chills, fever, sores, prickly heat, carbuncles, acne. Insufficient Metal year, rebound is sudden cold rain, people suffer mouth ulcers. Insufficient Water year, people suffer cold sores with fluid discharge.

Chapter on Great Theory of Five Constants and Administration (Wu Chang Zheng Da Lun): Wei He era, disease includes limb paralysis, carbuncles, sores. Bei Jian era, movement includes sores, swelling, rupture, carbuncles. He Xi era, disease includes laughing malaria, sores. Jian Cheng era, movement includes violent fracture, sores, epidemics. Shaoyang ruling Heaven, Fire Qi descends, nasal obstruction, sores. Taiyang ruling Heaven, Cold Qi descends, severe edema, posterior carbuncles. Shaoyin ruling Heaven, Heat Qi descends, severe sores. Earth has heights and depths, Qi has warmth and coolness. High places are cold, low places are hot. Thus, going to cold/damp causes distension, going to warm/hot causes sores. Purging cures distension, sweating cures sores.