Library

Xiao Shangda Formula (from *Danfang Jiyuan*)
Scorpio (three pieces) Walnut kernel (three pieces)
Grind together into a fine powder, take with hot wine. The swelling will naturally subside after one or two doses.

Zhongda (Middle Shoulder Carbuncle)
Wang Kentang stated: Zhongda is also known as Longju (Dragon Carbuncle). It arises on both sides of the ninth thoracic vertebra. It presents with sudden swelling and pain without a head, accompanied by severe chills and high fever. It belongs to the Taiyang meridian.
It is caused by disharmony of the Seven Emotions, specifically anger leading to accumulated heat. If the lesion is red, raised, and moist/lustrous, it is treatable; if it is black and depressed, accompanied by nausea, dizziness, loose stools, dysuria resembling strangury, and delirium, it is fatal. (From *Yixue Zhunsheng*)

Zuoyou Da (Left and Right Shoulder Carbuncle)
Wang Kentang stated: In cases of Zuoyou Da where the carbuncle spreads from left to right, arising on the left shoulder bone and spreading to the right, it is treatable; if it arises on the right shoulder bone and spreads to the left, it is difficult to treat. This was an ancient saying, but I disagree. If the pathogen attacks both left and right, it indicates disharmony of Qi and Blood and intermingling of Yin and Yang. If few of the "Seven Evil" syndromes are present, why worry about non-recovery? However, if the Yuan Qi is deficient and exhausted, what benefit can treatment bring? (From *Yixue Zhunsheng*)
Chen Shigong stated: Left Da belongs to the Liver, and Right Da belongs to the Lung. Both arise at the movable joints of the left and right shoulder bones and are treatable. However, if Left Da spreads to the right or Right Da spreads to the left, they are considered difficult to treat. (From *Waike Zhengzong*)
Shen Douyuan stated: When carbuncles erupt simultaneously on both shoulders, left and right, it is called Shuangchuan Jianda Ju (Double-Stringing Shoulder Carbuncle). (From *Waike Qixuan*)

Baoju Fa (Acute Ulcerative Carbuncle Eruption)
Shen Douyuan stated: Baoju Fa arises on both sides of the back and belongs to the Foot-Taiyang Bladder Meridian, which is characterized by abundant blood and scarce Qi. If it arises in the center of the spine, it belongs to the Du Mai (Governing Vessel). Initially, it resembles a bean or a plum/prune in size. The color is indeterminate between black and white. The pain is severe and distressing to the heart. The surrounding swelling resembles an ox's lip. Patients under forty years old are treatable. Those who are already debilitated are difficult to cure. (From *Waike Qixuan*)

*Guiyi Fang* states: At the onset of Qinju (Bird Carbuncle), there are dozens of rash-like lesions, resembling the appearance of being struck by a fist, accompanied by chills and trismus (lockjaw). Such cases result in death within fourteen days; if punctured within ten days to drain pus, recovery ensues.
Wang Kentang stated: Qinju presents with sudden numbness and stiffness in the back without pain. Several patches of skin turn purple, resembling contusions from a fist blow. Cases presenting with chills, high fever, and trismus within seven days are fatal. Recovery is possible if sweating occurs; if no sweat occurs, it is untreatable. Coma with a restless pulse, or a faint or intermittent pulse, indicates death. For diffuse swelling that does not ulcerate, Taige Ziwei Wan should be administered. (From *Yixue Zhunsheng*)