Library

Weng Kentang stated: Shangyong (Upper Carbuncle), resembling a purple grape, is also known as Xuanyong (Hanging Carbuncle). It belongs to the Hand-Taiyin Lung Meridian and the Hand-Jueyin Pericardium Meridian. It causes severe chills and high fever, inability to extend or retract the tongue, inability to open or close the mouth, with a preference for lying on the back. Reddish nasal discharge occurs intermittently. This is caused by accumulated heat in the Hand-Shaoyin and Foot-Shaoyin meridians and the Sanjiao (Triple Burner). If left untreated beyond the appropriate time, leading to inability to ingest food, unconsciousness, and chaotic pulse, death will ensue. (From *Yixue Zhunsheng*)

Chen Shigong stated: Shangyong presents with red swelling and pain; upon suppuration, it becomes a carbuncle, and self-healing occurs once pus is discharged. Although the condition appears fierce, it is a superficial disease (biao bing) and poses no major threat. If distending pain is caused by pus accumulation, incision should be performed; if pain results from tissue damage, tonification methods should be applied, ensuring patient safety. (From *Waike Zhengzong*)

The Classics state: Failure to drain pus is not in accordance with proper medical practice.

Feng Luzhan stated: Shangyong is equivalent to Chuizhong (Drooping Carbuncle), resembling water held within a reed husk. Treatment involves pricking to release green, yellow, and red blood, followed by washing with salt water. A small amount of Yizi San (One-Character Powder) mixed with honey should be applied to the lesion. Repeated pricking may be performed if necessary. (From *Yangyi Jinnang*)

*Yilun Xuanya* states: Xuanyong arises in the upper part of the oral cavity. Although it does not directly involve the throat, sudden swelling is caused by heat qi. Urgent treatment is required, otherwise, it can be fatal.

Dou Hanqing stated: Xuanyong arises in the upper part of the oral cavity, resembling a purple plum, hanging down to touch the tongue. The patient cannot speak, extend the tongue, or lower the head, standing only with the face upward. Reddish nasal discharge occurs intermittently. If not treated promptly, toxins entering the brain will cause death. Use copper chopsticks to hold the mouth open, pierce the carbuncle head with a bamboo needle, clean thoroughly with salt water, allow all blood to drain, then blow Bingpian San (Borneol Powder) into the affected area. Keep the mouth closed until the medicine melts and is swallowed naturally. Repeat blowing three to five times. (From *Waike Quan shu*)

Kui Guang stated that Xuanyong occurs inside the mouth at the upper region, presenting as purple blisters the size of beans.

For cases where Shangyong has persisted for a long time, becoming swollen, hard, drooping, and un-ulcerated:
Shiyan (Halitum, Salt) [Amount unspecified]
Gufan (Alumen Exsiccatum, Dried Alum) [Equal amount]
Grind into fine powder, mix with decoction, and apply to the lesion using the tip of a chopstick.

Shen Douyuan stated: When infants are first born, a small sore the size of rice grains or beans appears inside the cheek. The next day, it gradually enlarges, eroding and ulcerating the cheek, hence named Hansai Chuang (Cheek-Eroding Sore). If not treated early, once fully perforated, it becomes difficult to cure. Erjin San (Two-Gold Powder) is suitable. (From *Waike Qixuan*)