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...then one might mistakenly consider it a excess syndrome and administer Rhubarb Decoction (Dahuang Tang); encountering slight cold or heat, failing to recognize it as disharmony of Qi and Blood (Qi Xue Bu He); then assuming an external contraction and employing diaphoretic methods. Such practices harm people very rapidly.

The *Jing Yao* (Essentials) states: Neituo San (Internal Support Powder), taken nearly ten doses within one to three days of onset, treats toxic factors attacking the Zang-Fu organs, also known as Huxin San (Heart-Protecting Powder). This formula is specifically for carbuncles and sores caused by the ingestion of cinnabar and sulfur pills (Dan Shi). If not caused by Dan Shi, it may not be a mandatory remedy. For the elderly, those with deep-seated disease, exhausted syndromes, or heavy constitutions, although Mung Bean (Lü Dou) has tonifying properties, there is a risk that they will not bear the burden effectively.

The *Ji Yao* (Key Essentials) states: The general principle in treating sores requires understanding only three methods: supporting the interior (Tuo Li), unblocking and draining (Shu Tong), and harmonizing Ying and Wei (He Rong Wei). If toxic pathogens are inside, pain is deep, the pulse must be deep and solid, external symptoms include fever and irritability, constipation, numbness and pain in the swelling without redness; Neishu Huanglian Tang (Internal Purging Coptis Decoction) should be used to unblock and drain the Zang-Fu. If toxic pathogens are in the skin, pain is superficial, the pulse must be floating and rapid, external symptoms include swelling and pain, regular urination and defecation, or aversion to cold and fever, stiffness, headache; fearing the pathogen moves from exterior to interior, formulas that support the interior should first be used to disperse it. If toxic pathogens are in the meridians, there is no external aversion to wind-cold, internal urination and defecation are harmonious, appetite is normal, taste is perceived, no aversion to wind and cold, only dryness and heat, the pulse is neither floating nor deep; this indicates the pathogen is in the meridians, and harmonizing Ying and Wei is appropriate.

Yuan Rong states: In the *Su Wen* regarding cold-induced abscesses, the classic says: When Kidney transfers cold to Spleen, it develops into abscesses with shortness of breath; when Spleen transfers cold to Liver, it develops into abscesses with spasms. It also says: All cold-induced abscesses, how do they arise? Qibo said: They arise from changes in the Eight Winds. It also says: Dampness of the earth, when contracted, harms the skin, flesh, sinews, and vessels. The *Sheng Ji Zong Lu* states: Wearing clothes too thickly makes the surface susceptible to cold. The source of acquisition is generally like this. Some sores do not change color, or become hard as stone, or are painless upon pressure; after a long time, they change color and become painful, gradually softening and forming pus like rice water, remaining thin, unable to heal for a long time, the sore opening does not close, transforming into gan fistulas, ruining muscle, invading bone marrow, leading to atrophy and bi-syndrome; Gusuibu Wan (Drynaria Pill) is indicated. (This formula uses Drynariae Rhizoma (Gushuib), Psoraleae Fructus (Buguzhi), Prepared Rehmanniae Radix (Shudi), Angelicae Sinensis Radix (Danggui), Teucrii Chini Ramulus et Folium (Chuanxuduan), Nanmu Cortex (Shinan Ye), Scrophulariae Radix (Huangjing - note: text says Huang, likely Huangqi or similar contextually but listed here as per text structure, usually Huangqi in such contexts but strictly transliterated as Huang if ambiguous, however standard is often Huangqi/Astragali Radix or Scutellariae Radix/Huangqin depending on context. Given "Huang" alone in list, often implies Huangqi or Huanglian. In Gusuibu Wan context, Astragali Radix is common. Let's use Astragali Radix (Huangqi) as it fits "tonify" context, but text just says Huang. I will use Huangqi (Astragali Radix) as standard interpretation for this formula component, or simply Huang if strict. Actually, looking at standard Gusuibu Wan, it contains Huangqi. I will use Astragali Radix (Huangqi))., Dendrobii Caulis (Shihu), Achyranthis Bidentatae Radix (Niuxi), Eucommiae Cortex (Duzhong), Dioscoreae Hypoglaucae Rhizoma (Bixie) each 2 liang, Aconiti Lateralis Radix Praeparata (Fuzi) 1 liang, Paeoniae Radix Alba (Baishao), Chuanxiong Rhizome (Chuanxiong), Cuscutae Semen (Tusizi), Codonopsis Radix (Shashen), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Angelicae Pubescentis Radix (Duhuo), Gastrodiae Rhizoma (Tianma) each 1.5 liang, honey-made pills, taken empty stomach with salt water.)

The *Xin Fa* states: Whenever a sore does not heal and pus/water is clear and thin, it is deficiency of both Qi and Blood; decreased diet and difficulty digesting indicate deficiency-cold of Spleen and Stomach; emaciated body and sallow skin indicate failure of Gallbladder Qi. Non-tonics like Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu) cannot tonify; non-Aconite cannot assist its efficacy. Now, with little food intake and difficult digestion, it belongs to deficiency-cold of Spleen and Stomach. Since Spleen belongs to Earth, this is due to deficiency of Mingmen Fire failing to generate Earth; one should not directly tonify Spleen and Stomach, but take Bawei Wan (Eight-Ingredient Pill) to tonify Fire to generate Earth.

It also states: "Qi has no tonification method" is a vulgar theory. Because Qi disease presents as fullness and obstruction, it seems difficult to tonify, but one does not know that if Zheng Qi (Upright Qi) is deficient and cannot circulate, Xie Qi (Evil Qi) stagnates and causes disease. The classic says: The strong recover when Qi moves; the weak suffer when Qi lingers. If one does not use tonification, how can Qi move?

Wang Kentang states: If a fistula closes abruptly when it shouldn't, it is caused by accumulated toxins and real worms. (*Zhun Sheng*)

Zhang Jingyue states: Treatment of sores includes purging, tonifying, dispersing, and harmonizing Ying/Blood while resolving toxins; medication depends on the syndrome. The classic says: If physical constitution and pathogenic factor are both in excess, purge rather than tonify; if both are deficient, tonify rather than purge. This is the general outline. Therefore, in examining diseases, if the pulse is slippery, solid, surging, and rapid, with severe swelling/pain, irritability, fullness, and internal/external obstruction, it is a true excess syndrome. The toxin is in the Zang-Fu; without harsh agents like Mirabilite (Xiaoshi) and Rhubarb (Dahuang) to sweep and expel, the toxin will not resolve, hence purging is necessary. However, without true accumulation and stagnation, purging is contraindicated; thus, purging must not be used lightly. If the pulse is faint and fine, blood/Qi is inherently weak, or swelling does not suppurate/suppurates but does not heal, or diet decreases, spirit tires, vomiting/diarrhea occur, hands/feet are cold, pus is clear/thin, these are signs of great deficiency, requiring complete warming and tonification without doubt. Furthermore, even if the pulse lacks surging/rapid qualities, external symptoms lack irritability/heat, internal symptoms lack obstruction, yet the toxin is concerning, although not a great deficiency, observing no real evil suggests one should support the interior and nourish Ying, pre-emptively protecting Yuan Qi. Why? Fearing that prolonged hardship or post-suppuration state leads to spontaneous deficiency before damage occurs. By the time crisis hits, is it too late! Thus, Zhu Danxi said: Abscesses due to accumulated toxins in Zang-Fu require first assisting Stomach and strengthening Qi to secure the root; then condensed Qi/Blood dissipates, formed pus bursts, dying muscles regenerate, dead muscles rot, ulcerated muscles heal. If only attacking the sore, Spleen/Stomach deficiency leads to seven evils arising like bees; survival would be luck! This is what he meant. If the pulse is tight and rapid, with fever/aversion to cold, headache, body pain, limb stiffness, no sweat, this is definitely abnormal seasonal Qi closing the skin/hair, wind-heat obstructing and causing abscesses; this exterior evil should be dispersed. Without exterior signs, dispersing is inappropriate to avoid loss of Yang and damage to Wei. Hence Zhang Zhongjing said: Those with sores should not be sweated; this refers to it. If Ying-Wei are disharmonious, Qi/Blood stagnate, causing occasional abscesses, but Yuan Qi is undamaged, diet normal, pulse not ominous, no seven evils, this is in the Fu organs, not Zang; in the exterior, not interior. Clear heat if present, resolve toxin if present, move Qi if stagnant; harmonize Ying and Wei to treat peacefully. Generally, sores with Yang syndromes where disease/Qi/physical constitution are all in excess are mild; Yin syndromes where all are deficient are severe; Zheng Qi deficient but Xie Du excessive, where tonification and purging are both impossible, are critical; if toxin is gone but Spleen/Kidney failed, Qi/Blood hard to restore, these are untreatable. Thus, clinicians must carefully examine deficiency/excess, evil/uprightness, exterior/interior, and weigh pros/cons; slight deviation causes great harm; responsibility is heavy, cannot be casual.

It also states: Sophora Flower (Huaihua) is most effective for clearing dampness and reducing heat. Generally, for swellings/toxins, if Garlic Moxibustion and Huaihua Wine are not used first to reduce the momentum, even with interior-supporting drugs, effects are not fast. Only for those with Stomach Cold, overuse is prohibited.

It also states: Honeysuckle Wine (Jindong Jiu) treats abscesses and back carbuncles; taking it at onset, regardless of location, or for women's breast abscesses, has miraculous effects. In poor rural areas, it is convenient and effective; combined with Wheat Meal Stone Paste (Maifan Shi Gao) and Shenyi Paste, it is very effective.

It also states: My previous discussion on swellings mentioned avoiding tonification and preferring purging, and forbidding Rhubarb. These seem contradictory but depend on different syndromes. Avoiding tonification avoids excess evil; fearing purging fears Qi deficiency. Swellings are mostly excess, ulcers mostly deficiency—this is constant. Yet swellings can have deficiency (tonify, don't purge); ulcers can have excess (purge, don't tonify)—this is variable. Tonify or purge depends on "deficiency/excess," which is often confusing, requiring firm judgment. Excess fire: clear. Qi stagnation: move. Heat plus obstruction: purge. No stagnation/obstruction: do not purge. Regarding tonification: if Qi pathway is obstructed, do not tonify; if fire evil is blazing, do not warm. If Qi pathway is clear, fire not intense, diet/urination/defecation normal, yet danger exists, even without obvious deficiency or pre-suppuration, immediate interior-supporting tonification is needed. Why? Fearing prolonged hardship leads to spontaneous deficiency. Pre-protecting Yuan Qi ensures easy pus formation/bursting/healing. Even in severe exhaustion/ulceration, survival is possible. Waiting for multiple deficiency signs or failure to heal after suppuration to support is late; mild becomes severe, severe becomes critical. Is this not too late! This addresses deficiency in swellings, which is significant and must be observed.

It also states: Four distinctions for excess in ulcers: 1. Original Qi strong, fire evil strong; post-suppuration internal heat remains, stool firm, eats well, pulse slippery—excess of form/Qi/disease, suitable for clearing/draining, not warming/tonifying. Fire retreats, self-heals, good sign. 2. True Yin internally deficient, Water fails to control Fire; post-suppuration heat worsens, pulse restless—clearing hurts Qi, tonifying helps Evil, Zheng cannot overcome Xie, terminal syndrome, untreatable. 3. Toxin deep but ulcer shallow; muscle pus drained but root toxin remains—false head, not true ulcer, do not rush to diagnose as ulcer or apply tonification/support. Misuse increases harm, distinguish carefully. 4. Original Qi deficient, seemingly needing tonification, but constitution turbid/stagnant, muscle dense/dark, Qi pathway obstructed—slight tonification adds stagnation/oppression. True deficiency cannot be tonified, false excess cannot be purged; hardest to regulate, prone to resentment, also untreatable. Total: Excess in ulcers is 10-20%; thus few ulcers need clearing. Deficiency in swellings is 40-50%; thus many swellings need tonification. This speaks to the life/death danger of abscesses, emphasizing prevention. For superficial meridian toxins, swelling leads to suppuration, suppuration leads to healing; why obsess over tonification/purging distinction? Readers, please examine.

Zhang Jiegu states: Treat interior excess with purging.

Jiang Shiji states: Physicians should tonify whenever a opportunity arises, and purge whenever necessity dictates, thereby honoring the ancients' intent to preserve life.

It also states: After ulceration, flesh rots, pus flows, blood scatters, Qi dissipates; deficiency necessitates tonification. Shiquan Dabu Tang (Complete Great Tonifying Decoction) serves as the chief formula for post-ulceration syndromes.

It also states: Mistakenly using harsh/cutting agents, massive pus/blood loss, vomiting/diarrhea, sexual indiscretion, labor damaging Yuan Qi, nocturnal emission, or external pathogen contact lead to fever/headache, dysuria, slippery/rapid bloody stool, soggy pulse with irritability/panting, shortness of breath/dizziness, fatigue/heat/thirst, desire to throw oneself in water, heat intolerance/restlessness, flailing limbs, opisthotonos—this is false heat from Yang collapse/sinking. Alternatively, aversion to cold/headache, cough/regurgitation, deaf/blind, urinary incontinence, dysentery/borborygmus, tenesmus/abdominal pain, penile retraction, floating tooth pain, limb numbness, cold limbs/body pain, teeth grinding/lip biting—this is true cold from Yang collapse/sinking. Upon seeing any of these false heat/true cold signs, ignore pulse/syndrome specifics; immediately use Shiquan Dabu Tang plus Aconite (Fuzi) and warming tonics for potential recovery.

It also states: Dark flesh indicates Yang deficiency/cold; add Aconite to Shiquan Tang. Red flesh indicates Blood deficiency/heat; add Gardenia (Zhizi) to Siwu Tang.

It also states: Failure to suppurate indicates Spleen deficiency; double Ginseng and Atractylodes in Shiquan Tang. White flesh that does not heal indicates isolated Yang; add Ginger and Aconite to Shiquan Tang.

It also states: Cold-cooling herbs are not favored for generating flesh; dispersing herbs are not suitable post-ulceration.

It also states: Before day seven, fire-toxin is raging; avoid spicy-hot/warming agents. After day seven, pus/blood forming; avoid suppressing with cold-cooling poultices.

It also states: Essence is Yin, human Water; Qi is Yang, human Fire. Water needs Fire; without Fire, Yin prevails causing cold. Fire needs Water; without Water, Yang prevails causing heat. Deficiency of Water: greatly tonify True Yin. Deficiency of Fire: greatly tonify Yuan Yang.

It also states: Decline of True Yang always stems from depletion of True Yin.

It also states: Medicine cures disease; tonification cannot change temperament. Patients with perverse natures are hardest to treat.

It also states: Pus flow and toxin discharge deplete both Qi and Blood.

It also states: Jin Gui Shen Qi Wan treats Mingmen Fire decline causing Spleen Earth deficiency-cold, inability to digest/absorb, poor appetite, umbilical/abdominal pain, frequent night urination, dry mouth preferring hot drinks, Kidney Water deficiency rising as phlegm, Spleen deficiency failing to control saliva as phlegm; this formula saves. It is a wonderful agent for guiding fire back to its source and restoring Yang/root.

It also states: Initial sores, skin/flesh intact, cluster of excess evil, intense heat-toxin; do not lightly use spicy-hot drugs. Post-ulceration, massive pus/blood loss, Zheng Qi depleted, Yuan Qi unrecovered; do not arbitrarily use cold-cooling agents.

It also states: According to Li Dongyuan, red face in sores, though due to hidden heat/fire depression, prohibits interior purging; this is Yang Qi oppression, pathogen in meridians, release via exterior to remove. Even with several days of no stool, focus on exterior dispersion, releasing Yang Qi, adding slight moistening herbs. Xue Lizhai said: Swellings with internal/external obstruction should prioritize interior support and exterior dispersion; using Rhubarb invites criticism of rashness. Thus, Rhubarb's difficulty in use is clear. But Zhu Danxi said: Rhubarb is key for abscesses. Are masters contradicting? Abscess initial stage: if Six Channels exterior signs exist, stool normal, pulse tight/floating/rapid, pathogen in exterior, absolutely no purging. If no exterior signs, stool dry/constipated, thirst drinking much, pulse floating/sinking solid/rapid, sore head hard/not rising, without Rhubarb, how to unblock Zang-Fu? Chu Yushi said: Initial abscess requires urgent purging with Rhubarb etc., ignoring hardship; this is a biased view, relying on distinguishing exterior/interior, cannot be a rule. Ultimately, truly knowing excess purges, truly knowing deficiency tonifies, superficial/shallow resolves externally, deep-hidden supports internally; thus no弊端.

It also states: Zhang Zhongjing said: Sores patients with body pain should not be sweated; sweating causes spasms. This refers to sores post-ulceration contracting cold. If sore initial stage within seven days, aversion to cold/fever, headache/body pain, high swollen sore, no sweat, normal urine/stool, pulse floating/tight/rapid, many exterior signs, non-sweating does not heal. If sweating agents misused post-ulceration or when exterior evil gone, disaster exceeds spasms.

It also states: After seven days, yellow head appears; apply Baijiang Dan (White Reduction Powder) to tip, lift head, draw out toxin, cover with plaster to prevent wind entry. Wash daily with Green Onion/Mugwort decoction, change plaster. Around eleventh day, pus exits, pain settles; smooth prognosis for Yang sores. Patient takes Simiao Tang to support. If ninth-tenth day pain without suppuration, momentum set, toxin gathered but no pus, use Shen Deng Zhao (Divine Lamp Illumination) method.

It also states: Generalized itching post-ulceration is external wind entering deficiency; use interior support to resolve.

It also states: Little pus, red color, non-healing indicates Blood deficiency; if triggered by foul odor, combine with Frankincense (Ruxiang) and Myrrh (Moyao).

It also states: Residual toxin incomplete; Simiao Tang plus Angelica Dahurica (Baizhi), Saposhnikovia (Fangfeng), Trichosanthes Root (Huafen), Forsythia (Lianqiao).

It also states: Cold evil stagnation; Shiquan Tang plus Saposhnikovia (Fangfeng), Cinnamon Twig (Guizhi). External wash with Green Onion/Mugwort decoction.

It also states: Yang deficiency causes aversion to cold; Yin deficiency generates heat.

It also states: Morning heat governed by tonifying Qi; afternoon heat governed by tonifying Blood.

It also states: Pain post-ulceration, foul敗 pus indicates Stomach deficiency with fire; Shiquan Tang plus Ophiopogon (Maidong), Schisandra (Wuweizi).

It also states: Rough breathing, shortness of breath, confusion/drowsiness indicates weak Spleen/Lungs; Buzhong Yiqi Tang plus Ophiopogon (Maidong), Schisandra (Wuweizi).

It also states: Spleen/Kidney damaged, shoulder/back stiff/heavy; Buzhong Yiqi Tang plus Cornus (Shanzhuyu), Dioscorea (Shanyao), North Schisandra (Bei Wuweizi).

It also states: Spleen/Lung Qi collapse, limb edema, sallow complexion, hoarse voice, blue-red lips/nose, facial swelling; Liu Junzi Tang plus Roasted Ginger (Pao Jiang). If ineffective, Shiquan Tang plus Roasted Ginger (Pao Jiang), Prepared Aconite (Shu Fuzi).

It also states: Internal invasion of cold, abdominal pain/vomiting/diarrhea, cold limbs/confusion, cough/hiccups, borborygmus/anorexia; evil syndrome of Yang deficiency. Use Tuoli Wenzhong Tang, followed by Liu Junzi Tang.

Wang Shengzhi stated: Post-ulceration, Qi/Blood scattered, internal/external deficient; promptly connect/tonify Yuan Qi with Ginseng. Cold-cooling is inappropriate; aromatic-dryness risks compounding deficiency. Must be cautious. (*Li Li*)

Chen Wenzhi stated: Pulse deep/solid, fever/irritability, no external red/swelling/pain, indicates deep latent interior evil; first unblock/draining, use Weisheng Tang. Severe heat binding: Neishu Huanglian Tang.

Chen Shigong stated: Constipation/dryness, promoting movement is appropriate.

Feng Luzhan stated: People easily suspect Ginseng/Prepared Rehmannia cause chest fullness/blockage; unaware that if Spleen transports well and Kidney stores well, ancestral Qi has root, Yuan Qi has source, why fear bloating/fullness?

It also stated: Internal/external syndromes most fear apparent excess with root deficiency; purging ineffective, tonifying useless, extremely dangerous. Relies on preventing micro-changes, balancing root/branch, allowing Spleen/Kidney Yuan Yang to generate, Yin evil stagnation to dissolve.

It also stated: Lung Qi deficient, do not further move Qi; Kidney Water declined, do not heavily promote diuresis.

It also stated: *Neijing* method of "treating obstruction with obstruction": small dose causes upper congestion, large dose causes lower drastic tonification. Middle Jiao deficiency/stagnation relies on major tonification to circulate Qi; thus Ginseng/Atractylodes should be used in larger doses.

It also stated: Method for deficiency treats excess correctly; method for excess treats deficiency incorrectly.

It also stated: Cold fails to cool = no Water; Heat fails to warm = no Fire. No Water: strengthen Water master to calm Yang light. No Fire: benefit Fire source to dispel Yin shadow. This reaches truth beyond rules.

It also stated: Jin Gui Shen Qi Wan tonifies without stagnation, unblocks without leakage; truly divine pill for swelling.

It also stated: Apparent excess symptoms, root reality is deficiency; distinguish by pulse.

It also stated: Abscesses/furuncles vary in severity/urgency; treatment examines deficiency/excess/cold/heat, adjusts dosage, matches syndrome, maintains sequence. Methods divide into early/middle/late: Early focuses on clearing heat/resolving toxin/unblocking meridians to eliminate; Middle focuses on draining/supporting to scatter residual toxin; Late focuses on tonifying/supporting/warming to facilitate healing. This is the general law.

It also stated: Initial abscess, moxibustion and external application around perimeter, leaving center open for toxin exit; if small sore, apply fully...