Library

Wu stated: Diseases of carbuncle and ulcer (Yongju) have more than thirty types of syndromes, including Fa (Hair-like eruption), Gu Fa (Stubborn eruption), Shi Fa (Stone eruption), Yan Fa (Rock eruption), Feng Ke Fa (Honeycomb eruption), Lian Zi Fa (Lotus seed eruption), Jiao Yan Fa (Pepper eye eruption), Lian Zhu Fa (String of pearls eruption), Jing Ti Fa (Whole body eruption), Chang Yong Nei Fa (Internal eruption of intestinal abscess), Nao Fa (Brain eruption), Bei Fa (Back eruption), Mei Fa (Eyebrow eruption), Sai Han Fa (Cheek and jaw eruption), Fei Yong (Lung abscess), Gua Hu Fa (Gourd eruption). Generally, treatment should be administered according to the depth and location (internal or external) of the disease, without delay. At the initial stage, symptoms resemble Taiyang disease (Diseases affecting the Taiyang channel), with a floating and tight pulse, which is its characteristic sign.

It is also said: The Shu-transport points of the Zang and Fu organs are all located on the back. For any patient suffering from sores and ulcers, if the membrane of the Zang organs is damaged, it often leads to death. Qi of the Fu organs floats on the surface, so swelling that is high and superficial is easy to treat; Blood of the Zang organs is heavy, cold, and governs the interior, so swelling that sinks inward is difficult to treat.

It is also said: "Jie" (Boil) refers to a node; "Yong" (Carbuncle) refers to obstruction; "Ju" (Ulcer/Gangrene) refers to blockage. A lesion one to two cun in diameter is called Jie; three to five cun is called Yong; one chi is called Ju; one to two chi is called Jing Ti Ju (Whole-body Ulcer). If the pulse is surging and rapid, it is difficult to treat; if the pulse is faint and choppy, it is easy to treat. At the initial sensation, clear heat and extract toxins; once ulcerated, drain pus and relieve pain; after pus is exhausted, promote tissue regeneration and apply dressing. Treatment should be carefully considered based on the severity and favorable/unfavorable prognosis.

*Fa Hui* states: Generally, for Back Eruption (Bei Fa), Brain Ulcer (Nao Ju), and Gangrene of the Toes (Tuo Ju), if there is swelling and pain with red color, this indicates Water deficiency and Fire hyperactivity, which is treatable; if the color is black or purple, it is a phenomenon of extreme Fire resembling Water, indicating that Kidney Water has been exhausted and Essence and Qi are withered, which is definitely untreatable. Furthermore, if the bone marrow is not withered and the Zang organs are not ruined, it is treatable; but if an elderly or weak person suffers from this, with the sore head not rising, or swelling hard and dull-colored, firm like the skin of an ox's neck, and the pulse even more choppy, this indicates that Essence and Qi have perished, and it is untreatable. Some may die before ulceration, while others may die after ulceration due to the inability of Qi and Blood to nourish.

*History of Later Han · Treatise on Rhythm and Calendar* records: During the Awakening of Insects (Jingzhe) solar term, the gnomon shadow is eight chi and two cun long. If the climate arrives before the solar term, many people will suffer from carbuncles, ulcers, and lower leg swelling.

Jiang Shiji stated: When deficiency reaches an extreme and transforms, causing palpitations and fright, locked jaw, restlessness in sleep, or fever with aversion to cold, thirst, spontaneous sweating, night sweats, flaccid hands, body heat, and a surging pulse that feels empty upon pressure, these are all ominous signs. (*Shuo Yue*)

It is also said: A red halo around the base of the sore and a mouth that does not close indicate that residual toxins are not yet cleared.

It is also said: Scanty pus and white flesh, with no new tissue growth, is due to the retention of Cold pathogen.

It is also said: Traumatic tetanus (Po Shang Feng) is caused by Wind invasion; traumatic dampness is caused by Damp invasion.

It is also said: At the initial stage, swelling is preferable to itching; itching after ulceration indicates tissue regeneration; itching is preferable to pain after ulceration; lack of pain at the initial stage indicates a Pure Yin syndrome.

It is also said: Sudden severe pain where there was none is not a good omen; numbness or itching is the most difficult to treat.

It is also said: Failure to digest food is due to Spleen deficiency; lack of appetite is due to Stomach weakness.

Chen Shigong stated: "Yong" (Carbuncle) means obstruction; it is Yang, associated with the Fu organs, with toxicity surging outward. It appears suddenly and superficially because the pathology originates in the Yang aspect. Since Yang Qi is light and clear, floating and high-rising, it easily swells, suppurrates, putrefies, and heals. Indeed, it is a condition that does not damage tendons and bones and is easy to treat. "Ju" (Ulcer/Gangrene) means blockage; it is Yin, associated with the Zang organs, with toxicity attacking inward. It appears slowly and deeply because the pathology stems from the Yin aspect. Since Yin Blood is heavy and turbid, with a sinking nature, it damages tendons and erodes bones, making it a difficult-to-treat condition. Generally, young people with strong Qi and Blood overcoming toxicity have a favorable course; old people with toxicity overwhelming Qi and Blood face danger. The Seven Emotions and Six Desires, when activated, cause Ju, as well as Phlegm nodules and Goiter. Among the Seven Emotions: Joy injures the Heart, Anger injures the Liver, Worry injures the Lung, Pensiveness injures the Spleen, Grief injures the Soul and Ethereal Soul, Fear injures the Kidney, Fright injures the Gallbladder. Among the Six Desires: Hearing sounds, seeing colors, smelling fragrances, craving tastes, contemplating heaven and earth, grasping myriad things. All diseases and sores arise from these emotions and desires. The Six Excessive Pathogenic Factors (Liu Yin), when activated, cause Yong, such as Wind eczema, scabies, and leprosy. Among the Six Excesses: Wind is the irregular Qi of the four seasons, vast and killing, capable of striking humans easily. Cold is due to irregular seasons, violent winds, heavy rains, ice, snow, and severe cold, or consuming raw and cold foods. Summerheat is due to intense sun, melting fire and flowing metal, and steaming Damp-Heat. Dampness comes from sitting or lying in damp, low places for long periods, or sudden exposure to wind, rain, and humid air. Dryness is internal heat due to Yin deficiency, consuming fluids, failing to nourish the Zang organs, leading to dry skin and constipation. This is stirred by mental disturbance, rich wine and fatty foods, and excessive sexual activity. Evil Qi lodges in the Zang organs, meridians, and joints. Accumulating over time, or triggered by internal injury or external evil, it erupts. Rich foods, fine wines, and greasy meats please the mouth and mind, ignoring the consumption of Yin and damage to organs, stimulating Yang and obstructing Essence, seeking momentary pleasure while unknowingly destroying Yin. Major toxic sores usually arise from rich diets, not coarse grains. However, anyone suffering from Yong or Ju first injures the Five Zang organs before eruption. One must distinguish between Yin/Yang and favorable/unfavorable patterns for treatment. In short, diffuse swelling (Man Zhong) is difficult to treat; localized swelling heals easily. Diffuse swelling involves muscle swelling without sore swelling, while sore swelling involves muscle without sore swelling. Favorable cases have distinct bases; dangerous cases have flat surroundings. The Classics state: When Qi is abundant, the top rises high; when Blood is abundant, the base gathers tightly. This is what is meant. (*Zheng Zong*)

Feng Luzhan stated: Carbuncles and ulcers mostly occur in people who indulge in rich foods and desires, formed by boiling Qi and Blood with deficient evil and hot toxins. "Yong" means obstruction, stagnating in the Yang collaterals, large and high-rising, belonging to Yang, with a floating and rapid pulse, thus mostly originating from the Fu organs. "Ju" means blockage, lying dormant in the Yin meridians, flat and internally developing, belonging to Yin, with a deep and rapid pulse, thus mostly originating from the Zang organs. "Jie" resembles the knotting of a boil. "Chuang" (Sore) is the general name for toxicity. The Classics state: All pain, itching, and sores belong to Heart Fire. Among all sores, Back Ulcer and Ding Sore are the most urgent, followed by Brain Ulcer, Intestinal Abscess, and Throat Abscess, which are also urgent. (*Jin Nang*)

It is also said: Human sores and swellings occur due to internal heat and external deficiency, allowing Wind-Damp to invade. The Lung governs skin and hair; the Spleen governs muscles. When Qi is deficient, pores open, and Wind-Damp invades. Moreover, Spleen deficiency generates internal heat, leading to sores. Swelling is caused by Cold-Heat toxic qi lodging in meridians, causing blood stasis and obstruction, forming swelling; Wind evil acting internally has no head or root; Qi and Blood struggling have a head and root; when obstruction is severe and Heat overwhelms Blood, pus forms. Minor toxins can be resolved by natural Qi and Blood without worry; major toxins require medicinal assistance to support Qi and Blood in circulating and expelling toxins.

It is also said: Carbuncles and ulcers result from Qi and Heat rebellion in households of rich food, often affecting fleshy and white individuals whose Qi resides on the surface and Middle Qi is necessarily deficient. Initially, use cooling blood and activating blood herbs, resolve nodules and detoxify, administering large doses continuously to attack internally and externally, ensuring resolution. Even if the pathogen is large and toxic, preventing complete resolution initially, eliminating seven or eight parts prevents later complications like mouth sores and internal attack. Even if ulceration occurs, major harm can be avoided. If treatment is delayed, Heat toxin sinks inward, membranes rupture, leading to critical danger. Books state: The Five Fa Carbuncles refer to Back Eruption, Brain Eruption, Temple Eruption, Eyebrow Eruption, and Cheek Eruption. However, slight congestion of Qi and Blood anywhere can erupt. Back Eruption involves Wind-Heat of the Five Zang and Evil Toxin of the Six Fu penetrating tendons and bones, erupting within meridians. Externally small like a coin, internally large like a fist. Do not neglect it. Initial red swelling and elevation are easy to treat; Yin collapse and depression are difficult. Brain, Eyebrow, Temple, and Cheek eruptions differ in location but share the cause of latent Yang stagnation and upward toxin obstruction along meridians. Abundant Qi and Blood tolerate toxins lightly; deficient Qi and Blood face danger. "Toxin" refers to disharmony, excess, and stagnation of Qi and Blood. Treatment must rely on pulse diagnosis to correct Yin/Yang and Qi/Blood imbalance, dispersing stagnation and saving critical cases. Mistaking toxin for a tangible object and using cold/cool purgatives worsens Yin stagnation; even Yang excess toxins become hard to ulcerate and heal. Since disease arises from Qi/Blood disharmony, further disrupting it increases illness!

It is also said: Carbuncles and ulcers begin with improper emotions, irregular diet and lifestyle, triggering minerals/herbs, or imbalance of Cold/Heat/Dryness/Dampness, leading to Yin/Yang disharmony and accumulation, stagnation of Ying and Wei, and putrefaction. Mild cases originate in Fu organs, surfacing as Yong; severe cases originate in Zang organs, sinking as Ju; shallow are Jie, solid are Yong, deep are Ju. External eruptions include Back Yong, Brain Ju, Temple/Eyebrow Ju; internal eruptions include Liver Yong, Lung Yong, Intestinal Umbilicus Yong. External signs are easy to identify; internal signs are hard to clarify. Taiyang deficiency erupts from the back; Shaoyang from temples; Yangming from whiskers; Du Mai from the brain.

Qi Dezhi stated: Generally, ulcers start small like millet grains, appearing insignificant, leading people to ignore them, hiding great danger. Early prevention and treatment, or morning detection and evening therapy under a good doctor, ensures safety. Delaying consultation with quacks leads to pus/blood accumulation, resignation to fate, and death, damaging tendons/bones and perforating organs, with 80-90% mortality. Entrusting life to quacks brings immediate danger; choosing a good doctor ensures recovery. A good doctor reads classics thoroughly, understands syndromes, masters decoctions, knows complexion and pulse, possesses benevolence, filial piety, loyalty, and trustworthiness, remains calm in crises, and makes decisive treatments. Patients must also self-discipline, avoiding anger, grief, shouting, arrogance, gluttony, and overwork, preferring tranquility and patience. (*Jing Yi*)

It is also said: Brain Ulcer and ulcers on the head, neck, and throat were traditionally considered untreatable. Two or three tenths are due to Damp-Heat ascending; eight or nine tenths are due to Deficient Fire flaming upward. Proper regulation can preserve life.

Heavenly Master Qi stated: Carbuncles/ulcers on the back, chest, abdomen, head, face, hands, or feet should be dissipated internally within five days; beyond five days, surgery is required. Within five days, one dose of Xiao Du Sheng Shen Dan dissipates it, two doses cure it. If not taken within five days, pus forms, the external opening becomes small while the internal cavity expands, like thieves in mountains narrowing passes but widening nests. Without direct assault,蔓延 continues. Use gold blades to remove necrotic tissue at the opening, preventing toxin concealment. Use a three-cun long, three-fen wide knife, sharp on both sides, slightly pointed. Hold firmly, look steadily, focus mind. Make horizontal and vertical cuts. Patient may faint briefly; do not panic. After recovery, apply powder medicine and plaster. One plaster with two qian of powder stops pain, drains foul pus. Three days of continuous treatment clears it. Internally take Tuo Li Sheng Shen Dan for two doses. This treats Yang syndrome sores. Yang sores protrude over one cun, red/swollen/shiny, painful and crying. Yin carbuncles/ulcers use same internal dissipation method, but ulceration treatment differs completely. Yin sores are dark, less painful, feeling heavy/drowsy, openings not raised or showing many tiny holes to deceive. Urgently use San Han Jiu Yin Zhi Sheng Dan. Yin syndromes require warm dispersion, not cold resolution. Externally apply plaster with five qian of Sheng Ji powder, changing twice daily. Yin sores often affect wealthy indulgent people or frustrated scholars, with Heart-Kidney non-interaction, Yin/Yang depletion, sorrow, depression, anger, causing Qi stagnation into major toxin. Regardless of location, they are critical. Taking my medicine and Yin-Yang Zhi Sheng Plaster ensures survival. Yang sores cool/resolve; Yin soars warm/disperse. (*Mi Lu*)

Thunder True Lord stated: Blood dryness and Lung dryness with carbuncles/ulcers are mostly incurable, lacking Blood to nourish. These patients often indulge in sex, depleting Essence and Blood, holding semen during intercourse, transforming unconverted essence into pus/blood. This is Yin Toxicity, not Yang Toxicity. Treating as Yang toxicity causes death. Use Hua Yong Tang. One dose changes Yin to Yang; two doses dissolve un-ulcerated sores and regenerate flesh in ulcerated ones; three doses cure; four doses complete recovery. Extremely effective. Even for large, rotten, bad-prognosis sores, persistent use saves life. This formula detoxifies without dispersing Qi, nourishes rather than attacks, treating Yin Toxicity carbuncles/ulcers with divine efficacy. (*Mi Lu*)

Flower True Lord stated: Carbuncles/ulcers form from accumulated toxins in Zang/Fu organs not flowing, causing Qi/Blood stagnation. They erupt in specific locations and return to specific origins. Eruption on throat/tongue is Heart toxin; on skin/hair is Lung toxin; on muscle is Spleen toxin; on tendons/vessels is Liver toxin; on bone/marrow is Kidney toxin; internal is Zang toxin; external is Fu toxin. Thus, external is "ulcerated," internal is "ruined"; upper is "following," lower is "rebellious"; upper erupts fast, lower slow; Fu infection is easy to treat, Zang infection hard to heal. Near-bone carbuncles are mostly cold; near-skin are mostly hot. Near-bone chronic cases turn blood into worms; near-skin chronic cases transmit Qi into fistulas. Worm formation causes more itch, less pain; fistula formation causes more pain, less itch. Internal deficiency/external excess causes more pain, less itch; external deficiency/internal excess allows toxin to swell and dissipate easily. Unstopping bleeding indicates internal dead pus; thin/clear pus indicates insufficient Primordial Yang. Vomiting excessively and poor intake after ulceration indicates fierce toxin. Observe carefully and treat accordingly. (*Mi Lu*)

Wang Shengzhi stated: Sores belong to Fire but must be treated internally/externally based on root. Classics state: Changes from rich food produce large Ding. Source is internal, manifesting externally, entering through deficiency, meaning internal knotting erupts externally from deficiency. Taiyang deficiency erupts from temples; Yangming from whiskers; Du Mai from brain; treat by clearing source to cut origin. Classics state: Earth's dampness harms skin/muscle/tendons/vessels; source is external, entering internally; treat by supporting interior to prevent evil invasion. Classics state: Ying Qi not following flow, reversing in flesh, generates swelling. This is extreme evil blocking meridians, causing swelling; middle-level external/internal cases treat by harmonizing Ying and Wei. (*Li Li*)

It is also said: Back Eruption, Brain Ulcer, Toe Gangrene with red swelling/pain indicate Water deficiency/Fire hyperactivity, treatable. Black/purple indicates extreme Fire resembling Water, Kidney Water exhausted, Essence depleted, untreatable.

Dou Menglin stated: Back Eruption with internal attack, flat depression, hard like ox neck skin, yellow blisters exuding fishy water, indicates toxin entered Lung. Without rapid treatment, death ensues. (*Experience Complete Book*)

Zhou Wencai stated: People over forty, with sores/boils on crown, neck, temples, cheeks, back, spine, waist, ribs, or hidden bony areas, must not ignore them. Dismissing as common illness often leads to death. Treat urgently for salvation. Like fighting fire, early stages are easy; spreading flames are unstoppable. (*Collected Experiences*)

It is also said: The Five Fa Carbuncles are Back, Brain, Temple, Eyebrow, Cheek eruptions. Qi/Blood flows continuously; slight congestion erupts wherever it goes, not just these five. Popular opinion includes Cancer, Stubborn, and Biao in the list, calling them Five Fa. But Biao and Gu/Cancer are merely types of Yong/Ju. Ancient texts mention Biao Ju, so Biao is same origin, different name. Cancer and Gu are unheard of previously; combining them as Five Fa is incorrect. Back Eruption is Wind-Heat of Five Zang and Evil Toxin of Six Fu pouring into tendons/bones, erupting in meridians, caused by Ying/Wei deficiency and Qi/Blood depletion. Initially millet-sized, never neglect, as it will develop massively. Red/swollen/elevated initially causes no harm later ("External like millet, internal holds grain; external like coin, internal holds fist"). If deep tube fills with sticky pus/blood, medicine cures; if foul pus lacks threads, blood fails/Qi declines, Yang perishes/Yin dominates, untreatable.

Luo stated: Head/face red swelling, worse behind ears, floating/tight pulse, surging/slow upon pressure, indicates Cold covering skin/hair, blocking meridians, Heat unable to rise, accumulating as red swelling. Classics say: Winter freezes water; human Qi stays inside; skin tight, pores closed, no sweat, Qi/Blood strong, flesh stiff. Good water runners cannot pour into ice; good diggers cannot drill frozen ground; good acupuncturists cannot treat Four Reversals until weather warms, ice melts, water flows, ground opens, and meridians follow. Winter storage, frozen ground, uses more medicine, fewer needles. Use bitter-warm formulas to warm meridians/disperse Cold. Mild Cold opens pores with bitter release, pungent dispersion. Use Tuo Li Wen Jing Tang: Mahuang (Ephedrae Herba) bitter-warm releases; Fangfeng (Saposhnikoviae Radix) pungent-warm disperses; Shengma (Cimicifugae Rhizoma) bitter-ping, Gegen (Puerariae Lobatae Radix) sweet-ping resolves muscle, treating Yangming evil, serving as Deputy. Stagnant blood causes pain; Xiang Baizhi (Angelicae Dahuricae Radix) and Danggui Shen (Angelicae Sinensis Radix) pungent-warm break blood/disperse stasis; Damp-Heat causes swelling; Cangzhu (Atractylodis Rhizoma) bitter-gentle-warm, light/floating, drains Damp-Heat from skin/pores; Renshen (Ginseng Radix) and Gancao (Glycyrrhizae Radix) sweet-warm, Shaoyao (Paeoniae Radix Alba) sour-mild-cold regulate middle/nourish Qi, supporting interior, serving as Envoy...