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Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Rheum Palmatum Rhizoma et Radix (Dahuang), and Glycyrrhizae Radix et Rhizoma (Gancao) are decocted in water and taken orally.

Yanzhi Tu Fa (Carmine Application Method): A good prescription for treating black acne (Heidou).
First, decoct a single herb, Cimicifugae Rhizoma (Shengma), to make a concentrated juice and filter out the dregs. Put carmine into the liquid and rub it to extract the juice. Dip a piece of cotton into this liquid and test it by applying it to the acne lesions.

Xi Taishun said: "Lingding" (acne carbuncle) is caused by the stagnation and accumulation of toxic fire, with closed interstices (Couli). After fever occurs, the lingding appears first, either as three to five grains or one or two distinct large spots. They are red, flat, broad, and must exude yellow pus upon emergence, crusting over (shouye) the next day. Patients will inevitably exhibit restlessness and mania. If accurately identified, they should be promptly punctured with a silver needle. The patient should hold clear water in their mouth while the practitioner sucks out the bad blood. Externally, apply rooster comb blood or Baidu San (Poison-Extracting Powder). Administer copious amounts of cooling and diaphoretic formulas so that the acne can erupt. It is stated in texts: "If cold lingding appears first, other acne eruptions dare not manifest their form." If not pricked early, toxic fire stagnates; prolonged stagnation leads to Zouhuang (toxicity spreading internally), causing generalized swelling. The acne remains hidden and fails to emerge through the pores, leaving the patient helpless and awaiting death, which is irretrievable regret. Physicians must exercise caution.

Chen Shigong said: "When the eruption of acne toxin is incomplete, residual toxin remains in the Heart and Liver meridians, manifesting as Doulingding (Acne Carbuncle)." Initially presenting as purple spots, they turn black the next day. Those that are elevated and moist indicate shallow toxicity; those that are deeply sunken and scorched indicate deep toxicity. This condition typically occurs around the seventh day, just before crusting. It arises on the buttocks, legs, hands, and feet. If the body temperature is mild, the acne is moist, and the voice is clear, it is auspicious. If it occurs on the abdomen, waist, and kidneys, accompanied by high fever, withered complexion, deafness, and muteness, it is ominous. Whenever encountering this syndrome, urgently prick the root of the lingding with a needle, insert a Chan Su strip (Toad Venom Strip). Wait until the surrounding area cracks and the lesion becomes loose, then excise it with a knife. Apply Yuhong Gao (Jade Red Ointment) to promote healing. If pricking yields no blood, or if inserted medication remains dry without suppurating, the prognosis is ultimately unfavorable. However, since this syndrome belongs to excess (Youyu), treatment throughout should primarily focus on Jiajian Niuniangzi Tang (Modified Burdock Seed Decoction). (From *Zhengzong*)

Jiajian Niuniangzi Tang (Modified Burdock Seed Decoction)
Arctii Fructus (Niuniangzi), Anemarrhenae Rhizoma (Zhimu), Trichosanthis Radix (Tianhuafen), Gardeniae Fructus (Shanzhi), Schizonepetae Herba (Jingjie) (each 6 fen); Glycyrrhizae Radix et Rhizoma (Gancao) (3 fen).
With 24 pieces each of Lophatheri Herba (Zhuye) and Junci Medulla (Dengxin), decoct in water and take orally.

Baidu San (Poison-Extracting Powder): Specifically treats Doulingding and Zeidou (rogue acne) with miraculous efficacy.
Transparent Realgar (Xionghuang) in any quantity, finely ground. Then, soak cotton carmine in boiling water to extract a concentrated juice. Mix with the powder and apply/dot onto the head of the lingding.

Sisheng Dan (Four Sages Pill): Specifically dots Doulingding, instantly restoring life.
Calculus Bovis (Niuhuang) (1.2 qian), Camelliae Semen (Ercha) (1.7 qian), Cinnabaris (Zhusha) (0.8 qian), Margarita (Zhenzhu) (0.2 fen).
Grind finely. Chew carmine in the mouth to create a mixture, blend well, and apply/dot.

Zhenzhu Gao (Pearl Ointment): Treats cases where acne fails to erupt, specifically when there is a Doulingding that is black, large, and foul-smelling. Urgent application is required.
Five pearls, 49 garden peas (Wandou), one qian of hair ash (Fahui).
Grind finely. Mix with carmine juice to form an ointment. Part the lingding and dot it on; the black lingding will immediately turn red and vibrant.

Doulingding (Acne Carbuncle): Dry sugarcane residue, burn it to ash using pure sesame oil in a lamp. Mix the ash with saliva. Puncture with a silver hairpin and apply the paste; immediate effect is expected.
Another prescription: Grind pearl into powder, mix with oily carmine, rub, and apply; miraculous effect.