Library

Carbuncle of the Hypochondrium.
*Sanguisorbae Radix* (Di Yu), *Honeysuckle Flower* (Jinyinhua) (each 5 qian); *Fritillariae Cirrhosae Bulbus* (Chuan Beimu), *Angelicae Sinensis Radix* (Danggui) (each 2 qian); *Manis Squama* (Chuanshanjia, prepared by frying); *Paeoniae Rubra Radix* (Chishao) (each 3 qian); *Gleditsiae Sinensis Spina* (Zaociao Ci), *Scutellariae Barbatae Herba* (Lianqiao), *Angelicae Dahuricae Radix* (Baizhi) (each 1.5 qian); *Glycyrrhizae Radix et Rhizoma* (Gancao Jie) (1 qian); *Prunellae Spica* (Xiakucao) (1 liang).
Decoct first, then add: *Arctii Fructus* (Shuniuzi, 1.5 qian); *Viola Yedoensis Herba* (Zihua Diding) (1 liang).
After decocting and filtering the juice, mix with fresh juice extracted from pounding 1 liang of *Chrysanthemi Indici Radix* (Xian Juhua Gen) and take orally.

Nei Fa Dan Du (Internal Onset Erysipelas)
Wang Kentang stated: Nei Fa Dan Du presents with swelling and pain from the hypochondrium to the waist and hip region, with skin redness like rosy clouds. If treatment is delayed slightly, the toxin attacks internally, leading to vomiting, hiccups, coma, and abdominal distension, which results in death; if there is obstruction of urination and defecation, and the whole body turns cyanotic/purple, it also results in death. Urgently use bian stone (stone lancet) to puncture and release foul blood. Administer *Fangfeng Tongsheng San* (Saposhnikovia Decoction for Unblocking the Supreme Health) excluding *Atractylodis Macrocephalae Rhizoma* (Baizhu) and *Glycyrrhizae Radix et Rhizoma* (Gancao), or administer *Zijin Dan* (Purple Gold Pill) and *Shengjin Dan* (Winning Gold Pill) to induce sweating. If sweating occurs after taking the diaphoretic agent, the patient survives; if no sweat occurs, the patient dies. Vomiting, inability to eat, and delirium indicate death. (From *Yixue Zhunsheng*)
*Yizong Jinjian: Xinfa Yaoyue* states: Nei Fa Dan Du is caused by extreme heat in the Liver and Spleen meridians generating wind. It arises in the ribs, extends to the waist and hips, appears red like rosy clouds, moves freely like clouds, and burns with pain like fire. Urgently puncture the periphery of the redness and swelling with a bian stone to release dark purple-black blood, and apply slices of lean beef or mutton to reduce the toxicity by half. If vomiting, hiccups, confusion, abdominal distension, and whole-body cyanosis occur, it indicates internal attack by toxic qi, which is a adverse prognosis (Ni syndrome).

Xia Ying Ju (Parasternal Carbuncle)
*Guiyi Fang* states: Xia Ying Ju presents with swelling rising to involve the ribs and both shoulders and elbows. If not drained within twenty days, death ensues. It can be punctured on the ninth day. If pus mixed with red and white discharge is profuse, it is treatable; if there is no red or white discharge, it is untreatable. It further states: Carbuncles arising in both hypochondria are named "Fa Lei" (Erupting Ribs). Initially, the swelling is severe; if not drained after several days, upon rupture, it swells like a cup or bowl, rises high like the back of an iron griddle, and causes pain piercing into the internal intestines as if wringing and stabbing. Pain in the left side corresponds to pain in the right, and vice versa. This location often involves internal toxins that attack inward, causing many deaths. For such conditions, urgently puncture with a needle to drain pus and blood to avoid internal damage.
*Yizong Jinjian: Xinfa Yaoyue* states: Lei Ju (Rib Carbuncle), also known as Xia Ying Ju, arises between the rib bones and is formed by the stagnation and accumulation of Liver Fire due to depression and anger. It initially resembles a plum or apricot, gradually enlarging to the size of a bowl, appearing purple and painful, extending to the shoulders and elbows. Lesions on the left cause pain radiating to the right hypochondrium, and lesions on the right cause pain radiating to the left hypochondrium. Obtaining thick pus by the twenty-first day is a favorable sign (Shun); if clear fluid oozes out when the time comes, it is an adverse sign (Ni).