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Shen Douyuan said: An elderly man, nearly sixty years old, suffered from umbilical fistula (Umbilical Fistula) for over half a year due to lack of moderation with his young wife. The odor was so foul that it was unbearable, and various treatments failed. He believed he would certainly die. His mother wept and knelt before me, begging for treatment, saying, "If you can save my son to continue the family line, mother and son will never forget your great virtue." I treated him internally with tonifying formulas and externally with moxibustion above the navel. By the next day, the odor had disappeared. I then applied plasters and filled the umbilical opening with Shengji San (Flesh-Regulating Powder). After taking Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for half a month, he recovered. Another elderly man, seventy-five years old, suddenly developed umbilical fistula for over three months due to anger and frustration. He also believed he would die. I treated him according to the previous method, and he recovered in less than half a month. He lived until eighty-three years old before passing away. Alas, how miraculous this prescription is! (From *Qixuan*)

The skin of the abdomen suddenly turns blue-black. If not treated urgently, death will occur within moments. Apply Hu Fen (Lead Carbonate) mixed with wine topically.

Wang Shengzhi said: Abdominal carbuncle (Abdominal Carbuncle) is a manifestation of the Hand-Yangming Large Intestine Meridian and Hand-Taiyang Small Intestine Meridian. Toxic heat accumulation erupts on the surface, congesting and gathering to form a carbuncle. (From *Lili*)

Dou Hanqing said: Abdominal carbuncle is toxicity of the Spleen Meridian. It arises from consuming fried and greasy foods, excessive alcohol intake, or sexual excess, causing toxicity to stagnate and gather into a carbuncle. It may arise internally or externally. If not treated promptly, perforation through the spleen membrane leads to death. (From *Quan Shu*)

*Xin Fa* states: Abdominal wall carbuncle arises in the abdomen, between the skin and the fascia. Regardless of left or right side, there is chronic dull pain, followed by swelling on the skin surface. A deep and rapid pulse at the Right Guan position accompanied by severe abdominal pain are its signs. It is caused by fire depression from rich and sweet foods. One must not overdose on purgative drugs. Seeking resolution through excessive draining damages Stomach Qi, leading to inability to suppurate or heal, resulting in immediate danger.

Miraculous Formula for Abdominal Carbuncle: Crush fresh red leaves of *Rhododendron anthopogonoides* (Shinan Tree) to extract juice (one teacup), mix with wine, and drink slowly. Apply the dregs to the carbuncle and bind. Five doses result in complete recovery.

Wang Kentang said: Lower abdominal carbuncle occurs 1.5 cun below the umbilicus. Using wind-dispersing and fire-clearing herbs is actually using Qi-tonifying and Yang-warming herbs. This is because Yin cold condenses into Yin toxicity due to deficiency and cold. Cold stagnates due to deficiency; toxicity coagulates due to cold. Using hot herbs to dispel cold naturally resolves the cold and disperses the toxicity. Bihan Jiufu Dan (Cold-Dispelling Abdomen-Saving Pill): Bai Zhu (Atractylodis Rhizoma) 3 liang, Fu Ling (Poria) 3 qian, Rou Gui (Cinnamomi Cortex) 3 qian, Jin Yin Hua (Lonicerae Japonicae Flos) 3 liang, Fu Zi (Aconiti Lateralis Radix Praeparata) 2 qian, Dang Gui (Angelicae Sinensis Radix) 2 liang, She Chuang Zi (Cnidii Fructus) 5 qian. Decoct in water; one dose eliminates it internally. For already ulcerated cases, three doses exhaust pus and regenerate flesh; four doses cure completely. Here, Bai Zhu tonifies Qi in the Qihai area. Two cun below the umbilicus is Dantian, and three cun is Guanyuan, both belonging to the Ren Mai (Conception Vessel). These conditions are caused by disharmony of the Seven Emotions. If ulcerated with sinking appearance, thin pus, or long-term non-healing, death ensues. (From *Zhunsheng*)

*Gui Yi Fang* states: Lower abdominal tubercle (Lower Abdominal Tubercle), also known as Chong Ju Fa, presents with lower abdominal pain and chills/fever. On the fourth or fifth day, discoloration appears; acupuncture may be used. Without acupuncture and drainage of pus/toxicity, it is incurable, leading to death after fifty-plus days.

Chen Yuan Gong said: Carbuncles arising in the lower abdomen generally lack Yang signs because the location is Yin. Yin generates Yin toxicity, which seems severe. However, in pure Yin without Yang, applying Yang herbs yields immediate success. Unfortunately, people often use Yin-cooling herbs to detoxify, worsening the condition. The Yang herbs I refer to do not serve as the Sovereign herb but specifically promote circulation in the waist and umbilicus. When these areas are clear, the lower body benefits. Subsequently, She Chuang Zi and Yin Hua remove toxic vapors. To penetrate extreme cold, Fu Zi and Rou Gui are added. These dry herbs remove pathogens but may consume blood; thus, Dang Gui (a Yin-within-Yang herb) is used to moderate their harshness, gradually dispersing Yin-cold without causing Yang hyperactivity, achieving efficacy. (From *Bing Jian*)

Chen Shigong said: Lower abdominal carbuncle manifests as diffuse swelling and hardness with unchanged skin color. If heat and redness develop, it is a Yang pattern, easy to treat. If no heat or redness, it is a Yin pattern, difficult to treat. This results from Fire depression of the Seven Emotions causing Spleen deficiency and Qi stagnation. (From *Zhengzong*)

He further stated: For early-stage cases (within seven days), apply seven moxa cones with a plaster cover. Internally administer formulas to strengthen Spleen/Stomach, nourish Qi/Blood, and support expulsion. Avoid purgatives, diuretics, and cooling herbs, which cause collapse. If collapse occurs, urgently use Shiquan Dabu Tang (Ten Complete Tonifying Decoction) plus Ren Shen (Ginseng), Huang Qi (Astragalus), Gan Jiang (Zingiberis Rhizoma), and Fu Zi to rescue. If tonification fails, even if healed, it may become a fistula.

Feng Luzhan said: Abdominal carbuncle occurring below the umbilicus or about two cun to the side belongs to the Spleen Meridian; near the flanks belongs to the Gallbladder Meridian. This is often caused by Spleen Yin deficiency, Qi stagnation, and Blood stasis damaging the Spleen. (From *Jinnang*)

Hu Gongbi said: Lower abdominal carbuncle, also known as Dan Du Yong, arises from dietary irregularity where cold and heat lodge in the intestines/stomach forming toxicity, often appearing on the sides of the lower abdomen. (From *Qingnang*)

*Bai Xiao Quan Shu* states: Abdominal carbuncle arises between skin and fascia, caused by Seven Emotions Fire depression leading to Spleen deficiency and Qi stagnation; in children, it is due to fright and food retention causing depletion. Regardless of stage (early or ulcerated), strengthen Stomach Qi and assist with Blood-invigorating formulas. Mistaken use of purgatives/cold herbs prevents suppuration/healing. If cooling/purgative herbs were taken, urgently rescue with large doses of Ren Shen, Huang Qi, Gan Jiang, Fu Zi, or Shiquan Dabu Tang. For diffuse hard swelling without pus, use Sijunzi Tang (Four Gentlemen Decoction) plus Chuan Xiong (Ligustici Rhizoma), Dang Gui, Bai Zhi (Angelicae Dahuricae Radix), and Zhi Ke (Aurantii Fructus). For severe swelling/pain, apply garlic-separated moxibustion (5-7 cones) to reduce toxicity, internally using interior-supporting formulas. For soft, non-red swelling indicating mature pus, lance horizontally to drain toxin (avoid vertical puncture to protect fascia). Internally take supporting herbs and apply Yuhong Gao (Jade Red Ointment) for healing.

*Xin Fa* states: Lower abdominal carbuncle arises from Seven Emotions Fire depression, typically affecting Qihai (1.5 cun below umbilicus), Dantian (2 cun below), and Guanyuan (3 cun below), all on the Ren Mai. Swelling in any of these points constitutes lower abdominal carbuncle. High, red, vibrant swelling with radiating pain and thick pus indicates an easy-to-treat case. Diffuse hard swelling, soft rotting, and watery pus indicate Ju (Tubercle), which is difficult to treat.