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Cheng Shanling stated: In the treatment of carbuncles and sores, if the opening is small but there is abundant pus, the pus may not discharge or may not be completely discharged; some thin pus may discharge, but hard pus is difficult to discharge. This leads to stasis preventing the growth of new tissue, resulting in a lingering condition that is difficult to heal. The method should involve using caustic agents to enlarge the opening, allowing the stasis and pus to discharge abundantly, which is favorable. Among such caustic agents, Wu Jin San (Gold Black Powder) is the best. It can remove necrotic flesh without injuring new tissue and causes little pain, which is extremely ingenious; if there are sinus tracts, cotton paper twists coated with medicine can be inserted, replaced frequently with several strands, until the pus dissolves and discharges. There are also cases of extreme stubborn hardness where the pus cannot be removed by Wu Jin Gao (Gold Black Ointment); in such cases, Bai Jiang Dan (White Reduction Cinnabar) or Hua Fu Zi Xia Gao (Rot-Transforming Purple Cloud Ointment) can be applied for smearing. However, none compare to Wu Jin Gao as being the most stable and secure. (From *Shi Fa*)

Li Dongyuan stated: Sores and ulcers arising externally are all caused by accumulated heat harbored internally. *Neijing* states: Heat in the blood causes flesh to rot, and the functioning of Ying and Wei (Nutritive and Defensive Qi) ceases, inevitably leading to pus formation. Retained in the interstices, it inevitably leads to decay. Generally, when sores and carbuncles are in the stage of pus suppuration and rotting, if the head is small and unruptured, the sore opening is not open, or the toxic factors cannot exit, causing unbearable pain, methods for pursuing and eroding pus were established. This allows toxic factors to vent externally rather than attack internally, making evil flesh easy to remove and good flesh easy to grow. If blood from the sore flows incessantly, caustic erosion for pus discharge should not be performed immediately. Caustic drugs should be sprinkled on the sore, waiting for it to mature before proceeding. If the pain of the sore extends to the root of the heart (deep tissues), forced erosion should also not be attempted. Accidental contact with the sore will double the pain, and complications may arise; caution is essential. If a boil has formed pus but remains unruptured, and the superficial skin is raised, an agent for breaking the head and acting like a needle should be applied on top, covered with an ointment plaster. After the pus discharges, drugs for searching out pus and resolving toxins should be used, yielding miraculous effects. (From *Shi Shu*)

Dou Hanqing stated: The onset of any sore or ulcer involves pain, which fundamentally belongs to Heart Fire. Over time, Yang Qi ascends, steaming the flesh into pus. Without careful consideration to determine the presence or absence of pus, if one rashly performs surgery, fresh blood will gush out, and where would the pus come from? This causes the patient to suffer from alternating chills and fever, day and night pain, with no way to stop it. One must first press the affected area with fingers; upon lifting, if the surrounding areas are soft, and observing the gathering point of the head, one should select an auspicious day to incise upwards with the knife blade, ensuring new tissue is not injured. After removing the knife, a cotton strip moistened with oil should be inserted to gather the pus and fluid. After half a day, it is pulled out, allowing the pus and fluid to dry easily. An external plaster is then applied, and powder is spread around the perimeter. (From *Quan Shu*)