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Shen Douyuan stated: In cases of carbuncle and ulcer (Yong Ju), trauma-induced toxicity, yaws condensation toxicity (Yangmei Jiedu), malignant sores, groin abscesses (Biandu), and carbuncles (Dingchuang), dead flesh often remains and corrodes healthy tissue. If the pain is unbearable and not removed early, it will become increasingly putrid. This is described as "malignant as wild wolves and tigers, toxic as snakes and scorpions," endangering life and potentially leading to untreatable conditions. One should assess the urgency and size of the dead flesh; some may be excised with needles or knives, while others may be treated with rotting flesh extractors (Furou Zhanzi) or powdered medicinal plasters, aiming for a level surface. Subsequently, medicines promoting tissue regeneration (Shengji Zhangrou) should be applied, along with internal administration of major tonifying decoctions and pills for recovery. The common people often mistakenly believe that applying tissue-regenerating plasters alone is miraculous, unaware that retained dead flesh causes harm and exacerbates putrefaction. If not thoroughly removed, healing cannot occur; this point warrants careful study. (From *Qixuan*)

Cheng Shanling stated: Boil pig trotter soup, filter out the dregs using silk gauze, and when the soup is half-warm, place it in a square basin positioned beneath the sore. Then, use soft silk to ladle the soup over the wound surface and into any cavities, gently pressing to expel internal pus, allowing necrotic matter and old pus to drain away with the soup until clean. Next, fold soft cloth into seven or eight layers (not too dry), soak it in the soup, and cover the wound. Gently press and rotate by hand for a moment; replace the cloth when it cools. Repeating this washing six or seven times naturally reduces pain and eliminates toxicity. During washing, avoid wind and human breath. (From *Shifa*)

Feng Luzhan stated: For open carbuncles and ulcers, daily washing with pig trotter soup is recommended; as healing approaches, reduce frequency to once every three days. (From *Jinnang*)

Wang Kentang stated: Ulcers are suitable for washing. However, if one does not first administer tonifying and connecting herbs to strengthen the interior, the temporary relief from washing may soon lead to fatigue and irritability in the patient, indicating deficiency. Is it not necessary to discuss tonification and connection first? (From *Zhunsheng*)

He also stated: To wash fistula sores (Lou Chuang), boil dried mugwort (Ai Ye) in water, add two or three qian of alum powder (Baifan Mo), and wash the sore opening. Since human blood and qi tend to be cold, mugwort's warming properties assist yang, and its nature can also kill parasites. (Note: Fistulas should not be closed hastily; condensation toxicity is indeed caused by parasites.)

Chen Liangfu stated: If a carbuncle fails to heal for a long time, with white flesh and scant pus, this indicates deficiency of both qi and blood, failing to circulate, resulting in a cold and astringent sore opening. Daily, boil a handful of mugwort leaves in water, wash avoiding wind and heat, fumigate with smoke from burning pine wood, or wash with pig trotter soup, then apply Shenyi Plaster. Strict adherence to dietary and lifestyle restrictions is required, otherwise efficacy will be lacking.

Tang Yuanzhen stated: For back carbuncles, if necrotic flesh is not removed, do not use knife excision. Instead, decose agarwood (Xiang) in water. Do not wash with hands. Pour the decoction into a wine pot and pour it over the sore. Sweep with a new wool brush, wipe dry, then apply a paste made from blackened and pounded bitter almond seeds (Badou). Applying this several times allows necrotic flesh to fall off and new flesh to grow naturally.