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The *Ling Shu* (Spiritual Pivot) states: When a carbuncle appears in the axilla, characterized by redness, hardness, and failure to suppurate, it is termed "Ma Dao Jia Ying" (Scrofula with Goiter), which requires urgent treatment.

Wang Shengzhi stated: Ma Dao is exclusively related to the Liver and Gallbladder meridians. Its shape is rather long and hard as stone. It may occur from below the ear to the Quepen point (ST12), or extend from the shoulder along to the hypochondrium, even appearing in clusters on the chest. After years, some form sores that do not break, while others break open with continuous discharge of pus and blood; this condition is nearly critical. (*Li Li*)

Feng Luzhan stated: If there are elongated nodules结 (knots) beside the chest or in both hypochondriac regions, this is named Ma Dao. (*Jin Nang*)

Zhou Wencai stated: Ma Dao sores arise between the neck and axilla, resembling Scrofula (Luo Li). However, at the initial stage, they resemble a horse knife, are red like fire burns, and extremely painful. This sore is very fierce; it should be treated urgently, otherwise, it often becomes critical. (*Ji Yan*)

Hu Gongbi stated: Nodules located on the chest and extending laterally to the hypochondrium are named Ma Dao. This is a manifestation of the Foot-Shaoyang Gallbladder Meridian. Initially small, they will inevitably grow larger. If they become painful, break open, and discharge pus, exposure to wind through the pus hole will certainly lead to a Fistula syndrome (Lou Zheng), which is extremely difficult to cure; only those who are young, strong, and have abundant Qi and Blood can be easily cured. (*Qing Nang*)

Chen Shigong stated: Ma Dao sores, shaped long like clams, arise on the side of the neck, below the ear, on the shoulder, at the Quepen point, and in the axilla. (*Zheng Zong*)

Jiang Shiji stated: Ma Dao tubercles are hard as stone and originate from the Hand-Shaoyang and Foot-Shaoyang meridians. If neglected and untreated, and if dietary/lifestyle taboos are not observed, the condition gradually extends to the Yangming meridian, reaching the submandibular area and Jiache point. For robust patients, Kui Jian Tang (Hardness-Dispersing Decoction) is used; for deficient patients, Zi Yin San Jian Tang (Nourishing Yin and Dispersing Hardness Decoction) is the primary prescription. (*Shuo Yue*)

I state: Ma Dao arises above the Quepen point, extending from the chest and axilla to the hypochondrium. It originally stems from Phlegm Nodules and Scrofula persisting over time, accompanied by tidal fevers, leading to exhaustion of Qi and Blood and diminished spirit. Compounded by improper medical treatment, it酿 (brews) into massive ulceration of pus and blood. The swelling becomes increasingly hard daily. In severe cases, it ulcerates leaking blood and serum without pus, or forms clusters like rock caves—swollen but painless—pushing outwards against the cheeks and obstructing the throat internally, hindering eating and drinking. Tendons and vessels become contracted and painful, pulling on the legs and feet. Even worse, anger rises upward, forcing blood to overflow from hair follicles, eventually transforming into Ma Dao. Why is it called Ma Dao? "Ma" (Horse) implies swiftness; "Dao" (Knife) implies sharpness. Being both swift and sharp, how can one resist it? Thus, the *Ling Shu Jing* states: "Ma Dao Jia Ying should be treated urgently." Nevertheless, even when a person is near death, there are methods to save them. To sit idly by and not rescue them is contrary to the heart of a benevolent person. Externally, moxibustion is suitable and may restore life; for example, apply three moxa cones each to the Jianjing (GB21), Feishu (BL13), Danzhong (CV17), Fengchi (GB20), Bailao (EX-HN5), and Quchi (LI11) acupoints. Internally, administer Yi Qi Yang Rong Tang (Qi-Nourishing and Blood-Sustaining Decoction), a formula that opens depression, clears phlegm, harmonizes Qi, and dissipates nodules, simultaneously supporting the Liver and Spleen throughout the treatment course and doubly supporting Qi and Blood. After moxibustion, use Wan Ling Gao (Myriad Spirits Ointment) for conditioning for one year, maintaining a tranquil and calm lifestyle, which can still preserve life. If treated recklessly, using cauterizing agents externally and attacking/purgative drugs internally, death will follow immediately.