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Jing Ju (Well Carbuncle) arises in the epigastric region, located at the Jiutui (CV15) acupoint of the Ren Mai (Conception Vessel), also known as Chuan Xin Du (Penetrating Heart Toxin). It is the most difficult condition to treat. This occurs due to the reckless movement of Heart Fire. If, at the onset, it resembles a soybean and subsequently becomes red, swollen, and elevated, accompanied by mental restlessness, feverish sensation of the skin like burning, dry lips, yellow and dry tongue coating, and thirst for cold water, one may use Liang Ge San (Cool the Diaphragm Powder) to unblock the fu-organs and purge heat, or use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) to clear the Ying (Nutritive) level and detoxify. If the course of the sore gradually recedes, recovery can be achieved through regulation. However, if the lesion becomes hard, purple, and black, with toxin sinking inward, aversion to food odors, incessant vomiting, mental confusion, abdominal distension, and diarrhea, it is incurable. Another type presents with initial swelling and hardness, unchanged skin color, which eventually ulcerates after a long period; this is named Chuan Xin Leng Lou (Penetrating Heart Cold Fistula). It is caused by consuming excessive amounts of raw, cold, and spoiled foods, allowing toxic accumulation over time to invade the Pericardium Luo (Collateral), thus manifesting externally on the heart/chest area. It should be treated with decoctions that warm and tonify Qi and Blood.

Xin Lou (Heart Fistula) initially presents as a sore in the chest. Due to lack of restraint regarding alcohol and sexual activity, a fistulous tract forms, often bleeding. Over time, the spirit and physical form become exhausted, lower back pain makes extension difficult, and gait resembles kyphosis. Although this external sore belongs to the Heart, its root lies in the Kidney; the Heart and Kidney are originally connected. Heart Qi must receive mutual generation from Kidney Qi, and Kidney Qi must receive mutual closure (consolidation) from Heart Qi. The formation of Heart Fistula results from the leakage of Kidney Qi; therefore, how can one fail to tonify the deficiency of Kidney Qi? However, if one tonifies the Kidney without closing/consolidating the Heart Qi, tonification is of no benefit, akin to having outflow without inflow control. Some say fistulas mostly result from Damp-Heat. Now, if one tonifies the Kidney without closing the Heart orifice, the fistula will not heal; if one closes the Heart orifice without eliminating Damp-Heat, treating only Heart and Kidney will not cure the fistula either. Yet, fistulas differ by location. Fistulas elsewhere can have their Damp-Heat drained; those in the chest cannot. Since the fistula forms due to Kidney Deficiency, Kidney Deficiency implies Cold rather than Heat; Kidney Deficiency refers to the deficiency of True Yin (Kidney Water) rather than the excess of pathogenic Water (Dampness). Tonifying True Yin causes pathogenic water to dissipate naturally; warming Kidney Cold causes Damp-Heat to retreat naturally. The principal formula is Wen Shen Wan (Warm Kidney Pill): Lu Rong (Cervus Nippon Cornu, Deer Antler) two pieces (de-haired, fried with butter), Fu Zi (Aconiti Lateralis Radix Praeparata, Prepared Aconite Root) two pieces (processed, peel and umbilicus removed), Ren Shen (Ginseng Radix et Rhizoma), Qing Yan (Natrii Chloridum, Rock Salt) each two liang, Wa Song (Parmelia Soredians, Rock Moss) two branches, Hong Zao (Zizyphi Fructus, Jujube Fruit) four liang. Boil the jujubes, mash them, and make pills. Take thirty pills orally with wine on an empty stomach; after one month of administration, the illness heals and the fistula self-cures. An alternative version excludes Wa Song and Ren Shen. This formula also treats lower back pain due to Kidney Deficiency with miraculous effect.