Library

Jia Yong (Clamp Abscess), also known as Ye Yong (Axillary Abscess), arises in the depression below the shoulder blade. If the skin color remains unchanged, with diffuse swelling lacking a head, and pain appearing only after some time, accompanied by chills and fever, this is caused by blood stasis in the Liver Channel and Qi stagnation in the Spleen Channel. This condition is difficult to resolve and will inevitably suppurate. Before rupture, Chaihu Qinggan Tang (Bupleurum Decoction for Clearing the Liver) is used; after rupture, Yiqi Yangying Tang (Qi-Nourishing and Nutrient-Supporting Decoction) is the primary formula. The treatment throughout should focus on warming and tonifying, strictly avoiding cold-cooling agents. If headache, chills, and fever occur within three or four days of onset, this is due to external contraction of Wind-Heat affecting the Foot Shaoyang Gallbladder Channel, Hand Jueyin Pericardium Channel, and Hand Shaoyin Heart Channel. Initially, one should disperse Wind and scatter pathogenic factors, while harmonizing Ying (Nutrient) and unblocking collaterals, so that pathogenic heat recedes and swelling subsides.

Among these, if the lesion presents with redness and hard swelling, it is named Mi Ju (Rice Carbuncle). At its onset, the shape resembles a bean kernel, accompanied by intermittent chills and fever. This is also caused by忧思恚怒 (worry, thought, anger, and resentment) affecting the Liver and Spleen channels, leading to Qi condensation and blood stasis, combined with external invasion of Wind-Warmth. Its treatment method can be referenced from the principles applied to the previous two conditions.

Bi Ju (Arm Carbuncle) and Yudufafa (Fish-Belly Swelling) both arise on the arm. Those on the lateral aspect of the arm are called Bi Yong (Arm Abscess), while those on the medial aspect where the flesh hangs down are called Yudufafa. Generally, this arises from extreme heat in the meridians, external interference by Wind Pathogen, and abnormal circulation of Qi and Blood. Treatment should differentiate by meridian, using herbs belonging to that specific meridian as guiding agents to promote Qi and Blood circulation; thus, unformed abscesses can dissipate, and formed ones can easily suppurate and heal. Regarding meridian-specific treatments, Li Dongyuan's discussion is very detailed. He stated that there are six pathways of arm pain. With both hands extended and hanging down, thumb forward and little finger backward, one can determine the location: Pain at the anterior margin belongs to the Yangming Channel, guided by Shengma (Cimicifugae Rhizoma), Gange (Puerariae Radix), and Baizhi (Angelicae Dahuricae Radix); pain at the posterior margin belongs to the Taiyang Channel, guided by Bencao (Ligustici Rhizoma et Radix) and Qianghuo (Notopterygii Rhizoma et Radix); pain at the lateral margin belongs to the Shaoyang Channel, guided by Chaihu (Bupleuri Radix); pain at the medial margin belongs to the Jueyin Channel, guided by Chaihu (Bupleuri Radix) and Qingpi (Citri Reticulatae Pericarpium Viride); pain at the anterior-medial margin belongs to the Taiyin Channel, guided by Shengma (Cimicifugae Rhizoma) and Baizhi (Angelicae Dahuricae Radix); pain at the posterior-medial margin belongs to the Shaoyin Channel, guided by Xixin (Asari Radix et Rhizoma) and Duhuo (Angelicae Pubescentis Radix). In the area above the elbow and below the junctional bones, internally connected to large and small tendons and vessels, abscesses and boils here often cause inconvenience in movement and a feeling of heaviness and pain when the hand hangs down. If pus penetrates deeply to the bone, it damages tendons and vessels, causing fist clenching, retraction, and spasms; in such cases, herbs that slowly relax tendons and vessels should be added. This constitutes the general principle of treatment. As for dispersing pathogens, clearing heat, resolving toxicity, and harmonizing Ying (Nutrient), the treatment is the same as for various other carbuncles and ulcers. If latent pathogens from autumn obstruct the collaterals, presenting with white tongue coating, nausea, vomiting, chills, fever, and chest tightness, Xie Xin Tang (Drain the Epigastrium Decoction) or Wendan Tang (Warm the Gallbladder Decoction) methods are used. If Wind-Warmth combines with Dampness and Fire entering the collaterals, herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Lingxian (Syneilesidis Rhizoma), and Pian Huang (Curcumae Longae Rhizoma) are employed.