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On Yang Syndrome Carbuncles and Ulcers, and Yin Syndrome Carbuncles and Ulcers

The Heavenly Master said: When a person develops carbuncles or ulcers on the back, or between the chest and abdomen, or on the head and face, or at the extremities of the hands and feet, if within five days of onset, internal medication should still be used to dissipate them; if beyond five days, surgical incision is necessary. The internal dissipation formula consists of: 4 liang (approx. 150g) of *Jinyinhua* (Lonicerae Japonicae Flos), 2 liang (approx. 75g) of *Pugongying* (Taraxaci Herba), 2 liang (approx. 75g) of *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens), 2 liang (approx. 75g) of *Danggui* (Angelicae Sinensis Radix), and 5 qian (approx. 18.75g) of *Tianhuafen* (Trichosanthis Radix). Decoct in water and take orally. One dose will cause resolution, two doses will lead to complete cure, and a third dose is unnecessary. *Jinyinhua* (Lonicerae Japonicae Flos) specializes in internally dissipating toxin from sores, but without high dosage, its efficacy is weak and success difficult; alone, *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens) is sufficient to detoxify, especially when combined with *Jinyinhua*, it effectively disperses pathogenic factors while protecting healthy Qi. *Pugongying* (Taraxaci Herba) is a herb for the Yangming channel, capable of resolving nodules and expelling pathogens; *Tianhuafen* (Trichosanthis Radix) is a supreme medicine for eliminating phlegm; *Danggui* (Angelicae Sinensis Radix) invigorates blood, which is its specific function. Stasis of blood leads to the formation of carbuncles; now that blood circulation is restored, the carbuncle heals itself. This is why this formula is considered both miraculous and potent. (Commentary: Disinfecting Divine Holy Pill.) If toxic-resolving dissipating medicines were not taken earlier, leading to suppuration and rupture, the external opening will likely be small while the internal cavity is large. This is like bandits dwelling deep in mountains: the passes are narrow, but their nests must be spacious. If one does not directly attack the stronghold, the condition will spread endlessly, potentially turning the populace into "bandits" (metaphor for spreading toxicity). Therefore, sharp instruments must be used to remove necrotic tissue around the wound edge, preventing internal toxins from hiding. The knife should be three cun long, three fen wide, sharp on both edges, with a blade thickness of half a fen, slightly pointed on one side. Hold firmly, gaze steadily, focus the mind, make one horizontal cut and one vertical cut. The patient may experience brief syncope; do not panic, as they will recover shortly. Afterwards, apply powdered medicine onto a plaster patch. Approximately two qian (approx. 7.5g) of powder per plaster. Application provides immediate pain relief, and purulent matter drains completely. After three consecutive days, the lesion should resolve entirely. Internal decoction: 1 liang (approx. 37.5g) of *Danggui* (Angelicae Sinensis Radix), 5 qian (approx. 18.75g) of *Huangqi* (Astragali Radix), 1 qian (approx. 3.75g) of *Renshen* (Ginseng Radix), 1 qian (approx. 3.75g) of *Jingjie* (Schizonepetae Spica), 2 liang (approx. 75g) of *Jinyinhua* (Lonicerae Japonicae Flos), and 3 qian (approx. 11.25g) of *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens). Decoct in water and take orally. Two doses are sufficient; excessive use is unnecessary. (Commentary: Toxin-Resolving Divine Holy Pill.) This is the method for treating Yang syndrome sores and ulcers. Yang syndrome carbuncles typically protrude more than one cun, appear red and swollen with a shiny surface, and are painful with crying out. For Yin syndrome carbuncles and ulcers, the internal dissipation treatment is the same as for Yang syndrome, but the treatment after rupture is completely different. Generally, Yin syndrome carbuncles appear dark in color, with mild pain, accompanied by a sensation of heaviness in the body. The wound does not protrude or presents numerous small openings to deceive observers. Urgently treat with: 3 qian (approx. 11.25g) of *Fuzi* (Aconiti Lateralis Radix Praeparata), 3 liang (approx. 112.5g) of *Renshen* (Ginseng Radix), 3 liang (approx. 112.5g) of *Sheng Huangqi* (Astragali Radix Recens), 1 liang (approx. 37.5g) of *Danggui* (Angelicae Sinensis Radix), 3 liang (approx. 112.5g) of *Jinyinhua* (Lonicerae Japonicae Flos), and 2 qian (approx. 7.5g) of *Baijiezhi* (Sinapis Semen). *Maidong* (Ophiopogonis Radix) can be added at 3 qian (approx. 11.25g); *Xuanshen* (Scrophulariae Radix) must not be used. (Commentary: Cold-Dispersing Yin-Saving Supreme Holy Pill.) In summary, Yin syndrome should be treated with warm-dispersing methods, never cold-clearing methods. For external application, add 5 qian (approx. 18.75g) of flesh-generating powder to the plaster, changing twice daily. Yin syndrome carbuncles often occur in wealthy individuals accustomed to rich diets, or those frustrated in their career ambitions. Disharmony between Heart and Kidney, depletion of both Yin and Yang, compounded by sorrow, depression, anger, and shouting, causes Qi stagnation, forming severe toxicity. Whether located on the back, head, abdomen, flanks, hands, or feet, these are critical conditions. With my internal medicine and external plasters, survival is assured. Yang syndrome can be resolved with cooling agents, whereas Yin syndrome requires warming dispersal. Plaster Formula: 1 jin (approx. 500g) of *Jinyinhua* (Lonicerae Japonicae Flos), 8 liang (approx. 400g) of *Shengdi* (Rehmanniae Radix Recens), 3 liang (approx. 150g) of *Danggui* (Angelicae Sinensis Radix), 2 liang (approx. 100g) of *Chuanxiong* (Chuanxiong Rhizoma), 1 liang (approx. 50g) of *Niuxi* (Achyranthis Bidentatae Radix), 1 liang (approx. 50g) of *Danpi* (Moutan Cortex), 3 liang (approx. 150g) of *Maidong* (Ophiopogonis Radix), 1 liang (approx. 50g) of *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens), 1 liang (approx. 50g) of *Jingjie* (Schizonepetae Spica), 5 qian (approx. 18.75g) of *Fangfeng* (Saposhnikoviae Radix), 3 liang (approx. 150g) of *Huangqi* (Astragali Radix), 5 qian (approx. 18.75g) of *Qiancaogen* (Rubiae Radix et Rhizoma), 5 qian (approx. 18.75g) of *Renshen* (Ginseng Radix), and 5 liang (approx. 250g) of *Xuanshen* (Scrophulariae Radix). Boil in 5 jin (approx. 2500g) of sesame oil until boiling several times, strain out the dregs, then continue simmering until the oil forms beads ("water-drop test"). Add the following finely powdered herbs: 1 liang (approx. 50g) of *Guangmuxiang* (Aquilariae Lignum Resinatum), 2 jin (approx. 1000g) of *Huandan* (Minii Oxidum Rubrum) [calcined and washed free of sand], 1 liang (approx. 50g) of *Myrrh* (Myrrha), 1 liang (approx. 50g) of *Ruxiang* (Olibanum), 1 liang (approx. 50g) of *Xuejie* (Draco Sanguis), 5 qian (approx. 18.75g) of *Xiangpi* (Elephantis Corium), and 1 qian (approx. 3.75g) of *Shexiang* (Moschus). Mix into the oil, simmer briefly, store in a porcelain jar. Use 1 liang (approx. 50g) per application; for back carbuncles (*Fabei*), 1 liang is mandatory; for other wounds, adjust according to size. (Commentary: Yin-Yang Supreme Holy Pill. Lei Gong said: Why is the discussion so profound and the formula so unique?) Powder Formula: 1 liang (approx. 50g) of *Renshen* (Ginseng Radix), 1 qian (approx. 3.75g) of *Bingpian* (Borneolum Syntheticum), 3 qian (approx. 11.25g) of *Ruxiang* (Olibanum) [de-oiled], 5 qian (approx. 18.75g) of transparent *Xuejie* (Draco Sanguis), 1 liang (approx. 50g) of *Sanqi* (Notoginseng Radix et Rhizoma) powder, 1 liang (approx. 50g) of *Ercha* (Catechu), 1 liang (approx. 50g) of *Chuanbeizi* (Fritillariae Thunbergii Bulbus) [water-washed free of sand], 3 qian (approx. 11.25g) of *Tenghuang* (Gambogi Resina), 2 qian (approx. 7.5g) of *Beimu* (Fritillariae Cirrhosae Bulbus), and 1 qian (approx. 3.75g) of *Qingfen* (Calomelas). Grind all into extremely fine powder, ensuring no sound is produced. These plasters and powders are incredibly miraculous. Except for back carbuncles, other wounds heal within two applications; Yin syndrome heals within three. Keep secret. (Commentary: Yin-Yang Supreme Holy Pill. Sun Gong said: Truly a miraculous formula!)

Master Zhang said: I have already transmitted the formulas for sores and ulcers; they can be appended here.

Carbuncles and ulcers are the most difficult to treat. Before the true form appears externally, the major acupoints internally have already ulcerated. As the ancients said: "Externally the size of a bean, internally the size of a fist; externally the size of a fist, internally the size of a plate." This is indeed accurate.

When one sees a sore opening on the back, do not underestimate it. Immediately apply a slice of garlic, one fen thick, to the wound, and moxa-burn it. If it hurts, burn until the pain stops; if it does not hurt, burn until sensation returns. Do not stop immediately if there is no pain, nor stop if it becomes painful before the desired effect is achieved. This method is excellent, unrecognized by the world, but I highlight it specifically for early-stage back carbuncles. Once moxa-burned, the toxin transforms with the fire; attacking fire with fire, what doubt remains? Physicians of the world should pay attention.

Master Hua said: The method transmitted to you is particularly unique; the formula transmitted to me is different. Carbuncle Formula: 3 liang (approx. 150g) of *Jinyinhua* (Lonicerae Japonicae Flos), 3 qian (approx. 11.25g) of *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens), 3 qian (approx. 11.25g) of *Pugongying* (Taraxaci Herba), 1 liang (approx. 50g) of *Danggui* (Angelicae Sinensis Radix), and 5 qian (approx. 18.75g) of *Tianhuafen* (Trichosanthis Radix). Decoct in water and take orally. My formula differs slightly from the Heavenly Master's transmission to you. However, observing the constitution of people today compared to the Three Kingdoms period, which is thinner/weakier, the Heavenly Master changed light dosages to heavy ones. Only *Tianhuafen* (Trichosanthis Radix) retains the same dosage, likely because phlegm cannot be aggressively attacked. Nevertheless, my formula is also very unique and should not be轻视 (underestimated). If the sore condition is slightly milder, consider using my formula; it will surely respond. The plaster and powder formulas are the same.

Qi Tian Shi said: Master Hua speaks correctly. (Commentary: Heavenly Master said: Wonderful.)

Lei Gong said: I also have a formula. Carbuncle/Ulcer Formula: 5 qian (approx. 18.75g) of *Sheng Gancao* (Glycyrrhizae Radix et Rhizoma Recens), 3 liang (approx. 150g) of *Jinyinhua* (Lonicerae Japonicae Flos), 1 liang (approx. 50g) of *Danggui* (Angelicae Sinensis Radix), 5 qian (approx. 18.75g) of *Xuanshen* (Scrophulariae Radix), 3 qian (approx. 11.25g) of *Tianhuafen* (Trichosanthis Radix), 1 qian (approx. 3.75g) of *Baifan* (Alumen), and one slice of *Fuzi* (Aconiti Lateralis Radix Praeparata). Decoct in water and take orally. For early stages, one dose resolves it; for swelling, two doses resolve it. A divine formula. (Commentary: Even more wonderful.)

Sun Zhen Jun said: I also have a miraculous formula to transmit. For any initial carbuncle, use 1 liang (approx. 50g) of *Baifan* (Alumen) and 3 liang (approx. 150g) of *Jinyinhua* (Lonicerae Japonicae Flos). Decoct in water and take orally. One dose resolves it; this applies to back carbuncles as well.