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Carbuncles (Yong) arise from the Six Fu organs, while deep abscesses (Ju) arise from the Five Zang organs. When Ying Qi (Nutritive Energy) fails to circulate properly and reverses within the muscle tissue, carbuncles and swellings are generated. This is the general principle of carbuncles and abscesses discussed by ancient sages, serving as the guiding outline for surgical diseases.

The condition has persisted for over a month, with toxicity erupting on the back. Initially, the lesion was flat and painless. After administering warming and tonifying internal-supporting medicines, the condition transformed from a Yin syndrome to a Yang syndrome, presenting with redness, swelling, suppuration, and sloughing of necrotic tissue, with new granulation tissue gradually closing the wound. However, just as one wave subsides, another rises. A few days ago, the gums swelled slightly and became painful, progressing to severe swelling and bleeding. The patient had already consumed little food during the illness; now, due to gum swelling, even rice gruel is difficult to swallow. Humans rely on Stomach Qi (Wei Qi) as their foundation. After ulceration, Stomach Qi is empty and entirely depends on the essence derived from dietary intake to nourish vital life force. If one cannot accept grain and food, the granaries (Spleen and Stomach) will surely collapse; what reliance can there be without fear? Moreover, post-ulceration is similar to postpartum conditions, where cultivating Qi and Blood is the proper approach. Currently, the gums are swollen and the throat dry, accompanied by diarrhea with feces resembling dark sauce color. The gum swelling and pain ease slightly during diarrhea but intensify again when the diarrhea stops. Carefully examining the pathogenesis, it seems residual toxicity remains unclarified. Yet, given the prolonged debilitation, reinforcing the healthy Qi would leave the fire unchecked, while clearing the fire would fail to preserve the healthy Qi. How should one proceed? Tentatively imitating the pattern of "Shao Yin insufficiency and Yang Ming excess," I follow the method of Yü Nü Jian (Jade Woman Decoction). The Kidney governs the bones, and teeth are considered the surplus of bones. The upper gums belong to the Hand-Yangming Large Intestine channel, and the lower gums belong to the Foot-Yangming Stomach channel. Based on theoretical deduction, I hope for a fortunate outcome.

Commentary by Anbo: It is suggested to incorporate the intent of Qing Wei San (Stomach-Clearing Powder) alongside Yü Nü Jian. The inclusion of Sheng Ma (Cimicifugae Rhizoma) facilitates the ascending of clear Qi and descending of turbid Qi, while Dan Pi (Moutan Cortex) disperses stagnation in the lower aspect. Thus, the treatment of this simultaneous upper and lower pathology would be comprehensive without omission.

The Classic states: Exhalation is governed by the Heart and Lungs, while inhalation is governed by the Kidneys and Liver. Therefore, the Lung governs exhalation, and the Kidney governs inhalation. The Lung is the master of Qi, and the Kidney is the root of Qi. The Mother organ resides in the Palace of the Child, and the Child organ hides within the Mother's womb, illustrating the principle of Metal and Water generating each other. Previously, we discussed preserving Metal to generate Water, grasping Qi to return it to its root, and purifying the source to rectify the origin; this treatment was not erroneous. According to the report, after taking the medicine, there was slight fullness in the epigastrium. Suspecting that the tonic nature of the medicine caused this, the patient dared not consume it further. This is due to the Spleen and Stomach's deficiency failing to transport the medicinal power, unrelated to whether the medicine is tonifying. If tonification were truly harmful, why would the asthma not increase and the disease not worsen? The Classic says: "If one can combine pulse and complexion diagnosis, one can achieve perfection." Does the complexion appear haggard and spirit exhausted, with panting breath that cannot continue? Can such a state be resolved through depletion? Ancient sages said: "When asthma arises, do not deplete Qi." If Qi is already weak and then depleted, and Yuan Ben (Primal Foundation) is already deficient and then exhausted, it is like carrying firewood to save a fire or throwing stones into a well; death will be near very quickly. Do not blame me for speaking ill omens.

Commentary by Anbo: Reading this case, I cannot help but sigh deeply. Although there are miraculous arts capable of reviving the dead, what can be done if they are not believed? Recently, I have seen many premature deaths. Generally, their lifespan was destined to end thus, and my medical principles ultimately could not be implemented. Is this not fate?