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The pulse at the chi position is large or weak accompanied by thirst; it is appropriate to nourish yin and descend fire. The pulse in the upper jiao is deep and solid accompanied by thirst; it is appropriate to purge fire. The pulse in the upper jiao is surging and rapid accompanied by thirst; it is appropriate to descend fire. [The text implies a missing condition here, likely related to lower jiao or deficiency] accompanied by thirst; it is appropriate to tonify qi and blood. When pus and blood are massively discharged, or when there is bleeding from the sore accompanied by thirst, one should greatly tonify qi and blood. If this does not work, immediately use Dushen Tang (Single Ginseng Decoction).

A man suffered from thirst and was about to develop a carbuncle; I treated him with Jiajian Bawei Wan (Modified Eight-Ingredient Pill), and the condition resolved.

A man suffered from a brain carbuncle, with fever and a rapid but weak pulse. He was treated according to the aforementioned pill, but he did not believe in it and self-administered yin-nourishing medicines, leading to an untreatable deterioration.

A man drank several bowls of water daily, even in winter. Relying on his robust constitution, he later developed sores in his mouth and tongue. I intended to treat him with the aforementioned pill, but he considered it erroneous and instead took fluids-generating medicines. His thirst could not be stopped, and he died from a back carbuncle.

A man developed a carbuncle on the dorsum of his foot. After healing, he experienced thirst, which was cured by treating him with the aforementioned pill.

Jiajian Bawei Wan (Modified Eight-Ingredient Pill) is a sacred medicine for treating hyperactive fire due to yin deficiency. Why would anyone abandon this formula when such symptoms are present?

A wealthy merchant had a robust constitution and historically suffered from thirst, drinking several bowls of water daily. A toxic swelling appeared on his face. It was treated with detoxifying medicines; although it ulcerated and healed, the chi pulse remained rapid, and the slip pulse indicated... [text missing] ...this was a hidden danger of carbuncle toxin." He did not believe this. In summer, he indeed developed a carbuncle on the dorsum of his foot. His pulse was rapid, and upon pressing, it was choppy and weak. His foot eventually turned black and putrefied, leading to death.

A man had a solid constitution but lacked offspring. He took medicines such as Fuzi (Prepared Aconite Root) and subsequently developed thirst. He developed a carbuncle on the big toe of his left foot, which was purple and painless. His pulse was also rapid and choppy, and he died.

Generally, for back carbuncles, brain carbuncles, and gangrene of the toes, if there is swelling, pain, and redness, this indicates water deficiency and fire hyperactivity, which is still treatable. If the color is black or purple, this is a sign of extreme fire resembling water; those who do not receive treatment will die nine out of ten times. When a carbuncle disease is about to resolve, if thirst has already appeared, it is appropriate to take Jiajian Bawei Wan (Modified Eight-Ingredient Pill). After the condition stabilizes, if the thirst has not recurred, one should still take this medicine first to prevent recurrence. If the disease morphology has already manifested, sudden rescue is difficult. After any abscess or carbuncle heals, tonic medicines should be taken; however, using harsh tonics may cause fever. Moreover, after recovering from abscesses/carbuncles, people often transition into thirst diseases during periods of comfort, which are hard to treat. Therefore, Jiajian Bawei Wan (Modified Eight-Ingredient Pill) should be taken prophylactically. Long-term use can prevent thirst diseases entirely and strengthen qi and blood. For those who have not yet developed carbuncles, or who previously had thirst symptoms, taking this medicine is especially appropriate. Once the thirst is controlled, carbuncles will not occur.

Another nobleman suffered from a carbuncle. Before the disease stabilized, thirst occurred, and he drank several liters of water a day. I offered this formula. The other physicians laughed, saying, "If this medicine can stop thirst..." [text missing] ...after several doses, there was no effect. Reluctantly, they used this medicine. After three doses, the thirst stopped, and they believed in it. They continued long-term use; not only did the thirst not recur, but qi and blood strengthened, food intake doubled, and he became stronger than in his youth. Using this medicine is not my stubborn opinion, but has a historical source. Since childhood, I heard my father, the County Magistrate, say: 'A scholar suffered from thirst. All physicians used thirst-treating medicines, but the condition persisted for years. A famous physician advised him to take Jiajian Bawei Wan (Modified Eight-Ingredient Pill), and within half a year, he recovered.' Thus, analyzing the pathology, current physicians treating abscesses/carbuncles mistakenly use fluids-generating and thirst-stopping medicines, failing to... [text missing] ...descend heart fire and generate kidney water, so thirst stops naturally. Furthermore, regarding the properties of the medicine: Bei Wuweizi (Schisandra Chinensis Fruit) is the most effective ingredient. This single herb plays a unique... [text missing] ...role. Patients should focus on taking this medicine for efficacy and not be confused by mediocre physicians, thereby extending the legacy of predecessors. It treats arm pain, Hong Kong foot (tinea pedis/gouty arthritis), wind-dampness, limb spasms, asthma/cough, aids digestion, promotes urination, and long-term use lightens the body, sharpens hearing and vision, enhances complexion, and increases fertility.

An elderly man developed sores in his mouth and tongue in winter, accompanied by thirst. His xin (heart) pulse was large and solid, and his chi (kidney) pulse was large and empty. I said, "This is Xia Xiao (Lower Wasting-Thirst), located in the kidney, requiring..." [text missing] ...eventually he died. Li Dongyuan said: Ge Xiao (Diaphragm Wasting-Thirst) is treated with Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction). Zhong Xiao (Middle Wasting-Thirst) involves excessive eating with emaciation, spontaneous sweating, hard stool, and frequent urination. Maijue (Pulse Classic) states: Dry mouth with abundant desire to drink, eating much but muscles becoming weak. Cheng Xiao Zhong (Established Middle Wasting-Thirst) is treated with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) and Sanhuang Wan (Three-Yellow Pill). Xia Xiao (Lower Wasting-Thirst) involves irritability and desire to drink, dry and scorched earlobes, and urine like paste. It also says: Scorched irritability depletes water; this is Kidney Xiao, treated with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) [adding Wuweizi and Rougui makes it Jiajian Bawei Wan]. Zonglu states: Those who have not transmitted but can eat will surely develop brain or back carbuncles; those who cannot eat will transmit to abdominal fullness... [text missing], treated with Qian Shi Baizhu San (Dr. Qian's Atractylodes Macrocephala Powder) with added Gegen (Kudzu Root). Once the Upper and Middle Jiao are balanced, transmission to Lower Xiao ceases. The medication of predecessors is profound! Someone asks: What about not transmitting to carbuncles? This is due to flourishing fire pathogen; the sore is very painful but does not ulcerate, or exudes red fluid. The Classics state:有形而不痛 (having form but no pain) belongs to Yang. Attack Yang urgently, do not attack Yin. Treatment is in the Lower Jiao; survival depends on strong Yuan Qi, death on weak Yuan Qi.

A woman had a toxic swelling on her face, with pain, fever, and thirst. Her pulse was rapid and solid upon pressure. She was treated with Liangge San (Cool the Palate Powder); after two doses, she improved slightly. Then, with detoxifying medicines, she healed after several doses.

A man developed a carbuncle with thirst. His pulse was rapid and forceful. He was treated with Huanglian Jiedu Tang (Coptis Decoction for Detoxification); after three doses, the thirst stopped. Then, with Xianfang Huoming Yin (Immortal Life-Saving Decoction), he healed after four doses.

A man felt irritable and thirsty after ulceration. He was calmed by Shengyu Tang (Sage’s Replenishing Decoction) over two doses. Thirst stopped after four doses of Renshen (Ginseng), Huangqi (Astragalus), Danggui (Angelica Sinensis), and Dihuang (Rehmannia). He healed after more than twenty doses of Bazhen Tang (Eight-Treasure Decoction).

Generally, these symptoms after ulceration belong to qi and blood deficiency. One must use Renshen (Ginseng) and Huangqi (Astragalus) to tonify qi, and Danggui (Angelica Sinensis) and Dihuang (Rehmannia) to nourish blood. Using bitter-cold agents will certainly lead to error.

A man had a toxic swelling with thirst. His right Guan (spleen/stomach) pulse was rapid. He was treated with Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction); he improved slightly. Then, with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Huangqin (Scutellaria), he healed.

A man had dry mouth after ulceration, worsening with fatigue. He was treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi (Schisandra) and Maimendong (Ophiopogon), and healed. Then, he used Huangqi Liuyi Tang (Astragalus Six-to-One Powder) to close the wound.

Attached Formulas

Jiajian Bawei Wan (Modified Eight-Ingredient Pill): Treats post-abscess/carbuncle recovery or impending recovery, dry mouth/thirst, severe cases with yellow tongue coating, or pre-existing thirst before illness. This is due to kidney water exhaustion... [text missing] ...drinking much, gradual muscle wasting, or leg swelling with thinning feet. Taking this generates kidney water, descends heart fire, and stops all symptoms. Also treats persistent mouth/tongue sores.

Shanyao (Dioscorea Opposita Rhizome, 1 liang), Guixin (Cinnamon Twig Bark, 0.5 liang, peeled), Shanzhuyu (Cornus Officinalis Fruit, 1 liang clean flesh, soaked in wine and pounded into paste), Zexie (Alisma Orientale Rhizome, sliced, steamed and baked), Baifuling (Poria Cocos Sclerotium, peeled, sliced, steamed and baked), Mudanpi (Moutan Cortex, bone removed, sliced, steamed and baked), Shudihuang (Prepared Rehmannia Root, steamed nine times and dried, pounded into paste). Pound into fine powder, add the two pastes, add a little refined honey, and make pills the size of wutong seeds. Take 60-70 pills early in the fifth watch, before speaking, or on an empty stomach with salt water.

Liangge San (Cool the Palate Powder): Treats accumulated heat causing abscess/carbuncle pain, fever, irritability/thirst, constipation, and throat swelling/pain or sores/toxins.

Lianqiao (Forsythia Suspensa Fruit, 1 qian), Shanzhizi (Gardenia Jasminoides Fruit, fried), Dahuang (Rhubarb Radix et Rhizoma, fried), Bohe (Mentha Haplocalyx, fried), Huangqin (Scutellaria Baicalensis Root, each 0.5 qian), Gancao (Licorice Radix et Rhizoma, 1.5 qian), Puxiao (Natrii Sulfas, 0.5 qian).

Xianfang Huoming Yin (Immortal Life-Saving Decoction) (See Back Carbuncle Section).

Huanglian Jiedu Tang (Coptis Decoction for Detoxification) (See Vomiting Section).

Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See Ulcer Fever Section).

Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction)

Zhuye (Bamboo Leaf, 2 qian), Shengdihuang (Raw Rehmannia Root), Maimendong (Ophiopogon Japonicus Rhizome, heart removed), Huangqi (Astragalus Membranaceus Root, honey-fried), Danggui (Angelica Sinensis Root, wine-soaked), Chuanxiong (Ligusticum Chuanxiong Rhizome), Gancao (Licorice Radix et Rhizoma), Huangqin (Scutellaria Baicalensis Root, fried), Shaoyao (Paeonia Lactiflora Root), Renshen (Ginseng Radix et Rhizoma), Banxia (Pinellia Ternata Tuber, ginger-processed), Shigao (Gypsum Fibrosum, calcined, each 2 qian). Make one dose, boil in two zhong of water to eight fen, take far from meals.

Bazhen Tang (Eight-Treasure Decoction) (See Ulcer Fever Section).

Shengyu Tang (Sage’s Replenishing Decoction).

Dushen Tang (Single Ginseng Decoction) (Two formulas see Bludgeon Injury Section).

Huangqi Liuyi Tang (Astragalus Six-to-One Powder): Treats thirst after ulceration. If a person develops unexplained thirst, a carbuncle will surely occur. Regular use of this medicine can prevent illness.

Mianhuangqi (Milky Astragalus Membranaceus Root, 6 liang; half raw-baked, half stored in salt water in porcelain, steamed over rice three times, then baked dry), Gancao (Licorice Radix et Rhizoma, 1 liang; half raw, half roasted).

Adding Renshen (Ginseng) is especially effective.