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A carbuncle (ju, 疽) occurring at the back of the head belongs to accumulated heat in the Taiyang Bladder Meridian (Taiyang Bladder Channel), or upward congestion of damp-toxin, or depletion of Yin fluids due to Kidney deficiency. In the initial stage, swelling and pain are severe, accompanied by irritability, thirst, and a surging and rapid pulse. If the swelling is hard and pus has not formed, it is appropriate to employ methods for dispelling dampness and resolving toxin. Severe pain indicates a Damp-Heat syndrome, for which Huanglian Xiaodu Yin (Coptis Decoction for Resolving Toxin) or similar formulas should be used. For cases with severe pain or no pain, garlic-separated moxibustion may be applied, along with administration of Zhenren Huoming Yin (True Person's Life-Saving Decoction) (see formula previously mentioned). If constipation occurs, indicating pathogenic factors within, purgation is indicated. For mild pain without pus formation, Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix) should be used for supporting the interior. Once pus has formed with pain, acupuncture should be employed alongside interior-supporting methods. For excessive discharge that fails to heal, substantial tonification of Qi and Blood is required. Preference for cold drinks indicates Fire excess, requiring fire-purging methods. For severe toxicity with constipation, Fangfeng Tongsheng San (Saposhnikovia Powder for Unblocking and Safeguarding) (see Wind Gate section) is indicated. This condition may also be treated with Qizhuma Moxibustion (Bamboo-Horse Moxibustion).

Main Formula: Huanglian (Coptidis Rhizoma, processed with wine), Qianghuo (Notopterygii Rhizoma et Radix), Shengdi (Rehmanniae Radix), Dangguishen (Radix Angelicae Sinensis, root part), Lianqiao (Forsythiae Fructus), Huangqi (Astragali Radix), Huangbai (Phellodendri Cortex), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Gaoben (Ligustici Chuanxiong Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Sumu (Pterocarpi Santalinus Lignum), Chenpi (Citri Reticulatae Pericarpium), Jiegeng (Platycodonis Radix) (each 1 qian), Zexie (Alismatis Rhizoma) (0.7 qian), Zhimu (Anemarrhenae Rhizoma, stir-fried with wine) (0.4 qian), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 qian). Decoct these ingredients in water, add a small amount of wine, and take orally.

This syndrome often arises from anger, or from Wind-Heat in the Liver, Gallbladder, and Sanjiao (Triple Burner), combined with Blood deficiency. Localized swelling and pain, accompanied by chills, fever, and physical stiffness, should first be treated with Jiabian Baidu San (Modified Detoxifying Powder) to disperse exterior pathogens. If caused by anger stirring up Liver-Fire, Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), and Jinyinhua (Lonicerae Japonicae Flos) should be administered, followed by Huoming Yin (Life-Saving Decoction) or similar formulas. If pus does not form and there is no ulceration, interior support is indicated. If pus forms with severe pain, interior support and toxin resolution are required. If pus has formed but not ruptured, acupuncture drainage is used. If the ulcer fails to close after rupture, substantial tonification of Qi and Blood is necessary.

Main Formula (Clearing Liver): Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus, stir-fried) (each 1.5 qian), Huangqin (Scutellariae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Renshen (Ginseng Radix et Rhizoma) (each 1 qian), Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix) (each 0.8 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian). Decoct in water and take after meals.

A carbuncle on the chest initially appears like a soybean, with unchanged skin color. If cold qi attacks the Heart, leading to mental confusion, vomiting of cold phlegm, internal sinking of toxic vapors, and abdominal distension, the prognosis is fatal. Signs such as mental restlessness, body agitation, skin feeling hot like fire, sweating, cracked lips, and thirst for cold water indicate this condition. Urgently administer Huoming Yin (Life-Saving Decoction) added with Huanglian (Coptidis Rhizoma) and Jiegeng (Platycodonis Radix), along with Dueming Dan (Life-Taking Pill), using diaphoretic or purgative methods. If malignant signs appear, Xijiao Jiedu Tang (Rhinoceros Horn Detoxifying Decoction) is used. A carbuncle on the Ying area (the high points on both sides of the chest) is called Yi Ju (Ying Carbuncle). With bluish discoloration and chills/fever, the treatment method is the same as above.

One occurring between the upper sternum and the two breasts is called Danzhong Ju (Danzhong Carbuncle). It arises in the Sea of Qi (Danzhong point), where Yin and Yang distribute, caused by disharmony of the Zang-Fu organs and emotional stagnation. It should be treated with Huoming Yin (Life-Saving Decoction) added with Zisu (Perillae Folium) and Bohe (Menthae Haplocalycis Herba) to induce sweating, combined with the selective use of Zijin Ding (Purple Gold Pellet).

A carbuncle on the Spleen region arises below the epigastrium, on both sides, resulting from excessive consumption of fried and roasted foods, and sexual activity while intoxicated or overly full. The treatment principles are largely similar with minor variations.