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(Attached Discussion on Back Carbuncles: Lotus Seed Eruption, Honeycomb Eruption, and Whole-Body Ulcer)

The back along the central spinal column is divided into upper, middle, and lower eruptions, all belonging to the Du Meridian (Governing Vessel).
The upper eruption occurs below the Tianzhu bone (C2 vertebra), caused by fire-toxin damaging the Lung; its shape is broad horizontally like a belly.
The middle eruption occurs at the center of the back, directly opposite the heart in the chest, caused by fire-toxin damaging the Liver; its shape is wide in the middle with pointed ends like a melon.
The lower eruption occurs in the middle of the waist, directly opposite the umbilicus in the front, caused by fire-toxin damaging the Kidney; its shape is flat and spreading like a turtle shell.
Initially, they appear like millet grains, accompanied by pain, numbness, itching, aversion to cold, fever, and limb stiffness. Moxibustion with garlic slices is appropriate.
Stop when the patient feels pain, so that the toxic qi dissipates with the heat.
If there are exterior symptoms, such as aversion to cold, fever, and anhidrosis, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction for Resolving Toxins) should be used to induce sweating.
If there are interior symptoms, such as dysuria and constipation, Neishu Huanglian Tang (Internal Purging Coptis Decoction) should be used to purge the interior.
If both exterior and interior symptoms are present, Shenshou Weisheng Tang (Divine Grant Health-Preserving Decoction) should be used to resolve both, thereby reducing the severity of the sore.
If redness, swelling, and pain are severe, and the pulse is surging, rapid, and forceful, it is a heat-toxin syndrome, which is easy to treat.
If there is diffuse swelling and redness, dark color, thirst, and a surging, rapid but weak pulse, it is a yin-deficiency syndrome, which is difficult to treat.
If there is no swelling or pain, or if there is diffuse swelling with dark color and a faint, fine pulse, it is a qi-deficiency syndrome, which is particularly difficult to treat.
If the top of the sore has one or two heads, is red, swollen, and protruding, it is a carbuncle (Yong, 痈), belonging to the Yang aspect; cool-clearing and detoxifying methods are appropriate.
If there is pain and fever with a rapid pulse, Neixiaosan (Internal Dissolution Powder) and Tuolisan (Supporting Interior Powder) are indicated.
If there is hard swelling and pain with a solid pulse, Niusheng Yin (Life-Saving Decoction) and Wuxiang Liaoqiao Tang (Five-Aromatic and Forsythia Decoction) are indicated.
If initially there is one head like a millet grain, without swelling or redness, but with stifling pain, restlessness, thirst, and constipation.
After four or five days, the number of sore heads becomes countless, each opening containing something like a millet grain or lotus stamen, failing to suppurate after many days.
Several days later, the sore heads burst out, merging into a single membrane-like layer; if it reforms after being removed and turns purple-dark, it is a deep abscess (Ju, 疽), belonging to the Yin aspect; warming, tonifying, and supporting interior methods are appropriate.
If there is deficiency of both qi and blood with alternating chills and fever, Tuolidanggui Tang (Supporting Interior Angelica Decoction) is indicated.
If it fails to rise or suppurate, Tuoli Yangying Tang (Supporting Interior Nourishing Ying Decoction) is indicated.
When about to suppurate, if the base spreads and lacks definition, apply Tietong Gao (Iron Bucket Plaster) around the perimeter.
After suppuration, if necrotic tissue remains, apply Bagao (Ba Plaster) externally to dissolve it.
If pain persists after suppuration, requiring both resolving and supporting methods, Neifu Tuolixiaodu San (Internal Supporting Interior Detoxification Powder) is taken orally.
If the pus is thin and not thick, or if pus forms but does not rupture, or if necrotic tissue dissolves slowly, take Tuolisan (Supporting Interior Powder) added with Renshen (Ginseng Radix et Rhizoma), [missing character, likely Baizhu or Huangqi], and Rougui (Cinnamon Bark).
If there is aversion to cold and cold limbs, or failure of the wound to heal, indicating yang qi deficiency, Shiquan Dabu Tang (Complete Great Tonifying Decoction) is indicated.
If there is afternoon fever or internal heat, or failure of the wound to heal, indicating yin-blood deficiency, Siwu Tang (Four Substance Decoction) added with Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) is indicated.
If there is vomiting or hiccups, or failure of the wound to heal, indicating stomach qi deficiency, Liujunzi Tang (Six Gentlemen Decoction) added with Paojiang (Prepared Ginger) is indicated.
If there is poor appetite and fatigue, or failure of the wound to heal, indicating spleen qi deficiency, Buzhong Tang (Middle-Boosting Decoction) added with Fuling (Poria) and Banxia (Pinelliae Rhizoma) is indicated.
If there is frequent urination, restlessness, and thirst, indicating kidney yin deficiency, Jiaban Bawei Wan (Modified Eight-Ingredient Pill) is indicated.
For other cases, refer to the general treatment principles for various sores.

The Upper Dashou (Upper Hand-Clinging Eruption) arises below the shoulder at Feishu (BL13), the third thoracic vertebra, 1.5 cun lateral.
It belongs to the Bladder Meridian; the left side relates to the Liver, and the right side to the Lung. It is formed by qi stagnation and phlegm-heat condensation.
Initially, Shenshou Weisheng Tang (Divine Grant Health-Preserving Decoction) is used for dual resolution, followed by Xiaoyao San (Free Wanderer Powder) to dissipate, combined with Liuyu Tang (Six Stagnations Decoction) to regulate.
The Middle Dashou arises at Gaohuang (BL43) beside the spine, the fourth thoracic vertebra, 3 cun lateral.
It belongs to the Bladder Meridian and arises from angry fire.
Initially, Sanxiang Liaoqiao Yin (Three-Aromatic and Forsythia Decoction) is used to disperse, followed by Qingqi Yin (Clear Qi Decoction) to dissipate.
If qi and blood are deficient and it fails to suppurate and rot promptly, Canqi Tuolisan (Ginseng and [Missing Character] Supporting Interior Powder) is used to tonify.
The Lower Dashou arises at Mangmen (BL47) beside the waist, the fourteenth thoracic vertebra (lumbar region), 3 cun lateral.
It also belongs to the Bladder Meridian and is formed by kidney meridian deficiency and blazing heat.
Initially, Niusheng Yin (Life-Saving Decoction) is used to detoxify, followed by Neituo Huangqi San (Internal Supporting Astragalus Powder) to support the interior and expel toxin, followed by Dihuang Tang (Rehmannia Decoction) to nourish yin.
Treatment after suppuration is the same as described above.
There are also eruptions arising on the spinal back and both flanks, shaped like a lotus pod, named Lianzi Fa (Lotus Seed Eruption), belonging to fire-toxin of the Gallbladder and Bladder meridians.
Eruptions arising behind the shoulders and beside the spine, shaped like a honeycomb, named Fengwo Fa (Honeycomb Eruption), are caused by heat accumulating in the Spleen meridian.
If high swelling occupies half the back and the head points upward, it indicates extreme heart fire; beware of internal attack by toxic fire.
If the shape is about one chi long and the root spreads across the entire back, it is named Jingti Ju (Whole-Body Ulcer); urgently administer Huanglian Xiaodu Yin (Coptis Detoxification Decoction) to clear the heart and detoxify.
Treat the remaining cases according to the aforementioned methods.