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Xue Lizhai treated a male patient with a toxic carbuncle on the shoulder. He experienced pain, desired cold drinks, restlessness, constipation, and his pulse was rapid and forceful. After two doses of Qingliang Yin (Cooling Drink Decoction), symptoms slightly improved. Subsequently, four doses of Jinyinhua San (Honeysuckle Powder) were administered, leading to complete resolution. Then, Shixuan San (Ten Acupoints Powder) was used with Cinnamon Twig removed, plus Trichosanthes Root and Honeysuckle Flower; after several doses, the abscess ruptured and healed. This case presented both pulse and symptoms indicating excess syndrome (exuberant pathogenic factors).

Another female patient, in the winter of the Gui-Mao year, became angry due to lost property, resulting in slight swelling in the supraclavicular fossa (Quepen). By the spring of the Jia-Chen year, the swelling enlarged to the size of an inverted bowl, with additional swelling on the left scapula, while skin color remained normal. Someone punctured it with a needle, releasing approximately three bowls of fresh blood. Thereafter, she suffered from abdominal pain like needle pricks, incessant diarrhea, cold limbs, vomiting, aversion to cold, intermittent fever, and had not eaten for seven days. Her pulse was surging yet occasionally thready and fine, indicating collapse and sinking of Yang Qi. Liu Jun Zi Tang (Six Gentlemen Decoction) was prescribed with Pao Jiang (Prepared Ginger, 3 qian) and Fu Zi (Aconite Root, 2 qian) taken in the morning. At noon, there was no response. In the second dose, Aconite was increased to 5 qian. After waking from a deep sleep, her symptoms subsided by 60-70%, and she began consuming thin porridge. After four more doses, all symptoms vanished, and appetite returned, though pain started in the supraclavicular fossa. Puncture released about two bowls of clear pus, causing the previous deficiency-cold symptoms to reappear due to extreme deficiency. Shiquan Dabu Tang (Perfect Great Tonifying Decoction) with Sheng Jiang (Fresh Ginger), Rou Gui (Cinnamon Bark), and Fu Zi each at 1 qian was given for three doses, stabilizing the condition. Later, dosages of Ginger, Cinnamon, and Aconite were reduced to 0.5 qian each, combined with Guipi Tang (Restore the Spleen Decoction); after over fifty doses, she recovered.

The wife of Shangshe Chen Lvxue initially felt a spot of coldness below the left shoulder. Three days later, a white sore appeared below the right shoulder, swollen like a cup, red like a wine saucer. Self-administered cooling dispersal herbs failed to reduce it. Next, four doses of Shixuan San were given, increasing pain and slight redness. Subsequently, continuous administration of formulas containing Ren Shen (Ginseng), Ding Xiang (Clove), Rou Gui (Cinnamon Bark), Fang Feng (Saposhnikovia Root), and Bai Zhi (Angelica Dahurica) led to pus rupture, followed by nausea, vomiting, persistent dizziness, cold limbs, chills, teeth grinding, and spontaneous sweating. The sore top was flat with clear pus. This resulted from the error of using cooling dispersal agents. The external plaster was urgently washed off, and a large dose of a formula containing Ren Shen, Ding Xiang, Dang Gui (Chinese Angelica), Bai Zhu (Atractylodes Macrocephala), Di Huang (Rehmannia Root), Sheng Jiang, and Fu Zi was administered. Initially, the cold spot below the left shoulder turned hot. After another dose, generalized swelling, floating heat, high elevation of the swelling, and thick pus occurred. Wujin Gao (Black Gold Ointment) was applied externally. Several days later, pieces of necrotic tendon resembling fat membrane were discharged. Taking the internal medicine twice daily, with Ren Shen dosage reaching 8 qian, stability was achieved after over two months. Post-recovery, fatigue-induced syncope occurred occasionally, resolved immediately by large doses of Ren Shen, Ding Xiang, Dang Gui, Bai Zhu, Sheng Jiang, and Fu Zi.

A male patient with a shoulder toxic carbuncle experienced pain, desire for cold drinks, restlessness, constipation, and a rapid, forceful pulse. Two doses of Qingliang Yin brought slight improvement. Four doses of Jinyinhua San cleared all symptoms. Then, Shixuan San without Cinnamon Twig, plus Trichosanthes Root and Honeysuckle Flower, cured him after several doses.

A female patient with a toxic carbuncle below the shoulder had a wiry and tight pulse. Two doses of Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) resolved exterior symptoms; subsequent interior-supporting herbs caused rupture and healing.

A weak male patient developed shoulder swelling. Attempting internal resolution with cooling herbs caused diarrhea and poor appetite. Ershen Wan (Two Divine Pills) and Xiangsha Liujun Zi Tang (Aromatic Six Gentlemen Decoction) plus Dou Kou (Cardamom) stopped diarrhea and restored appetite. Interior-supporting herbs subsequently reduced the swelling.

A male patient had a carbuncle below the shoulder for several days: diffuse swelling, slight pain, numerous pustules like millet grains, unchanged color, unable to suppurate or rise—indicative of Qi and Blood deficiency. Pulse confirmed this. Xianfang Huoming Yin (Immortal Formula for Life-Saving Decoction) for two doses subdued the major pathology. Interior-supporting herbs then promoted suppuration. Although pustules ruptured, only bloody fluid drained due to continued Qi and Blood deficiency preventing pus formation. The patient wished to use Taiyi Ding (Taiyi Plaster). I stated this drug only attacks toxicity but cannot support the interior. Disbelieving, he used it four times, leading to loss of appetite, black depressed sores, and incessant hiccups, indicating extreme Stomach Qi deficiency. It was incurable. Forced administration of warming middle-jiao and strengthening spleen herbs failed, and he died.

A male patient with a hard, painful shoulder carbuncle and successive malignant signs was treated with 3 qian of Bai Fan (Alum) powder made into pills, taken with decoction of seven green onion heads. Swelling and pain completely subsided; further medication resolved other symptoms. Two doses of Xianfang Huoming Yin caused drainage and resolution. This secret recipe is called Qianjin Huadu Tang (Thousand Gold Toxin-Resolving Decoction): Alum powder mixed with green onion water. Since powder is hard to swallow, it was made into pills. A practitioner treating carbuncles uses this for 2-3 doses regardless of swelling or rupture, followed by detoxification herbs, yielding excellent results. Often curing commoners without needing interior-supporting herbs, as their heat-toxin pathology does not deplete Qi and Blood. Especially effective for carbuncles induced by mineral drugs, as Alum resolves such toxicity. Another method uses 5 qian Alum powder and 0.5 qian Zhu Sha (Cinnabar) taken with hot wine, also effective. This formula supports the interior, stops diarrhea, resolves toxicity, drains pus, does not disturb viscera or damage Qi/Blood, is beneficial without harm, easily obtained, and highly efficacious; unknown persons in remote areas should know it. For insect or dog bites, melted and applied hot externally, or taken with hot wine, it is effective.

Huang, a Ministry Official from Fuquan, had a shoulder carbuncle with fever, aversion to cold, intense thirst, and restlessness, appearing as excess. However, his pulse was large but powerless, indicating deficiency. Danggui Buxue Tang (Dong Quai Blood-Nourishing Decoction) cured him.

Wang Qiaonian, over thirty, had a shoulder carbuncle. One dose of Renshen Baidu San (Ginseng Detoxication Powder) followed by Shixuan San without Ginseng and Cinnamon Twig, plus Honeysuckle and Trichosanthes, caused rupture after four doses.

Anger stirred Liver Fire, causing Wind-Heat to congest upward, resulting in red and swollen head and face, pain, and desire for cold drinks. Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxication Powder) plus Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), and Bo He (Mint) for two doses failed. Urgent bi-sticking (bloodletting) at the site released a cup of dark blood. One more dose reduced the condition by half. Further administration of Renshen Baidu San cured him in four doses. Diseases differ in exterior/interior and upper/lower locations; treatments vary in urgency and tonification/attacking. Without bi-sticking, toxin qi would knot internally, inaccessible to herbs, worsening swelling. Using harsh purgatives would leave upper heat unresolved while creating middle cold, likely fatal.

A Shangshe with a shoulder carbuncle had a rapid pulse. One dose of Huaihua Jiu (Sophora Flower Wine) instantly reduced the condition. Ten-plus doses of Jinyinhua, Huang Qi (Astragalus Root), and Gan Cao (Licorice Root) resolved it. Huaihua treats damp-heat with remarkable speed; however, it should not be overused in deficiency-cold constitutions.

Wang Hongxu treated Ms. Yao, aged twenty-nine, one month post-miscarriage. A toxic nodule appeared where her left hand rested on her left shoulder, five chi in circumference. Half a month later, a second nodule appeared on the back, three cun long, wider at top and pointed at bottom, both white and depressed. Treatment began ten days later; condition was severe. Three doses of Yanghe Tang (Warming Harmony Decoction) enabled sitting up; five doses allowed independent urination/defecation; twelve doses eliminated new nodules and the initial "hand-hanging" nodule. Remaining sore, chess-piece sized, non-painful, ruptured, and healed in four days. She reported feeling a board on her back, restricting movement. Ten pills of Xiao Jin Dan (Little Golden Pill), taken three times daily, fully cured her.