Library

The *Mai Jue* (Pulse Classic) states: A pulse that is rapid but forceless indicates sores and ulcers (Chuang Yang). The *Ji Yan Fang* records: A deep and solid pulse, accompanied by fever, irritability, and no external redness, swelling, or pain, indicates that the pathogenic factor is deeply seated in the interior. One should first promote unblocking to cut off the source. If the pulse is floating, large, and rapid, with swelling on the exterior, one should first support the interior to prevent the pathogenic factor from entering inward. If the pulse is neither floating nor deep, and internal and external symptoms are indistinct, with the disease located in the meridians, one should harmonize Ying and Wei (Nutritive and Defensive Qi). A rapid pulse with no body heat suggests internal abscesses and pus; a rapid pulse usually indicates fever, but if chills are present instead, and there is a painful area, carbuncles, sores, and ulcers will develop. A deep, slow, and relaxed pulse indicates survival; a rapid and hurried pulse indicates death.

Symptom Analysis: Surgical texts state that "Carbuncle of the Back" (Yong Ju Fa Bei) is listed at the beginning of surgical chapters as the primary among all sores. Why? Because this condition changes rapidly, and life hangs by a hair. Although there are more than twenty names for carbuncles and sores, the essentials are two: Yin and Yang. Those arising from the Yang aspect are called "Yong" (Carbuncle), characterized by heat and excess. Those arising from the Yin aspect are called "Ju" (Deep Abscess), characterized by cold and deficiency. Yang lesions have thin skin, red color, high swelling, often with dozens of pores like pepper seeds, and are painful. Yin lesions have thick skin, pale color, hard and firm swelling resembling ox neck skin, and are not painful. There is also "Yin within Yang," which seems hot but is not truly hot; although swollen, it is deficient; red but not dry; painful but without pus; fluctuating between swelling and subsiding; appearing vigorous externally but rotting internally. There is "Yang within Yin," which seems cold but is not truly cold; not swollen but solid; slightly red and dry; has pus and pain; appears mild externally but causes internal vexation. Patients with "Yin within Yang" are often obese with tight flesh but internal deficiency. Patients with "Yang within Yin" are often emaciated with loose flesh but internal excess. Yang transforming into Yin is caused by the misuse of cooling herbs by folk doctors; Yin transforming into Yang is caused by the abrupt use of moxibustion or hot medicines. However, Yang transforming into Yin can often revert to Yang, so most survive. Yin transforming into Yang rarely reverts to Yang, so most die. Occasional survivals occur only when the doctor accidentally follows the correct method, one in a hundred. "Fa" (Eruption) refers to accumulation internally manifesting externally. The human body is rooted in the Five Zang Organs, whose Qi is derived from Stomach Qi. The Stomach is the root of the Five Zang; it receives grain, and the Spleen transforms it to generate Qi and Blood. The Spleen governs muscles; Stomach Qi transmits to the Five Zang to circulate blood vessels and meridians, irrigating the whole body in a daily cycle. Although carbuncles and sores vary in deficiency/excess and cold/heat, they all result from Qi stagnation. Causes fall into three categories: Internal, External, and Neither-Internal-Nor-External. Internal causes are diagnosed via the Renying pulse (one cun anterior to the Guan position on the left wrist). External causes are diagnosed via the Qikou pulse (one cun anterior to the Guan position on the right wrist). If both pulses are balanced, it belongs to neither-internal-nor-external causes. There are five origins: 1. Seasonal epidemic pathogens; 2. Internal emotional depression; 3. Exterior contraction due to deficiency; 4. Heat combing with wind-cold; 5. Consumption of roasted foods, strong wine, or hot toxic drugs like Danchi. These five act as pathogens stagnating in the Stomach. If Stomach Qi is strong and the constitution robust, pathogens contend and flow into meridians, obstructing circulation, leading to congestion and knotting of blood vessels and meridians, forming a Yong (Carbuncle). If Stomach Qi is weak and the constitution deficient, pathogens prevail and lodge in meridians, coagulating and accumulating, blocking blood flow, leading to internal rotting and forming a Ju (Abscess). Thus, it is said: externally small like millet, internally capable of holding an axle hub; externally like a coin, internally capable of holding a fist. If the malignant pus tube is one cun long and deep, filled with sticky pus and blood, medication can cure it. If the pus is foul and stringless, blood is ruined, Qi is exhausted, Yang is extinct, and Yin is excessive, even immortals cannot save the patient. Skilled physicians must examine deficiency/excess, distinguish cold/heat, deduce causes, and investigate origins before treating. Internal and external aspects correspond; treatment cannot be uniform. For Yang-origin diseases with extreme heat, one must follow Qi dynamics and regulate Blood. Smooth Qi ensures unobstructed flow; regulated Blood flows freely and disperses naturally. Qi is Yang, Blood is Yin; harmony of Yin and Yang brings health. Applying cooling herbs externally might cause internal heat to surge; excessive heat makes Blood disperse easily upon cooling, or even congeal due to cold, preventing dispersion—this is Yang transforming into Yin, gradually becoming the root of necrosis. Urgently administer warming agents to treat, clearing the peripheral blood pathways and expelling formed pus/toxins, then follow protocol to conclude treatment. For Yin-origin diseases with extreme cold, internally use mild tonifying herbs to vent Qi, nourish Blood, assist Yuan Yang, and support the Spleen and Stomach. Wait for appetite to return, then regulate Qi and Blood as usual. Externally apply hot herbs to circulate Qi and Blood throughout the body, revive dead tissue, and extract toxic vapors, followed by warm herbs to dissipate. For extreme cold cases mistakenly treated with cooling herbs, resort to San Jian Tang (Three Establishments Decoction) to restore Yang. Recovery may involve temporary exacerbation, which is a good sign of Yin transforming into Yang and regeneration. If internal Yang does not return and external symptoms do not improve, it is "Solitary Yin cutting off Yang," which is incurable. Yang is Qi, Yin is Blood; Yang moves so Yin follows; Qi circulates so Blood flows; Qi exhaustion leads to Blood death, and Blood death leads to patient death. Cold conditions use hot herbs to act as the master of Qi movement. The Membrane is the sac of the Five Zang Organs. At the onset, toxins attack the Pericardium Collateral, causing vomiting/regurgitation before carbuncles appear, or vice versa, both rooted in toxin attacking the Pericardium and originating from the Heart. The Heart receives toxins; when Spirit has no abode, Yuan Qi becomes dim. Initially, toxins corrode muscles laterally. If treatment is delayed, toxins penetrate the Membrane; once penetrated, Yuan Qi leaks, organs lose nourishment, spirit withers, and pulses fail. In severe cases, if internal damage to Five Zang is visible, survival is possible only if the Membrane remains intact. In mild cases, death occurs before muscle ulceration because the Membrane ruptured first. Therefore, saving the Heart and protecting the Membrane must be the physician's priority, a fine method in surgery. This discusses the essence of carbuncles and sores; their divine efficacy cannot be fully described. It is beyond the grasp of ordinary practitioners relying merely on herbs or needles/knives.

Formula: Jiawei Tuoli San (Modified Supporting Interior Powder) treats Carbuncle of the Back and other sores, regardless of location (head, breast, bone-attached areas), as well as Ding Chuang (Furuncles) and Luo Li (Scrofula), and all types of swelling/toxicity. It resolves swelling before formation and promotes suppuration after formation, expels foul pus, removes necrotic tissue, and reduces pain spontaneously. It is highly effective.
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Jie Geng (Platycodonis Radix), Fang Feng (Saposhnikoviae Radix, remove radicle), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Guan Gui (Cinnamomi Cortex), Hou Po (Magnoliae Officinalis Cortex), Bai Zhi (Angelicae Dahuricae Radix) [all 1 qian], Gan Cao (Licorice Root, 0.5 qian), Bai Shao Yao (Paeoniae Radix Alba), Mu Xiang (Aucklandiae Radix), Da Fu Zi (Arecae Semen), Wu Yao (Linderae Radix), Zhi Ke (Aurantii Fructus), Zi Su (Perillae Folium) [all 1 qian].
Take one dose. Add 1.5 zhong of water, 2 slices of Sheng Jiang (Fresh Ginger), and 1 stalk of Cong Bai (Scallion White). Decoct to 0.7 zhong. Add a sip of Jiu (Alcohol). Take postprandially for upper body diseases, preprandially for lower body diseases. For concurrent symptoms, modify as follows:
If disease persists, add Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria), Shu Di Huang (Rehmanniae Radix Preparata) [each 1 qian].
If appetite is poor, add Sha Ren (Amomi Fructus Rotundus, 0.7 qian), Xiang Fu (Cyperi Rhizoma, 1 qian).
If pain is unrelenting, add Ru Xiang (Olibanum), Mo Yao (Myrrha) [separately ground, added to decoction, each 1 qian].
If wound exudate is profuse, add Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Cirrhosae Bulbus) [each 1 qian].
If sore does not ulcerate, add Zao Jiao Ci (Gleditsiae Spina, 1 qian).
If coughing, add Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma Preparatum), Xing Ren (Armeniacae Semen Amarum) [each 1 qian].
If constipation, add Da Huang (Rhei Radix et Rhizoma, 3 qian), Zhi Ke (1 qian).
If dysuria, add Mai Men Dong (Ophiopogonis Radix), Mu Tong (Akebiae Caulis), Che Qian Zi (Plantaginis Semen) [each 1 qian], Deng Cao (Junci Medulla, 20 roots).
For Hong Kong Foot (Podagra/Tinea Pedis), add Mu Gua (Chaenomelis Fructus), Huang Bo (Phellodendri Cortex) [each 1 qian].

Another Formula: Xian Fang Huo Ming Yin (Immortal Life-Preserving Decoction) treats all surgical conditions. It promotes suppuration if formed and resolution if unformed. Effects are seen in 2-3 doses; mild cases respond in one dose. I used this for Breast Carbuncle (Ru Yong) and Scrofula (Luo Li) with remarkable results.
Di Ru (Boswellia Resin, separately ground and dissolved), Fang Feng, Bai Zhi, Bei Mu, Chi Shao Yao (Paeoniae Radix Rubra), Dang Gui Wei (Angelicae Sinensis Radix Caudex), Ming Mo Yao (Myrrha, ground), Zao Jiao Ci, Tian Hua Fen (Trichosanthis Radix), Gan Cao Jie (Licorice Node), Chuan Shan Jia (Manis Squama, prepared) [all 1 qian], Chen Pi, Jin Yin Hua (Lonicerae Japonicae Flos) [each 3 qian].
For back Shu points, make Zao Jiao Ci the Sovereign herb (increase to 3 qian).
For abdominal Mu points, make Bai Zhi the Sovereign herb (increase to 3 qian).
For chest region, add Gua Lou Ren (Trichosanthis Semen, dehusked, 2 qian).
For limbs, make Jin Yin Hua the Sovereign herb (keep original amount).
For Ding Chuang (Furuncle), add Zi He Che (Placenta Humana), Cao Gen (Herbal Root, 3 qian).
For Luo Li (Scrofula), add Xia Ku Cao (Prunellae Spica, 3 qian).
For Ru Yong (Breast Carbuncle), add Xia Ku Cao (3 qian), Qing Pi (Citri Reticulatae Pericarpium Viride, 1 qian).
Take one dose. Use 5 tea-cups of Wui Hui Jiu (Pure Alcohol). Place in a spouted bottle, seal tightly with thick paper to prevent leakage. Decoct to 3 large cups. Strain. Divide into three doses, taken continuously without interruption. Take according to lesion location (upper/lower) and meal timing. If able to drink alcohol, consume 3-5 additional cups after medication. This formula has no alcoholic odor, does not disturb Zang-Fu, and does not injure Qi and Blood. Avoid sour foods, weak wines, and contaminated vessels. Lie on side after taking medicine; pain cessation indicates recovery. Efficacy is miraculous.

True Person's Verse:
Rare is the living method of the True Person in the world;
Great evils of carbuncles and sores can all be cured.
Disinfecting is like pouring boiling water on snow;
Transforming pus gradually allows flesh to grow.
Hidden merits save more than ten thousand lives;
Divine efficacy needs no fixed date.
Leave this immortal prescription with sincere trust;
Preserving benevolence and refining preparation, Heaven knows.

Note: This formula applies regardless of Yin/Yang, deficiency/excess, severity, or ulceration status, whether painful or painless. Use this agent first until the major trend recedes, then adjust treatment based on symptoms. Its action is swift; truly an immortal formula.

Another Method: Moxibustion for Luo Li (Scrofula). Regardless of duration, all cases of Luo Li are cured immediately upon moxibustion.
For males, use the left hand; for females, the right hand. Measure from the second joint of the middle finger up to the first horizontal crease near the palm using a grass stem. Cut the stem. Align one end of the stem with the bony prominence of the Bailao (Ex-UE4) acupoint. The other end marks the target point. Mark with ink. Apply moxibustion on the mark. Number of moxa cones equals age in years. Immediate cure.