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[Xue Ji] Neonatal carbuncle (Dan disease) caused by fetal toxin arises from fetal toxin lying dormant within, or due to frequent bathing in hot water, wearing garments heated by fire, or maternal internal heat generated by diet and the seven emotions (joy, anger, worry, thought, grief, fear, fright), which aids the pathogenic factor. The eruption occurs on the head, face, and limbs, extending to the chest and abdomen, appearing red and wandering without fixed location. Ancient texts state that cases starting from the limbs and entering the abdomen and scrotum are incurable. One should immediately have someone suck the toxic blood around the affected area, gather it to one spot, and pierce it with a Bian stone (stone needle). Urgently administer Huoming Yin (Life-Saving Decoction). However, infants under 100 days old are contraindicated for Bian therapy because their muscles cannot withstand it. If dispersing agents are overdosed, leading to deficient exterior heat and persistent redness, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica). If cold-cooling agents are overdosed, damaging Stomach Qi and causing persistent heat and redness, use Yigong San (Extraordinary Skill Powder) added with Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome). If accompanied by convulsions, use Sijunzi Tang (Four Gentlemen Decoction), Shengma, Danggui (Angelica Sinensis), and Gouteng (Uncaria Rhynchophylla). If toxic-clearing drugs are used again, it will inevitably lead to death. For eruptions on the forehead, lie the patient down and use a sickle-shaped Bian tool to pierce.

A child suffered from Dan disease, with red halos spreading over the entire body, making it difficult to pierce all areas. Someone sucked the toxic blood from several spots on the limbs, chest, and back, gathering the toxic blood locally before piercing. First, two doses of Huoming Yin powder were taken mixed with wine. Then, Jinyinhua (Lonicerae Japonicae Flos) and Gancao Jie (Glycyrrhizae Radix et Rhizoma joint) were powdered and taken mixed with human breast milk, leading to gradual recovery. Over a month later, both feet swelled; Bian therapy was applied again, and the previous medicine cured him. A few days later, the feet turned red again. Someone used Xijiao Jiedu Wan (Rhinoceros Horn Detoxifying Pill), causing loss of appetite and abdominal distension. This was due to further injury to the Spleen and Stomach. Shengong San (Divine Merit Powder) was applied externally, and Buzhong Yiqi Tang added with Fuling (Poria) was taken orally, resulting in recovery.

Another child had leg eruptions resembling cloud patches, wandering without fixed location. Sesame oil was first applied to the affected area, and evil blood was pierced out, dispersing the toxin. Jiwei Jiedu San (Nine-Ingredient Detoxifying Powder) brought stability. Another child had an arm infection; after piercing out toxic blood, he recovered. Confused by others' advice, he took Huxin San (Heart-Protecting Powder) to prevent future issues, but this caused vomiting, diarrhea, and abdominal distension, with the affected area turning red again and hands and feet becoming cold. I reasoned this was due to weak Spleen and Stomach, further injured by previous medicines. One dose of Liujunzi Tang (Six Gentlemen Decoction) cured him instantly, followed by Yigong San added with Shengma and Chaihu for full recovery.

Another child had leg lesions but maintained normal mental state and feeding habits. I reasoned the toxin erupted on the muscle surface. I ordered urgent Bian therapy to pierce out toxic blood for self-healing. The family did not believe me, applied cold-cooling herbs externally, and administered harsh medicines internally, leading to abdominal distension, refusal to nurse, and death.

Another child suffered from this condition with difficulty in urination and defecation, and swelling/tightness in the scrotum and abdomen. Bian therapy was used, followed by Huoming Yin added with Lulü (Euphorbia Humifusa), Mutong (Akebia Caulis), and Dahuang (Rhei Radix et Rhizoma) powdered and taken occasionally mixed with hot wine. After taking about one liang (approx. 30g), urination and defecation became smooth, and all symptoms subsided. The three added herbs were then removed, and the original formula continued until recovery.

Another child had this condition with difficulty in urination and defecation, abdominal distension, and cough. Huoming Yin added with Lulü, Mutong, and Mahuang (Ephedrae Herba) was powdered and taken occasionally mixed with hot wine. Urination and defecation soon cleared, sweating occurred over the whole body, and all symptoms subsided. Breathing became faint as if absent, lacking energy to move, occasionally appearing restless. This indicated the elimination of pathogenic factors and deficiency of Yuan Qi (Primary Qi). Urgent administration of Danggui Buxue Tang (Danggui Tonifies Blood Decoction) resulted in recovery.

Bian therapy is used to treat Dan Du (Carbuncle-Toxin) with wandering redness. It involves sucking toxic blood into a localized area, breaking fine porcelain vessels to obtain sharp fragments, splitting them with chopsticks, binding them with thread, holding the chopstick ends with two fingers, aligning the porcelain shard with the gathered toxic blood, and striking frequently with another chopstick to pierce out the toxic blood. For mild cases, only oral suction is needed, followed by topical medication application. For lesions on the head, Bian therapy is not used; instead, needles should be held horizontally to pick/stab the affected area to release toxic blood. Delay may allow toxic blood to enter the abdomen, making it hard to cure.

Shengong San is most effective for treating Dan Du. It should be used if toxicity is severe after Bian therapy. If toxicity is mild, it should not be used post-Bian, as the broken skin at the puncture site combined with Caowu (Aconiti Radix Preparata) may cause pain. (Formula see previous section.)