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[Xue Ji] Abdominal carbuncle occurs below the umbilicus or about two cun to the side, belonging to the Spleen Meridian. If it is near the hypochondrium, it belongs to the Gallbladder Meridian. This is generally caused by Yin deficiency of the Spleen Meridian leading to Qi stagnation and Blood stasis, or due to Spleen deficiency causing food retention and transformation into heat. If swelling and pain occur, use Xiehuang San (Yellow-Draining Powder). If hardness, swelling, and pain are present, use Qingwei San (Stomid-Clearing Powder). If there is swelling, pain, and constipation, use Qingliang Yin (Cooling Drink). If pain persists despite such treatment, it indicates Blood stasis and stagnation; use Huoming Yin (Life-Saving Decoction, i.e., Xianfang Huoming Yin). If the lesion does not resolve after using these medicines, it suggests that pus is forming internally; use Tuoli Xiaodu San (Supporting-the-Right-to-Discharge-Toxin Powder). If pain does not decrease after pus discharge, the toxin has not been resolved; continue using the aforementioned medicines. If pain increases after pus discharge, and the pus is thin and clear, it indicates Qi and Blood deficiency; use Shentuoli San (Ginseng Supporting-the-Right Decoction). If appetite is poor and the body feels fatigued, it indicates Spleen Qi deficiency; use Wuyi Yigong San (Five-Agent Extraordinary-Effort Powder) added with Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), and Shengma (Cimicifugae Rhizoma). If there is afternoon fever and internal heat, it indicates Spleen Blood deficiency; use Sijunzi Tang (Four-Gentlemen Decoction), Danggui, and Danpi (Moutan Cortex). If other symptoms exist, treat according to the specific syndrome.

[Xue Ji] Gluteal carbuncle belongs to Damp-Heat in the Bladder Meridian, or is due to congenital Yin deficiency. If there is hard swelling and pain, use Neituo Qianghuo Tang (Internal-Supporting Notopterygium Decoction). If there is slight swelling and pain, use Tuoli Xiaodu San. If severe pain occurs at the onset, or within five days the condition seems neither resolving nor suppurating, first use Xianfang Huoming Yin (Immortal Formula Life-Saving Decoction), followed by Tuoli Xiaodu San. If already ulcerated with poor appetite and fatigue, and the wound fails to generate flesh, indicating Spleen and Stomach weakness, use Wuyi Yigong San added with Chaihu and Shengma. If due to congenital Yin deficiency with frequent urination and failure of the wound to contract, use Jiaban Bawei Wan (Modified Eight-Ingredient Pill). If Qi deficiency causes prolonged failure of the wound to heal and close, use Douchi Bing (Fermented Soybean Cake) for external application and Buzhong Yiqi Tang (Middle-Warmer-Boosting and Qi-Invigorating Decoction) to nourish Yuanqi (Original Qi). If heat-clearing and toxin-attacking medicines are used, or cold-natured encircling agents are applied externally, Qi and Blood will be injured, inevitably leading to a Bai Zheng (defeat syndrome/incurable stage).

Neituo Qianghuo Tang: Treats carbuncles arising in the sacral and renal regions, characterized by hardness, swelling, and pain.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex, wine-processed, each 1 qian), Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma et Radix), Dangguiwei (Angelicae Sinensis Radix, tail portion, each 5 fen), Rougui (Cinnamomi Cortex), Lianqiao (Forsythiae Fructus), Gancao (Licorice Root, honey-fried), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium, each 3 fen), Huangqi (Astragali Radix, 8 fen).
Preparation and Administration: Divide into two doses. Boil with one zhong of water and one cup of wine. Take on an empty stomach.