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The *Ling Shu* states: A carbuncle arising in the chest is named Jing Ju (Well Carbuncle). Its appearance is like a soybean. If not treated promptly within three to four days, the pathogenic factor descends into the abdomen, leading to an incurable condition and death within seven days.

A question was raised: How about a carbuncle arising in the epigastric region? The answer is: This condition initially resembles jaundice, but the skin color remains unchanged; it is named Jing Ju, also known as Chuan Xin Leng Yong (Penetrating Heart Cold Abscess). If cold pathogenic factors attack the heart, causing mental confusion, vomiting of cold phlegm, aversion to food odors, internal sinking of toxic heat, and abdominal distension, it is incurable. However, if there is irritability as if burning, skin fever as if on fire, spontaneous night sweats, dry and yellow tongue with cracked lips, and thirst for cold water, this represents the typical presentation. Immediately administer Huo Ming Yin (Life-Saving Decoction) with added Huang Lian (Coptidis Rhizoma) and Jie Geng (Platycodonis Radix). Use Sheng Jin Dan (Golden Pill of Victory) or Duo Ming Dan (Life-Extending Pill) to induce sweating. For those with robust constitution, use Yi Li Jin Dan (One-Pill Golden Pill) to purge downward. If severe symptoms are prevalent and treatment is delayed, danger may ensue; Xi Jiao Jie Du Wan (Rhinoceros Horn Detoxification Pill) should be taken.

The *Ling Shu* states: A carbuncle arising in the Ying region (the upper lateral part of the chest, also called Yi) is named Gan Ju (Sweet Carbuncle). It appears blue-green in color and resembles the fruit of Trichosanthes kirilowii. The patient often suffers from alternating chills and fever. Urgent treatment is required to resolve the chills and fever; if neglected, death occurs within ten days, followed by pus discharge.

A question was raised: How about a carbuncle arising between the two breasts above the epigastrium? The answer is: This is Tan Zhong Fa Ju (Carbuncle of the Tanzhong Region). Tanzhong is the Sea of Qi, where Qi resides and distributes Yin and Yang. If the Yin and Yang of the Zang-Fu organs are disharmonious, or if the Seven Emotions are unbalanced, this condition arises. Huo Ming Yin (Life-Saving Decoction) with added Zi Su (Perillae Folium) and Bo He Ye (Menthae Haplocalycis Folium) should be used to induce sweating. Choose from Duo Ming Dan (Life-Extending Pill), Sheng Jin Dan (Golden Pill of Victory), or Zi Jin Dan (Purple Gold Pill). If treatment is delayed, ulceration will occur, and cases with severe symptoms are difficult to treat.

A question was raised: How about a carbuncle arising beside the lower epigastrium? The answer is: This is named Pi Fa Ju (Spleen-Originating Carbuncle). Toxicity accumulates in the Spleen Meridian due to excessive consumption of fried and roasted foods, or sexual activity after drunkenness and overeating. Huo Ming Yin (Life-Saving Decoction) with added Jie Geng (Platycodonis Radix) and Sheng Ma (Cimicifugae Rhizoma) is indicated. Zi Jin Dan (Purple Gold Pill) or Sheng Jin Dan (Golden Pill of Victory) can be used to induce sweating. For those with robust constitution, Ba Zhen San (Eight Arrays Powder) is used to purge downward. For the elderly or weak, Shi Quan Da Bu Tang (Decoction for Ten Thousand Benefits) is prescribed. If treatment is delayed, the spleen membrane may be damaged; if the pus resembles crab foam, death ensues. If vomiting occurs after taking medicine and food intake is impossible, death ensues.

A question was raised: A thirty-year-old man has a hard, stone-like swelling extending one chi on the chest and ribs, accompanied by severe chills and fever, inability to eat, generalized body pain, restlessness, and fullness/distension in the chest and diaphragm. What is the prognosis? The answer is: Any swelling located on the chest, its sides, or extending from the anterior shoulder to the hypochondrium, shaped like a clam, is called Ma Dao Chuang (Horse Knife Sores). These belong to the Hand-Shaoyang Sanjiao Meridian, Foot-Yangming Stomach Meridian, and Hand-Jueyin Pericardium Meridian, caused by accumulated phlegm due to constrained fire and anger. Moxibustion and sweating methods are appropriate. Combining attacking and tonifying methods can lead to resolution. Sheng Jin Dan (Golden Pill of Victory) and Wu Jin San (Black Gold Powder) are indicated. For robust constitutions, Yi Li Jin Dan (One-Pill Golden Pill) purges downward. Huo Ming Yin (Life-Saving Decoction) with added Chai Hu (Bupleuri Radix) is used. If treatment is delayed, ulceration penetrating the bone occurs, and non-healing lesions result in death. Delirium, coma, diarrhea, and vomiting before ulceration indicate an incurable condition.

A woman with a rigid and irritable temperament experienced chest pain with unchanged skin color and a rapid pulse accompanied by aversion to cold. The Classics state: A洪数 (Hong-Shu / Surging-Rapid) pulse typically corresponds to fever; if aversion to cold occurs instead, it indicates a carbuncle. Since the pulse is Hong-Shu, pus has already formed. However, due to her obese physique, the skin color did not change, appearing as if no pus were present. Only when the pain became extreme was acupuncture performed; several cun deep, several bowls of pus were drained. She was cured using Liver-Clearing and Toxin-Detoxifying herbs. Had one relied solely on the skin color and avoided acupuncture, there would have been no hope for rescue.

A man over forty suffered from a chest sore that developed into a fistula, draining about one bowl of pus daily. His appetite remained normal. He was treated with Shi Quan Da Bu Tang (Decoction for Ten Thousand Benefits) plus Yuan Zhi (Polygalae Radix), Bei Mu (Fritillariae Cirrhosae Bulbus), Bai Lian (Ampelopsis Radix), and Xu Duan (Dipsaci Radix), along with moxibustion using Fu Zi Bing (Aconite Cake). Pus secretion gradually decreased, and he recovered after more than a year of care.

A young woman had an opening ulcerated in the chest and pectoral region, discharging pus and blood simultaneously with coughed-up material. She was cured using Ren Shen (Ginseng Radix), [Text Missing], Dang Gui (Angelicae Sinensis Radix), along with antipyretic and pus-draining herbs. Some stated this was caused by Fei Wei (Lung Atrophy).

A man had a chest swelling that persisted for half a year without resolving. After moxibustion for one hundred Zhu units until ulceration occurred, large-tonifying herbs failed to promote healing. Healing was achieved using moxibustion with Fu Zi Bing (Aconite Cake).

A military officer (Bai Hu) suffered from a chest toxin characterized by high, red, hot swelling, rapid pulse, difficulty in urination and defecation, but normal diet. Qi Shi stated: Swelling that is red, accompanied by chills, fever, pain, hot skin, and heavy/dizzy head and eyes, indicates an Excess pattern of Qi and Blood. Furthermore: Difficulty in urination/defecation, normal diet, intestinal fullness/distension, chest/diaphragm oppression, and limb/joint pain, combined with fever, large pulse, and mental cloudiness, indicate an Excess pattern of the Zang-Fu organs. Two doses of Huang Lian Nei Shu Tang (Coptis Internal Purging Decoction) were administered, resolving all symptoms. Subsequently, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Detoxifying Powder) with added Huang Qin (Scutellariae Radix) and Shan Zhi (Gardeniae Fructus) was given for four doses, resulting in slight improvement. Finally, Si Wu Tang (Four Substance Decoction) with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Jie Geng (Platycodonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Jin Yin Hua (Lonicerae Japonicae Flos) was used for several doses, leading to resolution. (Wang Kentang’s Note: Although this treatment employs purgative methods because both pulse and symptoms indicate Excess, purgation follows a specific sequence: first attacking the interior, then releasing the exterior, and finally harmonizing. Ancients did not act rashly in treating diseases. Should not students take this as a standard?)