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When a carbuncle or ulcer has formed, if the patient's blood and qi are deficient, the pathogenic factor is deep, or the pathogenic factor is scattered, the lesion will not protrude and it will be difficult for pus to form. Or after rupture, there is little pus, or the pus is clear and thin, or the swelling is hard and does not soften; or although pus has formed, the base of the swelling is red and swollen and expanded; or the toxic heat cannot be discharged, the wound does not heal, the swelling gathers but is not red, and there is a nodule without pus; these are all signs of deficiency of blood and qi. Since blood and qi are already deficient, and complicated by the invasion of the six exogenous pathogens (wind, cold, summerheat, dampness, dryness, fire) leading to various syndromes, internal support therapy must be used to allow the toxic heat to emerge from the muscle surface, then recovery can occur. All medicines for internal support are primarily tonifying herbs, assisted by herbs that invigorate blood and dispel pathogens. Aromatic herbs may be used to move stagnation, or warming and hot herbs may be added to resist wind and cold. Generally speaking, Tuoli Xiaodu San (Support Interior and Disperse Toxin Powder), Tuoli San (Support Interior Powder), Xiao Tuoli San (Minor Support Interior Powder), and Shixuan San (Ten Acupoints Powder) are all important formulas, but they should be modified according to circumstances. For those in winter with qi stagnation, Wuxiang Lianqiao Tang (Five-Aroma Forsythia Decoction) is used, removing Dahuang (Rhubarb Root and Rhizome) for weak individuals. For those who generally do not tolerate cold-natured medicines, Xiaowuxiang Tang (Minor Five-Aroma Decoction) is used. For those with robust physique, solid pulse, thick pus color, and who cannot take tonics, Ren Dong Wan (Lonicera Pill) and similar preparations are used. When large amounts of pus have been discharged, necrotic tissue removed, and redness and swelling subsided, large doses of Huangqi (Astragalus Root), Renshen (Ginseng Root), Danggui (Angelica Sinensis Root), and Baizhu (Atractylodes Macrocephala Rhizome) should be used to nourish and abundantize blood and qi, facilitating the growth of new flesh. Xue Xinpu (Xue Ji) provided examples of modifying prescriptions according to syndromes, primarily using Tuoli Xiaodu San, which is indeed an excellent method for internal support. This is now incorporated into the respective syndromes, and further discussion here is omitted.

*Yuanrong* states: Carbuncles and ulcers entering from the exterior are not suitable for moxibustion, while those emerging from the interior are suitable for moxibustion. Those entering from the exterior are treated with supporting methods to prevent inward sinking; those emerging from the interior are treated with connecting methods to guide them outward. Thus, the classics state: Depressed lesions are treated with moxibustion. If there is no pain after moxibustion, stop when pain occurs. If there is no pain after moxibustion, it is because the moxa first reached the ulcerated area, hence no pain, and later reached healthy flesh, hence pain. If there is pain after moxibustion, stop when pain ceases. If there is pain after moxibustion, it is because the moxa first reached the un-ulcerated area, hence pain, and later reached the area about to ulcerate, hence no pain. Whenever a person initially feels a back carbuncle forming, with redness, heat, swelling, and pain before it fully consolidates, cover the area with wet paper and observe immediately. The place where the paper dries first is the head of the carbuncle. Take garlic, slice it to a thickness equivalent to a three-qian coin, place it on the head, and apply large moxa cones for three moxibustions (zhuang), then replace with a fresh garlic slice. If painful, moxa until painless; if painless, moxa until painful. Early detection and early moxibustion are most crucial. Within one or two days, ten moxibustions yield ten recoveries; within three to four days, six or seven out of ten recover; within five to six days, three or four out of ten recover; after seven days, it is incurable. If there are ten or more heads growing together, grind garlic into a paste, make a thin cake, place it on the heads, and burn moxa on the garlic cake; this can also save the patient. If the back initially presents with a patch of red swelling, with a yellow millet-grain-sized head in the center, use a single garlic clove, cut off both ends, take the middle half-inch thick part, place it directly on the sore, and apply moxibustion for fourteen zhuang, up to forty-nine zhuang. Another method states: Moxibustion is a method to open knots and break hardness. If there is a small white grain like a millet seed rising, with slight swelling around it like a coin, place moxa on the grain for fifteen to seventeen zhuang. Moxibustion within three days results only in a moxa scar that dissipates. After three days, the swelling gradually decreases; more moxibustion is appropriate. Where the moxa fire touches, the accumulated heat can be dispersed; where the moxa site ulcerates first, the toxic force is divided and reduced, thereby preventing spread, avoiding sinking into deeper tissues, damaging bones and tendons, and injuring blood and qi. "Moxa until painless" means applying to undamaged skin and flesh causes pain, but when the fire reaches the toxic area, there is no pain; one must ensure the fire energy reaches the toxic area before stopping. "Moxa until pain" means applying to the toxic area initially causes no pain, but reaching healthy flesh causes pain; one must ensure the fire energy reaches the healthy flesh before stopping. Those afraid of moxibustion may use a single garlic clove, or a fermented soybean cake, or a mixture of pepper, ginger, and salt, mashed into a cake of three-qian thickness, placed on the site for moxibustion; replace with a new cake when hot, which can also disperse the swelling. Moxibustion follows the principle of treating contrary to symptoms. Only the head is the gathering point of all yang meridians; moxa cones should be small and few. In the areas of the Shaoyang meridian, moxibustion is particularly contraindicated; excessive moxibustion may lead to untreatable conditions or even death. This is due to extreme deficiency where isolated yang is about to perish; the pulse will be floating, rapid, and large, and spirit will be agitated yet short and confused, unable to withstand the fire energy, hence the danger. Furthermore, *Jingyao* states: The brain is the meeting point of all yang meridians; the neck near the throat, and the Shenshu acupoint are vital locations; moxibustion should not be applied to any of these.

He Jian's moxibustion and acupuncture method states: For all carbuncles and ulcers, one must distinguish the meridian parts, the abundance or scarcity of blood and qi, and the distance of acupoints. Those emerging from the back should select from the five acupoints of the Taiyang meridian. Zhiyin (on the lateral side of the fifth toe, at the corner of the nail, width of a leek leaf.) Tonggu (on the lateral side of the fifth toe, in the depression anterior to the proximal interphalangeal joint.) Shugu (on the lateral side of the fifth toe, in the depression posterior to the proximal interphalangeal joint.) Kunlun (posterior to the lateral malleolus, in the depression above the calcaneus.) Weizhong (in the center of the popliteal crease, over the pulsating artery.) Those emerging from the temples should select from the five acupoints of the Shaoyang meridian. Qiaoyin (at the tip of the fifth and fourth toes, at the corner of the nail, width of a leek leaf.) Xiaxi (between the fifth and fourth toes, in the depression anterior to the proximal interphalangeal joint.) Linqi (between the fifth and fourth toes, in the depression posterior to the proximal interphalangeal joint.) Yangfu (four cun above the lateral malleolus, anterior to the end of the fibula, three fen forward.) Yanglingquan (one cun below the knee, in the depression on the lateral margin.) Those emerging from the beard area should select from the five acupoints of the Yangming meridian. Lidui (on the big toe and second toe, at the corner of the nail, width of a leek leaf.) Neiting (in the depression between the big toe and second toe.) Xangu (between the big toe and second toe, in the depression posterior to the proximal interphalangeal joint.) Chongyang (five cun on the dorsum of the foot, in the bone gap artery, three cun from Xangu.) Xiangu (one inch and five fen posterior to Chongyang, in the depression above the ankle joint.) Those emerging from the brain area involve only the Jiegu acupoint (three cun above the lateral malleolus, in the arterial pulse.) See *Yongju Jiu Jing* for details.

Riding Bamboo Horse Moxibustion: Treats all carbuncles and ulcers, ensuring recovery. Have the patient rest their elbow on a table, keeping the arm vertical and wrist straight. Use a bamboo strip, starting from the transverse crease of the wrist, on the left for men and right for women, measuring along the skin to the tip of the middle finger. Cut this length as the standard, excluding the nail. Then use a bamboo pole. Have the patient remove clothing, sit upright on the pole, supported by two people lifting it so the feet do not touch the ground, and two others holding them to prevent stooping. Place the previously measured bamboo strip from the sitting point at the coccyx, straight along the spine, to the end of the strip. Mark this point with ink. This merely finds the midpoint, not an acupoint. Make a scale from a thin bamboo strip. Measure the middle finger joint, taking the distance of two transverse creases as one unit. On the left for men and right for women, cut one unit. From the marked point, measure one unit to each side; these endpoints are the moxibustion points. Apply five to seven moxibustions to each point. If the carbuncle is on the left, moxa the right; if on the right, moxa the left; if severe, moxa both sides. These two points are where the Heart meridian passes. All carbuncles and ulcers are toxins滞留 by Heart Fire. Moxibustion here circulates Heart Fire and disperses toxins, having miraculous effects of restoring life from death, tested repeatedly.

Liu Zongnong said: This refers to moxibustion for initial carbuncles and ulcers. However, for chronic sores that have become fistulas, with continuous non-odorous pus and no necrotic tissue inside, Fuzi (Aconite Lateralis Radix Praeparata) soaked, sliced thickly (two to three fen), placed on the sore for moxibustion, combined with internal support medicine, repeated every two to three days, will naturally result in full muscle regeneration within five to seven sessions. For sores with foul pus and deep-rooted infection, Guo's treatment uses flour, sulfur, and garlic, mashed together into a cake of about three fen thickness, placed on the sore, and moxa for twenty-one cones, replacing each time. After four to five days, use Cuixia Dingzi (Emerald Cloud Plug) and Xinxiao Dingzi (Trustworthy Effect Plug) alternately, inserted into the sore, to remove necrotic tissue and level healthy flesh. Then apply astringent medicines and take internal remedies corresponding to the disease; regulation leads to recovery. Not only is moxibustion indicated at the onset of sores; generally, early moxibustion requires matching sweating, purgative, tonifying, and nourishing medicines. For cold sores, internal support medicines must also be appropriate. If contrary measures are taken, not only will healing fail, but other diseases may arise.