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Carbuncles and sores (suppurative infections of the skin and subcutaneous tissues) presenting with panting and急促 breathing, mental confusion, and excessive sleepiness indicate that Heart Fire is insulting Lung Metal. Ren Shen Ping Fei San (Ginseng Decoction to Calm the Lungs) should be used.

Ren Shen Ping Fei San (Ginseng Decoction to Calm the Lungs)
Sang Bai Pi (Cortex Mori Radicis, stir-fried), Zhi Mu (Rhizoma Anemarrhenae, 0.7 qian, stir-fried), Xing Ren (Semen Armeniacae Amarum, peeled and tip removed, stir-fried), Di Gu Pi (Cortex Lycii Radicis), Zi Su (Folium Perillae), Ju Hong (Pericarpium Citri Reticulatae), Ban Xia (Rhizoma Pinelliae, processed with ginger juice), Fu Ling (Poria, Qing Pi (Pericarpium Citri Reticulatae Viride), Ren Shen (Radix Ginseng, each 1 qian), Wu Wei Zi (Fructus Schisandrae, 20 grains, stir-fried and crushed), Gan Cao (Radix Glycyrrhizae, honey-roasted, 0.5 qian).
This constitutes one dose. Add two zhong of water and three slices of fresh ginger, decoct until eight fen of liquid remains. Take well after meals.

[Xue Ji] Commentary: This formula is an agent for regulating qi, clearing the lungs, and resolving phlegm. It is suitable for cases where the Lung pulse is surging, rapid, and deficient in force. If accompanied by fever and thirst, with a surging, rapid, and full pulse, Ru Jin Jie Du San (Decoction Like Gold to Detoxify) should be used. This condition represents the evil pattern of Fire overcoming Metal; if the face is red, it is also considered incurable.

Modifications of Tuo Li Xiao Du San (Decoction to Support the Interior and Eliminate Toxins): Chest stuffiness due to anger indicates stagnation of Liver Qi. Remove three ingredients and add Jie Geng (Radix Platycodi) and Shan Zhi (Fructus Gardeniae). If ineffective, temporarily use Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi) with added Jie Geng and Zhi Qiao (Pericarpium Aurantii Immaturum). Fatigue with chest stuffiness indicates deficiency of Middle Qi. Remove three ingredients and add Ren Shen, Bai Zhu (Rhizoma Atractylodis Macrocephalae), and Fu Ling. If ineffective, temporarily use Ba Zhen Tang (Eight Treasures Decoction) with added Chai Hu (Radix Bupleuri).

In carbuncles and sores, oblique gaze of the eyes and upward staring, with tightness and constriction of the black pupil (cornea) and cyanotic-red sclera (white part of the eye), indicate Liver harboring Fire pathogenic factors. Xie Qing Wan (Pill to Drain Blue/Green) should be used.

Xie Qing Wan (Pill to Drain Blue/Green)
Dang Gui (Radix Angelicae Sinensis, mixed with wine), Chuan Xiong (Rhizoma Chuanxiong), Shan Zhi Ren (Semen Gardeniae, stir-fried), Qiang Huo (Rhizoma Notopterygii), Cao Long Dan (Radix Gentianae, mixed with wine, stir-fried), Fang Feng (Radix Saposhnikoviae), Da Huang (Radix et Rhizoma Rhei, mixed with wine, stir-fried, equal parts).
Grind into fine powder, make pills with refined honey, size comparable to a chestnut. Take one pill per dose, dissolve and take with light bamboo leaf decoction. Take two or three times daily. If diarrhea occurs, remove Da Huang and add Jing Jie (Herba Schizonepetae), or use Huang Lian Xie Xin Tang (Decoction of Coptis to Drain the Heart) for one or two doses, which is also acceptable.

[Xue Ji] Commentary: The aforementioned symptoms belong to three of the "Seven Evils." If the Liver pulse is wiry, tight, surging, and rapid, this formula is most appropriate. In cases where vision is abnormal and unclear, with a faint or floating pulse, it indicates deficiency of True Qi. Large tonifying agents should be used. "Xie Qing" refers to draining the Fire pathogenic factor from the Liver channel; since the Liver belongs to Wood and its color is blue/green, hence the name.