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The *Gui Yi Fang* states: Whenever a carbuncle or ulcer presents with external coldness and internal pain, it is caused by Yin pathogenic factors pressing from the exterior. One should apply hot compresses; if even intense heat fails to elicit sensation, one must use hot compresses until the heat penetrates thoroughly, then immediately apply urgent pus-draining formulas to ensure complete evacuation of pus. Once swelling subsides, employ flesh-regenerating, warming, and Qi-nourishing medicines to facilitate continuous appetite.

For treating carbuncles, ulcers, and back abscesses during initial swelling:
Fenghua Duan Shi (Calcined Iron Pyrite, 2 liang) and Xixin (Asarum, 1 liang).
Grind these into coarse powder. Apply with hot vinegar to the affected area; reapply when dry. After three applications, the swelling will subside.

Si Hu San (Four Tigers Powder): Treats early-stage back abscesses characterized by tense and uncomfortable meridians and vessels.
Fuzi (Aconite Lateralis Radix Praeparata, raw, peeled, 1 liang), Tian Nanxing (Arisaema Cum Bile, 0.5 liang), Banxia (Pinelliae Rhizoma, 0.5 liang), Yelangdu (Stemonae Radix, 0.5 liang). An alternative prescription excludes Fuzi and uses Caowu (Aconiti Kusnezoffii Radix) in equal parts.
Grind the four ingredients into powder. Mix with hot wine to form a paste, spread on the swollen area, and secure with cooked silk cloth. A sensation of burning in the affected area is acceptable and not harmful.

Hui Yang Yu Long Gao (Return Yang Jade Dragon Ointment)
Caowutou (Aconiti Kusnezoffii Radix, 3 liang, stir-fried), Nanxing (Arisaema Cum Bile, 1 liang, baked), Jiangzhu (Zingiberis Rhizoma Recens, 2 liang, baked), Baizhi (Angelicae Dahuricae Radix, 1 liang, protected from fire), Chishao (Paeoniae Radix Rubra, 1 liang, stir-fried), Rougui (Cinnamomi Cortex, 0.5 liang, protected from fire).
This formula treats Yin-type back abscesses, cold Liuzhu (flowing deposits), Guzhuifeng (drum-pounding wind), chronic injury pain, cold Bi syndrome with wind-dampness, various Hong Kong foot conditions with cold swelling lacking redness, cold swelling without pain, stubborn numbness of the feet, women’s cold blood-wind, and is the premier medicine for all Yin syndromes. Apply mixed with hot wine; detailed usage follows. Generally, miscellaneous diseases manifest on the skin and extremities but originate in the Zang-Fu organs. The blood vessels and meridians of the Zang-Fu circulate throughout the body day and night, completing cycles. Disease in one organ manifests at points along its meridian pathway, corresponding to Yin-Yang divisions of the limbs. Diseases are either cold or hot; hot syndromes are easy to treat, while cold syndromes are difficult. Cold syndromes arise from deficiency of Yuan Yang (Primordial Yang) in the Zang-Fu, allowing Wind pathogens to invade due to disharmony of Qi and Blood. Pathogens lodge in the skin via meridians, obstructing pulse flow, causing stagnation. Greater cold leads to deeper accumulation. If quacks administer cooling agents, internal and external attacks compound the condition, often leading to critical danger. Practitioners must observe external signs to infer internal organ involvement, ensuring correspondence between interior and exterior for success. This ointment contains Jiangzhu and Rougui to warm and generate blood. However, warmth alone cannot disperse stagnation and may cause harm; thus, Caowu and Nanxing are included to break evil Qi, expel wind-toxins, revitalize necrotic tissue, relieve bone pain, dissipate nodules, and awaken Yang Qi. Chishao and Baizhi disperse stagnant blood, alleviate pain, and promote flesh growth. Wine enhances drug efficacy, disperses Qi and Blood. Even severe cold syndromes will heal, akin to reigniting cold ashes or restoring spring to dead wood. Cold syndromes cause muscle rot and loss of sensation; pain indicates deep attachment to bone. Without removal, cold roots penetrate marrow, beyond the reach of ordinary drugs. Only this ointment can vigorously expel Yin toxins, restore Yang, stop bone pain, and treat skin/muscle disorders. Use with caution to avoid excess. For a back abscess arising from Yin channels and mistreated with cold herbs, or a Yang-channel abscess mistreated with cold herbs turning Yin with black rot over the back, apply Hongbao Dan around the healthy perimeter and this ointment in the center. After one night, Yang returns, black turns red. Once vibrant red appears, stop this ointment and finish with Chonghe Xian Gao. If ineffective and suppuration is desired, add Nanxing and Caowu to Chonghe. If Yang returns and black turns red except for a central point of black rot indicating dead blood, use Poxiao (Natrii Sulfas) and Mingfan (Alumen). Alternatively, mix Baixiangding (Bubali Corneum), Sha (Realgar), and Ruxiang (Olibanum) with saliva, draw a circle at the black-red border, cover with Chonghe. Remove next morning; dead flesh falls off easily. Clean with medicine and finish with flesh-regenerating agents. Cold Liuzhu syndromes often present as hard, non-resolving masses attached to bone with cold pain and contracted tendons. Needle aspiration yields no pus, only milky fluid or stasis. Apply this ointment. For milder cases, mix Jiangzhu, Baizhi, Rougui, and Caowu equally, apply with hot wine. As bone cold resolves and pain stops, warmth restores tendon extension and softens hardness. Wood wax (Muzha) is essential for Liuzhu to break stagnation and reduce hardness, but use sparingly as excess neutralizes efficacy; this syndrome requires warming herbs. Guzhuifeng arises from dampness, residual toxicity from Shanghan, deteriorated Liuzhu, or wind-damp deficiency Bi. Three types exist: 1) Knees touching, trembling gait, slight swelling of knees and shins; 2) Swelling at knee-shin junction resembling thigh, with skin shrinking around bone; 3) Thigh swelling with cold, wasted calf. Knees belong to Liver; wind-cold-damp in Liver channel obstructs blood flow, causing knee cold. Stagnant flow prevents return circulation in calves, leading to wasting and coldness with tendon contraction. Accumulation in thighs causes swelling, heat, and wasting. If originating from Liuzhu, condensed flesh rots, cold toxin corrupts bone; once bone corruption occurs, even immortals cannot save. Before rupture, flesh is viable; urgently apply this ointment with hot wine to knees/shins to stop bone pain and restore Yang. Apply Chonghe to cold lower legs to guide blood flow downward. Apply this formula at shin junctions to connect meridians and dissipate accumulated Yin. Internally, take Zhuifeng Wan with extra Ruxiang to extend tendons. All recover. For open prescriptions, use Wuji San plus Ginger, Cinnamon, Baizhi, Danggui, Chuanxiong, Niuxi, Binglang, Mugua, taken with tea or wine. For men/women with chronic cold Bi blood-wind causing numbness or paralysis, wrap this ointment in cotton bags, place on pain sites, secure with silk. It relieves bone pain; skin tingling like ants crawling indicates efficacy. For Bi, add Dingpi, Wuyuzhuyu, Moyao, Da Chuawu equally, combined with Zhuifeng Wan for dual action. For unbearable wind-foot pain, take Zhuifeng Wan internally, apply this formula with flour and ginger juice externally. For immediate relief, add Ruxiang and Moyao dissolved in wine. For chronic injuries penetrating bone due to trauma without blood circulation, causing static blood accumulation resembling lung tissue or mossy stones, young people may not feel it, but elderly with declining blood/qi suffer upon exposure to wind-cold-damp. Apply this ointment with hot wine; internally take Sousun Xuntong Wan. Dual action is ideal. For weak patients with chest/flank/back pain termed Degou, failure to treat leads to Blood-Stasis Consumption. Regardless of age or duration, widespread or localized, treatment is uniform. These root diseases require prolonged therapy; pre-consumption is curable, established consumption is difficult. A variant uses Nanxing, Caowu, and little Rougui to clear black rot/pus, called Xiao Yulong, highly effective. For Shi Yong (Stone Carbuncle), apply this ointment with hot wine, surround with Hongbao Dan, wait for suppuration before lancing. For female breast carbuncles, often caused by weaning retention, excessive milk with low intake causing stagnation, irregular menstruation with reversed flow, or internal pathogen郁结. Initially, avoid cooling agents as milk is transformed blood; cooling causes condensation and hard nodules. Milk is cold in nature; cooling agents exacerbate stagnation. Eventually, heat builds, forcing suppuration with extreme pain and tissue destruction, resulting in lactation loss. Although milk is cold, cooling agents are used post-rupture. At onset, mix Nanxing, ginger juice, and wine equally for hot compress to resolve internally. For rapid effect, add Caowu. Caowu is potent, breaking masses, expelling cold/heat, dissolving in cold, suppurating in heat. For established abscesses, use Chonghe normally. Add Caowu/Nanxing if needed. Post-rupture, determine etiology: cold uses Chonghe, heat uses Hongbao for flesh generation. Use Ruxiang/Moyao for pain. Internally, use Gualou San adjusted for deficiency/excess, alternating with Tongshun San and Shixuan San. Multiple openings indicate Rufa; hardness indicates Rushi; nipple swelling indicates Chuiru; sac swelling indicates RuLou (difficult due to blood accumulation). Single sac/opening is Ruping; untreatable in elderly, except Rudie (abscess on hanging flesh near chest), which is treatable. For phlegm-derived abscesses without pus, apply this ointment to induce pointing/side drainage. Otherwise, Yuan Yang depletion leads to defeat syndrome. For defeat syndrome, apply full Yulong to induce pus; internally take Tongshun San with Jiegeng, Banxia, Danggui, Rougui. If red/vibrant/hot, use Danggui Chonghe. Avoid cooling agents. This ointment draws out toxins; stop when improved. Combining with Xianmai Shenji (from Waike Jingyao) is excellent. Du Yong (Abdominal Abscess) has high mortality due to Stomach being Yin, external cold/internal heat. Qi/Blood gathers to drive out heat/cold, forming internal abscesses rarely visible. If slight protrusion occurs, cold agents trigger complications. Even immortals fail if cooled. Initial symptom is lower back pain on pressure. Moving pain indicates Qi mass; fixed root with slight redness/swelling indicates internal abscess. Urgently apply this formula to draw toxins outward, forming external abscess, then finish with Chonghe. Internally, Tongshun San with Jindingteng. If abscess naturally externalizes, use only Chonghe; avoid needles/knives. If tetanus risk (iron exposure), apply Yulong on head, surround with Chonghe; natural rupture follows. If slow drainage, use Hongbao (3 parts) and ginger juice (7 parts) with tea. When pus clears, internally use Shixuan and Pingbu Shengji, finishing with Chonghe. This syndrome has excess Yin/deficient Yang, severely damaging. During stabilization, double internal tonics to generate Qi/Blood for easier recovery; otherwise, rebound swelling and non-healing occur. Post-stabilization, continue internal tonics with Fuzi to prevent weakness. For cold syndromes, take Fuzi formulas before rupture; after rupture, avoid astringents to prevent trapping toxins; natural healing occurs as drug potency acts. For formed internal abscesses unable to be drawn out, apply Chonghe externally to gently mature pus for exit from organs, preventing tissue rot. Survival depends on medication. See previous methods. Avoid toxic foods; recurrence is hard to treat. Pregnant women have different management: internally use Zisu Yin to calm fetus, avoid other drugs. Near term, fetus and pus pass together; earlier, pus passes via large intestine. Early stage may resolve with medicine alone. External abscesses are hot; use Chonghe cautiously based on severity.