Library

The *Suwen* (Plain Questions) states: When blood is excessive and stagnant, it is appropriate to drain it. Bian Que stated: For diseases in the blood vessels, treatment is performed with bi stones (lithic instruments). If swelling rises with wandering redness, resembling a danliu (red tumor), first apply raw oil to the red area, then incise it with a sickle to drain and release the toxicity; do not cut too deeply. The *Neijing* (Inner Canon) says, "Puncture the skin without injuring the flesh." Although this method is used for treating chongju (carbuncles and sores), it should not be used lightly.

When a sore or swelling first appears, seeming to have a head but not yet raised, warm-natured medicines should be applied as a plaster to draw out the heat-toxin, following the principle that "fire tends toward dryness." If a sore or swelling first appears, immediately rising high with redness on all sides, crushed cold-natured medicines should be applied as a plaster to subdue the heat trend and expel evil pathogens, following the principle of "extinguishing fire." Generally, the method of applying plasters aims to dissipate swelling and toxins and unblock the blood vessels; whether cold and heat are complex, the goal is to prevent suppuration. For areas where the skin is thick, use soft silk or cotton paper, apply medicine, and change it only after it dries. For areas where the skin is thin, use gauze or thin paper, apply medicine, and change it before it dries. After suppuration breaks, apply warming and flesh-generating plasters. The key lies in removing foul rot, draining bad fluids, eliminating necrotic tissue, and generating healthy flesh, relying entirely on the power of warm ointments. Do not use cold-cold water-based pastes for application, as this will cause blood stagnation and delay healing, because blood vessels prefer warmth and dislike cold. The *Jiyan Fang* (Collected Experiences) states: For carbuncles and sores without a head and not raised, apply Shenzhi Gao, Linggui Gao, Badu Gao, or Zheng Tiegu San; they will immediately subside. For those that have suppurated, apply Linggui Gao, or use Zuidu Gao to drain pus, or use a tube to collect pus. For youdu (sores with heads), after washing, observe the width of the red halo. Use Datiegu San mixed with cool water into a paste; in deep winter, mix with warm water and add Renrou (human flesh - *note: likely a textual error for a warming herb like Renshen*) for warm application. For severe swelling and redness, apply natural juice of Sheng Dihuang (Rehmanniae Radix). The method of encircling application involves applying around the red halo from all sides, covering the sore with hide paper. If white grains appear spinningly, scattered like rice or beans, use the tail of a silver comb to pick away the sore eyes, apply Laopi San, and then apply fresh medicine. Generally, abundant heat causes redness and swelling to scatter; extreme heat turns them purple-black; external cold constraint also results in purple color; blood deficiency combined with cold results in cyan-white. Datiegu San and Zhengtiegu San are commonly used medicines. Depending on conditions such as wind-cold-heat and pollution/aversion contact, and varying seasonal cold-heat, methods should be adjusted flexibly: for heat, use Sanhuang San; for extreme heat, use Sansan San; for wind, add Qianghuo and Fangfeng; for wind-stagnation, add Muxiang; for cold-constraint, add Guizhi; for pollution contact, fumigate with aromatic medicines. For tender swollen areas, remove Baiji (Bletillae Rhizoma). When removing the plaster, check if sweat droplets appear in the pores; this indicates unblocked blood vessels, dissipated heat-toxin, shrinking red halo, cessation of pain after suppuration, reversal of adverse conditions to favorable ones, and moist, active skin and hair, leading to healthy flesh growth. As long as there is slight necrosis at the top of the du, do not use knives or scissors. If no sweat droplets form under the medicine, necrosis will surely be extensive and abundant. After suppuration, encircling applications gather scattered residual toxins, which exit with the pus; apply Bodu Gao to the wound. If pus drainage is not smooth, use Zuidu Gao. If evil flesh remains, use Jinbao Gao. After necrotic flesh is removed, encircling applications activate qi and blood, facilitating new flesh growth; apply Changrou Gao to the wound. Plaster medicines and irrigation/washing medicines work in parallel with equal efficacy. Master Guo's method: For such youdu (sores with heads), place one pill of Zhusha Beijiji Gao (Cinnabar Emergency Prepared Ointment), sized like a soybean, on the sore head, and cover it with a soft adhesive plaster; the sore will inevitably break. If the sore halo is purple-black, apply Xuandu San externally around the toxic vapor. If the sore halo is red, apply Shui Cheng Gao; the next day, use Jianjun Biyun Dingzi (Firm Biyun Pill) to open the wound; then use Jinwan Bixia Dingzi (Tight Bixia Pill) to remove bad flesh; once slightly clean, use Manwan Biyu Dingzi (Slow Biyu Pill) to generate muscle, collectively named Qingjin Dingzi. Do not limit by days; continue until bad flesh is completely removed, then apply only ointment. Wait until pus and water are exhausted and muscles are level before allowing the application of medicines to generate good muscle and close the wound. Following this method avoids the suffering of knives, scissors, needles, and cauterization. For wutou yongzhong (abscesses without heads), wait until pus forms, puncture with a needle, and then follow this method to achieve success.