Library

The carbuncle occurring on the medial aspect of the elbow belongs to the Three Yin meridians, caused by stagnant fire in the Heart, Lung, and Bao Luo (Pericardium/Uterus). The guiding herbs are Huanglian (Coptis Rhizome), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).

The carbuncle occurring on the lateral aspect of the elbow belongs to the Three Yang meridians, caused by accumulated toxicity in the Stomach, Large Intestine, and Small Intestine. The guiding herbs are Ben (likely Fengfang or specific local herb, retained as text), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).

One may select from Huanglian Xiaodu Yin (Coptis Detoxification Decoction), Huoming Yin (Life-Saving Decoction), or alternatively Wujin San (Black Gold Powder), Zijin Dan (Purple Gold Pill), Shengjin Dan (Victory Gold Pill), or Yushu Dan (Jade Pivot Pill). For patients with robust constitution and excess syndrome in the interior, Yili Jin Dan (One-Pill Golden Pill) or Bazhen San (Eight-Array Powder) should be used to purge the accumulation. For elderly or weak patients, Huangmuxiang San (Costus Powder) or Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction), Qianjin Neituo San (Thousand-Gold Internal Support Powder) should be used to support and expel the toxin.

Furong Gao (Hibiscus Ointment): Treats toxic accumulations in the arms, wrists, elbows, and palms, characterized by redness, swelling, and pain.
Ingredients: Shanbugua root (Root of *Passiflora foetida* or similar local species), Furongye (Hibiscus Leaf), Zijinpi (Purple Skin/Bark), Lingxiaogen bark (Bark of *Campsis grandiflora* root), Tiannanxing (Arisaema Rhizome), Tianbugua root (Root of *Benincasa hispida* or similar), Jishigen bark (Bark of *Paederia scandens* root), Beizi Wugong (Centipede).
Preparation and Administration: Pound the ingredients into a paste, add some vinegar, warm it, and apply topically to the affected area.

Chige Gao (Red Kudzu Ointment): Treats "Bing'oujie" (Elbow Carbuncle) and toxic accumulations in the arms, wrists, and palms.
Ingredients: Chigegenpi (Bark of *Pueraria lobata* root), Shanbugua root, Shansumu (Mountain Sappan Wood), Shanzhanggenpi (Bark of *Cinnamomum camphora* root), Zijinpi (Purple Skin/Bark), Chiniuxi (Achyranthes Root), Chixionggen (Root of *Ligusticum chuanxiong*), Chimao tao gen (Root of *Prunus persica*).
Preparation and Administration: Use the barks of the above ingredients, pound them, stir-fry with wine lees until warm, and apply to the affected area.

Medicine for Applying to Muscle Ulcers:
Ingredients: Shanzhangziye (Leaf of *Cinnamomum camphora* fruit).
Preparation and Administration: Pound the leaves, stir-fry with wine lees, bind to the affected area. Additionally, decoct the roots in wine for oral administration.

When both the exterior and interior of the arm are swollen and painful, with redness, but slightly smaller at the elbow joint, it is named "Oubao" (Lotus Seed Pod). Differentiating by interior/exterior corresponds to Yin/Yang; the treatment methods are as described above.

Niyou Gao (Mud and Oil Ointment): Treats "Oubao".
Ingredients: Tangni (Pond Mud, 1 part), Tongyou (Tung Oil, 3 parts).
Preparation and Administration: Mix evenly, apply frequently with a duck feather brush, keeping it moist and not allowing it to dry.

Er Gua San (Two Melons Powder): Treats "Oubao".
Ingredients: Shanbugua root, Tianbugua root.
Preparation and Administration: Pound the roots, add a small amount of rice vinegar, mix well, warm it, and apply.

Question: A sore appears on the Yangming meridian of the arm, initially like millet grains, gradually enlarging to the size of a red bean, unbearable pain, and after ten days becomes as large as a walnut with a dry purple color. What is this?
Answer: This is called Gulou Ju (Bone Ant Tubercle). If the toxin spreads throughout the body, causing stiffness, convulsions, vomiting, hiccups, inability to eat, spontaneous cold sweat, diarrhea, irritability, and chaotic pulse, death ensues. Engaging in sexual activity or anger also leads to death. One patient suffered from this condition; after one month, the toxin spread all over the body, he vomited yellow fluid, and a foul odor filled the room. Subsequently, he vomited pus and blood, dying ten days later. Three or four days before his death, he could still eat and was bathed by others; when lifted, his skin and flesh were rotting. The patient did not believe it, and the doctor failed to recognize it, leading to his demise. This is caused by disharmony of the Seven Emotions, accumulated anger, accumulated sorrow, and accumulated heat, resulting in deficiency and collapse of the True Yuan, unable to resist the pathogenic factor. Even with pills and elixirs, it is a matter of fate. Only the wise prevent disaster before it happens, urgently administering Huanglian Xiaodu San (Coptis Detoxification Powder), Shengjin Dan (Victory Gold Pill), Wujin San (Black Gold Powder), or Huoming Yin (Life-Saving Decoction) with Qianghuo (Notopterygii Rhizoma et Radix). If treatment is delayed and multiple "Seven Evils" symptoms appear, death is certain. Commentary: This condition erupts violently and kills rapidly, due to extreme Yin deficiency with solitary blazing Fire. Therefore, the aforementioned medicines do not nourish the source of transformation, acting merely as stirring the boiling water to stop the boil; how can they save the patient?