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The *Ling Shu* (Spiritual Pivot) states: A carbuncle occurring in the thigh yang region is named "Gu Yang Ju" (Thigh Yang Carbuncle). Its manifestation shows little color change, but the swelling presses closely against the bone. If not treated urgently, death will occur within thirty days.

A question was raised: What is the prognosis for a carbuncle appearing five to six cun below the groin on the lateral side of the leg? The answer is: This is called "Fu Tu Fa" (Hidden Rabbit Eruption). It presents with severe chills and fever, pain radiating to the heart, and swelling without a head. It belongs to the Foot-Yangming Stomach Meridian. Ancient physicians considered this an incurable condition; early detection and prompt treatment are superior. Urgently apply garlic-partitioned moxibustion. If improvement occurs after moxibustion, it is treatable; if no reaction occurs, it is difficult to treat. Administer Huo Ming Yin (Life-Saving Decoction) with added Niu Xi (Achyranthes Root), Mu Gua (Chaenomeles Fruit), and Han Fang Ji (Stephania Tetrandra); or use Zi Jin Dan (Purple Gold Pill) and Sheng Jin Dan (Victory Golden Pill) to induce sweating. For robust individuals, Ba Zhen San (Eight Arrays Powder) or Yi Li Jin Dan (One Grain Golden Pill) can be used to purge downward.

One case involved a patient with a carbuncle on the lateral thigh, presenting with diffuse swelling and severe pain. After two doses of Nei Tuo Huang Qi Tang (Internal Support Astragalus Decoction) decocted in wine, symptoms slightly improved. Subsequently, several doses of Tuo Li (Support Interior) herbs were administered, leading to suppuration and recovery.

Another case involved a patient over twenty years old with weak constitution, suffering from toxicity on the lateral left thigh. Suppuration occurred only after three months, with thin purulent discharge and failure of muscle regeneration. Treatment with Shi Quan Bu Tang (Ten Complete Tonifying Decoction) plus Niu Xi (Achyranthes Root) for over twenty doses led to gradual improvement. Further treatment with Dou Chi Bing (Fermented Soybean Cake) moxibustion for over a month resulted in full recovery.

A female patient suffered from a chronic leg carbuncle that failed to heal, with a purple, depressed wound and thin pus. I diagnosed deficiency, but she did not believe me. She took detoxifying agents, which caused multiple deficiency syndromes to arise, prompting her to seek further treatment. I applied Fuzi Bing (Aconite Cake) moxibustion and administered Shi Quan Da Bu Tang (Ten Great Tonifying Decoction). After more than one hundred doses, she recovered.

One male patient had an internal ulceration of a leg carbuncle. Puncture yielded approximately four to five bowls of pus. He exhibited aversion to cold, poor appetite, and a thread-like pulse, indicating slight Yang Qi. Si Jun Zi Tang (Four Gentlemen Decoction) with Pao Fu Zi (Processed Aconite) was prescribed. Aversion to cold subsided slightly, and after four more doses, it stopped. Then, Liu Jun Zi Tang (Six Gentlemen Decoction) with Gui Zhi (Cinnamon Twig) was given for several doses, improving diet. Finally, Shi Quan Da Bu Tang and Fuzi Bing moxibustion were used, resulting in recovery after two months.

An elderly patient had a spontaneously ruptured leg carbuncle followed by sudden dizziness and confusion, with a fine and faint pulse, indicating extreme deficiency of Qi and Blood. Large tonifying formulas revived him.

One patient with a leg carbuncle experienced tendon spasms and pain, with a string-tight pulse. Wu Ji San (Five Accumulations Powder) plus Huang Bo (Phellodendron Bark), Chai Hu (Bupleurum Root), and Cang Zhu (Atractylodes Rhizome) cured him.

A female patient had left leg pain preventing extension, with a string-tight pulse and choppy sensation upon pressure. Two doses of Wu Ji San reduced pain, and two more doses stopped it completely. Shen Ying Yang Zhen Tang (Divine Response Nourishing True Essence Decoction) completed the cure. (String-tight and choppy pulses indicate Cold; thus, Wu Ji San, being acrid and hot, disperses the pathogen.)

One patient had red, swollen, painful right leg with a deep and rapid pulse. Dang Gui Niang Tong Tang (Angelica Relieving Pain Decoction) was used, but limb pain worsened. This indicated damp-toxin obstruction, where lower-body medications struggle to reach the site. It was not a mismatch of medicine and syndrome. Therefore, Bian Shi (stone lancet) was used to puncture the affected area and release toxic blood. The previous prescription was continued for one dose, causing immediate reduction, and four more doses eliminated the swelling.

A patient over fifty years old contracted a leg carbuncle in winter, presenting with rapid pulse, irritability, desire for cold drinks, constipation, and severe swelling/pain. This indicated excessive Heat inside. Bitter-cold herbs were appropriate. Qing Liang Yin (Cooling Drink) with doubled Huang Qin (Scutellaria Root) rapidly reduced the condition. Si Wu Tang (Four Substance Decoction) plus Huang Qin then cured him.

A thirty-year-old patient, subjected to repeated worry and labor, and indulging in sexual activity, developed red, swollen, chestnut-sized lesions on the lateral edge of the left thigh. One physician diagnosed Fu Organ Excess and prescribed Cheng Qi Tang (Ordering the Qi Decoction) twice for purgation. Another physician gave Da Huang (Rhubarb), Zhu Sha (Cinnabar), and Xue Jie (Dragon's Blood) for three doses. The pulse became large and excess, and the patient eventually died. This area corresponds to the Jueyin Liver Meridian, which has abundant Qi but scarce Blood.

One patient had a leg carbuncle. Upon puncture, about two bowls of pus were drained. One dose of Tuo Li (Support Interior) medicine caused high fever. Sheng Yu Tang (Sage Restore Life Decoction) for two doses controlled the fever. The next day, he had aversion to cold and anorexia, with a thread-like pulse. Ren Shen (Ginseng Root) 1 liang, Shu Fu Zi (Prepared Aconite) 3 slices, Jiang (Ginger) and Zao (Jujube) decocted together cured him. However, due to poor appetite and insomnia, Nei Bu Huang Qi Tang (Internal Nourishing Astragalus Decoction) stabilized his condition.

One patient had leg swelling with fever and aversion to cold. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was prescribed. Dissatisfied with the slow effect, he took Huang Qin (Scutellaria Root) and Lian Zi (Lotus Seed Plumule), worsening the heat. Upon re-consultation, Ren Shen Yang Rong Tang (Ginseng Nourishing Spirit Decoction) for over twenty doses led to suppuration. Further treatment with Ren Shen, [missing character], Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodes Macrocephala), Zhi Gan Cao (Honey-fried Licorice Root), and Rou Gui (Cinnamon Bark) for over a month led to healing.

A patient over thirty had mild swelling and pain in the left leg, unchanged skin color, and loss of appetite. Li Dongyuan stated: Swelling that is hard at the base indicates origin in tendons and bones, known as Gu Gu Ju (Bone-Attached Carbuncle). This results from deficiency of True Qi and invasion of Dampness into muscle textures. Since all deficiencies relate to the Stomach, and low intake weakens the Stomach, the method should be to assist the Stomach and strengthen Qi. Liu Jun Zi Tang plus Huo Xiang (Pogostemon) and Dang Gui for several doses improved diet. Shi Quan Da Bu Tang then cured him.

One patient had wandering pain throughout the body. Two months later, a swelling appeared on the dorsum of the foot, followed by another mass in the thigh/leg. Light palpation revealed floating pulse; heavy palpation revealed floating and moderate pulse. This indicated Qi and Blood deficiency, loose interstices, and invasion of Cold into deficiency. Jia Jian Xiao Xu Ming Tang (Modified Minor Sustaining Life Decoction) for four doses, followed by Du Huo Ji Sheng Tang (Angelica Pubescens and Taxillus Decoction) for several doses, removed pain. Tuo Li herbs with increased Ren Shen, [missing character], Dang Gui, and Bai Zhu for over one hundred doses cured him.

Wang Jingshan, Sima of the South, had leg swelling and pain, chills, fever, thirst, normal diet, and a large, rapid, forceful pulse. This indicated Damp-Heat stagnation in the Foot-Taiyang, Foot-Yangming, and Foot-Shaoyang meridians. Bin Su Bai Du San (Areca Peel and Perilla Detoxifying Powder) for one dose stopped chills and fever; two doses eliminated swelling and pain. Xiao Yao San (Free and Easy Wanderer Powder) restored Yuan Qi. Two months later, anger triggered stabbing pain and spreading redness. Huo Ming Yin for two doses relieved pain. Ba Zhen Tang (Eight Treasures Decoction) plus Chai Hu, Shan Zhi (Gardenia Fruit), and Dan Pi (Moutan Cortex) stopped pain. Later, fatigue caused lassitude, poor appetite, heavy legs, and dizziness, indicating Spleen-Stomach Qi deficiency failing to raise clear Yang. Bu Zhong Yi Qi Tang plus Man Jing Zi (Vernonia Fruit) brought peace.

A scholar had bilateral leg swelling and pain, unchanged skin color, chills, fever, poor appetite, and limb fatigue. This indicated Spleen Qi deficiency with Damp-Phlegm sinking. Bu Zhong Yi Qi Tang plus Ban Xia (Pinellia Tuber), Fu Ling (Poria), and Shao Yao (Peony Root) for two doses resolved chills, fever, swelling, and pain. Over ten more doses strengthened the Spleen-Stomach and physique.

A man engaged in intercourse while suffering from this condition, resulting in hard swelling of both legs and obstruction of urination and defecation. I stated: The Kidney opens into the two yin orifices; this is Liver-Kidney deficiency. Liu Wei Wan (Six Flavor Pill) material plus Che Qian Zi (Plantago Seed) and Niu Xi cured the obstruction. Bu Zhong Yi Qi Tang resolved the hardness and swelling. Fortunately, his youth aided survival.

A student of the Imperial Academy had internal stabbing pain, unchanged skin color, sallow complexion, poor appetite, severe pain inducing vomiting. This indicated pain injuring the Stomach. Liu Jun Zi Tang strengthened the Spleen-Stomach. Shi Quan Da Bu Tang assisted pus formation before puncture. The previous formula with increased Ren Shen, [missing character], Chuan Xiong (Ligusticum Rhizome), Dang Gui, Mai Men Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Berry), Yuan Zhi (Polygala Root), and Bei Mu (Fritillaria Bulb) healed the wound.

A man carried heavy loads and had irregular diet, causing chest pain. Mistaking it for carbuncle toxin, he took Da Huang and other drugs. This resulted in right thigh swelling with unchanged skin color, headache, aversion to cold, panting, thirst, fever, and a large but forceless pulse. This indicated exhaustion of Yuan Qi and damage to Stomach Qi by medication. Bu Zhong Yi Qi Tang for four doses, followed by Shi Quan Da Bu Tang for several doses, cured him, fortunate for his youth.