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The thin skin of a furuncle (boil) peels off, and the wound opening of a carbuncle or deep abscess is tight and narrow. After using fire needles to break the nodules in conditions such as scrofula (tuberculous lymphadenitis), medications with chasing and corrosive properties to expel pus can be applied. If the wound opening of a carbuncle or deep abscess closes again after opening, it should be treated with medication to unblock it, or materials such as paper, hair, or dry rice straw leaves can be twisted into strips, coated with toad venom (Chan Su), sand, white duxiang, bitter bean (Ba Dou), and cold food flour, or Wuhui Gao (Five Ashes Ointment) can be applied according to the severity. For necrotic tissue of sores and abscesses, it can be removed manually, or by applying Jinbao Gao (Golden Treasure Ointment), or by dusting with realgar (Xiong Huang) and calomel (Qing Fen); after waiting several days, it will naturally fall off. If fleshy protrusions appear after an abscess ruptures, coating them with powdered Polygala root (Yuan Zhi) mixed with wine will gradually cause them to subside. If they do not subside, applying Wuhui Gao will resolve them. When a carbuncle or deep abscess discharges pus for a long time without rotting or breaking down, it is because Qi and Blood fail to nourish the wound, allowing stagnant toxins to invade inward day by day, turning healthy flesh into necrotic flesh. Where pus flows, membranous tubes gradually form, soft like goose feather quills, and the wound opening resembles a fish mouth. If this persists for a long time without healing, tendons rot and bones decay. Apply Jinbao Gao, either by smearing, packing, or sealing, three to four times a day. For those intolerant to pain, apply twice a day. Once the necrotic flesh and membranous tubes are completely eliminated, apply moisturizing plasters. Xue Xinpu stated: In cases of sores and ulcers, when pus has formed, one must distinguish whether it is ripe or unripe, shallow or deep; regarding dead flesh, one must verify its state of putrefaction and detachment. Mr. Danxi stated: Carbuncles and deep abscesses arise from accumulated toxins in the Zang-Fu organs. Treatment should primarily focus on strengthening the Stomach and boosting Qi to solidify the root, assisted by herbs that promote circulation through meridians and invigorate Blood, allowing internal resolution. I often treat patients with weak pulse and symptoms using Tonifying Interior medications, which strengthen Qi and Blood so that flesh does not die. For patients with excess-heat pulse and symptoms, I use Clearing Heat formulas, which retreat toxic vapors so that flesh regenerates spontaneously. Sores gathering between sinews and bones, within muscles, are all due to deficiency of Qi and Blood. Using Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification) strengthens the Spleen and Stomach, causing unformed sores to dissipate spontaneously and formed sores to ulcerate spontaneously, leaving no room for dead flesh. If there is little pain, or numbness without pain, or lack of redness, or internal pus not draining, or external flesh not rotting, it indicates Qi and Blood deficiency. One should use Moxibustion with Mulberry Branch on Shiquan Dabu Tang, adding Ginger and Cinnamon Twig, to boost Yang Qi. Then swelling around the periphery will subside, the sore head will rot, and toxins will resolve spontaneously, making needle cutting unnecessary. If the Spleen and Stomach are weak, with poor appetite, use Liujun Zi Tang (Six Gentlemen Decoction) with doubled Atractylodes Macrocephala Rhizome (Baizhu) to strengthen Ying Qi. Then flesh infected by toxins will survive, dead flesh will ulcerate, and open wounds will heal. If at the onset, due to excessive purging or sexual misconduct, the color becomes dark and painless, it indicates collapse and sinking of Yang Qi, transforming into a Yin syndrome. Urgently use Shenfu Tang (Ginseng and Aconite Decoction) to warm, tonify, and restore Yang; survival is possible. Wu Yang, the wife of Shi Bangzhi, suffered from a back carbuncle in midsummer. Dead flesh did not ulcerate, fever and severe pain occurred, vomiting and poor appetite were present, thirst for drinking soup, and the pulse was flooding but empty upon pressure. This indicated true cold inside and false heat outside. One should disregard the season and follow the symptoms. First, use Liujun Zi Tang with roasted Ginger and Cinnamon Twig. After four doses, appetite returned abruptly, and all symptoms receded. Then, use Shiquan Dabu Tang, still adding Ginger and Cinnamon. After more than fifty doses, dead flesh ulcerated; after another fifty doses, new flesh grew. This person had abundant Qi and Blood, so the sore rose and healed easily. Had the physician anticipated this and preemptively used Tonifying Interior methods, this complication would surely have been avoided.

Liuhe Huisheng Dan (also known as Lihe Duoming San) treats back carbuncles and ulcerating carbuncles/abscesses, possessing miraculous life-restoring effects.
Lead Carbonate (Qianfen, 1 liang), Calomel (Qingfen), Vermilion (Yinzhu), Realgar (Xionghuang), Frankincense (Ruxiang, roasted until charred), Myrrh (Moyao, also roasted, each 2.5 fen, total 1 liang 1 qian 2.5 fen).
Select six genuine high-quality ingredients, grind into extremely fine powder, and store. To treat the disease, first brew strong tea, wash the sore clean, and dry with soft cloth. Cut open one pig kidney, sprinkle 1 fen of medicine onto the kidney, then apply to the affected area. Wait until the kidney feels hot like steaming, then remove. Thereafter, extract toxic vapors, reduce pain, stabilize the wound opening, and discharge pus and filth. Do not squeeze with hands. On the second day, repeat the previous method. On the third day, apply again. If the condition is severe, apply seven to nine times; if small, once may suffice. If the kidney does not feel hot, do not treat. Also treats "opposite mouth" sores similarly.

Old Gentleman Jiao Ge of Qinyang once used this formula, applying 1 fen once and stopping. Cha Xian used this formula, increasing the dose to 0.5 qian, applied several times, showing faster results; the merit lies mainly in extracting toxins. For large wound openings, fearing one pig kidney is insufficient, add half a kidney. The method of cutting the kidney: do not cut it completely into two separate pieces; they must remain connected as one. Roughly measure the size of the wound opening, sprinkle medicine, and using pig kidney is best. The kidney is toxic and should be buried deeply.

If "mole-scarf" sores (collar-button sores) do not heal for a long time, use yellow wax with a little good yellow lead oxide (Huangdan), melt and spread on paper. Measure the sore size, cut the wax paper, heat it, sprinkle 1-2 fen of medicine on top of the wax paper, stick it on the sore, bind with cotton cloth, and allow the sore to discharge all foul fluid until healed. For chancre (under-hard sore), cut pig kidney into wide slices, sprinkle medicine, and bind around the sore. Or pierce the pig kidney with a sharp knife, insert medicine inside, and cover the sore; this is also effective. Avoid mutton, fish, goose, chicken, dog, duck, and toxin-inducing vegetables.

Lilong San treats back carbuncles and abscesses, whether broken or unbroken, functioning swiftly.
Pearl (Zhenzhu, 5 fen), Cow Dung (Niufen, fresh in December; calcined to retain nature in other months), Iron Rust (Tie Xiu, each 1 liang).
Grind into fine powder. Mix with pig brain marrow and good vinegar, apply to the wound opening. Heals in three to five applications; early-stage cases resolve spontaneously. Avoid foods that induce toxins.

Maifan Shi Gao surrounds the wound opening after pus drainage.
Maifan Stone (Maifanshi, any amount, roast in charcoal fire until red, quench in good rice vinegar, repeat quenching ten-plus times, grind to powder, sieve to remove coarse particles, take fine powder. Put in mortar, multiple people take turns grinding for five to seven days until extremely fine like flour, which is ideal). White Peony Root (Bailian, ground to fine powder). Deer Antler (Lu Jiao, do not use shed ones; must use whole antlers with brain crown bone, freshly taken, cut into 2-3 cun lengths, roast in charcoal fire until smoke ceases, grind and sieve to powder, return to mortar, grind again until extremely fine).
Use Maifan Shi fine powder (2 liang), Bailian powder (2 liang), Deer Antler ash (4 liang). It is crucial to grind extremely fine to be effective; coarse powder causes severe pain, while fine powder greatly relieves pain, closes wounds, and expels pus. (This is the difference between fine and coarse.) Combine, measure the amount of powder, use aged good rice vinegar, boil in silver or earthenware vessel until bubbling like fish eyes. Gradually add powder, stir continuously with bamboo strip, boil for one to two hours until proper consistency. Remove, store in porcelain vessel, cover with paper when cool to avoid dust. Before use, wash away pus and blood with Pig Trotter Soup, dry with old cloth. Dip goose feather in ointment, smear around the perimeter, covering all red areas, but leave the center open, about the size of a coin. Unulcerated sores will resolve internally; ulcerated sores will expel pus like rushing water. Daily wound contraction occurs. For chronic sores with muscle rot and exposed bones/tendons, apply medicine-coated old cloth pieces to the sore. As long as the inner membrane is not penetrated, safety can be achieved. Do not touch tender flesh with hands when washing, nor blow with breath. Mixing medicine avoids people with axillary odor, and pregnant women during menstruation should not see it. Also boil a large bowl of good rice vinegar, store in porcelain. When using medicine on the sore daily, if the medicine dries over time, use goose feather dipped in vinegar to wipe the medicine, preventing tightening. Initially wash and change medicine once daily; after ten days, change every two days.
Ancient texts say: Maifan stone is yellow-white, resembling wheat rice; those used as millstones are especially good.
Note: Maifan stone should not be used as a millstone; it resembles lumps of wheat rice with raw grain points. If this stone is unavailable, commonly use stones near the teeth of old flour millstones as substitutes, taking advantage of their wheat-like nature. Or find white stones in streams, sized like beans or rice grains, which are suitable. Stones vary in size, some like fists, some like goose eggs, roughly resembling a handful of gathered wheat rice.

Jiedu Baiyong Gao
Roasted Chinese Date Plum Pit (Zhuya Zaojiao, roasted), Arisaema (Nanxing, each 1 liang), Rice (Dami, 1 he, stir-fried black), Stink Powder (Chouxiao Fen, dried 4 liang, stir-fried until charred to remove fire toxicity).
Grind to powder, mix evenly, adjust with honey water to form a paste for surrounding application. For trauma contusions, adjust with wine and vinegar.

Liu's Paste for Back Carbuncles/Abscesses: When pus is exhausted and skin adheres on four sides, fearing pus toxins may attack upward, use Bidu San.
Yellow Arrowroot Rhizome (Huang Yaozi), White Arrowroot Rhizome (Bai Yaozi, each 1 liang), Adzuki Bean (Chixiaodou, 2 liang), Realgar (Xionghuang, 1 liang).
Grind to powder, adjust with water for application.

Qingsan Zi treats back carbuncles/abscesses where pus is exhausted and flesh grows flat and full. Use this to tighten the wound opening and generate flesh.
Hibiscus Leaf (Jinhua Ye, harvest at peak, shade-dry, take 4 liang, grind to powder). Green and Red Adzuki Beans (Qingchi Xiaodou), Bletilla Rhizome (Baiji, each 2 liang).
Grind to powder. Temporarily use 3 qian of Hibiscus powder, 1 qian each of Bletilla and Adzuki Bean powders, mix, adjust with fresh well-water, spread on paper. Apply to four sides, do not apply to the central wound opening.

Xionghuang Jiedu San treats all swellings and ulcerating sores with intense toxic potential. Use this medicine two to three times first, then use Pig Trotter Soup thereafter.
Realgar (Xionghuang, 1 liang), Alum (Baifan, 4 liang), Calcined Hydrotalcite (Han Shui Shi, calcined, 1 liang).
Use two to three bowls of boiling water, add 1 liang of the above medicine while hot, wash the affected area. Cover with Taiyi Gao or Shenyi Gao.

Zhutí Tang treats all carbuncles, abscesses, swellings, and toxins. Disinfects toxic vapors, removes foul flesh. Any sore with an opening requires washing with this soup.
Angelica Dahurica (Xiang Baizhi, avoid fire), Scutellaria Root (Huangqin, remove heart), Red Peony Root (Chishaoyao), Exposed Honeycomb (Lufengfang, take those with bee larvae), Angelica Sinensis (Danggui, remove radicle), Notopterygium Rhizome (Qianghuo), Raw Licorice Root (Sheng Gancao, equal parts).
Grind into coarse powder. Adjust dosage based on abscess size; add ingredients if large. First, take two pairs (one jin) of pig front trotters, boil in three sheng of clear water until soft. Divide the broth into two portions, clarify to remove oil from surface, discard bottom sediment and meat. Add 1 liang of medicine to the broth each time, boil vigorously for ten-plus boils, filter dregs. Dip old cloth in medicinal soup, gently wipe the sore while warm. Dead flesh and foul blood wash away. After thorough washing, dry with cloth. Avoid wind, forbid blowing with breath. People with bromhidrosis, menstruating women, cats, and dogs are not allowed in the patient's room. Do not touch the sore with hands when washing. Many formulas for washing abscesses exist, but this one is extremely effective. The use of exposed honeycomb is logical, as it uses poison to drive out poison.

Jixiang San washes ulcerating carbuncles and abscesses.
Angelica Dahurica (Baizhi), Agastache (Huoxiang), Costus Root (Maoxiang), Cyperus Rhizome (Xiangfuzi), Saposhnikovia Root (Fangfeng, each 3 qian), Aucklandia Root (Muxiang), Licorice Root (Gancao, each 1 qian).
Make one dose. Boil in three bowls of water for several boils, filter dregs. Pour over the affected area for washing.
[Xue] Note: This formula is a fragrant agent. Classics state: Qi and Blood move upon smelling fragrance and reverse upon smelling stench, which is the meaning here. If sore toxins are nearly exhausted, use it. If toxins are not fully exhausted, or if there is necrotic flesh, first use Xionghuang Jiedu San to resolve them, then use this formula. Must protect with plaster to prevent wind evil entry, facilitating muscle generation. Generally, once a wound opening exists, apply plaster until closure. Most avoid flesh-generating agents.

Fumigation and Washing Formula: For various carbuncles, abscesses, scrofula, collar-button sores, scalds, burns, etc.; or other types with unbearable foul odors, these are severe syndromes. Whether broken or unbroken, small or large, treat urgently. Take a handful of Honeysuckle Stem (Jinyinteng), pound finely, filter juice with non-ash wine for oral administration, and apply residue around the sore. Grind Yunmu Gao separately. Alternatively, cut open a large mouth, cover the sore top, wait for pus to emerge, then wash thoroughly and for a long time with Zhuti Tang etc., which is excellent, even for one to two hours is acceptable. Next, fumigate with the following medicine.
High-quality Agarwood Powder (Xiang), Benzoin Resin Powder (Fengxiang).
Melt these two ingredients in a pot, roll into pills the size of marbles. Take an incense burner, make a paper smoke tube around the burner mouth, similar to burning ambergris. Slowly roast, tightly direct smoke tube mouth to fumigate the sore. Do not limit pill count; stop briefly if tired. Then fumigate again: un-drained pus will emerge; drained pus will dry. Continue until flesh generates and wound closes. Then stop. Later, if redness and swelling recur, fumigate again. Generally, the aim is to dispel foul air.