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Whenever using the needle cauterization method, one must first observe the depth of the carbuncle and ulcer (Yong Ju), as well as whether pus has formed. If the swelling is elevated and soft, the pathology originates in the blood vessels; if the swelling is flat and hard, it originates in the tendons and vessels; if the skin color is indistinguishable, it originates in the bone marrow. For those that are elevated and superficial, use a Pi Zhen (Bian Needle) to incise them. When an ulcer first appears as white granules, it can be resolved; if it gradually grows like a honeycomb, cauterize at the initial white granule site and select four or five spots around the periphery for cauterization. For cases resembling the thick skin of an ox's neck, or where the ulcer apex is flat and shallow, fire needle cauterization is appropriate. The needles used should be round needles, shaped like chopsticks, with a thickness similar to a weft shuttle pin, having a round and flat head, approximately six or seven cun in length, with two identical needles prepared. Dip the needles in sesame oil and heat them red over charcoal fire. Cauterize near the lower part of the wound head, inserting obliquely towards the softer area. Cauterize once; if penetration is not achieved, cauterize again until pus is discharged. Cauterizing an already ulcerated wound is called "Shu Chuang" (Mature Wound), where pus and fluid often flow downward without need for pressing. Medications should be used to keep the wound open and unhealed. Old methods used paper twists; new methods take Achyranthis Bidentatae Radix (Niu Xi), sized to match the wound, slightly scraping off the skin, and tying a thread to one end. Alternatively, use Cu Qing Ding or Sou Nong Ding medicated plasters, mixed with glutinous rice paste into soft strips according to depth, and apply external Du Du Gao (Detoxifying Ointment). If toxin has not yet formed pus, cauterization can disperse it; if ulcerated but not broken, needling can resolve it, provided the technique is applied appropriately. If needle cauterization is indicated but not used, toxins cannot drain via pus, leading to stagnation, erosion of fascia, rotting of tendons, and destruction of bones, making severe outcomes difficult to avoid. If toxins are deep but needling is shallow, pus cannot exit; if toxins are shallow but cauterization is deep, healthy flesh is damaged; improper placement may cause new lesions elsewhere. These failures do not cure the disease but increase pain. For chronic non-healing ulcers from scrofula (Luo Li) or fistulas lasting years, or open/closed states where wounds fail to close due to cold stagnation preventing contraction, cauterization on the inside, outside, and periphery of the wound is also suitable. During active inflammation of carbuncles/ulcers or after pus appearance with spreading redness and swelling, red-hot iron needles can be used to prick the periphery, causing immediate reduction of redness and swelling. Xue Xinpu stated: For established toxins ready to suppurate, employ Tuo Li (Supporting the Interior) methods to accelerate pus formation. Once pus has formed, assess its maturity and depth before needling. Needling immature pus depletes Qi and Blood, hindering further pus formation; failing to needle mature pus leads to deeper corruption and difficulty in healing. Deep wounds needled shallowly retain internal pus while bleeding externally; shallow wounds needled deeply discharge internal pus but damage healthy tissue. In cases of weak Yuan Qi (Original Qi), tonification must precede needling; once pus drains, symptoms naturally subside. Persistent pain, irritability, or vomiting after drainage indicates Stomach Qi deficiency, requiring urgent tonification. For severe back carbuncles with intense heat toxicity and dark central flesh, internally use Tuo Li to strengthen Spleen and Stomach, and externally apply Wu Jin Gao (Black Gold Ointment) to the dark areas. The red areas will gradually elevate, and dark areas recede. By the sixth or seventh day, a boundary forms between red and dark areas, appearing like knife cuts, with dark flesh gradually necrosing. Use needles and sharp scissors to slowly remove necrotic tissue, ensuring the patient feels no pain and sees no fresh blood. If cracks appear but pus does not flow freely, or if pain persists despite drainage, internal blockage remains; use needles to guide drainage through the cracks. For lesions on the upper back where rotting flesh releases pus but swelling and pain persist, internal toxic tendons may be blocking flow, necessitating guidance. If Yuan Qi is weak and purgatives were mistakenly taken, resulting in lack of pain or impending tissue death, urgently warm and tonify the Spleen and Stomach; recovery is possible, followed by pure tonics to promote healing. Reckless use of knives or needles causing bleeding leaves Qi without foundation, worsening Qi and Blood deficiency and damaging Yuan Qi, making tissue regeneration impossible. Furthermore, acupuncture and moxibustion involve taboos such as Tai Yi Shen Zhen, Ren Shen, Xue Ji, Kao Shen, and daily person spirits. Certain acupoints have contraindications for needling or moxa; violating these makes curing difficult, which is theoretically sound. However, in sores and ulcers where Qi and Blood are injured and muscles damaged, one should intercept and drain顺势 (following the trend), unlike standard acupuncture for healthy individuals, so what taboos exist? *Waike Jingyi* states: In sores and ulcers, if toxins cannot resolve and pus/stasis cannot drain, attacking internally causes collapse of Zheng Qi (Upright Qi); survival is unlikely. Critical eruptions at vital sites pose immediate danger. Abdominal abscesses, scrotal abscesses with urinary/fecal retention, chest/abdominal distension, lip carbuncles, and throat bi (obstruction) with swollen airways carry rapid fatal risks; patients must exercise caution. Leech Therapy: For early-stage carbuncles/ulcers, place a leech inside a pen tube, align the tube mouth with the wound head, allowing the leech to suck pus and blood, dispersing toxicity. For larger wounds, replace 3-4 leeches. If a leech sucks a major acupoint, it will die; this method has proven effective repeatedly. To stop bleeding, apply mud from lotus rhizomes. To locate unclear wound heads, apply well-side mud; the first dry spot indicates the head. This method applies only to excess blood and shallow toxins; deep visceral toxins cannot be resolved by external bloodletting. A case involved a large posterior neck carbuncle cured by this method. Another case involved a child with erysipelas; after sucking blood with seven or eight large leeches, the rash subsided, but the child died three days later from high fever.