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This is caused by cold pathogenic factors invading the meridians, where cold condenses with blood, causing blood flow to become sluggish and obstructed, leading to stagnation and accumulation that forms a deep abscess (ju). The heat within the zang-fu organs fails to dissipate; when this heat enters the large intestine and small intestine, it results in the obstruction of both urination and defecation.

When an carbuncle (yong) develops on the back, it often occurs at the Shu points of the six fu organs. Disharmony of the six fu organs gives rise to carbuncles. Since all Shu points of the fu organs are located on the back, and the qi and blood meridians circulate throughout the body, if the qi of the fu organs is disharmonious and the cou li (pores and interstices) are deficient, the meridians are invaded by cold. Cold damages the blood, causing stagnation and obstruction, which condenses into a carbuncle manifesting at its corresponding Shu point. When hot pathogenic factors affect the blood, the flesh and blood undergo putrefaction and transformation into pus. The initial appearance of a carbuncle is characterized by swelling with thin, shiny skin.
It is also stated: If a red swelling suddenly appears on the back with a white head, and shaking it reveals connection to the root with pulsation extending into the chest, this is a carbuncle.
Furthermore, for a back carbuncle that is intensely hot and cannot be touched, one should internally administer Wangbuliuxing San (Polygonatum Seed Powder) and externally apply Fabei Gao (Back Carbuncle Ointment) along with Dahuang Tie (Rhubarb Plaster). If it occurs on the back, rupture is not detrimental. If pus does not form after a long period, apply Shirou Gao or powder to the mouth of a jar and place the carbuncle head inside for fumigation. Once the body's excessive heat subsides, consume Shu San (Atractylodes Powder). After five days, if the carbuncle is nearing resolution, take Painong Neisai San (Pus-Draining and Internal-Sealing Powder).

This condition arises from cold pathogenic factors invading the meridians and impairing qi and blood, causing blood flow to become sluggish and obstructed, thereby forming a back carbuncle. After the pus drains, if the whites of the eyes turn blue-black and the eyes appear small, this is the first adverse sign (ni); vomiting after taking medicine is the second adverse sign; abdominal pain with extreme thirst is the third adverse sign; inability to move the arms and neck is the fourth adverse sign; hoarseness and loss of complexion luster is the fifth adverse sign. These five adverse signs indicate conditions that are incurable. However, if there is merely fever or thirst without sudden urgency, gradual treatment may be effective.

In cases of back carbuncles, heat pathogens flow into the zang-fu organs. After the pus ruptures, qi and blood become deficient, and the zang-fu organs become dry and hot, leading to thirst and desire for drinking. If cold drinks enter the stomach and intestines, they transform into diarrhea (xiali). Deficiency of stomach qi with rebellious qi leads to vomiting. If this vomiting and rebellious qi are constrained by cold, resulting in blocked qi flow, hiccups (yue) will occur.

If the pus within the sore is not completely drained and the wound closes prematurely, although it may seem healed, it will recur. Continuous discharge of foul fluid can transform into a fistula (lou).

This is caused by cold pathogenic factors invading the meridians and impairing qi and blood, causing blood flow to become sluggish and obstructed, thereby forming a carbuncle. When a carbuncle develops on the back accompanied by diarrhea, it is due to internal heat prompting the patient to drink water; excessive consumption of cold beverages causes cold to enter the stomach and intestines, leading to persistent diarrhea. Stomach deficiency with rebellious qi transforms into vomiting. The reason for this is that the spleen and stomach are exterior-interior related and both correspond to Earth. The spleen governs the muscles of the body, and the stomach is the sea of water and grain. Spleen deficiency allows pathogens to invade the muscles; stomach deficiency leads to dysentery/diarrhea. Persistent diarrhea and rebellious qi cause vomiting; if vomiting is constrained by cold, causing blocked rebellious qi, hiccups will occur.