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This condition arises from cold pathogenic factors invading the meridians and collaterals, obstructing the flow of Qi and blood. The blood becomes stagnant and unsmooth, eventually condensing to form a carbuncle (Yong). When a carbuncle manifests on the back, it is due to excessive heat in the five Zang organs combined with deficiency and dryness, leading to thirst. If frozen beverages are ingested into the stomach and intestines, this may transform into diarrhea.

The Lung governs Qi and its external manifestation is on the skin and hair. If Lung Qi is deficient, the interstices (Cou Li) are susceptible to cold invasion. Cold pathogens lodging in the meridians cause blood stasis and stagnation; when heat pathogens take advantage of this, they condense to form a carbuncle. If Lung Qi is already deficient and cold pathogens re-invade the Lung, causing the Lung to contract cold, cough will ensue. Therefore, a carbuncle may occur accompanied by coughing.

This results from cold pathogens lodging in the meridians, causing Qi and blood to become obstructed and stagnant, which generates heat. This heat accumulates and condenses to form a carbuncle. If Qi becomes congested within the Zang-Fu organs and heat enters the stomach and intestines, it causes abnormalities in bowel movements (text incomplete: "thus causing stool not...").

This occurs because cold pathogens lodge in the meridians, obstructing Qi and blood, making blood stagnant and unsmooth, thereby condensing into a carbuncle on the back. After the pus ruptures, if external wind pathogens contend with the wound, malignant flesh (necrotic tissue) may develop. If this blocks the sore, toxic vapors will invade internally; medicinal applications must be used to eliminate this malignant flesh.

Carbuncles on the back often arise at the Shu points of various Zang organs. Dysfunction of the five Zang organs leads to the development of a carbuncle (Ju). The Shu points of the five Zang organs are all located on the back, where Qi, blood, and meridians circulate throughout the body. If Zang-Fu dysfunction occurs and the interstices are deficient, meridians are invaded by cold. Cold damages the blood, causing stagnation and obstruction, thus condensing into a Ju that manifests at the Zang Shu points. Heat applied to the blood causes flesh and blood to rot and decay into pus. The initial appearance of a Ju features skin that is hard like the hide of an ox's neck. A Ju is more severe than a Carbuncle, and those who develop it often die. If needling is performed for a Ju starting at Feishu (BL13) or Ganshu (BL18), and purging methods are not employed, death will occur in twenty days. Needling can be performed on the eighth day. If the area is red and the flesh resembles peppercorns, it is an incurable fatal condition. At ages nineteen, twenty-five, thirty-three, forty-nine, fifty-seven, sixty, seventy-three, eighty-one, and ninety-seven, the Spirit resides in the back; bleeding should be avoided, as bleeding leads to death.

Bee-like Ju on the back starts at Xinshu (BL15) or the shoulder/arm region. If purging is not performed within twenty days, death will ensue. Needling can be performed on the eighth day. If the color is dark red-black and green appears in the pus, it is an incurable fatal condition. At ages six, eighteen, twenty-four, forty, fifty-six, sixty-seven, seventy-two, and ninety-eight, the Spirit resides in the shoulder/arm region; bleeding should be avoided, as bleeding leads to death.