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Yellow Emperor asked: When diseases arise, it is often due to unpredictable emotions (anger and joy), irregular diet, insufficiency of Yin Qi, excess of Yang Qi, and stagnation of Ying Qi (Nutritive Qi), leading to the development of carbuncles and sores (Yong Ju). When the Qi of Yin and Yang fails to circulate freely, heat pathogens clash and condense, transforming into pus. Can small needles treat this condition? Qibo replied: The causes that lead to carbuncles and sores, with the accumulation of pus and blood, are indeed far removed from the correct path (implying they result from gradual internal damage). The generation of carbuncles and sores, and the formation of pus and blood, stem from the accumulation of Qi and Blood. Therefore, sages regulate their health before symptoms manifest, while fools suffer only after the disease has taken shape. Yellow Emperor asked: If the disease has already taken shape and pus has formed, what should be done? Qibo said: Once pus has formed, nine out of ten patients will die; only one in ten survives. Yellow Emperor asked: Since pus and blood have already formed, can small needles be used for treatment? Qibo said: Using small needles to treat a large lesion yields little effect; using large needles to treat a large lesion yields great effect; using small needles to treat a large lesion often causes harm. Therefore, for cases where pus and blood have already formed, only bi stone (Bianshi) or sharp needles should be used. Yellow Emperor asked: If it causes harm, can it not be completely cured? Qibo said: It depends on whether the condition follows a favorable (Shun) or unfavorable (Ni) course. Yellow Emperor said: I wish to hear about favorable and unfavorable courses. Qibo said: If any of the following five conditions exist, it is an unfavorable course: First, the whites of the eyes turn blue-black and the eyes become small; Second, vomiting occurs after taking medicine; Third, abdominal pain accompanied by extreme thirst; Fourth, stiffness and inconvenience in the shoulder and neck; Fifth, hoarseness and loss of facial luster. Apart from these five, all others are considered favorable courses.

The pathogen enters the body deeply. Cold and heat pathogens clash and remain lodged internally for a long time. If cold exceeds heat, bone pain and muscle wasting occur; if heat exceeds cold, flesh rots and muscles decay into pus, damaging bones internally leading to bone erosion. If there is a prior illness causing tendons to contract and fail to extend, with Qi stagnating and unable to return, a tendon tumor (Jin Liu) develops. If Qi knots and Wei Qi (Defensive Qi) remains trapped without returning, fluids stay for a long time, combining to form intestinal carbuncle (Chang Ju); if lingering for years, it forms a soft mass upon palpation. If Qi knots and fluids accumulate, invaded by pathogenic factors, the condensation worsens daily, clustering to form Xi Liu, which feels hard upon palpation. If Qi knots deeply into bones, adhering to them, causing bone and Qi to stagnate and enlarge daily, it becomes bone carbuncle (Gu Ju). If Qi knots in flesh, with Zong Qi (Pectoral Qi) gathering there, and pathogenic factors remaining without heat turning to pus, or without heat forming flesh carbuncle (Rou Ju). These various Qi disorders manifest in no fixed location but have fixed names. Yellow Emperor asked: Regarding carbuncles and swelling, neck pain, chest fullness, and abdominal distension, what disease is this? Qibo said: This disease is called Jue Ni (Rebellious Counterflow). Moxibustion will cause aphonia, and stone therapy (bi-shi) will cause mania. One must wait until the Qi harmonizes before treating. Because Yang Qi is heavy and rises, accumulating above, moxibustion drives Yang into Yin, causing aphonia; stone therapy depletes Yang, causing mania. Treatment should only proceed when Qi is balanced to ensure recovery. Yellow Emperor asked: For neck carbuncles, some are cured by stone therapy, others by acupuncture. What is the rationale? Qibo said: These are diseases with the same name but different severities. For diffuse carbuncle Qi, needle incision and drainage are suitable; for cases with abundant Qi and blood stasis, stone therapy for draining is suitable. This is known as treating the same disease differently. Yellow Emperor asked: Where do various carbuncles, spasms, and bone pains originate? Qibo said: These are swellings caused by Cold Qi and changes in the Eight Winds. Yellow Emperor asked: How to treat them? Qibo said: These are seasonal diseases; treat them by selecting acupoints that overcome the pathogen. For sudden carbuncles, flaccid tendons, pain varying by location, unceasing sweat, and insufficiency of Bao Qi, treat the meridian acupoints. For hot axillary carbuncles, puncture five points of Foot Shaoyang; if heat persists, puncture three points of Hand Jueyin (Pericardium), three points of Hand Taiyin (Lung) collateral, and three points of Da Gu Zhi Hui. Do not delay treating carbuncles. If the location of a carbuncle is unknown, non-tender to pressure, and intermittent, puncture three points lateral to Hand Taiyin and two points of Ying Mai. To treat carbuncles, puncture above the lesion according to its size and depth. For large lesions, use multiple deep insertions, ensuring the needle is inserted straight (as stated in Su Wen: for large lesions drain much blood, for small ones insert deeply, ensuring straight insertion). For neck swelling preventing flexion/extension and cheek swelling radiating to the ear, Wanggu treats. For throat swelling impairing speech, Tianzhu treats. For lip swelling/carbuncle, Quanliao treats. For cheek swelling/pain, Tianchuang treats. For head/neck carbuncles preventing speech, Tianrong treats. For body swelling, Guanmen treats. For lower chest fullness/pain, chest swelling, and breast swelling, Rugen treats. For Mach Dao (scrofula) swelling, Yuanye, Zhangmen, and Zhigou treat. For facial swelling and eye carbuncles, bleeding Xangu stops it immediately. For Dubi swelling, one may puncture above it; however, if hard, do not attack, as attacking leads to death. For carbuncles/sore, Xiaoyin treats.

For Li Feng (Leprosy/Wind Disease), puncture above the swelling, suck the area after puncturing, press out evil blood until swelling subsides. Maintain a regular diet, avoiding other foods. Pulse wind manifestation leads to Li Feng.

Guan Ju inducing Li Feng is treated by Xiaoyin. Head swelling with extensive erosion is treated by Jianshi.

Yellow Emperor asked: I wish to hear fully about the shapes of carbuncles and sores and their taboo days. Qibo said: Carbuncle arising in the throat is called Meng Ju. If not treated urgently, it turns to pus. If pus blocks the throat without being drained, death occurs within half a day. If turned to pus, drain it, then administer Pig Fat (Shi Gao), consumed cold for three days for cure. Carbuncle arising in the neck is called Yao Ju. It appears large, red, and black. If not treated urgently, heat travels down to Yuanye, damages Ren Mai anteriorly, and steams Liver and Lung internally, causing death within ten days. Excessive Yang Qi expansion consuming brain marrow and neck is called Nao Shuo. With unhappy demeanor, piercing pain in brain/neck, and vexation, it is incurable death. Carbuncle arising in shoulder and armpit is called Ci Ju. Red and black, requires urgent treatment. Causes sweating to feet; if not harmful to Five Zang, but if carbuncle persists 4-5 days with adverse signs, death ensues. Carbuncle in armpit, red and hard, is called Mi Ju. Treat with bi-stone (fine and long), sparse puncture, apply Pig Fat, cure in six days, do not bandage. Hard carbuncle without ulceration is Ma Dao Jia Ying, treat urgently. Carbuncle in chest is called Jing Ju. Like a soybean, appearing in 3-4 days. If not treated early, descends to abdomen; untreated, death in seven days. Carbuncle in Ying (chest) is called Gan Ju. Green color, like melon seed, suffering from alternating cold and heat. Treat urgently to remove cold/heat; if not, death in ten years, pus discharges post-mortem. Carbuncle in hypochondrium is called Bai Ci. This is a female disease, treat with moxibustion. Large abscess with raw meat like red bean inside. Use Ling Qiao Gen and Chi Song Zi Gen, each one sheng, boiled in one dou six sheng water until reduced to three sheng. Drink strongly, sit on pot wrapped in thick clothes to induce sweating to feet for cure. Carbuncle in thigh/shin is called Gu Ting Ju. Color change minimal, pus presses against bone. Urgent treatment required; otherwise death in forty days. Carbuncle in sacrum is called Rui Ju. Red, hard, large. Urgent treatment required; otherwise death in thirty days. Carbuncle in inner thigh is called Chi Chi. Untreated, death in sixty days; if bilateral, death in ten days. Carbuncle in knee is called Ci Ju. Large abscess, color unchanged, aversion to cold. If on Yang aspect, death in hundred days; if on Yin aspect, death in forty days. Carbuncle in shin is called Tu Nie. Like red bean, reaching bone. Urgent treatment required; otherwise fatal. Carbuncle in medial malleolus is called Zou Huan. Abscess-like, color unchanged. Repeated puncture of acupoints to stop cold/heat; not fatal. Carbuncle in toe... (text missing) urgent removal required. Black color cannot dissipate; if neglected, death in hundred days. Carbuncle in toe is called Tuo Ju. Red/black indicates fatal incurable case; non-red/black is curable. If treatment fails, amputation is urgent; otherwise death.

Yellow Emperor asked: What is Yong (Carbuncle)? Qibo said: Ying Qi accumulates in meridians, blood congeals and stagnates. Wei Qi returns to this area but cannot pass, causing obstruction and heat. Unchecked heat rots flesh into pus. However, it does not sink to bone marrow, marrow does not dry, Five Zang are not damaged, hence named Yong. Yellow Emperor asked: What is Ju (Sore)? Qibo said: Pure excessive heat sinks into skin, sinews, marrow, bone, and flesh, connecting internally to Five Zang, exhausting Qi and Blood. When bone, sinew, and healthy flesh beneath the lesion are destroyed, it is named Ju. Ju at five locations leads to death: Forehead (Fei in Ling Shu), Back, Five Zang Shu points, Neck, and [Missing/Implied Location]. How does the body correspond to the Nine Regions? Qibo said: Left hand (or foot) corresponds to Start of Spring (Wuyin/Jichou days); Left chest (or side) corresponds to Spring Equinox (Yimao day); Left foot corresponds to Start of Summer (Wuchen/Jisi days); Chest, throat, head correspond to Summer Solstice (Bingwu day); Right hand corresponds to Start of Autumn (Wushen/Jiwei days); Right chest (or side) corresponds to Autumn Equinox (Xinyou day); Right foot corresponds to Start of Winter (Wuxu/Jihai days); Waist, sacrum, lower orifices correspond to Winter Solstice (Renzi day); Six Fu organs and Five Zang below diaphragm correspond to Central Region (Great Taboo days, Taiyi days, and all Wujie days). Observe the Eight Regular Seasons' positions. If treating swelling on left/right/upper/lower body, do not perform incision/drainage on the corresponding day. This is called Heavenly Taboo Day.

Wuzi (11pm-1am): Ye Ban; Wuchou (1am-3am): Ji Ming; Wuyin (3am-5am): Ping Dan; Wumao (5am-7am): Ri Chu; Wuchen (7am-9am): Shi Shi; Wusi (9am-11am): Ri Zhong (approx); Wuwu (11am-1pm): Ri Zhong; Wushi (1pm-3pm): Ri Die; Wushen (3pm-5pm): Bu Shi; Wuyou (5pm-7pm): Ri Ru; Wuxu (7pm-9pm): Huang Hun; Wuhai (9pm-11pm): Ren Ding. Diseases occurring during these hours generally do not survive.