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In recent times, several individuals suffered from back carbuncle (back abscess). After taking the previously mentioned herbal medicines, before the condition stabilized, they experienced alternating chills and fever all over their bodies. Sometimes chills preceded fever, sometimes fever preceded chills. These episodes occurred consecutively for several days or every other day. They would invariably vomit phlegm first, followed by chills and fever, and then cease after profuse sweating. Contemporary physicians mostly desired to use herbs such as Chaihu (Bupleuri Radix) and Muli (Ostreae Concha) to stop sweating. Others considered it malaria and wished to administer Hengshan Yinzi (Gambir Decoction) to purge. I strongly argued against this: following a back carbuncle, one cannot solely attribute the symptoms to heat pathogen. Some cases arise from Qi deficiency, while others result from anger causing Qi and Blood stagnation. The reason for the chills and fever is that cold pathogen was contracted first, leading to dysfunction of the Spleen Qi and excessive Phlegm, resulting in these symptoms. If Chaihu is used, it will inevitably drain the Liver; if the Mother organ is already deficient, draining its Child organ further weakens it. Muli has astringent properties; since Qi and Blood are already failing to nourish and circulate properly, administering astringent herbs and Hengshan Yinzi induces vomiting of phlegm and severely damages the Spleen and Stomach. Such medication usage can be deemed erroneous. I instructed them only to take my family's inherited Buhuanjin Zhengqi San (Non-exchangeable Upright Qi Powder) to dispel cold pathogen and rectify Spleen Qi, allowing Phlegm-Fluids to dissipate naturally and preventing chills and fever; concurrently, they took Painong Neibu San (Drain Pus and Interior-Nourishing Powder), substituting wine with Muxiang Tang (Costus Root Decoction) for administration to avoid inducing vomiting through alcohol consumption. After three days of taking these medicines, the chills and fever subsided spontaneously, vomiting ceased, and sweating stopped.

1. When a carbuncle or ulcer first breaks and forms an opening, it should immediately be washed with Zhuti Tang (Pig Trotter Decoction). Subsequently, wash daily for a few days; after five days, wash every other day; when nearing recovery, wash once every three days.

Zhuti Tang (Pig Trotter Decoction): Treats carbuncle and ulcer swelling, disinfects toxic vapors, and removes necrotic flesh. For any wound, this medicine should be used for irrigation and washing.
Xiangbaizhi (Angelicae Dahuricae Radix) (not roasted); Gancao (Licorice Root) (used raw); Duhuo (Angelicae Pubescentis Radix) (use old Qianghuo); Huangqin (Scutellariae Radix) (remove core); Chishaoyao (Red Peony Root) (remove peel); Danggui (Angelicae Sinensis Radix) (remove rhizome, wash clean of sand); Lufengfang (Apiis Cera cum Favus) (use those containing bee larvae; above ingredients in equal parts, made into coarse powder).
First, boil two pig front trotters (one jin) in three sheng of plain water until soft. Clarify the broth twice, removing oil scum from the top and dregs from the bottom. For each dose, add one liang of the coarse herb powder to the broth, then decoct over moderate to strong fire for more than ten boils. Filter out the dregs. Dip an old cloth in the warm medicinal liquid and gently wipe the wound. Necrotic tissue and foul blood will come off with washing. After thorough cleaning, dry with an old cloth. Continue to avoid wind and prevent people from blowing on the wound. Individuals with body odor, women during menstruation, cats, and dogs must not enter the ward. Do not touch the wound with hands while washing. Among the many methods for treating ulcers passed down (three or forty), this single formula is extremely effective. The inclusion of Lufengfang is particularly logical, based on the principle of using poison to treat poison.

1. To treat early-stage back carbuncle where the base is wide like a bowl and lacks a head, locate the acupoint for moxibustion thus: Whenever one feels swelling, hardness, and pain on the back, apply wet paper to the swollen area. The spot where the paper dries first indicates the head. Crush ten heads of garlic, add half he of Danchi (Light Fermented Soybean), and a piece of Ruxiang (Frankincense) the size of a longan fruit. Grind finely. According to the size of the carbuncle head, make a ring from bamboo strips about two fen wide. Place the ring on the carbuncle head, fill it with the ground mixture, and apply moxa on top. For painful areas, continue until itching is felt; for itchy areas, continue until pain is felt. Generally, aim for one hundred moxa cones.

1. Once the carbuncle has broken and pus and blood have drained significantly, apply Shenyi Gao (Divine Extraordinary Plaster) either five or seven days later. If the base is small, apply after five days; if wide, wait until seven or ten days before applying.

1. As the ulcer disease nears resolution, one should frequently take Jiaoliao Shiquan Tang (Modified Perfect Ten Decoction) to tonify Qi and Blood, facilitating muscle regeneration.

Jiaoliao Shiquan Tang (Modified Perfect Ten Decoction): Tonifies Qi and Blood after carbuncles/ulcers, promotes appetite. It should be taken when the ulcer disease is nearly resolved (70-80% healed), alternating daily with Painong Neibu San.
Huangqi (Astragali Radix) (select pieces without forked attachments or wormholes, cut into two-cun segments, flatten, moisten with cold salt water. Store in a ceramic vessel covered, steam three times in a steamer, dry-roast, then cut); Shudihuang (Prepared Rehmanniae Radix) (select plump, moist pieces, wash, dry-roast, moisten with good quality wine in a ceramic vessel covered, steam and sun-dry in a rice steamer, repeat seven times; cut, dry-roast). These two ingredients each use one liang, cleaned. Danggui (Angelicae Sinensis Radix) (remove rhizome, wash clean, take the segment from head to center, cut, dry-roast; reserve the segment from center to tail for other uses); Chuanxiong (Ligusticum Chuanxiong Rhizome) (cut, lightly dry-roast); Renshen (Ginseng Radix) (remove crown, cut, dry-roast); Baifuling (Poria) (remove black skin, cut, dry-roast); Gancao (Licorice Root) (honey-fried); Baishaoyao (White Peony Root) (purchase with skin, as skinless ones are fake. Peel, cut, dry-roast); Rougui (Cinnamon Bark) (remove rough bark, cut, do not roast); Tiantai Wuyao (Lithospermi Fructus) (if genuine is unavailable, buy large pieces from Longxing Prefecture. Cut, dry-roast); Baizhu (Atractylodis Macrocephalae Rhizome) (soak in rice-washing water for half a day, cut into pieces the size of a little finger, dry-roast, then stir-fry with wheat bran until yellow, avoiding burning. Remove bran, cut Baizhu); Chenpi (Citri Reticulatae Pericarpium) (do not use citrus peel. Soak in water, scrape off white pith, dry-roast, cut). Zhenbai Wuweizi (Schisandrae Chinensis Fructus) (seeds shaped like pig kidneys, flesh slightly black, heavier weight indicates genuine. Select, remove stems, stir-fry. Seeds resembling citrus seeds are local Schisandra, unsuitable. Above eleven ingredients each use half liang).
Weigh each ingredient cleanly, cut, mix into a powder evenly. For each dose of one liang, add one bowl of water, five slices of fresh ginger, and two northern dates. Decoct together until reduced to 0.8 bowls. Filter out dregs, take the clear liquid, divided into two doses. Reserve the dregs, dry them in the sun, grind into fine powder for future regular use: one cup of water, three slices of ginger, one date, decoct to 0.8 cups and take.

1. Patients who previously suffered from back carbuncle often developed thirst first, followed by the carbuncle; alternatively, the carbuncle healed first, followed by thirst. Many could not be saved due to this sequence. If a patient has thirst, they should exclusively take Jiajian Bawei Wan (Modified Eight-Ingredient Pill) to resolve the thirst and prevent the carbuncle from recurring. Even if one suddenly contracts back carbuncle, after it heals, regardless of whether thirst symptoms exist, one should regularly take Jiajian Bawei Wan. This not only prevents future thirst but also greatly tonifies Qi and Blood, promotes muscle growth, and strengthens spirit. This is a verified result from repeated trials.

Jiajian Bawei Wan (Modified Eight-Ingredient Pill): Indicates that tonic medicines should be taken after carbuncles/ulcers. Using harsh tonics may cause fever. Moreover, after carbuncles/ulcers heal, they often transform into incurable thirst conditions; therefore, this medicine should be taken prophylactically. Long-term use prevents thirst entirely, harmonizing and strengthening Qi and Blood. Individuals who have not yet developed carbuncles, or who have pre-existing thirst, should also take this medicine. Once thirst resolves, the carbuncle will not occur.
Shudihuang (Prepared Rehmanniae Radix) (select high-quality pieces according to method. Processed, dry-roasted, cut, two liang); Zhenshanyao (Dioscoreae Rhizoma) (cut finely, lightly stir-fried); Shanzhuyu (Corni Fructus) (remove pits, take flesh, dry-roast; these two ingredients each use one liang); Rougui (Cinnamon Bark) (select pungent, thin pieces. Remove rough bark, cut, do not roast. Use one liang, separately grind, take half liang of fine powder to mix with other herbs, discard remaining coarse dregs); Zexie (Alismatis Rhizoma) (wash, cut into chunks, moisten with non-grain wine, store in covered ceramic vessel, steam five times in steamer, cut, dry-roast); Mudanpi (Moutan Cortex) (remove heart and stems, cut, stir-fry); Baifuling (Poria) (remove black skin, cut, dry-roast; above three ingredients each use eight qian). Beiwuwei Zi (Schisandrae Chinensis Fructus) (select, remove stems, slow-fire stir-fry thoroughly without burning, one and a half liang, separately grind and sieve, mix with other herbs. This ingredient must be genuine; details are noted in Shiquan Tang).
Grind and sieve into fine powder. Prepare refined honey when cool, mix to form pills the size of paulownia seeds. Take thirty pills per dose, administered with non-grain wine or salt water on an empty stomach.