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After a person develops a carbuncle at the back of the neck (Duikou sore), small sores suddenly appear, initially causing itching followed by pain, and eventually leading to ulceration. People consider this an extremely dangerous abscess. However, an abscess occurring exactly on the midline is relatively mild, whereas one occurring off-center is more severe. This is because the area above the neck is governed by the Kidney Meridian and the Du Mai (Governing Vessel, one of the eight extraordinary vessels running along the midline of the back). This region belongs to Yin, so the abscesses formed there are mostly Yin abscesses rather than Yang ulcers. A Yang syndrome must protrude about one cun above the skin, with redness, swelling, brightness, and severe pain causing groaning. In contrast, a Yin syndrome is different: the color is necessarily dark, the pain is not severe, the body feels heavy, there is fatigue and a desire to lie down, moans are weak, the sore does not protrude, or it presents as numerous tiny openings where people do not know where to find the head of the pus. Nevertheless, both Yin and Yang poisons can be resolved internally; why wait until the skin breaks and swelling suppurates before treating? Regarding the method of internal resolution, at the initial stage, there is no need to distinguish between Yin and Yang; Sanxing Tang (Three Star Decoction) can be used for both. Only after rupture and suppuration, if one fails to distinguish Yin from Yang and administers medicine indiscriminately, disaster will occur instantly. If it is a Yang syndrome with ulceration, Sanxing Tang should still be used; if it is a Yin syndrome with ulceration, Shenxiao Tang (Miraculous Efficacy Decoction) [Note: This formula is renamed Qisheng Tang in *Bianzheng Qiwen* and *Bianzheng Lu*] must be used.

Sanxing Tang (Three Star Decoction):
Honeysuckle Flower (Jinyinhua, 2 liang)
Dandelion (Pugongying, 1 liang)
Licorice Root (Gancao, 3 qian)
Decoct in water and take orally. For those not yet ruptured, taking this can resolve the condition. For those already ruptured, after three doses, the pus will be exhausted and new flesh will grow.

Secret Formula:
Sanxing Tang treats Yang abscesses, two liang of Honeysuckle and one liang of Dandelion,
Take three qian of Licorice for three doses; naturally, pus exhausts and healthy flesh grows.

Shenxiao Tang (Miraculous Efficacy Decoction):
Angelica Sinensis Root (Danggui, 1 liang)
Astragalus Root (Huangqi, 1 liang)
Ginseng Root (Renshen, 1 liang)
Honeysuckle Flower (Jinyinhua, 2 liang)
White Peony Root (Baishao, 1 liang)
Cinnamon Twig (Rougui, 1 qian)
Schizonepeta Spike (Jingjie, 3 qian)
Decoct in water and take orally. After one dose, bleeding stops; after two doses, flesh grows; after three doses, the wound shrinks; after four doses, the skin closes. Taking two more doses leads to recovery. This formula treats carbuncles and toxins anywhere in the body. For any low-lying lesion that fails to suppurate and cannot close, urgent administration of this medicine yields miraculous results. It is not only effective for Yin poison of the Duikou sore but excels in achieving success. Indeed, this is because Yang syndromes can be treated with cooling purgatives, while Yin syndromes require warming tonification.

Secret Formula:
In Shenxiao Tang, there are Angelica and Ginseng, one liang of White Peony and two liang of Honeysuckle,
One qian of Cinnamon and three qian of Schizonepeta decocted well; six doses for Yin abscess bring back spring.

Using Sanhua Tang (Three Flowers Decoction) is also effective:
Sichuan Lovage Rhizome (Chuanxiong, 1 liang)
Viola Yedoensis (Zihuadiding, 1 liang)
Angelica Sinensis Root (Danggui, 2 liang)
Chrysanthemum Flower (Juhua, 5 qian)
Trichosanthes Root (Tianhuafen, 3 qian)
Decoct in water and take orally. Recovery occurs in two doses.

Secret Formula:
For carbuncles failing to suppurate, use Sanhua Tang: one liang each of Lovage and Viola, two liang of Angelica,
Five qian of Chrysanthemum and three qian of Trichosanthes; just two doses are wonderfully unique.

Duikou sores differ in being central or lateral: Those arising centrally are generated by the Du Mai (Governing Vessel); those lateral are governed by the Taiyang Bladder Meridian. The Du Mai runs downward and penetrates the spine upward. When toxic qi encounters it, it conflicts and rises high, preventing evil toxins from flowing downward, thus manifesting externally, making it easier to treat. Those originating from the Bladder Meridian are difficult to treat because the Bladder Meridian originates at the vertex, penetrates both sides of the spine, and flows downward. It intersects with the carbuncle toxin and flows downward, so the sores tend to be flat and difficult to rise, lacking redness, swelling, and ulceration. They easily flow into both shoulders causing swelling. If there is no pus formation after fifteen days, it inevitably transforms from Yang to Yin (indicating a complex or deteriorating prognosis), hence they are mostly difficult to treat.