Library

When sores suddenly appear between a person's two arms and develop into carbuncles (deep-seated suppurative infections), they are also classified as Yin Carbuncles. Although slightly less severe than those on the head, face, mouth, shoulders, or back, if treated improperly, they can still be fatal. Therefore, it is essential to differentiate their Yin or Yang nature for treatment. Generally speaking, Yang syndromes manifest with redness, swelling, and pain, making them easier to treat; Yin syndromes present with diffuse swelling, numbness, and itching, making them difficult to cure. For Yang syndromes, Sanxing Tang (Three Star Decoction) is appropriate, and the condition will resolve after one or two doses. However, this formula should not be used for Yin syndromes. Instead, one must greatly tonify Qi and Blood, supplemented by agents that resolve phlegm and transform toxins, to achieve efficacy. How can one claim that diseases of the hands and feet are not as critical as those of the heart and abdomen, and thus do not require tonification for deficiency?

Yin governs stillness, whereas the hands and feet are organs of extreme movement. The occurrence of a Yin Carbuncle in such a mobile area signifies a transformation from movement to stillness, which is an abnormal and dangerous deviation. One should certainly fear this! Moreover, moving towards stillness is a trend towards Yin. When Yang tends towards Yin, death is near. It is easy for Yang to revert to Yin, but difficult for Yin to revert to Yang. Who would dare to underestimate a carbuncle on the limbs? The prescribed formula is Xiaoyong Huan Yang Dan (Carbuncle-Resolving Yang-Returning Elixir):

* Bai Zhu (Atractylodis Rhizoma, 1 liang)
* Huang Qi (Astragali Radix, 1 liang)
* Ren Shen (Ginseng Radix, 3 qian)
* Tian Hua Fen (Trichosanthis Radix, 3 qian)
* Dang Gui (Angelicae Sinensis Radix, 5 qian)
* Jin Yin Hua (Lonicerae Japonicae Flos, 2 liang)
* Rou Gui (Cinnamomi Cortex, 1 qian)
* Ru Xiang (Olibanum, 1 qian)
* Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian)

Decoct in water and take orally. After one dose, the Yin syndrome transforms into Yang, changing from itching to pain; after two doses, the pain disappears completely; after three doses, the lesion vanishes entirely, without needing a fourth dose. This formula is similar to Shenxiao Tang (Miraculous Effect Decoction, known as Qisheng Tang in *Bianzheng Qiwen* and *Bianzheng Lu*), but its intent differs. Shenxiao Tang lacks Ru Xiang and Tian Hua Fen; it treats ulcerations and promotes flesh regeneration. In contrast, this formula treats lesions that have not yet ulcerated, facilitating internal resolution. The addition of Ru Xiang and Tian Hua Fen enhances the offensive power while maintaining protective strength.

Secret Formula:
Huan Yang Shen Dan treats arm carbuncles,
Bai Zhu and Huang Qi each one liang together.
Ren Shen and Tian Hua Fen three qian,
Dang Gui five qian, Jin Yin Hua two liang,
Rou Gui one qian follows suit,
Ru Xiang one qian, Gan Cao three qian,
Only suitable for Yang syndromes to take Sanxing Tang. *(Note: The original text contains a contradiction here, labeling the previous Yin-treating formula with a line suggesting it is for Yang/Sanxing Tang. Translated literally as per source.)*

This condition can also be treated with Zhuan Gong Tang (Turning Attack Decoction):

* Huang Qi (Astragali Radix, 2 liang)
* Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian)
* Bei Mu (Fritillariae Bulbus, 3 qian)
* Dang Gui (Angelicae Sinensis Radix, 1 liang)
* Bai Zhu (Atractylodis Rhizoma, 1 liang)
* Rou Gui (Cinnamomi Cortex, 1 qian)
* Yuan Zhi (Polygalae Radix, 5 qian)
* Zi Hua Di Ding (Violae Herba, 5 qian)

Decoct in water and take orally.

Secret Formula:
In Zhuan Gong Tang, two liang of Huang Qi,
Gan Cao and Bei Mu three qian, remove the heart,
Dang Gui and Bai Zhu one liang each,
Rou Gui one qian, followed by five qian of Yuan Zhi and Zi Hua Di Ding.