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[Note]: This section from the beginning of the chapter to "the signs are so, the Yellow Emperor said 'Excellent'" is found in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 81, "Yong Ju" (Carbuncles and Ulcers). Also, from the beginning of the chapter to "injury to the Zang organs leads to death," it is found in *Jia Yi Jing* (The Classic of A-Bian Points), Volume 11, Part 9 Upper. Also, from "The Yellow Emperor said, I wish to hear fully about the forms of Yong Ju" to "the signs are so, the Yellow Emperor said 'Excellent'," it is found in *Jia Yi Jing*, Volume 11, Part 9 Lower. Also, from "The Yellow Emperor asked Qi Bo, saying: There is a disease of swelling and pain" to "can be made whole, the Yellow Emperor said 'Excellent'," it is found in *Su Wen* (Basic Questions), Volume 13, Chapter 40, "Fu Zhong Lun" (Discourse on Abdominal Diseases). Also, from "The Yellow Emperor asked, all swellings, tendon cramping, bone pain" to the end, it is found in *Su Wen*, Volume 5, Chapter 17, "Mai Yao Jing Wei Lun" (Essential Discourse on the Pulse as the Essential Subtlety), and *Jia Yi Jing* is the same.

The Yellow Emperor asked Qi Bo, saying: I have heard that the Stomach and Intestines receive grain, the Upper Jiao (Upper Burner) emits Qi, which warms the Fen Rou (muscle spaces), nourishes the joints, and unblocks the Cou Li (skin texture and pores). [The Qi emitted by the Upper Jiao is Wei Qi (Defensive Qi); Wei Qi belongs to Yang, so it can warm the Fen Rou. The Qi moistens the joints; the joints and brain marrow all grow, so it is called nourishment. It prevents carbuncles in the Cou Li, so it is called unblocking.] The Qi emitted by the Middle Jiao (Middle Burner) is like dew, flowing upward into the Xi Gu (valleys between muscles), and seeping into the Sun Mai (finest collaterals) and Sun Luo (collateral vessels). The Jin Ye (Body Fluids) are harmonized, change, and become red blood. When the blood is harmonized, the Sun Mai fill first; when full, they pour into the Luo Mai (collateral vessels) until they are full, then pour into the Jing Mai (Main Meridians). [The emitted Qi refers to Ying Qi (Nutritive Qi). The meridians and collateral vessels have internal and external aspects; internally they connect to the Zang-Fu organs, externally they distribute among the sinews, bones, and muscles. Grain enters the Stomach, its essence and fluids seep into various Sun Luo, enter the Da Luo (Large Collaterals), the Da Luo enter the Jing Mai, and flow outward. The external Sun Luo receive the Qi of Cold, Warmth, and the Four Seasons, enter the Luo Mai, travel through the Jing Mai, and inject inward. This clarifies how water and grain fluids enter the Sun Luo and reach the Jing Mai. Internal and external meridians travel within the Zang-Fu organs; only when the Qi of the Zang-Fu organs is harmonized can life be sustained.] Yin and Yang Qi have expanded, and move with respiration. Movement has its order, circulation has its principles, conforming to the Heavenly Dao, never ceasing. [Expanded means dilation. Yin refers to Ying Qi. Yang refers to Wei Qi. The movement of Shen (Spirit) causes the movement of inhalation and exhalation; the movement of respiration causes the movement of Ying and Wei Qi. The movement of Ying and Wei Qi must have meridional order; the circulation of Ying and Wei has principles. Man and Heaven operate together; the operation of Heaven follows extraordinary ways, thus it does not stop.] Palpate and regulate deficiency and excess. Remove excess from deficiency; using the reducing method leads to insufficiency. Rapid reduction reduces Qi abundance; retention leads to disorder of sequence. Remove deficiency from excess; using the reinforcing method leads to surplus. Once Blood and Qi are regulated, Form and Spirit are maintained. I already know the balance and imbalance of Blood and Qi, but I do not yet know the origin of Carbuncles and Ulcers, the timing of success and failure, the periods of life and death, whether near or far. How can we measure this? May I ask you to explain? [Palpate implies focused attention. Using focused mind to regulate deficiency and excess. Reducing methods follow deficiency, specifically removing excessive excess; if reduced too much, it leads to insufficiency. If Qi arrives and is rapidly reduced, Qi becomes abundant. If Qi arrives and is retained without reduction, the needle and Qi do not coordinate. If following excess only removes deficiency, reinforcing too much leads to surplus. Therefore, the method of palpating and regulating lies in mental comprehension and cannot overemphasize deficiency or excess. Thus, those skilled in regulation reinforce and reduce Blood and Qi, allowing Form and Spirit to mutually preserve. 'Maintain' means to preserve. Through such regulation, knowing the balance of Blood and Qi is stated as known; however, one has not yet understood the theory of the three types of Carbuncles and Ulcers, hence asking for what is heard.]

Qi Bo replied: The flow of Qi and Blood in the meridians never stops, matching the degrees of Heaven and the measures of Earth. [This states that Heaven has degrees and Earth has measures.] Thus, if celestial bodies lose their degrees, eclipses occur; if earthly meridians lose their measures, waterways overflow, grass withers, grains fail to grow, paths are blocked, people cannot travel, villages and cities separate and dwell apart. [ , pronounced Cai Gu Qie, is a name of a grass, also meaning withering due to seasonal changes. This states that loss of Heavenly degrees and Earthly measures causes damage.] Human Qi and Blood are the same; let me explain the cause. Human blood vessels, Ying, and Wei flow together without rest, corresponding above to the stars and below to the measures of the earth. [This states that human Qi and Blood combine with Heaven and Earth.] When Cold Qi lodges in the meridians, Blood becomes stagnant and does not flow. When Blood does not flow, Wei Qi returns to it and cannot return elsewhere, resulting in swelling (Yong). Cold Qi transforms into Heat. When Heat is excessive, flesh rots; when flesh rots, pus forms. If pus is not drained, tendons rot; when tendons rot, bones are injured; when bones are injured, marrow diminishes. If it does not occur at bone openings and cannot drain, it boils and dries up the void, causing sinews, bones, and muscles to fail to nourish each other. Meridians break and leak, fuming upon the Five Zang organs. Injury to the Zang organs leads to death.

The Yellow Emperor said: I wish to hear fully about the forms and taboo days/names of Carbuncles and Ulcers. [There are three questions: 1. Forms of Carbuncles and Ulcers; 2. Taboo days for life and death; 3. Names of Carbuncles and Ulcers.] Qi Bo said: A Carbuncle appearing in the throat is called Meng Ju (Fierce Carbuncle). If Meng Ju is not treated, it turns to pus. If pus is not drained, it blocks the throat, leading to death within half a day. If it has turned to pus, after draining, hold pig fat in the mouth, avoid cold food, and it will heal in three days. [Below answers the shape, name, and location of twenty-one types of Carbuncles and Ulcers: eighteen have names, shapes, and locations; three have only locations. Among the twenty-one, seven have no life/death taboo days; the remaining fourteen do. All Carbuncles and Ulcers arise because Cold Qi lodges in the meridians, causing Blood stagnation and blockage. Wei Qi gathers there. Extreme Cold transforms into Heat, forming Carbuncles/Ulcers. Rotting flesh is Yong (Carbuncle); rotting tendons and damaging bones is Ju (Ulcer). Mild cases can be cured; severe cases injure Zang organs and cause death. Names like Meng Ju are established by Sages based on origins and forms. As conditions change, forms are countless. Modern doctors do not understand the original intent of names and create arbitrary ones, which cannot be trusted. 'Yi' means throat. Where Cold Qi lodges in the pulse, heat arises forming Carbuncles/Ulcers, with no fixed location.]

A Carbuncle appearing on the neck is called Tian Ju (Premature Death Carbuncle). Its swelling is large and dark red/black. If not treated urgently, Heat Qi descends into the fluids, injuring the Ren Mai (Conception Vessel) forward, and internally steaming the Liver and Lungs. Steaming the Liver and Lungs leads to death in ten-plus days. [The front of the neck is called neck.]

Excessive Yang Qi expands, consuming brain marrow and lingering in the nape, called Nao Shuo (Brain Fusing). The complexion is unhappy, the nape hurts as if pierced by a needle, and irritability indicates death that cannot be treated. [The white part behind the head is called the nape.]

A Carbuncle appearing on the shoulder and axilla is called Ci Yong. Its appearance is red and black. Treat urgently; this causes sweating down to the feet but does not harm the Five Zang organs. If the Carbuncle appears for four to five days and the rebellious Qi dissipates... [The muscle on the upper arm before the shoulder is called ...].

A hard, red swelling under the armpit is called Mi Ju (Rice Carbuncle). Treat with Bian stones (stone needles), which should be fine and long. Puncture frequently, apply pig fat ointment, and it heals in six days. Do not bandage it. [Bian, pronounced Fu Lian Fan, uses stone to treat disease. Fine and long because the injury is deep.]

If a swelling is hard and does not suppurate, it is called Ma Dao Xia Ying (Horse Knife and Adjacent Goiter). Treat urgently. [Ma Dao also refers to a Carbuncle that does not suppurate. The front of the neck is called Ying.]

A Carbuncle appearing in the chest is called Jing Ju (Well Ulcer). Its shape is like a soybean. It starts in three to four days. If not treated early, it descends into the abdomen. If untreated, death occurs in seven days. [Jing Ju starting in three to four days, if not treated and descending into the abdomen, with persistent chills and fever, death occurs in ten days.]

A Carbuncle appearing on the hypochondrium is called Bai Ci (Failed Blemish). Bai Ci is a disease of women. Moxibustion treats it. If it becomes a large abscess with pus, treatment reveals raw flesh inside, the size of a red adzuki bean. Decoct one sheng each of Qiao Cao Gen (Radix Consolidae) and Chi Xiao Dou (Red Bean), boil in one dou six sheng of water until reduced to three sheng. Drink strongly while sitting on a hot pot wrapped in thick clothes, inducing sweat down to the feet, and it heals. [Bai also means change. Considering this disease arises in women, steaming on a pot induces sweat and healing. Some versions have Qiao and Song each one sheng.]

A Carbuncle appearing on the inner thigh is called Tuo Ju (Falling Off Ulcer). Its appearance shows little change, but the abscess presses against the bone. If not treated urgently, death occurs in thirty days. [Inner thigh is Gu; outer thigh is Bi; the bone between knee and thigh is called Gu ...]

A Carbuncle appearing on the buttocks is called Dui Ju. Its appearance is red, hard, and large. Treat urgently. If untreated, death occurs in thirty days. [Kao, pronounced Shui.]

A Carbuncle appearing on the lower inner thigh is called Chi Shi. If not treated urgently, death occurs in six days. If in both inner thighs, untreated death occurs in sixty days. [Lower thigh of the Yin.]

A Carbuncle appearing on the knee is called Ci Ju. Its shape is a large abscess, color unchanged, with chills/fever and hardness. Do not puncture with stone; stone puncture causes death. Wait until it softens before puncturing with stone; this ensures survival. [Reason for not puncturing: normally all are bled/punctured, but here only stone is mentioned, possibly using cold stone moxibustion. Because it is hard due to cold accumulation, wait for softness before puncturing.]

Any Carbuncle or Ulcer appearing at a joint and corresponding to it cannot be treated. [When a Carbuncle arises at a joint, pus enters the joint space and damages fluid, so it cannot be healed.]

Those appearing in Yang areas die in one hundred days; those appearing in Yin areas die in forty days. [Male genitalia are Yang; female genitalia are Yin.]

A Carbuncle appearing on the calf is called Tu Nie (Rabbit Bite). Its redness extends to the bone. Treat urgently. If untreated, it harms the person. [Ting refers to the tibia below the knee.]

A Carbuncle appearing on the ankle is called Zou Huan. Its color is unchanged. Frequent puncturing of its Shu points and stopping chills/fever ensures survival. [Color unchanged means skin color is unchanged. Puncturing Shu points means using cold stone to moxa the relevant Shu point.]

A Carbuncle appearing on the top and bottom of the foot is called Si Yin. Its shape is a large abscess, color unchanged. Untreated, death occurs in one hundred days. [Top and bottom of foot refers to dorsum and plantar surface.]

A Carbuncle appearing on the side of the foot is called Li Ju. Its shape is not large, initially like a small finger protruding. Treat urgently. Remove the black parts. If it does not subside, it increases. Untreated, death occurs in one hundred days. [Side refers to medial and lateral sides of the foot.]

A Carbuncle appearing on the toe is called Tuo Ju. Its color is red and black; death is incurable. If not red and black, death is avoidable. If treatment fails, amputation is urgent for survival; otherwise, death ensues. [Not amputating leads to death.]

The Yellow Emperor said: Master, regarding Carbuncles and Ulcers, how do we distinguish them? Qi Bo said: When Ying and Wei Qi stagnate in the meridians, Blood stagnates and does not flow. When Blood does not flow, Wei Qi follows it. Following it but failing to circulate, it obstructs and cannot move, causing persistent high heat. Excessive Heat rots flesh; rotted flesh becomes pus. However, it cannot sink into the bone marrow, so marrow does not scorch, and the Five Zang organs are not injured. Hence, it is named Yong (Carbuncle).

The Yellow Emperor said: What is Ju (Ulcer)? Qi Bo said: When Heat Qi is dense and excessive, sinking into the skin, it withers sinews, marrow, and bones, connects internally to the Five Zang organs, exhausts Blood and Qi. At the site of the Yong, sinews, bones, and healthy flesh are completely destroyed. Hence, it is named Ju (Ulcer).

For Ju, the skin is pale and hard, resembling the hide of an ox's neck. For Yong, the skin is thin and glossy. These are their signs. The Yellow Emperor said: Excellent.

The Yellow Emperor asked Qi Bo, saying: There is a disease of swelling, neck pain, chest fullness, and abdominal distension. What disease is this? How did it arise? [Due to swelling, these three diseases exist, but the cause is unknown, hence the question.] Qi Bo said: It is named Jue Ni (Rebellious Counterflow). [Due to heat aggregation in swelling, Qi rebels upward. Upper excess causes neck pain; lower deficiency causes chest fullness and abdominal distension.]

Question: How to treat? Answer: Moxibustion causes aphonia; stone puncture causes mania. One must wait for the Qi to merge before treating. Question: Why? Answer: Yang Qi is heavy above, excessive in the upper body. Moxibustion drives Yang Qi into Yin, causing aphonia; stone puncture depletes Yang Qi, leading to mania due to deficiency. Treating after Qi merges allows for complete recovery. The Yellow Emperor said: Excellent.

The Yellow Emperor asked: Various swellings, tendon cramping, and bone pain—how do they arise? [Due to swelling, these two diseases exist, hence asking for origin.] Qi Bo said: These are swellings caused by Cold Qi and changes from the Eight Winds. Question: How to treat? Answer: These are diseases of the Four Seasons. Treat by overcoming them via their Shu points. [Sinews and bones are Yin; adding Cold Qi causes cold swelling. These are caused by deficient winds of the Four Seasons and Eight Directions. Invoking the controlling element cures them.]