典藏书目

Carbuncles, deep abscesses (Ju), sores, and boils are all caused by disharmony of Qi and Blood, irregular emotions (excessive joy or anger), unregulated diet, and improper adaptation to cold and heat. These factors cause the Qi of the Five Zang and Six Fu organs to become stagnant internally, leading to a disorder of Yin and Yang and stagnation of Qi and Blood, resulting in the onset of disease. There are also cases where long-term consumption of hot and dry cinnabar-mineral drugs causes heat-toxin to accumulate deeply, triggering carbuncles and deep abscesses.

Such diseases as carbuncles and deep abscesses often occur in wealthy individuals who consume rich and fatty foods. This is because they habitually eat greasy and roasted foods, sit idle without labor, and have unregulated desires, leading to internal attack by deficient pathogens and heat-toxin that scorch Qi and Blood. "Yong" (Carbuncle) means obstruction; it presents as large and elevated, belongs to Yang, is generated by the Qi of the Six Fu organs, and its pulse is floating and rapid. "Ju" (Deep Abscess) means blockage; it presents as flat and developing inwardly, belongs to Yin, is generated by the Qi of the Five Zang organs, and its pulse is deep and rapid. "Chuang" (Sore) is the general term for these conditions. "Jie" (Boil) refers to a small sore with a head. The Classics state: "All pain, itching, and sores belong to Heart Fire." Since the Heart governs Blood and circulates Qi, if Qi and Blood stagnate and carry the residual heat of Heart Fire, diseases such as carbuncles and deep abscesses arise. However, since the depth of pathogenic invasion varies, the severity and size of the lesions differ. When accumulated heat from the Six Fu organs surges outward between muscles, the onset is sudden and violent, with swollen, shiny, soft skin and extensive spread; this is a Carbuncle. When wind-toxin and accumulated heat from the Five Zang organs attack muscle and bone, the onset is fierce and malignant, initially presenting as a single head like millet, white and scorched, with pain upon touch that resonates with the Heart; this is a Deep Abscess. When heat erupts within the skin, causing swelling but with a root no larger than two or three cun, this is a Boil.

A Carbuncle arises from the Six Fu organs, resembling a prairie fire that ulcerates outward into the muscles. A Deep Abscess originates in the Five Zang organs, being deep, sluggish, and difficult to treat, resembling the friction stone used to make fire inside a room, consuming marrow from within. Carbuncles are easier to treat but require careful nursing and take longer to heal; Deep Abscesses are harder to treat but may recover more easily. Among various sores, back carbuncles and Ding sores (hard boils) are the most urgent. Next in urgency are brain carbuncles, intestinal carbuncles, and throat carbuncles. Conditions such as scrofula (Luo Li), hanging abscesses, hemorrhoids with fistulas, and other sores can be treated with less urgency. Scabies, tinea, wet sores, and wind-related malnutrition sores, although classified as sores, vary in severity and urgency.

In treating carbuncles and deep abscesses, one must ascertain whether the condition is Excess or Deficiency, Cold or Heat, severe or mild, and administer medicine accordingly without losing the correct sequence. For anyone over forty years old, any sore or boil appearing on the crown, temples, chin, back, spine, waist, flanks, or above tendons and bones, or in areas out of direct sight, must not be neglected. If treated casually as a common ailment, many die as the condition progresses from minor to major. Immediate treatment is advisable to save the patient. This is akin to fighting a fire: it is easy to extinguish when just starting, but impossible once it becomes an uncontrollable blaze. The principle is the same. When a sore has not yet ruptured and toxin attacks the Zang-Fu organs, absolutely no hot-natured medicines should be used. If it has already ruptured and the Zang-Fu organs are depleted with loss of appetite, absolutely no cold-natured medicines should be used. This is the crucial key to mastering the sequence of treatment.

Sores present with Five Good Signs and Seven Bad Signs, which must be distinguished:
Five Good Signs:
1. Calmness in movement and rest, with preserved taste for food.
2. Regular bowel movements and urination.
3. Pus discharges, swelling subsides, color is fresh and odorless.
4. Bright spirit and clear voice.
5. Harmonious body constitution.

Seven Bad Signs:
1. Restlessness, frequent coughing, severe thirst, uncontrolled diarrhea, and dysuria-like urination.
2. Massive discharge of pus and blood, extreme pain, and foul odor.
3. Rough breathing, shortness of breath, mental confusion, and lethargy.
4. Blackening before rupture, deep sinking with greenish face, dark lips, and fecal impurity.
5. Stiffness in shoulders and neck, heaviness in limbs.
6. Inability to eat, vomiting after taking medicine, and loss of taste.
7. Hoarse voice, ruined complexion, blue-black lips and nose, edema of face/eyes/extremities.
Additionally, belching with chest fullness, coughing with cold body, spontaneous sweating at random times, staring eyes with deafness, mental confusion with palpitations, and erratic speech are all Bad Signs. If three of the Five Good Signs appear, the prognosis is good; if four of the Seven Bad Signs appear, the condition is critical. If all Five Good Signs are present, there is peace and safety; if all Seven Bad Signs are present, death is inevitable. The above outlines the general principles; specific symptoms and treatments are discussed separately later.