The *Suwen* states: When Yang Qi gathers and invades, Cold transforms into Heat. When Heat is excessive, flesh rots and turns into pus. Generally, Fa Bei (Back Carbuncle) often arises from the ingestion of metallic minerals (Jinshi). It may also arise due to ancestral consumption of such substances. The manifestation usually occurs in relation to the Spleen, starting like a millet seed or chestnut, presenting with either pain or itching, often leading to untreatable conditions. Externally it resembles a fist (ancients said: externally dense like hemp seeds, internally deep like a melon), with dozens of pores; upon manual pressure, pus flows from all pores, followed immediately by aphonia (loss of voice). For such symptoms, one may use pure soil, mixed with water, formed into cakes of appropriate size based on severity, about 1 fen thick, and moxa cones are applied for moxibustion. Internally, Wuxiang Liaoqiao Tang (Five-Aromatic Forsythia Decoction) is administered, and crushed clam shell ash mixed with iron slurry vinegar is applied topically. Additionally, Qizhuma Moxibustion (Bamboo-Horse Moxibustion) is employed, which yields excellent results.

I observe: Regarding the aforementioned conditions, one must still refer to the treatment principles outlined in the opening chapter, likely because the nature of heat-toxin in the exterior and interior differs, and the deficiency or excess of Yuan Qi (Original Qi) varies.

The *Qianjin Fang* states: When carbuncles and sores first appear, there may be severe pain, mild pain, or eruption resembling millet grains, followed promptly by pus discharge. One should immediately restrict dietary flavors to facilitate the removal of toxins. Apply Qizhuma Moxibustion, or apply moxa directly to the affected area. For severe cases, apply a total of 100 to 200 moxa cones around the periphery and center. Apply cold-natured topical medications thereafter; the effect is very rapid.

I observe: If the aforementioned conditions result from the depletion of Yuan Qi (Original Qi) or from Qi stagnation, internal regulation and tonification are further required.

Wu Shi stated: Diseases of carbuncles and sores present with more than twenty types of manifestations, including Fa, Gu Fa (Stubborn Eruption), Shi Fa (Stone Eruption), Yan Fa (Rock Eruption), Feng Ke Fa (Honeycomb Eruption), Lian Zi Fa (Lotus Seed Eruption), Jiao Yan Fa (Pepper Eye Eruption), Lian Zhu Fa (String of Pearls Eruption), Jing Ti Fa (Whole Body Eruption); as well as Chang Yong Nei Fa (Internal Intestinal Abscess Eruption), Nao Bei Fa (Brain-Back Eruption), Mei Fa Sai He Fa (Eyebrow-Cheek-Jaw Eruption), Fei Yong (Lung Abscess), Gua Hu Fa (Gourd Eruption). Generally, treatment should be administered internally or externally according to the depth of the disease, without delay. In the initial stage, it resembles Taiyang Disease (Exterior Syndrome), with floating and tight pulses, which is its characteristic sign.

I observe: Although the names of the aforementioned conditions differ, the methods of management are detailed in their respective chapters. Fei Yong (Lung Abscess) and Wei Wan Yong (Gastric Abscess) are separately recorded in *Waike Shuyao*.

Chen Wuyue stated: In carbuncles and sores, if the pulse is rapid but the body has no fever, instead experiencing chills and shivering (Saxi Eg Han), and there is a painful area, this indicates the onset of a carbuncle. Covering the area with the hand: if it feels hot, pus is present; if not hot, pus is absent. If the pulse is not rapid, there is no fever, yet there is pain, it originates from the Yin aspect, representing a particularly malignant condition. For cases with extreme heat and rapid pulse, Loulu San (Rhinanthus Powder) and decoctions of single-boiled Rhubarb (Dahuang) are used. For cases with less heat and slow, weak pulse, Wuxiang Liaoqiao Tang (Five-Aromatic Forsythia Decoction) is administered. Treatment should strictly follow the sequence of the Four Sections and Eight Matters and the principle of Three Causes (San Yin); efficacy is assured.

I observe: The chills and shivering seen in the aforementioned conditions may belong to exterior pathogens of the sore, or to deficiency of Qi in the Spleen and Lung. If after ulceration, swelling and pain occur accompanied by chills, fever, irritability, thirst, and a rapid pulse, this indicates deficiency of True Qi and excess of pathogenic factors. Treatment should still refer to the main principles discussed in the opening chapter.