Li stated: In the treatment of carbuncles (ju, deep-seated suppurative infections), the efficacy of moxibustion surpasses that of herbal medicine, as it facilitates the external discharge of pathogenic toxins. This is analogous to a thief entering one's home; one should open the doors and windows to drive him out. Otherwise, the thief will enter the room and cause harm. For sores or ulcers in their initial stage of one or two days, thick slices (approximately 3 fen) of large single-clove garlic must be placed on the apex of the carbuncle, and moxibustion should be performed through the garlic. The garlic slice should be replaced every three moxa cones (zhuang). If the area is painful, moxibustion should continue until pain ceases; if painless, until pain is induced. Once the sore ulcerates, apply Shenyi Gao (Miraculous Ointment). This approach prevents the sore from enlarging, avoids tissue necrosis, and promotes easy healing, achieving three benefits with one action. The subtlety of this method is rarely known by people. However, if a carbuncle appears on the head or neck, this method should not be used (as recorded in the Stele of Wufu Jiguan).

I believe that for conditions involving sores and ulcers, internal pathology inevitably manifests externally. Lesions on the exterior should be guided and extracted outward, while those on the interior should be purged downward. If pathogenic toxins are stagnant and blood stasis is coagulated, mild cases can be resolved with herbs, but severe cases may not respond fully to medication alone; thus, the value of moxibustion is significant. Generally, moxibustion extracts stagnant toxins before ulceration and tonifies Yang Qi after ulceration. When treating sores on the limbs in patients whose Qi and Blood are not deficient, applying the aforementioned moxibustion method typically results in cure. However, for patients with weak Middle Qi, administering detoxifying herbs without moxibustion further damages the Middle Qi, leading invariably to deterioration. Patients with lesions on the head and neck are also suitable for moxibustion, but smaller moxa cones and fewer cones per session are advisable.

Li stated: For patients suffering from back carbuncles characterized by diffuse swelling without a distinct head, apply wet paper to the swollen area. The spot where the paper dries first indicates the head of the sore. Ten cloves of garlic, half he of Dan Chi (Fermented Soybean), and approximately one qian of Ruxiang (Frankincense) should be ground into a paste, applied to the sore, and covered with moxa for burning. Whether the patient feels pain or not, the procedure should follow the limits described above.

My commentary: The aforementioned conditions, such as Gujigu (Bone-attacking Carbuncle) or various toxic swellings initially arising in the buttocks or legs, often resolve internally when moxibustion is applied after locating the sore head. If the toxin is intense, administering Huoming Yin (Life-Saving Decoction) yields particularly rapid results. In cases of Qi and Blood deficiency, the primary treatment must focus on tonification and expulsion of pus. If a back carbuncle has extensively ulcerated and one wishes to verify whether the infection has penetrated the inner membrane, the method of inducing sneezing using Zaojiao (Gleditsia Sinensis Fruit) should not be used. Instead, cover the affected area with paper and instruct the patient to breathe with focused intent. If the paper does not move, penetration has not occurred. Conversely, inducing sneezing agitates the inner membrane and may inadvertently cause penetration; therefore, extreme caution is required.