典藏书目

The manifestations of carbuncles and sores appearing on the exterior have been fully explained in the preceding text. As for internal carbuncles (Nei Yong) and internal sores (Nei Ju), their pathologies are concealed and invisible; since they cannot be directly observed by the eyes, they are considered extremely difficult to diagnose. However, the five zang organs and six fu organs all have Shu (Transport) and Mu (Alarm) acupoints. Although the lesions may be firmly knotted within the interior, they inevitably manifest externally. By observing the external sites, one can ascertain the internal source. Determining the appropriate herbs and administering them corresponds to the pathology, making treatment as effective as removing a thorn.

[Note: The original text contains severe fragmentation and garbled characters such as "urine," "somnolence," "heaviness," "swelling," etc., which do not form coherent sentences. The translation below reflects the fragmented nature of the source.]

If there is a dull pain at Qimen (LR14, located in the 2nd intercostal space), it indicates Liver Sore (Gan Ju); if the flesh slightly protrudes, it indicates Liver Carbuncle (Gan Yong). If there is a dull pain at Zhongwan (CV12, also known as Taicang, located 1 cun below Shangwan), it indicates Stomach Sore (Wei Ju); if the flesh slightly protrudes, it indicates Stomach Carbuncle (Wei Yong). If there is a dull pain at Tianshu (ST25, located 2 cun lateral to the umbilicus in the depression), it indicates Large Intestine Sore (Dachang Ju); if the flesh slightly protrudes, it indicates Large Intestine Carbuncle (Dachang Yong). If there is a dull pain at Dantian (also known as Shimen, Jing Shi, or Mingmen, CV4, located 2 cun below the umbilicus), it indicates Sanjiao Sore (Sanjiao Ju); if the flesh slightly protrudes, it indicates Sanjiao Carbuncle (Sanjiao Yong). If there is a dull pain at Guanyuan (CV4, located 3 cun below the umbilicus), it indicates Small Intestine Sore (Xiaochang Ju); if the flesh slightly protrudes, it indicates Small Intestine Carbuncle (Xiaochang Yong).

By verifying these signs and considering the patient's preferences, one can determine the depth of the carbuncle or sore and identify which organ system it originates from. One should also inquire about previous consumption of mineral drugs (Rushi) and assess the deficiency or excess of Qi, then treat accordingly after comprehensive analysis.

When a carbuncle, sore, or boil first appears, it is initially the size of a millet seed. It feels slightly painful or itchy. If touched or broken, it may spread rapidly. Upon initial detection, one must immediately administer Rhinoceros Horn (Xijiao) [and other heat-clearing agents] to prevent stagnation of blood and necrosis of tissue.

For back carbuncles (Fa Bei) that have just emerged, initially the size of a millet seed, whether itchy or painful, one should wash and spray the area with hot decoctions and apply medicinal plasters. If it does not recede after one or two days, moxibustion of 100 to 200 moxa cones is required. The moxa cone should be the size of a mung bean. After moxibustion, the pain may temporarily intensify, stabilizing after one night as the fire qi descends. Using several Black Soybean Cakes (Chibingzi) and replacing them with fresh ones is optimal. If the wound causes severe pain, heavy moxibustion is necessary, with more moxa cones being better. However, for sores (Ju), moxibustion is generally contraindicated. Initially, a sore presents with a white, dry, and shriveled head, and the pathological qi is deep-seated. If the practitioner fails to distinguish it carefully and applies moxibustion indiscriminately, causing multiple burns, or if moxibustion is applied after pus has formed in a carbuncle or boil, careful nursing is essential. Do not take it lightly. If there is no pain after three initial moxa cones, it is an excellent sign, indicating necrotic flesh and deep pus below. However, after many cones, the pain will double due to intensified heat, causing the pus to attack internally while the fire burns externally, thereby increasing toxicity. This can be verified by reasoning through natural principles. The following lists acupoints unsuitable for moxibustion and those strictly forbidden:

Touwei (GB8, 1 cun lateral to Ben Shen at the hairline), Chengguang (BL9, 2 cun posterior to Wuchu), Shenting (GV24, straight above the nose at the hairline), Chengqi (ST1, below the eye), Qiangjian (GV18, 1.5 cun posterior to Qiangjian on the occipital bone), Fengfu (GV16, 1 cun above the posterior hairline beside the large tendon in the depression), Yanmen (GV19, in the depression at the posterior hairline of the vertex), Jizhong (GV12, between the spinous processes of the 11th thoracic vertebra), Sanyangluo (TE7, 1 cun above the pulse groove on the kidney region), Xiaguan (ST7, anterior to the ear where the artery beats), Erzhong (SI17), Ermen (TE21, both forbidden for moxibustion), Renying (ST9, on the carotid pulse beside the larynx, connecting to the five zang organs), Shimen (CV5, 2 cun below the umbilicus, forbidden for women), Futu (ST32, bilateral, 6 cun above the knee cap), Diwuhui (BL64, posterior to the second toe). According to the *Mingtang Jing*, all the above acupoints are forbidden for moxibustion. Even if boils appear near these points, moxibustion must not be applied. Instead, use various methods and wash with decoctions.

For chronic non-healing wounds using moxibustion: Place a piece of Realgar (Sulfur/Huang) over the wound according to its size. Take a small amount of sulfur, ignite it on fire, pick up the flame with the tip of a silver needle, and light the sulfur placed on the wound. Repeat this ignition two or three times to draw out pus until the wound dries and heals.