典藏书目

*Waike Jingyao* (Essentials of External Medicine) states: When heat pathogen manifests between the skin, presenting as edema with a small root and a diameter not exceeding two or three *cun*, it is termed **Jie** (Furuncle). This results from accumulated heat in the six fu organs steaming outward into the muscles. If the onset is sudden, with severe swelling, shiny and soft skin, and extensive spread, it is termed **Yong** (Carbuncle/Abscess). This occurs when wind-toxin and accumulated heat of the five zang organs attack the flesh and bones; the wind-toxin is fierce and violent. Initially resembling a bud, it subsequently becomes scorched and dry, and if tender to touch, it is termed **Ju** (Deep-seated Abscess/Necrosis).

Regarding the Five Auspicious Signs and Seven Inauspicious Signs:
1. Calm breathing and appetite are the first auspicious sign.
2. Regular bowel movements and urination are the second auspicious sign.
3. Clear pus, subsiding swelling, and lack of foul odor are the third auspicious sign.
4. Bright spirit and clear voice are the fourth auspicious sign.
5. Harmonious body constitution is the fifth auspicious sign.

Conversely:
1. Restlessness, frequent coughing, abdominal pain, extreme thirst, or uncontrolled diarrhea/dysentery, and dysuria constitute the first inauspicious sign.
2. Profuse discharge of pus and blood, worsening swelling, foul-smelling敗 pus, and unbearable pain constitute the second inauspicious sign.
3. Rapid and coarse breathing, shortness of breath, mental confusion, and lethargy constitute the third inauspicious sign.
4. Abnormal gaze, tight black pupils, tight white sclera, greenish-red discoloration of the sclera, and upward deviation of the pupil constitute the fourth inauspicious sign.
5. Stiffness in the shoulders and back, and heaviness in the four limbs constitute the fifth inauspicious sign.
6. Inability to eat, vomiting after taking medicine, and loss of taste constitute the sixth inauspicious sign.
7. Hoarse voice, deteriorated complexion, cyanotic and red nose, and edema of the face, eyes, and limbs constitute the seventh inauspicious sign.

If three of the five auspicious signs appear, recovery is expected; if four of the seven inauspicious signs appear, the condition is critical. However, the text notes that when sources are identical but seven inauspicious signs manifest, the skin is tense, indicating a specific pathological state; when five auspicious signs manifest, the skin is lax and weak, indicating another state. Understanding these distinctions is beyond the capacity of ordinary physicians.

*Lishi Nan Zhi Lun* (Discussion on the Difficulties of This Matter) identifies locations where carbuncles and necrosis are fatal: 1. Fubao area (anterior thigh); 2. Calf region; 3. Back; 4. Shu points of the five zang organs; 5. Upper neck; 6. Brain; 7. Mustache area; 8. [Text missing]; 9. Chin/Jaw area.

According to *Suwen* and *Lingshu*, the causes of sores, keys to life and death, and acupuncture treatments are detailed. One should study the original texts carefully. Generally, the aforementioned fatal locations are intersections of meridians and collaterals, internally connected to the zang-fu organs. If patients report symptoms early and physicians diagnose and treat according to principles, death can be avoided. Conversely, delayed treatment or incorrect diagnosis may lead to death even if the lesion arises in non-fatal locations.

Yuan Rong stated: Pathogens sinking into meridians linger, obstructing the muscle layers. When Ying Qi does not flow smoothly and rebels within the muscle texture, abscesses form. Ying Qi rebellion leads to blood stasis; blood stasis generates heat, which condenses into pus. *Zhengli Lun* states: Wherever heat passes, abscesses form. Can Ying Qi rebellion occur without heat? The answer is: Changes due to rich foods, delicacies, or overuse of mineral drugs can cause deficient Qi and Blood. Although Ying and Wei Qi are abundant, they are suppressed and cannot circulate, leading to obstruction, putrefaction, and abscess formation. Such cases require purgation to drain excess heat. However, in individuals with bland diets, depleted spirit, weak Qi and Blood, and thin muscles, Ying and Wei Qi are short, sluggish, and stagnant. Cold constrains the interstices, causing closure and abscess formation. These cases require tonification to support deficiency. Pulse floating or deep helps distinguish these. For excess, use purgatives like *Qiaoliao* (Forsythiae Fructus) and *Dahuang* (Rhei Radix et Rhizoma); for deficiency, use tonics like Neituo San (Internal Support Powder).

This analysis distinguishes sores caused by heat, cold, or Qi-Blood stagnation, prescribing different attacking or tonifying methods. It should be read alongside preceding and following chapters for comprehensive understanding. Unfortunately, laypeople often misunderstand this, confusing types of sores and indiscriminately administering *Wuxiang Liaoqiao Tang* (Five-Scent Forsythia Decoction), leading to variable results and errors. This stems from failing to assess constitutional excess/deficiency, depth of toxin, and whether to release the exterior or purge the interior. Here, the interpretations of methods from Danxi’s *Waike Jingyao Fahui* are appended below for the benefit of students.