Those that possess detoxicating action and effect of removing swelling and can promote the evacuation of pus and regeneration of tissues for the treatment of carbuncle, cellulites, sores and furuncles are known as prescriptions for treating carbuncles.
Carbuncles, cellulites, sores and furuncles may appear on the surface of the body (briefed as external carbuncle) or occur inside the body (briefed as internal carbuncle). Therefore this group of prescriptions is classified accordingly into two categories, namely the prescriptions for external carbuncles and those for internal carbuncles.
External carbuncles with local redness, swelling, pyrexia and pain, are known as yang syndrome and those with local diffuse swelling, hardness or softness, unchanged skin color in a scattered way are known as yin syndrome. Treatment of external carbuncles comprises external and internal therapies. Discussed in this chapter are only prescriptions of the latter therapy. In the application of internal therapy, resolving method, expulsion method and tonic method should be employed respectively in the light of the three stages of carbuncle development (i. e. initial stage, pus formation and post ulceration stage). Resolving method is used at the initial stage of non-suppuration to eliminate toxins and subdue swelling.
In case of yang syndrome, prescriptions should be aimed at clearing away heat and toxins, while in case of yin syndrome, aimed at dispelling cold and removing phlegm. Expulsion method is employed at the intermediate stage of carbuncles when pus is formed but difficult to be expelled due to deficiency of vital-qi and retaining of pathogenic factors. This method can cause the internal toxins to shift to the superficies of the body, and make pus easy to fester and the wound to heal soon. Tonic method is often applied at the later stage of carbuncles manifested as deficiency of both qi and blood, thin clear watery pus and unhealed vent. The tonic drugs can replenish qi and promote the production of blood and tissue regeneration.
Prescriptions for internal carbuncles mainly consist of drugs with the function of clearing away heat and toxins,removing stasis and draining pus, which can clear away heat from the vescera, remove stasis and evacuate pus as well as resolve mass and promote wound healing.
It is the first priority to differentiate the location,nature and different stages of carbuncles in the application of these prescriptions so that corresponding prescriptions could be employed properly. It is necessary to adopt tonic method at the later stage of carbuncles with deficiency of vital-qi, but not too early or exclusively so as to prevent the unremoved toxins from lingering on.