Boils, Furuncles

General

Clinical Manifestations	They usually occur on the neck, face, breast, back and buttocks It starts out moist and red Develops quickly into a painful swelling Central necrosis follows Discharge of necrotic tissue with yellow, bloody purulent exudate When there are many recurrent lesions there may be a slight fever Nodular Furuncles: Found on the head, neck, face or arm Initially: They are very hard, the size of a cherry and have a burning sensation Later: They become pustulant and yellow with a bloody, purulent exudate Severe Cases: High fever Aversion to Cold Nausea Vomiting Constipation Yellow urine T: Red C: Yellow and greasy P: Rapid Multiple Furuncles: Usually reddish and painful with a white tip They are purulent and recurrent Purulent Folliculitis: Usually found in the hair follicles or the lower cheek The area around the follicle will be inflamed and have a purulent infection Mastoid-type Furuncles: Usually found in the mastoid region They are hare, inflamed and purulent When healing, the skin color will become dark purple and hard They leave scars, are recurrent and difficult to treat Infantile Multiple Abscesses: Usually found on the head At first they are the size of a kidney bean and are very hard with a purulent exudate They usually leave scars, are connected, recurrent and difficult to treat
Treatment Principle
Herb Formulas	External and vestibular auditory canals and vestibulus nasi: Long Dan Xie Gan Tang Ru Yi Jin Huang San Jia Jian Topical: Topical #1 Yu Huang Gao San Huang Gao For early-stage: Stir-fry 3g dried Raw Ginger Sheng Jiang until brown. Grind into a powder and mix with vinegar to form into a paste. Apply to the lesion, leaving the head clear.
Points	HT-9, LI-11 DU-14, UB-15, UB-16, UB-17

Tai Yang Shang Han

Clinical Manifestations	Chills and fever Anhidrosis Stiff and rigid neck, shoulders and upper back Intolerance of Wind Dislike of Cold Inflammation Furuncles Diarrhea Muscle spasms Mucosal swelling Nasal congestion Sensitivity to dust Headache Wind-Cold Bi (few joints affected, inflammation intense but short lived, changes over days or weeks) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Release Wind-Cold in the exterior and muscle layer Generate Fluids Relieve muscle-ache of the neck
Herb Formulas	Ge Gen Tang
Points

Tai Yang Shang Han With Qi And Yang Deficiency

Clinical Manifestations	Slight fever Strong chills Anhidrosis Headache Cold extremities Fatigue with a constant desire to lie down Drowsiness Pale face Lassitude Low voice Weak voice T: Pale C: White P: Floating, big and forceless or Deep and forceless
Treatment Principle	Tonify Yang Augment Qi Release the Exterior Induce sweating
Herb Formulas	Zai Zao San
Points

Tai Yang - Yang Ming

Clinical Manifestations	Fever and chills with fever increasing and chills decreasing Headache Anhidrosis Stiffness and pain of the extremities Orbital pain Eye pain Shoulder and neck tension Dry nasal passages Irritability Insomnia Constipation Abdominal fullness Fever Tenesmus Vomiting Thirst Epistaxis T: Normal C: Thin and yellow P: Floating and slightly flooding
Treatment Principle	Dispel Wind Release the muscle layer Clear Interior Heat
Herb Formulas	Ge Gen Jian Ban Xian Tang
Points

Tai Yang - Yang Ming - Shao Yin Heat

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points

Wind-Heat

Clinical Manifestations	Inflammation of throat and/or tongue Fever and chills with more fever than chills Perspiration Cough with sticky yellow sputum Aversion to Wind and Heat Yellow nasal discharge Thirst with desire for cold drinks Red bumps around mouth and lips (herpes simplex) Headache Nasal obstruction Sore, swollen throat Dyspnea Chest pain Dry mouth Rapid breathing Maybe constipation Maybe scanty urine T: Red tip C: Thin and yellow P: Floating and rapid
Treatment Principle	Disperse Wind Clear Heat Clear the Lungs
Herb Formulas	Niu Bang Jie Ji Tang Sheng Ma Ge Gen Tang Zhi Tou Chuang Yi Fang Lian Qiao Bai Du Pian For Wind-Heat and toxins: Pu Ji Xiao Du Yin For Wind-Heat and toxins in the upper body: Qing Shang Fang Feng Tang Yin Qiao Bai Du San With underlying Spleen and Stomach Heat: Liu Shen Wan
Points	Bleed UB-40, needle Dingchuan, DU-14, DU-16, DU-23, DU-24, GB-20, LI-4, LI-11, LU-5, LU-7, LU-10, REN-22, SJ-5, ST-8, ST-40, Taiyang, UB-12, UB-13 For a mild case with cough, fever is not high, slight thirst: Bleed UB-40, needle DU-14, GB-20, LI-4, LI-11, LU-7, REN-22, SJ-5, UB-12, UB-13 For fear of Cold at the beginning stage: Bitong, DU-16, GB-20, KI-7, LI-4, LI-20, LU-7, SJ-5, UB-12, UB-13, Yintang

Wei Stage: Summerheat And Dampness

Clinical Manifestations	Boils occur around the face, head, neck and hips At the onset, they may be hard nodes Localized redness and swelling Pain and Heat Later the may become soft with a whitish-yellowish exudate A suppurating in-sized lesion may appear at the top The adjacent lymph nodes may be enlarged Fever and chills, fever more pronounced or Tidal fever Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Gastric disturbances: Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp Resolve swelling
Herb Formulas	Qing Shu Tang Wu Wei Xiao Du Yin modified Furuncles #1 Topical: 1. Smash fresh Hb. Portulacae Ma Chi Xian and apply to the lesion. 2. Dilute Si Huang San and apply topically. 3. Qian Chui Gao 4. Tai Yi Gao
Points	Bleed UB-40, needle DU-14, DU-23, DU-24, GB-20, LI-4, LI-11, REN-9, SJ-5, SP-6, SP-9, ST-8, ST-28, Taiyang, UB-12, UB-20

Xue Stage: Excess Heat In The Pericardium Generates Wind

Clinical Manifestations	High fever Irritability Restlessness Delirious speech Impaired consciousness Dizziness Muscle twitches Spasms Convulsions Thirst Parched lips Delirium Dysuria Dark or red urine Severe constipation Vertigo Childhood convulsions Coma Dry mouth Irrationality Cold limbs Hysteria T: Scarlet red C: Dry and yellow P: Forceful, wiry and rapid
Treatment Principle	Subdue Wind Clear Heat Nourish Yin Open the Orifices Stop convulsions
Herb Formulas	Zi Xue Dan
Points	To clear Heat and Toxins: Bleed the Jing Well points, DU-14, LI-11, ST-44 To promote Blood circulation: SP-10, UB-17 To treat hemafecia: SP-1, ST-25, ST-37 To restore consciousness: DU-26, K-1 To nourish Yin: KI-3, SP-6 To calm the Shen: HT-7

Wind-Dampness

Clinical Manifestations	Suppuration Delicate constitution Polyps Furuncles
Treatment Principle	Disperse Wind Resolve Dampness
Herb Formulas	Shi Wei Bai Du San
Points

Wind-Cold-Dampness

Clinical Manifestations	Fever Chills Anhidrosis Pain and stiffness of the head and neck Stuffy nose Blood shot eyes Sores that are red, swollen and painful Generalized body aches and pain Headache Swollen eyes Thirst or no thirst T: Normal C: Thin white P: Floating or Floating and rapid
Treatment Principle	Induce sweat Release the Exterior Dispel Wind Alleviate pain Treat the skin
Herb Formulas	Jing Fang Bai Du San
Points

Large Intestine Heat

Clinical Manifestations	Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Liang Ge San
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

Spleen Qi Deficiency With Dampness Accumulation

Clinical Manifestations	Intermittent discharge of pus The sores either do not suppurate or only leak pus slowly and fail to heal Viscous, thin fluid Mental and physical fatigue Lassitude Lack of luster Poor appetite Loose stools Fever T: Pale C:Thin white P:Thready and weak or Rapid and weak
Treatment Principle	Strengthen the Spleen Tonify Qi and Blood Eliminate Dampness Expel pus Draw out toxicity Promote the generation of flesh
Herb Formulas	Tuo Li Xiao Du Yin
Points

Liver Qi Stagnation With Damp-Heat And Phlegm

Clinical Manifestations	Ulcerations, abscesses and swellings that remain hard after discharge of pus Feeling of a lump in the throat The lump is soft and becomes larger or smaller according to the emotional situation The lump is small or medium sized, relatively soft and slippery The edges are indistinct Oppressive feeling in the chest and hypochondrium Difficulty swallowing Loose stools Irregular menstruation Pre-menstrual tension Suppurative sores Restlessness Insomnia Thirst Feeling of Heat Irritability Frequent sighing Bitter taste in the mouth Red eyes Red face Tremor of the hands T: Pale or dusky or Red with red tip and edges C: White or Thin and greasy or Dry and yellow P: Wiry
Treatment Principle	Disperse Qi Stagnation Dispel Heat and Dampness Resolve Phlegm Dissipate nodules Reduce swelling Drain pus
Herb Formulas	San Zhong Kui Jian Tang
Points

Liver And Stomach Fire

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain Liver Fire Attacks the Stomach: Hematemesis Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red or Red tip and edges C: Thick, yellow and dry P: Slippery, big, Excess and rapid or Wiry, Excess and rapid
Treatment Principle	Purge Fire Detoxify Draw out pus
Herb Formulas	Niu Huang Jie Du Pian
Points	GB-12, GB-34, GB-37, LI-4, LI-11, LIV-2, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-18, UB-19, UB-21

Damp-Heat In The Liver And Gall Bladder

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

Qi And Blood Stagnation

Clinical Manifestations	Pain that is fixed, stabbing and /or severe or Pains that move around Distention Depression Irritability Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Huo Luo Xiao Ling Dan
Points	GB-40, GB-41, LIV-3, LIV-14, PC-6, SJ-6, SP-6, SP-10, ST-36, UB-17, UB-18, UB-40

Blood Heat

Clinical Manifestations	Furuncles Facial flush Premenstrual women often an increase in lesions Red, itchy eyes Suppuration Earache Swelling, inflammation and infection of the ears and nose Abdominal rigidity Dry stools Constipation Yellow urine Dark brown discoloration of the skin Perspiration and an oiling feeling on the palms and soles Abdominal tension Maybe otitis Rhinitis T: Deep red, dry or purple red or Red tip C: Thin or None P:  Rapid or thready and rapid or thready and feeble or Tight or Thready, slippery and rapid
Treatment Principle	Dispel Wind Disperse Stagnation Clear Heat Remove Toxins
Herb Formulas	Jing Jie Lian Qiao Tang Huang Lian Jie Du Tang Liang Xue Wu Hua Tang Yin Hua Jie Du Tang Wu Hua Tang
Points	DU-14, LI-4, ST-36 Legs: + bleed UB-40 LI-11, LIV-1, LU-11, SP-10, UB-17, UB-40, if no Fire, use moxa Tonify LIV-13, LIV-14, reduce GB-39, PC-3, UB-62, UB-65 GB-21, KI-2, LI-11 Buttocks: + LIV-9 Superficially around the furuncle for 15 minutes 1-2 times daily Ahshi, DU-10, DU-12 With a high fever: + DU-14, LI-4 With mental cloudiness: + HT-7, PC-8 Reduce LI-4, bleed DU-12, UB-40 Bleed DU-10, DU-12, LI-4, UB-40 With a high fever: + DU-14, LI-11 With disorientation or delirium: + DU-26, PC-4, Shixuan, SI-8 LI-4, LI-11, ST-36, UB-40 Back: GB-21, GB-41, HT-3, HT-5, LIV-2, LIV-3, ST-36, UB-40 Face and mouth: moxa LI-4 Hands: moxa LI-11 Above the scapula:GB-41, ST-36, UB-40, moxa HT-3, HT-5, LIV-2, LIV-3 Both flanks: Emergency (the poison may go to the Heart) - 3-5 cones of moxa on the tip of the lesion, bleed above and below Put garlic around the base and moxa the tip until it bursts Ear: Adrenal, Back of head, Shenmen, Subcortex

Blood Deficiency With External Wind

Clinical Manifestations	Chronic eczema with thick, dry, dark flaky skin Anemia Itching which is worse at night Swelling Abscesses Boils Furuncles Ulceration T: Pale C: Thin and white P: Thready, floating and rapid or Thin and wiry
Treatment Principle	Nourish the Blood Moisten Dryness Clear Heat Dispel Wind Relieve itching
Herb Formulas	Dang Gui Yin Zi
Points

Toxic Heat

Clinical Manifestations	Local inflammation with pus Deep-rooted, hard and painful boils Erythema Swelling Heat Carbuncles Furuncles Fever and chills Pain The lesions appear on the head, face and extremities The lesions are grain-like with a hard base The lesions are yellowish-purplish in color A tingling sensation Blisters Fistulas T: Red C: Yellow and greasy P: Rapid
Treatment Principle	Clear Heat Purge Fire Relieve toxicity Cool the Blood Reduce swelling Reduce external carbuncles and furuncles
Herb Formulas	Wu Wei Xiao Du Yin Huang Lian Jie Du Tang Xi Huang Wan San Huang Xie Xin Tang Pai Nong San Shi Wei Bai Du San Ye Ju Bai Du Tang Qin Lian Jie Du Tang Xi Jiao Di Huang Tang Zhen Ren Huo Ming Yin With Qi, Blood and Phlegm Stagnation: Xian Fang Huo Ming Yin With a Cold, deficient constitution: Qian Jin Nei Tuo San With Phlegm Retention: Yu Shu Dan With underlying Qi and Blood Deficiency: Tou Nong San Topical: Jin Huang San San Huang Xi Ji Hong Bu Gao Yu Lu San Ru Yi Jin Huang San Jia Jian Yu Huang Gao Chinese Patent Medicines: Herbal Tortoise Jelly Lian Qiao Bai Du Pian Niu Huang Shang Qing Wan Niu Huang Xiao Yao Wan
Points	DU-10, DU-12, LI-4, PC-4, UB-40 DU-14, GB-20, LI-10 alternate with DU-14, UB-11, UB-40 DU-10 For furuncles on the head and face: + LI-4, LI-11 For furuncles on the chest and Stomach : + SP-6, ST-36 For furuncles on the back: + UB-40