汤火之症，若发热作渴，小便赤涩者，内热也，用四物加山栀、连翘、甘草。若肉未死而作痛者，热毒也，用四君
加芎、归、山栀、连翘。若肉已死而不溃者，气血虚也，用四君加当归、黄 ；外敷当归膏，或柏叶末蜡油调搽，至白
色其肉自生。若因烟熏将死者，以生萝卜汁灌之即苏。若饮食后被汤火所伤，发热腹胀，恶食发搐，变症者，当参食积
惊搐门治之。
一小儿火伤，两臂 痛，大便不利，小便赤涩，此火毒蓄于下焦也，用生地黄、当归、芍药、木通、山栀、赤茯
苓、生甘草，一剂二便调和而痛止；更以四物加山栀、参、 、白芷、甘草，而坏肉腐，又数剂而新肉生。
一小儿火伤足胫，专用败毒之剂，脓水淋漓，日晡肿胀，此脾虚下陷也，用补中益气汤及八珍汤而愈。
一女子沸汤伤胸，两月不敛，脉洪大而虚，发热作渴，此阴虚火毒所乘，用四物加柴胡、丹皮，热渴顿止，用加味
逍遥散，腐肉去而新肉生。
一女子被烟熏，痰气上壅，不省人事，用萝卜汁灌之而苏，但体倦欲睡，仍令噙萝卜汁，乃服六君子汤加桔梗、山
栀而安。伤轻者萝卜捣汁，饮之亦可。
一小儿火伤臀间，误用生肌散，阴囊溃脱，久而不愈，此助其药毒而然也，余用当归膏及四君子加芎、归，旬余肉
生而痊。
一小儿火伤其足，用冷水浸之，肿痛益甚，服败毒药，肉死不溃，此脾胃气伤而血滞也，用六君子加芎、归而愈。
后因劳役寒热，以八珍散加升麻、柴胡、白芷而痊。
一小儿火伤腿，用寒凉之药，久不愈，腿细筋挛，食少晡热，此因生肌药助其邪，寒凉损其胃也，用益气汤、当归
膏，不月而敛。
一小儿热汤伤足，久不愈，脓水清稀，口干足热，患处肿黯，晡热盗汗，肢体骨立，此禀肾气虚弱，寒药伤脾而
然，用益气汤、地黄丸三月余，佐以托里散、如圣饼而愈。
一小儿沸汤伤腿，搽药结痂，难于屈伸，痛不可忍，用四物加白术、茯苓，及当归膏而愈。
一小儿沸汤所伤，胸腹皆溃，久而不愈，喜脉弱按之而有力，盖脾主肌肉，当调补脾胃为主，外敷之药当缓。不
信，恪用敷贴之而殁。
一小儿汤伤胫溃而色赤如赭，日晡热甚，右关脉浮而数，按之则弦，此肝木乘脾土血虚而然耳，乃外敷内服，皆
于攻毒后果殁。
神效当归膏 治汤火等疮，不问已溃未溃，肉虽伤而未坏者，用之自愈，肉已死者，用之自溃，新肉易生，搽
至肉色渐白，其毒始尽，生肌最速。盖当归、生地黄、麻油、二蜡，皆主生肌止痛，补血续筋，与新肉相宜。此方余已
刊行，治者多验。
当归 生地黄（各一两） 麻油（四两） 黄蜡（一两，如白者止用五钱）
上先将当归、地黄入油煎枯，去渣，将蜡熔化，候冷搅匀即成膏矣。用涂患处，将细纸盖之。发背痈疽，杖疮溃
烂，用之尤效。凡死肉溃烂将脱，止有些须相连者，宜用利刀剪去。盖死肉有毒，去迟则伤新肉矣，死肉去尽，尤宜速
贴。盖新肉最畏风寒，不可忽也。
乳香定痛散 治伤损及一切疮疡，溃烂疼痛。
乳香 没药（各五钱） 滑石（一两） 冰片（一钱）
上为细末，搽患处痛即止，甚效。
猪蹄汤 治一切痈疽，杖疮溃烂，消肿毒，去恶肉，润疮口。
白芷 黄芩 当归 羌活 赤芍药 蜂房（多蜂儿者为佳） 生甘草（各五钱）
上用猪蹄一只，水四五碗煮熟，去油渣取清汤，入前药煎数沸，去渣温洗，随用膏药贴之。
四物汤（方见胁痈）
六君子汤（方见腹痈）
如圣饼（方见流注）
汤火伤造成的病症，如果出现发热、口渴、小便短赤且排尿涩痛的症状，这是体内有热邪，应当使用四物汤加入山栀、连翘、甘草。如果肌肉尚未坏死但感到疼痛，这是热毒蕴结所致，应当使用四君子汤加入川芎、当归、山栀、连翘。如果肌肉已经坏死且不溃烂，这是气血虚弱所致，应当使用四君子汤加入当归、黄芪；外用当归膏涂抹，或者用柏叶末加蜡油调和后搽涂，直到患处呈现白色，新肉自然生长。如果是因烟雾熏蒸导致几乎窒息的情况，灌入生萝卜汁即可苏醒。如果在饮食之后被汤火所伤，出现发热、腹胀、厌恶食物、抽搐等症状，属于变症，应当参考“食积惊搐”门的方法进行治疗。
有一个小儿被火烧伤，双臂疼痛，大便不通畅，小便短赤涩痛，这是火毒蓄积在下焦，使用生地黄、当归、芍药、木通、山栀、赤茯苓、生甘草，服用一剂后大小便调和，疼痛停止；随后改用四物汤加入山栀、人参、黄芪、白芷、甘草，使坏死腐肉脱落，又服用数剂后新肉生长。
有一个小儿火烧伤了小腿胫部，专门使用败毒（清热解毒）的药物，导致脓水淋漓不尽，傍晚时分肿胀加重，这是脾虚气陷所致，使用补中益气汤及八珍汤而痊愈。
有一个女子被沸水烫伤胸部，两个月伤口不愈合，脉象洪大但按之空虚，伴有发热、口渴，这是阴虚导致火毒乘虚而入，使用四物汤加入柴胡、丹皮，热渴症状立刻停止，随后使用加味逍遥散，腐肉去除而新肉生长。
有一个女子被烟熏，痰气上壅阻塞气道，不省人事，灌入萝卜汁后苏醒，但身体疲倦想睡觉，仍然让她含服萝卜汁，然后服用六君子汤加入桔梗、山栀而安定下来。伤势较轻的，将萝卜捣碎取汁饮用也可以。
有一个小儿火烧伤了臀部，误用了生肌散，导致阴囊溃烂脱落，长时间不愈合，这是因为药物毒性助长了病势，我使用当归膏以及四君子汤加入川芎、当归，十几天后新肉生长而痊愈。
有一个小儿火烧伤了脚，用冷水浸泡，肿痛更加严重，服用败毒药物，肌肉坏死却不溃烂，这是脾胃之气受伤导致血行滞涩，使用六君子汤加入川芎、当归而痊愈。后来因为劳累受寒出现寒热往来，使用八珍散加入升麻、柴胡、白芷而痊愈。
有一个小儿火烧伤了腿部，使用寒凉性质的药物，长期不愈合，腿部肌肉萎缩筋脉拘挛，食欲减少，傍晚发热，这是因为生肌药助长了邪气，寒凉药损伤了胃气，使用益气汤、当归膏，不到一个月伤口愈合。
有一个小儿被热汤烫伤脚部，长期不愈合，脓水清稀，口干足部发热，患处肿胀色暗，傍晚发热盗汗，肢体消瘦如骨立，这是先天肾气虚弱，加上寒凉药物损伤脾脏所致，使用益气汤、地黄丸三个月多，辅以托里散、如圣饼而痊愈。
有一个小儿被沸水烫伤腿部，搽药后结成痂皮，难以屈伸，疼痛难忍，使用四物汤加入白术、茯苓，以及当归膏而痊愈。
有一个小儿被沸水烫伤，胸腹部都溃烂，长期不愈合，喜欢摸脉发现脉弱但按之有力，大概是因为脾主肌肉，治疗应当以调补脾胃为主，外敷药物应当温和缓慢。患者不信从，坚持使用刺激性强的敷贴药物，最终死亡。
有一个小儿被汤烫伤小腿，溃烂处颜色红得像赭石，傍晚发热严重，右关脉浮而数，按之则弦，这是肝木乘克脾土、血虚所致，结果内外用药都在攻毒方面用力过猛，最终死亡。
神效当归膏：治疗汤火等疮疡，不论已经溃烂还是未溃烂，只要肌肉虽然受伤但未完全坏死的，使用它自愈；肌肉已经坏死的，使用它促使坏死组织脱落，新肉容易生长，搽涂至肉色逐渐变白，毒素才能排尽，生肌速度最快。因为当归、生地黄、麻油、黄蜡和白蜂蜡，都具有生肌止痛、补血续筋的功效，与新肉生长相适应。此方我已经刊印发行，治疗者大多验证有效。
配方：当归、生地黄（各一两），麻油（四两），黄蜡（一两，如果是白色的只用五钱）。
制法：先将当归、地黄放入油中煎至枯黄，去掉药渣，将蜡熔化，待冷却后搅拌均匀即成膏。涂抹于患处，盖上细纸。对于发背痈疽、杖疮溃烂，使用此药尤为有效。凡是死肉溃烂即将脱落，仅有一点相连的，宜用利刀剪去。因为死肉有毒，去除太晚会伤害新肉。死肉去尽后，尤其应该迅速贴敷。因为新肉最害怕风寒，不可忽视。
乳香定痛散：治疗损伤及一切疮疡，溃烂疼痛。
配方：乳香、没药（各五钱），滑石（一两），冰片（一钱）。
制法：研为细末，搽于患处，疼痛立即停止，效果显著。
猪蹄汤：治疗一切痈疽，杖疮溃烂，消肿毒，去除恶肉，润湿疮口。
配方：白芷、黄芩、当归、羌活、赤芍药、蜂房（多带蜂儿的为佳）、生甘草（各五钱）。
制法：用一只猪蹄，加水四五碗煮熟，去掉油脂和药渣，取清汤，加入前面的药物煎煮几沸，去掉药渣，温洗患处，随即用膏药贴敷。
The condition caused by scalds and burns, if accompanied by fever, thirst, and scanty, dark, and difficult urination, indicates internal heat. Use Siwu Tang (Four Substances Decoction) with added Zhizi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), and Gancao (Licorice Root). If the flesh is not yet necrotic but painful, it indicates heat-toxin accumulation. Use Sijunzi Tang (Four Gentlemen Decoction) with added Xiong (Ligustici Chuanxiong Rhizoma), Gui (Angelicae Sinensis Radix), Zhizi, and Lianqiao. If the flesh is already necrotic and does not ulcerate, it indicates deficiency of Qi and Blood. Use Sijunzi Tang with added Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix); externally apply Danggui Gao (Angelica Ointment), or mix Baiye Mo (Cacumen Platycladi Powder) with beeswax oil for application. When the tissue turns white, new flesh will grow naturally. If nearly suffocated due to smoke inhalation, instill raw radish juice to restore consciousness. If injured by scalds or burns after eating, presenting with fever, abdominal distension, anorexia, and convulsions, this is a complicated syndrome; treat according to the "Food Accumulation and Convulsion" chapter.
A child suffered burns on both arms, experiencing pain, constipation, and scanty, dark, difficult urination. This indicates fire-toxin accumulating in the Lower Jiao (Lower Burner). Use Shengdihuang (Rehmanniae Radix), Danggui, Shaoyao (Paeoniae Radix), Mutong (Akebiae Caulis), Zhizi, Chifuling (Poria with Red Hosta), and Shenggancao (Raw Licorice Root). After one dose, bowel movements and urination normalized, and pain ceased. Subsequently, use Siwu Tang with added Zhizi, Renshen (Ginseng Radix et Rhizoma), Huangqi, Baizhi (Angelicae Dahuricae Radix), and Gancao. The necrotic tissue sloughed off, and after several doses, new flesh grew.
A child burned the lower leg and exclusively used detoxifying herbs, resulting in profuse purulent discharge and worsening swelling at dusk. This indicates Spleen Qi sinking due to deficiency. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Bazhen Tang (Eight Treasures Decoction) for recovery.
A woman was scalded on the chest by boiling water. The wound did not heal for two months. The pulse was large and forceful at the surface but empty upon pressure, accompanied by fever and thirst. This indicates Yin deficiency allowing fire-toxin to invade. Use Siwu Tang with added Chaihu (Bupleuri Radix) and Danpi (Moutan Cortex). Fever and thirst stopped immediately. Then use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Necrotic tissue was removed, and new flesh grew.
A woman was smoky-inhaled, causing phlegm and Qi to obstruct upward, leading to unconsciousness. Instill radish juice to restore consciousness. Although she felt fatigued and sleepy, continue having her hold radish juice in the mouth, then administer Liujunzi Tang (Six Gentlemen Decoction) with added Jiegeng (Platycodonis Radix) and Zhizi to stabilize the condition. For mild injuries, chewing raw radish juice is also effective.
A child burned the buttocks and mistakenly applied Shengji San (Flesh-Generating Powder), causing the scrotum to ulcerate and detach, failing to heal for a long time. This was due to the drug's toxicity exacerbating the condition. I used Danggui Gao and Sijunzi Tang with added Xiong and Gui. New flesh grew within ten days, and the patient recovered.
A child burned the foot and soaked it in cold water, worsening swelling and pain. Taking detoxifying herbs caused necrotic flesh to fail to ulcerate. This indicates injury to Spleen and Stomach Qi leading to blood stasis. Use Liujunzi Tang with added Xiong and Gui for recovery. Later, due to overwork and alternating chills and fever, use Bazhen San with added Shengma (Cimicifugae Rhizoma), Chaihu, and Baizhi for recovery.
A child burned the leg and used cold-natured drugs, resulting in non-healing, muscle atrophy, tendon contraction, reduced appetite, and evening fever. This was because flesh-generating drugs aided the pathogen, and cold drugs damaged the Stomach. Use Yiqi Tang (Qi-Tonifying Decoction) and Danggui Gao. The wound healed within a month.
A child scalded the foot with hot water. The wound did not heal for a long time, with clear and thin pus, dry mouth, hot feet, swollen and dark lesions, evening fever, night sweats, and emaciation resembling skeletal limbs. This indicates congenital Kidney Qi weakness, exacerbated by cold drugs damaging the Spleen. Use Yiqi Tang and Dihuang Wan (Rehmannia Pill) for over three months, assisted by Tuoli San (Support the Interior Powder) and Rusheng Bing (Like-Sage Cake) for recovery.
A child scalded the leg with boiling water. Medication application formed a scab, making flexion and extension difficult and causing unbearable pain. Use Siwu Tang with added Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria), along with Danggui Gao, for recovery.
A child scalded by boiling water had ulcers on the chest and abdomen that failed to heal for a long time. The pulse was weak but firm upon pressure. Since the Spleen governs muscles, treatment should primarily focus on tonifying and regulating the Spleen and Stomach, and external applications should be gentle. The patient did not believe this and insisted on using irritating poultices, resulting in death.
A child burned the lower leg. The ulcerated area was red like ochre, with severe evening fever. The Right Guan pulse was floating and rapid, becoming wiry upon pressure. This indicates Liver Wood overacting on Spleen Earth due to blood deficiency. Both internal and external treatments focused too heavily on attacking toxins, resulting in death.
Shenxiao Danggui Gao (Miraculous Efficacy Angelica Ointment): Treats scalds, burns, and other sores. Whether ulcerated or not, if flesh is injured but not completely necrotic, it promotes self-healing. If flesh is necrotic, it promotes sloughing of dead tissue and easy growth of new flesh. Apply until the tissue color gradually turns white, ensuring toxins are fully eliminated. It generates flesh most rapidly. Danggui, Shengdihuang, Sesame Oil, and Beeswax all promote flesh generation, relieve pain, nourish blood, and reinforce tendons, harmonizing with new flesh growth. This formula has been published, and many practitioners have verified its efficacy.
Ingredients: Danggui, Shengdihuang (each 1 liang), Sesame Oil (4 liang), Huangla (Beeswax, 1 liang; if white, use only 0.5 liang).
Preparation: First, fry Danggui and Dihuang in the oil until browned, remove dregs. Melt the wax, let cool, and stir evenly to form the ointment. Apply to the affected area and cover with fine paper. For back carbuncles, abscesses, and whip-crack ulcers, this is particularly effective. For necrotic tissue about to detach but still slightly connected, cut it off with a sharp knife. Necrotic tissue is toxic; delaying removal harms new flesh. Once necrotic tissue is completely removed, apply promptly. New flesh fears wind and cold greatly; do not neglect this.
Ruxiang Dingtong San (Frankincense Pain-Calming Powder): Treats trauma and all types of sores with ulceration and pain.
Ingredients: Ruxiang (Boswelliae Resina), Moyao (Commiphora Resina) (each 5 qian), Huashi (Talcum), Bingpian (Borneolum Syntheticum) (1 qian).
Preparation: Grind into fine powder. Apply to the affected area to stop pain immediately. Highly effective.
Zhuti Tang (Pig Trotter Decoction): Treats all carbuncles, abscesses, whip-crack ulcers, reduces swelling and toxicity, removes foul flesh, and moistens sore edges.
Ingredients: Baizhi, Huangqin (Scutellariae Radix), Danggui, Qianghuo (Notopterygii Rhizoma et Radix), Chishaoyao (Red Paeoniae Radix), Fengfang (Vespa Nidus) (preferably those with many larvae), Shenggancao (each 5 qian).
Preparation: Boil one pig trotter in 4-5 bowls of water until cooked. Remove oil and dregs, take the clear broth. Add the aforementioned herbs and boil briefly. Remove dregs. Wash the affected area with warm liquid, then apply ointment.
Siwu Tang (See formula under Rib Abscess)
Liujunzi Tang (See formula under Abdominal Abscess)
Rusheng Bing (See formula under Flowing Abscess)