肿疡者，痈疽未见脓而肿者也。溃疡者，痈疽之脓已溃出者也。丹溪云∶肿疡内外皆壅，宜
以托里表散为主。设欲行大黄者，宜审其虚实之原。疡溃内外皆虚，宜以补接为主，设欲行香散
者，宜防其虚虚之失。由是言之，则痈疽之肿时与溃时不同，今分肿疡溃疡为二门。
痈疽方肿，未见脓者也。
〔洁〕疮疡者，火之属，须分内外。若其脉沉实，当先疏其内，以绝其原也。其脉浮大，当
先托里，恐邪气入内也。有内外之中者，邪气至甚，遏绝经络，故发痈肿。经曰∶荣气不从，逆
于肉理，乃生痈肿。此因失托里，及失疏通，又失和荣卫也。治疮之大要，须明托里、疏通、
行荣卫三法。托里者，治其外之内。疏通，治其内之外。行荣卫者，治其中也。内之外者，其脉
沉实，发热烦躁，外无 赤痛甚，邪气深于内也，故先疏通脏腑，以绝其原。外之内者，其脉
浮数， 肿在外，形证外显，恐邪气极而内行，故先托里，以防其内也。
内外之中者，外无 恶之气，内亦脏腑宣通，知其在经，当和荣卫也。用此三法之后，
虽未瘥，必无变证，亦可使邪气峻减而易痊也。
〔垣〕疮疽之发，其受之有内外之别，治之有寒温之异。受之外者，法当托里以温剂，反用
寒药，则是皮毛始受之邪，引入骨髓。受之内者，法当疏利以寒剂，反用温剂托里，则是骨髓之
病上彻皮毛，表里通溃，共为一疮，助邪为毒，苦楚百倍，轻则危殆，重则死矣。予闻洁古云∶
疮疡之生也，表里不同，或攻或发，少有
差舛，变证随能杀人，甚于伤寒也。针灸施治，各随其宜。所用之药，又当明入五脏君臣，是
其法也。
〔洁〕内疏黄连汤治呕 心逆，发热而烦，脉沉而实，肿硬木闷，而皮肉不变色，根系深大，
病远在内，脏腑秘涩，当急疏利之。
黄连 芍药 当归 槟榔 木香 黄芩 栀子 薄荷 桔梗 甘草（各一两） 连翘（二两）
上除槟榔、木香为末外，并锉，每服一两，水一盏半，煎一盏，先吃一二服，次每服加大黄
一钱，再加二钱，以利为度。如有热证，止服黄连汤。大便秘涩，加大黄。如无热证，止用复煎
散时时呷之。如此内外皆通，荣卫和调，则经络自不遏绝矣。
内托复煎散治肿 于外，根盘不深，形证在表，其脉浮，痛在皮内，恐邪气盛，则必侵
于内，急须内托，以救其里。
地骨皮 黄 防风（各二两） 芍药 黄芩 白术 茯苓 人参 甘草 当归 防己（各一两）
桂（五钱）
上 咀，先将苍术一斤，用水五升，煎至三升，去苍术滓，入前药十二味，再煎至三四盏，绞取清
汁，作三四服，终日服之，又煎苍术滓为汤，去滓，再根据前煎十二味药滓服之。此除湿散郁热，使
胃气和平。如或未已，再作半料服之。若大便秘及烦热，少服黄连汤。如微利，烦热已退，却
服复煎散半料。如此使荣卫俱行，邪气不能内侵也。
当归黄 汤治疮疡脏腑已行，而痛不可忍者。
当归 黄 地黄 川芎 地骨皮 芍药（各半钱）
上 咀，水煎服。如发热，加黄芩。如烦躁不能睡卧者，加栀子。如呕，则是湿气侵胃，倍
加白术。
〔海〕夺命丹治恶疮痈疽发背。
大黄（为末，置砂器中，以水搅八十一遍，飞过，一两） 牡蛎（一两） 生姜（一两）
没药 乳香（各一钱）
上为粗末，转作丸子。一钱，用好酒一升，木炭火熬一沸，分二碗盛之，夜露一宿，早晨去
滓，空心服。
治发背方 苍耳炒黄，擦其刺，再炒深黄，不见风研细末，每服五钱匕，好热酒调，食前临卧服。
一则用大黄、牡蛎，一则用苍耳，知有内外之别也。前用夺命丹，二药表里不同，何以然？
乃膏粱之变，脉沉而滑。地之湿气，感则害人皮肉筋脉，脉浮而滑，所以有泄之发之之异也。
〔丹〕痈疽，因积毒在脏腑非一朝夕，今发于外，宜以标本为治。当先助气壮胃，使根本坚固，
而以行经活血为佐，参以经络、时令，使毒瓦斯外发，此正仲景解表用麻黄、桂枝之意。施治之早，
可以内消，此乃内托之本意也。
〔垣〕通父家翟 ，于尻臀上足太阳经生痈，坚硬肿痛大作，左右尺脉俱紧，按之无力。
羌活 黄柏（酒洗。各二钱） 防风 本 连翘（各一钱） 肉桂（七分） 甘草（炙） 苍术
陈皮（各五分） 当归（一钱） 黄 （一钱半）
上作一服，酒二大盏，水一大盏，煎至一盏，去渣，热服空心。以夹被盖覆其痈，使药行
罢去之，一服愈。
〔丹〕王姑丈，七十余，患项疽，脉实而稍大，此因忧闷而生，太阳经治之。
归头（二钱） 黄柏（一钱半，酒） 黄 羌活 地黄（酒） 黄芩（酒炒） 桔梗（一钱）
黄连（酒炒） 连翘 防风 甘草（生） 人参 陈皮 防己 泽泻（五分） 白水煎服。
〔垣〕净腋汤治皮肤痒，腋下疮，背上疮，耳聋耳鸣。
麻黄（一钱） 桂枝（二钱） 草蔻（一钱） 当归梢（七分） 红花（少许） 羌活（二钱） 防
风（一钱） 柴胡（一钱） 升麻（半分） 连翘 桔梗（五分） 甘草（五分） 生地（五分） 黄芩（酒，
一钱） 苍术（一钱）
上锉，如麻豆大，都作一服，水二大盏，煎至一盏，去渣，稍热服。
尹老家素贫寒，形志皆苦，于手阳明经分出痈，第四日忽肿，幼有 疝，其臂外皆肿痛，
先肿在阳明，左右寸皆短，中得之俱弦，按之洪缓有力。此痈得自八风之变，以脉断之，邪气在表。
然其症大小便如故，饮食如常，腹中和，口知味，知不在里也。不恶风寒，止热躁，脉不浮，知
不在表也。表里既和，知邪止在经脉之中，凝滞为痈，出身半以上，风从生受之也。故与却
寒邪，和经脉中气血，使无凝滞也。白芷升麻汤。
白芷（七分） 升麻 桔梗（各五分） 甘草（炙） 黄芩（生） 归梢 生地（各一钱）
酒黄芩 黄 连翘（各二钱） 中桂（少） 红花（少）
上水酒各一盏，同煎至一盏，临卧热服，一服愈。
此症虽曰经脉之中，然得之自八风之变，其药制度，皆发表之意。此方黄芩重用，未免过
之，宜酌量。
妇人两乳间出黑头疮，疮顶陷下作黑眼子，其脉弦洪，按之细小。
升麻 连翘 葛根（各一钱半） 肉桂（三分） 黄 归身 甘草（炙。各一钱） 黍粘子（五分）
黄柏（二钱）
上作一服，水一盏，酒半盏，煎至一盏，二服愈。
〔罗〕汗之则疮已丁巳年，委予从军，回住曹州，有赵同知舅经历，病头面赤肿，耳前后尤甚，
疼痛不可忍，发热恶寒，牙关紧急，涕唾稠粘，饮食难下，不得安卧。一疡医肿上砭刺四五百余
针，肿赤不减，其痛益甚，不知所由然。予往诊，视其脉浮紧，按之洪缓，此寒覆皮毛，郁遏经
络，热不得升，聚而赤肿。经云∶天寒地冻则水冰。人气在中，皮肤致，腠理闭，汗不出，血气
强，内坚涩。当是之时，善行水者，不能注冰；善穿地者，不能凿冻；善用针者，亦不能取四厥。
必待天温冰释冻解，而水可行，地可穿，人脉亦犹是也。又曰∶冬月闭藏，水冰地坼，故用药多
而少针石也。宜以苦温之剂，温经散寒则已。所谓寒致腠理，以苦发之，以辛散之也，宜以托里
温经汤。麻黄苦温发之者也，防风辛温散之者也。升麻苦平，葛根甘平，解肌出汗，专治阳明经
中之邪，故以为臣。血流而不行者则痛，以香白芷、归身辛温，以破血散滞。湿热则肿，苍术
苦甘温，体轻浮，力雄壮，能泄皮肤腠间湿热。人参、甘草甘温，白芍药酸微寒，调中益气，使
托其里也，故以为佐。各锉如麻豆大，同秤，水煮饵之。以薄衣覆其手，以浓被覆其身，且卧于暖
处，则经血温，腠理开，寒乃散，阳气伸，大汗出，肿减八九。再服，去麻黄、防风，加连翘、
黍粘子，痛肿悉去。经言汗出则疮已，信哉。
托里温经汤治寒覆皮毛，郁遏经络，不得伸越，热伏荣中，聚而赤肿，痛不可忍，恶寒
发热，或相引肢体疼痛。
麻黄（去根节） 白芷 当归（各二钱） 防风（去芦） 葛根（各三钱） 升麻（四钱）
甘草（炙） 白芍药（各一钱半） 人参 苍术（各一钱）
上锉，如麻豆大，每服秤一两，水二盏，先煮麻黄，令沸熟，去沫，再下余药，同煎至一盏，
去渣，大温服讫，卧于暖处，即以绵衣覆之，得汗而散。
〔垣〕蒲津王世祥，年七十，感寒湿地气，二月间，得附骨痈于左腿外侧，足少阳之分，少
侵足阳明分，阔六七寸，长一小尺，坚硬漫 ，不辨肉色皮泽，深以指按至骨大痛，又行步作痛，
与药下咽，疼痛立止，二日后，柔软而肿消矣。
柴胡 黍粘子（各钱半） 连翘 肉桂（各一钱） 黄 当归梢（各二钱） 黄柏 甘草（炙。
各五分） 升麻（七分）
作一帖，好酒一盏半，煎至一盏，大温，空心食消尽服之，少时，以早膳压之，使不令大热
上攻，犯上中二焦也。
贾德茂，男十岁，四月天气大热，于左足大腿近膝股内，足厥阴肝之经，少侵足太阴脾之经
分出附骨疽，不辨肉色漫肿，皮泽木硬，痛势甚大，其脉在三部细弦，按之洪缓，略有力。
黄 （二钱） 柴胡梢（一钱） 羌活（五分） 连翘（一钱二分） 肉桂（三分） 土瓜根（三分）
生地（一钱） 黄柏（酒洗，二分） 当归尾（七钱半）
上作一服，酒一盏，水三盏，煎至一盏，空心热服，一服愈。
〔垣〕内托荣卫汤治风湿热郁其手足少阳，致血脉凝逆，使荣卫周身元气消弱。其风热滞
于下，其面色必赫赤而肿，微黯色。风木之性上冲，颜必忿色，其人多怒，其疮之色亦赫赤肿硬
微带黯色，其疮之情势亦奋然高起，结硬而作痛，其脉洪缓而弦，宜发其汗而通其荣卫，则邪气
去矣。
黄 桂枝（各五钱） 防风 羌活 黄芩 当归（各一钱半） 连翘 柴胡（各二钱） 甘草（炙）
人参（各一钱） 苍术 红花（各三钱）
上 咀，只作一服，水酒各一大盏，同煎至一盏，温服。
上九方，皆东垣及罗谦甫、丹溪随痈疽所发分野制之也。其方皆以发表为先，不过一二服
而愈。如痈疽发在太阳经分野，必用防风、羌活；阳明经分野，必用香白芷、升麻；少阳经分
野，必用柴胡；太阴经分野，必用芍药、升麻；少阴经分野，必用独活；厥阴经分野，必用青皮、
柴胡；皆以桂佐之。身半以下者，
必用酒水多，熟煎之，空心服，使药下行。身半以上者，必用酒水少，带生煎之，临卧服，
使药上行。脉细小无力，必于本经药中加辛热剂；服洪大有力，必于本经药中加苦寒剂。随症加减，
活泼泼地，其效如神，真良医也。
〔涓〕缩毒金粉散治但疼痛，不急胀。
干葛 甘草 郁金 川芎 栝蒌根 白芷
上等分，并生为末，每一钱，温酒入蜜调下，不拘时。此药大散五脏积毒凝滞，日三服。
〔垣〕羌活当归汤治脑疽。
黄芩（酒炒） 黄连（酒炒） 归身（酒浸） 甘草（炙。各一两） 羌活 黄柏（酒浸）
连翘（各五钱） 泽泻 独活 本（各三钱） 防风 栀子仁（各五分）
上 咀，分作四服，水一小碗，先浸一时许，入酒一匙，煎至八分，去渣，大温服，食后，
日二服。和渣计六服，三日服尽。去渣，清药调下后槟榔散。
槟榔散用槟榔为细末，将羌活当归汤调下。
黄柏当归汤治背疽。
黄柏（炒，七钱） 黄芩（炒） 当归身（炒） 甘草（炙。各一两） 黄连（炒） 防风（各五钱）
泽泻 山栀 知母 地骨皮（各三钱） 连翘（五分）
上 咀，分作四服。每服水一小碗，浸一时许，入酒一匙，煎至八分，去渣，调下槟榔散，
大温服与前药同。
〔丹〕吕孺人，恶寒发热，腹上有小疽，此血少有热，与此药。
白术 川芎（三钱） 赤芍药 连翘（二钱半） 陈皮 防风 黄芩（二钱） 木通（一钱半）
甘草（五分）
分五帖，水煎服。
〔丹〕治好酒妇人，用酒煨大黄，取汗。（法见膏粱条。）
〔《精要》〕十宣散
人参 当归 黄 （各二两） 川芎 防风 浓朴 桔梗 官桂 甘草 白芷（各一两）
上为细末，每服二钱，加至六钱止，热酒调下，日数服，以多为妙。不饮酒者，用木香
浓煎汤下，然不若酒力之胜也。许学士云∶此方得于都下异人，济苦者不可计数。
陈无择谓此药在第四节服者非也，早服中病者，必消散。
〔罗〕千金托里散 治发背疔疮。（方见疔疮。）
〔涓〕托毒散治痈疽初起高肿，发痛不定，喘息气粗。
附子（一枚，炮，去皮尖） 当归 麻黄 甘草 官桂 川芎 羌活 石苇 龙胆草
上九味等分，为末，每服二钱，水一大盏，姜三片，盐少许，同煎。
〔丹〕一男子年五十余，形实色黑，背生红肿，近胛骨下，痛甚，脉数而洪紧，食亦呕。正冬
月与麻黄桂枝汤，加酒黄柏、生附子、栝蒌子、甘草节、羌活、青皮、人参、黄 、半夏、生姜，
肿疡，是指痈疽尚未化脓而表现为肿胀的病症。溃疡，是指痈疽已经溃破并排出脓液的病症。朱丹溪说：肿疡阶段，体内和体表的气血都壅滞不通，治疗应以托里透脓和解表散邪为主。如果此时想要使用大黄等攻下药物，必须仔细审察其虚实的原因。疮疡溃破后，体内和体表都处于虚弱状态，治疗应以补益气血、接续生机为主，如果此时想要使用香燥理气或攻伐的药物，应当防止造成虚上加虚的错误。由此而言，痈疽在肿胀时期和溃破时期的病机不同，因此现在将肿疡和溃疡分为两个门类来论述。
痈疽刚刚肿胀，尚未见脓液。
李东垣（洁古）说：疮疡属于火邪一类，必须区分病位在体内还是体外。如果脉象沉实，应当先疏通内部，以断绝病源。如果脉象浮大，应当先托里固本，防止邪气内陷。有处于内外之间的情况，是因为邪气极盛，阻滞经络，从而发生痈肿。《内经》说：营气运行不畅，逆乱于肌肉纹理之间，就会生成痈肿。这是因为失于托里固本，以及失于疏通经络，又失于调和营卫所致。治疗疮疡的大要，必须明白托里、疏通、调和营卫这三种方法。托里法，是治疗由外入内的病证；疏通法，是治疗由内达外的病证；调和营卫法，是治疗处于中间状态的病证。所谓“由内达外”的病证，其脉象沉实，发热烦躁，体表没有严重的红肿疼痛，说明邪气深伏于体内，所以先疏通脏腑，以断绝病源。所谓“由外入内”的病证，其脉象浮数，肿胀在体表，症状表现于外，担心邪气极盛而向内传变，所以先托里固本，以防止邪气内侵。
所谓“内外之中”的病证，体表没有恶寒等表证，体内脏腑也宣通顺畅，知道病邪在经脉之中，应当调和营卫。运用这三种方法之后，即使病未痊愈，也必然不会发生变证，也能使邪气大幅减少而容易痊愈。
罗天益（垣）说：疮疽的发生，受邪途径有内外之别，治疗方法有寒温之异。受邪于体表的，治法应当用温剂托里，如果反而使用寒凉药物，就会把初受皮毛的邪气引入骨髓深处。受邪于体内的，治法应当用寒凉药物疏利清热，如果反而用温剂托里，就会使骨髓中的病邪上彻至皮毛，导致表里同时溃烂，共同形成一个大疮，助长邪气成为剧毒，痛苦百倍，轻则危及生命，重则死亡。我听说洁古先生说：疮疡的产生，表里病机不同，或者攻下或者发散，稍有差错，变证随之而来能致人死亡，比伤寒病更严重。针灸治疗，应各随其适宜的方法。所用药物，又应当明确进入五脏的君臣配伍关系，这就是治疗的法则。
李东垣说：内疏黄连汤治疗呕吐恶心、气逆、发热烦躁、脉象沉实、局部肿胀坚硬麻木闷痛、皮肉颜色不变、病根深大的病症，这是病位远在体内，脏腑秘结涩滞，应当紧急疏通利导。
药材：黄连、芍药、当归、槟榔、木香、黄芩、栀子、薄荷、桔梗、甘草（各一两），连翘（二两）。
以上除槟榔、木香研为细末外，其余切碎，每次服用一两，用水一盏半，煎至一盏，先服用一二服，随后每服增加大黄一钱，再增加到二钱，以大便通畅为度。如果有热证，只服用黄连汤。如果大便秘结涩滞，加大黄。如果没有热证，只服用复煎散，时时小口饮用。这样内外皆通，营卫调和，经络自然就不会阻滞了。
内托复煎散治疗肿胀在体表，病根不深，症状在表，脉象浮，疼痛在皮内，担心邪气旺盛，必定会侵入体内，急需内托，以救护里气。
药材：地骨皮、黄芪、防风（各二两），芍药、黄芩、白术、茯苓、人参、甘草、当归、防己（各一两），桂枝（五钱）。
以上切碎，先将苍术一斤，用水五升，煎至三升，去掉苍术渣，加入前十二味药，再煎至三四盏，过滤取清汁，分三四次服用，整天服用。再将苍术渣加水煎汤，去渣，再次根据前面的方法煎煮十二味药的药渣服用。此方能除湿散郁热，使胃气平和。如果病未停止，再制作半料服用。如果大便秘结及烦热，少量服用黄连汤。如果轻微腹泻，烦热已退，却服用复煎散半料。这样使营卫俱行，邪气不能内侵。
当归黄芪汤治疗疮疡脏腑功能已受影响，而疼痛难以忍受的病症。
药材：当归、黄芪、地黄、川芎、地骨皮、芍药（各半钱）。
以上切碎，水煎服。如果发热，加黄芩。如果烦躁不能睡卧，加栀子。如果呕吐，则是湿气侵犯胃腑，加倍使用白术。
王海藏说：夺命丹治疗恶疮、痈疽、发背。
药材：大黄（研末，放入砂器中，用水搅拌八十一遍，飞过，一两），牡蛎（一两），生姜（一两），没药，乳香（各一钱）。
以上制成粗末，转制成丸药。每次一钱，用好酒一升，用木炭火熬煮一沸，分两碗盛放，夜间露天放置一夜，早晨去渣，空腹服用。
治疗发背的方子：苍耳炒黄，擦去刺，再炒至深黄色，不见风研成细末，每次服五钱匕，用好热酒调服，饭前临睡前服用。
一方用大黄、牡蛎，一方用苍耳，可知有内外之别。前面用的夺命丹，这两味药表里不同，为什么这样呢？这是由于膏粱厚味引起的病变，脉象沉而滑。地之湿气，感之则伤害人皮肉筋脉，脉象浮而滑，所以有泄下和发散的差异。
朱丹溪说：痈疽，是因为积毒在脏腑并非一朝一夕形成，如今发于体表，应当以标本兼治为原则。应当先助气壮胃，使根本坚固，而以行经活血作为辅助，参酌经络、时令，使毒瓦斯向外发散，这正是张仲景解表时使用麻黄、桂枝的本意。施治越早，可以在内部消散，这乃是内托法的本意。
李东垣说：我的父亲家中有个姓翟的人，在尻臀部位足太阳经处生痈，坚硬肿痛剧烈，左右尺脉都紧，按之无力。
药材：羌活、黄柏（酒洗，各二钱），防风、藁本、连翘（各一钱），肉桂（七分），甘草（炙），苍术、陈皮（各五分），当归（一钱），黄芪（一钱半）。
以上作一服，酒两大盏，水一大盏，煎至一盏，去渣，热服，空腹服用。用夹被覆盖住痈肿部位，使药力运行完毕后去掉被子，一服即愈。
朱丹溪说：我的王姑丈，七十多岁，患颈部疽，脉象实而稍大，这是因为忧闷而生，属太阳经病症。
药材：归头（二钱），黄柏（一钱半，酒浸），黄芪、羌活、地黄（酒浸）、黄芩（酒炒）、桔梗（一钱），黄连（酒炒），连翘、防风、甘草（生），人参、陈皮、防己、泽泻（五分），白水煎服。
李东垣说：净腋汤治疗皮肤瘙痒、腋下疮、背上疮、耳聋耳鸣。
药材：麻黄（一钱），桂枝（二钱），草蔻（一钱），当归梢（七分），红花（少许），羌活（二钱），防风（一钱），柴胡（一钱），升麻（半分），连翘、桔梗（五分），甘草（五分），生地（五分），黄芩（酒，一钱），苍术（一钱）。
以上切碎，如麻豆大小，全部作一服，水两大盏，煎至一盏，去渣，稍热服。
尹老家素来贫寒，形体和精神都很困苦，在手阳明经分出之处生痈，第四日突然肿胀，幼年时有疝气，他的手臂外侧都肿痛，先肿在阳明经，左右寸脉都短，关脉得之俱弦，按之洪缓有力。这个痈是由于八风之邪变化引起，通过脉象判断，邪气在表。然而他的症状大小便正常，饮食如常，腹部平和，口知味道，知道不在里。不恶风寒，只有热躁，脉不浮，知道不在表。表里既已调和，知道邪气只在经脉之中，凝滞而成痈，生于身半以上，风从生发之气受之。所以给予驱除寒邪、调和经脉中气血的药物，使无凝滞。用白芷升麻汤。
药材：白芷（七分），升麻、桔梗（各五分），甘草（炙），黄芩（生），归梢、生地（各一钱），酒黄芩、黄芪、连翘（各二钱），中桂（少许），红花（少许）。
以上用水、酒各一盏，同煎至一盏，临睡前热服，一服即愈。
此症虽然说是经脉之中，但得自八风之变，药物的制度，都是发表的意思。此方重用黄芩，未免过当，应当斟酌用量。
妇人两乳间长出黑头疮，疮顶凹陷呈黑眼状，脉象弦洪，按之细小。
药材：升麻、连翘、葛根（各一钱半），肉桂（三分），黄芪、归身、甘草（炙，各一钱），黍粘子（五分），黄柏（二钱）。
以上作一服，水一盏，酒半盏，煎至一盏，二服即愈。
罗谦甫说：汗出则疮已。丁巳年，我随从军队回来住在曹州，有位赵同知的舅父经历，病头面赤肿，耳前后尤其严重，疼痛不可忍受，发热恶寒，牙关紧急，涕唾稠粘，饮食难下，不得安卧。一位疡医在肿处砭刺四五百余针，肿赤不减，疼痛更甚，不知原因所在。我去诊治，看其脉象浮紧，按之洪缓，这是寒邪覆盖皮毛，郁遏经络，热气不能上升，聚集而赤肿。《内经》说：天寒地冻则水结冰。人气在中，皮肤致密，腠理闭合，汗不出，血气强盛，内部坚涩。在这个时候，善于治水的人，不能注入冰中；善于掘地的人，不能凿开冻土；善于用针的人，也不能治疗四肢厥冷。必须等到天气温暖，冰融解冻，然后水可行，地可穿，人的脉络也是这样。又说：冬月闭藏，水冰地裂，所以用药多而少用针石。应当用苦温的药物，温经散寒即可。所谓寒致腠理闭塞，用苦味药发散它，用辛味药疏散它，宜用托里温经汤。麻黄苦温，能发散它；防风辛温，能疏散它。升麻苦平，葛根甘平，解肌出汗，专门治疗阳明经中的邪气，所以作为臣药。血流而不通则痛，用香白芷、归身辛温，以破血散滞。湿热则肿，苍术苦甘温，体轻浮，力雄壮，能泄皮肤腠间湿热。人参、甘草甘温，白芍药酸微寒，调中益气，使托护其里，所以作为佐药。各切碎如麻豆大，同秤，水煮服用。用薄衣覆盖其手，用厚被覆盖其身，且卧于暖处，则经血温，腠理开，寒乃散，阳气伸，大汗出，肿减八九。再服，去掉麻黄、防风，加连翘、黍粘子，痛肿悉去。经文说汗出则疮已，确实可信。
托里温经汤治疗寒邪覆盖皮毛，郁遏经络，不得伸越，热气伏于营中，聚集而赤肿，痛不可忍，恶寒发热，或牵引肢体疼痛。
药材：麻黄（去根节）、白芷、当归（各二钱），防风（去芦）、葛根（各三钱），升麻（四钱），甘草（炙）、白芍药（各一钱半），人参、苍术（各一钱）。
以上切碎如麻豆大，每次称一两，水二盏，先煮麻黄，令沸熟，去沫，再下余药，同煎至一盏，去渣，大温服讫，卧于暖处，即以绵衣覆盖，得汗而散。
李东垣说：蒲津的王世祥，七十岁，感受寒湿地气，二月间，左腿外侧足少阳经部位得附骨痈，稍微侵入足阳明经部位，阔六七寸，长一小尺，坚硬漫肿，不辨肉色皮泽，深以指按至骨大痛，行走时也痛，与药下咽，疼痛立止，二日后，柔软而肿消矣。
药材：柴胡、黍粘子（各钱半），连翘、肉桂（各一钱），黄芪、当归梢（各二钱），黄柏、甘草（炙，各五分），升麻（七分）。
作一帖，好酒一盏半，煎至一盏，大温，空心食消尽服之，少时，以早膳压之，使不令大热上攻，犯上中二焦也。
贾德茂，男十岁，四月天气大热，于左足大腿近膝股内，足厥阴肝之经，少侵足太阴脾之经分出附骨疽，不辨肉色漫肿，皮泽木硬，痛势甚大，其脉在三部细弦，按之洪缓，略有力。
药材：黄芪（二钱），柴胡梢（一钱），羌活（五分），连翘（一钱二分），肉桂（三分），土瓜根（三分），生地（一钱），黄柏（酒洗，二分），当归尾（七钱半）。
以上作一服，酒一盏，水三盏，煎至一盏，空心热服，一服愈。
李东垣说：内托荣卫汤治疗风湿热郁其手足少阳，致血脉凝逆，使荣卫周身元气消弱。其风热滞于下，其面色必赫赤而肿，微黯色。风木之性上冲，颜必忿色，其人多怒，其疮之色亦赫赤肿硬微带黯色，其疮之情势亦奋然高起，结硬而作痛，其脉洪缓而弦，宜发其汗而通其荣卫，则邪气去矣。
药材：黄芪、桂枝（各五钱），防风、羌活、黄芩、当归（各一钱半），连翘、柴胡（各二钱），甘草（炙）、人参（各一钱），苍术、红花（各三钱）。
以上切碎，只作一服，水酒各一大盏，同煎至一盏，温服。
上面九个方子，都是东垣及罗谦甫、丹溪根据痈疽所发的分野制定的。这些方子都以发表为先，不过一二服而愈。如痈疽发在太阳经分野，必用防风、羌活；阳明经分野，必用香白芷、升麻；少阳经分野，必用柴胡；太阴经分野，必用芍药、升麻；少阴经分野，必用独活；厥阴经分野，必用青皮、柴胡；皆以桂佐之。身半以下者，必用酒水多，熟煎之，空心服，使药下行。身半以上者，必用酒水少，带生煎之，临卧服，使药上行。脉细小无力，必于本经药中加辛热剂；服洪大有力，必于本经药中加苦寒剂。随症加减，活泼泼地，其效如神，真良医也。
刘涓子说：缩毒金粉散治疗只疼痛，不急胀。
药材：干葛、甘草、郁金、川芎、栝蒌根、白芷。
以上等分，并生为末，每一钱，温酒入蜜调下，不拘时。此药大散五脏积毒凝滞，日三服。
李东垣说：羌活当归汤治疗脑疽。
药材：黄芩（酒炒）、黄连（酒炒）、归身（酒浸）、甘草（炙，各一两），羌活、黄柏（酒浸）、连翘（各五钱），泽泻、独活、藁本（各三钱），防风、栀子仁（各五分）。
以上切碎，分作四服，水一小碗，先浸一时许，入酒一匙，煎至八分，去渣，大温服，食后，日二服。和渣计六服，三日服尽。去渣，清药调下后槟榔散。
槟榔散用槟榔为细末，将羌活当归汤调下。
黄柏当归汤治疗背疽。
药材：黄柏（炒，七钱）、黄芩（炒）、当归身（炒）、甘草（炙，各一两），黄连（炒）、防风（各五钱），泽泻、山栀、知母、地骨皮（各三钱），连翘（五分）。
以上切碎，分作四服。每服水一小碗，浸一时许，入酒一匙，煎至八分，去渣，调下槟榔散，大温服与前药同。
朱丹溪说：吕孺人，恶寒发热，腹上有小疽，此血少有热，与此药。
药材：白术、川芎（三钱），赤芍药、连翘（二钱半），陈皮、防风、黄芩（二钱），木通（一钱半），甘草（五分）。
分五帖，水煎服。
朱丹溪说：治好酒妇人，用酒煨大黄，取汗。（法见膏粱条。）
《精要》说：十宣散
药材：人参、当归、黄芪（各二两），川芎、防风、浓朴、桔梗、官桂、甘草、白芷（各一两）。
以上为细末，每服二钱，加至六钱止，热酒调下，日数服，以多为妙。不饮酒者，用木香浓煎汤下，然不若酒力之胜也。许学士云：此方得于都下异人，济苦者不可计数。
陈无择谓此药在第四节服者非也，早服中病者，必消散。
罗谦甫说：千金托里散 治疗发背疔疮。（方见疔疮。）
刘涓子说：托毒散治疗痈疽初起高肿，发痛不定，喘息气粗。
药材：附子（一枚，炮，去皮尖），当归、麻黄、甘草、官桂、川芎、羌活、石苇、龙胆草。
以上九味等分，为末，每服二钱，水一大盏，姜三片，盐少许，同煎。
朱丹溪说：一男子年五十余，形实色黑，背生红肿，近胛骨下，痛甚，脉数而洪紧，食亦呕。正冬月与麻黄桂枝汤，加酒黄柏、生附子、栝蒌子、甘草节、羌活、青皮、人参、黄芪、半夏、生姜，
Swelling sores (Zhongyang) refer to carbuncles and ulcers that are swollen but have not yet suppurated. Ulcerative sores (Kuangyang) refer to carbuncles and ulcers where the pus has already been discharged. Zhu Danxi stated: During the swelling stage, both internal and external qi and blood are obstructed; treatment should primarily focus on supporting the interior and dispersing pathogens from the exterior. If one wishes to use Rhubarb (Dahuang), one must carefully examine the root of deficiency or excess. After ulceration, both internal and external states are deficient; treatment should primarily focus on tonifying and restoring. If one wishes to use aromatic and dissipating herbs, one must guard against the error of "making deficiency more deficient." From this perspective, the pathology of carbuncles differs between the swelling stage and the ulceration stage; therefore, swelling sores and ulcerative sores are now divided into two separate categories.
Carbuncles just beginning to swell, with no pus visible.
[Jie] Sores and ulcers belong to the fire pathogen category and must be distinguished by whether the location is internal or external. If the pulse is deep and solid, one should first unblock the interior to cut off the source. If the pulse is floating and large, one should first support the interior to prevent pathogens from entering inward. There are cases in the middle of internal and external, where pathogens are extremely severe, blocking meridians and collaterals, thus causing carbuncle swelling. The Classic says: When Ying (Nutritive) Qi does not flow smoothly and rebels within the muscle tissue, carbuncles and swelling arise. This occurs due to a failure to support the interior, a failure to unblock, and a failure to harmonize Ying and Wei (Defensive) Qi. The general principle for treating sores requires understanding three methods: supporting the interior, unblocking, and promoting Ying and Wei circulation. Supporting the interior treats diseases moving from outside to inside. Unblocking treats diseases moving from inside to outside. Promoting Ying and Wei circulation treats diseases in the middle. "Inside-to-outside" refers to a deep internal condition manifesting externally: the pulse is deep and solid, with fever and irritability, but without severe external redness and pain, indicating pathogens are deep within; thus, one first unblocks the zang-fu organs to cut off the source. "Outside-to-inside" refers to an external condition fearing internal invasion: the pulse is floating and rapid, swelling is on the surface, signs and symptoms are apparent externally, and there is fear that extreme pathogens will move inward; thus, one first supports the interior to prevent internal invasion.
"Middle of internal and external" refers to cases where there are no external evil signs like aversion to wind/cold, and internal zang-fu organs are patent; knowing the pathogen is in the meridians, one should harmonize Ying and Wei Qi. After applying these three methods, even if the disease is not cured, complications will certainly not arise, and pathogens will be significantly reduced, making recovery easier.
[Yuan] The onset of carbuncles and ulcers has differences in the route of pathogen entry (internal vs. external) and differences in treatment temperature (cold vs. warm). For those receiving external pathogens, the method should be to support the interior with warm formulas; using cold medicines instead introduces pathogens initially at the skin and hair into the bone marrow. For those receiving internal pathogens, the method should be to drain and purgatively clear with cold formulas; using warm formulas to support the interior instead causes bone marrow diseases to penetrate to the skin and hair, resulting in simultaneous internal and external ulceration, creating a single sore that aids pathogens to become toxic, causing hundredfold suffering, leading to danger if mild, and death if severe. I heard Jieguo say: The generation of sores involves different internal and external mechanisms; whether attacking or releasing, even slight errors lead to complications that can kill, often more severely than Shanghan (Cold Damage). Acupuncture and moxibustion treatments should follow their respective appropriateness. Medicines used must clarify the sovereign-minister relationship entering the five zang organs; this is the method.
[Jie] Neishu Huanglian Tang (Internal Draining Coptis Decoction) treats vomiting, nausea, heart rebellion, fever, irritability, deep and solid pulse, local swelling and hardness with numbness and fullness, unchanged skin color, deep and large roots, distant internal pathology, and constipation/stagnation of zang-fu organs; urgent draining and purging is required.
Coptis Rhizome (Huanglian), Peony Root (Shaoyao), Angelica Sinensis Root (Danggui), Areca Seed (Binglang), Aucklandia Root (Muxiang), Scutellaria Root (Huangqin), Gardenia Fruit (Zhizi), Mint Herb (Bohe), Platycodon Root (Jiegeng), Licorice Root (Gancao) (each 1 liang), Forsythia Fruit (Lianqiao) (2 liang).
Except for Binglang and Muxiang which are powdered, all other herbs are chopped. Take 1 liang per dose, add 1.5 cups of water, decoct to 1 cup. Take 1-2 doses first, then increase Dahuang (Rhubarb Root) by 1 qian per dose, up to 2 qian, stopping when bowel movement is achieved. If heat signs exist, only use Huanglian Tang. If stool is dry and difficult, add Dahuang. If no heat signs, only use Fujian San (Double-Decoction Powder), taken frequently in small sips. This ensures both internal and external patency, harmonizes Ying and Wei Qi, and prevents meridian blockage.
Neituo Fujian San (Internal Support Double-Decoction Powder) treats swelling on the exterior with shallow roots, superficial signs and symptoms, floating pulse, pain within the skin, fearing that excessive pathogens will invade internally; urgent internal support is needed to save the interior.
Groundsel Root (Digupi), Astragalus Root (Huangqi), Saposhnikovia Root (Fangfeng) (each 2 liang), Peony Root (Shaoyao), Scutellaria Root (Huangqin), Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), Codonopsis Root (Renshen), Licorice Root (Gancao), Angelica Sinensis Root (Danggui), Podocarpus Stem (Fangji) (each 1 liang), Cinnamon Twig (Guizhi) (5 qian).
Chop the herbs. First, decoct 1 jin of Coix Seed Rhizome (Cangzhu) in 5 sheng of water until reduced to 3 sheng, remove Cangzhu dregs, add the previous twelve herbs, and decoct again to 3-4 cups. Strain to obtain clear juice, divide into 3-4 doses, and take throughout the day. Also decoct the Cangzhu dregs in water, remove dregs, and decoct the twelve herb dregs according to the previous method. This dispels dampness and scatters stagnant heat, harmonizing stomach qi. If unresolved, prepare half a dose. If constipation and irritability occur, take less Huanglian Tang. If mild diarrhea occurs and irritability subsides, take half a dose of Fujian San. This promotes the circulation of Ying and Wei Qi, preventing internal pathogen invasion.
Danggui Huangqi Tang (Angelica and Astragalus Decoction) treats sores where zang-fu qi has moved but pain is unbearable.
Angelica Sinensis Root (Danggui), Astragalus Root (Huangqi), Rehmannia Root (Dihuang), Szechwan Lovage Rhizome (Chuanxiong), Groundsel Root (Digupi), Peony Root (Shaoyao) (each 0.5 qian).
Chop and decoct in water. If fever, add Scutellaria Root (Huangqin). If irritability prevents sleep, add Gardenia Fruit (Zhizi). If vomiting, it indicates dampness invading the stomach; double the dose of Atractylodes Macrocephala Rhizome (Baizhu).
[Hai] Duoming Dan (Life-Restoring Pill) treats malignant sores, carbuncles, ulcers, and back carbuncles.
Rhubarb Root (Dahuang) (powdered, placed in a clay pot, stirred with water 81 times, washed/processed, 1 liang), Oyster Shell (Muli) (1 liang), Fresh Ginger Root (Shengjiang) (1 liang), Myrrh (Moyao), Frankincense (Ruxiang) (each 1 qian).
Make coarse powder, form into pills. Take 1 qian, decoct in 1 sheng of good wine over charcoal fire for one boil, divide into two bowls, leave overnight outdoors, strain in the morning, and take on an empty stomach.
Formula for Back Carbuncle: Cocklebur Fruit (Cangerzi) stir-fried until yellow, prickles rubbed off, stir-fried until dark yellow, protected from wind, ground to fine powder. Take 5 qian-bi, mix with hot wine, take before meals and before bed.
One uses Dahuang and Muli; the other uses Cangerzi, indicating a difference between internal and external. The previous Duoming Dan uses these two drugs differently for interior and exterior. Why? Changes from rich foods cause deep, slippery pulses. Dampness from the earth harms skin, flesh, sinews, and vessels, causing floating, slippery pulses. Hence, the difference between purgative and dispersing methods.
[Dan] Carbuncles and ulcers result from accumulated toxins in zang-fu organs over time, now manifesting externally. Treatment should address both root and branch. First, boost qi and strengthen the stomach to secure the foundation, assisting with herbs that promote channel circulation and invigorate blood. Consider meridians and seasons to allow toxins to emit outward, following Zhang Zhongjing's intent in using Ephedra Herb (Mahuang) and Cinnamon Twig (Guizhi) for exterior release. Early treatment allows internal resolution, which is the true meaning of internal support.
[Yuan] Tongfu's relative, Mr. Zhai, developed a carbuncle on the buttocks along the Foot-Taiyang channel, hard, swollen, painful, with tight pulses at both left and right Chi positions, weak upon pressure.
Notopterygium Rhizome (Qianghuo), Phellodendron Bark (Huangbai) (wine-washed, each 2 qian), Saposhnikovia Root (Fangfeng), Ligusticum Rhizome (Gaben), Forsythia Fruit (Lianqiao) (each 1 qian), Cinnamon Bark (Rougui) (7 fen), Licorice Root (Gancao) (roasted), Atractylodes Rhizome (Cangzhu), Tangerine Peel (Chenpi) (each 5 fen), Angelica Sinensis Root (Danggui) (1 qian), Astragalus Root (Huangqi) (1.5 qian).
Take as one dose, decoct in 2 large cups of wine and 1 cup of water until 1 cup remains, strain, and take hot on an empty stomach. Cover the carbuncle with a quilted blanket while the medicine acts, then remove. One dose cures.
[Dan] Wang Gu-zhang, over seventy years old, suffered from a neck carbuncle with a solid and slightly large pulse, caused by worry and depression, treated via the Taiyang channel.
Angelica Head (Guitou) (2 qian), Phellodendron Bark (Huangbai) (1.5 qian, wine), Astragalus Root (Huangqi), Notopterygium Rhizome (Qianghuo), Rehmannia Root (Dihuang) (wine), Scutellaria Root (Huangqin) (wine-fried), Platycodon Root (Jiegeng) (1 qian), Coptis Rhizome (Huanglian) (wine-fried), Forsythia Fruit (Lianqiao), Saposhnikovia Root (Fangfeng), Licorice Root (Gancao) (raw), Codonopsis Root (Renshen), Tangerine Peel (Chenpi), Podocarpus Stem (Fangji), Alisma Rhizome (Zexie) (5 fen), decoct in plain water.
[Yuan] Jingye Tang (Pure Armpit Decoction) treats skin itching, armpit sores, back sores, deafness, and tinnitus.
Ephedra Herb (Mahuang) (1 qian), Cinnamon Twig (Guizhi) (2 qian), Cardamom Seed (Caokou), Angelica Sinensis Tip (Danggui Shao), Safflower Flower (Honghua) (a little), Notopterygium Rhizome (Qianghuo) (2 qian), Saposhnikovia Root (Fangfeng) (1 qian), Bupleurum Root (Chaihu) (1 qian), Cimicifuga Rhizome (Shengma) (0.5 fen), Forsythia Fruit (Lianqiao), Platycodon Root (Jiegeng) (5 fen), Licorice Root (Gancao) (5 fen), Rehmannia Root (Shengdi) (5 fen), Scutellaria Root (Huangqin) (wine, 1 qian), Atractylodes Rhizome (Cangzhu) (1 qian).
Chop to size of hemp seeds. Take as one dose, decoct in 2 large cups of water until 1 cup remains, strain, and take slightly hot.
Old Man Yin was poor and suffered physically and mentally. He developed a carbuncle branching from the Hand-Yangming channel. On the fourth day, sudden swelling occurred. He had hernia in childhood. His arm was swollen and painful externally, starting in Yangming. Pulses at Cun positions were short; Middle position pulses were wiry, pressing revealed surging, slow, and forceful. This carbuncle resulted from Eight Winds changes. Pulse diagnosis indicates pathogens in the exterior. However, bowel/bladder functions were normal, diet was normal, abdomen was harmonious, taste was normal, indicating no interior involvement. No aversion to wind/cold, only heat and restlessness, pulse not floating, indicating no exterior involvement. With interior and exterior harmonized, pathogens are only in the meridians, stagnating to form carbuncles above the waist, wind received from growth points. Thus, expel cold pathogens, harmonize qi and blood in meridians, preventing stagnation. Baizhi Shengma Tang.
Angelica Dahurica Root (Baizhi) (7 fen), Cimicifuga Rhizome (Shengma), Platycodon Root (Jiegeng) (each 5 fen), Licorice Root (Gancao) (roasted), Scutellaria Root (Huangqin) (raw), Angelica Tip (Guishao), Rehmannia Root (Shengdi) (each 1 qian), Wine-Scutellaria Root (Jiu Huangqin), Astragalus Root (Huangqi), Forsythia Fruit (Lianqiao) (each 2 qian), Cinnamon Bark (Zhonggui) (little), Safflower Flower (Honghua) (little).
Decoct in 1 cup water and 1 cup wine until 1 cup remains, take hot before bed. One dose cures.
Although this case is in the meridians, it stems from Eight Winds changes; the formula principles aim at exterior release. Heavy use of Huangqin may be excessive; adjust accordingly.
A woman developed black-headed sores between breasts, with depressed black centers. Pulse was wiry and surging, thin and small upon pressure.
Cimicifuga Rhizome (Shengma), Forsythia Fruit (Lianqiao), Kudzu Root (Gegen) (each 1.5 qian), Cinnamon Bark (Rougui) (3 fen), Astragalus Root (Huangqi), Angelica Body (Guishen), Licorice Root (Gancao) (roasted, each 1 qian), Arnebia Root/Licorice Root (Shuniuzi) (5 fen), Phellodendron Bark (Huangbai) (2 qian).
Take as one dose, decoct in 1 cup water and 0.5 cup wine until 1 cup remains. Two doses cure.
[Luo] Sweating cures the sore. In Ding-Si year, I accompanied the army, returning to Caozhou. Zhao Tongzhi's uncle, a magistrate, suffered from red and swollen head and face, especially around ears, unbearable pain, fever, aversion to cold, locked jaw, thick sputum, difficulty eating/sleeping. A surgeon punctured the swelling 400-500 times with needles, swelling and redness did not decrease, pain increased, cause unknown. I diagnosed: pulse floating and tight, surging and slow upon pressure. Cold covers skin/hair, blocks meridians, heat cannot rise, accumulates causing redness/swelling. The Classic says: Cold weather freezes water. Human qi is internal, skin dense, pores closed, no sweat, blood/qi strong, internal stiffness. At this time, even skilled water-workers cannot inject ice; skilled diggers cannot drill frozen earth; skilled acupuncturists cannot treat four reversals. Must wait for warmth to melt ice, allowing water flow and earth drilling; similarly for human channels. Winter is storage, ice/frozen earth; thus use more medicine, fewer needles. Use bitter-warm agents to warm channels and scatter cold. Cold closes pores; use bitter to disperse, pungent to scatter. Use Tuoli Wenjing Tang. Mahuang is bitter-warm to disperse; Fangfeng is pungent-warm to scatter. Shengma is bitter-neutral; Gegen is sweet-neutral, releases muscle layer and induces sweat, treating Yangming pathogens, hence Minister drug. Blood flow obstruction causes pain; Xiangbaizhi and Guishen are pungent-warm to break blood stasis. Damp-heat causes swelling; Cangzhu is bitter-sweet-warm, light and floating, powerful, drains damp-heat from skin/pores. Renshen and Gancao are sweet-warm; Shaoyao is sour-mild-cold, harmonizes middle, boosts qi, supports interior, hence Assistant drug. Chop to hemp seed size, weigh together, decoct in water. Cover hands with thin cloth, body with thick quilt, lie in warm place. Channels warm, pores open, cold scatters, yang extends, heavy sweat ensues, swelling reduces 80-90%. Second dose: remove Mahuang and Fangfeng, add Lianqiao and Shuniuzi, pain and swelling disappear. The Classic says sweating cures sores; truly credible.
Tuoli Wenjing Tang (Interior-Supporting Channel-Warming Decoction) treats cold covering skin/hair, blocking meridians, heat trapped in Ying, accumulating as redness/swelling, unbearable pain, aversion to cold/fever, or limb pain.
Ephedra Herb (Mahuang) (remove roots/joints), Angelica Dahurica Root (Baizhi), Angelica Sinensis Root (Danggui) (each 2 qian), Saposhnikovia Root (Fangfeng) (remove rhizome), Kudzu Root (Gegen) (each 3 qian), Cimicifuga Rhizome (Shengma) (4 qian), Licorice Root (Gancao) (roasted), White Peony Root (Baishaoyao) (each 1.5 qian), Codonopsis Root (Renshen), Atractylodes Rhizome (Cangzhu) (each 1 qian).
Chop to hemp seed size. Weigh 1 liang per dose, add 2 cups water. Boil Mahuang first until boiling, skim foam, add remaining herbs, decoct to 1 cup, strain, take very hot, lie in warm place, cover with cotton clothes, induce sweat to resolve.
[Yuan] Wang Shixiang of Pubin, age 70, contracted cold-damp qi, February, developed Osteoperiostitis (Fugu Yong) on outer left leg, involving Foot-Shaoyang, slightly Foot-Yangming, 6-7 cun wide, 1 chi long, hard and diffuse, indistinguishable flesh/skin color, severe pain pressing to bone, walking pain. Medicine stopped pain immediately; after two days, soft and swelling subsided.
Bupleurum Root (Chaihu), Arnebia Root (Shuniuzi) (each 1.5 qian), Forsythia Fruit (Lianqiao), Cinnamon Bark (Rougui) (each 1 qian), Astragalus Root (Huangqi), Angelica Tip (Danggui Shao) (each 2 qian), Phellodendron Bark (Huangbai), Licorice Root (Gancao) (roasted, each 5 fen), Cimicifuga Rhizome (Shengma) (7 fen).
One packet, decoct in 1.5 cups good wine until 1 cup remains, take very hot on empty stomach after digestion. Eat breakfast shortly after to prevent excessive heat from attacking upper/middle jiao.
Jia Demao, male, 10 years old, April hot weather, developed Osteomyelitis (Fugu Ju) near knee inner thigh on left leg, involving Foot-Jueyin Liver channel, slightly Foot-Taiyin Spleen channel, diffuse swelling, indistinguishable flesh color, hard wood-like skin, severe pain. Pulses in three positions were thin and wiry, surging/slow/slightly forceful upon pressure.
Astragalus Root (Huangqi) (2 qian), Bupleurum Tip (Chaihu Shao) (1 qian), Notopterygium Rhizome (Qianghuo) (5 fen), Forsythia Fruit (Lianqiao) (1.2 qian), Cinnamon Bark (Rougui) (3 fen), Trichosanthes Root (Tugua Gen) (3 fen), Rehmannia Root (Shengdi) (1 qian), Phellodendron Bark (Huangbai) (wine-washed, 2 fen), Angelica Tail (Danggui Wei) (7.5 qian).
One dose, decoct in 1 cup wine and 3 cups water until 1 cup remains, take hot on empty stomach. One dose cures.
[Yuan] Neituo Yingwei Tang (Interior-Supporting Ying-Wei Decoction) treats wind-damp-heat stagnating in Hand/Foot-Shaoyang, causing blood vessel coagulation/reversal, weakening Ying-Wei and whole-body yuan qi. Wind-heat stagnates below, face is red/swollen, slightly dark. Wood nature rises, face angry, person irritable, sore red/swollen/hard/dark, sore rises high/hard/painful, pulse surging/slow/wiry. Induce sweat to open Ying-Wei, expelling pathogens.
Astragalus Root (Huangqi), Cinnamon Twig (Guizhi) (each 5 qian), Saposhnikovia Root (Fangfeng), Notopterygium Rhizome (Qianghuo), Scutellaria Root (Huangqin), Angelica Sinensis Root (Danggui) (each 1.5 qian), Forsythia Fruit (Lianqiao), Bupleurum Root (Chaihu) (each 2 qian), Licorice Root (Gancao) (roasted), Codonopsis Root (Renshen) (each 1 qian), Atractylodes Rhizome (Cangzhu), Safflower Flower (Honghua) (each 3 qian).
Chop, make one dose, decoct in 1 large cup water and 1 large cup wine until 1 cup remains, take warm.
The above nine formulas were created by Dongyuan, Luo Qianfu, and Danxi based on the location of carbuncles/ulcers. All prioritize exterior release, curing in 1-2 doses. Taiyang location: use Fangfeng, Qianghuo. Yangming location: use Xiangbaizhi, Shengma. Shaoyang location: use Chaihu. Taiyin location: use Shaoyao, Shengma. Shaoyin location: use Duduo. Jueyin location: use Qingpi, Chaihu; all assisted by Gui. Lower body: use more wine/water, fully decoct, take empty stomach to direct downward. Upper body: use less wine/water, partially raw decoct, take before bed to direct upward. Fine/weak pulse: add pungent-hot agents to channel-specific herbs. Surging/forceful pulse: add bitter-cold agents to channel-specific herbs. Adjust flexibly; efficacy is miraculous, truly excellent physicians.
[Liu] Suodu Jinfen San (Poison-Contraction Gold Powder) treats pain without urgent swelling.
Kudzu Root (Gegen), Licorice Root (Gancao), Turmeric Tuber (Yujin), Szechwan Lovage Rhizome (Chuanxiong), Trichosanthes Root (Gualou Gen), Angelica Dahurica Root (Baizhi).
Equal parts, raw powder. Take 1 qian, mix with warm wine and honey, anytime. This greatly scatters accumulated toxins/stagnation in five zang organs, take three times daily.
[Yuan] Qianghuo Danggui Tang (Notopterygium and Angelica Decoction) treats Brain Carbuncle (Nao Ju).
Scutellaria Root (Huangqin) (wine-fried), Coptis Rhizome (Huanglian) (wine-fried), Angelica Body (Guishen) (wine-soaked), Licorice Root (Gancao) (roasted, each 1 liang), Notopterygium Rhizome (Qianghuo), Phellodendron Bark (Huangbai) (wine-soaked), Forsythia Fruit (Lianqiao) (each 5 qian), Alisma Rhizome (Zexie), Angelica Pubescens Root (Duhuo), Ligusticum Rhizome (Gaben) (each 3 qian), Saposhnikovia Root (Fangfeng), Gardenia Seed (Zhizi Ren) (each 5 fen).
Chop, divide into four doses. Soak 1 small bowl water for 1 hour, add 1 spoon wine, decoct to 80%, strain, take very hot after meals, twice daily. Include dregs for six doses total, finish in three days. Strain, take clear liquid mixed with Binglang San.
Binglang San (Areca Powder): Grind Areca Seed (Binglang) to fine powder, mix with Qianghuo Danggui Tang.
Huangbai Danggui Tang (Phellodendron and Angelica Decoction) treats Back Carbuncle (Bei Ju).
Phellodendron Bark (Huangbai) (fried, 7 qian), Scutellaria Root (Huangqin) (fried), Angelica Body (Danggui Shen) (fried), Licorice Root (Gancao) (roasted, each 1 liang), Coptis Rhizome (Huanglian) (fried), Saposhnikovia Root (Fangfeng) (each 5 qian), Alisma Rhizome (Zexie), Gardenia Fruit (Shanzhi), Anemarrhena Rhizome (Zhimu), Groundsel Root (Digupi) (each 3 qian), Forsythia Fruit (Lianqiao) (5 fen).
Chop, divide into four doses. Each dose: soak 1 small bowl water for 1 hour, add 1 spoon wine, decoct to 80%, strain, mix with Binglang San, take very hot same as previous medicine.
[Dan] Lady Lv, aversion to cold/fever, small carbuncle on abdomen, slight blood heat, given this medicine.
Atractylodes Macrocephala Rhizome (Baizhu), Szechwan Lovage Rhizome (Chuanxiong) (3 qian), Red Peony Root (Chishaoyao), Forsythia Fruit (Lianqiao) (2.5 qian), Tangerine Peel (Chenpi), Saposhnikovia Root (Fangfeng), Scutellaria Root (Huangqin) (2 qian), Tetrapanax Stem (Mutong) (1.5 qian), Licorice Root (Gancao) (5 fen).
Divide into five packets, decoct in water.
[Dan] Treat alcoholic woman: stew Rhubarb Root (Dahuang) in wine, induce sweat. (Method seen in Gao Liang section.)
[Jing Yao] Shixuan San (Ten-Aperture Powder)
Codonopsis Root (Renshen), Angelica Sinensis Root (Danggui), Astragalus Root (Huangqi) (each 2 liang), Szechwan Lovage Rhizome (Chuanxiong), Saposhnikovia Root (Fangfeng), Magnolia Bark (N Hou), Platycodon Root (Jiegeng), Cassia Twig (Guangui), Licorice Root (Gancao), Angelica Dahurica Root (Baizhi) (each 1 liang).
Fine powder. Take 2 qian, up to 6 qian, mix with hot wine, several times daily, more is better. Non-drinkers: decoct Costus Root (Muxiang) strongly, take soup. But wine power is superior. Scholar Xu said: Obtained from strange person in capital, saves countless sufferers.
Chen Wuyue said taking it at the fourth stage is wrong; early effective intake leads to resolution.
[Luo] Qianjin Tuoli San (Thousand-Gold Interior-Supporting Powder) treats Back Carbuncle Ding Chuang. (Formula seen in Ding Chuang section.)
[Liu] Tuodu San (Poison-Supporting Powder) treats early-stage carbuncles/ulcers with high swelling, uncertain pain, rough breathing.
Aconite Root (Fuzi) (one piece, processed, peel/remove tip), Angelica Sinensis Root (Danggui), Ephedra Herb (Mahuang), Licorice Root (Gancao), Cassia Twig (Guangui), Szechwan Lovage Rhizome (Chuanxiong), Notopterygium Rhizome (Qianghuo), Pyrite Leaf (Shiwei), Gentian Root (Longdan Cao).
Nine ingredients equal parts, powder. Take 2 qian, 1 large cup water, 3 slices ginger, little salt, decoct together.
[Dan] Male, over 50, robust/black complexion, red/swollen back near shoulder blade, severe pain, rapid/surging/tight pulse, vomiting food. Mid-winter, give Mahuang Guizhi Tang, add Wine-Phellodendron Bark (Jiu Huangbai), Raw Aconite Root (Sheng Fuzi), Trichosanthes Seed (Gualou Zi), Licorice Joint (Gancao Jie), Notopterygium Rhizome (Qianghuo), Green Tangerine Peel (Qingpi), Codonopsis Root (Renshen), Astragalus Root (Huangqi), Pinellia Tuber (Banxia), Fresh Ginger Root (Shengjiang),