【方歌】失荣耳旁及项肩，起如痰核不动坚，皮色如常日渐大，
忧思怒郁火凝然。日久气衰形削瘦，愈溃愈硬现紫斑，
腐烂浸淫流血水，疮口翻花治总难。
【注】失荣证，生于耳之前后及肩项。其证初起，状如痰核，
推之不动，坚硬如石，皮色如常，日渐长大。由忧思、
恚怒、气郁、血逆与火凝结而成，日久难愈，形气渐衰
，肌肉削瘦，愈溃愈硬，色现紫斑，腐烂浸淫，渗流血
水，疮口开大，努肉高突，形似翻花瘤证。古今虽有治
法，终属败证。但不可弃而不治，初宜服和荣散坚丸，
外贴阿魏化坚膏，然亦不过苟延岁月而已。
方剂：和荣散坚丸
主治：治失荣，调和荣血，散坚开郁。
组成：川芎 白芍（酒炒）
当归 茯苓
熟地 陈皮
桔梗 香附
白术（土炒，各一钱） 人参
甘草（炙） 海粉
昆布 贝母（去心，各五钱）
升麻 红花（各三钱）
夏枯草（熬汤，再加红蜜四两，再熬成膏，一斤）
共研细末，夏枯草膏合丸，如梧桐子大。每服三钱
，食远白滚水送下。
身热，加黄芩、柴胡，自汗盗汗去升麻，倍人参，
加黄耆。饮食无味，加藿香、砂仁。饮食不化，加山查
、麦芽。胸膈痞闷，加泽泻、木香。欬嗽痰气不清，加
杏仁、麦冬。口干作渴，加知母、五味子。睡眠不宁，
加黄柏、远志、枣仁。惊悸健忘，加茯神、石菖蒲。有
汗恶寒，加薄荷、半夏。无汗恶寒，加苍术、藿香。妇
人经事不调，加延胡索、丹皮。腹胀不宽，加厚朴、大
腹皮。
【方歌】和荣散坚丸消郁，开结益虚理肝脾，八珍贝桔陈香附，
昆海升红枯草宜。
又方：阿魏化坚膏
组成：用蟾酥丸药末一料，金头蜈蚣五条，炙黄去头足，共研
匀；将太乙膏二十四两，重汤炖化，离火入前药末，搅
冷为度。每用时以重汤炖化，用红绢摊贴，半月一换。
轻者渐消，重者亦可少解，常贴可保不致翻花。
【方歌】阿魏化坚消结聚，蟾酥丸料研末细，蜈蚣炙黄太乙膏，
炖化搅匀功速极。
又方：太乙膏（见溃疡门）
蟾酥丸钮扣风（见疔疮门）
【方歌】失荣证发生在耳部前后以及颈部和肩部，肿块初起时像痰核一样，推之不动且坚硬如石，皮肤颜色正常但日渐增大，这是由于忧思、愤怒导致气郁化火凝结而成。病程日久后，患者正气衰败，形体消瘦，溃烂后反而更加坚硬并出现紫斑，疮面腐烂浸淫，流出血水，疮口外翻如花状，治疗非常困难。
【注】失荣证，生于耳部前后及肩颈部。此病初起时，形态如同痰核，推动它不移动，质地坚硬如石头，皮肤颜色如常，但逐渐长大。这是由忧思、恚怒（愤怒）、气机郁滞、血液逆乱与火邪凝结而成的。病程长久难以痊愈，患者的形体和气力逐渐衰弱，肌肉消瘦，越是溃烂越坚硬，色泽呈现紫斑，腐烂浸淫，渗出血液和水液，疮口扩大，腐肉高突，形状类似翻花瘤证。古今虽有治疗方法，但最终属于败证（难治之症）。然而不可放弃不治，初期适宜服用和荣散坚丸，外部贴敷阿魏化坚膏，但这也不过是勉强维持岁月而已。
方剂：和荣散坚丸
主治：治疗失荣，调和营血，消散坚结，开解郁结。
组成：川芎、白芍（酒炒）、当归、茯苓、熟地黄、陈皮、桔梗、香附、白术（土炒，各一钱）、人参、甘草（炙）、海粉、昆布、贝母（去心，各五钱）、升麻、红花（各三钱）、夏枯草（熬汤，再加红蜜四两，再熬成膏，总量一斤）。
以上药材共研为细末，用夏枯草膏混合制成丸药，大小如梧桐子。每次服用三钱，在饭后较远时用温开水送服。
若身热，加黄芩、柴胡；自汗或盗汗，去掉升麻，加倍人参用量，加黄芪；饮食无味，加藿香、砂仁；饮食不消化，加山楂、麦芽；胸膈痞闷，加泽泻、木香；咳嗽痰气不清，加杏仁、麦冬；口干口渴，加知母、五味子；睡眠不安宁，加黄柏、远志、酸枣仁；惊悸健忘，加茯神、石菖蒲；有汗且恶寒，加薄荷、半夏；无汗且恶寒，加苍术、藿香；妇女月经不调，加延胡索、牡丹皮；腹胀不宽舒，加厚朴、大腹皮。
【方歌】和荣散坚丸能消除郁结，开通结聚、补益虚弱、调理肝脾，方中含有八珍汤成分（此处指代补气养血药）及贝母、桔梗、陈皮、香附，还有昆布、海藻、升麻、红花、夏枯草适宜使用。
又一方：阿魏化坚膏
组成：取蟾酥丸药末一料，金头蜈蚣五条（炙黄，去掉头和足），共同研磨均匀；将太乙膏二十四两，隔水炖化，离火后加入前面的药末，搅拌至冷却即可。每次使用时，再次隔水炖化，用红绢摊涂贴敷，半个月更换一次。病情轻的会逐渐消退，重的也可以稍作缓解，经常贴敷可保证不致发展成翻花瘤。
[Prescription Verse] Shiring (Shi Rong) occurs around the ears, neck, and shoulders. Initially presenting as phlegm nodules that are immobile and hard as stone, with normal skin color but gradually enlarging, it is caused by the condensation of fire due to worry, thinking, anger, and qi stagnation. As time passes, qi declines and the body emaciates; the more it ulcerates, the harder it becomes, showing purple spots. The sores rot and ooze blood and water, with everted edges resembling flowers, making treatment extremely difficult.
[Annotation] Shiring syndrome arises at the front and back of the ears and on the neck and shoulders. Initially, the lesion resembles a phlegm nodule, is immobile upon pushing, hard as stone, has normal skin color, but grows day by day. It is formed by the condensation of worry, anger, qi stagnation, blood rebellion, and fire. Long-standing cases are difficult to heal; the patient's form and qi gradually decline, muscles emaciate, ulceration leads to increased hardness, purple spots appear, rotting and oozing blood and water, the sore opening enlarges, and granulation tissue protrudes high, resembling a flower-everted tumor. Although there are treatment methods in ancient and modern times, it ultimately belongs to a "defeated syndrome" (incurable or terminal stage). However, one must not abandon treatment. In the early stage, he Rong San Jian Wan (Harmonizing Ying and Dispersing Hardness Pill) should be taken internally, and Awei Huajian Gao (Asafoetida Hardness-Dissolving Plaster) applied externally, though this merely prolongs life for a few years.
Prescription: He Rong San Jian Wan (Harmonizing Ying and Dispersing Hardness Pill)
Indications: Treats Shiring, harmonizes Ying-blood, disperses hardness, and resolves stagnation.
Composition: Chuanxiong Rhizoma (Chuanxiong), Bai Shao Radix Paealae Albae (Bai Shao, stir-fried with wine), Danggui Radix Angelicae Sinensis (Danggui), Poria (Fuling), Shu Dihuang Radix Rehmanniae Preparata (Shudi), Chenpi Pericarpium Citri Reticulatae (Chenpi), Jiegeng Radix Platycodonis (Jiegeng), Xiangfu Rhizoma Cyperi (Xiangfu), Baizhu Rhizoma Atractylodis Macrocephalae (Baizhu, stir-fried with soil, 1 qian each), Renshen Radix Ginseng (Renshen), Gancao Radix Glycyrrhizae Preparata (Gancao, honey-fried), Haifen Natrii Boras (Haifen), Kunbu Thallus Laminariae seu Eckloniae (Kunbu), Beimu Bulbus Fritillariae Cirrhosae (Beimu, heart removed, 5 qian each), Shengma Rhizoma Cimicifugae (Shengma), Honghua Flos Carthami Tinctorii (Honghua, 3 qian each), Xiakucao Herba Prunellae Spicae (Xiakucao, decocted into soup, then add 4 liang of red honey, boil again into paste, total 1 jin).
Grind all herbs into fine powder. Mix with Xiakucao paste to form pills, size of Sophora japonica seeds. Take 3 qian per dose, washed down with warm boiled water far from meals.
If feverish, add Huangqin Cortex Scutellariae (Huangqin) and Chaihu Radix Bupleuri (Chaihu); if spontaneous or night sweating, remove Shengma, double Renshen, add Huangqi Radix Astragali Membranacei (Huangqi); if food tastes bland, add Huoxiang Herba Agastaches (Huoxiang) and Sharen Fructus Amomi Rotundus (Sharen); if food is indigestible, add Shanzha Fructus Crataegi (Shanzha) and Maiya Fructus Hordei Germinatus (Maiya); if chest and diaphragm feel stuffy, add Zexia Herba Alismatis (Zexia) and Muxing Fructus Aquilariae (Muxing); if coughing with unclear phlegm-qi, add Xingren Semen Armeniacae Amarum (Xingren) and Maidong Rhizoma Ophiopogonis (Maidong); if mouth dry and thirsty, add Zhimu Rhizoma Anemarrhenae (Zhmu) and Wuweizi Fructus Schisandrae Chinensis (Wuweizi); if sleep is restless, add Huangbai Cortex Phellodendri (Huangbai), Yuanzhi Radix Polygalae (Yuanzhi), and Zaoren Semen Ziziphi Spinosae (Zaoren); if palpitations and forgetfulness, add Fushen Sclerotium Poriae Cum Radice Xyli (Fushen) and Shichangpu Rhizoma Acori Tatarinowii (Shichangpu); if sweating with aversion to cold, add Bohe Herba Menthae haplocalycis (Bohe) and Banxia Rhizoma Pinelliae Preparata (Banxia); if no sweating with aversion to cold, add Cangzhu Rhizoma Atractylodis Lanceae (Cangzhu) and Huoxiang Herba Agastaches (Huoxiang); if women have irregular menstruation, add Yanhusuo Rhizoma Corydalis (Yanhusuo) and Danmu Pi Cortex Moutan (Danpi); if abdominal distension without relief, add Houpu Cortex Magnoliae Officinalis (Houpu) and Dafupi Pericarpium Arecae (Dafupi).
[Prescription Verse] He Rong San Jian Wan dissipates stagnation, opens knots, benefits deficiency, and regulates Liver and Spleen. It contains ingredients similar to Ba Zhen Tang, along with Beimu, Jiegeng, Chenpi, Xiangfu, Kunbu, Haizao, Shengma, Honghua, and Xiakucao.
Another Prescription: Awei Huajian Gao (Asafoetida Hardness-Dissolving Plaster)
Composition: Use one portion of Chan Su Wan (Toad Venom Pill) powder, five Golden-headed Wugong (Scolopendra Subspinipes mutilans, dried and roasted yellow, heads and feet removed), grind evenly together. Take 24 liang of Taiyi Gao (Taiyi Plaster), melt it in a double boiler, remove from fire, add the aforementioned powder, stir until cool. When using, melt again in a double boiler, spread on red silk, and apply. Change once every half month. Mild cases will gradually disappear; severe cases can be slightly relieved. Regular application can prevent progression to flower-everted tumors.
[Prescription Verse] Awei Huajian Gao eliminates accumulations. Chan Su Wan powder is ground fine, mixed with roasted Wugong and Taiyi Gao, melted and stirred evenly for rapid efficacy.
Another Prescription: Taiyi Gao (See Ulcer Section)
Chan Su Wan Niu Kou Feng (See Carbuncle/Furuncle Section)