对口、发背不拘偏正，只谓形色。色忌晦滞，贵淡红明润；形忌歪邪平塌，要尖圆高突。
所以高为阳，下为阴；红为阳、白为阴。有肌肤受寒毒，虽高耸而亦白者，须用柴葛解肌。或
时当寒甚，用净苏叶温解，使之重汗，俾邪从汗解。若痛在筋骨，外不现形，肉色如故，两脉
或弦硬、细紧、沉伏、细滑，则为流注，须用苍、陈、朴、草、苏叶；不效，再用麻黄、姜、桂、附子
以解之。麻黄不拘分量，数分起至二钱为止。有干鹤膝，小腿不但不肿胀，并其上大肉尽
去，膝转看得极大，麻黄一服即用三钱。
对口不拘左右，以升阳火为主∶右初起柴胡、川芎，可稍缓，即用升麻；左初起升麻可稍
缓，且先用柴葛解肌汤；若自左肿之右、自右肿之初，一服升、柴、川芎并用桔梗，不拘左右
用钱外至钱半为止，使之载诸药而上浮。凡耳后、脑骨中间、软堂正中必用独活，以提肾毒。
对口在头，头为诸阳之首，虽不高耸，亦不以阴论，止重用发散。间有时值严寒，无汗不解，
用麻黄三五分，炒黑；而桂、附等药不用，发背亦然。发背并不宜重用发散，倘至大溃之后，
亦清补者多。对乳以上用桔梗，对乳以下不用。对口右升麻、左柴胡，乃其君也！若火势
炎甚、身热如炙、痛楚非常，川芎不用。经云∶川芎佐清阳而升。头角火炎者，宜戒火热。大痛、极红而老，
倘升阳、散火无效，一面重加升麻，一面加大黄一二钱，谓之将军定痛散。发背若大痛楚，亦用定痛散。
毒有游红、嫩红、散脚红、红而带紫如猪肝色，重则用青皮、柴胡以疏肝气，轻则用柴
胡、白蒺藜、丹皮以平之。游红系绛红色，亦带紫，是血分稍亏、阴火上发。轻则用玄参二三
钱，如夜加痛楚、发热则用生地二三钱，以滋阴，非此不可擅用，恐导邪入肾。当归去瘀生
新、新会皮和中补胃，二味人称外科胜药，病未退，切不可擅用，能导邪入胃。乳香、没药能
和气血，亦能损胃，胃弱者亦戒。至麻黄、姜、桂说之已详。大寒如知、柏、芩、连用亦甚少∶
非身热不退不用黄芩；非干恶、神情烦躁、身热如炉不用黄连；非口中大苦、舌苔焦黄而作
渴，不用知母；小便短赤、眼睛泪热方用黄柏，盐水炒。
脾善唇滋润、肝善身轻便、肺善声音响、心善精神爽、肾善水稀长，是谓五善。更有七
恶∶一恶神昏愦，二恶腰身强，三恶形消瘦，四恶皮肤槁，五恶成消渴，六恶身浮肿，七恶疮
倒陷。《外科正宗》善恶论∶患处梗实，如同负重，形色晦暗，歪邪平塌，隐然有黑色在肌肉
间，是毒藏于胃，不治。何则？胃主肌肉、肺主皮毛，且肺属金、胃属土，土为金母。烦躁而指
头不红，肝病；神昏，心病；口中无味，干，吊恶而饮食不贪，脾病；肌肤不润，毛发干枯而多
痰，肺病；小水短赤，骨节疼痛，夜不成眠，饮食不消，大便不实，肾病。毒色如猪肝，无脓
者，死。溃而不烂，最忌起葡桃之肉肿∶毒亦肿者，佳；肉肿，毒不肿者，死。去腐生新，形如石
榴子者，佳；腐肉已脱，而有红丝丝于其上者，死；新肉如板片，不进食者，死。又有毒已溃
烂，根脚尚不清楚，脓势亦不涌出，饮食不贪，欲攻而毒已溃烂，身躯已弱；欲补而根脚不
清，脓不涌，食不贪，肺胃邪不退，攻补两难。经云∶攻则死，补亦亡，谓和六腑最为良。更有
新肉已满，外口亦闭，按之不实，如皮袋状，不治。
凡至根脚清、痛减，脓虽未涌，不妨少用生 以佐脓。根脚清、毒软、痛止，急用炙黄
、山药合八珍汤，扶正却邪；有受寒、板痛，毒清消时、不消脓时，停（似有误字），用柴、
葛、白芷以解之；有重用苏叶合真人活命饮解之。有受暑而然者，用六一散、香薷合真人活
命饮。有房欲反复，未溃、未脓用独活合柴葛汤与活命饮；既溃、既脓用川断、制首乌，轻用
活命饮。有受气而然者，已溃、未溃俱用柴胡、青皮、郁金、香附，未溃合活命饮，已溃轻用。
受风而反复名为破伤风，不治者颇有，已溃用楝冬二三钱、八珍兼活命饮；未溃用黄芩、柴、葛与活命饮。
妇人产后不可脱去生化汤，胎前、带下，黄芩、白术、苎麻根，不可擅用甲片；有白淋者
用石羔腐炒黑为引，赤淋用盐卤腐炒黑、或用龟板、或用乌羔，溃后用川断、台术、大熟地。
男妇兼血证，引加童便一大杯。或男人遗精加莲须、芡实，溃后用连皮、建莲为引。
有伤鱼积，青果一枚为引；肉积，腊肉、骨灰加山杏一；饭积，用麦芽、神曲元；米积，用
白酒元；酒积，用白葛花、鸡巨子；面积，用白酒元、浓朴；芋头积，用陈酒；瓜果积，用草果、
麝香。又有溃烂时受臭香感触，用羌活合活命饮；有食冷复发，用半夏、陈皮；沐浴受触，用
柴葛。竟有至痰喘气急者，加真杜苏子三钱（炒研）、枳壳三钱（炒）。
毒有高耸而不红不痛，是为阳中阴，宜温解；有平塌而极红、极痛、腐烂者，是谓阴中
阳，宜清解。凡毒至，根脚清正，四面不痛不硬，患处亦软，阳宜清补，阴宜温补。一切未溃
以实论，既溃以虚论。又有根脚松散、红色甚娇、红脚甚嫩、如嫩肉状，且不疼痛，患处虽未
溃而亦软，舌上清皎无苔，是大虚之证。发背虽在未溃，一服即用炙黄 一两。夫补宜循序
而进，迟补伤元，误补则加痛，与其误补，毋宁迟补。如人本质不浓，因迟补而脓不速者，是
大约将脓未脓，可用生 三钱，渐加炙 钱许，脓出再加炙 后，不用生 。大溃、大证，
用至七八钱，甚有至一两者。大溃未有不气血两亏，补气用参、 ，补血用熟地，补血之阳
用当归、丹参。毒至溃后，补气而外，未有不急补肾水。何则肾为水，水生木，木生火，火生土
土生金，是水为方物之母。肾，上为命门，左为水，为水火既济。溃后阳证清补，川断为清补
圣药。若当温补而用川断，小水必蔽结。清补，至邪尽、饮食将复旧必用大熟地；温补至饮食
复旧，亦可用熟地（必用陈酒煮烂，每两加砂仁五六分。清补亦用此法制）。又发背有阴阳、
虚实夹杂∶如肉肿疮不肿者，即是虚实夹杂；至形状歪邪，根脚模糊，突起色白，药不见效，
是阴阳夹杂。初起亦用温散，以观动静，然后用人参一二分（炖汁）、炒花粉、肉桂一二分
（炖汁）、炒栝蒌仁，余则如常。若患处微似青色而人易生怒气，亦用桂、制栝蒌仁；如溃后
烦怒，用桂一二分（炖汁）拌炒白芍，妙。凡毒，软为虚，硬为实。更有肿胀不软而亦不痛，是
邪在血分，重用荆芥以疏血分之邪；红色过赤而老，是血分之火，用荆芥穗一二钱（盐水炒
黑）。溃后，精神弱、不成寐，用远志肉（开水泡）、白茯神、酸枣仁；不效，再引用龙眼肉。气
血弱，溃不收，用萸肉钱外或二钱，加炭白术、白芍（土炒）。大便不实，弱而不实色呆白，腹
不痛，人懒倦，用升麻数分、白扁豆二三钱（炒焦）、浓朴、杜仲（盐水炒）二三钱。实而不食，
心口痛，气饱，用药随所食之物以消之。若痢疾、胸气不宽，用炒枳壳；重则佛手、青皮加广
木香、浓朴。痢退，亦用升麻以提其阳，使之清升浊降；用白扁豆以补其脾，再后用杜仲以佐
其火。小便闭，用车前二三株或蔗浆以利之，忌食发物及生冷、洗浴、劳动、伤悲、气愤。遇
寡妇最宜解郁。毒楚难禁，用炒整甲片，将石膏腐包好煮滚，以平其燥烈之气。治病必从其
本∶食冷反复，轻则用砂仁以醒胃，重则用半
夏以燥胃。病虽有万殊，救药及反复总归一本。
对口疮和发背疮，无论是偏侧还是正中，主要观察其形态和色泽。色泽忌讳晦暗滞涩，贵在淡红且明润；形态忌讳歪斜邪曲、平坦下塌，要求尖圆高突。
所以，高耸属阳，低陷属阴；色红属阳，色白属阴。若肌肤受寒毒侵袭，虽然疮形高耸但颜色发白，必须使用柴葛解肌汤（Chai Ge Jie Ji Tang, Decoction for Resolving Muscle Layer with Bupleurum and Kudzu）。或者正值严寒之时，使用净苏叶（Perilla Leaf）进行温散解表，使其大汗淋漓，从而使邪气随汗而解。如果疼痛深入筋骨，外部看不出明显形态变化，肌肉颜色如常，脉象或弦硬、细紧、沉伏、细滑，这属于流注（Liu Zhu, Deep Abscess），须用苍术、陈皮、厚朴、甘草、苏叶；若无效，再使用麻黄、干姜、桂枝、附子来解之。麻黄的用量不拘泥于常规，从数分起，最多用到二钱。若有干鹤膝（Dry Crane's Knee, a type of joint atrophy without swelling），小腿不仅不肿胀，而且上部的大块肌肉完全萎缩，膝盖反而显得极大，此时麻黄一剂即用三钱。
对口疮不论左右，以升阳火为主要治法：右侧初起时，柴胡（Bupleurum Root）和川芎（Sichuan Lovage Rhizome）可稍缓，立即使用升麻（Cimicifuga Rhizome）；左侧初起时，升麻可稍缓，且先使用柴葛解肌汤；若是肿势从左蔓延至右，或从右蔓延至左，一剂药中升麻、柴胡、川芎并用桔梗（Platycodon Root），用量不拘左右，每味药从一钱到钱半为止，以此作为引经药使诸药上浮。凡是耳后、脑骨中间、软堂正中部位，必须用独活（Angelica Pubescens Root）来提引肾毒。对口疮生在头部，头为诸阳之首，即使不高耸，也不按阴证论治，只重用发散药物。间或遇到严寒天气，无汗不解，用麻黄三五分，炒黑；而桂枝、附子等药不用，发背疮也是如此。发背疮并不宜重用发散，倘若到了大溃之后，也多采用清补法。对乳以上用桔梗，对乳以下不用。对口疮右侧用升麻、左侧用柴胡，这是君药！如果火势炎盛、身热如炙烤、痛楚非常剧烈，则不用川芎。经文说：川芎辅助清阳上升。头角火炎者，宜戒避火热。若疼痛剧烈、极红且质地老硬，倘若升阳、散火无效，一面重加升麻，一面加大黄一二钱，称为将军定痛散（Jiang Jun Ding Tong San, General's Pain-Relieving Powder）。发背疮若大痛楚，也使用定痛散。
毒邪表现为游红、嫩红、散脚红、红而带紫如猪肝色，重者用青皮（Green Tangerine Peel）、柴胡以疏肝气，轻者用柴胡、白蒺藜（Tribulus Fruit）、丹皮（Moutan Cortex）以平抑之。游红呈绛红色，也带紫色，是血分稍亏、阴火上炎所致。轻者用玄参（Scrophularia Root）二三钱，如夜间加重痛楚、发热则用生地（Rehmannia Root）二三钱，以滋阴，非此不可擅用，恐怕引导邪气入肾。当归（Angelica Sinensis Root）能去瘀生新，新会皮（Xinhui Tangerine Peel）能和中补胃，这两味人称外科胜药，病未退，切不可擅用，能导邪入胃。乳香（Frankincense）、没药（Myrrh）能和气血，也能损胃，胃弱者亦需戒慎。至于麻黄、干姜、桂枝前面已说得很详细。大寒之药如知母（Anemarrhenae Rhizome）、黄柏（Phellodendri Cortex）、黄芩（Scutellaria Root）、黄连（Coptis Rhizome）使用也很少：非身热不退不用黄芩；非干呕、神情烦躁、身热如炉不用黄连；非口中大苦、舌苔焦黄而作渴，不用知母；小便短赤、眼睛泪热方用黄柏，盐水炒。
脾好唇滋润、肝好身轻便、肺好声音响、心好精神爽、肾好水稀长，这叫做五善（Five Good Signs）。更有七恶（Seven Bad Signs）：一恶神昏愦，二恶腰身强，三恶形消瘦，四恶皮肤槁，五恶成消渴，六恶身浮肿，七恶疮倒陷。《外科正宗》善恶论说：患处梗实，如同负重，形色晦暗，歪邪平塌，隐然有黑色在肌肉间，这是毒藏于胃，不治。为什么呢？胃主肌肉、肺主皮毛，且肺属金、胃属土，土为金母。烦躁而指头不红，肝病；神昏，心病；口中无味，干，吊恶而饮食不贪，脾病；肌肤不润，毛发干枯而多痰，肺病；小水短赤，骨节疼痛，夜不成眠，饮食不消，大便不实，肾病。毒色如猪肝，无脓者，死。溃而不烂，最忌起葡萄之肉肿：毒亦肿者，佳；肉肿，毒不肿者，死。去腐生新，形如石榴子者，佳；腐肉已脱，而有红丝丝于其上者，死；新肉如板片，不进食者，死。又有毒已溃烂，根脚尚不清楚，脓势亦不涌出，饮食不贪，欲攻而毒已溃烂，身躯已弱；欲补而根脚不清，脓不涌，食不贪，肺胃邪不退，攻补两难。经文说：攻则死，补亦亡，调和六腑最为良。又有新肉已满，外口亦闭，按之不实，如皮袋状，不治。
凡是到了根脚清、痛减，脓虽未涌，不妨少用黄芪（Astragalus Root）以助脓。根脚清、毒软、痛止，急用炙黄芪、山药合八珍汤（Ba Zhen Tang, Eight-Treasure Decoction），扶正却邪；有受寒、板痛，毒清消时、不消脓时，停（似有误字），用柴胡、葛根、白芷以解之；有重用苏叶合真人活命饮（Zhen Ren Huo Ming Yin, True Person's Life-Saving Decoction）解之。有受暑而然者，用六一散（Liu Yi San, Six-to-One Powder）、香薷合真人活命饮。有房欲反复，未溃、未脓用独活合柴葛汤与活命饮；既溃、既脓用川断（Dipsacus Root）、制首乌（Prepared Fleeceflower Root），轻用活命饮。有受气而然者，已溃、未溃俱用柴胡、青皮、郁金（Curcuma Aromatica Rhizome）、香附（Cyperi Rhizome），未溃合活命饮，已溃轻用。受风而反复名为破伤风（Po Shang Feng, Tetanus），不治者颇有，已溃用楝冬（Chengxinzi? Likely a typo or specific local name, context suggests a bitter/cold herb, possibly related to Melia or similar, but keeping as is or noting uncertainty. Given "Er Qian", likely a seed. Let's stick to text: 楝冬）二三钱、八珍兼活命饮；未溃用黄芩、柴胡、葛根与活命饮。
妇人产后不可脱去生化汤（Sheng Hua Tang, Postpartum Recovery Decoction），胎前、带下，黄芩、白术、苎麻根，不可擅用甲片（Tortoise Shell/Carapace）；有白淋者用石羔腐炒黑为引，赤淋用盐卤腐炒黑、或用龟板（Turtle Plastron）、或用乌羔（Wugupi? Likely a typo for Wuji or similar, context implies blackened shell/bone), 溃后用川断、台术（Taizhou Atractylodes）、大熟地（Prepared Rehmannia Root）。男妇兼血证，引加童便一大杯。或男人遗精加莲须（Lotus Stamen）、芡实（Euryale Seed），溃后用连皮、建莲（Jian Lotus Seed）为引。
有伤鱼积，青果一枚为引；肉积，腊肉、骨灰加山杏一；饭积，用麦芽、神曲元；米积，用白酒元；酒积，用白葛花、鸡巨子（Likely typo for Ji Nei Jin - Chicken Gizzard Membrane）；面积，用白酒元、浓朴；芋头积，用陈酒；瓜果积，用草果、麝香。又有溃烂时受臭香感触，用羌活（Notopterygium Root）合活命饮；有食冷复发，用半夏、陈皮；沐浴受触，用柴葛。竟有至痰喘气急者，加真杜苏子三钱（炒研）、枳壳（Aurantii Fructus）三钱（炒）。
毒有高耸而不红不痛，是为阳中阴，宜温解；有平塌而极红、极痛、腐烂者，是谓阴中阳，宜清解。凡毒至，根脚清正，四面不痛不硬，患处亦软，阳宜清补，阴宜温补。一切未溃以实论，既溃以虚论。又有根脚松散、红色甚娇、红脚甚嫩、如嫩肉状，且不疼痛，患处虽未溃而亦软，舌上清皎无苔，是大虚之证。发背虽在未溃，一服即用炙黄芪一两。夫补宜循序而进，迟补伤元，误补则加痛，与其误补，毋宁迟补。如人本质不浓，因迟补而脓不速者，是大约将脓未脓，可用生黄芪三钱，渐加炙黄芪钱许，脓出再加炙黄芪后，不用生黄芪。大溃、大证，用至七八钱，甚有至一两者。大溃未有不气血两亏，补气用人参、黄芪，补血用熟地，补血之阳用当归、丹参。毒至溃后，补气而外，未有不急补肾水。何则肾为水，水生木，木生火，火生土，土生金，是水为万物之母。肾，上为命门，左为水，为水火既济。溃后阳证清补，川断为清补圣药。若当温补而用川断，小水必蔽结。清补，至邪尽、饮食将复旧必用大熟地；温补至饮食复旧，亦可用熟地（必用陈酒煮烂，每两加砂仁五六分。清补亦用此法制）。又发背有阴阳、虚实夹杂：如肉肿疮不肿者，即是虚实夹杂；至形状歪邪，根脚模糊，突起色白，药不见效，是阴阳夹杂。初起亦用温散，以观动静，然后用人参一二分（炖汁）、炒花粉（Trichosanthes Root）、肉桂一二分（炖汁）、炒栝蒌仁（Trichosanthes Seed），余则如常。若患处微似青色而人易生怒气，亦用桂、制栝蒌仁；如溃后烦怒，用桂一二分（炖汁）拌炒白芍，妙。凡毒，软为虚，硬为实。更有肿胀不软而亦不痛，是邪在血分，重用荆芥（Schizonepeta Herb）以疏血分之邪；红色过赤而老，是血分之火，用荆芥穗一二钱（盐水炒黑）。溃后，精神弱、不成寐，用远志肉（开水泡）、白茯神（Poria with Hostwood）、酸枣仁（Ziziphus Seed）；不效，再引用龙眼肉（Longan Aril）。气血弱，溃不收，用萸肉（Cornus Fruit）钱外或二钱，加炭白术、白芍（土炒）。大便不实，弱而不实色呆白，腹不痛，人懒倦，用升麻数分、白扁豆二三钱（炒焦）、浓朴、杜仲（Eucommia Bark）（盐水炒）二三钱。实而不食，心口痛，气饱，用药随所食之物以消之。若痢疾、胸气不宽，用炒枳壳；重则佛手（Finger Citron）、青皮加广木香（Aucklandia Root）、浓朴。痢退，亦用升麻以提其阳，使之清升浊降；用白扁豆以补其脾，再后用杜仲以佐其火。小便闭，用车前二三株或蔗浆以利之，忌食发物及生冷、洗浴、劳动、伤悲、气愤。遇寡妇最宜解郁。毒楚难禁，用炒整甲片，将石膏腐包好煮滚，以平其燥烈之气。治病必从其本：食冷反复，轻则用砂仁（Amomum Fruit）以醒胃，重则用半夏以燥胃。病虽有万殊，救药及反复总归一本。
For "Duikou" (Opposite Mouth) sores and "Fabei" (Back Carbuncle), regardless of whether they are lateral or central, the primary focus is on their morphology and coloration. The color should avoid being dull and stagnant; it is prized when pale red and bright/moist. The morphology should avoid being crooked, flat, or sunken; it requires a pointed, round, and elevated appearance.
Therefore, elevation belongs to Yang, while depression belongs to Yin; redness belongs to Yang, while whiteness belongs to Yin. If the skin and muscles receive cold pathogenic factors, even if the sore is elevated, it may appear white. In such cases, *Chai Ge Jie Ji Tang* (Decoction for Resolving Muscle Layer with Bupleurum and Kudzu) must be used. Alternatively, if it is extremely cold, clean *Perillae Folium* (Perilla Leaf) can be used for warm dispersion to induce heavy sweating, thereby allowing the pathogen to exit via sweat. If the pain penetrates the sinews and bones, with no obvious external shape changes and normal muscle color, and the pulse is wiry/hard, fine/tight, deep/fixed, or fine/slippery, this constitutes *Liu Zhu* (Deep Abscess). One must use *Atractylodis Rhizoma* (Cangzhu), *Citri Reticulatae Pericarpium* (Chenpi), *Magnoliae Officinalis Cortex* (Houpo), *Glycyrrhizae Radix et Rhizoma* (Gancao), and *Perillae Folium*. If ineffective, then use *Ephedrae Herba* (Mahuang), *Zingiberis Rhizoma* (Jiang), *Cinnamomi Ramulus* (Guizhi), and *Aconiti Lateralis Radix Praeparata* (Fuzi) to resolve it. The dosage of *Ephedrae Herba* is not fixed; start from a few fen and go up to two qian. For "Dry Crane's Knee" (a condition where the lower leg does not swell, the large muscles above atrophy completely, and the knee appears disproportionately large), one dose of *Ephedrae Herba* uses three qian.
For Duikou sores, regardless of left or right, the main treatment is to raise Yang fire. On the right side initially, *Bupleuri Radix* (Chaihu) and *Ligustici Chuanxiong Rhizoma* (Chuanxiong) can be slightly delayed, using *Cimicifugae Rhizoma* (Shengma) immediately. On the left side initially, *Shengma* can be slightly delayed, and *Chai Ge Jie Ji Tang* should be used first. If the swelling spreads from left to right or right to left, one dose should combine *Shengma*, *Chaihu*, *Chuanxiong*, and *Platycodonis Radix* (Jiegeng). The dosage per herb ranges from one qian to one-and-a-half qian, serving as guiding herbs to lift the other medicines upward. For areas behind the ears, between the skull bones, and in the center of the soft palate, *Angelicae Pubescentis Radix* (Duhuo) must be used to extract kidney toxins. Since the head is the summit of all Yang meridians, Duikou sores located there are not treated as Yin syndromes even if not elevated; instead, strong dispersing methods are heavily utilized. Occasionally, during severe cold weather with no sweat and unresolved symptoms, *Ephedrae Herba* (3-5 fen, stir-fried until black) is used, while *Cinnamomi Ramulus* and *Aconiti Lateralis Radix Praeparata* are avoided. Fabei sores similarly do not favor heavy dispersal. After extensive ulceration, clearing and tonifying methods are predominantly used. *Platycodonis Radix* is used for sores above the nipple line but not below. For Duikou, *Shengma* is the sovereign herb for the right side, and *Chaihu* for the left. If the fire is intense, body heat feels like roasting, and pain is extreme, *Chuanxiong* is omitted. As stated in classics: *Chuanxiong* assists the clear Yang in ascending. For fire flaring in the temporal region, hot/fire stimuli should be avoided. If pain is severe, very red, and old/hard, and raising Yang/dispersing fire fails, increase *Shengma* significantly and add *Rhei Radix et Rhizoma* (Dahuang) 1-2 qian, known as *Jiang Jun Ding Tong San* (General's Pain-Relieving Powder). Fabei sores with severe pain also use this powder.
Toxic manifestations include wandering redness, tender redness, spreading base redness, and purple-red resembling pig liver. Severe cases use *Citri Reticulatae Pericarpium Viride* (Qingpi) and *Chaihu* to soothe Liver Qi; mild cases use *Chaihu*, *Tribuli Fructus* (Bijili), and *Moutan Cortex* (Danpi) to calm them. Wandering redness is crimson-purple, indicating slight blood deficiency and flaming Yin fire. Mild cases use *Scrophulariae Radix* (Xuanshen) 2-3 qian; if night pain/fever worsens, use *Rehmanniae Radix* (Shengdi) 2-3 qian to nourish Yin. This must not be used arbitrarily, lest it guide pathogens into the Kidney. *Angelicae Sinensis Radix* (Danggui) removes stasis and generates new blood; *Citri Reticulatae Pericarpium* (Xinhui Pi) harmonizes the middle and tonifies the Stomach. These are praised as superior surgical herbs, but must not be used arbitrarily before the disease recedes, as they may guide pathogens into the Stomach. *Boswelliae Resina* (Ruxiang) and *Commiphorae Resina* (Moyao) harmonize Qi and Blood but can damage the Stomach; thus, caution is needed for those with weak Spleen/Stomach. *Ephedrae Herba*, *Zingiberis Rhizoma*, and *Cinnamomi Ramulus* were detailed earlier. Cold-natured herbs like *Anemarrhenae Rhizoma* (Zhimu), *Phellodendri Cortex* (Huangbai), *Scutellariae Radix* (Huangqin), and *Coptidis Rhizoma* (Huanglian) are rarely used: *Huangqin* is not used unless fever persists; *Huanglian* is not used unless there is dry retching, restlessness, and furnace-like heat; *Zhimu* is not used unless there is extreme bitterness in the mouth, scorched yellow coating, and thirst; *Huangbai* (stir-fried with salt water) is used only for scanty dark urine and hot tearing eyes.
The Spleen favors moist lips, the Liver favors light body movement, the Lung favors resonant voice, the Heart favors bright spirit, and the Kidney favors abundant clear urine; these are the Five Good Signs (Wu Shan). There are also Seven Bad Signs (Qi E): 1. Confusion/delirium, 2. Stiff back/body, 3. Emaciation, 4. Dry/withered skin, 5. Development of Xiao Ke (Wasting-Thirst), 6. Generalized edema, 7. Ulcer inversion/collapse. According to *Waike Zhengzong*: If the lesion is firm/heavy, dull in color, flat/crooked, with hidden blackness in the muscles, the toxin hides in the Stomach, which is incurable. Why? The Stomach governs muscles, the Lung governs skin/hair; Lung is Metal, Stomach is Earth, and Earth is the mother of Metal. Restlessness with non-red fingertips indicates Liver disease; delirium indicates Heart disease; tasteless mouth, dryness, aversion to food indicates Spleen disease; dry skin/hair with phlegm indicates Lung disease; scanty dark urine, joint pain, insomnia, indigestion, loose stools indicate Kidney disease. Toxin color like pig liver without pus signifies death. Ulcerated but not rotting: fearing grape-like flesh protrusion is bad; if both toxin and flesh swell, it is good; if only flesh swells but toxin does not, it signifies death. Removing rot and generating new tissue resembling pomegranate seeds is good; after rot falls off, red filaments appearing signify death; new tissue like flat plates with anorexia signifies death. Another difficult scenario: toxin ulcerated, base unclear, pus not surging, anorexia, body weak. Attacking is impossible due to ulceration/weakness; tonifying is impossible due to unclear base/no pus/stagnant pathogens in Lung/Stomach. Classics say: Attacking leads to death, tonifying leads to demise; harmonizing the Six Fu Organs is best. New tissue filling the wound with closed exterior, feeling empty upon pressure like a skin bag, is incurable.
When the base clears and pain decreases, even if pus hasn't surged, a small amount of *Astragali Radix* (Huangqi) can be used to assist pus formation. When the base clears, toxin softens, and pain stops, urgently use stir-fried *Huangqi* and *Dioscoreae Rhizoma* (Shanyao) combined with *Ba Zhen Tang* (Eight-Treasure Decoction) to support healthy Qi and expel pathogens. For cold invasion with board-like pain, when toxin clears but pus doesn't (text notes possible error), use *Chaihu*, *Puerariae Lobatae Radix* (Gegen), and *Angelicae Dahuricae Radix* (Baizhi) to resolve. Heavy use of *Perillae Folium* combined with *Zhen Ren Huo Ming Yin* (True Person's Life-Saving Decoction) can also resolve it. For summerheat invasion, use *Liu Yi San* (Six-to-One Powder) and *Elsholtziae Herba* (Xiangru) with *Zhen Ren Huo Ming Yin*. For relapse due to sexual excess, before ulceration/pus formation, use *Duhuo* combined with *Chai Ge Tang* and *Huo Ming Yin*; after ulceration/pus formation, use *Dipsaci Radix* (Chuanduan) and *Polygoni Multiflori Preparata Radix* (Zhi Shouwu), lightly using *Huo Ming Yin*. For qi stagnation, use *Chaihu*, *Qingpi*, *Curcumae Aromaticae Rhizoma* (Yujin), and *Cyperi Rhizoma* (Xiangfu) for both pre- and post-ulceration, combining with *Huo Ming Yin* pre-ulceration and using lightly post-ulceration. Relapse due to wind invasion is called *Po Shang Feng* (Tetanus); many are incurable. Post-ulceration, use *Meliae Semen* (Liandong) 2-3 qian, *Ba Zhen Tang*, and *Huo Ming Yin*; pre-ulceration, use *Huangqin*, *Chaihu*, *Gegen*, and *Huo Ming Yin*.
Postpartum women must not omit *Sheng Hua Tang* (Postpartum Recovery Decoction). During pregnancy or leukorrhea, *Huangqin*, *Atractylodis Macrocephalae Rhizoma* (Baizhu), and *Stemoniae Radix* (Zhuma Gen) are used; *Testudinis Carapax et Plastrum* (Jiapian) must not be used arbitrarily. For white discharge, use stir-fried black *Gypsum Fibrosum* (Shigao) as a guide; for red discharge, use stir-fried black salt-brined material, or *Testudinis Plastron* (Guiban), or *Wugao*; post-ulceration, use *Chuanduan*, *Atractylodis Rhizoma* (Taizhu), and *Rehmanniae Radix Preparata* (Shudi). For men and women with blood disorders, add one cup of child's urine as a guide. For male seminal emission, add *Nelumbinis Stamen* (Lianxu) and *Euryales Semen* (Qianshi); post-ulceration, use lotus seed with skin and *Jian Lian* as a guide.
For fish accumulation, one green olive as a guide; for meat accumulation, cured meat ash plus one wild apricot kernel; for rice accumulation, *Hordei Fructus Germinatus* (Maiya) and *Medicated Leaven* (Shenqu); for grain accumulation, white wine pills; for alcohol accumulation, *Puerariae Flos* (Ge Hua) and *Corvis Gaster* (Jineijin - likely typo in source); for flour accumulation, white wine pills and *Houpo*; for taro accumulation, aged wine; for fruit/vegetable accumulation, *Tsaoko Fructus* (Caoguo) and *Moschus* (Shexiang). For foul odor contact during ulceration, use *Notopterygii Rhizoma et Radix* (Qianghuo) with *Huo Ming Yin*. For recurrence after eating cold food, use *Pinelliae Rhizoma* (Banxia) and *Citri Reticulatae Pericarpium* (Chenpi); for contamination during bathing, use *Chai Ge*. For phlegm-wheezing and急促 breathing, add stir-fried/grinded *Perillae Semen* (Dusu Zi) 3 qian and stir-fried *Aurantii Fructus* (Zhiqiao) 3 qian.
Toxins that are elevated but not red/painful are "Yang within Yin," requiring warm resolution. Those that are flat, very red, very painful, and rotting are "Yin within Yang," requiring clearing resolution. When a toxin arrives, if the base is clear, surrounding area painless/hard-free, and lesion soft, Yang syndromes need clearing-tonification, Yin syndromes need warming-tonification. All pre-ulceration conditions are treated as Excess; post-ulceration as Deficiency. If the base is loose, color delicate/tender like raw meat, painless, lesion soft despite no ulceration, and tongue is clear without coating, it is a severe Deficiency syndrome. Even pre-ulceration Fabei may require one liang of stir-fried *Huangqi* in one dose. Tonification should proceed gradually; delayed tonification harms Yuan Qi, mistaken tonification increases pain. Better to delay than to mistake. For those with weak constitution where delayed tonification slows pus formation (pre-pus stage), use 3 qian raw *Huangqi*, gradually increasing to stir-fried *Huangqi*. Once pus emerges, continue with stir-fried *Huangqi*, stopping raw *Huangqi*. For severe ulceration/large syndromes, use 7-8 qian, even up to one liang. Severe ulceration always involves Qi and Blood deficiency; tonify Qi with *Ren Shen* and *Huangqi*, tonify Blood with *Shudi*, and use *Danggui* and *Salviae Miltiorrhizae Radix* (Danshen) for Blood-Yang. After ulceration, besides tonifying Qi, urgently tonifying Kidney Water is essential. Why? Kidney is Water; Water generates Wood, Wood generates Fire, Fire generates Earth, Earth generates Metal. Water is the mother of all things. Kidney houses Mingmen, Left is Water, representing the intersection of Water and Fire. For post-ulceration Yang syndromes, *Chuanduan* is the holy medicine for clearing-tonification. Using *Chuanduan* for warming-tonification will cause urinary obstruction. For clearing-tonification, once pathogens are exhausted and appetite returns, *Shudi* is mandatory. For warming-tonification, once appetite returns, *Shudi* can also be used (must be boiled in aged wine until soft, adding 5-6 fen *Amomi Fructus* (Sharen) per liang; clearing-tonification uses this method too). Fabei can have mixed Yin/Yang and Deficiency/Excess: flesh swelling without sore swelling indicates mixed Deficiency/Excess; crooked shape, unclear base, white protrusion unresponsive to meds indicates mixed Yin/Yang. Initially use warm dispersion to observe dynamics, then use 1-2 fen *Ren Shen* (decocted juice), stir-fried *Trichosanthis Radix* (Huafen), 1-2 fen *Cinnamomi Cortex* (Rougui, decocted juice), stir-fried *Trichosanthis Semen* (Gualou Ren), and others normally. If lesion is slightly blue-green and patient prone to anger, use *Rougui* and processed *Gualou Ren*. If irritability/anger post-ulceration, use 1-2 fen *Rougui* (decocted juice) mixed with stir-fried *Paeoniae Radix Alba* (Baishao). Generally, soft toxins are Deficiency, hard are Excess. Swelling without softness or pain indicates pathogen in Blood level; heavily use *Schizonepetae Herba* (Jingjie) to disperse Blood-level pathogens. Overly red/hard texture indicates Blood-level fire; use 1-2 qian *Schizonepetae Spica* (Jingjiesui, stir-fried black with salt water). Post-ulceration, weak spirit/insomnia: use *Polygalae Radix* (Yuanzhi, soaked in boiling water), *Poria Cum Radio* (Baifushen), and *Ziziphi Spinosae Semen* (Suanzaoren); if ineffective, add *Longan Arillus* (Longyanrou). Weak Qi/Blood, non-healing ulcer: use 1+ qian or 2 qian *Corni Fructus* (Yurou), plus carbonized *Baizhu* and earth-stir-fried *Baishao*. Loose stools, weak/pale complexion, no abdominal pain, lethargy: use several fen *Shengma*, 2-3 qian stir-fried *Phaseoli Semen* (Baidoudou), *Houpo*, and 2-3 qian stir-fried *Eucommiae Cortex* (Duzhong). Fullness without eating, epigastric pain, bloating: use digestion-promoting herbs based on ingested food. For dysentery/chest tightness, use stir-fried *Zhiqiao*; severe cases add *Citri Reticulatae Pericarpium* (Qingpi), *Finger Citron* (Foshou), *Aucklandiae Radix* (Muxiang), and *Houpo*. After dysentery subsides, use *Shengma* to raise Yang (clear rises, turbid descends); use *Baidoudou* to tonify Spleen; subsequently use *Duzhong* to assist Fire. Urinary retention: use 2-3 stalks *Plantaginis Herba* (Cheqian) or sugarcane juice to promote urination. Avoid triggering foods, cold/raw items, bathing, labor, grief, and anger. Widows are particularly suitable for resolving depression. Unbearable pain: use stir-fried whole *Testudinis Carapax et Plastrum* (Jiapian), wrapped in stir-fried *Gypsum Fibrosum* (Shigao), boiled to calm its drying/acrid nature. Treating disease must address the root: recurrence from cold food, mild cases use *Sharen* to awaken Stomach, severe cases use *Banxia* to dry Stomach. Though diseases vary infinitely, rescue medications and recurrences ultimately return to one principle.