瘴疽因受山瘴毒，伏藏久痛附筋骨，初黑次青如拳打，急砭恶血后脓熟。
【注】此证因受山岚瘴气，伏藏筋骨之间，年月久远，令人痛附筋骨，始发黑色，
顽痹如木石。其毒附着于筋骨，重按方知微痛，五七日后毒势涌出浮肿，次变青色，如
拳打之状，寒战似疟，头颤口偏，手足厥逆
黑睛紧小。始见黑色时，急用砭法，令出恶血，随服不换金正气散加羚羊角以泄邪毒，
次按痈疽肿疡、溃疡治法。脓熟溃黄白脓为顺，出黑汁者险。
\r瘴疽图\p04-34a252.bmp\r
不换金正气散
苍术（米泔水浸，炒） 浓朴（姜制） 陈皮 藿香 半夏曲（炒，各二钱） 甘草（炙，一钱）
水二盅，生姜五片，红枣二枚，煎一盅，去渣，稍热服。忌生冷、油腻。
【方歌】正气散因山瘴感，伏久生疽身战寒，平胃散加半夏曲，藿香姜枣服平安。
产后痈疽最属险，七情之伤六淫感，瘀血稽留成痈疽，势溃托里不宜缓。
【注】此证因产后气血经络俱虚，或因七情所伤，或因六淫所感，与瘀血相稽而成，
最属险候，法宜大补，扶助根本，兼活瘀生新为要，其客病以末治之。初服生化汤，随
证加减，以消毒；有表邪服清魂散，有里热服回生丹。势欲溃脓时，急宜托里，迟则恐
毒内陷，药味宜和平纯善，最忌汗下峻剂。其余肿溃治法，俱按痈疽肿疡、溃疡门。
\r产后痈疽图\p04-34a253.bmp\r
生化汤
当归（八钱） 川芎（四钱） 姜炭 甘草（炙，各四分） 桃仁（去皮尖，研泥，十粒）
水一盅半，煎六分，加无灰酒一小杯和服。
【方歌】生化汤宜产后疽，通滞和荣又补虚，归芎姜炭炙甘草，桃仁酒服善消瘀。
清魂散
荆芥（一钱） 川芎（五分） 人参 甘草（炙） 泽兰叶（各三分）
为末，黄酒调服。
【方歌】清魂产后风邪侵，荆芥川芎与人参，炙甘泽兰同作剂，能疏表证效通神。
回生丹
黑豆（煮熟取，汁三碗，去豆，三升） 红花（炒黄色，入醇酒，大壶同煮三五滚
，去红花用汁，三两） 生大黄（研末，一斤） 苏木（锉，用河水五碗煎汁三碗，去渣，二两）
先将大黄末，以好米醋三四碗搅匀，文武火熬成膏，如此二遍；次下红花酒、苏木
汤、黑豆汁共熬成膏，离火再入后药∶
当归 熟地 川芎 白茯苓 延胡索 乌药 香附 蒲黄 牛膝 桃仁（另研） 苍术
（米泔水浸，炒，各二两） 白芍（酒炒） 甘草（炙） 羌活 山萸肉（酒浸） 三棱 陈皮
地榆 木香 五灵脂（各五钱） 人参 白术（土炒） 青皮 木瓜（各三钱） 良姜（四钱）
乳香 没药（各一钱）
共研细末，用大黄膏为丸，如弹子大。每服一丸，黄酒炖化，通口服。
【方歌】回生产后存恶露，致发痈疽服可逐，除热活瘀荣卫和，红花大黄豆苏木，
八珍羌萸棱延胡，乌药青陈榆香附，乳没蒲黄良膝瓜，木香灵脂桃苍术。
瘴疽是由于感受山间瘴气毒邪所致，毒邪潜伏日久，疼痛深附于筋骨。初起时皮肤呈黑色，随后变为青色，状如被拳头殴打后的瘀肿，此时急需使用砭石刺破排出恶血，待脓液成熟后再行处理。
【注】此病证因感受山岚瘴气，毒邪潜伏在筋骨之间，经年累月，导致疼痛深入筋骨。初发时颜色变黑，患处僵硬麻木如同木石。其毒邪附着于筋骨，重按才能感到轻微疼痛。五到七日后，毒势涌出，局部浮肿，继而变为青色，状如拳打之痕，伴有寒战似疟疾发作，头部颤抖，口眼歪斜，手足厥冷，黑睛紧缩变小。刚见到黑色时，立即使用砭法，令恶血流出，随即服用不换金正气散加羚羊角以泄除邪毒，之后按照痈疽肿疡、溃疡的治疗方法进行处理。脓液成熟溃破后，流出黄白色脓液为顺证，流出黑色汁液者则病情险恶。
不换金正气散
苍术（用米泔水浸泡，炒制） 浓朴（姜汁炮制） 陈皮 藿香 半夏曲（炒制，各二钱） 甘草（炙制，一钱）
用水两盅，生姜五片，红枣二枚，煎煮至一盅，去渣滓，稍热后服用。忌食生冷、油腻食物。
【方歌】正气散因山瘴感，伏久生疽身战寒，平胃散加半夏曲，藿香姜枣服平安。
产后痈疽最为危险，多由七情内伤或六淫外感引起，瘀血滞留形成痈疽，当脓势将溃时，托里透脓之法不宜迟缓。
【注】此病证因产后气血经络俱虚，或因七情所伤，或因六淫所感，与体内瘀血相搏结而成，属于最危险的证候。治法宜大补气血，扶助根本，兼以活血化瘀、生新养血为关键，对于外来邪气则作为次要治疗。初起服用生化汤，随证加减以消毒；若有表邪，服用清魂散；若有里热，服用回生丹。当脓势即将溃破时，急需使用托里法，若迟缓则恐毒邪内陷，药味宜平和纯善，最忌使用发汗、攻下的峻猛药剂。其余肿胀溃烂的治疗方法，均按照痈疽肿疡、溃疡门的法则处理。
生化汤
当归（八钱） 川芎（四钱） 姜炭 甘草（炙制，各四分） 桃仁（去皮尖，研成泥状，十粒）
用水一盅半，煎煮至六分，加入无灰酒一小杯调和服用。
【方歌】生化汤宜产后疽，通滞和荣又补虚，归芎姜炭炙甘草，桃仁酒服善消瘀。
清魂散
荆芥（一钱） 川芎（五分） 人参 甘草（炙制） 泽兰叶（各三分）
研为细末，用黄酒调服。
【方歌】清魂产后风邪侵，荆芥川芎与人参，炙甘泽兰同作剂，能疏表证效通神。
回生丹
黑豆（煮熟取汁三碗，去掉豆渣，用量三升） 红花（炒至黄色，放入醇酒中，与大壶一同煮沸三五滚，去掉红花只用汁液，三两） 生大黄（研成末，一斤） 苏木（锉碎，用河水五碗煎煮取汁三碗，去渣，二两）
先将大黄末，用好米醋三四碗搅拌均匀，用文武火熬成膏，如此重复两次；然后加入红花酒、苏木汤、黑豆汁共同熬成膏，离火后再加入以下药物：
当归 熟地黄 川芎 白茯苓 延胡索 乌药 香附 蒲黄 牛膝 桃仁（另研） 苍术（用米泔水浸泡，炒制，各二两） 白芍（酒炒） 甘草（炙制） 羌活 山萸肉（酒浸） 三棱 陈皮 地榆 木香 五灵脂（各五钱） 人参 白术（土炒） 青皮 木瓜（各三钱） 良姜（四钱） 乳香 没药（各一钱）
共研为细末，用大黄膏作为粘合剂制成丸药，大小如弹子。每次服用一丸，用黄酒炖化，通口服下。
【方歌】回生产后存恶露，致发痈疽服可逐，除热活瘀荣卫和，红花大黄豆苏木，八珍羌萸棱延胡，乌药青陈榆香附，乳没蒲黄良膝瓜，木香灵脂桃苍术。
Zhangju (Miasma Carbuncle) is caused by contracting the toxic miasma of mountainous regions. The pathogen lies latent for a long time, causing pain that penetrates deep into the sinews and bones. Initially, the skin turns black, then changes to cyanosis, resembling the bruising from a fist blow. It is urgent to use bian stone therapy (scarification with a stone knife) to expel evil blood, and only after the pus has matured should further treatment proceed.
[Note] This condition arises from contracting mountain miasma qi. The toxin hides between the sinews and bones over many years, causing pain that attaches deeply to the sinews and bones. When it first appears, the color is black, and the area becomes stiff and numb like wood or stone. The toxin adheres to the sinews and bones; slight pain is felt only upon heavy pressure. After five to seven days, the toxic force surges outward, causing swelling. It subsequently turns cyanotic, resembling the mark of a fist blow, accompanied by chills similar to malaria, head tremors, deviation of the mouth and eyes, coldness of the hands and feet, and tightening and shrinking of the black pupil. When the black color is first seen, immediately use bian stone therapy to let out the evil blood. Subsequently, administer Buhuanjin Zhengqi San (Golden Change Upright Qi Powder) added with Lingyangjiao (Antelope Horn) to drain the evil toxin. Thereafter, treat according to the methods for carbuncles and ulcers in their swollen/ulcerated stages. If yellow-white pus flows after rupture when mature, it is a favorable sign; if black fluid flows, it is dangerous.
Buhuanjin Zhengqi San (Golden Change Upright Qi Powder)
Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried) Nongpo (Magnoliae Officinalis Cortex, processed with ginger juice) Chenpi (Citri Reticulatae Pericarpium) Huoxiang (Agastaches Herba) Banxiaqu (Pinelliae Fermentatum, stir-fried, each 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 qian)
Use two zhong of water, five slices of fresh ginger, and two red dates. Decoct until one zhong remains. Strain and drink while slightly warm. Avoid raw, cold, and greasy foods.
[Prescription Verse] Zhengqi San treats contraction of mountain miasma, Long latency generates carbuncles with body chills and cold, Pingwei San plus Pinelliae Fermentatum, With Agastaches Herba, fresh ginger, and red dates, peace is ensured.
Chanhou Yongju (Postpartum Carbuncle and Ulcer) is extremely perilous. It results from injury by the seven emotions or invasion by the six climatic pathogens. Stagnant blood accumulates to form carbuncles and ulcers. When the abscess is about to rupture, the method of supporting the interior and promoting pus discharge must not be delayed.
[Note] This condition occurs because postpartum qi, blood, meridians, and collaterals are all deficient. It may be caused by emotional injury, invasion by the six climatic pathogens, or interaction with stagnant blood. It is a most critical syndrome. The treatment principle should be major tonification to support the root, combined with activating blood to resolve stasis and generate new tissue. Exogenous pathogens are treated as secondary concerns. Initially, administer Shenghua Tang (Life-Restoring Decoction), modified according to symptoms to eliminate toxicity. If there are exterior pathogens, administer Qinghun San (Clear Soul Powder); if there is interior heat, administer Huisheng Dan (Life-Returning Pill). When pus is about to rupture, urgently apply methods to support the interior; delay risks the internalization of toxins. Medicinal flavors should be mild and pure. Harsh diaphoretic or purgative agents are strictly contraindicated. Other treatments for swelling and ulceration follow the regulations for carbuncles and ulcers in their swollen/ulcerated stages.
Shenghua Tang (Life-Restoring Decoction)
Danggui (Angelicae Sinensis Radix, 8 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 4 qian) Jiangtan (Zingiberis Rhizoma Carbonisatum) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 4 fen) Taoren (Persicae Semen, peeled and pitted, pounded into paste, 10 grains)
Use one and a half zhong of water. Decoct until six fen remains. Add a small cup of unadulterated wine and take mixed.
[Prescription Verse] Shenghua Tang is suitable for postpartum carbuncles, Unblocking stagnation, harmonizing nutritive qi, and tonifying deficiency, Angelicae Sinensis Radix, Ligustici Chuanxiong Rhizoma, Zingiberis Rhizoma Carbonisatum, and honey-fried Glycyrrhizae Radix et Rhizoma, Persicae Semen taken with wine effectively resolves stasis.
Qinghun San (Clear Soul Powder)
Jingjie (Schizonepetae Spica, 1 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 fen) Renshen (Ginseng Radix) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Zelan Ye (Lycii Cortex, each 3 fen)
Grind into fine powder. Take mixed with yellow wine.
[Prescription Verse] Qinghun San treats wind-pathogen invasion in postpartum, Schizonepetae Spica, Ligustici Chuanxiong Rhizoma, and Ginseng Radix, Honey-fried Glycyrrhizae Radix et Rhizoma and Lycii Cortex made into a preparation, Can relieve exterior syndromes with miraculous efficacy.
Huisheng Dan (Life-Returning Pill)
Heidou (Sojae Semen Nigrum, boiled and juiced, three bowls, beans removed, volume equivalent to three sheng) Honghua (Carthami Flos, stir-fried until yellow, placed in strong wine, boiled together in a large pot for three to five boils, flowers removed, juice used, 3 liang) Sheng Dahuang (Rhei Radix et Rhizoma, ground into powder, 1 jin) Sumu (Sappan Lignum, chopped, decocted in river water five bowls to yield three bowls of juice, dregs removed, 2 liang)
First, mix the powder of Sheng Dahuang with three to four bowls of good rice vinegar, stirring evenly. Simmer on gentle and strong fire to form a paste; repeat this process twice. Then add Honghua wine, Sumu decoction, and Heidou juice, boiling together into a paste. Remove from fire and add the following herbs:
Danggui (Angelicae Sinensis Radix) Shudi (Rehmanniae Radix Praeparata) Chuanxiong (Ligustici Chuanxiong Rhizoma) Baifuling (Poria, 2 liang each) Yanshusuo (Cyperi Rhizoma) Wuyao (Linderae Radix) Xiangfu (Cyperi Rhizoma) Puhuang (Typhae Pollen) Niuxi (Achyranthis Bidentatae Radix) Taoren (Persicae Semen, separately pounded) Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried, 2 liang each) Baishao (Paeoniae Radix Alba, wine-fried) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Qianghuo (Notopterygii Rhizoma et Radix) Shanyurou (Corni Fructus, wine-soaked) Sanleng (Sparganii Rhizoma) Chenpi (Citri Reticulatae Pericarpium) Diyu (Sanguisorbae Radix) Muxiang (Aucklandiae Radix) Wulingzhi (Trogopterori Faeces, each 5 qian) Renshen (Ginseng Radix) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried) Qingpi (Citri Reticulatae Pericarpium Viride) Mugua (Chaenomelis Fructus, each 3 qian) Liangjiang (Alpiniae Officinarum Rhizoma, 4 qian) Ruxiang (Olibanum) Moyao (Myrrha, each 1 qian)
Grind all into fine powder. Use the Dahuwang paste as a binder to make pills the size of a bullet. Take one pill per dose, melt in yellow wine, and swallow orally.
[Prescription Verse] Huisheng Dan addresses lochia retention postpartum, Causing carbuncles and ulcers, taking it can expel them, Clearing heat, activating blood, harmonizing nutritive and defensive qi, Carthami Flos, Rhei Radix et Rhizoma, Sojae Semen Nigrum, Sappan Lignum, Eight-Tonics Formula, Notopterygii Rhizoma et Radix, Corni Fructus, Sparganii Rhizoma, Cyperi Rhizoma, Linderae Radix, Citri Reticulatae Pericarpium Viride, Sanguisorbae Radix, Aucklandiae Radix, Cyperi Rhizoma, Olibanum, Myrrha, Typhae Pollen, Alpiniae Officinarum Rhizoma, Achyranthis Bidentatae Radix, Chaenomelis Fructus, Aucklandiae Radix, Trogopterori Faeces, Persicae Semen, Atractylodis Rhizoma.