痈疽之疾，男子与妇人无异。惟妇人有月闭、血虚、气结三症之异耳，余当根据常法治之。
愚按∶男子之症，多属肝肾；女子之症，多属肝脾。治者亦当辨之。
凡小儿属纯阳，其痈疽之疾也，多因心气热而患之。
愚按∶前症亦有因禀赋而致者。尝治少参史南湖孙，阴囊赤肿，余作胎毒治之而瘥。后
患发热痰嗽，见症不一，难以明状，遂诊其母，有郁火血热之症，乃用解毒清肝等药，子母
俱服而愈（详见《保婴粹要》）。
崔氏方 治手足甲疽，或因修甲伤肉，或因损足成疮，溃烂上脚，用绿矾置铁板上
沸，色赤如溶金色者为真，沸定取出，研末，以盐汤洗搽之。
愚按∶前症即脱疽也。此方固有良验，尤当调元气为善。大抵此症，先因醇酒炙爆膏粱
浓味伤脾，或房劳亏损肾水，故有先渴而后患，有先患而后渴者。若色赤作痛自溃，可治；
色黑不溃，不治。色赤作痛者，先用隔蒜灸，活命饮、托里散，再用十全汤、大补汤加减八
味丸；色黯不痛者，隔蒜灸，桑枝灸，亦用十全大补汤加减八味丸，则毒瓦斯不致上侵，元气
不至亏损，庶可保生。亦有因修手足口咬等伤者，若元气怯弱，或犯房事，外涂寒凉，内服
克伐，损伤脾胃，患处不溃，色黯上延，亦多致死。重者须解去，当以脚力转解周HT ，轻拽
之，使筋随骨出，而毒得泄。否则毒筋内断，仍上溃，虽去无益。且偏僻之处，气血罕到，
药难导达。况攻毒之剂，先伤脾胃，反损元气，不若灸法为良。重者须解去为善。故孙真人
云，在肉则割，在指则截。虽亲之遗体不忍毁伤，然不如连则势必至于天殁，亦非体亲之心
也。况患处已坏，虽解不痛，又何惮而不为乎？女子亦有此患，多因郁怒亏损肝脾所致。治
法当与前同，患者知之（治验见《外科枢要》）。
经验方 治刀伤磕损，跌扑肿痛，或出血。用葱白细切杵烂，炒热敷患处，蒜冷再易，神效。
愚按∶《医学纲目》称前方有神效。余尝以治前症青肿不散，死肉不溃，佐以健脾胃之
药，其功尤捷。此内外所以合一也。
百一方 治竹刺在肉，以蛴螬研敷立出。
衍羲方 治竹木刺入肉，嚼牛膝根罨之，即出。
肘后方 治箭镞入骨，以巴豆肉微炒，以蜣螂研匀，涂伤处，俟痒极拔出。
孙真人治箭镞、针刺在咽喉胸膈，杵蝼蛄，涂患处，自出。
愚按∶前四方用之果有良验。
肘后方 治热油及火烧，用丹参八两，调以羊脂二斤，煎三五沸，取敷之。
至圣膏 治汤火疮，用鸡子黄置银石器内熬油，调胡粉敷之。
愚按∶前症若发热作渴，小便赤涩，用四君、芎、归、山栀、连翘、甘草健脾胃以消
毒。若患处肉已死而不溃，用八珍、白芷、甘草补气血以排脓，如未应，加肉桂。若患处死
肉已溃而不收敛，用四君、芎、归、黄 健脾胃以生肌，如未应，加炮姜。若小儿患之，或
目扎头摇等症，用四君加芎、归、山栀、健脾胃以清肝木。若食后即有此患，或腹胀作痛，
用四君、山栀、山楂、神曲壮脾气以消导。大凡初患此症，用神效当归膏敷之。轻者自愈，
重者自腐，良肉易生。其色赤者，乃火毒未尽，必搽至色白为度。倘患于肢节伸屈之处，若
敷此且免生痂伤碍新肉复溃难痊。倘回禄烟熏致死者，以萝卜捣汁灌之即苏，以其辛能散气
也（治验见正体部）。
附治验
锦衣杨永兴，厨下夜间回禄，凡睡此房已死将死者，灌以萝卜汁，良久悉愈。凡罹此患
者，以此治之，其应如响。
骑竹马灸法图 万金散
内托散 远志酒
五香连翘汤 忍冬酒
沉麝汤 忍冬草图
五香汤 以上方见前卷
漏芦汤 追毒丸
柞木饮 转毒散
阿胶饮 单煮大黄汤
牛胶饮 神仙截法
黄矾饮 秘传连翘汤
国老膏 千金漏芦汤
六味车螫散 神硝散
止痛灵宝散 圣效散
神效麻仁丸 神仙陷脉散
清心内固散 漏芦汤
清膻竹叶汤 猪蹄汤
以上方见中卷
痈疽这类疾病，男子和女子没有区别。只是女子有月经闭止、血虚、气结这三种情况的差异罢了，其余情况应当根据常规法则治疗。
我按语：男子的病症，多归属于肝肾；女子的病症，多归属于肝脾。治疗者也应当辨别这一点。
凡是小儿属于纯阳之体，他们患痈疽这类疾病，多是因为心气热所致。
我按语：前面的病症也有因为先天禀赋导致的。我曾经诊治少参史南湖的孙子，阴囊红肿，我将它作为胎毒来治疗而痊愈。后来他出现发热、痰嗽等症状，表现不一，难以详细描述，于是诊察他的母亲，发现她有郁火、血热的症状，于是使用解毒、清肝等药物，母子同服而痊愈（详见《保婴粹要》）。
崔氏方：治疗手足甲疽，可能是因为修剪指甲伤及肌肉，或者损伤脚部形成疮口，溃烂向上蔓延至脚部。用绿矾放在铁板上烧沸，颜色红得像熔化的金子那样的是真品，烧沸后取出，研磨成粉末，用盐水清洗并涂抹患处。
我按语：前面的病症就是脱疽。这个方子确实有良效，但尤其应当调理元气才是上策。大抵这种病症，起初是因为饮用醇酒、食用烤炙肥甘厚味损伤了脾胃，或者因为房劳过度亏损了肾水，所以有的先口渴而后发病，有的先发病而后口渴。如果颜色红且疼痛自行溃破，可以治疗；如果颜色黑且不溃破，无法治疗。颜色红且疼痛的，先用隔蒜灸，服用活命饮、托里散，再服用十全汤、大补汤加减八味丸；颜色暗且不痛的，用隔蒜灸、桑枝灸，也使用十全大补汤加减八味丸，这样毒邪就不会向上侵袭，元气也不会亏损，或许可以保全生命。也有因为修剪手脚或被狗咬等受伤的情况，如果元气怯弱，或者犯忌房事，外用寒凉药物，内服克伐药物，损伤脾胃，患处不溃破，颜色暗黑向上蔓延，也多导致死亡。严重的必须解除坏死组织，应当以脚力转动关节周HT（此处疑为原文讹误或特定手法描述，暂译为转动关节周围），轻轻拉扯，使筋随骨头脱出，从而让毒邪得以排泄。否则毒邪侵蚀筋骨内部断裂，仍然向上溃烂，即使去除也无益。况且偏僻之处，气血很少到达，药物难以引导到达。何况攻毒的药物，先损伤脾胃，反而损害元气，不如灸法好。严重的必须解除坏死组织才好。所以孙真人说，在肉里就割除，在手指就截肢。虽然不忍心毁坏父母给予的身体，但是如果不连根切断，势必会导致夭折，这也不是爱护父母身体的心意啊。况且患处已经坏死，即使切除也不痛，又有什么害怕而不做的呢？女子也有这种病患，多因为郁怒亏损肝脾所致。治疗方法应当与前面相同，患者要知道（治验见《外科枢要》）。
经验方：治疗刀伤磕碰损伤，跌打肿痛，或者出血。用葱白细细切碎捣烂，炒热敷在患处，蒜凉了再更换，效果神奇。
我按语：《医学纲目》称前方有神效。我曾经用它治疗前面的病症青肿不散，死肉不溃破，辅助以健脾胃的药物，功效尤其快捷。这就是内外治法合一的道理。
衍羲方：治疗竹木刺入肉里，嚼碎牛膝根敷贴在上面，刺就会出来。
肘后方：治疗箭头射入骨头，将巴豆肉轻微炒制，与蜣螂一起研匀，涂在伤口处，等到痒得厉害时拔出。
孙真人治疗箭头、针刺在咽喉胸膈部位，捣碎蝼蛄，涂在患处，刺会自动出来。
我按语：前四个方子使用果然有良效。
肘后方：治疗热油烫伤以及火烧伤，用丹参八两，调和羊脂二斤，煎煮三五次沸腾，取药液敷在患处。
至圣膏：治疗汤火疮，用鸡蛋黄放在银器或石器中熬制成油，调和胡粉敷在患处。
我按语：前面的病症如果出现发热口渴，小便赤涩，使用四君子汤、川芎、当归、山栀、连翘、甘草健脾胃以消除毒邪。如果患处肌肉已经坏死但不溃破，使用八珍汤、白芷、甘草补气血以排出脓液，如果无效，加肉桂。如果患处死肉已经溃破但不收敛，使用四君子汤、川芎、当归、黄芪健脾胃以生肌，如果无效，加炮姜。如果是小儿患病，或者有眼睛抽搐、头摇等症状，使用四君子汤加川芎、当归、山栀，健脾胃以清肝木。如果在进食后立即出现这种病患，或者腹胀作痛，使用四君子汤、山栀、山楂、神曲壮脾气以消食导滞。大凡初患这种病症，使用神效当归膏敷贴。轻的自己痊愈，重的自己腐烂，好的肌肉容易生长。如果颜色发红，那是火毒未尽，必须涂抹直到颜色变白为止。倘若患处在肢体关节伸屈的地方，如果敷此药可以避免结痂阻碍新肉生长再次溃烂难愈。倘若因火灾烟熏致死的人，用萝卜捣汁灌入即可苏醒，因为萝卜辛味能散气（治验见正体部）。
附治验
锦衣卫杨永兴，厨房夜间发生火灾，凡是睡在这个房间已死或将死的人，灌入萝卜汁，很久之后全都痊愈。凡是遭受这种祸患的人，用这种方法治疗，反应迅速如响。
骑竹马灸法图 万金散
内托散 远志酒
五香连翘汤 忍冬酒
沉麝汤 忍冬草图
五香汤 以上方剂见前卷
漏芦汤 追毒丸
柞木饮 转毒散
阿胶饮 单煮大黄汤
牛胶饮 神仙截法
黄矾饮 秘传连翘汤
国老膏 千金漏芦汤
六味车螯散 神硝散
止痛灵宝散 圣效散
神效麻仁丸 神仙陷脉散
清心内固散 漏芦汤
清膻竹叶汤 猪蹄汤
以上方剂见中卷
Diseases of carbuncles and sores (Yongju) are no different between men and women. The only differences in women lie in three conditions: amenorrhea (menstrual closure), blood deficiency, and qi stagnation. For the rest, treatment should follow standard protocols.
My commentary: Men's diseases often relate to the Liver and Kidney; women's diseases often relate to the Liver and Spleen. Practitioners must distinguish between them.
Children possess a "pure yang" constitution. Their susceptibility to carbuncles and sores is often due to heat in the Heart Qi.
My commentary: The aforementioned conditions can also result from congenital endowment. I once treated the grandson of Vice Minister Shi Nanhu, who suffered from redness and swelling of the scrotum. I treated it as fetal toxin, and he recovered. Later, he developed fever and phlegm-cough with various symptoms that were difficult to describe precisely. I then examined his mother and found she had symptoms of constrained fire and blood heat. I prescribed detoxifying and liver-clearing herbs. Both mother and son took the medicine and recovered (see *Baoying Cuiyao*).
Cui’s Formula: Treats paronychia (nail bed infection) on hands and feet, caused by trimming nails injuring the flesh or foot injuries becoming ulcers that spread upward. Calcined green vitriol (Luofan, Green Vitriol) is heated on an iron plate until it melts like gold, indicating authenticity. After cooling, it is ground into powder. The area is washed with salt water and the powder applied.
My commentary: The aforementioned condition is gangrene (Tuoju). While this formula is effective, regulating Yuan Qi (Original Qi) is paramount. Generally, this disease arises initially from damaging the Spleen through rich foods and alcohol, or depleting Kidney Yin through sexual excess. Thus, some experience thirst before onset, while others develop thirst after onset. If the lesion is red, painful, and spontaneously ulcerates, it is treatable; if black and non-ulcerating, it is untreatable. For red, painful lesions, apply garlic-separated moxibustion first, followed by Huoming Yin (Life-Saving Decoction) and Tuoli San (Supporting Interior Powder), then adjust Shiquan Tang (Ten Complete Decoction), Dabu Tang (Great Tonifying Decoction), and Bawei Wan (Eight-Ingredient Pill). For dark, painless lesions, apply garlic-separated moxibustion and mulberry branch moxibustion, along with Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) adjusted with Bawei Wan. This prevents toxic factors from ascending and preserves Yuan Qi, offering a chance for survival. Injuries from nail trimming or dog bites may lead to death if the patient has weak Yuan Qi, engages in sexual activity, uses external cold-cooling agents, or internal attacking drugs, thereby damaging the Spleen and Stomach, causing non-ulceration, dark discoloration spreading upward, and death. Severe cases require amputation/debridement. One should rotate the joint around the affected area gently to extract tendons with the bone, allowing toxins to drain. Otherwise, toxic tendons break internally and continue to ulcerate upward, making removal futile. Moreover, peripheral areas have poor Qi and Blood circulation, making drug delivery difficult. Attacking toxins damages the Spleen and Stomach and harms Yuan Qi; thus, moxibustion is superior. Severe cases require debridement. As Sun Simiao stated, cut flesh if necessary, amputate fingers if necessary. Although one hesitates to damage the body given by parents, leaving it connected leads to certain death, which contradicts filial piety. Since the necrotic tissue is already dead and painless, there is no reason not to act. Women can also suffer from this, usually due to emotional constraint damaging the Liver and Spleen. Treatment follows the same principles (see *Waike Shuyao* for case records).
Empirical Formula: Treats knife wounds, contusions, sprains, swelling, pain, or bleeding. Finely chop and pound white parts of scallions (Congbai, Scallion Stem), stir-fry until hot, and apply to the affected area. Replace when cool. Highly effective.
My commentary: *Yixue Gangmu* praises this formula. I used it for persistent bruising and non-ulcerating necrotic tissue, assisting with spleen-strengthening herbs, achieving excellent results. This demonstrates the unity of internal and external treatments.
Bai’s Formula: Treats bamboo splinters embedded in flesh. Apply crushed woodworms (Qilao, Woodworm Larva) topically for immediate extraction.
Yanyi’s Formula: Treats bamboo or wood splinters. Chew Achyranthes root (Niuxi, Achyranthes Root) and apply as a poultice for immediate extraction.
Zhouhou Fang: Treats arrowheads embedded in bone. Lightly stir-fried bitter almond kernel (Badou, Croton Seed) mixed with pounded dung beetles (Qiángláng, Dung Beetle) is applied to the wound. When intense itching occurs, pull out the arrowhead.
Sun Simiao’s Method: For arrowheads or needles in the throat or chest/diaphragm, crush mole crickets (Lougu, Mole Cricket) and apply topically for automatic extraction.
My commentary: The above four formulas are indeed effective.
Zhouhou Fang: Treats burns from hot oil or fire. Mix 8 liang of Salvia miltiorrhiza root (Danshen, Salvia Root) with 2 jin of sheep fat. Boil three to five times, then apply.
Zhisheng Gao: Treats scalds and burns. Render chicken egg yolks (Jizihuang, Egg Yolk) in silver or ceramic vessels to extract oil. Mix with lead carbonate (Hufen, Lead Carbonate) and apply.
My commentary: If the aforementioned condition presents with fever, thirst, and dark, scanty urine, use Sijunzi Tang (Four Gentlemen Decoction) plus Chuanxiong, Danggui, Gardenia, Forsythia, and Licorice to strengthen the Spleen and Stomach and resolve toxicity. If necrotic tissue does not ulcerate, use Bazhen Tang (Eight Treasures Decoction) plus Angelica dahurica and Licorice to tonify Qi and Blood and expel pus; add Cinnamon Bark if ineffective. If necrotic tissue ulcerates but fails to heal, use Sijunzi Tang plus Chuanxiong, Danggui, and Astragalus to strengthen the Spleen and Stomach and generate flesh; add roasted Ginger if ineffective. For children with this condition, or those exhibiting eye twitching or head shaking, use Sijunzi Tang plus Chuanxiong, Danggui, and Gardenia to strengthen the Spleen and Stomach and clear Liver heat. If symptoms appear immediately after eating, accompanied by abdominal distension and pain, use Sijunzi Tang plus Gardenia, Hawthorn, and Medicated Leaven to strengthen Spleen Qi and aid digestion. Initially, apply Shenxiao Danggui Gao (Miraculous Angelica Ointment). Mild cases heal spontaneously; severe cases undergo necrosis, allowing healthy flesh to regenerate. Redness indicates residual fire-toxin; continue application until whiteness returns. If applied to flexor/extensor joints, this ointment prevents scabbing that might impede new tissue growth and cause re-ulceration. For deaths caused by smoke inhalation from fire, administer fresh radish juice to revive, as its pungency disperses stagnant Qi (see Zhengti Bu for case records).
Attached Case Records
Yang Yongxing of the Imperial Guard suffered a kitchen fire at night. Those who had died or were near death in that room were revived by administering radish juice, eventually recovering fully. This treatment yields rapid results for such incidents.
[List of Formulas and Diagrams]
Bamboo-Horse Moxibustion Diagram
Wanjing San (Ten Thousand Gold Powder)
Neituo San (Internal Support Powder)
Yuanzhi Jiu (Polygala Wine)
Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction)
Rendong Jiu (Honeysuckle Wine)
Chenshe Tang (Musk and Amber Decoction)
Rendong Cao Tu (Honeysuckle Herb Diagram)
Wuxiang Tang (Five-Aromatic Decoction) [See previous volume]
Lulü Tang (Rhaponticum Decoction)
Zhidu Wan (Poison-Chasing Pill)
Zhamu Yin (Oak Wood Drink)
Zhundu San (Poison-Transforming Powder)
Ejiao Yin (Donkey-Hide Gelatin Drink)
Dan Zhu Dahuang Tang (Single-Boiled Rhubarb Decoction)
Niu Jiao Yin (Ox Glue Drink)
Shenxian Jie Fa (Immortal Amputation Method)
Huangfan Yin (Yellow Alum Drink)
Mizhuan Lianqiao Tang (Secretly Transmitted Forsythia Decoction)
Guolao Gao (Old Man’s Paste - Licorice Extract)
Qianjin Lulü Tang (Thousand-Gold Rhaponticum Decoction)
Liwei Chexi San (Six-Ingredient Tridacna Powder)
Shenxiao San (Divine Nitre Powder)
Zhitong Lingbao San (Pain-Relieving Spiritual Treasure Powder)
Shengxiao San (Holy Efficacy Powder)
Shenxiao Maren Wan (Miraculous Hemp Seed Pill)
Shenxian Xianmai San (Immortal Sunken Meridian Powder)
Qingxin Neigu San (Heart-Clearing Internal-Solidifying Powder)
Lulü Tang (Rhaphistigma Decoction)
Qingshan Zhuye Tang (Clearing Chest Bamboo Leaf Decoction)
Zhuti Tang (Pig Trotter Decoction)
[See middle volume for above formulas]