李氏云∶近有数人病背疽，或先寒后热，先热后寒，或连日或间日必呕痰大汗而止，皆
用柴胡、恒山不应。余谓此因脾气不正，复感寒邪，痰盛而作，遂先用不换金正气散，次用
排脓内补散，木香汤，三日即愈。
愚按∶前症若外邪既去而仍作，宜用六君子汤以补脾胃。大凡胃气虚而作呕者，必喜温
热；毒内攻而作呕者，必喜寒。治当辨之（详见附录用药关键）。
家传不换金正气散 治感冒风寒，或伤生冷，或瘴疟，或疫疠。
苍术（米泔浸炒四两） 浓朴（姜汁拌炒四两） 粉甘草（炙二两） 橘红（焙三两） 藿香
叶半夏（姜制各二两） 木香（湿纸里煨） 人参 白茯苓（各一两）
上每服五钱，姜枣水煎。
李氏论云∶凡痈不可食牛羊鸡鹅虾鱼酒面爆炙之物。犯之必发热，宜服栀子黄 汤。大
凡脏腑已利，疮毒已溃，气血既虚，最当调护。若发热而服凉药，无不致祸。
栀子黄 汤
漏芦 连翘 山栀子（炒） 防风 苦参（炒） 人参 犀角镑 甘草（炒） 白茯苓 石韦
（如无桑皮代之各三钱半）
上每服五钱，水煎。
愚按∶前症若饮食伤脾胃而发热，用六君、神曲、山楂；若阴血不足而发热，用四物、
参、术、黄 ；若脓血出多而发热，用十全大补汤。东垣先生云∶胃为五脏之根本，胃气一
伤，诸脏皆虚，七恶蜂起，可不慎哉。
李氏说：近来有几个人患背疽，有的先恶寒后发热，有的先发热后恶寒，或者连续几天或隔天必定呕吐痰涎并大汗淋漓后才停止，都使用柴胡、恒山治疗却无效。我认为这是因为脾气不正，又感受了寒邪，导致痰湿盛而发病，于是先用不换金正气散，接着用排脓内补散、木香汤，三天就痊愈了。
我按语：前面的病症如果外邪已经去除但仍然发作，应该使用六君子汤来补益脾胃。大凡胃气虚弱引起的呕吐，一定喜欢温热；毒邪内攻引起的呕吐，一定喜欢寒凉。治疗时应当辨别清楚（详见附录用药关键）。
家传不换金正气散 治疗感冒风寒，或损伤生冷食物，或瘴疟，或疫疠。
苍术（米泔水浸泡炒制四两） 浓朴（姜汁拌炒四两） 粉甘草（炙二两） 橘红（焙干三两） 藿香叶、半夏（姜制各二两） 木香（湿纸包裹煨） 人参 白茯苓（各一两）
以上药物每次服用五钱，加生姜、大枣用水煎服。
李氏论述说：凡是痈疮患者不可食用牛、羊、鸡、鹅、虾、鱼、酒、面食以及爆炒烤炙的食物。触犯这些食物必然会导致发热，适宜服用栀子黄芩汤。大凡脏腑已经通畅，疮毒已经溃破，气血既然虚弱，最应当注意调养护理。如果发热而服用寒凉药物，没有不招致祸害的。
栀子黄芩汤
漏芦 连翘 山栀子（炒） 防风 苦参（炒） 人参 犀角（镑片） 甘草（炒） 白茯苓 石韦（如果没有桑皮替代，各三钱半）
以上药物每次服用五钱，用水煎服。
我按语：前面的病症如果是饮食损伤脾胃而导致发热，使用六君子汤、神曲、山楂；如果是阴血不足而导致发热，使用四物汤、人参、白术、黄芩；如果是脓血流出过多而导致发热，使用十全大补汤。东垣先生曾说：胃是五脏的根本，胃气一旦受伤，诸脏都会虚弱，七恶之证蜂拥而起，能不谨慎吗？
Li stated: Recently, several individuals suffered from back carbuncle (back abscess). Some experienced chills followed by fever, others fever followed by chills, and some vomited phlegm and sweated profusely to cessation either daily or every other day. Treatments using Chaihu Tang (Bupleurum Decoction) and Hengshan (Dichroa Root) were ineffective. I reasoned that this was due to spleen qi deviation compounded by cold pathogen invasion, resulting in excessive phlegm-dampness. Thus, I first administered Bu Huan Jin Zheng Qi San (Unchanging Metal Rectifying Qi Powder), followed by Pai Nong Nei Bu San (Draining Pus and Interior-Nourishing Powder) and Mu Xiang Tang (Costus Decoction), leading to recovery within three days.
My commentary: In the aforementioned conditions, if symptoms recur after external pathogens have been expelled, Liu Jun Zi Tang (Six Gentlemen Decoction) should be used to tonify the spleen and stomach. Generally, vomiting caused by deficient stomach qi is relieved by warmth; vomiting caused by internal attack of toxins is relieved by cold. Treatment must distinguish between these two (see Appendix on Key Principles of Medication Use).
Family-inherited Bu Huan Jin Zheng Qi San treats wind-cold common cold, injury from raw/cold foods, miasma malaria, or epidemic pestilence.
Cang Zhu (Atractodis Rhizoma, soaked in rice water and stir-fried, 4 liang) Hou Po (Magnoliae Officinalis Cortex, stir-fried with ginger juice, 4 liang) Fen Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, honey-fried, 2 liang) Ju Hong (Citri Reticulatae Pericarpium Rubrum, baked, 3 liang) Huo Xiang Ye (Pogostemonis Herba) and Ban Xia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine, each prepared with ginger juice, 2 liang) Mu Xiang (Aucklandiae Radix, baked in wet paper) Ren Shen (Ginseng Radix) Bai Fu Ling (Poria, each 1 liang).
Take 5 qian per dose, decoct with fresh ginger and jujube in water.
Li’s discussion states: Patients with carbuncles must avoid consuming beef, mutton, chicken, goose, shrimp, fish, alcohol, wheat products, and fried/roasted foods. Violating this will inevitably cause fever; Zhi Zi Huang Qin Tang (Gardenia and Scutellaria Decoction) is appropriate. Generally, when the zang-fu organs are unobstructed and the sore has ulcerated, with qi and blood already depleted, careful nursing is paramount. If fever occurs and cooling medicines are administered, disaster is inevitable.
Zhi Zi Huang Qin Tang
Lou Lu (Leuzeae Radix) Lian Qiao (Forsythiae Fructus) Shan Zhi Zi (Gardeniae Fructus, stir-fried) Fang Feng (Saposhnikoviae Radix) Ku Shen (Sophorae Flavescentis Radix, stir-fried) Ren Shen (Ginseng Radix) Xi Jiao (Rhinocerotis Cornu, shaved slices) Gan Cao (Glycyrrhizae Radix et Rhizoma, stir-fried) Bai Fu Ling (Poria) Shi Wei (Pyri Folium) (If unavailable, replace with Sang Bai Pi [Mori Cortex], each 3.5 qian).
Take 5 qian per dose, decoct in water.
My commentary: For the aforementioned condition where dietary injury to the spleen and stomach causes fever, use Liu Jun Zi Tang (Six Gentlemen Decoction), Shen Qu (Massa Medicata Fermentata), and Shan Zha (Crataegi Fructus). For fever due to yin-blood deficiency, use Si Wu Tang (Four Substances Decoction), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Huang Qin (Scutellariae Radix). For fever due to excessive loss of pus and blood, use Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction). Mr. Dongyuan stated: The stomach is the root of the five zang organs. Once stomach qi is injured, all zang organs become deficient, and the seven evils arise like bees swarming. Can one not be cautious?