（附论）
夫痈者。由寒气客于肌肉。血气结聚。乃成痈也。痈溃之后有逆顺。其眼白睛青黑而眼
小者一逆也。服药而呕者二逆也。伤痛渴甚者三逆也。有肩背不便者四逆也。音嘶色脱者五
逆也。除此五者并为顺也。肠胃受冷而变下利。利则肠胃俱虚。而冷搏于胃气。则变呕逆。
气若不通。遇冷折之。则变哕也。
方
黄 散（出圣惠方）治痈溃后。补虚去客热。
黄 （二两锉） 知母（二两） 石膏（二两） 白芍药 麦门冬（去心各一两） 甘
草（半两
炙微赤锉） 白茯苓 桂心 川升麻 熟干地黄 人参（去芦头各一两） 上为粗散。每服
四
钱。水一中盏。煎至六分。去滓温服。日三四服。
栀子散（出圣惠方）治痈已溃后。散肿气。
栀子仁 川大黄 黄连（去须） 白芨 牡蛎 白蔹 木通（锉） 川升麻 黄芩（各
一两） 上为细散。每用以鸡子白调。涂故帛上贴肿处。燥复易之。
内塞散 疗痈疽溃漏。血脉空竭。
黄 细辛 芍药 薏苡仁 白芷 瞿麦（各二两） 赤小豆（半两） 干地黄 人参 防
风上为以新成白苦酒置新器中。内赤小豆。须臾出。铜器中熬令燥。复须内苦酒中更熬。
下五丸及止。合捣为散。酒服方寸匕。日夜六七过。腹痛甚倍芍药。口未闭倍薏苡仁。脓多
倍黄 。忌生菜葱芜等物。
洗药猪蹄汤
本（去苗） 川当归（去芦） 杜独活（去芦） 蔺草（一方作茴香） 黄连（去须）
蔷薇根
野狼牙草 甘草 大黄 芍药（各二两） 上为粗末。先用 猪前蹄一只。煮取浓汁。澄去滓
肉。
与上面油花。每用药化末半两。蹄汁一碗。葱白一根。汉椒二十余粒。同煎三五沸。去滓。
热通手。遂洗之。
黄 茯苓汤（出千金方）治痈疽溃后。脓大多虚热。
黄 麦门冬（各三两） 五味子（四合） 芎 （二两） 生姜（四两） 茯苓（一
两） 桂心
（二两） 大枣（二十枚） 上为粗 咀。以水一斗半。煮取四升。分六服。千金翼有远志、
当归、人参。各二两。甘草六两。
猪蹄汤（出经验方）治一切痈疽肿毒。消毒瓦斯。去恶肉。凡疮有口。便用此洗
。
香白芷（不见火切） 生甘草 老羌活 露蜂房（取有儿者） 黄芩（去心） 赤芍药
（去皮）
川当归（去芦洗焙各等分） 上为粗末。看疽大小用药。如疽大加料用。先将猪前蹄两只一
斤。
只用白水二升煮软。将汁分为两次。澄去面上油花。并下面滓肉。每次用药一两。投于汁中。
再用文武火煎十数沸。去滓。以故帛蘸药汤。温温徐薄揩疮上。死肉恶血随洗而下。净洗讫。
以故帛挹干。仍避风。忌人口气吹之。有狐臭人。并月经现行妇人。犹不许入病患房。洗疮
切勿以手触。看洗疽之方。所传甚多。惟此方极神效。其用露蜂房极有理。盖以毒去毒也。
一方无羌活。澹寮方无黄芩。
猪蹄洗汤 疗痈疽等毒溃烂。
猪蹄（一具治如食法） 蔷薇根（一斤） 甘草（五两炙） 芍药 白芷（各五两） 上
以水二
斗。煮猪蹄取八升。去滓。下诸药味取四升。稍稍洗疮上。
洗肌散 治脓水未干者。以药夹黄葱洗之。
青木香 白蔹 槟榔 贯众 荆芥 上同煎。洗之甚妙。
白芷摩膏 疗疽已溃。
白芷 甘草（各二分） 乌头（三分） 薤白（十五挺） 青竹茹（鸡子大一枚） 上
以猪膏一
升合。煎白芷黄、膏成。绞去滓。涂疮四边。勿着疮中。
白蔹汤（出圣惠方） 治痈肿已溃后。结强宜拓方。
白蔹 黄芩 赤芍药 丹参（各一两） 上药细锉。以水三升。煮至一升半。以帛浸拓
肿
上。频频换之为妙。
白芷散（出圣惠方）治痈疮已溃。
白芷 黄连（去须） 地榆（锉各一两） 上为细散。以鸡子白调。涂布上贴。日三四
度换
之。
去水膏（出直指方）治痈疽破穴后。误入皂角水。及诸毒水。以致疼痛。
甘草（一分生为末） 沙糖 糯米粉（各三分） 上为膏。摊在绢上贴之。毒水自出。
驴马
汗及尿粪一切毒水。皆治之。
治痈疮溃后烂方（出圣惠方）
取陈久酱汁和面搽疮上。日三易之。
治痈后流脓不尽。或更移结肿。松脂封方。（出圣惠方）
以松脂蜡等分。同溶成汁。密封之。
【附论】
痈，是由于寒气侵入肌肉，导致血气凝结聚积，从而形成痈肿。痈溃破之后，有顺证和逆证的区别。眼睛白睛呈现青黑色且眼球变小，这是一逆；服药后出现呕吐，这是二逆；伤痛剧烈且极度口渴，这是三逆；肩背活动不便，这是四逆；声音嘶哑、面色枯槁脱色，这是五逆。除了这五种情况外，其余都属于顺证。如果肠胃受寒而变为下利（腹泻），腹泻会导致肠胃俱虚，寒气搏结于胃气，就会转变为呕吐呃逆。如果气机不通畅，再遇到寒气折损，就会转变为呃逆（打嗝）。
方剂
黄芪散（出自《圣惠方》）治疗痈溃破后，补虚并清除客热。
黄芪（二两，锉碎） 知母（二两） 石膏（二两） 白芍药 麦门冬（去心，各一两） 甘草（半两，炙至微赤，锉碎） 白茯苓 桂心 川升麻 熟干地黄 人参（去芦头，各一两）。以上药物制成粗散。每次服用四钱，用水一中盏，煎煮至六分，滤去药渣，温服。每日服用三四次。
栀子散（出自《圣惠方》）治疗痈已溃破后，消散肿气。
栀子仁 川大黄 黄连（去须） 白芨 牡蛎 白蔹 木通（锉碎） 川升麻 黄芩（各一两）。以上药物制成细散。每次使用时用鸡蛋清调和，涂在旧布上贴敷于肿胀处，干燥后更换。
内塞散 治疗痈疽溃破漏脓，血脉空虚枯竭。
黄芪 细辛 芍药 薏苡仁 白芷 瞿麦（各二两） 赤小豆（半两） 干地黄 人参 防风。以上药物，先用新制成的白醋放入新容器中，放入赤小豆，片刻后取出，放入铜器中熬至干燥，再放入醋中再次熬制。如此反复五次即可停止。混合捣碎为散剂。用酒送服一方寸匕大小的量，日夜服用六七次。腹痛严重则加倍使用芍药，口未闭合则加倍使用薏苡仁，脓多则加倍使用黄芪。忌食生菜、葱、芜荑等物。
洗药猪蹄汤
本（去苗） 川当归（去芦） 杜独活（去芦） 蔺草（另一版本作茴香） 黄连（去须） 蔷薇根 野狼牙草 甘草 大黄 芍药（各二两）。以上药物制成粗末。先用猪前蹄一只，煮取浓汁，澄清去掉渣肉。去除上面的油花，每次用药末半两，蹄汁一碗，葱白一根，汉椒二十余粒，一同煎煮三五沸，滤去药渣。温度适宜手掌时，随即清洗患处。
黄芪茯苓汤（出自《千金方》）治疗痈疽溃破后，脓多且虚热明显。
黄芪 麦门冬（各三两） 五味子（四合） 川芎（二两） 生姜（四两） 茯苓（一两） 桂心（二两） 大枣（二十枚）。以上药物制成粗咀片。用水一斗半，煮取四升，分六次服用。《千金翼方》中有远志、当归、人参，各二两，甘草六两。
猪蹄汤（出自《经验方》）治疗一切痈疽肿毒，消毒瓦斯，去除恶肉。凡疮疡有开口，便使用此方清洗。
香白芷（不经过火炒切制） 生甘草 老羌活 露蜂房（选取有幼虫的） 黄芩（去心） 赤芍药（去皮） 川当归（去芦、洗净、焙干，各等分）。以上药物制成粗末，根据疽的大小决定用药量。如疽大则增加药料用量。先将猪前蹄两只（一斤重），只用白水二升煮软，将汁液分为两次使用。澄清去掉面上的油花以及下面的渣肉。每次用药一两，投入汁液中，再用文火武火交替煎煮十余沸，滤去药渣。用旧布蘸取药汤，温热地慢慢擦拭疮面，死肉恶血随清洗而下落。洗净后，用旧布擦干，注意避风，忌让人口气吹到。有狐臭的人，以及月经正在来潮的妇女，都不允许进入病患房间。清洗疮疡切勿用手触摸。查看清洗疽的方剂，流传很多，只有这个方子极其神效。其中使用露蜂房非常有道理，大概是以毒攻毒的意思。另一版本没有羌活，《澹寮方》没有黄芩。
猪蹄洗汤 治疗痈疽等毒溃烂。
猪蹄（一具，按食用方法处理） 蔷薇根（一斤） 甘草（五两，炙） 芍药 白芷（各五两）。以上药物用水二斗，煮猪蹄取八升，滤去药渣，加入诸药味煮取四升，稍稍清洗疮面。
洗肌散 治疗脓水未干者。用药物夹带黄葱清洗，效果很好。
青木香 白蔹 槟榔 贯众 荆芥。以上药物一同煎煮，清洗效果甚妙。
白芷摩膏 治疗疽已溃破。
白芷 甘草（各二分） 乌头（三分） 薤白（十五挺） 青竹茹（鸡子大一枚）。以上药物用猪脂一升合煎，煎至白芷变黄、膏成，绞去药渣。涂抹于疮口四周，不要涂入疮口中。
白蔹汤（出自《圣惠方》） 治疗痈肿已溃破后，僵硬宜用拓敷法。
白蔹 黄芩 赤芍药 丹参（各一两）。以上药物细锉，用水三升，煮至一升半，用布浸透后拓敷于肿胀处，频繁更换为好。
白芷散（出自《圣惠方》）治疗痈疮已溃破。
白芷 黄连（去须） 地榆（锉碎，各一两）。以上药物制成细散，用鸡蛋清调和，涂在布上贴敷，每日换药三四次。
去水膏（出自《直指方》）治疗痈疽破穴后，误入皂角水及诸毒水，导致疼痛。
甘草（一分，生研为末） 沙糖 糯米粉（各三分）。以上药物制成膏，摊在绢上贴敷。毒水自然流出。驴马汗及尿粪等一切毒水，都能治疗。
[Attached Discussion]
Yong (carbuncle) is formed when cold pathogen invades the muscles, causing blood and qi to condense and accumulate. After a carbuncle ulcerates, there are favorable (Shun) and unfavorable (Ni) prognoses. The first unfavorable sign is when the sclera appears blue-black and the eyes become small; the second is vomiting after taking medicine; the third is severe pain accompanied by extreme thirst; the fourth is inability to move the shoulders and back; the fifth is hoarseness of voice and loss of facial luster. Apart from these five signs, all others are considered favorable. If the intestines and stomach are affected by cold, leading to diarrhea, the deficiency of the intestines and stomach allows cold to clash with stomach qi, resulting in vomiting and hiccups. If qi circulation is obstructed and further compromised by cold, it transforms into hiccups (Yue).
Formulas
Huang San (Astragalus Powder) [from *Sheng Hui Fang*]: Treats post-ulceration of carbuncles, tonifying deficiency and clearing exogenous heat.
Huangqi (Radix Astragali, 2 liang, crushed) Zhimu (Rhizoma Anemarrhenae, 2 liang) Shigao (Gypsum Fibrosum, 2 liang) Baishao (Radix Paeoniae Alba) Maimendong (Radix Ophiopogonis, decentered, each 1 liang) Gancao (Radix Glycyrrhizae, half liang, honey-fried until slightly red, crushed) Bai Fuling (Poria, 1 liang) Guixin (Cortex Cinnamomi, 1 liang) Chuan Shengma (Rhizoma Cimicifugae, 1 liang) Shu Gadihuang (Radix Rehmanniae Preparata, 1 liang) Renshen (Radix Ginseng, de-stalked, each 1 liang). Grind the above ingredients into a coarse powder. Take 4 qian per dose, decoct with one zhong of water until reduced to six parts, filter the dregs, and take warm. Administer three to four times daily.
Zhizi San (Gardenia Powder) [from *Sheng Hui Fang*]: Treats post-ulceration of carbuncles, dissipating swelling and qi stagnation.
Zhiziren (Semen Gardeniae) Chuan Dahuang (Radix et Rhizoma Rhei) Huanglian (Rhizoma Coptidis, de-stalked) Baiji (Bulbus Allii Macrostemonis) Muli (Concha Ostreae) Bailing (Rhizoma Akebiae) Mutong (Caulis Akebiae, crushed) Chuan Shengma (Rhizoma Cimicifugae) Huangqin (Radix Scutellariae, each 1 liang). Grind the above ingredients into a fine powder. Mix with egg white for application, spread on old cloth, and apply to the swollen area. Replace when dry.
Nei Sai San (Internal Plugging Powder): Treats ulcerated and leaking carbuncles and sores, where blood vessels are empty and depleted.
Huangqi (Radix Astragali) Xixin (Herba Asari) Shaoyao (Radix Paeoniae) Yiyiren (Semen Coicis) Baizhi (Radix Angelicae Dahuricae) Qumai (Herba Dianthi, each 2 liang) Chixiaodou (Semen Phaseoli Angularis, half liang) Gan Dihuang (Radix Rehmanniae Recens) Renshen (Radix Ginseng) Fangfeng (Radix Saposhnikoviae). Place new white vinegar in a new vessel, add Chixiaodou, let sit briefly, then remove. Fry in a copper vessel until dry, then return to vinegar and fry again. Repeat this process five times. Grind into a powder. Take one fangcun bi (measure) with wine, six or seven times day and night. Increase Shaoyao if abdominal pain is severe; increase Yiyiren if the mouth remains open; increase Huangqi if pus is abundant. Avoid raw vegetables, green onions, and Wuwu.
Xi Yao Zhu Ti Tang (Washing Medicine Pig Trotter Decoction)
Bencao (de-seeded) Chuan Danggui (Radix Angelicae Sinensis, de-stalked) Du Huoxiong (Radix et Rhizoma Angelicae Pubescentis, de-stalked) Lincao (Foeniculum Vulgare in another version) Huanglian (Rhizoma Coptidis, de-stalked) Qiangweigen (Radix Rosae Rugosae) Yelangyacao (Herba Agrimoniae) Gancao (Radix Glycyrrhizae) Dahuang (Radix et Rhizoma Rhei) Shaoyao (Radix Paeoniae, each 2 liang). Grind into coarse pieces. Boil one pig trotter to obtain thick broth, clarify and remove meat residues. Remove oil from the surface. For each use, mix half liang of herb powder, one bowl of trotter juice, one scallion white, and over twenty grains of Han pepper. Boil for three to five boils, filter, and wash the area while warm.
Huangqi Fuling Tang (Astragalus and Poria Decoction) [from *Qian Jin Fang*]: Treats post-ulceration of carbuncles and sores with abundant pus and significant deficient heat.
Huangqi (Radix Astragali) Maimendong (Radix Ophiopogonis, each 3 liang) Wuweizi (Fructus Schisandrae, 4 he) Chuanxiong (Rhizoma Chuanxiong, 2 liang) Shengjiang (Rhizoma Zingiberis Recens, 4 liang) Fuling (Poria, 1 liang) Guixin (Cortex Cinnamomi, 2 liang) Dazao (Fructus Jujubae, 20 pieces). Cut into coarse pieces. Decoct with 1.5 dou of water until 4 sheng remain. Divide into six doses. *Qian Jin Yi Fang* includes Yuanzhi (Radix Polygalae), Danggui (Radix Angelicae Sinensis), and Renshen (Radix Ginseng), each 2 liang, and Gancao (Radix Glycyrrhizae) 6 liang.
Zhu Ti Tang (Pig Trotter Decoction) [from *Jing Yan Fang*]: Treats all carbuncles, sores, swellings, and toxins; disinfects and removes necrotic tissue. Use for washing any ulcerated sore.
Xiang Baizhi (Radix Angelicae Dahuricae, not roasted) Sheng Gancao (Radix Glycyrrhizae) Lao Qianghuo (Rhizoma et Radix Notopterygii) Lu Fengfang (Nidus Vespae, select those with larvae) Huangqin (Radix Scutellariae, de-centered) Chi Shaoyao (Radix Paeoniae Rubra, peeled) Chuan Danggui (Radix Angelicae Sinensis, de-stalked, washed, dried, equal parts). Grind into coarse pieces. Adjust dosage based on the size of the sore; increase ingredients for larger sores. Boil two pig trotters (one jin) in two sheng of plain water until soft. Divide the juice into two portions. Clarify to remove oil and sediment. Add one liang of herbs to the juice, boil over medium-high heat for ten-plus boils, filter. Soak old cloth in the warm decoction and gently wipe the wound. Necrotic tissue and foul blood will wash away. Dry with an old cloth, avoid wind, and prevent breath from blowing on the wound. Individuals with body odor or menstruating women should not enter the patient's room. Do not touch the wound with hands during washing. Among many流传 formulas for washing sores, this one is extremely effective. The use of Lu Fengfang exemplifies "treating toxicity with toxicity." Another version lacks Qianghuo; *Dan Liao Fang* lacks Huangqin.
Zhu Ti Xi Tang (Pig Trotter Washing Decoction): Treats ulcerated carbuncles and sores caused by toxins.
Zhu Ti (one set, prepared for cooking) Qiangweigen (Radix Rosae Rugosae, one jin) Gancao (Radix Glycyrrhizae, five liang, fried) Shaoyao (Radix Paeoniae) Baizhi (Radix Angelicae Dahuricae, each five liang). Decoct pig trotters in two dou of water until eight sheng remain. Filter, add herbs, and decoct until four sheng remain. Wash the wound gently.
Xi Ji San (Muscle-Washing Powder): Treats wounds with un-dried pus. Wash with herbs wrapped around yellow scallions; very effective.
Qingmuxiang (Radix Aucklandiae) Bailing (Rhizoma Akebiae) Binglang (Semen Arecae) Guanzhong (Rhizoma Cyrtomii) Jingjie (Herba Schizonepetae). Decoct together and wash.
Baizhi Mo Gao (Angelica Dahurica Massage Ointment): Treats ulcerated gangrenous sores.
Baizhi (Radix Angelicae Dahuricae) Gancao (Radix Glycyrrhizae, each two fen) Wutou (Radix Aconiti Lateralis Preparata, three fen) Xiebai (Bulbus Allii Tuberosi, fifteen stems) Qing Zhuru (Bamboo Shavings, size of one egg). Simmer in one sheng of pig fat until Baizhi turns yellow and the ointment forms. Strain and apply to the four sides of the wound, avoiding the center.
Bailing Tang (Akebia Decoction) [from *Sheng Hui Fang*]: Treats post-ulceration induration of carbuncles and swellings; suitable for compress therapy.
Bailing (Rhizoma Akebiae) Huangqin (Radix Scutellariae) Chi Shaoyao (Radix Paeoniae Rubra) Danshen (Radix Salviae Miltiorrhizae, each one liang). Finely crush herbs, decoct in three sheng of water until one and a half sheng remain. Soak cloth in the decoction and apply as a compress to the swollen area. Change frequently for best results.
Baizhi San (Angelica Dahurica Powder) [from *Sheng Hui Fang*]: Treats ulcerated carbuncles and sores.
Baizhi (Radix Angelicae Dahuricae) Huanglian (Rhizoma Coptidis, de-stalked) Diyu (Radix Sanguisorbae, crushed, each one liang). Grind into fine powder. Mix with egg white, apply to cloth, and patch. Change three to four times daily.
Qu Shui Gao (Water-Removing Ointment) [from *Zhi Zhi Fang*]: Treats pain caused by accidental exposure to soapberry water or other toxic waters after ulceration of carbuncles and sores.
Gancao (Radix Glycyrrhizae, one fen, raw, ground) Shatang (Saccharum Officinale) Nuomicifen (Glutinous Rice Flour, each three fen). Make into an ointment, spread on silk, and apply. Toxic water will drain out. Also treats sweat, urine, and feces from donkeys and horses.
Formula for Ulcerated Carbuncles [from *Sheng Hui Fang*]:
Apply aged soy sauce mixed with flour to the wound. Change three times daily.
Formula for Incomplete Pus Drainage or Migrating Swelling after Carbuncle (Songzhi Seal Formula) [from *Sheng Hui Fang*]:
Melt equal parts of Songzhi (Resina Pini) and wax. Apply and seal tightly.