(附论)
夫发背寒热者。由寒气客于经络。折于血气。血涩不行。乃结成疮肿。又诸阳气臻集。
寒化为热。热盛则肉腐为脓。此皆脏腑壅滞。毒瓦斯不得宣通。故令寒热也。
痈疽发背作寒热。痈疽发背。病为急切。然五脏 皆在背。发于何部。宜精详之。其作
也、邪毒内鼓。寒热交攻。气血壅滞。阴阳相干。故令人身热而恶寒也。当以疗痈疽之法治
之。
李氏云。近时有数人病背疽。服前方药未安之间。遍身寒热。或先寒后热。或先热后寒。
或连日作。或间日作。必先呕痰。然后寒热。寒热解大汗出。然后止。时医多欲用柴胡、牡
蛎。止汗之药。又有以为疟疾。欲下常山饮子。愚力辨云。背疽之疾。不可专以为有热。亦
有气虚而得之。亦有因怒气并气血凝滞而得之。所以发寒热者。先感寒邪。脾气不正。痰盛
而有此证。若下柴胡必泻肝。母既虚而又泻其子。牡蛎涩气。气血又不荣运。又服涩气药。
常山饮子吐痰。大损脾胃。用药如此。可谓误谬。愚但令服家传不换金正气散。祛寒邪。正
脾气。痰饮自消。寒热不作。兼服排脓内补散以退热。
方
地黄丸 治痈疽发背。时作寒热。疼痛不食。解毒。
生干地黄(焙二两) 黄 (锉) 栝蒌根 黄芩(去黑心) 麦门冬(去心焙各一两
半) 桑
螵蛸(十五枚锉炒) 大黄(锉炒) 人参 栀子仁 肉苁蓉(焙) 前胡(去芦头) 升
麻芍药 知母(焙) 王不留行(各一两) 远志(去心) 败酱 地脉草(各半两) 干
枣(一十五枚汤
浸去皮核以蜜一升和蒸成膏) 上为末。入枣膏和丸如梧桐子大。每服三十丸。加至五十丸。
空心米饮下。日晚再服。
人参散 治发背肿毒。寒热疼痛。口干心燥。
人参(去芦头) 芎 (各一两) 生干地黄 石膏(各二两) 甘草(生锉) 知母
(各一两)
黄(一两半锉) 黄芩(一两) 前胡(一两去芦头) 麦门冬(一两半去心) 赤芍药
(一两)
枳实(一两半麸炒微黄) 川升麻(一两半) 柏子仁(一两半) 上为散。每服四钱。水
一中盏。
入竹叶二七片。小麦一百粒。煎至六分。去滓。不计时候温服。
木通散 治痈始发于背。便生寒热。口干心烦。不得卧。
木通(一两半锉) 知母(一两半) 赤芍药(一两) 当归(一两) 生干地黄(一
两半) 川
升麻(一两半) 黄 (一两半锉) 枳实(一两麸炒微黄) 甘草(一两生锉) 赤茯苓
(一两)
前胡(一两半去芦头) 麦门冬(一两去心) 黄芩(五分) 芎 (一两) 上为散。每
服四钱。
水一中盏。入竹叶二七片。小麦一百粒。煎至六分。去滓。不计时候温服。
枳实散 治发背结硬气盛。或经一月不已。作苦寒热。
枳实(三分麸炒微黄) 芎 (三分) 生干地黄(三分) 赤芍药(三分) 木通(三
分锉)
黄芩(三分) 前胡(三分去芦头) 知母(半两) 赤茯苓(半两) 细辛(半两) 人
参(半两去
芦头) 甘草(半两生锉) 黄 (半两锉) 上为散。每服四钱。水一中盏。煎至六分。
去滓。
不计时候温服。
五香散 升降诸气。宣利三焦。疏导壅滞。发散邪热。治阴阳之气。郁结不消。诸
热蕴毒。肿痛结核。或似痈疖而非。使人头痛恶心。寒热气结。
柴胡煎 治热毒痈肿。血不散。初觉憎寒干渴。四肢烦闷。能令速消。
柴胡(去苗一两) 知母(焙一两) 木通(一两半) 淡竹叶(一百片) 瞿麦穗(一
两) 连
翘(一两) 防风(二两) 大黄(生二两细锉) 生麦门冬(汁三合汤成下) 生藕汁(三
合汤成
下) 甜硝(四两汤成下) 上先将八味锉如麻豆大。以水三升。煮取一升半。去滓。下甜
硝
令散。次入麦门冬藕汁等。共分为八服。空腹两服。以溏利为度。余药食后缓缓服之。
漏芦散 治发背及一切疮毒。攻冲寒热。大肠秘涩。除烦热解毒。
漏芦 白蔹 黄芩 麻黄(去根节) 知母 枳实(麸炒微黄) 川升麻 犀角屑 赤
芍药
(各一两) 川大黄(二两锉碎微炒) 甘草(三分) 上为散。每服四钱。水一中盏。煎
至六
分。去滓。不计时候温服。
犀角散 治发背痈疽。一切疮肿未穴时。攻刺疼痛。或发寒热。渴燥不食。解毒匀
气。
犀角(镑一分) 人参 大黄(锉炒) 栝蒌实(焙) 甘草(炙锉各半两) 葛根(锉)
赤茯
苓(去黑心) 槟榔(锉) 木香(各三分) 芎 (一两) 上为散。每服二钱。空心晚
间粥饮调
下。以瘥为度。
麦门冬散 治发背壅盛。作寒热、疼痛不止。
麦门冬(一两去心) 前胡(一两去芦头) 黄芩(一两) 川升麻(一两) 远志(一
两去心)
黄(一两锉) 赤芍药(一两) 生干地黄(一两) 栝蒌根(一两) 当归(半两) 上
为散。每
服四钱。水一中盏。入竹叶二七片。小麦一百粒。煎至六分。去滓。不计时候温服。
黄 散 治发背热毒瓦斯盛。作寒热往来。疼痛不止。
黄 (一两锉) 川升麻(一两) 犀角屑(一两) 赤茯苓(三分) 麦门冬(三分
去心) 人
参(三分去芦头) 赤芍药(三分) 石膏(二两) 生干地黄(三分) 蓝叶(半两) 上
为散。每
服四钱。水一中盏。入竹叶二七片。煎至六分。去滓。不计时候温服。
真方不换真金正气散。治疽疮未安之间。遍身寒热。或先寒后热。或先热后寒。或
连日作。或间日作。必先呕痰。而后寒热。大汗出然后止。服此去寒邪。正脾气。痰饮
自消。寒热不作。一法用川芎半两。不用人参。兼治四时感风寒冷热之气。中伤冷物。
或伤瘴疟之疾。痰盛头痛。常服能辟山岚瘴气。四时疫疠。
苍术(米泔浸半日炒令黄色) 大浓朴(紫色者去粗皮切姜汁炒各二两) 粉草(炙一
两)
真橘红(水洗净去白两半以上四味再入锅内炒去火毒) 半夏(汤洗七次姜制) 藿香叶 人
参
(去芦) 木香(去芦) 白茯苓(去皮各一两) 一方有川芎 上锉散。每服三钱。水一
盏半。
生姜三片。枣二枚。煎至八分。入盐少许。温服无时。一方最能发出风毒。可与排脓内补散
并行。若疮陷不发。多加辣桂、当归。
升麻汤 治痈疽始作。坚硬皮色紫赤。恶寒壮热。一二日未成脓者。
升麻 连翘 大黄(锉炒) 生地黄(切焙炒) 木香(各一两) 白蔹 玄参(各三
分) 上
粗捣筛。每服五钱水二盏。煎至一盏。入芒硝末半钱。去滓。空心温服。取利为度。未利再
服。
人参散 治发背未成脓。身体寒热。
人参 当归(焙) 密陀僧( ) 没药(研) 雄黄(研各半两) 丹砂(研一钱) 栝
蒌实
(二枚去瓤取皮子生用) 上为细散。每服二钱。用甘草煎汤。放温调下。日三。
羊髓膏 治痈疽始作。便败坏。发寒热疼痛。及瘭疽浸淫。广大 赤。黑烂成疮。
一名甘草膏。
羊髓 甘草(锉捣各二两) 胡粉(研) 大黄(锉捣各二两) 猪脂(半斤) 上先
熬脂髓令
沸。下甘草、大黄。煎候甘草黑色。绵滤去滓。入胡粉以柳篦搅匀。瓷盒盛。每日三五度。
涂敷疮上。以瘥为度。
神效托里散 治痈疽、发背、肠痈、乳痈、无名肿毒。 作疼痛。憎寒壮热。类若
伤寒之证。
黄 (去芦用盐水炙) 忍冬叶(各五两) 当归(酒浸去芦一两八钱) 粉草(炙八
钱) 上
为细末。每服二钱。以酒一盏半。煎至一盏。若病在上食后服。病在下空心服。少顷再进留
滓外敷。未成脓者内消。已成脓者即溃。老少虚人。皆可服之。
黄柏散 治发背未溃。身体寒热。亦治痈疖。
黄柏 烟熏壁土〔多年者各三(二)两〕 上为细散。每服二钱。茅根煎汤调下。仍用
生
姜汁调药。敷之。
苦茄散 治发背未溃。身体寒热。
苦茄种 甘草(炙各一两) 上为细散。每服二钱。甘草汤调下。一方酒调服。
痈疽虚证寒战方。
用明乳香研细半两。每服一钱。熟水调下。战发于肝。乳香着肝而温之。寒战随止。
(附论)
所谓发背出现寒热症状,是因为寒气侵袭经络,导致血气受阻。血液运行涩滞不畅,从而结成疮肿。此外,诸阳之气汇聚于此,寒气转化为热邪。热势炽盛则肌肉腐烂化为脓液。这些都是由于脏腑壅塞阻滞,毒气无法宣通所致,因此引发寒热症状。
痈疽发背伴有寒热症状,病情十分急迫。然而五脏都位于背部,需要精确详细地辨别发病的具体部位。其发作时,邪毒在体内鼓动,寒热相互交攻,气血壅滞,阴阳相互干扰,从而导致人体发热且恶寒。应当采用治疗痈疽的方法来施治。
李氏说:近来有几个人患背疽,服用前面的方药后病情未稳,全身出现寒热交替。有的先恶寒后发热,有的先发热后恶寒,有的连续多日发作,有的隔日发作。必定先呕吐痰涎,然后才出现寒热。待寒热消退,大汗出后,症状才会停止。当时的医生大多想用柴胡、牡蛎等止汗的药物。又有人认为是疟疾,想用常山饮子来攻下。我极力辩驳说:背疽之病,不能单纯认为是有热邪,也有因气虚而得的,也有因愤怒导致气血凝滞而得的。所以出现寒热症状,是因为先感受了寒邪,脾气不正,痰湿盛重而有此证。如果使用柴胡,必然损伤肝脏;母脏既已虚弱,再泻其子脏(肝木生心火,此处指代关系或五行相克逻辑,原文意指误治伤正),牡蛎收敛涩气,使气血更加不能荣养运行。如果再服用收敛涩气的药物,以及用常山饮子催吐痰涎,会严重损伤脾胃。用药如此,可以说是错误的。我只让患者服用家传的不换金正气散,以祛除寒邪,调理脾气,痰饮自然消除,寒热不再发作。同时服用排脓内补散以退热。
方剂
地黄丸:治疗痈疽发背,时常出现寒热,疼痛且食欲不振,具有解毒功效。
生干地黄(焙干二两)、黄芪(锉碎)、栝蒌根、黄芩(去除黑心部分)、麦门冬(去心焙干,各一两半)、桑螵蛸(十五枚,锉碎炒制)、大黄(锉碎炒制)、人参、栀子仁、肉苁蓉(焙干)、前胡(去除芦头)、升麻、芍药、知母(焙干)、王不留行(各一两)、远志(去心)、败酱草、地脉草(各半两)、干枣(十五枚,用水浸泡,去皮核,用蜂蜜一升调和蒸制成膏)。以上药材研为细末,加入枣膏和匀,制成如梧桐子大小的丸药。每次服用三十丸,加至五十丸,空腹时用米汤送服,晚上再服一次。
人参散:治疗发背肿毒,伴有寒热疼痛,口干心烦。
人参(去芦头)、川芎(各一两)、生干地黄、石膏(各二两)、甘草(生锉)、知母(各一两)、黄芪(一两半,锉碎)、黄芩(一两)、前胡(一两,去芦头)、麦门冬(一两半,去心)、赤芍药(一两)、枳实(一两半,麸炒至微黄)、川升麻(一两半)、柏子仁(一两半)。以上药材研为散剂。每次服用四钱,加水一中盏,放入竹叶十四片,小麦一百粒,煎煮至六分,去渣,不限时候温服。
木通散:治疗痈疽初发于背部,随即出现寒热,口干心烦,无法安卧。
木通(一两半,锉碎)、知母(一两半)、赤芍药(一两)、当归(一两)、生干地黄(一两半)、川升麻(一两半)、黄芪(一两半,锉碎)、枳实(一两,麸炒至微黄)、甘草(一两,生锉)、赤茯苓(一两)、前胡(一两半,去芦头)、麦门冬(一两,去心)、黄芩(五分)、川芎(一两)。以上药材研为散剂。每次服用四钱,加水一中盏,放入竹叶十四片,小麦一百粒,煎煮至六分,去渣,不限时候温服。
枳实散:治疗发背结块坚硬,气盛,或者经过一个月仍未痊愈,出现剧烈寒热。
枳实(三分,麸炒至微黄)、川芎(三分)、生干地黄(三分)、赤芍药(三分)、木通(三分,锉碎)、黄芩(三分)、前胡(三分,去芦头)、知母(半两)、赤茯苓(半两)、细辛(半两)、人参(半两,去芦头)、甘草(半两,生锉)、黄芪(半两,锉碎)。以上药材研为散剂。每次服用四钱,加水一中盏,煎煮至六分,去渣,不限时候温服。
五香散:升降诸气,宣利三焦,疏导壅滞,发散邪热。治疗阴阳之气郁结不消,各种热蕴毒气,肿痛结核,或者类似痈疖而非痈疖的症状,使人头痛恶心,寒热气结。
柴胡煎:治疗热毒痈肿,血液不散。初觉憎寒干渴,四肢烦闷,能使肿块迅速消散。
柴胡(去苗一两)、知母(焙干一两)、木通(一两半)、淡竹叶(一百片)、瞿麦穗(一两)、连翘(一两)、防风(二两)、大黄(生用二两,细锉)、生麦门冬(取汁三合,汤成时下)、生藕汁(三合,汤成时下)、甜硝(四两,汤成时下)。先将前八味药材锉如麻豆大小,用水三升,煮取一升半,去渣。加入甜硝使其溶解,其次加入麦门冬汁、藕汁等,共分为八份服用。空腹时服两份,以大便溏泄为度。剩余药液饭后缓缓服用。
漏芦散:治疗发背及一切疮毒,攻冲引起寒热,大肠便秘涩滞,除烦热解毒。
漏芦、白蔹、黄芩、麻黄(去根节)、知母、枳实(麸炒至微黄)、川升麻、犀角屑、赤芍药(各一两)、川大黄(二两,锉碎微炒)、甘草(三分)。以上药材研为散剂。每次服用四钱,加水一中盏,煎煮至六分,去渣,不限时候温服。
犀角散:治疗发背痈疽,一切疮肿尚未溃破时,攻刺疼痛,或者出现寒热,口渴烦躁不食,具有解毒调气功效。
犀角(镑片一分)、人参、大黄(锉碎炒制)、栝蒌实(焙干)、甘草(炙干锉碎,各半两)、葛根(锉碎)、赤茯苓(去除黑心)、槟榔(锉碎)、木香(各三分)、川芎(一两)。以上药材研为散剂。每次服用二钱,空腹及晚间用粥饮调服,以病愈为度。
麦门冬散:治疗发背壅盛,出现寒热,疼痛不止。
麦门冬(一两,去心)、前胡(一两,去芦头)、黄芩(一两)、川升麻(一两)、远志(一两,去心)、黄芪(一两,锉碎)、赤芍药(一两)、生干地黄(一两)、栝蒌根(一两)、当归(半两)。以上药材研为散剂。每次服用四钱,加水一中盏,放入竹叶十四片,小麦一百粒,煎煮至六分,去渣,不限时候温服。
黄芪散:治疗发背热毒旺盛,出现寒热往来,疼痛不止。
黄芪(一两,锉碎)、川升麻(一两)、犀角屑(一两)、赤茯苓(三分)、麦门冬(三分,去心)、人参(三分,去芦头)、赤芍药(三分)、石膏(二两)、生干地黄(三分)、蓝叶(半两)。以上药材研为散剂。每次服用四钱,加水一中盏,放入竹叶十四片,煎煮至六分,去渣,不限时候温服。
真方不换金正气散:治疗疽疮病情未稳之间,全身寒热,或先寒后热,或先热后寒,或连续多日发作,或隔日发作。必定先呕吐痰涎,而后出现寒热,大汗出后停止。服用此方可祛寒邪,正脾气,痰饮自消,寒热不作。另一法是用川芎半两,不用人参。兼治四季感受风寒冷热之气,中伤冷物,或者感染瘴疟之疾,痰盛头痛。常服能辟除山岚瘴气及四季疫疠。
苍术(米泔水浸泡半天,炒至黄色)、大浓朴(紫色者,去粗皮切丝,姜汁炒,各二两)、粉草(炙干一两)、真橘红(水洗净去白,半两以上)。这四味药再放入锅内炒去火毒。半夏(汤洗七次,姜制)、藿香叶、人参(去芦)、木香(去芦)、白茯苓(去皮,各一两)。一方中有川芎。以上锉为散剂。每次服用三钱,加水一盏半,生姜三片,枣二枚,煎煮至八分,加入少许盐,不限时候温服。一方最能发出风毒,可与排脓内补散并行使用。若疮陷不发,多加辣桂、当归。
升麻汤:治疗痈疽初起,坚硬皮色紫赤,恶寒壮热,一二天尚未成脓者。
升麻、连翘、大黄(锉碎炒制)、生地黄(切焙炒)、木香(各一两)、白蔹、玄参(各三分)。以上粗捣筛。每次服用五钱,加水二盏,煎煮至一盏,加入芒硝末半钱,去渣,空腹温服,以大便通利为度。若未通利再服。
人参散:治疗发背尚未成脓,身体寒热。
人参、当归(焙干)、密陀僧(煅)、没药(研)、雄黄(研,各半两)、丹砂(研一钱)、栝蒌实(二枚,去瓤取皮子生用)。以上研为细散。每次服用二钱,用甘草煎汤,放温调服,每日三次。
羊髓膏:治疗痈疽初起,便败坏,发寒热疼痛,以及瘭疽浸淫,范围广大,红肿,黑烂成疮。又名甘草膏。
羊髓、甘草(锉捣,各二两)、胡粉(研)、大黄(锉捣,各二两)、猪脂(半斤)。先将猪脂和羊髓熬令沸腾,下入甘草、大黄,煎候甘草变黑色,用绵布滤去渣。加入胡粉,用柳条搅拌均匀,装入瓷盒。每日涂敷疮上三五次,以病愈为度。
神效托里散:治疗痈疽、发背、肠痈、乳痈、无名肿毒,出现疼痛,憎寒壮热,症状类似伤寒。
黄芪(去芦,用盐水炙)、忍冬叶(各五两)、当归(酒浸去芦一两八钱)、粉草(炙干八钱)。以上研为细末。每次服用二钱,用酒一盏半,煎煮至一盏。若病在上部食后服,病在下部空腹服。稍后再进服,留下药渣外敷。未成脓者可内消,已成脓者可溃破。老少体虚之人皆可服用。
黄柏散:治疗发背未溃,身体寒热。也治疗痈疖。
黄柏、烟熏壁土(多年的,各三两)。以上研为细散。每次服用二钱,用茅根煎汤调服。仍用生姜汁调药敷之。
(Attached Discussion)
The occurrence of chills and fever in "Fa Bei" (back carbuncle) is caused by cold pathogenic factors invading the meridians, obstructing Qi and Blood. The blood flow becomes sluggish and stagnant, leading to the formation of sores and swelling. Furthermore, when Yang Qi converges at this site, the cold transforms into heat. Excessive heat causes flesh to rot and turn into pus. These conditions are all due to the stagnation and blockage of the Zang-Fu organs, preventing the dispersion and unblocking of toxic factors, thus causing chills and fever.
Chills and fever accompanying back carbuncles indicate an urgent condition. Since all five Zang organs are located on the back, it is essential to precisely identify the specific area of onset. During the attack, evil toxins surge internally, with chills and fever attacking each other; Qi and Blood become stagnant, and Yin and Yang interfere with one another, resulting in body heat and aversion to cold. Treatment should follow the methods for managing carbuncles and ulcers.
Li stated: Recently, several patients suffered from back carbuncles. While taking previous prescriptions without full relief, they experienced systemic chills and fever alternating. Some had chills followed by fever, others fever followed by chills; some had daily episodes, others every other day. Vomiting of phlegm invariably preceded the chills and fever. Once the chills and fever subsided, profuse sweating occurred, after which the symptoms ceased. Contemporary physicians often wished to use Chai Hu (Bupleuri Radix) and Mu Li (Ostreae Concha), herbs that stop sweating. Others diagnosed Malaria (Nue Ji) and desired to administer Chang Shan Yin Zi (Dichroa Decoction) to purge. I strongly refuted this, stating: Back carbuncles cannot be solely attributed to heat pathogens; they can also arise from Qi deficiency or from anger causing Qi and Blood stagnation. The reason for chills and fever here is first contracting cold pathogens, with improper Spleen Qi and excessive Phlegm-Dampness. Using Chai Hu would inevitably drain the Liver; if the Mother organ is already deficient, draining its Child organ further weakens the body. Mu Li astringes Qi, hindering the nourishment and circulation of Qi and Blood. Administering astringent herbs, along with Chang Shan Yin Zi to induce vomiting of phlegm, severely damages the Spleen and Stomach. Such medication usage constitutes a grave error. I instructed only the use of Jia Chuan Bu Huan Jin Zheng Qi San (Family-Inherited Golden Change Upright Qi Powder) to dispel cold pathogens and rectify Spleen Qi, allowing Phlegm-Fluids to dissipate naturally and preventing chills and fever. Concurrently, Pai Nong Nei Bu San (Pus-Discharging Internal-Nourishing Powder) was administered to reduce heat.
Prescriptions
Di Huang Wan (Rehmannia Pill): Treats back carbuncles with intermittent chills and fever, pain, and loss of appetite; detoxifies.
Sheng Gan Di Huang (Fried Dried Rehmanniae Radix, 2 liang), Huang Qi (Astragali Radix, cut), Gua Lou Gen (Trichosanthis Radix), Huang Qin (Scutellariae Radix, remove black heart), Mai Men Dong (Ophiopogonis Radix, remove heart and fry, 1.5 liang each), Sang Piao Xiao (Mantidis Oötheca, 15 pieces, cut and stir-fried), Da Huang (Rhei Radix et Rhizoma, cut and stir-fried), Ren Shen (Ginseng Radix), Zhi Zi Ren (Gardeniae Semen, 1 liang each), Rou Cong Rong (Cistanches Herba, fried), Qian Hu (Peucedani Radix, remove rhizome), Sheng Ma (Cimicifugae Rhizoma), Shao Yao (Paeoniae Radix), Zhi Mu (Anemarrhenae Rhizoma, fried, 1 liang each), Wang Bu Liu Xing (Vaccariae Semen, 1 liang), Yuan Zhi (Polygalae Radix, remove heart), Bai Jiang Cao (Patriniae Herba), Di Mai Cao (Plantaginis Herba, 0.5 liang each), Gan Zao (Jujubae Fructus, 15 pieces, soaked in water, skin and pits removed, mixed with 1 sheng of honey and steamed into paste). Grind the above into powder, mix with the jujube paste, and form pills the size of paulownia seeds. Take 30 pills initially, increasing to 50 pills, taken with rice decoction on an empty stomach, and again in the evening.
Ren Shen San (Ginseng Powder): Treats back carbuncle swelling and toxicity with chills, fever, pain, dry mouth, and restlessness.
Ren Shen (Ginseng Radix, remove rhizome), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 1 liang each), Sheng Gan Di Huang (Fresh Dried Rehmanniae Radix), Shi Gao (Gypsum Fibrosum, 2 liang each), Gan Cao (Licorice Radix, raw and cut), Zhi Mu (Anemarrhenae Rhizoma, 1 liang each), Huang Qi (Astragali Radix, 1.5 liang, cut), Huang Qin (Scutellariae Radix, 1 liang), Qian Hu (Peucedani Radix, 1 liang, remove rhizome), Mai Men Dong (Ophiopogonis Radix, 1.5 liang, remove heart), Chi Shao Yao (Red Paeoniae Radix, 1 liang), Zhi Shi (Aurantii Fructus Immaturus, 1.5 liang, bran-fried until slightly yellow), Chuan Sheng Ma (Cimicifugae Rhizoma, 1.5 liang), Bai Zi Ren (Biota Semen, 1.5 liang). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, add 14 leaves of Zhu Ye (Bambusae Folium) and 100 grains of Xiao Mai (Tritici Fructus), decoct until 6 fen remains, strain, and take warm at any time.
Mu Tong San (Tetrapanacis Decoction): Treats carbuncles initially appearing on the back with immediate chills and fever, dry mouth, irritability, and inability to sleep.
Mu Tong (Akebiae Caulis, 1.5 liang, cut), Zhi Mu (Anemarrhenae Rhizoma, 1.5 liang), Chi Shao Yao (Red Paeoniae Radix, 1 liang), Dang Gui (Angelicae Sinensis Radix, 1 liang), Sheng Gan Di Huang (Fresh Dried Rehmanniae Radix, 1.5 liang), Chuan Sheng Ma (Cimicifugae Rhizoma, 1.5 liang), Huang Qi (Astragali Radix, 1.5 liang, cut), Zhi Shi (Aurantii Fructus Immaturus, 1 liang, bran-fried until slightly yellow), Gan Cao (Licorice Radix, raw and cut, 1 liang), Chi Fu Ling (Red Poria, 1 liang), Qian Hu (Peucedani Radix, 1.5 liang, remove rhizome), Mai Men Dong (Ophiopogonis Radix, 1 liang, remove heart), Huang Qin (Scutellariae Radix, 0.05 liang), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 1 liang). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, add 14 leaves of Zhu Ye (Bambusae Folium) and 100 grains of Xiao Mai (Tritici Fructus), decoct until 6 fen remains, strain, and take warm at any time.
Zhi Shi San (Aurantii Powder): Treats back carbuncles with hard nodules and excess Qi, persisting for a month or more, causing severe chills and fever.
Zhi Shi (Aurantii Fructus Immaturus, 3 fen, bran-fried until slightly yellow), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 3 fen), Sheng Gan Di Huang (Fresh Dried Rehmanniae Radix, 3 fen), Chi Shao Yao (Red Paeoniae Radix, 3 fen), Mu Tong (Akebiae Caulis, 3 fen, cut), Huang Qin (Scutellariae Radix, 3 fen), Qian Hu (Peucedani Radix, 3 fen, remove rhizome), Zhi Mu (Anemarrhenae Rhizoma, 0.5 liang), Chi Fu Ling (Red Poria, 0.5 liang), Xi Xin (Asari Radix et Rhizoma, 0.5 liang), Ren Shen (Ginseng Radix, 0.5 liang, remove rhizome), Gan Cao (Licorice Radix, raw and cut, 0.5 liang), Huang Qi (Astragali Radix, 0.5 liang, cut). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, decoct until 6 fen remains, strain, and take warm at any time.
Wu Xiang San (Five Fragrances Powder): Regulates the movement of Qi, promotes the free flow of the Triple Burner, resolves stagnation, and disperses evil heat. Treats depression and failure to resolve of Yin and Yang Qi, accumulation of various hot toxins, painful swelling and nodules, or lesions resembling carbuncles but not being them, causing headache, nausea, chills, fever, and Qi knotting.
Chai Hu Jian (Bupleuri Decoction): Treats hot-toxin carbuncles where blood does not disperse. Initially perceived as aversion to cold, dry thirst, and limb restlessness; promotes rapid resolution.
Chai Hu (Bupleuri Radix, remove stems, 1 liang), Zhi Mu (Anemarrhenae Rhizoma, fried, 1 liang), Mu Tong (Akebiae Caulis, 1.5 liang), Dan Zhu Ye (Bambusae Folium, 100 slices), Qu Mai (Dianthi Herba, 1 liang), Lian Qiao (Forsythiae Fructus, 1 liang), Fang Feng (Saposhnikoviae Radix, 2 liang), Da Huang (Rhei Radix et Rhizoma, raw, 2 liang, finely cut), Sheng Mai Men Dong (Fresh Ophiopogonis Radix, juice 3 he, added when decoction is ready), Sheng Ou Zhi (Fresh Lotus Root Juice, 3 he, added when decoction is ready), Tian Xiao (Sweet Saltpeter/Nitrum, 4 liang, added when decoction is ready). First, cut the first eight herbs like hemp seeds, boil in 3 sheng of water to obtain 1.5 sheng, strain. Add Tian Xiao to dissolve. Then add Mai Men Dong juice and lotus root juice. Divide into 8 doses. Take 2 doses on an empty stomach, stopping when loose stools occur. Take remaining doses slowly after meals.
Lou Lu San (Rhyncholirion Powder): Treats back carbuncles and all sores/toxicities causing chills and fever, constipation, removing irritability and heat, and detoxifying.
Lou Lu (Rhyncholirii Rhizoma), Bai Lian (Ampelopsis Radix), Huang Qin (Scutellariae Radix), Ma Huang (Ephedrae Herba, remove roots and joints), Zhi Mu (Anemarrhenae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus, bran-fried until slightly yellow), Chuan Sheng Ma (Cimicifugae Rhizoma), Xi Jiao (Rhinocerotis Cornu, shaved), Chi Shao Yao (Red Paeoniae Radix, 1 liang each), Chuan Da Huang (Rhei Radix et Rhizoma, 2 liang, cut and slightly stir-fried), Gan Cao (Licorice Radix, 3 fen). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, decoct until 6 fen remains, strain, and take warm at any time.
Xi Jiao San (Rhinocerotis Powder): Treats back carbuncles/ulcers and all swellings before ulceration, causing stabbing pain, chills, fever, thirst, irritability, and anorexia; detoxifies and harmonizes Qi.
Xi Jiao (Rhinocerotis Cornu, shaved, 1 fen), Ren Shen (Ginseng Radix), Da Huang (Rhei Radix et Rhizoma, cut and stir-fried), Gua Lou Shi (Trichosanthis Fructus, fried), Gan Cao (Licorice Radix, honey-fried and cut, 0.5 liang each), Ge Gen (Puerariae Lobatae Radix, cut), Chi Fu Ling (Red Poria, remove black heart), Bing Lang (Arecae Semen, cut), Mu Xiang (Aucklandiae Radix, 3 fen each), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 1 liang). Grind the above into powder. Take 2 qian per dose, taken with congee broth on an empty stomach and in the evening, until cured.
Mai Men Dong San (Ophiopogonis Powder): Treats severe back carbuncles with chills, fever, and persistent pain.
Mai Men Dong (Ophiopogonis Radix, 1 liang, remove heart), Qian Hu (Peucedani Radix, 1 liang, remove rhizome), Huang Qin (Scutellariae Radix, 1 liang), Chuan Sheng Ma (Cimicifugae Rhizoma, 1 liang), Yuan Zhi (Polygalae Radix, 1 liang, remove heart), Huang Qi (Astragali Radix, 1 liang, cut), Chi Shao Yao (Red Paeoniae Radix, 1 liang), Sheng Gan Di Huang (Fresh Dried Rehmanniae Radix, 1 liang), Gua Lou Gen (Trichosanthis Radix, 1 liang), Dang Gui (Angelicae Sinensis Radix, 0.5 liang). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, add 14 leaves of Zhu Ye (Bambusae Folium) and 100 grains of Xiao Mai (Tritici Fructus), decoct until 6 fen remains, strain, and take warm at any time.
Huang Qi San (Astragali Powder): Treats back carbuncles with intense heat-toxins, alternating chills and fever, and persistent pain.
Huang Qi (Astragali Radix, 1 liang, cut), Chuan Sheng Ma (Cimicifugae Rhizoma, 1 liang), Xi Jiao (Rhinocerotis Cornu, shaved, 1 liang), Chi Fu Ling (Red Poria, 3 fen), Mai Men Dong (Ophiopogonis Radix, 3 fen, remove heart), Ren Shen (Ginseng Radix, 3 fen, remove rhizome), Chi Shao Yao (Red Paeoniae Radix, 3 fen), Shi Gao (Gypsum Fibrosum, 2 liang), Sheng Gan Di Huang (Fresh Dried Rehmanniae Radix, 3 fen), Lan Ye (Isatidis Folium, 0.5 liang). Grind the above into powder. Take 4 qian per dose, with 1 zhong zhan of water, add 14 leaves of Zhu Ye (Bambusae Folium), decoct until 6 fen remains, strain, and take warm at any time.
Zhen Fang Bu Huan Jin Zheng Qi San (True Formula Golden Change Upright Qi Powder): Treats carbuncles/ulcers with unstable condition, systemic chills and fever, alternating patterns, daily or every-other-day episodes, preceded by vomiting phlegm, ending with profuse sweating. This formula dispels cold pathogens, rectifies Spleen Qi, eliminates Phlegm-Fluids, and stops chills and fever. Alternative method: Use Chuan Xiong (Ligustici Chuanxiong Rhizoma) 0.5 liang instead of Ren Shen. Also treats seasonal wind-cold-heat invasion, injury from cold foods, or miasma-malaria with excessive phlegm and headache. Regular use wards off mountain miasma and seasonal epidemics.
Cang Zhu (Atractylodis Rhizoma, soaked in rice wash water for half a day, fried until yellow), Da Nong Po (Magnoliae Officinalis Cortex, purple variety, remove rough bark, cut, stir-fried with ginger juice, 2 liang each), Fen Cao (Licorice Radix, honey-fried, 1 liang), Zhen Ju Hong (Citri Reticulatae Pericarpium Rubrum, washed clean, remove white pith, >0.5 liang). Stir-fry these four ingredients in a pot to remove fire toxicity. Ban Xia (Pinelliae Tuber, washed seven times in water, processed with ginger), Huo Xiang Ye (Agastaches Folium), Ren Shen (Ginseng Radix, remove rhizome), Mu Xiang (Aucklandiae Radix, remove rhizome), Bai Fu Ling (Poria, remove skin, 1 liang each). One formula includes Chuan Xiong. Cut into coarse powder. Take 3 qian per dose, with 1.5 zhong zhan of water, 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens), 2 dates, decoct until 8 fen remains, add a little salt, take warm at any time. This formula effectively expels wind-toxin and can be used concurrently with Pai Nong Nei Bu San. If the sore sinks and fails to erupt, add more La Gui (Cinnamomi Cortex) and Dang Gui (Angelicae Sinensis Radix).
Sheng Ma Tang (Cimicifugae Decoction): Treats initial carbuncles/ulcers that are hard, with purple-red skin, aversion to cold, and high fever, before suppuration occurs in 1-2 days.
Sheng Ma (Cimicifugae Rhizoma), Lian Qiao (Forsythiae Fructus), Da Huang (Rhei Radix et Rhizoma, cut and stir-fried), Sheng Di Huang (Rehmanniae Radix, sliced, fried), Mu Xiang (Aucklandiae Radix, 1 liang each), Bai Lian (Ampelopsis Radix), Xuan Shen (Scrophulariae Radix, 3 fen each). Coarsely grind and sieve. Take 5 qian per dose, with 2 zhong zhan of water, decoct until 1 zhong zhan remains, add 0.5 qian of Mang Xiao (Natrii Sulfas) powder, strain, and take warm on an empty stomach. Stop when bowel movement occurs; repeat if necessary.
Ren Shen San (Ginseng Powder): Treats back carbuncles before suppuration, with body chills and fever.
Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix, fried), Mi Tuo Seng (Lithargyri Calcitum, calcined), Mo Yao (Myrrha), Xiong Huang (Realgar, ground, 0.5 liang each), Dan Sha (Cinnabaris, ground, 1 qian), Gua Lou Shi (Trichosanthis Fructus, 2 pieces, remove pulp, use skin and seeds raw). Grind into fine powder. Take 2 qian per dose, mixed with Licorice decoction cooled to warm temperature, three times daily.
Yang Sui Gao (Sheep Marrow Ointment): Treats initial carbuncles/ulcers that deteriorate quickly, causing chills, fever, and pain, as well as Bao Ju (acute infectious sores) spreading widely, redness, blackening, and ulceration. Also known as Gan Cao Gao.
Yang Sui (Sheep Marrow), Gan Cao (Licorice Radix, cut and pounded, 2 liang each), Hu Fen (Lead Carbonate, ground), Da Huang (Rhei Radix et Rhizoma, cut and pounded, 2 liang each), Zhu Zhi (Porcine Fat, 0.5 jin). First, boil the fat and marrow until bubbling. Add Gan Cao and Da Huang, decoct until Gan Cao turns black. Filter through silk cloth to remove dregs. Add Hu Fen and stir evenly with a willow stick. Store in porcelain boxes. Apply to the sore 3-5 times daily until cured.
Shen Xiao Tuo Li San (Divine Efficacy Supporting Interior Powder): Treats carbuncles, back carbuncles, intestinal abscesses, breast abscesses, and nameless swellings with pain, aversion to cold, and high fever, resembling Tai Yang disease (Cold Damage syndrome).
Huang Qi (Astragali Radix, remove rhizome, honey-fried with salt water), Ren Dong Ye (Lonicerae Japonicae Folium, 5 liang each), Dang Gui (Angelicae Sinensis Radix, wine-soaked, remove rhizome, 1.8 qian), Fen Cao (Licorice Radix, honey-fried, 0.8 qian). Grind into fine powder. Take 2 qian per dose, with 1.5 zhong zhan of wine, decoct until 1 zhong zhan remains. If the disease is in the upper body, take after meals; if in the lower body, take on an empty stomach. Shortly after, take again. Reserve the dregs for external application. Unsuppurated sores will resolve internally; suppurated sores will rupture. Suitable for young, old, and deficient individuals.
Huang Bo San (Phellodendri Powder): Treats non-ulcerated back carbuncles with body chills and fever. Also treats carbuncles and furuncles.
Huang Bo (Phellodendri Cortex), Yan Xun Bi Tu (Wall Earth Smoked by Cooking Fires, aged, 2 liang each). Grind into fine powder. Take 2 qian per dose, mixed with Mugwort Root decoction. Still, mix medicine with fresh Ginger Juice for topical application.
Ku Qie San (Bitter Eggplant Powder): Treats non-ulcerated back carbuncles with body chills and fever.
Ku Qie Zhong (Solanum Melongena Seed), Gan Cao (Licorice Radix, honey-fried, 1 liang each). Grind into fine powder. Take 2 qian per dose, mixed with Licorice decoction. One formula uses wine for mixing.
Carbuncle/Ulcer Deficiency Syndrome Chills Formula:
Use Ming Ru Xiang (Frankincense, purified), finely ground, 0.5 liang. Take 1 qian per dose, mixed with boiled water. Chills originate from the Liver; Ru Xiang enters the Liver to warm it, stopping the chills immediately.