（附论）
凡身体盛热。不可当风。盖风冷之气。入于肌内。则热气搏伏不得出。故附着于骨而成
痈也。其状无头。但肿而阔。皮肤薄泽者。以毒瓦斯伏留于内故也。法宜外散其寒。内达蕴热。
乃中标本之治乎。
方
金石凌法（出圣济总录）治附骨痈。
栀子仁（半斤） 犀角屑 麝香（研各半两） 桔梗（锉炒二两半） 石膏（捶碎） 寒
水石
（捶碎各四两） 木通（锉） 甘草（锉炙） 郁金（锉各二两） 青木香（锉一分） 朴
硝（研四斤）
金二十两 上除朴硝、麝香外。先将寒水石、石膏、金。以水二斗。于银器内慢火煎至一斗。
次下前犀角等药七味。再煎至五升。以生绢滤去滓。下朴硝。以柳木篦搅。勿住手。候稍凝
即住火。入麝香拌令匀。盛密器中。每服一钱。新水调下。老幼加减服。
贯众汤（出圣济总录）治附骨痈。生股上。伏肉腠。
贯众 地骨皮 谷精草 枇杷叶（拭去毛炙） 荆芥（去梗） 蜀椒（去目并闭口者各
一两）
（案∶此方缺制法及服法。）
当归散（出神效方）治附骨痈。及一切恶疮。
当归（半两） 甘草（一两） 山栀子（十二个） 木鳖子（一个去皮） 上为细末。
每服三五
钱。冷酒调下。
密陀僧散（出圣济总录）治附骨痈。
密陀僧 自然铜（各半两） 杏仁（去皮尖双仁二七枚） 上用苦竹筒一枚。入药在内。
纸封筒口。慢火煨。候竹筒黄色。取研极细。看疮大小用药。以新汲水调匀。用鸡翎扫药
涂痈上。甚者不过二七日效。
蛇皮散（一名三生散）治附骨痈疽、痈肿、疔肿、诸毒。根在脏腑。疮口久
不合。
蛇皮 露蜂房 乱发（各半两） 上烧灰存性。研细。每服二钱。温酒调下。日三服。
一
方其蜂房用橱上悬得风露者。其蜂黄黑色。长寸许。螫马牛人及自死者。用此皆有效。非人
家屋下小小蜂房也。
牛胶散（出圣济总录）治附骨痈。
牛皮胶（黄明者慢火炙令黄） 甘草（用水一盏蘸炙水尽锉各半两） 上为散。每服二
钱。
浓煎木贼汤调下。空心服。复取药末以井水调膏。看疮大小摊纸贴之。
甘草汤（出圣济总录）治附骨痈。
甘草（炙二两） 露蜂房（一两） 上锉。以水五升。煎至三升。去滓。以故帛二片浸
汤中。
更互洗疮上。日三。
槲皮散（出圣济总录）治附骨痈疽。
用槲皮三两。烧令烟尽。细研为末。每服二钱。空心米饮调下。日晚再服。
治附骨痈方（出圣济总录）
用生地黄取汁一盏。于银石器中煎如膏。候冷。涂敷肿上。日三五度。
又方（出圣济总录）
用新鼠皮一张。看疮大小裁贴。日二次。出脓。若已溃者。用猪脊脂贴。吮脓出尽即瘥。
五香连翘汤（一名连翘散）治附骨痈、结核。脓水肿痛。心肠气满。方见本门
发背类。
内托黄 柴胡汤（出试效方）治附骨痈。
黄 （二钱） 柴胡（一钱） 羌活（五分） 连翘（一钱三分） 肉桂（三分） 土
瓜根（一钱
酒制） 生地黄（一分） 黄柏（五分） 当归尾（七分半） 上 咀。作一服。水三盏。
酒一盏。
同煎至一盏。去滓热服。宿食消尽服。一服而愈。昔贾德茂男年十岁。丁未四月十一日。于
左腿近膝股内出附骨痈。肉色不变。漫肿皮泽未硬。疮势甚大。其左脚乃肝之脾土也。在足
厥阴肝经之分。少侵足太阴脾经之分。具脉左三部细而弦。按之洪缓。微有力。一方无黄柏。
内托黄 酒煎汤（出试效方）治附骨痈。
柴胡（一钱半） 连翘（一钱） 肉桂（一钱） 黍粘子（炒一钱） 黄 （二钱） 当
归尾（二
钱） 黄柏（五分） 升麻（七分） 甘草（炙五分） 上 咀。好糯米酒一盏半。水一大
盏半。
同煎至一大盏。去滓温服。空心宿食消尽服之。待少时。以早 压之。使不令大热上攻中上
二焦也。丁未季春二十二日。蒲度主老七十。因寒湿地气得附骨痈。于左腿外侧。足少阳胆
经之分。微侵足阳明分。阔六七寸。长一尺。坚硬漫肿。不变肉色。皮泽深。但行步作痛。
以指按至骨大痛。与药一服立止。再日坚硬而肿消。
【附论】
凡是身体发热严重，不能吹受风邪。因为风寒之气侵入肌肉内部，导致体内的热气被遏制伏留而无法散发出去，所以热毒附着在骨骼上而形成痈疽。其症状表现为没有脓头，只是肿胀且范围宽大，皮肤薄而光亮，这是因为毒气潜伏留在体内所致。治疗法则应当外散寒邪，内达蕴结之热，这才是符合标本兼治的方法。
方剂：
金石凌法（出自《圣济总录》），治疗附骨痈。
栀子仁（半斤）、犀角屑、麝香（研细，各半两）、桔梗（锉碎炒制，二两半）、石膏（捶碎）、寒水石（捶碎，各四两）、木通（锉碎）、甘草（锉碎炙烤）、郁金（锉碎，各二两）、青木香（锉碎，一分）、朴硝（研细，四斤）、金箔（二十两）。
以上药物，除了朴硝和麝香外，先将寒水石、石膏和金箔放入银器中，加入水二斗，用慢火煎煮至一斗。然后加入前面提到的犀角等七味药，再煎煮至五升。用生绢过滤去除药渣，加入朴硝，用柳木篦不断搅拌，不要停手。等到药液稍微凝固时停止加热，加入麝香搅拌均匀。装入密封容器中。每次服用一钱，用新汲水调服。老人和儿童根据情况加减剂量服用。
贯众汤（出自《圣济总录》），治疗附骨痈生于大腿上，潜伏在肌肉腠理之间。
贯众、地骨皮、谷精草、枇杷叶（拭去毛后炙烤）、荆芥（去掉梗）、蜀椒（去掉目及闭合口者，各一两）。
（按语：此方缺少制作方法和服用方法。）
当归散（出自《神效方》），治疗附骨痈以及一切恶疮。
当归（半两）、甘草（一两）、山栀子（十二个）、木鳖子（一个，去皮）。
以上药物研成细末。每次服用三到五钱，用冷酒调服。
密陀僧散（出自《圣济总录》），治疗附骨痈。
密陀僧、自然铜（各半两）、杏仁（去皮尖的双仁者十四枚）。
以上药物放入一根苦竹筒内，用纸封住筒口，用慢火煨烧。等到竹筒变成黄色时取出，研磨至极细。根据疮口大小用药量，用新汲水调匀，用鸡毛蘸药涂抹在痈肿上。严重的不过两三天见效。
蛇皮散（又名三生散），治疗附骨痈疽、痈肿、疔肿以及各种毒症。病根在脏腑，疮口长期不愈合。
蛇皮、露蜂房、乱发（各半两）。
以上药物烧成灰但保留药性，研细。每次服用二钱，用温酒调服，每日三次服用。
另一说法认为，蜂房应选用挂在屋檐下经受风吹露淋的，这种蜂房黄黑色，长约一寸，是被马牛蜇伤的人或自行死去的蜜蜂所筑，使用这些均有效，不是人家屋檐下的小小蜂房。
牛胶散（出自《圣济总录》），治疗附骨痈。
牛皮胶（选择黄色的，用慢火炙烤至变黄）、甘草（用水一盏蘸湿炙烤至水尽，锉碎，各半两）。
以上药物制成散剂。每次服用二钱，用浓煎的木贼汤调服，空腹服用。剩下的药末用井水调成膏状，根据疮口大小摊在纸上贴敷。
甘草汤（出自《圣济总录》），治疗附骨痈。
甘草（炙烤，二两）、露蜂房（一两）。
以上药物锉碎，用水五升，煎煮至三升，去除药渣。取两块旧布浸在药汤中，交替清洗疮口，每日三次。
槲皮散（出自《圣济总录》），治疗附骨痈疽。
取槲皮三两，烧至烟尽，细细研磨成末。每次服用二钱，空腹时用米饮调服，晚上再服一次。
治疗附骨痈方（出自《圣济总录》）
取新鲜地黄汁一盏，在银器或石器中煎煮如膏状。冷却后，涂抹敷在肿胀处，每日三到五次。
又一方（出自《圣济总录》）
取一张新鼠皮，根据疮口大小裁剪贴敷，每日两次。排出脓液。如果已经溃破，用猪脊脂贴敷，吸出脓液后即可痊愈。
五香连翘汤（又名连翘散），治疗附骨痈、结核，脓液水肿疼痛，心腹胀满。方剂见本门“发背”类。
内托黄芪柴胡汤（出自《试效方》），治疗附骨痈。
黄芪（二钱）、柴胡（一钱）、羌活（五分）、连翘（一钱三分）、肉桂（三分）、土瓜根（一钱，酒制）、生地黄（一分）、黄柏（五分）、当归尾（七分半）。
以上药物切碎，作为一剂服用。加水三盏，酒一盏，同煎至一盏，去除药渣热服。待宿食消化完后服用。服用一剂即可痊愈。
以前贾德茂的儿子十岁时，丁未年四月十一日，左腿靠近膝盖的大腿内侧长出附骨痈，肌肉颜色不变，漫肿皮肤光亮但未变硬，疮势很大。左脚属于肝之脾土，位于足厥阴肝经的分野，轻微涉及足太阴脾经的分野。脉象左三部细而弦，按压时洪缓，微有力。另一方无黄柏。
内托黄芪酒煎汤（出自《试效方》），治疗附骨痈。
柴胡（一钱半）、连翘（一钱）、肉桂（一钱）、黍粘子（炒，一钱）、黄芪（二钱）、当归尾（二钱）、黄柏（五分）、升麻（七分）、甘草（炙，五分）。
以上药物切碎，用好糯米酒一盏半，水一大盏半，同煎至一大盏，去除药渣温服。空腹且宿食消化完后服用。过一会儿，用早饭压住药力，防止药性大热向上攻冲中上二焦。
丁未年季春二十二日，蒲度主老七十岁，因寒湿地气侵袭患上附骨痈，位于左腿外侧，足少阳胆经的分野，轻微涉及足阳明经分野，宽六七寸，长一尺，坚硬漫肿，肌肉颜色不变，皮肤光亮深沉，只是行走时疼痛，用手指按至骨头处剧痛。给予药物一剂，疼痛立即停止。第二天坚硬消退，肿胀也消了。
[Supplementary Discussion]
Whenever the body is severely hot, one must not be exposed to wind. This is because cold and wind qi penetrates into the muscles, causing the internal heat to be constrained and trapped, unable to dissipate. Consequently, the heat toxin attaches to the bone, forming an abscess (Fu Gu Yong). The presentation involves no visible head, but rather diffuse swelling that is broad, with thin and lustrous skin, due to the toxin lurking within. The treatment principle should be to disperse cold externally and vent the accumulated heat internally, thereby addressing both the root and the branch.
Formulas:
Jin Shi Ling Method (from *Sheng Ji Zong Lu*), treating Fu Gu Yong.
Gardenia Seed (Zhi Zi Ren, 8 ounces), Rhinoceros Horn Shavings (Xi Jiao Xie), Musk (She Xiang, ground, each 0.5 ounce), Platycodon Root (Jie Geng, chopped and stir-fried, 2.5 ounces), Gypsum (Shi Gao, crushed), Arsenolite (Han Shui Shi, crushed, each 4 ounces), Akebia Stem (Mu Tong, chopped), Licorice Root (Gan Cao, chopped and honey-fried), Turmeric Tuber (Yu Jin, chopped, each 2 ounces), Costus Root (Qing Mu Xiang, chopped, 1 fen), Mirabilite (Pu Xiao, ground, 4 jin), Gold Leaf (Jin Bo, 20 liang).
Except for Mirabilite and Musk, first place Arsenolite, Gypsum, and Gold Leaf in a silver vessel with two dou of water. Simmer slowly over low heat until reduced to one dou. Then add the seven previously mentioned herbs (including Rhinoceros Horn, etc.). Decoct again until reduced to five sheng. Filter through raw silk to remove dregs. Add Mirabilite. Stir continuously with a willow wood spatula without stopping. When the mixture begins to congeal slightly, remove from heat. Add Musk and mix evenly. Store in a sealed container. Take 1 qian per dose, mixed with fresh well water. Adjust dosage for the elderly and children.
Guan Zhong Decoction (from *Sheng Ji Zong Lu*), treating Fu Gu Yong arising on the thigh, latent in the muscle interstices.
Cyathula Root (Guan Zhong), Bark of Ground Cherry Root (Di Gu Pi), Flower Spine of Rice Paddy Eye (Gu Jing Cao), Loquat Leaf (Pi Pa Ye, wiped clean of hairs and roasted), Schizonepeta Spike (Jing Jie, stems removed), Sichuan Pepper (Shu Jiao, eyes and closed-mouthed ones removed, each 1 liang).
(Note: This formula lacks preparation and administration instructions.)
Dang Gui Powder (from *Shen Xiao Fang*), treating Fu Gu Yong and all kinds of malignant sores.
Angelica Sinensis Root (Dang Gui, 0.5 liang), Licorice Root (Gan Cao, 1 liang), Gardenia Fruit (Shan Zhi Zi, 12 pieces), Momordica Seed (Mu Bie Zi, 1 piece, peeled).
Grind all into fine powder. Take 3-5 qian per dose, mixed with cold wine.
Mi Tuo Seng Powder (from *Sheng Ji Zong Lu*), treating Fu Gu Yong.
Litharge (Mi Tuo Seng), Natural Pyrite (Zi Ran Tong, each 0.5 liang), Apricot Kernel (Xing Ren, peeled and tip removed, double-kernelled, 14 pieces).
Place these herbs inside a single bitter bamboo tube. Seal the mouth with paper. Roast slowly over low heat until the bamboo turns yellow. Remove and grind to an extremely fine powder. Apply according to the size of the sore. Mix with fresh well water to form a paste. Use a chicken feather to sweep/apply the medicine onto the abscess. Severe cases may resolve within two to seven days.
She Pi Powder (also known as San Sheng Powder), treating Fu Gu Yong Ju, carbuncles, furuncles, and various toxins rooted in the zang-fu organs, with sores that fail to heal for a long time.
Snake Skin (She Pi), Exposed Beehive (Lu Feng Fang), Tangled Hair (Luan Fa, each 0.5 liang).
Burn to ash while preserving the medicinal nature. Grind finely. Take 2 qian per dose, mixed with warm wine. Administer three times daily.
Another prescription specifies using bee hives hung under eaves exposed to wind and dew. These are yellow-black, about one cun long, built by bees that stung horses or cattle or died naturally. These are effective; they are not the small hives found under ordinary houses.
Niu Jiao Powder (from *Sheng Ji Zong Lu*), treating Fu Gu Yong.
Ox Hoof Gelatin (Niu Jiao, select yellowish Ming gelatin, roast slowly over low heat until yellow), Licorice Root (Gan Cao, dip in one cup of water, roast until water is dry, chop, each 0.5 liang).
Process into a powder. Take 2 qian per dose, mixed with strongly decocted Equisetum Tea (Mu Zei Tang). Take on an empty stomach. Use the remaining powder mixed with well water as a paste. Spread on paper according to the sore's size and apply as a patch.
Gan Cao Decoction (from *Sheng Ji Zong Lu*), treating Fu Gu Yong.
Licorice Root (Gan Cao, roasted, 2 liang), Exposed Beehive (Lu Feng Fang, 1 liang).
Chop the ingredients. Decoct in five sheng of water until reduced to three sheng. Remove dregs. Soak two pieces of old cloth in the decoction. Alternately wash the sore with the cloth three times daily.
Hu Pi Powder (from *Sheng Ji Zong Lu*), treating Fu Gu Yong Ju.
Take 3 liang of Oak Bark (Hu Pi). Burn until smoke ceases. Grind finely into powder. Take 2 qian per dose on an empty stomach, mixed with rice drink. Take again in the evening.
Formula for Treating Fu Gu Yong (from *Sheng Ji Zong Lu*)
Extract juice from fresh Rehmannia Root (Sheng Di Huang) to obtain one cup. Decoct in a silver or earthenware vessel until it becomes like paste. Allow to cool. Apply to the swollen area three to five times daily.
Another Formula (from *Sheng Ji Zong Lu*)
Use one fresh rat skin. Cut to fit the size of the sore and apply twice daily to drain pus. If already ulcerated, apply pork spinal fat. Suck out all pus until healed.
Wu Xiang Lian Qiao Decoction (also known as Lian Qiao San), treating Fu Gu Yong, scrofula, edematous pain with pus, and abdominal fullness. See the "Back Carbuncle" section for the formula.
Nei Tuo Huang Qi Chai Hu Decoction (from *Shi Xiao Fang*), treating Fu Gu Yong.
Astragalus Root (Huang Qi, 2 qian), Bupleurum Root (Chai Hu, 1 qian), Notopterygium Root (Qiang Huo, 5 fen), Forsythia Fruit (Lian Qiao, 1.3 qian), Cinnamon Twig (Rou Gui, 3 fen), Trichosanthes Root of Earth (Tu Gua Gen, 1 qian, prepared with wine), Fresh Rehmannia Root (Sheng Di Huang, 1 fen), Phellodendron Bark (Huang Bai, 5 fen), Angelica Sinensis Tail (Dang Gui Wei, 0.75 qian).
Chop the herbs. Prepare as one dose. Add three cups of water and one cup of wine. Decoct until one cup remains. Strain and take hot. Take after the residual food in the stomach has digested. One dose results in cure.
Previously, the ten-year-old son of Jia Demao developed Fu Gu Yong on April 11 of the Dingwei year, on the inner thigh near the left knee. The flesh color remained unchanged, with diffuse swelling, lustrous skin, but hardness had not yet set in. The condition was severe. The left foot corresponds to the spleen earth of the liver, located in the distribution of the Foot Jueyin Liver Meridian, slightly involving the Foot Taiyin Spleen Meridian. The pulse at the left three positions was fine and wiry, but forceful upon pressing, appearing flood-like and slow. Another version of this formula excludes Huang Bai.
Nei Tuo Huang Qi Wine-Decoction (from *Shi Xiao Fang*), treating Fu Gu Yong.
Bupleurum Root (Chai Hu, 1.5 qian), Forsythia Fruit (Lian Qiao, 1 qian), Cinnamon Twig (Rou Gui, 1 qian), Burdock Fruit (Shu Nian Zi, fried, 1 qian), Astragalus Root (Huang Qi, 2 qian), Angelica Sinensis Tail (Dang Gui Wei, 2 qian), Phellodendron Bark (Huang Bai, 5 fen), Cimicifuga Rhizome (Sheng Ma, 7 fen), Licorice Root (Gan Cao, roasted, 5 fen).
Chop the herbs. Add one and a half cups of good glutinous rice wine and one and a half large cups of water. Decoct until one large cup remains. Strain and take warm. Take on an empty stomach after digestion of residual food. After a short while, eat breakfast to suppress the medicine, preventing the intense heat from attacking the Middle and Upper Jiao.
On the 22nd day of the late spring of the Dingwei year, Pu Du Zhu, aged seventy, contracted Fu Gu Yong due to cold-damp pathogenic qi. It appeared on the lateral aspect of the left leg, in the distribution of the Foot Shaoyang Gallbladder Meridian, slightly involving the Foot Yangming Stomach Meridian. It was six to seven cun wide and one chi long, hard and diffusely swollen, with unchanged flesh color but deep lustrous skin. Walking caused pain, and pressing to the bone elicited severe pain. One dose of the prescribed medicine stopped the pain immediately. By the next day, the hardness subsided and the swelling decreased.