留都郑中翰，仲夏患发背，已半月。疮头十余枚，皆如粟许，漫肿坚硬，根如大盘，背
重如负石，即隔蒜灸五十余壮，其背顿轻，彼因轻愈，不守禁忌，三日后大作，疮不起发，
但苦作痛。用活命饮四剂，势少退。用香砂六君子汤四剂，饮食少进。彼恃知医，自用败毒
药二剂，饮食益少，口流涎沫，若不自知，此脾虚之甚也。每用托里药加参 各三钱，彼密
自拣去大半，后虽用大补药加姜桂亦不应。遂令其子，以参 各一斤，归术各半斤，干姜、
桂、附各一两，煎膏一罐，三日饮进，涎顿止，腐顿溃，食顿进，再用托里健脾药，腐肉自
脱而愈。（下俱薛按）
张侍御，患背疮三枚，皆如粟，彼以为小毒，服清热化痰药，外用凉药贴敷，数日尚
不起，色黯不 ，胸中气不得出入，势甚可畏。连用活命饮二剂，气虽利，脓清稀，疮不
起。欲用补剂，彼泥于素有痰火，不受参术之补。因其固执，遂阳以败毒之剂与视之，而阴以
参归术各五钱，姜桂各二钱，服二剂，背觉热，腐肉得溃，方信余言，始明用大补药乃愈。
南都聂姓者，时六月患发背，腐肉已去，疮口尺许，色赤 肿，发热不食，欲呕不呕，
服十宣散等药，自为不起，请余决之。其脉轻诊则浮而散，重诊则弱而涩，此溃后之正脉。
然疮口开张，血气虚也。欲呕不呕，脾胃虚也。色赤 肿，虚火之象也，尚可治。遂与十全
大补汤加酒炒黄柏、知母、五味、麦冬，及饮童便，饮食顿进，肌肉顿生。服至八剂，疮口
收如粟许。又惑于人言，谓余毒未尽，乃服消毒药二剂，复发热昏愦，急进前药，又二十余
剂乃愈。后两月，因作善事，一昼夜不睡，以致劳倦发热，似睡不睡。与前汤二剂，更加发
热，饮食不进，惟饮热汤后，以前药加附子一钱，二剂复愈。
高秋官贞甫，孟秋发背，色黯而硬，不痛不起，脉沉而细，四肢逆冷，急用大艾隔蒜灸
三十余壮，不痛。遂用艾如粟大者，着肉灸七壮，乃始知痛。与六君子汤二剂，每剂入附子
二钱，不应。后剂又加肉桂二钱，始应而愈。
一男子，胁肿一块，日久不溃，按之微痛，脉微而涩，此形证俱虚也。经曰∶形气不足
，病气不足，当补不当泻。予以人参养营汤治之，彼不信，乃服流气饮。虚证悉至，方服前
汤。月余少愈。但肿处尚硬，以艾叶炒热熨患处，至十日余日脓成。以火针刺之，更灸以豆豉饼
，又服十全大补汤，百剂而愈。
南京的郑中翰，在仲夏时节患发了背疽，病程已经半个月。疮头有十余个，都像粟米大小，漫肿坚硬，根部像大盘子一样大，背部沉重得像背着石头。即使隔着蒜片灸了五十多壮，他的背部顿时感到轻松，他因为感觉轻快痊愈，就不遵守禁忌（饮食起居等），三天后病情大作，疮疡不起发，只是痛苦地疼痛。使用仙方活命饮四剂，势头稍微减退。使用香砂六君子汤四剂，饮食稍微进补。他倚仗自己懂医，自行服用败毒药两剂，饮食更加减少，口流涎沫，好像自己都不知道，这是脾虚非常严重的表现。每次使用托里药加上人参、黄芪各三钱，他私下偷偷去掉大半，后来虽然使用大补药加上干姜、肉桂也不见效。于是让他的儿子，用人参、黄芪各一斤，当归、白术各半斤，干姜、肉桂、附子各一两，煎制成膏一罐，三天内喝进去，口水顿时停止流出，腐肉顿时溃破，饮食顿时增加，再用托里健脾药，腐肉自然脱落而痊愈。（以下都是薛己的按语）
张侍御，背上长了三个疮，都像粟米大小，他认为毒邪小，服用清热化痰药，外用凉药贴敷，几天还不起来，颜色暗红不光泽，胸中气机不得出入，形势非常可怕。连续使用仙方活命饮两剂，气机虽然通畅，但脓液清稀，疮疡不起发。想要用补剂，他拘泥于平时素有痰火，不接受人参、白术的补益。因为他固执，于是表面上给他看败毒的药剂，而暗中给人参、当归、白术各五钱，干姜、肉桂各二钱，服用两剂，背部觉得热，腐肉得以溃破，才相信我的话，才明白使用大补药才能痊愈。
南京姓聂的人，当时六月患发背疽，腐肉已经去除，疮口有一尺左右，颜色赤红肿痛，发热不吃东西，想吐又吐不出来，服用十宣散等药，自己认为起不来，请我决断。他的脉象轻取则浮而散，重取则弱而涩，这是溃破后的正常脉象。但是疮口开张，是血气虚的表现。想吐又吐不出来，是脾胃虚的表现。颜色赤红肿痛，是虚火的征象，还可以治疗。于是给予十全大补汤加上酒炒黄柏、知母、五味子、麦冬，以及饮用童便，饮食顿时增加，肌肉顿时生长。服用到八剂，疮口收缩如粟米大小。又被别人言语迷惑，说余毒未尽，于是服用消毒药两剂，再次发热昏愦，急忙进服前面的药，又二十多剂才痊愈。两个月后，因为做善事，一昼夜不睡觉，导致劳倦发热，似睡非睡。给前面的汤药两剂，更加发热，饮食不进，只有喝热汤后，用前面的药加附子一钱，两剂又痊愈。
高秋官贞甫，孟秋时节发背疽，颜色暗红而硬，不痛不起发，脉沉而细，四肢逆冷，紧急使用大艾团隔着蒜片灸三十多壮，还是不痛。于是用像粟米大小的艾团，直接着肉灸七壮，才开始知道痛。给予六君子汤两剂，每剂加入附子二钱，不见效。后面的药方又加入肉桂二钱，才见效而痊愈。
一个男子，胁部肿了一块，日子久了不溃破，按压微微疼痛，脉微而涩，这是形体和证候都虚的表现。经书说：形气不足，病气不足，应当补而不应当泻。我用人参养营汤治疗他，他不相信，于是服用流气饮。虚证全部出现，才服用前面的汤药。一个多月稍微好转。但是肿胀处还硬，用艾叶炒热熨烫患处，到了十多天脓成。用火针刺之，再用豆豉饼灸，又服用十全大补汤，一百剂才痊愈。
Zheng Zhonghan, a civil official in Nanjing, suffered from a carbuncle on the back (Fabei) in mid-summer, with the disease lasting for half a month. There were more than ten sores, each the size of a millet grain, diffusely swollen and hard, with a base as large as a plate. His back felt heavy as if carrying a stone. Even after moxibustion with garlic slices for over fifty moxa cones, his back suddenly felt lighter. Believing he was recovering due to this relief, he did not observe dietary and lifestyle taboos. Three days later, the condition worsened significantly; the sore failed to suppurate or rise, causing only severe pain. He took four doses of Xianfang Huoming Yin (Immortal Life Elixir), and the severity slightly subsided. He then took four doses of Xiangsha Liujunzi Tang (Aucklandia and Amomum Six Gentlemen Decoction), and his appetite slightly improved. Relying on his medical knowledge, he self-administered two doses of detoxifying herbs, which further reduced his food intake. He drooled saliva involuntarily, seemingly unaware of it, indicating severe Spleen deficiency. Each time he used internal support herbs with Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi) at 3 qian each, he secretly removed most of them. Later, even when using major tonifying herbs with Zingiberis Rhizoma Recens (Shengjiang) and Cinnamomi Cortex (Guirui), there was no response. Consequently, I instructed his son to prepare a decoction paste using one jin each of Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi), half a jin each of Angelicae Sinensis Radix (Danggui) and Atractylodis Macrocephalae Rhizoma (Baizhu), and one liang each of Zingiberis Rhizoma (Ganjiang), Cinnamomi Cortex (Guirui), and Aconiti Lateralis Radix Praeparata (Fuzi). This was consumed over three days. The salivation stopped immediately, the necrotic tissue ulcerated promptly, and his appetite returned. Subsequent use of internal support and Spleen-fortifying herbs led to the natural shedding of necrotic tissue and recovery. (The following are comments by Xue Ji)
Zhang Shiyu, a court attendant, had three sores on his back, each the size of a millet grain. He considered the toxicity minor and took heat-clearing and phlegm-resolving herbs, applying cold external patches. After several days, the sores remained flat, dark in color without luster, and his chest qi was obstructed, unable to circulate freely, presenting a dire situation. Two doses of Xianfang Huoming Yin (Immortal Life Elixir) were administered consecutively; although his qi flow improved, the pus remained thin and clear, and the sores did not rise. When considering tonifying formulas, he resisted the inclusion of Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) due to his belief in his chronic Phlegm-Fire condition. Due to his stubbornness, I ostensibly prescribed detoxifying agents while secretly administering a decoction containing five qian each of Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), and Atractylodis Macrocephalae Rhizoma (Baizhu), along with two qian each of Zingiberis Rhizoma (Shengjiang) and Cinnamomi Cortex (Guirui). After two doses, his back felt warm, and the necrotic tissue began to slough off. Only then did he believe my advice and understand that major tonification was necessary for recovery.
A man surnamed Nie in Nanjing suffered from a carbuncle on the back in June. The necrotic tissue had been removed, leaving a sore about one chi in diameter, red, swollen, and painful. He experienced fever, anorexia, and nausea without vomiting. After taking Shixuan San (Ten-Aperture Powder) and believing it ineffective, he sought my diagnosis. His pulse was floating and scattered on light palpation, and weak and choppy on heavy palpation, which is a normal pulse pattern after ulceration. However, the open sore indicated Blood and Qi deficiency. The nausea without vomiting indicated Spleen and Stomach deficiency. The redness and swelling indicated deficient Fire. The condition was still treatable. I prescribed Shiquan Dabu Tang (Perfect Tonifying Decoction) modified with wine-fried Phellodendri Cortex (Huangbai), Anemarrhenae Rhizoma (Zhimu), Schisandrae Fructus (Wuweizi), and Ophiopogonis Radix (Maidong), along with drinking child urine. His diet immediately improved, and flesh regenerated. After eight doses, the sore contracted to the size of a millet grain. Misled by others who claimed residual toxins remained, he took two doses of detoxifying herbs, leading to recurrent fever and confusion. Urgent administration of the previous formula resulted in recovery after another twenty-plus doses. Two months later, due to charitable acts involving staying awake for a full day and night, he developed fatigue-induced fever and drowsiness. Two doses of the previous decoction exacerbated the fever and loss of appetite. Only after consuming hot water and taking the previous formula with the addition of one qian of Aconiti Lateralis Radix Praeparata (Fuzi) did he recover after two doses.
Gao Qiu Guan Zhenfu developed a carbuncle on the back in early autumn. The lesion was dark, hard, painless, and non-suppurating. His pulse was deep and fine, and his limbs were cold. Emergency moxibustion with large moxa cones over garlic slices for over thirty cones did not elicit pain. Subsequently, small moxa cones the size of millet grains were applied directly to the skin for seven cones, which finally elicited pain. He was given two doses of Liujunzi Tang (Six Gentlemen Decoction) with two qian of Aconiti Lateralis Radix Praeparata (Fuzi) added to each dose, but there was no response. In subsequent doses, two qian of Cinnamomi Ramulus (Rougui) were added, after which the treatment became effective and he recovered.
A male patient had a swelling on his hypochondrium that had persisted for a long time without ulcerating. Palpation revealed slight pain. His pulse was faint and choppy, indicating both physical constitution and pathological signs of deficiency. The Classics state: "When both form/energy and pathogenic energy are insufficient, tonification is indicated, not purgation." I treated him with Renshen Yangying Tang (Ginseng Nourishing Camp Decoction). Disbelieving in this approach, he took Liuqi Yin (Flowing Qi Decoction). All deficiency symptoms manifested, and only then did he take the previous tonic. After more than a month, he showed slight improvement. However, the swelling remained hard. I applied hot-wrapped mugwort leaves to the affected area. After more than ten days, pus formed. It was punctured with a fire needle, followed by moxibustion with fermented soybean cakes. He then took Shiquan Dabu Tang (Perfect Tonifying Decoction) for one hundred doses before fully recovering.