肿脉沉数者，邪气实也，宜泄之。肿痛，增寒发热，或拘急者，邪在表也，宜发散。
因怒
弱者，补气为主。肿硬不溃者，补气血为主。抑郁所致者，解郁结调气血。溃后不敛者，属
气血俱虚，宜大补。虚劳所致者，补之。因有核而不敛者，腐而补之。脉实而不敛，或不消
者，下之。
一男子患此，肿痛发寒热，大便秘，以射干连翘散，六剂热退大半；以仙方活命饮，四
剂而消。
一妇人耳下肿痛，发寒热，与荆防败毒散，四剂表证悉退；以散肿溃坚汤，数剂肿消大
半，再以神效栝蒌散，四剂而平。
一男子肝经风热，耳下肿痛发热，脉浮数，以薄荷丹治之而消。
一男子每怒，耳下肿，或胁作痛，以小柴胡汤，加青皮、木香、红花、桃仁，四剂而愈
一男子肿硬不作脓，脉弦而数，以小柴胡汤兼神效栝蒌散，各数剂；及隔蒜灸数次，月
余而消。
一妇人颈肿不消，与神效栝蒌散，六剂稍退；更以小柴胡汤，加青皮、枳壳、贝母，数
剂消大半；再以四物对小柴胡，数剂而平。
一男子因暴怒，项下肿痛结核，滞闷兼发热，用方脉流气饮二剂，胸膈利；以荆防败毒
散，
将平，唯一核不消，乃服遇仙无比丸二两而瘳。
一妇人久郁，患而不溃，既溃不敛，发热口干，月水短少，饮食无味，日晡尤倦，以益
气养
毒药，去而复结，以致不能收敛，出水不止，遂致不救。然此证，属虚劳气郁所致，宜补形
气，调经脉，未成者自消，已成自溃，若投 悍之剂，则气血愈虚，多变为瘵证。然坚而不
溃，溃而不合，气血不足明矣，况二经之血，原自不足，不可不察。
一男子久而不敛，神思困倦，脉虚，余欲投以托里，彼以为迂，乃服散肿溃坚汤，半月
余，
初觉，宜内消之；如经久不除，气血渐衰，肌寒肉冷，或脓汁清稀，毒瓦斯不出，疮口不合，
聚肿不赤，结核无脓，外证不明者，并宜托里；脓未成者，使脓早成；脓已溃者，使疮无变
坏之证，所以宜用也。
一男子久不敛，脓出更清，面黄羸瘦，每侵晨作泻，与二神丸，数服泻止；更以六君子
汤，加芎归，月余肌体渐复；灸以豆豉饼，及用补剂作膏药贴之，三月余而愈。
一妇溃后核不腐，以益气养荣汤三十余剂，更敷针头散腐之，再与前汤三十余剂而敛。
一男子未溃，倦怠发热，以补中益气汤，治之稍愈；以益气养荣汤，月余而溃，又月而
瘥。
一妇人肝经积热，患而作痛，脉沉数，以射干连翘汤，四剂稍愈；更用散肿溃坚丸，月
余而
毒、曰风、曰热，皆此二端，拓引变换，须分虚实。实者易治，虚者可虑。此经主决断，有
相火，且气多血少，妇人见此，若月水不调，寒热变生，稍久转为潮热，自非断欲食淡，神
医不能疗也。
一男子患面肿硬，久不消，亦不作脓，服散坚败毒药，不应。令灸肘尖、肩尖二穴，更
服益
，月经每过期且少，用逍遥散兼前汤，两月余气血复而疮亦愈，但一口不收，敷针头散，更
灸前穴而痊。常治二三年不愈者，连灸三次，兼用托里药，即愈。一妇人因怒，结核肿痛，
察其气血俱实，先以神效散下之，更以益气养荣汤，三十余剂而消。常治此证，虚者先用益
气养荣汤，待其气血稍充，乃用神效散，取去其毒，仍进前药，无不效者。
一 妇咽间如一核所鲠，咽吐不出，倦怠发热，先以四七汤治之，而咽利，更以逍遥散
。一妇所患同前，兼胸膈不利，肚腹膨胀，饮食少思，睡卧不安，用分心气饮，并愈。
一室女年十七，项下时或作痛，乍寒乍热，如疟状，肝脉弦长，此血盛之证也。先以小
柴胡
仓公传与褚澄，略而论及，言寡者，孟子正谓无夫曰寡是也。如师尼丧夫之妇，独阴无阳，
欲男子而不可得，是以郁悒而成病也。《易》曰∶天地 ，万物化醇，男女媾精，万物化
生。孤阴独阳可乎？夫既处闺门，欲心萌而不遂，致阴阳交争，乍寒乍热，有类疟疾，久而
为痨。又有经闭白淫，痰逆头风，膈气痞闷，面 瘦瘠等证，皆寡妇之病。诊其脉，独肝脉
弦，出寸口而上鱼际，宽其脉，原其疾，皆血盛而得。经云∶男子精盛则思室，女人血盛则
怀胎。观其精血，思过半矣。
一男子耳下患五枚如贯珠，年许尚硬，面色痿黄，饮食不甘，劳而发热，脉数软而涩。
以益气养荣汤，六十余剂，元气已复，患处已消，一核尚存，以必效散，二服而平。
一妇人久不作脓，脉浮而涩，余以气血俱虚，欲补之，使自溃。彼欲内消，专服斑蝥，
及散坚之药，气血愈虚而死。
一男子因劳，而患怠惰发热，脉洪大，按之无力，余谓须服补中益气汤。彼不信，辄服
攻伐
治先以调经解郁，更以隔蒜灸之，多自消。如不消，即以琥珀膏贴之，俟有脓，即针之，否
则变生他处。设若兼痰兼阴虚等证，只宜加兼证之剂，不可干扰余经。若气血已复而核不消
，却服散坚之剂，至月许不应，气血亦不觉损，方进必效散，或遇仙无比丸，其毒一下，即
止二药，更服益气养荣汤数剂以调理。若疮口不敛，宜用豆豉饼灸之，用琥珀膏贴之。气血
俱虚，或不慎饮食起居七情者，俱不治。然而此证以气血为主，气血壮实，不用追蚀之剂，
彼亦能自腐，但取去，便易于收敛；若气血虚，不先用补剂，而数用追蚀之药，不惟徒治，
适足以败矣；若发寒热，眼内有赤脉贯瞳人者，亦不治。一脉者，一年死；二脉者，二年死
一男子素弱，溃后核不腐，此气血皆虚，用托里养荣汤，气血将复，核尚在，以簪梃拨
去，又服前药，月余而痊。
一男子气血已复，核尚不腐，用针头散，及必效散，各三次，不旬日而愈。
一男子患之，痰盛胸膈痞闷，脾胃脉弦，此脾土虚肝木乘之也，当以实脾土伐肝木为主
。彼
，饮食少思；以补中益气汤，倍加白术，月余中气少健；又以益养荣汤，两月肿消，而血气
亦复矣。夫右关脉弦，弦属木，乃木盛而克脾土，为贼邪也，虚而用苦寒之剂，是虚虚也，
况痰之为病，其因不一，主治之法不同。凡治痰，用利药过多，则脾气愈虚，虚则痰愈易生
，如中气不足，必用参术之类为主，佐以痰药。
一妇人因怒项肿，后月经不通，四肢浮肿，小便如淋，此血分证也。先以椒仁丸数服，
经行
经水不通，名曰水分，宜葶苈丸治之。《妇人良方》云∶妇人肿满，若先因经水断绝，后至
四肢浮肿，小便不通，名曰血分。水化为血，血不通，则复化为水矣，宜服椒仁丸。若先因
小便不利，后身浮肿，致经水不通，名曰水分，宜服葶苈丸。
一室女年十九，颈肿一块，硬而色不变，肌肉日削，筋挛急痛，此七情所伤，气血所损
之证
伤于忧愁则肢废，魂伤于悲哀则筋挛，魄伤于喜乐则皮槁，志伤于盛怒则腰脊难以俯仰也。
柯侍郎有女适人，夫早逝，女患十指挛拳，掌垂莫举，肤体疮疡粟粟然，汤剂杂进，饮食顿
减，几于半载。适与诊之，则非风也，此乃忧愁悲哀所致尔。病属内因，于是内因药，仍以
鹿角胶辈，多用麝香熬膏贴痿处，挛能举，指能伸，病渐安。
一 妇四肢倦怠类痿证，以养血气健脾胃药而愈。
一室女性急好怒，耳下常肿痛，发寒热，肝脉弦急。投以小柴胡汤，加青皮、牛蒡子、
荆芥
余谓∶肝内主藏血，外主荣筋，若恚怒气逆则伤肝。肝主筋，故筋蓄结而肿，须病者自能调
摄，庶可免患，否则肝逆受伤，则不能藏血，血虚则为难瘥之证矣。后不戒，果结三核，屡
用追蚀药，不敛而殁。
一少妇耳下患肿，素勤苦，发热口干，月水每过期而至，且少。一老媪以为经闭，用水
蛭之
上为乳汁，下为月水，为经络之余气。苟外无六淫所侵，内无七情所伤，脾胃之气壮，则冲
任
不
一放出宫女，年逾三十，两胯作痛，不肿，色不变，大小便作痛如淋，登厕尤痛，此瘀
血渍
为商，常在外，可见此妇在内久怀幽郁，及在外又不能如愿，是以致生此疾。愈见流注瘰
，乃七情气血，皆已损伤，不可用攻伐之剂皎然矣。故《精血篇》云∶精未通而御女，以通
其精，则五体有不满之处，异日有难状之疾。阴已痿而思色，以降其精，则精不出而内败，
小便道涩而为淋。精已耗而复竭之，则大小便道牵疼，愈疼则愈欲大小便，愈便则愈疼。女
人天癸既至，逾十年无男子合，则不调；未逾十年，思男子合，亦不调。不调则旧血不出，
新血误行，或渍而入骨，或变而为肿，或虽合而难于合。男子多则沥枯虚人，产乳众则血枯
杀人。观其精血，思过半矣。
一室女年十七，患瘰 久不愈，月水尚未通，发热咳嗽，饮食少思。有老媪欲用巴豆、
肉桂
养气血，益津液，其经自行。彼惑于速效之说，仍用之。余曰∶“非其治也，比类乃剽悍之
剂，大助阳火，阴血得之则妄行，脾胃得之则愈虚。”经果通而不止，饮食愈少，更加潮热
，遂致不救。经云∶女子七岁肾气盛，齿更发长，二七天癸至，任脉通，太冲脉盛，月事以
时下。然过期而不至，是为失常，必有所因。夫人之生，以血气为本。人之病，未有不先伤
其气血者，妇女得之，多患于七情。寇宗 曰∶夫人之生，以血气为本，人之病，未有不先
伤其气血者。世有室女童男，积想在心，思虑过当，多致劳损，男子则神色先散，女子则月
水先闭，何以致然？盖愁忧思虑则伤心，心伤则血逆竭，血逆竭则神色先散，而月水先闭也
。火既受病，不能荣养其子，故不嗜食。脾既虚则金气亏，故发嗽；嗽既作，水气绝，故四
肢干；木气不充，故多怒；鬓发焦，筋骨痿。俟五脏传遍，故卒不能死者，然终死矣！此一
种于劳中最难治。盖病起于五脏之中，无有已期，药力不可及也。若或自能改易心志，用药
扶接，如此则可得九死一生。举此为例，其余诸方，可按脉与证而治之。 张氏云∶室女月
水
冷则凝。养生必用方，言之甚详，此说大有理，不可不知。若经候微少，渐渐不通，手足骨
肉烦疼，日渐羸瘦，渐生潮热，其脉微数，此由阴虚血弱，阳往乘之，小水不能灭盛火，火
逼水涸，亡津液。当养血益阴，慎毋以毒药通之，宜柏子仁丸、泽兰丸。
一男子先于耳前耳下患之，将愈，次年延及项侧缺盆，三年遂延胸腋，不愈。诊之肝脉
弦数
诊如前，以清肝养血及前丸而愈。
一 妇溃后发热，烦躁作渴，脉大无力，此血虚而然也。以当归补血汤，六剂顿退；又
以圣
，烦躁肌热，不欲近衣，其脉洪大，按之无力，或目痛鼻干者，非白虎汤证也。此血虚发躁
，当以当归补血汤主之。又有火郁而热者，如不能食而热，自汗气短者，虚也。以甘寒之剂
，泻热补气。如能食而热，口舌干燥，大便难者，以辛苦大寒之剂下之，以泻火补水。
附方
射干连翘散 治寒热瘰 。
射干 连翘 玄参 赤芍药 木香 升麻 前胡 山栀仁 当归 甘草（炙，各七分）
大黄（炒，二钱） 作一剂，水二钟，煎八分，食后服。
荆防败毒散（方见溃疡发热门）
仙方活命饮（方见发背门）
小柴胡汤 治瘰 乳痈，便毒下疳，及肝胆经分，一切疮疡，发热潮热，或饮食
少思。
半夏（姜制，一钱） 柴胡（二钱） 黄芩（炒，二钱） 人参（一钱） 甘草（炙，五分） 作
一剂，水二钟，姜三片，煎八分，食远服。
薄荷丹 治风热瘰 ，久服其毒自小便宣出。若未作脓者，自消。
薄荷 皂角（去内核） 连翘 三棱（煨） 何首乌（米泔水浸） 蔓荆子（各净，一
两） 豆
日二服。病虽愈，须常服之。
益气养荣汤 治抑郁，或劳伤气血，或四肢颈项患肿，或软或硬，或赤不赤，或
痛不痛，或日晡发热，或溃而不敛。
人参 茯苓 陈皮 贝母 香附 当归（酒拌） 川芎 黄 （盐水拌炒） 熟地黄（酒拌）
芍
，煎八分，食远服。如胸膈痞，加枳壳，香附各一钱，人参、熟地黄各减二分，饮食不甘，
暂加浓朴、苍术。往来寒热，加柴胡、地骨皮。脓溃作渴，加参、 、归、术。脓多或清，
加当归、川芎。胁下痛或痞，加青皮、木香。肌肉生迟，加白蔹、官桂。痰多，加橘红、半
夏。口干，加五味子、麦门冬。发热，加柴胡、黄芩。渴不止，加知母、赤小豆（俱酒拌炒
。）脓不止，倍加人参、黄 、当归。
豆豉饼（方见臂痈门）
二神丸（方见作呕门）
隔蒜灸法（方见发背门）
针头散 治一切顽疮瘀肉不尽，及 核不化，疮口不合，宜用此药腐之。
赤石脂（五钱） 乳香 白丁香（各二钱） 砒（生） 黄丹（各一钱） 轻粉 麝香（各五分）
蜈
之。凡疮久不合者，内有脓管，须用此药腐之，兼服托里之剂。
如神散 治瘰 已溃，瘀肉不去，疮口不合。
松香末（一两） 白矾（三钱） 为末，香油调搽，干搽亦可。
神效栝蒌散（方见乳痈门）
六君子汤（方见作呕门）
脉象沉而数，说明邪气盛实，应当采用泻法。若出现肿胀疼痛，伴有恶寒发热，或身体拘急不舒，说明邪气在体表，应当采用发散的方法。
因愤怒导致病情加重的，以补气为主。肿块坚硬且不溃破的，以补益气血为主。由抑郁引起的，应疏解郁结、调理气血。溃破后伤口不愈合的，属于气血俱虚，宜用大补之法。由虚劳引起的，予以补益。因有结核结节而不愈合的，先化腐生肌再行补益。脉象实而不愈合，或肿块不消散的，采用攻下法。
有一男子患此病，肿痛并伴有恶寒发热，大便秘结，服用射干连翘散六剂后，热退大半；继服仙方活命饮四剂，肿块消散。
有一妇人耳下肿痛，伴有恶寒发热，给予荆防败毒散，四剂后面表证全部消退；继服散肿溃坚汤，数剂后肿块消去大半，再服神效栝蒌散，四剂后痊愈。
有一男子肝经风热，耳下肿痛发热，脉浮数，用薄荷丹治疗而消散。
有一男子每次发怒时，耳下肿胀，有时胁部作痛，用小柴胡汤，加青皮、木香、红花、桃仁，四剂后痊愈。
有一男子肿块坚硬不作脓，脉弦而数，用小柴胡汤配合神效栝蒌散，各服数剂；并隔蒜灸数次，月余后消散。
有一妇人颈部肿块不消，给予神效栝蒌散，六剂后稍见减退；改用小柴胡汤，加青皮、枳壳、贝母，数剂后消去大半；再用四物汤合小柴胡汤，数剂后痊愈。
有一男子因暴怒，项下肿痛且有结核，胸膈滞闷兼发热，用方脉流气饮二剂，胸膈通畅；继服荆防败毒散，病情将平，唯有一个结核未消，于是服用遇仙无比丸二两而痊愈。
有一妇人长期抑郁，患病不溃破，既已溃破也不愈合，发热口干，月经量少，饮食无味，午后尤其疲倦，使用益气养荣汤（注：原文此处可能有脱字或误植，结合上下文及后文“益气养荣汤”推断，或指代此类补益药，但原文写作“益气养毒药”，疑为笔误，此处依原文翻译但需指出其意），去而复结，以致不能收敛，出水不止，最终导致不治。然而此证，属于虚劳气郁所致，宜补益形体之气，调理经脉，未形成的自然消散，已形成的自然溃破，如果投用峻猛之剂，则气血更虚，多转变为痨瘵证。然而坚硬不溃破，溃破不愈合，显然是气血不足，何况这两条经络的血，原本就不足，不可不仔细考察。
有一男子久不愈合，精神困倦，脉虚，我想给他用托里透脓法，他认为迂腐，于是服用散肿溃坚汤，半月多，起初觉得有效，宜内消；如果经久不除，气血渐衰，肌肉寒冷，或脓汁清稀，毒气不出，疮口不合，聚肿不红，结核无脓，外证不明的，都宜用托里法；脓未成的，使脓早成；脓已溃的，使疮不发生变坏之证，所以适宜使用。
有一男子久不愈合，脓出更清稀，面色黄瘦，每天早晨腹泻，给予二神丸，数服后腹泻停止；再给六君子汤，加川芎、当归，月余后肌体逐渐恢复；用豆豉饼灸，并用补剂制成膏药贴敷，三月多后痊愈。
有一妇人溃后核不散腐，用益气养荣汤三十多剂，再敷针头散化腐，又与前汤三十多剂后愈合。
有一男子未溃破，倦怠发热，用补中益气汤，治疗稍愈；用益气养荣汤，月余后溃破，又一月后痊愈。
有一妇人肝经积热，患病作痛，脉沉数，用射干连翘汤，四剂后稍愈；再用散肿溃坚丸，月余后毒消。
关于病因，曰风、曰热，皆出于这两个端绪，推演变化，必须分辨虚实。实证易治，虚证可虑。此经主决断，有相火，且气多血少，妇人见此病，若月经不调，寒热变生，稍久转为潮热，如果不是断绝性欲、饮食清淡，神医也不能治愈。
有一男子面部肿胀坚硬，久不消，也不作脓，服用散坚败毒药，无效。令灸肘尖、肩尖二穴，再服用益……（原文此处似有缺漏，推测为益气类方药），月经每过期且量少，用逍遥散配合前汤，两月多气血复而疮亦愈，但一个口不收，敷针头散，再灸前穴而痊愈。常治二三年不愈者，连灸三次，兼用托里药，即愈。一妇人因怒，结核肿痛，察其气血俱实，先以神效散下之，更以益气养荣汤，三十多剂而消。常治此证，虚者先用益气养荣汤，待其气血稍充，乃用神效散，取去其毒，仍进前药，无不效者。
一妇人咽间如有一核梗阻，咽吐不出，倦怠发热，先以四七汤治之，咽喉通畅，更以逍遥散……（原文此处似有缺漏）。一妇所患同前，兼胸膈不利，肚腹膨胀，饮食少思，睡卧不安，用分心气饮，并愈。
一室女年十七，项下时而作痛，乍寒乍热，如疟状，肝脉弦长，这是血盛的证候。先以小柴胡……（原文此处似有缺漏）。
仓公传与褚澄，略而论及，言寡者，孟子正谓无夫曰寡是也。如师尼丧夫之妇，独阴无阳，欲男子而不可得，是以郁悒而成病也。《易》曰∶天地……（原文此处似有缺漏），万物化醇，男女媾精，万物化生。孤阴独阳可乎？夫既处闺门，欲心萌而不遂，致阴阳交争，乍寒乍热，有类疟疾，久而为痨。又有经闭白淫，痰逆头风，膈气痞闷，面……（原文此处似有缺漏）瘦瘠等证，皆寡妇之病。诊其脉，独肝脉弦，出寸口而上鱼际，宽其脉，原其疾，皆血盛而得。经云∶男子精盛则思室，女人血盛则怀胎。观其精血，思过半矣。
有一男子耳下患五枚如贯珠，年许尚硬，面色痿黄，饮食不甘，劳而发热，脉数软而涩。以益气养荣汤，六十多剂，元气已复，患处已消，一核尚存，以必效散，二服而平。
有一妇人久不作脓，脉浮而涩，我以气血俱虚，欲补之，使自溃。彼欲内消，专服斑蝥，及散坚之药，气血愈虚而死。
有一男子因劳，而患怠惰发热，脉洪大，按之无力，我谓须服补中益气汤。彼不信，辄服攻伐……（原文此处似有缺漏）。
治先以调经解郁，更以隔蒜灸之，多自消。如不消，即以琥珀膏贴之，俟有脓，即针之，否则变生他处。设若兼痰兼阴虚等证，只宜加兼证之剂，不可干扰余经。若气血已复而核不消，却服散坚之剂，至月许不应，气血亦不觉损，方进必效散，或遇仙无比丸，其毒一下，即止二药，更服益气养荣汤数剂以调理。若疮口不敛，宜用豆豉饼灸之，用琥珀膏贴之。气血俱虚，或不慎饮食起居七情者，俱不治。然而此证以气血为主，气血壮实，不用追蚀之剂，彼亦能自腐，但取去，便易于收敛；若气血虚，不先用补剂，而数用追蚀之药，不惟徒治，适足以败矣；若发寒热，眼内有赤脉贯瞳人者，亦不治。一脉者，一年死；二脉者，二年死……（原文此处似有缺漏）。
有一男子素弱，溃后核不腐，此气血皆虚，用托里养荣汤，气血将复，核尚在，以簪梃拨去，又服前药，月余而痊。
有一男子气血已复，核尚不腐，用针头散，及必效散，各三次，不旬日而愈。
有一男子患之，痰盛胸膈痞闷，脾胃脉弦，此脾土虚肝木乘之也，当以实脾土伐肝木为主。彼……（原文此处似有缺漏），饮食少思；以补中益气汤，倍加白术，月余中气少健；又以益养荣汤，两月肿消，而血气亦复矣。夫右关脉弦，弦属木，乃木盛而克脾土，为贼邪也，虚而用苦寒之剂，是虚虚也，况痰之为病，其因不一，主治之法不同。凡治痰，用利药过多，则脾气愈虚，虚则痰愈易生，如中气不足，必用参术之类为主，佐以痰药。
有一妇人因怒项肿，后月经不通，四肢浮肿，小便如淋，此血分证也。先以椒仁丸数服，经行……（原文此处似有缺漏）。经水不通，名曰水分，宜葶苈丸治之。《妇人良方》云∶妇人肿满，若先因经水断绝，后至四肢浮肿，小便不通，名曰血分。水化为血，血不通，则复化为水矣，宜服椒仁丸。若先因小便不利，后身浮肿，致经水不通，名曰水分，宜服葶苈丸。
一室女年十九，颈肿一块，硬而色不变，肌肉日削，筋挛急痛，此七情所伤，气血所损之证……（原文此处似有缺漏）。伤于忧愁则肢废，魂伤于悲哀则筋挛，魄伤于喜乐则皮槁，志伤于盛怒则腰脊难以俯仰也。柯侍郎有女适人，夫早逝，女患十指挛拳，掌垂莫举，肤体疮疡粟粟然，汤剂杂进，饮食顿减，几于半载。适与诊之，则非风也，此乃忧愁悲哀所致尔。病属内因，于是内因药，仍以鹿角胶辈，多用麝香熬膏贴痿处，挛能举，指能伸，病渐安。
一室女性急好怒，耳下常肿痛，发寒热，肝脉弦急。投以小柴胡汤，加青皮、牛蒡子、荆芥……（原文此处似有缺漏）。
我谓∶肝内主藏血，外主荣筋，若恚怒气逆则伤肝。肝主筋，故筋蓄结而肿，须病者自能调摄，庶可免患，否则肝逆受伤，则不能藏血，血虚则为难瘥之证矣。后不戒，果结三核，屡用追蚀药，不敛而殁。
一少妇耳下患肿，素勤苦，发热口干，月水每过期而至，且少。一老媪以为经闭，用水蛭之……（原文此处似有缺漏）。上为乳汁，下为月水，为经络之余气。苟外无六淫所侵，内无七情所伤，脾胃之气壮，则冲任……（原文此处似有缺漏）。
一放出宫女，年逾三十，两胯作痛，不肿，色不变，大小便作痛如淋，登厕尤痛，此瘀血渍……（原文此处似有缺漏）。为商，常在外，可见此妇在内久怀幽郁，及在外又不能如愿，是以致生此疾。愈见流注瘰……（原文此处似有缺漏），乃七情气血，皆已损伤，不可用攻伐之剂皎然矣。故《精血篇》云∶精未通而御女，以通其精，则五体有不满之处，异日有难状之疾。阴已痿而思色，以降其精，则精不出而内败，小便道涩而为淋。精已耗而复竭之，则大小便道牵疼，愈疼则愈欲大小便，愈便则愈疼。女人天癸既至，逾十年无男子合，则不调；未逾十年，思男子合，亦不调。不调则旧血不出，新血误行，或渍而入骨，或变而为肿，或虽合而难于合。男子多则沥枯虚人，产乳众则血枯杀人。观其精血，思过半矣。
一室女年十七，患瘰疬久不愈，月水尚未通，发热咳嗽，饮食少思。有老媪欲用巴豆、肉桂……（原文此处似有缺漏）。养气血，益津液，其经自行。彼惑于速效之说，仍用之。余曰∶“非其治也，比类乃剽悍之剂，大助阳火，阴血得之则妄行，脾胃得之则愈虚。”经果通而不止，饮食愈少，更加潮热，遂致不救。经云∶女子七岁肾气盛，齿更发长，二七天癸至，任脉通，太冲脉盛，月事以时下。然过期而不至，是为失常，必有所因。夫人之生，以血气为本。人之病，未有不先伤其气血者，妇女得之，多患于七情。寇宗奭曰∶夫人之生，以血气为本，人之病，未有不先伤其气血者。世有室女童男，积想在心，思虑过当，多致劳损，男子则神色先散，女子则月水先闭，何以致然？盖愁忧思虑则伤心，心伤则血逆竭，血逆竭则神色先散，而月水先闭也。火既受病，不能荣养其子，故不嗜食。脾既虚则金气亏，故发嗽；嗽既作，水气绝，故四肢干；木气不充，故多怒；鬓发焦，筋骨痿。俟五脏传遍，故卒不能死者，然终死矣！此一种于劳中最难治。盖病起于五脏之中，无有已期，药力不可及也。若或自能改易心志，用药扶接，如此则可得九死一生。举此为例，其余诸方，可按脉与证而治之。张氏云∶室女月水……（原文此处似有缺漏）。冷则凝。养生必用方，言之甚详，此说大有理，不可不知。若经候微少，渐渐不通，手足骨肉烦疼，日渐羸瘦，渐生潮热，其脉微数，此由阴虚血弱，阳往乘之，小水不能灭盛火，火逼水涸，亡津液。当养血益阴，慎毋以毒药通之，宜柏子仁丸、泽兰丸。
有一男子先于耳前耳下患之，将愈，次年延及项侧缺盆，三年遂延胸腋，不愈。诊之肝脉弦数……（原文此处似有缺漏）。诊如前，以清肝养血及前丸而愈。
一妇溃后发热，烦躁作渴，脉大无力，此血虚而然也。以当归补血汤，六剂顿退；又以圣……（原文此处似有缺漏），烦躁肌热，不欲近衣，其脉洪大，按之无力，或目痛鼻干者，非白虎汤证也。此血虚发躁，当以当归补血汤主之。又有火郁而热者，如不能食而热，自汗气短者，虚也。以甘寒之剂，泻热补气。如能食而热，口舌干燥，大便难者，以辛苦大寒之剂下之，以泻火补水。
附方
射干连翘散 治寒热瘰疬。
射干 连翘 玄参 赤芍药 木香 升麻 前胡 山栀仁 当归 甘草（炙，各七分）
大黄（炒，二钱） 作一剂，水二钟，煎八分，食后服。
荆防败毒散（方见溃疡发热门）
仙方活命饮（方见发背门）
小柴胡汤 治瘰疬乳痈，便毒下疳，及肝胆经分，一切疮疡，发热潮热，或饮食少思。
半夏（姜制，一钱） 柴胡（二钱） 黄芩（炒，二钱） 人参（一钱） 甘草（炙，五分） 作一剂，水二钟，姜三片，煎八分，食远服。
薄荷丹 治风热瘰疬，久服其毒自小便宣出。若未作脓者，自消。
薄荷 皂角（去内核） 连翘 三棱（煨） 何首乌（米泔水浸） 蔓荆子（各净，一两） 豆……（原文此处似有缺漏）日二服。病虽愈，须常服之。
益气养荣汤 治抑郁，或劳伤气血，或四肢颈项患肿，或软或硬，或赤不赤，或痛不痛，或日晡发热，或溃而不敛。
人参 茯苓 陈皮 贝母 香附 当归（酒拌） 川芎 黄芪（盐水拌炒） 熟地黄（酒拌） 芍……（原文此处似有缺漏），煎八分，食远服。如胸膈痞，加枳壳，香附各一钱，人参、熟地黄各减二分，饮食不甘，暂加浓朴、苍术。往来寒热，加柴胡、地骨皮。脓溃作渴，加参、芪、归、术。脓多或清，加当归、川芎。胁下痛或痞，加青皮、木香。肌肉生迟，加白蔹、官桂。痰多，加橘红、半夏。口干，加五味子、麦门冬。发热，加柴胡、黄芩。渴不止，加知母、赤小豆（俱酒拌炒。）脓不止，倍加人参、黄芪、当归。
豆豉饼（方见臂痈门）
二神丸（方见作呕门）
隔蒜灸法（方见发背门）
针头散 治一切顽疮瘀肉不尽，及瘰核不化，疮口不合，宜用此药腐之。
赤石脂（五钱） 乳香 白丁香（各二钱） 砒（生） 黄丹（各一钱） 轻粉 麝香（各五分） 蜈……（原文此处似有缺漏）之。凡疮久不合者，内有脓管，须用此药腐之，兼服托里之剂。
如神散 治瘰疬已溃，瘀肉不去，疮口不合。
松香末（一两） 白矾（三钱） 为末，香油调搽，干搽亦可。
神效栝蒌散（方见乳痈门）
六君子汤（方见作呕门）
If the pulse is deep and rapid, it indicates excess pathogenic qi; purgation should be employed. If swelling and pain are accompanied by aversion to cold and fever, or muscle stiffness, the pathogen is in the exterior; dispersing methods should be used.
For cases caused by anger, tonifying Qi is the primary approach. For hard, non-ulcerating swellings, tonifying both Qi and Blood is primary. For those caused by depression, resolving stagnation and regulating Qi and Blood is indicated. For ulcers that fail to heal after rupture, this belongs to deficiency of both Qi and Blood; major tonification is required. For cases caused by consumptive disease (Xu Lao), tonification is applied. For nodules that fail to heal due to the presence of lumps, putrefaction followed by tonification is used. If the pulse is excess and healing does not occur, or if the lump does not resolve, purgation is indicated.
A male patient suffered from this condition with swelling, pain, aversion to cold, fever, and constipation. After taking Shegan Lianqiao San (Belamcanda and Forsythia Powder) for six doses, the fever subsided significantly. Subsequently, Xianfang Huoming Yin (Immortal Life-Rescuing Decoction) was administered for four doses, resulting in the resolution of the swelling.
A female patient presented with swelling and pain below the ear, accompanied by aversion to cold and fever. Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxins) was given for four doses, completely resolving the exterior symptoms. Sanzhong Kuijian Tang (Decoction to Reduce Swelling and Harden Nodules) was then administered for several doses, reducing the swelling by more than half. Finally, Shenxiao Gualou San (Miraculous Trichosanthes Powder) was given for four doses, leading to recovery.
A male patient with Wind-Heat in the Liver Channel presented with swelling, pain, and fever below the ear, and a floating, rapid pulse. Bohe Dan (Mint Pills) was used to treat him, resulting in resolution.
A male patient experienced swelling below the ear and occasional hypochondriac pain upon anger. Xiaochaihu Tang (Minor Bupleurum Decoction) was prescribed with added Qingpi (Green Tangerine Peel), Muxiang (Costus Root), Honghua (Safflower), and Taoren (Peach Kernel). Recovery occurred after four doses.
A male patient had a hard, non-suppurating mass with a wiry and rapid pulse. Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Shenxiao Gualou San (Miraculous Trichosanthes Powder) was administered for several doses each. Garlic-partitioned moxibustion was also performed several times. Resolution occurred after more than a month.
A female patient had a persistent neck swelling. Shenxiao Gualou San (Miraculous Trichosanthes Powder) was given for six doses, showing slight improvement. Then, Xiaochaihu Tang (Minor Bupleurum Decoction) with added Qingpi (Green Tangerine Peel), Zhike (Aurantii Fructus), and Beimu (Fritillaria Bulb) was administered for several doses, reducing the swelling by more than half. Finally, Siwu Tang (Four Substance Decoction) combined with Xiaochaihu Tang (Minor Bupleurum Decoction) was given for several doses, leading to recovery.
A male patient suffered from swelling, pain, and nodules in the neck after sudden anger, accompanied by chest oppression and fever. Fangmai Liuqi Yin (Flowing Qi Decoction for Pulse Diagnosis) was administered for two doses, relieving chest obstruction. Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxins) was then given, bringing the condition near resolution. However, one nodule remained. Yuxian Wubi Wan (Peerless Pill of Encountering Immortals) was taken in a dosage of two liang, resulting in cure.
A female patient with long-term depression presented with a lesion that did not ulcerate initially, and failed to heal after ulceration. Symptoms included fever, dry mouth, scanty menstruation, loss of appetite, and extreme fatigue in the afternoon. [The text mentions "Yiqi Yangdu Yao" which likely refers to a tonifying formula, possibly a typo for Yiqi Yangrong Tang, but translated literally as Tonifying Qi and Nourishing Poison Drugs]. The condition recurred despite treatment, failing to heal, with continuous discharge of fluid, ultimately leading to death. This condition is attributed to consumptive disease and Qi stagnation. It requires tonifying the body's Qi and regulating the meridians. Unformed lesions will resolve spontaneously; formed ones will ulcerate spontaneously. Using harsh agents would further deplete Qi and Blood, often transforming into tuberculosis (Zhai Syndrome). Hardness without ulceration, or failure to close after ulceration, clearly indicates Qi and Blood deficiency. Moreover, the blood in these two channels is originally insufficient, a fact that must not be overlooked.
A male patient had a non-healing wound with mental fatigue and a deficient pulse. I intended to use Tuoli (Supporting Interior) methods, but he considered it too slow and took Sanzhong Kuijian Tang (Decoction to Reduce Swelling and Harden Nodules). After more than half a month, there was initial improvement. Internal resolution is suitable initially. If the condition persists, Qi and Blood gradually decline, muscles become cold, pus becomes thin, toxins do not exit, wounds do not close, swelling is not red, nodules lack pus, and external signs are unclear; Tuoli methods are appropriate in all such cases. For unformed pus, it promotes early formation; for ulcerated wounds, it prevents deterioration.
A male patient had a non-healing wound with thin pus, sallow complexion, emaciation, and morning diarrhea.ershensan Wan (Two Spirits Pill) was administered for several doses, stopping the diarrhea. Liu Junzi Tang (Six Gentlemen Decoction) with Chuanxiong (Szechuan Lovage Rhizome) and Danggui (Angelica Sinensis) was then given. Muscle mass recovered over a month. Fermented soybean cake moxibustion was applied, and tonic plasters were used. Recovery occurred after more than three months.
A female patient had non-putrefying nodules after ulceration. Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction) was administered for over thirty doses. Zhentou San (Needle Head Powder) was applied externally to promote putrefaction. Another thirty doses of the decoction led to healing.
A male patient with non-ulcerated lesions presented with fatigue and fever. Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) was used, providing slight relief. Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction) was then administered. Ulceration occurred after a month, and full recovery followed a month later.
A female patient with accumulated Heat in the Liver Channel presented with painful lesions and a deep, rapid pulse. Shegan Lianqiao Tang (Belamcanda and Forsythia Decoction) was given for four doses, showing slight improvement. Sanzhong Kuijian Wan (Pills to Reduce Swelling and Harden Nodules) was then used. After a month, the toxin resolved.
Regarding etiology, Wind and Heat are the two main factors, evolving through transformation. One must distinguish between Excess and Deficiency. Excess is easy to treat; Deficiency is concerning. This channel governs decision-making and contains Ministerial Fire; it has abundant Qi but scarce Blood. In women, if menstruation is irregular and alternating chills and fever arise, progressing to tidal fever over time, only by abstaining from sexual desire and eating bland food can even a divine physician cure it.
A male patient had a hard, non-resolving facial swelling that did not suppurate. Sanjian Baidu Yao (Hardness-Scattering and Toxin-Expelling Medicine) was ineffective. Moxibustion at Zhoushi (Elbow Tip) and Jianjian (Shoulder Tip) acupoints was performed, along with internal medication [text missing, likely a tonic]. Menstruation was delayed and scanty. Xiaoyao San (Free and Easy Wanderer Powder) combined with the previous decoction was used. After two months, Qi and Blood recovered, and the sore healed, except for one opening. Zhentou San (Needle Head Powder) was applied, and the previous acupoints were moxibusted again, leading to complete recovery. For chronic cases lasting two to three years, three sessions of moxibustion combined with interior-supporting medicines usually result in cure. A female patient with angry-induced nodular swelling had Excess Qi and Blood. Shenshao San (Miraculous Scattering Powder) was used first for purgation, followed by Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction) for over thirty doses, resulting in resolution. Generally, for deficiency cases, Yiqi Yangrong Tang is used first until Qi and Blood are slightly replenished, then Shenshao San is used to remove toxins, followed by resumption of the tonic. This approach is invariably effective.
A female patient felt a sensation of a lump in the throat, unable to swallow or spit out, accompanied by fatigue and fever. Siqi Tang (Four Words Decoction) was used first, relieving throat obstruction. Xiaoyao San (Free and Easy Wanderer Powder) was then administered [text incomplete]. Another female patient with similar symptoms, plus chest oppression, abdominal distension, poor appetite, and restlessness, was cured using Fenxin Qi Yin (Dividing Heart Qi Decoction).
A seventeen-year-old unmarried girl had intermittent neck pain, alternating chills and fever resembling malaria, and a long, wiry Liver pulse. This indicates abundant Blood. Xiaochaihu Tang (Minor Bupleurum Decoction) was used first [text incomplete].
Cang Gong passed knowledge to Chu Cheng, briefly discussing widows. Mencius defined a widow as a woman without a husband. Nuns or widows, possessing only Yin without Yang, desiring men but unable to obtain them, develop illness due to depression. The *I Ching* states: Heaven and Earth interact, and all things mature; men and women unite, and all things are born. Can isolated Yin or Yang exist? Women confined to their chambers, whose desires arise but are unfulfilled, experience conflict between Yin and Yang, causing alternating chills and fever resembling malaria, which over time becomes consumption (Lao). Other conditions include amenorrhea, leukorrhea, phlegm-induced headache, diaphragmatic Qi stagnation, and emaciation, all diseases of widows. Diagnosis reveals a wiry Liver pulse extending from Cun Kou above the fish-mouth area. These conditions stem from abundant Blood. The Classics state: When men's Essence is abundant, they desire intercourse; when women's Blood is abundant, they conceive. Observing their Essence and Blood, one understands half the matter.
A male patient had five pearl-like nodules below the ear, remaining hard for a year. His complexion was sallow, appetite poor, and he had labor-induced fever with a soft, choppy, rapid pulse. Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction) was administered for over sixty doses. Vital Qi recovered, and most lesions resolved. One nodule remained. Bixiao San (Highly Effective Powder) was taken twice, resulting in resolution.
A female patient had no pus formation for a long time, with a floating and choppy pulse. I diagnosed Qi and Blood deficiency and recommended tonification to allow spontaneous ulceration. She desired internal resolution and exclusively took Banmao (Mylabris) and hardness-scattering medicines. Her Qi and Blood became increasingly depleted, leading to death.
A male patient suffering from fatigue and fever due to overwork had a large, forceful pulse that was weak upon pressure. I advised Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi). He did not believe me and took attacking medicines [text incomplete].
Treatment begins with regulating menstruation and resolving depression, followed by garlic-partitioned moxibustion, which often resolves spontaneously. If it does not resolve, Hupo Gao (Amber Plaster) is applied. Once pus forms, it should be punctured; otherwise, complications may arise elsewhere. If complicated by Phlegm or Yin Deficiency, add corresponding formulas without interfering with other channels. If Qi and Blood have recovered but nodules persist, hardness-scattering medicines may be tried. If there is no response after a month and Qi and Blood remain intact, Bixiao San (Highly Effective Powder) or Yuxian Wubi Wan (Peerless Pill of Encountering Immortals) can be used. Once the toxin is expelled, stop these drugs and take Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction) for several doses to regulate. For non-healing wounds, fermented soybean cake moxibustion and Hupo Gao (Amber Plaster) are indicated. Cases with severe Qi and Blood deficiency, or those who neglect diet, lifestyle, and emotional regulation, are untreatable. However, this disease depends primarily on Qi and Blood. If strong, lesions will self-putrefy and heal easily once removed. If deficient, using corrosive medicines without prior tonification is futile and harmful. If accompanied by fever and red veins penetrating the pupil, it is untreatable. One vein indicates death within one year; two veins indicate death within two years [text incomplete].
A frail male patient had non-putrefying nodules after ulceration, indicating Qi and Blood deficiency. Tuoli Yangrong Tang (Interior-Supporting and Blood-Nourishing Decoction) was used. As Qi and Blood recovered, the nodule remained. It was mechanically removed with a hairpin, and the previous medicine was continued. Recovery occurred after a month.
A male patient with recovered Qi and Blood still had non-putrefying nodules. Zhentou San (Needle Head Powder) and Bixiao San (Highly Effective Powder) were used three times each. Healing occurred within ten days.
A male patient with profuse Phlegm, chest oppression, and a wiry Spleen/Stomach pulse indicated Spleen Earth deficiency with Liver Wood invasion. Strengthening Spleen Earth and subduing Liver Wood was the primary strategy. [Text incomplete] poor appetite. Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) with doubled Baizhu (Atractylodes Macrocephala Rhizome) improved middle Qi over a month. Yiyangrong Tang (Nourishing Qi and Blood Decoction) reduced swelling and restored Qi and Blood over two months. A wiry Right Guan pulse indicates Wood excess overcoming Spleen Earth (Thief Evil). Using bitter-cold medicines in deficiency worsens the deficiency. Phlegm has various causes and treatments. Overusing draining medicines damages Spleen Qi, making Phlegm easier to generate. For middle Qi deficiency, Ginseng and Atractylodes should be primary, assisted by Phlegm-resolving herbs.
A female patient had neck swelling after anger, followed by amenorrhea, limb edema, and dysuria resembling strangury. This is a Blood Division syndrome. Jiaoren Wan (Pepper Seed Pill) was taken for several doses, restoring menstruation [text incomplete]. Amenorrhea is called Water Division, treated with Tingli Wan (Descurainia Seed Pill). *Furen Liangfang* states: If menstruation stops first, followed by limb edema and urinary obstruction, it is Blood Division. Water transforms into Blood; if Blood does not flow, it reverts to Water. Jiaoren Wan is indicated. If urinary difficulty occurs first, followed by edema and amenorrhea, it is Water Division. Tingli Wan is indicated.
A nineteen-year-old unmarried girl had a hard, colorless neck swelling, daily muscle wasting, and tendon spasms/pain. This is a syndrome damaged by Seven Emotions and depleted Qi and Blood [text incomplete]. Sadness damages limbs; grief damages sinews causing spasms; excessive joy dries skin; rage damages Will, making bending and stretching difficult. Vice Minister Ke’s daughter married early, her husband died young. She developed curled fingers, drooping palms, and skin eruptions. Medicines were mixed, appetite dropped, and the condition lasted half a year. Upon diagnosis, it was not Wind, but caused by sorrow and grief. Belonging to Internal Causes, internal cause medicines were used. Deer Antler Glue and Musk paste were applied to the affected areas. Spasms resolved, fingers extended, and the condition improved.
A female patient with limb fatigue resembling flaccidity syndrome was cured with medicines nourishing Blood, tonifying Qi, and strengthening the Spleen and Stomach.
An impatient, anger-prone unmarried girl had frequent swelling, pain, and fever below the ear with a wiry, urgent Liver pulse. Xiaochaihu Tang (Minor Bupleurum Decoction) with Qingpi (Green Tangerine Peel), Niubangzi (Arctium Fruit), and Jingjie (Schizonepeta) was administered [text incomplete].
I stated: The Liver stores Blood internally and nourishes sinews externally. Anger causes Qi reversal, damaging the Liver. Since the Liver governs sinews, sinew accumulation causes swelling. The patient must regulate themselves to avoid recurrence. Otherwise, Liver Qi reversal damages Blood storage. Blood deficiency leads to difficult-to-cure syndromes. Later, she did not heed advice, developed three nodules, and died after repeated use of corrosive medicines without healing.
A young wife had swelling below the ear, worked hard, had fever, dry mouth, and delayed, scanty menstruation. An old woman mistook it for amenorrhea and used Leeches [text incomplete]. Milk above and menstruation below are residual Qi of the meridians. Without external Six Evils or internal Seven Emotions, strong Spleen/Stomach Qi ensures healthy Chong and Ren [text incomplete].
A released palace maid over thirty years old had hip pain without swelling or color change, painful urination resembling strangury, worse during defecation. This is stagnant Blood [text incomplete]. Being a merchant's wife, she was often outside, while this woman harbored long-term inner depression and could not fulfill desires outside, causing this disease. Seeing flowing abscesses and scrofula, it is clear that Seven Emotions and Qi/Blood were damaged, and attacking medicines are contraindicated. *Jingxue Pian* states: If a boy engages in sex before his Essence is complete, his body will have deficiencies, leading to difficult diseases later. If a man with impotence seeks sexual gratification, Essence fails to exit and rots internally, causing涩 (obstruction) and strangury. If Essence is exhausted and further drained, urination/defecation pain increases, driving more urges, worsening pain. For women, after Tian Gui arrives, ten years without male union causes irregularity; less than ten years, desiring union also causes irregularity. Irregularity means old Blood does not exit, new Blood flows wrongly, soaking into bones or becoming swelling. Even with union, difficulties may persist. Excessive sex drains men; frequent childbirth kills women. Observing Essence and Blood, one understands half the matter.
A seventeen-year-old unmarried girl had prolonged scrofula, unstarted menstruation, fever, cough, and poor appetite. An old woman wanted to use Radix Crotonis (Badou) and Cinnamon Bark (Rougui) [text incomplete]. Nourish Qi and Blood, benefit fluids, and menstruation will start naturally. Confused by promises of quick effects, she still used them. I said: "This is not the correct treatment. These are harsh agents, greatly assisting Yang Fire. Yin Blood will flow recklessly, and Spleen/Stomach will become more deficient." Menstruation started but did not stop, appetite decreased further, tidal fever increased, leading to death. The Classics state: At seven, Kidney Qi is strong, teeth change, hair grows. At fourteen, Tian Gui arrives, Ren Mai is open, Tai Chong Mai is abundant, menstruation comes on time. Delayed menstruation is abnormal and has a cause. Human life is based on Qi and Blood. Illness always injures Qi and Blood first. Women often suffer from Seven Emotions. Kou Zongshi said: Human life is based on Qi and Blood. Illness always injures Qi and Blood first. Maidens and boys with excessive thoughts often suffer consumption. Men lose spirit/color first; women have amenorrhea first. Why? Worry and thought damage the Heart. Heart damage causes Blood reversal and exhaustion. Exhausted Blood loses spirit/color and causes amenorrhea. Fire is diseased, cannot nourish its child (Earth), so appetite is lost. Spleen deficiency weakens Metal, causing cough. Cough exhausts Water, drying limbs. Wood is insufficient, causing anger. Hair turns gray, sinews/bones become flaccid. After transmission through five organs, death ensues. This type is hardest to treat among consumption. Disease originates in the five organs, has no fixed end, and medicine cannot reach it. If the patient changes their mindset and uses medicine to support, one in nine might survive. This example applies to other formulas; treat according to pulse and syndrome. Zhang Shi said: Maiden menstruation [text incomplete]. Cold causes coagulation. *Yangsheng Biyong Fang* discusses this in detail; the theory is sound and must be known. If menstruation is scanty and gradually stops, with limb pain, emaciation, tidal fever, and a faint, rapid pulse, it is Yin Deficiency and Blood weakness, with Yang invading. Small water cannot extinguish strong Fire; Fire forces Water dry, losing fluids. Nourish Blood and benefit Yin. Do not use toxic medicines to induce flow. Baizi Ren Wan (Biota Seed Pill) or Zelan Wan (Eclipta Pill) are indicated.
A male patient had lesions in front of and below the ear. As they healed, the next year spread to the side of the neck and collarbone. Three years later, it spread to the chest and axilla, not healing. The Liver pulse was wiry and rapid [text incomplete]. Diagnosed as before, cleared Liver and nourished Blood with the previous pill, resulting in cure.
A female patient had fever, irritability, and thirst after ulceration, with a large, weak pulse. This is due to Blood deficiency. Danggui Buxue Tang (Angelica Tonifying Blood Decoction) was given for six doses, rapidly reducing symptoms. Then Sheng [text incomplete], irritability, muscle heat, aversion to clothing, large pulse weak on pressure, or eye pain/dry nose, is not Baihu Tang syndrome. This is Blood deficiency causing irritability; Danggui Buxue Tang (Angelica Tonifying Blood Decoction) is primary. There is also Heat constrained by Fire. If unable to eat with fever, sweating, and shortness of breath, it is deficiency. Use sweet-cold medicines to drain Heat and tonify Qi. If able to eat with fever, dry mouth/tongue, and difficult stool, use pungent-bitter great-cold medicines to purge downward, draining Fire and benefiting Water.
Attached Formulas
Shegan Lianqiao San (Belamcanda and Forsythia Powder): Treats alternating chills/fever and scrofula.
Shegan, Lianqiao, Xuanshen, Chishaoyao, Muxiang, Shengma, Qianhu, Shanzhiren, Danggui, Gancao (Honey-fried, 0.7 fen each); Dahuang (Stir-fried, 2 qian). One dose, boil in 2 zhong water to 0.8 zhong. Take after meals.
Jingfang Baidu San (See Ulcer Fever Chapter).
Xianfang Huoming Yin (See Back Carbuncle Chapter).
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats scrofula, breast abscess, groin abscess, chancre, and all sores in Liver/Gallbladder channels with fever/tidal fever or poor appetite.
Banxia (Ginger-processed, 1 qian), Chaihu (2 qian), Huangqin (Stir-fried, 2 qian), Renshen (1 qian), Gancao (Honey-fried, 0.5 fen). One dose, boil in 2 zhong water with 3 ginger slices to 0.8 zhong. Take far from meals.
Bohe Dan (Mint Pills): Treats Wind-Heat scrofula. Long-term use expels toxin via urine. Non-suppurating lesions resolve spontaneously.
Bohe, Zaorao (De-seeded), Lianqiao, Sanleng (Roasted), Heshouwu (Soaked in rice water), Manjingzi (Each purified, 1 liang). [Text incomplete] Twice daily. Continue even after cure.
Yiqi Yangrong Tang (Tonifying Qi and Nourishing Blood Decoction): Treats depression, labor-induced Qi/Blood injury, or swelling in limbs/neck (soft/hard, red/non-red, painful/non-painful), afternoon fever, or non-healing ulcers.
Renshen, Fuling, Chenpi, Beimu, Xiangfu, Danggui (Wine-mixed), Chuanxiong, Huangqi (Salt-water stir-fried), Shudihuang (Wine-mixed), Shaoyao [Text incomplete]. Boil to 0.8 zhong. Take far from meals. Add Zhike/Xiangfu (1 qian each) for chest oppression; reduce Renshen/Shudihuang by 0.2 fen. Add Houpo/Cangzhu temporarily for poor appetite. Add Chaidu/Digupi for alternating chills/fever. Add Renshen/Huangqi/Danggui/Baizhu for thirst after ulceration. Add Danggui/Chuanxiong for excessive/thin pus. Add Qingpi/Muxiang for hypochondriac pain/oppression. Add Bailian/Guigui for slow flesh growth. Add Juhong/Banxia for Phlegm. Add Wuweizi/Mendong for dry mouth. Add Chaihu/Huangqin for fever. Add Zhimu/Xiaodoudou (Wine-stir-fried) for inextinguishable thirst. Double Renshen/Huangqi/Danggui for non-stop pus.
Douchi Bing (Fermented Soybean Cake - See Arm Abscess Chapter).
Ershen Wan (Two Spirits Pill - See Vomiting Chapter).
Gesan Jiu Fa (Garlic-Partitioned Moxibustion - See Back Carbuncle Chapter).
Zhentou San (Needle Head Powder): Treats stubborn sores with residual necrotic tissue, non-resolving nodules, and non-healing wounds. Promotes putrefaction.
Chishizhi (5 qian), Ruxiang, Baixingding (2 qian each), Pi (Raw), Huangdan (1 qian each), Qingfen, Muxiang (0.5 fen each), Wugong [Text incomplete]. Grind to powder. Apply to sores. For chronic non-healing sores with sinus tracts, use this to promote putrefaction, combined with interior-supporting medicines.
Rushen San (Miraculous Powder): Treats ulcerated scrofula with retained necrotic tissue and non-healing wounds.
Songxiangmo (1 liang), Baifan (3 qian). Grind to powder. Mix with sesame oil for application, or apply dry.
Shenxiao Gualou San (See Breast Abscess Chapter).
Liu Junzi Tang (See Vomiting Chapter).