薛立斋治一弱人，谷道前结核，如大豆许，劳则肿痛。先以十全大补汤去桂枝，加车前、麦冬、
酒炒黄柏、知母少愈，更服制甘草渐愈，（即国老膏。）仍以四物、车前之类而消。
一男子患悬痈， 肿发热，以龙胆泻肝汤二剂，及制甘草四剂而溃，再用滋阴之剂而愈。若脓未
成，以葱炒熟敷上，冷则易之。隔蒜灸之亦可。数日不消，或不溃，或溃而不敛，以十全大补汤加柴
胡为主，间服制甘草并效。若不保守，必成漏矣。
一男子患悬痈，服坎离丸及四物、知、柏之类，不应。脉浮洪，按之微细，以为足三阴之虚，用
托里散及补阴八珍汤愈。又用六味丸、补中益气汤，调补化源，半年而痊。大凡疮疡等症，若肾经火
气亢盛，致阴水不能生化，而患阴虚发热者，宜用坎离丸，取其苦寒，能化水中之火，令火气衰而水
自生；若阳气衰弱，致阴水不能生化，而患阴虚发热者，宜用六味丸，取其酸温，能生火中之水，使
阳气旺而阴自生。况此症属肾经精气亏损者，十有八九；属肾经阳气亢盛者，十无一二。然江南之人，
患此者多属脾经阴血亏损，元气下陷，须用
补中益气汤，升补阳气，使阳生而阴长。若嗜欲过多，亏损真阴者，宜用六味丸，补肾经元气，以生
精血。仍用补中益气汤，以培脾肺之生气，而滋肾水。经云∶阴虚者，脾虚也。但多认为肾经火症，
用黄柏、知母之类，复伤脾肺，绝其化源，反致不起。惜哉。
通府张敬之患悬痈，久不愈，日晡热甚，作烦渴而喘。或用四物汤、知、柏之类，病益甚，肢体
倦，少食，大便不实，小便频数。问何故？曰∶此肺虚之症，前药复伤而然。遂用补中益气加茯苓、
半夏，数剂饮食渐进，症渐减。更加麦冬、五味，调理乃痊。经曰∶脾属太阴，为阴土而主生血。故
东垣云∶脾虚元气下陷，发热烦渴，肢体倦怠等症，用补中益气汤，以升补气而生阴血。若误认为肾
虚火盛，而用四物、知、柏之类，反伤脾胃生气，是虚其虚矣。况知、柏乃泻阳损阴之剂，若非膀胱
阳火盛而不能生阴水，以致发热者，不可用也。
魏玉横治江云溪兄，初春患痔，即令服一气汤加减。不信，致卧月余，后遂成管。冬月复患悬痈，
初时如大豆，半月来大如鸡卵，按之甚痛，行动有妨，幸未服药。脉之，惟左关尺略大而微，此脓尚
未成也。仍与一气汤加减，大生地、麦冬、北沙参、甘杞子、生米仁、蒌仁、丹皮、地丁等，令服八
剂。二剂知，四剂消其半，八剂完而全愈。
薛立斋治尚宝鲍希，传足发热，服四物、知母、黄柏之类年余。患悬痈，唾痰，作渴饮汤，其热
至膝，更加芩、连、二陈，热痰益甚。问故，曰∶此足三阴亏损，水泛为痰，寒凉之剂伤胃而甚耳。
遂朝用补中益气，夕用六味丸，间佐以当归补血汤，半载乃愈。
上舍刘克新，悬痈溃后作痛，发热口干，小便赤色，自用清热消毒之药不应。左尺洪数，此阳气
盛而阴气虚也。先用四物汤加知母等诸剂，泻其阳气，使阴自生，数剂诸症渐愈。后用益气汤、地黄
丸，补脾肺，滋肾水而愈。
一儒者患悬痈，小便赤涩，劳则足软肿痛，发热，口干舌燥，体倦，日晡益盛，此气血虚而未能
溃也。遂
用八珍加麦冬、山药，倍用制甘草，数剂诸症悉退。但患处肿痛，此脓内 也。又五剂脓自涌出，又
五十余剂而疮口将完。又因劳役且停药，寒热作渴，脓多肿痛，用补中益气汤加炒栀，二剂少愈。又
以八珍汤加麦冬、五味，百余剂肿痛悉去。喜其慎起居，节饮食，常服补剂而安。但劳则脓出一二滴，
后惑于他言，内用降火，外用追蚀，必其收敛，致患处大溃，几至不起，仍补而愈。
一男子悬痈肿痛，小便赤涩，以加减龙胆泻肝汤加制甘草，二剂少愈。以参、 、归、术、知、
柏、制甘草，四剂而溃。更以四物汤加知、柏、参、 、制甘草而愈。
一男子患悬痈，脓清不敛，内有一核，以十全大补汤加青皮、柴胡、制甘草，更以豆豉饼灸之，
核消而敛。
一男子患悬痈，久而不敛，脉大而无力。以十全大补汤加五味、麦冬，灸以豆豉饼，月余而愈。
一老人患悬痈，年余不敛。诊其脉，尚有湿热，以龙胆泻肝汤二剂，湿退。乃以托里药及豆豉饼
灸之而愈。
一男子患此症，肿痛发热，以小柴胡汤加黄连、青皮，四剂少愈，更以加减龙胆泻肝汤而消。
一男子患悬痈，脓不溃，胀痛，小便不利，急针之，尿脓皆利。更以小柴胡汤加黄柏、白芷、金
银花，四剂痛止，以托里消毒四剂而愈。常见患者多不肯用针，待其自破。殊不知紧要之地，若一有
脓，宜灸针之，使毒外发，不致内溃。故前人云∶凡疮，若不针烙，毒结无从而解，脓瘀无从而泄。
又云∶宜开户以逐之。今之患者，反谓地部紧要，而不用针，何其悖哉。
一男子悬痈，脓熟不溃，脉数无力，此气血俱虚也。欲治以滋阴益血之剂，更针之使脓外泄。彼
不从，仍用降火散毒药，致元气愈虚，疮势益甚，后溃不敛，竟致不救。夫悬痈之症，原系肝肾二经
阴虚，虽一于补，尤多不治，况脓成而又克伐，不死何俟？常治初起肿痛，或小便赤涩，先以制甘草
一二剂，及隔蒜灸，更饮龙胆泻肝汤。若发热肿痛者，以小柴胡汤加车前、黄柏、芎、归；脓已成即
针之；已溃者，用八珍汤加制甘草、柴胡梢、酒炒知、柏；小便涩，而脉有力者，仍用龙胆泻肝汤加
制甘草；小便涩，而无力者，用清心莲子饮加制甘草；脓清不敛者，用大补之剂，间以豆豉饼灸之；
久而不敛者，用附子饼灸之并效。
薛立斋治一男子，患悬痈 痛，发寒热，以小柴胡汤加制甘草，二剂少退。又用制甘草四剂而消。
大抵此症属阴虚，故不足之人多患之。寒凉之药，不可过用，恐伤胃气。惟制甘草一药，不损气血，
不动脏腑，其功甚捷，最宜用之，不可忽也。
马铭鞠治谈公武，患跨马痈，外势不肿，毒内攻，脓多，疮口甚小，突出如指大一块，触之痛不
可忍，多饮寒剂，敷凉药，毒内攻，胃气俱损。令尽去围药，洗净疮口，但用一膏药以护其风，用大
剂黄 、山药、生地、白芷、牛膝、米仁、银花，杂以健脾药。十余剂脓尽，再数剂肉长，突出者平
矣。后服六味丸斤许，精神始复。（《广笔记》）
薛立斋治黄吏部，谷道前患毒， 痛寒热。此肝经血虚湿热所致，名曰悬痈，属阴虚症。先以制
甘草，二服顿退。用以四物加车前子、青皮、甘草节、酒制知、柏，数服而消。
一男子岁逾五十，患悬痈，脓清，肝肾脉弱，此不慎酒色，湿热壅滞也。然脓清脉弱，老年值此，
甚难收敛。况谷道前任脉发源之地，肝经宗筋之所。辞不治，后果死。尝治此痈，惟涧水制甘草有效。
已破者，兼十全大补汤为要法。
柴屿青以省觐舟行，舟人患骑马痈，哀号痛楚，怜而治之，先用大归汤十余剂，外贴回生膏，日
令其以药水勤洗，继惟十全大补汤。因贫人，若无力购参，携有扁党参，给以半斤，始备药。又用玉
蟾生肌散，人参末敷患处，调理月余而愈。
薛立斋治疗一位体弱之人，其肛门前方出现结核样肿块，大小如大豆，劳累时便会肿痛。先用十全大补汤去掉桂枝，加入车前子、麦冬、酒炒黄柏和知母，症状稍减后，再服用制甘草（即国老膏）逐渐痊愈，最后仍以四物汤、车前子等药物调理以消除余邪。
一名男子患悬痈（生于会阴部的痈疽），局部肿胀发热，服用龙胆泻肝汤两剂，以及制甘草四剂后脓肿溃破，随后再用滋阴的药物治愈。如果脓液尚未形成，可用葱炒熟后敷在患处，变冷则更换；也可采用隔蒜灸法。若数日后肿块不消退，或不溃破，或溃破后不愈合，应以十全大补汤加柴胡为主方，间服制甘草也有效。如果不注意调养保守，必然形成漏管（瘘管）。
一名男子患悬痈，服用坎离丸及四物汤、知母、黄柏等药，未见疗效。诊得脉象浮洪，重按却微细，判断为足三阴经（肝、脾、肾）虚损，使用托里散及补阴八珍汤治愈。之后又服用六味丸、补中益气汤，调理脾胃化源，半年后痊愈。大凡疮疡等疾病，如果是肾经火气亢盛，导致阴水不能生化，从而出现阴虚发热的，宜用坎离丸，取其苦寒之性，能化去水中的火气，使火气衰退而阴水自生；如果是阳气衰弱，导致阴水不能生化，从而出现阴虚发热的，宜用六味丸，取其酸温之性，能生起火中的阴水，使阳气旺盛而阴精自生。况且此症属于肾经精气亏损的，十有八九；属于肾经阳气亢盛的，十无一二。然而江南地区的人，患此病多属脾经阴血亏损，元气下陷，须用补中益气汤，升提补益阳气，使阳生而阴长。如果因嗜欲过多，亏损真阴的，宜用六味丸，补肾经元气，以生成精血。同时仍用补中益气汤，来培补脾肺的生气，从而滋助肾水。《内经》说：阴虚者，实为脾虚。但人们大多误认为是肾经火症，使用黄柏、知母等药，反而损伤脾肺，断绝了气血化源，反而导致病情恶化无法救治。可惜啊。
通政司副使张敬之患悬痈，久治不愈，傍晚时分发热严重，感到烦躁口渴且气喘。有人用四物汤、知母、黄柏等药，病情更加加重，肢体疲倦，食欲减少，大便不成形，小便频数。询问原因，回答说：这是肺虚之症，之前的药物反而造成了伤害。于是用补中益气汤加茯苓、半夏，服用数剂后饮食逐渐增加，症状逐渐减轻。再加麦冬、五味子，调理后痊愈。《内经》说：脾属太阴，为阴土而主生血。所以李东垣说：脾虚导致元气下陷，出现发热、烦躁口渴、肢体倦怠等症状，应用补中益气汤，以升提补气而生阴血。如果误认为是肾虚火盛，而用四物汤、知母、黄柏等药，反而损伤脾胃的生气，这是使虚者更虚。况且知母、黄柏是泻阳损阴的药物，如果不是因为膀胱阳火盛而不能生阴水，以致发热的，不可使用。
魏玉横治疗江云溪的兄长，初春患痔疮，立即让他服用一气汤加减。他不相信，导致卧床一个多月，后来形成了窦道（慢性瘘管）。冬季又患悬痈，起初如大豆大小，半个月后大如鸡卵，按压时非常疼痛，行动不便，幸好没有服药。诊脉，只有左关尺脉略大而微弱，这说明脓液尚未形成。仍然给予一气汤加减，用药包括大生地、麦冬、北沙参、甘杞子、生薏苡仁、瓜蒌仁、丹皮、地丁等，令其服用八剂。服用两剂后见效，四剂后肿块消了一半，八剂服完完全痊愈。
薛立斋治疗尚宝司丞鲍希，患有足部发热，服用四物汤、知母、黄柏等药一年多。患悬痈，咳吐痰涎，口渴想喝热水，热感甚至延伸至膝盖，医生又加上黄芩、黄连、二陈汤，导致热痰更加严重。询问病因，回答说：这是足三阴经亏损，水湿泛滥成为痰饮，寒凉药物损伤胃气所致。于是早晨服用补中益气汤，晚上服用六味丸，间或佐以当归补血汤，半年后才痊愈。
上舍刘克新，悬痈溃破后疼痛，发热口干，小便颜色深红，自行服用清热消毒的药物无效。诊得左尺脉洪数，这是阳气盛而阴气虚。先用四物汤加知母等药剂，泻其过盛的阳气，使阴气自生，服用数剂后各种症状逐渐好转。后用益气汤、地黄丸，补益脾肺，滋补肾水而痊愈。
一位儒生患悬痈，小便赤涩，劳累后足部软弱肿痛，发热，口干舌燥，身体疲倦，傍晚时症状加重，这是气血虚弱且脓液未能排出。于是用八珍汤加麦冬、山药，加倍使用制甘草，服用数剂后各种症状全部消退。但患处仍然肿痛，这是因为脓液积聚在内。又服用五剂后脓液自然涌出，再服用五十多剂后疮口即将愈合。后来又因劳累且停药，出现寒热、口渴，脓液增多且肿痛，用补中益气汤加炒栀子，两剂后稍有好转。又以八珍汤加麦冬、五味子，服用一百多剂后肿痛全部去除。庆幸他谨慎起居，节制饮食，常服补益药物而平安。只是劳累时会有少量脓液流出，后来听信他人之言，内服降火药，外用腐蚀收敛药，导致患处大面积溃烂，几乎致死，经过补益治疗后痊愈。
一名男子患悬痈肿痛，小便赤涩，用加减龙胆泻肝汤加制甘草，两剂后稍有好转。用人参、黄芪、当归、白术、知母、黄柏、制甘草，四剂后脓肿溃破。再用四物汤加知母、黄柏、人参、黄芪、制甘草而痊愈。
一名男子患悬痈，脓液清稀且不愈合，内部有一个硬结，用十全大补汤加青皮、柴胡、制甘草，并用豆豉饼灸之，硬结消散后疮口愈合。
一名男子患悬痈，日久不愈合，脉象大而无力。用十全大补汤加五味子、麦冬，用豆豉饼灸之，月余后痊愈。
一名老人患悬痈，一年余不愈合。诊其脉，尚有湿热，用龙胆泻肝汤两剂，湿气退去。然后用托里药及豆豉饼灸之而痊愈。
一名男子患此症，肿痛发热，用小柴胡汤加黄连、青皮，四剂后稍有好转，再用加减龙胆泻肝汤而消除。
一名男子患悬痈，脓液未溃，胀痛，小便不利，紧急针刺患处，尿液和脓液皆通畅。再用小柴胡汤加黄柏、白芷、金银花，四剂后疼痛停止，用托里消毒散四剂而痊愈。常见患者多不肯用针，等待其自行破溃。殊不知这是紧要部位，一旦有脓，应当灸刺，使毒邪外发，不致向内溃烂。所以前人说：凡是疮疡，如果不针刺烙治，毒邪结聚无从解除，脓液瘀滞无从排泄。又说：应当开门逐盗。现在的患者，反而认为会阴部位置紧要，而不肯用针，多么荒谬啊。
一名男子悬痈，脓液成熟但不溃破，脉数而无力，这是气血俱虚。想要用滋阴益血的药物治疗，并针刺使其脓液外泄。患者不听从，仍用降火散毒的药物，导致元气更加虚弱，疮势更加严重，后来溃破后不愈合，最终导致死亡。夫悬痈之症，原本就是肝肾二经阴虚，即使单纯进补，大多也难以治愈，何况脓成之后又用攻伐药物，不死还等什么？通常治疗初起肿痛，或小便赤涩，先服制甘草一二剂，以及隔蒜灸，再饮用龙胆泻肝汤。如果发热肿痛的，用小柴胡汤加车前子、黄柏、川芎、当归；脓已成即针刺；已溃破的，用八珍汤加制甘草、柴胡梢、酒炒知母、黄柏；小便涩痛而脉有力的，仍用龙胆泻肝汤加制甘草；小便涩痛而脉无力的，用清心莲子饮加制甘草；脓液清稀不愈合的，用大补之剂，间或用豆豉饼灸之；日久不愈合的，用附子饼灸之也有效。
薛立斋治疗一名男子，患悬痈疼痛，发寒热，用小柴胡汤加制甘草，两剂后稍退。又用制甘草四剂而消除。大抵此症属于阴虚，所以体质不足的人多患此病。寒凉药物，不可过度使用，恐怕损伤胃气。只有制甘草这一味药，不损伤气血，不扰动脏腑，功效甚捷，最宜使用，不可忽视。
马铭鞠治疗谈公武，患跨马痈（生于两腿之间的痈疽），外部形势不肿，毒邪内攻，脓液多，疮口很小，突出如手指大的一块，触碰时疼痛难忍，大量饮用寒凉药剂，敷用凉药，导致毒邪内攻，胃气受损。命令去掉所有围药，洗净疮口，只用一种膏药以保护防风邪，用大剂量黄芪、山药、生地、白芷、牛膝、薏苡仁、银花，夹杂健脾药物。十余剂后脓液排尽，再服数剂后肌肉生长，突出的部分平了。后来服用六味丸数斤，精神才恢复。（出自《广笔记》）
薛立斋治疗黄吏部，肛门前方患毒，疼痛伴寒热。这是肝经血虚湿热所致，名为悬痈，属于阴虚症。先用制甘草，两服后症状顿退。后用四物汤加车前子、青皮、甘草节、酒制知母、黄柏，数服后消除。
一名男子年过五十，患悬痈，脓液清稀，肝肾脉弱，这是不慎饮酒色欲，湿热壅滞所致。然而脓清脉弱，老年人遇到这种情况，很难收敛。况且肛门前方任脉发源之地，也是肝经宗筋汇聚之处。辞谢不治，后果死亡。曾经治疗此痈，只有涧水制的甘草有效。已经破溃的，兼用十全大补汤是主要方法。
柴屿青因探望父母乘船而行，船夫患骑马痈，哀号痛苦，心生怜悯而治疗他，先用大归汤十余剂，外贴回生膏，每天让他用药水勤洗，接着只用十全大补汤。因为病人贫穷，若无力购买人参，携带有党参，给他半斤，才备齐药物。又用玉蟾生肌散，用人参末敷于患处，调理月余而痊愈。
Xue Lizhai treated a weak patient who had a tubercle-like mass in front of the anus, about the size of a soybean, which became swollen and painful upon exertion. Initially, Shiquan Dabu Tang (Ten Thousand Tonic Decoction) was used with Guizhi (Cinnamon Twig) removed, and Cheqianzi (Plantago Seed), Maidong (Ophiopogon Root), Jiuchao Huangbai (Alcohol-fried Phellodendron Bark), and Zhimu (Anemarrhena Rhizome) added. After symptoms slightly subsided, Zhi Gancao (Prepared Licorice Root, also known as Guolao Gao) was taken to gradually achieve recovery, followed by Siwu Tang (Four Substances Decoction) and Cheqianzi to eliminate residual pathogenic factors.
A male patient suffered from Xuan Yong (carbuncle located at the perineum), presenting with local swelling and fever. He took Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) for two doses and Zhi Gancao for four doses, after which the abscess ruptured. He was subsequently cured using yin-nourishing agents. If pus had not yet formed, cooked scallions could be applied topically and replaced when cool; moxibustion with garlic separation (Ge Suan Jiu) was also applicable. If the lump did not subside after several days, or failed to rupture, or failed to heal after rupture, Shiquan Dabu Tang (Ten Thousand Tonic Decoction) with Chaihu (Bupleurum Root) should be used as the main formula, with intermittent use of Zhi Gancao proving effective. Without conservative care, it would inevitably develop into a fistula (Lou Guan).
A male patient suffered from Xuan Yong but showed no improvement after taking Kanli Wan (Kanli Pill) and herbs such as Siwu Tang (Four Substances Decoction), Zhimu (Anemarrhena Rhizome), and Huangbai (Phellodendron Bark). The pulse was floating and forceful on the surface but faint and fine upon deep pressure, indicating deficiency of the Three Yin meridians of the foot (Liver, Spleen, Kidney). Tuoli San (Interior-Supporting Powder) and Buyin Bazhen Tang (Yin-Nourishing Eight-Treasure Decoction) were used to cure him. Subsequently, Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) were administered to regulate the source of transformation for half a year until complete recovery. Generally speaking, regarding sores and ulcers, if excessive fire in the Kidney meridian prevents the generation of Yin fluids, leading to deficient-yin fever, Kanli Wan is appropriate due to its bitter-cold nature, which transforms fire within water, allowing fire to decline and water to generate naturally. If Yang qi is weak, preventing the generation of Yin fluids and causing deficient-yin fever, Liuwei Wan is appropriate due to its sour-warm nature, which generates water within fire, allowing Yang to flourish and Yin to generate naturally. Moreover, nine out of ten cases of this condition belong to deficiency of Jing-Qi in the Kidney meridian, while only one or two belong to hyperactive Yang in the Kidney meridian. However, people in the Jiangnan region often suffer from this disease due to deficiency of Yin blood in the Spleen meridian and sinking of Yuan Qi. In such cases, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to raise and tonify Yang qi, promoting the generation of Yin through Yang. If true Yin is damaged due to excessive sexual desire, Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used to tonify the Yuan Qi of the Kidney meridian to generate essence and blood. Simultaneously, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to cultivate the generating Qi of the Spleen and Lung, thereby nourishing Kidney Water. The Classics state: "Deficient Yin is actually Spleen deficiency." Yet, many mistakenly attribute it to Kidney fire and use Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome), which further damage the Spleen and Lung, cutting off the source of transformation and worsening the condition. Regrettable.
Zhang Jingzhi, Vice Director of the Secretariat, suffered from Xuan Yong that failed to heal for a long time. He experienced severe fever in the late afternoon, accompanied by irritability, thirst, and asthma. Treatment with Siwu Tang (Four Substances Decoction), Zhimu (Anemarrhena Rhizome), and Huangbai (Phellodendron Bark) worsened the condition, leading to limb fatigue, poor appetite, loose stools, and frequent urination. Upon inquiry, it was determined that this was a Lung deficiency syndrome exacerbated by previous medications. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Fuling (Poria) and Banxia (Pinellia Rhizome) was prescribed. After several doses, diet improved and symptoms subsided. Maidong (Ophiopogon Root) and Wuweizi (Schisandra Berry) were added for final regulation and recovery. The Classics state: "The Spleen belongs to Taiyin, is Yin Earth, and governs the generation of blood." Therefore, Li Dongyuan stated: For symptoms such as fever, irritability, thirst, and limb fatigue caused by Spleen deficiency and sinking of Yuan Qi, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to raise Qi and generate Yin blood. Mistaking this for Kidney deficiency with excess fire and using Siwu Tang (Four Substances Decoction), Zhimu (Anemarrhena Rhizome), and Huangbai (Phellodendron Bark) damages the generating Qi of the Spleen and Stomach, making the deficiency worse. Furthermore, Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark) are agents that drain Yang and damage Yin; they should not be used unless there is excessive Yang fire in the Bladder meridian preventing the generation of Yin water, causing fever.
Wei Yuheng treated the elder brother of Jiang Yunxi, who developed hemorrhoids in early spring. Wei immediately prescribed Yiqi Tang (One-Energy Decoction) with modifications. The patient did not believe in the treatment, resulting in bed rest for over a month, eventually forming a sinus tract. In winter, he developed Xuan Yong. Initially the size of a soybean, it grew to the size of a chicken egg within half a month, causing severe pain upon pressure and hindering movement. Fortunately, he had not taken any medication. Pulse diagnosis revealed only the left Guan and Chi positions slightly large and faint, indicating that pus had not yet formed. Yiqi Tang (One-Energy Decoction) with modifications was prescribed again, including Dihuang (Rehmannia Root), Maidong (Ophiopogon Root), Beishashen (Glehnia Root), Gouqi (Goji Berry), Sheng Yiyiren (Raw Coix Seed), Louren (Trichosanthes Seed), Mudanpi (Moutan Cortex), and Dingguang (Viola Herb). Eight doses were taken. Improvement was seen after two doses, half resolution after four doses, and complete recovery after eight doses.
Xue Lizhai treated Bao Xi, Director of the Directorate of Palace Attendants, who had been suffering from foot heat for over a year, taking Siwu Tang (Four Substances Decoction), Zhimu (Anemarrhena Rhizome), and Huangbai (Phellodendron Bark). He then developed Xuan Yong, coughing up phlegm, feeling thirsty and desiring hot drinks, with heat sensation extending to the knees. The doctor added Huangqin (Scutellaria Root), Lianzi (Lotus Plumule), and Erchen Tang (Two-Aged Substance Decoction), which worsened the heat-phlegm. Upon inquiry, it was determined that this was due to deficiency of the Three Yin meridians of the foot, causing water overflow into phlegm, and cold-natured medicines damaging the Stomach Qi. Thus, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered in the morning, Liuwei Wan (Six-Ingredient Pill with Rehmannia) in the evening, supplemented occasionally with Danggui Buxue Tang (Angelica Tonifying Blood Decoction). Recovery took half a year.
Liu Kexin, a scholar-official, experienced pain, fever, dry mouth, and dark urine after the rupture of Xuan Yong. Self-medication with heat-clearing and detoxifying agents was ineffective. The left Chi pulse was flooding and rapid, indicating excess Yang and deficient Yin. Siwu Tang (Four Substances Decoction) with Zhimu (Anemarrhena Rhizome) and other agents were first used to drain excess Yang, allowing Yin to generate naturally. Symptoms gradually improved after several doses. Subsequently, Yiqi Tang (Qi-Tonifying Decoction) and Dihuang Wan (Rehmannia Pill) were used to tonify the Spleen and Lung and nourish Kidney Water, leading to recovery.
A Confucian scholar suffered from Xuan Yong, presenting with dark and difficult urination, soft and swollen painful legs upon exertion, fever, dry mouth and tongue, body fatigue, and worsening symptoms in the late afternoon. This indicated Qi and Blood deficiency with failure of pus to discharge. Bazhen Tang (Eight-Treasure Decoction) with Maidong (Ophiopogon Root) and Shanyao (Dioscorea Rhizome), with doubled Zhi Gancao (Prepared Licorice Root), was prescribed. Symptoms subsided after several doses. However, local swelling and pain persisted due to accumulated pus. After five more doses, pus discharged spontaneously. After fifty-plus doses, the wound was nearly healed. Later, due to overwork and stopping medication, chills, fever, thirst, increased pus, and swelling occurred. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with fried Zhizi (Gardenia Fruit) provided slight relief after two doses. Bazhen Tang (Eight-Treasure Decoction) with Maidong (Ophiopogon Root) and Wuweizi (Schisandra Berry) eliminated swelling and pain after over a hundred doses. Fortunately, he maintained careful daily routines and diet, frequently taking tonic supplements. However, minor pus discharge occurred upon exertion. Later, influenced by others, he took internal fire-draining drugs and external cauterizing/astringent agents, causing massive ulceration and near-death status. He recovered only after resuming tonic therapy.
A male patient suffered from swollen and painful Xuan Yong with dark, difficult urination. Jianjia Longdan Xiegan Tang (Modified Gentiana Liver-Draining Decoction) with Zhi Gancao (Prepared Licorice Root) provided slight relief after two doses. Renshen (Ginseng), Huangqi (Astragalus Root), Danggui (Angelica Sinensis), Baizhu (Atractylodes Macrocephala Rhizome), Zhimu (Anemarrhena Rhizome), Huangbai (Phellodendron Bark), and Zhi Gancao (Prepared Licorice Root) led to rupture after four doses. Siwu Tang (Four Substances Decoction) with Zhimu (Anemarrhena Rhizome), Huangbai (Phellodendron Bark), Renshen (Ginseng), Huangqi (Astragalus Root), and Zhi Gancao (Prepared Licorice Root) completed the cure.
A male patient suffered from Xuan Yong with clear pus and non-healing, containing an internal nodule. Shiquan Dabu Tang (Ten Thousand Tonic Decoction) with Qingpi (Aurantii Fructus Perforatus), Chaihu (Bupleurum Root), and Zhi Gancao (Prepared Licorice Root), combined with Douchi Bing Jiu (Fermented Soybean Cake Moxibustion), resolved the nodule and promoted healing.
A male patient suffered from Xuan Yong that failed to heal for a long time, with a large but forceless pulse. Shiquan Dabu Tang (Ten Thousand Tonic Decoction) with Wuweizi (Schisandra Berry) and Maidong (Ophiopogon Root), combined with Douchi Bing Jiu (Fermented Soybean Cake Moxibustion), resulted in recovery after over a month.
An elderly patient suffered from Xuan Yong that failed to heal for over a year. Pulse diagnosis indicated damp-heat. Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) for two doses reduced the dampness. Subsequent treatment with interior-supporting agents and Douchi Bing Jiu (Fermented Soybean Cake Moxibustion) led to recovery.
A male patient suffered from swollen, painful, and febrile Xuan Yong. Xiaochaihu Tang (Minor Bupleurum Decoction) with Huanglian (Coptis Rhizome) and Qingpi (Aurantii Fructus Perforatus) provided slight relief after four doses. Jianjia Longdan Xiegan Tang (Modified Gentiana Liver-Draining Decoction) eliminated the condition.
A male patient suffered from Xuan Yong with unruptured pus, distending pain, and difficulty urinating. Urgent acupuncture relieved both urine and pus flow. Xiaochaihu Tang (Minor Bupleurum Decoction) with Huangbai (Phellodendron Bark), Baizhi (Angelica Dahurica Root), and Yinhua (Honeysuckle Flower) stopped pain after four doses. Tuoli Xiaodu San (Interior-Supporting and Toxin-Resolving Powder) for four doses completed the cure. It is common for patients to refuse acupuncture, waiting for spontaneous rupture. However, this is a critical area; once pus forms, moxibustion and acupuncture should be used to expel toxins externally and prevent internal collapse. As predecessors stated: "For all sores, without needling and cautery, trapped toxins cannot resolve, and stagnant pus cannot drain." Also: "Open the door to drive out the thief." Patients today wrongly consider the perineal area too sensitive for needling, which is absurd.
A male patient had ripe but unruptured Xuan Yong, with a rapid but forceless pulse, indicating dual deficiency of Qi and Blood. The intention was to treat with Yin-nourishing and Blood-tonifying agents and needle to drain pus. The patient refused, continuing with fire-draining and toxin-resolving drugs, worsening Qi deficiency and the condition. Eventually, the ulcer failed to heal, leading to death. Xuan Yong originates from Yin deficiency of the Liver and Kidney meridians; even with pure tonification, many cases are incurable, let alone using attacking drugs after pus formation. Death is inevitable. Standard treatment for initial swelling, pain, or dark/difficult urination involves Zhi Gancao (Prepared Licorice Root) for 1-2 doses, Ge Suan Jiu (Garlic Separation Moxibustion), and Longdan Xiegan Tang (Gentiana Liver-Draining Decoction). For fever and swelling, Xiaochaihu Tang (Minor Bupleurum Decoction) with Cheqianzi (Plantago Seed), Huangbai (Phellodendron Bark), Xiong (Ligusticum Rhizome), and Danggui (Angelica Sinensis) is used. Once pus forms, needle it. For ruptured cases, Bazhen Tang (Eight-Treasure Decoction) with Zhi Gancao (Prepared Licorice Root), Chaihu Shao (Bupleurum Tip), and Jiuchao Zhimu/Huangbai (Alcohol-fried Anemarrhena/Phellodendron) is used. For difficult urination with a strong pulse, Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) with Zhi Gancao (Prepared Licorice Root) is retained. For difficult urination with a weak pulse, Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Drink) with Zhi Gancao (Prepared Licorice Root) is used. For clear pus and non-healing, major tonics with intermittent Douchi Bing Jiu (Fermented Soybean Cake Moxibustion) are used. For long-term non-healing, Fuzi Bing Jiu (Aconite Cake Moxibustion) is effective.
Xue Lizhai treated a male patient with painful Xuan Yong, chills, and fever. Xiaochaihu Tang (Minor Bupleurum Decoction) with Zhi Gancao (Prepared Licorice Root) reduced symptoms after two doses. Zhi Gancao (Prepared Licorice Root) alone for four doses resolved the condition. Generally, this condition belongs to Yin deficiency, affecting those with weak constitutions. Cold-natured medicines should not be overused to avoid damaging Stomach Qi. Only Zhi Gancao (Prepared Licorice Root) does not damage Qi and Blood or disturb organs, acting swiftly. It is highly recommended and should not be neglected.
Ma Mingju treated Tan Gongwu, who suffered from Kuma Yong (carbuncle between the thighs). Externally, there was no swelling, but toxins attacked inwardly. There was abundant pus, a small opening, and a protruding mass the size of a finger, extremely painful to touch. Heavy intake of cold medicines and application of cooling topical agents caused inward toxin attack and damaged Stomach Qi. All surrounding medicines were removed, the wound cleaned, and a single plaster applied to protect against wind. A large dose of Huangqi (Astragalus Root), Shanyao (Dioscorea Rhizome), Dihuang (Rehmannia Root), Baizhi (Angelica Dahurica Root), Niuxi (Achyranthes Root), Yiyiren (Coix Seed), and Yinhua (Honeysuckle Flower), mixed with Spleen-strengthening herbs, was given. Pus cleared after ten-plus doses, and flesh regenerated after several more, flattening the protrusion. Subsequently, Jin Xu (several catties) of Liuwei Wan (Six-Ingredient Pill with Rehmannia) restored his spirit. (From *Guang Biji*)
Xue Lizhai treated Huang Libu, who had a toxic lesion in front of the anus with pain and chills/fever. This was caused by Blood deficiency and damp-heat in the Liver meridian, named Xuan Yong, belonging to Yin deficiency. Zhi Gancao (Prepared Licorice Root) for two doses rapidly reduced symptoms. Siwu Tang (Four Substances Decoction) with Cheqianzi (Plantago Seed), Qingpi (Aurantii Fructus Perforatus), Gancao Jie (Licorice Joint), and Jiuzhi Zhimu/Huangbai (Wine-processed Anemarrhena/Phellodendron) resolved the condition after several doses.
A male patient over fifty suffered from Xuan Yong with clear pus and weak Liver/Kidney pulses, due to immoderate alcohol and sexual activity causing damp-heat stagnation. Clear pus and weak pulse in an elderly person make healing difficult. The area in front of the anus is the source of the Ren Meridian and the gathering place of the Liver meridian's sinews. Declining treatment, he subsequently died. In treating this carbuncle, only Jian Shui Zhi Gancao (Stream-water processed Licorice Root) proved effective. For ruptured cases, combining with Shiquan Dabu Tang (Ten Thousand Tonic Decoction) is essential.
Chai Yuqing, traveling by boat to visit parents, treated a boatman suffering from Qima Yong (riding horse carbuncle) who was wailing in pain. Pitying him, Chai first prescribed Da Gui Tang (Great Return Decoction) for over ten doses, applied Huisheng Gao (Life-Returning Ointment) externally, and instructed frequent washing with medicinal water. Subsequently, only Shiquan Dabu Tang (Ten Thousand Tonic Decoction) was used. Due to poverty, unable to afford Ginseng, Banjin Dangshen (Half a catty of Codonopsis) was substituted. Yuchan Shengji San (Toad Flesh Regenerating Powder) and Renshen Mo (Ginseng Powder) were applied to the site. Recovery occurred after one month of regulation.