(徐灵胎曰∶流注者,缠绵不已,或五或七或九,愈者愈,发者发,变化万端。若新生一两个,
旋即消溃,非真流注也。)
薛立斋治一妇人,因暴怒而腰肿一块,或胸膈不利,或走气作痛。此荣气郁滞,与方脉流气饮,
数剂而止。更以小柴胡汤对四物加香附、贝母,月余而愈。
一妇人患流注,遇劳必痛,众手按之,痛乃止。属气血俱虚,用十全大补汤、六味丸、逍遥散而
愈。
一妇人先肢体作痛,后患流注,发热恶寒,食少胁胀,月经不调,痰盛喘嗽,五心烦热,健忘惊
悸,盗汗无寐。悉属肝脾亏损,气血不足,用十全大补、加味归脾兼服,诸症悉痊。
一妇人素头晕,患流注,月经迟少。此属中气虚弱,用补中益气汤而愈。后因劳仆地,月经如涌,
此劳伤火动,用前汤加五味子,一剂而愈。
一妇人患前症,用行气化痰等,胸膈不利,饮食少思。用疏利之药,大便作泄,中满不食。此脾
胃复伤,用补中益气汤加炮姜,脾胃健,饮食进。又用六君子加芎、归,百余剂始全愈。
一妇人素郁结,肩臂各肿如覆杯,此肝脾亏损。用加味逍遥散,多用补气药。右手脉不足,补气
药当多于补血药,切不可发表。
薛立斋治一男子,腿患肿,肉色不变,不痛,脉浮而滑。以补中益气汤加半夏、茯苓、枳壳、木
香饮之,以香附饼熨之。彼谓气无补法,乃服方脉流气饮,愈虚。复求治,以六君子汤加芎、归,数
剂,饮食稍进。再用补剂,月余而消。夫气无补法,俗论也。以其为病痞闷壅塞,似难于补。殊不知
正气虚而不能营运,则邪气滞而为病。经云∶壮者气行则愈,弱者则着而为病。苟不用补法,气何由
而行乎?(经语,在流注门尤为吃紧。)
一妇人溃后发热,以为虚。彼不信,仍服败毒药,果发大热,竟至不救。夫溃疡虽有表症发热,
宜以托里药为主,佐以表散之剂,何况瘰 流注乎?若气血充实,经络通畅,决无患者。此症之因,
皆由气血素亏,或七情所伤,经络郁结,或腠理不密,六淫外侵,坠道壅塞。若不审其所因,辨其虚
实,鲜不误人。
一男子腿患流注,久而不敛,饮大补药及附子饼,更用针头散 之而愈。
一男子患臂年余尚硬,饮食少思,朝寒暮热。以八珍汤加柴胡、地骨皮、丹皮,月余而寒热少止。
继以益气养荣汤,及附子饼灸之,两月余脓成,针之,更服人参养荣汤,半载而痊。
一妇人患此症,脓溃清稀,脉弱恶寒,久而不愈。服内塞散,灸以附子饼而痊。
一妇人腰间患一小块,肉色如常,不溃发热。谓当以益气养荣汤,解郁之药治之。不信,别服流
气饮,后针破出水,年余而殁。
一妇人流注久不敛,忽发寒热。决其气血俱虚,彼反服表散之剂,果大热亦死。大抵流注之症,
多因郁结,或暴怒,或脾气虚,湿气逆于肉理;或腠理不密,寒邪客于经络;或闪扑,或产后,瘀血
流注关节;或伤寒,
余邪未尽为患。皆因真气不足,邪得以乘之。常治郁者开之,怒者平之,闪扑及产后瘀血者散之,脾
虚及腠理不密者徐而补之,伤寒余邪者调而解之。大要以固元气为主,佐以见症之药。如久而疮寒者,
更用豆豉饼或附子饼灸之。有脓管或瘀肉者,用针头散腐之自愈,锭子尤效。若不补气血,及不慎饮
食起居七情,俱不治。(雄按∶因于痰饮者,亦甚多也。)
一男子元气素弱,时患流注,胸膈不利,饮食少思。欲治健脾胃,解郁结,养气血。彼不从,乃
服辛香流气之剂,致腹胀。又服三 、蓬术、浓朴之类,饮食愈少,四肢微肿,兼腰肿一块,不溃而
殁。盖此症本虚痞,今用克伐之剂,何以不死?况辛香燥热之剂,但能劫滞气,取快于一时。若不佐
制,过服益增郁火,煎熬气液为痰,日久不散,愈成流注之症。
一聘士流注久溃,肌肉消瘦,发热作渴,恶寒饮食。以六君子加归、 、附子,服数剂,患处遂
红活。又服十全大补汤三十余剂,脓渐稠而愈。后惑于人言,谓盛暑不宜用附子,彼又因场屋不遂意,
复患前症,专服败毒流气之剂,元气消烁,肌肉日瘦。医以为不治,自分不起。其师滕洗马云∶向者
病危,得附子药而起。今药不应,以致危笃,何不仍服附子药?遂复求治,其脉微细,症属虚寒,并
无邪毒,仍用附子药乃得愈。
贾阁老子患流注,脉数作渴,不喜饮冷,脓水清稀,面带赤色。曰∶此气血虚而兼火也,治难奏
功。彼以为迂,别服燥湿分利之剂,两月余反加烦渴,寒热往来。复邀治,形体已脱。曰∶虽治亦无
功矣。后果不起。
陈进士遂初,年逾三十,患腹肿硬,逾年而疮头破,时出血水。此七情所伤,荣气绝于肉理而然,
名曰流注。诊之,肝脉涩。盖肝病脉不宜涩,小腹正属肝经,须涩脉退,乃可愈。欲以甘温之剂,补
其气血,令自消溃。不信,仍服攻伐之药,致气血愈虚,果殁于金旺之月。丹溪云∶诸经惟少阳厥阴
之生痈疽,宜预防之,以其多气少血也。少血而肌肉难长,疮久不合,必成败症。苟不知此,辄欲用
峻利毒药,以伐其阴分之血,则其祸不旋踵矣。
一室女背肿,结一块如钞大而不 ,但倦怠少食,日晡发热,脉软而涩,此虚劳气郁所致也。用
益气养血开郁之药,又令饮人乳,精神稍健。彼不深信,又复流气饮,饮食遂少,四肢痿软,乃悔之,
复求治。以为决不可起矣,后果毙。
一男子年三十余,素饥寒,患右肋肿如覆瓢,转作水声,脉数。经曰∶阴虚阳气凑袭,寒化为热,
热甚则肉腐为脓,即此症也。及按其肿处即起,是脓已成矣。遂以浓煎黄 六一汤,( 六草一。)
令先饮二钟,然后针之,脓出数碗,而虚症并至。遂以大补药治之,三月余而愈。大抵脓血大泄,气
血必虚,当峻补之。虽有他病,皆宜缓治。盖元气一复,诸症自退。若老弱之人,不问肿溃,尤当补
也。
一妇人十九,腰间肿一块,无头,色不变,三月不溃,饮食少思,肌肉日瘦。此寒搏腠理,荣气
不行,郁而为肿也,名曰湿毒流注。百余剂,元气复而肿消。后因劳役怒气,经行不止,服凉血之剂,
其血如崩。此因脾气复伤下陷,而血从之。朝用补中益气汤,夕用归脾汤而愈。
一妇人禀弱性躁,胁臂肿痛,胸膈痞闷,服流气败毒药反发热。以四七汤数剂,胸宽气利。以小
柴胡对四物加陈皮、香附,肿痛亦退。大抵妇人性执着,不能宽解,多被七情所伤,遂致遍身作痛,
或肢节肿痛,或气填胸满,或如梅核塞喉,咽吐不出,或痰涎涌盛,上气喘急,或呕逆恶心,甚者渴
闷欲绝,产妇多有此症。宜服四七汤,先调滞气,更以养血之药。若因忧思,致小便白浊者,用此汤
吞青州白丸子,屡效。
一妇人腿患筋挛骨痛,诸药不应,脉迟紧,用大防风汤二剂顿退,又二剂而安。又一妇人亦然,
先用前汤二剂,更服黑丸子而痊。此二患失治,必溃成败症。
一老人伤寒,表邪未尽,股内患肿发热。以人参败毒散二剂,热止。灸以香附饼,又小柴胡加二
陈、羌活、川芎、归身、白术、枳壳,数剂而散。
一男子肩胛患之,微肿,形劳气弱。以益气养荣汤,服黑丸子及木香、生地作饼覆患处,熨之。
月余脓成针之,仍服前药而愈。
一男子臂肿筋挛骨痛,年余方溃,不敛。诊其脉更虚,以内塞散一料,少愈。以十全大补汤,及
附子饼灸之而痊。《精要》云∶留积经久,极阴生阳,寒化为热,以此溃多成 ,宜早服内塞散排之。
一男子腿患流注,溃而不敛。用人参养荣汤及附子饼,更以补剂煎膏贴之,两月而愈。
通府李廷仪患流注,唾痰气促,自恃知医,用化痰理气等剂,半载而溃。用托里等剂,脓水淋漓,
肿硬不消,寒热往来,饮食少思,肌肉消瘦,大便不实,手足时冷,两尺脉浮大,按之微细。曰∶此
属命门火衰,当用八味丸。不信,乃服参、 、归、术之类,更加痰喘,泄泻。服八味丸、益气汤,
年余而痊。
一妇人背患流注,内溃胀满,服流气化痰之剂,自汗盗汗,脉大而弱,此元气亏损之症也。与参、
各一两,归、术各五钱,肉桂二钱,服而针之。至夜半,始出稀脓二碗许。翼日,大汗倦甚,烦热
作渴,扬手气促,脉洪大而数,仍用前药加附子一钱,炙草二钱,二剂脉症悉退。又以六君子加姜、
桂,二十余剂,始离床褥。后因劳复寒热,作渴汗出,时仲冬,寝帏气出如雾,用十全大补汤加桂、
附,二剂而痊。
一学士年十六,患此症二载矣,脉洪大而数,脓清热渴,食少体倦,夜间盗汗,午前畏寒。曰∶
真气不足,邪气有余,治之无功矣。午前以四君子汤加芎、归、炙草,午后以四君子加五味、麦冬、
参、 ,两月诸症遂可一二。又有用渗利之剂,保其必生者,三月后,形体骨立,后竟不救。
一弱人患流注内溃,出败脓五六碗,是时口眼歪斜,以独参汤加附子二钱,二剂少愈。更以十全
大补之剂,月余而痊。大抵疮疡脓血既泄,当大补气血为先,虽有他症,当以末治之。凡痈溃发热恶
寒,皆属气血虚甚。若左手脉不足者,用补血药。元戎云∶若人饮食疏,精神气血弱,肌肉消薄,荣
卫之气短促而涩滞,故寒搏腠理,闭郁而为痈肿。当补之,以接虚怯之气。遂以十全大补加香附、陈
皮,三十余剂始针之,出白脓二碗。仍用前药倍参,及以豆豉饼灸之,渐愈。彼欲速效,内服败毒,
外贴寒凉,反致食少,脓稀色紫。喜得精气未丧,仍以前药加远志、贝母、白蔹,百剂而愈。
刘文通室,年逾二十,腰间突肿寸许,肉色不变,微痛不溃,发热脉大。此七情所伤,气血凝涩
于隧道而
然也。当益气血,开郁结,更以香附饼熨之,使气血充畅,内自消散,虽溃亦无虞。不听,乃服十宣
流气药,气血愈虚,破出清脓,不敛而毙。
王洪绪治陈姓妇,年七十余,膝下患阴疽流注,溃经数月,患下及旁又起硬肿二块,与前患相连。
一医误以为前患旁肿,与托毒药二剂,致新发者被托发疽,始延王治。王令服阳和丸汤三剂,新发之
二毒皆消。接服小金丹十丸,后服滋阴剂,以杏仁散敷,半月脓浓。令再服保元汤加肉桂,十余剂愈。
流注之症,毒发阴分,盖因痰塞清道,气血虚寒凝结,一曰寒痰,一曰气毒。初起皮色不变,惟肿惟
痛,虽身体发热,内未作脓,二陈汤加阳和丸同煎,数服即消。消后接服小金丹七丸,杜其复发。如
皮色稍变,极痛难忍,须服阳和汤以止其痛,消其未成脓之毒瓦斯。使已成脓者,至不痛而溃,如患顶
软,即为穿之,脓多白,以阳和膏贴之。但此症溃后定增毒痰流走,患生不一。故即溃之后,五日内
宜服小金丹十丸,以杜后患。接用犀黄丸、阳和汤,早晚轮服,使毒消尽,方可收功。
王洪绪治一儿,甫岁半,太阳一毒,背上心脐对处二毒,颈口对此一毒,腰腹二毒,二腿五毒,
共十一毒,皆皮色无异,其大腿二毒已经医开刀。王以小金丹,令日每服二次。至五日,九毒俱消。
又以小金丹日服一次,十日后二孔皆红活。以保元汤, 、草皆用生者,加肉桂三分,煎服,另以参
六分,水煎和入。半月后, 、草皆易炙者,一月收功。小金丹方∶白胶香一两五钱,草乌一两五钱,
地龙一两五钱,木鳖一两五钱,五灵脂一两五钱,没药七钱五分,乳香七钱五分,炮姜一钱二分,当
归身七钱五分,麝香三钱。共研末,以糯米粉一两二钱为糊,捣千锤,为丸如芡实大。此一料约为丸
二百五十丸,晒干忌烘。临用,取一丸布包,于石上敲碎,入杯内,以好酒浸之约一二时,以银物加
研,陈热酒送下,醉盖取汗。如流注初起,及一切痰核、瘰 、乳岩、横 ,服至消乃止。如流注等
症,成功将溃,及溃久者,当以十丸,作五日早晚服之,以杜流走后患。但方内有五灵脂,不可与人
参同服。又方中乳香、没药,每一斤用灯心四两同炒,至圆脆可粉为度,扇去
灯心磨粉。草乌去皮,取白肉,每斤用绿豆半斤同煮,俟豆开花,去豆取草乌切片晒干。木鳖子用水
浸半月,入锅煮数滚,再浸热汤中数日,刮去皮心。入香油锅中,煮至油沫尽,再煮百滚,透心黑脆,
以铁丝筛捞出,即用土末拌,拌至土末有油气,入粗筛筛去油土,另换土末拌至三次。净以木鳖同土
炒,入盆中拌罨一夜,取鳖磨粉听用。以上各药,须如法泡制,方可用。
(徐灵胎说:流注病,缠绵难愈,病程或长或短,有的痊愈了,有的又发作,变化多端。如果是新发的一两个肿块,很快自行消退溃破,那就不是真正的流注病。)
薛立斋治疗一位妇人,因暴怒导致腰部肿胀一块,有时胸膈不适,有时气窜作痛。这是营气郁滞所致,给予方脉流气饮,服用几剂后症状停止。随后用小柴胡汤合四物汤,加入香附、贝母,一个月左右痊愈。
另一位妇人患流注病,劳累时必定疼痛,众人用手按压患处,疼痛才停止。这属于气血俱虚,使用十全大补汤、六味丸、逍遥散而治愈。
还有一位妇人先出现肢体疼痛,后来患流注病,伴有发热恶寒、食欲不振、胁肋胀满、月经不调、痰多气喘咳嗽、五心烦热、健忘惊悸、盗汗失眠。这些症状全属肝脾亏损,气血不足,使用十全大补汤与加味归脾汤兼服,所有症状全部痊愈。
又一位妇人平时容易头晕,患流注病,月经推迟且量少。这属于中气虚弱,使用补中益气汤而治愈。后来因劳累跌倒在地,月经量如涌出般增多,这是劳损伤及火动,使用前一方加入五味子,一剂即愈。
又一位妇人患前述病症,使用行气化痰等药后,胸膈仍感不利,饮食减少思虑。再用疏利之药,导致大便泄泻,腹部胀满不能进食。这是脾胃再次受伤,使用补中益气汤加炮姜,待脾胃功能恢复,饮食增加。后又用六君子汤加入川芎、当归,服用百余剂才完全痊愈。
又一位妇人平素情绪抑郁结块,肩臂各肿胀如倒扣的杯子,这属于肝脾亏损。使用加味逍遥散,多用补气药物。右手脉象不足,补气药应当多于补血药,切不可使用发表药物。
薛立斋治疗一名男子,腿部患肿,肤色不变,不痛,脉象浮而滑。用补中益气汤加入半夏、茯苓、枳壳、木香煎服,并用香附饼熨烫患处。那人认为气病没有补法,于是服用方脉流气饮,导致身体更加虚弱。再次求治,用六君子汤加入川芎、当归,服用数剂,饮食稍进。再用补益药剂,一个月左右肿块消散。所谓“气无补法”,是世俗的错误观点。因为该病表现为痞闷壅塞,似乎难以补益。殊不知正气虚弱而不能运行,邪气停滞而致病。经书说:壮盛者气行则病愈,体弱者气滞着而为病。如果不使用补法,气从哪里运行呢?(这段经文的话,在流注门中尤为关键。)
又一位妇人溃烂后发热,认为是虚证。患者不信,仍服用败毒药物,果然引发高热,最终不治身亡。溃疡虽有表证发热,应以托里药为主,佐以解表发散之剂,何况是瘰疬和流注呢?如果气血充实,经络通畅,绝不会患病。此症的成因,皆由气血素来亏虚,或因七情所伤,经络郁结,或因腠理不密,六淫外侵,导致坠道壅塞。如果不审察病因,辨别虚实,很少有不误人的。
又一名男子腿部患流注,日久不愈合,饮用大补药及贴附子饼,更用针头散外敷而治愈。
又一名男子手臂患病一年多仍然坚硬,饮食少思,早晨怕冷晚上发热。用八珍汤加入柴胡、地骨皮、丹皮,一个月左右寒热症状稍止。接着用益气养荣汤,并用附子饼灸治,两个多月后脓成,针刺排脓,再服人参养荣汤,半年后痊愈。
又一名妇人患此症,脓液溃破清稀,脉弱恶寒,日久不愈。服用内塞散,用附子饼灸治而痊愈。
又一名妇人腰间患一小块,肉色如常,未溃烂但发热。说是应当用益气养荣汤和解郁之药治疗。患者不信,另服流气饮,后来针刺破流出水,一年多后死亡。
又一名妇人流注日久不愈合,忽然发生寒热。判断其气血俱虚,患者反而服用解表发散之剂,果然高热而死。大抵流注之症,多因郁结,或暴怒,或脾气虚,湿气逆于肌肉纹理;或腠理不密,寒邪客于经络;或闪挫扑跌,或产后,瘀血流注关节;或伤寒,余邪未尽为患。皆因真气不足,邪气得以乘虚而入。通常治疗郁结者开导之,暴怒者平复之,闪挫扑跌及产后瘀血者消散之,脾虚及腠理不密者徐徐补益之,伤寒余邪者调和解除之。大要以固护元气为主,佐以针对症状的药物。如日久疮口寒冷者,更用豆豉饼或附子饼灸治。有脓管或瘀肉者,用针头散腐蚀之自愈,锭子效果尤佳。若不补气血,以及不慎饮食起居七情,均不可治。(徐灵胎按:因痰饮引起的,也很多见。)
又一名男子元气素来虚弱,时常患流注,胸膈不利,饮食少思。想要治疗健脾胃,解郁结,养气血。患者不听从,乃服用辛香流气之剂,导致腹胀。又服用三棱、莪术、厚朴之类,饮食更少,四肢微肿,兼腰部肿胀一块,未溃烂而死亡。大概此症本属虚痞,今用克伐之剂,怎么能不死?况且辛香燥热之剂,只能劫夺滞留之气,取快于一时。如果不加以制约,过服只会增加郁火,煎熬气液成为痰,日久不散,越发形成流注之症。
又一名聘士流注久溃,肌肉消瘦,发热口渴,恶寒饮食不佳。用六君子汤加入当归、黄芪、附子,服用数剂,患处遂变红活。又服十全大补汤三十余剂,脓渐稠而愈。后来听信他人言语,谓盛暑不宜用附子,他又因科举不顺,复发前症,专服败毒流气之剂,元气消烁,肌肉日渐消瘦。医生认为不可治,他自己也认定起不来。他的老师滕洗云说:先前病危,得附子药而起死回生。现在药不应验,以致危重,为何不服用附子药?于是再次求治,其脉微细,症属虚寒,并无邪毒,仍用附子药才得以痊愈。
贾阁老之子患流注,脉数口渴,不喜欢喝冷水,脓水清稀,面带赤色。我说:这是气血虚而兼火,治疗难见效。他认为迂腐,另服燥湿分利之剂,两个多月反而加重烦渴,寒热往来。再次邀请诊治,形体已脱。我说:即使治疗也无功了。后果然不起。
陈进士遂初,年过三十,患腹肿硬,逾年疮头破,时而出血水。这是七情所伤,营气绝于肌肉纹理所致,名叫流注。诊之,肝脉涩。肝病脉不宜涩,小腹正属肝经,须涩脉退去,才可愈。想用甘温之剂,补其气血,令其自消溃。患者不信,仍服攻伐之药,致气血更虚,果然在金旺之月死亡。丹溪说:诸经中只有少阳厥阴生痈疽,宜预防之,因为它们多气少血。少血而肌肉难长,疮久不合,必成败症。如果不知此理,辄想用峻烈毒药,以伐其阴分之血,那么祸患就不远了。
一名室女背肿,结一块如钞票大小而不溃烂,只是倦怠少食,傍晚发热,脉软而涩,这是虚劳气郁所致。用益气养血开郁之药,又令饮人乳,精神稍健。患者不深信,又服流气饮,饮食遂少,四肢痿软,后悔之,再次求治。认为决不可起了,后果然毙命。
一名男子年三十余,平素饥寒,患右肋肿如覆瓢,转动有水声,脉数。经书说:阴虚阳气凑袭,寒化为热,热甚则肉腐为脓,就是此症。及按其肿处即起,是脓已成矣。遂用浓煎黄芪六一汤,(黄芪六,甘草一。)令先饮二钟,然后针刺,脓出数碗,而虚症并至。遂以大补药治之,三月余而愈。大抵脓血大泄,气血必虚,当峻补之。虽有他病,皆宜缓治。盖元气一复,诸症自退。若老弱之人,不问肿溃,尤当补也。
一名妇人十九岁,腰间肿一块,无头,色不变,三月不溃,饮食少思,肌肉日瘦。这是寒搏腠理,营气不行,郁而为肿也,名叫湿毒流注。百余剂,元气复而肿消。后因劳役怒气,经行不止,服凉血之剂,其血如崩。这是因为脾气复伤下陷,而血从之。朝用补中益气汤,夕用归脾汤而愈。
一名妇人禀赋弱性急,胁臂肿痛,胸膈痞闷,服流气败毒药反发热。用四七汤数剂,胸宽气利。用小柴胡对四物加陈皮、香附,肿痛亦退。大抵妇人性执着,不能宽解,多被七情所伤,遂致遍身作痛,或肢节肿痛,或气填胸满,或如梅核塞喉,咽吐不出,或痰涎涌盛,上气喘急,或呕逆恶心,甚者渴闷欲绝,产妇多有此症。宜服四七汤,先调滞气,更以养血之药。若因忧思,致小便白浊者,用此汤吞青州白丸子,屡效。
一名妇人腿患筋挛骨痛,诸药不应,脉迟紧,用大防风汤二剂顿退,又二剂而安。又一妇人亦然,先用前汤二剂,更服黑丸子而痊。此二患失治,必溃成败症。
一名老人伤寒,表邪未尽,股内患肿发热。用人参败毒散二剂,热止。灸以香附饼,又小柴胡加二陈、羌活、川芎、归身、白术、枳壳,数剂而散。
一名男子肩胛患之,微肿,形劳气弱。用益气养荣汤,服黑丸子及木香、生地作饼覆患处,熨之。月余脓成针之,仍服前药而愈。
一名男子臂肿筋挛骨痛,年余方溃,不敛。诊其脉更虚,以内塞散一料,少愈。用十全大补汤,及附子饼灸之而痊。《精要》说:留积经久,极阴生阳,寒化为热,以此溃多成漏,宜早服内塞散排之。
一名男子腿患流注,溃而不敛。用人参养荣汤及附子饼,更以补剂煎膏贴之,两月而愈。
通府李廷仪患流注,唾痰气促,自恃知医,用化痰理气等剂,半载而溃。用托里等剂,脓水淋漓,肿硬不消,寒热往来,饮食少思,肌肉消瘦,大便不实,手足时冷,两尺脉浮大,按之微细。我说:这属于命门火衰,当用八味丸。不信,乃服参、芪、归、术之类,更加痰喘,泄泻。服八味丸、益气汤,年余而痊。
一名妇人背患流注,内溃胀满,服流气化痰之剂,自汗盗汗,脉大而弱,这是元气亏损之症也。给与人参、黄芪各一两,当归、白术各五钱,肉桂二钱,服而针之。至夜半,始出稀脓二碗许。次日,大汗倦甚,烦热作渴,扬手气促,脉洪大而数,仍用前药加附子一钱,炙草二钱,二剂脉症悉退。又以六君子加姜、桂,二十余剂,始离床褥。后因劳复寒热,作渴汗出,时仲冬,寝帏气出如雾,用十全大补汤加桂、附,二剂而痊。
一名学士年十六,患此症二载矣,脉洪大而数,脓清热渴,食少体倦,夜间盗汗,午前畏寒。我说:真气不足,邪气有余,治之无功矣。午前以四君子汤加芎、归、炙草,午后以四君子加五味、麦冬、参、芪,两月诸症遂可一二。又有用渗利之剂,保其必生者,三月后,形体骨立,后竟不救。
一名弱人患流注内溃,出败脓五六碗,是时口眼歪斜,用独参汤加附子二钱,二剂少愈。更以十全大补之剂,月余而痊。大抵疮疡脓血既泄,当大补气血为先,虽有他症,当以末治之。凡痈溃发热恶寒,皆属气血虚甚。若左手脉不足者,用补血药。元戎说:若人饮食疏,精神气血弱,肌肉消薄,营卫之气短促而涩滞,故寒搏腠理,闭郁而为痈肿。当补之,以接虚怯之气。遂用十全大补加香附、陈皮,三十余剂始针之,出白脓二碗。仍用前药倍参,及以豆豉饼灸之,渐愈。彼欲速效,内服败毒,外贴寒凉,反致食少,脓稀色紫。喜得精气未丧,仍以前药加远志、贝母、白蔹,百剂而愈。
刘文通之妻,年过二十,腰间突肿寸许,肉色不变,微痛不溃,发热脉大。这是七情所伤,气血凝涩于隧道而然也。当益气血,开郁结,更以香附饼熨之,使气血充畅,内自消散,虽溃亦无虞。不听,乃服十宣流气药,气血愈虚,破出清脓,不敛而毙。
王洪绪治疗陈姓妇人,年七十余,膝下患阴疽流注,溃经数月,患下及旁又起硬肿二块,与前患相连。一医误以为前患旁肿,给托毒药二剂,致新发者被托发疽,始延王治。王令服阳和丸汤三剂,新发之二毒皆消。接服小金丹十丸,后服滋阴剂,以杏仁散敷,半月脓浓。令再服保元汤加肉桂,十余剂愈。
流注之症,毒发阴分,盖因痰塞清道,气血虚寒凝结,一曰寒痰,一曰气毒。初起皮色不变,惟肿惟痛,虽身体发热,内未作脓,二陈汤加阳和丸同煎,数服即消。消后接服小金丹七丸,杜其复发。如皮色稍变,极痛难忍,须服阳和汤以止其痛,消其未成脓之毒瓦斯。使已成脓者,至不痛而溃,如患顶软,即为穿之,脓多白,以阳和膏贴之。但此症溃后定增毒痰流走,患生不一。故即溃之后,五日内宜服小金丹十丸,以杜后患。接用犀黄丸、阳和汤,早晚轮服,使毒消尽,方可收功。
王洪绪治疗一幼儿,刚一岁半,太阳穴一毒,背上心脐对处二毒,颈口对此一毒,腰腹二毒,二腿五毒,共十一毒,皆皮色无异,其大腿二毒已经医开刀。王以小金丹,令日每服二次。至五日,九毒俱消。又以小金丹日服一次,十日后二孔皆红活。用保元汤,参、草皆用生者,加肉桂三分,煎服,另以参六分,水煎和入。半月后,参、草皆易炙者,一月收功。小金丹方:白胶香一两五钱,草乌一两五钱,地龙一两五钱,木鳖一两五钱,五灵脂一两五钱,没药七钱五分,乳香七钱五分,炮姜一钱二分,当归身七钱五分,麝香三钱。共研末,以糯米粉一两二钱为糊,捣千锤,为丸如芡实大。此一料约为丸二百五十丸,晒干忌烘。临用,取一丸布包,于石上敲碎,入杯内,以好酒浸之约一二时,以银物加研,陈热酒送下,醉盖取汗。如流注初起,及一切痰核、瘰疬、乳岩、横痃,服至消乃止。如流注等症,成功将溃,及溃久者,当以十丸,作五日早晚服之,以杜流走后患。但方内有五灵脂,不可与人参同服。又方中乳香、没药,每一斤用灯心四两同炒,至圆脆可粉为度,扇去灯心磨粉。草乌去皮,取白肉,每斤用绿豆半斤同煮,俟豆开花,去豆取草乌切片晒干。木鳖子用水浸半月,入锅煮数滚,再浸热汤中数日,刮去皮心。入香油锅中,煮至油沫尽,再煮百滚,透心黑脆,以铁丝筛捞出,即用土末拌,拌至土末有油气,入粗筛筛去油土,另换土末拌至三次。净以木鳖同土炒,入盆中拌罨一夜,取鳖磨粉听用。以上各药,须如法泡制,方可用。
(Xu Lingtai said: Liuzhu (Flowing Abscess) is a lingering condition that does not cease easily. Its duration may vary, with some cases resolving while others recur, presenting myriad changes. If one or two new lumps appear and quickly subside or ulcerate spontaneously, it is not true Liuzhu.)
Xue Lizhai treated a woman who, due to sudden anger, developed a swelling in the waist, accompanied by occasional discomfort in the chest and diaphragm, and wandering Qi pain. This was attributed to stagnation of Ying Qi (Nutritive Qi). She was prescribed Fangmai Liuqi Yin (Fangmai Flowing Qi Decoction), and after several doses, the symptoms ceased. Subsequently, she was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substance Decoction), augmented with Xiangfu (Cyperus Rhizome) and Beimu (Fritillaria Bulb), and recovered after more than a month.
Another woman suffered from Liuzhu, experiencing pain upon exertion which ceased when pressed by multiple hands. This belonged to deficiency of both Qi and Blood. She was cured using Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction), Liuwei Wan (Six-Ingredient Pill with Rehmannia), and Xiaoyao San (Free and Easy Wanderer Powder).
A third woman first experienced limb pain, then developed Liuzhu, accompanied by fever and aversion to cold, poor appetite, hypochondriac distension, irregular menstruation, profuse phlegm with wheezing and cough, five-palm heat, forgetfulness, palpitations, night sweats, and insomnia. All these symptoms were attributed to Liver and Spleen deficiency with insufficient Qi and Blood. She was treated concurrently with Shiquan Dabu Tang and Jiawei Guipi Tang (Modified Heart-Spleen Tonifying Decoction), resulting in the complete resolution of all symptoms.
Another woman, who usually suffered from dizziness, developed Liuzhu with delayed and scanty menstruation. This was attributed to deficiency of Middle Qi. She was cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Later, due to overexertion and falling, her menstruation became profuse like a gush. This was caused by labor injuring the Fire moving internally. The previous formula was used with Wuweizi (Schisandra Fruit) added, and she recovered after one dose.
Another woman suffering from the aforementioned condition, after taking Qi-moving and Phlegm-resolving medicines, still felt chest discomfort and had little desire for food. After taking draining and regulating medicines, she suffered from diarrhea, abdominal fullness, and inability to eat. This indicated further injury to the Spleen and Stomach. She was treated with Buzhong Yiqi Tang plus Paojiang (Prepared Ginger). Once the Spleen and Stomach functioned well and appetite returned, she was given Liujunzi Tang (Six Gentlemen Decoction) with Chuanxiong (Sichuan Lovage Rhizome) and Danggui (Angelica Sinensis Root). After more than a hundred doses, she fully recovered.
Another woman with chronic emotional depression developed swellings on her shoulders and arms resembling inverted cups. This was attributed to Liver and Spleen deficiency. She was treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), using a larger proportion of Qi-tonifying herbs. Since her Right pulse was deficient, Qi-tonifying herbs should exceed Blood-nourishing herbs, and releasing exterior methods must strictly be avoided.
Xue Lizhai treated a man with leg swelling, unchanged skin color, no pain, and a floating and slippery pulse. He was given Buzhong Yiqi Tang with Banxia (Pinellia Tuber), Fuling (Poria), Zhike (Aurantii Fructus), and Muxiang (Aucklandiae Radix) to drink, and the affected area was moxa-compressed with Xiangfu cakes. The patient believed that Qi disorders cannot be treated with tonification, so he took Fangmai Liuqi Yin, which made him weaker. Seeking treatment again, he was given Liujunzi Tang with Chuanxiong and Danggui. After several doses, his diet improved slightly. With continued tonification, the swelling subsided after a month. The saying "Qi disorders cannot be treated with tonification" is a vulgar misconception. Because the disease presents as stuffiness and obstruction, it seems difficult to tonify. However, it is unknown that when Zheng Qi (Upright Qi) is deficient and cannot circulate, Xie Qi (Pathogenic Qi) stagnates and causes disease. The Classics state: "The robust recover as Qi moves; the weak suffer from stagnation." If tonification is not used, how can Qi move? (This Classic quote is particularly crucial in the context of Liuzhu.)
Another woman developed fever after ulceration, which was considered a deficiency pattern. She did not believe this and continued taking detoxifying drugs, resulting in severe fever and eventual death. Although ulcers may present with exterior syndrome fever, the primary treatment should be interior-supporting herbs, assisted by exterior-releasing agents, especially for Luoli (Scrofula) and Liuzhu. If Qi and Blood are sufficient and meridians are unobstructed, such diseases will not occur. The cause of this condition lies in inherent deficiency of Qi and Blood, injury from Seven Emotions causing meridian stagnation, or loose interstices allowing Six Evils to invade, leading to blockage of pathways. Without investigating the cause and distinguishing deficiency from excess, errors are inevitable.
A man with leg Liuzhu that failed to heal for a long time was cured by drinking major tonifying medicines, applying Aizi cakes (Moxa cakes with Aconite), and using Zhentou San (Needle Head Powder) externally.
A man suffered from arm hardness for over a year, with poor appetite, morning chills, and evening fevers. Bazhen Tang (Eight Treasure Decoction) with Chaihu (Bupleuri Radix), Digupi (Lycii Cortex), and Danpi (Moutan Cortex) stopped the chills and fevers after a month. Subsequently, Yiqi Yangrong Tang (Augment Qi and Nourish Ying Decoction) was used, along with moxa compression using Aizi cakes. After more than two months, pus formed, was drained by needle, and Ren Shen Yangrong Tang (Ginseng Nourishing Ying Decoction) was taken, leading to recovery after half a year.
A woman with this condition had thin, clear pus, a weak pulse, aversion to cold, and failure to heal for a long time. She was cured by Neisai San (Interior Blocking Powder) and moxa compression with Aizi cakes.
Another woman had a small lump on her waist with normal skin color, no ulceration, but fever. It was advised to use Yiqi Yangrong Tang and Qi-regulating herbs. Disbelieving this, she took Liuqi Yin instead. After being pricked, water flowed out, and she died after more than a year.
Another woman with long-standing Liuzhu suddenly developed chills and fever. Her Qi and Blood deficiency was diagnosed, but she took exterior-releasing herbs, resulting in high fever and death. Generally, Liuzhu often results from emotional depression, sudden anger, Spleen Qi deficiency with dampness counterflowing into muscle tissue, loose interstices allowing cold pathogens to lodge in meridians, trauma, postpartum blood stasis flowing into joints, or residual pathogens from Taiyang disease. All stem from insufficiency of True Qi, allowing pathogens to take advantage. Treatment involves opening depression, calming anger, dispersing stasis from trauma/postpartum, slowly tonifying Spleen deficiency/loose interstices, and harmonizing/resolving residual pathogenic factors. The main principle is consolidating Yuan Qi (Source Qi), assisted by symptom-specific herbs. For chronic cold ulcers, Douchi cakes (Fermented Soybean cakes) or Aizi cakes should be used for moxibustion. For sinus tracts or necrotic flesh, Zhentou San is used to slough them off naturally, with Dingzi (Ointment pills) being particularly effective. Without tonifying Qi and Blood, and without careful attention to diet, lifestyle, and emotions, the condition is untreatable. (Xu Lingtai notes: Cases caused by Phlegm-fluid retention are also very common.)
A man with inherently weak Qi frequently suffered from Liuzhu, chest discomfort, and poor appetite. The intention was to strengthen the Spleen and Stomach, resolve depression, and nourish Qi and Blood. He refused, taking Xinxiang Liuqi agents (Acrid-Aromatic Flowing Qi preparations), leading to abdominal distension. He then took Sanleng (Sparganii Rhizome), Ezhu (Curcumae Rhizome), and Houpo (Magnolia Bark), resulting in less food intake, slight limb swelling, and a waist lump, dying without ulceration. This condition was originally deficiency-type stagnation; using attacking herbs inevitably leads to death. Moreover, acrid-aromatic hot-dry herbs only temporarily seize stagnant Qi. Without restraint, excessive use increases郁 Fire (Stagnant Heat), boiling Qi and fluids into Phlegm, which persists and worsens Liuzhu.
A scholar with long-standing ulcerated Liuzhu, emaciation, fever, thirst, chills, and poor diet, was treated with Liujunzi Tang plus Danggui, Huangqi (Astragali Radix), and Fuzi (Aconiti Lateralis Radix Praeparata). After several doses, the lesion turned red and vibrant. Taking Shiquan Dabu Tang for over thirty doses thickened the pus and led to recovery. Later swayed by rumors that Fuzi is unsuitable in midsummer, and frustrated by imperial examinations, he relapsed and exclusively took detoxifying Liuqi agents. His Yuan Qi was depleted, muscles wasted away. Doctors deemed it incurable, and he despaired. His teacher Teng Xi Yun said: "Previously, you were critical but revived with Fuzi medicine. Now the medicine fails, leading to criticality; why not resume Fuzi?" Upon re-treatment, his pulse was faint and fine, indicating deficiency-cold without toxic pathogens. Resuming Fuzi medicine led to recovery.
Jia Gelao's son suffered from Liuzhu with rapid pulse, thirst, dislike for cold drinks, thin pus, and ruddy complexion. I stated: This is Qi and Blood deficiency with accompanying Fire; treatment will be difficult. He considered this pedantic, taking drying-dampness and separating-clearance agents. After two months,煩渴 (irritability and thirst) worsened, with alternating chills and fever. Re-inviting treatment, his body was emaciated. I said: Even if treated, it would be futile. He indeed died.
Chen Jinshi Suchu, over thirty years old, suffered from hard abdominal swelling. After a year, an abscess head broke, bleeding fluid intermittently. This was caused by Seven Emotions injuring Ying Qi at the muscle level, named Liuzhu. Diagnosis showed a choppy Liver pulse. Liver disease pulses should not be choppy; the lower abdomen belongs to the Liver Meridian. Recovery requires the choppy pulse to disappear. I intended to use sweet-warm agents to tonify Qi and Blood for spontaneous resolution. He disbelieved, continuing attacking herbs, worsening Qi and Blood deficiency, and died in the Metal-prosperous month. Danxi said: Among all meridians, Shaoyang and Jueyin are prone to carbuncles and sores and require prevention because they have abundant Qi but scarce Blood. Scarce Blood makes muscle growth difficult; prolonged non-healing leads to failure syndromes. Ignoring this and using harsh toxic drugs to attack Yin-Blood brings disaster swiftly.
A maiden had a back swelling, a coin-sized lump that did not ulcerate, accompanied by fatigue, poor appetite, afternoon fever, and soft-choppy pulse. This was deficiency-labor Qi depression. Using Qi-augmenting, Blood-nourishing, and depression-resolving herbs, plus human milk, her spirit improved slightly. Disbelieving, she took Liuqi Yin, reducing food intake and causing limb flaccidity. Regretting this, she sought help again. It was deemed hopeless, and she indeed died.
A man in his thirties, accustomed to hunger and cold, developed a right hypochondriac swelling like an inverted bowl with fluid sounds, and a rapid pulse. The Classics say: "Yin deficiency allows Yang Qi to gather; Cold transforms into Heat. Excessive Heat rots flesh into Pus," describing this condition. Pressing the swelling caused rebound, indicating pus formation. Thickly decocted Huangqi Liuyi Tang (Astragalus Six-One Decoction: 6 parts Astragalus, 1 part Licorice) was drunk first, then punctured, yielding several bowls of pus, followed by immediate deficiency symptoms. Major tonification restored health after three months. Generally, massive loss of pus and blood causes Qi and Blood deficiency, requiring vigorous tonification. Other ailments should be treated gently. Once Yuan Qi recovers, other symptoms retreat. In the elderly and weak, tonification is essential regardless of swelling or ulceration.
A nineteen-year-old woman had a waist lump, headless, unchanged color, non-ulcerated for three months, poor appetite, and daily emaciation. This was Cold binding interstices, Ying Qi stagnation causing swelling, named Shidu Liuzhu (Damp-Toxin Flowing Abscess). After over a hundred doses, Yuan Qi recovered and swelling subsided. Later, due to labor and anger, menstruation persisted. Cooling-blood herbs caused hemorrhage. This was due to Spleen Qi sinking and failing to control blood. Morning Buzhong Yiqi Tang and evening Guipi Tang cured her.
A woman with weak constitution and irritable temper had painful swelling in hypochondrium and arms, chest stuffiness. Taking Liuqi and detoxifying herbs caused fever. Several doses of Sini Tang (Four Substances Decoction) relieved chest tightness and regulated Qi. Xiaochaihu Tang combined with Siwu Tang plus Chenpi (Tangerine Peel) and Xiangfu reduced swelling and pain. Women are often stubborn and unable to relax, susceptible to Seven Emotions injuries, causing whole-body pain, joint swelling, chest fullness, globus hystericus (plum-pit sensation), profuse saliva/phlegm with asthma, nausea/vomiting, or extreme thirst/stifling sensation. Postpartum women often suffer this. Sini Tang should regulate stagnant Qi first, followed by Blood-nourishing herbs. For urinary turbidity due to worry/thought, swallowing Qingzhou Baiwanzi (Qingzhou White Pills) with this decoction is effective.
A woman with leg tendon spasms and bone pain unresponsive to other medicines, with slow-tight pulse, was instantly relieved by Dafangfeng Tang (Great Wind-Expelling Decoction) in two doses, and settled in another two. Another similar case resolved with black pills after initial treatment. Neglecting these would lead to ulceration and failure syndromes.
An elderly man with incomplete Taiyang exterior pathogen developed thigh swelling and fever. Ren Shen Baidu San (Ginseng Detoxifying Powder) stopped fever in two doses. Moxa compression with Xiangfu cakes, followed by Xiaochaihu Tang with Erchen Tang, Qianghuo (Notopterygii Rhizoma), Chuanxiong, Danggui, Baizhu (Atractodylis Macrocephalae Rhizoma), and Zhike, dispersed the swelling in several doses.
A man with shoulder blade swelling, frail physique, and weak Qi was treated with Yiqi Yangrong Tang, black pills, and cakes of Muxiang and Shengdi (Rehmanniae Radix) applied and compressed. After a month, pus formed, was drained, and continued medication led to recovery.
A man with arm swelling, tendon spasms, and bone pain ulcerated after a year without healing. Pulse was even more deficient. One dose of Neisai San improved symptoms slightly. Shiquan Dabu Tang and Aizi cake moxibustion cured him. *Jingyao* states: Long-standing accumulation generates Yang from extreme Yin; Cold transforms to Heat. Ulceration often becomes fistulas; early Neisai San drainage is appropriate.
A man with leg Liuzhu, ulcerated but unhealed, was cured by Ren Shen Yangrong Tang, Aizi cakes, and topical tonifying paste over two months.
Li Tingyi of Tongfu suffered from Liuzhu with sputum and shortness of breath. Relying on medical knowledge, he took Phlegm-resolving and Qi-regulating agents for six months before ulceration. Interior-supporting agents yielded dripping pus, persistent hardness, alternating chills/fever, poor appetite, emaciation, loose stools, cold extremities, and floating-large superficial but faint-deep Chi pulses. I diagnosed Mingmen Fire decline, recommending Bajian Wan (Eight-Ingredient Pill). Disbelieving, he took Ren Shen, Huangqi, Danggui, Baizhu, worsening phlegm/wheezing and diarrhea. Bajian Wan and Yiqi Tang cured him after a year.
A woman with back Liuzhu, internal ulceration/fullness, sweating, large-weak pulse, had Yuan Qi deficiency. Given Ren Shen and Huangqi (1 liang each), Danggui and Baizhu (5 qian each), Rougui (Cinnamon Bark, 2 qian), and punctured. At midnight, two bowls of thin pus discharged. Next day, profuse sweating, exhaustion, irritability, thirst, gasping, and large-rapid pulse. Previous formula plus Fuzi (1 qian) and Zhi Gancao (Honey-fried Licorice, 2 qian) resolved symptoms in two doses. Liujunzi Tang with Jiang (Ginger) and Gui (Cinnamon) for twenty doses allowed her to leave bed. Later relapse with chills/fever/thirst/sweating in mid-winter, with warm breath visible in curtains, was cured by Shiquan Dabu Tang plus Gui and Fu in two doses.
A sixteen-year-old scholar had this condition for two years, with large-rapid pulse, post-pus fever/thirst, poor appetite/fatigue, night sweats, and morning chills. I diagnosed insufficient True Qi and excess Pathogenic Qi, predicting futility. Morning Sizijunzi Tang with Chuanxiong, Danggui, Zhi Gancao; afternoon Sizijunzi with Wuweizi, Maidong (Ophiopogonis Radix), Ren Shen, Huangqi. Symptoms improved after two months. Another practitioner used draining agents promising survival; three months later, the patient was skeletal and died.
A weak person with internal ulcerated Liuzhu discharged five-six bowls of foul pus, with facial deviation. Dushen Tang (Single Ginseng Decoction) plus Fuzi (2 qian) improved symptoms in two doses. Shiquan Dabu Tang cured him in a month. Generally, after pus/blood discharge, major Qi/Blood tonification is priority; other symptoms are secondary. Carbuncle ulceration with fever/chills indicates severe Qi/Blood deficiency. Left pulse deficiency requires Blood tonification. Yuanrong stated: Poor diet, weak spirit/Qi/Blood, thin muscles, and short/choppy Ying-Wei Qi cause Cold binding interstices and closure leading to swelling. Tonification connects deficient Qi. Shiquan Dabu plus Xiangfu and Chenpi for thirty doses, then puncture yielding white pus. Continued medication with doubled Ren Shen and Douchi cake moxibustion led to gradual recovery. Desiring quick results, he took internal detoxifiers and external cooling pastes, worsening appetite and turning pus thin/purple. Fortunately, Essence/Qi remained intact. Adding Yuanzhi (Polygalae Radix), Beimu, and Bailian (Pleeae Radix) to previous formula cured him after a hundred doses.
Wen Liutong's wife, over twenty, had a one-cun waist protrusion, unchanged color, slight pain, no ulceration, fever, and large pulse. Caused by Seven Emotions, Qi/Blood stagnation in tunnels. Tonify Qi/Blood, open depression, apply Xiangfu cakes to promote circulation and internal resolution; even if ulcerated, no danger. Disbelieving, she took Shixuan Liuqi Medicine, worsening Qi/Blood deficiency, breaking out with clear pus, failing to heal, and dying.
Wang Hongxu treated a seventy-something Chen woman with Yin-Ju (Yin Carbuncle) Liuzhu under the knee, ulcerated for months, with two new hard swellings below and beside the original. A doctor mistakenly treated the new swelling with interior-supporting toxins, causing the new lesions to erupt as carbuncles. Wang prescribed Yanghe Wan/Tang (Yanghe Pill/Decoction) for three doses, resolving new toxins. Followed by Xiao Jin Dan (Little Golden Pill) ten pills, then Yin-nourishing agents, and Xingren San (Apricot Kernel Powder) dressing. Pus thickened in half a month. Baoyuan Tang (Protect Origin Decoction) plus Rougui for ten doses cured her.
Liuzhu toxin originates in the Yin division, caused by Phlegm blocking clear pathways, Qi/Blood deficiency-cold coagulation. Types include Cold-Phlegm and Qi-Toxin. Early stage: unchanged skin, only swelling/pain, possible fever but no internal pus. Erchen Tang with Yanghe Wan decocted together resolves it in few doses. Followed by seven Xiao Jin Dan pills to prevent recurrence. If skin color changes slightly and pain is unbearable, Yanghe Tang stops pain and dissolves pre-pus toxin. If pus forms, it ulcerates painlessly; if soft, puncture immediately. White pus indicates good prognosis; apply Yanghe Gao (Yanghe Ointment). Post-ulceration, toxic Phlegm may flow elsewhere, varying presentations. Within five days post-ulceration, ten Xiao Jin Dan pills prevent complications. Alternate Xihuang Wan (Rhino Horn Yellow Pill) and Yanghe Tang morning/evening until toxin clears.
Wang Hongxu treated a one-and-a-half-year-old boy with eleven toxic nodules: one on Taiyang, two opposite heart/navel on back, one opposite neck/mouth, two on waist/abdomen, five on legs. Skin colors unchanged. Two thigh nodules already incised. Wang prescribed Xiao Jin Dan twice daily. Nine nodules resolved in five days. Once daily for ten days, two holes became red/vibrant. Baoyuan Tang with raw Ren Shen and Gancao plus Rougui (0.3 qian) orally, plus Ren Shen (0.6 qian) water-decocted mixed in. After half a month, roasted Ren Shen/Gancao used. Cured in one month.
Xiao Jin Dan Formula: Baijiaoxiang (White Dragon's Blood Resin) 1.5 liang, Caowu (Aconitum Carmichaelii Radix) 1.5 liang, Dilong (Pheretima) 1.5 liang, Mugua (Momordica Semen) 1.5 liang, Wulingzhi (Trogopteri Dung) 1.5 liang, Moyao (Myrrha) 0.75 liang, Xuxiang (Boswellia) 0.75 liang, Paojiang (Prepared Ginger) 0.12 liang, Danggui Shen (Angelica Sinensis Root Heart) 0.75 liang, Shexiang (Moschus) 0.3 qian. Grind to powder, make paste with Nuomicifen (Glutinous Rice Flour, 1.2 liang), beat thousand times, form pills like Euryale seeds. One batch yields ~250 pills. Air-dry, avoid baking. To use: wrap one pill in cloth, crush on stone, soak in good wine for 1-2 hours, grind with silver tool, swallow with aged hot wine, cover warmly to induce sweat. For early Liuzhu, Tanhe (Phlegm Nodules), Luoli (Scrofula), Ruyan (Breast Cancer), Hengxuan (Inguinal Hernia/Abscess), take until resolved. For Liuzhu approaching ulceration or chronic ulcers, take ten pills over five days morning/evening to prevent spreading. Note: Wulingzhi contradicts Ren Shen. Moyao/Moyao processing: Stir-fry 1 jin with Dengxin (Junci Medulla, 4 liang) until round/crisp/powdery, fan away Dengxin, grind. Caowu processing: Peel, take white flesh, boil 1 jin with 0.5 jin Moudou (Mung Bean) until beans bloom, remove beans, slice/dry Caowu. Mugua processing: Soak in water half month, boil several times, soak in hot water days, scrape peel/core. Boil in sesame oil until foam gone, boil 100 times until center black/crisp. Sieve, mix with earth powder until oily, sieve, repeat mixing three times. Stir-fry clean Mugua with earth overnight, grind powder. All herbs must be processed correctly.