薛立斋治一男子，患瘰 肿痛，发热，大便秘结。以射干连翘散，服六帖，热退大半。以仙方活
命饮四帖而消。
一男子患此症，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，六剂少退。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。
一男子因怒，项下结核，肿痛痞闷，兼发热。用方脉流气二帖，胸膈利。以荆防败毒散，二帖而
热退。肝脉尚弦涩，以小柴胡加芎、归、白芍，四剂，脉症顿退。以散肿溃坚丸，一料将平。唯一核
不消，乃服遇仙无比丸，二两而痊。
薛立斋治一妇人，久郁，患瘰 不溃，既溃不敛，发热口干，月水短少，饮食无味，日晡尤倦。
以益气养荣汤，二十余帖少健。谓须服百帖，庶保无虞。彼欲求速效，反服斑猫之剂，及数用追蚀毒
药，去而复结，致
不能收敛，出水不止，遂不救。此症属虚劳气郁所致，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，多变为瘵症。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。
一男子瘰 溃久不敛，神思困倦，脉虚。欲投以托里，彼以为迂，乃服散肿溃坚汤。半月余，果
发热，饮食愈少。复求治，投益气养荣汤三月，喜其谨守，得以收效。齐氏云∶结核无脓，外症不明
者，并宜托里；脓未成者，使脓早成；已溃者，使新肉早生；血气虚者，托里补之；阴阳不和，托里
调之。大抵托里之法，使疮无变坏之症。（所以宜用也。）
一男子瘰 久不敛，脓出更清，面黄羸瘦，每清晨作利泻，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。
一妇人患此症，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。
一男子瘰 未溃，倦怠发热，以补中益气汤治之少愈。以益气养荣汤，月余而溃，又一月而痊。
一妇人肝经积热，患瘰 作痛，脉沉数。以射干连翘汤，四帖少愈。更用散肿溃坚丸，月余而消。
丹溪云∶瘰 必起于足少阳一经，不守禁忌，延及足阳明经，食味之浓，郁气之久，曰毒、曰风、曰
热，皆此二端。拓引变换，头分虚实，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，此血盛之症也。先以小柴胡汤二剂，
少愈。更以地黄丸治之而痊。《妇人良方》云∶寡妇之病，自古未有言也，惟《仓公传》与褚澄略为
论及。言寡者，孟子所谓无夫曰寡是也。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。孤阳独阴可乎？夫处闺门，欲已萌而不遂，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 、瘦瘠等症，皆寡妇之病。诊其脉，
独肝脉弦出寸口，而上鱼际。究其病源，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。（雄按∶此脉有由阴虚火动所致，未可均指为血盛。）
一男子耳下患五枚如贯珠，年许尚硬，面色萎黄，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。
一男子因劳而患怠惰发热，脉洪大，按之无力，谓须服补中益气汤。彼不信，乃服攻伐之剂，吐
泻不食而死。大抵此症，原属虚损。若不审虚实，而犯病禁经禁，鲜有不误。常治先以调经解郁，更
以隔蒜灸之，多自消。如不消，即以琥珀膏贴之，自有脓，即针之，否则变生他处。设若兼痰兼阴虚
等症，只宜兼症之剂，不可干扰余经。若气血已复，而核不消，却服坚散之剂，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。此症以气血为主，
气血壮实，不用追蚀之剂亦自腐，但取去使易收敛。若气血虚，不先用补药剂，而数用追蚀之药，适
足取败耳。（雄按∶洪大无力之脉，显属阴亏。攻伐固谬，补中益气亦岂可投？其余议论，皆是见到
之言。）
一男子体素弱，瘰 溃后肉不腐，此气血皆虚，用托里养荣汤，气血将复。核尚在，以簪挺拨去。
又服前药，月余而愈。
一男子患此症，气血已复，核尚不腐。用针头散及必效散各三次，不旬日而愈。
一男子患瘰 ，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。
彼以治痰为先，乃服苦寒化痰药不应。又加以破气药，病愈甚。始用六君子加芎、归，数剂，饮食少
思。以补中益气汤倍加白术，月余中气少旺健。又以益气养荣汤，两月肿消而血气亦复矣。夫左关脉
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，利药过多，
则脾气愈虚，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，月经不通，四肢浮肿，小便如淋，此血分症也。先以椒仁丸数服，经行肿消。
更以六君子汤加柴胡、枳壳，数剂，项肿亦消矣。亦有先因小便不利，后身发微肿，致经水不通，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，后致四肢浮肿，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，气血所损之症也。
当先滋养血气。不信，乃服风药，后果不起。卢砥镜曰∶经云，神伤于思虑则肉脱，意伤于忧愁则肢
废，魂伤于悲哀则筋挛，魄伤于喜乐则皮稿，志伤于盛怒则腰脊难以俯仰。何侍郎有女适人，夫早逝，
患十指挛拳，垂莫能举，肤体疮疡如栗粟果然，又汤剂杂进，饮食顿减，几于半载。适与诊之，则非
风也，正乃忧愁悲哀所致耳。病属内因，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，类痿症，以养气血健脾胃药而愈。
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、荆、防而寒热
退。更以小柴胡对四物，数剂而肿消。其父欲除病根，勿令再发。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，否则肝迭受伤，则不能藏血，血
虚则为难瘥之症矣。后不戒，果结三核，屡用追蚀药而殁。
一少妇耳患肿毒，勤苦，发热口干，月水每过期而至且少。一老媪以为经闭，用水蛭之类通之，
以致愈虚而殁。夫月水之为物，乃手太阳手少阴二经主之。此二经相为表里，主上为乳汁，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，则冲任之气盛，故为月水，适时而至。
若面色萎黄，四肢消瘦，发热口干，月水过期且少，乃阴血不足也，非有余热之症。宜以滋养血气之
剂，徐而培之，则经气盛
而经水自根据时而下。
一放出宫女，年逾三十，两胯作痛，肉不肿，色不变，大小便作痛如淋，登厕尤痛。此瘀血溃入
隧道为患，乃男女失合之症也，难治。后溃不敛，又患瘰 而殁。此妇为汤氏外家，汤为商常在外，可
见此妇在内，久怀忧郁，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，已降其精，则精不出而内败，小便道塞而为淋。精已耗而复竭之，则大小便道挛疼，
愈疼则愈欲便，愈便则愈疼。女人天癸既至，逾十年无男子合，则经不调。未逾十年思男子合，亦不
调。不调则旧血不出，新血误行，或溃而入骨，或变而为肿，或虽合而难子。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。有老妪欲用巴豆、肉桂之类，
先通其经。谓此症潮热，经候不调者，不治。但喜脉不涩，且不潮热，尚可治，须养气血，益津液，
其经自行。彼惑于速效之说，仍用之。薛曰∶非其治也。此类乃 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，未有不先伤阴血者。妇女得之，多患于七情。寇宗 曰∶世有室女童男，
积想在心，思虑过多，当多致劳损。男子则神色先丧，女子则月水先闭。何以致然？盖忧愁思虑则伤
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，故致咳嗽既作。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，其余诸方可按脉与症而治之。
一男子先于耳前下患瘰 将愈，次年延及项侧、缺盆，三年遂延胸及腋，不愈。诊之肝脉弦数，
以龙荟、散坚二丸治之，将愈，肝脉尚数。四年后，小腹阴囊内股皆患毒，年余不敛，脉诊如前，以
清肝养血及前丸而愈。
薛立斋云∶一富商项有瘰痕一片，颇大，云因怒而致，困苦二年，百法不应。忽方士与药一服，
即退二三，再服顿退，四服而平。以重礼求之，乃必效散。又一媪治此，乃用中品锭 疮内，以膏药
贴之，其根自腐。未尽再用，更搽生肌散药，数日即愈。又一道人治此，用鸡子七个，每个入斑猫一
枚，饭上蒸熟，每日空心食一枚。求者甚多。各书瘰 门及本草云∶合前二法观之，惟气血不虚者有
验，虚者恐不能治也。
薛立斋治一瘰妇，面黄体倦，咽酸嗳气。此中气虚弱，欲用补中益气汤加茯苓、半夏。不信，反
降火利气，胸膈痞满， 疮肿痛。又散坚利气，嗳气不绝，大便不实，四肢时冷。曰∶今变中气虚寒
矣。用六君子汤加姜、桂，少用升麻、柴胡，渐愈，更佐以补中汤全愈。
一妇人患瘰 ，嗳气，用降火清胃，食少吞酸，胸膈痞闷。用利气消导，吐痰气促，饮食日少。
用清热化痰，大便坚涩，内热身瘦。曰∶吞酸嗳气，脾胃气虚也；胸痞痰喘，脾肺气虚也；大便坚涩，
内热日瘦，脾肺血虚也。遂以补中益气汤加炒黑吴茱萸三分，数剂，佐以六味丸，诸症顿退。乃用归
脾汤、逍遥散，间服而愈。
一男子患瘰 肿硬，久不消，亦不作脓，服散坚败毒药不应。令灸肩尖、肘尖二穴，更服益气养
荣汤，月余而愈。
一妇人瘰 久溃发热，月经每过期且少。用逍遥兼前汤，两月余气血复而疮亦愈。但一口不收，
敷针头散，灸前穴而痊。常治二三年不愈者，连灸三次，兼用托里药必愈。
田氏妇年逾三十，瘰 已溃不愈。与八珍汤加柴胡、地骨皮、夏枯草、香附、贝母，五十余剂，
形气渐转。更与必效散二服，疮口遂合。惟气血未平，再与前药三十余剂而愈。后田生执此方，不问
虚实，概以治人，殊不知散中斑猫性毒，虽瘰 多服则损元气。若气血实者，以此下之，而投补剂，
或可愈。或虚而用下药，或用追蚀药，瘀肉虽去，而疮口不合，反致难治。
一儒者 愈后，体瘦发热，昼夜无定，此足三阴气血俱虚。用八珍汤加麦冬、五味，二十余剂，
又用补中益气加麦冬、五味及六味而愈。
儒者张子容素善怒，患瘰 久而不愈，疮出鲜血，左关弦洪，重按如无，此肝火动而血妄行，症
属气血俱虚。用补中益气汤以补脾肺，六味丸以滋肾而愈。
陆子温病两耳下肿硬，用伐肝软坚之剂益甚，其脉左关弦紧，左尺洪数，此肾水亏损而筋挛也。
当生肺金滋肾水，则肝得血而筋自舒矣。彼不悟，仍服前药，竟至不起。
杨乘六治俞某患瘰 ，左右大小十余枚，俱坚硬如石，头项肿大，不能转侧，吐血咳嗽，梦遗半
年，皆服滋阴降火，固精伐肝之剂。脉之，弦劲中兼见躁动，左关尺独紧，细如刃，口舌青嫩而胖滑，
知其肝胆用事，肝胆先病，延及心脾。其痰嗽不绝者，肝气虚逆，痰随气上也；其梦泄不止者，肝血
薛立斋治疗一名男子，患瘰疬（颈部淋巴结结核），局部肿痛，伴有发热，大便秘结。使用射干连翘散，服用六帖后，热势退去大半。再服用仙方活命饮四帖，肿块消散。
另一男子患此症，肿块坚硬且不化脓，脉象弦而数，用小柴胡汤配合神效栝蒌散，各服数剂，并配合隔蒜灸数次，一个月多月后消散。
一名妇女颈部肿胀不消，给予神效栝蒌散，服用六剂后稍见减退。随后改用小柴胡汤加青皮、枳壳、贝母，服用数剂后肿块消退大半。再用四物汤合小柴胡汤，服用数剂后病情平复。
一名男子因愤怒导致项下出现结核，肿痛痞闷，兼有发热。先服用流气饮二帖，胸膈通畅。再服用荆防败毒散，二帖后热退。此时肝脉仍呈弦涩之象，给予小柴胡汤加川芎、当归、白芍，服用四剂，脉象和症状顿时减退。再服用散肿溃坚丸一料，病情即将平复。仅余一枚核未消，于是服用遇仙无比丸，服用二两后痊愈。
薛立斋治疗一名妇女，长期抑郁，患瘰疬未溃破，既已溃破也不收敛，伴有发热口干，月经量少，饮食无味，下午时分尤其疲倦。给予益气养荣汤，服用二十余帖后身体稍健。薛立斋说必须服用一百帖，才能确保无虞。患者想要追求速效，反而服用斑蝥制剂，以及多次使用追蚀毒药，导致疮口去而复结，致使不能收敛，流出液体不止，最终死亡。此症属于虚劳气郁所致，应当补益形气，调理经脉。未形成的自然会消散，已形成的自然会溃破。如果投用峻猛之剂，则气血更加虚弱，多转变为痨症。然而肿块坚硬而不溃破，溃破后伤口不合，这是气血不足的明证。况且足少阳胆经与足厥阴肝经的血，原本就不足，不可不仔细考察。
一名男子瘰疬溃破很久不愈合，精神困倦，脉象虚弱。想要给予托里透脓之法，患者认为迂腐，于是服用散肿溃坚汤。半个多月后，果然发热，饮食更少。再次求治，给予益气养荣汤，服用三个月，庆幸其谨守医嘱，得以见效。齐氏说：结核无脓，外症不明显的，都宜用托里法；脓未成的，使脓早日形成；已溃的，使新肉早日生长；血气虚的，托里补益；阴阳不和的，托里调和。大致托里之法，能使疮疡不发生变坏的症状。（所以适宜使用。）
一名男子瘰疬久不愈合，脓液清稀，面色萎黄，形体消瘦，每天清晨腹泻，给予二神丸，服用数次后腹泻停止。再给予六君子汤加川芎、当归，一个多月后肌体逐渐恢复。用豆豉饼灸，并使用补剂制成膏药贴敷，三个多月后痊愈。
一名妇女患此症，溃破后核块不腐烂，给予益气养荣汤三十余剂，再外敷针头散使其腐烂，然后再次给予前汤三十余剂后愈合。
一名男子瘰疬未溃，倦怠发热，用补中益气汤治疗稍有好转。再用益气养荣汤，一个多月后溃破，又过一个月痊愈。
一名妇女肝经积热，患瘰疬作痛，脉象沉数。用射干连翘汤，四帖后稍见好转。再用散肿溃坚丸，一个多月后消散。
朱丹溪说：瘰疬必定起于足少阳胆经，如果不遵守禁忌，会延及足阳明胃经，饮食滋味浓厚，郁结之气日久，称为毒、风、热，都源于这两条经络。蔓延变换，头绪分为虚实，虚证的令人担忧。这条经络主决断，有相火，且气多血少。妇女见此症，如果月经不调，寒热变化产生，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。
一名十七岁的少女，项下时而作痛，乍寒乍热如疟疾状，肝脉弦长，这是血盛的病症。先用小柴胡汤二剂，稍见好转。再用地黄丸治疗而痊愈。《妇人良方》说：寡妇的病，自古以来没有专门论述的，只有《仓公传》和褚澄略微论及。所谓寡，就是孟子所说的没有丈夫叫寡。如尼姑、丧夫之妇，独阴无阳，想男子而不可得，因此忧郁而成病。《易经》说：天地交感，万物化育醇厚，男女交合精气，万物化生。孤阳独阴可以吗？处于闺门之中，欲望已萌动而不能实现，导致阴阳交争，乍寒乍热，类似疟疾，久了成为痨症。又有经闭、白淫、痰逆、头风、膈气、痞闷、面色黧黑、瘦弱等症，都是寡妇的病。诊察其脉，唯独肝脉弦出寸口，而上达鱼际。探究其病源，这些疾病都是血盛所致。经书说：男子精盛则思室，女人血盛则怀胎。观察其精血，道理过半了。（按语：这种脉象也有由阴虚火动引起的，不可以都指为血盛。）
一名男子耳下患五枚如串珠状，一年多还坚硬，面色萎黄，饮食不甘，劳累后发热，脉象数软而涩。用益气养荣汤六十余剂，元气已恢复，患处已消。一枚核尚存，用必效散二服而平复。
一名男子因劳累而患怠惰发热，脉象洪大，按之无力，说必须服用补中益气汤。他不相信，乃服用攻伐之剂，吐泻不食而死。大致此症，原本属于虚损。如果不审察虚实，而犯病禁经禁，很少有不误人的。常规治疗先以调经解郁，再以隔蒜灸之，大多自然消散。如不消散，即以琥珀膏贴之，自有脓，即针刺，否则变生他处。如果兼有痰证兼阴虚等症，只宜用兼症之剂，不可干扰其他经络。如果气血已恢复，而核块不消，却服用散坚之剂，到一个月左右不应验，气血也不觉得受损，才进服必效散，或遇仙无比丸。其毒一下，即停这两种药，再服益气养荣汤数剂以调理。如果疮口不敛，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的，都不治。此症以气血为主，气血壮实，不用追蚀之剂也自然腐烂，只要取去腐肉使容易收敛。如果气血虚，不先用补药剂，而多次用追蚀的药，恰好足以导致败坏罢了。（按语：洪大无力的脉象，明显属于阴亏。攻伐固然错误，补中益气难道可以投用吗？其余议论，都是见到的真知灼见。）
一名男子体质素来虚弱，瘰疬溃破后肌肉不腐烂，这是气血皆虚，用托里养荣汤，气血将恢复。核块还在，用簪挺拨去。又服前药，一个多月后痊愈。
一名男子患此症，气血已恢复，核块尚不腐烂。用针头散及必效散各三次，不到十天痊愈。
一名男子患瘰疬，痰多，胸膈痞闷，脾胃脉弦，这是脾土虚，肝木乘之。应当以实脾土、伐肝木为主。他以治痰为先，于是服用苦寒化痰药无效。又加上破气药，病更重。始用六君子汤加川芎、当归，数剂后，饮食稍增。用补中益气汤倍加白术，一个多月后中气稍旺健。又以益气养荣汤，两个月后肿消而血气也恢复了。左关脉弦，弦属木，是木盛而克脾土，为贼邪。虚而用苦寒之剂，是虚虚也。况且痰之为病，其原因不一，主治之法不同。凡治痰，利药过多，则脾气愈虚，则痰愈易生。如中气不足，必用人参、白术之类为主，佐以化痰药。
一名妇女因怒导致项肿，月经不通，四肢浮肿，小便如淋，这是血分症。先用椒仁丸数服，经行肿消。再用六君子汤加柴胡、枳壳，数剂后，项肿也消了。也有先因小便不利，后身发微肿，致经水不通，名叫水分，宜葶苈丸治疗。《妇人良方》说：妇人肿满，如果先因经水断绝，后致四肢浮肿，小便不通，名叫血分。水化为血，血不通则复化为水矣，宜服椒仁丸。如果先因小便不利，后身浮肿致经水不通，名叫水分，宜服葶苈丸。
一名十九岁的少女，颈部长一块肿，硬而颜色不变，肌肉日渐消瘦，筋挛急痛，这是七情所伤，气血所损的病症。应当先滋养血气。不信，乃服用风药，后果不治身亡。卢砥镜说：经书说，神伤于思虑则肉脱，意伤于忧愁则肢废，魂伤于悲哀则筋挛，魄伤于喜乐则皮稿，志伤于盛怒则腰脊难以俯仰。何侍郎有个女儿出嫁，丈夫早逝，患十指挛拳，垂下不能举起，肤体疮疡如粟米般密集，又汤剂杂进，饮食顿减，几乎半年。恰逢诊治，则不是风邪，正是忧愁悲哀所致。病属内因，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。
一名少女性急好怒，耳下常肿，痛发寒热，肝脉弦急。投以小柴胡汤加青皮、牛蒡、荆芥、防风而寒热退。再用小柴胡汤合四物汤，数剂后肿消。其父欲除病根，勿令再发。说肝内主藏血，外主荣筋。如果恚怒气逆则伤肝，肝主筋，故筋蓄结而肿。须患者自己能够调摄，才可以免患，否则肝迭受伤，则不能藏血，血虚则为难瘥之症矣。后来不戒，果然结三核，屡用追蚀药而死亡。
一名少妇耳患肿毒，勤苦，发热口干，月经每过期而至且少。一老媪以为经闭，用水蛭之类通之，以致愈虚而死亡。夫月经之物，乃手太阳小肠经、手少阴心经主之。此二经相为表里，主上为乳汁，下为月经，为经络之余气。假如外无六淫所侵，内无七情所伤，脾胃之气壮，则冲任之气盛，故为月经，适时而至。如果面色萎黄，四肢消瘦，发热口干，月经过期且少，乃阴血不足也，非有余热之症。宜以滋养血气之剂，徐而培之，则经气盛而经水自根据时而下。
一名放出宫女，年逾三十，两胯作痛，肉不肿，色不变，大小便作痛如淋，登厕尤痛。这是瘀血溃入隧道为患，乃男女失合之症也，难治。后溃不敛，又患瘰疬而死亡。此妇为汤氏外家，汤为商人常在外，可见此妇在内，久怀忧郁，及在外，又不能如愿，是以致生此疾。愈见流注瘰疬，乃七情气血皆已损伤，不可用攻伐之剂皎然矣。故精血篇说：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，已降其精，则精不出而内败，小便道塞而为淋。精已耗而复竭之，则大小便道挛疼，愈疼则愈欲便，愈便则愈疼。女人天癸既至，逾十年无男子合，则经不调。未逾十年思男子合，亦不调。不调则旧血不出，新血误行，或溃而入骨，或变而为肿，或虽合而难子。合男子多则沥枯虚人，产乳众则血枯杀人。观其精血，道理过半了。
一名十七岁少女，患瘰疬久不愈，月经尚未通，发热咳嗽，饮食少思。有老妪欲用巴豆、肉桂之类，先通其经。说此症潮热，经候不调者，不治。但喜脉不涩，且不潮热，尚可治，须养气血，益津液，其经自行。彼惑于速效之说，仍用之。薛立斋说：非其治也。此类乃峻悍之剂，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。经书说：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，未有不先伤阴血者。妇女得之，多患于七情。寇宗奭说：世上有室女童男，积想在心，思虑过多，当多致劳损。男子则神色先丧，女子则月水先闭。何以致然？盖忧愁思虑则伤心，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，故致咳嗽既作。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，其余诸方可按脉与症而治之。
一名男子先在耳前下患瘰疬将愈，次年延及项侧、缺盆，三年遂延胸及腋，不愈。诊之肝脉弦数，用龙荟丸、散坚丸二种丸药治疗，将愈，肝脉尚数。四年后，小腹阴囊内股皆患毒，年余不敛，脉诊如前，用清肝养血及前丸而愈。
薛立斋说：一富商项有瘰疬痕一片，颇大，说因怒而致，困苦二年，百法不应。忽方士给药一服，即退二三，再服顿退，四服而平。以重礼求之，乃是必效散。又一老妇治此，乃用中品锭剂擦疮内，以膏药贴之，其根自腐。未尽再用，更搽生肌散药，数日即愈。又一道人治此，用鸡蛋七个，每个入斑蝥一枚，饭上蒸熟，每日空心食一枚。求者甚多。各书瘰疬门及本草说：合前二法观之，惟气血不虚者有验，虚者恐不能治也。
薛立斋治疗一瘰疬妇女，面黄体倦，咽酸嗳气。这是中气虚弱，想用补中益气汤加茯苓、半夏。不信，反降火利气，胸膈痞满，疮肿痛。又散坚利气，嗳气不绝，大便不实，四肢时冷。说：今变中气虚寒矣。用六君子汤加姜、桂，少用升麻、柴胡，渐愈，更佐以补中汤全愈。
一名妇女患瘰疬，嗳气，用降火清胃，食少吞酸，胸膈痞闷。用利气消导，吐痰气促，饮食日少。用清热化痰，大便坚涩，内热身瘦。说：吞酸嗳气，脾胃气虚也；胸痞痰喘，脾肺气虚也；大便坚涩，内热日瘦，脾肺血虚也。遂以补中益气汤加炒黑吴茱萸三分，数剂，佐以六味丸，诸症顿退。乃用归脾汤、逍遥散，间服而愈。
一名男子患瘰疬肿硬，久不消，亦不作脓，服散坚败毒药不应。令灸肩尖、肘尖二穴，更服益气养荣汤，月余而愈。
一名妇女瘰疬久溃发热，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，灸前穴而痊。常规治疗二三年不愈者，连灸三次，兼用托里药必愈。
田氏妇年逾三十，瘰疬已溃不愈。与八珍汤加柴胡、地骨皮、夏枯草、香附、贝母，五十余剂，形气渐转。更与必效散二服，疮口遂合。惟气血未平，再与前药三十余剂而愈。后田生执此方，不问虚实，概以治人，殊不知散中斑蝥性毒，虽瘰疬多服则损元气。若气血实者，以此下之，而投补剂，或可愈。或虚而用下药，或用追蚀药，瘀肉虽去，而疮口不合，反致难治。
一名儒者瘰疬愈后，体瘦发热，昼夜无定，这是足三阴气血俱虚。用八珍汤加麦冬、五味子，二十余剂，又用补中益气加麦冬、五味子及六味丸而愈。
儒者张子容素善怒，患瘰疬久而不愈，疮出鲜血，左关弦洪，重按如无，这是肝火动而血妄行，症属气血俱虚。用补中益气汤以补脾肺，六味丸以滋肾而愈。
陆子温病两耳下肿硬，用伐肝软坚之剂益甚，其脉左关弦紧，左尺洪数，这是肾水亏损而筋挛也。当生肺金滋肾水，则肝得血而筋自舒矣。彼不悟，仍服前药，竟至不起。
杨乘六治疗俞某患瘰疬，左右大小十余枚，俱坚硬如石，头项肿大，不能转侧，吐血咳嗽，梦遗半年，皆服滋阴降火，固精伐肝之剂。诊其脉，弦劲中兼见躁动，左关尺独紧，细如刃，口舌青嫩而胖滑，知其肝胆用事，肝胆先病，延及心脾。其痰嗽不绝者，肝气虚逆，痰随气上也；其梦泄不止者，肝血
Xue Lizhai treated a male patient suffering from scrofula (tuberculosis of cervical lymph nodes), presenting with local swelling, pain, fever, and constipation. He prescribed Shegan Lianqiao San (Belamcanda and Forsythia Powder), which was taken for six doses; the fever subsided by more than half. Subsequently, Xianfang Huoming Yin (Immortal Recipe for Activating Life Decoction) was administered for four doses, resulting in the resolution of the mass.
Another male patient presented with this condition, characterized by hard swelling without suppuration, and a wiry and rapid pulse. Xiao Chaihu Tang (Minor Bupleurum Decoction) was combined with Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder), each taken for several doses, along with garlic-separated moxibustion applied several times. The condition resolved after more than a month.
A female patient had persistent neck swelling. Shenxiao Gualou San was given, and after six doses, there was slight improvement. Then, Xiao Chaihu Tang was modified with Qingpi (Green Tangerine Peel), Zhike (Bitter Orange), and Beimu (Fritillaria Bulb). After several doses, the swelling reduced significantly. Finally, Siwu Tang (Four Substance Decoction) was combined with Xiao Chaihu Tang, and after several doses, the condition stabilized.
A male patient developed nodules under the neck due to anger, accompanied by swelling, pain, fullness, and fever. Liuyang Liuqi Yin (Regulating Qi and Blood Decoction) was taken for two doses, relieving chest and diaphragm stagnation. Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxins) was then administered for two doses, resolving the fever. The liver pulse remained wiry and choppy. Xiao Chaihu Tang was modified with Xiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), and Baishao (White Peony Root). After four doses, the pulse and symptoms improved markedly. Sanzhong Kuijian Wan (Powder to Disperse Swelling and Harden Nodules) was taken for one preparation, bringing the condition near resolution. Only one nodule remained, so Yuxian Wubi Wan (Matchless Pill Encountering Immortals) was administered for two taels, leading to recovery.
Xue Lizhai treated a female patient with long-standing depression who developed scrofula that neither ulcerated nor healed after ulceration. Symptoms included fever, dry mouth, scanty menstruation, loss of appetite, and extreme fatigue in the afternoon. Qiyi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) was prescribed for over twenty doses, yielding slight improvement. Xue advised that one hundred doses were necessary to ensure safety. Desiring quick results, the patient instead took Mayscan preparations and repeatedly used cauterizing toxic medicines. This caused the wound to re-close rather than heal, leading to continuous discharge and eventual death. This condition resulted from deficiency labor and qi stagnation; treatment should have focused on tonifying form and qi and regulating meridians. Unformed nodules would resolve spontaneously, and formed ones would ulcerate spontaneously. Using harsh agents would further deplete qi and blood, often transforming into consumption diseases. Hardness without ulceration or failure to heal after ulceration clearly indicated qi and blood deficiency. Moreover, the blood of the Shaoyang and Jueyin channels is inherently insufficient, a fact that must not be overlooked.
A male patient had scrofula that ulcerated but failed to heal for a long time, accompanied by mental fatigue and a deficient pulse. A method to support the interior was proposed, but the patient considered it too slow and instead took Sanzhong Kuijian Tang. More than half a month later, fever appeared, and food intake decreased further. Upon seeking treatment again, Qiyi Yangrong Tang was administered for three months. Fortunately, he adhered strictly to the regimen, leading to efficacy. Qi Shi stated: For tubercles without pus and unclear external signs, supporting the interior is appropriate. If pus has not formed, it promotes early formation; if already ulcerated, it promotes early granulation. For qi and blood deficiency, tonify via supporting the interior; for yin-yang disharmony, regulate via supporting the interior. Generally, this method prevents adverse changes in sores.
A male patient had chronic non-healing scrofula with thin pus, sallow complexion, emaciation, and morning diarrhea. Ershen Wan (Two Spirits Pill) was given, stopping diarrhea after several doses. Liujunzi Tang (Six Gentlemen Decoction) modified with Xiong and Danggui was then administered. Within a month, physical strength gradually recovered. Moxibustion with fermented soybean cakes and application of tonic plasters led to recovery after more than three months.
A female patient had scrofula that ulcerated but the nodule did not necrose. Qiyi Yangrong Tang was given for over thirty doses, followed by topical application of Zhentousan (Needle Head Powder) to induce necrosis. Another thirty doses of the previous decoction led to healing.
A male patient with un-ulcerated scrofula presented with fatigue and fever. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) provided slight relief. Qiyi Yangrong Tang was then administered; the lesion ulcerated after a month and healed after another month.
A female patient with accumulated heat in the Liver channel suffered from painful scrofula and a deep, rapid pulse. Shegan Lianqiao Tang was given for four doses, showing slight improvement. Sanzhong Kuijian Wan was then used, resolving the condition after a month.
Zhu Danxi stated: Scrofula invariably originates in the Foot-Shaoyang Gallbladder channel. Without observing taboos, it spreads to the Foot-Yangming Stomach channel. Rich diet and prolonged emotional stagnation generate toxins, wind, and heat, all stemming from these two channels. The progression varies between excess and deficiency, with deficiency being concerning. This channel governs decision-making, contains ministerial fire, and 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 seventeen-year-old maiden experienced intermittent neck pain and alternating chills and fever resembling malaria, with a long and wiry liver pulse, indicating abundant blood. Xiao Chaihu Tang was given for two doses, providing slight relief. Dihuang Wan (Rehmannia Pill) was then used for complete recovery. *Funren Liangfang* states: Diseases of widows have rarely been discussed since antiquity, except briefly in *Canggong Zhuan* and Chu Cheng's writings. "Widow" refers to a woman without a husband, such as nuns or widows. Being purely yin without yang, desiring men but unable to attain them leads to melancholy and disease. The *I Ching* says: Heaven and earth interact, and all things are transformed harmoniously; male and female essence joins, and all things are born. Can isolated yang and isolated yin exist? Women confined to inner quarters whose desires arise but remain unfulfilled experience yin-yang conflict, causing alternating chills and fever similar to malaria, which eventually becomes consumption. Other symptoms include amenorrhea, leukorrhea, phlegm reversal, headache, chest oppression, palpitations, dark complexion, and emaciation, all characteristic of widows' diseases. Pulse diagnosis reveals the liver pulse wiry and extending beyond the cunkou to the fish-mouth area. The root cause is abundant blood. The classics state: When a man's essence is abundant, he desires intercourse; when a woman's blood is abundant, she conceives. Observing their essence and blood, half the understanding is gained. (Note: This pulse may also result from yin deficiency with fire hyperactivity and should not always be attributed to abundant blood.)
A male patient had five pearl-like nodules below the ear, hard for over a year, with sallow complexion, poor appetite, fatigue-induced fever, and a soft, choppy, rapid pulse. Qiyi Yangrong Tang was administered for over sixty doses, restoring primal qi and reducing the lesions. One remaining nodule was resolved with two doses of Bixiao San.
A male patient developed lethargy and fever due to overwork, with a large pulse that was empty upon pressure. Buzhong Yiqi Tang was recommended, but he refused and took attacking agents, leading to vomiting, diarrhea, anorexia, and death. This condition is essentially deficiency. Failing to distinguish excess from deficiency and violating dietary or meridian taboos almost guarantees error. Standard treatment involves regulating menstruation and resolving stagnation, followed by garlic-separated moxibustion, which often resolves the condition. If unresolved, Hupo Gao (Amber Plaster) is applied; once pus forms, it is lanced. Otherwise, it may spread. If complicated by phlegm or yin deficiency, treat those specific patterns without interfering with other channels. If qi and blood are restored but nodules persist, avoid hard-resolving agents initially. If no response after a month and qi/blood remain stable, Bixiao San or Yuxian Wubi Wan may be tried. Stop these toxic agents immediately after use and follow with Qiyi Yangrong Tang for regulation. For non-healing wounds, apply fermented soybean cake moxibustion and Hupo Gao. Cases with severe qi-blood deficiency or negligence in diet, lifestyle, and emotions are incurable. This disease centers on qi and blood; if robust, sores will necrose and heal without caustics, provided necrotic tissue is removed. If deficient, failing to tonify first and using caustics leads to deterioration. (Note: A large, empty pulse indicates yin deficiency. Attacking agents are wrong, and Buzhong Yiqi Tang may also be inappropriate. The rest of the commentary represents insightful observation.)
A male patient with inherent weakness had scrofula that ulcerated but did not necrose, indicating qi and blood deficiency. Tuoli Yangrong Tang was used to restore qi and blood. The nodule remained and was mechanically removed with a hairpin. Continued medication led to recovery after a month.
A male patient with restored qi and blood still had non-necrotic nodules. Zhentousan and Bixiao San were applied topically three times each, leading to recovery within ten days.
A male patient with scrofula had excessive phlegm, chest oppression, and a wiry spleen/stomach pulse, indicating spleen earth deficiency with liver wood invasion. Treatment should focus on strengthening spleen earth and subduing liver wood. He initially treated phlegm with bitter-cold expectorants without success, then added qi-breaking herbs, worsening the condition. Liujunzi Tang modified with Xiong and Danggui was given, improving appetite. Buzhong Yiqi Tang with doubled Baizhu was used for a month, strengthening middle qi. Qiyi Yangrong Tang was then administered for two months, resolving swelling and restoring qi and blood. A wiry left guan pulse indicates wood excess overcoming spleen earth (robber pathogen). Using bitter-cold agents in deficiency worsens deficiency. Phlegm etiology varies, requiring different treatments. Excessive draining herbs weaken spleen qi, generating more phlegm. For middle qi deficiency, Ginseng and Atractylodes should be primary, supplemented by phlegm-resolving herbs.
A female patient with anger-induced neck swelling, amenorrhea, limb edema, and dysuria suffered from blood-pattern disorder. Jiaoren Wan was given for several doses, inducing menstruation and reducing swelling. Liujunzi Tang modified with Chaihu and Zhike resolved the neck swelling. Conversely, if edema precedes amenorrhea due to urinary difficulty, it is called water pattern, treated with Tingli Wan. *Funren Liangfang* states: If menstruation stops first, followed by edema and urinary obstruction, it is blood pattern; water transforms into blood, and blocked blood turns back to water, treated with Jiaoren Wan. If urinary difficulty precedes edema and amenorrhea, it is water pattern, treated with Tingli Wan.
A nineteen-year-old maiden had a hard, colorless neck lump, wasting muscles, and painful tendon spasms, caused by emotional injury and qi-blood damage. Nourishing qi and blood was advised, but she took wind-dispersing herbs instead, leading to death. Lu Dijing cited the classics: Mental worry damages flesh, sorrow damages limbs, grief damages tendons, joy damages skin, and rage damages waist/spine. Official He’s daughter, widowed young, suffered from clenched fingers, inability to lift arms, and widespread ulcers. After half a year of mixed treatments, Xue diagnosed it as emotional sorrow, not wind. Treating internal causes with Deer Antler Glue and muscat plaster allowed finger extension and gradual recovery.
A female patient with limb fatigue resembling flaccidity recovered with qi-blood nourishing and spleen-strengthening herbs.
A hot-tempered maiden had recurrent ear swelling, pain, chills, and fever, with a wiry-tight liver pulse. Xiao Chaihu Tang modified with Qingpi, Niupang, Jingjie, and Fangfeng resolved chills and fever. Xiao Chaihu Tang combined with Siwu Tang reduced swelling. Her father sought permanent cure. Xue explained: The Liver stores blood and nourishes tendons externally. Anger injures the Liver, causing tendon accumulation and swelling. Self-regulation is essential; otherwise, repeated Liver injury leads to blood deficiency and difficult-to-cure conditions. Ignoring advice, she developed three nodules and died after repeated caustic treatments.
A young wife had ear swelling, fatigue, fever, dry mouth, and scanty, delayed menstruation. An old woman mistook this for amenorrhea and used Leeches to promote flow, causing death from excessive depletion. Menstruation is governed by the Hand-Taiyang Small Intestine and Hand-Shaoyin Heart channels. These exterior-interior paired channels produce milk above and menstruation below. With strong spleen/stomach qi and no external/internal pathogens, Chong and Ren qi flourish, ensuring timely menstruation. Sallow complexion, emaciation, fever, dry mouth, and scanty/delayed menses indicate yin-blood deficiency, not excess heat. Nourishing qi and blood gently restores regular cycles.
A released palace maid over thirty suffered hip pain without swelling or color change, painful urination/defecation resembling strangury, worse during toilet visits. This was blood stasis penetrating tunnels due to sexual deprivation, a difficult case. She later died from non-healing ulcers and scrofula. Her husband, a merchant, was often away. Long-term frustration and unfulfilled desires caused this. The prevalence of flowing deposits and scrofula shows severe qi-blood damage from emotions, making attacking agents contraindicated. The *Jingxue Pian* states: Premature sexual activity damages the body, leading to future obscure diseases. Impotence with sexual desire causes internal decay and strangury. Depleting exhausted essence causes pain in urination/defecation. Women with established Tian Gui who lack male contact for over ten years develop irregular menstruation. Those desiring contact within ten years also become irregular. Irregularity causes old blood retention and new blood misdirection, potentially entering bones or causing swelling. Frequent intercourse drains essence and causes deficiency; multiple births deplete blood and cause death. Observing essence and blood clarifies much.
A seventeen-year-old maiden had chronic scrofula, amenorrhea, fever, cough, and poor appetite. An old woman suggested Ban Dou and Rou Gui to induce menstruation, claiming tidal fever and irregular menses were untreatable. Xue noted her pulse was not choppy and she lacked true tidal fever, suggesting treatment with qi-blood nourishment and fluid enrichment would naturally restore menstruation. Seduced by promises of quick results, she used the harsh herbs. Xue criticized this: Such agents strongly assist yang fire, causing wild bleeding and spleen/stomach deficiency. Induced menstruation continued excessively, worsening anorexia and fever, leading to death. The classics state: At seven, kidney qi flourishes; at fourteen, Tian Gui arrives, Ren vessel opens, Taichong vessel flourishes, and menstruation begins. Delayed menstruation implies pathology. Humans rely on qi and blood as roots; illness always injures yin-blood first. Women are particularly susceptible to emotional injuries. Kou Zongshi stated: Repeated thoughts and worries cause consumption. Men lose spirit/color first; women lose menstruation first. Worry injures the Heart, causing blood reversal and exhaustion, leading to scattered spirit and closed menstruation. Fire disease fails to nourish its offspring (Earth), causing anoremia. Spleen deficiency weakens Metal, causing cough. Water qi exhaustion dries limbs. Wood qi insufficiency causes irritability, brittle hair, and flaccid sinews. Once the Five Viscera are affected, death is inevitable, though not immediate. This is the hardest type of consumption. Disease originating in the viscera has no fixed end, and medicine cannot reach it. Only if the patient changes their mindset and uses supportive medicine can survival occur. Other cases should be treated according to pulse and symptoms.
A male patient had scrofula near the ear that nearly healed, but spread to the neck and clavicle the next year, and to the chest and axilla after three years. Liver pulse was wiry and rapid. Longhui Wan and Sanjian Wan were used. Near recovery, the liver pulse remained rapid. Four years later, abscesses appeared in the lower abdomen, scrotum, and inner thighs, failing to heal for over a year. Pulse remained similar. Qinggan Yangxue Tang and the previous pills cured him.
Xue Lizhai reported: A wealthy merchant had a large scarred area on his neck from scrofula, caused by anger, lasting two years despite various treatments. A Daoist gave a powder; one dose reduced it slightly, two doses significantly, and four doses cleared it. Seeking the formula, he learned it was Bixiao San. Another old woman treated it by applying a medium-grade pill inside the sore and covering it with plaster, causing the root to necrose. Reapplication and Shengji San accelerated healing. A Daoist treated it by steaming seven eggs, each containing one May chan, and having patients eat one daily on an empty stomach. Many sought this. Texts on scrofula and materia medica suggest these methods work only for those with sufficient qi and blood; they are likely ineffective for the deficient.
Xue Lizhai treated a scrofula patient with sallow face, fatigue, acid regurgitation, and belching, indicating middle qi deficiency. Buzhong Yiqi Tang plus Fuling and Banxia was proposed. She refused, taking heat-clearing and qi-draining herbs instead, leading to chest oppression, sore swelling, continuous belching, loose stools, and cold limbs. Xue diagnosed middle qi deficiency and cold. Liujunzi Tang plus Jiang and Rong, with small amounts of Shengma and Chaihu, gradually improved the condition, followed by Buzhong Tang for full recovery.
A female patient with scrofula and belching was treated with heat-clearing and stomach-cooling herbs, leading to poor appetite, acid regurgitation, and chest oppression. Qi-moving and digestion-promoting herbs caused shortness of breath and reduced intake. Heat-clearing and phlegm-resolving herbs led to dry stool, internal heat, and emaciation. Xue diagnosed: Acid regurgitation/belching indicates spleen/stomach qi deficiency; chest oppression/phlegm wheezing indicates spleen/lung qi deficiency; dry stool/internal heat/emaciation indicates spleen/lung blood deficiency. Buzhong Yiqi Tang plus roasted Wu Zhu Yu was given for several doses, supported by Liuwei Wan, resolving symptoms. Guipi Tang and Xiaoyao San were then alternated for recovery.
A male patient with hard, non-suppurating scrofula unresponsive to hard-resolving and toxin-expelling drugs was treated with moxibustion at Jianjian and Zhoujian acupoints and Qiyi Yangrong Tang, recovering in a month.
A female patient with chronic ulcerated scrofula, fever, and scanty/delayed menstruation was treated with Xiaoyao San combined with the previous decoction. After two months, qi and blood were restored, and the sore healed, except for one opening. Zhentousan and moxibustion at the previous points cured it. Chronic cases (2-3 years) usually require three sessions of moxibustion and interior-supporting herbs.
Mrs. Tian, over thirty, had unhealed ulcerated scrofula. Bazhen Tang plus Chaihu, Digupi, Xiakucao, Xiangfu, and Beimu was given for fifty doses, improving constitution. Two doses of Bixiao San closed the wound. Remaining qi-blood imbalance was treated with thirty doses of the previous prescription for full recovery. Later, Mr. Tian used this formula indiscriminately for others, unaware that the toxic May chan in the powder damages primal qi if overused. It may work for excess patterns followed by tonification, but using purgatives or caustics on deficiency removes necrotic tissue but prevents healing, making it difficult.
A scholar with post-scrofula emaciation and irregular fever had deficiency of qi and blood in the Three Yin foot channels. Bazhen Tang plus Maidong and Wuweizi for twenty doses, followed by Buzhong Yiqi Tang plus Maidong, Wuweizi, and Liuwei Wan, led to recovery.
Confucian Zhang Zirong, prone to anger, had chronic scrofula with bloody discharge and a wiry-large left guan pulse that vanished under pressure, indicating Liver fire disturbing blood and qi-blood deficiency. Buzhong Yiqi Tang tonified spleen/lung, and Liuwei Wan nourished kidney, leading to recovery.
Lu Ziwen had hard swelling below both ears. Liver-subduing and hard-softening agents worsened the condition. Left guan pulse was wiry-tight; left chi was large-rapid, indicating Kidney water deficiency and tendon spasm. Generating Lung metal to nourish Kidney water would allow Liver blood to relax tendons. He ignored this, continued previous meds, and died.
Yang Chengliu treated Yu with scrofula: over ten hard, stone-like nodules on both sides, swollen head/neck, inability to turn, hemoptysis, cough, and nocturnal emission for half a year. Previous treatments included yin-nourishing, fire-descending, essence-stabilizing, and Liver-subduing agents. Pulse was wiry-firm with agitation; left guan/chip were tight and fine as blades; tongue was blue-green, tender, fat, and slippery. This indicated Liver/Gallbladder dominance, with initial Liver/Gallbladder disease spreading to Heart/Spleen. Continuous phlegm/cough resulted from deficient Liver qi reversing upward, carrying phlegm. Nocturnal emissions resulted from Liver blood...