薛立斋治进士申天益，臂患痈，寒热头痛，形气虚弱，此手足阳明经风热邪之症，用桔梗升麻汤
二剂，外邪顿散。用托里消毒散二剂，肿痛顿退。乃用补中益气散汤调理，形气渐复而愈。
一妇人臂患肿，恶寒，不作脓，以十宣散六剂而溃，以托里散数剂而瘳。
一妇人臂肿未成脓，饮食少思，遇劳作痛，发热，以补中益气汤二剂，痛少止。补气血，健脾胃
药而消。
一妇人臂患毒，肿硬，咽喉壅塞，四肢逆冷，发寒热，以五香连翘汤二剂顿愈，以疮科流气散四
剂而消。
一男子臂患痈，脉弦紧有力，以白芷升麻汤二剂顿退，又二剂而消。
一男子臂患痈，不作脓，灸以豆豉饼及饮托里药，三十余剂而溃，又月余而瘳。
一妇人患臂痈，疮口紫陷，脓清不敛。彼以为毒未尽，欲服攻毒之剂。谓疮疡之症，肿起坚硬脓
稠者，实也；肿下软慢脓稀者，虚也。遂以附子饼灸之，及饮十全大补汤，百剂始愈。
西蜀彭黄门太安人，臂痛数年，服活络丹二十丸而瘥。
朱丹溪治从叔，平生多虑，质弱神劳，年近五十，忽左膊外侧 上，起一小红肿，大约如栗。曰∶
慎勿轻视，且先与人参大料作汤，二三斤为好。彼未之信，慢进小帖，数服未解而止。旬余值大风拔
木，疮上起一道红线，绕至背胛，直抵右胛肋。曰∶必大料人参，少加川芎、陈皮、白术等补剂与之。
后与此方，两阅月而安。
东垣曰∶尹老家素贫，己酉岁，十月初寒，形志皆苦，于手阳明大肠经分出痈，初有 疝，其臂
外皆肿痛，先肿在阳明，左右寸脉皆短，中得之俱弦，按之洪缓有力，此痈得自八风之变。以脉断之，
邪气在经脉之表。其症大小便如故，饮食如常，腹中和，口知味，知不在里也。不恶风寒，止热躁，
脉不浮，知不在表也。表里既和，邪气止在经脉之中。《内经》曰∶凝于经络为疮痈。其痈出身半以
上，风从上受之，故知是八风之变为疮者也。宜治其寒邪，调其经络中血气，使无凝而已。以白芷升
麻汤疗之，一服而愈。炙甘草、升麻、桔梗、白芷、当归梢、生地黄、生黄芩、酒黄芩、连翘、黄 、
肉桂、红花。上 咀，水酒各大盏半，同煎服愈。
薛治王挥使，臂肿一块，不痛不赤，惟脉软，懒食时呕，以六君子加藿香、酒芍，呕止食进。再
以八珍汤二十余剂，成脓刺之。又以十全大补而愈。次年伤寒后，此臂仍肿微痛，乃伤寒余毒也。无
表症，但虚弱，先用十宣散四剂，取参、 、芎、归扶助元气，防风、桔梗、白芷、浓朴行散肿结，
肉桂引经破血，肿退三四。
再以八珍汤，脓溃而愈。至冬，臂复作痛，因复祛风药，反筋挛痛甚，此血虚不能养筋，筋虚不能束
骨，遂以加味十全大补而愈。
一室女臂患肿，溃久不敛，寒热交作，五心烦热，饮食少思，月水不通，与逍遥散、八珍汤，经
行疮愈。一妇人月水不行，潮热咳嗽，肌体日瘦，胸膈不利，颈肿一块，日久不消，亦服前药，热退
肿消，经行而愈。
宋琰年逾三十，臂患痈，溃而不痛，脓稀，脉弱。丹溪云∶疽溃深而不痛者，胃气大虚，而不知
痛也。东垣云∶脓水清稀，疮口不合，气血俱虚也，当以大补药治。彼不听，服消毒药，气血虚甚，
遂不救。丹溪云∶才见肿痛，参之脉症虚弱，便与滋补，气血无亏，可保终吉。又云∶溃疡内外皆虚，
宜接补为主。
王时亨年逾四十，臂患毒， 痛作呕，服托里消毒药愈甚。以凉膈散二剂顿退，更以四物汤加芩、
连，四剂而消。
王文远臂患毒，作痛，服寒凉药，遂致食少，大便不实。以理中丸二服，更以六君子汤加砂仁、
藿香治之，再以托里药，脓溃而愈。大凡疮痛甚者，如禀浓有火，则宜苦寒之剂。若禀薄者，则宜补
中益气汤加芩、连之类，在下加黄柏。人肥而疮作痛者，用荆、防、羌、独之类，盖取其风能胜湿也。
方云起臂生一疽，脓溃百日方愈，中有恶肉突起，如蚕豆大，月余不消，医治不效。因阅本草，
得刘涓子鬼遗方，用乌梅肉烧存性，研敷。试之，一日夜去其大半，再上，一日而平。乃知世有奇方
如此，遂留心搜刻诸方，始基于此方也。（《本草纲目》）
薛立斋治疗进士申天益，手臂患痈疽，伴有寒热、头痛，形体与正气虚弱，这是手足阳明经感受风热邪气所致的病证。服用桔梗升麻汤两剂后，外邪顿时消散。接着服用托里消毒散两剂，肿痛顿时消退。随后用补中益气散（汤）进行调理，形体与正气逐渐恢复而痊愈。
一位妇女手臂患肿，恶寒，不能化脓，服用十宣散六剂后溃破，再服用托里散数剂后痊愈。
一位妇女手臂肿胀但未成脓，饮食减少且食欲不振，劳作时疼痛加剧并发热，服用补中益气汤两剂后，疼痛稍止。再用补气血、健脾胃的药物调理，肿块消散。
一位妇女手臂患毒疮，肿胀坚硬，咽喉壅塞，四肢逆冷，发寒热，服用五香连翘汤两剂后顿时痊愈，再服用疮科流气散四剂后肿块消散。
一位男子手臂患痈，脉象弦紧有力，服用白芷升麻汤两剂后症状顿时减退，又服两剂后肿块消散。
一位男子手臂患痈，不能化脓，用豆豉饼灸治并饮用托里药物，三十多剂后溃破，又过一个多月才痊愈。
一位妇女患臂痈，疮口颜色紫暗下陷，脓液清稀不收敛。她认为毒邪未尽，想要服用攻毒的药物。我指出疮疡病症中，肿胀高耸坚硬、脓液稠厚的是实证；肿胀低平软慢、脓液稀薄的是虚证。于是用附子饼灸治，并饮用十全大补汤，服用一百剂后才痊愈。
西蜀彭黄门太安人，手臂疼痛数年，服用活络丹二十丸后痊愈。
朱丹溪治疗其堂叔，此人平生多思虑，体质弱且神气劳损，年近五十，忽然左臂外侧上方起一个小红肿，大约像栗子大小。朱丹溪说：“千万不要轻视，先用人参大量煎汤，喝二三斤为好。”那人没有相信，缓慢地服用小帖药，服了几次未见效便停止了。十多天后遇到大风拔树，疮上出现一道红线，绕到背胛，直抵右肩肋部。朱丹溪说：“必须用大量人参，少加川芎、陈皮、白术等补益药给他。”后来给予此方，两个月后安定痊愈。
李东垣说：尹老家境一向贫穷，己酉年十月天气刚变冷，形体与精神都受苦，在手阳明大肠经分出的部位生痈，起初有疝气样感觉，手臂外部都肿痛，先肿在阳明经，左右寸脉皆短，关脉得之俱弦，重按洪缓有力，这个痈是由于八风之变引起的。通过脉象判断，邪气在经脉的表层。其症状大小便正常，饮食如常，腹部平和，口中知味，知道病不在里。不恶风寒，只有热躁，脉不浮，知道病不在表。既然表里调和，邪气只停留在经脉之中。《内经》说：“凝滞于经络就会形成疮痈。”这个痈生于身体上半部分，风邪从上受之，所以知道是八风之变导致的疮疡。适宜治疗其寒邪，调和经络中的血气，使其不再凝滞即可。用白芷升麻汤治疗，一服就痊愈了。药材包括炙甘草、升麻、桔梗、白芷、当归梢、生地黄、生黄芩、酒黄芩、连翘、黄芪、肉桂、红花。将药材切碎，用水和酒各一大盏半，同煎服用即愈。
薛立斋治疗王挥使，手臂肿起一块，不痛不红，只有脉象软弱，懒食且时常呕吐，用六君子汤加藿香、酒芍药，呕吐停止，食欲增进。再用八珍汤二十多剂，成脓后刺破排脓。又用十全大补汤治愈。次年伤寒后，这只手臂仍然微肿微痛，这是伤寒余毒所致。没有表证，只是虚弱，先用十宣散四剂，取人参、黄芪、川芎、当归扶助元气，防风、桔梗、白芷、浓朴行散肿结，肉桂引经破血，肿块消退三四成。
再用八珍汤，脓溃后痊愈。到了冬天，手臂再次作痛，因为又用了祛风药，反而导致筋挛剧痛，这是血虚不能养筋，筋虚不能束骨，于是用加味十全大补汤治愈。
一位未婚女子手臂患肿，溃烂很久不收敛，寒热交替发作，五心烦热，饮食减少且食欲不振，月经不通，给予逍遥散、八珍汤，月经来潮后疮疡痊愈。一位妇女月经不行，潮热咳嗽，肌体日渐消瘦，胸膈不利，颈部长一块肿物，日久不消，也服用前面的药物，热退肿消，月经来潮后痊愈。
宋琰年过三十，手臂患痈，溃烂而不痛，脓液稀薄，脉象微弱。朱丹溪说：“疽疮溃烂深而不痛的，是胃气大虚，以至于不知道痛。”李东垣说：“脓水清稀，疮口不合，是气血俱虚，应当用大补药治疗。”那人不听，服用消毒药，导致气血更虚，最终不治身亡。朱丹溪说：“刚见到肿痛，参合脉症发现虚弱，就给予滋补，气血无亏，可保终吉。”又说：“溃疡内外皆虚，宜以接续补益为主。”
王时亨年过四十，手臂患毒疮，疼痛并作呕，服用托里消毒药后病情加重。用凉膈散两剂后顿时减退，再用四物汤加黄芩、黄连，四剂后肿块消散。
王文远手臂患毒疮，作痛，服用寒凉药，导致进食少，大便不成形。用理中丸两服，再用六君子汤加砂仁、藿香治疗，最后用托里药，脓溃后痊愈。大凡疮痛剧烈的，如果禀赋浓厚且有火，则宜用苦寒药剂。如果禀赋薄弱者，则宜用补中益气汤加黄芩、黄连之类，在下肢加黄柏。人肥胖而疮作痛者，用荆芥、防风、羌活、独活之类，大概取其风能胜湿的道理。
方云起手臂生一疽，脓溃百日才愈，其中有恶肉突起，如蚕豆大小，月余不消，医治无效。因阅读本草，得到刘涓子鬼遗方，用乌梅肉烧存性，研末外敷。试用后，一天一夜去除了大半，再敷一次，一天就平了。才知道世上有如此奇方，于是留心搜刻诸方，开始基于此方。（《本草纲目》）
Xue Lizhai treated Shen Tianyi, a Jinshi degree holder, who suffered from an arm carbuncle accompanied by chills, fever, headache, and deficiency of both physical constitution and vital qi. This was a syndrome caused by wind-heat pathogenic factors affecting the Hand and Foot Yangming meridians. After taking Jiegeng Shengma Decoction (Platycodon and Cimicifuga Decoction) for two doses, the external pathogens were instantly dispersed. Subsequently, taking Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder) for two doses caused the swelling and pain to instantly recede. He then used Buzhong Yiqi San (Tang) [Tonifying the Middle and Augmenting Qi Powder/Decoction] for regulation, gradually restoring his physical constitution and vital qi until he recovered.
A woman suffered from arm swelling with aversion to cold and failure to suppurate. She took Shixuan San (Ten Acupoints Powder) for six doses until it ulcerated, and then took Tuoli San (Supporting Interior Powder) for several doses until she healed.
Another woman had arm swelling without suppuration, reduced appetite, exacerbated pain upon exertion, and fever. She took Buzhong Yiqi Tang (Tonifying the Middle and Augmenting Qi Decoction) for two doses, which slightly relieved the pain. Her condition resolved after treatment with herbs that tonified qi and blood and strengthened the spleen and stomach.
A woman suffered from a toxic arm lesion with hard swelling, pharyngeal congestion, cold limbs, chills, and fever. She took Wuxiang Liaoqiao Tang (Five Fragrant and Forsythia Decoction) for two doses and recovered instantly, then took Chuangke Liuqi San (Wound Specialist’s Regulating Qi Powder) for four doses until the swelling disappeared.
A man suffered from an arm carbuncle with a wiry, tight, and forceful pulse. His symptoms instantly receded after taking Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) for two doses, and the swelling disappeared after another two doses.
A man suffered from an arm carbuncle that failed to suppurate. He underwent moxibustion with Fermented Soybean Cake (Douchi Bing) and drank interior-supporting medicines. After more than thirty doses, it ulcerated, and he fully recovered after another month.
A woman suffered from an arm carbuncle with a purplish, sunken wound surface and thin pus that failed to heal. Believing the toxin was not yet exhausted, she wished to take detoxifying agents. I pointed out that in sores and ulcers, high, hard swelling with thick pus indicates excess; low, soft, slow swelling with thin pus indicates deficiency. Therefore, I applied moxibustion using Aconite Cake (Fuzi Bing) and administered Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). It took one hundred doses for her to recover.
Lady Tai’an of Peng Huangmen in Western Shu suffered from arm pain for several years and recovered after taking Huoluo Dan (Meridian-Activating Pills), twenty pills at a time.
Zhu Danxi treated his paternal uncle, a man prone to excessive worry, with weak constitution and fatigued spirit, nearing fifty years of age. Suddenly, a small red swelling appeared on the upper outer side of his left arm, about the size of a chestnut. Zhu said, "Do not underestimate this. First, prepare a large dose of Ginseng decoction; drinking two or three jin is ideal." The patient did not believe him and slowly took small doses of minor prescriptions. After several doses without relief, he stopped. More than ten days later, during a storm that uprooted trees, a red line appeared on the sore, winding to the shoulder blade and reaching the right costal region. Zhu said, "You must use a large dose of Ginseng, with a small addition of Ligusticum Chuanxiong Rhizome (Chuanxiong), Tangerine Peel (Chenpi), and Atractylodes Macrocephala Rhizome (Baizhu) as tonifying agents." After receiving this prescription, he stabilized within two months.
Li Dongyuan stated: Old Man Yin was always poor. In the tenth lunar month of the Jiyou year, when the weather turned cold, both his body and mind suffered hardship. A carbuncle developed on the branch of the Hand Yangming Large Intestine Meridian. Initially, there was a sensation similar to hernia, and the entire outer arm was swollen and painful. The swelling first appeared in the Yangming meridian. The cun pulses on both left and right were short; the guan pulses were wiry, and deep pressure revealed them to be surging, slow, and forceful. This carbuncle resulted from changes due to the Eight Winds. Based on the pulse diagnosis, the pathogenic factor was on the exterior of the meridians. His urination and defecation were normal, diet was unchanged, abdomen was peaceful, and taste perception was intact, indicating the disease was not in the interior. He had no aversion to wind or cold, only heat and restlessness, and the pulse was not floating, indicating the disease was not on the superficial exterior. Since the interior and exterior were harmonious, the pathogen remained only within the meridians. The *Neijing* states: "Coagulation in the meridians leads to sores and carbuncles." Since this carbuncle arose in the upper half of the body, wind pathogen entered from above, confirming it was a sore caused by Eight Wind changes. It was appropriate to treat the cold pathogen and regulate the qi and blood in the meridians to prevent coagulation. He was treated with Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) and recovered after one dose. The ingredients included Prepared Licorice Root (Zhigancao), Cimicifuga Rhizome (Shengma), Platycodon Root (Jiegeng), Angelica Dahurica Root (Baizhi), Angelica Sinensis Root Tip (Danggui Shao), Raw Rehmannia Root (Shengdihuang), Raw Scutellaria Root (Sheng Huangqin), Wine-processed Scutellaria Root (Jiu Huangqin), Forsythia Fruit (Lianqiao), Astragalus Membranaceus Root (Huangqi), Cinnamon Twig (Rougui), and Safflower (Honghua). These were chopped, decocted together with water and wine (one large cup and a half each), and taken orally to cure the condition.
Xue Lizhai treated Commander Wang, who had a single swollen area on his arm that was neither painful nor red, but had a soft pulse, reluctance to eat, and occasional vomiting. He was given Liujunzi Tang (Six Gentlemen Decoction) added with Agastache Rugosus Herb (Huoxiang) and Wine-processed White Peony Root (Jiu Shaoyao). The vomiting ceased, and appetite improved. He then took Bazhen Tang (Eight Treasures Decoction) for over twenty doses until suppuration occurred, which was then lanced. He recovered after taking Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). The following year, after contracting Shanghan (Cold Damage), this arm swelled again with slight pain, which was residual toxin from the Shanghan. There were no exterior symptoms, only weakness. He first took Shixuan San (Ten Acupoints Powder) for four doses, utilizing Ginseng, Astragalus, Ligusticum Chuanxiong Rhizome (Chuanxiong), and Angelica Sinensis Root (Danggui) to support primal qi;防风 (Fangfeng), Platycodon Root (Jiegeng), Angelica Dahurica Root (Baizhi), and Magnolia Officinalis Bark (N Houpo) to disperse swelling and nodules; and Cinnamon Twig (Rougui) to guide the medicine and break blood stasis. The swelling receded by three or four parts.
He then took Bazhen Tang (Eight Treasures Decoction), leading to ulceration and recovery. In winter, the arm pain recurred. Because wind-dispelling herbs were used again, it led to severe tendon spasms and pain. This was due to blood deficiency failing to nourish the tendons, and tendon deficiency failing to secure the bones. He was cured using Jiawei Shiquan Dabu Tang (Modified Comprehensive Great Tonifying Decoction).
An unmarried girl suffered from arm swelling that ulcerated and failed to heal for a long time, alternating chills and fever, five-palm heat, reduced appetite, and amenorrhea. She was given Xiaoyao San (Free and Easy Wanderer Powder) and Bazhen Tang (Eight Treasures Decoction). Her menstruation resumed, and the sore healed. Another woman with amenorrhea, tidal fever, cough, emaciation, chest and diaphragm discomfort, and a long-standing neck swelling also took the aforementioned medicines. Her fever subsided, swelling disappeared, menstruation resumed, and she recovered.
Song Yan, over thirty years old, suffered from an arm carbuncle that ulcerated without pain, with thin pus and a weak pulse. Danxi said: "When a joo (deep abscess) ulcerates deeply without pain, it indicates severe deficiency of Stomach Qi, resulting in insensitivity to pain." Dongyuan said: "Thin, clear pus and non-healing wounds indicate deficiency of both qi and blood; they should be treated with major tonifying medicines." The patient did not listen, took detoxifying medicines instead, became severely deficient in qi and blood, and ultimately died. Danxi said: "When swelling and pain are first observed, if the pulse and symptoms indicate weakness, immediately provide tonification. If qi and blood are not depleted, auspicious outcomes can be ensured throughout." He also said: "Ulcers involve deficiency inside and outside; the primary approach should be continuous tonification."
Wang Shiheng, over forty years old, suffered from a toxic arm lesion with pain and vomiting. Taking Tuoli Xiaodu Yao (Interior-Supporting and Detoxifying Medicines) worsened his condition. He took Liangge San (Cooling the Diaphragm Powder) for two doses, which instantly reduced the symptoms, followed by Siwu Tang (Four Substances Decoction) added with Scutellaria Root (Huangqin) and Coptis Rhizome (Lian), which resolved the swelling in four doses.
Wang Wenyuan suffered from a toxic arm lesion with pain. Taking cold-natured medicines led to poor appetite and loose stools. He took Lizhong Wan (Regulate the Middle Pill) twice, then Liu Junzi Tang (Six Gentlemen Decoction) added with Amomum Villosum Fruit (Sharen) and Agastache Rugosus Herb (Huoxiang) for treatment, followed by interior-supporting medicines, leading to ulceration and recovery. Generally, for severe sore pain, if the constitution is robust with fire, bitter-cold agents are suitable. If the constitution is thin/weak, Buzhong Yiyi Tang (Tonifying the Middle and Augmenting Qi Decoction) added with Scutellaria Root (Huangqin) and Coptis Rhizome (Lian) is appropriate; add Phellodendron Bark (Huangbai) for lesions below the waist. For obese individuals with painful sores, Schizonepeta Spike (Jingjie), Saposhnikovia Root (Fangfeng), Notopterygium Rhizome (Qianghuo), and Lepidobotys Stems (Duhuo) are used, exploiting the principle that wind can overcome dampness.
Fang Yunqi had a carbuncle on his arm that took one hundred days to heal after ulceration. Within it, malignant flesh protruded, the size of a broad bean, remaining for over a month despite medical treatment. While reading herbal texts, he found the *Liu Juanzi Guiyi Fang* (Liu Juanzi's Ghost Relic Formula), which used Vine Fruit (Wumei) roasted to retain its nature, ground and applied externally. Upon testing, more than half disappeared within a day and night. After reapplication, it flattened in one day. He realized such miraculous formulas existed in the world and thus began carefully collecting and printing various formulas, starting with this one. (*Bencao Gangmu*)