痈疽有死肉不去者。用白丁香、霜梅，深则 之，浅则干掺于膏药上，甚妙。
〔海〕 又方 膏药内入雄黄、巴豆少许，不伤好肉，止去恶肉，不惟恶疮凡痈毒有恶
肉者，俱可去。
又方雄黄散 以雄黄一钱另研，巴豆不去皮，研如泥。入乳香、没药少许，再研细。
少上，恶肉自去。
乌金膏 治发背中央肉死，涂之即腐；未死涂之即生。若初起肿痛，用点数处，其毒
顿消。若肉腐涂之即溃。若恶疮顽疮，元气无亏，久不收敛者，内有毒根，以纸捻蘸
其内。有等发背，因元气虚弱，或因克伐元气，胃气亏损，毒瓦斯散漫，中黯外赤，不腐
不溃，服大补之剂中涂三四寸许，至五六日间，赤黯之界，自有裂纹如刀割之状，中央
渐黑渐脱，须用纯阳之药，以接其元气，庶能收敛。若妄用刀针，去肉出血，阳随阴散，
元气愈伤，或涂凉药，则毒瓦斯不解，气血愈虚，非从无益而又害之。
用巴豆一味，去壳炒黑研如膏。点于患处，临用合之。
追毒丹 治疮疽黑陷者。用针刀开疮，内此丹使之溃，然后去败肉排脓，随证治之，痈
疽、疔疮、附骨疽，并皆治之。
巴豆（七粒，去皮心，不去油，研如泥） 白丁 香轻粉（各一钱） 雄黄 黄丹（各二钱）
上件研和。加白面三钱，滴水为丸，如麦大。针破疮内之，覆以乳香膏，追出脓血
毒物，漏疮四壁死肌不去不可治，亦以此追毒去死肌，乃养肉令愈，疾小者，用一粒；大
者加粒数用之。
追毒乌金散 治疮口恶肉毒，溃脓血。
巴豆（五钱） 寒食面（一两） 好细墨（一锭）
上为细末。用水和面作饼子，将巴豆包定，休教透气，文武火烧成深黑色，为细末，
量疮贴之。用胆汁就和成锭子，新水磨用，扫五七次妙。
梧桐泪方
痈疽势肿恶，不溃坚硬。以快利刀将患处割成十字路。用面、水调稠浓周遭疮口外
高起五分许，如塘池样。将泪填半满，用好米醋滴泪上，须臾自沸，勿令滚出面外。次
日用金银花煎汤洗净，再如前用一次。只用醋洗不痛，烂肉自去。
〔薛〕 按∶此方果恶疮恶肉，不腐宜用之。亦有阳气虚不能腐化者，宜用大补之剂。
治恶疮有死肉者及追脓（《保命》）
白丁香 轻粉 粉霜 雄黄 麝香（各一钱） 巴豆霜（三个）
上为细末，新饭和作锭子，用之。
神异膏 治痈疽坏烂及诸疮发毒。
雄黄（五钱） 滑石（倍用）
上为末。洗后掺疮上，外用绵子覆盖相护。凡洗后破烂者，用此贴之。
止痛拔毒膏 治一切疮发，臭烂不可近。未破则贴破，已破则生肉，杖疮、疔疮皆用
之。
斑蝥（四十九枚） 柳枝（四十九条） 木鳖子（七个） 乳香（三钱） 没药（三钱） 麝香（少许）
松脂（三
钱）
上用真清油十四两，煎黑柳条焦枯，滤去渣。入黄丹五两，滴入水中成珠为度，却
入诸药，搅令匀，入瓷器中，收了后用。
郭氏青金锭子
铜绿（三钱） 青矾 胆矾 轻粉 砒霜 白丁香 苦葶苈（各一钱） 脑子（少许） 麝香
上将葶苈研细，次下各药同研极细，打稠糊为锭子。或炼蜜加白芨末一钱为锭，如
麻黄粗细，约二三寸长。看疮口深浅 入，疼者可治，不疼难治。
第一般，紧峻碧云锭子，砒霜生，开疮口用。
第二般，紧缓碧霞锭子，砒霜 ，去死肉用。
第三般，缓慢碧玉锭子，去砒霜加枯矾，生好肉用。
翠霞锭子 治年深冷漏，日久恶疮，有歹肉用之。
铜绿 寒水石（ ） 滑石（各三钱） 明矾 腻粉 砒霜 云母石（研如粉，各一钱二分半）
上研细末。糊为锭子，如麻黄粗细，长短不拘，量疮口深浅 之。如修合，候天色
晴明则可。
信效锭子 治一切恶疮。
红娘子 黄丹 砒霜 鹰屎 土硝 白芨 铜绿（各一钱半） 脑子 麝香（各少许）
上研细末。些儿乳汁和为锭子用。中病即止。
红玉锭子 去歹肉生肌。
干胭脂 白矾（枯，各三钱） 轻粉 砒霜 黄丹 脑子 麝香（各少许）
上研极细末。稠糊和为锭子用之。
时效针头散 追蚀恶疮、歹肉，兼治瘰 。
赤石脂（半两） 乳香 白丁香（各二钱） 砒霜（生） 黄丹（各一钱） 轻粉 麝香（各半钱） 蜈蚣
（一条，焙干）
上为极细末，掺于疮口，歹肉自去矣。若动刀针，其疮虽可，有瘢。
追毒饼 治诸般恶疮，因针开了口，后又闭合生脓，胀痛不可忍。用此捻成小麦子
大，入放疮中，永不闭，脓水自出，疮自干好。
极好信石（半钱） 雄黄 雌黄 大朱砂（各一钱） 轻粉（少许）
上研为细末。糯米糊丸，如麦子大。若疮口闭合生脓，将药入内，仍以膏药贴之。
内服内追毒丹（方见前）。
〔薛〕 按∶此以毒攻毒之意也。尝治一县尹背疮，竟背腐溃色黯，重若负石，甚危。
喜饮食颇进，用桃红散色渐赤，负渐轻，再用而肌生，更服托里药而愈。盖此亦大毒证，
非此峻药莫能治，此亦用砒，故攻毒有效。然有气血虚不能腐溃。宜补养气血。常治发背
初起，未成脓，先用乌金膏或援生膏，点患处，数点以杀其大势，更服仙方活命饮。如
饮食少思或不甘美，用六君子汤加藿香，连进三五剂。如外皮腐动，用雄黄解毒散洗之。
每日用乌金膏涂腐处，候有疮口，即用纸作捻。蘸乌金膏 入疮内。若有脓，为筋膜间
隔不出，致作胀痛，用针引之，腐肉堵塞者去之。若瘀肉腐动，用猪蹄汤洗。如脓稠
痛，饮食如常，瘀肉自腐，用消毒药与托里相兼服之，仍用乌金膏涂搽。若瘀肉已离好
肉，即去之。如脓不稠不稀，仍作痛，饮食不甘，瘀肉腐迟，用桑枝灸患处，更用托里
药主治之。瘀肉不腐，或脓清稀不 痛者，服大补之剂，仍用桑枝灸之，以补接阳气，解
散郁毒，其肉自腐。
痈疽（一种严重的化脓性感染）如果有坏死组织不去除，可以使用白丁香、霜梅。如果创面深，则将其填入；如果创面浅，则干燥地撒在膏药上，效果非常好。
〔薛己〕 又一方：在膏药中加入少许雄黄、巴豆，不损伤健康肌肉，只去除腐败恶肉，不仅恶疮，凡是痈毒有恶肉的，都可以去除。
又一方：雄黄散。取雄黄一钱单独研磨，巴豆不去皮，研磨成泥状。加入少许乳香、没药，再次研磨细。少量撒在上面，恶肉自然脱落。
乌金膏：治疗发背（背部痈疽）中央肌肉坏死，涂抹后即刻腐烂；未坏死的涂抹后即刻生长。如果在初起肿痛时，用此药点涂几处，毒气立刻消散。如果肌肉已腐烂，涂抹后即刻溃破。如果是恶疮、顽疮，元气没有亏损，长期不能收敛的，内部有毒根，用纸捻蘸取药液插入其中。有一些发背，因为元气虚弱，或者因为过度攻伐损伤元气，导致胃气亏损，毒瓦斯散漫，中间颜色暗红外部赤红，既不腐烂也不溃破，服用大补剂后，在患处中央涂抹三四寸左右，到五至六天之间，赤色与暗色的交界处，自然出现像刀割一样的裂纹，中央逐渐变黑并脱落，必须使用纯阳性质的药物，来接续其元气，这样才能收敛。如果妄自使用刀针，去肉出血，阳气随阴血散失，元气更加受伤；或者涂抹凉性药物，则毒瓦斯不解，气血更加虚弱，这是从无益处反而有害。
用巴豆一味，去壳炒黑研磨如膏状。点涂于患处，临用时调和。
追毒丹：治疗疮疽黑陷者。用针刀切开疮口，放入此丹使其溃破，然后去除败肉排脓，根据证候进行治疗，痈疽、疔疮、附骨疽，都适用。
巴豆（七粒，去皮心，不去油，研磨如泥） 白丁香、轻粉（各一钱） 雄黄、黄丹（各二钱）
以上药材研和均匀。加白面三钱，滴水制成丸药，如麦粒大小。针刺破疮口后放入，覆盖乳香膏，追出脓血毒物。漏疮四壁的坏死肌肉如果不去除，无法治愈，也用此药追毒去死肌，从而滋养肌肉令其痊愈。病小的，用一粒；病大的增加粒数使用。
追毒乌金散：治疗疮口恶肉毒，溃破流脓血。
巴豆（五钱） 寒食面（一两） 好细墨（一锭）
以上研为细末。用水和面做成饼子，将巴豆包定，不要透气，用文武火烧成深黑色，研为细末，根据疮口情况贴敷。用胆汁调和做成锭子，新水磨开使用，扫涂五七次很好。
梧桐泪方
痈疽势头肿胀恶劣，不溃破且坚硬。用锋利的刀将患处割成十字路。用面粉和水调成稠浓状，在疮口周围高起约五分许，像池塘样。将梧桐泪填半满，用好米醋滴在梧桐泪上，一会儿自然沸腾，不要让液体滚出到外面。第二天用金银花煎汤洗净，再像前面那样用一次。只用醋洗不痛，烂肉自然去除。
〔薛己〕 按语：这个方子确实适用于恶疮恶肉，不腐烂的情况应该使用。也有阳气虚弱不能腐化的，应该使用大补之剂。
治疗恶疮有死肉者及追脓（出自《保命》）
白丁香、轻粉、粉霜、雄黄、麝香（各一钱） 巴豆霜（三个）
以上研为细末，用新米饭和成锭子使用。
神异膏：治疗痈疽坏烂及诸疮发毒。
雄黄（五钱） 滑石（用量加倍）
以上研为末。清洗后撒在疮上，外用绵子覆盖保护。凡是清洗后破烂的，用此贴敷。
止痛拔毒膏：治疗一切疮发，臭烂不可靠近。未破则贴敷使破，已破则生肉，杖疮、疔疮都适用。
斑蝥（四十九枚） 柳枝（四十九条） 木鳖子（七个） 乳香（三钱） 没药（三钱） 麝香（少许） 松脂（三钱）
以上用真清油十四两，煎煮黑柳条至焦枯，滤去渣滓。加入黄丹五两，滴入水中成珠为度，然后加入诸药，搅匀，装入瓷器中收藏备用。
郭氏青金锭子
铜绿（三钱） 青矾、胆矾、轻粉、砒霜、白丁香、苦葶苈（各一钱） 脑子（少许） 麝香
先将葶苈研细，其次下各药同研极细，打稠糊为锭子。或者炼蜜加白芨末一钱为锭，如麻黄粗细，约二三寸长。看疮口深浅插入，疼的可以治，不疼的难治。
第一般，紧峻碧云锭子，砒霜生用，开疮口用。
第二般，紧缓碧霞锭子，砒霜制过，去死肉用。
第三般，缓慢碧玉锭子，去砒霜加枯矾，生好肉用。
翠霞锭子：治疗年深冷漏，日久恶疮，有歹肉用之。
铜绿、寒水石（制过）、滑石（各三钱） 明矾、腻粉、砒霜、云母石（研如粉，各一钱二分半）
以上研细末。糊为锭子，如麻黄粗细，长短不拘，根据疮口深浅插入。如果修合，候天气晴明则可。
信效锭子：治疗一切恶疮。
红娘子、黄丹、砒霜、鹰屎、土硝、白芨、铜绿（各一钱半） 脑子、麝香（各少许）
以上研细末。少许乳汁和为锭子使用。中病即止。
红玉锭子：去歹肉生肌。
干胭脂、白矾（枯，各三钱） 轻粉、砒霜、黄丹、脑子、麝香（各少许）
以上研极细末。稠糊和为锭子使用。
时效针头散：追蚀恶疮、歹肉，兼治瘰疬。
赤石脂（半两） 乳香、白丁香（各二钱） 砒霜（生）、黄丹（各一钱） 轻粉、麝香（各半钱） 蜈蚣（一条，焙干）
以上为极细末，掺于疮口，歹肉自然去除。如果动刀针，疮虽可愈，会有瘢痕。
追毒饼：治疗诸般恶疮，因针开了口，后又闭合生脓，胀痛不可忍。用此捻成小麦子大，放入疮中，永不闭合，脓水自出，疮自干好。
极好信石（半钱） 雄黄、雌黄、大朱砂（各一钱） 轻粉（少许）
以上研为细末。糯米糊丸，如麦子大。若疮口闭合生脓，将药入内，仍以膏药贴之。
内服内追毒丹（方见前）。
〔薛己〕 按语：这是以毒攻毒的意思。曾治疗一位县尹背疮，竟然背部腐溃色黯，重若负石，非常危险。幸好饮食颇进，用桃红散后颜色渐赤，负重感渐轻，再用后肌肉生长，更服托里药而愈。这亦是大毒证，非此峻药莫能治，这也用了砒，所以攻毒有效。然而有气血虚不能腐溃的，宜补养气血。常治发背初起，未成脓，先用乌金膏或援生膏，点患处，数点以杀其大势，更服仙方活命饮。如饮食少思或不甘美，用六君子汤加藿香，连进三五剂。如外皮腐动，用雄黄解毒散洗之。每日用乌金膏涂腐处，候有疮口，即用纸作捻，蘸乌金膏插入疮内。若有脓，为筋膜间隔不出，致作胀痛，用针引之，腐肉堵塞者去之。若瘀肉腐动，用猪蹄汤洗。如脓稠痛，饮食如常，瘀肉自腐，用消毒药与托里相兼服之，仍用乌金膏涂搽。若瘀肉已离好肉，即去之。如脓不稠不稀，仍作痛，饮食不甘，瘀肉腐迟，用桑枝灸患处，更用托里药主治之。瘀肉不腐，或脓清稀不痛者，服大补之剂，仍用桑枝灸之，以补接阳气，解散郁毒，其肉自腐。
If there is necrotic tissue in carbuncles and sores (severe purulent infections) that needs to be removed, use Baidingxiang (Guano of White Pigeon) and Shuangmei (Frost Plum). If the wound is deep, pack it in; if shallow, sprinkle it dry onto a plaster. This is very effective.
[Xue Ji] Another prescription: Add a small amount of Xionghuang (Realgar) and Badou (Croton Seed) to the plaster. It does not damage healthy flesh but only removes foul necrotic tissue. Not only for foul ulcers, but for any carbuncle or toxin with foul tissue, this can remove it.
Another prescription: Xionghuang San (Realgar Powder). Take one qian of Realgar and grind separately. Do not peel Croton Seed, grind into a paste. Add a small amount of Ruxiang (Frankincense) and Moyao (Myrrh), grind finely again. Sprinkle a little on top, and the foul tissue will naturally fall off.
Wujin Gao (Black Gold Ointment): Treats central necrosis in back carbuncles. Applied, it causes immediate putrefaction of dead tissue; applied to living tissue, it promotes immediate growth. If used at the initial stage of swelling and pain, applying it to a few points will instantly dissipate the toxicity. If the flesh has already rotted, application leads to immediate ulceration. For foul or stubborn ulcers where the vital energy (Yuan Qi) is not depleted but healing is prolonged due to internal toxic roots, dip paper twists in the medication and insert them into the wound. Some back carbuncles occur due to depletion of vital energy, or excessive purging damaging the stomach qi, causing toxic vapors to scatter. The center appears dark red while the periphery is bright red, neither rotting nor ulcerating. After taking major tonifying formulas, apply the ointment centrally over an area of three to four cun. Within five to six days, cracks resembling knife cuts will naturally appear at the boundary between the red and dark areas. The center will gradually turn black and detach. Pure yang medications must be used to reconnect the vital energy, allowing for convergence. If knives or needles are recklessly used to remove flesh and cause bleeding, yang energy scatters with yin blood, further injuring vital energy. Or if cooling medications are applied, toxic vapors are not resolved, and qi and blood become more deficient. This is useless and harmful.
Use only Croton Seed, remove the shell, stir-fry until black, and grind into a paste. Dab onto the affected area, mixing when ready for use.
Zuidu Dan (Toxin-Chasing Pill): Treats carbuncles and sores that have turned black and sunken. Use a needle or knife to open the sore, insert this pill to induce ulceration, then remove necrotic tissue and drain pus. Treat according to the syndrome. It treats carbuncles, sores, ding sores (hard boils), and deep bone abscesses.
Ingredients: Croton Seed (7 seeds, remove skin and heart, do not remove oil, grind to paste); Baidingxiang (Guano of White Pigeon) and Qingfen (Calomel) (each 1 qian); Xionghuang (Realgar) and Huangdan (Lead Oxide) (each 2 qian).
Grind these ingredients together evenly. Add 3 qian of white flour, mix with water drops to form pills the size of wheat grains. Pierce the sore and insert the pill, cover with Frankincense Plaster to chase out pus, blood, and toxic matter. If necrotic muscle on the walls of a fistula is not removed, it cannot be cured. This formula also chases toxins and removes dead muscle to nourish new tissue. For small lesions, use one pill; for larger ones, increase the number of pills.
Zuidu Wujin San (Toxin-Chasing Black Gold Powder): Treats foul tissue and toxins in sore openings, discharging pus and blood.
Ingredients: Badou (Croton Seed) (5 qian); Hanshi Mian (Cold Food Flour) (1 liang); Hao Xi Mo (Fine Ink Stick) (1 stick).
Grind into fine powder. Mix with water and flour to make cakes, wrap the Croton Seed tightly inside without letting air escape. Fire-roast over mild to strong heat until deep black, then grind to fine powder. Apply to the sore as needed. Mix with gallbladder bile to form pellets. Grind with fresh water for use. Scanning/applying 5-7 times is excellent.
Wutong Lei Fang (Tallow Tree Resin Formula)
For carbuncles with severe swelling, foul nature, induration, and lack of ulceration. Use a sharp knife to cut the affected area into a cross shape. Mix flour and water to a thick consistency, building up the perimeter of the sore opening by about 0.5 fen high, like a pond. Fill half full with Tallow Tree Resin. Drop good rice vinegar onto the resin; it will boil shortly. Do not let it boil over. The next day, wash clean with decoction of Jinyinhua (Honeysuckle Flower), and repeat the application. Washing only with vinegar causes no pain, and rotten flesh falls off naturally.
[Xue Ji] Commentary: This formula is indeed suitable for foul ulcers and necrotic tissue that does not slough. However, cases where yang qi is deficient and cannot promote putrefaction should be treated with major tonifying formulas.
Treating foul ulcers with necrotic tissue and chasing pus (from *Baoming*)
Ingredients: Baidingxiang (Guano of White Pigeon), Qingfen (Calomel), Fenshuang (White Lead Powder), Xionghuang (Realgar), Shexiang (Musk) (each 1 qian); Badoushuang (Croton Seed Frost/Paste) (3 units).
Grind into fine powder, mix with fresh rice dough to form pellets for use.
Shenyi Gao (Miraculous Ointment): Treats carbuncles and sores with decay and various toxic eruptions.
Ingredients: Xionghuang (Realgar) (5 qian); Huashi (Talcum) (double the amount).
Grind to powder. After washing, sprinkle on the sore, and cover externally with cotton for protection. Use this plaster for any washed, broken sores.
Zhitong Badu Gao (Pain-Relieving Toxin-Pulling Ointment): Treats all types of eruptive sores that are foul-smelling and unbearable to approach. If unbroken, apply to induce rupture; if broken, promotes flesh regeneration. Used for beating injuries and ding sores.
Ingredients: Banmao (Mylabris Beetle) (49 pieces); Liuzhi (Willow Branch) (49 strips); Mugua Zi (Momordica Seed) (7 pieces); Ruxiang (Frankincense) (3 qian); Moyao (Myrrh) (3 qian); Shexiang (Musk) (a little); Songzhi (Pine Rosin) (3 qian).
Boil the black willow branches in 14 liang of pure clear sesame oil until charred and dry. Filter out the dregs. Add 5 liang of Huangdan (Lead Oxide), testing by dropping into water until pearls form. Then add the other medicines, stir well, and store in porcelain jars for later use.
Guoshi Qingjin Dingzi (Gu Family Green Gold Pellets)
Ingredients: Tonglv (Malachite) (3 qian); Qingfan (Green Vitriol), Danfan (Blue Vitriol), Qingfen (Calomel), Pishuang (Arsenic Trioxide), Baidingxiang (Guano of White Pigeon), Kutingli (Seed of Lepidium) (each 1 qian); Naizi (Borneol) (a little); Shexiang (Musk).
First grind Tulingli finely, then add all other medicines and grind extremely fine. Make into pellets with thick paste. Alternatively, refine honey with 1 qian of Baiji (Bulbus Belamcandae) powder to form pellets, similar in thickness to Mahuang (Ephedra), about 2-3 cun long. Insert according to the depth of the sore opening. If painful, it is treatable; if painless, difficult to treat.
Type 1: Jinjun Biyun Dingzi (Tight Jade Cloud Pellet), raw Pishuang (Arsenic Trioxide), used to open the sore.
Type 2: Jinwan Bixia Dingzi (Loose Jade Glow Pellet), processed Pishuang, used to remove dead flesh.
Type 3: Manwan Biyu Dingzi (Slow Jade Jade Pellet), remove Pishuang, add Kufan (Burnt Alum), used to generate healthy flesh.
Cuixia Dingzi (Emerald Glow Pellet): Treats chronic cold fistulas and long-standing foul ulcers with bad flesh.
Ingredients: Tonglv (Malachite), Hanshuishi (Calcined Halloysite) (processed, each 3 qian); Huashi (Talcum) (3 qian); Mingfan (Alum), Nifen (Calomel), Pishuang (Arsenic Trioxide), Yunmushi (Mica) (ground to powder, each 1.25 qian).
Grind into fine powder. Make into pellets with paste, thickness of Mahuang, length unrestricted. Insert according to sore depth. Preparation should be done on clear, sunny days.
Xinxiao Dingzi (Faithful Effect Pellet): Treats all foul ulcers.
Ingredients: Hongniangzi (Red Lady Beetle), Huangdan (Lead Oxide), Pishuang (Arsenic Trioxide), Yingshi (Eagle Droppings), Tuxiao (Saltpeter), Baiji (Bulbus Belamcandae), Tonglv (Malachite) (each 1.5 qian); Naoren (Borneol), Shexiang (Musk) (each a little).
Grind into fine powder. Mix with a little milk to form pellets. Stop when the disease is cured.
Hongyu Dingzi (Red Jade Pellet): Removes bad flesh and generates muscle.
Ingredients: Gan Yanzhi (Dry Rouge), Baifan (Alum) (calcined, each 3 qian); Qingfen (Calomel), Pishuang (Arsenic Trioxide), Huangdan (Lead Oxide), Naoren (Borneol), Shexiang (Musk) (each a little).
Grind to extremely fine powder. Mix with thick paste to form pellets.
Shixiao Zhentou San (Timely Needle-Head Powder): Erodes foul ulcers and bad flesh, also treats scrofula.
Ingredients: Chishizhi (Red Kaolin) (0.5 liang); Ruxiang (Frankincense), Baidingxiang (Guano of White Pigeon) (each 2 qian); Pishuang (Arsenic Trioxide, raw), Huangdan (Lead Oxide) (each 1 qian); Qingfen (Calomel), Shexiang (Musk) (each 0.5 qian); Wugong (Centipede) (1 piece, dried by roasting).
Grind to extremely fine powder. Sprinkle into the sore opening; bad flesh will naturally fall off. If knives/needles are used, the sore may heal but will leave scars.
Zuidu Bing (Toxin-Chasing Cake): Treats various foul ulcers where an opened sore closes up again, generating pus with unbearable swelling and pain. Roll this into balls the size of wheat grains, insert into the sore to prevent closure, allowing pus to drain naturally until the sore dries and heals.
Ingredients: High-quality Xinshi (Arsenolite) (0.5 qian); Xionghuang (Realgar), Cihuang (Orpiment), Dashazhu (Cinnabar) (each 1 qian); Qingfen (Calomel) (a little).
Grind to fine powder. Form pills with sticky rice paste, size of wheat grains. If the sore closes and generates pus, insert the medicine and cover with a plaster.
Internal medicine: Neizhidu Dan (see previous formula).
[Xue Ji] Commentary: This represents the principle of using toxicity to combat toxicity. I once treated a county magistrate with a back sore that became necrotic, dark, and heavy as if carrying a stone, critically ill. Fortunately, his appetite was good. After using Taohong San (Peach Red Powder), the color gradually turned red, the heaviness decreased, and after further use, muscle grew. He recovered after taking Tuoli (Supporting Interior) herbs. This is a major toxic condition, requiring harsh drugs. Since arsenic is used, it effectively attacks the toxin. However, in cases of qi and blood deficiency preventing putrefaction, one should tonify qi and blood. Commonly, for early-stage back carbuncles before suppuration, first use Wujin Gao or Yuansheng Gao, dabbing several points to reduce the main pathogenic force, then take Xianfang Huoming Yin. If appetite is poor or food tastes bland, use Liujunzi Tang (Six Gentlemen Decoction) with Huoxiang (Patchouli), taken for 3-5 doses. If the outer skin begins to rot/move, wash with Xionghuang Jiedu San (Realgar Detoxification Powder). Daily, apply Wujin Gao to the rotting area. When a sore opening forms, make paper twists dipped in Wujin Gao and insert them. If pus is trapped by fascial septa causing swelling and pain, use a needle to guide it out, removing blocked necrotic tissue. If bruised flesh moves/rots, wash with Zhu Ti Tang (Pig Trotter Decoction). If pus is thick and painful, but diet is normal, the bruised flesh will rot naturally; combine Xiaodu (Disinfecting) herbs with Tuoli (Supporting Interior) herbs, still applying Wujin Gao. If the bruised flesh separates from healthy flesh, remove it. If pus is neither thick nor thin, pain persists, diet is poor, and flesh rots slowly, moxa burn the affected area with Sangzhi (Mulberry Twig), and primarily treat with Tuoli herbs. If flesh does not rot, or pus is clear/thin and painless, take major tonifying formulas and continue Sangzhi moxibustion to supplement and connect yang qi, dissipate stagnant toxins, and the flesh will rot naturally.