《内经》曰∶汗之则疮已。东垣云∶东南二方者，在人则为丙，小肠热甲胆风，小肠
与胆，皆居其下，其性炎上，其疮外有六经之形证，内无便溺之阻隔，饮食如故，清便
自调，知不在里，非疽疮也，止痈疖也。小则为疖，大则为痈，其邪所受于下，风湿之
地气，自外而来侵加于身者也。经云∶营气不从，逆于肉理，乃生痈肿。诸痛痒疮，皆
属心火。此疮自外而入，是丙小肠左边，入于胆作痛而非痒也。此二方皆主血，血为病
必痛。此元气不足，营气逆行，其疮初出，未有传变，在于肌肉之上，皮毛之间，只于风
热，六经所行经络地分出矣。宜泻其风湿热，医者只知阴覆其阳则汗也。此宜发汗者，乃
湿热郁其手足少阳，致血脉凝逆，使荣卫周身元气消弱也。其风热郁滞于下，其面色必
赫赤而肿，微黯色，东方青，埋没之色也。风木之性上冲，颜必忿色，其人多怒，其疮之
色亦赫赤肿硬，微带黯色，其疮之情势，亦奋然高起，结硬而作痛也，其脉止在左手，左
手主表，左寸外洪缓，左关洪缓而弦，是客邪在于血脉之上，皮肤之间，宜急发其汗而
通其荣卫，则邪气去矣。以托里荣行汤主之。刘宗浓曰∶前论大要三法即此。疮宜汗之，及
先托里，恐邪气入内，言外因也。宜先疏内，以绝其源，言内因也。当和荣卫，谓不内外
因之证也。故疮之发于皮表者，因大略言汗，其汗下和之间，然亦有外治之次第焉。如郭
氏治验云∶一妇人五十九岁，右耳下天容穴间，患一疔疮，其头黑大 ，四边泡起，黄
水时流，浑身麻木，发热谵语，时时昏沉，六脉浮洪，用乌金散汗之。就以 针，先刺疮
心不痛，周遭再刺十余下，紫黑血出，方知疼痛，就以寸金锭子， 入疮内，外用提丁
锭子，放于疮上，膏药贴护，次日汗后，精神微爽，却用破棺丹下之，病即定，其疔溃
动。后用守效散贴涂，红玉锭子 之，八日其疔自出矣。兹所谓审脉证汗下之间，外治
次第如此。殊胜不察脉证，但见发热谵语，便投凉剂与下，或兼以香窜之药，遂致误人者
远矣。
丹溪曰∶痈疽因积毒在脏腑，非一朝夕，今发于外宜以标本为治，当先助气壮胃，使
根本坚固，而以行经活血为佐，参以经络、时令，使毒瓦斯外发，此正仲景解表用麻黄、桂
枝之意。施治之早，可以内消，此乃内托之本意也。
托里荣卫汤 治痈疽疔肿。及无名肿毒。
桂枝（七分） 人参 黄 红花 苍术
柴胡 连翘 当归身 羌活 黄芩 防风
甘草（炙，各一钱）
上作一服，水一盅、酒一盅，煎至一盅，食前服。
加味当归饮子 治诸疮疡，诸痛痒疮皆属心火。火郁则发之。
当归 生地黄 升麻（各五钱） 防风（二钱五分） 荆芥穗 何首乌（各二钱） 紫胡 白芍
药川芎 羌活 黄 （各二钱） 红花 苏木 甘草（各一钱）
上 咀，每服五钱。水二盏，生姜三片，煎至八分。食远服。沐浴取微汗效速，使血
气通和，服之应效。
人参败毒散
人参 独活 柴胡 桔梗（炒） 羌活 枳壳（麸炒） 茯苓 川芎 前胡 甘草（各一钱）
作一剂。水二盅，姜三片，煎一盅。服后服内托复煎散。
郭氏神效乌金散 治痈疽、疔肿、时毒、附骨疽、诸恶疮等证。若疮黑陷如石坚，四
肢冷，脉细，或时昏昧，谵语、循衣，烦渴，危笃者，服此汗之疮起。
苍耳头（端午日午时收） 小草乌头 火麻头（火日收） 木贼（去节） 蛤蟆头 桦皮节（酥炙）
麻黄（去根、节）
上晒干，各等分。同入瓷器内，盐泥固济，炭火内从早 至申分，如黑煤色为度，碾
为末。每服二钱，病重者三钱，用热酒调下；未汗再一服，如汗干，却服解毒疏利之药。如
修合此药，必选天晴、好日，于静室中，勿令鸡犬、猫畜，及阴人见也。又名首功玄黑
散。
夺命丹 治诸般肿毒、疔疽、恶疮。
蟾酥 轻粉（各五分） 朱砂（三钱） 白矾（枯） 寒水石 铜绿（各一钱） 蜗牛（三十一粒，
另研） 乳香 没药 麝香（一钱）
上件为细末。将蜗牛另碾一处丸，如丸不就，用好酒糊为丸，如绿豆大。每服一丸，
生葱三五茎，嚼极烂，吐于手心，包药在内，热酒和葱送下，如重车行五七里，汗出为效。
重者，再服一、二丸。
蟾酥丸 治疔黄，一切恶疮。
川乌 莲花蕊 朱砂（各一钱半） 乳香 没药（各二钱） 轻粉 蟾酥（各一钱） 麝香（五分）
上为细末。糊为丸，豌豆大。每服一丸，病重者二丸。根据前法服，取汗。
上三方，郭氏称为首药，皆主乎发散。首出太阳例，后二方出少阴例，然皆劫剂也，智
者当较轻重阴阳之分，取择用之。
寸金丹 二名返魂丹，三名再生丸，四名追命丹，五名延寿丸，六名来苏丸，七名
知命丸，八名得道丸，非人勿示此方。若有人患疮，身未烂者，与三丸服之，咽下便活。
如口噤，但斡开牙关，研化三丸，灌下喉中立生。此方治发背、脑疽、痈肿、偏身附骨
肿痛。先觉时饮水，口中烦渴发热，四肢沉重，体壮热。
麝香（一分） 南乳香 乌金石 轻粉 雄黄 狗宝 没药（各一钱） 蟾酥（二钱） 粉霜
黄腊（各三钱） 砂（五钱） 鲤鱼胆 狗胆（各一个，干用） 金头蜈蚣（七条，全者，酥炙黄色） 头
首男孩儿乳（一合）
上件为细末。除黄腊、乳汁二味，熬成膏子，同和丸如绿豆大；小儿丸如芥子大。每
服一丸，病重者，加三丸，白丁香七个。研烂，新汲水调送下，用衣服盖之睡，勿令透
风，汗出为度。大段疼痛，如无头疮肿，不过三服立效。眼药后吃白粥、瓜齑，就睡大
妙。
乌金散 治疔毒肿痛。
牙皂（四分） 人言（制） 蟾酥 麝香（各五分） 血余（ 过） 蛇蜕（ 过） 蜂房（ ，各一钱）
蝉蜕（酒洗） 血竭 乳香（炙） 僵蚕（炒去丝，各二钱） 辰砂（研，水飞） 雄黄 穿山甲（炙黄，各
二钱五分） 全蝎（三钱，汤泡七次） 天龙（四钱，酒炙去头足） 川乌尖 没药（炙）
上各为细末，称准分两，和匀。每服三分，赤砂糖调葱头酒送下，取汗为度。
胜金丹 治症同前。
麝香 白砒（制各五分） 蟾酥（一钱） 雄黄 辰砂 乳香 没药 血竭（各一钱五分） 全
蝎（泡，炙）
上为细末，炙和匀。服法同前。
夺命丹 治证同前。
轻粉 麝香 白砒（制，各五分） 白矾（ ） 辰砂（为衣） 血竭（各一钱） 蟾酥（干者二钱，酒化
入药） 铜绿 寒水石（ ） 乳香 没药 雄黄（各二钱） 蜗牛（二十一个，连壳）
上为末。先将蜗牛研烂如泥，匀和前药为丸，如绿豆大。如丸不就，加好酒打三五
百下。每服二三丸，先用葱白三寸与病者嚼烂，吐于男左女右手心，将药丸裹入葱白，用
无灰酒三四盏，温热送下，被盖取汗为度。重者不过三服。
上自乌金散以下，皆治毒疮初发，憎寒壮热面赤，身拘急疼痛者，取汗之峻剂。东
垣虽左袒汗而托里荣卫，一方则固。丹溪所谓，助气壮胃，使根本坚固，而以行经活血
为佐者也，与乌金、夺命之取汗异矣。当归饮子亦同此意，而微有气血温凉之分焉，故
与败毒散同列为发表之方。而后所列东垣分经诸方，则正丹溪所云云，虽曰解表，不以
取汗为功，尤可师法，学人详之。
〔垣〕 通父家翟梗，于尻臀上足太阳经生痈，坚硬肿痛大作，左右尺脉俱紧，按之
无力。
内托羌活汤
羌活 黄柏（酒洗，各二钱） 防风 本 连翘 当归（各一钱） 肉桂（三分） 甘草（炙） 苍
术陈皮（各五分） 黄 （一钱五分）
上作一服，酒二大盏，水一大盏，煎至一盏。去渣，热服空心。以夹被盖覆其痈，使
药行罢去之，一服愈。
〔丹〕 王姑丈七十余，患项疽，脉实而稍大，此因忧闷而生，太阳经治之。
归头（二钱） 黄柏（一钱半，酒） 黄 羌活 地黄（酒） 黄芩（酒炒） 桔梗（一钱） 黄连
（酒炒） 连翘 防风 甘草（生） 人参 陈皮 防己 泽泻（五分）
白水煎服。
净腋汤 治皮肤痒，腋下疮，背上疮，耳聋耳鸣。
麻黄 草蔻 防风 柴胡 黄芩（酒） 苍术（各一钱） 桂枝 羌活（各二钱） 桔梗 甘草
生地（各五分） 当归梢（七分） 红花（少许） 升麻（半分） 连翘（一钱半）
上锉如麻豆大，都作一服。水二大盏，煎至一盏，去渣，稍热服。
尹老，家素贫寒，形志皆苦，于手阳明经分出痈，第四日忽肿，幼有 疝，其臂外
皆肿痛，先肿在阳明。左右寸皆短，中得之俱弦，按之洪缓有力，此痈得自八风之变，以
脉断之，邪气在表，然其证大小便如故，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，知邪止在经脉之中，凝滞为痈，出
身半以上，风从上受之也，故与却寒邪，和经脉中气血，使无凝滞也。
白芷升麻汤
白芷（七分） 升麻 桔梗（各五分） 甘草（炙） 黄芩（生） 归梢 生地（各一钱） 酒黄芩
黄 连翘（各二钱） 中桂（少） 红花（少）
上水酒各一盏，同煎至一盏。临卧热服，一服愈。此证虽曰经脉之中，然得之自八风
之变，其药制度皆发表之意。
妇人两乳间出黑头疮，疮顶陷下，作黑眼子，其脉弦洪，按之细小。
升麻 连翘 葛根（各一钱半） 肉桂（三分） 黄 归身 甘草（炙，各一钱） 黍粘子（五分）
黄柏（二钱）
上作一服。水一盏，酒半盏，煎至一盏，二服愈。
〔罗〕 汗之则疮已。丁巳年，委予从军。回住曹州，有赵同知舅，经历。病头面赤肿，
耳前后尤甚，疼痛不可忍，发热恶寒，牙关紧急，涕唾稠粘，饮食难下，不得安卧。一
疡医，肿上砭刺四五百余针，肿赤不减，其痛益甚，不知所由然。予往诊视，其脉浮紧，
按之洪缓，此寒覆皮毛，郁遏经络，热不得升，聚而赤肿。经云∶天寒地冻，则水冰。人
气在中，皮肤致，腠理闭，汗不出，血气强，内坚涩，当是之时，善行水者不能注冰，善
穿地者不能凿冻，善用针者亦不能取四厥，必待天温冰释，冻解而水可行，地可穿，人脉
亦犹是也。又曰∶冬月闭藏，水冰地坼，故用药多而少针石也，宜以苦温之剂，温经散
寒则已，所谓寒致腠理，以苦发之，以辛散之也，宜以托里温经汤。麻黄苦温发之者也，
故以为君；防风辛温散之者也，升麻苦平、葛根甘平解肌出汗，专治阳明经中之邪，故
以为臣；血流而不行者则痛，以香白芷、归身辛温，以破血散滞；湿热则肿，苍术苦甘
温，体轻浮，力雄壮，能泄皮肤腠间湿热；人参、甘草甘温，白芍药酸微寒，调中益气，使
托其里也，故以为佐。各锉如麻豆大，同秤水煮饵之，以薄衣覆其首，以浓被覆其身，
且卧于暖处，则经血温，腠理开，寒乃散，阳气伸，大汗出，肿减八九；再服去麻黄、防
风，加连翘、黍粘子，痛肿悉去，经言汗出则疮已，信哉。
托里温经汤 治寒覆皮毛，郁遏经络，不得伸越，热伏荣中，聚而赤肿，痛不可忍，恶
寒发热，或相引肢体疼痛。
麻黄（去根、节） 白芷 当归（各二钱） 防风（去芦） 葛根（各三钱） 升麻（四钱） 甘草（炙） 白芍
药（各一钱半） 人参 苍术（各一钱）
上锉如麻豆大。每服秤一两，水二盏，先煮麻黄令沸熟去沫，再下余药，同煎至一盏，
去渣。大温服讫，卧于暖处，即以绵衣覆之，得汗而散。
〔垣〕 蒲津，王世祥，年七十。感寒湿地气，二月间得附骨痈，于左腿外侧足少阳
之分，少侵足阳明分，阔六七寸，长一小尺，坚硬漫肿，不辨肉色皮泽，深以指按，至骨
大痛，又行步作痛，与药下咽，疼痛立止，二日后柔软而肿消矣。
内托黄 酒煎汤
柴胡 黍粘子（各钱半） 连翘 肉桂（各一钱） 黄 当归梢（各二钱） 黄柏 甘草（炙，各
五分） 升麻（七分）
作一帖。好酒一盏半，煎至一盏，大温空心食消尽服之，少时以早膳压之，使不令
大热上攻，犯上中二焦也。
贾德茂男，十岁。四月天气大热，于左足大腿近膝股内，足厥阴肝之经，少侵足太
阴脾之经分，出附骨疽，不辨肉色，漫肿，皮泽木硬，痛势甚大，其脉在三部细弦，按之
洪缓，略有力。
内托黄 柴胡汤
黄 （二钱） 柴胡梢（一钱） 羌活（五分） 连翘（一钱二分） 肉桂（三分） 土瓜根（酒制，一钱）
生地（一钱） 黄柏（酒洗，三分） 当归尾（七分半）
上作一服。酒一盏，水三盏，煎至一盏。空心热服，一服愈。
上方皆东垣及罗谦甫、丹溪随痈疽所发分野制之也，其方皆以发表为先，不过一二
服而愈。如痈疽发在太阳经分野，必用防风、羌活；阳明经分野，必用香白芷、升麻；少
《黄帝内经》说：发汗则疮疡痊愈。李东垣说：东南两个方位，在人体对应丙火（小肠）和甲木（胆），小肠与胆都位于身体下部，其性质炎上。这种疮疡外部有六经的形证表现，内部没有大小便的阻隔，饮食正常，二便调和，可知病邪不在里，不是疽疮，只是痈疖罢了。小的叫疖，大的叫痈，这是邪气受于下焦，风湿的地气从外侵袭身体所致。经文说：营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。各种疼痛、瘙痒、疮疡，都属于心火。这种疮疡是从外而入，涉及丙火小肠左侧，进入胆经导致疼痛而不是瘙痒。这两个方剂都主治血分病变，血为病必然疼痛。这是因为元气不足，营气逆行，疮疡初起，尚未传变，位于肌肉之上、皮毛之间，只是风热在六经所行的经络部位发散出来。应当泻除风湿热邪，医生只知道阴寒覆盖阳气才会出汗。这里适宜发汗，是因为湿热郁滞在手足少阳经，导致血脉凝涩逆乱，使营卫周身元气消弱。风热郁滞于下，面色必定红赤而肿，微带暗色，东方属青，是埋没之色。风木之性向上冲逆，脸色必显愤怒之态，其人容易发怒，疮的颜色也红赤肿胀坚硬，微带暗色，疮的情势也是奋然高起，结硬而作痛。脉象仅在左手出现，左手主表，左寸脉洪缓，左关脉洪缓而弦，说明客邪在血脉之上、皮肤之间，应当急用发汗法以通畅营卫，这样邪气就能去除。用托里荣行汤主治。刘宗浓说：前面的论述大要包含三种方法即在此处。疮疡宜发汗，以及先托里，是怕邪气入内，说的是外因。宜先疏理内部，以断绝病源，说的是内因。应当调和营卫，说的是不内外因的证候。所以疮发于皮表的，大致说来用汗法，在汗、下、和之间选择，然而也有外治疗的次序。如郭氏治验记载：一位五十九岁的妇人，右耳下天容穴间，患一疔疮，疮头黑大，四边起泡，黄水时常流出，浑身麻木，发热谵语，时时昏沉，六脉浮洪，用乌金散使其发汗。随即用针，先刺疮心不痛，周围再刺十余下，流出紫黑血，才感到疼痛，就用寸金锭子插入疮内，外用提丁锭子放在疮上，膏药贴护。次日发汗后，精神稍爽，却用破棺丹攻下，病情即定，疔疮溃动。后用守效散贴涂，红玉锭子敷之，八日疔疮自出。这就是所谓审察脉证，在汗下之间选择，外治疗序如此。比不察脉证，只见发热谵语，就投凉剂与下药，或兼用香窜之药，从而误人的情况好得多。
朱丹溪说：痈疽因为积毒在脏腑，不是一朝一夕形成的，现在发于外部，应当以标本为治，当先助气壮胃，使根本坚固，而以行经活血为佐，参酌经络、时令，使毒瓦斯外发，这正是张仲景解表用麻黄、桂枝的意思。施治得早，可以内消，这就是内托的本意。
托里荣卫汤 治疗痈疽疔肿，以及无名肿毒。
桂枝（七分） 人参 黄芪 红花 苍术
柴胡 连翘 当归身 羌活 黄芩 防风
甘草（炙，各一钱）
以上为一服，用水一盅、酒一盅，煎至一盅，饭前服用。
加味当归饮子 治疗诸疮疡，诸痛痒疮皆属心火。火郁则发之。
当归 生地黄 升麻（各五钱） 防风（二钱五分） 荆芥穗 何首乌（各二钱） 柴胡 白芍药 川芎 羌活 黄芪（各二钱） 红花 苏木 甘草（各一钱）
以上锉碎，每服五钱。水二盏，生姜三片，煎至八分。饭后远时服用。沐浴取微汗效果迅速，使血气通和，服用应效。
人参败毒散
人参 独活 柴胡 桔梗（炒） 羌活 枳壳（麸炒） 茯苓 川芎 前胡 甘草（各一钱）
作一剂。水二盅，姜三片，煎一盅。服后接着服用内托复煎散。
郭氏神效乌金散 治疗痈疽、疔肿、时毒、附骨疽、诸恶疮等证。若疮黑陷如石坚，四肢冷，脉细，或时昏昧，谵语、循衣摸床，烦渴，危笃者，服此药发汗则疮起。
苍耳头（端午日午时收） 小草乌头 火麻头（火日收） 木贼（去节） 蛤蟆头 桦皮节（酥炙）
麻黄（去根、节）
以上晒干，各等分。同入瓷器内，盐泥密封，炭火内从早烧至申时，如黑煤色为度，碾为末。每服二钱，病重者三钱，用热酒调下；未出汗再服一次，如汗已干，却服解毒疏利之药。如修合此药，必选天晴好日，于静室中，勿令鸡犬、猫畜，及阴人见也。又名首功玄黑散。
夺命丹 治疗诸般肿毒、疔疽、恶疮。
蟾酥 轻粉（各五分） 朱砂（三钱） 白矾（枯） 寒水石 铜绿（各一钱） 蜗牛（三十一粒，另研） 乳香 没药 麝香（一钱）
以上为细末。将蜗牛另碾一处丸，如丸不就，用好酒糊为丸，如绿豆大。每服一丸，生葱三五茎，嚼极烂，吐于手心，包药在内，热酒和葱送下，如重车行五七里，汗出为效。重者，再服一、二丸。
蟾酥丸 治疗疔黄，一切恶疮。
川乌 莲花蕊 朱砂（各一钱半） 乳香 没药（各二钱） 轻粉 蟾酥（各一钱） 麝香（五分）
以上为细末。糊为丸，豌豆大。每服一丸，病重者二丸。根据前法服，取汗。
以上三方，郭氏称为首药，皆主乎发散。首出太阳例，后二方出少阴例，然皆劫剂也，智者当较轻重阴阳之分，取择用之。
寸金丹 二名返魂丹，三名再生丸，四名追命丹，五名延寿丸，六名来苏丸，七名知命丸，八名得道丸，非人勿示此方。若有人患疮，身未烂者，与三丸服之，咽下便活。如口噤，但斡开牙关，研化三丸，灌下喉中立生。此方治发背、脑疽、痈肿、偏身附骨肿痛。先觉时饮水，口中烦渴发热，四肢沉重，体壮热。
麝香（一分） 南乳香 乌金石 轻粉 雄黄 狗宝 没药（各一钱） 蟾酥（二钱） 粉霜
黄腊（各三钱） 砂（五钱） 鲤鱼胆 狗胆（各一个，干用） 金头蜈蚣（七条，全者，酥炙黄色） 头首男孩儿乳（一合）
以上为细末。除黄腊、乳汁二味，熬成膏子，同和丸如绿豆大；小儿丸如芥子大。每服一丸，病重者，加三丸，白丁香七个。研烂，新汲水调送下，用衣服盖之睡，勿令透风，汗出为度。大段疼痛，如无头疮肿，不过三服立效。眼药后吃白粥、瓜齑，就睡大妙。
乌金散 治疗疔毒肿痛。
牙皂（四分） 人言（制） 蟾酥 麝香（各五分） 血余（煅过） 蛇蜕（煅过） 蜂房（煅，各一钱）
蝉蜕（酒洗） 血竭 乳香（炙） 僵蚕（炒去丝，各二钱） 辰砂（研，水飞） 雄黄 穿山甲（炙黄，各二钱五分） 全蝎（三钱，汤泡七次） 天龙（四钱，酒炙去头足） 川乌尖 没药（炙）
以上各为细末，称准分两，和匀。每服三分，赤砂糖调葱头酒送下，取汗为度。
胜金丹 治疗症同前。
麝香 白砒（制各五分） 蟾酥（一钱） 雄黄 辰砂 乳香 没药 血竭（各一钱五分） 全蝎（泡，炙）
以上为细末，炙和匀。服法同前。
夺命丹 治疗证同前。
轻粉 麝香 白砒（制，各五分） 白矾（煅） 辰砂（为衣） 血竭（各一钱） 蟾酥（干者二钱，酒化入药） 铜绿 寒水石（煅） 乳香 没药 雄黄（各二钱） 蜗牛（二十一个，连壳）
以上为末。先将蜗牛研烂如泥，匀和前药为丸，如绿豆大。如丸不就，加好酒打三四五百下。每服二三丸，先用葱白三寸与病者嚼烂，吐于男左女右手心，将药丸裹入葱白，用无灰酒三四盏，温热送下，被盖取汗为度。重者不过三服。
以上自乌金散以下，皆治毒疮初发，憎寒壮热面赤，身拘急疼痛者，取汗之峻剂。李东垣虽偏袒汗法而用托里荣卫一方则固。朱丹溪所谓，助气壮胃，使根本坚固，而以行经活血为佐者也，与乌金、夺命之取汗异矣。当归饮子亦同此意，而微有气血温凉之分焉，故与败毒散同列为发表之方。而后所列东垣分经诸方，则正丹溪所云云，虽曰解表，不以取汗为功，尤可师法，学人详之。
〔李东垣〕 通父家翟梗，于尻臀上足太阳经生痈，坚硬肿痛大作，左右尺脉俱紧，按之无力。
内托羌活汤
羌活 黄柏（酒洗，各二钱） 防风 藁本 连翘 当归（各一钱） 肉桂（三分） 甘草（炙） 苍术陈皮（各五分） 黄芪（一钱五分）
以上为一服，酒二大盏，水一大盏，煎至一盏。去渣，热服空心。以夹被盖覆其痈，使药行罢去之，一服愈。
〔朱丹溪〕 王姑丈七十余，患项疽，脉实而稍大，此因忧闷而生，太阳经治之。
归头（二钱） 黄柏（一钱半，酒） 黄芪 羌活 地黄（酒） 黄芩（酒炒） 桔梗（一钱） 黄连（酒炒） 连翘 防风 甘草（生） 人参 陈皮 防己 泽泻（五分）
白水煎服。
净腋汤 治疗皮肤痒，腋下疮，背上疮，耳聋耳鸣。
麻黄 草蔻 防风 柴胡 黄芩（酒） 苍术（各一钱） 桂枝 羌活（各二钱） 桔梗 甘草
生地（各五分） 当归梢（七分） 红花（少许） 升麻（半分） 连翘（一钱半）
以上锉如麻豆大，都作一服。水二大盏，煎至一盏，去渣，稍热服。
尹老，家素贫寒，形志皆苦，于手阳明经分出痈，第四日忽肿，幼有疝，其臂外皆肿痛，先肿在阳明。左右寸皆短，中得之俱弦，按之洪缓有力，此痈得自八风之变，以脉断之，邪气在表，然其证大小便如故，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，知邪止在经脉之中，凝滞为痈，出身半以上，风从上受之也，故与却寒邪，和经脉中气血，使无凝滞也。
白芷升麻汤
白芷（七分） 升麻 桔梗（各五分） 甘草（炙） 黄芩（生） 归梢 生地（各一钱） 酒黄芩 黄芪 连翘（各二钱） 中桂（少） 红花（少）
以上水酒各一盏，同煎至一盏。临卧热服，一服愈。此证虽曰经脉之中，然得之自八风之变，其药制度皆发表之意。
妇人两乳间出黑头疮，疮顶陷下，作黑眼子，其脉弦洪，按之细小。
升麻 连翘 葛根（各一钱半） 肉桂（三分） 黄芪 归身 甘草（炙，各一钱） 黍粘子（五分）
黄柏（二钱）
以上为一服。水一盏，酒半盏，煎至一盏，二服愈。
〔罗谦甫〕 汗之则疮已。丁巳年，委予从军。回住曹州，有赵同知舅，经历。病头面赤肿，耳前后尤甚，疼痛不可忍，发热恶寒，牙关紧急，涕唾稠粘，饮食难下，不得安卧。一疡医，肿上砭刺四五百余针，肿赤不减，其痛益甚，不知所由然。予往诊视，其脉浮紧，按之洪缓，此寒覆皮毛，郁遏经络，热不得升，聚而赤肿。经云∶天寒地冻，则水冰。人气在中，皮肤致，腠理闭，汗不出，血气强，内坚涩，当是之时，善行水者不能注冰，善穿地者不能凿冻，善用针者亦不能取四厥，必待天温冰释，冻解而水可行，地可穿，人脉亦犹是也。又曰∶冬月闭藏，水冰地坼，故用药多而少针石也，宜以苦温之剂，温经散寒则已，所谓寒致腠理，以苦发之，以辛散之也，宜以托里温经汤。麻黄苦温发之者也，故以为君；防风辛温散之者也，升麻苦平、葛根甘平解肌出汗，专治阳明经中之邪，故以为臣；血流而不行者则痛，以香白芷、归身辛温，以破血散滞；湿热则肿，苍术苦甘温，体轻浮，力雄壮，能泄皮肤腠间湿热；人参、甘草甘温，白芍药酸微寒，调中益气，使托其里也，故以为佐。各锉如麻豆大，同秤水煮饵之，以薄衣覆其首，以浓被覆其身，且卧于暖处，则经血温，腠理开，寒乃散，阳气伸，大汗出，肿减八九；再服去麻黄、防风，加连翘、黍粘子，痛肿悉去，经言汗出则疮已，信哉。
托里温经汤 治疗寒覆皮毛，郁遏经络，不得伸越，热伏荣中，聚而赤肿，痛不可忍，恶寒发热，或相引肢体疼痛。
麻黄（去根、节） 白芷 当归（各二钱） 防风（去芦） 葛根（各三钱） 升麻（四钱） 甘草（炙） 白芍药（各一钱半） 人参 苍术（各一钱）
以上锉如麻豆大。每服秤一两，水二盏，先煮麻黄令沸熟去沫，再下余药，同煎至一盏，去渣。大温服讫，卧于暖处，即以绵衣覆之，得汗而散。
〔李东垣〕 蒲津，王世祥，年七十。感寒湿地气，二月间得附骨痈，于左腿外侧足少阳之分，少侵足阳明分，阔六七寸，长一小尺，坚硬漫肿，不辨肉色皮泽，深以指按，至骨大痛，又行步作痛，与药下咽，疼痛立止，二日后柔软而肿消矣。
内托黄芪酒煎汤
柴胡 黍粘子（各钱半） 连翘 肉桂（各一钱） 黄芪 当归梢（各二钱） 黄柏 甘草（炙，各五分） 升麻（七分）
作一帖。好酒一盏半，煎至一盏，大温空心食消尽服之，少时以早膳压之，使不令大热上攻，犯上中二焦也。
贾德茂男，十岁。四月天气大热，于左足大腿近膝股内，足厥阴肝之经，少侵足太阴脾之经分，出附骨疽，不辨肉色，漫肿，皮泽木硬，痛势甚大，其脉在三部细弦，按之洪缓，略有力。
内托黄芪柴胡汤
黄芪（二钱） 柴胡梢（一钱） 羌活（五分） 连翘（一钱二分） 肉桂（三分） 土瓜根（酒制，一钱）
生地（一钱） 黄柏（酒洗，三分） 当归尾（七分半）
以上为一服。酒一盏，水三盏，煎至一盏。空心热服，一服愈。
上方皆东垣及罗谦甫、丹溪随痈疽所发分野制之也，其方皆以发表为先，不过一二服而愈。如痈疽发在太阳经分野，必用防风、羌活；阳明经分野，必用香白芷、升麻；少
The *Neijing* (Yellow Emperor's Inner Classic) states: "Sweating will cure the sores." Li Dongyuan said: The southeast directions correspond to Bing Fire (Small Intestine) and Jia Wood (Gallbladder) in the human body. The Small Intestine and Gallbladder are both located in the lower part of the body, but their nature is inflammatory and upward-moving. These sores present external manifestations of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), but internally there is no obstruction in urination or defecation; diet is normal, and excretions are regulated. Knowing that the pathogen is not in the interior, it is not a deep abscess (Ju Chuang, deep-seated suppurative disease), but merely a superficial carbuncle or furuncle. Small ones are called furuncles (Jie, acute localized infection), large ones are called carbuncles (Yong, larger soft tissue infection). The pathogen is received in the lower jiao; it is the damp-wind earth qi invading from the exterior. The classics state: "When Ying Qi (Nutritive Qi) does not flow smoothly and reverses into the muscle tissue, carbuncles and swellings arise." All pain, itching, and sores belong to Heart Fire. This sore enters from the exterior, involving the left side of Bing Fire (Small Intestine), entering the Gallbladder channel causing pain rather than itching. Both these formulas primarily treat blood disorders; blood diseases inevitably cause pain. This is due to insufficiency of Yuan Qi (Original Qi) and reversal of Ying Qi. At the initial stage of the sore, before transmission occurs, it is located above the muscles and between the skin and hair follicles. It is merely wind-heat dispersing in the meridians traversed by the Six Channels. One should drain the wind-damp-heat. Physicians only know that sweating occurs when Yin covers Yang. Here, sweating is appropriate because damp-heat is stagnant in the Hand and Foot Shaoyang channels, causing blood vessels to coagulate and reverse, weakening the Yuan Qi circulating through the Ying and Wei (Defensive) systems. Wind-heat stagnates below, so the face must be red and swollen, slightly dark. East corresponds to Green, a color of being buried/submerged. The nature of Wind-Wood rushes upward, so the facial expression must show anger; such people are prone to anger. The sore's color is also red, swollen, hard, with a slight dark tint. The condition of the sore rises vigorously, becoming hard and painful. The pulse is found only on the left hand; the left hand governs the exterior. The Cun position on the left is surging and moderate, the Guan position is surging, moderate, and wiry. This indicates the guest pathogen is above the blood vessels and between the skin. One should urgently induce sweating to unblock Ying and Wei, so the pathogenic qi will depart. Use Tuoli Rongxing Tang (Support Interior and Nourish Circulation Decoction) as the main treatment. Liu Zongnong said: The general principles discussed earlier include three methods here. Sores should be treated by sweating, and first supporting the interior to prevent the pathogen from entering inward, referring to external causes. One should first soothe the interior to cut off the source, referring to internal causes. One should harmonize Ying and Wei, referring to non-external/non-internal causes. Therefore, for sores erupting on the skin surface, sweating is generally used, choosing among sweating, purging, and harmonizing methods. However, there is also a sequence for external treatments. For example, Guo Shi's case record states: A fifty-nine-year-old woman developed a Ding Chuang (hard chancre/boil) between the Tianrong acupoint below her right ear. The head was black and large, with blisters rising around the edges, and yellow fluid flowed intermittently. Her whole body felt numb, she had fever and delirious speech, and was frequently drowsy. Her six pulses were floating and surging. She was given Wu Jin San (Black Gold Powder) to induce sweating. Immediately after, needles were used; first piercing the center of the sore caused no pain, but piercing more than ten times around the periphery released purple-black blood, at which point pain was felt. Then, Cunjin Dingzi (Inch Gold Plug) was inserted into the sore, and Tiding Dingzi (Lifting Plug) was placed on top, covered with a plaster. After sweating the next day, her spirit slightly recovered. She then took Po Guan Dan (Coffin-Breaking Pill) to purge, stabilizing the illness and causing the Ding to ulcerate. Later, Shou Xiao San (Guarding Efficacy Powder) was applied, followed by Hongyu Dingzi (Red Jade Plug). On the eighth day, the Ding expelled itself spontaneously. This illustrates examining pulses and symptoms to choose between sweating and purging, and following this external treatment sequence. This is far superior to failing to examine pulses and symptoms, seeing only fever and delirium, and immediately administering cooling and purgative agents, or adding aromatic penetrating drugs, which leads to serious errors.
Zhu Danxi said: Carbuncles and deep abscesses arise from accumulated toxins in the zang-fu organs over time, not overnight. Now that they have erupted externally, treatment should address both root and branch. First, support Qi and strengthen the Stomach to solidify the foundation, assisting with herbs that move meridians and invigorate blood. Consider the meridians and seasons to allow the toxin to erupt outward. This aligns with Zhang Zhongjing's intention of using Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) to release the exterior. Early intervention can resolve the condition internally; this is the true meaning of internal support (Tuo Li).
Tuoli Rongwei Tang (Support Interior and Harmonize Ying-Wei Decoction) treats carbuncles, deep abscesses, Ding Chuang, and unknown swellings/toxins.
Guizhi (Cinnamon Twig, 7 fen) Renshen (Ginseng Root) Huangqi (Astragalus Root) Honghua (Carthamus Flower) Cangzhu (Atractylodes Rhizome)
Chaihu (Bupleurum Root) Lianqiao (Forsythia Fruit) Dangguishen (Angelica Sinensis Root Body) Qianghuo (Notopterygium Rhizome) Huangqin (Scutellaria Root) Fangfeng (Saposhnikovia Root)
Gancao (Licorice Root, roasted, 1 qian each)
Take one dose. Boil with one cup of water and one cup of wine until reduced to one cup. Take before meals.
Jiawei Danggui Yinzi (Modified Angelica Drink) treats various sores and ulcers. "All pain, itching, and sores belong to Heart Fire." When Fire is stagnant, it should be vented.
Danggui (Angelica Sinensis Root) Shengdihuang (Rehmannia Root, fresh) Shengma (Cimicifuga Rhizome, 5 qian each) Fangfeng (Saposhnikovia Root, 2.5 qian) Jingjiesui (Schizonepeta Spike) Heshouwu (Polygonum Multiflorum Root, 2 qian each) Chaihu (Bupleurum Root) Baishaoyao (White Peony Root) Chuanxiong (Ligusticum Rhizome) Qianghuo (Notopterygium Rhizome) Huangqi (Astragalus Root, 2 qian each) Honghua (Carthamus Flower) Sumu (Sappan Wood) Gancao (Licorice Root, 1 qian each)
Crush into coarse powder. Take 5 qian per dose. Boil with two cups of water and three slices of ginger until reduced to 0.8 cup. Take well after meals. Bathing to achieve slight sweating yields rapid results, ensuring smooth circulation of Blood and Qi.
Renshen Baidu San (Ginseng Detoxification Powder)
Renshen (Ginseng Root) Duhuo (Angelica Pubescens Root) Chaihu (Bupleurum Root) Jiegeng (Platycodon Root, stir-fried) Qianghuo (Notopterygium Rhizome) Zhike (Bitter Orange Fruit, bran-stir-fried) Fuling (Poria Sclerotium) Chuanxiong (Ligusticum Rhizome) Qianhu (Peucedanum Root) Gancao (Licorice Root, 1 qian each)
Make one dose. Boil with two cups of water and three slices of ginger until reduced to one cup. Follow with Neituo Fujian San (Support Interior and Re-decoct Powder).
Guo Shi Shenxiao Wu Jin San (Guo Shi's Divine Efficacy Black Gold Powder) treats carbuncles, Ding Chuang, seasonal toxins, deep bone abscesses, and various malignant sores. If the sore is black and sunken like hard stone, limbs are cold, pulse is fine, or there is occasional confusion, delirium, picking at bedclothes, irritability, thirst, and critical condition, taking this medicine to induce sweating will raise the sore.
Canger tou (Cocklebur Head, harvested at noon on Dragon Boat Festival) Xiao Cao Wutou (Small Grass Aconite) Huo Ma tou (Fire Hemp Head, harvested on Fire days) Muze (Equisetum Stem, remove joints) Hamadou (Toad Head) Hua pi jie (Birch Bark Joint, fried with butter)
Mahuang (Ephedra Herb, remove roots and joints)
Dry thoroughly. Mix equal parts. Place in a porcelain jar, seal with salt mud, and roast over charcoal fire from morning until Shen hour (3-5 PM), until black like coal powder. Grind into fine powder. Take 2 qian per dose (3 qian for severe cases), mixed with hot wine. If sweating has not occurred, take another dose. If sweat has dried, take detoxifying and purgative medicines instead. When preparing this medicine, choose sunny days, work in a quiet room, and do not let chickens, dogs, cats, or yin persons see it. Also known as Shougong Xuanhei San.
Duoming Dan (Life-Seizing Pill) treats various swellings, Ding Chuang, and malignant sores.
Chansu (Toad Venom) Qingfen (Calomel, 5 fen each) Zhusha (Cinnabar, 3 qian) Bai fan (Alum, calcined) Hanshui shi (Aqua Marina) Tong lv (Malachite, 1 qian each) Woniu (Snail, 31 grains, ground separately) Ruxiang (Frankincense) Moyao (Myrrh) Shexiang (Musk, 1 qian)
Grind all into fine powder. Grind snails separately. If pills cannot form, use good wine paste to make pills the size of mung beans. Take one pill per dose. Chew 3-5 stalks of raw green onion until very soft, spit into palm, wrap the pill inside, and swallow with hot wine mixed with onion juice. Walk about 5-7 li (as if pulling a heavy cart); sweating indicates efficacy. For severe cases, take 1-2 more pills.
Chansu Wan (Toad Venom Pill) treats Ding Huang (yellow Ding Chuang) and all malignant sores.
Chuanwu (Aconite Root, Sichuan) Lianhua rui (Lotus Stamen) Zhusha (Cinnabar, 1.5 qian each) Ruxiang (Frankincense) Moyao (Myrrh, 2 qian each) Qingfen (Calomel) Chansu (Toad Venom, 1 qian each) Shexiang (Musk, 5 fen)
Grind into fine powder. Make pills with paste, size of pea seeds. Take one pill per dose (two for severe cases). Administer according to previous method to induce sweating.
These three formulas are called "First Medicines" by Guo Shi, all focusing on dispersion. The first follows the Taiyang pattern, the latter two follow the Shaoyin pattern. They are all drastic remedies. Wise physicians should weigh the severity and yin-yang distinctions before selecting them.
Cun Jin Dan (Inch Gold Pill), also named Fanshun Dan (Returning Soul Pill), Zaisheng Wan (Rebirth Pill), Zhuiming Dan (Life-Chasing Pill), Yanshou Wan (Longevity Pill), Lansu Wan (Revival Pill), Zhiming Wan (Knowing Fate Pill), Dedao Wan (Attaining Dao Pill). Do not show this formula to unworthy persons. If someone suffers from a sore and the body is not yet necrotic, give three pills. Swallowing brings immediate life. If the jaw is clenched, pry open the teeth, grind three pills, and force down the throat; life returns instantly. This formula treats Back Carbuncles (Fabei), Brain Abscesses (Nao Ju), swelling, and deep bone pain/swelling on one side. Early symptoms include drinking water, irritability, thirst, fever, heaviness in limbs, and strong body heat.
Shexiang (Musk, 1 fen) Nan Ruxiang (Southern Frankincense) Wujinshi (Wu Jin Stone) Qingfen (Calomel) Xionghuang (Realgar) Goubao (Dog Treasure) Moyao (Myrrh, 1 qian each) Chansu (Toad Venom, 2 qian) Fen shuang (Tin Oxide)
Huang la (Beeswax, 3 qian each) Sha (Sal Ammoniac, 5 qian) Liyu dan (Carp Gallbladder) Goudan (Dog Gallbladder, one each, dried) Jintou wugong (Golden-headed Centipede, seven whole, fried with butter until yellow) Toushou nanhaier ru (Breast milk from first-born boy, 1 he)
Grind into fine powder. Except for beeswax and milk, boil into a paste. Mix and make pills size of mung beans; smaller for children (size of mustard seed). Take one pill per dose (add three for severe cases, plus seven Baixiang [White Bird Dropping]). Grind finely, mix with fresh well water, and swallow. Cover with clothes and sleep, avoiding drafts. Sweating is the goal. For severe pain without head/sore swelling, relief comes within three doses. After applying eye medicine, eat white porridge and pickled melon, then sleep; this is excellent.
Wu Jin San (Black Gold Powder) treats Ding Du (Ding Toxin) swelling and pain.
Ya zao (Gleditsia Fruit, 4 fen) Ren yan (Arsenic Trioxide, processed) Chansu (Toad Venom) Shexiang (Musk, 5 fen each) Xue yu (Burnt Human Hair) She tui (Snake Skin, calcined) Feng fang (Honeycomb, calcined, 1 qian each)
Chan tui (Cicada Slough, washed with wine) Xue jie (Dragon's Blood) Ruxiang (Frankincense, roasted) Jiangcan (Silkworm, stir-fried to remove silk, 2 qian each) Chen sha (Vermilion, ground, water-suspended) Xionghuang (Realgar) Chanshanjia (Pangolin Scale, roasted yellow, 2.5 qian each) Quanxie (Whole Scorpion, 3 qian, soaked in boiling water seven times) Tianlong (Gecko, 4 qian, wine-roasted, head and feet removed) Chuanwu jian (Tip of Sichuan Aconite) Moyao (Myrrh, roasted)
Grind each into fine powder, weigh accurately, and mix evenly. Take 3 fen per dose, mixed with brown sugar and scallion head wine to induce sweating.
Shengjin Dan (Winning Gold Pill) treats conditions same as above.
Shexiang (Musk) Bai pi (White Arsenic, processed, 5 fen each) Chansu (Toad Venom, 1 qian) Xionghuang (Realgar) Chen sha (Vermilion) Ruxiang (Frankincense) Moyao (Myrrh) Xuejie (Dragon's Blood, 1.5 qian each) Quanxie (Scorpion, soaked, roasted)
Grind into fine powder, roast and mix evenly. Administration same as above.
Duoming Dan (Life-Seizing Pill) treats conditions same as above.
Qingfen (Calomel) Shexiang (Musk) Bai pi (White Arsenic, processed, 5 fen each) Bai fan (Alum, calcined) Chen sha (Vermilion, coating) Xuejie (Dragon's Blood, 1 qian each) Chansu (Toad Venom, dry 2 qian, dissolved in wine into medicine) Tong lv (Malachite) Hanshui shi (Aqua Marina, calcined) Ruxiang (Frankincense) Moyao (Myrrh) Xionghuang (Realgar, 2 qian each) Woniu (Snail, 21 with shell)
Grind into powder. First grind snails into mud, mix evenly with other medicines to make pills size of mung beans. If pills don't form, beat well wine 300-500 times. Take 2-3 pills per dose. First, chew 3 cun of white scallion with the patient, spit into the palm (left for men, right for women), wrap the pill in the scallion, and swallow with 3-4 cups of unrefined warm wine. Cover with blankets to induce sweating. Severe cases require no more than three doses.
From Wu Jin San downwards, all are harsh sweating agents treating early-stage toxic sores with aversion to cold, high fever, red face, body stiffness, and pain. Although Li Dongyuan favored sweating, Tuoli Rongwei Tang is solid. Zhu Danxi's advice to support Qi and strengthen the Stomach to solidify the foundation, assisting with moving meridians and invigorating blood, differs from the sweating approach of Wu Jin and Duoming. Danggui Yinzi shares this intent but has slight differences in warming/cooling Qi and Blood, hence listed with Baidu San as exterior-releasing formulas. The subsequent formulas by Li Dongyuan categorized by meridian align with Zhu Danxi's words. Although called releasing the exterior, they do not aim primarily at sweating, making them models worthy of study. Scholars should examine them carefully.
[Li Dongyuan] Tongfu family member Zhai Geng developed a carbuncle on the foot Taiyang meridian above the buttocks. It was hard, swollen, painful, and severe. Both Chi pulses on left and right were tight, but weak upon pressure.
Neituo Qianghuo Tang (Support Interior and Notopterygium Decoction)
Qianghuo (Notopterygium Rhizome) Huangbai (Phellodendron Bark, wine-washed, 2 qian each) Fangfeng (Saposhnikovia Root) Gaoben (Ligusticum Rhizome) Lianqiao (Forsythia Fruit) Danggui (Angelica Sinensis Root, 1 qian each) Rougui (Cinnamon Bark, 3 fen) Gancao (Licorice Root, roasted) Cangzhu (Atractylodes Rhizome) Chenpi (Tangerine Peel, 5 fen each) Huangqi (Astragalus Root, 1.5 qian)
One dose. Boil with two large cups of wine and one cup of water until reduced to one cup. Strain, drink hot on an empty stomach. Cover the carbuncle with a quilted blanket to allow the medicine to act and disperse the pathogen. Cured in one dose.
[Zhu Danxi] Wang's uncle-in-law, over seventy years old, suffered from a neck abscess. Pulse was excess and slightly large. This arose from worry and depression, treated via the Taiyang meridian.
Gui tou (Angelica Root Head, 2 qian) Huangbai (Phellodendron Bark, 1.5 qian, wine) Huangqi (Astragalus Root) Qianghuo (Notopterygium Rhizome) Dihuang (Rehmannia Root, wine) Huangqin (Scutellaria Root, wine-stir-fried) Jiegeng (Platycodon Root, 1 qian) Huanglian (Coptis Rhizome, wine-stir-fried) Lianqiao (Forsythia Fruit) Fangfeng (Saposhnikovia Root) Gancao (Licorice Root, raw) Renshen (Ginseng Root) Chenpi (Tangerine Peel) Fangji (Stephania Root) Zexie (Alisma Rhizome, 5 fen)
Boil in plain water and take.
Jingye Tang (Pure Axilla Decoction) treats skin itching, axillary sores, back sores, deafness, and tinnitus.
Mahuang (Ephedra Herb) Caokou (Cardamom Seed) Fangfeng (Saposhnikovia Root) Chaihu (Bupleurum Root) Huangqin (Scutellaria Root, wine) Cangzhu (Atractylodes Rhizome, 1 qian each) Guizhi (Cinnamon Twig) Qianghuo (Notopterygium Rhizome, 2 qian each) Jiegeng (Platycodon Root) Gancao (Licorice Root)
Shengdi (Rehmannia Root, 5 fen each) Danggui shao (Angelica Sinensis Root Tip, 7 fen) Honghua (Carthamus Flower, small amount) Shengma (Cimicifuga Rhizome, 0.5 fen) Lianqiao (Forsythia Fruit, 1.5 qian)
Cut into hemp-seed size. One dose. Boil with two large cups of water until reduced to one cup. Strain, drink slightly hot.
Old Man Yin, whose family was always poor and cold, suffering physically and mentally, developed a carbuncle branching from the Hand Yangming meridian. Suddenly swollen on the fourth day. He had had hernia since childhood. His arm outside was swollen and painful, starting in Yangming. Left and Right Cun pulses were short; middle positions were wiry, surging, moderate, and forceful upon pressure. This carbuncle resulted from changes of the Eight Winds. Based on the pulse, the pathogen is in the exterior. However, urination and defecation are normal, diet is regular, abdomen is harmonious, taste is normal, indicating it is not in the interior. No aversion to wind/cold, only heat and restlessness, pulse not floating, indicating it is not in the exterior. Since interior and exterior are harmonized, the pathogen is confined within the meridians, stagnating to form a carbuncle. Emerging above the halfway line of the body, wind is received from above. Thus, dispel cold pathogen, harmonize Qi and Blood in the meridians, preventing stagnation.
Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction)
Baizhi (Angelica Dahurica Root, 7 fen) Shengma (Cimicifuga Rhizome) Jiegeng (Platycodon Root, 5 fen each) Gancao (Licorice Root, roasted) Huangqin (Scutellaria Root, raw) Guishao (Angelica Sinensis Root Tip) Shengdi (Rehmannia Root, 1 qian each) Jiu Huangqin (Wine Scutellaria Root) Huangqi (Astragalus Root) Lianqiao (Forsythia Fruit, 2 qian each) Zhonggui (Cinnamon, small amount) Honghua (Carthamus Flower, small amount)
Boil with one cup of water and one cup of wine until reduced to one cup. Drink hot before bed. Cured in one dose. Although this condition is in the meridians, it arises from Eight Wind changes; the medication system focuses on releasing the exterior.
A woman developed a black-headed sore between her breasts. The sore head was sunken, forming a black pupil-like opening. Pulse was wiry and surging, but fine and small upon pressure.
Shengma (Cimicifuga Rhizome) Lianqiao (Forsythia Fruit) Gegen (Pueraria Root, 1.5 qian each) Rougui (Cinnamon Bark, 3 fen) Huangqi (Astragalus Root) Guishen (Angelica Root Body) Gancao (Licorice Root, roasted, 1 qian each) Shuniuzi (Arnebia/Lithospermum Seed, 5 fen)
Huangbai (Phellodendron Bark, 2 qian)
One dose. Boil with one cup of water and half a cup of wine until reduced to one cup. Cured in two doses.
[Luo Qianfu] "Sweating cures sores." In the Ding Si year, I was commissioned to accompany the army. Returning to reside in Caozhou, Zhao Tongzhi's uncle, a Jingli official, suffered from red and swollen head and face, especially around the ears, unbearable pain, fever and aversion to cold, locked jaw, thick sticky snot and saliva, difficulty eating, inability to lie down peacefully. A surgeon punctured the swelling with four or five hundred needles. The redness and swelling did not decrease, and pain increased. We did not know why. I went to diagnose. Pulse was floating and tight, surging and moderate upon pressure. This is cold covering skin and hair, obstructing meridians, preventing heat from ascending, gathering to cause redness and swelling. The classics say: "When heaven is cold and earth frozen, water turns to ice. Human Qi is in the interior, skin is dense, pores closed, no sweat, Blood and Qi are strong, interior is firm and stagnant. At this time, even a skilled boatman cannot navigate ice, a skilled digger cannot pierce frozen ground, and a skilled acupuncturist cannot treat tetraplegia. One must wait for warmth, ice melting, thawing, so water can flow and ground can be dug. Human meridians are the same." It also says: "In winter, storage is closed, water freezes, earth cracks. Therefore, use more medicine and fewer needles/stones. Use bitter-warm agents to warm meridians and scatter cold. This is 'cold constricts pores, vent with bitter, disperse with pungent.' Use Tuoli Wenjing Tang (Support Interior and Warm Meridian Decoction)." Mahuang is bitter-warm to vent, so it is the Sovereign herb. Fangfeng is pungent-warm to disperse, Shengma is bitter-neutral, Gegen is sweet-neutral to resolve muscle layer and induce sweating, specifically treating Yangming meridian pathogens, so they are Ministers. Blood flowing but not circulating causes pain; Xiangbaizhi and Guishen are pungent-warm to break blood and disperse stagnation. Damp-heat causes swelling; Cangzhu is bitter-sweet-warm, light and floating, powerful, able to drain damp-heat from skin and pores. Renshen and Gancao are sweet-warm, Baishaoyao is sour-mildly-cold, regulating middle and boosting Qi to support the interior, so they are Assistants. Cut into hemp-seed size. Weigh equally, boil in water, and take. Cover head with thin cloth, cover body with thick quilt, lie in a warm place. Then meridian blood warms, pores open, cold scatters, Yang Qi extends, profuse sweating occurs, swelling reduces by 80-90%. Take again, removing Mahuang and Fangfeng, adding Lianqiao and Shuniuzi. Pain and swelling completely disappear. The classics say "sweating cures sores," truly reliable.
Tuoli Wenjing Tang (Support Interior and Warm Meridian Decoction) treats cold covering skin/hair, obstructing meridians, preventing extension, heat hiding in Ying, gathering to cause redness/swelling, unbearable pain, aversion to cold/fever, or radiating limb pain.
Mahuang (Ephedra Herb, remove roots/joints) Baizhi (Angelica Dahurica Root) Danggui (Angelica Sinensis Root, 2 qian each) Fangfeng (Saposhnikovia Root, remove radicle) Gegen (Pueraria Root, 3 qian each) Shengma (Cimicifuga Rhizome, 4 qian) Gancao (Licorice Root, roasted) Baishaoyao (White Peony Root, 1.5 qian each) Renshen (Ginseng Root) Cangzhu (Atractylodes Rhizome, 1 qian each)
Cut into hemp-seed size. Weigh 1 liang per dose. Boil with two cups of water. First boil Mahuang until boiling, skim foam, then add remaining herbs. Simmer until reduced to one cup. Strain. Drink very warm. Lie in a warm place, cover with cotton clothes. Disperse upon sweating.
[Li Dongyuan] Pu Jin, Wang Shixiang, age seventy. Contracted cold-damp earth qi. In February, developed a deep bone carbuncle on the outer side of the left leg, in the Foot Shaoyang distribution, slightly invading Foot Yangming. Width 6-7 cun, length one chi. Hard, diffuse swelling, unable to distinguish flesh color or skin luster. Deep pressure to bone caused severe pain. Walking caused pain. After taking medicine, pain stopped immediately. Softened and swelling subsided after two days.
Neituo Huangqi Wine Decoction
Chaihu (Bupleurum Root) Shuniuzi (Arnebia/Lithospermum Seed, 1.5 qian each) Lianqiao (Forsythia Fruit) Rougui (Cinnamon Bark, 1 qian each) Huangqi (Astragalus Root) Danggui shao (Angelica Root Tip, 2 qian each) Huangbai (Phellodendron Bark) Gancao (Licorice Root, roasted, 5 fen each) Shengma (Cimicifuga Rhizome, 7 fen)
One packet. Boil with 1.5 cups of good wine until reduced to one cup. Drink very warm on empty stomach after food digestion. Shortly after, eat breakfast to suppress excessive heat from attacking upper/middle jiao.
Jia Demao's son, ten years old. April weather very hot. Developed deep bone abscess near knee inner thigh on left leg, in Foot Jueyin Liver meridian, slightly invading Foot Taiyin Spleen meridian. Unable to distinguish flesh color, diffuse swelling, skin hard like wood, severe pain. Pulses in three positions were fine and wiry, surging/moderate/forceful upon pressure.
Neituo Huangqi Chaihu Tang (Support Interior Astragalus and Bupleurum Decoction)
Huangqi (Astragalus Root, 2 qian) Chaihu shao (Bupleurum Root Tip, 1 qian) Qianghuo (Notopterygium Rhizome, 5 fen) Lianqiao (Forsythia Fruit, 1.2 qian) Rougui (Cinnamon Bark, 3 fen) Tugua gen (Melon Root, wine-processed, 1 qian)
Shengdi (Rehmannia Root, 1 qian) Huangbai (Phellodendron Bark, wine-washed, 3 fen) Danggui wei (Angelica Root Tail, 0.75 qian)
One dose. Boil with one cup of wine and three cups of water until reduced to one cup. Drink hot on empty stomach. Cured in one dose.
The above formulas were created by Li Dongyuan, Luo Qianfu, and Zhu Danxi according to the meridian distributions where carbuncles/abscesses erupt. Their formulas prioritize releasing the exterior, curing in one or two doses. If carbuncle/abscess erupts in Taiyang meridian distribution, must use Fangfeng and Qianghuo. In Yangming meridian distribution, must use Xiangbaizhi and Shengma. In Shaoyang...