凉血饮 即引兵先锋方。治心肺有热，或作寒热，口干好饮水，浑身疼，腹内作热，头
面赤色。
内托散 即前锋正将方。治同上。兼用敷角洗贴。已溃多服加味十奇散。（以上并见肿
疡门。）
八味丸 治肾虚嗜欲过度，外挟寒邪，发为痈肿，不可施以凉剂宜服。（方见溃疡门。）
加味十奇散 治同上。兼用葱白、橘叶、椒叶、猪蹄汤淋洗，仍贴金丝膏。（方见前肿疡
门。）
疔疮者，以其疮形如丁盖之状而得名。皆生头面、四肢，发黄 中或紫黑，必先痒后
痛，先寒后热，凡人一二日间恶寒发热，四肢沉重，心悸眼花，头疼体痛，稍异如常之
证，须宜遍身寻认，如有小疮，与尝患之疮稍异，即是疔也。大抵起紫 者多，起堆核
者少，发于手上者多，发于别处者少。生两足者，多有红丝至脐，生两手者，多有红丝
至腋，生唇面口内者，多有红丝入喉，以针刺疮，不痛无血，是其候也。经云∶膏粱之
变，足生大疔。大抵多由恣食浓味，卒中饮食之毒，或感四时不正之气，或感蛇虫之毒，
或感疫死牛马、猪羊之毒，或人汗入肉而食之，皆生疔疮，各宜审而治之，若呕逆直视，
谵语如醉者，不可治矣。又有内疔一证与外疔之证大同，但疮形不现，过数日间有一处
肿起者，即是内疔所发之处，但腹痛甚者，便须作内疔治之。不可缓也，缓则杀人。华元
化云∶疔有五色属五脏，红属心发于舌根，青属肝发于目下，黄属脾发于口唇，白属肺发
于右鼻，黑属肾发于耳前。以种类言之，《千金方》、《外台秘要》、《神巧万全方》皆称一
十三种，殆不止也。麻子疔，状如麻子而稍黑，四边微赤，多痒少痛，忌食麻子油、衣
麻衣，并入麻田中行，穿麻布人。火疔发于顶门，或发于面，身热如火，状如汤火烧灼，
疮头有黑 ，四边烟焰，又如赤粟米，忌火灸烧针烙。脾疔生于唇四白。眉疔生于眉。髭
疔生于髭中。龙泉疔生于唇上。虎须疔生于唇下。鱼尾疔生于眼角外。颧骨疔生于颧骨
上，亦名赤面疔，其状色白，顶陷如钱孔，鼻有紫色者大凶。耳疔生于耳中，亦名黑疔，连
腮赤肿。鼻疔生于鼻内，痛引脑门，不能运气，鼻如大瓶，黑色者不治。颊疔生于面频
骨尖高处。气疔形如气泡，感怒而生。腐疔色白有 ，三日内顶陷，状如初灸疮，因夏
月造豆腐时，人汗滴于内食之而生，忌食豆腐。鬼疔因中阴邪之毒而生，瓜藤疔延蔓无
数，忌瓜田中行。石疔皮肉相连，坚硬如石，刺之不入，肉微痛，忌砂砾。盐肤疔大如匙
面，四边皆赤，有黑点如粟粒起，忌食咸物。水洗疔状如钱形，或如钱孔疮，头白里黑 ，
汁出而中硬，极痒透骨，搔则快然，忌水洗、渡河及饮浆水。浮沤疔其状圆曲少许不合，长
而狭如薤叶大，内黄外黑，黑处刺不痛，黄处刺则痛。三十六疔，其状头黑浮起，形如
黑豆，四畔起大赤色，今日生一明日二，后日三乃至十。若满三十六，药所不能治。未
满者可治，俗名黑 。忌嗔怒蓄积愁恨。猪疔形圆而小，疮口内有油。羊疔，形长而白
色。牛疔形圆而小，疮内无油， 起掐不破，有寒热。狗疔色赤而长，或带尖，与牛疔同，
无忌，不杀人。驴马疔其状三角，顶上有黑点，根脚有赤色，或突起。水疔状如水泡，因
饮隔宿水而生，忌饮水。脐疔生于脐。胁疔生于胁，刀镰疔状如薤叶。长寸许，肉黑如
烧烙，忌刀针。暗疔生两腋下而无头，但腋下坚硬，四肢拘急，寒热大作。阴囊肿痛，睾
丸附生突兀如疔，寒热并作，亦名暗疔。寸疔生手指骨节间。虎口疔生合谷穴，鱼脐疔
状如鱼脐。茱萸疔中凹边突。蛇眼疔头黑皮浮，形如小豆，状似蛇眼，忌恶眼看，并嫉
妒人之见之，及触毒药。红丝疔一名血箭疔，一名赤疔，一名红演疔。生于舌根下，或生
头面，或生手足骨节间，其证最急，宜迎其经刺出恶血则愈，稍迟毒瓦斯攻心，呕哕迷闷
者死。若丝近心腹者，就于丝尽处刺出恶血，更挑破初起疮头，以泄其毒。芝麻疔走注不
定，遍身疼痛，不能转侧。烂疔溃出脓水，大如匙面，色稍黑，有白斑，忌沸汤、热食、烂
物。雌疔疮头稍黄向里 ，亦似灸疮，四面 浆起，心凹色赤大如钱孔，又有一枚在他
处，以水 之，则见大，忌房事。雄疔其状头黑 突起；四畔仰， 浆起有水出，色黄，
大如钱孔，忌房事。黄疔有眼在皮，发如齿龈之色，手足麻木，涎出不语者死。黑疔状
如黑 。樱桃疔状如樱桃。蛇头疔生手指头两旁，状如蛇头，甚腥秽紫黑色，痛引心，有
溃烂脱落者。足面疔，状如粟米，痒极入骨，急隔蒜灸之。大抵如豆，如臼，如箔金，如
茱萸，如石榴子。或发疹搔破，而青黄赤色汁出；或衣物触着而疼痛，忽生或白而肿实；
或赤而浮虚，其状不一。初觉顶不起者，急隔蒜灸之。灸而有 者吉，无 者凶；服汗
剂得汗则生，无汗则死。刺出紫血者危，出黑血者死。缓者一日疮顶 色微白，二日
色大白，三日色微紫，四日色真紫，皆缓之候也。急者五日色微青小紧，六日色深青大
紧，七日色黑，其形如鱼脐，或如灸疮之状，皆急之候也。凡生疔疮，身热头疼，手足温
和，饮食如常，疔之四围赤肿，名曰护场可治。凡生疔疮，眼白睛痴不转，渴欲饮水，内
热疮盛，唇舌青，卧床不能起，五心肿，头晕眼花，气粗食不进，脉伏谵语恶心，腹痛
冷汗出，手足冷，滑泄无度，疔之四围无赤肿，名曰不护场，不可治。疮证急者有应，如
生一疔之外，别处肉上再生一小疮，即是有应，可用针挑破，护场疮四围有赤肿。生多
疮者，谓之满天星，饮食如常，头痛身热，手足温。疮证凶者无应，别处肉上无疮不护场，
疔四围无赤肿。腹痛甚者，有内疔。若毒入心腹，眼黑如见火光，烦闷呕逆，恍惚痴眠，
瞳人不动，赤脉贯睛，胸胁赤肿，疮陷不起发，皆死候也。凡疔疮必有红丝路，急用针
于红丝所至之处出血及刺疔头四畔出血。若针之不痛，或无血者，以针烧红频烙患处，以
痛为度。若下部所患，多宜隔蒜灸之，痛则灸至不痛，不痛则灸至痛。若灸之而不痛者，
宜明灸之，及针疔四畔出去恶血，却以棱针深刺破疔头，疮口用海马拔毒散敷之，或雄矾丹敷之，
待疔四围发黄 ，浮肿知痛为佳。若疔未发，用火针四畔乱刺，如有红丝脉尽
处，亦以火针三向刺断，如此样刺了，即敷药。若疔不痛不发者，用艾火于疔疮上灸之三壮，候疮边起
黄，发后方可贴膏药。凡疔肿皆刺中心至痛，又刺四畔令出恶血，去血敷药，药气入针孔佳。
\r图\ps96a3.bmp\r若不针透，
疮内不得力也，若起紫 初然，切不可针破，服药赶出， 自破出血水为妙。若服药 又不
破，方以针挑破无妨。若起紫 肿痛者，以万病解毒丸外涂、内服。若成脓不干者，以
米醋调铁锈涂之，自然凸出，脓水即干。多有患此不觉而暴死者，用灯照看，遍身有小
疮即是。疔毒宜灸疮处，候苏更服败毒药，并追疔夺命汤。若内疔之证，用化毒丸置舌上，
含化出涎，或只用蟾酥一粒，重者二粒，置病患舌上含化，化后良久，用井水漱去毒涎
为妙。若牙关紧急，及喉内患者，并宜含蟾酥丸，或朱墨丸，良久用井水漱去，更宜服
二丸，少停又眼二丸，又服夺命丹，或雄黄丸，通利一行，得利为度，又用霹雳火汗之，
再用前药调之。或初生一个，次生二个，逐渐流注者，急将初生者，用铁筒拔毒膏点破，
消蚀恶肉，即不流注，却以油发、蛇蜕、土蜂房、皂角刺，各另烧存性等分，白芨减半
为末 之，以平疮口，此即前所谓三十六疔者也。其鱼脐疔疮，头深黑，破之黄水渗出，
四畔浮浆，其毒尤甚，通用前法，及服万病解毒丸，以清心行血。治法∶表实者宜解表，
以荆防败毒散、追疔夺命汤。初发之时，必发热身疼，此乃毒瓦斯在表，故发表则毒从毛
腠而出。里实者宜攻里，以救命追黄汤、连翘攻里散。表证皆罢，毒瓦斯入里，口渴便秘，
毒在内也，故攻里则毒从脏腑而出。表里俱实者，宜解表和里，以化毒消肿和里散，加
紫河车、独脚莲、紫金藤、苦花子。其证发热身疼，口渴便秘，乃表里俱见，故攻发并
用也。肿势盛，脉浮数者，宜散之，蟾酥丸、返魂丹。毒势盛，脉沉实者，宜下之，夺命
丹、万病解毒丸。无表里证，服散毒消毒药，后以复元通气散，加麝香少许。虚弱人，以
五香连翘汤合十宣散，稍虚者，只以人参败毒散。（按∶五香连翘汤，乃温热走窜之药，即是虚
人，岂其所宜！当用薛氏法为长。）疔毒拔出，用金银白芷散、十宣散调理，未溃者，不须此
药。初发恶寒发热，或拘急，或头疼，或寒热交作，或肢体重痛，或大便秘结，宜以败
毒散加防风、荆芥、连翘、黄芩、青木香、金银花、天花粉、大黄、生地黄。若无恶寒，但
发热者，可服劫瘴消毒散、十神散、万全散。若表证皆罢，毒瓦斯入里者，可用雄黄丸。怯
弱之人不可用峻利药攻之，宜隔蒜灸五十壮，以人参败毒散数剂。若生道远位僻之处，非
峻利则药力不到；若以峻利，则胃气先伤，虚虚之祸有所不免，不若灸之为宜。疔疮四畔
红赤渐散，开阔走胤不止，此名疔疮走黄，宜以通圣消毒散，通利两三行，次去大黄、朴
硝，调理而愈，或解毒消瘴散，亦可用之有
效，此宜作瘴气治之无误。疔疮肿硬脉数，烦躁喜冷，口渴便秘，宜以连翘攻里散一服，次
用蟾酥丸。若兼有表邪者，以荆防败毒散加金银花、天花粉、大黄、连翘。脉实有热更
加黄连、黄芩、或只加苦花子退热，治瘴之妙药也。若因剥割疫死牛马猪羊，瞀闷身冷，
遍体俱有紫泡，此疔毒也，急灸泡处，良久遂苏，即以人参败毒散加防风、荆芥，投之。
若忽然恶寒作呕，肩臂麻木，手心瘙痒，遂瞀闷不自觉知，但有一泡，此疔毒也，急灸
五十壮而苏，又五十壮知痛，投以荆防败毒散而愈。古人谓∶暴死多是疔毒。急用灯照
遍身，若有小疮紫泡异常者即是，急灸其疮，
但是胸腹温者，可救。若因开割瘴死牛马猪羊之毒，或食其肉致发疔毒，或在手足，或
在头面，或在胸腹，或在胁肋，或在背脊，或在阴胯，或起紫泡，或起堆核肿痛，创人发
热烦闷，头疼身痛，骨节烦疼，先用天马夺命丹，次用四神丸、解毒消瘴散，次以七神
散，又以万病解毒丸、劫瘴消毒散，兼服朱墨丸，并用祛瘴散，多用毛屎梯根磨水服，或
仙人薯根磨水服。如不热磨酒服，大热不退者，宜用退热消毒饮，又要以箍瘴散箍住，不
使走胤。又以洗瘴散淋洗，次以刷瘴散涂刷。若成疮，以 瘴散 之，好膏药贴之。若患
疔疮，始初不觉，不曾用前法出汗，过数日外证皆罢。或在胸腹之间，或在胸之下肿起，
此乃毒瓦斯入里所致，用霹雳火治之；若服当归散，外证不解者，亦急用霹雳火发散。若
疔疮在两胁间，毒瓦斯欲奔心，乃危急之证也。可急于疮尖上，用艾柱灸三五壮，仍于灸穴
前后左右，针出少血，灸疮四围有疮起吉，无 凶。若疔在虚软不便处，不可用针，只可
用松针法，针断红丝路。若生两胯间，毒瓦斯欲奔肾者，用松针法于两胯红丝路尽处，针
断出血。若生头面上者，可于项间红丝路尽处，针断出血。若各处红丝路，亦有不现者，
亦可以消，详用松针法针之。凡用松针者，盖因红丝路不现，无可下针故用此法，于项下、
胁下、腋胯，虚软之处针断红丝路，不使毒瓦斯攻心、攻肾而已。若手足厥冷，六脉俱绝
者，此毒瓦斯已深，气血为毒瓦斯所并，不能通流，故体冷而脉不见，宜木香流气饮连进数
服，气血通流，脉自回矣，然后根据法治之，万不失一。内疔之证与外疔并同，亦发寒热，头
疼身痛，但疮形不现，不过数日，胸背、腹胁、头面、手足间，或有一处肿起，即内疔
所发之处，急用霹雳火如前，不护场，汗法于肿处出汗。若身体寒热，虽未有肿起，但
腹痛甚者，便须作内疔证，用后法治之，不可缓也。治内疔蟾酥须于取时，用桑叶小钱
大，入蟾酥捣和得所，丸如珍珠大，阴干用。
〔治验〕
张嗣伯尝闻屋中呻吟声，曰∶此劳甚重。乃往视之，见一老姥称体痛，而处处有黯黑
无数。张还，煮斗余汤送令服之，服讫，痛势愈甚，跳投床者无数。须臾，所黯处皆拔
出钉，长寸许，以膏涂疮口，三月而复。云此名钉疽也，罗谦甫曰∶丙午岁，予居 城，
人多患疔疮。县尹董公谓予曰∶今岁患疔疮者极多，贫民无力医治，近于史侯处得数方，
用之者无不效，官给药钱，君当舍手治之，遂诺其语。董公榜示通衢，命予施药，如此一
年全活甚众，其用保生锭子、千金托里散、神圣膏药、破棺丹，凡四方。郭氏治一妇，年
近六十，右耳下天窗穴间，患一疔疮。其头黑靥，四边泡起，黄水时流，浑身麻木，发
凉血饮，就是引兵先锋方。治疗心肺有热，或者出现寒热往来，口干喜欢喝水，全身疼痛，腹内发热，头面部发红。
内托散，就是前锋正将方。治疗同上。同时配合使用敷角洗贴。已经溃破的疮疡多服用加味十奇散。（以上均见《肿疡门》。）
八味丸，治疗肾虚因房事过度，外受寒邪侵袭，引发痈肿，不可使用凉性药剂，适宜服用此方。（方剂见《溃疡门》。）
加味十奇散，治疗同上。同时配合葱白、橘叶、花椒叶、猪蹄汤淋洗患处，并贴上金丝膏。（方剂见前文《肿疡门》。）
疔疮，是因为疮形像钉子盖住的样子而得名。都生长在头面、四肢，疮顶发黄中间或呈紫黑色，必定先痒后痛，先恶寒后发热。凡人在一两天间出现恶寒发热，四肢沉重，心悸眼花，头痛身体疼痛，稍微不同于平常的症状，必须遍身寻找辨认，如果有小疮，与以前患过的疮稍有不同，这就是疔疮。大抵起紫黑色的多，起堆核的少，发在手上的多，发在其他地方的少。生在两足的，多有红丝延伸到肚脐；生在手上的，多有红丝延伸到腋窝；生在嘴唇、面部、口内的，多有红丝进入咽喉。用针刺疮口，不痛且不出血，这是其征候。医经说：“膏粱之变，足生大疔。”大抵多由恣意食用浓味食物，突然中受饮食之毒，或者感受四时不正之气，或者感受蛇虫之毒，或者感受疫死牛马、猪羊之毒，或者人汗滴入肉中食用，都会产生疔疮，各自应当审慎而治。如果出现呕吐逆气、直视、胡言乱语如醉酒状态，就不可治愈了。又有内疔这一证候，与外疔的证候大体相同，只是疮形不显现，过了几天有一处肿起的，就是内疔发作的地方，如果腹痛严重的，就必须按内疔来治疗。不可以拖延，拖延就会杀人。华元化说：疔有五色对应五脏，红色属心发于舌根，青色属肝发于眼下，黄色属脾发于口唇，白色属肺发于右鼻，黑色属肾发于耳前。从种类来说，《千金方》、《外台秘要》、《神巧万全方》都称有一十三种，大概不止这些。麻子疔，形状像麻子而稍黑，四边微红，多痒少痛，忌食麻子油、穿麻衣，以及进入麻田行走，穿麻布的人也不能接触。火疔发于头顶，或者发于面部，身体发热如火，状如热水烫烧灼伤，疮头有黑点，四边如烟焰，又如赤粟米，忌用火灸、烧针烙。脾疔生于唇四周的白色部位。眉疔生于眉毛处。髭疔生于胡须中。龙泉疔生于上唇。虎须疔生于下唇。鱼尾疔生于眼角外侧。颧骨疔生于颧骨上，也叫赤面疔，其状色白，顶端凹陷如钱孔，鼻子有紫色者为大凶。耳疔生于耳中，也叫黑疔，连及腮部红肿。鼻疔生于鼻内，疼痛牵引脑门，不能呼吸通畅，鼻子像大瓶子，黑色者不治。颊疔生于面颊骨尖高处。气疔形如气泡，因愤怒而生。腐疔色白有脓，三日内顶端凹陷，状如初灸的疮，因夏天制作豆腐时，人汗滴入其中食用而生，忌食豆腐。鬼疔因中阴邪之毒而生。瓜藤疔蔓延无数，忌在瓜田中行走。石疔皮肉相连，坚硬如石，刺不入，肉微痛，忌砂砾。盐肤疔大如匙面，四边皆红，有黑点如粟粒突起，忌食咸物。水洗疔状如铜钱形，或如钱孔疮，头白里黑，汁出而中间硬，极痒透骨，搔抓则舒适，忌水洗、渡河及饮浆水。浮沤疔其状圆曲少许不合，长而狭如薤叶大，内黄外黑，黑处刺不痛，黄处刺则痛。三十六疔，其状头黑浮起，形如黑豆，四畔起大红色，今日生一个明日两个，后日三个乃至十个。如果满三十六个，药物不能治愈。未满的可以治愈，俗名黑疔。忌嗔怒蓄积愁恨。猪疔形圆而小，疮口内有油。羊疔，形长而白色。牛疔形圆而小，疮内无油，突起掐不破，有寒热。狗疔色赤而长，或带尖，与牛疔相同，无忌，不杀人。驴马疔其状三角，顶上有黑点，根脚有红色，或突起。水疔状如水泡，因饮隔夜水而生，忌饮水。脐疔生于肚脐。胁疔生于胁肋，刀镰疔状如薤叶，长约寸许，肉黑如烧烙，忌刀针。暗疔生两腋下而无头，但腋下坚硬，四肢拘急，寒热大作。阴囊肿痛，睾丸附生突兀如疔，寒热并作，也叫暗疔。寸疔生手指骨节间。虎口疔生合谷穴，鱼脐疔状如鱼脐。茱萸疔中间凹陷边缘突起。蛇眼疔头黑皮浮，形如小豆，状似蛇眼，忌恶眼看，并嫉妒之人看见，以及触碰毒药。红丝疔一名血箭疔，一名赤疔，一名红演疔。生于舌根下，或者生头面，或者生手足骨节间，其证最急，宜迎着经络刺出恶血则痊愈，稍迟毒瓦斯攻心，呕吐呃逆昏迷闷绝者死。如果红丝靠近心腹，就在红丝尽头处刺出恶血，再挑破初起疮头，以泄其毒。芝麻疔走注不定，遍身疼痛，不能转侧。烂疔溃出脓水，大如匙面，色稍黑，有白斑，忌沸汤、热食、烂物。雌疔疮头稍黄向里凹，也似灸疮，四面流浆突起，中心凹陷色赤大如钱孔，又有一枚在别处，用水浇它，则见变大，忌房事。雄疔其状头黑突起；四畔仰起，流浆出水，色黄，大如钱孔，忌房事。黄疔有眼在皮，发如齿龈之色，手足麻木，涎出不语者死。黑疔状如黑疔。樱桃疔状如樱桃。蛇头疔生手指头两旁，状如蛇头，甚腥秽紫黑色，痛引心，有溃烂脱落者。足面疔，状如粟米，痒极入骨，急隔蒜灸之。大抵如豆，如臼，如箔金，如茱萸，如石榴子。或者发疹搔破，而青黄赤色汁出；或者衣物触着而疼痛，忽生或者白而肿实；或者赤而浮虚，其状不一。初觉顶端不起的，急隔蒜灸之。灸而有脓者为吉，无脓者为凶；服发汗剂得汗则生，无汗则死。刺出紫血者危，出黑血者死。缓症者一日疮顶色微白，二日色大白，三日色微紫，四日色真紫，都是缓症的征候。急症者五日色微青小紧，六日色深青大紧，七日色黑，其形如鱼脐，或如灸疮之状，都是急症的征候。凡是生疔疮，身体发热头疼，手足温和，饮食如常，疔的四周围赤肿，名叫护场，可治。凡是生疔疮，眼白睛痴滞不转动，渴欲饮水，内热疮盛，唇舌青，卧床不能起，五心肿，头晕眼花，气粗食不进，脉伏谵语恶心，腹痛冷汗出，手足冷，滑泄无度，疔的四周围无赤肿，名叫不护场，不可治。疮证急者有应验，如生一个疔之外，别处肉上再生一小疮，就是有应验，可用针挑破，护场疮四围有赤肿。生多疮的，谓之满天星，饮食如常，头痛身热，手足温。疮证凶者无应验，别处肉上无疮不护场，疔四围无赤肿。腹痛严重的，有内疔。如果毒入心腹，眼黑如见火光，烦闷呕逆，恍惚痴眠，瞳人不动，赤脉贯睛，胸胁赤肿，疮陷不起发，都是死候。凡是疔疮必有红丝路，急用针于红丝所至之处出血及刺疔头四畔出血。如果针之不痛，或者无血的，把针烧红频繁烙患处，以痛为度。如果下部所患，多宜隔蒜灸之，痛则灸至不痛，不痛则灸至痛。如果灸之不痛的，宜明灸之，以及针疔四畔出去恶血，然后用棱针深刺破疔头，疮口用海马拔毒散敷之，或者雄矾丹敷之，待疔四围发黄浮肿知痛为佳。如果疔未发，用火针四畔乱刺，如有红丝脉尽头处，也以火针三向刺断，如此样刺了，即敷药。如果疔不痛不发的，用艾火于疔疮上灸之三壮，候疮边起黄，发后方可贴膏药。凡是疔肿皆刺中心至痛，又刺四畔令出恶血，去血敷药，药气入针孔佳。如果不针透，疮内不得力也，如果起紫黑初然，切不可针破，服药赶出，自然破出血水为妙。如果服药又不破，才以针挑破无妨。如果起紫黑肿痛者，用万病解毒丸外涂、内服。如果成脓不干者，用米醋调铁锈涂之，自然凸出，脓水即干。多有患此不觉而暴死的，用灯照看，遍身有小疮即是。疔毒宜灸疮处，候苏更服败毒药，并追疔夺命汤。如果是内疔的证候，用化毒丸置舌上，含化出涎，或者只用蟾酥一粒，重者二粒，置病患舌上含化，化后良久，用井水漱去毒涎为妙。如果牙关紧急，以及喉内患者，并宜含蟾酥丸，或者朱墨丸，良久用井水漱去，更宜服二丸，少停又眼二丸，又服夺命丹，或者雄黄丸，通利一行，得利为度，又用霹雳火汗之，再用前药调之。或者初生一个，次生二个，逐渐流注者，急将初生者，用铁筒拔毒膏点破，消蚀恶肉，即不流注，却以油发、蛇蜕、土蜂房、皂角刺，各另烧存性等分，白芨减半为末掺之，以平疮口，此即前所谓三十六疔者也。其鱼脐疔疮，头深黑，破之黄水渗出，四畔浮浆，其毒尤甚，通用前法，及服万病解毒丸，以清心行血。治法：表实者宜解表，以荆防败毒散、追疔夺命汤。初发之时，必发热身疼，此乃毒瓦斯在表，故发表则毒从毛腠而出。里实者宜攻里，以救命追黄汤、连翘攻里散。表证皆罢，毒瓦斯入里，口渴便秘，毒在内也，故攻里则毒从脏腑而出。表里俱实者，宜解表和里，以化毒消肿和里散，加紫河车、独脚莲、紫金藤、苦花子。其证发热身疼，口渴便秘，乃表里俱见，故攻发并用也。肿势盛，脉浮数者，宜散之，蟾酥丸、返魂丹。毒势盛，脉沉实者，宜下之，夺命丹、万病解毒丸。无表里证，服散毒消毒药，后以复元通气散，加麝香少许。虚弱人，以五香连翘汤合十宣散，稍虚者，只以人参败毒散。（按：五香连翘汤，乃温热走窜之药，即是虚人，岂其所宜！当用薛氏法为长。）疔毒拔出，用金银白芷散、十宣散调理，未溃者，不须此药。初发恶寒发热，或者拘急，或者头疼，或者寒热交作，或者肢体重痛，或者大便秘结，宜以败毒散加防风、荆芥、连翘、黄芩、青木香、金银花、天花粉、大黄、生地黄。如果没有恶寒，但发热者，可服劫瘴消毒散、十神散、万全散。如果表证皆罢，毒瓦斯入里者，可用雄黄丸。怯弱之人不可用峻利药攻之，宜隔蒜灸五十壮，以人参败毒散数剂。如果生道远位僻之处，非峻利则药力不到；如果用峻利，则胃气先伤，虚虚之祸有所不免，不如灸之为宜。疔疮四畔红赤渐散，开阔走胤不止，此名疔疮走黄，宜以通圣消毒散，通利两三行，次去大黄、朴硝，调理而愈，或者解毒消瘴散，也可用之有效，此宜作瘴气治之无误。疔疮肿硬脉数，烦躁喜冷，口渴便秘，宜以连翘攻里散一服，次用蟾酥丸。如果兼有表邪者，以荆防败毒散加金银花、天花粉、大黄、连翘。脉实有热更加黄连、黄芩、或者只加苦花子退热，治瘴之妙药也。如果因剥割疫死牛马猪羊，瞀闷身冷，遍体俱有紫泡，此疔毒也，急灸泡处，良久遂苏，即以人参败毒散加防风、荆芥，投之。如果忽然恶寒作呕，肩臂麻木，手心瘙痒，遂瞀闷不自觉知，但有一泡，此疔毒也，急灸五十壮而苏，又五十壮知痛，投以荆防败毒散而愈。古人谓：暴死多是疔毒。急用灯照遍身，若有小疮紫泡异常者即是，急灸其疮，但是胸腹温者，可救。如果因开割瘴死牛马猪羊之毒，或者食其肉致发疔毒，或者在手足，或者在头面，或者在胸腹，或者在胁肋，或者在背脊，或者在阴胯，或者起紫泡，或者起堆核肿痛，创人发热烦闷，头疼身痛，骨节烦疼，先用天马夺命丹，次用四神丸、解毒消瘴散，次以七神散，又以万病解毒丸、劫瘴消毒散，兼服朱墨丸，并用祛瘴散，多用毛屎梯根磨水服，或者仙人薯根磨水服。如不热磨酒服，大热不退者，宜用退热消毒饮，又要以箍瘴散箍住，不使走胤。又以洗瘴散淋洗，次以刷瘴散涂刷。如果成疮，以箍瘴散箍之，好膏药贴之。如果患疔疮，始初不觉，不曾用前法出汗，过数日外证皆罢。或者在胸腹之间，或者在胸之下肿起，此乃毒瓦斯入里所致，用霹雳火治之；如果服当归散，外证不解者，亦急用霹雳火发散。如果疔疮在两胁间，毒瓦斯欲奔心，乃危急之证也。可急于疮尖上，用艾柱灸三五壮，仍于灸穴前后左右，针出少血，灸疮四围有疮起吉，无脓凶。如果疔在虚软不便处，不可用针，只可用松针法，针断红丝路。如果生两胯间，毒瓦斯欲奔肾者，用松针法于两胯红丝路尽处，针断出血。如果生头面上者，可于项间红丝路尽处，针断出血。如果各处红丝路，也有不现的，也可以用消法，详用松针法针之。凡是用松针的，盖因红丝路不现，无可下针故用此法，于项下、胁下、腋胯，虚软之处针断红丝路，不使毒瓦斯攻心、攻肾而已。如果手足厥冷，六脉俱绝者，此毒瓦斯已深，气血为毒瓦斯所并，不能通流，故体冷而脉不见，宜木香流气饮连进数服，气血通流，脉自回矣，然后根据法治之，万不失一。内疔的证候与外疔并同，也发寒热，头疼身痛，但疮形不现，不过数日，胸背、腹胁、头面、手足间，或者有一处肿起，即内疔所发之处，急用霹雳火如前，不护场，汗法于肿处出汗。如果身体寒热，虽未有肿起，但腹痛严重的，便须作内疔证，用后法治之，不可缓也。治内疔蟾酥须于取时，用桑叶小钱大，入蟾酥捣和得所，丸如珍珠大，阴干用。
〔治验〕
张嗣伯曾经听到屋中有呻吟声，说：这是劳损很重。于是前往查看，见一位老妇人称全身疼痛，而且处处有无数黯黑斑点。张嗣伯回去，煮斗余汤送令服用，服完后，痛势愈发严重，跳投床榻者无数。片刻，那些黯黑处皆拔出钉子，长寸许，用膏涂抹疮口，三个月后复原。云此名叫钉疽也。罗谦甫说：丙午年，我居住在某城，许多人患疔疮。县尹董公对我说：今年患疔疮者极多，贫民无力医治，最近在史侯处得到几个方子，使用者无不效验，官府给药钱，您应当施手救治，于是答应他的话。董公榜示通衢，命我施药，如此一年全活甚众，所用保生锭子、千金托里散、神圣膏药、破棺丹，共四方。郭氏治疗一妇人，年近六十，右耳下天窗穴间，患一疔疮。其头黑靥，四边泡起，黄水时流，浑身麻木，发
Liangxue Yin (Cooling Blood Decoction), also known as the Vanguard Pioneer Formula, treats heat in the Heart and Lung, or alternating chills and fever, dry mouth with desire to drink water, whole-body pain, internal abdominal heat, and redness of the head and face.
Neituo San (Supporting the Interior Powder), also known as the Vanguard General Formula, treats the same conditions as above. It is used concurrently with Fujiao Xi Tie (Corner-Washing Paste Application). For ulcers that have already suppurated, Jiawei Shiqi San (Modified Ten Miracles Powder) should be taken in large quantities. (The above are all found in the *Swelling Ulcer Section*.)
Bawei Wan (Eight-Ingredient Pill) treats carbuncles and swellings caused by Kidney deficiency due to excessive sexual indulgence, compounded by external invasion of Cold pathogenic factors. Cool-natured agents should not be applied; this formula is suitable. (The formula is found in the *Ulcer Section*.)
Jiawei Shiqi San (Modified Ten Miracles Powder) treats the same conditions as above. It is used concurrently with washing using Scallion White, Tangerine Peel, Pepper Leaf, and Pig Trotter Decoction, and applying Jinshi Gao (Golden Thread Plaster). (The formula is found in the preceding *Swelling Ulcer Section*.)
Ding Chuang (Carbuncle/Furuncle resembling a nail) gets its name because the shape of the sore resembles a nail cover. They occur on the head, face, and limbs. The center may turn yellow, purple, or black. There is invariably itching before pain, and chills before fever. Within one or two days, a person experiences chills and fever, heaviness in the four limbs, palpitations, blurred vision, headache, and body pain. These symptoms differ slightly from normal conditions. One must search the entire body for recognition; if there is a small sore that differs slightly from previously experienced sores, it is Ding Chuang. Generally, those presenting with purple coloration are more common, while those presenting with nodular masses are less common. Those occurring on the hands are more common, while those occurring elsewhere are less common. When occurring on both feet, there is often a red thread extending to the umbilicus; when occurring on the hands, there is often a red thread extending to the axilla; when occurring on the lips, face, or inside the mouth, there is often a red thread entering the throat. Puncturing the sore with a needle results in no pain and no bleeding, which is its characteristic sign. The Classics state: "Changes from rich food and fine flavors can produce large Ding." Generally, this arises from indulging in rich and heavy foods, suddenly contracting dietary toxins, or being affected by abnormal Qi of the four seasons, snake or insect venom, toxins from epidemic-dead cattle, horses, pigs, or sheep, or human sweat dripping into meat which is then consumed. All generate Ding Chuang, and each should be treated after careful examination. If vomiting, upward reversal, staring fixedly, or delirious speech resembling drunkenness occurs, it is incurable. There is also a condition called Nei Ding (Internal Carbuncle), which is largely similar to Wai Ding (External Carbuncle), except the sore form does not appear. After several days, if one area swells up, that is where the Internal Carbuncle has manifested. If abdominal pain is severe, it must be treated as an Internal Carbuncle. Delay is not permissible; delay leads to death. Hua Yuanhua said: "There are five colors of Ding corresponding to the Five Zang organs: Red corresponds to the Heart and manifests at the root of the tongue; Green corresponds to the Liver and manifests under the eyes; Yellow corresponds to the Spleen and manifests on the lips; White corresponds to the Lungs and manifests on the right nostril; Black corresponds to the Kidneys and manifests in front of the ears." In terms of categories, *Qianjin Fang*, *Waitai Miyao*, and *Shenqiao Wanquan Fang* all list thirteen types, but there are likely more than that. Mazi Ding (Hemp Seed Carbuncle) looks like a hemp seed but slightly darker, with slightly red edges, mostly itchy with little pain. Avoid consuming hemp seed oil, wearing hemp clothes, walking in hemp fields, or contact with people wearing hemp cloth. Huo Ding (Fire Carbuncle) occurs on the vertex or face. The body feels hot as fire, resembling scalding or burning. The sore head has black spots, with edges like smoke flames, resembling red millet grains. Avoid moxibustion, cauterization needles, or branding. Pi Ding (Spleen Carbuncle) occurs on the white area around the lips. Mei Ding (Eyebrow Carbuncle) occurs in the eyebrows. Zi Ding (Moustache Carbuncle) occurs in the moustache. Longquan Ding (Dragon Spring Carbuncle) occurs on the upper lip. Huxu Ding (Tiger Whisker Carbuncle) occurs on the lower lip. Yuwai Ding (Fish Tail Carbuncle) occurs outside the eye corner. Quangu Ding (Cheekbone Carbuncle) occurs on the cheekbone, also called Chimi Ding (Red Face Carbuncle). Its appearance is white, with the apex sunken like a coin hole. Purple coloration on the nose indicates a dire prognosis. Er Ding (Ear Carbuncle) occurs in the ear, also called Hei Ding (Black Carbuncle), connecting to the cheek with red swelling. Bi Ding (Nose Carbuncle) occurs inside the nose, pain radiating to the forehead, causing breathing difficulty, with the nose appearing like a large bottle. Black coloration is untreatable. Jia Ding (Cheek Carbuncle) occurs at the high point of the zygomatic bone. Qi Ding (Qi Carbuncle) resembles a bubble, arising from anger. Fu Ding (Rotting Carbuncle) is white with pus. The apex sinks within three days, resembling a newly moxa-burned sore. It arises from human sweat dripping into tofu during summer production, which is then eaten. Avoid tofu. Gui Ding (Ghost Carbuncle) arises from contracting Yin Evil toxins. Guateng Ding (Melon Vine Carbuncle) spreads endlessly. Avoid walking in melon fields. Shi Ding (Stone Carbuncle) adheres to skin and flesh, hard as stone, cannot be pierced, with slight muscle pain. Avoid gravel. Yanku Ding (Salt Skin Carbuncle) is as large as a spoon surface, with all edges red, having black dots like millet grains protruding. Avoid salty foods. Shuixi Ding (Water Wash Carbuncle) resembles a coin shape or coin-hole sore. The head is white, the interior black. Fluids exude, the center is hard, extremely itchy penetrating to the bone. Scratching brings relief. Avoid water washing, crossing rivers, and drinking sour rice water. Fou'ou Ding (Floating Bubble Carbuncle) is round and curved, slightly incomplete, long and narrow like a leek leaf. The interior is yellow, the exterior black. Puncturing the black area causes no pain; puncturing the yellow area causes pain. Sanshiliu Ding (Thirty-Six Carbuncles) have heads that are black and floating, shaped like black beans, with large red edges. One appears today, two tomorrow, three the day after, up to ten. If thirty-six appear, medicine cannot cure them. Fewer than thirty-six are treatable. Commonly called Hei Ding (Black Carbuncle). Avoid anger and accumulated sorrow. Zhu Ding (Pig Carbuncle) is round and small, with oil inside the sore mouth. Yang Ding (Sheep Carbuncle) is long and white. Niu Ding (Cow Carbuncle) is round and small, without oil inside, protruding and unbreakable by pinching, accompanied by chills and fever. Gou Ding (Dog Carbuncle) is red and long, or pointed, similar to Cow Carbuncle, with no taboos, does not cause death. Lvma Ding (Donkey/Horse Carbuncle) is triangular, with a black dot on top, red roots, or protruding. Shui Ding (Water Carbuncle) resembles a water blister, arising from drinking overnight water. Avoid drinking water. Qi Ding (Umbilical Carbuncle) occurs at the umbilicus. Xie Ding (Flank Carbuncle) occurs at the flank. Daolian Ding (Sickle Carbuncle) resembles a leek leaf, about one cun long. The flesh is black as if branded. Avoid knives and needles. An Ding (Hidden Carbuncle) occurs in both axillae without a head, but the axilla is hard, with limb stiffness and severe chills and fever. Scrotal swelling and pain, with testicles protruding abnormally like a carbuncle, accompanied by chills and fever, is also called An Ding. Cun Ding (Inch Carbuncle) occurs between finger joints. Hukou Ding (Tiger Mouth Carbuncle) occurs at the Hegu acupoint. Yuqi Ding (Fish Umbilicus Carbuncle) resembles a fish umbilicus. Zhuyu Ding (Cornel Carbuncle) is concave in the middle and convex at the edges. Sheyan Ding (Snake Eye Carbuncle) has a black head and floating skin, shaped like a small bean, resembling a snake's eye. Avoid evil gazes, jealousy, and toxic substances. Hongsi Ding (Red Thread Carbuncle), also known as Xuejian Ding (Blood Arrow Carbuncle), Chi Ding (Red Carbuncle), or Hongyan Ding (Red Spreading Carbuncle), occurs under the root of the tongue, or on the head/face, or between finger/toe joints. This condition is most urgent. One should pierce along the meridian to release bad blood for recovery. If delayed, the toxin attacks the Heart, leading to death from vomiting, hiccuping, coma, and suffocation. If the thread is near the heart or abdomen, pierce the end of the thread to release bad blood, then lacerate the initial sore head to drain the toxin. Zhima Ding (Sesame Carbuncle) moves unpredictably, causing whole-body pain and inability to turn over. Lan Ding (Rotten Carbuncle) ulcerates with pus, as large as a spoon surface, slightly black with white patches. Avoid boiling soup, hot food, and rotten matter. Ci Ding (Female Carbuncle) has a slightly yellow head turning inward, resembling a moxa sore. The four sides have exudate, the center is sunken and red like a coin hole. Another lesion appears elsewhere. Water makes it larger. Avoid sexual intercourse. Xiong Ding (Male Carbuncle) has a black, protruding head; the four sides are raised with exudate, yellow in color, as large as a coin hole. Avoid sexual intercourse. Huang Ding (Yellow Carbuncle) has an opening in the skin, emitting color like gum tissue. Numbness in hands and feet, drooling, and inability to speak indicate death. Hei Ding (Black Carbuncle) resembles a black spot. Yingtao Ding (Cherry Carbuncle) resembles a cherry. Shetou Ding (Snake Head Carbuncle) occurs on both sides of the fingertip, resembling a snake head, very foul-smelling, purple-black, pain radiating to the heart, with ulceration and shedding. Zuomian Ding (Foot Surface Carbuncle) resembles a millet grain, extremely itchy penetrating to the bone. Apply garlic-separated moxibustion urgently. Generally, they resemble beans, mortars, gold foil, cornels, or pomegranate seeds. Or they erupt as rashes scratched open, discharging green, yellow, or red fluid; or touch clothing causes pain; suddenly appearing white and swollen/firm; or red and floating/hollow. Their forms vary. If initially the apex does not rise, apply garlic-separated moxibustion urgently. Moxibustion producing pus is auspicious; no pus is ominous. Taking diaphoretic agents resulting in sweating indicates survival; no sweating indicates death. Piercing yielding purple blood is critical; yielding black blood indicates death. Slow-progressing cases: Day 1, apex slightly white; Day 2, very white; Day 3, slightly purple; Day 4, truly purple. These are signs of slow progression. Urgent cases: Day 5, slightly cyanotic and tight; Day 6, deeply cyanotic and very tight; Day 7, black, shaped like a fish umbilicus or moxa sore. These are signs of urgency. Whenever Ding Chuang occurs, if the body has fever and headache, hands and feet are warm, diet is normal, and the four sides of the Ding are red and swollen, named Huchang (Protecting Field), it is treatable. Whenever Ding Chuang occurs, if the whites of the eyes are dull and immobile, thirst with desire to drink, internal heat and abundant sores, blue-green lips and tongue, unable to get out of bed, swelling of the five centers, dizziness and blurred vision, coarse breathing, inability to eat, hidden pulse, delirium, nausea, abdominal pain with cold sweat, cold hands and feet, uncontrolled diarrhea, and the four sides of the Ding lack redness/swelling, named Bu Huchang (No Protecting Field), it is untreatable. Urgent sore conditions with a response: besides one Ding, another small sore appears on other flesh. This is a response. It can be picked with a needle; the Huchang sore has redness/swelling on its four sides. Many sores are called Mantianxing (Sky-Filling Stars). Diet is normal, headache and body heat, warm hands and feet. Ominous sore conditions without response: no sores on other flesh, no Huchang, no redness/swelling around the Ding. Severe abdominal pain indicates Internal Ding. If toxin enters the Heart/Abdomen, eyes go black seeing firelight, restlessness, vomiting/reversal,恍惚 (trance-like) sleep, immobile pupils, red vessels piercing the eyeballs, red/swollen chest and hypochondrium, sunken/non-raising sores—all are death omens. All Ding Chuang must have a Hongsi Lu (Red Thread Path). Urgently use a needle to bleed at the path of the red thread and pierce the four sides of the Ding head to bleed. If needling causes no pain or no blood, heat the needle until red and frequently cauterize the affected area until pain is felt. For lower body lesions, garlic-separated moxibustion is preferred. If painful, moxa until painless; if painless, moxa until painful. If moxibustion causes no pain, use clear moxibustion, and needle the four sides of the Ding to remove bad blood. Then use a three-edged needle to deeply pierce the Ding head. Apply Haima Badu San (Sea Horse Antidote Powder) or Xiongfan Dan (Realgar Alum Pill) to the sore mouth. Wait until the four sides turn yellow, become swollen, and feel pain—this is good. If the Ding has not erupted, use a fire needle to randomly prick the four sides. If there is a red thread path ending, use a fire needle to pierce in three directions to sever it. After such pricking, apply medicine. If the Ding is painless and non-eruptive, use moxa fire to burn three cones on the Ding sore. Wait for the edge to turn yellow and erupt before applying plasters. All Ding swellings should be pricked at the center to extreme pain, and the four sides pricked to release bad blood. Remove blood, apply medicine; medicinal qi entering the needle hole is ideal. If not penetrated through, the medicine lacks efficacy inside the sore. If purple/black appears initially, absolutely do not pierce with a needle. Take medicine to drive it out; natural rupture releasing blood/fluid is wonderful. If medicine fails to rupture it, then piercing with a needle is acceptable. If purple/black with swelling/pain, apply Wanbing Jiedu Wan (Ten Thousand Diseases Detoxification Pill) externally and internally. If suppuration does not dry, mix iron rust with rice vinegar and apply; it will naturally protrude and the pus will dry. Many die suddenly without realizing the illness. Use a lamp to inspect; small sores all over the body confirm it. For Ding toxin, moxa the sore area. Upon regaining consciousness, take detoxifying drugs and Zhuiting Duoming Tang (Chasing Carbuncle Life-Seizing Decoction). For Internal Ding, place Huadu Wan (Detoxification Pill) on the tongue to dissolve and salivate, or use one pill of Chan Su (Toad Venom), two for severe cases, placed on the patient's tongue to dissolve. After some time, rinse with well water to remove toxic saliva—this is best. For lockjaw or throat involvement, hold Chan Su Wan (Toad Venom Pill) or Zhumo Wan (Cinnabar Ink Pill) in the mouth. Rinse with well water after some time. Take two pills, wait a moment, take two more, then take Duoming Dan (Life-Seizing Pill) or Xionghuang Wan (Realgar Pill). Promote bowel movement once; stop when effective. Use Pilihuo (Thunderfire) to induce sweating, then regulate with previous medicines. If one appears first, then two, gradually spreading, urgently pierce the first one with Tietong Badu Gao (Iron Tube Antidote Paste) to corrode bad flesh, preventing spread. Then use Youfa (Hair Oil), Shed Snake Skin, Earth Beehive, and Gleditsia Spine, each calcined to retain char, in equal parts, with half amount of Baiji (Bletilla Rhizome) ground into powder, sprinkled to level the sore mouth. This is the aforementioned Thirty-Six Ding. The Yuqi Ding sore has a deep black head. Breaking it releases yellow fluid, with floating exudate on the four sides. The toxin is especially severe. Universally use the previous methods and take Wanbing Jiedu Wan to clear the Heart and move Blood. Treatment Methods: Exterior Excess requires releasing the exterior with Jingfang Baidu San (Aster and Saposhnikovia Decoction to Overcome Toxicity) or Zhuiting Duoming Tang. At initial onset, fever and body pain occur because the toxin is in the exterior; thus, releasing the exterior allows the toxin to exit via hair follicles. Interior Excess requires purging the interior with Mieming Zhuohuang Tang (Saving Life Purging Rhubarb Decoction) or Lianqiao Gongli San (Forsythia Interior-Purging Powder). Once exterior signs cease and toxin enters the interior, causing thirst and constipation, the toxin is inside; thus, purging the interior allows the toxin to exit via the Zang-Fu organs. Exterior and Interior Excess require releasing the exterior and harmonizing the interior with Huadu Xiaozhong Helisan (Detoxification and Swelling-Reducing Harmonizing Powder), adding Zihewche (Placenta Humanum), Dujiaolian (Single Foot Lotus), Zijinteng (Purple Gold Vine), and Kuhuazi (Bitter Flower Seeds). Fever, body pain, thirst, and constipation indicate both exterior and interior involvement; thus, attacking and releasing are used together. Vigorous swelling with floating/rapid pulse requires dispersing with Chan Su Wan (Toad Venom Pill) or Fanhun Dan (Returning Soul Pill). Vigorous toxin with deep/solid pulse requires purging with Duoming Dan (Life-Seizing Pill) or Wanbing Jiedu Wan (Ten Thousand Diseases Detoxification Pill). Without exterior/interior signs, take anti-toxin/detoxifying medicines, followed by Fuyuan Tongqi San (Restoring Origin Ventilating Qi Powder) with a little Moshe (Musk). For weak persons, use Wuxiang Lianqiao Tang (Five Fragrances Forsythia Decoction) combined with Shixuan San (Ten Acupoints Powder). Slightly weak persons use only Renshen Baidu San (Ginseng Decoction to Overcome Toxicity). (Note: Wuxiang Lianqiao Tang consists of warm, moving, and penetrating herbs; even for weak persons, is this appropriate? Using Dr. Xue’s method is superior.) After Ding toxin is extracted, regulate with Jinyin Baizhi San (Honeysuckle and Angelica Dahurica Powder) or Shixuan San. Not needed for un-ulcerated sores. Initial chills, fever, stiffness, headache, alternating chills/fever, heavy limb pain, or constipation: use Baidu San (Decoction to Overcome Toxicity) plus Fangfeng, Jingjie, Lianqiao, Huangqin, Qingmuxiang, Jinyinhua, Tianhuafen, Dahuang, and Shengdiye. If no chills, only fever: take Jiezhang Xiaodu San (Quelling Miasma Detoxifying Powder), Shishen San (Ten Spirits Powder), or Wanquan San (Complete Safety Powder). If exterior signs cease and toxin enters the interior: use Xionghuang Wan (Realgar Pill). Weak persons should not use harsh purgatives. Apply garlic-separated moxibustion fifty cones, and take several doses of Renshen Baidu San. If located in remote areas, harsh medicines are necessary for efficacy; otherwise, medicinal power won't reach. Harsh medicines damage Stomach Qi first, inevitably causing deficiency-of-deficiency disaster. Moxibustion is preferable. If the four sides of the Ding are red, gradually dissipating, expanding and spreading uncontrollably, this is named Dingchuang Zouhuang (Carbuncle Spreading Yellow/Wandering Yellow). Use Tongsheng Xiaodu San (Supreme Sage Detoxifying Powder), promote bowel movements two or three times, then remove Dahuang and Poxiao, and regulate to recovery. Or use Jiedu Xiaozhang San (Detoxifying and Quelling Miasma Powder), which is also effective. Treat this as Miasma Qi without error. Hard swelling with rapid pulse, irritability, preference for cold, thirst, and constipation: take one dose of Lianqiao Gongli San, followed by Chan Su Wan. If accompanied by exterior pathogens: use Jingfang Baidu San plus Jinyinhua, Tianhuafen, Dahuang, and Lianqiao. Solid pulse with heat: add Huanglian, Huangqin, or only Kuhuazi to reduce heat—a wonderful herb for treating miasma. If caused by slaughtering epidemic-dead cattle, horses, pigs, or sheep, experiencing dizziness, cold body, and purple blisters all over, this is Ding toxin. Urgently moxa the blister area. After some time, recover, then administer Renshen Baidu San plus Fangfeng and Jingjie. If suddenly chills, vomiting, shoulder/arm numbness, palm itching, followed by dizziness and loss of awareness, with only one blister, this is Ding toxin. Urgently moxa fifty cones to recover, another fifty cones to feel pain, then administer Jingfang Baidu San for recovery. Ancients said: Sudden death is mostly due to Ding toxin. Urgently illuminate the whole body with a lamp. If there are abnormal small sores or purple blisters, moxa them urgently. If the chest and abdomen are warm, rescue is possible. If caused by toxins from slaughtering miasma-dead cattle, horses, pigs, or sheep, or eating their meat causing Ding toxin, whether on limbs, head/face, chest/abdomen, flanks, back/spine, or groin; whether purple blisters or nodular swelling/pain; causing fever, restlessness, headache, body pain, joint ache: first use Tianma Duoming Dan (Heavenly Horse Life-Seizing Pill), then Six Shen Wan (Four Spirits Pill), Jiedu Xiaozhang San (Detoxifying and Quelling Miasma Powder), Seven Shen San (Seven Spirits Powder), Wanbing Jiedu Wan (Ten Thousand Diseases Detoxification Pill), Jiezhang Xiaodu San (Quelling Miasma Detoxifying Powder), concurrently take Zhumo Wan (Cinnabar Ink Pill), and use Quzhang San (Expelling Miasma Powder). Grind Maoshiti Gen (Mao Shi Ti Root) or Xianrenshu Gen (Immortal Potato Root) in water and drink. If not hot, grind in wine. If high fever persists, use Tuire Xiaodu Yin (Heat-Reducing and Detoxifying Decoction). Also use Guzhang San (Encircling Miasma Powder) to contain it, preventing spread. Wash with Xizhang San (Washing Miasma Powder), then brush with Shuazhang San (Brushing Miasma Powder). If a sore forms, encircle with Guzhang San and apply good plaster. If suffering from Ding Chuang, initially unaware, not using previous methods to induce sweating, after several days external signs cease. Swelling occurs between chest/abdomen or below the chest. This is caused by toxin entering the interior. Use Pilihuo (Thunderfire) to treat it. If Danggui San (Angelica Decoction) fails to resolve external signs, urgently use Pilihuo to release the exterior. If Ding Chuang is between the two hypochondria, and toxin threatens the Heart, it is a critical condition. Urgently moxa three to five cones on the sore apex. Still, needle around the moxa point (front, back, left, right) to release a little blood. Appearance of sores around the moxa sore is auspicious; absence of pus is ominous. If the Ding is in a soft/inconvenient place, do not needle. Use Songzhen Fa (Pine Needle Method) to sever the red thread path. If occurring between both groins, and toxin threatens the Kidneys, use Songzhen Fa at the end of the red thread path in both groins to sever and bleed. If occurring on the head/face, sever and bleed at the end of the red thread path in the neck. If red thread paths in various places do not appear, use Xiao (Resolution) method, specifically using Songzhen Fa to needle. The reason for using Songzhen Fa is that the red thread path is not visible, leaving no place to needle. It severs the red thread path in soft areas like the neck, hypochondria, axillae, and groins, preventing toxin from attacking the Heart or Kidneys. If hands and feet are cold and all six pulses are absent, the toxin is deep. Qi and Blood are merged by the toxin and cannot flow freely, hence cold body and invisible pulses. Continuously take MuXiang Liuqi Yin (Costus Flowing Qi Decoction). Once Qi and Blood flow and pulses return, then treat according to method. This never fails. Internal Ding symptoms are the same as External Ding, also featuring chills, fever, headache, and body pain, but the sore form does not appear. Within a few days, swelling occurs in one area of the chest/back, abdomen/flanks, head/face, or limbs—that is where the Internal Ding manifests. Urgently use Pilihuo as before. For Bu Huchang (No Protecting Field), use sweating method on the swollen area. If body has chills/fever, though no swelling yet, but severe abdominal pain, treat as Internal Ding using subsequent methods. Do not delay. For treating Internal Ding, Chan Su (Toad Venom) must be prepared at harvest time. Use a mulberry leaf the size of a small coin, add Chan Su, pound and mix properly, roll into pills the size of pearls, and dry in shade.
[Case Record]
Zhang Sibo once heard groaning in a house and said, "This is severe exhaustion." He went to investigate and saw an old woman complaining of whole-body pain with countless dark black spots everywhere. Zhang returned, boiled more than a dou of decoction, and had her take it. After ingestion, the pain intensified severely, and she jumped onto the bed countless times. Moments later, nails were pulled from the dark spots, each about one cun long. Applying plaster to the sore mouths led to recovery after three months. He said this is called Ding Ju (Nail Carbuncle). Luo Qianfu said: In the Bingwu year, I resided in [City Name]. Many people suffered from Ding Chuang. County Magistrate Mr. Dong told me, "This year, many suffer from Ding Chuang. Poor people lack funds for treatment. I recently obtained several formulas from Marquis Shi. Users find them effective. The government provides payment for medicine. You should practice charity and treat them." I agreed. Magistrate Dong posted notices on main streets, ordering me to distribute medicine. Thus, for one year, many lives were saved. The formulas used were Bao Sheng Dingzi (Life-Preserving锭), Qianjin Tuoli San (Thousand Years Supporting Interior Powder), Shensheng Gaoyao (Divine Sacred Plaster), and Po Guan Dan (Breaking Coffin Pill), totaling four formulas. Ms. Guo treated a woman, nearly sixty years old, who developed a Ding Chuang between the Tianchuang acupoint below the right ear. The head was black and crusty, with blisters rising on the four sides, flowing yellow fluid intermittently. The whole body was numb, and she began...