或问∶绕腰生疮，累累如珠何如？曰∶是名火带疮，亦名缠腰火丹。由心肾不交，肝
火内炽，流入膀胱，缠于带脉，故如束带。急服内疏黄连汤。壮实者，一粒金丹下之。活
命饮加芩、连、黄柏，外用清热解毒药敷之。此证若不早治，缠腰已遍，则毒由脐入，膨
胀不食而死。
治蛇缠疮
上用雄黄研为末，以醋调涂，仍用酒调服。凡为蛇伤，及蜂虿、蜈蚣毒虫，癫犬所
伤，皆可用之。
《鬼遗》云∶腿 两处起为便毒。跨下两臀尖下，大道前（谷道）。小道后（水道）。成悬痈。皆
是虚极人患此痈，近谷道左右，亦名痔痈。宜急补脾脏及发处贴药，既用发穴散，破后用
抽脓膏，脓尽用合疮口散合之。慎勿过冬，即成冷漏难治。夫便毒生于小腹下，两腿合缝
之间，其毒初发，寒热交作，腿间肿起疼痛是也。夫肾为作强之官，所藏者精与智也，男
女大欲，不能直遂其志，故败精搏血，留聚经隧，乃结为便毒矣。盖腿与小腹合缝之间，
精气所出之道路也，或触景而动心，或梦寐而不泄，即不得偶合阴阳，又不能忘情息念，
故精与血交滞而成肿结也。初起切不可用寒凉之药，恐气血愈滞，不得宣通，反成大患。
惟当开郁散气，清利热毒，使精血宣畅，则自然愈矣。
〔孙〕 按∶前论盖思想无穷，所愿不遂者设也，此固一说而意犹未完。果如此论，当
僧尼、孀妇、官人、旷夫，多有此患，然予
目击商贾中野合不洁淫妓，便构此疾。或疳疮，或杨梅者，亦由欲火淫炽，一旦交合不
洁，为淫火冲动，肤腠开通。是以受毒初发之时，慎不宜以败毒之药泻之何也？毒邪非
虚不入，若复虚胃气，则毒邪下陷，治之非弥年累月不愈也。捷法，只宜发汗，其次利
小便。肤腠所感之邪，汗易散也，阴茎腿缝皆肝经络。肝肾主下焦，又肝主小便，使毒
邪从小便中出。所治皆顺也，故治之不旬日便可奏功。若曾已发汗，利小便。体浓邪固
而不得宣通者，乃以破毒活血调气之剂攻之。俟毒瓦斯宣通，随以补剂托之，亦不失先后着
也。
〔薛〕 便痈属厥阴肝经，内热外寒，或劳倦过度，或房欲不节，或欲心不遂，或强
固其精，或肝经湿热而致。治法内热外寒者，双解散。劳倦过度者，补中益气汤。房欲不
节者，六味丸料。欲心不遂者，先用五苓散加大黄，疏其精滞，后用地黄丸以补其肝肾，
强固其精。或湿热壅滞者，宜用龙胆泻肝汤疏肝导滞。夫便痈血疝也，属厥阴肝经之络
脉，冲任督脉之隧道。故妇人患此，多在两 肿痛，或腹中结块，小便涩滞，苟治者得
法，患者又能调摄，何难敛之有。若概用大黄等剂，以求其内消，或令脓从便下，损其
气血，及不慎起居饮食者，皆为不治。
〔表〕
一人肿痛发热，以荆防败毒散二剂而止；以双解散剂而消。
荆防败毒散 治便痈，发寒热或拘急疼痛。（方见肿疡。）
〔里〕
一人 肿作痛，大小便秘，脉有力。以玉烛散二剂顿退，更以龙胆泻肝汤四剂而消。
子和玉烛散 （即四物汤，调胃承气汤各半服之。）
〔世〕 又方
刘寄奴 王不留行 大黄 金银花 木鳖子
上等分，酒水煎，露一宿，五更服。
〔丹〕 治便毒初起
射干（二寸） 生姜（如指大，捣细）
上取顺流水煎微沸。服之以泻为度；又用牛皮胶醋煮，涂患处。（射干紫花者是，红花者
非。）
治已结成脓者
大黄（半两） 枳实 浓朴（各三钱） 甘草节（一钱） 连翘（半两） 桃仁泥（二十一枚）
上分三服。姜三片，水煎服。
又治便毒
青皮 白芷 柴胡 赤芍药 槟榔 朴硝 乌药 木瓜 大黄 连翘 栝蒌 生地
黄甘草节 黄芩 三棱 蓬术 犀角 皂角刺
上为 咀。以水三碗，煎至一碗。候大饥服，以泻为度。
三物汤 治便痈
牡蛎 大黄 山栀子（各等分）
上为末。以酒水一大盏，煎至七分，露一宿。空心温服。
四神散 治便毒，初起寒热，欲成痈疽，服此神效。
大黄 木鳖子 僵蚕 贝母（各二钱半）
用酒水各一盅。煎至一盅。食前热服，若得汗下为妙。
双解散 治便毒，内蕴热气，外挟寒邪，精血交滞，肿结疼痛。
川大黄（三钱） 泽泻 牵牛 白芍药 桃仁（去皮尖，各二钱） 辣桂 甘草（各一钱）
上作一服。水二盅，生姜五片，煎至一盅，食前服。
补骨脂散
破故纸（炒研） 牛蒡子（微炒） 牵牛（炒） 大黄酒（拌炒，各等分）
上为末。每服一两，酒调下。
消毒五圣汤 治便毒肿疼神效。
五灵脂 白僵蚕 郁金 贝母 大黄（各三钱）
上酒水各半煎服，连服三帖立愈。
消毒饮 治便毒初发，三四日可消。
皂角针 金银花 防风 当归 大黄 甘草节 栝蒌实（各等分）
上 咀。水酒各半煎，食前温服。仍频提掣顶中发立效。
又方
木鳖子、大黄、栝蒌、桃仁、草龙胆。
咀，浓煎，露一宿。清晨温服立愈。
止痛妙绝饮 治便毒肿硬，不消不溃，疼痛无已，此方一服，立能止痛。
人参 大黄（各五钱）
上用酒水各一盅。煎至一盅，人乳香、没药各一钱，空心食前服。
牡蛎散 治血疝，即便毒。
当归（酒拌） 甘草节 滑石（ ） 牡蛎（ 各一钱半） 大黄（三钱） 木鳖子（五枚，杵）
作一剂。用水二盅，煎一盅，露一宿。五更顿服，冬月火温服。已未溃脓血从大便出。
〔薛〕 按∶此方乃咸寒导滞之剂。若久旷房室，大小便秘，发热 痛，或交感强固
精气，致精血交错，肿结疼痛，便秘者宜用。若劳倦之人，不甚 痛，大小便如常，或小
便赤色，发热不作脓，及溃而不敛，宜用十全大补汤。盖此证多起于劳役不足，或房劳
过度，精气俱虚之人。俗云∶一石米疮，此言百日后可愈也。若大补气血，不旬日而愈，
何用百日？盖疮之收敛，在乎血气之盛也。尝治举人凌待之，虚而服克伐药，几致危殆，予
用托里健脾药而消。秀才王文远，劳苦患之，服小柴胡汤而表证散，后用托里药，脓成针
之而旬日愈。胡判官，脓清脉弱，以大补之药而已愈。因新婚后发，自用连翘消毒散，致
泻痢不止，竟致不救。可见此证属不足多矣，非补不可。大抵便毒属肝经，初起坚硬，肝
主筋故也，五七日后当赤软，脓成故也。若尚坚硬，乃元气不能腐化。往往人见坚硬，只
欲内消，反服攻散药，多致虚虚之祸，前所治者，即其验也。
又方
山栀 大黄 乳香 没药 当归（各半钱） 栝蒌仁（二钱） 代赭石（一钱）
上作一服水煮。
〔表里〕
一人不慎房劳，患此肿痛，以双解散二服，其病即止。更以补中汤数剂而脓成针之，
以八珍汤加五味、麦门、柴胡三十余剂。大抵便痈者血疝也，俗呼为便毒，言于不便处
患之故也。乃足厥阴肝经络，及冲任督脉亦属肝之旁络也，是气血流通之道路，今壅而
肿痛，此则热毒所致，宜先疏导其滞，更用托里之剂，此临证制宜也。
防风通圣散 治疮汤便毒。若泻去芒硝、大黄。能解暑月热毒，或遍身头面患疮。
芍药（焙） 芒硝 滑石（ ） 川芎 大黄（煨） 桔梗 石膏（ ） 荆芥 麻黄（各四分半）
山栀 白术 连翘 当归 薄荷 甘草 防风 黄芩（焙，各八分）
作一剂。水二盅，煎八分服。
愚按∶此方非表里俱实，大小便秘者，恐不可用，宜审之。通圣散合益元散，名双解
散。
苏方散 治便毒。
木鳖肉 当归尾 芍药 白芷 粉甘草 川芎 射干 忍冬（即金银花） 大黄 没药 苏木
穿山甲（ 火煨，各六分）
上细切，作一服。水酒各一盏，煎至一盏，食前服。
〔流气活血〕
东垣青皮汤 治便毒。
青皮 防风 当归身 甘草梢（生，各等分）
上 咀，分作四服。水一小碗，煎至八分，去渣。大温服空心，日进三服。
撤消通气散 便毒初发用此。
南木香 延胡索 天花粉（酒浸） 舶上 香（怀） 白牵（牛炒） 白芷 当归 甘草（各一
两） 青木香（半两） 穿山甲（酒浸，炙焦，二两）
上为细末。每服二钱，食前温酒调服，木
香汤亦可。
〔补虚〕
府庠沈尼文，年二十，左拗患之，余以肝肾阴虚，先用托里药，溃而将愈。因入房
发热作渴，右边亦作痛，脓水清稀，虚证悉至，脉洪大而无力，势甚可畏，用十全大补
加附子一钱，脉证顿退，再剂全退。后用大补汤三十余剂而痊。 一男子，肿而不溃，余
谓∶此因阳气虚弱，用参、 、归、术，以补托元气，用白芷、皂角刺、柴胡、甘草节，
以排脓清肝，数剂而溃；以八珍加柴胡，补其气血，数剂而愈。 一人患便毒，脓稀脉
弱。以十全大补汤加五味、麦门、白蔹，三十剂稍愈，更以参 归术膏而平。因新婚复
发，聚肿坚硬，四肢冷，脉弱皮寒，饮食少思，此虚极也，仍用前药，加桂附三剂稍可。
彼欲速愈，自用连翘消毒饮，泄利不止而殁。
一人年逾四十，素劳苦，患便毒，发寒热，先以小柴胡汤加青皮一服，表证悉退，次以
补中益气汤加穿山甲二剂，肿去三四，更以托里之药五六服，脓成刺去，旬日而敛。
一人肿而不溃，以参、 、归、术、甘草节、皂角针、白芷、柴胡，数剂而溃，以八珍汤
加柴胡，数剂愈。 一人溃而肿不消，且不敛。诊之脉浮而涩，以豆豉灸，更以十全大
补汤，月余而愈。
〔消毒清火〕
儒者肿痛便涩，用八正散二剂，清肝火导湿热而肿痛愈，再以小柴胡加芎、归、泽
泻、山栀二剂，清肝火补脾血，而小便利。一男子，溃而肿痛不止，此余毒未解，用活
命饮一剂而痛止，再剂而肿消。 一男子，痛甚发热，用前饮一剂痛止，再以神效栝蒌散
加山栀、柴胡二剂而消。 一男子，已溃而痛不止，小便秘涩，此肝火未解也，与小柴
胡汤加黄柏、知母、芎、归，痛止便利，更以托里当归汤而疮敛。若毒未解而痛不止者，
须用活命饮。 一人脓未成大痛，服消毒托里内疏药，不应，脉洪大，毒尚在，以仙方
活命饮，一剂痛止，又剂而消。 一人溃而痛不止，诸药不应。诊之脉大，按之则数，乃
毒未解也，以仙方活命饮而止。又二剂而消。 一人肿痛，日晡发热，以小柴胡加青皮、天
花粉四剂，痛止热退，以神效栝蒌散四剂而消。
栝蒌散 治便痈等恶疮。
栝蒌（一枚） 金银花 牛蒡子（炒，各三钱） 生姜 甘草（各半两）
上将药不犯铜铁器，捶碎。用酒一大升煎数沸，空心温服。
威灵仙散 治便毒。
威灵仙 贝母 知母（各一两）
上三味为末。每服三钱，空心温酒调下。如不散，再服。
〔薛〕 按∶此方通经，去脓消毒，补虚益气。盖此证多患于阴虚之人，此方乃是一
见也。亦有 痛小便数者，宜先用加减龙胆泻肝汤。大小便秘， 肿作痛，宜八正散。憎
寒发热，荆防败毒散。然后用此方。若不作脓或脓不溃，宜用大补之剂。溃而不敛者，更
用豆豉饼灸之。
〔小便不利〕
一老妇，肿痛脓未作，小便滞，肝脉数，以加减龙胆泻肝汤加山栀、黄柏，四剂而消。
加减龙胆泻肝汤
龙胆草（酒拌，炒） 泽泻 车前子（炒） 木通 生地黄 当归尾 山栀（炒） 黄芩（各一钱）
甘草（生用，五分）
作一剂。用水二盅，煎至八分，食前服。如湿盛，加黄连。大便秘，加大黄。
〔大便不实〕
一人服克伐药。以求内消，致泻利少食。以二神丸先止其泻，以十全大补倍加白术、茯
苓，数剂而消。 一人年逾四十，患便毒，克伐太过，饮食少思，大便不实，遗精脉微。东
垣云∶精滑不禁，大便不利，腰脚沉重，下虚也。仲景曰∶微弱之脉，主气血俱虚。以
六君子加破故纸、肉豆蔻煎服，泄止食进，更
以十全大补汤加行经药，十余剂而消。
〔妇人〕
一妇素清苦，因郁怒患前症，或用败毒寒凉之药，反晡热内热，自汗盗汗，月经不
行，口干咽燥。余谓∶此郁气伤脾，因药复损，先以当归汤数剂，后兼逍遥散，各五十
余剂，而诸证皆愈。 一妇小腹内，如有所梗，两拗与人门俱肿，小便淋沥，经候不调，
内热作渴，饮食少思，腹内初如鸡卵而渐大，脉洪数而虚，左关尤甚，属肝脾郁结之证也，
用加味归脾汤，肝火退而脾土健，间以逍遥散下芦荟丸而愈。 一妇人，两拗肿痛，腹
内一块不时上攻，月余不调，小便不利。余以为肝脾气滞，以四君加芎、归、柴胡、山
栀而愈，后因郁怒，前证复作，却兼胸胁胀满，盗汗，此肝木甚而伤脾土，用加味归脾
汤，下芦荟丸而痊。 一妇小腹内或作痛，或痞闷，两拗肿痛，内热寒热，胸膈不利，饮
食不甘，形体日瘦，此肝气滞而伤脾气，朝用补中益气汤；夕用六味丸渐愈，更用芦荟
丸而全愈。 一妇两拗肿痛，小腹痞胀，小便时数，白带时下，寒热往来，小水淋沥。余
有人问：腰部周围生疮，像珠子一样连成串，这是什么情况？回答说：这叫做火带疮，也叫缠腰火丹。这是由于心肾不交，肝火在体内炽盛，流入膀胱，缠绕在带脉上，所以症状像束带一样。应当立即服用内疏黄连汤。身体壮实的人，可以用一粒金丹来泻下排毒。或者使用活命饮加入黄芩、黄连、黄柏，外用清热解毒的药物敷贴。这个病证如果不早点治疗，等到疮毒绕满腰部，那么毒邪就会从肚脐进入体内，导致腹部膨胀、无法进食而死。
治疗蛇缠疮（缠腰火丹）
用雄黄研成粉末，用醋调匀后涂抹患处，同时用酒调服。凡是遇到蛇咬伤，以及蜂蝎、蜈蚣等毒虫叮咬，疯狗咬伤，都可以使用这种方法。
《鬼遗钞》说：大腿根部两侧起肿称为便毒。位于胯下两臀尖下方，前方是肛门（谷道），后方是尿道（水道）。形成悬痈。这都是极度虚弱的人患这种痈疽，位置靠近肛门左右，也叫做痔痈。应当紧急补益脾脏，并在发病部位贴敷药物。先用发穴散，脓破后用抽脓膏，脓液排尽后用合疮口散促进愈合。千万不要拖到冬天，否则会变成冷性漏症，难以治愈。便毒生于小腹下方，两条腿内侧接缝之间。毒邪初发时，会出现寒热交替发作，腿部肿胀疼痛的症状。肾是作强之官，所藏的是精气和智慧。男女情欲过大，不能顺遂心意，导致败精与血搏结，滞留于经络隧道，从而结成便毒。大概大腿与小腹接缝之间，是精气运行的道路。如果看到景色而动心，或者做梦而泄精，即不能阴阳交合，又不能忘记情欲平息念头，导致精与血交结阻滞而成肿块。初起时切不可使用寒凉药物，恐怕气血更加滞涩，不能宣通，反而造成大祸。只应当开郁散气，清利热毒，使精血宣畅，自然就会痊愈。
孙一奎按语：前面的论述大概是针对思虑无穷、愿望不能实现的情况设立的，这固然是其中一种说法，但意思还不完整。如果真的像上述论述那样，僧尼、寡妇、单身男子应该有很多患此病的，然而我亲眼目睹商贾中野外不洁性交的妓女，也容易构成这种疾病。或者是杨梅疮等，也是由于欲火淫炽，一旦交合不洁，被淫火冲动，皮肤腠理开通，因此受毒初发之时，谨慎不宜用败毒的药物泻下。为什么呢？毒邪非正气虚不能侵入，如果再损伤胃气，则毒邪下陷，治疗就不是长年累月不能痊愈了。快捷的方法，只适宜发汗，其次是利小便。皮肤腠理所感受的邪气，通过汗法容易消散。阴茎和腿缝都是肝经的络脉。肝肾主管下焦，肝又主管小便，使毒邪从小便中排出。治疗都顺应病机，所以治疗不到十天就能见效。如果已经发汗、利小便，体质厚实邪气坚固而不能宣通的，才用破毒活血调气的药剂攻伐。等到毒气宣通，随即用补剂托举，也不失先后次序。
薛己按语：便痈属于厥阴肝经，表现为内热外寒，或者因过度劳累，或者房事不节制，或者欲望不能实现，或者强行固摄精气，或者肝经湿热所致。治疗方法：内热外寒的，用双解散；过度劳累的，用补中益气汤；房事不节制的，用六味丸料；欲望不能实现的，先用五苓散加大黄，疏通精液停滞，之后用地黄丸补益肝肾，固摄精气。如果是湿热壅滞的，宜用龙胆泻肝汤疏肝导滞。便痈属于血疝，归属于厥阴肝经的络脉，以及冲任督脉的隧道。所以妇女患此病，多在两腿间肿痛，或者腹中有结块，小便涩滞，如果治疗者得法，患者又能调养摄护，有什么难收敛的呢？如果一概使用大黄等药剂，以求内部消散，或者让脓液从大便排出，损伤气血，以及不注意起居饮食的，都属于难治之症。
〔表证〕
一个人肿痛发热，服用荆防败毒散两剂而停止；再用双解散剂而消除。
荆防败毒散 治疗便痈，出现恶寒发热或拘急疼痛。（方剂见肿疡篇。）
〔里证〕
一个人睾丸肿胀作痛，大小便秘结，脉象有力。服用玉烛散两剂迅速消退，再用龙胆泻肝汤四剂而消除。
子和玉烛散 （即四物汤和调胃承气汤各半量合用。）
〔世传方〕 又一方
刘寄奴 王不留行 大黄 金银花 木鳖子
以上等分，用水和酒煎煮，露天放置一夜，五更时分服用。
〔丹溪〕 治疗便毒初起
射干（二寸） 生姜（如手指大，捣细）
以上取顺流水煎煮微沸。服用以腹泻为度；另外用牛皮胶加醋煮，涂敷患处。（射干以紫花者为佳，红花者不是。）
治疗已经结成脓液的
大黄（半两） 枳实 浓朴（各三钱） 甘草节（一钱） 连翘（半两） 桃仁泥（二十一枚）
以上分三次服用。姜三片，水煎服。
又治便毒
青皮 白芷 柴胡 赤芍药 槟榔 朴硝 乌药 木瓜 大黄 连翘 栝蒌 生地黄 甘草节 黄芩 三棱 蓬术 犀角 皂角刺
以上锉碎。用水三碗，煎至一碗。待肚子非常饥饿时服用，以腹泻为度。
三物汤 治疗便痈
牡蛎 大黄 山栀子（各等分）
以上研成粉末。用一大盏酒水，煎至七分，露天放置一夜。空腹温服。
四神散 治疗便毒，初起寒热，将要成为痈疽，服用此方神效。
大黄 木鳖子 僵蚕 贝母（各二钱半）
用酒和水各一盅。煎至一盅。饭前热服，如果能出汗或腹泻为妙。
双解散 治疗便毒，体内蕴积热气，体外夹杂寒邪，精血交结阻滞，肿胀疼痛。
川大黄（三钱） 泽泻 牵牛 白芍药 桃仁（去皮尖，各二钱） 辣桂 甘草（各一钱）
以上作为一剂。水两盅，生姜五片，煎至一盅，饭前服用。
补骨脂散
破故纸（炒研） 牛蒡子（微炒） 牵牛（炒） 大黄酒拌炒（各等分）
以上研成粉末。每次服用一两，酒调下。
消毒五圣汤 治疗便毒肿痛神效。
五灵脂 白僵蚕 郁金 贝母 大黄（各三钱）
以上酒水各半煎服，连服三帖立刻痊愈。
消毒饮 治疗便毒初发，三四天可以消除。
皂角针 金银花 防风 当归 大黄 甘草节 栝蒌实（各等分）
以上锉碎。水酒各半煎，饭前温服。仍然频繁提拉头顶百会穴立效。
又一方
木鳖子、大黄、栝蒌、桃仁、草龙胆。
锉碎，浓煎，露天放置一夜。清晨温服立刻痊愈。
止痛妙绝饮 治疗便毒肿硬，不消不溃，疼痛不止，此方一服，立刻能止痛。
人参 大黄（各五钱）
以上用酒和水各一盅。煎至一盅，加入乳香、没药各一钱，空腹饭前服用。
牡蛎散 治疗血疝，即便毒。
当归（酒拌） 甘草节 滑石（煅） 牡蛎（煅）（各一钱半） 大黄（三钱） 木鳖子（五枚，捣碎）
作为一剂。用水两盅，煎成一盅，露天放置一夜。五更时分顿服，冬季用火温服。无论是否溃破，脓血从大便排出。
〔薛己〕 按语：此方是咸寒导滞的药剂。如果长期禁欲，大小便秘结，发热疼痛，或者交感时强行固摄精气，导致精血交错，肿胀结聚疼痛，便秘者适宜使用。如果是劳累之人，疼痛不严重，大小便正常，或者小便颜色红，发热但不化脓，以及溃破后不收敛，适宜用十全大补汤。大概这个病证多起于劳役不足，或者房劳过度，精气俱虚的人。俗语说：一石米疮，这是说一百天后可以痊愈。如果大补气血，不到十天就痊愈，何必用百日？大概疮口的收敛，在于血气的旺盛。曾经治疗举人凌待之，体虚却服用克伐药，几乎导致危殆，我用托里健脾药而消除。秀才王文远，劳苦患病，服用小柴胡汤而表证消散，后用托里药，脓成针刺而十天痊愈。胡判官，脓液清稀脉弱，用大补药而已痊愈。因为新婚后来复发，自己用连翘消毒散，导致泻痢不止，最终致死。可见这个病证属于不足的多，不补不行。大概便毒属于肝经，初起坚硬，因为肝主筋的缘故，五七日后应当变红软，因为脓成的缘故。如果仍然坚硬，是元气不能腐化。往往人们见到坚硬，只想内部消散，反而服用攻散药，多导致虚虚之祸，前面治疗的案例，就是验证。
又一方
山栀 大黄 乳香 没药 当归（各半钱） 栝蒌仁（二钱） 代赭石（一钱）
以上作为一剂水煮。
〔表里同病〕
一个人不慎房劳，患此病肿痛，服用双解散两服，病情即止。再用补中汤数剂而脓成针刺，用八珍汤加五味子、麦门冬、柴胡三十余剂。大概便痈是血疝，俗呼为便毒，言说不方便之处患病的原因。这是足厥阴肝经络，以及冲任督脉也属于肝的旁络，是气血流通的道路，现在壅滞而肿痛，这是热毒所致，应当先疏导其滞塞，再用托里的药剂，这是临证制宜。
防风通圣散 治疗疮疡便毒。如果腹泻去掉芒硝、大黄。能解暑月热毒，或者遍身头面患疮。
芍药（焙） 芒硝 滑石（煅） 川芎 大黄（煨） 桔梗 石膏（煅） 荆芥 麻黄（各四分半）
山栀 白术 连翘 当归 薄荷 甘草 防风 黄芩（焙，各八分）
作为一剂。水两盅，煎八分服。
愚按：此方如果不是表里俱实，大小便秘的人，恐怕不可用，应当审察。通圣散合益元散，名叫双解散。
苏方散 治疗便毒。
木鳖肉 当归尾 芍药 白芷 粉甘草 川芎 射干 忍冬（即金银花） 大黄 没药 苏木 穿山甲（炮火煨，各六分）
以上细切，作为一剂。水酒各一盏，煎至一盏，饭前服用。
〔流气活血〕
东垣青皮汤 治疗便毒。
青皮 防风 当归身 甘草梢（生，各等分）
以上锉碎，分作四服。水一小碗，煎至八分，去渣。大温服空心，日进三服。
撤消通气散 便毒初发用此。
南木香 延胡索 天花粉（酒浸） 舶上沉香（怀） 白牵牛（炒） 白芷 当归 甘草（各一两） 青木香（半两） 穿山甲（酒浸，炙焦，二两）
以上为细末。每次服用二钱，饭前温酒调服，木香汤也可以。
〔补虚〕
府庠沈尼文，年二十岁，左侧患病，我认为他是肝肾阴虚，先用托里药，溃破后将愈。因为入房后发热口渴，右边也开始疼痛，脓水清稀，虚证全部出现，脉洪大而无力，形势很可怕，用十全大补加附子一钱，脉证顿时减退，再剂全退。后用大补汤三十余剂而痊愈。一个男子，肿而不溃，我说：这是因为阳气虚弱，用人参、黄芪、当归、白术，以补托元气，用白芷、皂角刺、柴胡、甘草节，以排脓清肝，数剂而溃；用八珍加柴胡，补其气血，数剂而愈。一个人患便毒，脓稀脉弱。用十全大补汤加五味子、麦门冬、白蔹，三十剂稍愈，再用参芪归术膏而平复。因为新婚复发，聚肿坚硬，四肢冷，脉弱皮寒，饮食少思，这是虚极，仍用前药，加桂附三剂稍可。他想要速愈，自己用连翘消毒饮，泄利不止而死亡。
一个人年过四十，素来劳苦，患便毒，发寒热，先以小柴胡汤加青皮一服，表证悉退，次以补中益气汤加穿山甲二剂，肿去三四，再用托里的药五六服，脓成刺去，十天而敛。
一个人肿而不溃，用人参、黄芪、当归、白术、甘草节、皂角针、白芷、柴胡，数剂而溃，用八珍汤加柴胡，数剂愈。 一个人溃而肿不消，且不敛。诊之脉浮而涩，用豆豉灸，再用十全大补汤，月余而愈。
〔消毒清火〕
儒者肿痛便涩，用八正散二剂，清肝火导湿热而肿痛愈，再用小柴胡加川芎、当归、泽泻、山栀二剂，清肝火补脾血，而小便利。一个男子，溃而肿痛不止，这是余毒未解，用活命饮一剂而痛止，再剂而肿消。 一个男子，痛甚发热，用前饮一剂痛止，再用神效栝蒌散加山栀、柴胡二剂而消。 一个男子，已溃而痛不止，小便秘涩，这是肝火未解也，与小柴胡汤加黄柏、知母、川芎、当归，痛止便利，再用托里当归汤而疮敛。如果毒未解而痛不止者，须用活命饮。 一个人脓未成大痛，服消毒托里内疏药，不应，脉洪大，毒尚在，用仙方活命饮，一剂痛止，又剂而消。 一个人溃而痛不止，诸药不应。诊之脉大，按之则数，乃毒未解也，用仙方活命饮而止。又二剂而消。 一个人肿痛，日晡发热，用小柴胡加青皮、天花粉四剂，痛止热退，用神效栝蒌散四剂而消。
栝蒌散 治疗便痈等恶疮。
栝蒌（一枚） 金银花 牛蒡子（炒，各三钱） 生姜 甘草（各半两）
以上将药不犯铜铁器，捶碎。用酒一大升煎数沸，空腹温服。
威灵仙散 治疗便毒。
威灵仙 贝母 知母（各一两）
以上三味为末。每次服用三钱，空腹温酒调下。如果不消散，再服。
〔薛己〕 按语：此方通经，去脓消毒，补虚益气。大概这个病证多患于阴虚之人，此方是一见。也有睾丸疼痛小便频数的，宜先用加减龙胆泻肝汤。大小便秘，睾丸肿胀作痛，宜八正散。憎寒发热，荆防败毒散。然后用此方。如果不作脓或脓不溃，宜用大补之剂。溃而不敛者，更用豆豉饼灸之。
〔小便不利〕
一个老妇，肿痛脓未作，小便滞，肝脉数，用加减龙胆泻肝汤加山栀、黄柏，四剂而消。
加减龙胆泻肝汤
龙胆草（酒拌，炒） 泽泻 车前子（炒） 木通 生地黄 当归尾 山栀（炒） 黄芩（各一钱）
甘草（生用，五分）
作为一剂。用水两盅，煎至八分，饭前服用。如果湿盛，加黄连。大便秘，加大黄。
〔大便不实〕
一个人服用克伐药，以求内部消散，导致泻利少食。用二神丸先止其泻，用十全大补倍加白术、茯苓，数剂而消。 一个人年过四十，患便毒，克伐太过，饮食少思，大便不实，遗精脉微。李东垣说：精滑不禁，大便不利，腰脚沉重，是下虚。张仲景说：微弱之脉，主气血俱虚。用六君子加破故纸、肉豆蔻煎服，泄止食进，再用十全大补汤加行经药，十余剂而消。
〔妇人〕
一个妇人素来清苦，因郁怒患前症，或用败毒寒凉之药，反而傍晚发热内热，自汗盗汗，月经不行，口干咽燥。我说：这是郁气伤脾，因药复损，先用当归汤数剂，后兼逍遥散，各五十余剂，而诸证皆愈。 一个妇人小腹内，如有梗塞感，两腿与人门俱肿，小便淋沥，经候不调，内热作渴，饮食少思，腹内初如鸡卵而渐大，脉洪数而虚，左关尤甚，属于肝脾郁结之证，用加味归脾汤，肝火退而脾土健，间以逍遥散下芦荟丸而愈。 一个妇人，两腿肿痛，腹内一块不时上攻，月余不调，小便不利。我以为肝脾气滞，用四君加川芎、当归、柴胡、山栀而愈，后因郁怒，前证复作，却兼胸胁胀满，盗汗，这是肝木甚而伤脾土，用加味归脾汤，下芦荟丸而痊。 一个妇人小腹内或作痛，或痞闷，两腿肿痛，内热寒热，胸膈不利，饮食不甘，形体日瘦，这是肝气滞而伤脾气，朝用补中益气汤；夕用六味丸渐愈，再用芦荟丸而全愈。 一个妇人两腿肿痛，小腹痞胀，小便时数，白带时下，寒热往来，小水淋沥。我
A person asked: "What is the condition when sores appear around the waist, linked together like beads?" The answer was: "This is named Huodai Chuang (Fire Belt Sore), also known as Chanyao Huodan (Coiling Waist Fire Dan). It arises from the failure of communication between the Heart and Kidney, with Liver Fire blazing internally, flowing into the Bladder, and coiling around the Dai Mai (Girdle Vessel), hence resembling a belt. One should immediately take Neishu Huanglian Tang (Internal Draining Coptis Decoction). For those with robust constitution, Yili Jindan (One Pill Golden Elixir) can be used to purge. Huoming Yin (Life-Saving Drink) added with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Huangbai (Phellodendri Cortex) can be taken internally, while external application of heat-clearing and detoxifying medicines is recommended. If this condition is not treated early, and the toxin spreads all around the waist, the toxin will enter through the umbilicus, leading to abdominal distension, anorexia, and death."
Treatment for Shechan Chuang (Snake-Coiling Sore / Herpes Zoster):
Grind Xionghuang (Realgar) into powder, mix with vinegar for topical application, and simultaneously take it mixed with wine orally. This method is applicable for snake bites, as well as stings from bees, scorpions, centipedes, and other venomous insects, and bites from mad dogs.
*Guiyi* states: "Swelling arising at both sides of the upper thighs is called Biandu (Genital Abscess). Located below the tips of the buttocks in the perineal region, anterior to the anus (Gu Dao) and posterior to the urethra (Shui Dao). It forms Xuanyong (Hanging Abscess). This type of carbuncle occurs in individuals who are extremely deficient. Located near the anus on either side, it is also called Shiyong (Hemorrhoidal Carbuncle). Urgent tonification of the Spleen is required, along with topical herbal pastes applied to the affected area. First, use Faxue San (Acupoint-Expelling Powder); after rupture, use Chounong Gao (Pus-Withdrawing Ointment); once the pus is exhausted, use Hechuangkou San (Wound-Closing Powder) to promote healing. Do not let the condition persist until winter, or it will become a cold fistula that is difficult to treat. Biandu originates below the lower abdomen, in the crease between the two legs. Upon initial onset, alternating chills and fever occur, accompanied by swelling and pain in the legs. The Kidney is the official of strength, storing essence and intelligence. Excessive sexual desire that cannot be fulfilled causes degraded essence and blood to contend and stagnate in the meridians and collaterals, forming Biandu. The crease between the thigh and lower abdomen is the pathway where essence and qi emerge. If visual stimuli arouse the mind, or nocturnal emissions occur without release, failing to achieve yin-yang union or extinguish desires, essence and blood interact and stagnate, forming swellings. In the initial stage, cold-natured medicines must strictly be avoided, lest they cause further stagnation of qi and blood, preventing free flow and exacerbating the condition. Instead, one should resolve depression and dissipate qi, clear heat and drain toxicity, allowing essence and blood to flow freely, leading to natural recovery."
Sun Yikui commented: "The preceding discussion seems designed for cases involving endless thoughts and unfulfilled wishes. While this is one perspective, it is incomplete. If this were true, monks, nuns, widows, and unmarried men would suffer from this frequently. However, I have witnessed prostitutes engaging in unclean outdoor intercourse among merchants contracting this disease. Similarly, chancre or syphilis lesions arise from excessive lustful fire; upon unclean intercourse, the lustful fire agitates, opening the skin and pores. Therefore, at the initial stage of toxin invasion, it is inadvisable to use bitter-cold purgatives to drain the toxin. Why? Toxins do not invade unless there is deficiency. Further damaging Stomach Qi would cause the toxin to sink downward, resulting in a chronic condition lasting years. The expedient method is to induce sweating first, followed by promoting urination. Pathogens affecting the skin and pores are easily dispersed via sweating. The penis and leg creases are collaterals of the Liver Meridian. The Liver and Kidney govern the Lower Jiao, and the Liver controls urination, facilitating the exit of toxins via urine. Such treatments follow the pathogenic mechanism, achieving results within ten days. If sweating and diuresis have been attempted but the patient has a robust constitution with entrenched pathogens that cannot be dispersed, then formulas that break up toxins, invigorate blood, and regulate qi should be used. Once the toxic qi is dispersed, tonics should be employed to support the body, maintaining the correct sequence of treatment."
Xue Ji commented: "Bi Yong (Genital Carbuncle) belongs to the Jueyin Liver Meridian, presenting with internal heat and external cold. Causes include excessive fatigue, immoderate sexual activity, unfulfilled desires, forced retention of essence, or damp-heat in the Liver Meridian. Treatment methods: For internal heat and external cold, use Shuangjie San (Double Resolution Powder); for excessive fatigue, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); for immoderate sexual activity, use Liuwei Wan (Six-Ingredient Pill with Rehmannia); for unfulfilled desires, first use Wuling San (Five-Ling Powder) with Dahuang (Rhei Radix et Rhizoma) to unblock seminal stagnation, followed by Dihuang Wan (Rehmannia Pill) to tonify the Liver and Kidney. For damp-heat obstruction, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to soothe the Liver and guide out stagnation. Bi Yong is a type of Xue Shan (Blood Hernia), belonging to the collaterals of the Jueyin Liver Meridian and the tunnels of the Chong, Ren, and Du vessels. Thus, women suffering from this often experience swelling and pain in the inner thighs, abdominal masses, or dysuria. If treated correctly and managed properly, healing is assured. However, indiscriminate use of Dahuang to seek internal resolution, or allowing pus to discharge via stool, damages qi and blood. Neglecting lifestyle and diet renders the condition incurable."
[Exterior Syndrome]
A patient with swelling, pain, and fever was treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) for two doses, stopping the symptoms; subsequently, Shuangjie San resolved the swelling.
Jingfang Baidu San treats Bi Yong with chills, fever, or spasmodic pain. (Formula see Swollen Ulcer section.)
[Interior Syndrome]
A patient with testicular swelling and pain, constipation of both stool and urine, and a forceful pulse was treated with Yuzhu San (Jade Candle Powder) for two doses, causing rapid subsidence; followed by Longdan Xiegan Tang for four doses to eliminate the condition.
Zihe's Yuzhu San (Combines Siwu Tang [Four Substances Decoction] and Tiaowei Chengqi Tang [Regulate the Stomach and Direct Downward Decoction] in equal parts.)
[Worldly Formula] Another Prescription
Liujinu (Artemisiae Annuae Herba), Wangbuliuxing (Vaccariae Semen), Dahuang, Jinyinhua (Lonicerae Japonicae Flos), Mubiezi (Strychni Semen).
Equal parts, decocted in water and wine, exposed overnight, taken at dawn (5-7 AM).
[Danjxi] Treating Early Stage Biandu
Shegan (Belamcandae Rhizoma, 2 cun), Shengjiang (Fresh Ginger, size of a finger, crushed).
Decoct in flowing water until slightly boiling. Take until purgation occurs. Additionally, boil Niupijiao (Asini Corii Colla) in vinegar and apply topically. (Use purple-flowered Shegan; red-flowered is ineffective.)
Treating Established Pus
Dahuang (0.5 liang), Zhishi (Immaturus Citri Fruuctus), Houpo (Magnoliae Officinalis Cortex) (each 3 qian), Gancao Jie (Glycyrrhizae Radix et Rhizoma joint), Lianqiao (Forsythiae Fructus) (0.5 liang), Taoren泥 (Persicae Semen paste) (21 seeds).
Divide into three doses. Add three slices of ginger, decoct in water, and take orally.
Another Treatment for Biandu
Qingpi (Citri Reticulatae Pericarpium Viride), Baizhi (Angelicae Dahuricae Radix), Chaihu (Bupleuri Radix), Chishaoyao (Paeoniae Radix Rubra), Binglang (Arecae Semen), Poxiao (Natrii Sulfas), Wuyao (Linderae Radix), Mugua (Chaenomelis Fructus), Dahuang, Lianqiao, Gualou (Trichosanthis Fructus), Shengdi Huang (Rehmanniae Radix), Gancao Jie, Huangqin (Scutellariae Radix), Sanleng (Sparganii Rhizoma), Pengzhi (Curcumae Zedoariae Rhizoma), Xijiao (Rhinoceoris Cornu), Zaojiaoci (Gleditsiae Sinensis Spina).
Crush into coarse powder. Decoct three bowls of water to one bowl. Take when very hungry, aiming for purgation.
Sanwu Tang (Three-Ingredient Decoction) Treating Bi Yong
Muli (Ostreae Concha), Dahuang, Shanzhizi (Gardeniae Fructus) (equal parts).
Powder form. Decoct one large cup of water and wine to 70%, expose overnight. Take warm on an empty stomach.
Sishen San (Four-God Powder) Treating Biandu
Effective for early-stage chills/fever and impending abscess formation.
Dahuang, Mubiezi, Jiangcan (Bombyx Batryticatus), Beimu (Fritillariae Cirrhosae Bulbus) (each 2.5 qian).
Decoct one cup each of water and wine to one cup. Take hot before meals. Sweating or purgation is ideal.
Shuangjie San (Double Resolution Powder) Treating Biandu
For internal heat accumulation with external cold constraint, causing qi-blood stagnation, swelling, and pain.
Chuan Dahuang (3 qian), Zexie (Alismatis Rhizoma), Qianniu (Pharbitidis Semen), Baishaoyao (Paeoniae Radix Alba), Taoren (Persicae Semen, de-skinned and de-pitted, each 2 qian), Lagui (Cinnamomi Ramulus), Gancao (Licorice Root) (each 1 qian).
One dose. Decoct two cups of water with five slices of ginger to one cup. Take before meals.
Buguzhi San (Psoralea Powder)
Poguozhi (Psoraleae Fructus, stir-fried and ground), Niubangzi (Arctii Fructus, lightly stir-fried), Qianniu (Stir-fried), Dahuang (Stir-fried with wine, equal parts).
Powder. Take 1 liang each time, mixed with wine.
Xiaodu Wusheng Tang (Five-Saints Detoxifying Decoction) Highly Effective for Biandu Swelling/Pain.
Wulingzhi (Trogopterori Faeces), Bai Jiangcan (Bombyx Batryticatus), Yujin (Curcumae Longae Radix), Beimu, Dahuang (each 3 qian).
Decoct half water, half wine. Take three consecutive doses for immediate cure.
Xiaodu Yin (Detoxifying Drink) Treating Early Biandu
Resolvable in 3-4 days.
Zaojiaozhen (Gleditsiae Sinensis Spina tip), Jinyinhua, Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Dahuang, Gancao Jie, Gualou Shi (Trichosanthis Fructus) (equal parts).
Crush. Decoct half water, half wine. Take warm before meals. Frequently lifting the hair at the vertex (Baihui point) enhances efficacy.
Another Formula
Mubiezi, Dahuang, Gualou, Taoren, Caolongdan (Gentiana Scabra).
Crush, decoct strongly, expose overnight. Take warm at dawn for immediate cure.
Tongzhi Miaojue Yin (Wonderfully Pain-Relieving Drink) Treating Hard, Non-Resolving, Non-Ulcerated Biandu with Unrelenting Pain
One dose provides immediate pain relief.
Renshen (Ginseng Radix), Dahuang (each 5 qian).
Decoct one cup each of water and wine to one cup. Add Ruxiang (Olibanum) and Moyao (Myrrha) (each 1 qian). Take warm on an empty stomach before meals.
Muli San (Oyster Shell Powder) Treating Xue Shan (Blood Hernia), i.e., Biandu.
Danggui (Soaked in wine), Gancao Jie, Huashi (Kaolin, calcined), Muli (Calcined) (each 1.5 qian), Dahuang (3 qian), Mubiezi (5 seeds, pounded).
One dose. Decoct two cups of water to one cup, expose overnight. Take all at once at dawn. Warm over fire in winter. Whether ulcerated or not, pus/blood discharging via stool indicates progress.
[Xue Ji] Commentary: This formula uses salty-cold herbs to guide out stagnation. It is suitable for those abstaining from sex for long periods, experiencing constipation, fever, pain, or forced retention of essence leading to qi-blood stagnation and hard swelling. For fatigued patients with mild pain, normal bowel/bladder function, or red urine without suppuration, or non-healing ulcers, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) is appropriate. This condition mostly affects those with insufficient labor recovery or excessive sexual exertion, leading to qi-essence deficiency. Folk saying: 'One stone of rice sore' implies healing takes 100 days. However, with strong tonification, healing occurs in less than 10 days. Healing depends on abundant qi and blood. I once treated Scholar Ling Daizhi, who was deficient but took draining herbs, nearly dying; I cured him with interior-supporting and spleen-tonifying herbs. Scholar Wang Wenyuan, suffering from fatigue-induced Biandu, had exterior symptoms resolved by Xiaochaihu Tang (Minor Bupleurum Decoction), then suppuration promoted by interior-supporting herbs, punctured, and healed in 10 days. Judge Hu, with thin pus and weak pulse, healed with major tonics. A case of recurrence post-marriage treated self-medicated with Liaoqiao Xiaodu Yin led to fatal diarrhea. This proves the condition is largely deficiency-based and requires tonification. Generally, Biandu belongs to the Liver Meridian; initial hardness is due to Liver governing tendons. After 5-7 days, it should soften and redden as pus forms. If still hard, Yuan Qi fails to transform toxins. People often mistake hardness for excess and use dispersing drugs, causing deficiency complications. The previous cases validate this.
Another Formula
Shanzhi (Gardeniae Fructus), Dahuang, Ruxiang, Moyao, Danggui (each 0.5 qian), Gualou Ren (Trichosanthis Semen) (2 qian), Daizheshi (Haematitum) (1 qian).
One dose, decoct in water.
[Exterior-Interior]
A patient with swelling/pain from improper sexual activity was treated with Shuangjie San for two doses, stopping the disease. Then Buzhong Tang (Tonify Middle Decoction) for several doses to promote suppuration and puncture, followed by Bazhen Tang (Eight-Treasure Decoction) plus Wuweizi (Schisandrae Fructus), Maidong (Ophiopogonis Radix), and Chaihu for over 30 doses. Generally, Bi Yong is Xue Shan,俗称 Biandu (inconvenient place sore). It involves the Foot Jueyin Liver Meridian and collateral channels of Chong, Ren, and Du, pathways of qi-blood flow. Obstruction causes heat-toxin swelling/pain. First resolve stagnation, then use interior-supporting agents. This is clinical adaptation.
Fangtong Tongsheng San (Wind-Barrier Universal Success Powder) Treating Sores and Biandu. Remove Mangxiao (Natrii Sulfas) and Dahuang if diarrhea occurs. Clears summerheat-toxin or sores on head/body.
Shaoyao (Roasted), Mangxiao, Huashi (Calcined), Chuanxiong (Ligustici Chuanxiong Rhizoma), Dahuang (Roasted), Jiegeng (Platycodonis Radix), Shigao (Gypsum Fibrosum, calcined), Jingjie (Schizonepetae Spica), Mahuang (Ephedrae Herba) (each 4.5 fen).
Shanzhi, Baizhu (Atractodis Macrocephalae Rhizoma), Lianqiao, Danggui, Bohe (Menthae Haplocalycis Herba), Gancao, Fangfeng, Huangqin (Roasted, each 8 fen).
One dose. Decoct two cups of water to 80%. Take orally.
Commentary: This formula is unsuitable for patients without full exterior-interior excess and constipation. Exercise caution. Tongsheng San combined with Yiyuan San is named Shuangjie San.
Sufang San (Sandalwood Powder) Treating Biandu.
Mubie Rou (Strychni Semen endocarp), Danggui Wei (Angelicae Sinensis Radix tail), Shaoyao, Baizhi, Fen Gancao (Licorice Root), Chuanxiong, Shegan, Rendong (Lonicerae Japonicae Flos), Dahuang, Moyao, Sumu (Santalum Album Lignum), Chanshanjia (Manis Squama, fire-roasted) (each 6 fen).
Finely chop. One dose. Decoct one cup each of water and wine to one cup. Take before meals.
[Qi-Circulating Blood-Invigorating]
Dongyuan Qingpi Tang (Blue Peel Decoction) Treating Biandu.
Qingpi, Fangfeng, Danggui Shen (Angelicae Sinensis Radix heart), Gancao Shao (Licorice Root tip, raw, equal parts).
Crush. Divide into four doses. Decoct one small bowl of water to 80%, strain. Take warm on an empty stomach, three times daily.
Che Xiao Tong Qi San (Eliminate Swelling Unblock Qi Powder) For Early Biandu.
Nanmuxiang (Aquilariae Lignum Resinatum), Yanhusuo (Corydalis Rhizoma), Tianhuafen (Trichosanthis Radix, wine-soaked), Boshang Xiang (Agarwood), Baixianqiu (Arctii Fructus, stir-fried), Baizhi, Danggui, Gancao (each 1 liang), Qingmuxiang (Aucklandiae Radix) (0.5 liang), Chanshanjia (Wine-soaked, roasted until scorched, 2 liang).
Fine powder. Take 2 qian before meals with warm wine. Muxiang Tang is also acceptable.
[Tonifying Deficiency]
Shen Niwen, age 20, suffered from left-sided Biandu. Diagnosed as Liver-Kidney Yin Deficiency, treated initially with interior-supporting herbs. After ulceration and nearing recovery, he engaged in sexual activity, developing fever/thirst and right-sided pain. Pus was thin/watery, signs of deficiency were prominent, pulse was flooding but weak. Condition appeared critical. Used Shiquan Dabu Tang plus 1 qian Fuzi (Aconiti Lateralis Radix Praeparata). Pulse/symptoms improved immediately; second dose resolved them. Followed by major tonifying decoction for 30+ doses for full recovery.
A male patient with swelling but no ulceration: Attributed to Yang Qi deficiency. Used Renshen, Huangqi (Astragali Radix), Danggui, Baizhu to tonify/support Yuan Qi; Baizhi, Zaojiaoci, Chaihu, Gancao Jie to drain pus and clear Liver heat. Several doses led to ulceration. Then Bazhen Tang plus Chaihu to tonify qi-blood, resolving the condition.
A patient with thin pus and weak pulse: Treated with Shiquan Dabu Tang plus Wuweizi, Maidong, Bailian (Verbenae Herba) for 30 doses, showing slight improvement. Then Shenqi Gui Zhu Gao (Ginseng, Astragalus, Angelica, Atractylodes Paste) normalized the condition. Recurrence post-marriage presented with hard swelling, cold limbs, weak pulse, cold skin, poor appetite (extreme deficiency). Continued previous formula plus Rougui (Cinnamomi Cortex) and Fuzi for 3 doses, showing slight improvement. Patient sought quick cure, self-medicated with Liaoqiao Xiaodu Yin, leading to fatal diarrhea.
A man over 40, chronically fatigued, developed Biandu with chills/fever. First dose of Xiaochaihu Tang plus Qingpi resolved exterior symptoms. Then Buzhong Yiqi Tang plus Chanshanjia for 2 doses reduced swelling by 30-40%. Followed by 5-6 doses of interior-supporting herbs, suppuration promoted, punctured, healed in 10 days.
Patient with swelling/no ulceration: Treated with Renshen, Huangqi, Danggui, Baizhu, Gancao Jie, Zaojiaozhen, Baizhi, Chaihu. Several doses led to ulceration. Bazhen Tang plus Chaihu resolved it.
Patient with ulceration/non-resolving swelling/non-healing: Pulse floating and choppy. Treated with Fermented Soybean (Danshi) moxibustion, then Shiquan Dabu Tang. Healed in over a month.
[Detoxifying Clearing Fire]
A scholar with swelling/pain and dysuria: Treated with Bazheng San (Eight-Righteous Powder) for 2 doses, clearing Liver fire and guiding damp-heat, resolving swelling/pain. Then Xiaochaihu Tang plus Chuanxiong, Danggui, Zexie, Shanzhi for 2 doses, clearing Liver fire, tonifying Spleen blood, restoring smooth urination.
Male patient with persistent pain/swelling after ulceration: Residual toxin unresolved. Huoming Yin (Life-Saving Drink) for 1 dose stopped pain, 2nd dose reduced swelling.
Male patient with severe pain/fever: Previous drink for 1 dose stopped pain. Shenxiao Gualou San (Miraculous Trichosanthes Powder) plus Shanzhi, Chaihu for 2 doses resolved swelling.
Male patient with persistent pain after ulceration, scanty/difficult urination: Liver fire unresolved. Xiaochaihu Tang plus Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Chuanxiong, Danggui stopped pain and restored urination. Then Tuoli Danggui Tang (Interior-Supporting Angelica Decoction) healed the sore. If toxin unresolved with persistent pain, Huoming Yin is necessary.
Patient with large pain before pus formation, unresponsive to detoxifying/interior-supporting/internal-draining drugs, flooding pulse, toxin present: Xianfang Huoming Yin (Immortal Formula Life-Saving Drink) for 1 dose stopped pain, 2nd dose resolved swelling.
Patient with persistent pain after ulceration, unresponsive to various drugs: Pulse large, rapid on pressure, toxin unresolved. Xianfang Huoming Yin stopped pain. 2 more doses resolved swelling.
Patient with swelling/pain, afternoon fever: Xiaochaihu Tang plus Qingpi, Tianhuafen for 4 doses stopped pain/fever. Shenxiao Gualou San for 4 doses resolved swelling.
Gualou San (Trichosanthes Powder) Treating Bi Yong and other malignant sores.
Gualou (1 fruit), Jinyinhua, Niubangzi (Stir-fried, each 3 qian), Shengjiang, Gancao (each 0.5 liang).
Do not use copper/iron vessels. Pound herbs. Decoct one large sheng of wine, boil several times. Take warm on empty stomach.
Weilingxian San (Serissa Powder) Treating Biandu.
Weilingxian (Sinomenii Caulis), Beimu, Zhimu (Anemarrhenae Rhizoma) (each 1 liang).
Powder. Take 3 qian before meals with warm wine. Repeat if unresolved.
[Xue Ji] Commentary: This formula unblocks meridians, drains pus, detoxifies, tonifies deficiency, and augments qi. Commonly seen in Yin-deficient patients. For testicular pain with frequent urination, use Modified Longdan Xiegan Tang first. For constipation and testicular swelling/pain, use Bazheng San. For chills/fever, use Jingfang Baidu San. Then use this formula. If no pus forms or pus does not drain, use major tonics. For non-healing ulcers, use Danshi cake moxibustion.
[Urinary Difficulty]
Old female patient with swelling/pain, no pus yet, urinary stagnation, rapid Liver pulse: Modified Longdan Xiegan Tang plus Shanzhi, Huangbai for 4 doses resolved swelling.
Modified Longdan Xiegan Tang
Longdancao (Gentianae Radix, wine-soaked, stir-fried), Zexie, Cheqianzi (Plantaginis Semen, stir-fried), Mutong (Akebiae Caulis), Shengdi Huang, Danggui Wei, Shanzhi (Stir-fried), Huangqin (each 1 qian), Gancao (Raw, 5 fen).
One dose. Decoct two cups of water to 80%. Take before meals. Add Huanglian (Coptidis Rhizoma) if dampness is heavy. Add Dahuang if constipated.
[Loose Stools]
Patient taking draining herbs seeking internal resolution developed diarrhea/anorexia. Ershen Wan (Two-Spirit Pill) stopped diarrhea first. Shiquan Dabu Tang with doubled Baizhu and Fuling (Poria) for several doses resolved swelling.
Man over 40 with Biandu, excessive draining, poor appetite, loose stools, spermatorrhea, faint pulse. Li Dongyuan stated: Uncontrolled sperm leakage, difficult defecation, heavy waist/legs indicate Lower Jiao deficiency. Zhang Zhongjing stated: Faint pulse indicates qi-blood deficiency. Liujunzi Tang (Six-Gentlemen Decoction) plus Poguozi, Roudoukou (Myristicae Semen) stopped diarrhea and improved appetite. Then Shiquan Dabu Tang plus blood-invigorating herbs for 10+ doses resolved swelling.
[Females]
Female patient, previously ascetic, contracted prior symptoms from depression/anger. Used toxic/cold drugs, leading to evening fever, internal heat, spontaneous/night sweats, amenorrhea, dry mouth/throat. Diagnosis: Depression injuring Spleen, worsened by drugs. Treated with Danggui Tang for several doses, then Xiaoyao San (Free and Easy Wanderer Powder) for 50+ doses each, resolving all symptoms.
Female patient with sensation of blockage in lower abdomen, swelling of inner thighs/vulva, dribbling urination, irregular menstruation, internal heat/thirst, poor appetite, abdominal mass growing from egg-sized, flooding-rapid-deficient pulse (stronger at Left Guan): Liver-Spleen depression-stagnation. Jiawei Guipi Tang (Modified Restore the Spleen Decoction) cleared Liver fire and strengthened Spleen earth. Intermittently used Xiaoyao San plus Lushui Wan (Aloe Pill) for cure.
Female patient with inner thigh swelling/pain, abdominal mass attacking upwards, irregular menstruation >1 month, dysuria. Diagnosed as Liver-Spleen qi stagnation. Sijunzi Tang (Four-Gentlemen Decoction) plus Chuanxiong, Danggui, Chaihu, Shanzhi cured her. Later, recurrence with depression/anger, chest/hypochondriac distension, night sweats indicated Liver Wood overacting on Spleen Earth. Jiawei Guipi Tang plus Lushui Wan cured her.
Female patient with lower abdominal pain/distension, inner thigh swelling/pain, internal heat/chills, chest discomfort, poor taste, emaciation. Liver qi stagnation injuring Spleen qi. Morning: Buzhong Yiqi Tang; Evening: Liuwei Wan. Gradually improved, fully cured with Lushui Wan.
Female patient with inner thigh swelling/pain, lower abdominal distension, frequent urination, leukorrhea, alternating chills/fever, dribbling urination. I...