丹溪云∶环跳穴痛，防生附骨疽，以苍术佐黄柏之辛，行以青皮、冬加桂枝，夏加
黄芩，体虚加杜牛膝，以生甘草为使，大料煎入生姜汁，食前饮之。痛甚者，恐十数帖
发不动，少加麻黄一二帖又不动，恐疽将成。急掘地成坎，以火 红，沃以小便。赤体坐
其中，以席围下体，使热气熏蒸，腠理开，气血畅而愈。 或问∶附骨疽，何以别之？曰∶
凡患流注，表未尽则余毒附骨而为疽。在股外属足太阳、阳明经，在股内属足厥阴、足
少阴经。又云∶风湿折热，热结而附骨成疽。盖骨者肾之余，肾虚则骨冷而遂附着于骨也，
骨冷则气愈滞而血愈积，但能为肿不能为脓。流注者伤寒之余毒，骨疽者，流注之坏证也。
流注非伤寒之罪，乃医者表之未尽也，骨疽非流注之过，乃庸医凉药之误也，又云∶久
得浓味及醉后涉水；或履冰霜雪，寒入髀枢，积痰瘀血相搏而成疽，初时暂痛无时，乍寒
乍热而无汗，久则痛深，入骨而不移处，按之痛不止者是也。初觉即隔蒜灸之，以多为
上。宜胜金丹、乌金散汗之。壮实者，一粒金丹下之，或八阵散。久则极阴生阳，寒化
为热，肉腐而成脓，脓成则宜烙，十全大补汤加牛膝、木瓜补之。有久溃毒结，留连展
转，经岁不已，腐出朽骨者，骨虽出而不愈，有终身之咎。视其白脓清稀者，碎骨初脱，肉
深难取。脓白而稠者，碎骨将出，肉浅可取。大抵久腐出骨，不论强弱老幼，必须补益，使
气血和畅，正气渐复，邪气渐退，自然收敛，十全大补汤、人参养荣汤，在所当用。未成
脓者，以冲和膏贴之。盖有独活能动汤气血也。已溃者，宜服何首乌散，此药能调和阴
阳也。
〔薛〕 附骨疽有因露卧，风寒深袭于骨者，有因形气损伤，不能起发者，有因克伐
之剂，亏损元气，不能发出者，有因外敷寒药，血凝结于内者，凡此皆宜灸熨患处，解
散毒瓦斯，补接阳气，温补脾胃为主。若饮食如常，先用仙方活命饮，解毒散郁，随着六
君子汤，补托荣气。若体倦食少。但用前汤，培养诸脏，使邪不得胜正。若脓已成即针之，
使毒不得内侵，带生用针亦无妨。如用火针亦不痛，且使易敛，其隔蒜灸，能解毒行气。
葱熨法能助阳气，行壅滞，此虽不见于方书，余常用之大效，其功是不能尽述，唯气血虚
脱者不应。 一女髀枢穴，生附骨疽，在外侧廉少阳经分，始末用五香汤、十宣散，一
日恶寒发热，膈满犹大，服五香汤，一夕喘死。此升散太过，孤阳发热于上也。 一人
年逾四十，夏患附骨痈。予以火针刺去瘀血，更服托里药而愈。至秋忽不饮食，痰气壅盛，
劳则口舌生疮，服寒药腹痛，彼疑为疮。脾胃脉轻取似大，按之无力，此真气不足，虚
火炎上也，治以八味丸。彼不信，自服二陈、四物汤，几殆，复请予。仍以前丸治之而愈。
一人附骨痈，畏针不开，臀膝通溃，脉数发渴，烦躁时嗽，饮食少思。齐氏曰∶疮疡
烦躁时嗽，腹痛渴甚。或泄利无度，或小便如淋，此恶证也，脓出之后，若脉洪数难治，
微涩迟缓易治。刺之，脓出四五碗，即服参、 、归、术大剂，翌日脉稍敛，更服八珍汤
加五味子、麦门、肉桂、白蔹，三十余帖脉缓脓稠，三月乃愈。 一老，腿患附骨疽肿
硬，大按方痛，口干脉弱，肿聚不溃，饮食少思。予谓∶肿下而坚者，发于筋骨；肉色
不变者，发于骨髓。遂托以参 等药三十余剂，脓虽熟不穿。予谓∶药力难达，必须针
刺。不听，至旬日方刺，涌出清脓五六碗，然衰老气血不足，养毒又久，竟不救。大抵疮
疽旬日不退，宜托之，有脓刺之，有腐肉取之，虚则补之，此十全之功也。 一人患贴
骨疽，腿细短软，疮口不合，以十全大补汤，外灸附子饼，贴补药膏，调护得宜，百帖而
愈。 一人环跳穴患附骨疽。彼谓小疮，服败毒药，外以寒药敷帖，因痛极针之，脓瘀
大泄，方知为痈请治。其脉右关浮大，此胃气已伤，故疮口开张，肉紫下陷，扪之不热，
彼谓疮内更觉微冷，自谓必成漏矣。灸以豆豉饼，饮六君子加藿香、砂仁、炮姜，数剂
胃气渐醒，饮食渐进，患处渐暖，肌肉渐生，更以十全大补汤而愈。 一人亦患此，内痛
如锥，外色不变，势不可消，喜其未用寒剂，只因痛伤胃气而不思食，以前药去炮姜治之，
饮食稍进，更以十全大补汤二十余剂，脓成针去，仍以大补汤倍加参、 、芎、归，脓
久不止，更加麦门、五味、贝母、远志，数服渐止，疮亦寻愈。 二证盖因湿热滞于肉
理，真气不能运化，其始宜除湿热，实脾土，和气血，则湿自消散，若脓未成，以隔蒜灸
之立效。 一妇四十余，近环跳生疽，尺脉沉紧，腿不能伸。经曰∶脾移寒于肝，壅肿
筋挛。盖脾主肉，肝主筋，肉温则筋舒，肉冷则筋急，遂与乳香定痛丸少愈，更以助胃
壮气血药，二十余剂而消。 一人因痢骤涩，环跳穴作痛，与四物汤加桃仁、酒黄芩、红
花、苍术、枳壳、黄柏、柴胡、青皮、生姜，十余剂稍可，更刺委中，出黑血而愈。 一
后生，HT 骨痛，以风药饮酒一年，予以防风通圣散去硝黄，加生犀角、浮萍百余帖，成
一疽，近皮革脓出而愈。后五六年，其处再痛。予曰∶旧病作，无能为矣。盖发于新娶
之后，多得香辣肉味，若能茹淡，远房劳，犹可生也。出脓血四五年，延及腰背皆空，又
三年而死，此纯乎病热者。 一少年，天寒极劳，HT 骨痛，两月后生疽，深入骨边，卧
二年，取剩骨而安。此寒搏热者也。（取久疽及痔漏中朽骨，用乌骨鸡胫骨，以砒实之，盐泥固济，
火红，地上出火毒，去泥用骨，研细饭丸，如粟米大，以纸捻送入窍内，更以膏贴之。） 万历乙亥，
予方闭关作举子业，适姻家虞懋庵，股内侧痛久矣，医作痛风治月余不效，脓熟肉浓，不
得穿穴出，因溃入腹，精神昏愦，粥药不入，医不能措手，请教于余。余特破例为诊之，脉
细如蛛丝，气息奄奄欲绝，曰∶无伤也，可以破针刺其腹，脓大泄数升，然皆清如水，疮
口若蟹吐沫，医疑其透膜不可治。余曰∶无伤也，可以参、 、附子，加厥阴引经药，大
剂饮之，为制八味丸，食前辄吞百丸，食大进，日啖饭升余，肉数脔，旬日而平。所以
知可治者，溃疡之脉，洪实者死，微细者生，今脉微细，形病相合，知其受补，故云可治
也。所以刺其腹者，脓不泄，必有内攻之患。且按之而知其创深，即刺之无苦也。所以信
其不透膜，即透膜无损者，无恶候也。所以服八味丸者，八味丸补肾，肾气旺而上升，则
胃口开而纳食，故食大进也。泄脓即多，刀圭之药。其何能济。迁延迟久且变生。故进
开胃之药，使多食粱肉以补之，肌乃速生。此治溃疡之大法也。
黄狗下颏方 治肚痈、少腹痈、及腿上贴骨痈，神效。又云可治发背，大抵此方，治
下部痈疽妙。
用黄狗下颏，连舌、连皮毛、劈下，入罐盐泥封固，铁盏盖口， 一炷香，觉烟清
即止，务宜存性，不可过，过则无用矣。视其骨灰，正黑色者为妙，若带白色，其性已
过勿用，（用时，研极细） 白蔹末 豌豆粉（俗名水寒豆，又名小寒豆。生用）
上三味等分，以各五钱为率，酒调空腹服外，又以三味等分，为敷药，香油调敷患
处。其验以服药后出臭汗，及熟睡为准。史鹤亭太史，亲见顾天宇室人验过。（宜于屠家取
己杀者，制以备用。若生取特杀，反招不祥。）
按∶此方世多用之。《万氏家抄》，亦已收载。然但知其可为敷药，散肿止痛，而不
知其可以内服，为下部痈疽内消之圣药也。予有轿夫，环跳穴痛甚，如鸡啄火灼，适制有
药，以酒调三钱饮之未愈，更进一服，霍然如失，明日舁轿如故。了无苦矣
三生散 治诸疮大痛，不辨肉色漫肿光色，名附骨痈，如神。
露蜂房 蛇蜕 头发（洗净，各等分）
上烧灰存性，研细，酒下三钱。
内托黄 柴胡汤 治附骨痈。
黄 （二钱） 柴胡 土瓜根（酒洗，各一钱） 羌活（半钱） 连翘（一钱三分） 官桂 黄柏 生
地黄（各二分） 当归（七分半）
上 咀作一服。水三盏，酒一盏，同煎至一盏，去滓。热服，宿食消尽服。一服而
愈。昔贾德茂男，年十岁，丁未四月十一日，于左腿近膝股内，出附骨痈，不辩肉色漫肿，
皮泽木硬，疮势甚大，其左脚乃肝之脾土也，更在足厥阴肝经之分，少侵足太阴脾之分，其
脉左三部细而弦，按之缓而微有力，为制此方主治。一方，无黄柏。
内托黄 酒煎汤
黄 当归尾（各二钱） 柴胡（一钱半） 升麻（七分） 连翘 肉桂 黍粘子（炒，各一钱） 黄
柏炙甘草（各半钱）
上 咀。好糯米酒一盏半，水一大盏半，同煎至一大盏，去滓。空心宿食消尽温服，待
少时，早膳压之，使不令大热上攻中上二焦也。丁未季春，薄度主老，年七十，因寒湿
地气，得附骨疽于左腿外侧，足少阳胆经之分，微侵足阳明分，阔六七寸，长一尺，坚
硬漫肿，不辨肉色，皮泽深，但行步作痛，以指按至骨大痛，与药一服立止，再服坚硬肿
消。
当归散 治附骨痈，及一切恶疮。
当归（半两） 甘草（一两） 山栀子（十二枚） 木鳖子（一枚，去壳）
上为细末。每服三钱，冷酒调服。
漏芦汤 治附骨疽。
漏芦（去芦） 升麻 连翘 麻黄（去根节，各一两） 防己 木香 白蔹 沉香（各半两） 大
黄（锉炒，一两半）
上锉碎。每服五钱，水一盏半，入竹叶七片，煎至七分，入芒硝一钱，搅匀，去滓。
空心温服，取利三二行，未利再服。
应痛丸 治走注疼痛，疑是附骨疽者。
苍术（去皮） 当归 黑牵牛 草乌头（炮，各一两）
上为细末，醋糊为丸，如小豆大。每服三十丸，空心醋汤下。
贯众汤 治附骨痈，生股上伏肉间，淋渫。
地骨皮 谷精草 枇杷叶（拭去毛，刷炙） 荆芥（去梗） 蜀椒（去目并合口者，以上各一两）
上捣筛。以水三升，煮取二升，和滓淋渫，蘸布帛拓之。
密陀僧散
密陀僧 自然铜（各半两） 杏仁（去皮尖、双仁，二七枚）
上用苦竹筒一枚，入药在内，纸封筒口，慢火煨，候筒黄色。取出研极细。看疮大小，
用药以新汲水调匀，用鸡翎扫涂痈上，甚者不过二七日效。
朱丹溪说：环跳穴疼痛，要预防发生附骨疽。用苍术辅助黄柏的辛味，配合青皮；冬天加桂枝，夏天加黄芩；体质虚弱的加杜牛膝；以生甘草为使药。大剂量煎煮，加入生姜汁，饭前服用。疼痛剧烈的，恐怕十几帖药发不出来，如果少加麻黄一二帖还是发不出来，恐怕疽就要形成了。急忙在地上挖一个坑，用火烧红，浇上小便。赤身坐在其中，用席子围住下半身，使热气熏蒸，腠理开泄，气血通畅而痊愈。有人问：附骨疽，怎么辨别它？回答说：凡是患流注病，表证未尽则余毒附着在骨骼上成为疽。在股外侧属于足太阳膀胱经、足阳明胃经；在股内侧属于足厥阴肝经、足少阴肾经。又说：风湿折损热邪，热结聚而附着在骨骼上形成疽。大概骨骼是肾脏的剩余部分，肾虚则骨冷，从而附着在骨骼上；骨冷则气更加停滞而血更加积聚，只能造成肿胀而不能化脓。流注是伤寒病的余毒，骨疽是流注病的恶化证候。流注不是伤寒病的过错，而是医生解表不彻底造成的；骨疽不是流注病的过错，而是庸医误用凉药的后果。又说：长期食用浓味食物及醉酒后涉水；或者踩在冰霜雪地上，寒气侵入髀枢（大腿根部），积痰和瘀血相互搏结而成疽。初起时暂时疼痛无定时，忽冷忽热而无汗，时间久了则疼痛深入，入骨且位置固定不移，按压时疼痛不止的就是这种病。刚觉得不适时就隔蒜灸患处，以多灸为佳。宜用胜金丹、乌金散发汗。身体壮实的人，用一粒金丹泻下，或者用八阵散。时间久了则极阴产生阳气，寒转化为热，肌肉腐烂而成脓。脓成后宜用烙法，用十全大补汤加牛膝、木瓜来补益。有久溃烂毒结聚，留连辗转，经过一年不愈，排出朽骨的，骨头虽然排出了但伤口不愈合，会有终身的遗憾。观察如果是白色清稀的脓，说明碎骨刚开始脱落，肉深难以取出。脓白而稠厚的，说明碎骨将要排出，肉浅可以取出。大抵久腐出骨的情况，不论强弱老幼，必须补益，使气血调和通畅，正气逐渐恢复，邪气逐渐消退，自然收敛，十全大补汤、人参养荣汤，是应当使用的。未成脓的，用冲和膏贴敷。因为独活能调动汤剂的气血。已溃破的，宜服用何首乌散，此药能调和阴阳。
薛己说：附骨疽有的因露天睡觉，风寒深深侵袭骨骼；有的因形体元气损伤，不能起发；有的因攻伐药剂，亏损元气，不能发出；有的因外敷寒凉药物，血液凝结在内。凡这些情况都适宜灸熨患处，解散毒瓦斯，补接阳气，以温补脾胃为主。如果饮食正常，先用仙方活命饮，解毒散郁，接着用六君子汤，补托营气。如果身体疲倦、食量减少，只用前面的汤剂，培养各脏腑，使邪气不能战胜正气。如果脓已成就针刺，使毒气不得内侵，带生用针也无妨。如果用火针也不痛，而且容易收敛。那隔蒜灸，能解毒行气。葱熨法能助长阳气，运行壅滞，这虽然不见于方书，但我常用且效果显著，其功效不能尽述，只有气血虚脱者不适用。有一个女子环跳穴生附骨疽，在外侧廉少阳经部位，始终用五香汤、十宣散，一天中恶寒发热，胸膈胀满很大，服用五香汤，一夜之间喘死。这是升散太过，孤阳发热于上。一个人年过四十，夏天患附骨痈。我用火针刺去瘀血，再服用托里药而痊愈。到了秋天突然不进食，痰气壅盛，劳累则口舌生疮，服用寒凉药腹痛，他怀疑是疮疡所致。脾胃脉轻取似乎大，重按无力，这是真气不足，虚火上炎，治疗用八味丸。他不相信，自己服用二陈汤、四物汤，几乎丧命，又请我诊治。仍然用前面的丸药治疗而痊愈。一个人患附骨痈，害怕针刺不肯切开，臀部膝盖全部溃烂，脉数、口渴、烦躁、时常咳嗽、饮食少想。齐氏说：疮疡烦躁、时常咳嗽、腹痛、极度口渴，或者腹泻无度，或者小便像淋病，这是恶证。脓出之后，如果脉洪数难治，微涩迟缓易治。针刺后，脓流出四五碗，立即服用人参、黄芪、当归、白术的大剂量药，第二天脉稍收敛，再服用八珍汤加五味子、麦门冬、肉桂、白蔹，三十多帖后脉缓脓稠，三个月才痊愈。一个老人，腿部患附骨疽肿硬，大力按压方痛，口干脉弱，肿聚不溃，饮食少想。我说：肿下而坚硬的，发于筋骨；肉色不变的，发于骨髓。于是用参、芪等药托里三十多剂，脓虽熟但不穿破。我说：药力难达，必须针刺。他不听，过了十天方才针刺，涌出清脓五六碗，然而衰老气血不足，供养毒邪又久，最终没能救活。大抵疮疽十天不退，宜托里；有脓就刺；有腐肉就去除；虚则补益，这是十全的功效。一个人患贴骨疽，腿细短软，疮口不合，用十全大补汤，外灸附子饼，贴补药膏，调护得当，一百多帖而痊愈。一个人环跳穴患附骨疽。他认为小疮，服用败毒药，外用寒药敷贴，因疼痛剧烈针刺，脓瘀大量泄出，才知道是痈请求治疗。他的脉右关浮大，这是胃气已伤，所以疮口开张，肉紫下陷，摸之不热，他说疮内更觉微冷，自认为必成漏症了。用豆豉饼灸，饮用六君子汤加藿香、砂仁、炮姜，几剂后胃气渐醒，饮食渐进，患处渐暖，肌肉渐生，再用十全大补汤而痊愈。另一个人也患此病，内痛如锥刺，外色不变，势不可消，庆幸他没使用寒凉药剂，只因疼痛损伤胃气而不思饮食，用前面的药去掉炮姜治疗，饮食稍进，再用十全大补汤二十多剂，脓成针刺排出，仍用大补汤倍加人参、黄芪、川芎、当归，脓久不止，再加麦门冬、五味子、贝母、远志，几服后渐止，疮也很快痊愈。这两个证候大概是因为湿热滞留于腠理，真气不能运化，起初宜除湿热，实脾土，和气血，则湿自消散，如果脓未成，用隔蒜灸之立效。一个妇女四十多岁，近环跳处生疽，尺脉沉紧，腿不能伸。经上说：脾移寒于肝，壅肿筋挛。大概脾主肉，肝主筋，肉温则筋舒，肉冷则筋急，于是给予乳香定痛丸稍愈，再用助胃壮气血药，二十多剂而消。一个人因痢疾突然涩滞，环跳穴作痛，给予四物汤加桃仁、酒黄芩、红花、苍术、枳壳、黄柏、柴胡、青皮、生姜，十余剂稍好，再刺委中穴，放出黑血而痊愈。一个年轻人，髀骨痛，用风药饮酒一年，我用防风通圣散去硝石、大黄，加生犀角、浮萍一百多帖，成一个疽，靠近皮革处脓出而愈。后来五六年，该处再痛。我说：旧病发作，无能为力了。大概发生在新婚之后，多得香辣肉味，如果能吃清淡，远离房劳，还可以生存。流出脓血四五年，延及腰背皆空，又三年而死，这是纯乎病热的人。一个少年，天寒极劳，髀骨痛，两个月后生疽，深入骨边，卧床二年，取出剩骨而安。这是寒搏热的人。（取出久疽及痔漏中的朽骨，用乌骨鸡胫骨，用砒霜充实其中，盐泥密封牢固，火烧红，在地上出火毒，去掉泥用骨，研细做成饭丸，如粟米大，用纸捻送入窍内，再用膏药贴敷。）万历乙亥年，我正闭关准备科举考试，恰逢姻亲虞懋庵，股内侧痛了很久，医生当作痛风治疗一个多月无效，脓熟肉腐，不得穿穴而出，因而溃入腹中，精神昏愦，粥药不入，医生不能措手，请教与我。我特别破例为他诊脉，脉细如蛛丝，气息奄奄欲绝，说：无妨，可以用破针刺其腹部，脓大量泄出数升，然而都是清如水，疮口像螃蟹吐沫，医生怀疑其透膜不可治。我说：无妨，可以用人参、黄芪、附子，加厥阴引经药，大剂量饮用，为他配制八味丸，饭前吞服百丸，饮食大进，每天吃饭一升多，吃肉几块，十天而平复。之所以知道可治，溃疡的脉，洪实的死，微细的生，现在脉微细，形病相合，知道他受补，所以说可治。之所以刺其腹部，脓不泄，必有内攻的祸患。而且按压而知其创深，即刺之无痛苦。之所以信其不透膜，即使透膜无损者，无恶候。之所以服八味丸，八味丸补肾，肾气旺而上升，则胃口开而纳食，故饮食大进。泄脓即多，刀圭之药，有什么能济事。迁延迟久且变生。故进开胃之药，使多吃粱肉以补之，肌肉乃速生。这是治溃疡的大法。
黄狗下颏方 治疗肚痈、少腹痈、及腿上贴骨痈，神效。又说可治发背，大抵此方，治下部痈疽妙。
用黄狗下颏，连舌、连皮毛，劈下，放入罐中用盐泥封固，铁盏盖口，燃一炷香的时间，觉得烟清即停止，务必存性，不可过火，过火则无用了。看其骨灰，正黑色者为妙，若带白色，其性已过勿用，（用时，研极细）
白蔹末 豌豆粉（俗名水寒豆，又名小寒豆。生用）
以上三味等分，以各五钱为标准，酒调空腹服外，又以三味等分，作为敷药，香油调敷患处。其验证以服药后出臭汗，及熟睡为准。史鹤亭太史，亲眼见顾天宇的妻子验证过。（宜于屠家取已杀者，制以备用。若生取特杀，反招不祥。）
按：此方世人多用。《万氏家抄》，也已收录。然而只知道它可以做敷药，散肿止痛，而不知道它可以内服，为下部痈疽内消的圣药。我有轿夫，环跳穴痛甚，如鸡啄火灼，恰好制成有药，用酒调三钱饮用未愈，再进一服，霍然如失，明日抬轿如故。毫无苦楚了。
三生散 治疗诸疮大痛，不辨肉色漫肿光色，名附骨痈，如神。
露蜂房 蛇蜕 头发（洗净，各等分）
以上烧灰存性，研细，酒送下三钱。
内托黄芪柴胡汤 治疗附骨痈。
黄芪（二钱） 柴胡 土瓜根（酒洗，各一钱） 羌活（半钱） 连翘（一钱三分） 官桂 黄柏 生地黄（各二分） 当归（七分半）
以上锉咀作一服。水三盏，酒一盏，同煎至一盏，去滓。热服，宿食消尽服。一服而愈。昔贾德茂男，年十岁，丁未四月十一日，于左腿近膝股内，出附骨痈，不辩肉色漫肿，皮泽木硬，疮势甚大，其左脚乃肝之脾土也，更在足厥阴肝经之分，少侵足太阴脾之分，其脉左三部细而弦，按之缓而微有力，为制此方主治。一方，无黄柏。
内托黄芪酒煎汤
黄芪 当归尾（各二钱） 柴胡（一钱半） 升麻（七分） 连翘 肉桂 黍粘子（炒，各一钱） 黄柏炙甘草（各半钱）
以上锉咀。好糯米酒一盏半，水一大盏半，同煎至一大盏，去滓。空心宿食消尽温服，待少时，早膳压之，使不令大热上攻中上二焦也。丁未季春，薄度主老，年七十，因寒湿地气，得附骨疽于左腿外侧，足少阳胆经之分，微侵足阳明分，阔六七寸，长一尺，坚硬漫肿，不辨肉色，皮泽深，但行步作痛，以指按至骨大痛，与药一服立止，再服坚硬肿消。
当归散 治疗附骨痈，及一切恶疮。
当归（半两） 甘草（一两） 山栀子（十二枚） 木鳖子（一枚，去壳）
以上为细末。每服三钱，冷酒调服。
漏芦汤 治疗附骨疽。
漏芦（去芦） 升麻 连翘 麻黄（去根节，各一两） 防己 木香 白蔹 沉香（各半两） 大黄（锉炒，一两半）
以上锉碎。每服五钱，水一盏半，入竹叶七片，煎至七分，入芒硝一钱，搅匀，去滓。空心温服，取利三二行，未利再服。
应痛丸 治疗走注疼痛，疑是附骨疽者。
苍术（去皮） 当归 黑牵牛 草乌头（炮，各一两）
以上为细末，醋糊为丸，如小豆大。每服三十丸，空心醋汤下。
贯众汤 治疗附骨痈，生股上伏肉间，淋渫。
地骨皮 谷精草 枇杷叶（拭去毛，刷炙） 荆芥（去梗） 蜀椒（去目并合口者，以上各一两）
以上捣筛。以水三升，煮取二升，和滓淋渫，蘸布帛拓之。
密陀僧散
密陀僧 自然铜（各半两） 杏仁（去皮尖、双仁，二七枚）
上用苦竹筒一枚，入药在内，纸封筒口，慢火煨，候筒黄色。取出研极细。看疮大小，用药以新汲水调匀，用鸡翎扫涂痈上，甚者不过二七日效。
Zhu Danxi said: Pain in the Huantiao acupoint (GB30) warns of the potential development of Gujuzhong (Bone-attached Abscess). Use Cangzhu (Atractylodis Rhizoma) to assist Huangbai (Phellodendri Cortex) for its pungency, combined with Qingpi (Citri Reticulatae Pericarpium Viride); add Guizhi (Cinnamomi Ramulus) in winter and Huangqin (Scutellariae Radix) in summer; for those with weak constitutions, add Dunniuxi (Achyranthis Bidentatae Radix); use Sheng Gancao (Glycyrrhizae Radix et Rhizoma) as a guiding agent. Decoct in large quantities, add Jiangzhi (Zingiberis Recens Juice), and drink before meals. For severe pain, if ten or more doses fail to induce sweating, and adding Mahuang (Ephedrae Herba) for one or two doses also fails, it is feared that the abscess is about to form. Urgently dig a pit in the ground, heat it red with fire, and pour urine into it. Sit naked in it, surround the lower body with mats, allowing the hot steam to penetrate, opening the Couli (skin pores and interstices), promoting smooth Qi and Blood flow, leading to recovery. Someone asked: How to distinguish Gujuzhong? The answer is: In cases of Liuzhu (Flowing Tubercles), if the exterior syndrome is not fully resolved, residual toxins attach to the bones forming an abscess. Lesions on the lateral aspect of the thigh belong to the Foot-Taiyang Bladder Channel and Foot-Yangming Stomach Channel; lesions on the medial aspect belong to the Foot-Jueyin Liver Channel and Foot-Shaoyin Kidney Channel. It is also said: Wind-dampness obstructs heat, which condenses and attaches to the bone to form an abscess. Bones are the surplus of the Kidneys; when Kidney deficiency occurs, the bones become cold and subsequently attach to the bone. Bone cold causes Qi to stagnate further and Blood to accumulate, resulting in swelling but no suppuration. Liuzhu is the residual toxin of Shanghan (Cold Damage disease), while Gujuzhong is the deteriorated stage of Liuzhu. Liuzhu is not the fault of Shanghan, but of physicians failing to resolve the exterior sufficiently; Gujuzhong is not the fault of Liuzhu, but of incompetent physicians mistakenly using cooling herbs. It is also said: Long-term consumption of rich flavors and wading in water after drunkenness; or walking on ice, frost, and snow, allowing cold to enter the Bitshu (hip joint), where accumulated phlegm and blood stasis struggle to form an abscess. Initially, there is temporary, intermittent pain, alternating chills and fever without sweat. Over time, the pain becomes deep, fixed in the bone, and pressing exacerbates the pain. Upon initial sensation, apply Moganjiu (Garlic-Separated Moxibustion) to the affected area, preferably with multiple applications. It is suitable to use Shengjin Dan (Winning Gold Pill) or Wujin San (Black Gold Powder) to induce sweating. For robust individuals, use Yili Jin Dan (One-Pill Golden Pill) to purge, or Bazhen San (Eight-Array Powder). After a long duration, extreme Yin generates Yang, cold transforms into heat, flesh rots and forms pus. Once pus is formed, cauterization is appropriate; supplement with Shiquan Dabu Tang (Complete Great Tonifying Decoction) plus Nixi (Achyranthis Bidentatae Radix) and Mugua (Chaenomelis Fructus). In cases of chronic ulceration with toxic accumulation lingering for over a year, expelling necrotic bone, even if the bone is expelled, the wound may not heal, causing lifelong regret. If the pus is white and thin, it indicates the beginning of fragment expulsion, and the tissue is deep, making removal difficult. If the pus is white and thick, the fragments are about to be expelled, and the tissue is shallow, making removal feasible. Generally, for chronic bone exposure, regardless of age or strength, tonification is essential to harmonize Qi and Blood, restore healthy Qi, and eliminate pathogenic factors, leading to natural contraction. Shiquan Dabu Tang (Complete Great Tonifying Decoction) and Renshen Yangrong Tang (Ginseng Nourishing Nutritive Decoction) should be used. For unformed pus, apply Chonghe Gao (Harmonizing Ointment), as Duohuo (Angelicae Pubescentis Radix) can mobilize the Qi and Blood of the decoction. For ulcerated cases, consume Heshouwu San (Polygoni Multiflori Powder), which harmonizes Yin and Yang.
Xue Ji stated: Gujuzhong may arise from sleeping outdoors, allowing wind-cold to deeply invade the bones; from damage to physical constitution and Yuan Qi, preventing eruption; from purgative agents damaging Yuan Qi, preventing emergence; or from external application of cold herbs causing blood coagulation internally. All such cases require moxibustion and warming compresses on the affected area to dissipate toxic vapors, replenish Yang Qi, and primarily warm and tonify the Spleen and Stomach. If appetite is normal, first use Xianfang Huoming Yin (Immortal Formula Life-Saving Decoction) to detoxify and disperse stagnation, followed by Liujunzi Tang (Six Gentlemen Decoction) to support Ying Qi. If fatigue and poor appetite prevail, use only the aforementioned decoction to nourish the Zang organs, preventing pathogens from overcoming healthy Qi. If pus has formed, puncture it to prevent internal invasion; using a needle without prior heating is acceptable. Fire needles cause less pain and facilitate closure. Moganjiu (Garlic-Separated Moxibustion) detoxifies and moves Qi. Congwei (Green Onion Compress) boosts Yang Qi and resolves stagnation; though not recorded in classic texts, I use it frequently with great effect, except in cases of Qi and Blood collapse. A woman developed Gujuzhong at the Huantiao acupoint (GB30) on the lateral Shaoyang channel. She was treated continuously with Wuxiang Tang (Five Fragrances Decoction) and Shixuan San (Ten Acupoints Powder). One day she experienced chills, fever, and severe chest fullness. After taking Wuxiang Tang, she died of asthma overnight. This was due to excessive ascending and dispersing actions, causing solitary Yang to flare upwards. A man over forty developed a Gujuyong (Bone-attached Carbuncle) in summer. I used fire needles to remove blood stasis and prescribed interior-supporting herbs, leading to recovery. In autumn, he suddenly lost his appetite, had abundant phlegm-Qi obstruction, developed mouth ulcers upon exertion, and suffered abdominal pain from cold herbs. He suspected it was related to the sore. His Spleen and Stomach pulse felt large on light pressure but weak on deep pressure, indicating insufficient True Qi and flaming deficient fire. I treated him with Bawei Wan (Eight-Ingredient Pill). He did not believe me, self-medicated with Erchen Tang (Two-Aged Decoction) and Siwu Tang (Four Substances Decoction), nearly dying, then sought my help again. I continued with the same pill, and he recovered. Another man with Gujuyong refused needle drainage. His buttocks and knees ulcerated extensively. He had a rapid pulse, thirst, irritability, occasional cough, and poor appetite. Qi Shi stated: Irritability, cough, abdominal pain, extreme thirst, profuse diarrhea, or dysuria-like symptoms in sores indicate a malignant condition. After pus discharge, a surging and rapid pulse is hard to treat, while a faint, choppy, slow, or delayed pulse is easier. After puncturing and draining four to five bowls of pus, administer a large dose of Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma). The next day, the pulse stabilized slightly. Continue with Bazhen Tang (Eight Treasures Decoction) plus Wuweizi (Schisandrae Fructus), Maidong (Ophiopogonis Radix), Rougui (Cinnamomi Cortex), and Bailian (Trollii Radix). After thirty-plus doses, the pulse slowed, pus thickened, and he recovered in three months. An elderly man had a hard, swollen Gujuzhong on his leg, painful on deep pressure, with dry mouth and weak pulse. The swelling did not ulcerate, and appetite was poor. I said: Hardness below the swelling indicates origin in sinews and bones; unchanged skin color indicates origin in bone marrow. I used Renshen and Huangqi to support the interior for thirty doses. Although the pus matured, it did not rupture. I advised that herbal power was insufficient and needle drainage was necessary. He refused. Ten days later, he allowed drainage, releasing five to six bowls of clear pus. However, due to old age, insufficient Qi and Blood, and prolonged toxicity, he could not be saved. Generally, sores and carbuncles persisting for ten days require interior support; those with pus need drainage; necrotic flesh must be removed; deficiency requires tonification. This achieves perfection. A man with Tieguju (Bone-adhering Abscess) had thin, short, soft legs and non-healing wounds. He used Shiquan Dabu Tang (Complete Great Tonifying Decoction), external moxibustion with Fuzi Bing (Aconite Cake), and tonic ointments. With proper care, he recovered after over a hundred doses. Another man had Gujuzhong at Huantiao (GB30). He considered it a minor sore, took detoxifying herbs, and applied cold external medicines. Due to extreme pain, he was needled, releasing large amounts of pus and blood stasis. Only then did he realize it was a carbuncle and seek treatment. His Right Guan pulse was floating and large, indicating damaged Stomach Qi. The wound opened, flesh was purple and sunken, and cool to touch. He felt internal cold and feared a fistula. I applied Douchi Bing (Fermented Soybean Cake) moxibustion and prescribed Liujunzi Tang (Six Gentlemen Decoction) plus Huoxiang (Pogostemonis Herba), Sharen (Amomi Fructus), and Paojiang (Prepared Ginger). After several doses, Stomach Qi revived, appetite improved, the lesion warmed, and flesh regenerated. He finally recovered with Shiquan Dabu Tang (Complete Great Tonifying Decoction). Another patient had similar symptoms: internal pain like needle pricks, unchanged external color, irreducible swelling. Fortunately, he had not used cold herbs. The pain had damaged Stomach Qi, causing anorexia. I used the previous formula minus Paojiang (Prepared Ginger). Appetite improved slightly. Then, twenty doses of Shiquan Dabu Tang (Complete Great Tonifying Decoction) were given. Pus formed and was drained. The major tonifying decoction was doubled with Renshen (Ginseng Radix), Huangqi (Astragali Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix). For persistent pus, Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Beimu (Fritillariae Cirrhosae Bulbus), and Yuanzhi (Polygalae Radix) were added. After several doses, pus stopped, and the wound healed quickly. These two cases were likely due to damp-heat stagnating in the Couli (interstices), preventing True Qi transformation. Initially, damp-heat should be cleared, Spleen Earth strengthened, and Qi-Blood harmonized, causing dampness to dissipate naturally. If pus has not formed, Moganjiu (Garlic-Separated Moxibustion) is immediately effective. A woman in her forties developed an abscess near Huantiao (GB30). Her Chi pulse was deep and tight, and her leg could not extend. The Classic states: "Spleen transmits cold to the Liver, causing swelling and tendon spasm." The Spleen governs flesh, the Liver governs tendons. Warm flesh relaxes tendons; cold flesh contracts them. I prescribed RuXiang Dingtong Wan (Frankincense Pain-Stopping Pill) for slight relief, followed by herbs to boost Stomach Qi and strengthen Qi and Blood. After twenty doses, it resolved. A man with sudden onset of dysentery experienced pain at Huantiao (GB30). I prescribed Siwu Tang (Four Substances Decoction) plus Taoren (Persicae Semen), Jiu Huangqin (Scutellariae Radix prepared with wine), Honghua (Carthami Flos), Cangzhu (Atractylodis Rhizoma), Zhike (Aurantii Fructus), Huangbai (Phellodendri Cortex), Chaihu (Bupleuri Radix), Qingpi (Citri Reticulatae Pericarpium Viride), and Shengjiang (Zingiberis Recens Rhizoma). After ten doses, he improved. Puncturing Weizhong (BL40) released black blood, leading to cure. A young man suffered Bitong (hip/thigh bone pain) for a year using wind-dispelling herbs and alcohol. I prescribed Fangfeng Tongsheng San (Saposhnikovia Unblocking and Releasing Powder) minus Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma), plus Sheng Xijiao (Rhinocerotis Cornu - substitute available) and Fuping (Urticae Herba) for over a hundred doses. A carbuncle formed near the skin surface, discharged pus, and healed. Five or six years later, pain recurred. I said: Old disease returning, powerless to help. It likely started after marriage, exacerbated by spicy and meat-rich foods. If he ate bland food and avoided sexual excess, he might survive. He discharged pus and blood for four to five years, extending to emptying the waist and back, and died three years later. This was purely a heat disease. A youth, exhausted in extreme cold, suffered hip bone pain. Two months later, an abscess formed deep near the bone. He lay bedridden for two years until remaining bone fragments were extracted, bringing peace. This was cold contending with heat. (To extract necrotic bone from chronic abscesses or hemorrhoidal fistulas, use Tibia of Black-bone Hen, fill with Ashi (Arsenic Trioxide), seal with salt mud, fire until red, extinguish fire toxicity on ground, remove mud, grind bone finely, make rice pills sized like millet seeds, insert via paper twist, and apply ointment.) In the Yi Hai year of Wanli, I was secluded preparing for imperial examinations. My relative Yu Maonan had long-standing pain in the medial thigh. Doctors treated it as gout for over a month without effect. The pus matured and rotted but failed to drain through a pore, instead rupturing into the abdomen. He became delirious, unable to take food or medicine, and doctors were helpless. They consulted me. I broke protocol to examine him. His pulse was fine as a spider's thread, breath faint and near extinction. I said: No danger. Puncture the abdomen with a broken needle. Several liters of clear, watery pus drained. The wound looked like crab bubbles. Doctors doubted perforation of the membrane deemed it incurable. I said: No danger. Administer a large dose of Renshen (Ginseng Radix), Huangqi (Astragali Radix), Fuzi (Aconiti Lateralis Radix Praeparata), plus Jueyin channel-guiding herbs. Prepare Bawei Wan (Eight-Ingredient Pill). Swallow one hundred pills before meals. Appetite increased greatly, consuming over a liter of rice and several pieces of meat daily. Recovered in ten days. Why curable? In ulcers, surging/full pulses indicate death, faint/fine pulses indicate life. Current faint pulse matches the condition, indicating tolerance for tonification. Why puncture abdomen? Undrained pus risks internal attack. Palpation confirmed deep wound, ensuring minimal pain during puncture. Why confident no membrane perforation? Even if perforated, absence of malignant signs suggests safety. Why Bawei Wan (Eight-Ingredient Pill)? It tonifies Kidneys. Strengthened Kidney Qi ascends, opening Stomach appetite, hence increased intake. Massive pus drainage renders small medicinal doses ineffective. Delay invites complications. Thus, open Stomach appetite, encourage grain/meat intake to tonify, accelerating flesh regeneration. This is the major principle for treating ulcers.
Yellow Dog Mandible Formula: Treats abdominal carbuncles, lower abdominal carbuncles, and thigh tie-gu carbuncles with miraculous effect. Also said to treat Back Carbuncles. Generally excellent for lower body abscesses.
Take the mandible of a yellow dog, including tongue and skin/hair. Split it, place in a jar, seal with salt mud, cover with an iron lid. Burn one incense stick's worth of time. Stop when smoke clears. Must preserve nature, do not overcook, or it becomes useless. Ash should be pure black; white indicates overcooking, discard. (Grind extremely fine before use.)
Bailian End (Trollii Radix powder)
Wandou Fen (Vicia Sativa L. flour, common name Shuihandou/Xiaohandou. Raw)
Mix these three in equal parts, typically 5 qian each. Take with wine on an empty stomach. Also mix equal parts for external paste, blend with sesame oil, apply to lesion. Efficacy verified by foul sweat and deep sleep after ingestion. Historian Shi Heting witnessed Mrs. Gu Tianyu verify this. (Obtain from slaughterhouses after killing. Killing specifically for this brings bad luck.)
Note: Widely used in the world. Wan Family Secret Copy also records it. But people only know it as an external paste for reducing swelling and pain, unaware it can be taken internally as a holy medicine for resolving lower body abscesses. I had a sedan chair bearer with severe Huantiao (GB30) pain, like chicken pecking or fire burning. I had just made this medicine. Mixed 3 qian with wine and drank. Not cured. Took another dose. Suddenly cured. Next day carried sedan as usual. No suffering.
Sansheng San (Three Lives Powder): Treats severe pain in all sores, indistinguishable flesh color, diffuse swelling, named Fujie Yong (Bone-attached Carbuncle). Miraculous.
Lufengfang (Apiis Alveolus)
Shetui (Serpent Skin)
Toufa (Human Hair, washed clean, equal parts)
Burn to ash preserving nature, grind fine. Take 3 qian with wine.
Neituo Huangqi Chaihu Tang (Interior-Supporting Astragalus and Bupleurum Decoction): Treats Fujie Yong (Bone-attached Carbuncle).
Huangqi (Astragali Radix, 2 qian)
Chaihu (Bupleuri Radix, 1 qian)
Tugua Gen (Trichosanthes Thunbergiana Radix, wine-washed, 1 qian)
Qianghuo (Notopterygii Rhizoma et Radix, 0.5 qian)
Lianqiao (Forsythiae Fructus, 1.3 qian)
Guangui (Cinnamomi Cortex, amount unspecified in source text context implies small dose)
Huangbai (Phellodendri Cortex, amount unspecified)
Sheng Dihuang (Rehmanniae Radix Recens, 0.2 qian)
Danggui (Angelicae Sinensis Radix, 0.75 qian)
Cut into pieces for one dose. Decoct with 3 cups water and 1 cup wine until 1 cup remains. Strain. Drink hot after宿食 (overnight food) is digested. Cured in one dose. Formerly, Jia Demao's son, age 10, on April 11, Dingwei year, developed Fujie Yong on inner left thigh near knee. Indistinguishable flesh color, diffuse swelling, shiny and woody hard skin, severe condition. Left foot corresponds to Liver's Spleen Earth, involving Foot-Jueyin Liver Channel, slightly invading Foot-Taiyin Spleen Channel. Pulse left three positions fine and wiry, slow and slightly forceful on pressure. Prescribed this formula. Alternative version excludes Huangbai (Phellodendri Cortex).
Neituo Huangqi Wine-Decoction Soup
Huangqi (Astragali Radix, 2 qian)
Danggui Wei (Angelicae Sinensis Radix tail, 2 qian)
Chaihu (Bupleuri Radix, 1.5 qian)
Shengma ( Cimicifugae Rhizoma, 0.7 qian)
Lianqiao (Forsythiae Fructus, 1 qian)
Rougui (Cinnamomi Cortex, 1 qian)
Shuniu Zi (Arctii Fructus, stir-fried, 1 qian)
Huangbai (Phellodendri Cortex, 0.5 qian)
Zhigancao (Glycyrrhizae Radix et Rhizoma Prepared, 0.5 qian)
Cut into pieces. Decoct with 1.5 cups good glutinous rice wine and 1.5 cups water until 1 cup remains. Strain. Drink warm on empty stomach after宿食 digestion. Wait a moment, then eat breakfast to suppress heat from attacking Middle/Upper Jiao. In late spring of Dingwei year, an old master Bodu, age 70, contracted Fujie Ju (Bone-attached Abscess) on outer left leg due to cold-damp earth qi, involving Foot-Shaoyang Gallbladder Channel, slightly invading Foot-Yangming Stomach Channel. Width 6-7 cun, length 1 chi. Hard, diffuse swelling, indistinguishable flesh color, dark shiny skin. Pain on walking, severe pain on pressing to bone. One dose stopped pain immediately. Second dose reduced hardness and swelling.
Danggui San (Angelica Powder): Treats Fujie Yong (Bone-attached Carbuncle) and all malignant sores.
Danggui (Angelicae Sinensis Radix, 0.5 liang)
Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang)
Shanzhizi (Gardeniae Fructus, 12 fruits)
Mubiezi (Momordicae Semen, 1 fruit, shell removed)
Grind to fine powder. Take 3 qian per dose, mixed with cold wine.
Loulu Tang (Rhaponticum Decoction): Treats Fujie Ju (Bone-attached Abscess).
Loulu (Rhapontici Rhizoma, remove rhizome base)
Shengma (Cimicifugae Rhizoma)
Lianqiao (Forsythiae Fructus)
Mahuang (Ephedrae Herba, remove roots/joints, 1 liang each)
Fangji (Stephaniae Tetrandrae Radix)
Muxiang (Aucklandiae Radix)
Bailian (Trollii Radix)
Chenxiang (Aquilariae Lignum Resinatum, 0.5 liang each)
Dahuang (Rhei Radix et Rhizoma, cut and stir-fried, 1.5 liang)
Cut into pieces. Take 5 qian per dose. Decoct with 1.5 cups water and 7 bamboo leaves until 0.7 cups remain. Add Mangxiao (Natrii Sulfas, 1 qian), mix well, strain. Drink warm on empty stomach. Aim for 2-3 bowel movements. If not achieved, repeat dose.
Yingtong Wan (Pain-Relieving Pill): Treats migrating pain, suspected Fujie Ju (Bone-attached Abscess).
Cangzhu (Atractylodis Rhizoma, peeled)
Danggui (Angelicae Sinensis Radix)
Heiqianniu (Brassicae Semen Nigrum)
Caowutou (Aconiti Radix Preparata, processed, 1 liang each)
Grind to fine powder. Make pills with vinegar paste, size of small beans. Take 30 pills per dose, with vinegar soup on empty stomach.
Guanzhong Tang (Cyatheae Decoction): Treats Fujie Yong (Bone-attached Carbuncle) growing in deep flesh of upper thigh, wash/rinse application.
Digupi (Lycii Cortex)
Gujingcao (Eriocauli Flos)
Pipaye (Loquat Leaf, wipe off hairs, brush-roasted)
Jingjie (Schizonepetae Spica, remove stems)
Shujiao (Zanthoxyli Fructus, remove eyes and closed ones, 1 liang each above)
Pound and sieve. Boil 3 sheng water down to 2 sheng. Mix dregs. Rinse/wash lesion, dip cloth, apply compress.
Mituo seng San (Lead Monoxide Powder)
Mituo seng (Lithargyri)
Ziran tong (Pyritum, 0.5 liang each)
Xingren (Armeniacae Semen Amarum, peel tip, double kernels, 14 fruits)
Place medicine in a bitter bamboo tube. Seal mouth with paper. Slow-fire roast until tube turns yellow. Remove, grind extremely fine. Apply according to sore size, mix with fresh water, sweep onto carbuncle with chicken feather. Severe cases effective within 2-7 days.