人有背心间先发红瘰，后渐渐红肿，此发背之兆也，最为可畏。古人云∶外大
如豆，内大如拳；外大如拳，内大如盘。言其外小而内实大也。然而痈疽等毒，必
须辨其阴阳∶有先阴而变阳者，有先阳而变阴者；有前后俱阳者，有前后俱阴者。
阳症虽重而实轻，阴症虽轻而实重；先阴而变阳者生，先阳而变阴者死。病症既殊，
将何以辨之？阳症之形，必高突而肿起；阴症之形，必低平而陷下；阳症之色纯红，
阴症之色带黑；阳症之初起必痛，阴症之初起必痒；阳症之溃烂，必多其脓；阴症
之溃烂，必多其血；阳症之收口，身必轻爽；阴症之收口，身必沉重。至于变阴变
阳，亦以此消息断断不差也。倘见红肿而高突，乃阳症之痈也。乘其肉肿初发，
毒犹未化，急以散毒之药治之，可随手愈也。发背而至横决者，皆因循失治，以致
破败而不可救，阳变阴者多矣。救痈如救火，宜一时扑灭，切勿见为阳症无妨，而
轻缓治之也。方用急消汤∶
忍冬藤（二两） 茜草（三钱） 紫花地丁（一两） 甘菊花（三钱） 贝母（二钱） 黄柏（一钱）
天花粉（三钱） 桔梗（三钱） 生甘草（三钱） 水煎服。一剂轻，二剂又轻，三剂全消，不必四
剂也。
此方消阳毒之初起极神。既无迅烈之虞，大有和解之妙。世人不知治法，谓阳
毒易于祛除，孟浪用虎野狼之药，虽毒幸消散，而真气耗损于无形，往往变成别病，
乃医者成之也。
人有背心发瘰，痒甚，已而背如山重，悠悠发红晕，如盘之大，此阴痈初起之
形象也，最为可畏，尤非前症阳痈可比。乃一生罪孽，鬼祟缠身，必然谵语胡言。
如见此等症候，本不可救。然而人心善恶成于一念之迁悔，求生无术，亦见医道无
奇。盖阳症有可救之术，阴症岂无可生之理，总在救之得法耳。大约阴痈之症，虽
成于鬼祟之缠身，然必正气大虚，邪得而入之也。设正气不虚，邪将安入。故救阴
痈之症，必须大用补气补血之药，而佐之散郁散毒之品。则正旺而邪自散矣。方用
变阳汤∶
人参（二两） 黄 （二两） 金银花（半斤，煎汤代水） 附子（一钱） 荆芥（炒黑，三钱）
柴胡（二钱） 白芍（一两） 天花粉（五钱） 生甘草（五钱） 井花水煎汁二碗服，渣再煎，服后阴必
变阳而作痛。再一剂而痛亦消，再服一剂而全愈，竟消灭无形也。
然人不致皮破血出，断不肯信，虽然先用此等之药以治发背，毋论病患不肯服，
即医生亦不肯用，或医生知用此治疗，而病患之家亦不肯信。往往决裂溃烂，疮口
至如碗大而不可收，始悔参、 之迟用矣。予既论此症，又多戒辞，劝人早服此方，
万不可观望狐疑，丧人性命。盖阳毒可用攻毒之剂，而阴毒须用补正之味。用人参、
黄以补气，气旺则幽阴之毒不敢入心肺之间。而金银花性补，善解阴毒，得参、
而其功益大，然非得附子则不能直入阴毒之中而又出于阴毒之外。毒深者害深，
又益之生甘草以解其余毒。然毒结于背者，气血之壅也，壅极者郁之极也。故加柴
胡、荆芥、白芍、天花粉之类消痰通滞，开郁引经，自然气宣而血活，痰散而毒消矣。
人有背痈溃烂，洞见肺腑，疮口黑陷，身不能卧，口渴思饮，人以为阳症之败
坏也，谁知是阴虚而不能变阳乎。夫背痈虽有阴阳之分，及至溃脓之后，宜补内不宜
消外，则阴阳之症一也。溃烂而至肺腑皆见，此乃失补之故，使毒过于沿烧，将好
肉尽化为瘀肉耳。肉瘀自必成腐肉，而腐自必洞见底里。见此等症候，亦九死一生
之兆也。倘胃气健而能食者，犹可救。倘见食则恶者，断无生意。虽然，能用参、
、归、熟亦有可生，不可弃之竟不救也。方用转败汤救之。
人参（二两） 生黄 （一两） 熟地（二两） 肉桂（二钱） 白术（四两） 当归（一两）
金银花（四两） 麦冬（二两） 山茱萸（一两） 远志（三钱） 北五味子（一钱） 茯苓（三钱）
水煎服。一剂而胃气大开者，即可以转败为功也。倘饮之而稍能健饭，亦在可救。惟恐饮之杳无
应验者，是胃气日绝也，不必再治之矣。或饮之而饱闷，少顷而少安者，亦有生机。
此方补其气血，而更补其肺肾之阴。盖阴生则阳长，阴阳生长则有根，易于接
续。而后以金银花解其余毒，则毒散而血生，血生而肉长，肉长而皮合，必至之势
也。倘日以解毒为事，绝不去补气血之阴阳，则阴毒不能变阳，有死而已，可胜悲
悼哉。
人有背痈将愈，而疮口不收，百药敷之绝无一验，人以为余毒之未尽也，孰知
是阴虚而不能济阳。夫痈疽，初起则毒盛，变脓则毒衰，脓尽则毒化矣。疮口不收，
乃阴气之虚，而非毒瓦斯之旺。世人不知治法，尚以败毒之药攻之，是已虚而益虚也，
欲其肌肉之长，何可得乎。然亦有用补法而仍未效者，但用阳分之品以补其阳，而
不用阴分之药以补其阴也。独阴不长，而独阳亦不生。痈疽至脓血已尽，则阴必大
虚，止补其阳，则阳旺阴虚，阴不能交于阳矣。阳有济阴之心，阴无济阳之力，所
以愈补阳而阴愈虚，而疮口愈难合也。治法必须大补其阴，使阴精盛满，自能灌注
于疮口之中，不用生肌外敷之药而疮口之肉内生矣。方用生肤散∶
麦冬（一两） 熟地（二两） 山茱萸（一两） 人参（五钱） 肉桂（一钱） 当归（一两）
忍冬藤（一两） 白术（五分） 水煎服。二剂而肉自长，又二剂外口自平，又二剂全愈。
此方补阴之药多于补阳，使阴胜阳也。然补阳仍是补阴之助，以其能入阴之中，
交于阳之内也。忍冬藤非特解余剩之毒，取其能领诸药至于疮口之间也。
人有背疮长肉，疮口已平，忽然开裂流血，人以为疮口之肉未坚也，谁知是色
欲恼怒之不谨耳。大凡疮痈之症，最忌色欲，次忌恼怒。犯恼怒新肉有开裂之虞，
犯色欲新肉有流血之害；犯恼怒者不过疾病，犯色欲者多致死亡。其疮口开裂之
处，必然色变紫黑，而流水之处，必然肉变败坏矣。此时必须急补气血，万不可仍
治其毒。盖前毒未尽，断难收口，复至腐烂，新肉不坚，而自涌决裂也。况发背新愈
之后，其精神气血尽为空虚，若交合泄精，遂至变害非常，舍补气血，又安求再活
乎？即补气血以些小之剂，欲收危乱之功，大厦倾颓，岂一木能支哉。故又须大剂
救之，而后可方用寒变回生汤∶
人参（四两） 黄 （三两） 当归（二两） 北五味子（二钱） 麦冬（二两） 肉桂（三钱）
白术（二两） 山茱萸（五钱） 忍冬藤（二两） 茯苓（一两） 水煎服。一剂而肉不腐，二剂而肉
自生，三剂而皮仍合，四剂疮口平复。切戒再犯，再犯无不死者，即再服此方无益也，可
不慎乎！
此救疮疡坏症仙丹，不止疗发背愈后犯色之败腐也。人疑泄精以致决裂，宜用
熟地以大补之，何故反置而不用？以熟地补阴最缓，而症犯甚急，所以舍熟地之不
可用。此方服数剂之后，各宜减半，惟多加熟地，留为善后之计耳。
人有夏月生背痈，疮口不起，脉大而无力，发热作渴，自汗盗汗，用参、 大
补之剂，益加手足逆冷，大便不实，喘促呕吐，人以为火毒太盛也，谁知是元气大
虚，补不足以济之。夫痈分阴阳，疮口不起，乃阴症而非阳症也。脉大似乎阳症，
大而无力，非阴而何。发热作渴，此水不足以济火，故陡渴陡汗也。既阴症似阳，
用参、 阳药以助阳，正气足以祛阴而返阳矣，何以愈补而反逆冷呕吐？此阴寒之
气正甚，而微阳之品力不能胜耳。非加附子辛热之品，又何能斩关入阵以祛荡其阴
邪哉。方用助阳消毒汤∶
人参（半斤） 黄 （一两） 当归（四两） 白术（四两） 陈皮（一两） 附子（五钱）
水煎膏，作二次服，诸症退。连服数剂，疮起而溃，乃减半。又用数剂而愈。
此非治痈之法也，然治痈之法而轻治此等之症，鲜不立亡。可见治痈不可执也。
大约阳痈可以消毒化痰之药治之，阴痈之病万不可用消毒化痰之味。此实治痈之变
法，医者不可不知。
人有背生痈疽，溃脓之后，或发热，或恶寒，或作痛，或脓多，或流清水，自
汗盗汗，脓成而不溃，口烂而不收，人以为毒瓦斯之未尽也，谁知五脏亏损，血气大
虚之故。凡人气血壮盛，阴阳和平，何能生毒？惟其脏腑内损，而后毒瓦斯得以内藏，
久之外泄，及至痈疽发出，其毒自不留内。然脏腑原虚，又加流脓流血，则已虚益
虚。观其外，疮口未敛，似乎有余；审其内，气血未生，实为不足。法当全补，不
宜偏补夫一脏，致有偏胜之虞也。方用十全大补汤最妙，以其合气血而两补之耳。
然而用之往往不效者，非方之不佳，乃用方之不得其法耳。夫背痈何等之症，岂用
寻常细小之剂所能补之？必须多加分两，大剂煎饮，庶几有济。予因酌定一方，以
请正于同人也。用∶
人参（一两） 黄 （二两） 白芍（五钱） 肉桂（二钱） 川芎（三钱） 熟地（二两）
当归（一两） 白术（五钱） 茯苓（五钱） 生甘草（三钱） 水煎服。服一剂有一剂之效。
世疑此方绝不败毒，如何化毒而生肉。不知痈疽未溃之前以化毒为先，已溃之
后补正为急，纵有余毒未尽，不必败毒。盖败毒之药，非寒凉之品，即消耗之味也。
消耗则损人真气，寒凉则伤人胃气。真气损则邪气反盛，胃气伤则谷气全无，又何
能生长肌肉哉。惟十全大补汤专助真气以益胃气，故能全效耳。且此方不特治背痈
之已溃，即疮疡已溃者皆宜用之。
【背痈门】
有人背部中间先出现发红的小肿块，随后逐渐红肿，这是发背病的征兆，最为可怕。古人说：外部像豆子一样小，内部却像拳头一样大；外部像拳头一样大，内部却像盘子一样大。说的是外表小而内部实际很大的情况。然而对于痈疽等毒疮，必须辨别其阴阳属性：有先表现为阴证后转变为阳证的，有先表现为阳证后转变为阴证的；有前后都表现为阳证的，有前后都表现为阴证的。阳证虽然症状严重但实际上病情较轻，阴证虽然症状轻微但实际上病情较重；先阴后转为阳证的可以存活，先阳后转为阴证的会死亡。病症既然不同，用什么来辨别呢？阳证的外形，必然高突且肿胀；阴证的外形，必然低平且凹陷；阳证的颜色纯红，阴证的颜色带黑；阳证初起必然疼痛，阴证初起必然瘙痒；阳证溃烂时，脓液较多；阴证溃烂时，血液较多；阳证收口时，身体必然轻快舒畅；阴证收口时，身体必然沉重。至于阴证变阳或阳证变阴，也以此为依据判断，绝不会出错。如果看到红肿且高突，那就是阳证的痈。趁着肌肉肿胀刚发出，毒邪尚未化脓，急忙用散解毒药治疗，可以随手痊愈。发背病发展到横决（溃烂扩散）的，都是因为沿袭旧习、延误治疗，导致破败而无法挽救，其中阳证转阴证的情况很多。救治痈疽就像救火一样，应当一时扑灭，千万不要认为阳证无妨而轻率缓慢地治疗。方剂用急消汤：
忍冬藤（二两） 茜草（三钱） 紫花地丁（一两） 甘菊花（三钱） 贝母（二钱） 黄柏（一钱）
天花粉（三钱） 桔梗（三钱） 生甘草（三钱） 水煎服。一剂后症状减轻，两剂后更轻，三剂完全消除，不需要四剂。
此方在消除阳毒初起时极为神奇。既没有猛烈药物的危险，又有和解的妙处。世人不知道治疗方法，认为阳毒容易祛除，鲁莽地使用如虎狼般猛烈的药物，虽然毒邪侥幸消散，但真气却在无形中耗损，往往变成其他疾病，这是医生造成的。
有人背部发生小肿块，非常瘙痒，随后背部感觉如山般沉重，悠悠然发红晕，如盘子大小，这是阴痈初起的形象，最为可怕，尤其不同于前面的阳痈症。这似乎是平生罪孽深重，鬼祟缠身，必然会出现胡言乱语。如果见到这种症候，本来是不可救的。然而人心的善恶在于一念之间的悔改，求生无术，也能看到医道的奇妙。因为阳证有可救的方法，阴证难道没有生存的道理吗？关键在于救治得法罢了。大概阴痈之症，虽然形成于鬼祟缠身，但必然是正气极度虚弱，邪气才得以侵入。假如正气不虚，邪气将进入哪里呢？所以救治阴痈之症，必须大量使用补气补血的药物，并辅以散郁散毒的药物。那么正气旺盛而邪气自然消散。方剂用变阳汤：
人参（二两） 黄芪（二两） 金银花（半斤，煎汤代水） 附子（一钱） 荆芥（炒黑，三钱）
柴胡（二钱） 白芍（一两） 天花粉（五钱） 生甘草（五钱） 井花水煎汁二碗服用，药渣再煎，服用后阴证必然转为阳证并开始疼痛。再服一剂疼痛也会消失，再服一剂完全痊愈，竟然无形地消灭了。
然而人不致皮破血出，断不肯相信，虽然先用这些药物治疗发背，无论病患不肯服用，就是医生也不肯使用，或者医生知道用此治疗，而病患家属也不肯相信。往往导致溃烂开裂，疮口大如碗口而无法收敛，这时才后悔参、芪用得迟了。我既然论述了这个病症，又多加告诫之辞，劝人早服此方，万万不可观望犹豫，丧人性命。因为阳毒可以用攻毒的药剂，而阴毒必须用补正气的药物。用人参、黄芪来补气，气旺则幽暗阴冷的毒邪不敢进入心肺之间。而金银花性质补益，善于解除阴毒，得到参、芪的帮助功效更大，然而如果没有附子就不能直接深入阴毒之中而又出于阴毒之外。毒邪深的危害深，再加上生甘草以解其余毒。然而毒邪结聚在背部，是气血壅滞，壅滞至极就是郁结至极。所以加入柴胡、荆芥、白芍、天花粉之类消除痰湿通滞，开郁引经，自然气机宣通而血液活跃，痰散而毒消。
有人背痈溃烂，洞见肺腑，疮口黑陷，身体不能卧倒，口渴想喝水，人们以为是阳证的败坏，谁知道这是阴虚而不能转化为阳证呢。背痈虽然有阴阳之分，等到溃脓之后，应该补内而不宜消外，那么阴阳的病症就是一样的了。溃烂到脏腑皆可见，这是因为失于补益，使毒邪过度蔓延燃烧，将好肉全部化为瘀肉。肉瘀自然成为腐肉，而腐烂自然洞见底里。见到这种症候，也是九死一生的征兆。如果胃气健旺能进食的，还可以救治。如果看见食物就厌恶的，绝对没有生机。虽然如此，如果能用参、芪、归、熟地等药，也有存活的希望，不可以放弃不救治。方剂用转败汤救治。
人参（二两） 生黄芪（一两） 熟地黄（二两） 肉桂（二钱） 白术（四两） 当归（一两）
金银花（四两） 麦冬（二两） 山茱萸（一两） 远志（三钱） 北五味子（一钱） 茯苓（三钱）
水煎服。一剂后胃气大开，就可以转败为功。如果喝了之后稍微能增进食欲，也在可救范围内。只怕喝了之后毫无反应，这是胃气日渐断绝，不必再治疗了。或者喝了之后饱闷，片刻后稍感舒适，也有生机。
此方补益气血，并且更补益肺肾之阴。因为阴生则阳长，阴阳生长则有根，易于接续。然后用金银花解其余毒，那么毒散而血生，血生而肉长，肉长而皮合，这是必然的趋势。如果每天以解毒为事，绝不补益气血之阴阳，那么阴毒不能变阳，只有死亡而已，多么可悲啊。
有人背痈将要痊愈，而疮口不收敛，百药敷之绝无有效，人们以为是余毒未尽，谁知道这是阴虚而不能济助阳。痈疽，初起则毒盛，变为脓则毒衰，脓尽则毒化解了。疮口不收敛，是阴气虚，而不是毒瓦斯旺盛。世人不知道治疗方法，还用败毒的药物去攻伐，这是已虚而又益虚，想要肌肉生长，怎么可能呢。然而也有用补法仍未见效的，只是用阳分的药物来补阳，而不用阴分的药物来补阴。独阴不长，独阳也不生。痈疽到脓血已尽，则阴必大虚，只补阳，则阳旺阴虚，阴不能交于阳了。阳有济助阴的心意，阴没有济助阳的力量，所以越补阳阴越虚，而疮口越难愈合。治疗方法必须大补其阴，使阴精盛满，自然能灌注于疮口之中，不用生肌外敷的药而疮口的肉内生。方剂用生肤散：
麦冬（一两） 熟地黄（二两） 山茱萸（一两） 人参（五钱） 肉桂（一钱） 当归（一两）
忍冬藤（一两） 白术（五分） 水煎服。两剂后肉自长，又两剂后外口自平，又两剂后全愈。
此方补阴的药多于补阳，使阴胜阳。然而补阳仍是补阴的辅助，因为它能入阴之中，交于阳之内。忍冬藤不仅解除剩余之毒，取其能引领诸药到达疮口之间。
有人背疮长肉，疮口已平，忽然开裂流血，人们以为是疮口的肉不坚固，谁知道是房事和恼怒不慎所致。大凡疮痈之症，最忌房事，其次忌恼怒。犯恼怒新肉有开裂的危险，犯房事新肉有流血的害处；犯恼怒者不过是疾病，犯房事者多导致死亡。其疮口开裂之处，必然颜色变紫黑，流水之处，必然肉变败坏。此时必须急补气血，万万不可仍治其毒。因为前毒未尽，很难收口，再次腐烂，新肉不坚，自然涌出决裂。况且发背新愈之后，其精神气血尽为空虚，若性交泄精，遂至变化危害非常，除了补气血，又怎能求得再活呢？即使补气血用少量药剂，想收危乱之功，大厦倾颓，岂是一木能支撑的？所以必须用大剂救治，然后方可用寒变回生汤：
人参（四两） 黄芪（三两） 当归（二两） 北五味子（二钱） 麦冬（二两） 肉桂（三钱）
白术（二两） 山茱萸（五钱） 忍冬藤（二两） 茯苓（一两） 水煎服。一剂后肉不腐，二剂后肉自生，三剂后皮仍合，四剂后疮口平复。切记不再犯，再犯没有不死者，即再服此方也无益，可不谨慎吗！
这是救治疮疡坏症的仙丹，不止治疗发背愈后犯房事的败腐。人们怀疑泄精导致决裂，应该用熟地黄以大补之，为何反而放置不用？因为熟地黄补阴最缓，而症情犯险甚急，所以舍弃熟地黄而不用。此方服数剂之后，各宜减半，惟多加熟地黄，留为善后的计策。
有人在夏天生背痈，疮口不起，脉大而无力，发热作渴，自汗盗汗，用参、芪大补之剂，更加手足逆冷，大便不实，喘促呕吐，人们以为是火毒太盛，谁知道是元气大虚，补不足以济助它。痈分阴阳，疮口不起，是阴证而非阳证。脉大似乎阳证，大而无力，不是阴证是什么。发热作渴，这是水不足以济火，所以突然口渴突然出汗。既然阴证似阳，用参、芪等阳药以助阳，正气足以祛阴而返阳了，为什么越补反而逆冷呕吐？这是阴寒之气正盛，而微阳之品力量不能胜任。如果不加附子辛热之品，怎么能斩关入阵以驱荡其阴邪呢？方剂用助阳消毒汤：
人参（半斤） 黄芪（一两） 当归（四两） 白术（四两） 陈皮（一两） 附子（五钱）
水煎膏，分两次服用，诸症退。连服数剂，疮起而溃，乃减半。又用数剂而愈。
这不是治痈的方法，然而治痈的方法而轻治此类病症，很少有不立即死亡的。可见治痈不可固执。大概阳痈可以用消毒化痰的药物治之，阴痈之病万万不可用消毒化痰的味道。这实际上是治痈的变法，医者不可不知。
有人背生痈疽，溃脓之后，或发热，或恶寒，或作痛，或脓多，或流清水，自汗盗汗，脓成而不溃，口烂而不收，人们以为是毒瓦斯未尽，谁知道是五脏亏损，血气大虚的缘故。凡人气血壮盛，阴阳和平，怎么能生毒？只有脏腑内损，而后毒瓦斯得以内藏，久之外泄，等到痈疽发出，其毒自然不留内。然而脏腑原虚，又加流脓流血，则已虚益虚。观其外，疮口未敛，似乎有余；审其内，气血未生，实为不足。方法应当全补，不宜偏补某一脏，致使有偏胜的忧虑。方剂用十全大补汤最妙，因为它合气血而两补。
然而用之往往不效的，不是方子不好，是使用方子不得法。背痈何等严重的症，岂是用寻常细小剂量所能补的？必须多加分量，大剂煎饮，或许有济。我因此酌定一方，以请教于同仁。用：
人参（一两） 黄芪（二两） 白芍（五钱） 肉桂（二钱） 川芎（三钱） 熟地黄（二两）
当归（一两） 白术（五钱） 茯苓（五钱） 生甘草（三钱） 水煎服。服一剂有一剂的效果。
世人怀疑此方绝不败毒，如何化毒而生肉。不知道痈疽未溃之前以化毒为先，已溃之后补正为急，纵有余毒未尽，不必败毒。因为败毒的药物，非寒凉之品，即消耗之味。消耗则损人真气，寒凉则伤人胃气。真气损则邪气反盛，胃气伤则谷气全无，又怎么能生长肌肉呢？只有十全大补汤专助真气以益胃气，所以能全效。而且此方不仅治背痈之已溃，即疮疡已溃者皆宜用之。
[Chapter on Back Carbuncles]
There are cases where a person first develops a red, small lump in the center of the back, which gradually becomes swollen and red. This is a sign of "Fa Bei" (Back Carbuncle), which is most terrifying. The ancients said: "Externally as small as a bean, internally as large as a fist; externally as large as a fist, internally as large as a plate." This describes the condition where the exterior appears small but the interior is actually very large. However, for toxins such as carbuncles and sores, one must distinguish between Yin and Yang syndromes: there are those that start as Yin and transform into Yang, those that start as Yang and transform into Yin, those that are entirely Yang throughout, and those that are entirely Yin throughout. Although Yang syndromes appear severe, they are actually lighter in pathology; although Yin syndromes appear mild, they are actually heavier in pathology. Those who start as Yin and transform into Yang will survive; those who start as Yang and transform into Yin will die. Since the symptoms differ, how can they be distinguished? The shape of a Yang syndrome must be elevated and swollen; the shape of a Yin syndrome must be flat and depressed. The color of a Yang syndrome is purely red; the color of a Yin syndrome carries black. At the initial stage, a Yang syndrome must be painful; at the initial stage, a Yin syndrome must be itchy. Upon ulceration, a Yang syndrome produces much pus; upon ulceration, a Yin syndrome produces much blood. During the healing phase, a Yang syndrome results in a light and refreshing body sensation; during the healing phase, a Yin syndrome results in a heavy body sensation. As for the transformation from Yin to Yang or Yang to Yin, judgment should also be based on these signs without error. If one sees redness and swelling that is elevated, it is a Yang syndrome carbuncle. While the flesh is just beginning to swell and the toxin has not yet transformed into pus, urgently treat it with herbs that dissipate toxicity, and it can be cured instantly. Cases of "Fa Bei" progressing to horizontal spreading (ulcerative diffusion) are all due to negligence and delayed treatment, leading to destruction that cannot be saved, among which many are cases of Yang transforming into Yin. Rescuing a carbuncle is like fighting a fire; it should be extinguished immediately. Do not think that because it is a Yang syndrome it is harmless and treat it lightly or slowly. Use the formula Ji Xiao Tang (Urgent Elimination Decoction):
* *Lonicerae Japonicae Caulis* (Jindong Teng, Honeysuckle Vine) – 2 liang
* *Rubia Cordifolia Radix* (Qian Cao, Madder Root) – 3 qian
* *Viola Yedoensis Herba* (Zihua Diding, Purple Flower Violet Herb) – 1 liang
* *Chrysanthemi Indici Flos* (Gan Ju Hua, Chrysanthemum Flower) – 3 qian
* *Fritillariae Thunbergii Bulbus* (Beimu, Thunberg Fritillary Bulb) – 2 qian
* *Phellodendri Cortex* (Huangbai, Phellodendron Bark) – 1 qian
* *Tetrastigma Rhizoma* (Tianhuafen, Trichosanthes Root) – 3 qian
* *Platycodonis Radix* (Jiegeng, Balloon Flower Root) – 3 qian
* *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle* (Sheng Gancao, Raw Licorice Root) – 3 qian
Decoct in water and take orally. After one dose, symptoms lighten; after two doses, they lighten further; after three doses, complete elimination occurs. Four doses are unnecessary.
This formula is extremely effective for eliminating early-stage Yang toxins. It avoids the danger of violent drugs and possesses the wonder of harmonization. People do not know the correct treatment method, believing that Yang toxins are easy to remove, and rashly use drugs as fierce as tigers and wolves. Although the toxin may luckily dissipate, the True Qi is consumed invisibly, often transforming into other diseases. This is caused by the physician.
In some cases, a person develops a small lump on the back, itching severely. Subsequently, the back feels as heavy as a mountain, with a slow-spreading red halo as large as a plate. This is the image of an early-stage Yin carbuncle, which is most terrifying and incomparable to the previous Yang carbuncle. It seems as if the patient bears heavy sins and is haunted by evil spirits, inevitably leading to delirious speech. If such symptoms are seen, it is originally incurable. However, human goodness and evil lie in a single thought of repentance. Seeking life without skill can still reveal the wonders of medical arts. Since Yang syndromes have curable methods, why would Yin syndromes lack the principle of survival? It depends entirely on whether the rescue method is appropriate. Generally, Yin carbuncles, although formed by haunting spirits, require extreme deficiency of Righteous Qi for pathogens to enter. If Righteous Qi were not deficient, where would the pathogen enter? Therefore, to rescue Yin carbuncles, one must heavily use herbs that tonify Qi and Blood, assisted by herbs that dissipate stagnation and toxicity. Then, when Righteous Qi is strong, pathogens will naturally dissipate. Use the formula Bian Yang Tang (Transforming into Yang Decoction):
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 2 liang
* *Astragali Membranacei Radix* (Huangqi, Astragalus Root) – 2 liang
* *Lonicerae Japonicae Flos* (Jinyinhua, Honeysuckle Flower) – 0.5 jin (decocted as water substitute)
* *Aconiti Lateralis Radix Praeparata* (Fuzi, Prepared Aconite Lateral Root) – 1 qian
* *Schizonepetae Spica* (Jingjie, Schizonepeta Spike) – 3 qian (stir-fried until black)
* *Bupleuri Radix* (Chaihu, Bupleurum Root) – 2 qian
* *Paeoniae Radix Alba* (Baishao, White Peony Root) – 1 liang
* *Tetrastigma Rhizoma* (Tianhuafen, Trichosanthes Root) – 5 qian
* *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle* (Sheng Gancao, Raw Licorice Root) – 5 qian
Decoct well-water to yield two bowls of juice and take orally. Decoct the dregs again. After taking, the Yin syndrome must transform into Yang and become painful. Take one more dose, and the pain will disappear. Take another dose, and full recovery will occur, disappearing formlessly.
However, people refuse to believe unless the skin breaks and bleeds. Even if these herbs are used first to treat "Fa Bei," whether the patient refuses to take them or the doctor refuses to prescribe them, or even if the doctor knows to use this treatment, the patient's family may not believe. Often, it leads to rupture and ulceration, with the wound opening as large as a bowl, impossible to close, only then regretting the late use of Ginseng and Astragalus. Having discussed this syndrome, I add many warnings, advising people to take this formula early. Do not hesitate or doubt, causing loss of life. Yang toxins can be treated with detoxifying agents, but Yin toxins require agents that tonify Righteous Qi. Using Ginseng and Astragalus to tonify Qi makes Qi strong, so that dark, yin-cold toxins dare not enter the Heart and Lung. *Lonicerae Japonicae Flos* (Honeysuckle Flower) has a tonifying nature and is good at resolving Yin toxins; its efficacy is greatly enhanced by Ginseng and Astragalus. However, without *Aconiti Lateralis Radix Praeparata* (Prepared Aconite Lateral Root), it cannot penetrate directly into the Yin toxin and emerge from it. Deep toxins cause deep harm; adding *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle* (Raw Licorice Root) resolves remaining toxins. Toxins binding in the back indicate Qi and Blood stagnation; extreme stagnation is extreme depression. Thus, adding *Bupleuri Radix* (Bupleurum Root), *Schizonepetae Spica* (Schizonepeta Spike), *Paeoniae Radix Alba* (White Peony Root), and *Tetrastigma Rhizoma* (Trichosanthes Root) eliminates phlegm and unblocks stagnation, opens depression, and guides the meridians. Naturally, Qi circulates, Blood moves, Phlegm scatters, and toxins dissipate.
In some cases, a back carbuncle ulcerates, revealing the internal organs, with the wound sunken and black. The patient cannot lie down, feels thirsty and desires drink. People think this is the deterioration of a Yang syndrome, but who knows it is Yin deficiency failing to transform into Yang? Although back carbuncles are divided into Yin and Yang, after ulceration and pus discharge, one should tonify the interior rather than eliminate the exterior; thus, the Yin and Yang syndromes become one. Ulceration reaching the point where internal organs are visible is due to neglecting tonification, allowing toxins to spread and burn excessively, turning healthy flesh into necrotic flesh. Necrotic flesh naturally becomes putrid flesh, and rot naturally penetrates to the bottom. Seeing such symptoms indicates nine deaths and one life. If Stomach Qi is robust and the patient can eat, it can still be saved. If the patient feels nauseated by food, there is absolutely no hope. Nevertheless, if *Panax Ginseng Radix* (Ginseng Root), *Astragali Membranacei Radix* (Astragalus Root), *Angelicae Sinensis Radix* (Danggui, Angelica Root), and *Rehmanniae Radix Praeparata* (Shudi, Prepared Rehmannia Root) are used, there is still a chance of survival; do not abandon them without treatment. Use Zhuan Bai Tang (Turning Defeat into Victory Decoction):
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 2 liang
* *Astragali Membranacei Radix* (Sheng Huangqi, Raw Astragalus Root) – 1 liang
* *Rehmanniae Radix Praeparata* (Shudi, Prepared Rehmannia Root) – 2 liang
* *Cinnamomi Cortex* (Rougui, Cinnamon Bark) – 2 qian
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, Large-headed Atractylodes Rhizome) – 4 liang
* *Angelicae Sinensis Radix* (Danggui, Angelica Root) – 1 liang
* *Lonicerae Japonicae Flos* (Jinyinhua, Honeysuckle Flower) – 4 liang
* *Ophiopogonis Radix* (Maidong, Ophiopogon Root) – 2 liang
* *Corni Fructus* (Shanzhuyu, Cornus Fruit) – 1 liang
* *Polygalae Radix* (Yuanzhi, Polygala Root) – 3 qian
* *Schisandrae Chinensis Fructus* (Bei Wuweizi, North Schisandra Fruit) – 1 qian
* *Poria* (Fuling, Poria Sclerotium) – 3 qian
Decoct in water and take orally. After one dose, if Stomach Qi opens widely, defeat can be turned into victory. If drinking it slightly improves appetite, it is still salvageable. Fear only that if there is no response after drinking, Stomach Qi is daily perishing, and no further treatment is needed. Or if after drinking there is fullness and distension, but slight comfort shortly after, there is still vitality.
This formula tonifies Qi and Blood, and further tonifies the Yin of the Lung and Kidney. Because Yin generates Yang, the growth of Yin and Yang has roots and is easy to continue. Then, using *Lonicerae Japonicae Flos* (Honeysuckle Flower) to resolve remaining toxins, toxins scatter, Blood generates, Flesh grows, and Skin closes. This is an inevitable trend. If one focuses solely on detoxification and never tonifies the Yin and Yang of Qi and Blood, Yin toxins cannot transform into Yang, leading only to death. How sorrowful!
In some cases, a back carbuncle is about to heal, but the wound does not close. Applying hundreds of medicines externally yields no effect. People think residual toxins remain, but who knows it is Yin deficiency failing to assist Yang? For carbuncles and sores, initially toxins are strong; when transforming into pus, toxins weaken; when pus is exhausted, toxins dissolve. Failure of the wound to close is due to deficiency of Yin Qi, not excess of toxic vapors. People do not know the treatment method and still attack with anti-toxic drugs, making the already deficient even more deficient. How can muscle growth be expected? However, there are cases where tonification fails. This is because only Yang-branch herbs are used to tonify Yang, without using Yin-branch herbs to tonify Yin. Independent Yin does not grow, and independent Yang does not generate. When carbuncles reach the point where pus and blood are exhausted, Yin must be greatly deficient. Only tonifying Yang leads to Yang excess and Yin deficiency, preventing Yin from interacting with Yang. Yang has the desire to assist Yin, but Yin lacks the power to assist Yang. Thus, the more Yang is tonified, the more deficient Yin becomes, and the harder the wound is to close. The treatment method must heavily tonify Yin, making Yin Essence abundant, naturally irrigating the wound. Without external muscle-generating medicines, the flesh inside the wound will grow. Use Sheng Fu San (Skin Regeneration Powder):
* *Ophiopogonis Radix* (Maidong, Ophiopogon Root) – 1 liang
* *Rehmanniae Radix Praeparata* (Shudi, Prepared Rehmannia Root) – 2 liang
* *Corni Fructus* (Shanzhuyu, Cornus Fruit) – 1 liang
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 5 qian
* *Cinnamomi Cortex* (Rougui, Cinnamon Bark) – 1 qian
* *Angelicae Sinensis Radix* (Danggui, Angelica Root) – 1 liang
* *Lonicerae Japonicae Caulis* (Jindong Teng, Honeysuckle Vine) – 1 liang
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, Large-headed Atractylodes Rhizome) – 5 fen
Decoct in water and take orally. After two doses, flesh grows spontaneously; after another two doses, the outer mouth flattens; after another two doses, full recovery.
This formula contains more Yin-tonifying herbs than Yang-tonifying ones, making Yin overcome Yang. However, tonifying Yang still assists tonifying Yin, as it can enter Yin and interact within Yang. *Lonicerae Japonicae Caulis* (Honeysuckle Vine) not only resolves residual toxins but also leads the various herbs to the site of the wound.
In some cases, back sores grow flesh, and the wound is flat, but suddenly cracks and bleeds. People think the flesh of the wound is not firm, but who knows it is due to imprudence in sexual activity and anger? Generally, for carbuncle and sore conditions, sexual activity is most taboo, followed by anger. Anger risks cracking new flesh; sexual activity risks bleeding new flesh. Violating anger causes merely disease; violating sexual activity often leads to death. The cracked area of the wound must turn purple-black, and the flowing fluid area must have deteriorating flesh. At this time, urgently tonify Qi and Blood. Do not still treat the toxin. If previous toxins are not exhausted, closing the wound is difficult, leading to rot again, new flesh not firm, and spontaneous bursting. Moreover, after "Fa Bei" newly heals, Spirit and Qi/Blood are empty. If intercourse and essence emission occur, extraordinary harm ensues. Besides tonifying Qi and Blood, how else to seek life? Even with small doses of Qi and Blood tonics, hoping to achieve miraculous results in a collapsing situation is like trying to support a falling mansion with a single stick. Therefore, large doses are required. Use Han Bian Hui Sheng Tang (Cold Transformation Returning Life Decoction):
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 4 liang
* *Astragali Membranacei Radix* (Huangqi, Astragalus Root) – 3 liang
* *Angelicae Sinensis Radix* (Danggui, Angelica Root) – 2 liang
* *Schisandrae Chinensis Fructus* (Bei Wuweizi, North Schisandra Fruit) – 2 qian
* *Ophiopogonis Radix* (Maidong, Ophiopogon Root) – 2 liang
* *Cinnamomi Cortex* (Rougui, Cinnamon Bark) – 3 qian
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, Large-headed Atractylodes Rhizome) – 2 liang
* *Corni Fructus* (Shanzhuyu, Cornus Fruit) – 5 qian
* *Lonicerae Japonicae Caulis* (Jindong Teng, Honeysuckle Vine) – 2 liang
* *Poria* (Fuling, Poria Sclerotium) – 1 liang
Decoct in water and take orally. After one dose, flesh does not rot; after two doses, flesh grows spontaneously; after three doses, skin closes; after four doses, the wound flattens. Strictly forbid re-offending. Re-offending leads to death; even taking this formula again is useless. Can one not be cautious!
This is an immortal pill for rescuing damaged sores, not only treating decay after "Fa Bei" heals and violates sexual taboos. People suspect that semen emission causes rupture and should use *Rehmanniae Radix Praeparata* (Prepared Rehmannia Root) for heavy tonification. Why is it omitted? Because *Rehmanniae Radix Praeparata* (Prepared Rehmannia Root) tonifies Yin slowly, while the condition is urgent. Hence, it is discarded. After taking this formula for several doses, reduce each ingredient by half, but increase *Rehmanniae Radix Praeparata* (Prepared Rehmannia Root) significantly for follow-up care.
In summer, a person develops a back carbuncle. The wound does not rise, pulse is large but forceless, fever with thirst, spontaneous sweating, and night sweats. Using large tonifying doses of Ginseng and Astragalus worsens cold limbs, loose stools, panting, and vomiting. People think Fire-Toxin is too strong, but who knows it is extreme deficiency of Yuan Qi, insufficient to be aided by tonification? Carbuncles are divided into Yin and Yang. A wound that does not rise is a Yin syndrome, not Yang. A large pulse seems like Yang, but large and forceless is undoubtedly Yin. Fever and thirst indicate Water failing to control Fire, causing sudden thirst and sweating. Since Yin syndrome mimics Yang, using Ginseng and Astragalus (Yang herbs) to assist Yang, Righteous Qi should be sufficient to expel Yin and return to Yang. Why does tonification worsen cold limbs and vomiting? This is because Yin-Cold Qi is very strong, and the weak Yang herbs cannot overcome it. Without adding *Aconiti Lateralis Radix Praeparata* (Prepared Aconite Lateral Root), a pungent and hot herb, how can it break through barriers to sweep away Yin pathogens? Use Zhu Yang Xiao Du Tang (Assisting Yang and Eliminating Toxin Decoction):
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 0.5 jin
* *Astragali Membranacei Radix* (Huangqi, Astragalus Root) – 1 liang
* *Angelicae Sinensis Radix* (Danggui, Angelica Root) – 4 liang
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, Large-headed Atractylodes Rhizome) – 4 liang
* *Citri Reticulatae Pericarpium* (Chenpi, Tangerine Peel) – 1 liang
* *Aconiti Lateralis Radix Praeparata* (Fuzi, Prepared Aconite Lateral Root) – 5 qian
Decoct into paste, divide into two doses. All symptoms recede. Continue for several doses until the wound rises and ulcerates, then halve the dose. Use several more doses to cure.
This is not the standard method for treating carbuncles, but applying standard methods lightly to such cases rarely fails to cause immediate death. Thus, treating carbuncles requires flexibility. Generally, Yang carbuncles can be treated with detoxifying and phlegm-resolving herbs, but Yin carbuncles must never use such herbs. This is a variable method for treating carbuncles; physicians must know it.
In some cases, a person develops a back carbuncle/sores. After ulceration and pus discharge, there may be fever, aversion to cold, pain, excessive pus, clear fluid discharge, spontaneous sweating, and night sweats. Pus forms but does not ulcerate fully, or ulcers fail to close. People think toxic vapors remain, but who knows it is damage to the Five Zang Organs and extreme deficiency of Blood and Qi? When a person's Qi and Blood are robust and Yin-Yang are balanced, how can toxins arise? Only when internal organs are damaged internally can toxins hide inside, eventually leaking out. When carbuncles erupt, toxins naturally do not stay inside. However, since organs were originally deficient, plus pus and blood loss, deficiency increases. Externally, the open wound seems like excess; internally, Qi and Blood have not regenerated, indicating true deficiency. The method should be comprehensive tonification, avoiding partial tonification of one Zang to prevent imbalance. The best formula is Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) because it tonifies both Qi and Blood.
However, it often fails. This is not because the formula is bad, but because it is not used correctly. How serious is a back carbuncle! Can ordinary small doses suffice? One must increase dosages and decoct large doses for it to help. I have therefore formulated a prescription to consult with colleagues:
* *Panax Ginseng Radix* (Renshen, Ginseng Root) – 1 liang
* *Astragali Membranacei Radix* (Huangqi, Astragalus Root) – 2 liang
* *Paeoniae Radix Alba* (Baishao, White Peony Root) – 5 qian
* *Cinnamomi Cortex* (Rougui, Cinnamon Bark) – 2 qian
* *Chuanxiong Rhizoma* (Chuanxiong, Szechwan Lovage Rhizome) – 3 qian
* *Rehmanniae Radix Praeparata* (Shudi, Prepared Rehmannia Root) – 2 liang
* *Angelicae Sinensis Radix* (Danggui, Angelica Root) – 1 liang
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, Large-headed Atractylodes Rhizome) – 5 qian
* *Poria* (Fuling, Poria Sclerotium) – 5 qian
* *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle* (Sheng Gancao, Raw Licorice Root) – 3 qian
Decoct in water and take orally. Each dose brings its effect.
People doubt this formula does not detoxify at all, asking how it transforms toxins and generates flesh. They do not know that before ulceration, resolving toxins is priority; after ulceration, tonifying Righteous Qi is urgent. Even if residual toxins remain, detoxification is not necessary. Detoxifying herbs are either cold-cooling or consuming. Consuming harms True Qi; cold-cooling damages Stomach Qi. If True Qi is harmed, pathogens flourish; if Stomach Qi is damaged, Grain Qi vanishes. How can muscle grow? Only *Shi Quan Da Bu Tang* (Ten Complete Great Tonifying Decoction) specifically assists True Qi and benefits Stomach Qi, hence achieving full efficacy. Moreover, this formula is suitable not only for ulcerated back carbuncles but for any ulcerated sores.