近时有数人病背疽，服前方药饵，未安之前，遍身寒热，或先寒后热，或先热后寒，连日
作或间日作，必先呕痰，然后寒热，寒热后大汗，然后止。时医多欲用柴胡、牡蛎止汗之药，
又有以为疟疾，欲下恒山饮子。愚力辩云∶背疽之后，不可专以为有热，亦有气虚而得之，
亦有因怒气并血气凝滞而得之。其所以发寒热者，先感寒邪，脾气不正，痰盛而有此证。若
下柴胡，必泻肝，母既虚而又泻其子；牡蛎涩气，气血已不荣运，服涩气、恒山饮子，发吐
痰，大损脾胃。用药如此，可谓误谬。愚但令服家传不换金正气散，祛寒邪，正脾气，痰饮
自消，寒热不作；兼服排脓内补散，以木香汤易酒，不欲饮引呕吐故也。服此药三日，寒自
退，呕吐不作，汗亦自止。
一、痈疽才破有口，便合用猪蹄汤洗。其次（一作初）连日洗；五日后，间日洗；欲安之
际，三日一洗。
猪蹄汤 治痈疽肿块，消毒瓦斯，去恶肉。凡有疮口，便用此药淋洗。
香白芷（不见火） 甘草（生用） 独活（用老羌活） 黄芩（去心） 赤芍药（去皮）
当归（去芦，洗净沙土） 露蜂房（取有蜂儿者用，已上各等分，为粗末）
上先将 猪前蹄两只一斤，只用白水三升煮软，将汁水两次澄清，去上面油花、下面
滓肉，每次用药粗末一两，投于汁中，再用文武火煎十数沸，滤去滓。以故帛蘸药温汤，徐
徐薄揩疮上，死肉、恶血随洗而下，净洗讫，以故帛试干，仍避风，忌入口气吹之。有狐臭人，
并月经见行妇人，猫、犬，并不令入病房。洗疮切弗以手搐着。洗疽之方，所传三、四十，用之
止此一方，极神效。内所用露蜂房最有理，谓其以毒驱毒也。
一、治背疽初作，根脚阔大如碗，未有尖头，寻灸穴法∶凡觉背上肿硬、疼痛，用湿纸贴肿上，看先干处是
头。碾大蒜十头，入淡豉半合、乳香一块如龙眼大，细碾，随疮头大小，用竹片作圈子，竹片阔二分许，随其
大小顿在疮头上，将所碾药填平，铺艾灸之。痛处以痒为度，痒处以痛为度，亦以百壮为准。
一、痈疽既破，脓血溃多，或五日、或七日后，用神异膏贴敷，若根脚小，五日后贴；如阔大，须七日、
十日后可贴。
一、疽疾将安之际，合多服加料十全汤以补其气血，使易生肌肉故也。
加料十全汤 治痈疽后补气血，进饮食，疽疾将安及七八分，盒饭服此药，每日与排脓内补散相间服。
黄 （拣不用叉附及蛀者，锉作二寸长截，拍扁，以冷盐汤湿润之。瓦器盛盖，甑上蒸三次，焙锉用）
熟干地黄（拣肥大滋润者，洗净，焙干，用好瓶酒湿润，瓦器盛盖，于饭甑上蒸晒，如此七次；锉，焙）二味
各用一两净 当归（去芦，净洗，取自头至中心一截，锉，焙干；用自中至尾留合别药） 川芎（锉，微焙）
人参（去顶，锉，焙） 白茯苓（去黑皮，锉，焙） 甘草（炙） 白芍药（拣有皮者买，无皮是伪者。
削去皮，锉、焙用） 肉桂（削去粗皮，锉，不见火） 天台乌药（如无真者，可买隆兴府大块者用。锉焙）
白术（用米泔浸半日，锉到小指头大框，焙干，再用麦麸炒至黄色，不得伤火，去麸，将白术锉用） 陈皮（不
用沙柑子皮。水浸，削去白瓤，焙，锉） 真白五味子（核如猪肾形，肉微黑，重者是真，拣去枝杖，炒过
用。核如沙柑子核者，是土五味子，不堪用。已上十一味各半两）
上各干净称，锉，作散和匀。每服药一两，用水一碗，生姜五片，北枣二枚，同煎至八分碗，滤去滓，取清汁，
分作两服。留滓晒干，碾罗为细末，后来常服，水一盏，生姜三片，枣一枚，煎至八分服之。
一、前后病背疽人，多是先发渴而后背疽作，不然，背疽安而后发渴疾，因此不救者甚
多。若有渴疾人，则合专服加减八味丸，能使渴疾既安，疽疾不作。若骤得背疽之疾，既安
之后，不问有无渴证，便合常服加减八味丸，非特可以杜渴疾之将来，亦且大能滋益气血，
生长肌肉，使精神强健，此乃累试之验。
加减八味丸 治痈疽后合服补药。若用峻补之药则发热，又况痈疽既安之后，多传作
渴疾不可治疗，当预服此药。如能久服，永不生渴疾，气血和壮。未发疽人，或先有渴症，亦
合服此药，渴疾既安，疽亦不作。
熟干地黄（如法拣好者买。制度过，焙，锉，二两） 真山药（锉细，微炒） 山茱萸（去核
取肉，焙干，二味各一两） 肉桂（味辛辣、薄者买。削去粗皮，锉，不见火。用一两，别研，取
半两滓末和入众药，余粗滓仍勿用） 泽泻（水洗，锉作块，无灰酒湿，瓦器盛盖，甑上蒸
五次，锉，焙） 牡丹皮（去心、枝杖，锉，炒） 白茯苓（去黑皮，锉，焙，已上三味各八钱） 北真五
味子（拣去枝杖，慢火炒至透，不得伤火，一两半，别研、罗，和入众药。此一味最要真者，其
详已着十全汤内）
上研、罗为细末，炼蜜候冷，和丸如梧桐子大。每服三十丸，空心无灰酒或盐汤任下。
近年来有几个人患背疽，服用前面的方药后，在病情未稳定之前，全身出现寒热交替，有时先冷后热，有时先热后寒，连续几天发作或隔天发作，必定先呕吐痰涎，然后才出现寒热症状，寒热过后大汗淋漓，然后停止。当时的医生大多想用柴胡、牡蛎等止汗的药物，又有人认为这是疟疾，想要用恒山饮子来攻下。我极力辩解说：背疽之后，不能专门认为是有热邪，也有因气虚而得的，也有因愤怒导致气血凝滞而得的。之所以出现寒热，是因为先感受了寒邪，脾气不正，痰盛而出现此证。如果使用柴胡，必然损伤肝脏，母脏既已虚弱，又再泻其子脏；牡蛎具有收敛涩气的作用，气血已经不能荣养运行，服用收敛涩气的药物和恒山饮子，引发呕吐痰涎，大大损伤脾胃。用药如此，可以说是错误谬误。我只让他们服用家传的不换金正气散，祛除寒邪，调理脾气，痰饮自然消除，寒热不再发作；同时服用排脓内补散，用木香汤代替酒送服，不想因为饮酒引起呕吐的缘故。服用这些药三天后，寒热自然消退，呕吐不再发生，汗也自然停止。
一、痈疽刚刚破溃有伤口时，就应当使用猪蹄汤清洗。其次（一作初）连续几天清洗；五日后，隔天清洗；快要痊愈之际，三天清洗一次。
猪蹄汤 治疗痈疽肿块，消毒瓦斯，去除恶肉。凡是有疮口的，就用此药淋洗。
香白芷（不经过火炒） 甘草（生用） 独活（使用老羌活） 黄芩（去掉心） 赤芍药（去掉皮） 当归（去掉芦头，洗净沙土） 露蜂房（选取有蜂儿的用，以上各等分，制成粗末）
先将猪前蹄两只（一斤），只用白水三升煮软，将汁水两次澄清，去掉上面的油花、下面的渣肉，每次用药粗末一两，投入汁中，再用文火武火煎煮十几沸，过滤去渣。用旧布蘸药温汤，慢慢轻轻擦拭疮口，死肉、恶血随着清洗而脱落，洗净后，用旧布擦干，仍然要避风，忌讳人口气吹它。有狐臭的人，以及月经来潮的妇女，猫、狗，都不让它们进入病房。洗疮千万不要用手去触碰。治疗疽的方法，流传有三四十种，使用的只有这一方，极其神效。其中所用的露蜂房最有道理，说是以毒攻毒。
一、治疗背疽刚发作时，根脚宽阔如碗大，还没有尖头，寻找灸穴的方法：凡是觉得背上肿硬、疼痛，用湿纸贴在肿处，看哪里先干就是头。碾碎大蒜十头，加入淡豆豉半合、乳香一块如龙眼大小，细细碾碎，根据疮头的大小，用竹片做成圈，竹片宽约二分，根据大小放在疮头上，将所碾的药填平，铺上艾绒灸治。痛的地方以感到痒为度，痒的地方以感到痛为度，也以一百壮为准。
一、痈疽已经破溃，脓血溃烂较多，或者五日后、或者七日后，使用神异膏贴敷，如果根脚小，五日后贴；如果宽阔大，必须七日后、十日后才可以贴。
一、疽病将要痊愈之际，应当多服用加料十全汤来补益气血，使肌肉容易生长的缘故。
加料十全汤 治疗痈疽后补益气血，增进饮食，疽病将要痊愈及七八分时，应当服用此药，每日与排脓内补散交替服用。
黄芪（挑选不用叉附及蛀虫咬过的，锉成二寸长的段，拍扁，用冷盐汤湿润。瓦器盛盖，在蒸笼上蒸三次，焙干后锉用） 熟干地黄（挑选肥大滋润的，洗净，焙干，用好瓶酒湿润，瓦器盛盖，在饭甑上蒸晒，如此七次；锉，焙）这两味各用一两净 当归（去掉芦头，净洗，取从头部到中心的一截，锉，焙干；用从中间到尾部的部分留作别药用） 川芎（锉，微焙） 人参（去掉顶，锉，焙） 白茯苓（去掉黑皮，锉，焙） 甘草（炙） 白芍药（挑选有皮的买，无皮的是伪品。削去皮，锉、焙用） 肉桂（削去粗皮，锉，不经过火） 天台乌药（如果没有真的，可以买隆兴府大块的使用。锉焙） 白术（用米泔水浸泡半天，锉到小指头大的块，焙干，再用麦麸炒至黄色，不得伤火，去掉麸，将白术锉用） 陈皮（不用沙柑子皮。水浸，削去白瓤，焙，锉） 真白五味子（核如猪肾形，肉微黑，重的是真的，挑选去掉枝杖，炒过用。核如沙柑子核的，是土五味子，不堪用。以上十一味各半两）
以上各干净称量，锉，做成散剂混合均匀。每次服药一两，用水一碗，生姜五片，北枣二枚，同煎至八分碗，过滤去渣，取清汁，分作两服。留下药渣晒干，碾罗为细末，后来常服，水一盏，生姜三片，枣一枚，煎至八分服用。
一、前后患背疽的人，多是先发渴症而后背疽发作，不然，背疽痊愈后发渴症，因此无法救治的很多。如果有渴症的人，就应当专门服用加减八味丸，能使渴症既愈，疽病不再发作。如果突然得背疽之病，既痊愈之后，不问有无渴证，就应当常服加减八味丸，不仅可以杜绝渴症的将来，而且能大补气血，生长肌肉，使精神强健，这是多次试验验证的结果。
加减八味丸 治疗痈疽后应当服用补药。如果用峻补的药物则发热，何况痈疽既安之后，多转变成渴症不可治疗，应当预先服用此药。如果能久服，永不生渴症，气血调和强壮。未发疽的人，或先有渴症，也应当服用此药，渴症既愈，疽也不发作。
熟干地黄（如法挑选好的购买。制度过，焙，锉，二两） 真山药（锉细，微炒） 山茱萸（去掉核取肉，焙干，这两味各一两） 肉桂（味道辛辣、薄的购买。削去粗皮，锉，不经过火。用一两，另研，取半两滓末混入众药，其余粗滓仍不要用） 泽泻（水洗，锉作块，用无灰酒湿润，瓦器盛盖，在蒸笼上蒸五次，锉，焙） 牡丹皮（去掉心、枝杖，锉，炒） 白茯苓（去掉黑皮，锉，焙，以上三味各八钱） 北真五味子（挑选去掉枝杖，慢火炒至透，不得伤火，一两半，另研、罗，混入众药。这一味最重要的是真的，详情已在十全汤内注明）
以上研、罗为细末，炼蜜候冷，和丸如梧桐子大。每次服用三十丸，空腹用无灰酒或盐汤任下。
In recent times, several individuals suffered from back carbuncle (back abscess). After taking the previously mentioned herbal medicines, before the condition stabilized, they experienced alternating chills and fever all over their bodies. Sometimes chills preceded fever, sometimes fever preceded chills. These episodes occurred consecutively for several days or every other day. They would invariably vomit phlegm first, followed by chills and fever, and then cease after profuse sweating. Contemporary physicians mostly desired to use herbs such as Chaihu (Bupleuri Radix) and Muli (Ostreae Concha) to stop sweating. Others considered it malaria and wished to administer Hengshan Yinzi (Gambir Decoction) to purge. I strongly argued against this: following a back carbuncle, one cannot solely attribute the symptoms to heat pathogen. Some cases arise from Qi deficiency, while others result from anger causing Qi and Blood stagnation. The reason for the chills and fever is that cold pathogen was contracted first, leading to dysfunction of the Spleen Qi and excessive Phlegm, resulting in these symptoms. If Chaihu is used, it will inevitably drain the Liver; if the Mother organ is already deficient, draining its Child organ further weakens it. Muli has astringent properties; since Qi and Blood are already failing to nourish and circulate properly, administering astringent herbs and Hengshan Yinzi induces vomiting of phlegm and severely damages the Spleen and Stomach. Such medication usage can be deemed erroneous. I instructed them only to take my family's inherited Buhuanjin Zhengqi San (Non-exchangeable Upright Qi Powder) to dispel cold pathogen and rectify Spleen Qi, allowing Phlegm-Fluids to dissipate naturally and preventing chills and fever; concurrently, they took Painong Neibu San (Drain Pus and Interior-Nourishing Powder), substituting wine with Muxiang Tang (Costus Root Decoction) for administration to avoid inducing vomiting through alcohol consumption. After three days of taking these medicines, the chills and fever subsided spontaneously, vomiting ceased, and sweating stopped.
1. When a carbuncle or ulcer first breaks and forms an opening, it should immediately be washed with Zhuti Tang (Pig Trotter Decoction). Subsequently, wash daily for a few days; after five days, wash every other day; when nearing recovery, wash once every three days.
Zhuti Tang (Pig Trotter Decoction): Treats carbuncle and ulcer swelling, disinfects toxic vapors, and removes necrotic flesh. For any wound, this medicine should be used for irrigation and washing.
Xiangbaizhi (Angelicae Dahuricae Radix) (not roasted); Gancao (Licorice Root) (used raw); Duhuo (Angelicae Pubescentis Radix) (use old Qianghuo); Huangqin (Scutellariae Radix) (remove core); Chishaoyao (Red Peony Root) (remove peel); Danggui (Angelicae Sinensis Radix) (remove rhizome, wash clean of sand); Lufengfang (Apiis Cera cum Favus) (use those containing bee larvae; above ingredients in equal parts, made into coarse powder).
First, boil two pig front trotters (one jin) in three sheng of plain water until soft. Clarify the broth twice, removing oil scum from the top and dregs from the bottom. For each dose, add one liang of the coarse herb powder to the broth, then decoct over moderate to strong fire for more than ten boils. Filter out the dregs. Dip an old cloth in the warm medicinal liquid and gently wipe the wound. Necrotic tissue and foul blood will come off with washing. After thorough cleaning, dry with an old cloth. Continue to avoid wind and prevent people from blowing on the wound. Individuals with body odor, women during menstruation, cats, and dogs must not enter the ward. Do not touch the wound with hands while washing. Among the many methods for treating ulcers passed down (three or forty), this single formula is extremely effective. The inclusion of Lufengfang is particularly logical, based on the principle of using poison to treat poison.
1. To treat early-stage back carbuncle where the base is wide like a bowl and lacks a head, locate the acupoint for moxibustion thus: Whenever one feels swelling, hardness, and pain on the back, apply wet paper to the swollen area. The spot where the paper dries first indicates the head. Crush ten heads of garlic, add half he of Danchi (Light Fermented Soybean), and a piece of Ruxiang (Frankincense) the size of a longan fruit. Grind finely. According to the size of the carbuncle head, make a ring from bamboo strips about two fen wide. Place the ring on the carbuncle head, fill it with the ground mixture, and apply moxa on top. For painful areas, continue until itching is felt; for itchy areas, continue until pain is felt. Generally, aim for one hundred moxa cones.
1. Once the carbuncle has broken and pus and blood have drained significantly, apply Shenyi Gao (Divine Extraordinary Plaster) either five or seven days later. If the base is small, apply after five days; if wide, wait until seven or ten days before applying.
1. As the ulcer disease nears resolution, one should frequently take Jiaoliao Shiquan Tang (Modified Perfect Ten Decoction) to tonify Qi and Blood, facilitating muscle regeneration.
Jiaoliao Shiquan Tang (Modified Perfect Ten Decoction): Tonifies Qi and Blood after carbuncles/ulcers, promotes appetite. It should be taken when the ulcer disease is nearly resolved (70-80% healed), alternating daily with Painong Neibu San.
Huangqi (Astragali Radix) (select pieces without forked attachments or wormholes, cut into two-cun segments, flatten, moisten with cold salt water. Store in a ceramic vessel covered, steam three times in a steamer, dry-roast, then cut); Shudihuang (Prepared Rehmanniae Radix) (select plump, moist pieces, wash, dry-roast, moisten with good quality wine in a ceramic vessel covered, steam and sun-dry in a rice steamer, repeat seven times; cut, dry-roast). These two ingredients each use one liang, cleaned. Danggui (Angelicae Sinensis Radix) (remove rhizome, wash clean, take the segment from head to center, cut, dry-roast; reserve the segment from center to tail for other uses); Chuanxiong (Ligusticum Chuanxiong Rhizome) (cut, lightly dry-roast); Renshen (Ginseng Radix) (remove crown, cut, dry-roast); Baifuling (Poria) (remove black skin, cut, dry-roast); Gancao (Licorice Root) (honey-fried); Baishaoyao (White Peony Root) (purchase with skin, as skinless ones are fake. Peel, cut, dry-roast); Rougui (Cinnamon Bark) (remove rough bark, cut, do not roast); Tiantai Wuyao (Lithospermi Fructus) (if genuine is unavailable, buy large pieces from Longxing Prefecture. Cut, dry-roast); Baizhu (Atractylodis Macrocephalae Rhizome) (soak in rice-washing water for half a day, cut into pieces the size of a little finger, dry-roast, then stir-fry with wheat bran until yellow, avoiding burning. Remove bran, cut Baizhu); Chenpi (Citri Reticulatae Pericarpium) (do not use citrus peel. Soak in water, scrape off white pith, dry-roast, cut). Zhenbai Wuweizi (Schisandrae Chinensis Fructus) (seeds shaped like pig kidneys, flesh slightly black, heavier weight indicates genuine. Select, remove stems, stir-fry. Seeds resembling citrus seeds are local Schisandra, unsuitable. Above eleven ingredients each use half liang).
Weigh each ingredient cleanly, cut, mix into a powder evenly. For each dose of one liang, add one bowl of water, five slices of fresh ginger, and two northern dates. Decoct together until reduced to 0.8 bowls. Filter out dregs, take the clear liquid, divided into two doses. Reserve the dregs, dry them in the sun, grind into fine powder for future regular use: one cup of water, three slices of ginger, one date, decoct to 0.8 cups and take.
1. Patients who previously suffered from back carbuncle often developed thirst first, followed by the carbuncle; alternatively, the carbuncle healed first, followed by thirst. Many could not be saved due to this sequence. If a patient has thirst, they should exclusively take Jiajian Bawei Wan (Modified Eight-Ingredient Pill) to resolve the thirst and prevent the carbuncle from recurring. Even if one suddenly contracts back carbuncle, after it heals, regardless of whether thirst symptoms exist, one should regularly take Jiajian Bawei Wan. This not only prevents future thirst but also greatly tonifies Qi and Blood, promotes muscle growth, and strengthens spirit. This is a verified result from repeated trials.
Jiajian Bawei Wan (Modified Eight-Ingredient Pill): Indicates that tonic medicines should be taken after carbuncles/ulcers. Using harsh tonics may cause fever. Moreover, after carbuncles/ulcers heal, they often transform into incurable thirst conditions; therefore, this medicine should be taken prophylactically. Long-term use prevents thirst entirely, harmonizing and strengthening Qi and Blood. Individuals who have not yet developed carbuncles, or who have pre-existing thirst, should also take this medicine. Once thirst resolves, the carbuncle will not occur.
Shudihuang (Prepared Rehmanniae Radix) (select high-quality pieces according to method. Processed, dry-roasted, cut, two liang); Zhenshanyao (Dioscoreae Rhizoma) (cut finely, lightly stir-fried); Shanzhuyu (Corni Fructus) (remove pits, take flesh, dry-roast; these two ingredients each use one liang); Rougui (Cinnamon Bark) (select pungent, thin pieces. Remove rough bark, cut, do not roast. Use one liang, separately grind, take half liang of fine powder to mix with other herbs, discard remaining coarse dregs); Zexie (Alismatis Rhizoma) (wash, cut into chunks, moisten with non-grain wine, store in covered ceramic vessel, steam five times in steamer, cut, dry-roast); Mudanpi (Moutan Cortex) (remove heart and stems, cut, stir-fry); Baifuling (Poria) (remove black skin, cut, dry-roast; above three ingredients each use eight qian). Beiwuwei Zi (Schisandrae Chinensis Fructus) (select, remove stems, slow-fire stir-fry thoroughly without burning, one and a half liang, separately grind and sieve, mix with other herbs. This ingredient must be genuine; details are noted in Shiquan Tang).
Grind and sieve into fine powder. Prepare refined honey when cool, mix to form pills the size of paulownia seeds. Take thirty pills per dose, administered with non-grain wine or salt water on an empty stomach.