王姓媳，颈上瘰 数个，两腋生恶核三个，大腿患一毒，不作痛痒，百余日后日渐发大
，形大如斗，按之如石，皮现青筋，常作抽痛。经治数人皆称曰瘤。余曰∶瘤乃软者，世无
石硬之瘤耳。此是石疽，阴症也。问可治否？签曰∶初起时皆可消。日久发大，上现筋纹，
虽按之如石，然其根下已成脓矣。如偶作一抽之痛，乃是脓脓之证也。上现青筋者，其内已
作黄浆可治。如上现小块，高低如石岩者不治，三百日后主发大痛，不溃而死。如现红筋者
，其内已通血海不治。倘生斑点，即自溃之证，溃即放血，三日内毙。今患所现青筋，医其
至软为半功，溃后脓变浓浓可冀收功也。外以活商陆捣涂，内服阳和汤，十日则止一抽之痛
，十三剂里外作痒，十六剂顶软，十八剂通患软，其颈项之 块，两腋之恶核，尽行消散，
一无形迹，止剩石疽，立起内脓袋下。令服参一钱，因在筋络之处，先以银针刺穿，后以刀
阔其口，以纸钉塞入孔内，次日两次流水斗许，大剂滋补托时，删去人参，倍增黄 ，连进
十剂，相安已极。适有伊芳戚亦行外科道者，令其 、草换炙服，不三日，四围发肿，内作疼
痛，复延余治。余令以照前方服，又服二十余剂，外以阳和膏随其根盘贴满，独留患孔，加
以布捆绑。人问∶因何用膏贴，又加捆绑。签曰∶凡属阴疽，外皮活、内膜生，故开刀伤膜
，膜烂则死，所出之脓在皮里膜外，仅似弄，又不能生肌药放入，故内服温补滋阴活血之剂
，外贴活血温暖膏药，加之以捆使其皮膜相连，易于脓尽，且又易于连接生肌。果绑后数日
，内脓浓浓，加参服两月收功。
阊门龚姓，腰生一疽，根盘宽二尺余，前接腹，后接背，不红不肿，不痛不软，按之如
木。初延余治，以肉桂、炮姜书于方首，后另延三四名家众视余方皆曰∶酷暑安可用此热药
！大以为非，议用攻托清凉之剂，连治五六日，病者神昏胃败。复延余治∶患仍不痛，色如
隔夜猪肝，言语不清，饮食不进。余曰∶能过今晚再议。是夜即死。不久，伊芳戚亦患此症，
延余治以阳和汤，服下次日觉松，再服疽消小半，才以犀黄丸与阳和汤，逐日早晚轮服，服
至第五日全愈。后有背疽相同者，亦照治而愈。
木渎镇谭姓妇，背生一疽如碗，初起色白、后转红痛甚、时正三伏，余以阳和汤服。旁
人云∶此暑天何用麻黄发表及姜、桂热药？余曰∶此阴症也。彼云∶色既转红，阴已变阳。
余曰∶无防。服后淡一时痛止，接服四剂不痛而破，五日收功。
宜兴徐姓子，年岁半，太阳一毒，背上、心脐对处二毒，颈后对口一毒，腰、腹二毒，
两腿五毒，皆皮色不变。其大腿二毒，已经别医开刀割破。延余往治，因孩小不能服药，用
小金丹日服二次，第五日消去九毒。又以小金丹日服一次，并添一乳母，十日后所破二孔皆
红润，以保元汤加肉桂三分，煎一杯，另水煎参六分兑服，服至半月后，将 、草炙过用之
，一月收功。
兴邑路姓子，年七岁，顶门上寸许大连生三疽，溃烂久不收口，孔如棋子大，浅而无脓
，干而色灰，人倦无神，饮食少进，因服凉药过多所致。延余往治。余曰∶色似香灰，气血
两尽，干枯无脓，精神已绝，何能治之？次日而夭。
山塘姚姓妇，年二十九，小产月余，左肩搭手处先发一毒，周遭尺五，半月后背脊添生
一毒，自上至下长一尺三寸，皆色白低陷。十日后始请余治，势甚危险，连服阳和汤三剂，
人能起坐，五剂自能大小便，十二剂以后，发者全消，先发之搭手，四围皆消，止其顶脓足
不痛而穿，四日收功。复言背上如负一板，舒转不快，以小金丹十丸，日服二丸全愈。
一人身患杨梅疮，又患鱼口。余思鱼口乃阳虚之证，药宜温补，杨梅系火毒之证，药宜
凉解，二症相反，必两相宜之药，非犀黄丸不可，令其每日空心时酒送三钱，十服二症全愈
。后一人患亦相同，因毒重，二十服收功。
程姓母，年七十，膝下患一流注阴疽，溃烂数月，患下及旁接连又起硬种二块，延一医
以新发之毒，认为旧患旁肿，不识流注，竟以消毒之剂与服，以致新发者被托发痛，始延余
治，余以阳和汤服三剂，新发二毒皆消。接服小金丹十丸，后进滋阴温补，以杏仁散敷半月
，脓浓，服保元汤加肉桂十余剂而愈。
一妇颈生痰核三处，年久生管。余以拔管药插入，日换一次，半月已愈两处，有一处管
已医浅，不意根据夫远归，两日管深如旧。余曰∶此刻治定无功效，俟根据夫出外半月方可收功
。数日后妇回母家，延余往治而愈。
洞庭秦卜年，颈上及两腋生恶核十二处，破烂三载不愈。余以阳和汤、犀黄丸轮服，半
月十已愈八，喜甚带药而回，路遇凉粉买食，归家又食冷水过面，次日大小便闭，第五日死
。此其自不惜命，故记以为病者之戒。
枫镇闵性，年十七，患瘰 烂成一片，延烂耳、腋及腰，如手掌大者数处，瘦弱异常。
初以洞天救苦丹服之，毒水大流，十日后以阳和汤、醒消丸每日早晚各服一次，十日颈项即
能舒转，饮食日增。外贴阳和膏，内服大枣丸，始终用荆芥汤洗，以山莲散敷，九十日收功
。因未服子龙、小金二丸，毒根未除，后腋复生恶核，仍以子龙丸消之。
王姓人家的儿媳，脖子上长了数个瘰疬（颈部淋巴结结核），双侧腋下长了三个恶核（恶性肿块或淋巴结肿大），大腿患了一个毒疮，不痛也不痒。一百多天后，患处日渐增大，形状大如斗，按上去像石头一样硬，皮肤表面显现青色筋脉，经常发生抽掣样疼痛。经过几位医生诊治，都称之为“瘤”。我说：“瘤通常是柔软的，世上没有像石头一样硬的瘤。”这是石疽，属于阴证。问能否治疗？回答说：初起时都可以消散。如果日久变大，表面出现筋纹，虽然按上去像石头，但根部下面已经化脓了。如果偶尔出现一次抽掣样的疼痛，这是脓液将成的征象。表面出现青筋的，内部已经形成黄浆，可以治疗。如果表面出现小块，高低不平像岩石一样的，则无法治疗，三百天后会引发剧烈疼痛，不溃破而死亡。如果出现红筋的，说明内部已经通达血海，无法治疗。倘若生出斑点，就是自行溃破的征象，一旦溃破就会大量出血，三天内死亡。现在患处呈现青筋，只要等到患处变软，就能收到一半的效果；溃破后脓液变得浓稠，就有希望痊愈。外用活商陆捣烂敷涂，内服阳和汤。十日后，抽掣样疼痛停止；十三剂药后，内外感到瘙痒；十六剂药后，肿疡顶部变软；十八剂药后，整个患处变软，脖子上的肿块、腋下的恶核全部消散，不留痕迹，只剩下石疽，立起来可以看到内部脓袋下方。令其服用人参一钱，因为病灶在筋络之处，先用银针刺穿，然后用刀扩大创口，用纸捻塞入孔内。第二天两次流出约一斗多的液体，使用大剂量的滋补托毒药物时，删去人参，加倍使用黄芪，连续服用十剂，病情非常平稳。恰好有一位亲戚也是从事外科的，让他用甘草换炙（蜜炙）服用，不到三天，四周肿胀，内部疼痛，又请我诊治。我让他照前方继续服药，又服二十余剂，外用阳和膏随其根盘贴满，唯独留出患孔，加上布带捆绑。有人问：“为什么用膏药贴敷，还要加捆绑？”回答说：“凡是属于阴疽，外皮要活动，内膜要生长，所以开刀伤及内膜，内膜腐烂就会死亡，流出的脓在皮里膜外，仅仅像弄脏了一样，又不能放入生肌药，所以内服温补滋阴活血的药物，外贴活血温暖的膏药，加上捆绑使其皮膜相连，易于脓液排尽，而且又易于连接生肌。果然捆绑后数日，内部脓液浓稠，加入人参服用两个月才痊愈。”
阊门龚姓人家，腰部生了一个疽，根盘宽二尺多，前面连着腹部，后面连着背部，不红不肿，不痛不软，按上去像木头一样。起初请我诊治，我在方剂开头写了肉桂、炮姜。后来另外延请三四位名医共同查看我的方子，都说：“酷暑天气怎么可以用这些热药！”认为非常不对，商议使用攻托清凉的药剂，连续治疗五六天，病人神志昏迷，胃气衰败。又请我诊治：患处仍然不痛，颜色像隔夜的猪肝，言语不清，饮食不进。我说：“能熬过今晚再议。”当天夜里就死了。不久，他的亲戚也患了同样的症状，请我用阳和汤治疗，服用后第二天感觉轻松，再服用后疽缩小了一半，才用犀黄丸与阳和汤轮流早晚服用，服到第五天完全痊愈。后来有背疽情况相同的，也按照这个方法治愈。
木渎镇谭姓妇人，背上生了一个像碗大的疽，初起时颜色白，后来转红且疼痛剧烈，当时正值三伏天。我用阳和汤让她服用。旁边的人说：“这是暑天，为什么要用麻黄发表以及姜、桂等热药？”我说：“这是阴证。”那人说：“颜色既然转红，阴证已经变成阳证了。”我说：“不要紧。”服用后过了一会儿疼痛停止，接着服用四剂，不痛而破溃，五天痊愈。
宜兴徐姓人家的儿子，半岁大，太阳经部位有一个毒疮，背上心脐相对处有两个毒疮，颈后对口处有一个毒疮，腰、腹各有一个毒疮，两条腿上有五个毒疮，皮肤颜色都没有改变。他大腿上的两个毒疮，已经被其他医生开刀割破。请我去诊治，因为孩子太小不能服药，用小金丹每天服用两次，第五天消去了九个毒疮。又以小金丹每天服用一次，并添置一个乳母，十天后那两个被割破的孔洞都变得红润，用保元汤加入三分肉桂，煎一杯，另用水煎六分人参兑服，服到半个月后，将甘草炙过后使用，一个月痊愈。
兴邑路姓人家的儿子，七岁，头顶上寸许大面积连生三个疽，溃烂很久不收口，孔洞像棋子那么大，浅而没有脓，干燥且颜色灰暗，人疲倦无神，饮食少进，这是因为服用凉药过多导致的。请我去诊治。我说：“颜色像香灰，气血两尽，干枯无脓，精神已绝，怎么能治呢？”第二天就夭折了。
山塘姚姓妇人，二十九岁，小产一个多月，左肩搭手处先发一个毒疮，周围有一尺五寸，半个月后背脊添生一个毒疮，从上到下长一尺三寸，都是白色低陷。十天后才请我诊治，形势非常危险，连续服用阳和汤三剂，人能坐起来了，五剂后能自行大小便，十二剂以后，新发的全部消退，先发的搭手，四周都消退了，只留下顶部的脓足不痛而穿破，四天痊愈。后又说背上像背着一块板，舒展转动不舒服，用小金丹十丸，每天服用二丸，完全痊愈。
一个人身上患有杨梅疮，又患有鱼口（性病引起的腹股沟淋巴结炎）。我想鱼口是阳虚的证候，药物宜温补；杨梅疮是火毒的证候，药物宜凉解。两种病症相反，必须用两相适宜的药物，非犀黄丸不可，让他每天空腹时用酒送服三钱，十服后两种病症全部痊愈。后来一个人患病也相同，因为毒重，二十服后痊愈。
程姓母亲，七十岁，膝盖下患一流注阴疽，溃烂几个月，患处下方及旁边接连又起了两块硬结。请一位医生诊治，把新发的毒疮认为是旧患旁边的肿胀，不认识流注病，竟然给服消毒药剂，导致新发的被托发疼痛，这才请我诊治。我用阳和汤服用三剂，新发的两个毒疮都消退了。接着服用小金丹十丸，后进滋阴温补药物，用杏仁散敷贴半个月，脓液浓稠，服用保元汤加肉桂十余剂而痊愈。
一个妇人的脖子上生了三处痰核，多年形成窦管。我用拔管药插入，每天更换一次，半个月好了两处，有一处窦管已经医浅，没想到她的丈夫远归，两天后窦管又深如从前。我说：“此刻治疗肯定没有功效，等她丈夫外出半个月才可以痊愈。”几天后妇人回娘家，请我去诊治而痊愈。
洞庭秦卜年，脖子上及腋下生了十二处恶核，破烂三年不愈。我用阳和汤、犀黄丸轮流服用，半个月已经好了八处，非常高兴带着药回去，路上遇到卖凉粉的买了吃，回家又吃了冷水过面，第二天大小便闭塞，第五天死亡。这是他自己不爱惜性命，所以记录下来作为病人的警戒。
枫镇闵性，十七岁，患瘰疬溃烂成一片，蔓延到耳、腋及腰部，像手掌大的有好几处，瘦弱异常。起初用洞天救苦丹服用，毒水大量流出，十天后用阳和汤、醒消丸每天早晚各服一次，十天颈项就能舒展转动，饮食日益增加。外贴阳和膏，内服大枣丸，始终用荆芥汤清洗，用山莲散敷贴，九十天痊愈。因为没有服用子龙丸、小金丸，毒根未除，后来腋下又生恶核，仍然用子龙丸消除它。
The daughter-in-law of the Wang family had several scrofula (tuberculous lymphadenitis of the neck) on her neck, three malignant nodules (malignant masses or enlarged lymph nodes) in both axillae, and a toxic sore on her thigh that was neither painful nor itchy. After more than a hundred days, the lesion gradually enlarged, becoming as large as a bushel basket, hard as stone upon palpation, with cyanotic veins visible on the skin surface, and accompanied by frequent spasmodic pain. Several physicians treated her and all diagnosed it as a "tumor" (liu). I stated, "Tumors are typically soft; there are no tumors in the world that are hard as stone." This is a Stone Abscess (Shi Ju), which belongs to Yin syndromes. When asked if it could be treated, I replied: "If treated at the onset, it can be resolved. If it enlarges over time and shows venous patterns on the surface, although it feels hard as stone, pus has already formed at the root. Occasional spasmodic pain indicates that pus is forming. The presence of cyanotic veins suggests yellowish serum inside, indicating a treatable condition. However, if small, uneven nodules resembling rock appear on the surface, it is untreatable; after three hundred days, severe pain will erupt, leading to death without ulceration. If red veins appear, it indicates connection to the Blood Sea, making it untreatable. If spots appear, it signifies spontaneous ulceration; once ulcerated, massive hemorrhage will occur, leading to death within three days. Currently, the presence of cyanotic veins means that if the lesion becomes soft, half the treatment effect will be achieved. After ulceration, if the pus becomes thick, recovery is hopeful. Externally apply fresh Phytolacca esculenta (Shanglu) paste; internally administer Yanghe Decoction (Warming Yang and Resolving Masses Decoction). After ten doses, the spasmodic pain ceased. After thirteen doses, itching occurred both internally and externally. After sixteen doses, the apex softened. After eighteen doses, the entire lesion softened. The nodules on the neck and axillae completely dissipated without a trace, leaving only the Stone Abscess, where an internal pus sac was visible below when standing. Prescribe one qian of Ginseng Radix et Rhizoma Rubra (Renshen). Since the lesion is located in the meridians and collaterals, first puncture with a silver needle, then enlarge the opening with a knife, and insert a paper wick. The next day, about one dou of fluid drained twice. When using large doses of tonifying and expelling-toxicity formulas, omit Ginseng and double the dose of Astragali Radix (Huangqi). Continue for ten doses; the condition stabilized significantly. A relative who practiced surgery advised him to use honey-fried Glycyrrhizae Radix et Rhizoma (Gancao). Within three days, swelling erupted around the area with internal pain, requiring my re-evaluation. I instructed him to continue the previous formula. After another twenty-plus doses, apply Yanghe Plaster covering the base, leaving the wound open, and bind tightly with cloth. Asked why plaster and binding were used, I explained: "For Yin abscesses, the outer skin must remain mobile while the inner membrane regenerates. Surgical incision damaging the inner membrane leads to necrosis and death. The pus lies between the skin and the membrane, merely causing superficial irritation, and cannot accommodate topical tissue-nourishing herbs. Therefore, internally administer warming, tonifying, yin-nourishing, and blood-invigorating agents; externally apply warming and blood-invigorating plasters. Binding ensures the skin and membrane adhere, facilitating pus drainage and tissue regeneration. Indeed, after binding, the internal pus became thick. Adding Ginseng, the patient recovered after two months."
Mr. Gong from Changmen developed a carbuncle on his waist, with a base spanning over two chi wide, extending anteriorly to the abdomen and posteriorly to the back. It was non-erythematous, non-edematous, painless, and firm like wood. Initially, I prescribed Cinnamon Twig (Guizhi) and Prepared Ginger (Paojiang) at the head of the prescription. Later, three or four renowned physicians reviewed my prescription and objected, stating, "How can such hot herbs be used in intense summer heat!" They deemed it incorrect and proposed cooling and draining formulas. After five to six days of this treatment, the patient fell into coma with stomach qi exhaustion. I was called again: the lesion remained painless, the color resembled overnight pork liver, speech was slurred, and food intake ceased. I said, "Let us see if he survives the night before discussing further." He died that night. Soon after, his relative suffered from the same condition. I treated him with Yanghe Decoction. Relief was felt the next day, and the carbuncle reduced by half after subsequent doses. Then, Xihuang Pills (Rhino Horn and Musk Pill) were alternated with Yanghe Decoction morning and evening. Full recovery was achieved on the fifth day. Subsequent cases of back carbuncles with similar presentations were also cured using this method.
A woman from Mudu Town developed a bowl-sized carbuncle on her back. Initially white, it turned red with severe pain during the Sanfu (dog days) period. I prescribed Yanghe Decoction. Bystanders questioned, "Why use Ma Huang (Ephedra) to release the exterior and hot herbs like Ginger and Cinnamon in summer?" I replied, "This is a Yin syndrome." They argued, "Since the color turned red, Yin has transformed into Yang." I responded, "Do not worry." After administration, pain ceased briefly. After four additional doses, the lesion ulcerated without pain, and healing was completed in five days.
The son of Mr. Xu from Yixing, aged six months, had one toxic sore on the Taiyang channel, two opposite the heart and umbilicus on the back, one on the nape ("duikou"), one each on the waist and abdomen, and five on both legs. All maintained normal skin color. The two sores on his thighs had been incised by another physician. Due to the child's young age and inability to take oral medicine, I administered Xiaojin Dan (Little Gold Pill) twice daily. By the fifth day, nine sores had resolved. I continued Xiaojin Dan once daily and arranged a wet nurse. Ten days later, the two incised wounds appeared healthy and red. I prescribed Baoyuan Decoction (Protect the Origin Decoction) with three fen of Cinnamon Bark (Rougui). Separately decoct six fen of Ginseng Radix et Rhizoma Rubra (Renshen) and mix. After half a month, honey-fried Glycyrrhizae Radix et Rhizoma (Gancao) was added. Recovery was achieved in one month.
The son of Mr. Lu from Xingyi, aged seven, had three coalescing carbuncles on the vertex, approximately one cun in diameter. They had ulcerated for a long time without healing, with holes the size of chess pieces, shallow, devoid of pus, dry, and grayish in color. The child was lethargic and spiritless with poor appetite, caused by excessive consumption of cold-natured medicines. Upon examination, I stated, "The color resembles incense ash, indicating depletion of Qi and Blood, dryness without pus, and extinction of spirit. How can this be treated?" The child died the following day.
Mrs. Yao from Shantang, aged twenty-nine, experienced a miscarriage over a month prior. A toxic sore initially appeared at the left shoulder ("dashou" point), surrounding an area of 1.5 chi. Half a month later, another sore appeared on the spine, extending vertically for 1.3 chi. Both were white and depressed. Treatment was sought ten days later due to critical condition. Three doses of Yanghe Decoction enabled her to sit up. Five doses allowed normal urination and defecation. After twelve doses, new lesions resolved completely. For the initial "dashou" lesion, the surrounding area resolved, leaving only the apex which ulcerated painlessly. Healing was completed in four days. She subsequently complained of a sensation of heaviness on the back, like carrying a board, restricting movement. Ten pills of Xiaojin Dan, taken twice daily, resulted in full recovery.
A man suffered from syphilis (Yangmei Chuang) and bubo (Yukou). I reasoned that bubo indicates Yang deficiency, requiring warming and tonification, whereas syphilis involves fire toxin, requiring cooling and resolution. These opposing conditions require a balanced formula; only Xihuang Pills are suitable. Instructed him to take three qian with wine on an empty stomach daily. Two symptoms resolved after ten doses. Another case with similar presentation but heavier toxicity required twenty doses for recovery.
Mother Cheng, aged seventy, suffered from a flowing abscess (Liuzhu) Yin abscess under the knee, ulcerated for months. Two hard nodules appeared below and beside the lesion. A physician misdiagnosed the new nodules as swelling adjacent to the old lesion, failing to recognize Liuzhu, and administered detoxifying agents. This aggravated the new nodules, causing pain. Upon my consultation, three doses of Yanghe Decoction resolved the new nodules. Followed by ten pills of Xiaojin Dan, then yin-nourishing and warming-tonifying herbs. Apply Xingren San (Almond Powder) for half a month until pus thickened. Finally, Baoyuan Decoction with Rougui for over ten doses led to cure.
A woman had three phlegm nodules on her neck that formed sinuses over many years. I inserted sinus-extracting medicine, changing it daily. Two sites healed in half a month. One site had been treated superficially. Unexpectedly, upon her husband's return from afar, the sinus deepened again within two days. I stated, "Treatment now will be ineffective. Wait until her husband travels away for half a month for recovery." Days later, she returned to her maternal home, and I treated her successfully there.
Qin Bunian from Dongting had twelve malignant nodules on the neck and axillae, ulcerated for three years without healing. I alternated Yanghe Decoction and Xihuang Pills. Eight out of twelve healed in half a month. Delighted, he took the medicine home. On the way, he bought and ate cold jelly noodles, and upon returning, consumed cold water with noodles. The next day, he suffered urinary and fecal retention, dying on the fifth day. This serves as a warning against disregarding health precautions.
Min Xing from Fengzhen, aged seventeen, suffered from extensive ulcerated scrofula spreading to the ears, axillae, and waist, with palm-sized areas in multiple locations. He was extremely emaciated. Initially treated with Dongtian Jiuku Dan, resulting in profuse discharge of toxic fluid. After ten days, Yanghe Decoction and Xingxiao Pills were administered morning and evening. Neck mobility improved within ten days, and appetite increased. External application of Yanghe Plaster, internal administration of Dazao Wan (Jujube Pill), washing with Jingjie Decoction, and applying Shanlian San throughout the process led to recovery in ninety days. Because Zilong Wan and Xiaojin Wan were not used, the root of the toxin remained. Later, malignant nodules recurred in the axilla, which were resolved using Zilong Wan.