唐左 夭疽肿硬，位在左耳之后，症由情志抑郁，郁而生火，郁火挟血瘀凝结，营卫不从，颇虑毒不外泄，
致有内陷之变。急与提托，冀其速溃速腐，得脓为佳。
银柴胡（一钱） 全当归（二钱） 京赤芍（二钱） 川象贝（各二钱） 陈广皮（一钱） 生草节（八分）
炙远志（一钱） 炙僵蚕（三钱） 炙甲片（一钱五分） 皂角针（一钱五分） 琥珀蜡矾丸（开水化服，一粒）
二诊 前投提托透脓之剂，疮顶红肿高活，有溃脓之象，是属佳兆。惟恙从七情中来，务须恬 虚无，心
旷神怡，胜乞灵于药石也。
生黄 （三钱） 全当归（二钱） 京赤芍（二钱） 紫丹参（二钱） 生草节（八分） 银柴胡（八分）
生香附（一钱） 皂角针（一钱五分） 川象贝（各三钱） 炙僵蚕（三钱） 笋尖（三钱） 琥珀蜡矾丸（开水
化服，一粒）
三诊 疽顶隆起，内脓渐化，旋理调护，可保无虑矣。
全当归（二钱） 京赤芍（二钱） 银柴胡（八分） 生草节（八分） 川象贝（各三钱） 炙僵蚕（三钱）
陈广皮（一钱） 半夏曲（二钱） 制首乌（三钱） 香白芷（六分）
何右 夭疽匝月，色黑平塌，神糊脉细，汗多气急，阴阳两损，肝肾俱败，疡症中之七恶已见，虽华佗再
世，亦当谢不敏也。勉方冀幸。
吉林参（二钱） 生黄 （六钱） 血鹿片（八分） 生于术（二钱）
清炙草（八分） 云茯苓（三钱） 炮姜炭（五分） 川贝母（三钱） 大熟地（四钱） 五味子（六分）
左牡蛎（四钱） 半夏曲（三钱）
二诊 服药后，神清思食，脉象弦硬，此系孤阳反照，不足恃也。勉宗前法，以冀万一。
原方加熟附片（一钱）。
Mr. Tang presented with a *Yao Ju* (Tian Ju, a severe and sudden carbuncle) located behind the left ear, characterized by swelling and induration. The condition arises from emotional depression, leading to qi stagnation transforming into fire; this stagnant fire combines with blood stasis to coagulate, disrupting the flow of Ying (Nutritive Qi) and Wei (Defensive Qi). There is considerable concern that the pathogenic toxin may fail to excrete outwardly, potentially leading to internal collapse of the toxin. Urgent treatment with lifting and promoting suppuration methods is required, hoping for rapid ulceration and necrotic tissue shedding, with pus discharge being the ideal outcome.
*Yin Chai Hu* (Radix Bupleuri Scorzonerae, 1 qian), *Quan Dang Gui* (Radix Angelicae Sinensis, 2 qian), *Jing Chi Shao* (Radix Paeoniae Rubra, 2 qian), *Chuan Xiang Bei Mu* (Bulbus Fritillariae Cirrhosae, 2 qian each), *Chen Guang Pi* (Pericarpium Citri Reticulatae, 1 qian), *Sheng Cao Jie* (Node of Radix Glycyrrhizae Uralensis, 8 fen);
*Zhi Yuan Zhi* (Radix Polygalae Tenuifoliae, 1 qian), *Zhi Jiang Can* (Bombyx Batryticatus, 3 qian), *Zhi Jia Pian* (Scuta Testudinis et Carapax Trionycis processed, 1.5 qian), *Zao Jiao Zhen* (Gali Fructus Spina, 1.5 qian);
*Hu Po La Fan Wan* (Amber and Wax Pill, dissolve in boiling water to take, 1 pill).
Second visit: After administering the previous formula for lifting and promoting suppuration, the apex of the sore shows redness, swelling, and elevation, indicating signs of impending ulceration and pus discharge, which is a favorable omen. However, since the illness originates from emotional factors (Seven Emotions), it is essential to maintain a tranquil and empty mind, keeping the spirit joyful and relaxed, which is superior to relying solely on medicinal herbs.
*Sheng Huang Qi* (Radix Astragali Membranacei, 3 qian), *Quan Dang Gui* (Radix Angelicae Sinensis, 2 qian), *Jing Chi Shao* (Radix Paeoniae Rubra, 2 qian), *Zi Dan Shen* (Radix Salviae Miltiorrhizae, 2 qian), *Sheng Cao Jie* (Node of Radix Glycyrrhizae Uralensis, 8 fen), *Yin Chai Hu* (Radix Bupleuri Scorzonerae, 8 fen);
*Sheng Xiang Fu* (Rhizoma Cyperi Rotundi, 1 qian), *Zao Jiao Zhen* (Gali Fructus Spina, 1.5 qian), *Chuan Xiang Bei Mu* (Bulbus Fritillariae Cirrhosae, 3 qian each), *Zhi Jiang Can* (Bombyx Batryticatus, 3 qian), *Sun Jian* (Bamboo Shoot Tip, 3 qian);
*Hu Po La Fan Wan* (Amber and Wax Pill, dissolve in boiling water to take, 1 pill).
Third visit: The apex of the abscess has risen, and the internal pus is gradually resolving. With subsequent nursing care, there should be no cause for worry.
*Quan Dang Gui* (Radix Angelicae Sinensis, 2 qian), *Jing Chi Shao* (Radix Paeoniae Rubra, 2 qian), *Yin Chai Hu* (Radix Bupleuri Scorzonerae, 8 fen), *Sheng Cao Jie* (Node of Radix Glycyrrhizae Uralensis, 8 fen), *Chuan Xiang Bei Mu* (Bulbus Fritillariae Cirrhosae, 3 qian each), *Zhi Jiang Can* (Bombyx Batryticatus, 3 qian);
*Chen Guang Pi* (Pericarpium Citri Reticulatae, 1 qian), *Ban Xia Qu* (Massa Medicata Fermentata, 2 qian), *Zhi Shou Wu* (Prepared Rhizoma Polygoni Multiflori, 3 qian), *Xiang Bai Zhi* (Radix Angelicae Dahuricae, 6 fen).
Mr. He suffered from *Yao Ju* for nearly a month. The lesion is black and flat/collapsed. His consciousness is confused, pulse is fine/thready, he sweats excessively, and breathes rapidly/short of breath. This indicates damage to both Yin and Yang, and failure of the Liver and Kidney. The "Seven Evils" (Qi E, ominous signs in surgical diseases) of external sores are already present. Even if Hua Tuo were reborn, he would decline treatment due to the severity. A formula is reluctantly prescribed in hopes of a slight chance of success.
*Jilin Ren Shen* (Radix Ginseng Coralyloides, 2 qian), *Sheng Huang Qi* (Radix Astragali Membranacei, 6 qian), *Xue Lu Pian* (Cornu Cervi Nipponis Sanguineum, 8 fen), *Sheng Bai Zhu* (Rhizoma Atractylodis Macrocephalae, 2 qian);
*Qing Zhi Gan Cao* (Radix Glycyrrhizae Uralensis processed with honey, 8 fen), *Yun Fu Ling* (Poria, 3 qian), *Pao Jiang Tan* (Carbonized Rhizoma Zingiberis Officinalis, 5 fen), *Chuan Bei Mu* (Bulbus Fritillariae Thunbergii, 3 qian), *Da Shu Di Huang* (Radix Rehmanniae Glutinosae Preparata, 4 qian), *Wu Wei Zi* (Fructus Schisandrae Chinensis, 6 fen);
*Zuo Mu Li* (Concha Ostreae, 4 qian), *Ban Xia Qu* (Massa Medicata Fermentata, 3 qian).
Second visit: After taking the medicine, his consciousness cleared, and appetite returned. The pulse is wiry and hard. This represents the reflection of isolated Yang floating outward (rebound phenomenon), which is not reliable. Reluctantly adhering to the previous method, hoping for a slight chance of success.
Add *Shu Fu Pian* (Radix Aconiti Lateralis Preparata, 1 qian) to the original formula.