气汤加麦门、五味。心火刑克肺金，人参平肺散。阴火伤肺，六味丸加五味子煎服。）
若肩背不便、四肢沉重者，脾肾亏损，五恶也。（补中益气汤加山茱萸、山药、五味。如不应，
用十全大补汤加山茱萸、山药、五味。）
若不能下食、服药而呕、食不知味者，胃气虚弱，六恶也。（六君子汤加木香、砂仁。如不应，
急加附子。）
若声嘶色败、唇鼻青赤、面目四肢浮肿者，脾肺俱虚，七恶也。（补中益气汤加大枣、生姜。
如不应，用六君子汤加炮姜。更不应，急加附子，十全大补汤加附子、炮姜。）
若腹痛泄泻、咳逆昏愦者，阳气虚、寒气内淫之恶症也。（急用托里温中汤，后用六君子汤加附子，
或加姜桂温补。）
若有溃后发热、恶寒作渴、或怔忡惊悸、寤寐不常、牙关紧急、或头目赤痛、自汗盗汗、寒战切牙、
手撒身热、脉洪大、按之如无；或身热恶衣、欲投于水、其脉浮大、按之微细、衣浓仍寒，此气虚极，
传变之恶症也。
若手足逆冷、肚腹疼痛、泄痢肠鸣、饮食不入、呃逆呕吐，此阳气虚、寒气所乘之恶症也。
若有汗而又恶寒，或无汗而恶寒、口噤足冷、腰背反张、颈项头强，此血气虚极，变痉之恶症也。
（急用参、 、归，术、附子救之，间有可生者。）
大抵五善见三则吉，七恶见四必危。虚中见恶症者难治，
实症无恶候者易治。
六味丸（又名六味地黄丸） 此壮水之剂。夫人之生，以肾为主。凡病皆由肾虚而致。
此方乃天一生水之剂，无有不可用者，世所罕知。若肾虚发热作渴、小便淋闭、痰气壅盛、咳
嗽吐血、头目眩晕、小便短少、眼花耳聋、咽喉内燥、口热疮裂、齿不坚固、腰腿痿软、五脏齐
损、肝经不足之症，尤当用之，水能生木故也。若肾虚发热、自汗盗汗、便血诸血、失喑，水泛
为痰之圣药，血虚发热之神剂也。
熟地黄（用生者自制，八两） 山茱萸（酒浸去复选肉） 山药（各四两） 白茯苓（去皮）
牡丹皮 泽泻（各三两）
上地黄酒蒸黑杵膏，余为末，炼蜜丸，如梧子大。每服七八十丸，滚水下。
八味丸 治命门火衰，不能生土，以致脾土虚寒而患流注鹤膝等症，不能消溃收敛，
或饮食少思，或食而不化、脐腹疼痛、夜多漩溺。即六味丸加肉桂、附子各一两。经云∶
益火之源，以消阴翳，即此方也。
加减八味丸 治痈疽疮疡痊后及将痊，口干渴甚、舌或生黄及未患先渴，此肾水不能上润，
致心火上炎，水火不能既济，故心烦躁、小便频涩、或白浊阴痿，饮食减少、肌肤瘦削诸症。
服此以生肾水、降心火，诸症顿止。及治口舌生疮不绝。
山药（一两） 山茱萸（去核净肉酒浸杵膏） 桂心（去粗皮） 泽泻 白茯苓（去皮。各五钱）
五味子（二两半） 牡丹皮（五钱） 熟地黄（用生者半斤，酒拌砂锅蒸半日捣膏）
上为末。入膏加蜜少许同丸，如梧子大。每服六七十丸，五更初未言语前，或空心用盐汤送下。
补中益气汤 治元气虚损，或因克伐，恶寒发热、肢体
倦怠、饮食少思、或不能起发消散、生肌收敛、或兼饮食劳倦、头疼身热、烦躁作渴、脉洪大弦虚、
或微细软弱。
黄 （蜜炙） 人参 白术（去芦） 甘草（炙用一钱五分） 当归（一钱） 陈皮（五分）
升麻 柴胡（三分）
上锉一剂，姜枣煎服。
四君子汤 治脾胃虚弱，或因克伐，肿痛消散，溃敛不能，宜用此以补脾胃，诸症自愈。
若误用攻毒，七恶随至，脾胃虚弱，疮口出血、吐血便血，尤宜用之，益气能摄血故
也。凡气血俱虚之症，宜此汤但加当归。脾胃既壮，饮食自进，阴血自生。若用四物汤沉阴之剂，
脾胃复伤，诸症蜂起。若命门火衰而脾胃虚寒，必用八味丸以补土母。
人参 白术（去芦） 茯苓（各二钱） 甘草（炙，一钱）
上锉一剂，姜枣水煎服。
六君子汤 治脾胃虚弱，或寒凉克伐，肿痛不消，或不溃敛，宜服此汤，以壮荣气，诸症自愈。
即四君子汤加陈皮、半夏。
八珍汤 治脾胃虚损，恶寒发热、烦躁作渴，或疮疡溃后，气血亏损，脓水清稀，久不能愈。
即四物、四君子合方。
十全大补汤 治疮疡气血虚弱，肿痛不愈，或溃疡脓消，寒热、自汗盗汗、食少体倦、发热作渴、
头痛眩晕似中风状。即八珍汤加黄 、肉桂。
托里温中汤 治疮疡脓溃，元气虚寒，或因克伐，胃气脱陷，肠鸣腹痛、大便溏泄、神思昏愦，
此寒变内陷，缓则不治。
羌活 附子（炮去皮脐。各四钱） 干姜（炒） 益智 丁香 沉香 木香 茴香
陈皮（各二钱） 甘草（炙，三钱）
上锉，姜水煎服。
人参黄 汤 治溃疡饮食少思、无睡发热。
人参 白术 陈皮 麦门冬 苍术（米泔浸，各五分） 黄 （一钱） 归身 升麻（各五分）
黄柏（炒，四分）
上锉，水煎服。
竹叶黄 汤 治痈疽气血虚、胃火盛而作渴。
淡竹叶（一钱） 芍药 麦门冬 半夏 川芎 黄 （炒） 人参 当归 甘草 石膏 生地黄（各二钱。）
上锉作二剂，水煎服。
人参平肺散 治心火克肺，传为疽痿，咳嗽喘呕、痰涎壅盛、胸膈痞满、咽嗌不利；若因肺火太过，
而治当补肺；若因肾水不足而患，当补脾肺；若因心火旺而自病，当利小便。
人参 茯苓 陈皮 地骨皮 甘草（各一钱） 知母（炒，七分） 五味子 青皮 天门冬
（去心。各四分） 桑白皮（炒，一钱）
上锉一剂，水煎服。
一痈疽发背、诸疮出脓溃烂，日久不愈，饮食少思、身体倦怠、口舌干燥、或寒热往来、惊怖少睡，
用补中益气汤去柴胡，加苍术、麦门冬、神曲、五味子、黄柏；少睡加炒酸枣仁；疮肉生迟，加白蔹一钱、
肉桂五分；如脓多或清，倍加黄 、人参、当归、白术。
外治敷贴之药
琥珀膏 治痈疽发背、诸般肿毒、久年顽疮。
香油四两，下沉香一钱，炸浮待油熟去之，次下嫩松香八两，文武火不住手搅，如琥珀色住火，下乳香、
没药、银朱、血竭各一钱为末，搅入膏内，令匀，退火毒，用油纸摊贴神效。
白龙膏 治背疽及糜疮皆效。
香油四两，煎数沸，入官粉一两研细，次入黄蜡一两熔化，搅匀退火，待药将皱面，用浓连四纸剪
大小下一拖药在上收候。若贴时，先将葱须煎汤洗净贴之。
治发背 官粉不拘多少，研细，用槐枝大梃锉碎，拌炒官粉，黄色去槐枝。每粉一两，入银朱
一钱研匀，用猪蜡油调，摊膏棉纸上贴之。
一、疮疡肌肉不生。若赤色而不生者，血热也，四物汤加牡丹皮；若脓水清稀，气血俱虚也，十全
大补汤；食少体倦，脾气虚也，补中益气汤；烦热作渴，起居如常，胃火也，竹叶黄 汤；烦热作渴，
日晡热甚，肾虚也，用加减八味丸。
(If it is qi deficiency fever, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). If Heart fire attacks Lung metal, use Renshen Pingfei San (Ginseng Powder to Calm the Lung). If Yin fire damages the Lung, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Wuweizi.)
If the shoulder and back are stiff and difficult to move, and the four limbs feel heavy, this indicates Spleen and Kidney deficiency, which belongs to the "Five Evils" (Wu E). (Use Buzhong Yiqi Tang plus Shanzhuyu (Corni Fructus), Shanyao (Dioscoreae Rhizoma), and Wuweizi. If ineffective, use Shiquan Dabu Tang (Decoction for Complete Great Tonification) plus Shanzhuyu, Shanyao, and Wuweizi.)
If one cannot eat, vomits after taking medicine, and food tastes bland, this indicates weak Stomach qi, which belongs to the "Six Evils". (Use Liujunzi Tang (Six Gentlemen Decoction) plus Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus). If ineffective, urgently add Fuzi (Aconiti Lateralis Radix Praeparata).)
If the voice is hoarse, complexion is sallow and ruined, lips and nose are cyanotic or red, and the face, eyes, and four limbs are edematous, this indicates simultaneous deficiency of the Spleen and Lung, which belongs to the "Seven Evils". (Use Buzhong Yiqi Tang plus Dazao (Jujubae Fructus) and Shengjiang (Zingiberis Rhizoma Recens). If ineffective, use Liujunzi Tang plus Paojiang (Zingiberis Rhizoma Praeparatum). If still ineffective, urgently add Fuzi, or use Shiquan Dabu Tang plus Fuzi and Paojiang.)
If there is abdominal pain with diarrhea, cough with counterflow qi, and mental confusion, this is an evil syndrome caused by yang qi deficiency and internal invasion of cold pathogens. (Urgently use Tuoli Wenzhong Tang (Interior-Tonifying and Middle-Warming Decoction), followed by Liujunzi Tang plus Fuzi, or add Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) for warming tonification.)
If after ulceration there is fever, aversion to cold with thirst, palpitations and fright, irregular sleep, trismus, red and painful head and eyes, spontaneous sweating and night sweats, rigors with teeth grinding, flaccid hands with body heat, a surging pulse that feels empty upon pressure; or body heat with aversion to clothing, desire to throw oneself into water, a floating and large pulse that feels minute and fine upon pressure, and feeling cold even under thick clothes, this is an evil syndrome resulting from extreme qi deficiency and transformation.
If the hands and feet are cold, there is abdominal pain, dysentery with borborygmus, inability to take food, hiccups and vomiting, this is an evil syndrome caused by yang qi deficiency and multiplication of cold pathogens.
If there is sweating with aversion to cold, or no sweating with aversion to cold, trismus with cold feet, opisthotonos, and stiffness of the neck and head, this is an evil syndrome where blood and qi are extremely deficient, transforming into spasm. (Urgently treat with Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi; survival is occasionally possible.)
Generally, if three of the "Five Good" signs appear, it is auspicious; if four of the "Seven Evil" signs appear, it is critical. Cases with deficiency presenting evil signs are difficult to treat, while cases with excess without evil signs are easy to treat.
Liuwei Wan (also known as Liuwei Dihuang Wan / Six-Ingredient Pill with Rehmannia) is a formula to nourish water (Kidney yin). Human life depends primarily on the Kidney. Most diseases arise from Kidney deficiency. This formula corresponds to the principle of "Heaven generates Water," and is applicable in almost all cases, though rarely understood by the world. It is especially indicated for symptoms such as fever and thirst due to Kidney deficiency, stranguria, phlegm-qih obstruction, cough with hemoptysis, dizziness, scanty urine, blurred vision, deafness, dry throat, mouth heat with ulcers, loose teeth, soreness and weakness of the waist and legs, simultaneous damage of the five Zang organs, and Liver channel insufficiency, because water generates wood. It is also a holy medicine for phlegm generated by water overflowing, and a divine agent for fever due to blood deficiency, manifesting as fever, spontaneous/night sweats, hematochezia/hematuria, and aphonia.
Shudihuang (Prepared Rehmanniae Radix, made from raw material, 8 liang), Shanzhuyu (Corni Fructus, soaked in wine, flesh selected), Shanyao (Dioscoreae Rhizoma, 4 liang each), Baifuling (Poria cum Ramis et Mycelium, peeled), Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma, 3 liang each).
Steam the Shudihuang in yellow rice wine until black, pound into a paste. Grind the remaining herbs into powder. Mix with refined honey to make pills the size of wutong seeds. Take 70–80 pills per dose with boiling water.
Bawei Wan (Eight-Ingredient Pill) treats failure of the Mingmen fire to generate Earth, leading to Spleen Earth deficiency and cold, resulting in conditions like liuzhu (flowing deposits) and hexikufeng (crane knee wind), where ulcers cannot resolve or close. It also treats poor appetite, indigestion, umbilical and abdominal pain, and frequent nocturia. It consists of Liuwei Wan plus Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata), 1 liang each. The Classics state: "Augment the source of fire to eliminate yin shadows," referring to this formula.
Jiajian Bawei Wan (Modified Eight-Ingredient Pill) treats post-recovery or impending recovery from carbuncles and sores, characterized by severe dry mouth and thirst, yellow tongue coating, or thirst preceding the illness. This indicates Kidney water failing to moisten upward, causing Heart fire to flare up, preventing the harmonious interaction of water and fire. Symptoms include irritability, frequent and difficult urination, leukorrhea or impotence, reduced diet, and emaciation. Taking this pill generates Kidney water and descends Heart fire, stopping symptoms instantly. It also treats persistent oral ulcers.
Shanyao (1 liang), Shanzhuyu (flesh selected, pips removed, soaked in wine, pounded into paste), Guixin (Cinnamomi Cortex, bark removed), Zexie, Baifuling (peeled, 5 qian each), Wuweizi (2.5 liang), Mudanpi (5 qian), Shudihuang (raw half jin, mixed with wine, steamed in clay pot for half a day, pounded into paste).
Grind into powder. Add the paste and a little honey to form pills the size of wutong seeds. Take 60–70 pills at dawn before speaking, or on an empty stomach with salted water.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) treats yuanqi (original qi) deficiency or damage from purgatives, manifesting as aversion to cold and fever, limb fatigue, poor appetite, inability to raise qi or dissipate swelling, promote granulation, or close ulcers. It also treats complications from diet and overwork, headache, body heat, irritability, thirst, surging/wiry/empty pulses, or minute/weak pulses.
Huangqi (honey-fried), Renshen, Baizhu (rhizome tips removed), Gancao (roasted, 1.5 qian), Danggui (1 qian), Chenpi (Citri Reticulatae Pericarpium, 0.5 qian), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix, 0.3 qian).
Cut into pieces for one dose. Decoct with Shengjiang and Dazao.
Sijunzi Tang (Four Gentlemen Decoction) treats Spleen and Stomach deficiency or damage from purgatives, where swelling and pain have subsided but ulcers fail to heal. Use this to tonify the Spleen and Stomach, allowing symptoms to resolve spontaneously. If toxic-clearing agents are mistakenly used, the Seven Evils may follow. In cases of Spleen/Stomach deficiency with bleeding from ulcers, hematemesis, or hematochezia, this is particularly suitable because tonifying qi controls bleeding. For combined qi and blood deficiency, add Danggui to this decoction. Once the Spleen and Stomach are strong, appetite improves, and yin blood generates naturally. Using Siwu Tang (Four Substances Decoction), a heavy yin formula, would further injure the Spleen and Stomach, causing myriad symptoms. If Mingmen fire is deficient with Spleen/Stomach cold, Bawei Wan must be used to tonify the mother of Earth.
Renshen, Baizhu (rhizome tips removed), Fuling (Poria, 2 qian each), Gancao (roasted, 1 qian).
Cut into pieces for one dose. Decoct with Shengjiang and Dazao in water.
Liujunzi Tang (Six Gentlemen Decoction) treats Spleen and Stomach deficiency or damage from cold/purgative agents, where swelling and pain do not subside or ulcers do not heal. Take this to strengthen Ying qi (nutritive qi), allowing symptoms to resolve. It is Sijunzi Tang plus Chenpi and Banxia (Pinelliae Rhizoma).
Shenzhen Tang (Eight Treasures Decoction) treats Spleen and Stomach damage with aversion to cold and fever, irritability and thirst, or post-ulceration qi and blood deficiency with thin pus and chronic non-healing. It combines Siwu Tang and Sijunzi Tang.
Shiquan Dabu Tang (Complete Great Tonification Decoction) treats qi and blood deficiency in sores, with persistent swelling and pain, or post-ulceration resolution of pus with chills, fever, spontaneous/night sweats, poor appetite, fatigue, fever with thirst, and headache/dizziness resembling stroke. It is Shenzhen Tang plus Huangqi and Rougui.
Tuoli Wenzhong Tang (Interior-Tonifying and Middle-Warming Decoction) treats post-ulceration with yuanqi deficiency and cold, or damage from purgatives leading to Stomach qi collapse. Symptoms include borborygmus, abdominal pain, loose stools, and mental confusion. This is cold transformation sinking inward; if delayed, it is untreatable.
Qianghuo (Notopterygii Rhizoma et Radix), Fuzi (prepared, skin and脐 removed, 4 qian each), Ganjiang (Zingiberis Rhizoma, stir-fried), Yizhi (Alpiniae Oxymataria Fructus), Dingxiang (Caryophylli Flos), Chenxiang (Aquilariae Lignum Resinatum), Muxiang (Aucklandiae Radix), Huixiang (Foeniculi Fructus), Chenpi (2 qian each), Gancao (roasted, 3 qian).
Cut into pieces. Decoct with Shengjiang in water.
Renshen Huangqi Tang (Ginseng and Astragalus Decoction) treats poor appetite and insomnia with fever after ulceration.
Renshen, Baizhu, Chenpi, Maidong, Cangzhu (soaked in rice wash water, 0.5 qian each), Huangqi (1 qian), Danggui shen (root part), Shengma (0.5 qian each), Huangbai (Phellodendri Cortex, stir-fried, 0.4 qian).
Cut into pieces. Decoct in water.
Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction) treats qi and blood deficiency with excessive Stomach fire causing thirst in carbuncles and sores.
Dan Zhuye (Bambusae Folium, 1 qian), Shaoyao (Paeoniae Radix), Maidong, Banxia, Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqi (stir-fried), Renshen, Danggui, Gancao, Shigypsum (Gypsum Fibrosum), Shengdihuang (Rehmanniae Radix, 2 qian each).
Cut into two doses. Decoct in water.
Renshen Pingfei San (Ginseng Powder to Calm the Lung) treats Heart fire attacking the Lung, transmitting to carbuncle and atrophy, with cough, wheezing, vomiting, copious phlegm, chest fullness, and difficulty in the throat. If caused by excessive Lung fire, tonify the Lung. If caused by insufficient Kidney water, tonify Spleen and Lung. If caused by hyperactive Heart fire, promote urination.
Renshen, Fuling, Chenpi, Digupi (Lycii Cortex), Gancao (1 qian each), Zhimu (Anemarrhenae Rhizoma, stir-fried, 0.7 qian), Wuweizi, Qingpi (Citri Reticulatae Pericarpium Viride), Tiantong (Asparagi Radix, heart removed, 0.4 qian each), Sangbaipi (Mori Cortex, stir-fried, 1 qian).
Cut into one dose. Decoct in water.
For carbuncles on the back and other sores with pus and ulceration that do not heal for a long time, with poor appetite, body fatigue, dry mouth and tongue, alternating chills and fever, fear, and insomnia, use Buzhong Yiqi Tang minus Chaihu, plus Cangzhu, Maidong, Shenqu (Medicated Leaven), Wuweizi, and Huangbai. For insomnia, add Chao Suanzaoren (Ziziphi Spinosae Semen, stir-fried). For slow granulation, add Bailian (Bletillae Rhizoma, 1 qian) and Rougui (0.5 fen). If pus is abundant or thin, double the dosage of Huangqi, Renshen, Danggui, and Baizhu.
External Application Medicines
Hupo Gao (Amber Ointment) treats carbuncles on the back, various swellings, and chronic stubborn sores.
Take 4 liang of Sesame Oil, add 1 qian of Chenxiang, fry until floating, remove when oil is hot. Then add 8 liang of fresh Pine Rosin, stir continuously over moderate heat until amber-colored, then remove from fire. Add powdered Xurxiang (Boswelliae Resina), Moyao (Commiphora Resina), Yinzhu (Cinnabar), and Xuexie (Dracaenae Sanguis, 1 qian each), mix into the ointment evenly, let cool to reduce fire toxicity, spread on oiled paper, and apply with miraculous effect.
Bailong Gao (White Dragon Ointment) is effective for back carbuncles and eroding sores.
Boil 4 liang of Sesame Oil, add 1 liang of finely ground Guanfen (Lead Carbonate), then melt 1 liang of Huangla (Yellow Beeswax), stir evenly to cool. When the mixture wrinkles, pour onto thick Liansi paper cut to size. Before application, wash the area with Scallion Root decoction.
Treatment for Back Carbuncle: Use any amount of Guanfen, grind finely. Crush large Huai branch (Sophorae Tonkinensis Ramulus), stir-fry with Guanfen until yellow, remove branches. For every 1 liang of powder, add 1 qian of Yinzhu, grind evenly, mix with Pig Wax Oil, spread on cotton paper, and apply.
Regarding sores where muscle does not regenerate: If red and not healing, it is Blood Heat; use Siwu Tang plus Mudanpi. If pus is thin, it is combined Qi and Blood deficiency; use Shiquan Dabu Tang. If poor appetite and fatigue, it is Spleen Qi deficiency; use Buzhong Yiqi Tang. If irritability, heat, thirst, but normal daily routine, it is Stomach Fire; use Zhuye Huangqi Tang. If irritability, heat, thirst, worse in the afternoon, it is Kidney deficiency; use Jiajian Bawei Wan.