杨（十九） 疮痍四肢偏多。长夏入秋。懒倦欲眠。干咳无痰。颇知味。听纳已少。此阳明胃阴。因热致耗。
即热伤元气之征。当与甘药。养胃阴以供肺。如金匮麦门冬汤去半夏加黄 皮。（疮）
吴（十八） 脉不浮大。非关外风。初起右掌二指。已不屈伸。头面身半以上。常有疮泡之形。此乃阳明脉络。内
留湿热。若非疠气吸入。定然食物中毒。姑与宣解缓攻。
连翘 犀角 赤芍 酒煨大黄 荆芥 片姜黄
又 能食。二便通调。脏腑无病。初因脓疮。疮愈有泡。自面及肢体。至于右指掌屈伸皆痛。为脉络留邪。以致隧
道为壅。前方辛凉入血。先开后降。已得小效。今制清脉络壅热。藉酒力以引导。通复营卫。亦一法也。
银花 连翘 犀角 生大黄 荆芥 丹皮 黄芩 川芎 当归 泽兰 羚羊角 大豆黄卷
用无灰酒十斤浸。
金（四六） 血舍空隙。内风蠕动。外以热汤先洗。湿热蒸袭肌窍。遂有裂脓流水。况周身渐加麻痹。阳脉亦衰。
图治之法。清营以熄内风。疏利湿热以肃隧道。辛辣腥鲜勿进。尚可缓以计功。
制首乌 鲜生地 柏子仁 川斛 黑 豆皮 虎骨 蚕砂 黄柏 萆 熬膏。
吴 疮痍之后。湿热未去。壅阻隧道。水谷下咽。亦化为痰。中焦受病。故不知饥饿。痰气上干。渐
至喘闷矣。但服药四十剂。纯是破气消克。胃阳受伤。痰气愈不得去矣。
半夏 茯苓 紫老姜 炒粳米
又 疮痍大发。营卫行动于脉中脉外。可免腹满之累矣。第谷食尚未安适。犹是苦劣多进之
故。胃阳未复。仍以通调利湿主之。
半夏 苡仁 金石斛 茯苓 泽泻
秦（十七） 久热疮痍五六年。环口燥裂。溺涩茎痛。
鲜生地 熟首乌 丹皮 丹参 茺蔚子 银花 地丁 紫草 共熬膏。
王 血热风动。肤痒。
荆芥 防风 地肤子 赤芍 银花 小生地 木通 甘草
张（三四） 初因呕吐。是肝胃不和致病。故辛香刚燥愈剧。然久病。必入血络。热则久疮不愈矣。夫木
火皆令燥液。易饥易饱。间有呕逆。斯胃病仍在。凡呆滞药味。皆非对症。
三角胡麻 冬桑叶 生首乌 杏仁 郁金 佩兰叶 茯苓 苡仁 熬自然膏。
杨（十五） 身瘦久疮。血分有热。精通之年。最宜安养。脉象非有病。
生首乌（三两） 三角胡麻（一两五钱捣碎水洗） 细生地（四两） 地骨皮（二两） 金银花（二两）
丹皮（二两） 生白芍（二两） 生甘草（一两） 蜜丸。早服。
王（三九） 脉来濡浮。久疮变幻未罢。是卫阳疏豁。不耐寒暄。初受客邪不解。混处气血。浸淫仅在阳
分。肌腠之患。议升举一法。气壮斯风湿尽驱。
人参 生黄 川芎 当归 防风 僵蚕 蝉蜕 炙草 生姜 大枣
蒋（四岁） 鼻疮口疮。尿黄肤热。
冬瓜皮 苡仁
邹（四三） 痰因于湿。久而变热。壅于经隧。变现疮疾疥癣。己酿风湿之毒。混在气血之中。邪正混处。
搜逐难驱。四肢为甚。姑从阳明升降法。
连翘 赤芍 白僵蚕 白藓皮 防风 升麻 滑石 酒浸大黄
汪（氏） 风热既久未解。化成疮痍。当以和血驱风。
当归 赤芍 川芎 夏枯草花 牛蒡子 制僵蚕
金 头巅热疖。未能泄邪。此身热皆成脓之象。辛凉兼理气血可愈。（疖）
连翘 犀角 银花 丹皮 元参 生甘草 青菊叶
某 风热毒闭。项后肿。（风热项肿）
竹叶 滑石 芦根 牛蒡 马勃 薄荷叶 黑山栀 连翘 川贝 生甘草
王 疔毒咯血失血。都是暑入阴伤。（疔）
竹叶心 元参心 鲜生地 黑 豆皮 麦冬 知母
屠（三四） 秋痢。半年未愈。瘰坚硬痛。疡脓。郁久成热。腑经病。可冀其愈。（瘰 痰核）
夏枯草 香附 茯苓 苡仁 川贝 丹皮
糜（氏） 颈项结核。腹膨足肿。肝木犯中。痰气凝滞。
夏枯草（三两） 牡蛎（二两） 泽泻（一两半） 茯苓（二两） 半夏（炒二两） 浓朴（一两半）
橘红（一两） 神曲（一两半）
生香附一两。水磨汁泛丸。
某 气郁痰核。
夏枯草 生香附 丹皮 山栀 连翘 郁金 赤芍 橘红
王（十四） 脉左数右长。颈项结瘿。时衄。（瘿）
生地（三两） 丹皮（一两半） 犀角（二两） 生夏枯草（一两半） 生钩藤（一两半） 黑山
栀（二两） 土贝母（二两） 生薄荷（五钱）
陈 躁急善怒。气火结瘿。烁筋为痛。热郁化风。气阻痹塞。则腹鸣脘胀。苟非开怀欢畅。不能向安。
土贝母 山栀 栝蒌皮 郁金 白芥子 海藻 昆布 夏枯草
沈（氏） 肝气郁遏。宿痞乳痈。（乳）
川楝子 夏枯草 薄荷梗 丹皮 黑山栀 栝蒌实 青橘叶 香附汁
刘（氏） 乳房为少阳脉络经行之所。此经气血皆少。由情怀失畅。而气血郁痹。有形而痛。当治在
络。恐年岁日加。竟成沉痼。非痈脓之症。以脉不浮数。无寒热辨之。
柴胡 夏枯草 归身 白芍 川贝 茯苓 甘草
某（氏） 乳房结核。是少阳之结。此经络气血皆薄。攻之非易。恐产育有年。酿为疡症耳。
青蒿 香附 橘叶 青菊叶 丹皮 泽兰 郁金 当归须
孙 因嗔忿失血以来。致颈项左右筋肿。痛连背部。此属郁伤气血。经脉流行失司。已经百日
不痊。竟有流注溃脓延绵之忧。治在少阳阳明。（流注）
小生香附 夏枯草 鲜菊叶 薄荷梗 黑山栀 钩藤 丹皮 郁金
陈 脉左数实。血络有热。暑风湿气外加。遂发疹块。壅肿瘙痒。是属暑疡。（暑疡）
杏仁 连翘 滑石 寒水石 银花 晚蚕砂 黄柏 防己
程 疡毒热症。与参 不效。即当清解为是。消导亦是未合。今者身热正晡。神识欲昏。便溏溺
赤烦渴。是暑气攻入。内侵肺胃。有痉厥之变。昨用宣肺解毒。虽与暑邪无益。然亦无害若加
黄。又属相反。大凡热气蒙闭清窍。都令神昏。当以牛黄清心丸。清痰气之阻。使其窍开。况
暑门中大有是法。与解毒勿悖矣。
李（六四） 初病湿热在经。久则瘀热入络。脓疡日多未已。渐至筋骨热痛。金匮云。经热则痹。络热则
痿。数年宿病。勿事速攻（疡）。
犀角 连翘心 元参 丹参 野赤豆皮 细生地 姜黄 桑枝 午服 夜服蒺藜丸。
某（三七） 疮疡。服凉药。阳伤气阻。脘闷不运。腹膨。最怕疡毒内闭。急宜通阳。
浓朴 广皮 姜皮 茯苓皮 连皮杏仁 桂枝木 泽泻 大腹皮
某 服疡科寒凝之药。以致气冲作胀。喘急不卧。无非浊阴上攻。议来复丹。
顾（五八） 脉微小。溃疡半月。余肿未消。脓水清稀。浮肿汗出。呕恶恶食。此胃阳垂败。痈毒内攻欲脱。
夫阳失煦。则阴液不承元气撒。则毒愈弥漫。清解苦寒究竟斫伐生阳。议甘温胃受。培植其
本。冀陷者复振。余非疡医。按色脉以推其理耳。加桂理中汤。（溃疡）
姚（妪） 溃疡久不靥。气血耗尽。中宫营液枯涸。气不旋转。得汤饮则痰涎上涌。势如噎膈。况久恙
若是。药饵难挽。勉拟方。
人参 炒麦冬 代赭石 化橘红
胡 纳食主胃。运化主脾。痈疡痛溃。卧床不得舒展。脏腑气机呆钝何疑。外科守定成方 术
归地。不能补托气血。反壅滞于里。出纳之权交失。且是症乃水谷湿气下垂而致。结于足厥
阴手阳明之界。若湿热不为尽驱。藉补托以冀生机。养贼贻害。焉能济事。
金石斛（五钱） 槐米（一钱半） 金银花（三钱） 茯苓（一钱半） 晚蚕砂（二钱） 寒水石（二钱）
徐 营伤心辣。纳食无味。此伤痛大虚。当调其中。
人参 归身 炒白芍 木瓜 熟术 广皮 茯神 炙草
某 脓血去多。痛犹未息。胃伤不嗜谷。口无味左关尺细弱无力。正虚之着。据理进药。仍宜补
托。
人参 熟地 玉竹 柏子仁 归身 丹参 茯神 枣仁 远志
某 疡溃脓血去多。元真大耗。脉无力不嗜食。恶心。中州不振。寐则惊惕。神不守也。以养营法。
人参 熟术 广皮 茯神 炙草 归身 白芍 五味 枣仁
某（八岁） 疡损。能食身热。六味汤加青蒿节。
曹（三四） 因疡漏。过进寒凉。遂患腰痛。牵引脊膂。今晨起。周身不得自如。乃经脉络脉之中。气血流
行失畅。久病谅非攻逐。议两和方法。（疡漏）
羚羊角 当归 黄 白蒺藜 桂枝 桑枝
顾 溃疡不合成漏。脂液渗去。必阳络空隙。内风暗动。攻胃。则呕逆吞酸。腹痛泄泻不食。津液
不升。舌焦黑。不渴饮。内外兼病。难治之症。
人参（一钱同煎） 炒乌梅肉（五分） 炒黑川椒（三分） 茯苓（三钱） 生淡姜（五分） 炒广皮（一钱）
白芍（一钱半）
顾 久损漏疡。胃减腹痛。议用戊己汤意。
人参 茯神 白芍 炙草 炒菟丝子
王（四五） 痛久。屈伸不得自如。经脉络脉呆钝。气痹血瘀。郁蒸上热。旬日频频大便。必有血下。复喘
促烦躁。不饥不食。并无寒热汗出。全是锢结在里。欲作内痈之象。部位脐左之上。内应乎肝。
痈者。壅也血结必入于络。吐痰口气皆臭。内痈已见一班矣。（肝痈）
炒桃仁 新绛 降香末 野郁金汁 紫菀 冬瓜子 金银花
某 脐旁紫黑。先厥后热。少腹痛如刀刮。二便皆涩。两足筋缩。有肠痈之虑。（肠痈）
老韭白 两头尖 小茴香 当归须 炙山甲
某 舌焦黄。小腹坚满。小便不利。两足皆痿。湿热结聚。六腑不通。有肠痈之虑。
川楝子 小茴 丹皮 山栀 通草 青葱
某 壮热旬日。周身筋脉牵掣。少腹坚硬。小便淋滴。忽冷忽热。欲酿脓血。乃肠痈为病。仿孙真
人牡丹皮大黄汤主之。
戴（十九） 痔疮下血。湿热居多。今色衰微。显是虚寒。无速效法则。当补脾胃。因痔疮犹痛。肿势尚存。
佐以淡渗通腑。（痔）
生于术 生菟丝粉 生象牙末 生白蜡
外症本有专科。先生并非疡医。然观其凭理立方。已胜专科什伯矣。惜其案无多。法亦
未备。余不叙述。大凡疡症虽发于表。而病根则在于里。能明阴阳虚实寒热。经络俞穴。大
症化小。小症化无。善于消散者。此为上工。其次能审明五善七恶。循理用药。其刀针砭割。
手法灵活。敷贴熏洗。悉遵古方。虽溃易敛。此为中工。更有不察症之阴阳虚实。及因郁则
营卫不和。致气血凝涩。酿成疡症。但知概用苦寒攻逐。名为清火消毒。实则败胃戕生迨
至胃气一败。则变症蜂起矣。又有藉称以毒攻毒秘方。类取毒药。合就丹丸。随症乱投。希
冀取效于目前。罔顾贻祸于后日。及问其经络部位。症之顺逆。概属茫然。此殆下工之不
如也。至于外治之法。疡科尤当究心。若其人好学深思。博闻广记。随在留心。一有所闻。即
笔之于书。更能博览医籍。搜采古法。海上实有单方。家传岂无神秘。其所制敷贴膏丹。俱
临症历试百治百验。能随手应效者。即上工遇之。亦当为之逊一筹矣。（华玉堂）
徐评 凡治病必有专家。一切丸散外治等法。一有不备。即不能建愈功。理虽同而法各别。如
欲治外症。不可不另有一番功夫也。
Yang (19 years old): There are many sores on the four limbs. It is the time from late summer to early autumn. He feels lazy, fatigued, and sleepy. He has a dry cough without phlegm, but his sense of taste is still good, while his appetite has decreased. This indicates that the Yin of the Yangming Stomach has been consumed by heat, which is also a sign of Qi damage caused by heat. One should administer sweet medicines to nourish Stomach Yin to support the Lungs, such as Maidong Tang (Ophiopogon Decoction) from *Jin Gui Yao Lue*, removing Banxia (Pinellia Rhizome) and adding Huangpi (Citrus Peel). (Sore)
Wu (18 years old): The pulse is not floating and large; this is not related to external wind. Initially, two fingers on the right palm could not flex or extend. The head, face, and upper half of the body often had the appearance of pustules. This is due to damp-heat retained within the Yangming meridians. If it was not inhalation of pestilential qi, it must be food poisoning. Temporarily use methods to diffuse and resolve, with mild purgation.
Qiaqiao (Forsythiae Fructum), Xijiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Chishao (Red Peony Root), Jiuwei Dahuang (Rhizoma Rhei Prepared with Wine), Jingjie (Schizonepetae Herba), Pian Jianghuang (Curcumae Radix Sliced).
Second visit: The patient can eat, and bowel and bladder movements are smooth; the zang-fu organs have no major disease. Initially, due to suppurative sores, after healing, blisters appeared, spreading from the face to the limbs, causing pain upon flexion and extension of the right hand and palm. This is because pathogenic factors remained in the collaterals, causing blockage in the channels. The previous prescription used acrid-cool herbs entering the blood level, first opening then descending, achieving slight effect. Now, formulate a prescription to clear heat and unblock collateral stasis, using wine as a guide to regulate Ying and Wei. This is another method.
Yinhua (Lonicerae Japonicae Flos), Qiaqiao (Forsythiae Fructum), Xijiao (Rhinoceros Horn), Sheng Dahuang (Raw Rhizoma Rhei), Jingjie (Schizonepetae Herba), Danpi (Moutan Cortex), Huangqin (Scutellariae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Zelan (Leonuri Herba), Lingyangjiao (Antelope Horn), Dadou Huangjuan (Sojae Semen Praeparatum).
Soak in ten jin of pure wine.
Jin (46 years old): Blood resides in the interstices; internal wind trembles. First wash externally with hot water. Damp-heat steams and attacks the skin pores, leading to fissures, suppuration, and fluid discharge. Moreover, general paralysis is gradually worsening, and the Yang pulses are declining.
The treatment strategy is to clear the Ying level to extinguish internal wind, and to disperse and drain damp-heat to cleanse the meridians. Avoid spicy, pungent, fishy, and fresh foods. Recovery can be expected slowly over time.
Zhi Shouwu (Prepared Polygoni Multiflori Radix), Xian Shengdi (Fresh Rehmanniae Radix), Baizi Ren (Biota Seed), Chuan Hu (Dendrobii Caulis), Heidou Pi (Black Soybean Skin), Hugu (Tiger Bone - *Note: Substitute with legal alternatives*), Can Sha (Bombyx Batryticatus), Huangbai (Phellodendri Cortex), Bibi (Dioscoreae Hypoglaucae Rhizoma), decocted into a paste.
Wu: After sores, damp-heat has not cleared, blocking the meridians. Food and drink turn into phlegm upon swallowing. The Middle Jiao is diseased, hence lack of hunger. Phlegm-Qi rises upward, gradually leading to wheezing and oppression. However, taking forty doses of prescriptions solely focused on breaking Qi and reducing accumulation has injured Stomach Yang, making it even harder for phlegm-Qi to dissipate.
Banxia (Pinelliae Rhizoma), Fuling (Poria), Zi Laojiang (Old Ginger), Chao Jingshen (Stir-fried Rice).
Second visit: Sores have erupted significantly; Ying and Wei circulate inside and outside the vessels, avoiding abdominal fullness. However, grain intake is still uncomfortable, likely due to excessive consumption of bitter and harsh foods. Stomach Yang has not recovered; continue with regulating and draining dampness as the main treatment.
Banxia (Pinelliae Rhizoma), Yiren (Coicis Semen), Jin Shihu (Dendrobii Caulis), Fuling (Poria), Zexie (Alismatis Rhizoma).
Qin (17 years old): Chronic fever and sores for five or six years. Dryness and cracking around the mouth. Dysuria and penile pain.
Xian Shengdi (Fresh Rehmanniae Radix), Shu Shouwu (Prepared Polygoni Multiflori Radix), Danpi (Moutan Cortex), Danshen (Salviae Miltiorrhizae Radix), Chongwezi (Leonuri Fructus), Yinhua (Lonicerae Japonicae Flos), Diding (Violaris Herba), Zicao (Arnebiae Radix et Rhizoma), decocted together into a paste.
Wang: Heat in the blood stirring wind causes skin itching.
Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Difuzi (Kochiae Fructus), Chishao (Red Peony Root), Yinhua (Lonicerae Japonicae Flos), Xiao Shengdi (Young Rehmanniae Radix), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma).
Zhang (34 years old): Initially vomiting indicates Liver-Stomach disharmony causing the disease. Therefore, acrid-aromatic and drying drugs worsen the condition. However, chronic diseases enter the blood collaterals. Heat causes chronic sores to fail to heal. Wood and Fire both dry up fluids, leading to alternating hunger and satiety, with occasional retching, indicating the Stomach disease persists. Any cloying or stagnant herbs are inappropriate.
Sanjiao Huma (Sesamum indicum seed with triangular shape), Dong Sangye (Mulberry Leaf), Sheng Shouwu (Raw Polygoni Multiflori Radix), Xingren (Prunus Armeniaca Seed), Yujin (Curcumae Radix), Peilan (Eupatorii Herba), Fuling (Poria), Yiren (Coicis Semen), decocted into natural paste.
Yang (15 years old): Emaciated body with chronic sores; Heat in the Blood level. At the age of prime vitality, peace and nourishment are most suitable. The pulse shows no serious illness.
Sheng Shouwu (Raw Polygoni Multiflori Radix, 3 liang), Sanjiao Huma (1.5 liang, crushed and washed with water), Xi Shengdi (Fine Fresh Rehmanniae Radix, 4 liang), Digupi (Lycii Cortex, 2 liang), Jinyinhua (Lonicerae Japonicae Flos, 2 liang), Danpi (Moutan Cortex, 2 liang), Sheng Baishao (Raw White Peony Root, 2 liang), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 1 liang). Honey pills. Take in the morning.
Wang (39 years old): Pulse is soft and floating. Chronic sores change and do not cease; this is due to deficient and loose Wei Yang, intolerant to cold and heat. Initial exogenous pathogens remain unresolved, mixing with Qi and Blood, infiltrating only the Yang level. This is a disorder of muscle and interstices. Propose lifting method. When Qi is strong, Wind-Damp is driven away.
Renshen (Ginseng Radix et Rhizoma), Sheng Huang (Raw Astragali Membranacei Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Jiangcan (Bombyx Batryticatus), Chantui (Cicadae Periostracum), Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Shengjiang (Fresh Ginger Rhizome), Dazao (Jujubae Fructus).
Jiang (4 years old): Nasal sores and oral ulcers. Yellow urine and hot skin.
Dongguapi (Winter Melon Peel), Yiren (Coicis Semen).
Zou (43 years old): Phlegm originates from Dampness; prolonged stagnation transforms into Heat, obstructing the meridians, manifesting as sores, scabies, and tinea. Rheumatic-Toxin has already formed, mixing within Qi and Blood. Pathogen and Healthy Qi mix, making it difficult to search out and expel. The four limbs are especially affected. Temporarily follow the Yangming ascending-descending method.
Qiaqiao (Forsythiae Fructum), Chishao (Red Peony Root), Bai Jiangcan (White Bombyx Batryticatus), Baixianpi (Dictamni Cortex), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Huashi (Talcum), Jiu Jin Dahuang (Rhizoma Rhei Steeped in Wine).
Wang (Lady): Wind-Heat lingering for a long time fails to resolve, transforming into sores. Should harmonize Blood and expel Wind.
Danggui (Angelicae Sinensis Radix), Chishao (Red Peony Root), Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiakucao (Prunellae Spica), Niubangzi (Arctii Fructus), Zhi Jiangcan (Processed Bombyx Batryticatus).
Jin: Hot boils on the vertex fail to vent pathogens. The body heat is a sign of pus formation. Acrid-cool combined with regulating Qi and Blood can cure. (Boil)
Qiaqiao (Forsythiae Fructum), Xijiao (Rhinoceros Horn), Yinhua (Lonicerae Japonicae Flos), Danpi (Moutan Cortex), Yuan Shen (Scrophulariae Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Qing Juye (Green Chrysanthemum Leaf).
Certain case: Wind-Heat toxin closure causes swelling behind the neck. (Wind-Heat Neck Swelling)
Zhuye (Bambusae Folium), Huashi (Talcum), Lugeng (Reed Rhizome), Niubang (Arctii Fructus), Mabo (Fly Agaric - *Note: Likely refers to specific herb contextually, possibly Magbo/Polyporus or similar local term, standard translation varies*), Bohe Ye (Menthae Haplocalycis Herba), Hei Shanzhi (Gardeniae Fructus charred), Qiaqiao (Forsythiae Fructum), Chuan Bei (Fritillariae Cirrhosae Bulbus), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma).
Wang: Ding toxin causing hemoptysis and blood loss is due to Summer-Heat invading Yin and damaging fluids. (Ding Toxin)
Zhuye Xin (Bambusae Folium Heart), Yuan Shen Xin (Scrophulariae Radix Heart), Xian Shengdi (Fresh Rehmanniae Radix), Heidou Pi (Black Soybean Skin), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma).
Tu (34 years old): Autumn dysentery, unresolved for half a year. Scrofula is hard and painful, with ulcerated pus. Long-term stagnation generates Heat; this is a Fu-meridian disease. Recovery can be hoped for. (Scrofula / Phlegm Nodule)
Xiakucao (Prunellae Spica), Xiangfu (Cyperi Rhizoma), Fuling (Poria), Yiren (Coicis Semen), Chuan Bei (Fritillariae Cirrhosae Bulbus), Danpi (Moutan Cortex).
Mi (Lady): Cervical lymphadenopathy, abdominal distension, and leg edema. Liver Wood invades the Center; Phlegm-Qi stagnates.
Xiakucao (Prunellae Spica, 3 liang), Muli (Ostreae Concha, 2 liang), Zexie (Alismatis Rhizoma, 1.5 liang), Fuling (Poria, 2 liang), Banxia (Pinelliae Rhizoma stir-fried, 2 liang), Houpo (Magnoliae Officinalis Cortex, 1.5 liang), Juhong (Citri Reticulatae Pericarpium Rubrum, 1 liang), Shenqu (Massa Medicata Fermentata, 1.5 liang).
Sheng Xiangfu (1 liang), ground in water to make pills.
Certain case: Qi stagnation and Phlegm nodules.
Xiakucao (Prunellae Spica), Sheng Xiangfu (Cyperi Rhizoma raw), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Qiaqiao (Forsythiae Fructum), Yujin (Curcumae Radix), Chishao (Red Peony Root), Juhong (Citri Reticulatae Pericarpium Rubrum).
Wang (14 years old): Left pulse rapid, right pulse long. Goiter in the neck, frequent epistaxis. (Goiter)
Shengdi (Rehmanniae Radix, 3 liang), Danpi (Moutan Cortex, 1.5 liang), Xijiao (Rhinoceros Horn, 2 liang), Sheng Xiakucao (Prunellae Spica raw, 1.5 liang), Sheng Gouteng (Uncariae Ramulus cum Uncis raw, 1.5 liang), Hei Shanzhi (Gardeniae Fructus charred, 2 liang), Tu Beimu (Fritillariae Thunbergii Bulbus, 2 liang), Sheng Bohe (Menthae Haplocalycis Herba raw, 5 qian).
Chen: Irritable and prone to anger. Qi-Fire forms goiter, burning sinews causing pain. Heat stagnation transforms into Wind. Qi obstruction causes bi-sensation, abdominal borborygmus, and epigastric distension. Unless one opens the heart and rejoices, peace cannot be achieved.
Tu Beimu (Fritillariae Thunbergii Bulbus), Shanzhi (Gardeniae Fructus), Gualou Pi (Trichosanthis Pericarpium), Yujin (Curcumae Radix), Baijiezi (Sinapis Semen), Haizao (Sargassum), Kunbu (Sargassum pallidum), Xiakucao (Prunellae Spica).
Shen (Lady): Liver Qi depression, chronic mass and breast carbuncle. (Breast)
Chuanlianzi (Toosendan Fructus), Xiakucao (Prunellae Spica), Bohe Geng (Menthae Haplocalycis Herba stem), Danpi (Moutan Cortex), Hei Shanzhi (Gardeniae Fructus charred), Gualou Shi (Trichosanthis Fructus), Qing Juye (Green Tangerinae Exocarpium), Xiangfu Zhi (Cyperi Rhizoma juice).
Liu (Lady): The breasts are where the Shaoyang meridians pass. Qi and Blood in these meridians are scarce. Due to emotional frustration, Qi and Blood become depressed and blocked, forming tangible masses with pain. Treatment should focus on the collaterals. Fear that with advancing age, it will become a chronic stubborn disease. It is not an abscess/pus syndrome, distinguished by the pulse not being floating-rapid and absence of chills/fever.
Chaihu (Bupleuri Radix), Xiakucao (Prunellae Spica), Guishen (Angelicae Sinensis Radix tip), Baishao (White Peony Root), Chuan Bei (Fritillariae Cirrhosae Bulbus), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma).
Certain case (Lady): Breast lymphadenopathy is a Shaoyang knot. Qi and Blood in these collaterals are thin. Attack is difficult. Fear that after years of childbirth, it may develop into a surgical lesion.
Qinghao (Artemisiae Annuae Herba), Xiangfu (Cyperi Rhizoma), Juye (Tangerinae Exocarpium), Qing Juye (Green Chrysanthemum Leaf), Danpi (Moutan Cortex), Zelan (Leonuri Herba), Yujin (Curcumae Radix), Danggui Xu (Angelicae Sinensis Radix tip).
Sun: Since losing blood due to anger, tendons on both sides of the neck have swollen, pain radiating to the back. This belongs to Qi-Blood injury from depression, with loss of regulation in meridian circulation. Unresolved for a hundred days, there is fear of continuous dripping abscesses. Treatment focuses on Shaoyang and Yangming. (Dripping Abscess)
Xiao Sheng Xiangfu (Small Raw Cyperi Rhizoma), Xiakucao (Prunellae Spica), Xian Juye (Fresh Chrysanthemum Leaf), Bohe Geng (Menthae Haplocalycis Herba stem), Hei Shanzhi (Gardeniae Fructus charred), Gouteng (Uncariae Ramulus cum Uncis), Danpi (Moutan Cortex), Yujin (Curcumae Radix).
Chen: Left pulse is rapid and excess. Heat in blood collaterals. External Summer-Heat, Wind, and Dampness cause rash blocks, swelling, and itching. This is Summer-Heat Sores. (Summer-Heat Sores)
Xingren (Prunus Armeniaca Seed), Qiaqiao (Forsythiae Fructum), Huashi (Talcum), Hanshui Shi (Calcitum), Yinhua (Lonicerae Japonicae Flos), Wan Can Sha (Late Silkworm Frass), Huangbai (Phellodendri Cortex), Fangji (Stephaniae Tetrandrae Radix).
Cheng: Surgical toxin heat syndrome. Ren Shen (Ginseng) is ineffective. Clearing and resolving is appropriate. Digestive promotion is also incorrect. Currently, body heat peaks at dusk, consciousness is fading, loose stools, dark urine, irritability, and thirst indicate Summer-Heat attacking inward, invading Lungs and Stomach, with risk of convulsions. Yesterday, lung-releasing and detoxifying herbs were used; although useless against Summer-Heat, they are harmless. Adding Huanglian (Coptidis Rhizoma) would be contradictory. Generally, Heat misting the clear orifices causes coma. Use Niuhuang Qingxin Wan (Calculus Bovis Cardiac Clearing Pill) to clear Phlegm-Qi obstruction and open orifices. Summer-Heat treatments include this method, consistent with detoxification.
Li (64 years old): Initially, Damp-Heat in meridians; long-term, Stagnant-Heat enters collaterals. Suppurative sores increase daily without ceasing, gradually leading to bone and joint heat pain. *Jin Gui* says: Heat in meridians causes Bi; Heat in collaterals causes Wei. Chronic disease for years, do not use rapid attack. (Ulcer)
Xijiao (Rhinoceros Horn), Lianqiao Xin (Forsythiae Fructum Heart), Yuan Shen (Scrophulariae Radix), Danshen (Salviae Miltiorrhizae Radix), Ye Chi Dou Pi (Wild Vigna Seed Coat), Xi Shengdi (Fine Fresh Rehmanniae Radix), Jianghuang (Curcumae Radix), Sangzhi (Mori Ramulus). Take during day; take Jili Wan (Tribulus Pill) at night.
Certain case (37 years old): Sores. Taking cooling drugs injures Yang and blocks Qi. Epigastric oppression and poor movement, abdominal distension. Most feared is internal closure of toxin. Urgently need to unblock Yang.
Houpo (Magnoliae Officinalis Cortex), Guangpi (Tangerinae Exocarpium), Jiangpi (Zingiberis Rhizoma Cum Scama), Fuling Pi (Poria Cum Ligno), Lianpi Xingren (Apricot Seed with skin), Guizhi Mu (Cinnamomi Ramulus), Zexie (Alismatis Rhizoma), Dafupi (Arecae Pericarpium).
Certain case: Taking cold-congealing surgical drugs causes Qi rushing and bloating, panting and inability to lie flat. All turbid Yin attacking upward. Propose Laifu Dan.
Gu (58 years old): Pulse is minute and small. Ulcer for half a month, residual swelling not gone, pus and water clear and thin, edema and sweating, nausea and aversion to food. This is failing Stomach Yang, with toxin attacking inward towards collapse. When Yang loses warmth, Yin fluids do not receive support; when Yuan Qi scatters, toxin spreads more. Bitter-cold clearing ultimately destroys generating Yang. Propose sweet-warm to nourish Stomach, cultivate the root, hoping to lift the collapsed. I am not a surgeon; I deduce principles based on color and pulse. Add Gui Zhi Li Zhong Tang (Cinnamon Twig and Poria Decoction). (Ulcer)
Yao (Old Woman): Ulcer does not heal for a long time; Qi and Blood exhausted, Middle Jiao Nutrient fluids dried up, Qi does not rotate. Drinking soup causes phlegm-saliva surging, resembling dysphagia. Given chronic illness like this, medicine is hard to save. Tentatively prescribe.
Renshen (Ginseng Radix et Rhizoma), Chao Maidong (Stir-fried Ophiopogonis Radix), Daizheshi (Haematitum), Hua Juhong (Transformed Citri Reticulatae Pericarpium Rubrum).
Hu: Ingestion is governed by Stomach, transformation by Spleen. Painful and ulcerated sores, bedridden and unable to stretch, how can organ Qi mechanism not be dull? Surgeons stick to fixed formulas of Atractylodes, Angelica, and Rehmannia, which cannot tonify and support Qi and Blood, instead causing internal stagnation. Control of intake and output is lost. This disease is caused by downward sinking of Grain-Dampness, knotting at the boundary of Foot Jueyin and Hand Yangming. If Damp-Heat is not fully expelled, relying on tonification to hope for life sustains the thief and brings harm, how can it work?
Jin Shihu (Dendrobii Caulis, 5 qian), Huaimi (Sophorae Flavescentis Flos, 1.5 qian), Jinyinhua (Lonicerae Japonicae Flos, 3 qian), Fuling (Poria, 1.5 qian), Wan Can Sha (Late Silkworm Frass, 2 qian), Hanshui Shi (Calcitum, 2 qian).
Xu: Ying damaged, heart burns, ingestion lacks taste. This is severe deficiency from trauma/pain. Should regulate the Middle.
Renshen (Ginseng Radix et Rhizoma), Guishen (Angelicae Sinensis Radix tip), Chao Baishao (Stir-fried White Peony Root), Mugua (Chaenomelis Fructus), Shu Zhu (Prepared Atractylodis Macrocephalae Rhizoma), Guangpi (Tangerinae Exocarpium), Fushen (Poria with Pine Root), Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma).
Certain case: Much pus and blood lost, pain still not ceased. Stomach injured, no desire for grain, mouth lacks taste. Left Guan and Chi pulses are fine, weak, and powerless. This is marked deficiency. According to principle, medication should still tonify and support.
Renshen (Ginseng Radix et Rhizoma), Shudi (Prepared Rehmanniae Radix), Yuzhu (Polygonati Odorati Rhizoma), Baizi Ren (Biota Seed), Guishen (Angelicae Sinensis Radix tip), Danshen (Salviae Miltiorrhizae Radix), Fushen (Poria with Pine Root), Zaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix).
Certain case: Ulcer ruptured, much pus and blood lost, Yuan Zhen greatly depleted. Pulse powerless, no desire to eat, nausea, Middle Jiao不振 (not uplifting), startles during sleep, Spirit does not reside. Use Ying-nourishing method.
Renshen (Ginseng Radix et Rhizoma), Shu Zhu (Prepared Atractylodis Macrocephalae Rhizoma), Guangpi (Tangerinae Exocarpium), Fushen (Poria with Pine Root), Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Guishen (Angelicae Sinensis Radix tip), Baishao (White Peony Root), Wuwei Zi (Schisandrae Chinensis Fructus), Zaoren (Ziziphi Spinosae Semen).
Certain case (8 years old): Ulcer damage, able to eat, body heat. Liuwei Tang (Six-Ingredient Pill) plus Qinghao Jie (Artemisiae Annuae Herba node).
Cao (34 years old): Due to fistula from sore, excessive cold-cooling drugs led to lower back pain, radiating to spine. Waking up this morning, whole body unable to move freely. Qi and Blood circulation in meridians and collaterals is unsmooth. Chronic disease is unlikely to be cured by attack. Propose harmonizing method. (Sore Fistula)
Lingyangjiao (Antelope Horn), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Membranacei Radix), Bai Jili (Tribuli Fructus), Guizhi (Cinnamomi Ramulus), Sangzhi (Mori Ramulus).
Gu: Ulcer does not heal, becomes fistula. Lipid fluids seep away, Yang collaterals must have gaps, internal wind moves secretly. Attacking Stomach causes retching, acid regurgitation, abdominal pain, diarrhea, anorexia. Fluids do not rise, tongue scorched black, no thirst. Internal and external diseases combined, difficult to treat.
Renshen (1 qian, decocted together), Chao Wumei Rou (Stir-fried Mume Fruit Flesh, 5 fen), Chao Hei Chuanjiao (Stir-fried Black Sichuan Pepper, 3 fen), Fuling (Poria, 3 qian), Sheng Danjiang (Raw Light Ginger, 5 fen), Chao Guangpi (Stir-fried Tangerinae Exocarpium, 1 qian), Baishao (White Peony Root, 1.5 qian).
Gu: Long-term damage and fistulous sores, reduced Stomach function, abdominal pain. Propose using Yi Jing Tang intent.
Renshen (Ginseng Radix et Rhizoma), Fushen (Poria with Pine Root), Baishao (White Peony Root), Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Chao Tusizi (Stir-fried Cuscutae Semen).
Wang (45 years old): Pain for a long time, unable to flex and extend freely. Meridians and collaterals are dull, Qi Bi and Blood stasis, depression steaming upward heat. Frequent bowel movements for ten days, likely blood stool. Then panting, irritability, no hunger, no eating, no chills or sweating. All firmly knotted inside, appearing as internal abscess. Location above left umbilicus, internally corresponds to Liver. "Abscess" means blockage; Blood knotting must enter collaterals. Vomiting phlegm and foul breath indicate internal abscess has shown its face. (Liver Abscess)
Chao Taoren (Stir-fried Prunus Persica Seed), Xin Jiang (New Crimson Silk), Jiangxiang Mo (Dalbergiae Odoriferae Lignum Powder), Ye Yujin Zhi (Wild Curcumae Radix Juice), Ziwan (Asteris Radix), Donggua Zi (Benincasae Semen), Jinyinhua (Lonicerae Japonicae Flos).
Certain case: Purple-black beside umbilicus, initial cold followed by heat, lower abdominal pain like scraping, both bowels and bladder obstructed, calf muscles contracted. Concern for intestinal abscess. (Intestinal Abscess)
Lao Jiubai (Old Leek White), Liang Toujian (Aconiti Kusnezoffii Radix), Xiaohui Xiang (Foeniculi Fructus), Danggui Xu (Angelicae Sinensis Radix tip), Zhi Shan Jia (Stir-fried Pangolin Scale).
Certain case: Tongue scorched yellow, lower abdomen hard and full, urination difficult, both legs flaccid. Damp-Heat knots, Six Fu organs blocked. Concern for intestinal abscess.
Chuanlianzi (Toosendan Fructus), Xiaohui (Foeniculi Fructus), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Tongcao (Tetrapanacis Medulla), Qing Cong (Allium Fistulosum Stem Base).
Certain case: High fever for ten days, whole body muscle spasms, lower abdomen hard, urinary dribbling, alternating chills and fever, about to form pus and blood. This is intestinal abscess. Follow Sun Simiao's Mudan Pi Dahuang Tang (Moutan Cortex and Rhubarb Decoction).
Dai (19 years old): Hemorrhoids with bleeding, mostly Damp-Heat. Now complexion is pale, clearly deficiency-cold. No quick effect rule. Should tonify Spleen and Stomach. Because hemorrhoids still hurt and swelling remains, assist with bland leaching and Fu-unblocking. (Hemorrhoid)
Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma), Sheng Tusifen (Raw Cuscutae Semen Powder), Sheng Xiangya Mo (Raw Ivory Powder), Sheng Baicha (Raw White Beeswax).
External diseases originally have specialized departments. Mr. Ye was not a surgeon, yet observing his prescriptions based on principles, he surpasses specialists by hundreds. Regretfully, his cases are few, and methods not complete, so I do not narrate further. Generally, surgical diseases although manifest on the surface, the root lies inside. Those who understand Yin-Yang, deficiency-excess, cold-heat, meridians, and acupoints, turning large diseases small and small diseases non-existent, skilled in dissipation, are superior physicians. Next are those who examine Five Goods and Seven Evils, follow principles in medication, flexible with knives, needles, cupping, application, fumigation, and washing, following ancient formulas, easy to heal once ruptured, are medium physicians. Worse are those who do not observe Yin-Yang deficiency-excess, nor note that depression causes Ying-Wei disharmony leading to Qi-Blood stagnation forming sores, but simply use bitter-cold attack, named clearing fire and detoxifying, actually destroying Stomach and harming life. Once Stomach Qi fails, complications arise like bees. Others claim secret recipes of "using poison to attack poison," mixing toxic drugs into pills, throwing them randomly hoping for immediate effect, ignoring future disaster. Asked about meridians, locations, prognosis, they are ignorant. These are inferior to inferior physicians. As for external treatment methods, surgeons should study them carefully. If one loves learning, thinks deeply, remembers widely, pays attention everywhere, records what is heard, reads medical books extensively, collects ancient methods, there are indeed single prescriptions in Shanghai, and family secrets exist. The pastes, plasters, and pills they make, tested clinically with hundred percent success, effective immediately, even superior physicians would yield to them. (Hua Yutang)
Xu's Comment: Treating diseases requires experts. All pill, powder, and external methods, if incomplete, cannot achieve cure. Principles may be same, but methods differ. To treat external diseases, one must have separate skills.