脉沉实发热烦躁，外无 赤痛，其邪深在内，故先疏通，以绝其源。
脉浮大数， 肿在外，当先托里，恐邪入于内。
脉不沉不浮，内外俱无证，知其在经，当和荣卫。
浮者宜行经，黄芩、黄连、连翘、人参、木香、槟榔、泽泻、黄柏，在上半加枳壳。
沉者，里，疏通脏腑，利后，用前药中加大黄，痛当归、黄 止之。
缓者，身重当除湿。
大者心脉有热。
弦者，眩运，当去肝风。
涩者，气滞血虚。
弦细为膀胱寒水，小便溺多，宜泻寒水。
盖疮疡诸症，皆营（营运也）气偏盛，助火邪而生，湿热相搏，肌肉败坏而为脓，
故从虚而出经络也，如太阳经从背而出，少阳虚从鬓而出，阳明虚从髭而出，
督脉虚从胸而出。微湿则痒，热甚则痛，又甚则痛，血虚则痛甚。
营气不从，逆于肉理，乃生痈肿（营气逆而不行，其原在经。）湿气外伤，害人皮肉（皆
营气之下行也，其在外盛则内行。）
膏梁之变，足生大丁（皆营气逆行，凝于经络，其原在里，发于表。）
治法 外者宜辛凉发之，通圣、凉膈、解毒是也。内者，宜苦寒下之，三黄、
玉烛是也。中者，宜调经凉血等是也。
肿疡宜解毒下之，溃疡宜托里补之。
如显经宜加通经之药。
夫邪气内搐肿热，宜砭射之也。气胜血聚者，宜石而泄之。
疮家呕吐有二，凡肿疡年壮谓伏热在心，宜降其火。如溃疡年老谓虚，宜大补之。
内疏黄连汤 治呕吐 ，发热，脉沉而实，肿哽色不变，根深，脏腑秘涩。
黄连 芍药 川归 黄芩 栀子 薄荷 桔梗 木香 槟榔 甘草 连翘
便秘加大黄。
复煎散 治肿 于外，根 不深，脉浮，邪气盛则必侵于内，宜托之。
地骨皮 四君子汤 桂 川归 芍药 黄芩 防风（二两） 黄 防己（一两） 热加黄连
上以苍术一斤，水五升，煎至半，去滓入药煎服。便秘加大黄。
黄连消毒汤 治一切疮疽背脑。
黄连（一钱） 黄芩 黄柏 地黄 知母（四钱） 羌活（一钱） 独活 防风 本 归
尾桔梗 连翘（四钱） 黄 人参 甘草（三分） 苏木 泽泻（二分） 防己（五分）
千金内托散 治痈疽使气血先实则脓如推出也，即前方加大黄、五加子。
验方 有人五十，形实，背生红肿，近骨下痛甚，脉浮数而洪紧，呕食。正冬月。
又 有妇七十，好酒形实，脑生疽，脉急切涩。
大黄 人参（各酒炒一钱）
又 麻黄 桂枝（冬月用之） 附子（脉紧用之） 黄柏（酒炒） 栝蒌 甘草节
羌活 青皮 半夏 人参 黄 姜煎
又 初生一切疮疽发背服之而效，云能下死血。
大黄 甘草 辰砂 血竭 酒下。
解毒丹 治一切发背痈疽、金石毒，散肿消毒，轻者可服。
紫背车鳌大者，盐泥固制， 红出火毒，甘草膏丸，甘草汤下；外用
寒水石 红，入瓮沉井中，腊猪脂调敷。
一方以轻粉为佐；又方以灯草为佐。
三生散 治漫肿光色，附骨痈，如神。
露蜂房 蝉蜕 头发
上等分，烧存性，三钱研细酒下。
清凉膏 治发背。
川归 白芷 木鳖肉 白芨 黄柏 白蔹（一两） 乳香（研） 腻粉（少粉） 白
胶（少许） 丹（五两） 麻油（十两）
煎如法，曾用五灰膏敷一宿，待恶肉腐以刀去之，却以绵蘸香油扭干覆之，
待好肉如岩 状，方可收口，收口用乳香、没药、龙骨、白蔹等。
丁疮刘方
乌头尖 附尖 蝎梢 雄黄（一钱） KT 砂 蜈蚣（一双） 粉霜 轻粉 麝香
乳香（五分） 信（二钱半）
上俱为末，先破疮出血了以草杖头用纸带入于内，以深为妙。
丁疮李方
归尾 没药 乳香 白芨 本 杏仁 黄丹 蓖麻 粉霜 巴霜 木鳖 麻油
桃柳条煎如法。
丁疮 毒瓦斯入腹，昏闷不食。
紫花地丁草 蝉蜕 贯众（五钱） 丁香 乳香 温酒下二钱。
疔 状初发先痒后痛，先寒后热，热定则寒，四肢沉重，头痛心惊，眼花，呕则危。
乳香散 治疮口大痛。
寒水石（ ） 活石（各一两） 乳香 没药（各五分） 脑（少许） 末掺口上。
雄黄散 治恶肉不去。
雄黄（一钱） 巴豆（一个去皮） 乳香 没药（少许）
上另研极细，和匀上肉。
木香散 治久不收口。
木香 槟榔 川归（一钱） 黄连（二钱）
末掺之。
出剩骨
血竭草罨之自出。
又青橘叶 地锦草
上二味杵成膏，先洗疮口净用土牛膝内入孔中。
治漏疮剩骨 远志 金银花 甘草 黄 （酒煮）
Pulse is deep and solid, accompanied by fever and irritability, with no redness or pain on the exterior; this indicates the pathogen is deep within. Therefore, one should first unblock and dredge to cut off the source.
Pulse is floating, large, and rapid, with swelling located externally; one should first support the interior (Tuo Li) to prevent the pathogen from entering inward.
Pulse is neither deep nor floating, with no evident signs internally or externally; this indicates the pathogen is in the meridians, so one should harmonize Ying and Wei (Nutritive and Defensive Qi).
For a floating pulse, it is appropriate to promote meridian circulation using Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Forsythiae Fructus (Lianqiao), Ginseng Radix et Rhizoma (Renshen), Aucklandiae Radix (Muxiang), Arecae Semen (Binglang), Alismatis Rhizoma (Zexie), and Phellodendri Cortex (Huangbai); if the pathology is in the upper half of the body, add Aurantii Fructus (Zhike).
For a deep pulse, the disease is in the interior; one should dredge the zang-fu organs and promote bowel movements. Add Rhei Radix et Rhizoma (Dahuang) to the aforementioned formula. For pain, use Angelicae Sinensis Radix (Chuan Gui) and Astragali Radix (Huangqi) to alleviate it.
For a slow pulse, with heavy body sensation, one should eliminate dampness.
For a large pulse, there is heat in the Heart meridian.
For a string-taut pulse, there is dizziness; one should dispel Liver wind.
For a choppy pulse, there is Qi stagnation and Blood deficiency.
A string-taut and fine pulse indicates cold water in the Bladder, with frequent urination; one should drain the cold water.
Generally, various symptoms of sores and ulcers arise from an excess of Ying Qi (Nutritive Qi) assisting Fire pathogens, where damp-heat struggles, causing muscle corruption and pus formation. Thus, pus exits through deficient meridians: for example, Taiyang Meridian deficiency causes pus to emerge from the back; Shaoyang Meridian deficiency from the temples; Yangming Meridian deficiency from the mustache area; and Du Mai (Governing Vessel) deficiency from the chest. Mild dampness causes itching; severe heat causes pain; even more severe heat intensifies pain; Blood deficiency makes pain more severe.
When Ying Qi does not follow its course and reverses into the muscle tissue, abscesses and swellings occur (Ying Qi reverses and fails to circulate, with the root in the meridians). External invasion by dampness harms the skin and flesh (this relates to the downward flow of Ying Qi; when excessive externally, it impedes internal movement).
Changes due to rich and greasy foods can lead to large ding sores on the feet (all involve reversed Ying Qi condensing in the meridians, rooted internally but manifesting externally).
Treatment methods: For external conditions, use acrid-cool diaphoretics, such as Fangfeng Tongsheng San (Siler and Peony Powder for Unblocking the Whole Body), Liangge San (Cooling Chest Powder), and detoxifying agents. For internal conditions, use bitter-cold purgatives, such as Sanhuang Wan (Three Yellows Pill) and Yuzhu San (Jade Candle Powder). For middle-jiao conditions, use methods like regulating meridians and cooling blood.
For unruptured swellings (Zhongyang), use detoxification and purgation; for ruptured ulcers (Kuiyang), use interior-supporting and tonifying methods.
If specific meridian patterns are evident, add herbs that unblock those meridians.
If pathogenic factors cause internal contraction with swelling and heat, use bian stone (lithotherapy) to bleed. If Qi excess leads to Blood accumulation, use stone needles to drain.
Vomiting in patients with sores has two types: In young, robust patients with unruptured swellings, it is considered latent heat in the Heart; fire should be descended. In elderly patients with ruptured ulcers, it is considered deficiency; major tonification is required.
Neishu Huanglian Tang (Internal Dredging Coptis Decoction): Treats vomiting, fever, deep and solid pulse, swollen throat with unchanged color, deep-rooted lesions, and constipation.
Ingredients: Coptidis Rhizoma (Huanglian), Paeoniae Radix Alba (Shaoyao), Angelicae Sinensis Radix (Chuan Gui), Scutellariae Radix (Huangqin), Gardeniae Fructus (Zhizi), Menthae Haplocalycis Herba (Bohe), Platycodonis Radix (Jiegeng), Aucklandiae Radix (Muxiang), Arecae Semen (Binglang), Glycyrrhizae Radix et Rhizoma (Gancao), Forsythiae Fructus (Lianqiao).
Add Rhei Radix et Rhizoma (Dahuang) for constipation.
Fujian San (Double-Decoction Powder): Treats external swelling with shallow roots and floating pulse; when pathogens are strong, they invade inward, requiring interior support.
Ingredients: Lycii Cortex (Digupi), Sijunzi Tang (Four Gentlemen Decoction), Cinnamomi Ramulus (Guizhi), Angelicae Sinensis Radix (Chuan Gui), Paeoniae Radix Alba (Shaoyao), Scutellariae Radix (Huangqin), Saposhnikoviae Radix (Fangfeng, 2 liang), Astragali Radix (Huangqi), Stephaniae Tetrandrae Radix (Fangji, 1 liang).
Add Scutellariae Radix (Huangqin) for heat.
Decoct 1 jin of Atractylodis Rhizoma (Cangzhu) in 5 sheng of water until half remains, strain, then add other herbs and decoct again. Add Rhei Radix et Rhizoma (Dahuang) for constipation.
Huanglian Xiaodu Tang (Coptis Detoxification Decoction): Treats all carbuncles and sores on the back or head.
Ingredients: Coptidis Rhizoma (Huanglian, 1 qian), Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), Rehmanniae Radix Preparata (Shudi), Anemarrhenae Rhizoma (Zhimu, 4 qian), Notopterygii Rhizoma et Radix (Qianghuo, 1 qian), Angelicae Dahuricae Radix (Duohuo), Saposhnikoviae Radix (Fangfeng), Ligustici Chuanxiong Rhizoma (Gaben), Angelicae Sinensis Radix (Guiwei), Platycodonis Radix (Jiegeng), Forsythiae Fructus (Lianqiao, 4 qian), Astragali Radix (Huangqi), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao, 3 fen), Sappan Lignum (Sumu), Alismatis Rhizoma (Zexie, 2 fen), Stephaniae Tetrandrae Radix (Fangji, 5 fen).
Qianjin Neituo San (Thousand-Year Internal Support Powder): Treats carbuncles and sores by strengthening Qi and Blood first, so pus is expelled smoothly. Add Rhei Radix et Rhizoma (Dahuang) and Acanthopanacis Senticosi Caulis (Wujiazi) to the previous formula.
Empirical Formula 1: A fifty-year-old male, robust in build, had red swelling on the back with severe pain near the bone, floating, rapid, surging, and tight pulse, and vomiting food. It was mid-winter.
Ingredients: Rhei Radix et Rhizoma (Dahuang), Ginseng Radix et Rhizoma (Renshen) (each 1 qian, stir-fried with wine).
Empirical Formula 2: A seventy-year-old female, fond of alcohol and robust in build, had a carbuncle on the head with urgent and choppy pulse.
Ingredients: Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi) (for winter), Aconiti Lateralis Radix Preparata (Fuzi) (for tight pulse), Phellodendri Cortex (Huangbai) (wine-fried), Trichosanthis Fructus (Gualou), Glycyrrhizae Radix et Rhizoma (Gancao Jie), Notopterygii Rhizoma et Radix (Qianghuo), Citri Reticulatae Pericarpium (Qingpi), Pinelliae Rhizoma Preparatum (Banxia), Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Zingiberis Rhizoma Recens (Jiang) decocted together.
Empirical Formula 3: Effective for initial carbuncles, sores, and back carbuncles; said to expel dead blood.
Ingredients: Rhei Radix et Rhizoma (Dahuang), Glycyrrhizae Radix et Rhizoma (Gancao), Cinnabaris (Chensha), Draconis Sanguis (Xuejie), taken with wine.
Jiedu Dan (Detoxification Pill): Treats all back carbuncles, sores, and mineral/stone toxins; reduces swelling and detoxifies. Suitable for mild cases.
Large purple-backed Tiankui (Zibeichegui), sealed with salt mud, fired red to remove fire toxicity, formed into pills with Licorice Paste, taken with Licorice Decoction. Externally: Calcitum (Hanshuishi) fired red, cooled in a well inside a jar, mixed with lard from the twelfth lunar month for application.
One formula uses Calomelas (Qingfen) as an assistant; another uses Junci Medulla (Dengcao) as an assistant.
Sansheng San (Three Lives Powder): Treats diffuse swelling without a head, shiny skin, and osteomyelitis (Fu Gu Yong), with miraculous effect.
Ingredients: Vespa Nidus (Lufengfang), Bombyx Batryticatus (Chantui), Human Hair.
Equal parts, calcined to retain nature, ground to fine powder. Take 3 qian with wine.
Qingliang Gao (Cooling Ointment): Treats back carbuncles.
Ingredients: Angelicae Sinensis Radix (Chuan Gui), Angelicae Dahuricae Radix (Baizhi), Momordicae Semen (Mubie Rou), Bletillae Rhizoma (Baiji), Phellodendri Cortex (Huangbai), Ampelopsis Radix (Bailian, 1 liang), Boswelliae Resina (Ruxiang, crushed), Calamina (Nifen, small amount), Lepidi Colla (Baijiao, small amount), Salviae Miltiorrhizae Radix (Danshen, 5 liang), Sesame Oil (Mayou, 10 liang).
Prepare according to method. Previously used Wuhui Gao (Five Ashes Ointment) applied overnight. After necrotic tissue decays, remove with a knife. Then cover with cotton soaked in sesame oil (wring dry). Wait for healthy granulation tissue to rise like rock formations before closing the wound. For closure, use Boswelliae Resina (Ruxiang), Myrrhae Resina (Moyao), Ossis Femoris (Longgu), and Ampelopsis Radix (Bailian).
Ding Chuang Liu Fang (Liu’s Formula for Ding Sores):
Aconiti Radix (Wutou Jian), Aconiti Lateralis Radix Preparata (Fu Jian), Scorpio (Xie Shao), Realgar (Xionghuang, 1 qian), Naocha (Naosha), Centipeda (Wugong, 1 pair), Calomelas (Fenshuang), Calomelas (Qingfen), Moschus (Shexiang), Boswelliae Resina (Ruxiang, 5 fen), Realgar/Arsenic compound (Xinshi, 2.5 qian).
Grind all to powder. First pierce the sore to bleed. Wrap the tip of a grass stick with paper and insert it into the sore, aiming for depth.
Ding Chuang Li Fang (Li’s Formula for Ding Sores):
Angelicae Sinensis Radix (Guiwei), Myrrhae Resina (Moyao), Boswelliae Resina (Ruxiang), Bletillae Rhizoma (Baiji), Ligustici Chuanxiong Rhizoma (Gaben), Amygdalus Persicae Semens (Xingren), Lithargyrum (Huandan), Ricini Semen (Bima), Calomelas (Fenshuang), Crotonis Fructus (Basuang), Momordicae Semen (Mubie), Sesame Oil (Mayou).
Decoct peach and willow branches, prepare according to method.
Ding Chuang Toxic Gas Entering Abdomen: Coma, inability to eat.
Ingredients: Viola Yedoensis Herba (Zihuadiding Cao), Bombyx Batryticatus (Chantui), Cyathulae Radix (Guanzhong, 5 qian), Caryophylli Flos (Dingxiang), Boswelliae Resina (Ruxiang). Take 2 qian with warm wine.
Ding Chuang Symptoms: Initially itchy then painful, chills followed by fever, chills after fever subsides, heavy limbs, headache, palpitations, blurred vision. Vomiting indicates danger.
Ruxiang San (Boswellia Powder): Treats severe pain at the sore site.
Ingredients: Calcitum (Hanshuishi, appropriate amount), Arsenolite (Huoshi, each 1 liang), Boswelliae Resina (Ruxiang), Myrrhae Resina (Moyao, each 5 fen), Borax/Borneol (Naobing, small amount). Grind to powder and sprinkle on the wound.
Xionghuang San (Realgar Powder): Treats persistent necrotic tissue.
Ingredients: Realgar (Xionghuang, 1 qian), Crotonis Fructus (Badou, 1 seed, peeled), Boswelliae Resina (Ruxiang), Myrrhae Resina (Moyao, small amount).
Grind separately to extreme fineness, mix evenly, and apply to the necrotic tissue.
Muxiang San (Aucklandia Powder): Treats non-healing wounds.
Ingredients: Aucklandiae Radix (Muxiang), Arecae Semen (Binglang), Angelicae Sinensis Radix (Chuan Gui, 1 qian), Coptidis Rhizoma (Huanglian, 2 qian).
Grind to powder and sprinkle.
Expelling Retained Bone:
Apply Draconis Sanguis (Xuejie) herb; the bone will exit naturally.
Another formula: Citri Reticulatae Pericarpium Viride (Qingju Ye), Euphorbiae Humifusae Herba (Dijin).
Pound these two into a paste. Clean the wound first, then insert Achyranthes Bidentatae Radix (Tu Niuxi) into the hole.
Treating Fistula with Retained Bone:
Polygala Radix (Yuanzhi), Lonicerae Japonicae Flos (Jinyinhua), Glycyrrhizae Radix et Rhizoma (Gancao), Astragali Radix (Huangqi) (decocted with wine).