丹溪先生云∶肿疡时呕，当作毒瓦斯攻心治之，溃疡时呕，当作阴虚补之。此论其常耳。窃谓前症，如肿赤 痛而
呕者，热毒甚也，用仙方活命饮。作脓而呕者，胃气虚也，用五味异功散。脓胀而呕者，血气虚也，用六君子加归、
。便秘而呕者，热在脏也，用内疏黄连汤。寒药服多而呕者，胃气伤也，用托里健中汤。食少胃寒而呕者，托里益中
汤。中虚寒淫而呕者，托里温中汤。肝气乘脾而呕者，托里抑青汤。胃虚停痰而呕者，托里清中汤。胃虚自病而呕者，
托里益黄汤。郁结伤脾而呕者，托里越鞠汤。徐阮令云∶治痈疽不可一日无托里药。确哉是言也。盖毒瓦斯者热有余也，
阴虚者脾不足也，皆因脾气虚弱以致之，但宜调补中气，则正气复而邪气自去矣。婴童当兼治其母。
一小儿臂患疮，服消毒之剂，作呕少食，肿硬不消，面色痿黄，此脾胃气虚而药复伤也，用六君、木香、干姜，更
增腹痛，此虚甚也，以前药入附子一片，诸症顿退。后饮食停滞，作呕不食，先用保和丸一服，次用异功散而愈。
一小儿腿痈，脓清作呕，疮口不敛，肝肾二脉洪数，此因禀肾水不足，而肝火为患，用六味地黄丸以补肾，九味芦
荟丸以清肝而愈。
一小儿手患疮，作呕流涎，面色痿黄，余谓脾气虚寒，遂用六君、干姜、木香而呕止；又用补中益气汤而涎止，不
数剂而疮愈。
一小儿疮痛作呕，手足并冷，此因痛而胃气复伤也，用六君、干姜、藿香，痛呕顿止，又用异功散加升麻、柴胡而
疮亦消。
一小儿面患疮作呕，手足并冷，面赤作痛，此胃经热毒所致，先用仙方活命饮而痛止，又用清热消毒散而疮愈。
一小儿腹患疮，作呕便秘，发热饮冷，蓄热也，用内疏黄连汤而便通呕止；又用清热消毒散而疮内消。
一小儿腿患疮，用护心散，呕吐不食，手足并冷。余曰∶此非毒瓦斯内攻，乃胃虚耳，宜用异功散补之。彼反见
疑，仍索前药，余以异功散为末，作护心散与服，呕止食进；又用托里散，脓溃而愈。后语其故，犹不信其效至此也。
一小儿臂患疮，服护心散，呕吐腹胀，余曰∶此脾胃复伤耳。不信，仍复攻毒，益加泄泻，余先用托里温中汤一
剂，次用六君、姜、桂，又用五味异功散而愈。
一小儿项患疮作呕，面黄发热饮汤，余谓胃气虚热，不信，反清热败毒，更加吐泻而殁。
一小儿面患疮作呕，发热作渴饮汤，余谓胃气虚而作呕，不能化生津液而作渴。不信，另用杂药攻毒，致吐泻吃
逆而殁。
托里益黄汤 治疮疡因脾胃虚弱，寒水反侮土，饮食少思，呕吐泄泻等症。（自制）
人参 白术（炒。各七分） 陈皮 茯苓 半夏 炮姜 丁香 炙甘草（各三分）
上姜水煎服。
托里越鞠丸 治乳母郁怒，肝脾内热，致儿患疮疡，母子并服。（自制）
人参（五分） 白术（炒，一钱） 陈皮（四分） 川芎 半夏 山栀（炒） 苍术（各三分） 炙甘草（二分）
上姜枣水煎，婴儿乳母并服。
托里健中汤 治疮疡，阳气虚寒，肠鸣切痛，大便溏泄，呕逆昏愦，此寒变而内陷也，急用此药，缓则不救。
溃疡误服寒剂多患之。（自制）
羌活（三分） 木香 附子（炮） 益智 丁香 沉香（各三分） 茴香（五分） 陈皮 炙甘草（五分）
上姜水煎，徐徐服之。
托里清中汤 治疮疡，脾胃虚弱，痰气不清，饮食少思等症。（自制）
人参 白术（炒） 陈皮 茯苓（各五分） 半夏（三分） 桔梗（二分） 甘草（炒） 柴胡（各二分）
上姜枣水煎服。
托里温中汤 治疮疡，元气虚弱，或因凉药所伤，饮食少思，呕吐泄泻等症。（自制）
人参 白术 茯苓（各一钱） 半夏 炮姜（各四分） 甘草（炒） 肉桂 黄 （炒。各一钱五分）
上每服三五钱，姜枣水煎。
托里益中汤 治疮疡，中气虚弱，饮食少思，或溃而不敛，或肿而不消。（自制）
人参 白术（炒） 陈皮（炒） 茯苓 半夏 炮姜（各五分） 木香 甘草（炒。各三分）
上姜枣水煎。
托里益青汤 治疮疡，脾土虚弱，肝木所侮，以致饮食少思，或胸膈不利。（自制）
人参 白术（炒。各五分） 陈皮（炒） 茯苓 半夏（各三分） 芍药（炒，一分） 柴胡（二分）
上姜枣水煎服。
保和丸
六味丸（二方见发热不止）
九味芦荟丸（方见腮痈）
六君子汤（方见腋痈）
补中益气汤（方见肌肉不生）
五味异功散（方见用败毒之药）
清热消毒散（方见热毒口疮）
仙方活命饮
托里消毒散
托里散（三方见热毒疮疡）
内疏黄连汤（方见作痛不止）
Mr. Danxi said: When vomiting occurs during the unruptured stage of a carbuncle or ulcer (肿疡), it should be treated as toxic heat attacking the heart; when vomiting occurs after the ulcer has ruptured (溃疡), it should be treated as Yin deficiency and supplemented accordingly. This discusses the general rule. I believe that for the aforementioned symptoms, if the swelling is red, painful, and accompanied by vomiting, it indicates severe heat toxicity, and Xianfang Huoming Yin (Immortal Life Elixir) should be used. If vomiting occurs during the suppuration stage, it indicates deficiency of Stomach Qi, and Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) should be used. If there is distension due to pus accumulation accompanied by vomiting, it indicates deficiency of Qi and Blood, and Liu Junzi Tang (Six-Gentleman Decoction) with Danggui (Angelica Sinensis) and [missing character] should be used. If constipation accompanies vomiting, it indicates heat in the Zang organs, and Neishu Huanglian Tang (Internal Draining Coptis Decoction) should be used. If vomiting results from taking too many cold-natured medicines, it indicates injury to Stomach Qi, and Tuoli Jianzhong Tang (Supporting Interior Strengthening Middle Decoction) should be used. If there is poor appetite, cold Stomach, and vomiting, Tuoli Yizhong Tang (Supporting Interior Enriching Middle Decoction) should be used. If middle Jiao deficiency with excessive cold-dampness causes vomiting, Tuoli Wenzhong Tang (Supporting Interior Warming Middle Decoction) should be used. If Liver Qi invading the Spleen causes vomiting, Tuoli Yiqing Tang (Supporting Interior Suppressing Green Decoction) should be used. If Stomach deficiency with retained phlegm causes vomiting, Tuoli Qingzhong Tang (Supporting Interior Clearing Middle Decoction) should be used. If Stomach deficiency itself causes vomiting, Tuoli Yihuang Tang (Supporting Interior Enriching Yellow Decoction) should be used. If emotional constraint injuring the Spleen causes vomiting, Tuoli Yueju Tang (Supporting Interior Resolving Depression Decoction) should be used. Xu Ruanling said: In treating carbuncles and sores, one must not go a day without using interior-supporting medicines. This statement is indeed correct. Toxic heat represents an excess of heat, while Yin deficiency represents insufficiency of the Spleen; both arise from weakness of Spleen Qi. One should only regulate and tonify the Middle Qi, then when Righteous Qi recovers, pathogenic factors will naturally disappear. For infants and children, treatment should also address the mother.
A child suffered from a sore on the arm. After taking detoxifying agents, he experienced vomiting, reduced food intake, persistent hard swelling, and sallow complexion. This indicated deficiency of Spleen and Stomach Qi compounded by further injury from the medication. Liu Junzi Tang (Six-Gentleman Decoction), Muxiang (Aucklandiae Radix), and Ganjiang (Zingiberis Rhizoma) were administered. However, abdominal pain increased, indicating severe deficiency. A slice of Fuzi (Aconiti Lateralis Radix Praeparata) was added to the previous prescription, and all symptoms subsided immediately. Later, due to food stagnation causing vomiting and refusal to eat, Baohe Wan (Harmonize the Stomach Pill) was given first, followed by Yigong San (Extraordinary Merit Powder), resulting in recovery.
A child had a carbuncle on the leg with thin pus, vomiting, and non-healing wound. The Kidney and Liver pulses were rapid and forceful. This was due to congenital insufficiency of Kidney Water leading to Liver Fire pathology. Liujun Dihuang Wan (Six-Ingredient Rehmannia Pill) was used to tonify the Kidney, and Jiawei Luhui Wan (Nine-Ingredient Aloe Pill) to clear the Liver, leading to recovery.
A child had a sore on the hand with vomiting and salivation, and a sallow complexion. I diagnosed it as deficiency-cold of Spleen Qi. Liu Junzi Tang (Six-Gentleman Decoction), Ganjiang (Zingiberis Rhizoma), and Muxiang (Aucklandiae Radix) stopped the vomiting. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) stopped the salivation. Within a few doses, the sore healed.
A child suffered from severe pain from a sore causing vomiting, with cold hands and feet. This was because the pain further injured Stomach Qi. Liu Junzi Tang (Six-Gentleman Decoction), Ganjiang (Zingiberis Rhizoma), and Huoxiang (Pogostemonis Herba) stopped the pain and vomiting immediately. Yigong San (Extraordinary Merit Powder) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) resolved the sore.
A child had a facial sore causing vomiting, with cold hands and feet, red face, and pain. This was caused by heat toxicity in the Stomach meridian. Xianfang Huoming Yin (Immortal Life Elixir) stopped the pain first, and Qingre Xiaodu San (Clear Heat and Detoxify Powder) healed the sore.
A child had an abdominal sore with vomiting, constipation, fever, and desire for cold drinks, indicating accumulated heat. Neishu Huanglian Tang (Internal Draining Coptis Decoction) relieved constipation and vomiting. Qingre Xiaodu San (Clear Heat and Detoxify Powder) resolved the sore internally.
A child had a leg sore and used Huxin San (Protect Heart Powder), resulting in vomiting, refusal to eat, and cold extremities. I stated: This is not internal attack by toxic heat, but Stomach deficiency. Tuoli Yigong San (Supporting Interior Extraordinary Merit Powder) should be used for supplementation. The parent doubted this and insisted on the previous medicine. I powdered Tuoli Yigong San and gave it as Huxin San. Vomiting stopped, and appetite returned. Tuoli San (Supporting Interior Powder) was then used, and the pus drained, leading to recovery. Later, upon explaining the reason, they still did not believe the efficacy was so profound.
A child had an arm sore and took Huxin San (Protect Heart Powder), resulting in vomiting and abdominal distension. I said: This is further injury to the Spleen and Stomach. Disbelieving this, they continued to attack the toxin, worsening diarrhea. I first used Tuoli Wenzhong Tang (Supporting Interior Warming Middle Decoction) for one dose, then Liu Junzi Tang (Six-Gentleman Decoction) with Ginger and Guizhi (Cinnamomi Ramulus), followed by Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder), resulting in recovery.
A child had a neck sore causing vomiting, yellow face, fever, and desire for hot drinks. I diagnosed it as deficiency-heat of Stomach Qi. Disbelieving this, they used heat-clearing and detoxifying herbs, leading to worsened vomiting, diarrhea, and death.
A child had a facial sore causing vomiting, fever, thirst, and desire for hot drinks. I diagnosed it as Stomach Qi deficiency causing vomiting, unable to transform fluids into body fluids, leading to thirst. Disbelieving this, they used miscellaneous drugs to attack the toxin, resulting in vomiting, diarrhea, hiccups, and death.
Tuoli Yihuang Tang (Supporting Interior Enriching Yellow Decoction): Treats carbuncles and ulcers due to Spleen-Stomach weakness, where Cold Water insults Earth, causing poor appetite, vomiting, and diarrhea. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Banxia (Pinelliae Rhizoma Preparatum), Paojiang (Zingiberis Rhizoma Preparatum), Dingxiang (Caryophylli Flos), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata). Each ingredient 7 fen except Dingxiang and Zhigancao at 3 fen.
Decoct with ginger water and take orally.
Tuoli Yueju Wan (Supporting Interior Resolving Depression Pill): Treats nursing mothers with emotional depression causing internal heat in Liver and Spleen, leading to infant carbuncles/ulcers. Mother and infant take together. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Chenpi (Citri Reticulatae Pericarpium), Chuanxiong (Chuanxiong Rhizoma), Banxia (Pinelliae Rhizoma Preparatum), Zhizi (Gardeniae Fructus - stir-fried), Cangzhu (Atractylodis Rhizoma). Each 3 fen except Renshen 5 fen, Baizhu 1 qian, Chenpi 4 fen, Zhigancao 2 fen.
Decoct with ginger and jujube water. Infant and nursing mother take together.
Tuoli Jianzhong Tang (Supporting Interior Strengthening Middle Decoction): Treats carbuncles/ulcers with Yang deficiency-cold, borborygmus, cutting pain, loose stools, vomiting, retching, and confusion. This is cold transformation sinking inward. Use urgently; delay is fatal. Often seen after misusing cold-natured medicines for ulcers. (Self-made)
Qianghuo (Notopterygii Rhizoma et Radix), Muxiang (Aucklandiae Radix), Fuzi (Aconiti Lateralis Radix Praeparata), Yizhi (Alpiniae Oxyphyllae Fructus), Dingxiang (Caryophylli Flos), Chenxiang (Aquilariae Lignum Resinatum). Each 3 fen except Huixiang (Foeniculi Fructus) 5 fen, Chenpi (Citri Reticulatae Pericarpium) and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) 5 fen.
Decoct with ginger water. Take slowly.
Tuoli Qingzhong Tang (Supporting Interior Clearing Middle Decoction): Treats carbuncles/ulcers with Spleen-Stomach weakness, unclear phlegm-Qi, and poor appetite. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria). Each 5 fen. Banxia (Pinelliae Rhizoma Preparatum) 3 fen. Jiegeng (Platycodonis Radix) 2 fen. Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) and Chaihu (Bupleuri Radix). Each 2 fen.
Decoct with ginger and jujube water and take orally.
Tuoli Wenzhong Tang (Supporting Interior Warming Middle Decoction): Treats carbuncles/ulcers with Yuan Qi weakness, or injury from cool medicines, causing poor appetite, vomiting, and diarrhea. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria). Each 1 qian. Banxia (Pinelliae Rhizoma Preparatum), Paojiang (Zingiberis Rhizoma Preparatum). Each 4 fen. Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Rougui (Cinnamomi Cortex), Huangqi (Astragali Radix - stir-fried). Each 1 qian 5 fen.
Take 3-5 qian per dose. Decoct with ginger and jujube water.
Tuoli Yizhong Tang (Supporting Interior Enriching Middle Decoction): Treats carbuncles/ulcers with Middle Qi weakness, poor appetite, non-healing ulcers, or unresolved swelling. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Chenpi (Citri Reticulatae Pericarpium - stir-fried), Fuling (Poria), Banxia (Pinelliae Rhizoma Preparatum), Paojiang (Zingiberis Rhizoma Preparatum). Each 5 fen. Muxiang (Aucklandiae Radix), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata). Each 3 fen.
Decoct with ginger and jujube water.
Tuoli Yiqing Tang (Supporting Interior Suppressing Green Decoction): Treats carbuncles/ulcers with Spleen Earth weakness insulted by Liver Wood, causing poor appetite or chest/diaphragm discomfort. (Self-made)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried). Each 5 fen. Chenpi (Citri Reticulatae Pericarpium - stir-fried), Fuling (Poria), Banxia (Pinelliae Rhizoma Preparatum). Each 3 fen. Shaoyao (Paeoniae Radix Alba - stir-fried) 1 fen. Chaihu (Bupleuri Radix) 2 fen.
Decoct with ginger and jujube water and take orally.
Baohe Wan (Harmonize the Stomach Pill)
Liujun Wan (Six-Ingredient Pill) (See "Unremitting Fever" chapter)
Jiawei Luhui Wan (Nine-Ingredient Aloe Pill) (See "Mumps Carbuncle" chapter)
Liu Junzi Tang (Six-Gentleman Decoction) (See "Axillary Carbuncle" chapter)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See "Failure of Muscle Regeneration" chapter)
Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) (See "Use of Detoxifying Medicines" chapter)
Qingre Xiaodu San (Clear Heat and Detoxify Powder) (See "Heat-Toxic Mouth Ulcer" chapter)
Xianfang Huoming Yin (Immortal Life Elixir)
Tuoli Xiaodu San (Supporting Interior Detoxify Powder)
Tuoli San (Supporting Interior Powder) (Three formulas see "Heat-Toxic Carbuncle/Ulcer" chapter)
Neishu Huanglian Tang (Internal Draining Coptis Decoction) (See "Unremitting Pain" chapter)