疮疡作痛，当审邪之所在，症之所因。如寒热而痛，邪在表也，用人参败毒散。便秘而痛，邪在里也，用内疏黄连
汤。肿 而痛，血凝滞也，用仙方活命饮。作脓而痛者，用托里消毒散排之。脓胀而痛者，针之。脓溃而痛者，补之。
气虚而痛，则用四君、归、 。血虚而痛，则用四物、参、 。大抵形伤痛，气伤肿，不知此数者，徒以乳香没药为止
痛之方，则非所以为法矣。仍审五脏相胜相兼之症而治之，后仿此。
一小儿腿痈，溃而作痛，服败毒之药，肿势益甚，更呕腹痛。余谓脓出而反痛，攻毒而反呕，其属胃气虚弱明矣，
急宜补之，或谓痛无补法，仍用前药，诸症蜂起。余用六君、干姜、木香，胃气渐复，再用益气汤、托里散而愈。东
垣、丹溪云∶脓出而反痛，此为虚也，宜补之；秽气所触，和解之；风冷所逼者，温养之。信矣。
一小儿臂疮溃而作痛，脉洪数而有力，缘乳母食浓味，胃经积热所致，母服清胃散，子服泻黄散，痛止；又母子服
加味逍遥散而愈。
一小儿项患疮， 肿作痛，左颊色赤，此胆经热毒，母用仙方活命饮，末一服痛止；再服而溃，又用加味小柴胡
汤、加味逍遥散，母子俱服而敛。
一小儿左胁肿痛，赤色而硬，此禀胆经热毒所致也，子
服活命饮，母服加味小柴胡汤而软，又子服三味解毒散，母服加味逍遥散而溃。复恶寒不食，腹胀吐酸，此脾气弱而饮
食停滞也，用六君子汤，脾气渐健，用托里散，肌肉渐生。又呕吐寒热，面色青白，此脾气虚而肝邪所侮也。用异功散
加柴胡、升麻而安，又用异功散加当归、黄 而愈。
一小儿臂患疮，赤肿作痛，服大黄药，敷铁箍散，肿痛顿消。余曰∶此脾气虚疮内陷不知痛耳，非毒退而内消也。
遂朝用益气汤，夕用异功散各数剂，色微赤微肿，又用葱熨法及托里散而疮消。设或再用前药，则患处得寒而愈滞，胃
气得寒而不生，多致不起矣。
一小儿臂疮溃而作痛，疮口色白，面赤饮汤，此禀肾膀胱阴虚也，朝用八珍汤，夕用加减八味丸，诸症渐退，面色
顿白，此热退而真虚之色见也，用托里散、异功散而愈。
一小儿胸患疮，作痛发热，大小便秘，此邪在里也，先用大连翘饮一服，热痛顿止，更以五味异功散加升麻、白芷
而愈。
一小儿面患疮， 肿，发热恶寒，此邪在表也，先用荆防败毒散解其表邪；次用七味白术散固其胃气而愈。
一小儿背患疮， 肿大痛，发热饮冷，服败毒之药，其痛益甚，此膀胱经热毒炽盛也，用活命饮加麻黄、羌活一
剂，诸症顿退；乃去麻黄、羌活，又二剂而脓溃；再用清热消毒饮而疮痊。次年腹患痈， 肿作痛，大便不通，其热虽
剧，悉属形病俱实，用活命饮加硝、黄一剂，大便即通，肿痛顿止；又用清热消毒散而痊。
一小儿腿痈溃而脓清脉弱，面色痿黄，自汗有痰，余谓当补脾肺，彼以为缓，遂降火败毒，呕吐喘嗽，余曰∶脾肺
气绝。不信，后果殁。
一小儿臂痈，溃而面黄痰喘，余谓禀脾肾气虚，不信，乃服四物、黄柏、知母而殁。余治此症，用地黄丸、补中汤
滋其化源，多有生者。若用四物、黄柏之类，益伤脾肺，乃速其危也。
神效解毒散 治一切疮疡作痛不止，凡初起肿者，服之即消，已溃仍肿者，服之即退，已溃不解者，服之即愈。
婴儿母亦服。（自制）
金银花（一钱） 甘草节（五分） 黄 （炒） 皂角刺（炒） 当归（各三钱） 乳香 没药（各二钱）
上为末，每服三钱，酒煎。为末温酒调服亦可。如疮已溃，肿痛已止者，去乳、没、金银花，倍加黄 。
黄连解毒汤 治疮疡，烦躁饮冷，脉洪数，或发狂言。
黄芩 黄柏 黄连（俱炒） 山栀（各一钱五分）
上每用一二钱，水煎热服。
内疏黄连汤 治疮疡发热而呕，大便秘结，脉洪而实。
黄连（炒） 芍药（炒） 当归（各二钱） 槟榔 木香（各五分） 黄芩（炒） 栀子（炒） 薄荷 桔梗（炒）
甘草 连翘 大黄（炒。各一钱）
上每服一二钱，姜水煎。
乳香定痛散 治疮疡，溃烂疼痛。
乳香 没药（各五钱） 滑石 寒水石（ 。各一两） 冰片（一钱）
上为细末，干敷患处。
小柴胡汤（加山栀、牡丹皮，即加味小柴胡汤） 治肝胆经部分疮疡作痛，或身热恶寒，颈项强直，胸胁作痛。
（方见胁痈）
三味解毒汤（方见出血不止）
加减八味丸（方见作渴不止）
五味异功散（方见败毒之药）
清胃散
四物汤
四君子汤（三方见腹痈）
大连翘饮（方见臂痈）
荆防败毒散（即人参败毒散加荆芥、防风，方见发斑）
葱熨法（方见流注）
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）
七味白术散
八珍汤
加味逍遥散（三方见发热不止）
泻黄散（方见头面疮）
Ulcerative sores causing pain require an examination of the location of the pathogenic factor and the cause of the symptoms. If there are alternating chills and fever accompanied by pain, the pathogen is in the exterior; treat with Renshen Baidu San (Ginseng Detoxification Powder). If constipation accompanies pain, the pathogen is in the interior; treat with Neishu Huanglian Tang (Internal Purging Coptis Decoction). If swelling accompanies pain, it indicates blood stasis; treat with Xianfang Huoming Yin (Immortal Life-Activating Decoction). If suppuration is occurring with pain, use Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) to drain the pus. If tension from accumulated pus causes pain, puncture it with a needle. If pain persists after the pus has drained, apply tonification. If pain is due to Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction) added with Renshen (Ginseng) and Huangqi (Astragalus). If pain is due to Blood deficiency, use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng) and Danggui (Angelica Sinensis). Generally, injury to the form causes pain, while injury to Qi causes swelling. Those who do not understand these principles and merely use Rushiang (Frankincense) and Moyao (Myrrh) as analgesic formulas are not following the correct method. One must still examine the symptoms of mutual overcoming and combination among the Zang organs to treat accordingly; subsequent cases follow this principle.
A child suffered from a carbuncle on the leg. After ulceration, pain persisted. After taking detoxifying herbs, the swelling worsened, accompanied by vomiting and abdominal pain. I stated that pain persisting after pus drainage and vomiting induced by attacking toxins clearly indicate weak Stomach Qi, requiring urgent tonification. Others argued that "pain has no tonification method" and continued using the previous drugs, leading to a multitude of new symptoms. I used Liujunzi Tang (Six Gentlemen Decoction), Ganjiang (Dried Ginger), and Muxiang (Aucklandia), which gradually restored Stomach Qi. Subsequently, Yiqi Tang (Qi-Benefiting Decoction) and Tuoli San (Interior-Supporting Powder) were used, resulting in recovery. Dongyuan and Danxi stated: Pain persisting after pus drainage indicates deficiency and should be treated with tonification; if caused by foul odors, use harmonization; if forced by wind-cold, use warming and nourishing methods. This is indeed true.
A child had an ulcer on the arm that became painful after ulceration. The pulse was surging, rapid, and forceful. This was caused by the wet nurse consuming rich flavors, leading to accumulated heat in the Stomach channel. The mother took Qingwei San (Stomach-Clearing Powder), and the child took Xiehuang San (Draining Yellow Powder), stopping the pain. Later, both mother and child took Jiawei Xiaoyao San (Modified Free Wanderer Powder) for complete recovery.
A child had a sore on the neck with redness, swelling, and pain, and the left cheek was red. This was due to heat-toxin in the Gallbladder channel. The mother took Xianfang Huoming Yin (Immortal Life-Activating Decoction); after one dose, the pain stopped. After another dose, it ulcerated. Then, Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) and Jiawei Xiaoyao San (Modified Free Wanderer Powder) were taken by both mother and child, leading to healing.
A child had swelling and pain on the left hypochondrium, with red and hard skin. This was due to inherited heat-toxin in the Gallbladder channel. The child took Huoming Yin (Life-Activating Decoction), and the mother took Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction), softening the mass. Then, the child took Sanwei Jiedu San (Three-Ingredient Toxin-Expelling Powder), and the mother took Jiawei Xiaoyao San (Modified Free Wanderer Powder), leading to ulceration. Later, chills, loss of appetite, abdominal distension, and acid regurgitation occurred, indicating weak Spleen Qi and food stagnation. Liujunzi Tang (Six Gentlemen Decoction) was used, strengthening the Spleen Qi. Tuoli San (Interior-Supporting Powder) was then used, promoting tissue regeneration. Vomiting, alternating chills and fever, and a blue-white complexion appeared, indicating Spleen Qi deficiency with Liver pathogen oppression. Yigong San (Extraordinary Merit Powder) added with Chaihu (Bupleurum) and Shengma (Cimicifuga) stabilized the condition. Yigong San (Extraordinary Merit Powder) added with Danggui (Angelica Sinensis) and Huangqi (Astragalus) led to recovery.
A child had a red, swollen, and painful sore on the arm. After taking Dahuang (Rhubarb) medications and applying Tiegu San (Iron Hoop Powder), the swelling and pain disappeared instantly. I said: This is because weak Spleen Qi caused the sore to sink inward, resulting in insensitivity to pain, not because the toxin receded and dissolved internally. Therefore, Yiqi Tang (Qi-Benefiting Decoction) was used in the morning and Yigong San (Extraordinary Merit Powder) in the evening for several doses. When the color became slightly red and slightly swollen, Congyun Fa (Scallion Fomentation Method) and Tuoli San (Interior-Supporting Powder) were used, resolving the sore. Had the previous drugs been used again, the cold nature would have caused further stagnation in the affected area, and the cold would have inhibited Stomach Qi generation, likely leading to death.
A child had an arm ulcer that became painful after draining. The wound margin was white, the face was red, and there was thirst for water. This indicated Yin deficiency of the Kidney and Bladder channels. Bajun Tang (Eight Treasures Decoction) was used in the morning, and Jiabajun Wan (Modified Eight-Flavor Pill) in the evening. Symptoms gradually subsided, and the face suddenly turned pale, indicating that after the heat receded, the true deficiency color appeared. Tuoli San (Interior-Supporting Powder) and Yigong San (Extraordinary Merit Powder) were used for recovery.
A child had a chest sore with pain, fever, and constipation of both stool and urine. This indicated the pathogen was in the interior. Dalianqiao Yin (Large Lonicera Decoction) was administered first; after one dose, fever and pain ceased. Wuyi Yigong San (Five-Ingredient Extraordinary Merit Powder) added with Shengma (Cimicifuga) and Baizhi (Angelica Dahurica) led to recovery.
A child had a facial sore with redness, swelling, fever, and aversion to cold. This indicated the pathogen was in the exterior. Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder) was used first to release the exterior pathogen. Qimi Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) was then used to consolidate Stomach Qi, leading to recovery.
A child had a back sore with severe redness, swelling, and pain, fever, and thirst for cold drinks. After taking detoxifying herbs, the pain intensified. This indicated excessive heat-toxin in the Bladder channel. Huoming Yin (Life-Activating Decoction) added with Mahuang (Ephedra) and Qianghuo (Notopterygium) was used; after one dose, all symptoms receded. Mahuang (Ephedra) and Qianghuo (Notopterygium) were then removed, and two more doses led to pus drainage. Qingre Xiaodu Yin (Heat-Clearing and Toxin-Expelling Decoction) was used for full recovery. The following year, an abdominal carbuncle developed with redness, swelling, pain, and constipation. Although the heat was severe, it belonged entirely to excess in both form and disease. Huoming Yin (Life-Activating Decoction) added with Xiaoshi (Mirabilite) and Dahuang (Rhubarb) was used; after one dose, bowel movements resumed, and swelling and pain ceased. Qingre Xiaodu San (Heat-Clearing and Toxin-Expelling Powder) led to recovery.
A child had a leg carbuncle that ulcerated with clear pus, a weak pulse, sallow complexion, spontaneous sweating, and phlegm. I advised tonifying the Spleen and Lung, but he considered it too slow and instead used fire-descending and detoxifying herbs, leading to vomiting, wheezing, and coughing. I stated: This is exhaustion of Spleen and Lung Qi. He did not believe me, and subsequently died.
A child had an arm carbuncle that ulcerated with a yellow face and phlegmatic wheezing. I attributed this to inherited weakness of Spleen and Kidney Qi. He did not believe me and took Siwu Tang (Four Substances Decoction), Huangbai (Phellodendron), and Zhimu (Anemarrhena), leading to death. In treating such cases, I used Dihuang Wan (Rehmannia Pill) and Buzhong Yiqi Tang (Center-Boosting Qi-Benefiting Decoction) to nourish the source of transformation, with many survivors. Using Siwu Tang (Four Substances Decoction) or Huangbai (Phellodendron) would further damage the Spleen and Lung, accelerating the critical condition.
Shenxiao Jiedu San (Divine Efficacy Toxin-Expelling Powder) treats persistent pain from all types of ulcers. For initial swelling, it dissipates immediately upon ingestion. For ulcerated sores that remain swollen, it reduces swelling immediately. For ulcerated sores that fail to heal, it promotes immediate recovery. Infants' mothers should also take it. (Self-made formula)
Jinyinhua (Honeysuckle Flower) (1 qian) Gancao Jie (Licorice Joint) (0.5 qian) Huangqi (Astragalus) (stir-fried) Zaocis Spina (Gleditsia Thorn) (stir-fried) Danggui (Angelica Sinensis) (each 3 qian) Rushiang (Frankincense) Moyao (Myrrh) (each 2 qian)
Grind into powder. Take 3 qian per dose, decocted with wine. Alternatively, mix powder with warm wine. If the sore is ulcerated and pain/swelling have ceased, remove Rushiang (Frankincense), Moyao (Myrrh), and Jinyinhua (Honeysuckle Flower), and double the amount of Huangqi (Astragalus).
Huanglian Jiedu Tang (Coptis Detoxification Decoction) treats ulcers with irritability, thirst for cold drinks, surging-rapid pulse, or delirious speech.
Huangqin (Scutellaria) Huangbai (Phellodendron) Huanglian (Coptis) (all stir-fried) Shanzhi (Gardenia) (each 1.5 qian)
Take 1-2 qian per dose, decocted in water and taken hot.
Neishu Huanglian Tang (Internal Purging Coptis Decoction) treats ulcers with fever and vomiting, constipation, and a surging-excess pulse.
Huanglian (Coptis) (stir-fried) Shaoyao (Peony) (stir-fried) Danggui (Angelica Sinensis) (each 2 qian) Binglang (Areca Seed) Muxiang (Aucklandia) (each 0.5 qian) Huangqin (Scutellaria) (stir-fried) Zhizi (Gardenia) (stir-fried) Bohe (Mint) Jiegeng (Platycodon) (stir-fried) Gancao (Licorice) Lianqiao (Forsythia) Dahuang (Rhubarb) (stir-fried. each 1 qian)
Take 1-2 qian per dose, decocted in ginger water.
Rushiang Ding Tong San (Frankincense Pain-Stopping Powder) treats ulcerated and painful sores.
Rushiang (Frankincense) Moyao (Myrrh) (each 5 qian) Huashi (Talcum) Hanshui Shi (Halloysitum Rubrum) (calcined. each 1 liang) Bingpian (Borneol) (1 qian)
Grind into fine powder and apply dry to the affected area.
Xiao Chaihu Tang (Minor Bupleurum Decoction) (add Shanzhi (Gardenia) and Mudanpi (Moutan Cortex), i.e., Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction)) treats ulcers in the Liver/Gallbladder channels causing pain, or body fever with aversion to cold, stiff neck, and chest/hypochondriac pain.
(See formula under Hypochondriac Carbuncle)
Sanwei Jiedu Tang (Three-Ingredient Toxin-Expelling Decoction) (See formula under Unstoppable Bleeding)
Jiabajun Wan (Modified Eight-Flavor Pill) (See formula under Unstoppable Thirst)
Wuyi Yigong San (Five-Ingredient Extraordinary Merit Powder) (See formula under Detoxifying Herbs)
Qingwei San (Stomach-Clearing Powder)
Siwu Tang (Four Substances Decoction)
Sijunzi Tang (Four Gentlemen Decoction) (See three formulas under Abdominal Carbuncle)
Dalianqiao Yin (Large Lonicera Decoction) (See formula under Arm Carbuncle)
Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder) (i.e., Renshen Baidu San (Ginseng Detoxification Powder) added with Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia), See formula under Maculae)
Congyun Fa (Scallion Fomentation Method) (See formula under Flowing Abscess)
Qingre Xiaodu San (Heat-Clearing and Toxin-Expelling Powder) (See formula under Heat-Toxic Mouth Ulcer)
Xianfang Huoming Yin (Immortal Life-Activating Decoction)
Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder)
Tuoli San (Interior-Supporting Powder) (See three formulas under Heat-Toxic Ulcers)
Qimi Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder)
Bajun Tang (Eight Treasures Decoction)
Jiawei Xiaoyao San (Modified Free Wanderer Powder) (See three formulas under Unstoppable Fever)
Xiehuang San (Draining Yellow Powder) (See formula under Head and Face Ulcers)