疮疡发热，初患乃毒瓦斯所 ，已成乃内 作脓，已溃乃血气亏损，不可概行败毒，以伤元气。盖未成者当分邪之在
表在里，将成者当分邪之可攻可补，已成者当分脓之作与未作，脓已成者，当分脓之浅深高漫，脓已溃者，当分痛之止
与不止。若作痛而发热者，用仙方活命饮。作脓而发热者，用托里消毒散。脓胀而发热者，用加味托里散。脓出而发热，
用八珍、黄 。午前发热者，阳气虚也，用补中益气汤。午后发热者，阴血虚也。用四物汤加参 。日晡恶寒发热者，
阳气下陷于阴分也，用补中益气汤。发热作渴，小便频数者，肾气虚弱也，加减八味丸。脓血多而热者，阳无所附也，
十全大补汤。日将晡而热者，气血虚也，八珍汤。若无寐而热者，内补黄 汤。烦躁者，血脱也，当归补血汤。自汗而
热者，胃气虚也，四君子汤。恶寒发热者，肺气虚也，补中益气汤，或四君、黄 、当归主之。亦有五脏相胜，夹食夹
惊，或乳母六淫七情所致者，不能备述，治者临症详之。
一小儿腿痈，发热肿痛，肉色不赤，此形气虚而病气实也，先用活命饮二剂，随用益气汤二剂，外用葱熨法而愈。
一小儿十五岁，眉患痈，敷、服者皆败毒之药，腹痛肿硬，此脾胃复伤而然也，朝用异功散，夕用大补汤，两月余
而愈。
一小儿十一岁，腿内侧患痈，漫肿坚硬，肉色不变，自汗盗汗，此禀肝脾虚羸也，用大补汤、异功散，元气渐复，
脓溃针之，仍服前药而愈。
一小儿腿内股患疮，发热不愈，诊乳母肝脾血虚有热，用异功散加柴胡、升麻，及加味逍遥散与乳母服，儿日服数
匙，两月余而愈。
一小儿臂痈肿痛色白，余用托里之剂，不从，反内外用败毒之剂，发热不食，手足并冷，仍欲败毒。余曰∶此脾胃
复伤而变症耳，若再行攻毒，则胃气益损，五脏皆虚，诸症蜂起矣。乃用益气汤，佐以异功散而渐安。
一小儿溃后发热，饮乳不歇，面目或赤，此胃气虚热，
津液不足而作渴也，用白术散末以乳调服而愈。后发热作呕，吐酸腹胀，此乳食停滞，先用保和丸、异功散各末一服；
又用托里散、八珍汤而疮敛。
一小儿溃后发热懒食，日晡益甚，此脾气虚弱也，先用四君、升麻、归、 ，饮食渐进；次用八珍、牡丹皮，发热
渐止，后用托里散而痊。
一小儿腹痈溃后，发热作渴，手足并冷，余谓脾胃阳虚，用六君、姜、桂治之。不信，反清热败毒，果吃逆腹痛而
殁。
一小儿臀痈，溃而发热，面色青白，服败毒药益甚，余谓脾气虚寒而隔阳于外，非热也，用人参理中汤。不信，后
吐泻，手足并冷而殁。
加味托里消毒散 治溃疡余毒，发热作痛。
人参 黄 （炒） 当归（酒拌。各一钱） 川芎 芍药 白芷 茯苓（各五分） 金银花 甘草 连翘 乳香
没药（各三分）
上作三剂，水煎服。
八珍汤 治溃疡气血俱虚者，用此方主之。若因脾气虚弱而不能生血者，宜用异功散。
当归（一钱） 川芎（五分） 芍药（炒，七分） 熟地黄（酒拌） 人参 白术 茯苓（各一钱） 甘草（炙，
五分）
上每服三五钱，姜枣水煎。
加味逍遥散 治因乳母肝脾血虚发热，致儿患疮，或儿肝脾有热，致疮不愈。
当归 甘草（炙） 芍药（酒拌） 茯苓 白术（炒。各一钱） 柴胡 牡丹皮 山栀（炒。各七分）
上作四剂水煎服。若乳母肝脾血虚内热，或寒热遍身，瘙痒等症，尤宜用之。
七味白术散 治胃气虚弱，或因克伐，或因吐泻，口干作渴，饮食少思。（作渴饮冷者去木香。）
藿香 白术 木香 白茯苓 甘草（炒） 人参 干葛（各等分）
上每二钱水煎服。
保和丸 治饮食停滞发热者，不可多服。
神曲（炒） 山楂 半夏 茯苓 陈皮（各一两） 连翘 萝卜子（各五钱）
上为末糊丸，小桐子大。每服二三十丸，白汤送下，化服亦可。（加白术名大安丸）
当归补血汤 治疮疡血气亏损，或妄服峻剂，致血气俱虚，肌热大渴，喜饮，目赤面红，昼夜不息，其脉洪大
而虚，重按全无，其症似宜服白虎汤，但脉不长实为可验耳。若服白虎汤必死。
黄 （炙，一两） 当归（二钱）
上水煎，徐徐服。
内补黄 汤 治溃疡脓水出多，或过服败毒之剂，致气虚血弱，发热无寐，或兼盗汗内热，或不生肌。（自制）
黄 （炒，二钱） 人参 白术（炒） 茯苓 陈皮 当归（各一钱半） 酸枣仁（炒，一钱） 五味（杵）
甘草（炒。各五分）
上水煎，徐徐服。
十全大补汤（方见便痈）
葱熨法（方见流注）
补中益气汤（方见肌肉不生）
四君子汤
六君子汤（二方见腹痈）
仙方活命饮
五味异功散
托里散
托里消毒散（四方见热毒疮疡）
加减八味丸（方见作渴不止）
Fever caused by sores and ulcers: in the initial stage, it is due to the accumulation of toxic heat; when pus is forming, it is because internal qi and blood are stagnating and transforming into pus; after ulceration, it is due to the deficiency of qi and blood. Therefore, one cannot indiscriminately use detoxifying herbs, as this would damage the primordial qi. For lesions not yet suppurated, one must distinguish whether the pathogen is in the exterior or interior; for those about to suppurate, one must determine if the pathogen can be purged or requires tonification; for those already suppurated, one must ascertain if pus has formed; for those with formed pus, one must assess the depth and extent of the swelling; for those already ulcerated, one must determine if pain has ceased or persists. If accompanied by pain and fever, Xian Fang Huo Ming Yin (Immortal Life-Reviving Powder) is used. If suppuration is occurring with fever, Tuo Li Xiao Du San (Support Interior and Eliminate Toxin Powder) is used. If there is distension from pus with fever, Jia Wei Tuo Li San (Modified Support Interior Powder) is used. If fever occurs after pus discharge, Ba Zhen Tang (Eight Treasure Decoction) or Huang Qi (Astragalus Root) is used. Fever in the morning indicates deficiency of yang qi, treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Fever in the afternoon indicates deficiency of yin blood, treated with Si Wu Tang (Four Substance Decoction) added with Ren Shen (Ginseng Root) and Huang Qi. Chills and fever during the Ding hour (3–5 PM) indicate yang qi sinking into the yin aspect, treated with Bu Zhong Yi Qi Tang. Fever with thirst and frequent urination indicates weakness of kidney qi, treated with Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill). Abundant pus and blood with fever indicates yang qi having no anchor, treated with Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction). Fever approaching dusk indicates deficiency of qi and blood, treated with Ba Zhen Tang. Insomnia with fever is treated with Nei Bu Huang Qi Tang (Internal Nourishing Astragalus Decoction). Restlessness indicates loss of blood, treated with Dang Gui Bu Xue Tang (Angelica Sinensis Tonifying Blood Decoction). Spontaneous sweating with fever indicates weakness of stomach qi, treated with Si Jun Zi Tang (Four Gentlemen Decoction). Chills and fever indicate weakness of lung qi, treated with Bu Zhong Yi Qi Tang, or primarily with Si Jun Zi Tang, Huang Qi, and Dang Gui. There are also cases caused by mutual overacting among the five zang organs, food retention, fright, or maternal exposure to the six exogenous pathogens and seven emotions, which cannot be exhaustively listed; practitioners must examine the case carefully at the bedside.
A child suffered from a carbuncle on the leg, with fever, swelling, and pain, but the skin color was not red. This indicates deficient healthy qi and excess pathogenic qi. Initially, two doses of Huo Ming Yin were administered, followed by two doses of Yi Qi Tang. Externally, Cong Xi Fa (Scallion Moxibustion Method) was applied, resulting in recovery.
A fifteen-year-old child developed a carbuncle on the eyebrow. Both topical applications and oral medications were detoxifying agents, leading to abdominal pain and hard swelling. This resulted from further injury to the spleen and stomach. In the morning, Yi Gong San (Yi Gong Powder) was given; in the evening, Da Bu Tang (Great Tonifying Decoction) was given. Recovery occurred after more than two months.
An eleven-year-old child developed a carbuncle on the inner thigh, presenting as diffuse swelling and hardness with unchanged skin color, spontaneous sweating, and night sweats. This indicated congenital deficiency and emaciation of the liver and spleen. Da Bu Tang and Yi Gong San were used. As primordial qi gradually recovered, the pus was drained via needle puncture, and the previous medicines were continued until recovery.
A child had a sore on the inner thigh that did not heal despite fever. Examination revealed the nursing mother had liver-spleen blood deficiency with internal heat. The mother was prescribed Yi Gong San added with Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome), along with Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). The child took a few spoonfuls daily, recovering after more than two months.
A child had a carbuncle on the arm with swelling, pain, and pale color. I prescribed interior-supporting formulas, but they were refused. Instead, both internal and external detoxifying agents were used, leading to fever, anorexia, and cold hands and feet. The family still desired detoxification. I stated: "This is a complication arising from further injury to the spleen and stomach. If detoxification continues, stomach qi will be further damaged, all five zang organs will become deficient, and various symptoms will arise." Thus, Yi Qi Tang was used, assisted by Yi Gong San, leading to gradual stabilization.
After ulceration, a child had fever and drank milk incessantly, with occasional redness of the face and eyes. This indicated stomach qi deficiency with empty heat, insufficient body fluids, and thirst. Bai Zhu San (Atractylodes Macrocephala Powder) mixed with milk was administered orally, resulting in recovery. Later, fever, vomiting, acid regurgitation, and abdominal distension occurred, indicating milk and food stagnation. First, Bao He Wan (Preserve Harmony Pill) and Yi Gong San were given. Subsequently, Tuo Li San and Ba Zhen Tang were used to close the wound.
After ulceration, a child had fever, poor appetite, worsening in the late afternoon, indicating spleen qi deficiency. Si Jun Zi Tang, Sheng Ma, Dang Gui, and Huang Qi were first used to gradually restore diet. Then, Ba Zhen Tang and Mu Dan Pi (Moutan Cortex) were used to stop the fever. Finally, Tuo Li San was used for complete recovery.
After ulceration of an abdominal carbuncle, a child had fever, thirst, and cold hands and feet. I diagnosed spleen-stomach yang deficiency and treated with Liu Jun Zi Tang (Six Gentlemen Decoction) added with Sheng Jiang (Fresh Ginger) and Rou Gui (Cinnamon Bark). Disbelieving this, they used cooling and detoxifying herbs instead. The child subsequently developed hiccups, abdominal pain, and died.
A child had a gluteal carbuncle that ulcerated with fever and a blue-white complexion. Detoxifying herbs worsened the condition. I diagnosed spleen qi deficiency and cold causing yang qi to be repelled to the exterior, not true heat, and prescribed Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). Disbelieving this, the child later developed vomiting and diarrhea, cold hands and feet, and died.
Jia Wei Tuo Li Xiao Du San (Modified Support Interior and Eliminate Toxin Powder): Treats residual toxins after ulceration, causing fever and pain.
Ren Shen (Ginseng Root), Huang Qi (Astragalus Root, stir-fried), Dang Gui (Angelica Sinensis Root, wine-soaked) – each 1 qian; Chuan Xiong (Ligusticum Rhizome), Bai Shao (White Peony Root), Bai Zhi (Angelica Dahurica Root), Fu Ling (Poria) – each 0.5 qian; Jin Yin Hua (Honeysuckle Flower), Gan Cao (Licorice Root), Lian Qiao (Forsythia Fruit), Ru Xiang (Olibanum), Mo Yao (Myrrh) – each 0.3 qian.
Prepare as three doses, decoct in water, and take orally.
Ba Zhen Tang (Eight Treasure Decoction): Treats dual deficiency of qi and blood after ulceration. Use this formula as primary. If inability to generate blood is due to spleen qi deficiency, Yi Gong San should be used.
Dang Gui (1 qian), Chuan Xiong (0.5 qian), Bai Shao (stir-fried, 0.7 qian), Shu Di Huang (Prepared Rehmannia Root, wine-soaked), Ren Shen, Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling – each 1 qian; Gan Cao (Licorice Root, honey-fried) – 0.5 qian.
Take 3–5 qian per dose, decoct with fresh ginger and jujube in water.
Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder): Treats infant sores caused by maternal liver-spleen blood deficiency with fever, or infant liver-spleen heat preventing healing.
Dang Gui, Gan Cao (honey-fried), Bai Shao (wine-soaked), Fu Ling, Bai Zhu (stir-fried) – each 1 qian; Chai Hu, Mu Dan Pi, Shan Zhi (Gardenia Fruit, stir-fried) – each 0.7 qian.
Prepare as four doses, decoct in water. Particularly suitable for mothers with liver-spleen blood deficiency and internal heat, or systemic chills/fever and itching.
Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Powder): Treats weak stomach qi, or dry mouth and thirst with poor appetite due to excessive purgation or vomiting/diarrhea. (If thirst prefers cold drinks, remove Mu Xiang.)
Huo Xiang (Patchouli Herb), Bai Zhu, Mu Xiang (Costus Root), Bai Fu Ling (Poria), Gan Cao (stir-fried), Ren Shen, Ge Gen (Kudzu Root) – equal parts.
Take 2 qian per dose, decoct in water.
Bao He Wan (Preserve Harmony Pill): Treats fever due to food stagnation. Do not administer in large quantities.
Shen Qu (Medicated Leaven), Shan Zha (Hawthorn Fruit), Ban Xia (Pinellia Tuber), Fu Ling, Chen Pi (Tangerine Peel) – each 1 liang; Lian Qiao, Luo Bo Zi (Radish Seed) – each 5 qian.
Grind into powder, make pills with paste, size of small sesame seeds. Take 20–30 pills per dose with warm water, or dissolve in water. (Adding Bai Zhu creates Da An Wan/Great Peace Pill).
Dang Gui Bu Xue Tang (Angelica Sinensis Tonifying Blood Decoction): Treats qi and blood deficiency from sores/ulcers, or dual deficiency from misuse of harsh drugs. Symptoms include surface heat, severe thirst, desire to drink, red eyes and face, continuous day and night, pulse surging and large but empty upon heavy pressure. Although symptoms resemble those treatable by Bai Hu Tang (White Tiger Decoction), the pulse being long and solid is the key differentiator. Taking Bai Hu Tang will cause death.
Huang Qi (honey-fried, 1 liang), Dang Gui (2 qian).
Decoct in water, take slowly.
Nei Bu Huang Qi Tang (Internal Nourishing Astragalus Decoction): Treats excessive pus discharge from ulcers, or qi and blood weakness from overuse of detoxifying herbs, causing fever, insomnia, night sweats, internal heat, or failure of tissue regeneration. (Self-made formula)
Huang Qi (stir-fried, 2 qian), Ren Shen, Bai Zhu (stir-fried), Fu Ling, Chen Pi, Dang Gui – each 1.5 qian; Suan Zao Ren (Ziziphus Seed, stir-fried) – 1 qian; Wu Wei Zi (Schisandra Berry, crushed), Gan Cao (stir-fried) – each 0.5 qian.
Decoct in water, take slowly.
Shi Quan Da Bu Tang (see section on Perianal Abscess)
Cong Xi Fa (see section on Flowing Accumulation)
Bu Zhong Yi Qi Tang (see section on Failure of Muscle Regeneration)
Si Jun Zi Tang (Four Gentlemen Decoction)
Liu Jun Zi Tang (see section on Abdominal Carbuncle)
Xian Fang Huo Ming Yin (Immortal Life-Reviving Powder)
Wu Wei Yi Gong San (Five-Ingredient Yi Gong Powder)
Tuo Li San (Support Interior Powder)
Tuo Li Xiao Du San (see section on Heat-Toxic Sores and Ulcers)
Jia Jian Ba Wei Wan (see section for Unremitting Thirst)