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Treatment for sores or ulcers occurring below the ear, extending to the depression above the clavicle (Quepen), or on the shoulder. The lesions are hard as stone and feel unrooted when moved. This condition is called "Madao" (Scrofula of the neck), originating from the Hand-Shaoyang and Foot-Shaoyang meridians. It may also occur in the hypochondriac region, or have already suppurated into an ulcer without breaking open. All these conditions are treated with this formula.

Chaihu (Bupleuri Radix, 1 liang 2 qian), Caolongdan (Gentianae Macrophytae Radix, washed four times with wine), Tugegen (Trichosanthis Radix, prepared with wine, each 1 liang), Huangqin (Scutellariae Radix, fried twice with wine, 7 qian), Danggui Shao (tip of Angelicae Sinensis Radix), Sheng Huangqin (raw Scutellariae Radix), Guangzhu (Curcumae Longae Rhizoma), Jing Sanleng (Sparganii Rhizoma, stir-fried with wine together with Guangzhu), Lianqiao (Forsythiae Fructus), Shaoyao (Paeoniae Radix, each 5 qian), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 3 qian), Huanglian (Coptidis Rhizoma, fried twice with wine), Cangzhu (Atractylodis Rhizoma, each 2 qian).

Take half of the above ingredients by weight, grind into a fine powder, and mix with refined honey to make pills the size of mung beans. Take over one hundred pills per dose. For the remaining half of the ingredients, chop them coarsely, take 5 qian per dose, add two zhan of water, soak for more than half a day, decoct until one zhan remains, strain, and drink hot before retiring. Remove the pillow and lie supine after taking the medicine. Swallow the liquid in ten portions throughout the night, using the last portion to wash down the pills. After finishing, sleep as usual. Then apply the following external preparation:

Longquanfen (Stir-fried), Wafen (Tile powder), Guangzhu (Curcumae Longae Rhizoma), Jing Sanleng (Sparganii Rhizoma, washed and stir-fried with wine), Kunbu (Laminariae Thallus, each 5 qian).

Grind all together into a fine powder. Mix with hot water to form a paste for topical application. This medication removes disease especially quickly.

Treatment for Luoli (Scrofula), Madao, and Jiaying (Goiter associated with scrofula). The pathology extends from below the ear or behind the ear down the neck to the shoulder, or enters the Quepen area; this belongs to the Hand-Shaoyang and Foot-Shaoyang meridians. If Luoli occurs under the chin or at the Jiache point, it belongs to the Foot-Yangming meridian, caused by pathogenic factors from the Heart and Spleen. Here, both syndromes are treated together.

Huangqi (Astragali Radix, 1 qian): Protects the skin and hair, consolidates the Couli (pores and interstices), invigorates blood vessels, and generates blood when deficient. It is a sacred herb for wound healers and can tonify the weakness of Yuan Qi (Original Qi) in the exterior.

Renshen (Ginseng Radix, 3 fen): Tonifies Lung Qi. Add if there is shortness of breath or irregular breathing, and wheezing.

Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 5 fen): Harmonizes other herbs, clears heat, benefits Stomach Qi, and expels pathogenic factors from sores.

Zhen Loulu (Euphorbiae Humifusae Radix), Shengma (Cimicifugae Rhizoma, each 1 qian), Gegen (Puerariae Lobatae Radix, 5 fen): These three herbs belong to the Foot-Yangming meridian.

Lianqiao (Forsythiae Fructus, 1 qian): Indispensable for sores and ulcers in all twelve meridians. It dissipates blood stasis and qi stagnation; it is a divine herb for wound healing.

Mudanpi (Moutan Cortex, 3 fen): Removes stagnant old blood in the intestines and stomach.

Danggui Shen (body of Angelicae Sinensis Radix), Sheng Dihuang (Rehmanniae Radix Recens), Shu Dihuang (Rehmanniae Radix Praeparata, each 3 fen): These three herbs harmonize, invigorate blood, generate blood, and clear heat in various meridians.

Baishaoyao (White Peony Root, 3 fen): In summer, double the dosage. Its flavor is sour and nature cold; it tonifies the middle and benefits Lung deficiency, and is essential for treating abdominal pain. Do not use in winter cold.

Rougui (Cinnamomi Cortex, 2 fen): Greatly pungent and hot; it dissipates nodules and accumulations in Yin-type sores. Use sparingly. This illustrates the principle of "treating cold with heat." It counteracts the floating cold qi covering the sore. Discontinue if irritability is present.

Chaihu (Bupleuri Radix, 8 fen): Efficacy similar to Lianqiao. Remove if the sore is not in the Shaoyang meridian.

Shuniuzi (Arctii Fructus, 3 fen): Do not use if there is no swelling.

Qianghuo (Notopterygii Rhizoma et Radix, 1 qian), Duhuo (Angelicae Pubescentis Radix, Fangfeng (Saposhnikoviae Radix, each 5 fen): These three herbs relate to Hand-Taiyang and Foot-Taiyang syndromes, characterized by back pain, stiff neck, inability to look back, waist feeling like breaking, and neck feeling like pulling. Fangfeng is pungent and warm. Even if there are no Taiyang symptoms, if the sore is above the diaphragm, it should be used to dissipate nodules and remove wind pathogens from the upper body. Physical stiffness in patients indicates wind pathogen.

Kunbu (Laminariae Thallus, 2 fen): Very salty in flavor. Use if the sore is hard and indurated, as salt softens hardness.

Jing Sanleng (Sparganii Rhizoma, roasted, 2 fen), Guangzhu (Curcumae Longae Rhizoma, roasted, 3 fen): Use these two only if the sore is extremely hard and severe. Do not use if not hard.

Yizhiren (Alpiniae Oxyphyllae Fructus, 2 fen): If there is excessive saliva, it indicates Stomach disharmony. Add if the patient spits foam or vomits food due to Cold in the Stomach. Remove if absent.

Damai Mian (Barley Flour, 1 qian): Treats abdominal contraction and urgency; aids digestion and tonifies the Stomach.

Shenqu Mo (Fermented Medicinal Leaven Powder, stir-fried yellow, 2 fen): Used for undigested food.

Huanglian (Coptidis Rhizoma, de-stemmed, 3 fen): Treats restlessness and oppression.

Huangbai (Phellodendri Cortex, stir-fried, 3 fen): Add if there is heat or weakness in the legs and feet. Add if there is irritability and desire to remove clothes, indicating latent fire in the Kidney. Do not use if these signs are absent.

Houpo (Magnoliae Officinalis Cortex, 3 qian 2 fen, processed with ginger): Add if there is abdominal distension. Do not use if absent.

Grind all into a fine powder. Soak in decoction, mix with steamed wheat cake dough, shape into cakes, dry in the sun, and crush to the size of rice grains. Take 3 qian per dose with plain warm water.

If Qi is not smooth, add Chenpi (Citri Reticulatae Pericarpium); if severe, add a small amount of Muxiang (Aucklandiae Radix). Adjust according to the patient's deficiency or excess temporarily. Do not let the medicine interfere too much with diet. This is the general principle of treatment.

If the condition is solely Luoli in the Yangming division, remove Chaihu and Shuniuzi; use the rest.

If the condition is Madao or Jiaying in the Shaoyang division, remove Duhuo, Loulu, Shengma, and Gegen; add Qumai Sui (Setariae Milicae Spica, 3 fen).

If the patient usually has weak Qi, but during the onset of the disease, the Qi appears strong without shortness of breath, do not rely solely on their usual state. Instead, adapt to the apparent excess of the disease. Add Huangqin, Huanglian, Huangbai, Zhimu (Anemarrhenae Rhizoma), and Fangji (Stephaniae Tetrandrae Radix) to drain pathogenic factors in the Upper, Middle, and Lower Jiao.

Assuming the pathogen is in the Upper Jiao, add Huangqin (half wine-washed, half raw). In the Middle Jiao, add Huanglian (half wine-washed, half raw). In the Lower Jiao, add wine-processed Huangbai, Zhimu, and Fangji, selecting as appropriate. If the patient has constipation and the pathogen is abundant, add wine-processed Dahuang (Rhei Radix et Rhizoma) to promote bowel movement. If blood dryness causes dry stool, add Taoren (Persicae Semen) and wine-processed Dahuang.

If wind-induced dryness obstructs bowel movement, add Haren (Cannabis Semen) and Dahuang.

If wind-dryness prevents bowel movement, add roasted Zaorao Ren (Gleditsiae Sinensis Spina Fructus Seed), Dahuang, and Qinjiao (Gentianae Macrophytae Radix) to promote bowel movement.

If the pulse is choppy, the body itches, Qi is stagnant, and there is constipation, add Yuziren (Prunus Armeniaca Semen Amarum) and Dahuang to remove Qi dryness.

If it is a Yin-Cold disease causing constipation due to cold obstruction, use Banshu Wan (Half-Sulfur Pill) from the Ju Fang, or decoct Fuzi (Aconiti Lateralis Radix Praeparata) and Ganjiang (Zingiberis Rhizoma), and administer cold. Generally, the method of medication applies not only to sores and ulcers but to all diseases. For patients with weak constitution, remove bitter-cold herbs and increase Renshen, Huangqi, and Gancao to drain fire and first tonify Yuan Qi. Apply this principle to other cases.