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Treatment for pustular scabies involves using fifty seeds of *Aleurites fordii* (Da Feng Zi), fifty seeds of *Ricinus communis* (Bi Ma Zi), and three qian of *Cnidium monnieri* (She Chuang Zi) (the above three ingredients are ground into fine powder and packed separately). Half a qian of *Ephedrae Herba* (Ma Huang), three *Mylabris* (Ban Mao) (with wings and feet removed), and one liang of male pig fat. First, fry the *Ephedrae Herba* and *Mylabris* together in the pig fat until charred, filter out all dregs, then add the first three ingredients, simmer slowly until the dregs turn black, then remove. Wrap in a silk bag and frequently rub onto the affected area. This prescription was passed down by Wu Zijia, who claimed it had been tested and was very effective.

Zijia also transmitted a miraculous formula for treating carbuncles on the back, any unnamed severe toxins, as well as sores and boils, named Xun Feng Sao Tuo San (Rapid Wind Sweeping Husk Powder), claiming it originated from Changshu and had never failed in repeated trials. It uses seven slices of *Manis pentadactyla* (Chuan Shan Jia), seven *Scolopendra* (Wu Gong) (heads and feet removed), five qian of *Bombyx Batryticatus* (Chan Tui) washed, two qian of *Bombyx Batryticatus* (Jiang Can) stir-fried to remove silk, two and a half qian of *Boswellia carterii* (Ru Xiang) de-oiled, two and a half qian of *Myrrha* (Mo Yao) de-oiled, seven *Scorpio* (Quan Xie) (complete head and feet, soaked in wine, intestines removed), seven *Mylabris* (Ban Mao) (wings and feet removed, stir-fried with glutinous rice), five qian of Realgar (Xiong Huang), one qian of *Moschus* (She Xiang), eight fen of *Borneolum Syntheticum* (Bing Pian), and one liang five qian of *Galae Chinensis* (Wu Bei Zi). All are ground into a fine powder, dried in the sun, avoiding fire, sprinkled on the toxin, and covered with ordinary plaster. The effect is miraculous. For severe toxins, add a small amount of Sheng Dan (Calculus Mercurii), mixed with the powder. The Sheng Dan must be self-made; those bought in the market are ineffective.

Sheng Dan Formula: One liang of Hydrargyrum (Shui Yin), one liang two qian of Alumen (Bai Fan), one liang two qian of Natrii Sulfas (Ya Xiao) (Pi Xiao cannot be used). First grind Alumen and Natrii Sulfas finely, then add Hydrargyrum. Place the medicine in a small pot, cover with a coarse bowl. Seal the rim with wet paper strips made from thin white bark paper, sprinkle fine Alumen powder on the paper, cover the bottom of the bowl completely with Gypsum Fibrosum (Sheng Shi Gao), press with an iron scale weight, and fix four large nails into the mud. Burn three incense sticks of hard charcoal (protect surroundings with bricks to ensure strong heat). The first stick uses low heat, the second medium-high heat (prevent leakage between the first and second sticks), the third high heat while fanning. After cooling, open to reveal the formed calculus. (The calculus is on the lid; discard the dregs.)

Medical texts discussing internal abscesses generally detail those of the lung, stomach, large intestine, and small intestine, omitting other organs. In my hometown, a patient suffered from liver abscess (Gan Yong). The physician misdiagnosed it as lung abscess (Fei Yong). After medication, the condition worsened critically. Zhang Menglu, a scholar, diagnosed it as liver abscess treated incorrectly, but it was untreatable, and the patient died. According to the *Neijing*: "Dull pain at Qimen indicates liver abscess (Gan Ju); slight swelling of the flesh above indicates liver abscess." It also states: "Liver abscess presents with fullness in both hypochondria, waking in fright during sleep, and inability to urinate." Thus, the symptoms are relatively easy to distinguish; it is merely that common physicians lack learning, leading to fatal errors. Chen Yuangong stated: "Liver abscess occurs on the left, not the right. The skin on the left hypochondrium must show red-purple discoloration, and the tongue must appear cyanotic. Treatment must focus on soothing the liver, assisted by clearing heat and detoxifying. Use Hua Gan Xiao Du Tang: Bai Shao and Dang Gui each three liang, Jin Yin Hua five liang, Hei Zhi Zhi five qian, Sheng Gan Cao three qian, decocted in water. Its treatment differs significantly from lung abscess."

Wang Hongxu, in *Waike Quansheng Ji*, commented on *Fengshi Jinnang*'s treatment of yin abscesses (Yin Ju), advocating warming tonification combined with expelling pus. He argued that since initial lesions are flat, expulsion methods should not be used? If expulsion succeeds, ulceration is preferred. Even for metastatic nodules or malignant lymphadenopathy, if ulceration occurs, expulsion should still be avoided; otherwise, while existing ulcers heal, new ones may proliferate. Therefore, he established Yang He Tang for treatment (Shu Di Huang one liang, Lu Jiao Jiao three qian, Bai Jie Zi two qian, Rou Gui one qian, Gan Cao one qian, Ma Huang five fen, Jiang Tan five fen). For large, flat, painless abscesses, double the Shu Di Huang. Yan Jian-san followed this method for yin syndromes throughout his life, achieving remarkable results. Once, in June, he treated a man with widespread heat-toxin, except for a single abscess on the abdomen that was flat and painless. The pulse was deep, faint, and weak. He prescribed Yang He Tang with added Fu Zi and Huang Qi. The abscess resolved and healed. Heat-toxin manifests on the exterior, whereas yin abscesses root internally; thus, treating the root is essential. Reflecting on ancient formulas for all sores and abscesses, such as Xian Fang Huo Ming Yin, which resolves unformed lesions and promotes ulceration of formed ones, hailed as the holy medicine for sores, it contains cooling herbs like Jin Yin Hua, Chi Shao, Hua Fen, and Bei Mu when applied to yin abscesses. It is inferior to Yang He Tang, which specializes in warming tonification, eliminating disease before it arises.

Xu Xinmu, a department official from Haining, was proficient in medical theory, especially surgery. His plasters and pills were made only from premium herbs, personally refined, saving many critical cases. He once said that for lymphadenitis (Luo Li), oral medication is hardest to effect, and external treatments lack good formulas. He tried *Wangshi Quansheng Ji*'s Xiao He Gao, but in cases of heavy accumulated heat, it turned red and swollen, likely due to toxic and harsh ingredients. Therefore, he used Kong Xian Dan as the main component, adding Ma Huang to make a plaster, which proved widely effective. His late friend Tang Xu added several more ingredients, after which seekers came continuously. Not only for lymphadenitis, but also for phlegm nodules and breast cancer, applying this plaster initially causes resolution; even for long-standing cases, while they may not fully resolve, they do not enlarge further. The brilliance lies in the absence of toxic herbs like Ban Mao, Wu Gong, and Quan Xie; it causes no harm even applied to healthy skin. A doctor's daughter in Shimen had lymphadenitis on her neck for over ten years, self-treatment failed, and some ulcerated. Hearing of the official's self-made Xiao He Gao, she sought it. Unulcerated areas were treated with this plaster, ulcerated areas with Yang He Jie Ning Gao (see *Quansheng Ji*), and Jiu Yi Dan. Each time dozens of sheets were requested. After months, un-ulcerated lesions resolved, ulcerated ones healed, and there was no recurrence. She later married and had children. Many were cured by this formula. Ingredients: Zhi Gan Sui two liang, Hong Ya Da Ji three liang, Bai Jie Zi eight qian, Ma Huang four qian, Sheng Nan Xing one liang six qian, Zhi Tian Chong one liang six qian, Po Xiao one liang six qian, Teng Huang one liang six qian, Jiang Ban Xia one liang six qian. Jiu Yi Dan: Nine parts Jiang Yao (reducing agent), one part Sheng Shi Gao.

Surgical conditions often resemble internal medicine diseases, requiring careful differentiation. Initially, various sores and toxins presenting with aversion to cold and fever must not be mistaken for Shang Han (Cold Damage). Gu Cao Feng (Bone trough wind) must not be mistaken for toothache; He Xi Feng (Crane knee wind) must not be mistaken for painful bi-syndrome; hemorrhoidal blood must not be mistaken for intestinal bleeding; lung abscess must not be mistaken for exogenous cough; intestinal abscess must not be mistaken for general abdominal pain. There are many such cases, not exhaustively listed here.

*Zhizhi Tan Er* records Chen Tianshi, a surgeon from old Qingpu Town, whose fame spread far and wide, receiving dozens of patients daily. His medicines were secret and applied manually. Years of exposure to medicinal vapors led to a malignant sore on his thumb in his later years. Knowing it was incurable, he heard of an old man in Tanzhong, 150 li south, skilled in acupuncture and moxibustion, who kept a low profile. Chen changed his name and rushed to seek treatment. The old man said: "This is medicinal toxicity. You likely know medicine; you were poisoned deeply. If it does not erupt, fine; if it erupts, it will be difficult to treat, beyond my power. Why not go question Chen Tianshi?" Chen was terrified, returned home quickly, the sore erupted, and he died in delirium. I believe although Chen could practice medicine, his skills were not yet refined.

*Qiudeng Conghua* states: A northern merchant trading in Jiangnan loved eating pig heads, consuming the equivalent of several people per meal. A physician skilled in Qi-Huang arts saw him and told his servant: "Eating like this for over ten years... Disease will arise; no medicine can cure it." Following him north upon his return, intending to sell this insight as a rare commodity. After a long time, he remained safe. Investigating further, the servant revealed: "After meals, the master always drinks several cups of Songluo tea." The physician realized: "Only Songluo can解毒 this toxin." He returned disappointed. If Chen had foreseen prevention like this merchant, how would he have become incurable?

*Waike Zhengzong* is popular in recent times; physicians trust and follow it, often using Pi Zhen (Needle) and San Pin Yi Tiao Qiang methods, causing much error. Xu Lingtai has a commentary version. I borrowed and copied it from Chen Zai'an. Later, Xu Xinmu added annotations and asked me to correct them, aiming to remedy the faults of contemporary surgeons. It was prepared for publication but interrupted by war. My copy was destroyed. In autumn of Xinyou, taking refuge behind Donglin Mountain, I borrowed a duplicate from Tang Xin'an and excerpted it here for surgical students to observe, hopefully preventing them from being misled by the book. *Zhengzong* states: For early-stage unformed lesions, use Pi Zhen to puncture the peak at the point of pain, release evil blood, open the orifice, and insert Chan Su strip to the bottom. (See after "Brain Carbuncle Discussion".) Commentary says: This is a fatal method, misleading countless people. Those who survive must lie in bed for months and take major tonics to recover.

*Zhengzong* states: Insert Pi Zhen to the point of pain, then insert Toad strip to the bottom. (See under "Miraculous Root-Pulling Formula".) Also: Add inserted medicine after three days, causing the root to swell and hurt. Commentary says: For unformed sores, once blood appears, toxin spreads damaging muscles. Mild cases worsen; severe cases die. Moreover, inserting medicinal strips causes extreme pain and rotting; resolution is impossible. This evil method harms people deeply. Although originally stated for yin syndromes, modern practitioners ignore this, using it for all yin/yang, mild/severe cases, killing countless people. Survivors endure agony, escaping death, yet revere it as golden rules. The world follows suit; no one corrects it, which is heartbreaking. Another commentary note: I have seen dozens killed by this method. Even true yin syndromes should not use it. Yin syndromes are rare (one in a thousand); not all flat lesions are yin syndromes.

Commentary after San Pin Yi Tiao Qiang: This treats malignant stubborn sores, occasionally usable. Recently, quack doctors use it for any sore, killing countless people, detestable. The formulator intended it only for numb, dead tissue/stubborn flesh. Who knew later malicious people would make it a mandatory item? Blame must fall on the originator. I recall Academician Zhou Minfan died of a tumor caused by Fei using San Pin Yi Tiao Qiang (see "Medical Mirror Gate"), precisely because he did not see Xu's commentary. Physicians sticking to one school, lacking humility and broad research, hope to avoid error? Impossible.