〔丹〕漏疮，须先服补药，以生气血，即参、 、术、归、芎为主，大剂服之。外以附子末，
唾和作饼，如钱浓，艾炷灸，炷随漏之大小，便灸令微热，不可令痛。干则易之，干者再研为末，
再和再灸。如困则止，来日再灸，宜至肉平为效。亦有用附片灸，仍用前血气药作膏药贴之。
经云∶肉之大会为谷，肉之小会为溪。肉分之间，溪谷之会，以行荣卫，以会大气。邪溢气
壅，脉热肉败，荣卫不行，必将为脓，内销骨髓，外破大 ，留于节凑，必将为败，积寒留舍，
荣卫不养，肉缩筋肋，肘不得伸，内为骨痹，外为不仁，命曰大寒留于溪谷也。此用附子灸者，
盖此义也。
梅师云∶肾移寒于脾，发为痈疽，少气。脾移寒于肝，发为痈肿，拘挛。又云∶诸
痈肿此皆安生？岐伯曰∶生于八风之所变也。又云∶地之湿气感则害人皮肉筋脉。《圣济》云∶
衣服之表易着寒，所得之源，大抵如此。
或发不变色，或坚硬如石，或捻之不痛，久则然后变色疼痛，渐 而成脓，如泔而稀，久不能瘥，
疮口不合，变易为疳漏，败坏肌肉，销损骨髓，以致痿跛，宜以此骨碎补丸主之。
骨碎补 补骨脂 熟地 当归 续断 石楠 石斛 牛膝 杜仲 萆 附子 芍药 川芎
菟丝子 沙参 羌活 防风 独活 天麻 黄
此方与大偻方相表里，各等分为末，炼蜜丸，空心盐汤服。
阳气者，精则养神，柔则养筋，开阖不得，寒气从之，乃生大偻。宜用
羌活 防风 细辛 附子 甘草 川芎 续断 白芍 白术 当归 桂心 麻黄 黄 熟地
此方与前骨碎补丸相表里。
营气不从，逆于肉理，乃生痈肿。陷脉为 ，留连肉腠， 气化薄，传为善畏，及为惊骇。
（全文见阴阳门。）
〔《精》〕桂附丸治气漏诸疮。
桂心 附子（炮裂，米醋中浸，再炮三五次，去皮脐） 浓朴（姜制） 粉草（炙） 白术（各一两）
木香（一分） 乳香（研，二钱）
上为细末，炼蜜丸，如桐子大，空心米饮下二三十丸。丹溪云∶《精要》治冷漏诸疮，与
桂附丸，此冷只因疮久不合，风冷乘之，血气不潮而成也。浓朴虽温，其泻卫尤速，恐不若参、
佐以陈皮，庶乎与病情相得。此方治冷漏疮，若寒而虚者，只以加味十全汤，随时令经络加减用
之为当。又虚甚者，宜参 归术膏。
陷脉散治漏疮，及二三十年瘿瘤，或大如杯盂，久久不瘥，致有漏溃。令人骨肉消尽，或坚
或软或溃，令人惊惕，卧寐不安，体中掣痛，愈而复作。
干姜（炮） 琥珀（研） 大黄 附子（炮去皮。各一两） 丹参（三分） 石硫黄（研）
白石英（研） 钟乳粉（研） 乌贼骨（研。各半两）
上为末，贮以瓷合韦囊，勿令泄气，若疮湿即敷，无汁即煎猪脂和敷之，以干为度。或死肌
不消，加芒硝二两益佳。一法，胡燕巢一枚。
〔子和〕小渠袁三，因强寇入家，伤其两胫，外廉作疮，数年不已，脓汁常涓涓然，但饮冷则
疮间冷水浸
淫而出，延为湿疮求治。戴人曰∶尔中焦当有绿水二三升，涎数掬。袁曰∶何也？戴人曰∶当
被盗时，感惊气入腹，惊则胆伤，足少阳经也，兼两外廉皆足少阳之部，此胆之甲木受邪，甲木
色青，当有绿水。少阳在中焦如沤，既伏惊涎在中焦，饮冷水咽为惊涎所阻，水随经两旁入疮中，
故饮水疮中水出。乃上涌寒痰，汗如流水，次下绿水，果二三升，一夕而痂干，真可怪也。
尝治足膝下至踝漏疮，通足肿大于好足二倍，行步不全，用五龙丸大下之者六番，每番皆五
七行。下后用黄柏、苍术、 、芍、地、草、升、葛、星、半、牛膝、活石、桂调之，近三四个
月而安。
〔丹〕治漏疮
川芎（半两） 细辛（二钱半） 白芷梢（二钱半） 甘草（细末）
上每日作汤服，上疮食后，下疮食前，看疮孔大小，用隔年黄麻根刮去粗皮槌软，捻成绳子，
捻入孔中，至不可入则止，日浅一日，疮用好膏药贴之。
〔《本草》〕治 有头出脓水不止。以啄木鸟一只烧灰，酒调服一钱匕，立瘥。
〔世〕神应膏治久漏疮，此宋褚防御治理宗久漏疮诸方不效，独此膏愈之。如肠毒、胃毒，为
丸服之，神效。
当归（一两一钱） 赤芍药 大黄（各一两五钱） 香白芷 官桂（各一两） 玄参（一两三钱）
川续断（一两二钱） 莪术（一两） 生地（一两二钱）
上九味，细锉用真香油二斤浸，春五日，夏三日，秋七日，冬十日，入锅内以文武火煎
令黑色，滤去渣。如热天，用黄丹二十两，冷月十五两，旋旋下丹，不住手搅，试水中沉为度。不
可令妇人鸡犬见。如漏有孔者，以膏送入孔内，外仍以膏摊贴之。
〔海〕槟榔散治痈疽疮疖，脓溃之后，外触风寒，肿 僵硬，脓水清稀，出而不绝，肉腠空
虚，恶汁臭败，疮边干及好肌不生。及疗疳 恶疮，浸溃不敛。方见疮疡敛疮口药，即木香、
槟榔、黄连等分为末敷贴也。
〔丹〕治漏外寒药。
炉甘石（童便 ） 牡蛎粉
上为极细末敷之。
〔济〕乌金散贴恶疮疳 。
橡 子二个，内一个实黄丹，一个实白矾末，相合定，用黑俏麻皮缠了，火内烧，研细，加
麝香少许，洗净疮贴之。
〔垣〕截疳散治年深疳 疮。
黄连（半两） 白蔹 白芨 黄丹（各一两） 轻粉（一钱） 龙脑 麝香（另研。各半两）
密陀僧（一两）
上为细末，和匀干掺在 上，以膏贴之。
〔丹〕取朽骨久疽，及痔漏中有者。
取黑骨鸡胫骨，上等砒霜实之，盐泥固济，火 通红，取出地上，出火毒，去盐泥，用骨研
细，饭丸如粟米大，以纸捻送入孔窍内，更用膏药贴之。
〔《本》〕雄黄治疮疡尚矣。《周礼》疡医，凡疗疡以五毒攻之。郑康成注云∶今医方有五毒
之药，作之用黄蝥置石胆、丹砂、雄黄、矾石、磁石其中，烧三日三夜，其烟上着，以鸡羽取
之以注创，恶肉破骨则尽出。杨大年尝记其事，族人杨偶年少时，有疡于颊连齿，辅车外肿若覆瓯，
肉溃出脓血不辄，吐之痛楚难忍，疗之百方，弥久不瘥。人语郑法，根据法制药成，注之疮中，
少顷，取朽骨连两牙溃出，遂愈。信古方攻病甚速也。黄蝥，即瓦盒也。
〔东〕久漏疮∶足内踝上一寸（灸三壮、六壮） 如在上者∶肩井 鸠尾
肺脉微缓，为痿 。（缓者多热。全文见治虚实法。）
〔垣〕疮医自幼至老，凡所经验，必须写之。尝记疳 恶疮，诸药不效者，取蛴螬剪去两头，
安疮口上，以艾炷灸之七壮，一易不过七枚，无不效者。又法，用乞火婆虫儿灸之，同前法累验，
神效，人皆秘之，往往父子不传。
[Background Information]
Book: *Yixue Gangmu* (Outline of Medicine)
Author: Lou Ying
Dynasty: Ming
Chapter: Chronic Ulcer with Discharge (Jiu Lou Chuang)
Category: Medical Discussion
[Dan] For chronic ulcers with discharge (chronic ulcer with persistent purulent discharge), one must first administer tonifying medicines to generate Qi and Blood, primarily using Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), and Chuan Xiong (Ligusticum Chuanxiong Rhizome), taken in large doses. Externally, use Fu Zi (Prepared Aconite Lateralis Radix) powder, mixed with saliva to form a cake, as thick as a coin. Apply moxa cones for moxibustion; the size of the moxa cone should correspond to the size of the ulcer. Moxa until it feels slightly warm; do not cause pain. Replace when dry; grind the dried cake into powder again, mix with saliva, and continue moxibustion. If the patient feels fatigued, stop and resume the next day. The treatment is effective when the flesh grows level. Alternatively, use Fu Zi slices for moxibustion, while still applying the aforementioned blood- and Qi-tonifying medicine as a plaster.
The *Classic of Internal Medicine* states: The large convergence of muscles is called "Gu" (Valley); the small convergence of muscles is called "Xi" (Stream). Between muscle fibers, at the junctions of Xi and Gu, Ying Wei Qi (Nutritive and Defensive Qi) circulates, and Zong Qi (Gathering Qi) converges. When pathogenic factors overflow and Qi becomes stagnant, the vessels become hot and muscles deteriorate. If Ying Wei Qi cannot circulate, pus will inevitably form, consuming bone marrow internally and destroying major tendons externally. If it remains in the joint spaces, it will lead to destruction. Accumulated cold lingers, failing to nourish the muscles with Ying Wei Qi; muscles shrink, tendons contract, and elbows cannot extend. Internally, this manifests as Bone Bi (Bone Impediment); externally, as numbness and insensitivity. This is termed "Great Cold lingering in the Xi and Gu." The use of Fu Zi moxibustion here is based on this principle.
Master Mei says: When Kidney transfers cold to the Spleen, it develops into Carbuncle and Ulcer (Yong Ju) with shortness of breath. When Spleen transfers cold to the Liver, it develops into swelling and spasms. It is also said: How are all carbuncles and swellings generated? Qibo answered: They arise from changes caused by the Eight Winds. It is also said: Dampness from the earth, when felt, harms the skin, flesh, sinews, and vessels. The *Shengji Zonglu* (General Records of Holy Relief) states: The body surface covered by clothes is prone to cold; the source of such diseases is generally like this.
Some sores do not change color, or are hard as stone, or are painless upon pressure. After a long time, they change color and become painful, gradually suppurating. The pus is thin like rice water, failing to heal for a long time, the wound does not close, transforming into Gan Lou (Gangrenous Fistula), destroying muscle and wasting bone marrow, leading to flaccidity and limping. One should treat this with Gu Sui Bu Wan (Drynaria Pill).
Ingredients: Gu Sui Bu (Drynaria Rhizome), Bu Gu Zhi (Psoralea Fruit), Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis Root), Xu Duan (Teasel Root), Shi Nan (Rhododendron Leaf), Shi Hu (Dendrobium Stem), Niu Xi (Achyranthes Root), Du Zhong (Eucommia Bark), Bi Xie (Dioscorea Hypoglauca Rhizome), Fu Zi (Prepared Aconite Lateralis Radix), Shao Yao (Peony Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Tu Si Zi (Cuscuta Seed), Sha Shen (Glehnia Root), Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Du Huo (Angelica Pubescens Root), Tian Ma (Gastrodia Rhizome), Huang Qi (Astragalus Root).
This formula is mutually related to the Da Lou Formula. Grind each ingredient into fine powder equally, make pills with refined honey, and take orally on an empty stomach with salt water.
Yang Qi, in its refined aspect, nourishes the Spirit; in its soft aspect, it nourishes the sinews. If opening and closing functions fail, cold Qi enters, leading to Da Lou (Severe Kyphosis/Spinal Deformity). One should use Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Xi Xin (Asarum Root), Fu Zi (Prepared Aconite Lateralis Radix), Gan Cao (Licorice Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Xu Duan (Teasel Root), Bai Shao (White Peony Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), Gui Xin (Cinnamon Twig Heart), Ma Huang (Ephedra Stem), Huang Qi (Astragalus Root), and Shu Di Huang (Prepared Rehmannia Root).
This formula is mutually related to the previous Gu Sui Bu Wan.
When Ying Qi (Nutritive Qi) does not follow its normal course and reverses into the muscle tissue, carbuncles and swellings arise. Pathogens sinking into the vessels become fistulas, lingering in the muscle clefts. Qi transformation is compromised, transmitting to fearfulness and palpitations. (Full text see Yin Yang Section.)
[*Jingyao*] Gui Fu Wan (Cinnamon and Aconite Pill) treats Qi leakage and various sores.
Gui Xin (Cinnamon Twig Heart), Fu Zi (Prepared Aconite Lateralis Radix - cracked, soaked in rice vinegar, processed 3-5 times, skin and navel removed), Hou Po (Magnolia Bark - ginger processed), Fen Cao (Licorice Root - roasted), Bai Zhu (Atractylodes Rhizome) (each 1 liang), Mu Xiang (Costus Root) (1 fen), Ru Xiang (Frankincense) (ground, 2 qian).
Grind all into fine powder, make pills with refined honey, size of paulownia seeds. Take 20-30 pills orally on an empty stomach with rice drink. Danxi said: *Jingyao* uses Gui Fu Wan for cold leakage sores. This cold condition arises because the sore has not healed for a long time, allowing wind-cold to invade, causing Qi and Blood to fail to moisten. Although Hou Po is warm, its action of draining Wei Qi is rapid. It might be better to add Ren Shen (Ginseng Root) and Chen Pi (Tangerine Peel) as assistants, so that it suits the pathology. For treating cold leakage sores, if the pattern is cold and deficient, it is appropriate to use Jia Wei Shi Quan Tang (Modified Ten Complete Decoction), adjusting according to seasons and meridians. For severe deficiency, Ren Shen, Dang Gui, and Bai Zhu Gao (Paste) is suitable.
Xian Mai San (Sunken Vessel Powder) treats chronic ulcers with discharge, and goiters lasting 20-30 years, which may be as large as a cup or bowl, failing to heal for a long time, leading to fistula formation. It causes wasting of bone and flesh, hardness or softness or ulceration, causing fright, restlessness during sleep, and pulling pain in the body, recurring after healing.
Gan Jiang (Dried Ginger - processed), Hu Po (Amber - ground), Da Huang (Rhubarb Root), Fu Zi (Prepared Aconite Lateralis Radix - processed, skin removed, each 1 liang), Dan Shen (Salvia Root) (3 qian), Shi Liu Huang (Native Sulfur - ground), Bai Shi Ying (Quartz - ground), Zhong Ru Fen (Stalactite Powder - ground), Ou Hai Gu (Cuttlefish Bone - ground, each 0.5 liang).
Grind all into powder, store in porcelain boxes and leather bags, preventing gas leakage. If the sore is wet, apply directly; if dry, mix with rendered pork fat and apply, keeping it dry. If dead flesh does not resolve, adding Mang Xiao (Mirabilite) 2 liang is better. Another method: use one Hu Yan Chao (Hut Swallow Nest).
[Zihe]* Yuan San from Xiaoqu, due to robbers entering his home, injured both lower legs laterally, developing sores that did not heal for years. Pus dripped constantly. Drinking cold water caused cold water to seep out from the sores, spreading into damp sores. He sought treatment. Dairen (Zhang Congzheng) said: You likely have 2-3 sheng of green water and several handfuls of phlegm in your Middle Jiao. Yuan asked why. Dairen said: During the robbery, shock Qi entered the abdomen. Shock injures the Gallbladder, which corresponds to the Foot Shaoyang Meridian. Both lateral aspects of the lower legs are also areas of the Foot Shaoyang Meridian. Thus, the Wood of Jia (Gallbladder) is affected by pathogens. Jia Wood is green, hence the green water. Shaoyang in the Middle Jiao is like fermentation. Since the latent shock-phlegm is in the Middle Jiao, drinking cold water is blocked by the shock-phlegm. Water follows the meridians sideways into the sores, hence water comes out of the sores after drinking. He then vomited cold phlegm, sweating like flowing water, followed by expelling green water, indeed 2-3 sheng. Scabs dried overnight. Truly strange.
Once treated a chronic ulcer from the knee/ankle down. The affected leg was twice as swollen as the healthy one, gait incomplete. Used Wu Long Wan (Five Dragon Pill) for strong purgation six times, each time resulting in 5-7 bowel movements. After purgation, regulated with Huang Bo (Phellodendron Bark), Cang Zhu (Atractylodes Rhizome), Fu Ling (Poria), Shao Yao (Peony Root), Di Huang (Rehmannia Root), Gan Cao (Licorice Root), Sheng Ma (Cimicifuga Rhizome), Ge Gen (Kudzu Root), Xing (Arisaema/Banxia), Ban Xia (Pinellia Tuber), Niu Xi (Achyranthes Root), Du Huo (Angelica Pubescens Root), Shi Gao (Gypsum), Gui Zhi (Cinnamon Twig). Stabilized after nearly 3-4 months.
[Dan] Treating chronic ulcers with discharge
Chuan Xiong (Ligusticum Chuanxiong Rhizome) (0.5 liang), Xi Xin (Asarum Root) (2.5 qian), Bai Zhi Shao (Angelica Dahurica Root Tip) (2.5 qian), Gan Cao (Licorice Root) (fine powder).
Decoct daily for oral administration. Take after meals for upper sores, before meals for lower sores. Depending on the size of the sore hole, take year-old Hemp Root (Huang Ma Gen), scrape off coarse skin, soften by pounding, twist into a rope. Insert into the hole until it cannot go further, progressing shallower to deeper daily. Apply good plaster to the sore.
[*Bencao*] Treating heady sores with unceasing pus/water discharge. Burn one woodpecker to ash, mix with wine, take 1 qian bi. Cures immediately.
[Shi] Shen Ying Gao (Divine Response Plaster) treats chronic ulcers with discharge. This was used by Song Dynasty Defense Officer Chu to treat Emperor Lizong's chronic ulcer after other formulas failed. Only this plaster cured it. For intestinal or gastric toxins, take as pills; effect is divine.
Dang Gui (Angelica Sinensis Root) (1.1 liang), Chi Shao Yao (Red Peony Root), Da Huang (Rhubarb Root) (each 1.5 liang), Xiang Bai Zhi (Angelica Dahurica Root), Guan Gui (Cinnamon Bark) (each 1 liang), Xuan Shen (Scrophularia Root) (1.3 liang), Chuan Xu Duan (Teasel Root) (1.2 liang), E Zhu (Curcuma Rhizome) (1 liang), Sheng Di Huang (Raw Rehmannia Root) (1.2 liang).
Finely chop these nine ingredients, soak in 2 jin of true sesame oil. Spring: 5 days; Summer: 3 days; Autumn: 7 days; Winter: 10 days. Cook in a pot over gentle fire until black. Filter dregs. In hot weather, use 20 liang Huang Dan (Lead Monoxide); in cold months, 15 liang. Add Huang Dan slowly, stirring continuously, until it sinks in water. Do not let women or dogs see it. If the fistula has a hole, insert plaster inside; externally, spread plaster over it.
[Hai] Bing Lang San (Areca Nut Powder) treats carbuncles, ulcers, boils, and pustules. After pus drains, external exposure to wind-cold causes swelling and stiffness. Pus is clear and thin, flowing incessantly. Muscle pores are empty, foul fluid smells bad, sore edges are dry, and healthy flesh does not grow. Also treats Gan erosion and evil sores, macerating without healing. See formula for closing sore mouths in Sores/Ulcers section: equal parts Mu Xiang (Costus Root), Bing Lang (Areca Nut), Huang Lian (Coptis Rhizome), ground and applied.
[Dan] External cold medicine for treating chronic ulcers.
Lu Gan Shi (Calamina Stone - quenched in child's urine), Mu Li Fen (Oyster Shell Powder).
Grind into extremely fine powder and apply.
[Ji] Wu Jin San (Black Gold Powder) applies to evil sores and Gan erosion.
Two Oak Galls. Fill one with Huang Dan (Lead Monoxide), the other with Bai Fan (Alum) powder. Bind them together, wrap with black hemp skin, burn in fire until red hot. Grind fine, add a little She Xiang (Musk). Clean the sore and apply.
[Yuan] Jie Gan San (Stop Gan Powder) treats deep-seated Gan erosion sores.
Huang Lian (Coptis Rhizome) (0.5 liang), Bai Lian (Bletilla Rhizome), Bai Ji (Bletilla Rhizome), Huang Dan (Lead Monoxide) (each 1 liang), Qing Fen (Calomel) (1 qian), Long Nao (Borneol), She Xiang (Musk) (separately ground, each 0.5 liang), Mi Tuo Seng (Litharge) (1 liang).
Grind into fine powder, mix evenly, sprinkle dry onto the sore, and cover with plaster.
[Dan] Removing rotten bone from chronic abscesses and hemorrhoidal fistulas.
Take tibial bone of black-boned chicken. Pack with top-grade Pi Shuang (Arsenic Trioxide). Seal with salt mud. Calcine in fire until red hot. Remove to ground to eliminate fire toxicity. Remove salt mud. Grind bone fine. Make pills the size of millet grains with rice paste. Insert into the orifice using paper twist. Cover with plaster.
[*Ben*] Xiong Huang (Realgar) has been used for sores since ancient times. *Rites of Zhou* Surgeon: Treat sores with Five Toxins. Zheng Kangcheng noted: Current medical formulas use Five Toxic Medicines. Prepare by placing Huang Mao (Blister Beetle) with Shi Dan (Melanterite), Dan Sha (Cinnabar), Xiong Huang (Realgar), Fan Shi (Alum), Ci Shi (Magnetite). Burn for three days and nights. The smoke rises and deposits. Collect with chicken feather and inject into the wound. Evil flesh and broken bone will all exit. Yang Daniang recorded this: His relative Yang Ou, in youth, had a sore on cheek connecting to teeth. Swelling outside the jaw like an inverted bowl. Flesh ulcerated, pus and blood flowed ceaselessly. Spit caused unbearable pain. Tried hundred remedies, long time no cure. Someone told Zheng Fa. Prepared medicine according to method, injected into sore. Shortly after, extracted rotten bone along with two teeth. Then cured. Believes ancient formulas attack disease very quickly. Huang Mao is also known as Wa He.
[Dong] Chronic Ulcer with Discharge: 1 cun above medial malleolus of foot (Moxa 3 or 6 cones). If located higher: Jian Jing (GB21), Jiu Wei (CV15).
Lung pulse slightly slow indicates Wei Bi (Flaccidity Paralysis). (Slow pulse often indicates heat. Full text see Treating Deficiency and Excess Methods.)
[Yuan] Surgeons must record all experiences from youth to old age. Once recorded treating Gan erosion evil sores where all medicines failed: Take Qi Lao (Ground Beetle Larva), cut off both ends, place on sore mouth. Moxa with 7 cones. Change no more than 7 larvae per session. All were effective. Another method: Use Qi Huo Po Er (a type of insect) for moxibustion, same method, repeatedly verified, divine effect. People keep it secret, often father to son not transmitted.