一概论也。若夫要害处，近虚处，怯薄处，前哲已曾论及，惟分经之言，未闻也。何则？诸经惟
少阳厥阴经之生痈疽，理宜预防，以其多气少血也。其血本少，肌肉难长，疮久未合，必成危证。
又云∶少阳经多气少血，与厥阴经同。少阳有相火，尤甚于厥阴经者，其有不思本经少血，遽用驱
毒利药，以伐其阴分之血，祸不旋踵矣。请述一二成败之迹以告来者。予族叔父，平生多虑，质弱
神劳，年近五十，忽右膊外侧廉上生结核，身微寒热而易怒，食味颇浓，脉之俱浮大弦数，而重似
涩。予曰∶此多虑而忧伤血，时在初秋，勿轻视之，宜急补以防变证，以
人参一斤作膏，下以竹沥。病者吝费，招一外科，以十宣、五香散相间与服，旬日后，一日大风拔木，病者发
热，神思不佳，急召予视之，核稍高硕似有脓，于中起一红线，延过肩后，斜走绕背脊，过入右胁下，
不痛，觉肩背重而急迫，食有呕意，脉同前，但弦多耳。急作人参膏，入芎、术、生姜汁饮之，用
人参三斤，疮溃脓干。又与四物汤，加参、术、陈皮、甘草、半夏、生姜，百余帖而安。此等若在春令，
虽神仙不治也，幸而在秋金之令，不幸因时下暴风激起木中相火而致此，自非参膏骤补，何由得免。
（此正涓子所谓补填脏腑之法也。又一人腿外廉生红肿，一人胁下生红肿，皆由庸医误下之而死，
详见后条。）或曰∶太阴经非多血少气者乎？何臀疽之生，初无甚苦，往往间有不救者，吾子其能治
之乎？予曰∶臀居小腹之后，而又在其下，此阴中之阴也，其道远，其位僻，虽曰多血，气运不到。
气既不到，血亦罕来，中年以后，不可生痈。才有痛肿，参之脉证，但见虚弱，便与滋补，血气无
亏，可保终吉。若用寻常驱热拔毒舒气之药，虚虚之祸，如指诸掌，可不慎欤。
〔《素》〕 帝曰∶诸痈肿筋挛骨痛，此皆安生？岐伯曰∶此寒气之肿，八风之变也。帝曰∶治之
奈何？岐伯曰∶此四时之病，以其胜治之愈也。（脉要精微论）
〔《灵》〕 血脉荣卫周流不休，上应星宿，下应经数。寒邪客之则血泣，血泣则不通，不通则卫气
归之，不得复反，故痈肿。寒气化为热，热胜则腐肉，腐肉则为脓。脓不泻则烂筋，筋烂则伤骨，
骨伤则髓消，不当骨空，不得泄泻，血枯空虚，则筋骨肌肉不相荣，经脉败漏，熏于五脏，脏伤故死
矣。（痈疽篇）
生气通天论云∶劳汗当风，寒薄为 ，郁乃痤。又云∶阳气者，开阖不得，寒气从之，乃生大偻。
荣气不从，逆于肉理，乃生痈肿。是亦寒邪从劳汗之隙，及阳气开阖不得其理之隙，久客之为痈肿也。
观此数论，则知痈疽之发，皆得之于寒邪所客也。独运气疮疡，一岁老幼相似之病，间有热者，不
可不知。（详见运气条。）
上经数节，皆论痈疽，乃因寒邪客之而发也，治法则《精要》十宣散、五香汤、洁古苍术复煎散
等，发表之剂是也。
〔丹〕朱郎年四十余，恶寒发热，右腿内廉厥阴分生一肿毒，此是冷折热在肺经血分，与此方。
栝蒌子 黄药子 赤芍药 当归头 条芩（三钱） 青皮 皂角刺 桂枝（二钱） 甘草节（生一钱）
上分四帖，煎取一盏，入忍冬藤汁二蛤壳，食前煎饮。以忍冬藤渣敷肿上。
〔涓〕安神散治诸色疮肿，调气顺荣卫。
人参 茯苓 甘草（炙） 枳壳（去穣，麸炒） 附子（炮，去皮尖） 白姜 山药 陈皮
上等分为末，每服一钱，水一盏，生姜三片，大枣一个，煎至七分，通口服。
〔垣〕膏粱之变，亦是滋味过度，荣气不从，逆于肉理，乃生痈肿。荣气者胃气也，饮食入于胃
中，先输于脾，而朝于肺。肺朝百脉，次及皮毛，先行阳道，下归五脏六腑，而气口成寸矣。今富
贵之人，不知其节，法酒肥羊，杂以浓味，积久太过，其气味俱浓之物乃阳中之阳，不能走于空窍
而先行阳道，今反行阴道，则湿气大胜，子令母实，火乃大旺。热湿既盛，必来克肾，若不慎房事，
损其真水，则水乏而湿热之化上行，其疮必出背上及脑，此为大疔之最重者。若毒瓦斯出肺，或脾胃
之部分，毒之次也。若出于他经，又其次也。湿热之毒，所止处无不溃烂，故经言膏粱之变，足生
大疔，受如持虚者，如持虚器以受物，则无不受矣。治大疔之法，必当泻其荣气。以标本言之，先
受病为本，非苦寒之剂为主为君，不能除其苦楚疼痛也。诸疮疡有痛，往往多以乳香、没药，杂以
芳香之药止之，必无少减之理，此其误也。若使经络流通，脏腑中去其壅滞，必无痛矣。痛则以苦
寒之剂除之，无不愈者。疮疡食肉，与自杀无异，法当泻气而反补之故也。
元好问饮酒太过，脉候
沉数，九月间脑下项上出小疮，不痛不痒，如白头疮，凡四日后，脑项麻木，肿势外散，热毒 发。
又二日，痛大作，夜不得寐，医处以五香连翘汤，后再邀东垣诊视。云∶膏粱之变，不当投五香连
翘汤，已无及矣。且疽已八日，当先以火攻之，然后用药，以火艾炷如两核许者，攻之百壮，始觉
痛。次为处方云∶是足太阳膀胱之经，其病逆当反治。脉中得弦紧，按之洪大而数，又且有力，必
当伏其所主，而先其所因，其始则同，其终则异，必先岁气，无伐天和。以时令言之，可收不可汗，
经与病俱禁下法，当结者散之，咸以 之。然寒受邪而禁咸，遂制黄连消毒饮治之。
黄连（五分） 黄芩（五分） 黄柏（五分，酒洗） 人参（五分） 知母（四分，酒炒，此以苦
寒引用通经为君） 羌活（一钱） 独活（五分） 防风（五分） 本（五分） 连翘（一钱，此以大
辛解本经之结为臣） 黄 （一钱） 甘草（炙，五分，此以甘温配诸苦寒者三之一，多则滋荣气
而补土） 当归身（一钱，酒洗） 生地（一钱，酒洗，此以辛温之剂和血补血） 陈皮（五分，
不去白，补胃气） 甘草梢（五分，生，此以甘寒泻肾火之邪，补下焦元气） 泽泻（七分，渗淡导
酒湿，扶助秋令） 防己（五分，酒洗，除膀胱留热） 归梢（五分） 苏木（五分，去恶寒）
桔梗（一钱，使诸药不下沉，为舟楫之用）
所用之药，用酒洗并入酒煎者，用酒热为因为使。
上俱作一服，水三盏，煎至半干，去渣，入酒少许，再煎，食后温服。投剂之后，大鼾日出
乃寤，疮肿减七分，精神旺，饮啖渐进，灸瘢渐脓出而痊。服药后，不得饮水，恐再作脓，效迟。
初患三日者，服之立效。凡疮皆阴中之阳、阳中之阴二证而已，东垣治疽，阳药七分，阴药三分，
名曰升阳益胃散，老人宜之，亦名复煎散。或加没药、乳香各一钱。
上东垣论膏粱肉食之变，治宜苦寒不宜芳香者，如解里条《撮要》内消升麻汤、孙真人单煮大
黄汤，皆为富贵食肉之辈设也。
〔丹〕尝治一妇人，年将七十，形实性急而好酒，脑生疽十五日，脉弦紧急且涩。予急用大黄酒
煨，细切酒拌炒，为末，又酒拌炒人参入姜煎调一钱重，又两时再与。得睡，而上半身汗，睡觉病
已，此亦内托之意也。
〔仲〕排脓散方
枳实（十六枚） 芍药（六分） 桔梗（二分）
上三味，杵为散，取鸡子黄一枚，以药散与鸡子黄相等揉和，煎如薄粥，温服一升，即瘥。
〔丹〕朱绍八官右脚肿，生附骨痈。吃草药酒，多生隔痰，热壅无力。
人参 黄连 茯苓（一钱） 栝蒌子（四十八粒）
分二帖，入竹沥热饮。
〔《保》〕 诸疮肿已破未破， 肿者，当归散主之。
川芎 黄 栝蒌 木香 黄连（各等分）
上为粗末，水煎一两服。如痛而大便秘，加大黄三钱。
〔涓〕凡痈疽外冷内疼者，由阴气外逼皮肤，用热物熨之。大热亦不觉者，须用热物前后熨令
透，随手便用紧急溃脓毒药，使脓外出尽，肿平，即用生肉暖疮和正气药，令进饮食不倦。
治痈疽发背，初肿时方。
风化锻石（二两） 细辛（一两）
上为粗末，用热醋敷患处，干再敷。三上其肿即消。
四虎散治发背初生，筋脉紧急不舒。
附子（生，去皮，一两） 天南星（泡） 半夏（汤洗，七次） 野狼毒（各半两）
上四味，为末，热酒调成膏，摊上肿处，以熟绢靥定，觉患处如火烧不妨。
凡痈疽外热内疼者，是有客邪，内有积毒，欲作脓透之候。治背疮初发时小，后五七日赤肿高，
即罨药令内毒散，减疼免牵引，乳香膏。
乳香（一两） 青薄荷叶（四两，洗干）
上研匀，浓罨患处，以青绢盖之，如干以新汲水润之，常令湿，其热毒自然消散。如热毒攻结可用，
气毒攻结不可用。
贴痈毒，令内消，金黄散。
白芷 白芨 白蔹
上等分，为细末，用新汲水调敷。
〔丹〕治阳症肿毒，并金疮。
大粉草，锉细，用竹一段，刮去青，两头留节，开一小窍，入草在内，满后却用油灰塞窍。
从冬至日放粪缸内，待立春日先一日取起，竖在有风无日阴处二十一日，验两窍好，却破竹取草
为细末，用水调敷。
〔世〕围药。
南星 草乌 黄柏 白芨（各二两） 五倍子（一两，炒）
上为末，调如糊，随血围匝如墙壁，可移险处于不险处，如神。
敷药∶白蔹 白芷 南星 白芨 贝母（各等分）
上为末，水调敷，外用围药束定，内用敷药提起，制之有理。
〔《药性论》〕甘蕉根，捣敷一切痈肿上，干即更敷，无不瘥者。
〔梅〕治痈疽发背，或发乳房，初起微赤，不急治之，即死，速消方。捣苎根敷之，数易效。
〔《济》〕诸疮肿痛不可忍者。以葵花根去黑皮，捣烂。若稠，点井花水少许，若不稠不须用
水，以纸摊如膏药贴之，立效。（《经验方》用蜀葵敷之，亦妙。）
〔世〕又方 芙蓉叶捣烂敷之，立效。晒干为末，水调敷亦妙。发背，蜗牛百个活者，置净
瓶内，新汲水一盏，浸瓶中封闭，自晚至晓，其水如涎，取水将真蛤粉不拘多少调之，刷疮上效。
〔丹〕治背痈与疖，久年烟壁土、黄柏等分，细末，生姜汁捏成膏，敷之。夏以茅香汤下一二
钱，妙。（《经验》）
〔《本》〕治痈疽，止痛拔毒，七宝散。干荷叶心当中如钱片，不计多少，为粗末，每用三匙，
水二盏慢火煎至一碗半，放温淋洗，干以太白膏敷之。
太白膏
寒水石飞，用腊月猪脂调成膏，随疮大小，用薄纸摊贴之。
敛疮内消方
黄明胶一两，水半升，熔消了，入黄丹一两，再煮三五沸，又放温冷，以鸡毛扫在疮口上。
如未成，即涂肿处自消。
〔《外》〕凡痈，不问已溃未溃者。以胶一片，水浸令软，随肿大小贴当头上开一孔。若已溃
合脓者，当
被胶，急发之，脓皆出尽。未有脓者，肿当自消矣。
〔海〕治发背秘法。李北海云∶此方神授，极奇秘。以甘草三大两，生捣别筛末，大麦面九两，
于一盘中相和，搅令匀。取上好酥少许，别捻入药令匀，百沸水搜和如饼剂，方员大于疮一分，
热敷肿上，以油纸隔令通风，冷则换之。已成者脓水自出，未成者肿便内消。
〔丹〕隔皮取脓法，治诸般肿毒。
驴蹄（细切，一两，炒） 荞麦面（一两） 白盐（半两） 草乌（四钱，去皮）
上为末，水调作饼子，慢火炙黄，出火毒，研。米醋调成膏，用白纸摊贴患处，毒自毛窍而出，
其肿自退。
〔《保》〕 治疮疡 肿木硬，针头散。
上以蟾酥、乳香各一钱，同研匀细，以儿乳汁和如泥，入磁石盒收之，干不妨。每用以唾调
拨少许于肿处，上以膏药贴之，毒瓦斯自消，虽然有疮亦轻。
〔《济》〕万应针头丸治一切脑背疽，恶毒大疮欲死者，一粒即愈。
麝香（二钱） 血竭（三钱，如蜡者用，散者不用，非真） 轻粉（三钱） 蟾酥（三钱，
舌试辣者） 砂（三钱） 片脑（一钱） 蜈蚣（一对，全用）
上为极细末，炼蜜和丸，为剂。如疮有头者，用针头挑破，微有血出。将药一黍米大，放挑
开疮内，上用纸花周遭唾津湿，贴疮上，不过时刻，即愈。如两腋见无头疮，即是暗疔，即将两
手虎口内白土纹，用针挑破，如前法用药封盖。忌鸡鹅酒湿面一切发热之物。
〔子和〕一省掾背项常有痤疖，愈而复生。戴人曰∶太阳血有余也，先令涌泄之，次于委中排
针出紫血，病更不复作也。予男衮，常喜热火烘灼其背及两足，又食自死肉，久而两足常生疖毒，
愈而复生者半年余。予以清凉饮子下之，得紫黑血积于便中去者，月余其疖毒顿除，是知积热毒
致痈肿者如此。
李世英患疽，数日后根脚开大，或腹疼泄泻，手足常冷，脉沉微细，或自汗出，急用姜附之
药，甚者于脐下关元着艾三五百壮，待手足温，泄泻止，饮食知味，方可为喜。
〔《精》〕愤郁不遂志欲之人，多犯此疾。
〔无〕痈疽瘰 ，不问虚实寒热，皆由气郁而成。经云∶气宿于经络，与血俱涩而不行，
壅结为痈疽，不言热之所作，而后成痈者，此乃因喜怒忧思有所郁而成也。
远志酒治七情内郁成痈疽。（方见虚实条。）
This is a general discussion. As for critical areas, locations near deficiency, and places where the constitution is weak and thin, ancient sages have already discussed them; however, discussions on differentiation by meridians (Bian Jing) have not been heard of. Why? Among all meridians, only when carbuncles and sores occur in the Shaoyang (Gallbladder) and Jueyin (Liver) meridians should prevention be considered, because these two meridians are characterized by abundant Qi and scarce Blood. Since their Blood is inherently insufficient, muscles are difficult to grow and heal; if a sore remains unhealed for a long time, it will inevitably become a critical condition.
It is also said: The Shaoyang meridian has abundant Qi and scarce Blood, similar to the Jueyin meridian. The Shaoyang meridian contains Ministerial Fire (Xiang Huo), which is even more severe than that in the Jueyin meridian. If one fails to consider the scarcity of Blood in this meridian and rashly uses drugs to expel toxins and promote drainage, thereby attacking the Blood of the Yin aspect, disaster will follow immediately. I will recount a few instances of success and failure to inform future practitioners.
My clan uncle was prone to excessive worry throughout his life, with a weak constitution and fatigued spirit. Near the age of fifty, he suddenly developed a nodule (hard lump) on the upper outer edge of his right arm. He experienced slight aversion to cold and fever, along with irritability. His diet was rich and heavy. His pulse was floating, large, wiry, and rapid in all positions, but felt choppy upon deep pressure. I said: "This is caused by worry and sorrow injuring the Blood. It is early autumn; do not underestimate it. Urgent tonification is needed to prevent complications." We prepared a paste using one jin (approx. 500g) of Renshen (Ren Shen, Ginseng Root), administered with Zhuli (Bamboo Sap). The patient was stingy with expenses and hired a surgeon who alternately administered Shixuan San (Ten Acupoints Powder) and Wuxiang San (Five Fragrances Powder). Ten days later, on a day when fierce winds uprooted trees, the patient developed fever and poor mental clarity. I was summoned urgently. The nodule had become slightly elevated and prominent, suggesting pus formation. A red line appeared in the center, extending over the shoulder, diagonally around the back, and entering the right hypochondrium. There was no pain, but a sensation of heaviness and urgency in the shoulder and back, with nausea after eating. The pulse remained the same as before, but with a more pronounced wiry quality. I urgently prepared Ren Shen Gao (Ginseng Paste), adding Xiong (Chuan Xiong, Szechuan Lovage Rhizome), Zhu (Bai Zhu, Atractylodes Macrocephala Rhizome), and Shengjiang Jiang (Fresh Ginger Juice) for him to drink. Three jin of Ren Shen were used. After the sore ulcerated and the pus dried up, Siwu Tang (Four Substances Decoction) was prescribed, added with Renshen, Bai Zhu, Chen Pi (Tangerine Peel), Gan Cao (Licorice Root), Ban Xia (Pinellia Tuber), and Sheng Jiang. After more than a hundred doses, he recovered. If this had occurred in spring, even immortals could not have cured him. Fortunately, it happened in autumn when Metal energy dominates. Unfortunately, the sudden storm stirred up the Ministerial Fire within Wood, causing this condition. Without the rapid tonification of Ren Shen paste, how could he have escaped? (This precisely aligns with the method of filling and tonifying Zang-Fu organs described by Jingzi.)
Another person developed redness and swelling on the outer side of his leg, and another developed it under his hypochondrium; both died due to misdiagnosis and erroneous purgation by quacks. This is detailed in the following section.
Someone asked: "Is not the Taiyin meridian characterized by abundant Blood and scarce Qi? Why does Buttock Carbuncle (Tun Ju) often begin without severe suffering, yet occasionally proves incurable? Can you treat it?" I said: "The buttock is located behind the lower abdomen and below it; this is Yin within Yin. Its pathway is distant, and its location is remote. Although it is said to have abundant Blood, Qi circulation does not reach there. Since Qi does not reach, Blood rarely arrives either. People past middle age should not develop carbuncles here. When swelling and pain first appear, referring to the pulse and symptoms, if weakness is observed, immediate tonification should be given. If Blood and Qi are not depleted, ultimate safety can be ensured. If ordinary heat-clearing, toxin-expelling, and Qi-regulating drugs are used, the disaster of 'deficiency inducing deficiency' will be obvious, like seeing one's palm. How can one not be cautious?"
*Suwen* states: The Yellow Emperor asked: "How are various carbuncles, sores, tendon spasms, and bone pains generated?" Qibo replied: "These are swellings caused by Cold Evil and changes from the Eight Winds." The Yellow Emperor asked: "How should they be treated?" Qibo replied: "These are diseases of the four seasons; they heal when treated by overcoming their nature [using the Five Elements theory]." (*Mai Yao Jing Wei Lun*)
*Linghu* states: Blood vessels, Ying (Nutritive) Qi, and Wei (Defensive) Qi circulate ceaselessly, corresponding to the stars above and the numbers of meridians below. When Cold Evil invades, Blood becomes stagnant (Qi). Stagnant Blood leads to obstruction. Obstruction causes Wei Qi to gather there and prevents it from returning, resulting in carbuncles and sores. Cold evil transforms into Heat. Excessive Heat rots flesh, and rotted flesh becomes pus. If pus is not drained, tendons rot; if tendons rot, bones are injured; if bones are injured, Marrow dissipates. If excretion does not occur through bone cavities, and stagnation is not released, Blood becomes dry and empty. Consequently, sinews, bones, and muscles lose mutual nourishment, meridians fail and leak, fumes熏 (mingle with/attack) the Five Zang organs, organ damage leads to death. (*Yong Ju Pian*)
*Sheng Qi Tong Tian Lun* says: Wind striking sweat from labor causes Cold to press upon the skin, leading to acneiform eruptions; stagnation results in acne. It also says: When the opening and closing functions of Yang Qi fail, Cold Evil enters, resulting in severe curvature of the spine (Da Lou). When Ying Qi does not flow smoothly and reverses into muscle tissue, carbuncles and sores arise. This indicates that Cold Evil lingers for a long time in the gaps created by labor-sweat and the dysfunction of Yang Qi's opening/closing, eventually forming carbuncles. Observing these discussions, we know that the onset of carbuncles and sores is always due to the lodging of Cold Evil. However, regarding sores and ulcers determined by Six Qi transformation (Yunqi), where symptoms are similar among young and old throughout the year, some may involve Heat; this must be understood. (See Yunqi section.)
The aforementioned sections of the classics all discuss carbuncles and sores arising from Cold Evil lodging. The treatment methods are those from *Jing Yao*, such as Shixuan San (Ten Acupoints Powder), Wuxiang Tang (Five Fragrances Decoction), and Jiegu Cangzhu Fujian San (Cangzhu Re-decoction Powder by Li Dongyuan), which are exterior-releasing agents.
**Zhu Danxi Case:** Mr. Zhu, over forty years old, suffered from aversion to cold and fever. A toxic swelling arose on the inner edge of his right leg, in the Jueyin distribution. This is Cold restraining Heat in the Blood aspect of the Lung meridian. Prescribe this formula: Gua Lou Zi (Trichosanthes Fruit), Huang Yao Zi (Dioscorea Hypoglauca Rhizome), Chi Shao Yao (Red Peony Root), Dang Gui Tou (Angelica Sinensis Head), Tiao Qin (Scutellaria Baicalensis Root, 3 qian), Qing Pi (Citrus Aurantium Peel), Zao Jiao Ci (Gleditsia Sinensis Thorn), Gui Zhi (Cinnamon Twig, 2 qian), Gan Cao Jie (Licorice Joint, raw, 1 qian). Divide into four doses. Decoct to obtain one cup. Add Ren Dong Teng Juice (Honeysuckle Stem Juice) and Ge Ke (Clam Shell). Take warm before meals. Apply the dregs of Ren Dong Teng to the swelling.
**Jingzi Case:** Anshen San (Calming Spirit Powder) treats various types of swollen sores, regulating Qi and smoothing Ying and Wei. Ren Shen (Ginseng Root), Fu Ling (Poria), Gan Cao (Licorice Root, honey-fried), Zhi Qiao (Aurantium Fructus, pith removed, bran-fried), Fu Zi (Aconite Lateral Root, processed, peel and sprout removed), Bai Jiang (White Ginger), Shan Yao (Dioscorea Rhizome), Chen Pi (Tangerine Peel). Grind the above into fine powder. Take 1 qian per dose with one cup of water, three slices of fresh ginger, and one jujube. Decoct to 70%, take orally.
**Li Geng (Dongyuan) Case:** Changes from rich food and wine are also due to excessive flavors. Ying Qi becomes disordered and reverses into muscle tissue, causing carbuncles and sores. Ying Qi is Stomach Qi. Food enters the Stomach, is first transported to the Spleen, and then ascends to the Lung. The Lung governs all vessels, extends to the skin and hair, first travels the Yang pathways, then descends to the Five Zang and Six Fu organs, forming the Cun position at the Qi Kou. Now, wealthy people lack moderation. They consume ritual wine and fatty mutton mixed with strong flavors. Over time, these substances with strong aromas and flavors—which are Yang within Yang—fail to travel through the orifices and Yang pathways as usual, but instead travel the Yin pathways. Dampness becomes excessive. Following the principle of 'Son reinforcing Mother,' Fire becomes vigorous. With excessive Heat and Dampness, Kidney Water is attacked. If sexual activity is not regulated, True Water is damaged. Water deficiency allows Heat-Dampness to ascend. Sores will appear on the back and head; this is the most severe type of Da Ding (Great Carbuncle). If the toxic vapor emerges from the Lung or Spleen/Stomach regions, the toxicity is secondary. If it emerges from other meridians, it is even less severe. Wherever Heat-Dampness toxicity stops, ulceration occurs. Hence, the classics state: "Changes from rich food produce great carbuncles; receiving them is like holding an empty vessel to receive objects—nothing is refused." The treatment for Da Ding must drain Ying Qi. From the perspective of Root and Branch, the initial pathogenesis is the Root. Without bitter-cold drugs as the Sovereign agent, the painful suffering cannot be eliminated. For painful sores, using Ru Xiang (Frankincense) and Mo Yao (Myrrh) mixed with aromatic drugs to stop pain is ineffective and erroneous. If meridians flow freely and stagnation in Zang-Fu is removed, there will be no pain. Pain should be treated with bitter-cold drugs, ensuring recovery. Eating meat for sores is akin to suicide, because one should drain Qi but instead tonifies.
**Yuan Haowen Case:** After excessive drinking, the pulse was deep and rapid. In September, small sores appeared below the brain and above the neck, painless and itchless, resembling white-headed sores. After four days, numbness spread to the brain and neck, swelling dispersed outward, and Heat Toxicity erupted. Two days later, severe pain prevented sleep. The physician prescribed Wuxiang Lianqiao Tang (Five Fragrances Forsythia Decoction). Later, Dongyuan was invited. He said: "For changes from rich food, Wuxiang Lianqiao Tang is inappropriate; it is too late now. The carbuncle has existed for eight days. Fire therapy should be applied first, followed by herbs. Use moxa cones the size of two nuts, applying 100 moxibustions until pain is felt. Then prescribe: This is a disease of the Foot-Taiyang Bladder Meridian. The pathology is rebellious, requiring reverse treatment. The pulse is wiry and tight, pressing reveals surging, large, rapid, and forceful qualities. One must subdue the ruling factor and address the cause. Initially similar, finally different. First respect the annual Qi, do not violate Heaven's Harmony. According to the season, harvesting is appropriate, sweating is contraindicated. Both the classic and the disease forbid purgation. For stagnation, scatter it; use Salty flavor to soften hardness. However, since Cold invaded, Salty is restricted. Thus, Huanglian Xiaodu Yin (Coptis Detoxification Decoction) was formulated."
Huang Lian (Coptis Rhizome, 5 fen), Huang Qin (Scutellaria Root, 5 fen), Huang Bo (Phellodendron Bark, 5 fen, wine-washed), Ren Shen (Ginseng Root, 5 fen), Zhi Mu (Anemarrhena Rhizome, 4 fen, wine-fried, used as Sovereign for bitter-cold channel-penetrating guidance), Qiang Huo (Notopterygium Rhizome, 1 qian), Du Huo (Angelica Pubescens Root, 5 fen), Fang Feng (Saposhnikovia Root, 5 fen), Ben Cao (Ligusticum Chuanxiong Rhizome, 5 fen), Lian Qiao (Forsythia Fruit, 1 qian, used as Minister for pungent-warm resolution of meridian stagnation), Huang Qi (Astragalus Root, 1 qian), Gan Cao (Licorice Root, honey-fried, 5 fen, sweet-warm combined with three parts of bitter-cold; excess would nourish Ying Qi and tonify Earth), Dang Gui Shen (Angelica Sinensis Body, 1 qian, wine-washed), Sheng Di (Rehmannia Root, 1 qian, wine-washed, used for pungent-warm harmonizing and blood-nourishing), Chen Pi (Tangerine Peel, 5 fen, peel retained to tonify Stomach Qi), Gan Cao Shao (Licorice Tip, raw, 5 fen, sweet-cold to drain Kidney Fire and tonify Lower Jiao Yuan Qi), Ze Xie (Alisma Rhizome, 7 fen, bland-draining to guide alcohol-dampness, supporting Autumn Qi), Fang Ji (Stephania Root, 5 fen, wine-washed, removing residual Heat in Bladder), Gui Shao (Angelica Sinensis Tip, 5 fen), Su Mu (Sappan Wood, 5 fen, removing Cold-Evil), Jie Geng (Platycodon Root, 1 qian, preventing downward sinking of drugs, acting as a boat/oar). Drugs washed in wine and decocted with wine use wine-heat as the Cause and Enabler.
Take all as one dose. Add three cups of water, decoct until half-dry, strain, add a little wine, decoct again, take warm after meals. After administration, loud snoring sleep lasted until sunrise. Swelling reduced by 70%, spirit revived, appetite gradually returned, moxa scars suppurated, and recovery ensued. Do not drink water after taking medicine to avoid delaying pus formation and efficacy. For cases three days old, immediate effect is seen. All sores are either Yang-within-Yin or Yin-within-Yang syndromes. Dongyuan treated carbuncles with 70% Yang-tonifying drugs and 30% Yin-nourishing drugs, named Shengyang Yiwu San (Raise Yang Benefit Stomach Powder), suitable for the elderly, also called Fujian San (Re-decoction Powder). Optionally add 1 qian each of Mo Yao and Ru Xiang.
Above is Dongyuan's discussion on changes from rich food/meat, advocating bitter-cold over aromatic treatments, such as Neixiao Shengma Tang (Internal-Forsythia Descending-Decoction) from *Cuoyao* and Sun Simiao's Single-Boiled Da Huang Tang (Rhubarb Decoction), designed for the wealthy who eat meat.
**Zhu Danxi Case:** I once treated a woman nearing seventy, with a solid constitution, impatient temperament, and fondness for wine. She had a brain carbuncle for fifteen days. Her pulse was wiry, urgent, and choppy. I urgently used Da Huang (Rhubarb Root), wine-baked, finely cut, wine-stir-fried, and powdered. I also wine-stir-fried Ren Shen, added ginger, decocted, adjusted to 1 qian weight, and administered again after two hours. She slept, sweated on the upper body, and woke cured. This embodies the concept of internal support (Nei Tuo).
**Zhang Zhongjing Formula:** Paion San (Drain Pus Powder). Zhi Shi (Immature Bitter Orange, 16 pieces), Shao Yao (Peony Root, 6 fen), Jie Geng (Platycodon Root, 2 fen). Pound the three ingredients into powder. Take one chicken egg yolk. Mix the powder with the yolk equally, knead well, decoct like thin porridge. Take one sheng warm, and cure follows.
**Zhu Danxi Case:** Official Zhu Shaoba had swelling in the right foot, developing Gu Ben Yong (Bone-Deep Abscess). He drank herbal medicine wine, generating phlegm obstruction, Heat stagnation, and weakness. Ren Shen (Ginseng Root), Huang Lian (Coptis Rhizome), Fu Ling (Poria, 1 qian), Gua Lou Zi (Trichosanthes Fruit, 48 seeds). Divide into two doses. Add Zhuli (Bamboo Sap) and take hot.
*Bao Ming Ji* Case: For sores and swellings, whether ruptured or not, with swelling, Dang Gui San (Angelica Powder) is indicated. Chuan Xiong (Szechuan Lovage Rhizome), Huang Qi (Astragalus Root), Gua Lou (Trichosanthes Fruit), Mu Xiang (Aucklandia Root), Huang Lian (Coptis Rhizome) (equal parts). Grind into coarse powder. Decoct 1 liang in water. If painful with constipation, add Da Huang (Rhubarb Root, 3 qian).
**Jingzi Case:** For carbuncles and sores that are cold externally but painful internally, caused by Yin Qi forcing onto the skin, apply hot compresses. If even intense heat is not felt, use hot compresses front and back thoroughly. Immediately apply urgent pus-draining toxic drugs to ensure complete pus expulsion and swelling reduction. Then use drugs to generate flesh, warm the sore, and strengthen Zheng Qi, encouraging continuous food intake.
Formula for early-stage Back Carbuncle (Fa Bei): Feng Hua Duan Shi (Weathered Iron Pyrite, 2 liang), Xi Xin (Asarum Root, 1 liang). Grind into coarse powder. Apply with hot vinegar to the affected area; reapply when dry. After three applications, swelling subsides.
Si Hu San (Four Tigers Powder) treats early Fa Bei with tight and uncomfortable sinews and vessels. Fu Zi (Aconite Lateral Root, raw, peeled, 1 liang), Tian Nan Xing (Arisaema Rhizome, processed), Ban Xia (Pinellia Tuber, boiled seven times), Ye Lang Du (Stellera Chamaejasme Root, 0.5 liang each). Grind the four ingredients into powder. Mix with hot wine to form a paste. Spread on the swelling, fix with cooked silk gauze. A burning sensation at the site is acceptable.
For carbuncles and sores that are hot externally but painful internally, there is an invading pathogen and accumulated internal toxicity, indicating impending pus penetration. For early small back sores, after five to seven days of redness, swelling, and elevation, apply medication to disperse internal toxicity, reduce pain, and prevent traction. Use Ru Xiang Gao (Frankincense Ointment). Ru Xiang (Frankincense, 1 liang), Qing Bo He Ye (Fresh Mint Leaf, 4 liang, washed and dried). Grind evenly. Apply thickly to the affected area, cover with green silk gauze. If dry, moisten with fresh water to keep it wet. Heat toxicity will naturally dissipate. Applicable for Heat-toxicity aggregation, not for Qi-toxicity aggregation.
Golden Yellow San (Jin Huang San) for adhering to toxic sores to induce internal resolution. Bai Zhi (Angelica Dahurica Root), Bai Ji (Bletilla Rhizome), Bai Lian (Ampelopsis Rhizome). Equal parts, grind to fine powder. Mix with fresh water and apply.
**Zhu Danxi Case:** Treat Yang-syndrome toxic swellings and metal wounds. Da Fen Cao (Large Licorice Root), finely chopped. Take a section of bamboo, scrape off the green skin, leave nodes at both ends, make a small hole, insert grass, fill completely, seal hole with oil clay. Place in a dung pit starting from Winter Solstice. Retrieve one day before Spring Equinox. Stand in a windy, sunless shaded place for 21 days. Check holes are good, break bamboo, take grass, grind to powder. Mix with water and apply.
Secular Case: Encircling Medicine. Nan Xing (Arisaema Rhizome), Cao Wu (Aconitum Carmichaelii Root), Huang Bo (Phellodendron Bark), Bai Ji (Bletilla Rhizome) (2 liang each), Wu Bei Zi (Chinese Gall, 1 liang, stir-fried). Grind to powder. Mix into paste. Apply encircling the wound like a wall. Can move danger to safety, miraculous.
Topical Medicine: Bai Lian (Ampelopsis Rhizome), Bai Zhi (Angelica Dahurica Root), Nan Xing (Arisaema Rhizome), Bai Ji (Bletilla Rhizome), Bei Mu (Fritillaria Bulb) (equal parts). Grind to powder. Mix with water and apply. Secure with encircling medicine externally, lift internally with topical medicine. Rational preparation.
*Yao Xing Lun* Case: Gan Jiao Gen (Banana Root), mash and apply to all carbuncles and swellings. Reapply when dry. No case fails.
**Mei Case:** Treat Fa Bei or breast carbuncles. Early stage shows slight redness; if not treated urgently, death ensues. Rapid Resolution Formula: Mash Zhu Gen (Ramie Root) and apply. Change frequently for efficacy.
*Ji Sheng Fang* Case: Unbearable pain and swelling in all sores. Remove black skin from Kui Hua Gen (Sunflower Root), mash. If too thick, add a few drops of well water; if not thick, no water needed. Spread on paper like a plaster and apply. Immediate effect. (*Jing Yan Fang* suggests using Shu Kui [Hollyhock] is also excellent.)
Secular Case: Another Formula. Fu Rong Ye (Hibiscus Leaf), mash and apply. Immediate effect. Dry, powder, mix with water and apply is also good. For Fa Bei: 100 live snails in a clean bottle, add one cup of fresh water, seal, soak from evening to morning. Water becomes like saliva. Take this water, mix with genuine Ge Fen (Clam Powder) in any amount, brush onto the sore. Effective.
**Zhu Danxi Case:** Treat back carbuncles and boils. Old smoke-wall earth and Huang Bo (Phellodendron Bark) in equal parts, fine powder. Mix with fresh ginger juice to form paste. Apply. In summer, take 1-2 qian with Mao Xiang Tang (Mugwort Fragrance Decoction). Excellent. (*Jing Yan*)
*Ben Cao* Case: Treat carbuncles and sores, stop pain, extract toxicity. Qi Bao San (Seven Treasures Powder). Heart of dry lotus leaf, coin-sized slices, any quantity. Coarse powder. Use three spoons, two cups of water, slow fire decoct to 1.5 cups. Cool and wash. When dry, apply Tai Bai Gao.
Tai Bai Gao. Han Shui Shi (Calcite), flown. Mix with pig fat from the twelfth lunar month to form paste. Apply thinly on paper according to sore size.
Wound Healing and Internal Resolution Formula. Huang Ming Jiao (Yellow Transparent Gelatin, 1 liang), half sheng of water. Melt. Add Huang Dan (Lead Monoxide, 1 liang). Boil 3-5 times. Cool. Apply to sore opening with chicken feather. If not formed, apply to swelling for self-resolution.
*Waitai Miyao* Case: For all carbuncles, whether ruptured or not. Take a piece of gelatin, soak in water until soft. Apply to the top of the swelling according to size, open one hole. If ruptured and filled with pus, the gelatin covers it, urging eruption, draining all pus. If no pus, swelling resolves itself.
**Haizang Case:** Secret Method for Fa Bei. Li Beihai said: This formula is divinely bestowed, extremely secret. Use 3 liang of Gan Cao (Licorice Root), raw pounded and sifted. Mix with 9 liang of Da Mai Mian (Barley Flour) in a plate, stir evenly. Add a little superior butter, knead into medicine evenly. Knead with boiling water into cake-like dough, slightly larger than the sore. Apply hot to swelling, cover with oiled paper for ventilation, replace when cold. If formed, pus drains spontaneously; if not formed, swelling resolves internally.
**Zhu Danxi Case:** Skin-Piercing Pus Extraction Method for all toxic swellings. Lv Ti (Donkey Hoof, finely cut, 1 liang, stir-fried), Qiao Mai Mian (Buckwheat Flour, 1 liang), Bai Yan (White Salt, 0.5 liang), Cao Wu (Aconitum Carmichaelii Root, 4 qian, peeled). Grind to powder. Mix with water to make cakes. Slow-fire roast until yellow, remove fire toxicity, grind. Mix with rice vinegar to form paste. Spread on white paper, apply to affected area. Toxicity exits via hair follicles, swelling recedes.
*Bao Ming Ji* Case: Treat sores with swelling, wood-hard texture. Zhen Tou San (Needle Head Powder). Chan Su (Toad Venom) and Ru Xiang (Frankincense), 1 qian each. Grind finely. Mix with infant milk to mud consistency. Store in magnetite box. Drying is acceptable. Use saliva to moisten a small amount, dab on swelling, cover with plaster. Toxicity dissipates; even if sore forms, it is mild.
*Ji Sheng Fang* Case: Wan Ying Zhen Tou Wan (Ten Thousand Response Needle Head Pill) treats all brain/back carbuncles, malignant large sores threatening death. One pill cures. She Xiang (Musk, 2 qian), Xue Jie (Dragon's Blood, 3 qian, use wax-like, not scattered, otherwise fake), Qing Fen (Calomel, 3 qian), Chan Su (Toad Venom, 3 qian, spicy on tongue test), Sha (Realgar, 3 qian), Pian Nao (Borneol, 1 qian), Wu Gong (Centipede, 1 pair, whole). Grind to ultra-fine powder. Mix with refined honey into pills. If sore has a head, pierce with needle tip until slight bleeding. Place a millet-sized pill inside the opened sore. Cover with paper flower moistened with saliva. Cure within moments. If headless sores appear in armpits, it is An Ding (Hidden Carbuncle). Pierce the white earth lines on the tiger's mouth of both hands with a needle. Seal with medicine as above. Avoid chicken, goose, alcohol, damp noodles, and all heating foods.
**Zi He Case:** A provincial official constantly had acne and boils on the back and neck, recurring after healing. Dai Ren said: "Excess Blood in Taiyang. First induce vomiting/drainage, then puncture Wei Zhong (BL60) to drain purple blood. Disease will not recur." My son Gun liked to burn his back and feet with hot fires and ate dead meat. For over half a year, boils repeatedly appeared on his feet. I used Qing Liang Yin Zi (Cooling Drink) to purge him. Purple-black blood accumulated and was expelled in stool. Within a month, boils disappeared. Thus, we know that accumulated Heat-Toxicity causes carbuncles thus.
Li Shiyeng suffered from carbuncle. After several days, the base widened. Abdominal pain and diarrhea occurred. Hands and feet were often cold. Pulse was deep, minute, and fine. Spontaneous sweating occurred. Urgently use Jiang Fu (Ginger and Aconite) drugs. For severe cases, apply 300-500 moxibustions at Guan Yuan (CV4) below the navel. Wait for hands/feet to warm, diarrhea to stop, appetite to return, then rejoice.
*Jing Yao* Case: People frustrated and unfulfilled in desires often suffer this disease.
**Wu HaoGu Case:** Carbuncles, sores, and scrofula, regardless of deficiency/excess or cold/heat, are all caused by Qi stagnation. Classics say: Qi lodges in meridians, stagnates with Blood and fails to flow, obstructing and knotting to form carbuncles. It does not mention Heat as the cause. Those who become carbuncles later do so due to emotional depression from anger, joy, worry, or thought.
Yuan Zhi Jiu (Polygala Wine) treats carbuncles formed by internal depression of Seven Emotions. (Formula see Deficiency/Excess section.)