【方歌】〔月廉〕疮常分内外廉，外廉易治内难痊，外属三阳湿
热结，内属三阴虚热缠。法宜搜风除湿热，外贴三香夹
纸钱。
【注】此证生在两胫内外廉骨，外廉属足三阳经湿热结聚，早
治易于见效；内兼属三阴有湿，兼血分虚热而成，更兼
廉骨皮肉浇薄，难得见效，极其绵缠。初发先痒后痛，
红肿成片，破津紫水。新起宜贴三香膏，色紫贴夹纸膏
；日久疮色紫黑，贴解毒紫金膏；又年久顽〔月廉〕，
疮皮乌黑下陷，臭秽不堪者，用蜈蚣钱法，去风毒，化
瘀腐，盖贴黄蜡膏，渐效。初服黄耆丸，日久者服四生
丸，下元虚冷者宜虎潜丸，常服甚效。但腿胫在至阴之
下，生疮者当戒劳动、发物，其证可愈，否则难痊。
方剂：三香膏
组成：轻粉 乳香
松香（各等分）
共为末，香油调稠，用夹纸一面，以针密刺细孔，
将药夹搽纸内；先以葱汤洗净患处，将药纸有针孔一面
，对疮贴之，三日一换。
【方歌】三香轻粉乳松香，研末油调纸内藏，葱汤洗患方贴药，
初起〔月廉〕疮用此良。
又方：夹纸膏
组成：黄丹（炒） 轻粉
儿茶 没药
雄黄 血竭
五倍子（炒） 银朱
枯矾（各等分）
共为末，量疮大小，剪油纸二张，夹药于内，纸周
围用面粘粘住，纸上用针刺孔；先将疮口用葱、椒煎汤
洗净拭干，然后粘贴，以帛缚之，三日一洗，再换新药
贴之。
【方歌】夹纸膏贴〔月廉〕疮破，黄丹轻粉身茶没，雄黄竭倍银
朱矾，油纸夹贴腐可脱。
又方：解毒紫金膏
组成：明净松香 皂矾（〔火段〕，各一斤）
共研极细末，香油调稠；先用葱、艾、甘草，煎汤
洗净碗处，再搽此药，油纸盖住，以软布扎紧，三日一
换。此药又治杨梅结毒，腐烂作臭，脓水淋漓，用之甚
效。
【方歌】解毒紫金〔月廉〕疮烂，明净松香皂矾〔火段〕，二味
研末香油调，葱艾草汤先洗患。
又方：蜈蚣钱
组成：蜈蚣 甘草
独活 白芷（各一钱）
桐油二两，将药煎滚；先以米泔水洗净〔月廉〕疮
，水和白面作圈，围在疮之四边，勿令泄气，将腿放平
，以茶匙挑油，渐渐乘热加满，待油温取下。已后风毒
自散，腐肉渐脱，其功甚速。
【方歌】蜈蚣钱治久〔月廉〕疮，皮黑下陷臭难当，桐油煎草独
活芷，白面圈疮油烫强。
又方：黄蜡膏
组成：血竭（〔火段〕） 赤石脂（〔火段〕）
龙骨（〔火段〕，各三钱）
共为细末，香油一两，入血余粟子大一团，炸枯去
滓；再入黄蜡一两，白胶香三钱，溶化尽离火，下血竭
等末，搅匀候冷，磁罐盛之。用时捏作薄片贴疮上，绢
帛缚定，三日后，翻过贴之。
【方歌】黄蜡血余竭白胶，石脂龙骨竹油调，蜈蚣钱后此膏盖，
肌肉能生痛自消。
又方：黄耆丸
组成：黄耆 川乌头（炮，去皮，弦）
赤小豆 蒺藜（炒，去刺）
地龙（去土，炒） 川楝子（盐水炮，去核）
茴香（炒） 防风（各一两）
乌药（五钱）
上为细末，酒煮，面糊为丸，如梧桐子大。每服十
五丸，空心温酒送下，盐汤亦可，妇人用醋煎滚，候温
送下。
【方歌】黄耆丸治〔月廉〕疮起，川乌赤豆共蒺藜，地龙川楝茴
香炒，防风乌药酒糊宜。
又方：四生丸
组成：地龙（去土，炒） 白附子
僵蚕（炒） 草乌（去皮、尖，炮）
五灵脂（各等分）
上为细末，米糊为丸，如梧桐子大。每服三、四十
丸，食前茶、酒任下。
【方歌】四生〔月廉〕疮久缠绵，骨节多疼举动难，地龙白附僵
蚕炒，草乌灵脂米糊丸。
又方：虎潜丸
组成：败龟板（酥炙，四两） 知母
黄柏（二味盐、酒炒） 熟地（各三两）
牛膝（酒蒸） 白芍（酒炒）
陈皮（盐水润，各二两） 琐阳（酒调）
当归（酒洗，各一两五钱） 虎胫骨（酥制，一两）
共研末，羯羊肉酒煮烂捣膏，和入药末内为丸，如
梧桐子大。每服三钱，空心淡盐汤送下。冬月加干姜一
两。
【方歌】虎潜丸疗筋骨痿，下元虚冷精血亏，龟板琐阳膝虎胫，
知柏芍陈熟地归。
[Formula Song] Jingchuang (Ulcers occurring on the lower leg) are generally divided into the medial and lateral aspects of the ankle. The lateral aspect is easy to treat, while the medial aspect is difficult to cure. The lateral aspect belongs to the accumulation of damp-heat in the Yang meridians of the foot, while the medial aspect belongs to the entanglement of deficiency-heat in the Yin meridians of the foot. The treatment method should be to dispel wind, remove dampness, and clear heat. Externally apply Sanxiang Jiazhi Gao (Three-Fragrance Paper-Clamped Plaster).
[Annotation] This condition occurs on the bones of the medial and lateral aspects of the shins. The lateral aspect belongs to the foot-Yang meridians, where damp-heat pathogens accumulate; early treatment yields effective results easily. The medial aspect involves dampness in the foot-Yin meridians combined with deficiency-heat in the blood level. Additionally, the skin and flesh around the malleolus are thin, making it difficult to see results, and the condition is extremely persistent. Initially, there is itching followed by pain, redness and swelling forming patches, which break open to discharge purple fluid. For newly onset ulcers, Sanxiang Gao (Three-Fragrance Plaster) is suitable for application; for those with a purple color, Jiazhi Gao (Paper-Clamped Plaster) is applied; for long-standing ulcers turning dark purple or black, Jiedu Zijin Gao (Detoxifying Purple Gold Plaster) is used. For chronic, stubborn Jingchuang with black, depressed ulcer skin and unbearable foul odor, the Wugong Qian (Centipede Coin) method is employed to expel wind-toxins and resolve stasis and putrefaction, followed by covering with Huangla Gao (Yellow Wax Plaster) for gradual improvement. Initially, Huangqi Wan (Astragalus Pill) is taken orally; for long-standing cases, Sisheng Wan (Four-Generations Pill) is taken; for those with deficiency-cold of the Lower Yuan (Kidney and Bladder), Hujian Wan (Tiger-Hiding Pill) is indicated, which is very effective when taken regularly. However, since the legs are located below the supreme Yin, patients with ulcers must abstain from labor and "fa-wu" (stimulating foods that may exacerbate disease); otherwise, recovery will be difficult.
Formula: Sanxiang Gao (Three-Fragrance Plaster)
Composition: Qingfen (Calomel), Ruxiang (Frankincense), Songxiang (Pine Rosin) (equal parts)
Preparation: Grind all ingredients into fine powder. Mix with sesame oil to form a thick paste. Apply the paste onto one side of a piece of paper reinforced with another layer (Jiazhi). Use a needle to densely prick small holes through the paper. First, wash the affected area with scallion water. Apply the medicated paper with the perforated side directly against the ulcer. Change every three days.
[Formula Song] Sanxiang Gao consists of Calomel, Frankincense, and Pine Rosin. Ground into powder and mixed with oil, it is stored within paper. After washing the lesion with scallion water, apply the medicine; this is excellent for initial Jingchuang.
Another Formula: Jiazhi Gao (Paper-Clamped Plaster)
Composition: Huangdan (Lead Tetroxide, stir-fried), Qingfen (Calomel), Ercha (Catechu), Moyao (Myrrh), Xionghuang (Realgar), Xuexie (Dragon's Blood), Wubeizi (Galla Chinensis, stir-fried), Yinzhu (Vermilion), Kufan (Alum, calcined) (equal parts)
Preparation: Grind all ingredients into fine powder. Cut two sheets of oiled paper according to the size of the ulcer. Place the medicine between the papers and seal the edges with flour paste. Prick holes in the top sheet with a needle. First, wash and dry the ulcer with a decoction of scallion and pepper. Apply the plaster and bind with cloth. Wash every three days, then replace with fresh medicine.
[Formula Song] Jiazhi Gao is applied to broken Jingchuang. It contains Lead Tetroxide, Calomel, Catechu, Myrrh, Realgar, Dragon's Blood, Galla Chinensis, Vermilion, and Alum. Clamped in oiled paper, it helps detach necrotic tissue.
Another Formula: Jiedu Zijin Gao (Detoxifying Purple Gold Plaster)
Composition: Mingjing Songxiang (Clear Pine Rosin), Zaojian (Green Vitriol, calcined) (one jin each)
Preparation: Grind into extremely fine powder. Mix with sesame oil to form a thick paste. First, wash the affected area with a decoction of scallion, mugwort, and licorice. Apply this medicine, cover with oiled paper, and tie tightly with soft cloth. Change every three days. This formula is also effective for Yangmei Jiedu (Syphilitic Chancre/Gumma) characterized by rotting, foul odor, and dripping pus.
[Formula Song] Jiedu Zijin Gao treats rotten Jingchuang. It consists of Clear Pine Rosin and Calcined Green Vitriol. Ground into powder and mixed with sesame oil, wash the lesion with Scallion, Mugwort, and Licorice decoction first.
Another Formula: Wugong Qian (Centipede Coin)
Composition: Wugong (Centipede), Gancao (Licorice), Duhuo (Angelica Pubescens), Baizhi (Angelica Dahurica) (each 1 qian)
Preparation: Boil the herbs in two liang of tung oil. First, wash the Jingchuang with rice water. Make a ring of white flour dough and place it around the four sides of the ulcer to prevent leakage. Keep the leg flat. Using a tea spoon, slowly add hot oil until full. Remove when the oil temperature is appropriate. Thereafter, wind-toxins will dissipate naturally, and necrotic flesh will gradually shed; the effect is rapid.
[Formula Song] Wugong Qian treats long-standing Jingchuang with black, depressed skin and unbearable odor. Tung oil is boiled with Licorice, Angelica Pubescens, and Angelica Dahurica. A white flour ring encircles the ulcer, and hot oil is applied strongly.
Another Formula: Huangla Gao (Yellow Wax Plaster)
Composition: Xuexie (Dragon's Blood, calcined), Chishizhi (Red Halloysite, calcened), Longgu (Fossilized Bone, calcined) (each 3 qian)
Preparation: Grind into fine powder. Take one liang of sesame oil and add a ball of human hair (Xueyu) the size of a millet seed. Fry until withered, then strain off the dregs. Add one liang of yellow wax and three qian of Baijiaoxiang (Mastic Resin). Melt completely, remove from fire, and add the powdered herbs. Stir evenly and let cool. Store in a porcelain jar. When using, pinch into thin slices and apply to the ulcer. Bind with silk cloth. After three days, flip and apply to the other side.
[Formula Song] Huangla Gao uses Dragon's Blood, Human Hair, Mastic Resin, Red Halloysite, and Fossilized Bone, mixed with oil. Applied after Wugong Qian, it promotes muscle growth and eliminates pain.
Another Formula: Huangqi Wan (Astragalus Pill)
Composition: Huangqi (Astragalus), Chuanwutou (Aconitum carmichaelii root, processed, peeled, sliced), Chixiaodou (Adzuki Bean), Jili (Tribulus terrestris, stir-fried, thorns removed), Dilong (Earthworm, cleaned, stir-fried), Chuanlianzi (Toosendan fruit, salt-water processed, pitted), Huixiang (Fennel, stir-fried), Fangfeng (Saposhnikovia root, each 1 liang), Wuyao (Lindera root, 5 qian)
Preparation: Grind all ingredients into fine powder. Cook with wine and make pills using wheat flour paste, sized like paulownia seeds. Take fifteen pills per dose, swallowed with warm wine on an empty stomach. Salt water decoction is also acceptable. For women, boil vinegar, let cool to warm temperature, and swallow.
[Formula Song] Huangqi Wan treats the onset of Jingchuang. It includes Chuanwu, Adzuki Bean, Tribulus, Earthworm, Toosendan Fruit, Fennel (stir-fried), Saposhnikovia Root, and Lindera Root. Prepared with wine and flour paste.
Another Formula: Sisheng Wan (Four-Generations Pill)
Composition: Dilong (Earthworm, cleaned, stir-fried), Baifuzi (Typhonium rhizome), Jiangcan (Bombyx batryticatus, stir-fried), Caowu (Aconitum kusnezoffii root, peeled, tip removed, processed), Wulingzhi (Trogopterus dung, equal parts)
Preparation: Grind all ingredients into fine powder. Make pills using rice paste, sized like paulownia seeds. Take thirty to forty pills per dose before meals, swallowed with tea or wine as preferred.
[Formula Song] Sisheng Wan treats persistent Jingchuang that lingers, often causing joint pain and difficulty in movement. It contains Earthworm, Typhonium Rhizome, Bombyx Batryticatus (stir-fried), Aconitum Kusnezoffii Root, and Trogopterus Dung, made into pills with rice paste.
Another Formula: Hujian Wan (Tiger-Hiding Pill)
Composition: Baiguiban (Tortoise plastron, fried with酥/suet, 4 liang), Zhimu (Anemarrhena rhizome), Huangbai (Phellodendron bark, these two stir-fried with salt and wine), Shudi (Rehmannia glutinosa root, prepared, each 3 liang), Niuxi (Achyranthes bidentata root, steamed with wine), Baishao (White Peony root, stir-fried with wine), Chenpi (Citrus reticulata peel, moistened with salt water, each 2 liang), Suoyang (Cynomorium songaricum, soaked in wine), Danggui (Angelica sinensis root, washed with wine, each 1.5 liang), Hu jinggu (Tiger tibia bone, prepared with suet, 1 liang)
Preparation: Grind all ingredients into powder. Boil male sheep meat (Jie yang rou) in wine until tender, mash into a paste, and mix with the herbal powder to form pills sized like paulownia seeds. Take three qian per dose, swallowed with light salt water decoction on an empty stomach. In winter, add one liang of Ganjiang (Dried Ginger).
[Formula Song] Hujian Wan treats flaccidity of sinews and bones due to deficiency-cold of the Lower Yuan and depletion of essence and blood. It contains Tortoise Plastron, Cynomorium, Achyranthes Root, Tiger Tibia Bone, Anemarrhena Rhizome, Phellodendron Bark, White Peony Root, Citrus Peel, Prepared Rehmannia Root, and Angelica Sinensis Root.