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Appendix: Xue Ji's General Formula for Treating Ulcers. It is used to treat all kinds of sores and ulcers; if pus has not yet formed, it dissipates them internally; if pus has already formed, it promotes suppuration and rupture. It is also a holy medicine for relieving pain and detoxification.

Schistochilae Cortex (Chuan Shan Jia, 穿山甲), Angelicae Dahuricae Radix (Bai Zhi, 白芷), Saposhnikoviae Radix (Fang Feng, 防风), Gleditsiae Sinensis Spina Fructus (Zao Jiao Ci, 皂角刺), Boswelliae Resina (Ru Xiang, 乳香), Myrrhae Resina (Mo Yao, 没药), Cauda Angelicae Sinensis Radix (Dang Gui Wei, 当归尾), Paeliae Radix Rubra (Chi Shao, 赤芍), Trichosanthis Radix (Hua Fen, 花粉), Fritillariae Cirrhosae Bulbus (Bei Mu, 贝母), Citri Reticulatae Pericarpium (Chen Pi, 陈皮), Lonicerae Japonicae Flos (Jin Yin Hua, 金银花), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草). These thirteen ingredients. Use one bowl of wine, boil for several times until boiling, then take orally.

[Collected Notes] Luo Qianfu said: This is the first formula in the department of surgery for attacking and eliminating toxins. The Classic says: When Ying Qi (Nutritive Qi) does not flow smoothly, it reverses into the muscle tissue. Therefore, the onset of carbuncles and sores always stems from the stagnation of Ying Qi, leading to blood coagulation and phlegm retention, which accumulate heat and transform into toxic pathogens. The method of treatment lies in unblocking the knots of the meridians, promoting the circulation of stagnant blood, assisted by resolving phlegm, regulating qi, and detoxifying. In this formula, Schistochilae Cortex breaks down hard accumulations, Gleditsiae Sinensis Spina Fructus reaches the site of the toxin, Angelicae Dahuricae Radix, Saposhnikoviae Radix, and Citri Reticulatae Pericarpium unblock the meridians and regulate qi to disperse stagnation, Boswelliae Resina stabilizes pain and harmonizes blood, Myrrhae Resina breaks blood stasis and dissipates nodules, Paeiliae Radix Rubra and Cauda Angelicae Sinensis Radix drive out blood heat and promote circulation to break up clots. Assisted by Fritillariae Cirrhosae Bulbus, Lonicerae Japonicae Flos, and Glycyrrhizae Radix et Rhizoma, one resolves phlegm and relieves depression, the other dissipates toxins and harmonizes blood. Thus, it is indeed suitable for breaking hardness and relieving pain. However, this formula is designed for patients whose Ying and Wei (Defensive) Qi are still strong and whose Middle Qi is not deficient. If the Spleen and Stomach have been weak since childhood, or Ying and Wei Qi are discordant, the method of Tuoli Xiaodu San (Support-the-Interior and Detoxify Powder) should be adopted, and it must be used with careful consideration. This is the theory of Xue Ji, an unchangeable treatment principle through the ages. Therefore, I append the principles of using formulas for treating ulcers below, so that students may keep them firmly in mind.

Xue Ji said: Regarding the method of treating ulcers, if there is swelling, elevation, burning sensation, and pain, first use Xianfang Huoming Yin (Immortal Life Elixir for Sores) to resolve the pathogen, followed by Tuoli Baidu San (Support-the-Interior and Defeat-Toxin Powder). If there is diffuse swelling without significant elevation and slight pain, use Tuoli San (Support-the-Interior Powder); if ineffective, add Zingiberis Rhizoma Recens (Sheng Jiang, 生姜) and Cinnamomi Cortex (Rou Gui, 肉桂). If pain persists after pus discharge, it indicates deficiency of Qi and Blood; use Bazhen San (Eight-Treasure Powder). If no pus forms and no ulceration occurs, it indicates deficiency of Yang Qi; use Sijunzi Tang (Four-Gentlemen Decoction) plus Dang Gui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), and Rougui (Cinnamomi Cortex). If granulation tissue does not grow and wounds do not contract, it indicates deficiency of Spleen Qi; use Sijunzi Tang plus Shaoyao (Paeoniae Radix Alba, Bai Shao, 白芍) and Muxiang (Aucklandiae Radix, 木香). If aversion to cold and chilliness occur, it indicates deficiency of Yang Qi; use Shiquan Dabu Tang (Perfectly Complete Great Tonifying Decoction) plus Sheng Jiang (Zingiberis Rhizoma Recens, 生姜) and Rougui (Cinnamomi Cortex, 肉桂). If afternoon fever and internal heat occur, it indicates deficiency of Yin and Blood; use Siwu Tang (Four-Materials Decoction) plus Renshen (Ginseng Radix, 人参) and Huangqi (Astragali Radix, 黄芪). If nausea or vomiting occurs, it indicates deficiency of Stomach Qi; use Liujunzi Tang (Six-Gentlemen Decoction) plus Paoshengjiang (Prepared Zingiberis Rhizoma, 炮姜). If spontaneous sweating or night sweats occur, it indicates deficiency of the Five Zang Organs; use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) material plus Wuweizi (Schisandrae Chinensis Fructus, 五味子). If poor appetite and physical fatigue occur, it indicates deficiency of Spleen Qi; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuling (Poria, 茯苓) and Banxia (Pinelliae Rhizoma, 半夏). If panting, shortness of breath, and cough occur, it indicates deficiency of Spleen and Lung; use the previous decoction plus Maidong (Ophiopogonis Radix, 麦冬) and Wuweizi (Schisandrae Chinensis Fructus, 五味子). If nausea and poor appetite occur, it indicates deficiency of Spleen and Stomach; use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction). If abdominal pain and diarrhea occur, it indicates Cold-Deficiency of Spleen and Stomach; use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). If heat, thirst, dysuria, or urinary retention occur, it indicates Kidney Deficiency with Ministerial Fire flaring up; use Jiaban Bawei Wan (Modified Eight-Ingredient Pill). Generally speaking, for those with weak constitutions, regardless of whether swelling or ulceration has occurred, one should first tonify Stomach Qi. For the occurrence of sores and ulcers stems from the depletion of Yin and Yang; once pus is discharged, Qi and Blood become even more deficient. How could it not be appropriate to use tonification! Some doubt that Renshen (Ginseng Radix, 人参) and Huangqi (Astragali Radix, 黄芪) fill the chest and middle jiao; occasionally, when these are used, dispersing and detoxifying herbs are added, resulting in the benefit not compensating for the loss. Others, because they have a disease, refuse to take tonifying agents, leading to many errors and mishaps. Is this not truly regrettable!