方剂：蟾酥拈子（瘰历溃后方）
组成：蟾酥（黄豆大一块）白丁香（十五粒）寒水石（黄豆大
一块）巴豆（去壳，十粒）寒食面（黄豆大一块）
上各研细，共合一处再研匀，炼蜜搓成捻子。每用
一根，用针将瘰历当顶针一孔，插拈子入孔内，用绿云
膏盖贴。连插三日后，单换膏药，候数日后，顽根自脱
，以脓净硬退为效。如硬未尽再用，以尽为度。
【方歌】蟾酥拈子化坚方，瘰历将溃纳入疮，寒水石共巴豆肉，
寒食面与白丁香。
又方：五云膏（瘰历溃后方）
主治：专贴鼠疮、马刀、瘰历已溃。
主治：银黝子（捶碎，四两） 黄丹（飞过，八两）
香油（二十两）
用砂锅一口盛香油，火温候油热，将银黝子投入油
内，用桃、柳、桑、槐、枣五样树枝搅之，候起珍珠花
时，捞去渣，用布滤净；复将油下入锅内，慢慢将黄丹
筛入油内，用五枝不住手搅之，以滴水成珠为度，取出
收贮。用时勿令见火，以重汤纯化，红缎摊贴。
【方歌】五云膏贴鼠疮证，瘰历溃后共马刀，银黝油熬渣滤净，
黄丹五枝搅成膏。
又方：绿云膏（瘰历溃后方）
组成：黄连 大黄
黄芩 元参
黄柏 木鳖子（去壳，各一钱）
上药共切片，用香油一两，炸焦色，去渣；入净松
香五两，再熬成膏，倾入水中，扯拔令金黄色，入铫内
再熬数滚，候温；将猪胆汁三枚，铜绿三钱，预用醋一
两，浸一宿，绢滤去渣；同入膏内，用柳枝搅之，候冷
为度。用时以重汤炖化，薄纸摊贴甚效。
【方歌】绿云历破贴最神，军柏连鳖元参芩，油炸滤渣加松脂，
胆汁铜绿入搅匀。
又方：蛇蜕膏（瘰历溃后方）
组成：蜜蜂（二十一个） 蛇蜕（七分半）
蜈蚣（端午前收者佳，二条）
上用香油四两，将前三药入油，用文武火炸枯，捞
去渣；入定粉二两，用如箸粗桑枝七条，急搅候冷，出
火气七日夜。方用纸摊贴患处。
【方歌】蛇蜕亮贴溃后历，专消余毒功效极，蜈蚣蜜蜂炸去渣，
定粉油熬出火气。
总结：凡治瘰历马刀溃破之后，应用方药，气血两虚，宜八珍
汤；坚硬未消者，宜香贝养荣汤；食少便泻者，宜香砂
六君子汤；血虚肝热，或疮口出血，或红肿者，宜逍遥
散，加丹皮、炒栀子；疮口敛迟，宜用十全大补汤加白
蔹；虚烦不寐者，宜归脾汤调理。但药剂大小，量人岁
数、虚实，斟酌用之。
方剂：八珍汤（见溃疡门）
香贝养荣汤（见石疽门）
香砂六君子汤（见溃疡门）
逍遥散（见背部上搭手）
十全大补汤（见溃疡门）
归脾汤（见乳部乳中结核）
益元散（即六一散加朱砂少许，见胸部蠹疽）
Formula: Chan Su Nian Zi (Decoction for Post-Ulceration of Scrofula)
Composition: Toad venom (Chan Su, 蟾酥) (size of a soybean), White starling droppings (Bai Ding Xiang, 白丁香) (15 grains), Calcitum (Han Shui Shi, 寒水石) (size of a soybean), Croton seed (Ba Dou, 巴豆) (shelled, 10 grains), Cold-food flour (Han Shi Mian, 寒食面) (size of a soybean).
Grind each ingredient into fine powder separately, mix them together and grind uniformly. Shape into thread-like sticks using refined honey. Use one stick per application: pierce a hole at the apex of the scrofula with a needle, insert the stick into the hole, and cover with Lv Yun Gao (Green Cloud Ointment). Continue insertion for three days, then change only the plaster. After several days, the stubborn root mass will naturally detach. The treatment is considered effective when pus is cleared and induration subsides. If induration remains, continue use until completely resolved.
Another Formula: Wu Yun Gao (Five Clouds Ointment) (for post-ulceration of scrofula)
Indications: Specifically applied to rat sores (Shu Chuang, 鼠疮), horse knife (Ma Dao, 马刀), and scrofula (Luo Li, 瘰疬) that have already ulcerated.
Composition: Lead monoxide (Yin You Zi, 银黝子/铅丹) (crushed, 4 liang), Litharge (Huang Dan, 黄丹) (refined by flying, 8 liang), Sesame oil (Xiang You, 香油) (20 liang).
Place sesame oil in a clay pot and heat gently over fire. When the oil is hot, add the lead monoxide. Stir with branches from five types of trees: peach, willow, mulberry, locust, and jujube. When pearl-like bubbles appear on the surface, remove the dregs and filter through cloth. Return the oil to the pot, slowly sift in the litharge while stirring continuously with the five branches, until the "drop forms a bead" test is passed. Remove and store. When using, avoid direct flame; melt it in a double boiler and spread onto red silk for application.
[Formula Song] Wu Yun Gao treats rat sores, scrofula and ma dao after ulceration; Lead monoxide boiled in oil and filtered, litharge stirred with five branches to form ointment.
Another Formula: Lv Yun Gao (Green Cloud Ointment) (for post-ulceration of scrofula)
Composition: Coptis rhizome (Huang Lian, 黄连), Rhubarb (Da Huang, 大黄), Scutellaria root (Huang Qin, 黄芩), Rehmannia root (Yuan Shen, 元参), Phellodendron bark (Huang Bo, 黄柏), Momordica charantia seed (Mu Bie Zi, 木鳖子) (shelled, 1 qian each).
Slice all herbs, fry in 1 liang of sesame oil until dark yellow, and filter out dregs. Add 5 liang of pure pine resin and boil into an ointment. Pour into water, pull and stretch until golden yellow. Boil again in a crucible for several boils, then let cool. Prepare pig bile (3 units) and copper green (Tong Lu, 铜绿) (3 qian): soak in 1 liang of vinegar overnight, filter through silk to remove dregs. Mix these liquids into the ointment, stir with a willow branch, and allow to cool. Melt in a double boiler before use, spread thinly on paper, and apply. Highly effective.
[Formula Song] Green Cloud Ointment is miraculous for ulcerated scrofula; Da Huang, Huang Bo, Huang Lian, Mu Bie Zi, Yuan Shen, Huang Qin; Fried in oil, filtered, plus pine resin; Pig bile and copper green mixed evenly.
Another Formula: She Tui Gao (Snake Slough Ointment) (for post-ulceration of scrofula)
Composition: Honeybee (Feng Mi, 蜜蜂 - whole body implied here as insect drug) (21 pieces), Snake slough (She Tui, 蛇蜕) (7.5 fen), Centipede (Wu Gong, 蜈蚣) (collected before Dragon Boat Festival is best, 2 pieces).
Add the first three ingredients to 4 liang of sesame oil. Fry with moderate heat until crisp, remove dregs. Add 2 liang of calamine (Ding Fen, 定粉). Stir rapidly with seven mulberry branches (thickness of chopsticks) until cool. Let stand for 7-10 days to dissipate the "fire qi". Spread on paper and apply to the affected area.
[Formula Song] Snake Slough Ointment applied to ulcerated scrofula eliminates residual toxins effectively; Centipedes and bees fried and filtered; Calamine boiled in oil and cooled.
Summary: For treating post-ulceration of scrofula and ma dao:
- If there is deficiency of both Qi and Blood, Ba Zhen Tang (Eight Treasures Decoction) is suitable.
- If hard masses remain unresolved, Xiang Bei Yang Rong Tang (Aucklandia and Citrus Nourishing Nutritive Decoction) is suitable.
- If appetite is poor and stools are loose, Xiang Sha Liu Jun Zi Tang (Citrus and Amomum Six Gentlemen Decoction) is suitable.
- If there is Blood deficiency with Liver Heat, or if the sore bleeds or becomes red and swollen, Xiao Yao San (Free and Easy Wanderer Powder) with added Moutan Cortex (Dan Pi, 丹皮) and stir-fried Gardenia (Chao Zhi Zi, 炒栀子) is suitable.
- If wound healing is delayed, Shi Quan Da Bu Tang (Great Tonifying Ten Ingredients Decoction) with added Bai Lian (Bai Lian, 白蔹) is suitable.
- If there is empty irritability and insomnia, Gui Pi Tang (Restore the Spleen Decoction) is suitable for regulation.
Dosage should be adjusted according to the patient's age and condition of excess or deficiency.
Formulas mentioned:
- Ba Zhen Tang (See Ulcer Section)
- Xiang Bei Yang Rong Tang (See Stone Abscess Section)
- Xiang Sha Liu Jun Zi Tang (See Ulcer Section)
- Xiao Yao San (See Upper Back Dashi Section)
- Shi Quan Da Bu Tang (See Ulcer Section)
- Gui Pi Tang (See Breast Nodule Section)
- Yi Yuan San (See Chest Du Ju Section; composed of Liu Yi San plus a small amount of Cinnabar)