《病源论》云∶凡痈若按之都牢坚者，未有脓也；按之半软者，有脓也。又，以手掩肿
上，不热者无脓。若热甚者，为有脓。凡觉有脓，宜急破之，不尔，侵食筋骨。
《刘涓子》云∶痈大坚者，未有脓。半坚半薄半有脓。当上薄者，都有脓，便可破。可
破之法，应在下逆上破之，令脓易出，用铍（披眉反）针。脓深难见，上肉浓而生内大针。
若外不别有脓，可当其上数按之，内便隐痛者，肉殃坚者，未有脓也。按更不痛于前者，内
脓已熟也。脓泄去热气，不尔长连，连则不良。
痈审知有脓者，按之处陷不复者无脓，按之即复者有脓；初肿大，按乃痛者病深；小按
便痛者病浅也。凡破痈之后，病患便绵 欲死，便内寒热，肿自有似痈而非者，当以手按肿
上，无所连是风毒耳，勿针，可服升麻汤、升麻膏，破痈，口当令下流三分，近下一分，令
针极热，极热便不痛。
夫痈坏后有恶肉者，当以猪蹄汤洗去其秽，次敷食肉膏、散，恶肉尽，乃敷生肉膏、散，
乃摩四边，令善肉速生。当绝房室，慎风冷，勿自劳动，须筋脉复常，乃可自劳耳。不尔，
新肉易伤，伤则重发，慎之。
治痈疽洗疮猪蹄汤方∶
猪蹄（一具） 黄连（五两） 芎 （三两） 当归（三两） 甘草（三两） 夕药（三
两） 蔷薇（一斤，又方代大黄三两）
上七物，以水二斗，煮蹄取一斗，纳诸药复四升洗之。
治痈疽食恶肉芦茹散方∶
芦茹（一两，柒头） 矾石（二分） 雄黄（二分） 硫黄（二分）
上四物，下筛，着兑头纳疮口中。（今按∶《录验方》∶雄黄一两，矾石一两，芦茹一两
也。）
治痈疽发背已溃未溃生肉排脓散方∶
当归（二两） 桂心（二两） 人参（二两） 芎 （一两） 浓朴（一两） 防风（一
两） 甘草（一两） 白芷（一两） 桔梗（一两）
上九物，捣下筛。温酒服方寸匕，日三夜再。疮未合可长服之。
（今按∶《僧深方》治痈肿自溃长肉排脓蜀椒散方∶
蜀椒 桂心 甘草 干姜 芎 当归各一两
凡六物，服法如上。
又方∶治痈肿排脓散方∶
黄 四分 夕药二分 白蔹二分 芎 二分 赤小豆一分
凡五物，冶下，服如上。）
治痈疽食恶肉膏方∶
松脂（五两） 雄黄（二两） 雌黄（二两） 冶葛皮（一两） 柒头芦茹（三两） 巴
豆（百枚） 猪膏（一升）
上七物，煎，松脂消下诸药，微火上煎三上三下，膏成绞去滓，着兑头，纳疮中，日六
七，食恶肉，初用病当更肿赤，但用如节度，恶肉尽止，勿使过也。
治痈疽发背已溃生肉膏方∶
甘草（二两） 当归（二两） 白芷（二两） 乌喙（六枚） 肉苁蓉（二两） 蜀椒
（二两） 蛇衔（一两） 细辛（二两） 薤白（二两） 干地黄（二两）
上十物，切，以好酒半升和渍再宿，以不中水猪肪三斤，煎一沸，下余止，复三上三下，
膏成，急手绞之。
（今按∶《录验方》治痈疽生肉膏方∶ 草二两，生地黄五两，当归二两，续断一两，
黄芩二两，白芷三两，甘草二两，薤白二两，猪脂一升，大黄四两。凡十物， 咀，煎三上
三下，膏成，敷之。）
治痈疽臭烂洗大黄汤方∶
大黄（二两） 黄芩（一两） 白蔹（一两）
上三物，合捣下筛，以水一升二合煮一沸，绞去滓，适冷暖以洗疮，日十过。
《范汪方》治痈疮热已退，脓血不止，疮中空虚，疼痛排脓，内塞散方∶
防风（一两） 茯苓（一两） 白芷（一两） 桔梗（一两） 远志（一两） 甘草（一
两） 桂心（二分） 人参（一两） 芎 （一两） 当归（一两） 附子（二枚，炮） 浓
朴（二两） 龙骨（一两） 黄 （一两） 赤小豆（五合，熬）
凡十五物，冶下筛，温酒服方寸匕，日三夜一。（《千金方》同之，有下发背条。）
《集验方》治痈疮脓血不止，疮中空虚疼痛，排脓内补散方∶
防风（一两） 远志（一两） 当归（二两） 黄 （一两） 白芷（一两） 甘草（一
两） 桔梗（一两） 通草（一两） 浓朴（二两） 人参（一两） 桂心（一两） 附子
（一两） 赤小豆（五合，熬） 芎 （一两） 茯苓（二两）
凡十五物，冶合筛，食未温酒服方寸匕，日三夜一。（今按∶《广济方》同之。）
《令李方》治痈内补排脓散方∶
黄 （二两） 当归（二两） 赤小豆（三十枚） 芎 （一两） 夕药（二两） 大
黄（一两）
凡六物，冶合下筛，以粥清服方寸匕，日三。
又云∶治痈肿桂心散方∶
黄 （六分） 夕药（四分） 桂心（一分）
凡三物，冶下筛。酒服方寸匕，日三。
《录验方》洗痈疽并恶疮毒瓦斯猪蹄汤方∶
当归（四两） 甘草（四两，炙） 夕药（五两） 芎 （二两） 白芷（四两）
草（二两） 黄芩（四两） 野狼牙（四两） 猪蹄（一具） 蔷薇根（一两） 大黄（四两）
凡十一物，先以水二升半，别煮猪蹄取一升半，去蹄纳诸药，煮得再沸下桑灰汁一升，
又煮取一升半，汤成稍稍以洗疮痈结疽。初肿时去野狼牙纳灰汁；疮既（所教反，断已）溃，
用野狼牙除灰汁。
《僧深方》治痈疽疮臭烂洗疮青木香汤方∶
青木香（一两） 夕药（一两） 白蔹（一两） 芎 （一两）
凡四物，水四升，煮取二升，去滓温洗疮，日三，明日以膏纳疮中，日三。
《医门方》疮痈肿已脓，惧针令脓自出方∶
上取鹿角刮取细末，和醋聚安肿上，经宿脓自出。若脓深者先嚼生栗敷之，撮脓向上，
极妙。
疗痈肿不消，已有脓不能针，自令穿溃方∶
空腹服葵子一枚，一宿即穿出脓，神妙。
《葛氏方》治痈已有脓，当使脓速溃坏方∶
雀屎以苦酒和，涂上如小豆。
又方∶吞薏苡子一枚，勿多。
《新修本草》云∶痈脓使速溃方∶
吞 （ ）实一枚，破痈肿。
《苏敬本草》注云∶吞恶实一枚，出痈疽头。
《千金方》治痈溃后疮不合方∶
烧鼠皮一枚，作灰封孔中。
又方∶涂牛屎，干易。
又方∶烧故蒲席灰，和猪脂，纳孔中。
《救急单验方》疗头痈因即骨陷方∶
先烧杏仁令黑，磨涂后取枣木、紫葛蔓及干鱼烧灰，和薰黄蜡月猪脂涂，神验。
According to *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases): When an abscess is pressed and feels uniformly hard, pus has not yet formed; when it feels half-soft and half-hard, pus has formed. Additionally, if one covers the swelling with their hand and it does not feel hot, there is no pus; if it feels very hot, there is pus. Whenever pus formation is suspected, it should be punctured immediately; otherwise, the pus will erode the sinews and bones.
According to *Liu Juanzi Guiyi Fang* (The Ghost's Legacy Formula by Liu Juanzi): If an abscess is large and hard, there is no pus. If it is half-hard and half-soft, there is pus. When the surface becomes thin, the pus is mature and can be punctured. The method for puncturing should be from the lower part upwards to facilitate the drainage of pus, using a Pi needle (Pi zhen). If the pus is deep and difficult to see, and the overlying flesh is thick, a larger internal needle should be used. If there is no obvious external abscess, pressing repeatedly on the upper area may cause hidden pain internally; if the flesh remains hard and stiff, there is no pus. If the pain upon pressing is less than before, the internal pus is ripe. Once the pus is drained, the heat dissipates; otherwise, the condition may spread continuously, which is unfavorable.
Regarding confirmed abscesses: If pressing causes an indentation that does not rebound, there is no pus; if it rebounds immediately, there is pus. Initial swelling with pain only upon firm pressure indicates a deep pathology; pain upon slight pressure indicates a superficial pathology. After puncturing an abscess, if the patient appears lethargic and weak, accompanied by chills and fever, and the swelling resembles but is not an abscess, pressing the swelling reveals no adhesion to surrounding tissues, indicating wind-toxin. Do not puncture; instead, administer Shengma Tang (Cimicifuga Decoction) or Shengma Gao (Cimicifuga Ointment). When puncturing, the incision should slope downwards by three parts, close to one part below, ensuring the needle is extremely hot to minimize pain.
If necrotic tissue (evil flesh) remains after the abscess breaks, wash the wound with Zhuti Tang (Pig Trotter Decoction) to remove impurities, then apply Shirou Gao (Flesh-Eating Ointment) or San (Powder). Once the necrotic tissue is completely removed, apply Shengrou Gao (Flesh-Generating Ointment) or San, and massage the periphery to promote rapid growth of healthy tissue. Sexual abstinence is required; protect against wind and cold; avoid physical exertion until meridians and sinews recover normal function. Otherwise, new tissue may be easily injured, leading to recurrence. Exercise caution.
**Zhuti Tang for Washing Sores in Carbuncles and Ulcers:**
Zhuti (Pig Trotter, 1 piece), Huanglian (Coptidis Rhizoma, 5 liang), Xiong (Chuanxiong Rhizome, 3 liang), Danggui (Angelicae Sinensis Radix, 3 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang), Shaoyao (Paeoniae Radix, 3 liang), Qiangwei (Rosae Rugosae Fructus, 1 jin; alternative formula uses Dahuang, 3 liang).
Boil the pig trotters in two dou of water to obtain one dou of broth. Add the remaining herbs and boil down to four sheng. Use this liquid to wash the sore.
**Luru San for Corroding Necrotic Tissue in Carbuncles and Ulcers:**
Luru (Rubia Cordifolia Root, 1 liang, 7 heads), Fanshi (Alumen, 2 fen), Xionghuang (Realgar, 2 fen), Liuhuang (Sulfur, 2 fen).
Grind these four ingredients into a fine powder. Apply the powder into the wound using a applicator tip. (Note: *Lu Yan Fang* prescribes Xionghuang 1 liang, Fanshi 1 liang, Luru 1 liang.)
**Shengrou Paimong San for Flesh Generation and Pus Drainage in Carbuncles and Back Abscesses (Open or Closed):**
Danggui (Angelicae Sinensis Radix, 2 liang), Guixin (Cinnamomi Cortex, 2 liang), Renshen (Ginseng Radix, 2 liang), Xiong (Chuanxiong Rhizome, 1 liang), Houpo (Magnoliae Officinalis Cortex, 1 liang), Fangfeng (Saposhnikoviae Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Baizhi (Angelicae Dahuricae Radix, 1 liang), Jiegeng (Platycodonis Radix, 1 liang).
Grind these nine ingredients into a fine powder. Take one fangcun bi (measure) with warm wine, three times daily and twice at night. Can be taken long-term until the wound heals.
(Note: *Seng Shen Fang* for similar purposes uses Shujiao (Zanthoxyli Pericarpium), Guixin, Gancao, Ganjiang (Zingiberis Rhizoma), Xiong, Danggui, each 1 liang. Take as above.)
(Another formula: Paipong San for Carbuncle Swelling: Huangqi (Astragali Radix, 4 fen), Shaoyao (Paeoniae Radix, 2 fen), Bailian (Belamcandae Rhizoma, 2 fen), Xiong (Chuanxiong Rhizome, 2 fen), Chixiaodou (Vigna Angularis Seed, 1 fen). Grind and take as above.)
**Gao for Corroding Necrotic Tissue in Carbuncles and Ulcers:**
Songzhi (Pinus Resin, 5 liang), Xionghuang (Realgar, 2 liang), Cihuang (Orpiment, 2 liang), Yegepi (Polygoni Multiflori Caulis, 1 liang), Qitou Luru (Rubia Cordifolia Root with 7 heads, 3 liang), Badou (Crotonis Fructus, 100 seeds), Zhigao (Suill Fat, 1 sheng).
Melt the Songzhi, add other herbs, and simmer over low fire, performing "three up and three down" movements. Strain the dregs. Apply the ointment into the wound six to seven times daily to corrode necrotic tissue. Initial application may cause increased redness and swelling; adhere strictly to dosage limits. Stop once necrotic tissue is gone.
**Shengrou Gao for Flesh Generation in Open Carbuncles and Back Abscesses:**
Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Baizhi (Angelicae Dahuricae Radix, 2 liang), Wuhui (Aconiti Lateralis Radix Preparata, 6 pieces), Rousongrong (Cynomorii Herba, 2 liang), Shujiao (Zanthoxyli Pericarpium, 2 liang), Sheyan (Patriniae Herba, 1 liang), Xixin (Asari Radix et Rhizoma, 2 liang), Xiebai (Allii Macrostemonis Bulbus, 2 liang), Gadihuang (Rehmanniae Radix Preparata, 2 liang).
Chop the ten ingredients, soak in half sheng of good wine for two nights. Boil with three jin of unadulterated suill fat until boiling. Perform "three up and three down." Strain quickly while hot.
(Note: *Lu Yan Fang* for flesh generation uses Cao [likely missing name], Shengdihuang (Rehmanniae Radix, 5 liang), Danggui (2 liang), Xuduan (Dipsaci Radix, 1 liang), Huangqin (Scutellariae Radix, 2 liang), Baizhi (3 liang), Gancao (2 liang), Xiebai (2 liang), Zhizhi (Suill Fat, 1 sheng), Dahuang (Rhei Radix et Rhizoma, 4 liang). Chop, boil three up/down, and apply.)
**Dahuang Tang for Washing Foul and Rotting Sores:**
Dahuang (Rhei Radix et Rhizoma, 2 liang), Huangqin (Scutellariae Radix, 1 liang), Bailian (Belamcandae Rhizoma, 1 liang).
Grind together, sieve. Boil in one sheng two he of water until boiling. Strain. Wash the sore at a comfortable temperature ten times daily.
**Neisai San from Fan Wang Fang for Carbuncles with Persistent Pus/Blood, Empty Cavities, and Pain:**
Fangfeng (Saposhnikoviae Radix, 1 liang), Fuling (Poria, 1 liang), Baizhi (Angelicae Dahuricae Radix, 1 liang), Jiegeng (Platycodonis Radix, 1 liang), Yuanzhi (Polygalae Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Guixin (Cinnamomi Cortex, 2 fen), Renshen (Ginseng Radix, 1 liang), Xiong (Chuanxiong Rhizome, 1 liang), Danggui (Angelicae Sinensis Radix, 1 liang), Fuzi (Aconiti Lateralis Radix Preparata, 2 pieces, processed), Houpo (Magnoliae Officinalis Cortex, 2 liang), Longgu (Fossilia Ossis Mastodi et Scapulae, 1 liang), Huangqi (Astragali Radix, 1 liang), Chixiaodou (Vigna Angularis Seed, 5 he, roasted).
Grind fifteen ingredients into powder. Take one fangcun bi with warm wine, three times daily and once at night. (*Qianjin Fang* contains this formula with a section on back abscesses.)
**Paipong Neibu San from Ji Yan Fang for Carbuncles with Persistent Pus/Blood, Empty Cavities, and Pain:**
Fangfeng (Saposhnikoviae Radix, 1 liang), Yuanzhi (Polygalae Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Huangqi (Astragali Radix, 1 liang), Baizhi (Angelicae Dahuricae Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Jiegeng (Platycodonis Radix, 1 liang), Tongcao (Tetrapanacis Medulla, 1 liang), Houpo (Magnoliae Officinalis Cortex, 2 liang), Renshen (Ginseng Radix, 1 liang), Guixin (Cinnamomi Cortex, 1 liang), Fuzi (Aconiti Lateralis Radix Preparata, 1 liang), Chixiaodou (Vigna Angularis Seed, 5 he, roasted), Xiong (Chuanxiong Rhizome, 1 liang), Fuling (Poria, 2 liang).
Grind fifteen ingredients. Take one fangcun bi with warm wine before meals, three times daily and once at night. (*Guangji Fang* is identical.)
**Neibu Paipong San from Ling Li Fang:**
Huangqi (Astragali Radix, 2 liang), Danggui (Angelicae Sinensis Radix, 2 liang), Chixiaodou (Vigna Angularis Seed, 30 seeds), Xiong (Chuanxiong Rhizome, 1 liang), Shaoyao (Paeoniae Radix, 2 liang), Dahuang (Rhei Radix et Rhizoma, 1 liang).
Grind six ingredients. Take one fangcun bi with rice water, three times daily.
(Also: Guixin San for Carbuncle Swelling: Huangqi (6 fen), Shaoyao (4 fen), Guixin (1 fen). Grind. Take one fangcun bi with wine, three times daily.)
**Zhuti Tang for Washing Carbuncles, Ulcers, and Toxic Sores from Lu Yan Fang:**
Danggui (Angelicae Sinensis Radix, 4 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 4 liang, honey-fried), Shaoyao (Paeoniae Radix, 5 liang), Xiong (Chuanxiong Rhizome, 2 liang), Baizhi (Angelicae Dahuricae Radix, 4 liang), Cao [Name missing] (2 liang), Huangqin (Scutellariae Radix, 4 liang), Yelangya (Saussureae Radix, 4 liang), Zhuti (Pig Trotter, 1 piece), Qiangweigen (Rosae Rugosae Radix, 1 liang), Dahuang (Rhei Radix et Rhizoma, 4 liang).
Boil the pig trotter separately in two sheng five he of water to obtain one sheng five he. Remove trotter, add herbs, boil to rolling boil. Add Sangzhi Zhi (Ash Juice from Mulberry Branches, 1 sheng). Boil down to one sheng five he. Wash sores gradually. For initial swelling, omit Yelangya and use ash juice. For open ulcers, use Yelangya and omit ash juice.
**Qingmuxiang Tang for Washing Foul Carbuncles and Ulcers from Seng Shen Fang:**
Qingmuxiang (Costi Radix, 1 liang), Shaoyao (Paeoniae Radix, 1 liang), Bailian (Belamcandae Rhizoma, 1 liang), Xiong (Chuanxiong Rhizome, 1 liang).
Boil four ingredients in four sheng of water to obtain two sheng. Strain. Wash wound warmly three times daily. Next day, apply ointment into the wound three times daily.
**Formula from Yi Men Fang for Spontaneous Pus Drainage from Abscesses:**
Scrape deer horn into fine powder, mix with vinegar, and apply to the swelling. Pus will drain spontaneously overnight. For deep pus, chew raw chestnut and apply to draw pus upward. This is excellent.
**Formula for Self-Puncture of Unresolved Abscesses with Pus:**
Take one Kuizi (Abelmoschi Semen) on an empty stomach. Pus will penetrate through overnight. Miraculous.
**Ge Shi Fang for Rapid Rupture of Existing Pus:**
Mix Sparrow droppings with vinegar, apply like a small bean.
(Alternative: Swallow one Coicis Semen [Job's Tears], do not take more.)
**Xinxiu Bencao says for Rapid Rupture of Pus:**
Swallow one fruit of [Missing Character, likely Tingli or Tusizi], breaks abscess swelling.
**Su Jing's Bencao Note:** Swallow one Cang'erzi (Xanthii Fructus) to expel the head of carbuncle/ulcer pus.
**Qianjin Fang for Non-healing Ulcers after Abscess Rupture:**
Burn one mouse skin to ash, seal the hole.
(Alternative: Apply cow dung, replace when dry.)
(Alternative: Burn old rush mat to ash, mix with suill fat, insert into hole.)
**Jiuji Dan Yan Fang for Head Abscess Causing Bone Depression:**
Burn apricot kernels until black, grind and apply. Then burn Zhaomu (Jujube Wood), Zigeman (Purple Vine Stem), and dried fish to ash. Mix with Xunhuang (Styrax) wax and Yuezhushi (Moon Pig Fat) to apply. Highly effective.