辩证
色红而高肿、按之而即痛者，为阳；色白而平板、按之而不痛者，为阴。色浮淡而根脚
模糊为虚，色沉着而根盘清正为实。色淡白青而板者，为寒；色深红紫而痛者，为热。审而治之，斯为得矣。
治诀
补则死，攻则亡，调和六腑最为良。
治法
凡初起，但用攻发，消去即了，不必补、托。若将作脓，方可内托。
见证
伏阴证（外软内硬，按之而后痛者）、伏阳证（外硬内软，按之即痛者）、半阴半阳证（或
外软内硬而按之即痛，或内软外硬按之而反不痛，或形属阳而色属阴，或色属阳而形反属
阴，是皆阴阳错乱，治无适从），法宜调和脏腑，燮理阴阳，皆用制甘草为君。秘传君，相通
神（审证之轻重，投剂之大小。慎勿误投，自取背戾）。
大剂∶大甘草一两，栝蒌仁八钱，甲片四钱；中剂∶大甘草八钱，栝蒌仁六钱，甲片三
钱；小剂∶大甘草六钱，栝蒌仁四钱，甲片二钱。更重者加金银子（左三十五粒，右四十
粒），日轻夜重者加炒黑荆芥二钱，极痛而不大便者加炒黑大黄二钱，肉内陷者花粉用人
参制，色青紫者栝蒌仁用肉桂制，恶心者加开口椒四十九粒。
凡初起方
大贝（二钱） 白芷（一钱） 花粉（三钱） 大甘草（六钱） 栝蒌仁（四钱，炒研） 甲片（
二钱，炒研） 葛根（一钱） 丹参（一钱） 僵蚕（一钱，炒研） 苏叶（一钱五分）
（左加柴胡一钱，右加桔梗七分）加酒（一大杯） 葱头（三个） 角针（三分）
伏阴证、纯阴证（内外板硬，白而不大肿，按而不大痛，觉同负重如磨）是皆重证。
苏叶（一钱） 大贝（二钱，研） 白芷（一钱五分） 花粉（三钱） 葛根（二钱） 丹参（一钱。纯
阴证可不用，要用荆芥二钱） （左加柴胡一钱，右加桔梗七分） 大甘草（一两） 制栝蒌仁（八钱，炒
研） 甲片（六钱，炒研） 僵蚕（一钱，炒研） 泽兰（四钱。纯阴证可不用，伏
阴证必用） 角针（三分） 荆芥（一钱）
加引同前。
伏阴证
大甘草（八钱） 栝蒌仁（六钱） 甲片（四钱） 泽兰（六钱）
余与前同。
半阴半阳证（宜调和六腑）
大甘草（一两） 制栝蒌仁（八钱） 甲片（六钱） 泽兰（八钱） 丹参（三钱） 余药同前。若势减收
功，手按之而软者，加芎、归、芍、地、苓、 、人参；若硬者，仍带攻发，宜加金银子。引同前。
托脓
（左柴胡一钱，右桔梗七分） 防风（一钱） 生黄 （一钱。毒甚者不可用）
大贝（二钱） 花粉（三钱） 白芷（一钱） 葛根（二钱） 大甘草（四钱） 栝蒌仁（二钱，炒）
甲片（一钱，炒） 僵蚕（一钱，炒，有脓即去） 丹参（一钱） 泽兰（三
钱） 加引同前，如有风寒，加苏叶（一钱）。
腐肉脱后（脓后未脱腐肉少用参、 ，勿要攻发）
防风（一钱） 花粉（三钱） 大贝（二钱） 丹参（三钱，有人参可不用） 大甘草（六钱）
甲片（一钱，炒，全软不用。左柴胡一钱，右桔梗七分） 栝蒌仁（四钱） 黄 （生熟各二钱） 泽兰（
五钱） 白茯苓（二钱） 川芎（八分） 当归（一钱，酒炒） 白芍（一钱，酒炒）
大生地（二钱，酒炒。腐肉未去不可用）
此药服之若痛，即用发散药；按之而根脚硬者，去人参、芎、归、芍、地；若不硬，熟地、黄
逐日可加，甘草、栝蒌仁、甲片逐日可减。全要性灵心活，切勿呆板。引同。
收功
防风（一钱） 黄 （四钱，蜜炙） 大贝（二钱） 花粉（二钱） 大熟地（三钱，炙） 川芎（
八分） 当归（一钱，
酒炒） 大甘草（二钱，炙） 白茯苓（三钱。有人参不可用） 白芍（一钱，酒炒） 泽兰（五钱）
外用陈玉红膏和陈香油调匀搽引（姜一片、枣三枚；否则桂圆肉五枚），若不思饮食，
熟地少用，甘草用生，加砂仁、炒谷芽。引用煨姜。
忌口（除食虾、蟹、鳗、牛、韭、 、生冷及洗浴行房，余概勿忌）。
收金银子法（秋分前后三日俱好）。
制甘草法（拣极大者，春分日，大河内潮水浸一昼夜，取出阴干用）。
制栝蒌法（用好肉桂，切细，和水入粗瓷器内，煎滚，即入栝蒌子煎十数沸，取出，去肉桂渣，研用）。
制花粉法（将人参煎水，再入花粉同煎十数沸，取用）。
Diagnosis and Differentiation
If the color is red, elevated, and swollen, and pressing it causes immediate pain, it is a Yang syndrome. If the color is white, flat, and pressing it causes no pain, it is a Yin syndrome. If the color is floating, pale, and the root is blurred, it is a deficiency syndrome; if the color is deep and the base is clear and upright, it is an excess syndrome. If the color is pale, white, cyanotic, and stiff, it is a Cold syndrome; if the color is deep red-purple and painful, it is a Heat syndrome. Carefully examining and treating accordingly is the correct approach.
Treatment Principles
Blind supplementation leads to death, while aggressive attack leads to demise; harmonizing the Six Fu Organs (Six Bowels) is the best method.
Treatment Methods
When the disease first appears, only use attacking and dispersing methods to eliminate the pathogen, without needing supplementation or pushing out toxins. Only when suppuration is imminent should internal pushing-out methods be used.
Manifestations
Hidden Yin Syndrome (externally soft but internally hard, painful only upon pressing), Hidden Yang Syndrome (externally hard but internally soft, painful immediately upon pressing), Half-Yin Half-Yang Syndrome (sometimes externally soft and internally hard with immediate pain upon pressing, sometimes internally soft and externally hard but painless upon pressing, sometimes form belongs to Yang while color belongs to Yin, or color belongs to Yang while form belongs to Yin; these are all cases of chaotic Yin and Yang where treatment has no clear direction). The method should harmonize the Zang-Fu Organs and regulate Yin and Yang, using Prepared Glycyrrhizae Radix et Rhizoma (Zhi Gancao) as the sovereign herb. The secret transmission sovereign formula, communicating with spirit (assess the severity of the syndrome to determine the dosage size. Do not mistakenly administer, lest you bring disaster upon yourself).
Large Dosage: Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 1 liang, Trichosanthis Semen (Gualou Ren) 8 qian, Pangolin Scales (Jiapian) 4 qian. Medium Dosage: Large Glycyrrhizae Radix et Rhizoma 8 qian, Trichosanthis Semen 6 qian, Pangolin Scales 3 qian. Small Dosage: Large Glycyrrhizae Radix et Rhizoma 6 qian, Trichosanthis Semen 4 qian, Pangolin Scales 2 qian. For more severe cases, add Lonicerae Flos (Jinyinhua Zi) (35 grains on the left side, 40 grains on the right); for cases lighter by day and heavier by night, add Stir-fried Black Schizonepetae Herba (Chao Hei Jingjie) 2 qian; for extreme pain with constipation, add Stir-fried Black Rheum Palmatum (Chao Hei Dahuang) 2 qian; for muscle sinking, use Prepared Trichosanthis Radix (Zhi Huafen) with Ginseng Radix et Rhizoma (Renshen); for cyanotic-purple color, use Cinnamomi Cortex (Guirui)-prepared Trichosanthis Semen; for nausea, add Opening-mouth Zanthoxyli Pericarpium (Kaikou Jiao) 49 grains.
Formula for Initial Onset
Fritillariae Thunbergii Bulbus (Dabei) 2 qian, Angelicae Dahuricae Radix (Baizhi) 1 qian, Trichosanthis Radix (Huafen) 3 qian, Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 6 qian, Trichosanthis Semen (Gualou Ren) 4 qian (stir-fried and ground), Pangolin Scales (Jiapian) 2 qian (stir-fried and ground), Puerariae Lobatae Radix (Gegen) 1 qian, Salviae Miltiorrhizae Radix (Danshen) 1 qian, Bombyx Batryticatus (Jiangcan) 1 qian (stir-fried and ground), Perilla Folium (Suye) 1.5 qian. (Add Bupleuri Radix (Chaihu) 1 qian on the left, Platycodonis Radix (Jiegeng) 0.7 qian on the right). Add Wine (one large cup), Scallion Head (Congtou) 3 pieces, Horn Needle (Jiaozhen) 0.3 fen.
Hidden Yin Syndrome, Pure Yin Syndrome (internally and externally stiff, white in color, not significantly swollen, not significantly painful upon pressing, feeling like carrying a heavy millstone) are all severe syndromes.
Perilla Folium (Suye) 1 qian, Fritillariae Thunbergii Bulbus (Dabei) 2 qian (ground), Angelicae Dahuricae Radix (Baizhi) 1.5 qian, Trichosanthis Radix (Huafen) 3 qian, Puerariae Lobatae Radix (Gegen) 2 qian, Salviae Miltiorrhizae Radix (Danshen) 1 qian (for Pure Yin Syndrome, this may be omitted; if used, add Schizonepetae Herba (Jingjie) 2 qian). (Add Bupleuri Radix (Chaihu) 1 qian on the left, Platycodonis Radix (Jiegeng) 0.7 qian on the right). Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 1 liang, Prepared Trichosanthis Semen (Zhi Gualou Ren) 8 qian (stir-fried and ground), Pangolin Scales (Jiapian) 6 qian (stir-fried and ground), Bombyx Batryticatus (Jiangcan) 1 qian (stir-fried and ground), Lantanae Herba (Zelan) 4 qian (for Pure Yin Syndrome, this may be omitted; for Hidden Yin Syndrome, it must be used), Horn Needle (Jiaozhen) 0.3 fen, Schizonepetae Herba (Jingjie) 1 qian.
Guiding herbs are the same as before.
Hidden Yin Syndrome
Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 8 qian, Trichosanthis Semen (Gualou Ren) 6 qian, Pangolin Scales (Jiapian) 4 qian, Lantanae Herba (Zelan) 6 qian.
The remaining herbs are the same as above.
Half-Yin Half-Yang Syndrome (Suitable for Harmonizing the Six Fu Organs)
Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 1 liang, Prepared Trichosanthis Semen (Zhi Gualou Ren) 8 qian, Pangolin Scales (Jiapian) 6 qian, Lantanae Herba (Zelan) 8 qian, Salviae Miltiorrhizae Radix (Danshen) 3 qian. The remaining herbs are the same as before. If the condition subsides approaching recovery and feels soft upon pressing, add Ligustici Chuanxiong Rhizoma (Xiong), Angelicae Sinensis Radix (Gui), Paeoniae Radix Alba (Shao), Rehmanniae Radix Preparata (Di), Poria (Ling), Astragali Membranaceus (Huang), and Ginseng Radix et Rhizoma (Renshen); if still hard, continue with attacking and dispersing methods, adding Lonicerae Flos (Jinyinhua Zi). Guiding herbs are the same as before.
Pushing Out Pus
(Bupleuri Radix (Chaihu) 1 qian on the left, Platycodonis Radix (Jiegeng) 0.7 qian on the right), Saposhnikoviae Radix (Fangfeng) 1 qian, Raw Astragali Membranaceus (Sheng Huangqi) 1 qian (do not use if toxicity is severe).
Fritillariae Thunbergii Bulbus (Dabei) 2 qian, Trichosanthis Radix (Huafen) 3 qian, Angelicae Dahuricae Radix (Baizhi) 1 qian, Puerariae Lobatae Radix (Gegen) 2 qian, Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 4 qian, Trichosanthis Semen (Gualou Ren) 2 qian (stir-fried), Pangolin Scales (Jiapian) 1 qian (stir-fried), Bombyx Batryticatus (Jiangcan) 1 qian (stir-fried, remove if pus is present), Salviae Miltiorrhizae Radix (Danshen) 1 qian, Lantanae Herba (Zelan) 3 qian. Add guiding herbs as before. If Wind-Cold is present, add Perilla Folium (Suye) 1 qian.
After Necrotic Tissue Sloughs Off (After suppuration, if necrotic tissue remains, use little Renshen and Huangqi, do not attack and disperse)
Saposhnikoviae Radix (Fangfeng) 1 qian, Trichosanthis Radix (Huafen) 3 qian, Fritillariae Thunbergii Bulbus (Dabei) 2 qian, Salviae Miltiorrhizae Radix (Danshen) 3 qian (omit if Ginseng Radix et Rhizoma (Renshen) is present), Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 6 qian, Pangolin Scales (Jiapian) 1 qian (stir-fried, omit if entirely soft; Bupleuri Radix (Chaihu) 1 qian on the left, Platycodonis Radix (Jiegeng) 0.7 qian on the right), Trichosanthis Semen (Gualou Ren) 4 qian, Astragali Membranaceus (Huangqi) (Raw and Prepared each 2 qian), Lantanae Herba (Zelan) 5 qian, White Poria (Bai Fuling) 2 qian, Ligustici Chuanxiong Rhizoma (Chuanxiong) 0.8 fen, Angelicae Sinensis Radix (Danggui) 1 qian (wine-fried), Paeoniae Radix Alba (Baishao) 1 qian (wine-fried), Large Rehmanniae Radix (Da Shengdi) 2 qian (wine-fried. Do not use if necrotic tissue has not been removed).
If pain occurs after taking this medicine, use dispersing medicines immediately. If the root is hard upon pressing, remove Ginseng Radix et Rhizoma (Renshen), Ligustici Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), and Rehmanniae Radix Preparata (Shudi). If not hard, Rehmanniae Radix Preparata (Shudi) and Astragali Membranaceus (Huangqi) can be increased daily, while Glycyrrhizae Radix et Rhizoma (Gancao), Trichosanthis Semen (Gualou Ren), and Pangolin Scales (Jiapian) can be decreased daily. It requires complete mental flexibility from the practitioner; do not be rigid. Guiding herbs are the same.
Recovery Phase
Saposhnikoviae Radix (Fangfeng) 1 qian, Astragali Membranaceus (Huangqi) 4 qian (honey-fried), Fritillariae Thunbergii Bulbus (Dabei) 2 qian, Trichosanthis Radix (Huafen) 2 qian, Large Prepared Rehmanniae Radix (Da Shudi) 3 qian (roasted), Ligustici Chuanxiong Rhizoma (Chuanxiong) 0.8 fen, Angelicae Sinensis Radix (Danggui) 1 qian (wine-fried), Large Glycyrrhizae Radix et Rhizoma (Da Gancao) 2 qian (roasted), White Poria (Bai Fuling) 3 qian (omit if Ginseng Radix et Rhizoma (Renshen) is present), Paeoniae Radix Alba (Baishao) 1 qian (wine-fried), Lantanae Herba (Zelan) 5 qian.
Externally apply Chen Yuhong Ointment mixed evenly with aged Sesame Oil for application, guided by (one slice of Ginger, three Jujubes; otherwise five Longan Arils). If there is no appetite, use less Rehmanniae Radix Preparata (Shudi), use raw Glycyrrhizae Radix et Rhizoma (Gancao), add Amomi Fructus (Sharen) and Stir-fried Setariae Milicae Fructus (Chao Guya). Guide with Roasted Ginger (Wei Jiang).
Dietary Restrictions (Except for shrimp, crab, eel, beef, Chinese chives, legumes, raw/cold foods, bathing, and sexual intercourse, nothing else needs to be restricted).
Method for Harvesting Lonicerae Flos (Jinyinhua Zi) (Three days before and after the Autumn Equinox are suitable).
Method for Preparing Glycyrrhizae Radix et Rhizoma (Zhi Gancao) (Select very large roots, on the Spring Equinox day, soak them in the river water with the tide for one day and night, take out and dry in the shade for use).
Method for Preparing Trichosanthis Semen (Zhi Gualou) (Use good quality Cinnamomi Cortex (Guirui), cut finely, mix with water in a coarse porcelain vessel, boil vigorously, then add Trichosanthis Semen (Gualou Zi) and boil for over ten boils, take out, remove Cinnamomi Cortex residue, grind for use).
Method for Preparing Trichosanthis Radix (Zhi Huafen) (Decoct Ginseng Radix et Rhizoma (Renshen) in water, then add Trichosanthis Radix (Huafen) and decoct together for over ten boils, take for use).