杨梅疮生有二般，精化气化是其源，精化淫欲气传染，气宜发汗精下痊。
【注】此证一名广疮，因其毒出自岭南；
一名时疮，以时气乖变，邪气凑袭之故；一名棉花疮，因其缠绵不已也，一名翻花杨梅，
因窠粒破烂，肉反突于外，如黄蜡色；一名天泡疮，因其夹湿而生白 也。有形如赤豆
嵌于肉内，坚硬如铁，名杨梅痘；有形如风疹作痒，名杨梅疹；先起红晕，后发斑点者，
名杨梅斑；色红作痒，其圈大小不一，二三相套，因食秽毒之物入大肠而发，名杨梅圈。
其名形虽异，总不出气化、精化二因。但气化传染者轻，精化欲染者重。气化者，或遇
生此疮之人，鼻闻其气，或误食不洁之物，或登圊受梅毒不洁之气，脾、肺受毒，故先
从上部见之，皮肤作痒，筋骨微疼，其形小而且干也。精化者，由交媾不洁，精泄时，
毒瓦斯乘肝肾之虚而入于里，此为欲染，先从下部见之，筋骨多痛、或小水涩淋、疮形大
而且坚。气化者毒在表，未经入里，稍有萌动，宜急服透骨搜风散；元气实者，杨梅一
剂散汗之。精化者毒在里，深伏骨髓，未透肌肤，宜服九龙丹，通利大、小二便，以泻
骨中之毒，甚者二服，降下毒物，以土深压之。行泻之后体实者，升麻解毒汤；体虚者，
归灵内托散，服至筋骨不疼，疮色淡白，内毒已解，再用金蟾脱壳酒一料扫余毒，以绝
其源。
如梅毒初发，服表药时，恐上攻头面，宜预服护面散；或疮势已发于面，愈后斑痕
不退，宜翠云散点之，以灭痕迹。若梅疮溃烂时，脓秽浸淫成片而痛者，以鹅黄散撒之。
又翻花杨梅，亦以本方加雄黄末，香油调敷之。外有护从丸，于发疮时，令侍从人服之
可免传染。梅疮初起，头不痛、筋骨不疼，小水通利，疮形碎小色鲜，头面稀少，口角
无疮，胸背稠密，谷道清楚者为顺；若先发下疳，次生便毒、鱼口，便觉筋骨疼痛，而
梅疮随发，色紫坚硬，手足多生，形如汤泼起 者为险。总之始终调治得法，轻者半年，
重者一载，始得全愈。若患者不遵正法医治，欲求速效，强服轻粉、水银、白粉霜劫药等
类，妄用熏、擦、哈、吸等法，以致余毒含藏骨髓，复为倒发结毒，轻则累及妻子，甚
则腐烂损形，不可不慎。
\r杨梅疮图\p04-34a239.bmp\r
透骨搜风散
透骨草（白花者，阴干） 生脂麻 羌活 独活 小黑豆 紫葡萄 槐子 白糖 六安
茶核桃肉（各一钱五分）
生姜三片，红枣肉三枚，水三盅，煎一盅；露一宿，空心热服被盖出汗，避风。
【方歌】透骨搜风散梅毒，筋骨微疼痒皮肤；脂麻羌独豆葡萄，槐子糖茶核桃肉。
杨梅一剂散
麻黄（蜜炙，一两） 威灵仙（八钱） 大黄（七钱） 羌活 白芷 皂刺 金银花 穿山甲（炙，研）
蝉蜕（各五钱） 防风（三钱）
山羊肉一斤，河水煮熟，取清汤二碗，用黄酒一碗，将药煎至一碗；令患者空心将
羊肉淡食令饱，随后服药，盖被出汗，避风。
【方歌】杨梅一剂元气壮，上部生毒瓦斯化疮，麻黄羌芷威灵刺，银花风甲蝉大黄。
升麻解毒汤
升麻 皂刺（各四钱） 土茯苓（一斤）
水八碗，煎四碗，作四次，一日服尽。每次炖热，加香油三茶匙和匀，量病上下，
食前后服之。
如疮生项上，加白芷。咽内，加桔梗。胸腹，加白芍。肩背，加羌活。下部，加牛膝。
【方歌】升麻解毒筋骨疼，梅毒缠绵壮服灵，土苓皂刺香油服，按部须加药引经。
归灵内托散
人参 木瓜 白术（土炒） 金银花 防己 天花粉 白鲜皮 薏苡仁（各一钱） 当归
熟地 白芍（酒炒） 川芎（各一钱） 土茯苓（二两） 威灵仙（六分） 甘草（五分）
水三盅，煎二盅，作二次，随病上下服之，渣再煎服。
下部，加牛膝五分。元气虚者，倍加参、归。毒瓦斯盛者，倍金银花、加蒲公英。外以
麦冬五钱去心、薏苡仁五钱、土茯苓一两，煎汤常服以代茶。
【方歌】归苓内托参木瓜，术银四物己天花，土苓鲜薏威灵草，梅疮体弱服堪夸。
金蝉脱壳酒
醇酒五斤，大蛤蟆一个，土茯苓五两浸酒内，瓶口封严，重汤煮二炷香时取出。待
次日饮之，以醉为度。无论冬夏，盖暖出汗为效，余存之酒，次日随量饮之，酒尽疮愈。
又治结毒筋骨疼痛诸药不效者，更妙。服酒七日后，禁见风为效，忌口及房欲。
护面散
女人头发（ 、存性） 明雄黄（各三分）
共研细，香油半酒盅调匀，滚黄酒冲服，一日三服。
【方歌】护面散医梅疮现，预服毒不攻头面，香油调药黄酒冲，只用雄黄头发 。
翠云散
轻粉（一两） 石膏（ ，一两） 胆矾 铜绿（各五钱）
共研极细末，湿疮干撒，干疮以公猪胆汁调浓点之，每日三次，斑痕自退。
【方歌】翠云散去疮后斑，轻粉石膏共胆矾，铜绿共研湿干撒，猪胆汁调能润干。
鹅黄散
轻粉 石膏（ ） 黄柏（炒，各等分）
共为末，干撒患处，即可生痂，再烂再撒，毒尽即愈。
【方歌】鹅黄散治梅疮烂，脓秽多疼浸成片，轻粉石膏黄柏研，干撒止疼解毒验。
护从丸
雄黄 川椒（各五钱） 杏仁（炒，去皮、尖一百粒）
共研末，烧酒打飞罗面糊为丸，如梧桐子大。每服十五丸，白滚水送下。
【方歌】护从丸避梅疮患，雄黄川椒各五钱，杏仁百粒酒糊入，从人服之毒不传。
九龙丹（见下部悬痈）
Chancre Yans (Syphilis) arises in two types, with Jing-transmission (transmission via sexual essence/fluids) and Qi-transmission (transmission via airborne pathogens) as their sources. Jing-transmission results from licentious desire, while Qi-transmission is contagious. For Qi-transmission, diaphoresis (sweating) is indicated; for Jing-transmission, purgation (downward draining) is required.
[Note] This condition is also known as Guang Chuang (Broad Sore), because its toxin originates from the Lingnan region; it is called Shi Chuang (Seasonal Sore) due to abnormal climatic changes allowing pathogenic factors to invade; it is named Mian Hua Chuang (Cotton Sore) because of its lingering and persistent nature; it is called Fan Hua Yang Mei (Reversed Flower Chancre Yans) because the nodules ulcerate and flesh protrudes outward like yellow wax; it is termed Tian Pao Chuang (Heaven Blister Sore) because it generates white blisters accompanied by dampness. If the lesion resembles a red bean embedded in the flesh and is hard as iron, it is called Yang Mei Dou (Chancre Yans Pox); if it resembles urticaria and causes itching, it is called Yang Mei Zhen (Chancre Yans Rash); if a red halo appears first followed by spots, it is called Yang Mei Ban (Chancre Yans Macules); if it is red, itchy, with circles of varying sizes overlapping two or three times, caused by ingesting foul toxins that enter the Large Intestine, it is called Yang Mei Quan (Chancre Yans Rings). Although names and forms differ, they all stem from either Qi-transmission or Jing-transmission. However, Qi-transmission is mild, whereas Jing-transmission is severe.
In Qi-transmission, one may inhale the odor of an infected person, ingest unclean substances, or be exposed to toxic miasma from syphilitic impurities in latrines. The Spleen and Lung are affected by the toxin, so symptoms appear first on the upper body: skin itching, slight bone and tendon pain, with small and dry lesions.
In Jing-transmission, due to unclean sexual intercourse, when essence is discharged, toxic vapors enter the interior taking advantage of Liver and Kidney deficiency. This is "desire-contamination," and symptoms appear first on the lower body: frequent bone and tendon pain, dysuria with dribbling, and large, hard lesions.
For Qi-transmission, the toxin is at the exterior and has not entered the interior. As soon as there are signs of emergence, urgently administer Tou Gu Sou Feng San (Bone-Penetrating Wind-Seeking Powder). If the patient's Yuan Qi (Primal Qi) is robust, Yang Mei Yi Ji San (Chancre Yans One-Dose Powder) will induce sweating to expel the toxin. For Jing-transmission, the toxin is deep within, lurking in the marrow, not yet penetrating the skin. Administer Jiu Long Dan (Nine Dragons Pill) to promote urination and defecation, thereby draining the toxin from the bones. In severe cases, take two doses to descend and expel the toxic matter, suppressing it deeply like earth pressing down. After purgation, if the constitution is strong, use Sheng Ma Jie Du Tang (Cimicifuga Detoxification Decoction); if weak, use Gui Ling Nei Tuo San (Gui Ling Internal-Supporting Powder). Continue until bone and tendon pain cease and the lesion color becomes pale white, indicating internal toxin resolution. Then, consume one course of Jin Chan Tuo Qiao Jiu (Golden Cicada Shedding Shell Wine) to clear residual toxins and cut off the source.
If syphilis is in its initial stage and external-releasing medicines are taken, fearing the toxin attacks the head and face, Hu Mian San (Face-Protection Powder) should be taken prophylactically. If the sore has already erupted on the face and scars remain after healing, Cui Yun San (Emerald Cloud Powder) should be applied locally to fade the marks. If chancre yans ulcerate, with pus and filth spreading in patches causing pain, apply E Huang San (Goose Yellow Powder). Additionally, for Fan Hua Yang Mei, add Realgar powder to this formula and mix with sesame oil for topical application. There is also Hu Cong Wan (Attendant-Protecting Pill); having attendants take this during an outbreak prevents transmission.
When syphilis first begins, if there is no headache or bone/tendon pain, urination is free, lesions are small and bright red, sparse on the head and face, absent at the mouth corners, dense on the chest and back, and clear around the anus, this is a favorable prognosis (Shun). If chancre (Xia Gan) appears first, followed by buboes (Bian Du) or fish-mouth abscesses (Yu Kou), accompanied by bone/tendon pain, with chancre yans erupting subsequently, purple and hard, appearing on hands and feet, resembling scald blisters, this is a dangerous prognosis (Xian). In summary, if treatment is appropriate throughout, mild cases heal in half a year, severe cases in one year. If patients do not follow orthodox methods but seek quick results, forcibly taking harsh detoxifying drugs like Calomel (Qing Fen), Mercury (Shui Yin), or White Lead Frost (Bai Fen Shuang), or recklessly using fumigation, rubbing, inhalation, etc., leading to residual toxins hiding in the marrow and recurring as condensed toxins (Dao Fa Jie Du), the consequences range from infecting spouses to disfigurement. Caution is essential.
Tou Gu Sou Feng San (Bone-Penetrating Wind-Seeking Powder)
Ingredients: Tou Gu Cao (Herba Lycii, white-flowered, dried in shade), Sheng Zhi Ma (Semen Sesami), Qiang Huo (Rhizoma Notopterygii), Du Huo (Radix Angelicae Pubescentis), Xiao Hei Dou (Semen Sojae Nigrae), Zi Pu Tao (Fructus Vitis Viniferae), Huai Zi (Semen Gleditsiae Sinensis), Bai Tang (Saccharum), Liu An Cha (Tea Leaves), He Tao Rou (Semen Juglandis Mandshuricae) (each 1.5 qian).
Preparation: Add 3 slices of Sheng Jiang (Rhizoma Zingiberis Recens), 3 pieces of Hong Zao Rou (Fructus Jujubae), and 3 bowls of water. Decoct to 1 bowl. Leave exposed overnight. Take warm on an empty stomach, cover with blankets to induce sweating, and avoid wind.
[Formula Song] Tou Gu Sou Feng San treats syphilis, slight bone/tendon pain and skin itching; Sesame, Notopterygium, Angelica pubescens, black soybeans, grapes, Gleditsia seeds, sugar, tea, walnut meat.
Yang Mei Yi Ji San (Chancre Yans One-Dose Powder)
Ingredients: Ma Huang (Herba Ephedrae, honey-fried, 1 liang), Wei Ling Xian (Radix Saposhnikoviae, 8 qian), Da Huang (Radix et Rhizoma Rhei, 7 qian), Qiang Huo (Rhizoma Notopterygii), Bai Zhi (Radix Angelicae Dahuricae), Zao Ci (Spina Gleditsiae), Jin Yin Hua (Flos Lonicerae Japonicae), Chuan Shan Jia (Squama Manis, fried and powdered), Chan Tui (Periostracum Cicadae) (each 5 qian), Fang Feng (Radium Saposhnikoviae, 3 qian).
Preparation: Boil 1 jin of Shan Yang Rou (Capra Hircus Meat) in river water until cooked, extract 2 bowls of clear broth. Add 1 bowl of Huang Jiu (Yellow Rice Wine). Decoct herbs to 1 bowl. Let the patient eat the plain mutton until full on an empty stomach, then take the medicine. Cover with blankets to induce sweating and avoid wind.
[Formula Song] Yang Mei Yi Ji San strengthens Yuan Qi, transforming toxic vapors in upper-body sores; Ephedra, Notopterygium, Angelica dahurica, Saposhnikovia, Spina Gleditsiae, Lonicera, Saposhnikovia, Manis scale, Cicada slough, Rheum.
Sheng Ma Jie Du Tang (Cimicifuga Detoxification Decoction)
Ingredients: Sheng Ma (Rhizoma Cimicifugae), Zao Ci (Spina Gleditsiae) (each 4 qian), Tu Fu Ling (Rhizoma Smilacis Glabrae, 1 jin).
Preparation: Add 8 bowls of water, decoct to 4 bowls. Divide into 4 doses, consumed within one day. Heat each dose before taking, mix with 3 teaspoons of Xi You (Sesame Oil). Take before or after meals depending on the location of the disease.
Modifications: If lesions are on the neck/upper area, add Bai Zhi. In the throat, add Jie Geng. On the chest/abdomen, add Bai Shao. On shoulders/back, add Qiang Huo. In the lower body, add Niu Xi.
[Formula Song] Sheng Ma Jie Du Tang relieves bone/tendon pain, effective for lingering syphilis in robust constitutions; Smilacea, Spina Gleditsiae, Sesame Oil taken; add meridian-guiding herbs according to location.
Gui Ling Nei Tuo San (Gui Ling Internal-Supporting Powder)
Ingredients: Ren Shen (Radix Ginseng), Mu Gua (Fructus Chaenomelis), Bai Zhu (Rhizoma Atractylodis Macrocephalae, stir-baked with soil), Jin Yin Hua (Flos Lonicerae Japonicae), Fang Ji (Radix Stephaniae Tetrandrae), Tian Hua Fen (Radix Trichosanthis), Bai Xian Pi (Cortex Dictamni), Yi Yi Ren (Semen Coicis) (each 1 qian); Dang Gui (Radix Angelicae Sinensis), Shu Di Huang (Radix Rehmanniae Preparata), Bai Shao (Radix Paeoniae Alba, wine-fried), Chuan Xiong (Rhizoma Chuanxiong) (each 1 qian); Tu Fu Ling (Rhizoma Smilacis Glabrae, 2 liang), Wei Ling Xian (Radix Saposhnikoviae, 6 fen), Gan Cao (Radix Glycyrrhizae Uralensis, 5 fen).
Preparation: Add 3 bowls of water, decoct to 2 bowls. Divide into 2 doses. Take according to the location of the disease. Decoct the dregs again for a second administration.
Modifications: For lower body lesions, add Niu Xi (5 fen). For deficient Yuan Qi, double Ren Shen and Dang Gui. For intense toxic vapors, double Jin Yin Hua and add Pu Gong Ying. Externally, decoct Mai Dong (Radix Ophiopogonis, 5 qian, heart removed), Yi Yi Ren (5 qian), and Tu Fu Ling (1 liang) to drink as tea regularly.
[Formula Song] Gui Ling Nei Tuo San with Ginseng and Chaenomeles, Atractylodes, Lonicera, Four Substances, Stephania, Trichosanthis; Smilacea, Dictamnus, Coix, Saposhnikovia, Licorice; excellent for weak constitutions with chancre yans.
Jin Chan Tuo Qiao Jiu (Golden Cicada Shedding Shell Wine)
Ingredients: Chun Jiu (Strong Rice Wine, 5 jin), Da Ha Ma (Bufo bufo gargarizans, 1 whole), Tu Fu Ling (Rhizoma Smilacis Glabrae, 5 liang).
Preparation: Soak ingredients in wine, seal bottle tightly. Steam over boiling water for the time it takes two incense sticks to burn. Remove and let cool. Drink the next day until intoxicated. Regardless of season, keep warm to induce sweating for efficacy. Store remaining wine and drink适量 the next day. When the wine is finished, the sore heals.
Additional Indication: Also excellent for bone/tendon pain caused by condensed toxins where other medicines fail. After 7 days of drinking, avoid wind, observe dietary restrictions, and abstain from sexual activity.
Hu Mian San (Face-Protection Powder)
Ingredients: Nu Ren Tou Fa (Human Hair, burned to ash), Ming Xiong Huang (Realgar, each 3 fen).
Preparation: Grind into fine powder. Mix with half a wine cup of Xi You (Sesame Oil). Take with boiling Huang Jiu (Yellow Rice Wine), three times daily.
[Formula Song] Hu Mian San treats emerging chancre yans, taken prophylactically to prevent toxin attacking head/face; mix with sesame oil, wash down with Huang Jiu; only uses Realgar and human hair.
Cui Yun San (Emerald Cloud Powder)
Ingredients: Qing Fen (Calomel, 1 liang), Shi Gao (Gypsum Fibrosum, calcined, 1 liang), Dan Fan (Alumen), Tong Lv (Chrysocolla) (each 5 qian).
Preparation: Grind into extremely fine powder. For wet sores, sprinkle dry powder directly. For dry sores, mix with male pig bile to a thick consistency and apply locally. Three times daily, scars will naturally fade.
[Formula Song] Cui Yun San removes post-sore scars; Calomel, Gypsum, Alumen; grind Copper Green together, sprinkle dry on wet sores, pig bile moistens dry ones.
E Huang San (Goose Yellow Powder)
Ingredients: Qing Fen (Calomel), Shi Gao (Gypsum Fibrosum, calcined), Huang Bo (Cortex Phellodendri, stir-baked) (equal parts).
Preparation: Grind into powder. Sprinkle dry on affected areas to form scabs. Reapply if ulceration recurs. Healing occurs when toxins are exhausted.
[Formula Song] E Huang San treats ulcerated chancre yans, painful pus/filth spreading in patches; Calomel, Gypsum, Phellodendrum ground, dry sprinkling stops pain and detoxifies effectively.
Hu Cong Wan (Attendant-Protecting Pill)
Ingredients: Xiong Huang (Realgar), Chuan Jiao (Fructus Zanthoxyli) (each 5 qian); Xing Ren (Semen Armeniacae Amarum, fried, peeled, de-seeded, 100 kernels).
Preparation: Grind into powder. Use Shao Jiu (Baijiu) and sifted flour paste to make pills the size of Sophora seeds. Take 15 pills per dose with plain boiled water.
[Formula Song] Hu Cong Wan prevents chancre yans infection; Realgar and Zanthoxylum each 5 qian, 100 Almond kernels mixed with wine paste; attendants taking it prevents toxin transmission.
Jiu Long Dan (Nine Dragons Pill) (See section on Xuan Yong in Lower Body)