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(For women's conditions, see *Furen Liangfang* [Good Advice for Women] and *Nuke Cuoyao* [Essentials of Gynecology]; for children's conditions, see *Baoying Cuiyao* [Precious Essentials for Infant Care].)

Liuzhu (Flowing Abscesses) may arise from improper diet and overwork, damaging the Spleen and Stomach; or from excessive sexual activity leading to Yin deficiency, allowing Yang pathogenic factors to invade; or from Ying Qi (Nutritive Qi) failing to flow smoothly, reversing into the muscle tissue. All these are due to Qi deficiency causing Blood stasis and coagulation. The swelling may occur in the joints of the limbs, or in the chest, abdomen, waist, and buttocks, presenting as a distinct mass, or diffuse swelling without a head, or pain. These result from chronic non-healing lesions. Adjuvant treatment with Fermented Soybean Cake (Douchi Bing) and Amber Ointment (Hupo Gao) is used to dispel cold pathogens and replenish Yang Qi. If an internal abscess cavity has formed but fails to heal, Zhentou San (Needle Head Powder) is applied to cauterize and dissolve necrotic tissue. The Classics state: "Injury to form causes pain; injury to Qi causes swelling." It also says: "Depletion of True Qi results in Deficiency; excess of Pathogenic Qi results in Excess." If one does not tonify Qi and Blood, regulate diet, maintain careful daily routines, and guard against the Seven Emotions, but instead exclusively uses cold and purgative drugs to attack the disease, survival would be merely fortunate.

Clinical Cases

Zhu Dongxi, a Court Gentleman, had a mass approximately four cun in size结 (formed) near the abdomen on the left hypochondrium, within the Liver and Gallbladder meridian region. The swelling was diffuse and redness-less, tender upon pressure. I stated: "This requires tonification..." [Text missing], combined with stir-fried Shaoyao (White Peony Root), Shengjiang (Fresh Ginger), and Rougui (Cinnamon Bark). After the Stomach Qi recovered and malignant symptoms subsided, Ganjiang (Dried Ginger) was removed, and Huangqi (Astragalus Root) was added for several doses, resulting in slight redness and pain. After another thirty-plus doses, the swelling increased with pain, indicating internal rupture of pus. A needle was then used. The patient recovered using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Jiaban Bawei Wan (Modified Eight-Ingredient Pill).

A man with inherently weak Yuan Qi presented with hard, swollen buttocks with unchanged skin color and poor appetite, lasting for over a year. This was Qi and Blood deficiency preventing suppuration. Initially, Liujunzi Tang (Six Gentlemen Decoction) was administered with Chuanxiong (Szechwan Lovage Rhizome), Danggui (Angelica Sinensis), and Shaoyao (Peony Root). As Yuan Qi gradually recovered and appetite improved, the affected area began to suppurate. Huangqi (Astragalus Root) and Rougui (Cinnamon Bark) were added, along with Cong Xi (Scallion Moxibustion/Fomentation). After about a month, once the pus matured, it was lanced. The patient healed using Shiquan Dabu Tang (Complete Great Tonifying Decoction) and Fuzi Bing (Aconite Cake) fomentation.

A man presented with leg swelling, unchanged muscle color, and no pain, indicating True Qi deficiency. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was given with Fuling (Poria) and Banxia (Pinellia Tuber), with minor additions of Zhiqiao (Immature Bitter Orange). After a few doses, food intake slightly increased. Subsequent use of tonic formulas led to resolution after more than a month.

A man had a long-standing swelling on the hypochondrium that did not suppurate, with mild tenderness upon pressure and a faint, choppy pulse. Both form and symptoms indicated deficiency; thus, tonification was indicated rather than purgation. Renshen Yangrong Tang (Ginseng Nourishing the Spirit Decoction) was used, along with hot mugwort fomentation on the lesion. Upon pus formation, fire-needle puncture was performed. The patient recovered after taking Douchi Bing (Fermented Soybean Cake) and Shiquan Dabu Tang (Complete Great Tonifying Decoction) for one hundred doses.

A man suffered from abdominal Liuzhu, presenting with hard, non-suppurating swelling, a weak pulse, and frequent vomiting with poor intake. One might wish to use Baidu (Detoxifying) herbs. I reasoned that hard, non-suppurating swelling indicates weak Yang Qi, and vomiting/poor intake indicates... [Text missing]. The Classics state: "Heat with a calm pulse, blood loss with a full pulse, and agitation after sweating are all adverse signs." I declined treatment, and the patient subsequently died.

While serving in the North, I treated the sixteen-year-old son of Academician Jia of Liudu (Nanjing), who had suffered from this condition for two years. When Mr. Jia was promoted to Minister of Rites in the North, he invited me to treat him. The pulse was large and rapid, and the pus was thin... [Text missing]. I prescribed Sijunzi Tang (Four Gentlemen Decoction) with Chuanxiong (Szechwan Lovage Rhizome), Danggui (Angelica Sinensis), and Zhigancao (Prepared Licorice Root). In the afternoon, I prescribed Sijunzi Tang with Wuweizi (Schisandra Berry), Maidong (Ophiopogon Tuber), Renshen (Ginseng Root), and Huangqi (Astragalus Root). After two months, symptoms alleviated slightly. Others suggested using diuretic/damp-draining agents to ensure survival. Three months later, the patient’s body became emaciated to the point of being skeletal. He sought my help again, but I was then ordered southward, and ultimately, he could not be saved.