暴怒所致。胸膈不利者。调气为主。
抑郁所致而不痛者。宜调经脉补气血。
肿硬作痛者。行气和血。
溃而不敛者。益气血为主。
伤寒余邪未尽者。和而解之。
脾气虚。湿热凝滞肉理而然。健脾除湿为主。
闪肭瘀血凝滞为患者。和气血。调经络。
寒邪所袭。筋挛骨痛。或遍身痛。宜温经络。养血气。
大抵流注之症。多因郁结。或暴怒。或脾虚湿气逆于肉理。或腠理不密。寒邪客于经络
闪扑。或产后瘀血流注关节。或伤寒。余邪未尽为患。皆因真气不足。邪得乘之。常治郁
者开之。怒者平之。闪扑及产后瘀血者散之。脾虚及腠理不密者。除而补之。伤寒余邪者。
调而解之。六要以固元气为主。佐以见症之药。如久而疮口寒者。更用豆豉饼或附子饼灸之
有脓管或瘀肉者。用针头散腐及锭子尤效。若不补血气。及不慎饮食起居七情。俱不治。
一人因怒。胁下作痛。以小柴胡对四物。加青皮、桔梗、枳壳而愈。（因情处治。）
一人臀肿一块微痛。脉弦紧。以疮科流气饮四剂而消。（因情处治。）
一人因怒胁下肿痛。胸膈不利。脉沉迟。以方脉流气饮数剂少愈。以小柴胡对二陈加青
皮、桔梗、贝母。数剂顿退。更以小柴胡二十余剂而痊。（因七情处治。）
一妇因闪肭。肩患肿。遍身作痛。以黑丸子二服而痛止。以（方脉）流气饮二剂而肿消。
更以二陈对四物加香附、枳壳、桔梗而愈。（凭症处治。）
一妇腿患筋挛骨痛。诸药不应。脉迟紧。用大防风汤一剂顿退。又二剂而安。又一妇患
之亦然。先用前汤二剂。更服黑丸子而痊。此二患若失治。溃作败症。（凭症凭脉处治。）
一妇禀弱性躁。胁臂肿痛。胸膈痞满。服流气败毒。反发热少食。用四七汤数剂。胸宽
气利。以小柴胡对四物。加香附、陈皮。肿痛亦退。（此因治不对病而变方。）
一人腿患溃而不敛。用人参养荣汤。及附子饼灸。更以补剂煎膏贴之。两月余愈。（凭
一人脾气素弱。臂肿一块。不痛。肉色不变。饮食少思。半载不溃。先以六君子加芎归
二十余剂。饮食渐进。更以豆豉饼日灸数壮。于前药再加黄 肉桂三十余剂。脓熟针去。以
十全大补汤及附子饼灸之。月余而敛。（此凭症处治。）
一人腿肿。肉色不变。不痛。脉浮而滑。以补中益气汤加半夏、茯苓、枳壳、木香饮之
香附饼熨之。彼谓气无补法。乃服方脉流气饮。愈虚。始用六君子汤加芎、归数剂。饮食少
进。再用补剂。月余而消。（凭脉凭症处治。）
夫气无补法。世俗论也。以其为病痞满壅塞。似难为补。殊不知正气虚不能营运。则邪
气滞而为病。不用补法。气何由行乎。
一人臂肿。筋挛骨痛。年余方溃。不敛。诊脉更虚。以内塞散一料。少愈。以十全大补
汤及附子饼灸而愈。（凭症凭脉处治。）
精要云。留积经久。极阴生阳。寒极为热。以此溃多成 。宜早服内塞散排之。
一人腿肿一块。经年不消。且不作脓。饮食少思。强食则胀。或作泻。日渐消瘦。诊脉
。此乃命门火衰。不能生土。以致脾虚而然也。遂以八味丸。饮食渐进。肿患亦消。（凭症
一人背髀。患之微肿。形劳气弱。以益气养荣汤。间服黑丸子及木香、生地黄作饼覆患
处。熨之月余。脓成针之。仍服前药而愈。（此凭所因而治。）
一人腿患。久而不敛。饮大补药及附子饼及针头散。 之而愈。（凭症处治。）
一人臂患。年余尚硬。饮食少思。朝寒暮热。八珍汤加柴胡、地骨、牡丹皮。月余寒热
。再用益气养荣汤附子饼灸。两月余脓成。针之。更服人参养荣汤。半载而愈。（凭症而治
一妇脓溃清稀。脉弱恶寒。久而不愈。服内塞散。灸附子饼而瘳。（凭脉凭症而治。）
一人臂患。出腐骨三块尚不敛。发热作渴。脉浮大而涩。乃气血俱损。须多服生气血之
庶可保全。彼谓火尚未尽。乃用凉药内服外敷。几危求治。其形甚悴。脉愈虚。先以六君
子加芎归月余。饮食渐进。以八珍汤加肉桂三十余剂。疮色乃赤。更以十全大补汤。外以附
子饼。仅年而瘥。（凭症凭脉。）
一老伤寒。表邪未尽。股内患肿发热。以人参败毒散二剂。热止。灸香附饼。又小柴
胡加二陈、羌活。川芎、归、术、枳壳。数剂而消。（凭症处治。）
一妇腰间患一小块。肉色如常。不溃。发热。予欲治以益气养荣解郁之剂。彼却别服流
气饮。后针破出水。
年余而没。又一妇久不敛。忽发寒热。予决其气血俱虚。彼反服表散之剂。果发大热。
亦死。（凭症处治）
一人元气素弱。将患此胸膈不利。饮食少思。予欲健脾。解郁。养气血。彼反服辛香流
剂。致腹胀。又服三棱、莪术、浓朴。之类。饮食少。四肢微肿。兼腰肿一块。不溃而殁
一妇经不调。两月或三月一至。四肢肿。饮食少。日晡发热。予曰。此脾土气血虚也。
脾滋气血药。饮食进则浮肿自消。血气充则经水自调。彼以为缓。用峻剂先通月经。果腹疼
泄不止。遍身浮肿。饮食少。没于木旺之月。
一人年逾三十。小腹肿硬。逾年成疮。头破时出血水。此七情所伤。营气逆于肉理也。
流注。诊之肝脉涩。盖肝病脉不宜涩。小腹正属肝经。须涩属金。脉退乃可。予欲以甘温之
药补其气血。令自消溃。彼不信。乃服攻伐之药。气血愈虚。果没于金旺之月。（此凭脉也
（丹溪曰。诸经惟少阳厥阴二经痈疽。宜预防之。以其多气少血也。少血则肌肉难长。
疮久不敛。必成败症。若不知此。辄用峻利之药。以攻伐其阴分之血。祸不旋踵。）
Caused by sudden anger. If accompanied by chest and diaphragm qi stagnation, treatment should focus on regulating qi.
Caused by depression without pain, it is appropriate to regulate the meridians and tonify qi and blood.
For local swelling, hardness, and pain, promote qi circulation and invigorate blood.
For ulcers that have ruptured but fail to heal, the primary approach is to tonify qi and blood.
For residual pathogenic factors from cold damage (Shanghan) not yet fully cleared, use harmonizing methods to resolve them.
When spleen qi is deficient, causing damp-heat to coagulate in the muscle layers, the main treatment is to strengthen the spleen and eliminate dampness.
For cases caused by sprains or falls leading to blood stasis, harmonize qi and blood, and regulate the meridians.
When attacked by cold pathogens, resulting in tendon spasms and bone pain, or generalized body pain, it is appropriate to warm the meridians, nourish blood, and tonify qi.
Generally speaking, Liu Zhu (flowing abscesses) are mostly due to emotional constraint, sudden anger, spleen deficiency with dampness counter-flowing into the muscle layers, or loose interstices (cou li) allowing cold pathogens to lodge in the meridians; or due to sprains/falls, postpartum blood stasis flowing into joints; or residual pathogens from cold damage. All these conditions arise because of insufficient true qi, allowing pathogens to take advantage of the deficiency. The general treatment principles are: for constraint, open and disperse; for anger, calm and subdue; for sprains/falls and postpartum stasis, dissipate; for spleen deficiency and loose interstices, eliminate [dampness] and tonify; for residual cold damage pathogens, harmonize and resolve. These six principles prioritize securing the original qi, supplemented by herbs targeting specific symptoms. For example, if the ulcer remains cold after a long duration, moxibustion with fermented soybean cakes or aconite cakes can be used. If there are sinus tracts or necrotic flesh, using Zhen Tou San to remove necrotic tissue and applying Ding Zi externally is particularly effective. If qi and blood are not tonified, and if one is careless with diet, daily life, and the seven emotions, the condition will be incurable.
One patient suffered hypochondriac pain due to anger, cured by combining Xiao Chai Hu Tang with Si Wu Tang, adding Qing Pi, Jie Geng, and Zhi Qiao. (Treatment based on emotional etiology.)
One patient had a slightly painful swelling on the buttock with a wiry-tight pulse, resolved after four doses of Chuang Ke Liu Qi Yin. (Treatment based on emotional etiology.)
One patient suffered hypochondriac swelling and pain with chest/diaphragm discomfort due to anger, with a deep-slow pulse. After several doses of Fang Mai Liu Qi Yin, slight improvement was seen. Then, Xiao Chai Hu Tang combined with Er Chen Tang, adding Qing Pi, Jie Geng, and Bei Mu, led to rapid symptom reduction over several doses. Finally, more than twenty doses of Xiao Chai Hu Tang resulted in full recovery. (Treatment based on the seven emotions.)
One woman suffered shoulder swelling and generalized body pain due to a sprain/fall. Pain stopped after two doses of Hei Wan Zi. Swelling subsided after two doses of (Fang Mai) Liu Qi Yin. She was then cured by combining Er Chen Tang with Si Wu Tang, adding Xiang Fu, Zhi Qiao, and Jie Geng. (Treatment based on symptoms.)
One woman suffered tendon spasms and bone pain in her leg, unresponsive to various medicines, with a slow-tight pulse. Da Fang Feng Tang provided rapid relief after one dose, and stability after two more doses. Another woman with similar symptoms first took two doses of the aforementioned decoction, followed by Hei Wan Zi, resulting in recovery. If these cases were neglected and ulcerated, they would become fatal complications. (Treatment based on symptoms and pulse.)
One woman with a weak constitution and irritable temper suffered swelling and pain in her hypochondrium and arms, with chest diaphragm fullness. After taking Liu Qi Bai Du Tang, she developed fever and anorexia. Switching to Si Qi Tang for several doses relieved the chest fullness and regulated qi. Subsequently, Xiao Chai Hu Tang combined with Si Wu Tang, adding Xiang Fu and Chen Pi, reduced the swelling and pain. (Formula adjustment due to incorrect initial treatment.)
One patient had a non-healing leg ulcer. Ren Shen Yang Rong Tang was used, along with moxibustion using Aconite Cakes. Additionally, a tonic paste was applied topically. Recovery occurred after more than two months. (Treatment based on symptoms.)
One patient with inherent spleen weakness had a non-painful arm swelling with normal skin color and poor appetite, lasting half a year without suppuration. Initially, Liu Jun Zi Tang added with Xiong Gui (Chuan Xiong and Dang Gui) was taken for over twenty doses, improving appetite. Daily moxibustion with Fermented Soybean Cakes was performed. Huang Qi and Rou Gui were added to the previous prescription for over thirty doses. After puncture upon suppuration, Shi Quan Da Bu Tang and Aconite Cake moxibustion were used, leading to healing within a month. (Treatment based on symptoms.)
One patient had leg swelling with normal skin color and no pain, with a floating-slippery pulse. Bu Zhong Yi Qi Tang added with Ban Xia, Fu Ling, Zhi Qiao, and Mu Xiang was administered, and the area was warmed with Xiang Fu cakes. The patient believed "qi disorders cannot be treated with tonification" and instead took Fang Mai Liu Qi Yin, worsening his deficiency. Later, Liu Jun Zi Tang added with Xiong Gui was taken for several doses, slightly improving appetite. Continued tonification led to resolution of swelling within a month. (Treatment based on pulse and symptoms.)
The saying "qi disorders cannot be treated with tonification" is a secular misconception. Because qi disorders manifest as fullness and obstruction, they seem difficult to treat with tonification. However, when righteous qi is deficient and fails to circulate, pathogenic qi stagnates and causes disease. Without tonification, how can qi move?
One patient had arm swelling, tendon spasms, and bone pain, ulcerating only after a year and failing to heal. The pulse indicated further deficiency. One dose of Nei Sai San brought slight improvement. Full recovery was achieved with Shi Quan Da Bu Tang and Aconite Cake moxibustion. (Treatment based on symptoms and pulse.)
Jing Yao states: Long-standing accumulation transforms from extreme yin to yang, and extreme cold transforms to heat, often leading to fistulas upon ulceration. Early administration of Nei Sai San to expel pathogens is advisable.
One patient had a leg swelling persisting for years without suppuration, poor appetite, abdominal distension upon forced eating, occasional diarrhea, and gradual emaciation. The pulse... (text missing, inferred deficiency) indicates Ming Men fire decline failing to generate Earth, causing spleen deficiency. Ba Wei Wan was prescribed. Appetite improved, and swelling subsided. (Treatment based on symptoms.)
One patient had mild swelling in the back/hip region, with physical fatigue and weak qi. Yi Qi Yang Rong Tang was taken intermittently with Hei Wan Zi. A cake of Mu Xiang and Sheng Di Huang was applied to the lesion and warmed. After one month, suppuration formed, was punctured, and continued medication led to recovery. (Treatment based on etiology.)
One patient had a chronic non-healing leg ulcer. Large tonics, Aconite Cakes, and Zhen Tou San were used, leading to recovery. (Treatment based on symptoms.)
One patient had an arm lesion remaining hard for over a year, with poor appetite, morning chills, and evening fevers. Ba Zhen Tang added with Chai Hu, Di Gu Pi, and Mu Dan Pi reduced the fever/chills over a month. Yi Qi Yang Rong Tang with Aconite Cake moxibustion was used next. Suppuration formed after two months, was punctured, and Ren Shen Yang Rong Tang was taken for half a year until recovery. (Treatment based on symptoms.)
One patient had thin pus discharge, weak pulse, aversion to cold, and chronic non-healing. Nei Sai San was taken, and Aconite Cake moxibustion led to cure. (Treatment based on pulse and symptoms.)
One patient expelled three pieces of necrotic bone from an arm lesion but failed to heal, presenting with fever, thirst, and a large-floating-choppy pulse indicating dual deficiency of qi and blood. Prolonged intake of qi-and-blood-generating herbs was necessary for survival. The patient believed the fire toxin was not cleared and used cooling herbs internally and externally, nearly dying. The patient appeared emaciated with a weaker pulse. Liu Jun Zi Tang added with Xiong Gui was taken for over a month, improving appetite. Ba Zhen Tang added with Rou Gui for over thirty doses turned the wound red. Shi Quan Da Bu Tang with external Aconite Cake application led to recovery in about a year. (Based on symptoms and pulse.)
An elderly patient with incomplete exterior cold damage had swelling and fever in the inner thigh. Ren Shen Bai Du San for two doses stopped the fever. Moxibustion with Xiang Fu cakes was applied. Xiao Chai Hu Tang combined with Er Chen Tang, Qiang Huo, Chuan Xiong, Dang Gui, Bai Zhu, and Zhi Qiao resolved the swelling after several doses. (Treatment based on symptoms.)
One woman had a small, non-ulcerating, feverish swelling on her waist with normal skin color. I intended to treat her with Yi Qi Yang Rong Jie Yu agents, but she took Liu Qi Yin instead. It was later lanced, draining fluid. She died one year later. Another woman with a chronic non-healing ulcer suddenly developed chills and fever. I diagnosed dual qi and blood deficiency, but she took exterior-releasing agents, developed high fever, and died. (Treatment based on symptoms.)
One patient with inherent weak yuan qi presented with chest/diaphragm discomfort and poor appetite. I intended to strengthen the spleen, resolve constraint, and nourish qi/blood. He instead took acrid-aromatic qi-moving agents, causing abdominal distension. He then took San Leng, E Zhu, Hou Po, etc., worsening anorexia, causing slight limb edema and a non-ulcerating lumbar swelling, leading to death.
One woman with irregular menstruation (every 2-3 months), limb edema, poor appetite, and afternoon fever was diagnosed with spleen-earth qi and blood deficiency. I stated that nourishing spleen qi and blood would improve appetite, resolve edema, and regulate menstruation. Disregarding this slow approach, she used harsh purgatives to induce menstruation, resulting in abdominal pain, intractable diarrhea, generalized edema, and death in the Wood-dominant month (Spring).
One patient over thirty had a hard lower abdominal swelling that ulcerated after a year, bleeding fluid. This was caused by seven emotions injuring Ying qi, causing counter-flow in muscle layers, classified as Liu Zhu. The liver pulse was choppy. Liver diseases should not present with a choppy pulse; the lower abdomen belongs to the Liver meridian. Choppy indicates Metal. The pulse should retreat. I intended to use sweet-warm herbs to tonify qi and blood for spontaneous resolution/ulceration. He did not believe me, took attacking herbs, worsened qi/blood deficiency, and died in the Metal-dominant month (Autumn). (Treatment based on pulse.)
(Danxi said: Among all meridians, only Shaoyang and Jueyin abscesses require prevention because they have abundant qi and scarce blood. Scarce blood makes muscle growth difficult, leading to chronic non-healing ulcers and fatal complications. Ignoring this and using harsh, draining drugs to attack yin-blood leads to swift disaster.)