夫附骨疽者，谓其毒瓦斯深沉，附着于骨也。此证多由忧愁之时露卧，为寒冷之气折之，
使风热之气不能发散，以致伏结附骨成疽。其痛而不能转，初按之应骨，皮肉微急，洪洪如
肥状者，是也。但痛无时，乍寒乍热而无汗者，经久不消，极阴生阳，寒化为热而溃也。又
有缓疽石疽，与附骨疽亦相类矣。所异者，盖缓疽石疽皆寒气所作，深伏于骨髓之间，有肿
与皮肉相似，若疼而坚硬如石，故谓之石疽。缓疽其热缓慢，积日不溃，久乃赤紫黯色，皮
肉俱烂，故名曰缓疽。此二者其治，初觉便宜补虚托里温热之剂，以取消矣。若附骨疽，其
治亦同，宜服漏芦汤、五香连翘散疏下之，次用内消升麻汤、 溃膏药贴之，令其浮浅则能
愈矣。
贯众汤
治附骨痈生股上伏肉间，淋渫方。
贯众 地骨皮 谷精草 枇杷叶（刷去毛，炙） 荆芥（去梗） 蜀椒（去目合口者，各一
上捣筛，以水三升煮取二升，和渣淋渫，蘸布帛拓之。
当归散
治附骨痈及一切恶疮。
当归（半两） 甘草（一两） 山栀子（十二枚） 木鳖子（一枚，去皮）
上为细末，每服三钱，冷酒调服。
内托柴胡黄 汤
治附骨痈。
黄 （二钱） 柴胡（一钱） 羌活（五分） 连翘（一钱三分） 官桂（三分） 黄柏（二分）
生地黄（一分） 土瓜根（一钱，酒制） 当归尾（七分半）
上 咀作一服，水三盏，酒一盏，同煎至一盏，去渣热服。宿食消尽，服一服而食。昔
贾德茂，男，年十岁，丁未四月十一日，于左腿近膝股内出附骨痈，不辨肉色，漫肿，皮泽
木硬，疮势甚大。其左脚乃肝之脾土也，更在足厥阴肝经之分，少侵足太阴脾经之分。其脉
左三部细而弦，按之缓而微有力。一方无黄柏。
内托黄 酒煎汤
治附骨痈。
黄 当归尾（各二钱） 柴胡（一钱半） 升麻（七分） 连翘 肉桂 鼠粘子（炒，各一
钱） 黄柏 甘草（炙，各五分）
上 咀，好糯米酒一盏半，水一大盏半，同煎至一大盏，去渣温服，空心宿食消尽服之
，待少时以早饭服之，使不令大热上攻中上二焦也。丁未季春二十二日，蒲度主老年七十，
因寒湿地气，得附骨痈于左腿外侧，足少阳胆经之分，微侵足阳明分，阔六七寸，长一尺，
坚硬漫肿，不辨肉色，皮泽深，但行步作痛，以指按至骨大痛。与药一服立止，再日坚硬肿
犀角汤
治石痈热毒瓦斯盛，肿硬疼痛，口干烦闷。
犀角（镑） 木香（各七钱半） 连翘 栀子仁 射干 当归（切焙） 升麻 赤芍药 玄
参枳壳（麸炒） 甘草（生，各一两） 大黄（炒，二两）
上锉碎，每服三钱，水一盏，煎六分，去渣，不拘时温服。
漏芦汤
治附骨疽。
漏芦（去芦） 升麻 连翘 麻黄（去根节，各一两） 防己 木香 白蔹 沉香（各五钱）
大黄（锉炒，一两半）
上锉碎，每服五钱，水一盏半入竹叶七片，煎至七分，入芒硝一钱搅匀，去渣空心温服
，取利三二行，未利再服。
应痛丸
治走注疼痛，疑是附骨疽者。
苍术（去皮） 当归 黑牵牛 草乌头（炮各一两）
上为细末，醋糊为丸，如小豆大，每服三十丸，空心醋汤下。
赤术丸
治附骨疽，脓汁淋漓，久而不瘥，已破未破皆可用。
赤术（一斤，泔浸去油用川椒葱白煮令黑色，焙干） 舶上茴香 破故纸（炒） 川楝子（
锉炒） 茯苓 土茴香 川白芷 桃仁（去皮尖，炒，各一两）
上为末，老人加黑附子，炼蜜丸梧桐子大，每服五十丸，温酒或盐汤吞下。
黑鲫膏
治附骨疽，未破已破或脓出不尽者。
上用黑色鲫鱼一个，去肠入白盐令腹满，用线缚定，用水一盏，铜石器中煮水尽干焦为
末。用猪油调敷，已破者干掺，少痛勿怪。
Fugu Ju (Periosteal Abscess) refers to a condition where toxic pathogens are deep-seated and adhere to the bone. This syndrome is often caused by sleeping outdoors while in a state of sorrow, allowing cold qi to invade, which prevents wind-heat qi from dispersing, leading to stagnation and adherence to the bone forming a ju (deep abscess). The pain is severe and limits movement; upon initial palpation, tenderness extends to the bone, with slight tension in the skin and flesh, and swelling resembling fatty tissue. This characterizes Fugu Ju. The pain occurs intermittently, accompanied by alternating chills and fever without sweating. If it persists without resolving, extreme yin generates yang, transforming cold into heat, leading to suppuration and ulceration. There are also Huan Ju (Slow Abscess) and Shi Ju (Stone Abscess), which resemble Fugu Ju. The difference lies in the etiology: Huan Ju and Shi Ju are caused by cold qi lying deep within the bone marrow. The swelling resembles the skin and flesh; if painful and hard as stone, it is called Shi Ju. Huan Ju has a slow onset of heat, does not ulcerate after many days, and eventually turns dark purple-red with rotting of skin and flesh, hence named Huan Ju. For these two conditions, early treatment should prioritize tonifying deficiency, supporting the interior, and using warm agents to resolve the pathogen. For Fugu Ju, the treatment is similar: administer Loulu Tang (Rhapontic Rhizome Decoction) or Wuxiang Liaoqiao San (Five-Aromatic Forsythia Powder) to vent and purge, followed by Neixiao Shengma Tang (Internal-Dissolving Cimicifuga Decoction) and applying Huigao plaster externally, aiming to bring the lesion superficial for healing.
Guanzhong Tang (Cyrtomium Decoction)
Indicated for Fugu Yong (Periosteal Carbuncle) occurring in the subcutaneous tissue of the thigh, used as a washing formula.
Cyrtomii Folium (Guanzhong), Lycii Cortex (Digupi), Sparganii Herba (Gujingcao), Eriobotryae Folium (Pipaye, brushed clean of hairs, stir-fried), Schizonepetae Herba (Jingjie, stems removed), Zanthoxyli Pericarpium (Shujiao, remove those with closed eyes/mouths, equal parts).
Crush and sieve the above herbs. Boil in 3 sheng of water to obtain 2 sheng. Strain and wash the affected area with the liquid and dregs, applying soaked cloth compresses.
Danggui San (Angelica Sinensis Powder)
Indicated for Fugu Yong and all kinds of malignant sores.
Angelicae Sinensis Radix (Danggui, half liang), Glycyrrhizae Radix et Rhizoma (Gancao, one liang), Gardeniae Fructus (Shanzhizi, twelve fruits), Momordicae Semen (Mubiezi, one fruit, peel removed).
Grind into fine powder. Take 3 qian per dose, mixed with cold wine.
Neituo Chaihu Huangqin Tang (Supporting Interior Bupleurum and Scutellaria Decoction)
Indicated for Fugu Yong.
Scutellariae Radix (Huangqin, 2 qian), Bupleuri Radix (Chaihu, 1 qian), Notopterygii Rhizoma et Radix (Qianghuo, 0.5 qian), Forsythiae Fructus (Liaoqiao, 1.3 qian), Cinnamomi Ramulus (Guangui, 0.3 qian), Phellodendri Cortex (Huangbai, 0.2 qian), Rehmanniae Radix Recens (Shengdihuang, 0.1 qian), Trichosanthis Radix (Tugua-gen, 1 qian, wine-processed), Angelicae Sinensis Radix (Dangguiwei, 0.75 qian).
Cut into pieces for one dose. Add 3 zhan of water and 1 zhan of wine. Decoct until 1 zhan remains. Strain and take hot. After the retention food is digested, take one dose before eating. Previously, Jia Demao's son, aged ten, on April 11 in the Dingwei year, developed Fugu Yong near the knee on the inner thigh. The muscle color was indistinguishable, with diffuse swelling, shiny skin, and woody hardness. The sore was large. The left foot corresponds to the spleen earth of the liver, located in the distribution of the Foot-Jueyin Liver Meridian, slightly involving the Foot-Taiyin Spleen Meridian. The pulse at the three positions on the left was thin and wiry, slow and slightly forceful upon pressure. One variation excludes Huangbai.
Neituo Huangqi Jiu Jian Tang (Supporting Interior Astragalus Wine-Decoction)
Indicated for Fugu Yong.
Astragali Radix (Huangqi), Angelicae Sinensis Radix (Dangguiwei) (each 2 qian), Bupleuri Radix (Chaihu, 1.5 qian), Cimicifugae Rhizoma (Shengma, 0.7 qian), Forsythiae Fructus (Liaoqiao), Cinnamomi Cortex (Rougui), Arctii Fructus (Niubangzi, stir-fried, each 1 qian), Phellodendri Cortex (Huangbai), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried, each 0.5 qian).
Cut into pieces. Add 1.5 zhan of good glutinous rice wine and 1.5 zhan of water. Decoct until 1 zhan remains. Strain and take warm on an empty stomach after digestion of retention food. Take again shortly before breakfast to prevent excessive heat from attacking the Middle and Upper Jiao. On March 22 in the Dingwei year, Pu Duzhu, a seventy-year-old man, contracted Fugu Yong on the lateral aspect of the left leg due to cold-damp qi, in the distribution of the Foot-Shaoyang Gallbladder Meridian, slightly invading the Foot-Yangming Stomach Meridian. It was 6-7 cun wide and 1 chi long, hard and diffusely swollen, with indistinct muscle color and deeply shiny skin. Walking caused pain, and pressing to the bone caused severe pain. One dose of medicine stopped the pain immediately; the hardness and swelling subsided the next day.
Xijiao Tang (Rhinoceros Horn Decoction)
Indicated for Shi Yong (Stone Carbuncle) with intense heat-toxin, diffuse hard swelling and pain, dry mouth, and irritability.
Rhinocerotis Cornu (Xijiao, sliced), Costi Radix (Muxiang) (each 7.5 qian), Forsythiae Fructus (Liaoqiao), Gardeniae Semen (Zhizi-ren), Belamcandae Rhizoma (Shegan), Angelicae Sinensis Radix (Danggui, cut and roasted), Cimicifugae Rhizoma (Shengma), Paeoniae Radix Rubra (Chishaoyao), Scrophulariae Radix (Xuanshen), Aurantii Fructus (Zhiqiao, bran-fried), Glycyrrhizae Radix et Rhizoma (Gancao, raw, each 1 liang), Rheii Radix et Rhizoma (Dahuang, fried, 2 liang).
Cut into fragments. Take 3 qian per dose. Add 1 zhan of water, decoct to 0.6 zhan. Strain and take warm at any time.
Loulu Tang (Rhaphistigma Decoction)
Indicated for Fugu Ju.
Rhaphistigmatis Radix (Loulu, remove rhizome), Cimicifugae Rhizoma (Shengma), Forsythiae Fructus (Liaoqiao), Ephedrae Herba (Mahuang, remove roots and joints, each 1 liang), Stephaniae Tetrandrae Radix (Fangji), Costi Radix (Muxiang), Acanthopanacis Cortex (Bailian), Aquilariae Lignum Resinatum (Chenxiang) (each 5 qian), Rheii Radix et Rhizoma (Dahuang, cut and fried, 1.5 liang).
Cut into fragments. Take 5 qian per dose. Add 1.5 zhan of water and 7 bamboo leaves. Decoct to 0.7 zhan. Add Mangxiao (Mirabilite) 1 qian, mix well. Strain and take warm on an empty stomach. Aim for 2-3 bowel movements; if not achieved, take again.
Yingtong Wan (Pain-Relieving Pill)
Indicated for migrating pain, suspected to be Fugu Ju.
Atractylodis Rhizoma (Cangzhu, peel removed), Angelicae Sinensis Radix (Danggui), Pharbitidis Semen (Heiqianniu), Aconiti Lateralis Radix Praeparata (Caowutou, processed, each 1 liang).
Grind into fine powder. Make pills with vinegar paste, size of small beans. Take 30 pills per dose on an empty stomach with vinegar water.
Chishu Wan (Red Atractylodes Pill)
Indicated for Fugu Ju with dripping pus, chronic non-healing, applicable whether ulcerated or not.
Atractylodis Rhizoma (Chishu, 1 jin, soak in rice water to remove oil, boil with Zanthoxyli Pericarpium (Chuanjiao) and Allii Fistulosi Bulbus (Congbai) until black, dry and roast), Foeniculi Fructus (Bo-shanghuixiang), Psoraleae Fructus (Po-guzhi, fried), Toosendan Fructus (Chuanlianzi, cut and fried), Poria (Fuling), Foeniculi Fructus (Tu-huixiang), Angelicae Dahuricae Radix (Chuanbaizhi), Persicae Semen (Taoren, remove peel and tip, fried, each 1 liang).
Grind into powder. For elderly patients, add Hei Fuzi (Prepared Black Aconite Root). Make pills with refined honey, size of Sophora seeds. Take 50 pills per dose with warm wine or salt water.
Heiji Gao (Black Crucian Carp Plaster)
Indicated for Fugu Ju, whether un-ulcerated, ulcerated, or with incomplete pus discharge.
Take one black crucian carp, remove intestines, fill abdomen with white salt, tie securely. Boil in 1 zhan of water in a copper or ceramic vessel until water evaporates and fish is charred. Grind to powder. Mix with lard for application. For ulcerated wounds, apply dry powder. Mild pain is normal.