夫二仪含象。三才贯形。五脏以类五行。六腑法之六律。人之肉也则脾主之。人之皮肤
则肺所管。肤肉受病。皆由滋味。而与浓衣。衣服浓暖。则表易招寒。滋味过多。则脏腑生
热
血败渍肉。肉腐成脓。实则为痈。浮则为肿。深则为疽。于发背者。服五石寒食更生散所致
。亦有单服钟乳而发者。又有平生不服石药。而自发背者。皆是上代有服之者。毒瓦斯流敷故
也。其候多于背两髀间。初起如粟米大。或痛或痒。四畔作赤色。日渐增长。若不早疗。经
数日遂至不救。其临困时。疮已圆阔三四寸。高一寸。有十数窍。以手按之。诸窍之中。脓
皆反出也。养生云。若小觉背上痛痒有异。则取净土。水和捻作饼子。径一寸半。浓二分。
贴着疮上。以艾火作炷灸之。一炷一易饼子。若粟米大时。可灸七饼子。若如榆荚大时。灸
七七炷。若至钱许大时。日夜不住灸。并服铁浆。及五香连翘散。疗之在速。则无不瘥也。
夫发背者。由三焦壅滞。六腑不和之所致也。多发于诸腑俞。其腠理虚者。经络为寒所
客
结
治发背初觉。毒瓦斯攻背上。苦牵痛。微有赤肿。宜服犀角散方。
犀角屑（一两） 玄参（一两） 川升麻（一两） 黄 （一两锉） 赤芍药（一两） 麦
门冬（
一两去心） 川大黄（二两锉碎微炒） 当归（三分） 甘草（一两生锉）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治积热毒瓦斯攻腑脏。出于皮肤。为发背壅肿。连翘散方。
连翘（一两） 沉香（一两） 玄参（一两） 川大黄（二两锉碎微炒） 川升麻（一
两） 桑根
白皮（一两研） 蓝子（一两） 犀角屑（二两） 寒水石（三两） 露蜂房（一两微炙研）
川朴硝
（二
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。以长利
为度。
治热毒瓦斯攻冲背上。初觉疼痛。烦闷。经月不瘥。玄参散方。
玄参（一两） 黄芩（一两） 当归（一两） 赤芍药（一两） 麦门冬（一两去心） 犀
角屑（
一两） 甘草（一
升麻（一
两半） 人参（一
上件药。捣筛为散。每服四钱。以水一中盏。入竹叶二七片。小麦五十粒。煎至六分。
去滓。不计时候温服。
治发背及诸疮。肿疼痛。前胡散方。
前胡（一两去芦头） 麦门冬（一两去心） 川升麻（一两） 黄芩（一两） 知母（一
两） 甘
草（一两锉生用） 川大黄（一两锉碎微炒） 黄 （一两生锉） 赤芍药（一两） 当归
（一两）
上件药。捣粗罗为散。每服四钱。以水一中盏。入竹叶二七片。煎至六分。去滓。不计
时候温服。
治热毒瓦斯盛。背上发痈肿。渐觉牵痛。麦门冬散方。
麦门冬（一两去心） 当归（一两） 玄参（一两） 甘草（三分生锉） 赤芍药（三
分） 生干
地黄（一两半） 蓝叶〔三斤（分）〕 地骨皮（三分） 犀角屑（三分）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治发背疼痛。身体壮热。心腹烦闷。升麻散方。
川升麻（一两半） 沉香（三分） 藿香（半两） 木香（半两） 甘草（一两生锉） 葛
根（一
两半锉） 麦门冬〔二（一）两去心〕 黄芩（一两） 赤芍药（一两）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治初觉皮肤及项背有疮疖。恐成痈疽。兼脏腑壅涩。或寒热口干心烦。犀角散方。
犀角屑（一两） 知母（三分） 木通（一两锉） 赤芍药（三分） 川升麻（三分） 荠
（三
分） 葳
两） 川
大黄（一
上件药。捣粗罗为散。每服四钱。以水一中盏。煎至六分。去滓。入竹沥半合。不计时
候温服。以利一两行为度。
治发背肿痛。烦闷。漏芦散方。
漏芦（一两） 白蔹（一两） 黄芩（一两） 白薇（一两） 赤芍药（一两） 甘草
（一两生锉）
枳实（一两麸炒微黄） 川大黄〔二（一）两半锉碎微炒〕 麻黄（一两去根节）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治发背热。每肿痛。四肢烦疼。黄 散方。
黄 （一两锉） 黄芩（一两） 远志（一两去心） 麦门冬（一两去心） 生干地黄
（半两）
人参
草（半两
生锉）
治发背毒肿如杏。烦热疼痛。大木香散方。
木香（一两） 地骨皮（二两） 玄参（二两） 甘草（一两生锉） 川升麻（二两） 川
大黄（
一两锉碎微炒）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分去滓。不计时候温服。
治大热发痈在背。或于阴股间。黄芩散方。
黄芩（一两半锉） 黄 （一两半锉） 木通（一两半锉） 前胡（一两半去芦头） 川
升麻（
一两
黄（二两锉
碎微
上件药。捣筛为散。每服四钱。以水一中盏。入竹叶二七片。小麦一百粒。生地黄一分
煎至六分去滓。不计时候温服。
治发背初欲作肿。宜服此方。
川大黄（一两锉碎微炒） 栀子仁（一两） 川升麻（一两） 黄芩（一两） 甘草（一
两生锉）
玄参（一两）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分去滓。不计时候温服。
治发背。肿如杏或如鸡子者。沉香散方。
沉香（一两） 麦门冬（一两去心） 木香（一两） 川升麻（一两） 麻黄（三两去
根节） 川
大黄（一两）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分去滓。不计时候温服。
治发背赤肿。发热疼痛脓不出。黄 散方。
黄 （一两锉） 赤小豆（一分熟） 赤芍药（半两） 白蔹（三分） 芎 （三分） 栝
蒌根（
三分）
上件药。捣细罗为散。不计时候。以温水调下二钱。
治发背疼痛不可忍。或未有脓。得快利即愈。宜服犀角丸方。
犀角屑（半两） 川大黄（二分锉微炒） 黄芩（三分） 川升麻（半两） 防风（半
两去芦头）
人
连
（半
上件药。捣罗为末。入巴豆研令匀。炼蜜和捣三五百杵。丸如绿豆大。每于食前以粥饮
下五丸。得利为度。
治发背初觉。宜服此方。
黄牛乳（二大盏） 秦艽（二两去苗锉）
上件药相和。煎至一大盏。去滓。分温三服。当得快利为效。
治发背初觉。热毒壅结。宜宣泄毒瓦斯。令不成疮肿方。
川乌头（半两生去皮脐捣罗为末） 巴豆（一分去皮心膜生研） 朱砂（一分细研）
上件药相和。研令匀细。以软粟米饭和丸。如梧桐子大。每服。以温水下五丸。以快利
为度。未利再服。
Heaven and Earth contain all phenomena, and the Three Powers (Heaven, Earth, and Man) penetrate the physical form. The Five Zang Organs correspond to the Five Elements, and the Six Fu Organs follow the Six Harmonies. Human flesh is governed by the Spleen, and human skin is managed by the Lung. Diseases of the skin and flesh arise from rich flavors in diet and wearing thick clothing. Thick and warm clothing makes the exterior easily susceptible to Cold pathogens; excessive rich flavors generate internal Heat in the Zang-Fu organs.
When blood deteriorates and soaks the muscles, the muscles rot and turn into pus. In excess conditions, it manifests as a carbuncle (Yong); superficially, it appears as swelling; deeply, it presents as a deep abscess (Ju). Back carbuncles are caused by taking Wushi San (Five Minerals Powder), Hanshi Gengsheng San (Cold Food Rejuvenation Powder), etc. Some develop this condition from taking Zhongru Shi (Stalactite) alone. Others who have never taken mineral drugs spontaneously develop back carbuncles; this is because ancestors took such drugs, and their toxic vapors flowed and spread within the body. Symptoms often appear between the two hips on the back. Initially, it is like a millet grain, either painful or itchy, with the surrounding area turning red, growing day by day. If not treated early, after a few days, it becomes incurable. When nearing death, the sore becomes round and wide, three to four cun in diameter, one cun high, with more than ten openings. Pressing with hands causes pus to flow out from all openings. Health preservation texts say: if you initially feel pain or itching on the back, take clean soil, mix with water to form a cake, one and a half cun in diameter and two fen thick, apply it to the sore, and moxibustion with an moxa cone. Replace the cake for each moxa cone. If it is millet-grain sized, moxa seven cakes; if plum-pit sized, moxa forty-nine cones; if coin-sized, moxa continuously day and night, and simultaneously take Tiejiang (Iron Slurry) and Wuxiang Lianqiao San (Five-Spice Forsythia Powder). If treatment is prompt, recovery is certain.
Back carbuncles result from stagnation of the Sanjiao (Triple Burner) and disharmony of the Six Fu Organs. They frequently occur at the Shu points of various Fu organs. In individuals with loose interstices (Cou Li), meridians are invaded and congealed by Cold pathogens.
For initial symptoms of back carbuncle, where toxic vapors attack the back causing pulling pain and slight redness and swelling, take Xijiao San (Rhinoceros Horn Powder):
Rhinoceros Horn slices (1 liang), Xuanshen (Scrophulariae Radix, 1 liang), Chuan Shengma (Cimicifugae Rhizoma, 1 liang), Huangqin (Scutellariae Radix, 1 liang, crushed), Chishao Yao (Paeoniae Rubra Radix, 1 liang), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Chuan Dahuang (Rhei Radix et Rhizoma, 2 liang, crushed, slightly stir-fried), Danggui (Angelicae Sinensis Radix, 3 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed).
Crush and sieve these medicines into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For accumulated Heat and toxic vapors attacking the Zang-Fu, emerging through the skin causing back carbuncle swelling, take Lianqiao San (Forsythiae Powder):
Lianqiao (Forsythiae Fructus, 1 liang), Chenxiang (Aquilariae Lignum Resinatum, 1 liang), Xuanshen (Scrophulariae Radix, 1 liang), Chuan Dahuang (Rhei Radix et Rhizoma, 2 liang, crushed, slightly stir-fried), Chuan Shengma (Cimicifugae Rhizoma, 1 liang), Sanggen Baipi (Mori Cortex, 1 liang, ground), Lanzi (Indigo Naturalis seeds?, 1 liang), Rhinoceros Horn slices (2 liang), Hanshuishi (Aragoniti Fibrosum, 3 liang), Lubofang (Vespa Nidus, 1 liang, slightly roasted and ground), Chuan Puxiao (Natrii Sulfas, 2 liang).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time. Continue until bowel movement is unobstructed.
For Heat-toxic vapors attacking the back, causing initial pain and restlessness, persisting for a month without healing, take Xuanshen San (Scrophulariae Powder):
Xuanshen (Scrophulariae Radix, 1 liang), Huangqin (Scutellariae Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 1 liang), Chishao Yao (Paeoniae Rubra Radix, 1 liang), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Rhinoceros Horn slices (1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Shengma (Cimicifugae Rhizoma, 1.5 liang), Renshen (Ginseng Radix, 1 liang).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water, add fourteen leaves of Zhuye (Bambusae Folium) and fifty grains of Xiaomai (Tritici Fructus), reduce to six parts, remove dregs, and take warm at any time.
For back carbuncles and other sores with swelling and pain, take Qianhu San (Peucedani Radix Powder):
Qianhu (Peucedani Radix, 1 liang, rhizome removed), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Chuan Shengma (Cimicifugae Rhizoma, 1 liang), Huangqin (Scutellariae Radix, 1 liang), Zhimu (Anemarrhenae Rhizoma, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed), Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang, crushed, slightly stir-fried), Huangqi (Astragali Radix, 1 liang, raw, crushed), Chishao Yao (Paeoniae Rubra Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 1 liang).
Coarsely sieve into a powder. Take 4 qian per dose, decoct with one zhann of water, add fourteen leaves of Zhuye (Bambusae Folium), reduce to six parts, remove dregs, and take warm at any time.
For abundant Heat-toxic vapors causing carbuncles on the back with pulling pain, take Maimendong San (Ophiopogonis Powder):
Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Danggui (Angelicae Sinensis Radix, 1 liang), Xuanshen (Scrophulariae Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen, raw, crushed), Chishao Yao (Paeoniae Rubra Radix, 3 fen), Shenggan Dihuang (Rehmanniae Radix Preparata, 1.5 liang), Lanye (Isatidis Folium, 3 jin - *note: unit likely erroneous in original*), Digupi (Lycii Cortex, 3 fen), Rhinoceros Horn slices (3 fen).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For back carbuncle pain, high fever, and chest/abdominal restlessness, take Shengma San (Cimicifugae Powder):
Chuan Shengma (Cimicifugae Rhizoma, 1.5 liang), Chenxiang (Aquilariae Lignum Resinatum, 3 fen), Huoxiang (Agastaches Herba, 0.5 liang), Muxiang (Aucklandiae Radix, 0.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed), Gegen (Puerariae Radix, 1.5 liang, crushed), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Huangqin (Scutellariae Radix, 1 liang), Chishao Yao (Paeoniae Rubra Radix, 1 liang).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For initial skin and neck/back sores fearing progression to carbuncles/deep abscesses, accompanied by Zang-Fu obstruction, chills/fever, dry mouth, and irritability, take Xijiao San (Rhinoceros Horn Powder):
Rhinoceros Horn slices (1 liang), Zhimu (Anemarrhenae Rhizoma, 3 fen), Mutong (Akebiae Caulis, 1 liang, crushed), Chishao Yao (Paeoniae Rubra Radix, 3 fen), Chuan Shengma (Cimicifugae Rhizoma, 3 fen), Jini (Jinyingzi? or similar, 3 fen - *text incomplete*), Weirui (Polygonati Rhizoma, 1 liang - *text incomplete*), Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang - *text incomplete*).
Coarsely sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, add Banhe Zhu Li (Bambusae Sap), and take warm at any time. Continue until bowel movement occurs one or two times.
For back carbuncle swelling/pain and restlessness, take Loulu San (Euphorbiae Humifusae Radix Powder):
Loulu (Euphorbiae Humifusae Radix, 1 liang), Bailian (Ampelopsis Radix, 1 liang), Huangqin (Scutellariae Radix, 1 liang), Baiwei (Clehorneae Radix, 1 liang), Chishao Yao (Paeoniae Rubra Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed), Zhishi (Aurantii Fructus Immaturus, 1 liang, bran-fried, slightly yellow), Chuan Dahuang (Rhei Radix et Rhizoma, 1.5 liang, crushed, slightly stir-fried), Mahuang (Ephedrae Herba, 1 liang, roots and joints removed).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For back carbuncle heat, swelling/pain upon onset, and limb restlessness/pain, take Huangqi San (Astragali Powder):
Huangqi (Astragali Radix, 1 liang, crushed), Huangqin (Scutellariae Radix, 1 liang), Yuanzhi (Polygalae Radix, 1 liang, heart removed), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Shenggan Dihuang (Rehmanniae Radix Preparata, 0.5 liang), Renshen (Ginseng Radix, 0.5 liang - *text incomplete*), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, raw, crushed).
For back carbuncle toxic swelling the size of an apricot kernel, with irritability, heat, and pain, take Damuxiang San (Large Aucklandiae Powder):
Muxiang (Aucklandiae Radix, 1 liang), Digupi (Lycii Cortex, 2 liang), Xuanshen (Scrophulariae Radix, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed), Chuan Shengma (Cimicifugae Rhizoma, 2 liang), Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang, crushed, slightly stir-fried).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For severe heat causing carbuncles on the back or groin, take Huangqin San (Scutellariae Powder):
Huangqin (Scutellariae Radix, 1.5 liang, crushed), Huangqi (Astragali Radix, 1.5 liang, crushed), Mutong (Akebiae Caulis, 1.5 liang, crushed), Qianhu (Peucedani Radix, 1.5 liang, rhizome removed), Chuan Shengma (Cimicifugae Rhizoma, 1 liang - *text incomplete*), Huangbo (Phellodendri Cortex, 2 liang, crushed, slightly stir-fried - *text incomplete*).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water, add fourteen leaves of Zhuye (Bambusae Folium), one hundred grains of Xiaomai (Tritici Fructus), and one fen of Shengdihuang (Rehmanniae Radix), reduce to six parts, remove dregs, and take warm at any time.
For initial swelling of back carbuncles, take this formula:
Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang, crushed, slightly stir-fried), Zhizi Ren (Gardeniae Fructus, 1 liang), Chuan Shengma (Cimicifugae Rhizoma, 1 liang), Huangqin (Scutellariae Radix, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, raw, crushed), Xuanshen (Scrophulariae Radix, 1 liang).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For back carbuncles swollen like apricot kernels or eggs, take Chenxiang San (Aquilariae Powder):
Chenxiang (Aquilariae Lignum Resinatum, 1 liang), Maimendong (Ophiopogonis Radix, 1 liang, heart removed), Muxiang (Aucklandiae Radix, 1 liang), Chuan Shengma (Cimicifugae Rhizoma, 1 liang), Mahuang (Ephedrae Herba, 3 liang, roots and joints removed), Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang).
Crush and sieve into a powder. Take 4 qian per dose, decoct with one zhann of water until reduced to six parts, remove dregs, and take warm at any time.
For red/swollen back carbuncles with heat/pain and no pus discharge, take Huangqi San (Astragali Powder):
Huangqi (Astragali Radix, 1 liang, crushed), Chixiaodou (Phaseoli Semen Rubrum, 1 fen, cooked), Chishao Yao (Paeoniae Rubra Radix, 0.5 liang), Bailian (Ampelopsis Radix, 3 fen), Xiong (Ligustici Chuanxiong Rhizoma, 3 fen), Gualou Gen (Trichosanthis Radix, 3 fen).
Finely sieve into a powder. Take 2 qian mixed with warm water at any time.
For unbearable back carbuncle pain or when pus has not yet formed, relief comes with rapid bowel movement. Take Xijiao Wan (Rhinoceros Horn Pills):
Rhinoceros Horn slices (0.5 liang), Chuan Dahuang (Rhei Radix et Rhizoma, 2 fen, crushed, slightly stir-fried), Huangqin (Scutellariae Radix, 3 fen), Chuan Shengma (Cimicifugae Rhizoma, 0.5 liang), Fangfeng (Saposhnikoviae Radix, 0.5 liang, rhizome removed), Renshen (Ginseng Radix, 0.5 liang - *text incomplete*), Lian (Coptidis Rhizoma, 0.5 liang - *text incomplete*).
Grind into powder, mix with Baidu (Crotonis Fructus) thoroughly, knead with refined honey for 300-500 beats, form pills the size of mung beans. Take five pills before meals with gruel broth, stopping when bowel movement occurs.
For initial symptoms of back carbuncle, take this formula:
Huangniu Ru (Cow's Milk, 2 large zhann), Qinjiao (Gentianae Macrophyllae Radix, 2 liang, seedlings removed, crushed).
Mix and decoct to one zhann, remove dregs, divide into three warm doses. Effective when rapid bowel movement occurs.
For initial back carbuncle with Heat-toxic congestion, to vent toxic vapors and prevent sore formation:
Chuan Wutou (Aconiti Radix, 0.5 liang, raw, skin and navel removed, ground to powder), Baidu (Crotonis Fructus, 1 fen, skin, heart, and membrane removed, raw ground), Zhusha (Cinnabar, 1 fen, finely ground).
Mix and grind finely, bind with soft millet rice paste into pills the size of paulownia seeds. Take five pills with warm water, stopping when rapid bowel movement occurs. Repeat if necessary.