（附论）
夫发背者。热毒之气发于背俞。为痈疽是也。此内本于五脏。外传诸腑。热气攻发。必
生于府俞之间。得之乳石发动。及肥甘滋味之过。脏腑壅热。经络为之不通。毒瓦斯凝滞。必
因俞穴而出。是以服石之人。于居处衣食。嗜欲喜怒。尤宜节慎。一有过举。则毒瓦斯乘隙而
发。初如芥粟。治之稍缓。则盈尺寸而难图。故始觉热搏于分肉。痛伤于经络。宜速治之。
盖其脉不通。则肿毒增甚。经所谓营气不从。逆于肉理。乃生痈肿是也。血败肉腐。为患不
一。实则为痈。浮则为肿。深则为疽。然发于背者两胛间。初起甚微。或痒或痛。往往忽之。
数日遂致不救者。治之始则度其肿之正中而灸之。壮数逾百。使恶气外出。次以药疏利腑脏
。决其邪毒。则有可治之理。
凡发背皆因服食五石。寒食更生散所致。亦有单服钟乳而发者。又有平生不服。而自发
者。此是上代有服之者。其候率多于背两胛间起。初如粟米大。或痛或痒。仍作赤色。人皆
初不为事。日渐长大。不过十日。遂至于死。其临困之时。已阔三寸。高一寸。疮有数十孔。
以手按之。诸孔中皆脓出。寻时大困。所以养生者。小觉背上痒痛有异。即火急取净土水和
为泥。捻作饼子。浓二分。阔一寸半。以粗艾火作炷。灸泥饼上。贴着疮上灸之。一炷一易
饼子。若粟米大时。可灸七饼子即瘥。如榆荚大。灸七七饼炷即瘥。如钱大。可日夜灸之。
不限炷数。仍服五香连翘汤。及铁浆诸药。攻之乃愈。又法诸发背未作大脓。可以冷水射之。
浸石令冷熨之。日夜莫住。瘥乃止。此病忌面酒五辛等。亦有当两肩上发者。
凡服石人。皆须劳役四体。无令自安。如其不尔者。多有发动。亦不得逐。便恣意取暖。
称已适情。必须遗欲以取寒冻。虽当时不宁。于后在身。多有所益。终无发动之虑耳。
凡肿起背胛间。头白如黍粟。四边相连肿赤黑。令人闷乱。即名发背也。禁房室酒蒜肉
面。若不灸治。即入内杀人。若灸当疮上。七八百壮。有人不识。多作杂肿治者、皆死。
背疽其原有五。天行一。瘦弱气滞二。怒气三。肾气虚四。饮火酒。食炙爆物。服丹药。热
毒五。盖治背疽。不可一概将为热毒。其治之难易。当自一而至五。
病有至甚而生。有微而至死。病证难辨。死生何从决乎。盖发背透膜者死不治。（此言
肝俞以上） 未溃肉陷、面青、唇黑、便污者死。（此言坏藏便下瘀血） 溃喉者不治。阴
入
腹者不治。入囊者死。鬓深及数月不治。（谓如及寸余者） 在颐后一寸三分。毒锐者不治。
无此者生。流注虽多。疗之必愈。
发背之人。虽云有热。未有不自肾虚而得之者。若疽疾减退五分之后。便合根据法五更初。
服山药丸。或加减八味丸。
背疽呕逆。乃是毒瓦斯冲心。非脾胃之冷。当服内托散。杨氏家藏方云。有人因鼻衄初愈。
不曾表汗。余毒在经络。背发大疽。自肩下连腰胁肿甚。坚如石。色极紫黑。医以凉药服之。
中夜大呕。乃连进此药。三四服呕遂止。既而疮溃。出赤水淋漓。四十日而愈。又有患瘰
者。痛过即呕。服此药呕亦止。近见有人病疽。医者不肯用此药。为恐伤脾胃。愚故引杨氏
之言。以解世人之惑。
凡发背疽之后。不曾服内托散。致使热毒冲于心经。必使后来咽喉口舌生疮。甚至黑烂。
合先服犀角散。以解散其毒。免有此证。
凡有背疽之人。难于隐几。但用绿豆十斗。作一大袋隐伏。则自然心凉身体安稳。饮食
居处。根据法戒忌。已安后。半年间血气未定。犹当谨之。不废药饵。方能保全。外科精要云。
氏叙源幼时学举业。全不知医药。甲申年自太学归省。国医常颖土器之。适在府下。求为母
氏一诊。云。有蓄热必渴。时母氏所饮。大略喜水。又云但防作疮。觉疮便着艾于上。热盛
则五花灸之。谓中及四旁。随赤到处灸。非方停也。切记。至辛巳年六月望日。母氏忽言背
胛间微痒。视之有赤半寸许方。有白粒如黍粟。记器之言。乃急着艾。其赤随消。至二十
七壮而止。信宿复觉微痛。视之有赤下流。长二寸。阔如韭叶。举家不悉。皆以前灸为悔。
亲戚交责。谓赤热如何用火。有诋器之者。遂呼外医用药膏覆之益引。一日夜增一晕。至二
十二日。衡斜约六七寸。痛楚不胜。间一呻吟。听之心碎。仓皇询告。或云等慈寺老智全者
。前病疮甚大。得灸而愈。奔问之。全云。剧时昏不知。但小师辈言。范八奉议守定。灸
八百余壮方苏。约艾一筛。尔亟归白之。见从。始以银杏作炷其上十数。殊不觉。乃截四旁
赤引。其炷减四之三。皆觉痛。七壮后觉痒。每一炷烬。则赤随缩入。灸至三十余壮。赤晕
方退。病者信。遂以艾作团。梅杏大。灸其上。渐加至鸡黄大。约四十团方觉痛。视火焦处
已寸余。盖灸之迟。而初发处肉已坏。攘盛隔至好肉方痛耳。四旁知痛者。肉未坏也。又有
言一番殿直居城南。施疮药每效。叙源即再拜邀请。时已熏黑。火 满背。番以手扪疮五六
寸许。试之云。疮高阜而热。不妨。且云只怕不高而热气少者。病者食粥讫。安寝。前此六
夜不寝。至晓视之。疮如覆一瓯。突然高三四寸。上有百数小窍。色正黑。以千金所说。与
潘氏高阜之言求之。突然高者。毒瓦斯出外而聚也。百数小窍者。毒未聚而浮攻皮肤也。色正
黑者。皮与肉俱坏也。非艾火出其毒于坏肉之里。则五脏毕矣。至是方悟明堂图与烟萝子所
画五脏。在背如悬挂然。今毒行分肉间。待其外穿溃。则内虚。外实则易入。内实则难出。
皎然可见。而听庸医用寻常赤肿敷贴凉冷药。以消散之。此借寇兵也。源痛自咎。为人子不
知医。致亲疾危甚。荷神明扶佑。于仓皇间问知艾灸。已危而获安。
医学类证论曰。治发背、发脑、发鬓、疔疮、鬼箭、射工、鱼脐等。一切恶疮。无不灵
验。方才觉有患。便用蒜横切作片子。如两重纸浓。贴在疮上。以绿豆火艾丸子灸之。待痛
稍可忍。即渐大作丸灸。痛又可忍。便除蒜灸之。若是正发背。二日内灸者。十得十愈。四
日内灸者。十得七八。六日内灸者十得五六。八日内灸者。十得一二愈。十日以后灸即不得
力。若得力者。即是热毒疮。非发背也。凡发背者。灸无多少定数。但初痛候不痛即住。若
初不痛候痛即住。然则大约如此。若住火后。又肿及痛者。即须更灸。候不肿不痛即住。火
每患一个疮。或灸三百圆。或灸五百圆。或一千圆。或二千圆。以差为度。若患三个五个疮。
直须各各用前法灸之。候不肿不痛。然后用膏，药贴之。或问曰。何以知是正发背与热毒疮。
愚应之曰。若有患者。待请人识认得是正发背。或者热毒疮。即已迟也。何异咨丈人而后救
火者哉。古人云。面无好靥。头无恶骨。背无好疮。但根据此灸之。又何须识别者。或问曰。
前言医一切恶疮后。但灸发背而已何也。愚应之曰。疮中人言医不得者。发背也。令若早灸。
无有不验。则其余不言可知也。或曰。忽遇春夏。火正旺相。得行灸乎。若灸多得无火毒入
心乎。愚又应之曰。此是未知灸法之人也。千万勿信。
本事方云。元 三年。夏四月。官京师。疽发于背。召国医治之。逾月势益甚。得徐州
萧县人张生。以艾火加疮上。自旦及暮。凡一百五十壮。知痛乃已。明日镊去黑痂。脓血尽
溃。肤里皆红。亦不复痛。始别以药敷之。日一易焉。易时旋剪去黑烂恶肉。月许疮乃平。
是岁夏间。京师士大夫病疽者七人。余独生。此虽司命事。然固有料理不知其方。遂至不幸
者。以人意论之。可为慨然。
儒门事亲云。一富家女子十余岁。好食紫樱。每食即二三斤。岁岁如此。至十余年。一
日潮热。如热劳。戴人诊其两手脉。皆洪大而有力。谓之曰。他日必作恶疮肿毒。热上攻目。
阳盛阴脱之证。其家大怒。不肯服解毒之药。不一二年。患一背疽如盘。痛不可忍。其女忽
思戴人曾有是言。再三悔。过请戴人。戴人以 针绕疽晕刺数百针。去血一斗。如此三次。
渐渐痛减肿消。微出脓而敛将作痂时。使服十补内托散乃痊。终身忌口。然目亦昏。终身无
子。
凡背疮初发。便可用藏用丸、玉烛散。大作剂料。下脏腑一二行。次用 针于肿 处。
循红晕周匝内。密刺三层出血尽。以湿软帛拭去血。甚者百会、委中皆出血。后用阳起散敷
之。不可便服十味内托散。其中犯官桂。更用酒煎。男子以背为阳。更以热投热。无乃太热
乎。
方
二乌丸（一名万灵丸）治发背托里定痛。驱风毒。凉血脉。
羌活（去苗） 薄荷叶（各三两） 川芎（三味不见火） 玄参 地榆 麻黄（去根节）
蔓荆
子（去蒂白膜） 旋复花（去萼蒂） 荆芥穗（各二两） 防风（去叉芦） 天麻 白芷（不
见火）
白僵蚕（直者去丝足口炒） 牛蒡子（炒各二两） 甘菊花（三两） 大川乌（去皮尖炮） 何
首乌
（各四两） 粉草（炙四两半） 蝉蜕（洗去土前足半两） 上为细末。炼蜜丸如弹子大。
每服
一丸。食后。细嚼茶酒任下。
大黄膏 治发背疼痛。日夜不可忍。涂敷。
大黄（锉） 雄黄（研） 芎 黄连（去须） 白芷 槟榔（锉） 当归（切焙） 木
香桂
（去粗皮） 黄柏（去粗皮） 芍药 附子（去皮脐） 乳香（研） 麒麟竭（各半两） 鸡
舌香
麝香（各一分） 猪脂（一斤） 上为末拌匀。先于银器内熬猪脂。令沸。去筋膜。下诸药
末。
调成膏。涂患处。日三上。以瘥为度。
竹叶黄 汤 疗动散肿。已自利。虚热不除宜服。
竹叶（切三升） 黄 （四两） 小麦（一升） 芍药（三两） 甘草（一两炙） 石
膏（二两研）
人参（二两） 升麻（一两） 茯苓（二两一用七分） 桂心（六分一用三分） 当归（三
两） 干枣
（十四枚） 五味子（三两） 生姜（三两） 干地黄（一两） 麦门冬（三两去心） 知
母（一两）
上切。以水一斗二升。煮竹叶小麦取九升。去滓内药。煮取三升。温分四服。
千金托里散（出儒门事亲书）治一切发背疔疮。
连翘（二两二钱） 黄 （一两半） 浓朴 防风 桔梗（各一两） 川芎 白芷 芍
药官
桂甘草（各一两） 木香 没药（各三钱） 乳香（三钱半） 当归 人参（各半两） 上
为细
末。每服三钱。用酒一大盏。煎三沸。和滓温服。
地黄丸 常服令人终身不患发背。
熟地黄（五两） 苁蓉（酒浸） 天门冬 石斛 当归 防风 白茯苓 川芎（各三两）
远
志黄 甘草（炙） 芍药（各二两） 人参 细辛 巴戟（各一两） 上为末。炼蜜为
丸。如
梧桐子大。每服三十丸。荆芥汤下。
莽草膏 疗发背痈肿。牢核成脓。
莽草 芎 当归 细辛 附子（炮） 黄芩 乌头（炮） 牛膝 踯躅 野葛 茯苓 防
风杜蘅（各一两） 猪脂（半斤） 上切。用猪脂合煎。去滓敷疮上。日再。忌猪肉、冷
水、
生菜、大酢。
神仙万灵散 专治发背疔疮。一切恶疮。
金银花（一两半） 皂角针 穿山甲 白芷 天花粉 甘草节 当归尾 防风 藿香 赤
芍药（各半两） 乳香（别研） 没药（各三钱另研） 上 咀。每服一两重。水一碗。无
灰好酒
一碗。砂石器内顿放。瓷盘盖口。纸条糊缝。文武火煎至重车行十里远。药香为度。热服。
仍饮好酒数杯。浓衣被汗出为效。滓再煎服。病重者不过三服。合煎服时。并忌鸡犬妇人见。
老病气衰者。加黄 半两。
连翘散 治发背肿。痈疽恶风结脓血。
连翘子 独活（去芦头） 木香 射干（各三分） 甘草（炙锉） 桑寄生（锉） 升
麻鸡舌
香沉香 乳香（研） 大黄（锉炒一两一分） 麝香（研一分） 上粗捣筛。每服五钱。
水一盏
半。煎至八分。入淡竹沥半合。去滓。空心温服。快利三五行为度。未利再服。
排脓内补铁屑散 疗痈发背。
当归 人参 细辛 甘草（炙） 苁蓉 黄 桂心 防风 黄芩 铁屑 芎 芍药
（各等分） 上为散。服方寸匕。忌海藻、菘菜、生葱、酢物等。
玄参散 治热毒瓦斯攻冲背上。初觉疼痛。心神烦闷。
玄参 黄芩 当归 赤芍药 麦门冬（去心） 犀角屑 甘草（生锉） 远志（去心） 生
干
地黄（各一两） 赤茯苓 川升麻 人参（去芦头各一两半） 上为散。每服四钱。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。
犀角散 治初觉皮肤及头背有疮疖。恐成痈疽。兼脏腑壅涩。或寒热口干心烦。
犀角屑（一两） 知母（三分） 木通（一两锉） 赤芍药 川升麻 荠 葳蕤 黄
芩甘
草（生各三分） 麦门冬（去心） 马牙硝 川大黄（锉碎微炒各一两） 上为粗散。每服
四钱。
(Attached Discussion)
Fa Bei (Back Carbuncle) is a condition where heat-toxin qi erupts at the Back-Shu points, manifesting as an abscess or ulcer. Internally, its root lies in the Zang organs, and externally it spreads to the Fu organs. The attacking heat must arise between the organ Shu points. It is caused by the activation of Stone Drugs (mineral pills such as Wushi San), and excessive consumption of rich, sweet, and greasy foods. This leads to stagnation and heat accumulation in the Zang-Fu organs, causing blockage in the meridians. Toxic vapors condense and stagnate, eventually exiting through the Shu points. Therefore, those taking Stone Drugs must be especially cautious and restrained regarding their residence, diet, desires, and emotions. Any lapse can allow toxic vapors to exploit the opening and erupt. Initially, it appears like a mustard seed or millet grain. If treatment is slightly delayed, it will expand to inches in size and become difficult to manage. Thus, when one first feels heat clashing in the muscle layers and pain damaging the meridians, immediate treatment is required. Because if the meridians are blocked, the swelling and toxicity will worsen, as stated in the Classics: "When Ying Qi does not follow its course and reverses into the muscle texture, abscesses and swellings occur." Blood failure and flesh corruption lead to various disasters: excess manifests as Yang abscesses (Yong), superficiality manifests as swelling (Zhong), and depth manifests as Yin ulcers (Ju). However, Fa Bei occurring between the two scapulae starts very subtly, sometimes with itching or pain, which people often ignore. After a few days, it may become incurable. Treatment should begin by measuring the center of the swelling and applying moxibustion, exceeding 100 moxa cones, to expel evil qi outward. Subsequently, use herbs to unblock and purify the Zang-Fu organs and resolve the pathogenic toxin, thereby offering a chance for cure.
All cases of Fa Bei are caused by taking Wushi San or Hanshi Gengsheng San. Some arise from taking only Zhuru (Galactodendron Resin). Others develop spontaneously despite never having taken medicine, due to residual effects from ancestors who took Stone Drugs. The symptoms usually start between the two scapulae on the back, initially the size of a millet grain, painful or itchy, and red. People initially disregard it. Over days, it grows larger, leading to death within ten days. At the time of death, the sore is three cun wide and one cun high, with dozens of holes. Pressing with hands causes pus to flow from all holes, followed by extreme exhaustion. Therefore, those practicing health preservation should, upon feeling unusual itching or pain on the back, immediately take clean earth mixed with water to form mud, shape it into cakes two fen thick and one-and-a-half cun wide. Use coarse moxa wool as cones, burn them on the mud cake placed directly on the sore. Replace the cake after each cone. If the size is like a millet grain, seven cakes suffice for recovery. If like a elm seed, forty-nine cakes are needed. If the size of a coin, moxa can be applied day and night without limit on the number of cones. Simultaneously, drink Wuxiang Lianqiao Tang and Tiejiang (Iron Slag Decoction) to attack the toxin until cured. Another method: for Fa Bei not yet suppurated, spray cold water on it, soak a stone to make it cold, and apply it as a compress day and night until healed. This disease forbids noodles, alcohol, and Five Pungent Spices. Some also occur on the upper shoulders.
Those taking Stone Drugs must engage in physical labor to avoid comfort. Otherwise, diseases are likely to erupt. One must not indulge in warmth and comfort, claiming it suits one's nature. One must restrain desires and seek cold environments. Although uncomfortable initially, it benefits the body later, eliminating the fear of future eruptions.
Whenever swelling rises between the back scapulae, white-headed like millet grains, surrounded by connected red, swollen, and black areas, causing chest oppression and confusion, it is named Fa Bei. Sexual intercourse, alcohol, garlic, meat, and noodles are forbidden. Without moxibustion treatment, internal invasion kills. If moxibustion is used, apply 700-800 cones on the sore. Those who do not recognize this disease and treat it as ordinary miscellaneous swellings all die.
The origins of Back Ju (Back Ulcer) are fivefold: 1. Epidemic qi; 2. Emaciation and Qi stagnation; 3. Anger; 4. Kidney Qi deficiency; 5. Drinking fire wine, eating roasted/fried foods, and taking elixirs causing heat toxin. Treating Back Ju cannot be uniformly treated as heat toxin. The difficulty of treatment varies from the first to the fifth cause.
Diseases range from severe onset to mild onset leading to death. Disease patterns are hard to distinguish, so how to decide life and death? Generally, Fa Bei penetrating the membrane is fatal and untreatable (referring to above Liver Shu). Unruptured with sunken flesh, blue face, black lips, and foul stool indicates death (indicating damaged organs and bloody stool). Rupture to the throat is untreatable. Internal invasion to the abdomen is untreatable. Invasion to the scrotum is fatal. Deep involvement in the temples lasting months (over one cun deep) is untreatable. Sharp toxicity at one inch and three fen behind the chin is untreatable. Absence of these signs indicates survival. Liu Zhu (Flowing Injection)虽多 (though multiple), treatment ensures recovery.
Patients with Fa Bei, though said to have heat, invariably derive from Kidney deficiency. After the ulcer reduces by five parts, one should take Shanyao Wan or Jiajian Bawei Wan at dawn according to the method.
Vomiting and reversal in Back Ju is due to toxic vapors rushing to the Heart, not Spleen-Stomach cold. One should take Neituo San. Yang Shi Jiacang Fang records: A person whose epistaxis had just healed, without sweating out residual toxins in the meridians, developed a large Back Ju extending from the shoulder to the waist and hypochondrium, severely swollen, hard as stone, extremely purple-black. The doctor administered cooling herbs, causing severe vomiting at midnight. Continuous administration of this medicine stopped the vomiting after three to four doses. The sore then ruptured, draining crimson fluid for forty days until healed. Another patient with Scrofula vomited when pain was severe; this medicine stopped the vomiting. Recently, a doctor refused to use this medicine for a carbuncle patient, fearing damage to the Spleen-Stomach. I cite Yang Shi to dispel worldly doubts.
After Fa Bei Ju, failing to take Neituo San allows heat toxin to rush to the Heart Meridian, inevitably causing sores in the throat and tongue later, even blackening and rotting. One should first take Xijiao San to dissipate the toxin and prevent this syndrome.
Patients with Back Ju find it difficult to lean on a table. Using ten dou of mung beans made into a large bag for leaning naturally cools the heart and stabilizes the body. Diet and living habits must follow taboos. After stabilization, for half a year while Qi and Blood are unsettled, caution is still needed, and medication should not be abandoned to ensure preservation. *Waike Jingyao* records: Cheng Xuyuan learned literature but knew no medicine in his youth. In the Jiashen year, returning from the Imperial Academy to visit home, State Physician Chang Ying Tuziqi was present. He requested a diagnosis for his mother. Chang said: "Heat retention causes thirst. Your mother prefers drinking water. Beware of sores. Apply moxa immediately upon sensation. For intense heat, use Five-Flower Moxibustion (center and surroundings) wherever redness appears, not fixed points. Remember this." In the Xinsi year, June 15th, his mother felt slight itching in the back scapulae. A red patch half-cun square with white millet-like grains appeared. Recalling Tuziqi's words, he urgently applied moxa, and the redness subsided, stopping at 27 cones. Two nights later, slight pain returned. A red streak flowed downward, two cun long and broad as a leek leaf. The family was confused and regretted the previous moxa. Relatives blamed them, asking why fire was used for red heat. Someone slandered Tuziqi. An external doctor was called to apply ointment, which only exacerbated the spread. Within a day and night, a new ring expanded. By the 22nd day, it spanned six or seven cun horizontally and vertically. Pain was unbearable, with intermittent groaning. Desperately seeking advice, someone mentioned Old Monk Zhiquan of Dengci Temple, who cured a large sore with moxa. They rushed to ask. Zhiquan said: "During severe stages, patients are unconscious. Novice monks told me Fan Bayi Yi held firm, moxa-ing over 800 cones until revival, using about one sieve of moxa. You must return and do so." Upon agreement, they started with ginkgo nut-sized moxa cones, numbering over ten, feeling little pain. Then they cut the peripheral redness, reducing cone size by three-quarters, causing pain. After seven cones, itching began. With each burnt cone, redness receded inward. After over thirty cones, the red halo faded. The patient believed, so moxa balls plum-apricot sized were applied, gradually increasing to chicken-yolk sized, totaling about forty balls before pain was felt. The burned area was over one cun deep. This was because moxa was late, and the initial tissue was necrotic; only when reaching healthy flesh did pain occur. Peripheral pain indicated viable tissue. Another account mentions a Dianzhi living south of the city effective with wound medicines. Xuyuan invited him. The sore was blackened, fire covering the back. The Dianzhi touched the five-six cun sore and said: "High and hot is fine. Only fear low height and less heat." After the patient ate porridge and slept (having not slept for six nights), morning inspection showed the sore raised like an inverted bowl, suddenly three-four cun high, with hundreds of small pores, jet black. Comparing with *Qianjin Fang* and Pan Shi's theory of elevation: sudden elevation indicates toxin gathering outward; hundreds of pores indicate toxin floating on skin without gathering; jet black color indicates skin and flesh necrosis. Without moxa fire extracting toxin from necrotic flesh, the Five Zang would perish. Only then did he understand that the Mingtang Chart and Yanluozi's drawings of the Five Zang on the back hang like suspended objects. Now toxin moves between muscle layers; waiting for external rupture makes the interior empty and exterior solid, making entry easy and exit difficult. This is clear. Listening to quacks using common cooling pastes for red swelling is lending weapons to bandits. Xuyuan blamed himself bitterly for not knowing medicine as a son, causing parental peril. Thanks to divine protection, finding moxa knowledge in desperation saved him from danger.
*Yixue Leizheng Lun* states: Treating Fa Bei, Fa Nao, Fa Bin, Ding Chuang, Gui Jian, She Gong, Yu Qi, and all malignant sores is invariably effective. As soon as a lesion is felt, slice garlic transversely to the thickness of two papers, apply to the sore, and moxa with mung-bean-sized moxa balls. When pain becomes bearable, increase ball size. When pain is again bearable, remove garlic and moxa directly. For true Fa Bei, moxa within two days yields 100% cure; within four days, 70-80%; within six days, 50-60%; within eight days, 10-20%. After ten days, moxa is ineffective. If effective, it is a heat-toxin sore, not Fa Bei. For Fa Bei, there is no fixed number of cones. Stop if initial pain ceases; stop if initial non-pain becomes painful. Generally, if swelling and pain return after stopping fire, resume moxa until swelling and pain cease. Each sore requires 300, 500, 1000, or 2000 cones, depending on recovery. For three or five sores, treat each individually. Once swelling and pain cease, apply paste. Question: How to distinguish true Fa Bei from heat-toxin sores? Answer: Waiting for identification is too late, like consulting elders before fighting a fire. Ancients said: No good dimples on the face, no bad bones on the head, no good sores on the back. Just moxa according to this principle; no need for identification. Question: Why mention all malignant sores but only specify moxa for Fa Bei? Answer: Among sores, Fa Bei is the one deemed "untreatable" by laymen. Early moxa ensures efficacy; thus others are implied. Question: What about spring/summer when fire is strong? Will excessive moxa cause fire toxin to enter the Heart? Answer: This shows ignorance of moxa technique. Do not believe it.
*Benshi Fang* records: In the third year of Yuanyou, April, summer, I was in the capital. A Back Ju erupted. State physicians treated it for a month, worsening. Zhang Sheng from Xiao County, Xuzhou, applied moxa to the sore from dawn to dusk, 150 cones, stopping when pain was felt. Next day, black crusts were removed, pus and blood drained completely, subcutaneous tissue turned red, pain ceased. Topical medicine was applied daily, trimming necrotic flesh. The sore flattened in a month. That summer, seven officials in the capital died of Ju; I alone survived. Though fate plays a part, poor management leads to misfortune. This is lamentable.
*Rumen Shiqin* records: A wealthy girl in her teens loved eating purple cherries, consuming two-three jin daily for over ten years. One day, tidal fever resembling consumptive fever arose. Dairen diagnosed her pulse as full, large, and forceless on both sides, saying: "You will develop malignant sores and swelling, heat attacking the eyes, a syndrome of Excess Yang and Deficient Yin." Her family was furious and refused detoxifying herbs. Within a year or two, she developed a plate-sized Back Ju, unbearable pain. Remembering Dairen's prediction, she repented and summoned him. Dairen pricked around the sore halo hundreds of times with needles, draining one dou of blood, repeated three times. Pain and swelling gradually decreased. Pus emerged slightly, and scabs formed. She took Shibu Neituo San and recovered. Lifelong dietary restrictions followed. Eyes became dim, and she remained childless.
For initial Back Sores, use Cangyong Wan and Yuzhu San in large doses to purge the Zang-Fu one or two times. Then, use needles to prick densely in three layers within the red halo until bleeding stops. Wipe blood with wet soft cloth. Severe cases bleed from Baihui and Weizhong. Apply Yangqi San afterwards. Do not immediately take Shiwei Neituo San, which contains Guirui (Cinnamon Twig). Brewing with wine adds heat. Since the back is Yang for men, adding heat to heat is excessively hot.
Formulas:
Er Wu Wan (also known as Wan Ling Wan): Treats Fa Bei, supports the interior, relieves pain, expels wind-toxin, cools blood vessels.
Qiang Huo (root removed), Bohe Ye (leaves) (each 3 liang), Chuan Xiong (these three not exposed to fire), Xuanshen, Diyu, Mahuang (roots and joints removed), Manjing Zi (pedicels and white membranes removed), Xuanfuhua (calyx and pedicels removed), Jingjie Sui (each 2 liang), Fangfeng (forks and reeds removed), Tianma, Baizhi (not exposed to fire), Bai Jiangcan (straight ones, silk feet and mouth removed, stir-fried), Niubang Zi (stir-fried, each 2 liang), Gan Juhua (3 liang), Da Chuanwu (skin and tips removed, processed), Heshouwu (each 4 liang), Fencacao (roasted 4.5 liang), Chantui (washed, soil and front legs removed, 0.5 liang). Pulverize into fine powder. Refine honey to make pills the size of bullet seeds. Take one pill after meals, chewed finely with tea or wine as desired.
Dahuang Gao: Treats Fa Bei pain, unbearable day and night. Apply externally.
Dahuang (chopped), Xionghuang (ground), Chuanxiong, Huanglian (whiskers removed), Baizhi, Binglang (chopped), Danggui (sliced and baked), Muxiang, Guirui (bark removed), Huangbai (bark removed), Shaoyao, Fuzi (skin and navel removed), Ruxiang (ground), Qilinjie (each 0.5 liang), Jishe Xiang, Shexiang (each 1 fen), Zhuzhi (pig lard, 1 jin). Mix powders. Boil pig lard in a silver vessel until bubbling, remove fascia, add herb powders, mix into a paste. Apply to affected area, three times daily, until healed.
Zhuye Huangqi Tang: Moves and disperses swelling, suitable for self-diarrhea with persistent deficient heat.
Zhuye (sliced 3 sheng), Huangqi (4 liang), Xiaomai (1 sheng), Shaoyao (3 liang), Gancao (roasted 1 liang), Shigao (ground 2 liang), Renshen (2 liang), Shengma (1 liang), Fuling (2 liang, or 0.7 liang), Guixin (0.6 liang, or 0.3 liang), Danggui (3 liang), Ganzao (dried dates, 14 pieces), Wuweizi (3 liang), Shengjiang (3 liang), Dihuang (dried, 1 liang), Maidong (heart removed, 3 liang), Zhimu (1 liang). Cut ingredients. Boil Zhuye and Xiaomai in 12 sheng of water to obtain 9 sheng. Strain, add remaining herbs, boil to obtain 3 sheng. Divide into four warm doses.
Qianjin Tuoli San (from *Rumen Shinqin*): Treats all Fa Bei and Ding Chuang.
Lianqiao (2.2 qian), Huangqi (1.5 liang), Houpo, Fangfeng, Jiegeng (each 1 liang), Chuanxiong, Baizhi, Shaoyao, Guirui, Gancao (each 1 liang), Muxiang, Moyao (each 3 qian), Ruxiang (3.5 qian), Danggui, Renshen (each 0.5 liang). Pulverize into fine powder. Take 3 qian per dose, decoct in one large cup of wine for three boils, drink warm with dregs.
Dihuang Wan: Regular use prevents Fa Bei for life.
Shudihuang (5 liang), Rongrong (soaked in wine), Tiandong, Shihu, Danggui, Fangfeng, Baifuling, Chuanxiong (each 3 liang), Yuanzhi, Huangqi, Gancao (roasted), Shaoyao (each 2 liang), Renshen, Xixin, Bajitian (each 1 liang). Pulverize, refine honey to make pills the size of paulownia seeds. Take 30 pills per dose, washed down with Jingjie decoction.
Mangcao Gao: Treats Fa Bei abscesses, firm nodules forming pus.
Mangcao, Chuanxiong, Danggui, Xixin, Fuzi (processed), Huangqin, Wutou (processed), Niuxi, Zhizhu, Yegen, Fuling, Fangfeng, Duoheng (each 1 liang), Zhuzhi (half jin). Cut ingredients. Decoct in pig lard, strain, apply to sore twice daily. Avoid pork, cold water, raw vegetables, and strong vinegar.
Shenxian Wanling San: Specifically treats Fa Bei Ding Chuang and all malignant sores.
Jinyinhua (1.5 liang), Zaojiaozhen, Chuanshanjia, Baizhi, Tianhuafen, Gancao Jie, Danggui Wei, Fangfeng, Huoxiang, Chi Shaoyao (each 0.5 liang), Ruxiang (separately ground), Moyao (each 3 qian, separately ground). Coarsely chop. Take 1 liang per dose, with one bowl of water and one bowl of good non-intoxicating wine. Place in sandstone vessel, cover with porcelain plate, seal seams with paper strip. Decoct with gentle fire until equivalent to a heavy cart traveling ten li, until medicinal aroma is reached. Drink hot. Follow with several cups of good wine. Sweating under thick clothing indicates efficacy. Decoct dregs again for second dose. Severe cases require no more than three doses. During preparation, avoid seeing chickens, dogs, or women. For elderly or weak patients, add Huangqi 0.5 liang.
Lianqiao San: Treats Fa Bei swelling, abscesses, aversion to wind, congealed pus and blood.
Lianqiao Zi, Duhuo (rhizome removed), Muxiang, Shegan (each 3 fen), Gancao (roasted and chopped), Sangjisheng (chopped), Shengma, Jishe Xiang, Chenxiang, Ruxiang (ground), Dahuang (chopped and stir-fried 1.1 liang), Shexiang (ground 1 fen). Coarsely grind and sieve. Take 5 qian per dose, with 1.5 cups of water, decoct to 0.8 cup. Add 0.5 he of Danzhuli (bamboo juice), strain, drink warm on an empty stomach. Aim for 3-5 loose stools. If not loose, repeat dose.
Painong Neibu Tiexie San: Treats abscesses and Fa Bei.
Danggui, Renshen, Xixin, Gancao (roasted), Rongrong, Huangqi, Guixin, Fangfeng, Huangqin, Tiexie, Chuanxiong, Shaoyao (equal parts). Make into powder. Take one fangcun bi (measure). Avoid Haizao, Songcai, raw scallions, and sour substances.
Xuanshen San: Treats heat-toxin vapors rushing to the back, initial pain, mental restlessness.
Xuanshen, Huangqin, Danggui, Chi Shaoyao, Maidong (heart removed), Xijiao Xie, Gancao (raw and chopped), Yuanzhi (heart removed), Sheng Gan Dihuang (each 1 liang), Chi Fuling, Chuan Shengma, Renshen (rhizome removed, each 1.5 liang). Make into powder. Take 4 qian per dose, with one medium cup of water, add 14 slices of Zhuye and 50 grains of Xiaomai. Decoct to 0.6 cup, strain, drink warm anytime.
Xijiao San: Treats initial skin sores on head and back, fearing progression to abscess/ulcer, combined with Zang-Fu obstruction, or chills/fever, dry mouth, irritability.
Xijiao Xie (1 liang), Zhimu (3 fen), Mutong (chopped 1 liang), Chi Shaoyao, Chuan Shengma, Qi, Weirui, Huangqin, Gancao (raw, each 3 fen), Maidong (heart removed), Mayaxiao, Chuan Dahuang (chopped, slightly stir-fried, each 1 liang). Make into coarse powder. Take 4 qian per dose.