治发背疮云。凡发背者。自内而外也。热毒中膈。上下不通。所以蒸背上虚处。先
三五日隐脉妨闷。即渐成脓。见出皮肤。结聚成脓也。其方如后。
白麦饭（颜色黄白类麦饭者曾作磨尤佳炭火烧红醋中浸之十次为末） 白蔹末（与上等
分）
鹿角（二三寸截之不用自脱者凡带脑骨者即非自脱炭火烧灰尽为度碾罗为末倍前二味） 上
并
捣细末。取多年米醋铛中煎令鱼眼沸。即下前件药末。调如稀饧。以篦子调敷肿上。只当疮
头留一指地面。勿令合。以出热气。如未脓。当内消。若已作头。当撮小。若日久疮甚。肌
肉损烂。筋骨出露。即布上涂药贴之疮上。干即再换。但以膈中不恶。无不瘥。切忌手伤。
宜慎之。此方东坡先生具载得效姓名甚多。兹不多述。惟后之用药君子。当信先生之说。故
予不敢私秘其良方也。
白散子 治发背、候取下毒物。次用清凉膏贴之。
白附子 大香附子（各半两） 半夏（一分姜制） 黑牵牛（二两半生半炒令熟） 大
甘遂
（一分以大麦炒侯麦黄赤色去麦不用次以极慢火炒之） 上为末。量患人虚实加减。每服二
钱。以蜜酒调下。续饮温酒一两盏。候所苦处刺痛为度。微利三五行。泻出恶物即瘥。次用
膏药贴之。气盛者一服二钱。余更裁度。
清凉膏 治发背等。先用白散子取之。次用此药贴之。
川当归（二两） 香白芷 木鳖子肉 白芨 芍药 黄柏 白蔹（各一两） 乳香（另
研）
腻粉（各少许） 白胶（少许） 黄丹（五两） 上用清麻油十两。煎上七味候紫色去之。
入槐柳
枝各七寸。再煎少顷又去之。入黄丹五两。熬成入乳香等。重绵滤入罐子内贮之。用如常贴。
治发背一切痈疽。金石药毒发。
上用紫背车螯大者。盐泥固济。火 通红。放冷、研为极细末。地上出火毒一宿。以甘
草膏子丸如梧桐子。每服三五十丸。甘草汤下。日进三服。第三日取下恶物。用后药贴之。
贴疮白膏药
上寒水石不拘多少。火 通红。入瓷器中。封口令密。沉井中一宿。取出研极细。以腊
月脂和膏。稀稠得所。自疮赤尽处涂之。阔一指许。上以薄纸为花子。中心留一孔贴定。渐
次赤退。即迤逦移近里至愈。红花孔子外所留纸。令与所留药阔狭等。
沉香散 治发背。止燥渴疼痛。内消毒瓦斯。
赤小豆（一合） 人参（一两） 甘草 瞿麦 黄芩 黄 （各一两锉） 白蔹（半两）
当归
（一两细锉炒） 沉香（一两） 上为细末。温水调下二钱。不计时候。日二三服。
车螯酒 治发背痈疽。
车螯壳（一二个泥固济火 过为细末） 灯心（三十茎） 蜜（一大匙） 栝蒌（一个）
上
碎。剥栝蒌。用酒一升。以下煎三味微熟。调车螯末二大钱。不过两服。痛止。
治发背、发乳、痈疽等。一切毒疮。
穿山甲（一两用土炒成弹子块） 白丁香（淘去沙净取半两） 上为细末。每服二钱。
用麝
香酒调下。
治发背
汤寿资云。光州有人患肾痈。大小便皆闭。甚以为苦。本州胡判官。令以明净牛皮胶炭
火上烧成黑灰。研极细。每服五钱。以米饮调下。服至二两许方通。所下皆秽恶物。痈肿遂
消。不复出脓。胡云。凡疮肿皆可服。不拘多少。以脏腑通利为度。
阎资钦、录寿州霍丘医疮人元立。治疮甚有声。元符己卯。予侍先子将漕江东。舟次寿
州。予因累日食鸡卵数十枚。暴得咽喉肿塞。及颈赤肿硬。下连心胸如铁石。日久号叫。喉
中水米不通。壅塞将死。召医者视之云。此喉痈也。泛泛药恐无益。因言可招元立治之必愈。
先子夜遣介。两日往还数百里。召立至。用药数服得效。报之颇浓。立感激予自传治发背方
四首。皆累用有奇功。今录于下。
一醉膏 治发背痈疽。一切恶疮。当先用托里药。使毒瓦斯皆出。凡初觉发背痈疽等
。即多服。用大黄、甘草等药。极疏转以行结毒。次用此药。
大甘草（半两为粗末） 没药（一分研） 栝蒌（一个大者去皮） 上用无灰酒三升。
熬至一
升。放温顿服之。如一服不尽。分三两服。连服尽。
收晕白玉膏 切忌用冷药外贴。必逼毒瓦斯入内杀人。
杏仁（二十粒去皮尖） 川椒（四十九粒去目为末） 清脂麻油（一两） 酒腊（半两
白者）
上同熬至紫黑。新绵滤过。用无灰薄纸。看疮大小剪作梳样。摊药在上。于疮晕尽处两边围
绕贴之。候晕渐收近里。即别剪差小者。再摊药为围贴。晕又收。即又再移近里贴。仍频换。
候晕已收见疮根脚。或疮口。即用次方。凡贴大恶疮。毒瓦斯方盛。不可以药当上贴。恐赶散
毒瓦斯。疮益大。
晕收见疮。次用槟榔散。
鸡心槟榔（半两） 川黄连（去须半两） 穿山甲（大者十片烧灰存性） 上同为细末。
先用
好腊茶清扫过疮。用药浓敷疮上。日三五次。以脓出为知。如见疮口后。用此药数次了。可
更用乳香膏。
脓已出。用生肌药。
黄狗脑盖骨（二两烧灰存性） 腻粉（一钱） 桑白皮末（一两） 上同为细末。用油
调涂疮
上。以上四方。是一宗元立自云。少年时初得此方。救十余人。后忽自病背疮。自信其药。
乃以此四药自治得愈。袒背示予。瘢痕犹盈尺也。予在汝州时。梁县吏人侯昱孝母病背疮。
予用此治之愈。
扬州杨吉老医名甚着。某郡一士人。状若有疾。厌厌无聊。莫能名其何等病苦。往谒之。
杨曰。君热证已极。气血消铄且尽。自此三年。当以背疽死。不可为也。士人不乐而退。闻
茅山观中一道士。医术通神。但不肯以技自名。未必为人致力。士人心计较。窃衣童仆之服。
诣山拜之。愿执薪水之役于席下。道士喜。留置弟子中。诲以经书。昼夜只事左右。颐指越
两月。觉其与常隶别。呼叩所从来。始再拜谢过。以实白之。道士笑曰。世间那有医不得的
病。汝试以脉示我。才诊脉。又笑曰。汝便可下山。吾亦无药与汝。但日买好梨吃一颗。如
生梨已尽。则以干者泡汤饮之。仍食其滓。此疾自当平。士人归。谨如其戒。经一岁往扬
州。吉老见之。惊其颜貌腴泽。脉息和平。谓之曰。君必遇异人。不然岂有痊安之理。士人
以告。吉老立具衣冠。焚香望茅山设拜。岂自咎其学之未至耶。又北梦琐言载医者赵鄂云。
一朝士疾危。或谓只有一法。请剩吃消梨。不限多少。如咀嚼不及。捩汁而饮。或希万一。
用其言遂愈。此意正同。
大凡有背疽之人。难于隐几。但用绿豆十数斗。作一大袋隐伏。则自然心凉。身体安稳。
得以尽心服药将息也。
治发背及痈疽恶疮、肿核。如初觉皮肉间有异。知是必作疮者。皆炙之。
切大蒜如铜钱浓片。安肿头上。炷艾灸之。不计炷数。其人被若初觉痛者。以痛定为准。
初不觉痛者。灸至极痛而止。若蒜焦即易。前后用此法救人。无不应者。若是疣赘之类。亦
如此灸之。便成痂自脱。其效如神。乃知方书之载无空言。但患人不能以意详之。故不得尽
应耳。
抵圣散 治发背痈疽。及一切疮疖肿毒。
栝蒌（四两去皮） 何首乌（四两） 大山慈菇（二两） 甘草节（二两） 地榆（二
两） 没药
（一两） 乳香（半两） 麝香（一钱别研） 上为细末。每服三钱。温酒调下。连进二服
便住痛。
一日三服。
治发背头未成疮。及诸热毒。
以湿纸拓上。先干处是热气冲上。欲作疮子。便灸之。如先疼痛。灸即不痛。如不知痛。
即以痛为度。
治痈肿发背\x
以千金藤煎服。
[Background Information]
Book: Puji Fang (Universal Effective Prescriptions)
Author: Zhu Zi
Dynasty: Ming Dynasty, Yongle 4th Year
Chapter: Fabei (Back Carbuncle) (4/4)
Category: Formulas
Discussion on treating back carbuncles states: Any case of "Fab" (back carbuncle) originates from the interior and manifests externally. Heat-toxin accumulates in the diaphragm region, causing obstruction of qi mechanism between the upper and lower body. Consequently, it steams and burns the deficient areas of the back. Initially, for three to five days, there are hidden meridian obstructions accompanied by stifling sensation. Gradually, pus forms and emerges through the skin, aggregating into abscesses. The specific formulas are as follows:
Baimai Fan (Wheat-meal-like grain, yellowish-white; preferably one used for grinding previously; roasted red over charcoal, soaked in vinegar ten times, then ground into powder) Baolian Powder (White Peony Root Powder; equal proportion to Baimai Fan)
Deer Antler (Cut into 2-3 cun segments; do not use naturally shed ones; those with brain bone attached are not naturally shed; roast over charcoal until completely ashed, then sieve into fine powder; dosage is double that of the previous two ingredients)
All above ingredients are finely pounded together. Take aged rice vinegar and boil in a pan until bubbles resemble fish eyes. Immediately add the aforementioned powders and stir into a consistency similar to thin maltose syrup. Apply the mixture onto the swollen area using a comb-like spatula, leaving an area the width of one finger at the center of the abscess uncovered to allow heat to escape. If pus has not yet formed, it should be resolved internally. If a head has formed, it should be kept small. If the condition persists for a long time with severe tissue damage and exposed bone/tendons, apply the medicated cloth directly onto the wound. Replace when dry. As long as there is no aversion to cold in the diaphragm region, recovery is assured. Strictly avoid touching or damaging the area with hands. Caution is advised. This formula was extensively recorded by Mr. Su Dongpo, with many successful cases reported hereafter omitted. It is hoped that future practitioners will trust his words. Therefore, I dare not keep this excellent prescription secret.
Baisan Zi (White Powder Pill) Treats back carbuncles; wait for toxic matter to be discharged, then apply Qingliang Gao (Cooling Ointment).
Baifuzi (Aconitum kusnezoffii Rhizome) Dafuxiang (Cyperi Rhizoma; both half liang) Banxia (Pinelliae Rhizoma; one fen, processed with ginger) Heiqianniu (Pharbitidis Semen; two and a half liang, half raw half stir-fried until cooked) Dasengui (Kansui Radix; one fen, stir-fried with large barley until barley turns yellow-red, remove barley, then stir-fry over very slow fire)
Grind all into powder. Adjust dosage according to the patient's deficiency or excess. Take two qian each time, mixed with honey wine. Follow with one liang cup of warm wine. Continue until a stinging pain is felt in the affected area. Mild diarrhea of three to five movements indicates discharge of foul matter, after which the patient recovers. Subsequently, apply ointment. For those with strong constitution, take two qian per dose; others adjust accordingly.
Qingliang Gao (Cooling Ointment) Treats back carbuncles etc. First use Baisan Zi to purge toxins, then apply this ointment.
Chuan Danggui (Angelicae Sinensis Radix; two liang) Xiangbaizhi (Angelicae Dahuricae Radix) Mugiezi Rou (Mucicis Pericarpium) Baiji (Bletillae Rhizoma) Shaoyao (Paeoniae Radix) Huangbai (Phellodendri Cortex) Bailian (Ampelopsis Radix; each one liang) Ruxiang (Olibanum; separately ground) Nifen (Calomel; each a small amount) Baijiao (Isinglass; a small amount) Huangdan (Lithargyrum; five liang)
Boil the first seven herbs in ten liang of pure sesame oil until the liquid turns purple, then remove dregs. Add Huai Liu Zhi (Locust and Willow branches), seven cun each, boil briefly, then remove branches. Add five liang of Huangdan, simmer into an ointment, add Ruxiang etc. Filter through heavy silk into a jar for storage. Apply as usual.
Treats back carbuncles, all types of carbuncles and sores, and toxicity caused by mineral drugs.
Use large Purple-backed Chelone shells. Seal firmly with salt mud, roast over fire until red hot. Cool down, grind into extremely fine powder. Place on the ground overnight to eliminate fire toxin. Form pills the size of Sophora seeds using Gancao Gao (Licorice Paste). Take 30-50 pills each time, washed down with Licorice decoction. Administer three times daily. On the third day, foul matter is discharged, then apply the following paste.
Paste Wound White Ointment
Hanshuishi (Halloysitum) in any quantity. Roast over fire until red hot. Put into porcelain vessel, seal tightly, and submerge in a well overnight. Take out, grind to extreme fineness. Mix with腊月脂 (December lard) to form an ointment of appropriate consistency. Apply starting from the outer edge of the redness around the sore, width about one finger. Cover with thin paper cut into flower shape, leaving a central hole aligned with the sore. As redness recedes, gradually move application inward until healed. The paper left outside the red area should match the width of the applied medicine.
Chenxiang San (Agarwood Powder) Treats back carbuncles, stops dry thirst and pain, resolves internal toxic heat.
Chixiaodou (Adzuki Bean; one he) Renshen (Ginseng Radix; one liang) Gancao (Licorice Root) Qumai (Diantherae Herba) Huangqin (Scutellariae Radix) Huang [Missing Character, likely Huangqi or similar] (each one liang, sliced) Bailian (Ampelopsis Radix; half liang) Danggui (Angelicae Sinensis Radix; one liang, finely sliced and stir-fried) Chenxiang (Aquilariae Lignum Resinatum; one liang)
Grind into fine powder. Take two qian mixed with warm water. No fixed time. Take two to three times daily.
Cheluo Jiu (Chelone Wine) Treats back carbuncles and sores.
Cheluoke (Chelone Shell; 1-2 pieces, sealed with mud, roasted, ground to fine powder) Dengxin (Junci Medulla; thirty stalks) Mi (Honey; one large spoon) Gualou (Trichosanthis Fructus; one piece)
Crush all. Peel Gualou. Use one sheng of wine to decoct the three ingredients until slightly cooked. Mix in two large qian of Cheluo powder. Within two doses, pain stops.
Treats back carbuncles, breast carbuncles, sores, and all toxic ulcers.
Chuanshanjia (Manis Scale; one liang, stir-fried with earth into bullet-shaped clumps) Baixiangding (Streptopelia Turtur Excrement; washed clean of sand, take half liang)
Grind into fine powder. Take two qian each time, taken with Moschus-infused wine.
Treatment of Back Carbuncle
Tang Shouzi said: A person in Guangzhou suffered from kidney carbuncle, with complete obstruction of urination and defecation, causing great suffering. Judge Hu of the prefecture ordered bright, clear ox-hide glue to be burned over charcoal fire into black ash, ground extremely fine. Take five qian each time, mixed with rice drink. After taking approximately two liang, passage opens. Discharged matter is foul and dirty. The swelling subsides, and pus ceases. Judge Hu stated: This can be taken for any swelling, regardless of quantity, until the internal organs are unobstructed.
Yan Ziqin recorded the story of Yuan Li, a physician from Huoqiu, Shouzhou, famous for treating sores. In the year Ji Mao of Yuanfu era, I accompanied my father, who was transporting grain to Jiangdong. Our boat stopped at Shouzhou. Having eaten dozens of chicken eggs consecutively, I suddenly developed throat swelling and blockage, neck redness and hardness extending down to the chest and heart like iron. After many days of screaming, unable to swallow water or rice, suffocating towards death. The doctor summoned diagnosed: Throat carbuncle. Ordinary medicines may be ineffective. Suggested inviting Yuan Li to treat, promising cure. My father sent a messenger overnight; round trip hundreds of li took two days. Yuan Li arrived. After several doses, improvement was seen. Reward was generous. Grateful, Yuan Li personally transmitted four formulas for treating back carbuncles, all proving miraculous upon repeated use. Recorded below:
Yi Zui Gao (Intoxication Ointment) Treats back carbuncles, all malignant sores. First use supportive interior medicines to expel toxins. Upon initial suspicion of back carbuncle, take generously. Use Dahuang (Rhei Radix et Rhizoma), Gancao (Licorice Root) etc. to vigorously promote bowel movement and resolve toxic stagnation. Then use this ointment.
Da Gancao (Large Licorice Root; half liang, coarse powder) Moyao (Myrrha) (one fen, ground) Gualou (Trichosanthis Fructus; one large piece, peeled)
Decoct in three sheng of non-fermented wine until reduced to one sheng. Let cool to warm, take in one dose. If not finished, divide into two or three doses. Finish continuously.
Shouyun Baiyu Gao (Cloud-Containing White Jade Ointment) Strictly forbid applying cold medicines externally, as this forces toxins inward, potentially killing the patient.
Xingren (Apricot Seed; twenty grains, peeled and tip removed) Chuanjiao (Sichuan Pepper; forty-nine grains, eye removed, ground) Qing Zhima You (Pure Sesame Oil; one liang) Jiu La (Alcohol Wax; half liang, white variety)
Simmer together until purple-black. Filter through new cotton. Cut non-fermented thin paper into comb-shape matching sore size. Spread medicine on paper. Apply around the perimeter of the sore's redness. As redness recedes inward, cut smaller pieces and reapply. Repeat frequently. Once redness recedes revealing the sore base or opening, switch to next formula. When treating large malignant sores with intense toxic heat, do not apply medicine directly on the sore surface, lest it scatter toxins and enlarge the sore.
When redness recedes revealing the sore, next use Binglang San (Betel Nut Powder).
Jixin Binglang (Chicken-heart Betel Nut; half liang) Chuan Huanglian (Coptidis Rhizoma; de-rhizome, half liang) Chuanshanjia (Manis Scale; ten large pieces, burnt to ash retaining nature)
Grind together into fine powder. First clean the sore with good aged tea. Apply thick layer of medicine on the sore. Three to five times daily. Effective when pus discharges. After seeing the sore opening, use this medicine several times, then can switch to Ruxiang Gao (Olibanum Ointment).
After pus discharges, use flesh-regenerating medicine.
Huanggou Naogai Gu (Yellow Dog Cranial Bone Cap; two liang, burnt to ash retaining nature) Nifen (Calomel; one qian) Sangbaipi Mo (Morus Alba Bark Powder; one liang)
Grind together into fine powder. Mix with oil and apply to sore. These four formulas were self-reported by Yuan Li. He claimed that in his youth, he received these formulas and saved over ten people. Later, he unexpectedly developed a back sore. Confident in the medicine, he treated himself with these four formulas and recovered. Showing his bare back to me, the scar was still a chi wide. When I was in Ruzhou, Hou Yu, a clerk from Liang County, whose mother had a back sore, I cured her using this method.
Yang Jilao, a physician from Yangzhou, was highly renowned. A scholar from a certain commandery appeared ill, listless, unable to describe his ailment. He visited Yang. Yang said: Your heat syndrome is extreme, qi and blood are exhausted. In three years, you will die of back gangrene. Irremediable. The scholar left unhappy. Hearing of a Daoist priest in Maoshan Temple with divine medical skills but unwilling to advertise, the scholar devised a plan. Dressing as a servant, he went to the mountain, requested menial labor. The Daoist accepted him into discipleship, teaching classics. Serving day and night for two months, the Daoist noticed his difference, asked his origin. The scholar bowed, apologized, and confessed truthfully. The Daoist laughed: Is there any disease in the world that cannot be cured? Let me feel your pulse. After palpation, he laughed again: You may descend the mountain. I have no medicine for you. Just buy good pears daily, eat one. If fresh pears run out, soak dried ones in water to drink, and consume the residue. The illness will naturally resolve. The scholar returned, obeyed strictly. One year later, he went to Yangzhou. Yang Jilao saw him, astonished by his rosy complexion and peaceful pulse, saying: You must have met a supernatural being. Otherwise, how could recovery occur? The scholar told him. Yang Jilao immediately dressed formally, incense-burned, and bowed towards Maoshan. Was he blaming his own lack of learning? Also, "Beimeng Suoyan" records physician Zhao E: A court official was critically ill. Someone suggested only one method: let him eat more pear juice, unlimited quantity. If chewing is difficult, squeeze juice to drink. Trying for a chance of survival, he followed advice and recovered. The meaning is identical.
Generally, patients with back gangrene find it difficult to lean on cushions. Using ten or more dou of mung beans made into a large bag to lie upon naturally cools the heart and stabilizes the body, allowing careful medication and rest.
Treating back carbuncles, sores, malignant ulcers, and swollen nodes. If initially feeling abnormality in skin/flesh, knowing a sore will form, moxibustion should be performed.
Slice garlic as thick as a copper coin. Place on the swelling. Apply moxa cone. Number of cones is not limited. If the patient feels pain initially, stop when pain ceases. If no pain felt initially, continue until extreme pain. Replace garlic if charred. This method has saved countless lives without fail. For warts etc., moxibustion similarly causes scabbing and shedding. Effect is miraculous. Thus, medical texts are not empty words; failure lies in patients' inability to understand details.
Diseng San (Approaching Sage Powder) Treats back carbuncles, sores, boils, and all toxic swellings.
Gualou (Trichosanthis Fructus; four liang, peeled) Heshouwu (Polygoni Multiflori Radix) Dashancigu (Araceae Bulb; two liang) Gancao Jie (Licorice Joint; two liang) Diyu (Sanguisorbae Radix; two liang) Moyao (Myrrha; one liang) Ruxiang (Olibanum; half liang) Muxiang (Moschus; one qian, separately ground)
Grind into fine powder. Take three qian each time, mixed with warm wine. Two consecutive doses stop pain. Take three times daily.
Treating back carbuncle head before ulceration, and various heat toxins.
Apply wet paper to the area. The first place to dry indicates rising heat, signaling impending sore. Perform moxibustion there. If painful initially, moxibustion stops pain. If insensitive, use pain as the limit.
Treating Carbuncles and Back Swelling
Decoct and drink Qianjin Teng (Stephaniae Tetrandrae Caulis).