（附论）
夫痈内虚者。营卫腐为脓血。经络不足。则五脏之气虚乏也。其证多生虚热。而心神为
之惊悸。以痈热不散。乘虚而入。又心独恶热。故惊悸不定也。
方
黄 散（出圣惠方）治痈内虚不足。脓水不绝。四肢乏力。不能饮食。久不瘥
。必为内漏。
黄 （锉一两） 山茱萸 五味子（各半两） 白茯苓（去黑皮三分） 当归（切焙半
两） 石
斛（去根三分） 远志（去心焙一两） 附子（炮去皮脐） 巴戟天（去心） 肉苁蓉（酒
浸切焙）
麦门冬（去心焙） 熟干地黄（焙各一两） 菟丝子（酒浸三日焙干半两为末） 人参（三
分） 石
苇（去毛一两） 白芍药（三分） 芎 （半两） 甘草（炙锉三分） 上为散。每服二钱。
荆芥汤
下。日三服。一方有地麦半两。
肉苁蓉散（出圣惠方）治痈经年不瘥。脓血过多。补虚。
干姜（炮一两） 巴戟天（去心一两） 菟丝子（酒浸别捣三分） 肉苁蓉（酒浸切焙
二两）
远志（去心） 人参（各一两） 甘草（炙锉） 麦门冬（去心焙各二两） 石苇（去毛） 白
芍药
桂（去粗皮） 芎 （各一两） 熟干地黄（焙各一两半） 山茱萸 当归（切焙各二两） 五
味子
（二两） 附子（炮制去皮脐二两） 白茯苓（去黑皮一两半） 上为散。每服二钱。荆芥
汤调
下。空心食前服。一方有地麦三分。
五香丸（出圣惠方）治痈脓血至甚。不生肌肉。内补。
沉香 乳香 木香 藿香叶 丁香 续断（各一两） 白芍药（一两） 熟干地黄（焙
二两）
附子（炮制去皮脐） 石长生（各一两） 败酱 人参 白茯苓（去黑皮各一两） 浓朴（去
粗皮
姜汁炙一两半） 鹿角屑 虎胫骨（酥炙黄各二两） 薰陆香（一两） 上为末。炼蜜和捣
三百
杵。丸如梧桐子大。每服三十丸。以地黄汤下。
蜀椒散（出圣济总录）治痈内虚。
蜀椒（去目并闭口炒出汗半两） 熟干地黄（焙） 白蔹 防风 黄芩（去黑心） 人
参桂
附子（去皮脐焙干各一两） 芎 甘草（炙各一两） 赤小豆（一合炒令熟） 上为散。
每服二
钱。温酒调下。早晚食前服。
熟地黄散（出圣惠方）治痈疽、发背、发乳。大去血脓后。内虚少气。
熟干地黄 黄 （锉） 人参（去芦头各一两） 当归（半两锉碎微炒） 芎 （二两）
白芍
药（半两） 白茯苓（一两） 甘草（半两炙微赤锉） 桂心（半两） 麦门冬（去心） 续
断（各一
两） 上为散。每服四钱。水一中盏。入生姜汁半分。枣三枚。煎至六分。去滓。不拘时温
服。
人参散（出圣惠方）治痈疽内虚不足。
人参（一两去芦头） 黄 （二两锉） 甘草（半两炙微赤锉） 当归 白芍药（半两）
枸杞
子（一两） 白术（一两） 熟地（二两） 白茯苓（一两） 桂心（半两） 上为散。每
服四钱。水
一中盏。入生姜汁半分。枣三枚。煎至六分。去滓。不拘时温服。
黄 散（出圣济总录）治痈溃漏血。空竭内塞。
黄 （锉） 芍药 细辛（去苗叶） 瞿麦穗 白芷 薏苡仁 人参 附子（炮去皮脐）
赤
小豆 熟干地黄（焙各一两） 上为散。每服二钱。空心温酒调下。晚再服。痛甚加芍药。
口
干加薏苡仁。脓多加黄 。
黄 汤（出圣济总录）治痈疽内虚。
黄 （锉） 人参 甘草（炙锉） 白术 远志（去心各半两） 芍药 当归（切焙各
一两）
熟地黄（焙） 白茯苓（去黑皮） 桂（去粗皮各三分） 上粗捣筛。每服五钱。水一盏半。
入生
姜半分拍碎。干枣三枚擘破。同煎至八分。去滓。空心温服。日晚再服。
生地黄汤（出圣济总录）治痈内虚热。
生干地黄（切焙二两） 人参（一两） 芍药（一两） 白茯苓（去黑皮） 芎 （一
两） 当归
（切焙一分） 黄 （锉一两） 黄芩（去黑心一两） 木通（锉二分） 上粗捣筛。每服
五钱。
水一中盏半。入竹叶七片。枣二枚擘破。同煎至八分。去滓。空心温服。日晚再服之。
排脓生肌散（出圣惠方）治痈发背。脓不止。内虚。
当归（锉微炒） 黄 （锉各半两） 人参（一两去芦头） 芎 （半两） 浓朴（一
两去皮生
姜汁炙香） 防风（半两去芦头） 白芷（半两） 桔梗（半两去芦头） 甘草（半两炙微
赤锉）
上为细散。每服二钱。以木香汤调下。日三四服。
[Attached Discussion]
The condition of "internal deficiency in carbuncle" refers to a state where the Ying (Nutrient) and Wei (Defensive) Qi deteriorate into pus and blood, leading to insufficiency in the meridians and collaterals, thereby causing a depletion of Qi in the five Zang organs. The clinical manifestations typically include deficiency heat, along with palpitations and fright due to the lingering heat of the carbuncle invading the Heart Spirit amidst this deficiency; furthermore, since the Heart specifically dislikes heat, this results in unstable palpitations and fright.
Formulas:
Huang San (Astragalus Powder) [Source: *Shenghui Fang*]: Treats internal deficiency and insufficiency caused by carbuncles, continuous discharge of pus and water, weakness in the four limbs, inability to eat, and if left untreated for a long time, inevitable development of internal fistula (neileak).
Ingredients: Huangqi (Astragali Radix, cut into pieces, 1 liang), Shanzhuyu (Corni Fructus), Wuweizi (Schisandrae Fructus) (each 0.5 liang), Baifuling (Poria, remove black skin, 3 qian), Danggui (Angelicae Sinensis Radix, cut and roasted, 0.5 liang), Shihu (Dendrobii Caulis, remove roots, 3 qian), Yuanzhi (Polygalae Radix, remove heart, roasted, 1 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed, remove skin and umbilicus), Bajitian (Morindae Officinalis Radix, remove heart), Rongshunrong (Cistanche Deserticolae Caulis, soaked in wine, sliced and roasted), Maimendong (Ophiopogonis Tuber, remove heart, roasted), Shugan Dihuang (Prepared Rehmanniae Radix, roasted, each 1 liang), Tusizi (Cuscutae Semen, soaked in wine for three days, dried and roasted, ground to powder, 0.5 liang), Renshen (Ginseng Radix et Rhizoma, 3 qian), Shiwei (Pyrrosiae Folium, remove hairs, 1 liang), Baishao (Paeoniae Radix Alba, 3 qian), Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut, 3 qian).
Usage: Grind the above ingredients into a powder. Take 2 qian per dose, administered with Jingjie Tang (Schizonepeta Decoction), three times daily. Another version includes Dimai (likely Ophiopogon or similar, 0.5 liang).
Rongshunrong San (Cistanche Powder) [Source: *Shenghui Fang*]: Treats carbuncles that do not heal after years, excessive discharge of pus and blood, with the function of tonifying deficiency.
Ingredients: Ganjiang (Zingiberis Rhizoma, processed, 1 liang), Bajitian (Morindae Officinalis Radix, remove heart, 1 liang), Tusizi (Cuscutae Semen, soaked in wine and separately pounded, 3 qian), Rongshunrong (Cistanche Deserticolae Caulis, soaked in wine, sliced and roasted, 2 liang), Yuanzhi (Polygalae Radix, remove heart), Renshen (Ginseng Radix et Rhizoma) (each 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Maimendong (Ophiopogonis Tuber, remove heart, roasted, each 2 liang), Shiwei (Pyrrosiae Folium, remove hairs), Baishao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus, remove coarse bark), Xiong (Ligustici Chuanxiong Rhizoma) (each 1 liang), Shugan Dihuang (Prepared Rehmanniae Radix, roasted, each 1.5 liang), Shanzhuyu (Corni Fructus), Danggui (Angelicae Sinensis Radix, cut and roasted, each 2 liang), Wuweizi (Schisandrae Fructus, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed, remove skin and umbilicus, 2 liang), Baifuling (Poria, remove black skin, 1.5 liang).
Usage: Grind the above ingredients into a powder. Take 2 qian per dose, mixed with Jingjie Tang (Schizonepeta Decoction), taken on an empty stomach before meals. Another version includes Dimai (3 qian).
Wuxiang Wan (Five Fragrances Pill) [Source: *Shenghui Fang*]: Treats severe carbuncle discharge of pus and blood, failure of muscle regeneration, with internal tonification effects.
Ingredients: Chenxiang (Aquilariae Lignum Resinatum), Rushen (Boswelliae Resina), Muxiang (Aucklandiae Radix), Huoxiangye (Agastaches Folium), Dingxiang (Syzygii Flos), Xuduan (Dipsaci Radix) (each 1 liang), Baishao (Paeoniae Radix Alba, 1 liang), Shugan Dihuang (Prepared Rehmanniae Radix, roasted, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed, remove skin and umbilicus), Shichangsheng (likely a local variant or specific herb, 1 liang), Baijiangcao (Patriniae Herba), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria, remove black skin) (each 1 liang), Houpo (Magnoliae Officinalis Cortex, remove coarse bark, ginger-juice fried, 1.5 liang), Lujiaoxie (Cervi Cornus Degelatinatum Fragment), Hujinggu (Tigris Ossis, roasted with butter until yellow, each 2 liang), Xunluxiang (Frankincense, 1 liang).
Usage: Grind the above ingredients into fine powder, mix with refined honey, and pound/beaten 300 times. Form pills the size of Sophora seeds. Take 30 pills per dose, administered with Dihuang Tang (Rehmannia Decoction).
Shujiao San (Sichuan Pepper Powder) [Source: *Shengji Zonglu*]: Treats internal deficiency in carbuncles.
Ingredients: Shujiao (Zanthoxyli Pericarpium, remove eyes and closed ones, stir-fry until sweat appears, 0.5 liang), Shugan Dihuang (Prepared Rehmanniae Radix, roasted), Bailian (Pentaphragmae Radix), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix, remove black heart), Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata, remove skin and umbilicus, dry-roasted, each 1 liang), Xiong (Ligustici Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 1 liang), Chixiaodou (Phaseoli Semen Rubrum, 1 he, stir-fry until cooked).
Usage: Grind the above ingredients into a powder. Take 2 qian per dose, mixed with warm wine, taken morning and evening before meals.
Shudihuang San (Prepared Rehmannia Powder) [Source: *Shenghui Fang*]: Treats carbuncles, back abscesses (Faback), and breast abscesses (Faru) after significant loss of blood and pus, characterized by internal deficiency and shortness of breath.
Ingredients: Shugan Dihuang (Prepared Rehmanniae Radix), Huangqi (Astragali Radix, cut) (each 1 liang), Renshen (Ginseng Radix et Rhizoma, remove rhizome head, 1 liang), Danggui (Angelicae Sinensis Radix, 0.5 liang, cut into pieces, slightly stir-fried), Xiong (Ligustici Chuanxiong Rhizoma, 2 liang), Baishao (Paeoniae Radix Alba, 0.5 liang), Baifuling (Poria, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red and cut), Guixin (Cinnamomi Cortex, 0.5 liang), Maimendong (Ophiopogonis Tuber, remove heart), Xuduan (Dipsaci Radix) (each 1 liang).
Usage: Grind the above ingredients into a powder. Take 4 qian per dose, with one zhong of water, add 0.5 fen of fresh ginger juice and 3 jujubes, decoct until 6 fen remains, filter dregs, take warm at any time.
Renshen San (Ginseng Powder) [Source: *Shenghui Fang*]: Treats internal deficiency and insufficiency in carbuncles and sores.
Ingredients: Renshen (Ginseng Radix et Rhizoma, 1 liang, remove rhizome head), Huangqi (Astragali Radix, 2 liang, cut), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red and cut), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, 0.5 liang), Gouqizi (Lycii Fructus, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Shudi (Prepared Rehmanniae Radix, 2 liang), Baifuling (Poria, 1 liang), Guixin (Cinnamomi Cortex, 0.5 liang).
Usage: Grind the above ingredients into a powder. Take 4 qian per dose, with one zhong of water, add 0.5 fen of fresh ginger juice and 3 jujubes, decoct until 6 fen remains, filter dregs, take warm at any time.
Huang San (Astragalus Powder) [Source: *Shengji Zonglu*]: Treats carbuncle ulceration with leaking blood, emptiness and internal blockage.
Ingredients: Huangqi (Astragali Radix, cut), Shaoyao (Paeoniae Radix), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Qumai (Dianthi Herba), Baizhi (Angelicae Dahuricae Radix), Yiyiren (Coicis Semen), Renshen (Ginseng Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, processed, remove skin and umbilicus), Chixiaodou (Phaseoli Semen Rubrum), Shugan Dihuang (Prepared Rehmanniae Radix, roasted, each 1 liang).
Usage: Grind the above ingredients into a powder. Take 2 qian per dose, mixed with warm wine on an empty stomach, take again in the evening. Increase Shaoyao (Paeoniae Radix) if pain is severe; increase Yiyiren (Coicis Semen) if mouth is dry; increase Huangqi (Astragali Radix) if pus discharge is heavy.
Huang Tang (Astragalus Decoction) [Source: *Shengji Zonglu*]: Treats internal deficiency in carbuncles and sores.
Ingredients: Huangqi (Astragali Radix, cut), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Baizhu (Atractylodis Macrocephalae Rhizoma), Yuanzhi (Polygalae Radix, remove heart, each 0.5 liang), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix, cut and roasted, each 1 liang), Shudihuang (Prepared Rehmanniae Radix, roasted), Baifuling (Poria, remove black skin), Guizhi (Cinnamomi Ramulus, remove coarse bark, each 3 qian).
Usage: Coarsely grind and sieve the above ingredients. Take 5 qian per dose, with 1.5 zhan of water, add 0.5 fen of fresh ginger (smashed) and 3 dried jujubes (torn open), decoct together until 8 fen remains, filter dregs, take warm on an empty stomach, take again in the evening.
Shengdihuang Tang (Fresh Rehmannia Decoction) [Source: *Shengji Zonglu*]: Treats internal deficiency heat in carbuncles.
Ingredients: Shengganhuidi (Fresh/Dried Prepared Rehmanniae Radix, cut and roasted, 2 liang), Renshen (Ginseng Radix et Rhizoma, 1 liang), Shaoyao (Paeoniae Radix, 1 liang), Baifuling (Poria, remove black skin), Xiong (Ligustici Chuanxiong Rhizoma, 1 liang), Danggui (Angelicae Sinensis Radix, cut and roasted, 1 fen), Huangqi (Astragali Radix, cut, 1 liang), Huangqin (Scutellariae Radix, remove black heart, 1 liang), Mutong (Akebiae Caulis, cut, 2 fen).
Usage: Coarsely grind and sieve the above ingredients. Take 5 qian per dose, with 1.5 zhan of water, add 7 bamboo leaves and 2 jujubes (torn open), decoct together until 8 fen remains, filter dregs, take warm on an empty stomach, take again in the evening.
Painong Shengji San (Pus-Discharging and Muscle-Growing Powder) [Source: *Shenghui Fang*]: Treats carbuncles and back abscesses with continuous pus discharge and internal deficiency.
Ingredients: Danggui (Angelicae Sinensis Radix, cut and slightly stir-fried), Huangqi (Astragali Radix, cut, each 0.5 liang), Renshen (Ginseng Radix et Rhizoma, 1 liang, remove rhizome head), Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Houpo (Magnoliae Officinalis Cortex, 1 liang, remove bark, stir-fry with ginger juice until fragrant), Fangfeng (Saposhnikoviae Radix, 0.5 liang, remove rhizome head), Baizhi (Angelicae Dahuricae Radix, 0.5 liang), Jiegeng (Platycodonis Radix, 0.5 liang, remove rhizome head), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red and cut).
Usage: Grind the above ingredients into a fine powder. Take 2 qian per dose, mixed with Muxiang Tang (Aucklandia Decoction), three to four times daily.