（附论）
夫疽者。五脏不调所生也。五脏主里。气行经络而沉。若喜怒不测。饮食不节。阴阳不
和。则五脏不调。营卫虚者。腠理则开。寒客经络之间。经络为寒所折。则营卫稽留于脉。
营者血也。卫者气也。营血得寒则涩而不行。卫气从之。与寒相搏。亦壅遏不通。气者阳也。
阳气蕴积。则生于热。寒热不散。故积聚成疽。脏气沉行主里。故疽肿深浓。其上皮强如牛
领之皮。久则热胜于寒。热气纯盛。蕴结伤肉也。血肉腐坏。化而为脓。乃至伤骨烂筋不可
治。初发疽时。一粒如麻豆大。身体便发热。生疽处肉赤热。肿大而高。多生疼痛。破后肉
色红紫。此为外发。虽大若盆碗。如用药有理。百人可百活。如初发疽时。不拘大小。身体
无热。自觉倦怠。生疽处亦不热。数日之间。渐渐开大。不肿不高。不疼不痛。低陷而坏烂。
破后肉色紫黑。此为内发。有此证者。未发见之先。脏腑已溃烂。百人百不救。虽有良药。
亦付之无可奈何。
黄帝问曰。有疽死者奈何。歧伯曰。身有五部。伏兔一、腓二、背三、五脏之俞四、项
五。此五部有痈疽者死也。
有缓疽者。初结肿形似痈回。回无头尾。其色不异。但痛有根核。又与皮相亲着。一名
肉痈。其有大者如拳。小者如桃李状。积日不溃。乃变紫色黯黑。久即皮肉俱烂。如牛领疮
状。
遍体通青黯色。不作头而穿溃脓出是也。初作服五香连翘汤。 去血。以小豆薄涂之。其间
数针 去血。又敷之。取消也。若不消色不变青黯者。以炼石敷之。若失时不得疗已溃者。
犹服五香连翘汤。及漏芦汤下之。随热多少投方也。外以升麻汤拓洗之。敷生麻膏。若生臭
恶者。可以单行一物白 茹散敷之。青肉去尽便停也。好肉既生。但敷升麻膏。若不生肉。
单服一物黄 散也。若敷白 茹散。积日青恶肉不尽者。可以漆头赤皮 茹取半钱。和三大
钱上白 茹散中合和敷之。恶肉去尽。还以纯用白 茹散也。视好肉欲生。可敷黄 散也。
黄散方。白 茹散方。漆头 茹散方。并一味单行。随多少捣筛为散。
治疽之法。灼艾之功胜于用药。缘热毒中隔。上下不通。必得毒瓦斯发泄。然后解散。古
人立论。譬诸盗入主人之家。必开其门户。逐之使去。万一门户闭塞。无从而出。伤主而后
已。人不幸而有此疾。适处贫困。适居僻邑村乡。难得药材。则灼艾尤为利便。灼艾之功。
须初发一日之内。尖头如麻豆大时。便好措手。其法用大独头蒜薄切如小钱浓。亦如钱大。
贴于疽顶尖上。以艾炷安蒜上灸之。三壮一易。痛者灸至不痛。不痛者以痛为度。大概以百
壮为准。用大蒜取其毒有力。多用艾炷。取其火力通透。如法灸之。疮一发脓溃。继以神异
膏贴之。即日而安。一能使疮不开大。二肉不坏。三口易合。一举而三得之。然人未知之。
而多迟疑未决。至二日之后。疽大如指。毒瓦斯开散。病者不能看火。不可灼艾矣。可不预知
之乎。但头上见疽。或顶以上见疽。决不可用此法灸。灸则反增其疾也。
疽疾既成。先服取毒之药。只用麦饭石膏涂贴。五七日之后。病渐减退。合服川乌丸、
二乌丸。驱余毒。活气血。生肌肉。排宿脓。去风邪。既破之后。合服内补十宣散。多服为
妙。
大凡疽口紧小而硬者。盖为风毒所胜。合用蚣蝎散。糁于神异膏上。止于近疮处糁一小
钱大。不必遍地糁药。
疽疾既安之后。或未安之际。口中干燥。舌上坚硬如鸡内金者。非渴之所能比。非水之
所能润。此乃亦是肾家枯竭。而搬运不上。致令心火上炎故也。此证最恶。非惟有疽疾之人。
见此可虑。每见寻常不问男女无疾之人。见之亦日危矣。诸家方论。未尝载此。古人云。玉
华池竭七朝亡者、此也。多见庸医不究其源。各立新说。自出己见。投之丹药。为镇坠心火。
以升肾水。病者不晓。信而服之。祸如反手。殊不知肾水既竭。更投之以丹。遂令肾水愈涸
。古人云。脾恶湿。肾恶燥。非滋润之药。不能疗之。所用加减八味丸。正合其意。外有桑
枝煎。及五味子汤。皆良药也。
疽疾将安及七八分。盒饭服加料十全大补汤。以补气血。每日当与排脓内补十宣散相间
服。大凡疽疾多因怒气而得之。若有此疾。必多怒。但服附子之药。进食宽气。
疽之证甚恶。多有陷下透膜者。服狗宝丸。疮四边必起。用乌龙膏、解毒散讫。须要针
刀开疮口。其内已溃烂。不复知痛。乃纳追毒丹于孔中。以速其溃。既溃后。割去死肌。洗
以猪蹄汤。敷以生肌散。覆以乳香膏。若证之善者。自然肿起红活。乃即如前法。
方
乳香圆（出危氏方）治发背。及一切疽疮溃烂。痛不可忍者。
当归 川芎 交趾桂 真绿豆粉 川香芷（各五钱） 羌活 独活 五灵脂 乳香（别
研）
没药（别研各三钱） 白胶香（五钱） 上为末。炼蜜为丸。如弹子大。每服一丸。用薄荷
汤嚼
下。手足损痛不能起者。加大草乌一味。用木瓜盐汤细嚼下。
漏芦汤（出鲍氏方）治疽作后二日。服此退毒下脓。可与五香连翘汤相间。
连日
服之。
生黄 （去芦头） 连翘 沉香 漏芦（有白茸者各一两） 生粉草（半两） 大黄（微
炒半
两） 上为细末。每服二钱。煎姜枣汤调下。
四虎散 治痈疽肿硬。浓如牛皮。按之痛。
天南星 草乌头 半夏（生） 野狼毒（各等分） 上为细末。醋蜜调敷。留头出毒瓦斯。
治疽溃后（出千金方）
以盐汤洗拭了。烧皂荚粉上良。一方皂角去皮了。治瘭疽溃后。
又方（出千金方）
用梁上尘和 中脂。敷之。
又方（出千金方）
用生麻油滓绵裹。布疮上虫出。
又方（出千金方）
用沸水汤灌疮中。三四遍。（汤一作饧）
芸苔熨散（出千金方）治疽似痈而小。有异脓。如小豆汁。（今日去明日满
者）
用芸苔熟捣。湿布袋盛之。埋热灰中。更互熨之。即便得安。不过再三即瘥。冬用干者。
一方将甘草汤洗疮令净干。以黄柏末涂敷了。即用以瘥为度。
又方（出千金方）
用皂荚煎汤洗疮拭干。以柏皮为末敷之。勿令作痂。
治疽疮并治软疖。
用多年螺壳烧灰。麻油调敷。
治疽初作方。（出肘后方）
用赤小豆为末。醋调敷之。
大蓟散（出济生方）治饮啖辛热。热邪伤肺。呕吐出血。曰肺疽。
大蓟根 犀角 升麻 桑白皮 蒲黄（炒） 杏仁（去皮尖） 桔梗（炒各一两） 甘
草（炙
半两） 上每服四钱。以水一盏半。姜三片。煎七分。去滓食后服。
三灰散（出三四方）治肺疽血病者。因饮啖辛热。热燥伤肺。血得热则溢。因
作呕吐。出血一合或半升许。名曰肺疽。伤腑则属胃。伤于脏则属肺。上以此无不可救
。
红枣（和核烧存性） 百药煎（烧存性各等分） 上为末。每服二钱。蜜调成膏。软柿
和嚼。
自效。或米汤下亦可。
治疽溃后。（出千金方）
用牛耳中垢。敷之良。
疽发人贴云母膏。痛如刀割。不可不审。不可不知也。亦不得用生肌药。只贴膏药
。自然敛合。如医治后时。为庸医药敷。或刀割伤风重者。兼以五香连翘汤。
木香 麝香 乳香 沉香 藿香 连翘 上等分为细末。每服二钱。水一盏。煎至七分。
放
五香连翘汤（出仁存方）治疽作二日后。宜与此汤。并漏芦汤相间。连日服之
。
木香 沉香 丁香（去核并不见火各半两） 连翘 射干 升麻 黄 （生锉） 木通 乳
香桑寄生 独活（各三分） 麝香（一钱） 上为粗末。每服三钱。水二盏。煎至一盏。
去滓。
取清汁为度。或下恶物。未生肉以前服不妨。以析毒热之气。气盛用大黄、竹沥、芒硝。恐
用药之后。不能斟量。是故不载。知者当自相度用之。
治久疽疮无不瘥方（出本草）
以伊芳洛水中蟹。形段不同。取其黄敷之。
治黑疽多死。宜急治之。
用王瓜根一斤。捣绞取汁六合。顿服。当有黄水随小便出。更服之瘥（王瓜根亦名土瓜
根。）
(Attached Discussion)
The disease of Ju (deep-seated abscess/necrotic ulcer) arises from the dysfunction of the Five Zang organs. The Five Zang govern the interior, and Qi circulates through the meridians in a deep manner. If emotions such as joy and anger are unpredictable, or if dietary habits are irregular, leading to disharmony between Yin and Yang, the Five Zang will become dysfunctional. When Ying (Nutritive Qi/Blood) and Wei (Defensive Qi/Air) are deficient, the Couli (pores and interstitial spaces) open, allowing Cold pathogens to invade between the meridians. The meridians are obstructed by Cold, causing Ying and Wei to stagnate within the vessels. Ying refers to Blood, while Wei refers to Qi. When Nutritive Blood encounters Cold, it becomes stagnant and fails to flow; Defensive Qi follows suit, battling with Cold, resulting in blockage and obstruction. Qi belongs to Yang; when Yang Qi accumulates and stagnates, Heat is generated. Since Cold and Heat do not dissipate, they accumulate to form Ju. Because Zang Qi is deep and governs the interior, the swelling of Ju is profound and the pus is thick. The skin over the lesion is hard like the hide of an ox's neck. Over time, Heat surpasses Cold, and pure excessive Heat accumulates, damaging the flesh. Muscle and blood rot and transform into pus, eventually damaging bones and destroying tendons, rendering the condition incurable. At the initial stage of Ju, a lump the size of a hemp seed or bean appears, accompanied by fever. The tissue at the site is red, hot, swollen, elevated, and painful. After rupture, the flesh turns red-purple, indicating an external manifestation. Even if the sore is as large as a basin or bowl, if treated correctly, all hundred patients can be saved. However, if at the onset, regardless of size, there is no fever, the patient feels fatigued, the site is not hot, and within days the lesion expands gradually without swelling or elevation, nor pain, but rather sinks and rots. After rupture, the flesh turns purple-black, indicating an internal manifestation. In such cases, the internal organs have already rotted before symptoms appear; none of the hundred patients can be saved. Even with excellent medicine, nothing can be done.
The Yellow Emperor asked: "What happens when death occurs due to Ju?" Qibo replied: "There are five parts of the body: one is the Futu area (anterior thigh), two is the calf (Fei), three is the back, four is the Shu points of the Five Zang on the back, and five is the neck. Ulcers or abscesses occurring in these five areas result in death."
Huan Ju (Slow-abscessing Ulcer) initially presents with swelling resembling a carbuncle, round without distinct head or tail, with normal color, but painful with a rooted nodule, adhering closely to the skin. It is also known as Rou Yong (Flesh Abscess). Large ones are fist-sized, small ones like plums or peaches. They persist for days without suppurating, later turning purple-dark black. Prolonged cases lead to necrosis of skin and flesh, resembling ulcers on an ox's neck. The whole body may show cyanotic dark discoloration without forming a head, yet bursting to discharge pus. Initially, treat with Wuxiang Liaoqiao Tang (Five Fragrant Forsythia Decoction) to remove blood toxins, apply thin powder of Adzuki Bean externally, puncture several times to bleed, and reapply medication to eliminate pathogenic factors. If the color does not fade or turn cyanotic-dark, apply refined stone powder. If treatment is delayed and the ulcer has already ruptured, continue administering Wuxiang Liaoqiao Tang and use Loulu Tang (Rhapontic Rhizome Decoction) to purge. Adjust dosage according to the degree of heat. Externally wash with Shengma Tang (Cimicifuga Decoction) and apply Shengma Gao (Cimicifuga Ointment). If foul odor develops, apply single-herb Bai Lian San (Akebia Powder). Discontinue when cyanotic necrotic tissue is gone. Once healthy granulation tissue grows, apply only Shengma Gao. If granulation fails to grow, administer single-herb Huang Bo San (Phellodendron Powder). If using Bai Lian San and cyanotic necrotic tissue persists after many days, mix half a qian of Qi Tou Chi Pi Bai Lian (Akebia with lac-coated red peel) with three qian of high-quality Bai Lian San for application. Once necrotic tissue is cleared, revert to pure Bai Lian San. When healthy tissue begins to regenerate, apply Huang Bo San. Formulas for Huang Bo San, Bai Lian San, and Qi Tou Bai Lian San consist of single herbs processed into powder as needed.
Regarding the treatment of Ju, moxibustion is more effective than herbal medicine. This is because heat-toxin blocks the middle jiao, preventing upper and lower communication; toxins must be vented before resolution. Ancient texts compare this to driving out thieves from a house: one must open the doors and windows to expel them. If blocked, the thief harms the owner. For patients in poverty or remote areas lacking herbs, moxibustion is particularly convenient. Moxibustion should be performed within one day of onset, when the lesion is pointed and bean-sized. Slice a large single-clove garlic thinly (like a coin thickness) and place it on the apex of the ulcer. Place moxa cones on the garlic. Change the garlic slice after every three moxa cones. For painful lesions, moxa until pain ceases; for painless lesions, moxa until pain is felt. Generally, aim for one hundred cones. Garlic is used for its potent detoxifying properties, and abundant moxa ensures penetrating heat. Upon suppuration, apply Shenyi Gao (Miraculous Efficacy Ointment) for immediate relief. This method prevents expansion, preserves tissue, and promotes rapid healing. However, hesitation often leads to missed opportunities; by the second day, the ulcer may enlarge to finger-size, toxins spread, and the patient cannot tolerate heat, making moxibustion impossible. Caution: Do not use this method for ulcers on the head or above the vertex, as it exacerbates the condition.
Once Ju is established, first administer detoxifying agents and apply Maifan Shi Gao (Maifan Stone Gypsum). After five to seven days, as symptoms subside, administer Chuan Wu Wan (Sichuan Aconite Pill) or Er Wu Wan to clear residual toxins, invigorate blood and Qi, generate flesh, drain old pus, and dispel wind. After rupture, take Neibu Shixuan San (Internal Tonification Ten-Acupoint Powder) frequently.
For tight, small, hard ulcer openings caused by prevailing wind-toxin, apply Gong Xie San (Centipede and Scorpion Powder) onto Shenyi Gao near the wound edge only, not broadly.
After the ulcer stabilizes or during instability, dry mouth and tongue hardness resembling chicken gizzard lining indicate severe dehydration, not simple thirst, nor responsive to water. This results from Kidney Essence exhaustion failing to ascend, causing Heart Fire to flare upward. This sign is ominous, appearing even in healthy individuals, signaling impending danger. Ancient texts state: "If the Jade Spring Pool dries up, death follows in seven days." Quack doctors often misdiagnose this, prescribing cinnabar pills to suppress Heart Fire and raise Kidney Water, worsening the condition since Kidney Water is already depleted. As stated, "Spleen dislikes dampness, Kidney dislikes dryness"; moistening herbs are required. Jiajian Bawei Wan (Modified Eight-Ingredient Pill) is appropriate. Sang Zhi Jian (Mulberry Twig Decoction) and Wuweizi Tang (Schisandra Decoction) are also beneficial.
When the ulcer is 70-80% healed, administer Jiaoshiu Shiquan Dabu Tang (Enhanced Complete Great Tonifying Decoction) to tonify Qi and Blood. Alternate daily with Painong Neibu Shixuan San. Ju often stems from anger; thus, administer Fuzi (Aconite) preparations and foods that soothe Qi.
Severe Ju with sinking and membrane penetration requires Gou Bao Wan (Dog Gallstone Pill). After applying Wulong Gao (Black Dragon Ointment) and Jiedu San (Detoxification Powder), incise the ulcer with needles/knives. Since sensation is lost due to necrosis, insert Zhuidu Dan (Toxin-Chasing Pellet) to accelerate drainage. Debride necrotic tissue, wash with Zhuti Tang (Pig Trotter Decoction), apply Shengji San (Flesh-Generating Powder), and cover with Ruxiang Gao (Frankincense Ointment). Favorable cases will show rising red vitality, following the aforementioned protocol.
Formulas:
Ruxiang Yuan (Frankincense Pill) [from *Wei Shi Fang*]: Treats Back Carbuncle and all suppurating ulcers with unbearable pain.
Ingredients: Dang Gui, Chuan Xiong, Jiaozhi Gui, Zhen Lü Dou Fen, Chuan Xiang Zhi (each 5 qian); Qiang Huo, Du Huo, Wu Ling Zhi, Ruxiang (separately ground), Moyao (separately ground, each 3 qian); Bai Jiao Xiang (5 qian). Process into powder, bind with refined honey into pills the size of quail eggs. Take one pill chewed down with Bo He Tang (Mint Decoction). For limb injury/pain preventing movement, add Da Cao Wu, taken with Mu Gua Yan Tang (Papaya Salt Decoction).
Loulu Tang [from *Bao Shi Fang*]: Administer two days after onset to reduce toxicity and drain pus. Alternate with Wuxiang Liaoqiao Tang daily.
Ingredients: Sheng Huang Qi (de-rooted), Liao Qiao, Chen Xiang, Loulu (with white fuzz, each 1 liang); Sheng Fen Cao (0.5 liang); Da Huang (lightly stir-fried, 0.5 liang). Process into fine powder. Take 2 qian, mixed with Ginger and Jujube decoction.
Si Hu San (Four Tigers Powder): Treats carbuncles/ulcers with hard swelling, thick pus like ox hide, painful on pressure.
Ingredients: Tian Nan Xing, Cao Wu Tou, Ban Xia (raw), Ye Lang Du (equal parts). Process into fine powder, mix with vinegar and honey for topical application. Leave the center open to vent toxins.
Treatment for Post-Suppurative Ulcers [from *Qian Jin Fang*]:
Wash with salt water, then apply burnt Sophora Flower powder. Alternative: Use peeled Sophora fruit.
Another Formula [from *Qian Jin Fang*]:
Apply dust from roof beams mixed with pig fat.
Another Formula [from *Qian Jin Fang*]:
Wrap raw hemp oil residue in cotton, apply to wound to draw out insects.
Another Formula [from *Qian Jin Fang*]:
Pour boiling water into the wound 3-4 times.
Yuntai Yi San (Rapeseed Compress Powder) [from *Qian Jin Fang*]: Treats ulcers resembling small carbuncles with abnormal pus like adzuki bean juice (replenishes overnight).
Mash ripe Yuntai (Rapeseed leaves), wrap in wet cloth, bury in hot ashes, and compress alternately. Relief is immediate; recovery in few applications. In winter, use dried leaves. Alternative: Wash wound with Licorice decoction, dry, apply Huang Bo powder until healed.
Another Formula [from *Qian Jin Fang*]:
Wash wound with Sophora decoction, dry, apply Platycladus bark powder. Avoid scabbing.
Treatment for Ulcers and Soft Furuncles:
Burn old snail shells to ash, mix with sesame oil for application.
Treatment for Initial Ulcer [from *Zhou Hou Fang*]:
Apply powdered Adzuki Bean mixed with vinegar.
Daji San [from *Ji Sheng Fang*]: Treats Lung Ju caused by spicy/hot diet damaging Lung Qi, leading to vomiting blood.
Ingredients: Da Ji Gen, Xi Jiao, Sheng Ma, Sang Bai Pi, Pu Huang (stir-fried), Xing Ren (skin/kernel removed), Jie Geng (stir-fried, each 1 liang); Gan Cao (roasted, 0.5 liang). Take 4 qian, decoct with 1.5 cups water and 3 ginger slices until reduced to 0.7 cup. Strain and take after meals.
San Hui San [from *San Si Fang*]: Treats Lung Ju with blood disorder. Caused by spicy/hot diet drying Lung, causing blood overflow and vomiting 0.5-1 sheng of blood. Damage to Fu relates to Stomach; damage to Zang relates to Lung. This formula is universally curative.
Ingredients: Hong Zao (burnt with pits intact), Bai Yao Jian (burnt, equal parts). Process into powder. Take 2 qian, mix with honey to form paste, chew with soft persimmon. Effective, or take with rice soup.
Treatment for Post-Suppurative Ulcers [from *Qian Jin Fang*]:
Apply earwax from cattle ears.
For Ulcers, apply Yunmu Gao (Mica Ointment). Pain is knife-like; caution is essential. Do not use flesh-generating drugs; only apply ointment for natural closure. If late treatment by quacks causes wind invasion via cutting, combine with Wuxiang Liaoqiao Tang.
Ingredients: Mu Xiang, She Xiang, Ruxiang, Chen Xiang, Huo Xiang, Liao Qiao. Process into fine powder. Take 2 qian, decoct with 1 cup water to 0.7 cup.
Wuxiang Liaoqiao Tang [from *Ren Cun Fang*]: Indicated two days after onset. Alternate with Loulu Tang daily.
Ingredients: Mu Xiang, Chen Xiang, Ding Xiang (pitted, unheated, each 0.5 liang); Liao Qiao, She Gan, Sheng Ma, Huang Qi (raw cut), Mu Tong, Ruxiang, Sang Ji Sheng, Du Huo (each 3 fen); She Xiang (1 qian). Process into coarse powder. Take 3 qian, decoct with 2 cups water to 1 cup. Strain, take clear liquid. Safe to take before granulation to resolve heat-toxin. For excess heat, add Da Huang, Zhu Li, Mang Xiao, though precise dosing is complex and omitted here for experts to judge.
Formula for Chronic Ulcers [from *Ben Cao*]:
Apply yellow roe from crabs found in Yi and Luo rivers.
Urgent Treatment for Black Ju (High Mortality):
Decoct 1 jin of Wang Gua Gen (Trichosanthes Root), extract 6 he of juice, take in one dose. Yellow fluid should pass in urine. Repeat until cured. (Wang Gua Gen is also known as Tu Gua Gen).