良方升麻和气饮治疮肿疖疥痒痛
甘草 陈皮(各一两半) 芍药(七钱半) 大黄(半两煨) 干葛 苍术 桔梗 升麻(各
一两) 当归 半夏 茯苓 白芷(各二钱) 干姜 枳壳(各半钱三因方有浓朴半钱)
上 咀每服一两水煎
按此手足太阴阳明经药也五积散加减法世俗多用之故收入盖欲燥脾胃胜湿和气为治疮之
剂然临证而不通变恐未合宜也
当归饮子治疮疥风癣湿毒燥痒疮
当归 白芍 川芎 生地黄 白蒺藜 防风 荆芥(各一两) 何首乌 黄 甘草(各
半两)
上 咀每服一两水煎或为末每服一二钱亦得
按此疏风热之剂手足三阴药也血虚者不可缺此圣济总录金针散治发背诸疮肿
皂角针春取一半新采一半黑者
上一味不拘多少晒干为末食后酒调二三钱服
按丹溪曰此药治痈疽已破未破皆用直 领到溃处意谓当入群队中用也
局方托里十补散
黄 人参 当归(各二钱) 浓朴 桔梗 川芎 防风 桂心 甘草 白芷(各一钱)
上 咀水煎
谨按卫生宝鉴曰诸痛痒疮疡皆属心火言其常也如疮盛形羸邪高痛下始热终寒此反常也固
当察时下之宜而
权治故曰经者常也法者用也医者意也随其宜而
治之可收十全之功矣故此方用之于痈疽初发或已发或内托然疮证脉缓涩或身倦恶
寒热少脉弦或紧细者宜用之散风寒助阳之剂也表里气血之药若施之于积热 毒更不分经络时
宜不能不无误也丹溪曰精要谓排脓内补十宣散治未成者速散已成者速溃诚哉是言也若用之于
些小痈疽与冬月时令尽用内托之功若于冬月肿疡用之亦可转重就轻移深于浅若溃疡于夏月用
之其桂朴之温散佐以防风白芷吾恐虽有参 难为倚仗比见世人用此者不分痈疽冬夏无经络无
前后如盲人骑瞎马半夜临深池危哉
十六味流气饮治无名恶肿痈疽等证
川芎 当归 芍药 防风 人参 木香 黄 官桂 桔梗 白芷 槟榔 浓朴 乌药
甘草 紫苏 枳壳
上 咀水煎
按此表里气血药也复以疏风助阳之剂世俗多用之故收入非脉之洪缓沉迟紧细者不宜用此
每见
外科诸家载此往往不分经络脉证不具时宜但云化毒消肿有云不退者加以补气血之药盖又使人
不能无疑也用者当触类而长之可矣
郭氏神效乌金散治痈疽疔肿时毒附骨疽诸恶疮等证若疮黑陷如石坚四肢冷脉细或时昏冒
谵语循衣烦渴危笃者服此汗之疮起
苍耳头(五月五日午时效) 小草乌头 火麻头(火日收采) 木贼(去节) 虾蟆头 桦皮
节(酥炙) 麻黄(去根节)
上晒干各等分同入瓷器内盐泥固济炭火内从早 至申分如黑煤色为度碾为末每服二钱病
重者三钱用热酒调下未汗再一服如汗干却服解毒疏
利之药如修合此药必选天睛好日于静室中勿令
鸡犬猫畜及阴人见也又名首功玄黑散
夺命丹治诸般肿毒疔疽恶疮
蟾酥 轻粉(各半钱) 朱砂(三钱) 白矾(枯) 寒水石 铜绿(各一钱) 蜗牛(二十一
个别研) 乳香 没药 麝香(一钱)
上件为细末将蜗牛别研一处丸如丸不就用好酒糊和丸如绿豆大每服一丸生葱三五茎嚼极
烂吐于手心包药在内热酒和葱送下如重车行五七里汗出为效重者再服一二丸
蟾酥丸治疗黄一切恶疮
川乌 莲花叶 朱砂(各一钱半) 乳香 没药(各二钱) 轻粉 蟾酥(各一钱) 麝香(
半钱)
上为细末糊丸菀豆大每服一丸病重者二丸根据前法服取汗
按以上三方郭氏称为首药皆主乎发散散出太阳例后二方出少阴例然皆劫剂也智者当较轻
重阴阳之分取择用之
东垣托里荣卫汤治证见前疮宜发汗论
黄 红花 桂枝(各五钱) 苍术(三钱) 柴胡 连翘(各二钱) 羌活 防风 当归身
炙甘草 黄芩(各一钱半) 人参(一钱)
上 咀每服一两水酒各半煎
按此足三阳太阴经药出桂枝例表里气血之剂也
Liangfang Shengma Heqi Yin (Sheng Ma Harmonizing Qi Decoction from Excellent Prescriptions) is used to treat sores, swellings, boils, scabies, itching, and pain.
Ingredients: Gancao (Licorice Root), Chenpi (Aged Tangerine Peel) (each 1 liang 5 qian); Shaoyao (Peony Root) (7 qian 5 fen); Dahuang (Rhubarb Root) (0.5 liang, stir-baked); Gange (Kudzu Root), Cangzhu (Atractylodis Rhizoma), Jiegeng (Platycodon Root), Shengma (Cimicifugae Rhizoma) (each 1 liang); Danggui (Angelicae Sinensis Radix), Banxia (Pinelliae Tuber), Fuling (Poria), Baizhi (Angelicae Dahuricae Radix) (each 2 qian); Ganjiang (Zingiberis Rhizoma), Zhike (Aurantii Fructus Immaturus) (each 0.5 qian; San Yin Fang adds Nongpo (Magnoliae Officinalis Cortex) 0.5 qian).
The above herbs are cut into small pieces. Each dose of 1 liang is decocted in water.
Commentary: These herbs belong to the Foot and Hand Taiyin and Yangming meridians. The modification method of Wuji San (Five Accumulations Powder) is commonly used in secular practice, hence it is included here. The intention is to dry dampness, strengthen the spleen and stomach, overcome dampness, and harmonize qi as a treatment for sores. However, if clinical application lacks flexibility, it may not be appropriate.
Danggui Yinzi (Angelica Decoction) is used to treat sores, scabies, wind-xuan (wind-induced skin lesions), wet-toxin causing dry itching sores.
Ingredients: Danggui (Angelicae Sinensis Radix), Baishao (White Peony Root), Chuanxiong (Chuanxiong Rhizome), Shengdihuang (Rehmanniae Radix), Baijili (Tribuli Fructus), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica) (each 1 liang); Heshouwu (Polygoni Multiflori Radix), Huangqi (Astragali Radix), Gancao (Licorice Root) (each 0.5 liang).
The above herbs are cut into small pieces. Each dose of 1 liang is decocted in water; or processed into powder, each dose of 1-2 qian is also acceptable.
Commentary: This is a formula for dispersing wind-heat, belonging to the Foot and Hand Three Yin meridians. It is indispensable for those with blood deficiency.
Jinzhen San (Golden Needle Powder) from Shengji Zonglu (General Records of Holy Relief) is used to treat back carbuncles and various other sores and swellings.
Ingredients: Zaogaozhen (Gleditsiae Sinensis Spina) (half newly harvested in spring, half black ones).
One ingredient only, quantity unrestricted. Dry and grind into fine powder. Take 2-3 qian mixed with wine after meals.
Commentary: Zhu Danxi said: This medicine treats yongju (abscesses and ulcers), whether broken or unbroken. Its purpose is to lead the effect directly to the ulcerated area, implying it should be used in combination with other herbs.
Ju Fang Tuoli Shibu San (Ten-Nourishing Interior-Supporting Powder from the Bureau Formulas)
Ingredients: Huangqi (Astragali Radix), Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix) (each 2 qian); Nongpo (Magnoliae Officinalis Cortex), Jiegeng (Platycodon Root), Chuanxiong (Chuanxiong Rhizome), Fangfeng (Saposhnikoviae Radix), Guixin (Cinnamomi Ramulus), Gancao (Licorice Root), Baizhi (Angelicae Dahuricae Radix) (each 1 qian).
The above herbs are cut into small pieces and decocted in water.
Careful Commentary: Weisheng Baojian (Treasures for Maintaining Health) states: "All pain, itching, sores, and ulcers belong to Heart Fire," which refers to the general rule. If the sore is severe but the constitution is emaciated, the pathogen is high while pain is low, starting with heat and ending with cold, this is an abnormal situation. Therefore, one must observe the current timing and apply flexible treatment. Thus, it is said that "Jing" (Classic) is the constant, "Fa" (Method) is the application, and "Yi" (Physician) relies on intuition. Treating according to appropriateness can achieve perfect results. Hence, this formula is used for the initial onset of yongju, or when already developed, or for internal support therapy. However, if the pulse is slow and choppy, or the body is fatigued, aversion to cold, little heat, or the pulse is wiry, tight, or thin, this formula is suitable. It is a formula to disperse wind-cold and assist yang, regulating the exterior, interior, qi, and blood. If applied to cases of accumulated heat and toxin without distinguishing meridians and seasonal appropriateness, errors are inevitable. Danxi stated: Jingyao suggests that Paimo Neibu Shixuan San (Ten-Ventilation Internal-Supporting Pus-Draining Powder) rapidly dissipates unformed sores and rapidly drains formed ones. This is indeed true. If used for minor yongju or entirely for internal support in winter, applying it to swelling ulcers in winter can turn heavy conditions lighter and deep conditions superficial. However, using it for ulcerated sores in summer, the warming and dispersing nature of Guizhi (Cinnamon Twig) and Nongpo (Magnolia Bark), assisted by Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica Root), I fear that even with Renshen (Ginseng) and Huangqi (Astragalus), reliance may be difficult. Recently, I have seen people use this formula without distinguishing between yongju types, seasons (winter/summer), meridians, or stages (early/late), like a blind man riding a blind horse facing a deep pool at midnight—how dangerous!
Shiliuwei Liuqi Yin (Sixteen-Ingredient Flowing-Qi Decoction) is used to treat nameless malignant swellings, yongju, and other conditions.
Ingredients: Chuanxiong (Chuanxiong Rhizome), Danggui (Angelicae Sinensis Radix), Shaoyao (Peony Root), Fangfeng (Saposhnikoviae Radix), Renshen (Ginseng Radix), Muxiang (Aucklandiae Radix), Huangqi (Astragali Radix), Guanzi Gui (Cassia Twig), Jiegeng (Platycodon Root), Baizhi (Angelicae Dahuricae Radix), Binglang (Areca Seed), Nongpo (Magnoliae Officinalis Cortex), Wuyao (Litseae Fructus), Gancao (Licorice Root), Zisu (Perilla Leaf), Zhike (Aurantii Fructus Immaturus).
The above herbs are cut into small pieces and decocted in water.
Commentary: This formula regulates the exterior, interior, qi, and blood, combined with wind-dispersing and yang-assisting agents. It is widely used in secular practice, hence included. It is not suitable for pulses that are surging-slow, deep-slow, tight, or thin. Often, surgical specialists record this formula without distinguishing meridians, lacking complete pulse and symptom analysis, and ignoring seasonal appropriateness, merely claiming it resolves toxins and reduces swelling. If ineffective, they add qi- and blood-nourishing herbs, causing further doubt. Users should extend their understanding analogously.
Guoshi Shenxiao Wujin San (Guo's Divine Efficacy Black Gold Powder) is used to treat yongju, dingzhong (carbuncles), shidu (seasonal toxins), fugujü (bone-attached abscesses), and various malignant sores. If the sore is black and sunken, hard as stone, limbs are cold, pulse is thin, or there is occasional dizziness, delirium, picking at clothes, irritability, thirst, and critical condition, taking this formula induces sweating, and the sore rises.
Ingredients: Cang'er Tou (Xanthii Fructus head) (harvested at noon on the fifth day of the fifth lunar month), Xiao Caowutou (Aconitum Carmichaelii Lateral Root Preparatio minor), Huomato (Hemp seed head) (harvested on fire days), Muze (Equiseti Herba) (remove joints), Xiamato (Toad head), Hua Pi Jie (Betula Platyphylla bark nodes) (roasted with butter), Mahuang (Ephedrae Herba) (remove roots and joints).
Dry all ingredients equally, place together in a porcelain jar, seal with salt mud, and roast over charcoal fire from morning until Shen hour (3-5 PM), until turning black like coal. Grind into powder. Take 2 qian per dose, 3 qian for severe cases, mixed with hot wine. If no sweat occurs, take another dose. After sweating, administer detoxifying and draining medicines. When preparing this medicine, choose clear sunny days, work in a quiet room, and do not allow chickens, dogs, cats, or women during menstruation/pregnancy to see it. Also known as Shougong Xuanhei San (First Merit Black Mystery Powder).
Duoming Dan (Life-Seizing Pill) is used to treat various swellings, toxins, dingju, and malignant sores.
Ingredients: Chansu (Bufonis Venenum), Qingfen (Calomel) (each 0.5 qian); Zhusha (Cinnabar) (3 qian); Baifan (Alumen Exsiccatum - calcined alum), Hanshuishi (Hydrocerussite), Tonglü (Chalcitis) (each 1 qian); Woniu (Helix Aspersa) (21 snails, ground separately); Ruxiang (Olibanum), Moyao (Myrrha), Shexiang (Moschus) (1 qian).
Grind all ingredients into fine powder. Grind the snails separately. Mix with good wine paste to form pills the size of mung beans. Take one pill per dose. Chew 3-5 stalks of raw green onion thoroughly, spit into the palm, wrap the pill inside, and swallow with hot wine mixed with onion. For severe cases, walking for five to seven li inducing sweat indicates efficacy. Severe cases may take 1-2 more pills.
Chansu Wan (Toad Venom Pill) treats huangshui chuang (weeping sores) and all malignant sores.
Ingredients: Chuanwu (Aconiti Radix Preparata), Lianhua Ye (Nelumbinis Nuciferae Folium), Zhusha (Cinnabar) (each 1.5 qian); Ruxiang (Olibanum), Moyao (Myrrha) (each 2 qian); Qingfen (Calomel), Chansu (Bufonis Venenum) (each 1 qian); Shexiang (Moschus) (0.5 qian).
Grind into fine powder, mix with paste to form pills the size of shepherd's purse seeds. Take one pill per dose, two for severe cases. Administer according to the previous method to induce sweat.
Commentary: The above three formulas, referred to by Guo as "Shou Yao" (Primary Medicines), primarily focus on dispersion, following the Taiyang meridian pattern. The latter two follow the Shaoyin meridian pattern. However, these are all "Jie Ji" (drastic/capturing agents). Wise practitioners should weigh the severity and yin-yang distinctions before choosing.
Dongyuan Tuoli Rongwei Tang (Dongyuan's Interior-Supporting Ying-Wei Decoction) treats conditions described in the preceding section "Sores Suitable for Sweating."
Ingredients: Huangqi (Astragali Radix), Honghua (Carthami Flos), Guizhi (Cinnamomi Ramulus) (each 5 qian); Cangzhu (Atractylodis Rhizoma) (3 qian); Chaihu (Bupleuri Radix), Lianqiao (Forsythiae Fructus) (each 2 qian); Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Danggui Shen (Danggui Root Tip), Zhigancao (Prepared Licorice Root), Huangqin (Scutellariae Radix) (each 1.5 qian); Renshen (Ginseng Radix) (1 qian).
The above herbs are cut into small pieces. Each dose of 1 liang is decocted in half water and half wine.
Commentary: These herbs belong to the Foot Three Yang and Taiyin meridians, derived from the Guizhi Tang pattern. It is a formula regulating the exterior, interior, qi, and blood.