痛，或不痛及麻木者，邪气盛也，隔蒜灸之。不痛者灸至痛，痛者灸至不痛，毒随火
而散
托之； 痛烦躁，或咽干，火在上也，宜泻之；肿痛，或不作脓者，邪气凝结也，宜解之；
肿痛饮冷，发热睡语者，火也，宜清之；不作脓，或不溃，及不敛者，阳气虚也，宜补之；
瘀肉不腐，或积毒不解者，阳气虚也，宜助阳气；脓多或清者，气血俱虚也，宜峻补之；脉
浮大或涩，而肌肉迟生者，气血俱虚也，宜补之；右关脉弱，而肌肉迟生者，宜健脾胃。
一男子患此痛甚，服消毒药，愈炽。余为隔蒜灸之而止，与仙方活命饮，二剂顿退；更
与托里药，溃之而愈。
一男子已四日，疮头如黍， 痛背重，脉沉实。与黄连内疏汤，二剂少退；更与仙方活
命饮，二剂而消。
一男子 肿作痛，脉浮数。与内托复煎散，二剂少退；与仙方活命饮，四剂痛止而溃，
再与托里药而愈。
一妇人发热烦躁，饮冷，与黄连解毒汤，四剂稍愈；更与托里消毒散，始溃，与托里药
而敛。
一男子毒势炽甚，痛不可忍，诸药不应。以仙方活命饮二剂，诸证悉退；又二剂而溃，
以金银花散，六剂而愈。
一妇人肿痛发热，睡语脉大。用清心汤一剂而安；以金银花、甘草、天花粉、当归、栝
蒌、黄 ，数剂渐溃，更以托里药而愈。
一男子腐肉渐脱，而脓微清，饮食无味。以十宣散，去白芷、防风，加茯苓、白术、陈
皮，月余而敛。
一男子已愈，唯一口不敛，诊之脉浮而涩。以十全大补汤，治之而愈。
一男子将愈，但肌肉生迟，诊之脾胃俱虚。以六君子汤加芎、归、五味子、黄 ，治之
而愈。
一男子已愈，唯一眼翻出 肉如菌，三月不愈，乃伤风寒也。以生猪脂调藜芦末涂之即
愈。亦有 肉出三寸许者，尤宜用此药也。乌梅涂之亦效，但缓硫黄亦可。
一男子背患毒， 痛饮冷，发热多汗，便秘谵语。以破棺丹二丸而宁；以金银花散四剂
，脓
之证，虽发热疼痛，情势高硕，烦渴不宁，脉若有力，饮食颇进，可保无虞，其脓一溃，诸
证悉退。多有因脓不得外泄，以致疼痛，若用败毒寒药攻之，反致误事。若有脓，急针之，
脓一出，苦楚即止。脓未成，而热毒作痛者，用解毒之药。亦有腐溃尺余者，若无恶证，投
以大补之剂，肉最易生，亦无所妨。惟岂肿不高，色不赤，不 痛，脉无力，不饮食，肿不
溃，腐不烂，脓水清，或多而不止，肌肉不生，属元气虚也。皆难治，宜峻补之。其或脓血
既泄，肿痛尤甚，脓水败臭，烦躁时嗽，腹痛渴甚，泻利无度，小便如淋，乃恶证也，皆不
治。
一弱妇，外皮虽腐，内脓不溃，胀痛烦热不安。余谓宜急开之，脓一出，毒即解，痛
即止，诸证自退。待其自溃，不惟疼痛，溃烂愈深！彼不从，待将旬日，脓尚未出，人已痛
疲矣。虽针之，终不能收敛，竟至不起。一男子溃而瘀肉不腐，余欲取之，更以峻补。一妇
素弱，未成脓，大痛发热，余谓须隔蒜灸以拔其毒，令自消，皆不从，俱致不救。常治不问
日期阴阳、肿痛或不痛、或痛甚、但不溃者，即与灸之，随手取效。势未定者，先用箍药围
之，若用乌金膏或援生膏，点患处数点尤好。若头痛拘急，乃表证，先服人参败毒散一二剂
。如 痛发热脉数者，用金银花散，或槐花酒、神效托里散；如疼痛肿硬脉实者，以清凉饮
、仙方活命饮、苦参丸；肿硬木闷，疼痛发热，烦躁饮冷，便秘脉沉实者，内疏黄连汤或清
凉饮；大便已利，欲其作脓，用仙方活命饮、托里散、蜡矾丸，外用神异膏；如饮食少思或
不甘美，用六君子汤加藿香连进三五剂，更用雄黄解毒散洗患处；每日用乌金膏涂疮口处。
俟有疮口，即用纸作捻，蘸乌金膏， 入疮内。若有脓，为脂膜间隔不出，或作胀痛者，宜
用
，用消毒与托里药相兼服之，仍用前二膏涂贴。若腐肉已离好肉，宜速去之。如脓不稠不稀
，微有疼痛，饮食不甘，瘀肉腐迟，更用桑柴灸之，亦用托里药。若瘀肉不腐，或脓清稀，
不痛者，急服大补之剂，亦用桑木灸之，以补接阳气，解散郁毒。常观患疽，稍重未成脓
者，不用蒜灸之法，及脓熟不开，或待腐肉自去，多致不救。大抵气血壮实，或毒少轻者，
可假药力，或自腐溃。怯弱之人，热毒中隔，内外不通，不行针灸，药无全功矣。然此证若
脓已成，宜急开之，否则，重者溃通脏腑，腐烂筋骨，轻者延溃良肉，难于收功，因而不敛
多矣。
一男子年逾五十，患已五日。 肿大痛，赤晕尺余，重如负石，势炽甚。当峻攻，察其
脉又
，疮口及砭处出血水而消。大抵疮毒势甚，若用攻剂，怯弱之人必损元气，因而变证者众矣
。
一妇人半月余，尚不发起，不作脓，痛甚脉弱，隔蒜灸二十余壮而止，更服托里药，渐
溃脓清，而瘀肉不腐。以大补药，及桑柴灸之渐腐，取之而寻愈。常治一日至四五日未成脓而痛
者，灸至不痛，不痛者灸至痛。若灸而不痛，或麻木者，明灸之，毒瓦斯自然随火而散。肿硬
不作脓， 痛或不痛，或微痛，或疮头如黍者，灸之尤效。亦有数日色尚微赤，肿尚不起，
痛不甚，脓不作者，尤宜多灸，勿拘日期。更服甘温托里药，切忌寒凉之剂，或瘀血不腐，
亦用桑木灸之。若脉数发热而痛者，发于阳也，可治。脉不数不发痛者，发于阴也，难治。
不痛，最恶，不可视为常疾。此证不可不痛，不可大痛。烦闷者，不治。大抵发背、脑疽、
大疔、悬痈、脱疽、脚发之类，皆由膏粱浓味，尽力房劳，七情六淫，或丹石补药，精虚气
怯所致，非独因荣卫凝滞而生也。必灸之以拔其毒，更辨其因，及察邪在脏腑之异虚实之殊
而治之，庶无误也。
一男子初生如粟，闷痛烦渴，便秘脉数实，此毒在脏也。余谓∶“宜急疏去之，以绝其
源，
如粟。肿硬木闷烦躁，至六日，其头甚多。脉大，按之沉细，为隔蒜灸，及托里，渐起发，
尚不溃，又数剂，内外虽腐，惟筋所隔，脓不得出，致胀痛不安。余谓∶“须开之”彼不从
，后虽自穿，毒已攻深矣，亦殁。大抵发背之患，其名虽多，惟阴阳二证为要。若发一头，
或二头，其形 赤，肿高头起，疼痛发热为痈，属阳，易治。若初起一头如黍，不肿不赤，
闷痛烦躁，大渴便秘，睡语切牙，四五日间，其头不计数，其疮口各含如一粟，形似莲蓬，
故名∶“莲蓬发”。积日不溃，按之流血，至八九日，或数日，其头成片，所含之物俱出，
通结一衣，揭去又结，其口共烂为一疮，其脓内攻，色紫黯为疽，属阴，难治。脉洪滑者尚
可，沉细尤难，如此恶证，惟隔蒜灸及涂乌金膏，有效。凡人背近脊并HT ，皮里有筋一层，
患此处者，外皮虽破，其筋难溃，以致内脓不出，令人胀痛苦楚，气血转虚，变证百出，
若待自溃，多致不救，必须开之，兼以托里。常治此证，以利刀剪之，尚不能去，似此坚物
，待其自溃，不亦反伤，非血气壮实者，未见其能自溃也。
一男子年逾五十患此，色紫肿痛，外皮将溃，寝食不安，神思甚疲，用桑柴灸患处，出
黑血
退
表，若专于攻毒，则胃气先损，反致误事。
一妇人发热致痛，专服降火败毒药，溃后尤甚，烦躁时嗽，小便如淋，皆恶证候。辞不
治，
中见恶证者不救，实中无恶者，自愈。此证虽云属火，未有不由阴虚而致者，故经云∶督脉
经虚，从脑而出；膀胱经虚，从背而出。岂可专泥于火。又赵太守患此，肿坚不泽，疮头如
粟，脉洪大，按之则涩。经云∶骨髓不枯，脏腑不败者，可治。然肿硬色夭，坚如牛领之皮
，脉更涩，此精气已绝矣，不治亦死。
附方
隔蒜灸法 治一切疮毒大痛，或不痛，或麻木，如痛者，灸至不痛。不痛者，灸
至痛，
，安疮头上，用艾壮于蒜上灸之二壮，换蒜复灸未成者即溃，已成者亦杀其大势，不能为害
。如疮大，用蒜捣烂摊患处，将艾铺上烧之，蒜败更换。如不痛，或不作脓，及不发起，或
阴疮，尤宜多灸。灸而仍不痛，不作脓，不起发者，不治。此气血虚极也。
内疏黄连汤
内托复煎散（二方见肿疡门）
黄连解毒汤（方见作呕门）
仙方活命饮 治一切疮疡，未作脓者内消，已成脓者即溃。又排脓止痛，消毒
之圣药也。
穿山甲（用蛤粉炒黄色） 甘草节 防风 没药 赤芍药 白芷 当归尾 乳香（各一钱）
天
同入瓶内，纸糊瓶口，弗令泄气，漫火煎数沸，去渣。分病在上下，食前后服之。能饮酒者
，再饮三二杯尤好。
偈曰∶“真人妙诀世间稀，一切痈疽总可医，消毒如同汤沃雪，化脓立见肉生肌。”
托里消毒散（方见肿疡门）
清心汤 治疮疡肿痛，发热饮冷，脉沉实，睡语不宁。即防风通圣散，每料加黄
连五钱，每剂一两，水二钟，煎八分服（方见天泡疮门。）
破棺丹 治疮疡热极，汗多大渴，便秘谵语，或发狂结阳之证。
大黄（二两五钱，半生半熟） 芒硝 甘草（各二两） 为末，炼蜜为丸，如弹子大。每服
一丸，食后，童便酒化下，白汤化服亦可。
十宣散 治疮疡，脉缓涩，身倦怠，恶寒，或脉弦，或紧细者，皆宜用之。散风
寒，助阳气也。
人参 当归（酒拌） 黄 （盐水拌炒，各一钱） 甘草（炙） 白芷 川芎 桔梗（炒，各一
钱） 浓朴（姜制，五分） 防风 肉桂（各三钱） 作一剂，水二钟，煎八分服。
箍药 治发背毒甚，胤走不住，此药围之而解。
芙蓉叶 白芷 大黄 白芨 山慈菇 寒水石（ ） 苍耳草 黄柏（炒，各等分） 各另
为末，用水调搽四围中，如干，以水润之。
乌金膏 解一切疮毒，及腐化瘀肉，最能推陈致新。用巴豆一味，去壳炒焦，研
如膏，
调稀可用。若余毒深伏，不能收敛者，宜用此 之，不致成痛。
援生膏 治一切恶疮，及瘰 初起，点破虽未全消，亦得以杀其毒。
轻粉（三钱） 乳香 没药 血竭（各一钱） 蟾酥（三钱） 麝香（五分） 雄黄（五钱） 用
荞麦
备日久药干添用。取二碗，盛于瓷器内，将前药碾为极细末，入灰汤内，用铁干或柳枝顺搅
，再入好细锻石一升，再搅匀，过一宿，却分于小碗收贮。凡遇诸恶疮，点当头一二点，一
日换二次，次日，又一次，须出血水为妙。如药干，却加所存灰汤少许调之。
人参败毒散（方见溃疡发热门）
神功散 治疮疡，不问阴阳肿溃并效。
黄柏（炒） 川乌（炮） 另为末，各等分，用唾津调敷患处，并涂疮口。一道人不问阴阳
肿溃，虚实痛否，此药用漱口水调搽，不留疮头，日易之，内服仙方活命饮，甚效。
金银花散（方见作呕门）
槐花酒 治发背及一切疮毒，不问已成未成，但 痛者，并治之。用槐花四五两
，微炒
，肠风痔漏，诸疮作痛，尤效。
神功托里散 治痈疽发背，肠痈乳痈，及一切肿毒，或 痛，增寒壮热。
黄 （盐水拌炒） 忍冬叶（即金银花） 当归 粉草（一钱） 作一剂，用酒水各一钟，煎
至一
。为末，酒调服，尤效。
清凉饮 治积热疮疡，烦躁饮冷， 痛脉实，大便闭结，小便赤涩。
大黄（炒） 赤芍药 当归 甘草（各二钱） 作一剂，用水二钟，煎八分，食前服。
苦参丸 治一切痈疽疮毒， 痛作渴，或烦躁。用苦参，不拘多少，为末。上用
水糊为丸，如梧桐子大，每服二三钱，温酒下。
托里散（方见肿疡门）
蜡矾丸 治一切痈疽，托里，止疼痛，护脏腑，神妙。不问老幼，皆可服之。
黄蜡（一两，黄色好者，溶开，离火，入矾末。一方用七钱） 白矾（一两，明亮好者，
研末）
二服。
神异膏（方见杨梅疮门）
六君子汤（方见作呕门）
雄黄解毒散 治一切痈肿溃烂，毒势甚者先用此药二三次，以后用猪蹄汤。
雄黄（一两） 白矾（四两） 寒水石（ ，一两半） 用滚水二三碗，乘势入前药末一两，
洗患处，以太乙膏或神异膏贴之。
猪蹄汤 治一切痈疽，消肿毒，去恶肉，润疮口，止痛。
白芷 黄芩 当归 羌活 赤芍药 露蜂房（蜂儿多者佳） 生甘草（各五钱） 用猪蹄一
只，水四五碗，煮熟去油渣，取清汤，入前药，煎数沸，去渣，温洗，随用前膏药贴之。
桑木灸法（方见溃疡门）
Pain, or lack of pain accompanied by numbness, indicates an excess of pathogenic factors; garlic-partitioned moxibustion should be applied. For those without pain, moxa should be applied until pain arises; for those with pain, until it ceases. The toxin will dissipate and be expelled along with the fire's heat. If pain is accompanied by irritability or dry throat, indicating fire in the upper jiao, purgation is appropriate. If swelling and pain occur, or suppuration fails to form, due to pathogenic stagnation, resolution is indicated. If swelling and pain are accompanied by a desire for cold drinks, fever, and somniloquy, indicating excessive fire, clearing heat is appropriate. If suppuration fails to form, or wounds fail to heal after rupture, due to deficiency of yang qi, tonification is indicated. If necrotic tissue does not slough off, or accumulated toxins remain unresolved, due to deficiency of yang qi, supporting yang qi is indicated. If pus is abundant yet thin, indicating dual deficiency of qi and blood, vigorous tonification is required. If the pulse is floating, large, or choppy, with slow muscle regeneration, indicating dual deficiency of qi and blood, tonification is indicated. If the right guan pulse (reflecting spleen and stomach) is weak, with slow muscle regeneration, strengthening the spleen and stomach is indicated.
A male patient suffered severe pain from this condition; after taking detoxifying herbs, his symptoms worsened. I treated him with garlic-partitioned moxibustion, which stopped the pain, followed by Xianfang Huoming Yin (Immortal Life Elixir), two doses of which rapidly reduced the symptoms. Subsequently, he was given Toli herbs (internal support formulas) to promote suppuration and healing.
A male patient had been ill for four days; the sore head was like a millet seed, with heavy back pain and a deep, solid pulse. He was given Huanglian Neishu Tang (Coptis Internal Purging Decoction); after two doses, symptoms slightly improved. Then, Xianfang Huoming Yin was administered, and after two doses, the swelling subsided.
A male patient presented with swelling and pain, and a floating, rapid pulse. He was given Neituo Fujian San (Internal Support Double-Boiled Powder); after two doses, symptoms slightly improved. Then, Xianfang Huoming Yin was administered, and after four doses, pain ceased and suppuration occurred. Further treatment with Toli herbs led to recovery.
A female patient presented with fever, irritability, and a desire for cold drinks. She was given Huanglian Jiedu Tang (Coptis Detoxification Decoction); after four doses, she slightly improved. Then, Tuoli Xiaodu San (Internal Support and Detoxification Powder) was given to promote suppuration, followed by Toli herbs to promote wound contraction.
A male patient suffered from extremely intense toxic heat and unbearable pain; various medications were ineffective. I prescribed Xianfang Huoming Yin; after two doses, all symptoms subsided. After another two doses, suppuration occurred. He was then treated with Jinyinhua San (Honeysuckle Powder) for six doses and recovered.
A female patient presented with swelling, pain, fever, and somniloquy with a large pulse. Qingxin Tang (Clear Heart Decoction) was administered; after one dose, she stabilized. Subsequently, Jinyinhua (Honeysuckle), Gancao (Licorice), Tianguafen (Trichosanthes Root), Danggui (Angelica Sinensis), Gualou (Trichosanthes Fruit), and Huangqin (Scutellaria) were used; after several doses, gradual suppuration occurred, and she recovered with Toli herbs.
A male patient’s necrotic tissue was gradually sloughing off, but pus was scant and thin, and he had no taste for food. Shixuan San (Ten-Accumulation Powder) was used, with Baizhi (Angelica Dahurica) and Fangfeng (Saposhnikovia) removed, and Fuling (Poria), Baizhu (Atractylodes Macrocephala), and Chenpi (Tangerine Peel) added. After more than a month, the wound contracted.
A male patient had nearly recovered, except for one non-healing sore. His pulse was floating and choppy. Shiquan Dabu Tang (Complete Great Tonifying Decoction) was prescribed, leading to recovery.
A male patient was nearing recovery, but muscle growth was slow. Examination revealed dual deficiency of the spleen and stomach. Liujunzi Tang (Six-Gentlemen Decoction) plus Chuanxiong (Ligusticum), Danggui, Wuweizi (Schisandra), and Huangqi (Astragalus) was prescribed, leading to recovery.
A male patient had recovered, except for one eye-like sore protruding with fungal-like flesh that persisted for three months; this was caused by wind-cold injury. Fresh pork lard mixed with Lili powder was applied topically, resulting in immediate cure. In cases where flesh protrudes up to three inches, this remedy is especially suitable. Smearing with Wumei (Mume Fruit) is also effective; sulfur powder can also be used.
A male patient suffered from back toxicity, with pain, desire for cold drinks, fever, profuse sweating, constipation, and delirium. Po Guan Dan (Coffin-Breaking Pill) was administered; two pills brought calm. Jinyinhua San was then given for four doses to promote pus discharge, leading to recovery.
Regarding back carbuncles, although they present with fever, pain, high severity, irritability, thirst, and a forceful pulse with good appetite—indicating a favorable prognosis where symptoms subside once pus drains—many cases suffer from pain because pus cannot drain externally. Using cold, detoxifying herbs to attack the pathology at this stage is counterproductive. If pus has formed, immediate needle drainage is required; once pus flows, suffering ceases. If pus has not formed and pain is due to heat-toxin, detoxifying herbs should be used. Even if necrosis extends over a chi, if there are no malignant signs, major tonifying agents facilitate easy muscle growth without harm. However, if swelling is low, color is not red, there is no pain, the pulse is weak, appetite is poor, the swelling does not suppurate, necrotic tissue does not rot, pus is clear or excessive, and muscle does not grow, this indicates deficiency of primordial qi. These are difficult to treat and require vigorous tonification. If, after pus and blood have drained, swelling and pain worsen, pus becomes foul-smelling, irritability and coughing occur, abdominal pain and severe thirst arise, diarrhea is uncontrollable, and urination resembles strangury, these are malignant signs indicating untreatable conditions.
A frail female patient had external skin necrosis but internal pus had not drained, causing distending pain, irritability, and restlessness. I advised urgent incision; once pus drained, the toxin would resolve, pain cease, and symptoms subside. Waiting for spontaneous rupture would only deepen the ulceration. She refused; ten days later, pus had not emerged, and she was exhausted from pain. Although later punctured, the wound failed to contract, and she died. A male patient had ruptured with non-sloughing necrotic tissue; I intended to remove it and apply vigorous tonics. A frail female patient had severe pain and fever before suppuration; I advised garlic-partitioned moxibustion to draw out toxin and allow natural resolution. Both refused and died. Generally, for any non-suppurating sore regardless of duration, yin-yang nature, or pain level, immediate moxibustion yields quick results. For indeterminate conditions, encircling pastes (Gu Yao) such as Wujin Gao (Black Gold Ointment) or Yuansheng Gao (Life-Supporting Ointment) applied to key points are beneficial. If headache and stiffness indicate exterior syndrome, Renshen Baidu San (Ginseng Rescue the Damaged Powder) should be taken first. If pain, fever, and rapid pulse occur, Jinyinhua San, Huaihua Jiu (Sophora Flower Wine), or Shenxiao Tuoli San (Miraculous Internal Support Powder) are used. If pain, hardness, and solid pulse occur, Qingliang Yin (Cooling Drink), Xianfang Huoming Yin, or Kushen Wan (Kushen Pills) are used. If swelling is hard and numb, with pain, fever, irritability, cold drink preference, constipation, and deep-solid pulse, Neishu Huanglian Tang or Qingliang Yin are used. If bowels are open and suppuration is desired, Xianfang Huoming Yin, Tuoli San, or Lafan Wan (Beeswax Alum Pill) are used, with Shenyi Gao applied externally. If appetite is poor or food tastes bland, Liujunzi Tang plus Huoxiang (Patchouli) is taken for three to five doses, followed by Xionghuang Jiedu San (Realgar Detoxification Powder) wash. Wujin Gao is applied daily to the wound. Once a cavity exists, paper wicks dipped in Wujin Gao are inserted. If pus is trapped by fatty membranes causing distension, ... [text missing] ... detoxifying and Toli herbs are combined, and the aforementioned ointments are applied. If necrotic tissue separates from healthy flesh, it should be removed promptly. If pus is neither thick nor thin, with mild pain, poor appetite, and slow necrosis, Sangchai Moxibustion (Mulberry Stick Moxa) and Toli herbs are used. If necrotic tissue does not slough, or pus is clear/thin and painless, major tonifying agents and mulberry stick moxibustion are urgently employed to restore yang qi and disperse stagnant toxin. Observations show that serious non-suppurating carbuncles often fail to heal if garlic moxibustion is omitted, or if rupture is delayed waiting for natural sloughing. Generally, robust individuals or those with mild toxins may heal via medication or spontaneously. Frail individuals with blocked heat-toxin require acupuncture/moxibustion alongside medication for success. If pus forms, urgent incision is necessary; otherwise, severe cases penetrate organs and rot bone, while mild cases destroy healthy flesh, leading to failure to heal.
A male patient over fifty years old had been ill for five days. Swelling was large and painful, with a red halo over a chi wide, and back heaviness like carrying a stone. The condition was severe. Although aggressive treatment was indicated, examination of the pulse suggested caution... [text missing]. Bleeding from the sore and pricking sites resolved the swelling. Generally, for severe carbuncles, attacking agents damage the qi of frail patients, leading to many complications.
A female patient had been ill for over half a month without elevation or suppuration, with severe pain and a weak pulse. Garlic-partitioned moxibustion (over twenty cones) was applied, followed by Toli herbs. Gradual suppuration occurred with thin pus and non-sloughing necrotic tissue. Major tonifying agents and mulberry stick moxibustion promoted sloughing, leading to quick recovery. Generally, for pain occurring within one to four days before suppuration, moxibustion is applied until pain ceases, or until pain arises if absent. If moxibustion yields no pain or numbness, strong moxibustion disperses the toxin. For hard swelling without suppuration, with pain or numbness, or millet-seed-like heads, moxibustion is highly effective. Even if redness is slight, swelling is flat, pain is mild, and no pus forms after several days, frequent moxibustion is advised without rigid adherence to timing. Sweet-warm Toli herbs should be taken; cold/clearing herbs are contraindicated. If blood stasis does not slough, mulberry stick moxibustion is used. If pulse is rapid with fever and pain, it is Yang onset (treatable). If pulse is not rapid and painless, it is Yin onset (difficult). Painlessness is most ominous and should not be dismissed as minor. This condition should not be painless, nor excessively painful. Irritability indicates untreatability. Generally, back carbuncles, brain furuncles, large ding sores, perineal abscesses, toe gangrene, and leg carbuncles result from rich diets, sexual excess, emotional/external pathogens, or mineral tonics causing essence/qi deficiency, not merely Ying-Wei stagnation. Moxibustion must be used to draw out toxin, etiology identified, and organ/pathogen differentiation made between deficiency and excess to avoid error.
A male patient initially presented with a millet-sized sore, stifling pain, irritability, thirst, constipation, and rapid-solid pulse, indicating toxin in the Zang organs. I stated: "Urgent purging is needed to cut off the source."
[Missing text regarding progression] ... Like a millet seed. Hard swelling, numbness, irritability progressed to numerous heads by day six. Pulse was large but deep-fine on pressure. Garlic-partitioned moxibustion and Toli therapy promoted elevation, but no suppuration. After several more doses, internal/external tissue rotted, but tendons blocked pus drainage, causing distending pain. I advised incision; he refused. Spontaneous rupture occurred later, but toxin had penetrated deeply, leading to death. Generally, back carbuncles vary in name but are categorized into Yin and Yang syndromes. Single or double heads, red, swollen, elevated, painful, febrile are Yang Abscesses (Yong), easily treated. Initial single millet-head, non-swollen, non-red, stifling pain, irritability, extreme thirst, constipation, somniloquy, teeth-grinding, multiplying heads over 4-5 days, each containing a millet-like core, resembling a lotus pod, is named "Lotus Pod Carbuncle" (Lianpeng Fa). If unruptured after days, pressing bleeds. By day 8-9, heads merge into a sheet, releasing contents, forming a unified membrane that reforms when peeled, eventually rotting into one large sore with internal-penetrating purple-dark pus, this is Yin Carbuncle (Ju), difficult to treat. Floating-slippery pulse is manageable; deep-fine is very difficult. For such malignant signs, garlic-partitioned moxibustion and Wujin Gao application are effective. Near the spine and [missing text], a tendon layer exists under the skin. Lesions here resist external rupture despite skin breakage, trapping internal pus, causing distension/pain, qi-blood deficiency, and complications. Waiting for spontaneous rupture often leads to death; incision and Toli therapy are mandatory. Even sharp knives may fail to remove hardened tissue; waiting for spontaneous rupture causes further injury unless qi-blood is robust.
A male patient over fifty presented with purple, swollen, painful skin nearing rupture, insomnia, and mental fatigue. Mulberry stick moxibustion was applied to the site, draining black blood and reducing symptoms.
[Missing text regarding exterior] ... If one focuses solely on detoxification, stomach qi is damaged first, causing errors.
A female patient developed pain from fever, taking only cooling/detoxifying herbs. Post-rupture, symptoms worsened with irritability, coughing, and strangury-like urination—all malignant signs. Treatment was declined.
[Missing text] ... Malignant signs indicate untreatability; excess patterns without malignant signs self-resolve. Although this condition is attributed to fire, it invariably stems from yin deficiency. Classics state: Deficiency of Du Mai channel leads to emergence from the brain; deficiency of Bladder Mai channel leads to emergence from the back. One cannot rigidly attribute it only to fire. Governor Zhao suffered from this: hard, non-lustrous swelling, millet-like heads, large pulse becoming choppy on pressure. Classics state: If marrow is not枯竭 and organs intact, it is treatable. However, hard/swollen, sallow color, hardness like ox neck skin, and choppy pulse indicate exhaustion of essence/qi; untreatable and fatal.
Attached Formulas
Garlic-Partitioned Moxibustion Method: Treats all carbuncles/toxins with severe pain, no pain, or numbness. Apply moxa on garlic placed on the sore. Two cones per garlic slice; replace garlic as needed. For large sores, spread crushed garlic on the area, place moxa on top, replace when garlic spoils. Especially suitable for painless, non-suppurating, non-elevating, or yin-type sores. If still painless/non-suppurating/non-elevating after moxibustion, it indicates extreme qi-blood deficiency and is untreatable.
Neishu Huanglian Tang (See Swelling Section)
Neituo Fujian San (See Swelling Section)
Huanglian Jiedu Tang (See Vomiting Section)
Xianfang Huoming Yin (Immortal Life Elixir): Treats all sores/ulcers. Dissolves internally if unsuppurated; promotes rupture if suppurated. It is the sacred medicine for draining pus, stopping pain, and detoxifying.
Ingredients: Schist (穿山甲, stir-fried with clam powder), Licorice Joint (Gancao Jie), Saposhnikovia (Fangfeng), Myrrh (Moyao), Red Peony Root (Chishaoyao), Angelica Dahurica (Baizhi), Angelica Sinensis Tail (Danggui Wei), Frankincense (Ruxiang) — each 1 qian. Tian... [Text Missing]. Place in a bottle, seal with paper, simmer slowly for a few boils, strain. Take according to lesion location and meal timing. Alcohol consumption enhances efficacy.
Verse: "The True Man's secret is rare in the world, All carbuncles and sores can be cured. Detoxification is like snow melting in hot water, Pus resolves instantly, flesh regenerates."
Tuoli Xiaodu San (See Swelling Section)
Qingxin Tang (Clear Heart Decoction): Treats sore swelling/pain, fever with cold drink desire, deep-solid pulse, somniloquy/restlessness. Based on Fangfeng Tongsheng San, add 5 qian Coptis (Huanglian) per portion, 1 liang per dose. Boil 2 zhong water to 0.8 zhong. (See Blister Sore Section).
Po Guan Dan (Coffin-Breaking Pill): Treats extreme heat in sores, profuse sweating, extreme thirst, constipation, delirium, or manic Yang-binding syndromes.
Ingredients: Rhubarb (Dahuang, 2.5 liang, half raw/half cooked), Mirabilite (Mangxiao), Licorice (Gancao) — each 2 liang. Powder, honey-pill size of a bullet. Take one pill post-meal, dissolved in child's urine and wine, or warm water.
Shixuan San (Ten-Accumulation Powder): Treats sores with slow-choppy pulse, fatigue, aversion to cold, or string-tight-thin pulse. Disperses wind-cold, supports yang qi.
Ingredients: Ginseng (Renshen), Angelica (Danggui, wine-soaked), Astragalus (Huangqi, salt-water stir-fried) — each 1 qian; Roasted Licorice (Zhi Gancao), Baizhi, Ligusticum (Chuanxiong), Platycodon (Jiegeng, stir-fried) — each 1 qian; Magnolia Bark (N Hou, ginger-processed) 0.5 qian; Saposhnikovia (Fangfeng), Cinnamon (Rougui) — each 3 qian. One dose, boil 2 zhong water to 0.8 zhong.
Encircling Paste (Gu Yao): Treats severe back carbuncles spreading uncontrollably. Apply around the lesion.
Ingredients: Hibiscus Leaf (Furong Ye), Baizhi, Rhubarb (Dahuang), Bletilla (Baiji), Fritillaria (Shancigu), Calcined Halloysite (Han Shui Shi), Xanthium Herb (Canger Cao), Phellodendron (Huangbai, stir-fried) — equal parts. Grind separately, mix with water, apply around the perimeter. Moisten if dry.
Wujin Gao (Black Gold Ointment): Resolves all toxins, sloughs necrotic tissue, promotes renewal. Use Croton Seed (Badou), shelled, stir-fried until charred, ground to paste. ... [Text Missing] ... Dilute for use. For deep-seated residual toxins preventing contraction, use this to ... [Text Missing] ... prevent pain formation.
Yuansheng Gao (Life-Supporting Ointment): Treats all malignant sores and early-stage scrofula. Pointing/breaking reduces toxicity even if not fully resolved.
Ingredients: Calomel (Qingfen) 3 qian, Frankincense (Ruxiang), Myrrh (Moyao), Dragon's Blood (Xuexue) — each 1 qian, Toad Venom (Chansu) 3 qian, Musk (Shexiang) 0.5 qian, Realgar (Xionghuang) 5 qian. Use Buckwheat ... [Text Missing] ... Prepare long-term; replenish when dry. Take two bowls, place in porcelain, grind herbs to fine powder, add ash-water, stir with iron spatula or willow branch. Add 1 sheng fine smelted lime (Duanshi), stir well, leave overnight. Divide into small bowls for storage. For malignant sores, apply 1-2 dots on the head twice daily. Next day, apply again; bleeding fluid is ideal. If dry, add stored ash-water.
Renshen Baidu San (See Ulcer Fever Section)
Shengong San: Treats sores, effective for all yin/yang, swelling/rupture.
Ingredients: Stir-fried Phellodendron (Huangbai), Processed Aconite (Chuanwu) — grind separately, equal parts. Mix with saliva, apply to lesion and wound. A Daoist priest used this with mouthwash for all sores regardless of yin/yang or deficiency/excess, changing daily, combined with internal Xianfang Huoming Yin, very effective.
Jinyinhua San (See Vomiting Section)
Huaihua Jiu (Sophora Flower Wine): Treats back carbuncles and all toxins, whether suppurated or not, especially for ... [Text Missing] ... pain. Use 4-5 liang Sophora flowers (Huaihua), lightly stir-fried ... [Text Missing] ... Effective for intestinal wind, hemorrhoids, and painful sores.
Shengong Tuoli San (Miraculous Internal Support Powder): Treats carbuncles/back sores, intestinal abscesses, breast abscesses, and all swelling/toxins, or ... [Text Missing] ... pain, chills, and high fever.
Ingredients: Salt-water stir-fried Astragalus (Huangqi), Honeysuckle Leaf (Ren Dong Ye/Jinyinhua), Angelica (Danggui), Licorice (Fencao) 1 qian. One dose, boil 1 zhong wine + 1 zhong water to ... [Text Missing]. Grind, take with wine, very effective.
Qingliang Yin (Cooling Drink): Treats heat-accumulation sores, irritability, cold drink desire, ... [Text Missing] ... pain, solid pulse, constipation, dark/scanty urine.
Ingredients: Stir-fried Rhubarb (Dahuang), Red Peony (Chishaoyao), Angelica (Danggui), Licorice (Gancao) — each 2 qian. One dose, boil 2 zhong water to 0.8 zhong, take before meals.
Kushen Wan (Kushen Pills): Treats all carbuncles/toxins, ... [Text Missing] ... pain, thirst, or irritability. Use Kushen (Sophora root), any amount, grind to powder. Mix with water/paste to make pills sized like paulownia seeds. Take 2-3 qian with warm wine.
Tuoli San (See Swelling Section)
Lafan Wan (Beeswax Alum Pill): Treats all carbuncles, supports interior, stops pain, protects organs. Effective for all ages.
Ingredients: Beeswax (Huangla) 1 liang (yellow quality, melted off heat, add alum powder; alternative 7 qian), White Alum (Bai Fan) 1 liang (bright quality, powdered). ... [Text Missing] ... Two doses.
Shenyi Gao (See Yaws Section)
Liujunzi Tang (See Vomiting Section)
Xionghuang Jiedu San (Realgar Detoxification Powder): Treats all suppurating/ulcerated sores with severe toxin. Use 2-3 times initially, then Zhu Ti Tang.
Ingredients: Realgar (Xionghuang) 1 liang, White Alum (Bai Fan) 4 liang, Calcined Halloysite (Han Shui Shi, calcined) 1.5 liang. Pour 2-3 bowls boiling water, add 1 liang herb powder, wash lesion, cover with Taiyi Gao or Shenyi Gao.
Zhu Ti Tang (Pig Trotter Soup): Treats all carbuncles, reduces swelling/toxin, removes bad flesh, moistens wounds, stops pain.
Ingredients: Baizhi, Scutellaria (Huang Qin), Angelica (Danggui), Notopterygium (Qianghuo), Red Peony (Chishaoyao), Honeycomb (Lufengfang, preferred with larvae), Raw Licorice (Sheng Gancao) — each 5 qian. Boil one pig trotter in 4-5 bowls water, remove oil/residue, take clear soup. Add herbs, boil briefly, strain, wash warm, then apply aforementioned ointments.
Sangchai Moxibustion Method (See Ulcer Section)