Library

Realgar (Xionghuang), Cinnabar (Zhusha), Dragon's Blood (Xuexie), Myrrh (Moyao) (each 1 qian), Musk (Shexiang) (equal parts), are ground together into powder. Take fourteen strips of cotton paper, dip them in lubricated sesame oil, ignite them, and use the flame to irradiate the sore/poison area. Keep the distance half a cun from the skin, irradiating around from the outside inward, allowing the medicinal vapor to fumigate the affected area until it feels hot. Start with three paper strips; once symptoms gradually subside, switch to applying medicated plasters. Plantago seed herb (Cheqiancao), [missing name] grass, Wulong grass, and Honeysuckle flower (Jinyinhua) (all fresh) are pounded finely together. Add aged small starch and a little refined salt, pound again into a paste, and apply frequently to the lesion, leaving the head of the sore open. Early application can resolve the swelling; late application may lead to slight ulceration. If fresh herbs are unavailable, take the roots or dried forms, grind into powder, mix with aged vinegar, and concurrently administer Baidu San (Poison-Resolving Powder), Huxin San (Heart-Protecting Powder), Huoming Yin (Life-Saving Decoction), or Shixuan San (Ten-Acupoint Resolving Powder) for better efficacy. Avoid cold/cool natured medicines.

For sores that have persisted for a long time and formed fistulas (Lou), the causes are manifold. Some arise in areas that are weak, soft, and low-lying, where Qi and blood vessels flow downward, making healing difficult; or due to deficiency and injury of Qi and blood, leading to prolonged non-healing; or because sexual intercourse was engaged in while the sore poison had not yet resolved, resulting in a fistula where a small hole continuously discharges fluid, gradually becoming an incurable condition. Use one large Aconite root (Fuzi), weighing one liang and possessing strong Qi, grind it into powder, and mix with saliva to form a cake. If the fistula opening is large, make the cake about thickness of three cash coins. Place moxa cones on the cake for moxibustion; internally administer a large dose of Shiquan Dabu Tang (Complete Great Tonifying Decoction) to assist, continuing until the hole closes. If Aconite is unavailable, use fermented soybean (Danshidouchi) pounded into a thin cake for moxibustion. If still in the stage of perforation and ulceration, with difficulty in generating flesh, and the carbuncle poison is deep-rooted with water discharging from within, use Sulfur (Liuhuang) ground into powder, mixed with wheat flour, and kneaded with crushed garlic into a cake. If the hole is large, make it three fen thick, apply moxibustion without causing pain, but ensure intense heat, totaling twenty-one moxa cones (zhuang), replacing the cake with each cone. After five days, use Cuiyun Ding (Emerald Cloud Pill) or Xinxiao Ding, inserting a small amount into the wound to remove foul flesh and promote healthy flesh growth. Then apply Shengji San (Flesh-Generating Powder) externally, and internally administer great tonifying and supporting medicines.

Acupuncture is highly valued in treating sores. If flesh has ulcerated but pus does not discharge, acupuncture is necessary, provided the depth is carefully assessed. If the skin is thin and the needle inserted too deeply, good flesh may be damaged; if the muscle is thick and the needle inserted too shallowly, pus and poison will not emerge. If blood appears first followed by pus, plug the opening with twisted cotton strips. For Osteomyelitis (Fugu Ju), Qi-toxic flowing accumulation, or internal ulceration that persists without resolving, use needles to open the area. For treating throat conditions, a triangular needle (Sanleng Zhen) should be used. For carbuncles painful with surrounding redness and swelling resembling burning, pierce with a porcelain blade (Bianshi); Gleditsia sinensis spine (Zaogao Ci) can also be used (once poison breaks and pus exits, severe cases become mild; avoid exposure to wind). For carbuncles with thin skin presenting as pepper holes or honeycomb structures, where pus and blood do not discharge, use needles to lacerate horizontally and vertically. Whenever a sore fails to rise/carry toxin, lacks pus for tonification, or has formed pus but fails to discharge, timely acupuncture is indicated, though it should not be done too early. In deficient areas near bones and tendons, acupuncture is contraindicated; however, avoiding acupuncture due to fear of pain is erroneous. Hesitating due to fear of damaging good flesh is also misguided. For sores arising in thin flesh areas with swelling about one cun high, insert the needle two fen deep; for Back Carbuncle (Fabai) swelling three to four cun high, insert the needle about one cun deep (same for Osteomyelitis). Moreover, since the flesh at the affected site is already necrotic, where is the pain? For frail individuals, or for Osteomyelitis that does not break, if delayed for a long time, pus turns into foul water and penetrates the inner membrane, inevitably leading to massive ulceration and death.