夏氏 暑月孕后，小水赤涩，子户痒甚，日晡寒热。此由胞宫虚，感受湿热也。内用龙胆泻肝汤，加
赤苓、灯心煎服。外用蛇床子、川椒、白矾、煎汤熏洗。再用杏仁、雄黄、朝脑研末，掺入户内愈。
姜氏 孕六月，湿袭子户，小水淋沥作痒，用茅术（生）、五加皮、苦参、当归、蛇床子、川椒，煎汤
熏洗，内服导赤散加滑石，愈。
王氏 产后气虚阴脱，两尺空。用补中汤去柴胡，加菟丝子、杜仲、芡实，外用龙骨、牡蛎（俱研细）
托之。
孔氏 阴挺时流脓水，脉虚涩。内服补阴益气煎加白芍，外用川芎、当归、白芷、熟矾、银花、甘草，
煎汤熏洗，拭干，用五倍子研末掺之。
唐氏 数年经闭，阴疮内溃，晡热食减，头眩口干，肢痛便燥，身面俱发丹毒红晕。据述为根据夫疳毒所染，
内服加味四物汤，添金银花、甘草、嫩桑枝。外用忍冬藤、鱼腥草、甘草、苦参，煎汤熏洗，拭干，用海螵蛸、
人中白、冰片，名螵蛸散掺之。数次热痛减，红晕消，改加味逍遥散去术，加生熟地黄、麦冬等服，又用青黛、
黄柏（研面）、山栀、薄荷（俱研）、麻油调搽。
经云∶诸痛痒疮，皆属于心。疮者痈疽之总名，凡红肿 热称痈，痈发六腑，为阳；白陷硬痛称疽，
疽生五脏，为阴。痈发速而疽起迟，疽根深而痈毒浅。总因气血凝结，经络阻滞而成。疖则痈毒之小焉者也。
古云∶阴滞于阳则发痈，阳滞于阴则发疽。脉浮洪滑数为阳，沉小涩迟为阴。亦有似阳不甚 赤，似阴不甚
木硬，漫肿微痛，此为半阴半阳症。凡寒热肿痛，如风邪内作，
无头无根；时毒漫肿，无头有根；气血交搏，有头有根。血与气壅则成肿，血为毒胜则成脓；毒为寒凝则平陷，
络为痰滞则结核。肿高而软者，发于血脉；陷下而坚者，发于筋骨；平漫色黯者，发于骨髓。宜分气血虚实，
毒势浅深轻重为治。疮根大而牢者深，盘小而浮者浅；初起恶寒壮热，拘急烦躁者重。起居如常，饮食知味
者轻；头如粟米，发如莲蓬者重；一头 赤，肿高知痛者轻。
凡肿疡主治，初起热甚 痛，宜清凉消散。真人活命饮，或金银花酒。若见表症，寒热往来，宜疏邪，
荆防败毒散。无表里症， 肿有头，宜和解兼消，清热消风散去 、术。里实便秘，宜疏通，内疏黄连汤。
若表里不实，内热口渴，宜生津，竹叶石膏汤。患成未消，宜化毒从小便出，内消散。若毒瓦斯内攻，呕恶烦躁
口干，宜护膜解毒，护心散、琥珀蜡矾丸。以指按患顶，陷而不高起，而不热者，脓未成也，作脓而痛，
托里消毒散。按之半软半硬者，脓未熟也，透脓散。按之随指而起，顶已软而热甚者，脓已熟也，针以泄之。
无脓仍宜消散，醒消丸。有脓勿令久留，代刀散。敷肿疡热毒，用如意金黄散，贴用五龙膏。其散漫未作脓者，
敷用真君妙贴散，或妙贴散，留顶以泄毒。溃疡主治，脓将成而根盘散漫者，气虚不能束血紧附也。内服托
里养营汤，外敷铁桶膏。红活而润者，气血化毒外出也，外红里黑者，毒滞于内也，托里消毒散。紫黯不明者，
气血未充不能化毒成脓也，托里散，或托里黄 汤。疮口久不敛者，气血两虚也，参 托里散，八珍汤。
口不敛，肌不生者，脾气虚也，四君子汤加白芍、木香。溃后反痛者，亦虚也，内补黄 汤，外敷乳香定痛散。
如气虚作痛，四君子汤加归 。血虚作痛，四物汤加参 。肾水虚作痛，六味地黄汤。已溃脉虚数 痛，营
分热也，宜滋阴。四物汤，生熟地黄并用，加地骨皮、银花。已溃作渴便秘者，胃火炽也，宜滋液。竹叶石
膏汤。溃后腐肉不化者，阳虚气陷也，宜温托。四君子汤加黄 、肉桂。凡毒发阴分，平漫木硬，不甚肿痛
者，乃由痰气阴寒，非阳和通腠，不能解其冰凝；营血枯衰，非温畅滋阴，何由浓其脓汁。如阳和汤，以麻
黄开腠，以白芥子理痰，以熟地、鹿胶和阴阳。以姜、桂解寒凝。盖毒以寒凝，温散
则毒自化；脓由气血，温托而脓乃成。如人参养营汤、十全大补汤。若清凉之剂，止可施于红肿痈疖而已。
其有呕逆者，不可泥于毒瓦斯内攻，概用败毒等散。有寒凉药，伤胃致呕者，宜托里温中汤。倘误用攻毒，则
内陷者不能外溃矣。其半阴半阳，似肿非肿，欲溃不溃，因元气失于补托，宜冲和汤，补而兼散可也。其脓熟
不溃，以替针丸涂疮头，脓自出。若脓未流利，用针于纹中引之，以线药纫之。脓出仍肿痛，或为筋膜间隔，
亦用针引，纫以线药。倘刀针割伤，疮口不合，用猪蹄汤洗敷，贴神异膏，服内托黄 丸，则疮口敛。溃后
血自出，四物汤加山栀、丹皮。溃后真阴亏，虚火炎，发热作渴，急用加减八味丸，或五味子汤。溃后发热，
烦躁不寐，血虚也，圣愈汤。自汗不止，气虚也，四君子汤加黄 、五味。发热烦扰，筋惕肉 ，气血虚也，八
珍汤。大渴面赤，脉浮洪，阴虚发热也，当归补血汤。烦扰面赤，脉沉微，阴盛发躁也，四君姜附汤。其溃
后便泻，有因胃伤寒凉不化者，六君子汤加神曲、干姜。有因脾气虚弱失运者，六君子汤送二神丸。有因脾胃
两虚，食少无味，呕泻者，八仙糕。有因气虚下陷者，补中益气汤送二神丸。有因脾肾虚寒者，参附汤送二神
丸。凡一切溃烂诸疮，宜贴贝叶膏，掺腐尽生肌散。溃烂红肿热痛，掺生肌定痛散，或轻乳生肌散。盖腐去则
新生，然必毒瓦斯已尽，方用生肌药。若太早，则患更腐溃。如果毒尽而脾气壮，则肌肉自生，以脾主肌肉也。
如欲腐脱肌生，宜贴绛珠膏。生肌通用，宜搽玉红膏，外以太乙膏盖之。梅疮、杖疮、 疮、下疳等症，去腐
生新，宜贴莹珠膏。新肉已满，不能生皮，宜月白珍珠散掺之。
Ms. Xia, during the summer months after becoming pregnant, experienced dark and scanty urine with dysuria, severe itching of the vulva, and alternating chills and fever in the late afternoon. This was caused by deficiency of the uterus (Zigong) and contraction of damp-heat pathogens. Internally, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) was administered with added Chifuling (Polyporus with Red Mycelium) and Dengxincao (Juncus Effusus), decocted and taken orally. Externally, Chuangzi (Cnidium Fruit), Chuanjiao (Sichuan Pepper), and Baifan (Alum) were decocted for fumigation and washing. Subsequently, Xingren (Apricot Seed), Xionghuang (Realgar), and Chaonao (Borneol) were ground into powder and applied inside the vagina until cured.
Ms. Jiang, at six months of pregnancy, had dampness invading the vulva, resulting in dribbling urine accompanied by itching. Sheng Cangzhu (Raw Atractylodes Rhizome), Wujia Pi (Acanthopanax Bark), Kushen (Sophora Root), Danggui (Angelica Sinensis), Chuangzi (Cnidium Fruit), and Chuanjiao (Sichuan Pepper) were decocted for external fumigation and washing. Internally, Daochi San (Guide Out the Red Powder) with Huashi (Talcum) was administered, leading to recovery.
Ms. Wang, postpartum, suffered from Qi deficiency causing uterine prolapse (Yinting), with empty pulses at both Chi positions. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) without Chaihu (Bupleurum Root) was used, supplemented with Tusizi (Cuscuta Seed), Duzhong (Eucommia Bark), and Qianshi (Euryale Seed). Externally, Longgu (Fossilized Bone) and Muli (Oyster Shell), both finely ground, were used to support and lift the prolapsed organ.
Ms. Kong, suffering from uterine prolapse with frequent discharge of purulent fluid, presented with a deficient and choppy pulse. Internally, Buyin Yiqi Jian (Decoction for Tonifying Yin and Augmenting Qi) with Baishao (White Peony Root) was administered. Externally, Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Baizhi (Angelica Dahurica), Shufan (Calcined Alum), Jinyinhua (Honeysuckle Flower), and Gancao (Licorice Root) were decocted for fumigation and washing. After drying, Wubeizi (Chinese Gall) powder was applied.
Ms. Tang, who had amenorrhea for several years, developed an internal ulceration of a genital chancre, evening fever, reduced appetite, dizziness, dry mouth, limb pain, dry stool, and erysipelas-like red rashes on the body and face. It was reported that she contracted the toxin from her husband's chancre. Internally, Jiawei Siwu Tang (Modified Four Substances Decoction) with added Jinyinhua (Honeysuckle Flower), Gancao (Licorice Root), and Nensangzhi (Young Mulberry Twig) was prescribed. Externally, Rendongteng (Japanese Honeysuckle Vine), Yuxingcao (Houttuynia Herb), Gancao (Licorice Root), and Kushen (Sophora Root) were decocted for fumigation and washing. After drying, Piaoxiao San (Cuttlebone Powder) consisting of Haipiaoxiao (Cuttlebone), Renzhongbai (Calculus Humanis), and Bingpian (Borneol) was applied. After several treatments, heat and pain decreased, and redness subsided. The prescription was changed to Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) without Baizhu (Atractylodes Macrocephala Rhizome), adding Sheng Dihuang (Rehmannia Root), Shu Dihuang (Prepared Rehmannia Root), and Maidong (Ophiopogon Tuber). Additionally, Qingdai (Indigo Naturalis), Huangbai (Phellodendron Bark), Shanzhi (Gardenia Fruit), and Bohe (Mint Leaf), all ground into powder, were mixed with Sesame Oil for topical application.
The *Neijing* states: "All pain, itching, and sores belong to the Heart." Sores are the general term for carbuncles and ulcers. Those characterized by redness, swelling, heat, and pain are called *Yong* (Carbuncle); they arise in the Six Fu Organs and are Yang in nature. Those characterized by white discoloration, depression, hardness, and pain are called *Ju* (Ulcer); they arise in the Five Zang Organs and are Yin in nature. Carbuncles develop rapidly while ulcers develop slowly; ulcers have deep roots while carbuncle toxins are superficial. Generally, these conditions result from the coagulation of Qi and Blood and the obstruction of meridians. A boil (*Jie*) is merely a small carbuncle. Ancient texts state: "When Yin stagnates within Yang, a carbuncle develops; when Yang stagnates within Yin, an ulcer develops." Pulses that are floating, surging, slippery, and rapid indicate Yang; those that are deep, small, choppy, and slow indicate Yin. There are also cases resembling Yang but not very red, or resembling Yin but not very hard and woody, presenting as diffuse swelling with slight pain; these are classified as Half-Yin Half-Yang syndromes. Regarding cold, heat, swelling, and pain: if caused internally by Wind pathogen, there is no head and no root; if it is epidemic toxicity with diffuse swelling, there is no head but has a root; if Qi and Blood struggle, there is both a head and a root. Stagnation of Blood and Qi leads to swelling; when Blood is overcome by Toxicity, pus forms; when Toxicity is congealed by Cold, it becomes flat and depressed; when collaterals are obstructed by Phlegm, nodules form. Swelling that is high and soft arises in the Blood vessels; sinking and hard swelling arises in the sinews and bones; flat, diffuse, and dark swelling arises in the bone marrow. Treatment should distinguish between deficiency and excess of Qi and Blood, and the depth, severity, and lightness of the toxin. Deep-rooted and firm sores indicate deep pathology; shallow and floating sores indicate superficial pathology. Severe cases present initially with aversion to cold, high fever, stiffness, and irritability. Mild cases feature normal daily activities and good appetite. Cases resembling millet grains or lotus pods are severe; cases with a single red head, high swelling, and pain are mild.
For the treatment of early-stage sores (Swollen Ulcers): If heat and pain are severe at onset, use cooling and dissipating methods. Zhenren Huoming Yin (Immortal Life Decoction) or Jinyinhua Wine may be used. If exterior symptoms such as alternating chills and fever are present, disperse pathogens using Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder). If there are no exterior or interior symptoms and the swelling has a head, harmonize and dissipate using Qingre Xiaofeng San (Clear Heat and Dispel Wind Powder) without Houpo (Magnolia Bark) and Baizhu (Atractylodes Macrocephala Rhizome). For interior excess with constipation, use unblocking methods with Neishu Huanglian Tang (Internal Purging Coptis Decoction). If exterior and interior are not excess but there is internal heat and thirst, generate fluids with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). If the lesion is formed but not resolved, promote detoxification via urination using Neixiaosan (Internal Dissolving Powder). If toxic vapors attack internally, causing vomiting, nausea, irritability, and dry mouth, protect membranes and detoxify using Huxin San (Heart-Protecting Powder) or Hupo Lafan Wan (Amber and Wax Pill). Pressing the apex of the lesion: if it sinks and does not rise, and is not hot, pus has not formed; treat with tonification and detoxification using Tuoli Xiaodu San (Interior-Tonifying and Toxin-Detoxifying Powder). If half-soft and half-hard upon pressing, pus is not ripe; use Tou Nong San (Pus-Penetrating Powder). If it rises immediately upon pressing, the apex is soft, and heat is intense, pus is ripe; puncture to drain. If no pus, continue dissipation using Xingxiao Wan (Awakening Dissolution Pill). Do not let pus remain long; use Daidao San (Knife-Replacement Powder). For applying to swollen ulcers with heat toxicity, use Ruyi Jinhuang San (Ruyi Golden Yellow Powder) and apply Wulong Gao (Five Dragon Ointment). For diffuse lesions without pus formation, apply Zhenjun Miaotie San (True Lord Miraculous Paste Powder) or Miaotie San, leaving the apex open to vent toxicity.
For the treatment of established ulcers (Ulcerated Sores): If pus is about to form but the base is diffuse, it indicates Qi deficiency failing to bind blood tightly. Internally, Tuoli Yangying Tang (Interior-Tonifying and Nutritive-Supporting Decoction) is taken; externally, Tie Tong Gao (Iron Bucket Ointment) is applied. If red and moist, it indicates Qi and Blood transforming toxin outward. If red outside but black inside, toxin is stagnant internally; use Tuoli Xiaodu San. If purple and dark unclear, Qi and Blood are insufficient to transform toxin into pus; use Tuoli San (Interior-Tonifying Powder) or Tuoli Huangqi Tang (Interior-Tonifying Astragalus Decoction). If the sore opening fails to heal for a long time, it indicates dual deficiency of Qi and Blood; use Renshen Huangqi Tuoli San (Ginseng and Astragalus Interior-Tonifying Powder) or Bazhen Tang (Eight Treasures Decoction). If the opening does not close and flesh does not grow, it indicates Spleen Qi deficiency; use Sijunzi Tang (Four Gentlemen Decoction) with Baishao (White Peony Root) and Muxiang (Aucklandia Root). If pain recurs after ulceration, it is also due to deficiency; internally, Neibu Huangqi Tang (Internal Replenishing Astragalus Decoction) is taken; externally, Ruxiang Dingtong San (Frankincense Pain-Stopping Powder) is applied. For pain due to Qi deficiency, use Sijunzi Tang with Danggui (Angelica Sinensis). For pain due to Blood deficiency, use Siwu Tang (Four Substances Decoction) with Renshen (Ginseng). For pain due to Kidney Water deficiency, use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). For post-ulceration with deficient, rapid pulse and pain, indicating Heat in the Ying (Nutrient) level, nourish Yin using Siwu Tang with both Sheng Dihuang (Raw Rehmannia) and Shu Dihuang (Prepared Rehmannia), plus Digupi (Dogwood Bark) and Yinhua (Honeysuckle). For post-ulceration thirst and constipation, indicating Blazing Stomach Fire, nourish fluids with Zhuye Shigao Tang. For post-ulceration where necrotic tissue does not resolve, indicating Yang deficiency and Qi sinking, warm and support using Sijunzi Tang with Huangqi (Astragalus) and Rougui (Cinnamon Bark). For toxins arising in the Yin level, presenting as flat, hard, and not severely painful/swollen, this is due to Phlegm-Qi and Yin-Cold; without warming and opening the interstices, ice-like congealment cannot be resolved; without warming, promoting, and nourishing Yin, how can pus become thick? Use Yanghe Tang (Warming Harmony Decoction): Mahuang (Ephedra) opens interstices, Baijiezi (White Mustard Seed) resolves phlegm, Shudi (Prepared Rehmannia) and Lujiao Jiao (Deer Antler Glue) harmonize Yin and Yang, Ginger and Cinnamon resolve cold congealation. Since toxins are congealed by cold, warming dispersion transforms them; since pus relies on Qi and Blood, warming support generates it. Examples include Renshen Yangying Tang (Ginseng Nutritive-Supporting Decoction) and Shiquan Dabu Tang (Ten Complete Tonifying Decoction). Cooling agents are only suitable for red, swollen carbuncles and boils. For patients with vomiting/retching, do not rigidly assume internal toxic attack and indiscriminately use detoxifying powders. If vomiting is caused by cold-natured medicines damaging the Stomach, use Tuoli Wenzhong Tang (Interior-Tonifying and Middle-Warming Decoction). Mistaken use of attacking/toxic-resolving drugs will cause internal sinking rather than external rupture. For half-Yin half-Yang cases, appearing swollen but not truly so, wanting to rupture but unable to, due to failure to tonify and support Yuan Qi, use Chonghe Tang (Harmonizing Decoction), which tonifies and disperses. For ripe pus that does not rupture, apply Tipian Wan (Needle-Replacement Pill) to the sore head for spontaneous drainage. If pus flow is not smooth, use a needle to guide along skin lines, threading with medicinal thread. If pain and swelling persist after drainage, or due to fascial septations, use needle guidance threaded with medicinal drug. If cut by knife/needle and the wound fails to close, wash and apply with Zhu Ti Tang (Pig Trotter Decoction), apply Shenyi Gao (Miraculous Ointment), and take Neituo Huangqi Wan (Interior-Supporting Astragalus Pill) to close the wound. For bleeding after ulceration, use Siwu Tang with Shanzhi (Gardenia) and Danpi (Moutan Bark). For post-ulceration True Yin deficiency with deficient fire flaring, causing fever and thirst, urgently use Jiawei Bawei Wan (Modified Eight-Ingredient Pill) or Wuweizi Tang (Schisandra Decoction). For post-ulceration fever, irritability, and insomnia, indicating Blood deficiency, use Shengyu Tang (Sage’s Rescue Decoction). For continuous spontaneous sweating, indicating Qi deficiency, use Sijunzi Tang with Huangqi (Astragalus) and Wuweizi (Schisandra Berry). For fever, irritability, muscle twitching, and tremors, indicating Qi and Blood deficiency, use Bazhen Tang (Eight Treasures Decoction). For extreme thirst, red face, and floating/surging pulse, indicating Yin deficiency with fever, use Danggui Buxue Tang (Angelica Tonifying Blood Decoction). For irritability, red face, and deep/faint pulse, indicating Yin excess with agitation, use Sijunzi Jiangfu Tang (Four Gentimens with Ginger and Aconite Decoction). For post-ulceration diarrhea due to Stomach Cold from excessive cooling herbs failing to digest, use Liujunzi Tang (Six Gentlemen Decoction) with Shenqu (Medicated Leaven) and Ganjiang (Dried Ginger). For diarrhea due to Spleen Qi weakness failing to transport, use Liujunzi Tang delivered withershens with Ershen Wan (Two Spirits Pill). For diarrhea and vomiting with poor appetite due to dual Spleen-Stomach deficiency, use Baxian Gao (Eight Immortals Cake). For diarrhea due to Qi deficiency sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) delivered with Ershen Wan. For diarrhea due to Spleen-Kidney Yang deficiency, use Shenfu Tang (Ginseng and Aconite Decoction) delivered with Ershen Wan. For all types of ulcerated sores, apply Beiye Gao (Banyan Leaf Ointment) and sprinkle Fijin Shengji San (Rot-Decayed Flesh-Growing Powder) once rot is gone. For ulcerated sores with redness, swelling, heat, and pain, sprinkle Shengji Dingtong San (Flesh-Growing Pain-Stopping Powder) or Qingru Shengji San (Light Milk Flesh-Growing Powder). Once rot is removed, new flesh grows; however, flesh-growing medicines should only be used when toxins are completely exhausted. Using them too early causes further rotting. If toxins are exhausted and Spleen Qi is strong, flesh will naturally grow because the Spleen governs muscles. To promote rot detachment and flesh growth, apply Jiangzhu Gao (Crimson Pearl Ointment). For general flesh growth, apply Yuhong Gao (Jade Red Ointment) and cover with Taiyi Gao (Supreme One Ointment). For Chancre, beating wounds, foul sores, and primary syphilis lesions, to remove rot and generate new tissue, apply Yingzhu Gao (Bright Pearl Ointment). When new flesh is full but skin cannot regenerate, sprinkle Yuebai Zhenzhu San (Moon-White Pearl Powder).