薛立斋治一男子，年逾二十，禀弱，左腿外侧患毒，三月方溃，脓水清稀，肌肉不生，以十全大
补汤加牛膝，二十余剂渐愈。更以豆豉饼灸之，月余而痊。
滁州于侍御髀胛患毒，痛甚，服消毒药，其势未减。即以槐花酒一服，其症大去。再以托里消毒
而愈。
丁兰年二十余，股内患毒，日久欲求内消。诊其脉滑数，知脓已成，且气血虚，不溃，遂刺之，
脓出作痛，以八珍汤治之少可。但脓水清稀，更以十全大补汤加炮姜、附子五分，数剂渐愈。仍服十
全大补汤，三十余剂而痊。
一僧患股内肿一块，不痛不溃，治以托药二十余剂，脓成，刺之作痛。谓肿而不溃，溃而反痛，
此气血虚甚也，宜峻补之。彼云∶痛无补法。曰∶正气不足，不可不补，补之则气化而痛邪自除。遂
以参、 、归、地、白术治之，两月而平。
一男子腿内患痈，漫肿作痛，四肢厥逆，咽喉闭塞，发寒热，诸治不效，乃邪郁筋络而然也。用五
香连翘汤一剂，诸症少退。又服之，大便行二次，诸症悉退而愈。
薛立斋治一男子，先腿痛，后四肢皆痛，游走不定，至夜益甚，服除败毒之剂，不应。其脉滑甚，
兼湿痰浊血为患。以二陈汤加苍术、羌活、桃仁、红花、牛膝、草乌，治之而愈。凡湿痰湿热，及死
血流注关节，非辛温之剂，开发腠理，流通隧道，使气行血和，焉能得愈？
上舍李通甫腿患疮作痛，少食作呕，恶寒。此痛伤胃气，用六君子汤加当归，四剂疼痛少止，饮
食加进。又以十宣散加白术、茯苓、陈皮，数剂脓成，针而出之。又以前散去防风、白芷，数剂而痊。
一老人腿患痈自溃，忽发昏瞀，脉细而微，此气血虚极也，以大补之剂而苏。
一男子患腿痛而不 肿，大小便利调和，用托里荣卫汤，数剂而消。
一男子内股患毒，肿硬痛甚，不作脓，隔蒜灸五十余壮，势退七八。以仙方活命饮，四剂而脓成。
用十宣散六剂，脓溃而愈。凡疮或大痛，或不痛，麻木，灸最良。
一男子腿内侧患痈，未作脓而肿痛，以内托黄 、柴胡，二剂少愈，又二剂而消。
一男子腿外侧患痈，漫肿大痛，以托里黄 酒煎汤，二剂少可。更以托里散数剂，溃之而愈。
一妇人腿痈，久而不愈，疮口紫陷，脓水清稀。以为虚，彼不信，乃服攻毒之剂，虚症蜂起。复
求治，令
灸以附子饼，服十全大补汤百余剂而愈。凡疮肿脓清不敛者，再或陷下，皆气血虚极也，最宜大补，
否则成败症。若更患他症，尤难治疗。
一男子腿痈内溃，针之脓出四五碗，恶寒畏食，诊脉如丝，此阳气微也。以四君子汤加炮附子一
钱，服之寒少止，又四剂而止。以六君子汤加桂，数剂饮食顿进。乃以十全大补汤及附子饼，两月而
愈。
一男子患腿痈，兼筋挛痛，脉弦紧，用五积散加黄柏、柴胡、苍术，治之而痊。
一男子腿痛，兼筋挛骨痛，脉弦紧，以大防风汤二剂，挛少愈，又二剂而肿消。但内一处尚作痛，
脉不紧，此寒邪已去，乃所滞瘀浊之物欲作脓，故痛不止。用托里药数剂，肿发起，脉滑数，乃脓已
成矣。针之，用十全大补汤，月余而安。
一男子右腿赤肿 痛，脉沉数，用当归拈痛汤，四肢反痛。乃湿毒壅遏，又况下部，药难达，非
药不对症也。遂砭患处去毒血，仍用前药，一剂顿减，又四剂而消。
丹溪诊东阳李兄子，年逾三十，形瘦肤浓，连得忧患，又因作劳过于色，忽足腿外侧 上红肿，
其大如栗。一医问其大府坚实，与承气汤，两帖不效。又一医教以大黄、朱砂、生粉草、麒麟竭，又
二三帖。半月后召视之，曰∶脉实大，事去矣。后果殁。
马铭鞠治江都尹子，九岁，患腿痈。治弥月，势渐盛。按之坚如石，幸儿气浓，可内消，用牛膝、
米仁、地榆、生地、牛蒡、银花、连翘、甘草。初剂加利药微利之，即稍宽。后两剂加汗药微汗之，
势益宽。至数剂，取穿山甲末五钱，半入煎，半调药送下。儿善饮，令一醉，自此顿消，半月地下行
矣。初一医欲开刀，遇马中止。凡外科宜以开刀为戒。（《广笔记》）
薛立斋治一男子，患腿痈，脓已成，针之出二碗许，饮以托里药一剂，大发热。更以圣愈汤，二
剂而止。翌日恶寒不食，脉细如丝，以人参一两，熟附子三片，姜、枣煎，再服而愈。但少食不寐，
更与大补黄 汤而平。
一男子腿肿发热畏寒，以补中益气汤治之。彼以为缓，乃服芩、连等药，热愈甚。复请治，与人
参养荣汤，二十余剂而溃。更以参、 、归、术、炙草、肉桂，又月余而敛。夫火之为病，当分虚实。
芩、连苦寒，能泻心肺有余之火。若老弱或饮食劳倦而发者，此为不足，当以甘温之剂治之。未尝有
实热而畏寒，虚热而喜寒者，（ 按∶二语却未然。）此其验也。
陆封公养质患腿痈，医用忍冬花、角刺、连翘、白芷、贝母、花粉、陈皮、乳香、没药，治之不
效。仲淳即前方加棉地榆、炙甘草、紫花地丁，服三四剂愈。
Xue Lizhai treated a man over twenty years old with a weak constitution who developed a toxic sore on the lateral side of his left leg. It took three months to ulcerate, producing thin and clear pus with no muscle regeneration. He was prescribed Shiquan Dabu Tang (Ten Ingredients Greatly Tonifying Decoction) with added Niuxi (Achyranthes Root). After more than twenty doses, he gradually improved. Subsequently, moxibustion using fermented soybean cakes was applied, and he recovered completely after more than a month.
Yu Shiyu from Chuzhou suffered from a toxic sore on his thigh and buttocks with severe pain. His condition did not improve after taking detoxifying herbs. A single dose of Huaihua Jiu (Sophora Flower Wine) significantly alleviated his symptoms. He was then cured by using Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder).
Ding Lan, in his early twenties, had a toxic sore inside his thigh that persisted for a long time without resolving internally. His pulse was slippery and rapid, indicating that pus had formed, but due to deficiency of Qi and Blood, it could not ulcerate spontaneously. Therefore, it was punctured. Pain occurred upon pus discharge. Treatment with Bazhen Tang (Eight Treasures Decoction) brought slight relief. However, since the pus remained thin and clear, Shiquan Dabu Tang (Ten Ingredients Greatly Tonifying Decoction) was supplemented with Paojiang (Prepared Ginger) and Fuzi (Prepared Aconite Root, 5 fen). After several doses, he gradually recovered. Continuing with Shiquan Dabu Tang for over thirty doses led to full recovery.
A monk had a swelling inside his thigh that was neither painful nor ulcerating. After more than twenty doses of herbs to support the interior and expel toxins, pus formed, and puncturing caused pain. It was explained that swelling without ulceration, or ulceration causing increased pain, indicates extreme deficiency of Qi and Blood, requiring strong tonification. The patient claimed, "Pain has no place for tonification." The physician replied, "When Zheng Qi (Upright Qi) is insufficient, tonification is essential; tonifying promotes Qi transformation, thereby eliminating pathogenic factors." Treatment with Renshen (Ginseng), Huangqi (Astragalus Root), Danggui (Angelica Sinensis), Dihuang (Rehmannia Root), and Baizhu (Atractylodes Macrocephala Rhizome) resolved the condition within two months.
A man suffered from a carbuncle on the inner side of his leg, presenting with diffuse swelling and pain, cold extremities, throat obstruction, and alternating chills and fever. Various treatments failed. This was attributed to pathogenic factors stagnating in the sinews and collaterals. One dose of Wuxiang Lianqiao Tang (Five Fragrances Forsythia Decoction) slightly relieved the symptoms. Upon further administration, resulting in two bowel movements, all symptoms disappeared, and he recovered.
Xue Lizhai treated a man who initially experienced leg pain, which later spread to all four limbs, moving unpredictably and worsening at night. Treatment with herbs to eliminate toxicity was ineffective. His pulse was very slippery, indicating pathology due to damp-phlegm and turbid blood stasis. He was treated with Erchen Tang (Two-Aged Decoction) plus Cangzhu (Atractylodes Lancea Rhizome), Qianghuo (Notopterygium Rhizome), Taoren (Peach Kernel), Honghua (Safflower), Niuxi (Achyranthes Root), and Caowu (Prepared Aconite Root), leading to recovery. For conditions involving damp-phlegm, damp-heat, or dead blood flowing into joints, only acrid-warm formulas can open the interstices, unblock the meridians, promote Qi circulation, harmonize Blood, and achieve healing.
Li Tongfu, a Shangshe (Imperial Scholar), had a painful sore on his leg, accompanied by vomiting after eating little and aversion to cold. This indicated that pain had damaged Stomach Qi. Liu Junzi Tang (Six Gentlemen Decoction) with added Danggui (Angelica Sinensis) was given for four doses, stopping the pain and improving appetite. Subsequently, Shixuan San (Ten Acupoints Powder) with Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), and Chenpi (Tangerine Peel) was administered for several doses until pus formed, which was then drained by needle. Removing Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica Root) from the previous formula and continuing treatment led to recovery.
An elderly man had an ulcerated carbuncle on his leg and suddenly became confused and dizzy with a fine and faint pulse, indicating extreme deficiency of Qi and Blood. He regained consciousness after receiving strong tonifying agents.
A man suffered from leg pain without swelling, and his urination and defecation were normal. Tuo Li Rong Wei Tang (Supporting Interior and Nourishing Defense Decoction) was used for several doses, resolving the condition.
A man had a hard, swollen, and severely painful toxic sore in his inner thigh that did not form pus. Moxibustion with garlic slices for over fifty moxa cones reduced the severity by seventy to eighty percent. Xianfang Huoming Yin (Immortal Formula for Preserving Life Decoction) for four doses promoted pus formation. Ten doses of Shixuan San (Ten Acupoints Powder) led to ulceration and recovery. For sores, whether painful or painless, numb, moxibustion is most beneficial.
A man had a carbuncle on the inner side of his leg, presenting with swelling, pain, and no pus yet. Neituo Huangqi (Internal Support Astragalus) and Chaihu (Bupleurum Root) were used. After two doses, there was slight improvement, and after another two doses, the swelling subsided.
A man had a carbuncle on the outer side of his leg with diffuse swelling and severe pain. Tuoli Huangqi (Supporting Interior Astragalus) decocted in wine was taken for two doses, bringing slight relief. Further doses of Tuoli San (Supporting Interior Powder) led to ulceration and recovery.
A woman had a chronic leg carbuncle that failed to heal, with a purple, sunken wound and thin, clear pus. She was diagnosed with deficiency but did not believe it. Instead, she took detoxifying herbs, causing numerous deficiency symptoms to arise. Seeking further treatment, she underwent moxibustion with Fuzi Bing (Aconite Cake) and took Shiquan Dabu Tang (Ten Ingredients Greatly Tonifying Decoction) for over a hundred doses, finally recovering. For sores with thin, non-converging pus or sunken wounds, extreme deficiency of Qi and Blood is the cause, requiring strong tonification; otherwise, it becomes a fatal condition. If other diseases complicate the situation, treatment becomes even more difficult.
A man had an internal ulceration of a leg carbuncle, draining four to five bowls of pus. He exhibited aversion to cold, poor appetite, and a thread-like pulse, indicating weak Yang Qi. Sijunzi Tang (Four Gentlemen Decoction) with one qian of Pao Fuzi (Prepared Aconite Root) stopped the chills after one dose, and continued for four doses. Liujunzi Tang (Six Gentlemen Decoction) with Guizhi (Cinnamon Twig) improved his appetite after several doses. Finally, Shiquan Dabu Tang (Ten Ingredients Greatly Tonifying Decoction) and Fuzi Bing (Aconite Cake) moxibustion led to recovery over two months.
A man suffered from a leg carbuncle accompanied by tendon spasms and pain, with a wiry and tight pulse. Wuji San (Five Accumulations Powder) plus Huangbai (Phellodendron Bark), Chaihu (Bupleurum Root), and Cangzhu (Atractylodes Lancea Rhizome) cured him.
A man had leg pain with tendon and bone spasms, and a wiry, tight pulse. Dafangfeng Tang (Great Wind-Expelling Decoction) for two doses alleviated the spasms, and for another two doses, the swelling subsided. However, pain persisted in one area, though the pulse was no longer tight. This indicated that the Cold pathogen had been expelled, and the remaining pain was due to stagnant turbid matter attempting to form pus. Several doses of interior-supporting herbs raised the swelling, and the pulse became slippery and rapid, confirming pus formation. After puncturing, Shiquan Dabu Tang (Ten Ingredients Greatly Tonifying Decoction) was used, leading to stability after a month.
A man had red, swollen, and painful right leg with a deep and rapid pulse. Danggui Niantong Tang (Angelica Relieving Pain Decoction) was prescribed, but his limbs became painful instead. This was due to damp-toxin blockage, especially in the lower body where medicine struggles to reach effectively. It was not a mismatch of medicine and syndrome. Phlebotomy was performed at the affected site to remove toxic blood, followed by the same herbal prescription. Symptoms decreased dramatically after one dose and resolved after four doses.
Danxi examined the nephew of Mr. Li from Dongyang, over thirty years old, thin with dense skin, who had suffered from worry and fatigue, compounded by excessive sexual activity. He suddenly developed a swelling on the outer side of his foot and leg, above the knee, as large as a chestnut. One doctor asked about his stool consistency and prescribed Chengqi Tang (Gut-Clearing Decoction), which was ineffective after two doses. Another doctor prescribed Dahuang (Rhubarb Root), Zhusha (Cinnabar), Sheng Gancao (Raw Licorice Root), and Qilinjie (Dragon's Blood), also ineffective after two to three doses. Half a month later, Danxi observed a solid and large pulse and predicted death, which subsequently occurred.
Ma Mingju treated a nine-year-old boy from Jiangdu suffering from a leg carbuncle. After a month of treatment, the condition worsened. The mass was hard as stone. Fortunately, the child had strong vitality, allowing for internal resolution. Niuxi (Achyranthes Root), Yimi (Coix Seed), Diyü (Sanguisorba Root), Shengdi (Rehmannia Root), Niubangzi (Arctium Fruit), Yinhua (Honeysuckle Flower), Lianqiao (Forsythia Fruit), and Gancao (Licorice Root) were used. The first dose included mild purgatives, causing slight loose stools and relief. The next two doses included mild diaphoretics, further reducing the severity. After several doses, five qian of Shanjiajia (Pangolin Scale) powder was taken, half decocted and half mixed with medicine. The child drank it thoroughly, leading to immediate resolution, and he could walk underground (meaning freely) within half a month. An initial doctor wanted to perform surgery, but Ma stopped him. Surgery should be avoided in external sores when possible. (From *Guang Biji*)
Xue Lizhai treated a man with a leg carbuncle where pus had formed. Two bowls of pus were drained. One dose of interior-supporting herbs caused high fever. Shengyu Tang (Holy to Restore Vitality Decoction) for two doses stopped the fever. The next day, he had chills and loss of appetite with a fine, thread-like pulse. Ren Shen (Ginseng, 1 liang) and Shu Fuzi (Prepared Aconite Root, 3 slices) decocted with Ginger and Jujube restored him. Due to poor appetite and insomnia, Dabu Huangqi Tang (Great Tonification Astragalus Decoction) stabilized him.
A man had leg swelling, fever, and aversion to cold. Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) was prescribed. Dissatisfied with the slow effect, he took Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome), worsening the heat. Re-seeking treatment, Ren Shen Yang Rong Tang (Ginseng Nourishing Nutrient Decoction) was given for over twenty doses, leading to ulceration. Further treatment with Renshen (Ginseng), Huangqi (Astragalus Root), Danggui (Angelica Sinensis), Baizhu (Atractylodes Macrocephala Rhizome), Zhi Gancao (Honey-fried Licorice Root), and Rougui (Cinnamon Bark) for over a month led to healing. Fire-related diseases must be differentiated as excess or deficiency. Huangqin and Huanglian are bitter-cold and drain excess fire from the Heart and Lungs. In cases of weakness, dietary irregularity, or fatigue, this represents deficiency, requiring sweet-warm formulas. There is no case of excess heat with aversion to cold, nor deficiency heat preferring cold. (Note: These two statements are debatable.) This serves as verification.
Lu Fenggong Yangzhi suffered from a leg carbuncle. Physicians used Jinyinhua (Honeysuckle Flower), Ciweimao (Porcupine Spine), Lianqiao (Forsythia Fruit), Baizhi (Angelica Dahurica Root), Beimu (Fritillaria Bulb), Huafen (Trichosanthes Root), Chenpi (Tangerine Peel), Rushen (Frankincense), and Moyao (Myrrh), but it was ineffective. Zhongchun added Mian Diyü (Cotton-root Sanguisorba), Zhi Gancao (Honey-fried Licorice Root), and Zihuadiding (Viola Yedoensis) to the previous formula. Recovery occurred after three to four doses.