Library

Xue Lizhai treated Shen Tianyi, a Jinshi degree holder, who suffered from an arm carbuncle accompanied by chills, fever, headache, and deficiency of both physical constitution and vital qi. This was a syndrome caused by wind-heat pathogenic factors affecting the Hand and Foot Yangming meridians. After taking Jiegeng Shengma Decoction (Platycodon and Cimicifuga Decoction) for two doses, the external pathogens were instantly dispersed. Subsequently, taking Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder) for two doses caused the swelling and pain to instantly recede. He then used Buzhong Yiqi San (Tang) [Tonifying the Middle and Augmenting Qi Powder/Decoction] for regulation, gradually restoring his physical constitution and vital qi until he recovered.

A woman suffered from arm swelling with aversion to cold and failure to suppurate. She took Shixuan San (Ten Acupoints Powder) for six doses until it ulcerated, and then took Tuoli San (Supporting Interior Powder) for several doses until she healed.

Another woman had arm swelling without suppuration, reduced appetite, exacerbated pain upon exertion, and fever. She took Buzhong Yiqi Tang (Tonifying the Middle and Augmenting Qi Decoction) for two doses, which slightly relieved the pain. Her condition resolved after treatment with herbs that tonified qi and blood and strengthened the spleen and stomach.

A woman suffered from a toxic arm lesion with hard swelling, pharyngeal congestion, cold limbs, chills, and fever. She took Wuxiang Liaoqiao Tang (Five Fragrant and Forsythia Decoction) for two doses and recovered instantly, then took Chuangke Liuqi San (Wound Specialist’s Regulating Qi Powder) for four doses until the swelling disappeared.

A man suffered from an arm carbuncle with a wiry, tight, and forceful pulse. His symptoms instantly receded after taking Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) for two doses, and the swelling disappeared after another two doses.

A man suffered from an arm carbuncle that failed to suppurate. He underwent moxibustion with Fermented Soybean Cake (Douchi Bing) and drank interior-supporting medicines. After more than thirty doses, it ulcerated, and he fully recovered after another month.

A woman suffered from an arm carbuncle with a purplish, sunken wound surface and thin pus that failed to heal. Believing the toxin was not yet exhausted, she wished to take detoxifying agents. I pointed out that in sores and ulcers, high, hard swelling with thick pus indicates excess; low, soft, slow swelling with thin pus indicates deficiency. Therefore, I applied moxibustion using Aconite Cake (Fuzi Bing) and administered Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). It took one hundred doses for her to recover.

Lady Tai’an of Peng Huangmen in Western Shu suffered from arm pain for several years and recovered after taking Huoluo Dan (Meridian-Activating Pills), twenty pills at a time.

Zhu Danxi treated his paternal uncle, a man prone to excessive worry, with weak constitution and fatigued spirit, nearing fifty years of age. Suddenly, a small red swelling appeared on the upper outer side of his left arm, about the size of a chestnut. Zhu said, "Do not underestimate this. First, prepare a large dose of Ginseng decoction; drinking two or three jin is ideal." The patient did not believe him and slowly took small doses of minor prescriptions. After several doses without relief, he stopped. More than ten days later, during a storm that uprooted trees, a red line appeared on the sore, winding to the shoulder blade and reaching the right costal region. Zhu said, "You must use a large dose of Ginseng, with a small addition of Ligusticum Chuanxiong Rhizome (Chuanxiong), Tangerine Peel (Chenpi), and Atractylodes Macrocephala Rhizome (Baizhu) as tonifying agents." After receiving this prescription, he stabilized within two months.

Li Dongyuan stated: Old Man Yin was always poor. In the tenth lunar month of the Jiyou year, when the weather turned cold, both his body and mind suffered hardship. A carbuncle developed on the branch of the Hand Yangming Large Intestine Meridian. Initially, there was a sensation similar to hernia, and the entire outer arm was swollen and painful. The swelling first appeared in the Yangming meridian. The cun pulses on both left and right were short; the guan pulses were wiry, and deep pressure revealed them to be surging, slow, and forceful. This carbuncle resulted from changes due to the Eight Winds. Based on the pulse diagnosis, the pathogenic factor was on the exterior of the meridians. His urination and defecation were normal, diet was unchanged, abdomen was peaceful, and taste perception was intact, indicating the disease was not in the interior. He had no aversion to wind or cold, only heat and restlessness, and the pulse was not floating, indicating the disease was not on the superficial exterior. Since the interior and exterior were harmonious, the pathogen remained only within the meridians. The *Neijing* states: "Coagulation in the meridians leads to sores and carbuncles." Since this carbuncle arose in the upper half of the body, wind pathogen entered from above, confirming it was a sore caused by Eight Wind changes. It was appropriate to treat the cold pathogen and regulate the qi and blood in the meridians to prevent coagulation. He was treated with Baizhi Shengma Tang (Angelica Dahurica and Cimicifuga Decoction) and recovered after one dose. The ingredients included Prepared Licorice Root (Zhigancao), Cimicifuga Rhizome (Shengma), Platycodon Root (Jiegeng), Angelica Dahurica Root (Baizhi), Angelica Sinensis Root Tip (Danggui Shao), Raw Rehmannia Root (Shengdihuang), Raw Scutellaria Root (Sheng Huangqin), Wine-processed Scutellaria Root (Jiu Huangqin), Forsythia Fruit (Lianqiao), Astragalus Membranaceus Root (Huangqi), Cinnamon Twig (Rougui), and Safflower (Honghua). These were chopped, decocted together with water and wine (one large cup and a half each), and taken orally to cure the condition.

Xue Lizhai treated Commander Wang, who had a single swollen area on his arm that was neither painful nor red, but had a soft pulse, reluctance to eat, and occasional vomiting. He was given Liujunzi Tang (Six Gentlemen Decoction) added with Agastache Rugosus Herb (Huoxiang) and Wine-processed White Peony Root (Jiu Shaoyao). The vomiting ceased, and appetite improved. He then took Bazhen Tang (Eight Treasures Decoction) for over twenty doses until suppuration occurred, which was then lanced. He recovered after taking Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). The following year, after contracting Shanghan (Cold Damage), this arm swelled again with slight pain, which was residual toxin from the Shanghan. There were no exterior symptoms, only weakness. He first took Shixuan San (Ten Acupoints Powder) for four doses, utilizing Ginseng, Astragalus, Ligusticum Chuanxiong Rhizome (Chuanxiong), and Angelica Sinensis Root (Danggui) to support primal qi;防风 (Fangfeng), Platycodon Root (Jiegeng), Angelica Dahurica Root (Baizhi), and Magnolia Officinalis Bark (N Houpo) to disperse swelling and nodules; and Cinnamon Twig (Rougui) to guide the medicine and break blood stasis. The swelling receded by three or four parts.

He then took Bazhen Tang (Eight Treasures Decoction), leading to ulceration and recovery. In winter, the arm pain recurred. Because wind-dispelling herbs were used again, it led to severe tendon spasms and pain. This was due to blood deficiency failing to nourish the tendons, and tendon deficiency failing to secure the bones. He was cured using Jiawei Shiquan Dabu Tang (Modified Comprehensive Great Tonifying Decoction).

An unmarried girl suffered from arm swelling that ulcerated and failed to heal for a long time, alternating chills and fever, five-palm heat, reduced appetite, and amenorrhea. She was given Xiaoyao San (Free and Easy Wanderer Powder) and Bazhen Tang (Eight Treasures Decoction). Her menstruation resumed, and the sore healed. Another woman with amenorrhea, tidal fever, cough, emaciation, chest and diaphragm discomfort, and a long-standing neck swelling also took the aforementioned medicines. Her fever subsided, swelling disappeared, menstruation resumed, and she recovered.

Song Yan, over thirty years old, suffered from an arm carbuncle that ulcerated without pain, with thin pus and a weak pulse. Danxi said: "When a joo (deep abscess) ulcerates deeply without pain, it indicates severe deficiency of Stomach Qi, resulting in insensitivity to pain." Dongyuan said: "Thin, clear pus and non-healing wounds indicate deficiency of both qi and blood; they should be treated with major tonifying medicines." The patient did not listen, took detoxifying medicines instead, became severely deficient in qi and blood, and ultimately died. Danxi said: "When swelling and pain are first observed, if the pulse and symptoms indicate weakness, immediately provide tonification. If qi and blood are not depleted, auspicious outcomes can be ensured throughout." He also said: "Ulcers involve deficiency inside and outside; the primary approach should be continuous tonification."

Wang Shiheng, over forty years old, suffered from a toxic arm lesion with pain and vomiting. Taking Tuoli Xiaodu Yao (Interior-Supporting and Detoxifying Medicines) worsened his condition. He took Liangge San (Cooling the Diaphragm Powder) for two doses, which instantly reduced the symptoms, followed by Siwu Tang (Four Substances Decoction) added with Scutellaria Root (Huangqin) and Coptis Rhizome (Lian), which resolved the swelling in four doses.

Wang Wenyuan suffered from a toxic arm lesion with pain. Taking cold-natured medicines led to poor appetite and loose stools. He took Lizhong Wan (Regulate the Middle Pill) twice, then Liu Junzi Tang (Six Gentlemen Decoction) added with Amomum Villosum Fruit (Sharen) and Agastache Rugosus Herb (Huoxiang) for treatment, followed by interior-supporting medicines, leading to ulceration and recovery. Generally, for severe sore pain, if the constitution is robust with fire, bitter-cold agents are suitable. If the constitution is thin/weak, Buzhong Yiyi Tang (Tonifying the Middle and Augmenting Qi Decoction) added with Scutellaria Root (Huangqin) and Coptis Rhizome (Lian) is appropriate; add Phellodendron Bark (Huangbai) for lesions below the waist. For obese individuals with painful sores, Schizonepeta Spike (Jingjie), Saposhnikovia Root (Fangfeng), Notopterygium Rhizome (Qianghuo), and Lepidobotys Stems (Duhuo) are used, exploiting the principle that wind can overcome dampness.

Fang Yunqi had a carbuncle on his arm that took one hundred days to heal after ulceration. Within it, malignant flesh protruded, the size of a broad bean, remaining for over a month despite medical treatment. While reading herbal texts, he found the *Liu Juanzi Guiyi Fang* (Liu Juanzi's Ghost Relic Formula), which used Vine Fruit (Wumei) roasted to retain its nature, ground and applied externally. Upon testing, more than half disappeared within a day and night. After reapplication, it flattened in one day. He realized such miraculous formulas existed in the world and thus began carefully collecting and printing various formulas, starting with this one. (*Bencao Gangmu*)