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Jiajian Tuoli Xiaodu San (Modified Decoction for Supporting the Interior and Disinfecting): Treats cold extremities, which is caused by deficiency-cold of Kidney Qi. Remove three ingredients from the original formula, add Rougui (Cinnamon Twig) and Fuzi (Aconite Root), and simultaneously administer Bawei Wan (Eight-Ingredient Pill).

For carbuncles and sores presenting with hoarseness, deteriorated complexion, cyanotic-red lips and nose, and edema of the face and eyes, Diaowei Baizhu San (Stomach-Regulating Atractylodes Macrocephala Powder) is appropriate.

Diaowei Baizhu San (Stomach-Regulating Atractylodes Macrocephala Powder)
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Fuling (Poria, two qian each); Chenpi (Citri Reticulatae Pericarpium), Shaoyaoyao (Paeoniae Radix Alba, stir-fried), Binglang (Arecae Semen), Zexie (Alismatis Rhizoma, one qian each); Muxiang (Aucklandiae Radix, five fen).
Usage: As one dose. Add two zhong of water and three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct to obtain eight fen of liquid, take after meals. If swelling does not subside, increase the dosage of Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried) and Zhishi (Immature Bitter Orange Fruit, bran-fried, one qian each).

[Xue Ji's Commentary]: The aforementioned symptoms belong to the "Seven Evils" syndrome; this formula should be used. If dampness is eliminated and qi deficiency recedes, formulas such as Liujunzi Tang (Six Gentlemen Decoction) or Shenling Baizhu San (Ginseng and Poria with Atractylodes Macrocephala Powder) may be employed, which are particularly effective for loose stools. Reusing Binglang (Arecae Semen) and Muxiang (Aucklandiae Radix) may damage true qi. There are also cases where the aforementioned symptoms are caused by deficiency of true qi, in which case these two herbs are especially contraindicated.

[Xue Ji]: In sores and ulcers, collapse of yang qi may result from the use of purgative/attacking agents, excessive loss of pus and blood, post-emesis/diarrhea states, or improper sexual activity. If fever, headache, dysuria, or a slippery-rapid pulse with hematochezia occurs, accompanied by red eyes, restlessness, panting, spontaneous sweating, fever, shortness of breath, dizziness, fatigue, heat-thirst, desire to drink but aversion to cold water, aversion to cold, feeling hot yet disliking clothing, tossing and turning, profuse sweating like water, opisthotonos, and delirious speech, these are false-heat symptoms arising from rootless deficient fire. If chills, headache, cough with vomiting, deafness, blurred vision, urinary incontinence or difficulty, diarrhea with borborygmus, tenesmus and abdominal pain, retraction of the penis, intermittent cold sweat, floating teeth, limb numbness, cold extremities with body pain, biting tongue/lips, or stiff tongue root occur, these are true-cold syndromes of collapsed yang qi. Regardless of the pulse or the nature of the sore, if any one or two of these signs are present, immediately administer Shenfu Tang (Ginseng and Aconite Decoction) to tonify; many patients recover. Generally, after ulceration, overwork causing yuanqi (primordial qi) deficiency, seminal emission, slippery-rapid pulse with hematochezia, external pathogen invasion, or misuse of cold-cooling herbs can lead to collapse of qi and blood causing these symptoms. Treatment with the aforementioned drugs has resulted in recovery. Yang Gaohu, an Hanlin Academician, suffered from a back carbuncle in early summer. After taking attacking herbs for over twenty days, he presented with diffuse swelling and hardness, feeling heavy as if carrying a stone. After fifty moxa cones applied via garlic partition on the back, the heaviness lightened. He took Liujunzi Tang (Six Gentlemen Decoction) with Sharen (Amomi Fructus) for two doses, resulting in profuse salivation and reduced appetite, indicating spleen deficiency with collapsed yang qi. Although warm-tonifying agents were indicated, he vomited and refused food. The previous formula was used in a large dose with added Fuzi (Aconiti Lateralis Radix Praeparata), Jiang (Zingiberis Rhizoma), and Guizhi (Cinnamomi Ramulus). When this failed, one jin of Renshen (Ginseng Radix et Rhizoma) each, half jin of Danggui (Angelicae Sinensis Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma), plus Chenpi (Citri Reticulatae Pericarpium), and one liang of Fuzi (Aconiti Lateralis Radix Praeparata) were decocted and taken over three days. Salivation stopped instantly, necrotic tissue sloughed off immediately, and appetite returned. Subsequently, herbs like Jiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus) were used to support the interior and strengthen the spleen; upon sloughing of necrotic tissue, the sore healed. The wife of Shi Nanhu, Vice Minister, developed a non-suppurating carbuncle in summer with a large but forceless pulse, fever, thirst, spontaneous and night sweats. After administering a large tonic containing Renshen (Ginseng Radix et Rhizoma), her cold extremities worsened, bowel movement became difficult, she experienced panting and occasional vomiting, and her pulse became minute and fine, imperceptible on pressure, except for the Taichong (LR3) pulse. She was given Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Fuling (Poria), and Chenpi (Citri Reticulatae Pericarpium) totaling about one jin, plus five qian of Fuzi (Aconiti Lateralis Radix Praeparata), decocted in two zhong of water as a single dose. Symptoms subsided instantly, and the pulse recovered. The next day, the sore rose and suppurated. Four doses of the previous formula were continued, followed by daily use of interior-supporting herbs for over two months until resolution. A woman bedridden for thirteen years suffered increased depression after a house fire. In March of the following year, a lump appeared under her right shoulder, swollen like a bowl, red in the center and white on the periphery. One dose of cooling herbs failed. Four doses of Shixuan San (Ten Acupoints Powder) slightly reduced pain and redness. A physician was consulted and administered continuous doses of Renshen (Ginseng Radix et Rhizoma), Dingxiang (Caryophylli Flos), Rougui (Cinnamomi Cortex), Fangfeng (Saposhnikoviae Radix), and Baizhi (Angelicae Dahuricae Radix). After suppuration, the physician declared her safe and left. She then developed dizziness, vomiting, aversion to cold, and shivering, with sunken apex and clear pus. Consulting *Waike Fahui* (Explication of External Medicine), the section on Back Carbuncles stated: If initially appearing as a millet-grain-sized head without swelling or redness, accompanied by restlessness and constipation, numerous heads may emerge within four to five days, each sore mouth resembling a grain of millet, named Lotus-Pad Carbuncle. Initially alarmed by this malignant sign, though treatment methods were detailed, I was unfamiliar with their application. Xue Ji was summoned. Diagnosis indicated that acrid-cool dispersing methods are contraindicated for qi-blood deficiency. Large doses of Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Dihuang (Rehmanniae Radix), Jiang (Zingiberis Rhizoma), and Fuzi (Aconiti Lateralis Radix Praeparata) were continuously administered. The swelling rose, pus became thick, and Wujin Gao (Black Gold Ointment) was applied for several days. Necrotic tissue sloughed off, including several pieces of fascia-like tissue. Renshen (Ginseng Radix et Rhizoma) was taken up to eight qian per dose, twice daily. Recovery occurred after more than two months.

Fuzi Lizhong Tang (Aconite and Poria Regulating the Middle Decoction): Treats spleen-stomach deficiency-cold in sores and ulcers, or injury from mistaken purgation, presenting with cold extremities, inability to eat, borborygmus, abdominal pain, vomiting, and diarrhea.
Ingredients: Fuzi (Aconiti Lateralis Radix Praeparata), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Shaoyaoyao (Paeoniae Radix Alba) (three qian each); Baizhu (Atractylodis Macrocephalae Rhizoma, four qian).
Usage: Decoct in water and take orally.

Jiangfu Tang (Ginger and Aconite Decoction): Treats depletion of true yang in sores and ulcers due to mistaken sweating/purgation or excessive loss of pus/blood without adequate support, leading to panting, spontaneous and night sweats, shortness of breath, and dizziness.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed, one liang each), Ganjiang (Zingiberis Rhizoma, processed), Baizhu (Atractylodis Macrocephalae Rhizoma, five qian each).
Usage: Prepare as two doses. Decoct in water and take orally.

Shenfu Tang (Ginseng and Aconite Decoction): Treats conditions such as excessive blood loss, massive discharge of pus and stasis, or collapse of true yang due to mistaken cold-cooling/sweating/purgation, presenting with panting, spontaneous and night sweats, shortness of breath, and dizziness. Take urgently to rescue primordial qi; delay leads to untreatability.
Ingredients: Renshen (Ginseng Radix et Rhizoma, one liang); Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed, five qian).
Usage: Add five slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water and take. If ineffective, double the dosage.