Library

A male patient, after the ulceration of a sore, presented with fever and headache. The pulse was floating and tight, indicating deficiency combined with exterior pathogenic factors. He was treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) supplemented with Chuanxiong Rhizoma (Chuanxiong) and Baizhi Radix Angelicae Dahuricae (Baizhi). After two doses, the symptoms ceased, and he was subsequently cured using Tuo Li Yao (Supporting Interior Medicines).

Another male patient suffered from wind pathogen invading the wound, resulting in trismus (lockjaw) and opisthotonos (backward arching of the back). One dose of Yuzhen San (Jade True Powder) cured him, and he was then treated with Tuo Li Yao to promote healing.

A third male patient had a carbuncle that was about to heal but experienced generalized pruritus with a floating pulse. Two doses of Xiaofeng San (Eliminate Wind Powder) stopped the itching, and he was subsequently cured with Tuo Li Yao.

[Xue Ji] A man developed a carbuncle on his chest, presenting with painful irritability, fever, thirst, and a rapid, full pulse. It was late winter. I stated: This is internal accumulation of heat toxin; one must disregard the season and treat according to the syndrome. I intended to use Neishu Huanglian Tang (Internal Draining Coptis Decoction), but because it was severe cold, he mistakenly used cooling and detoxifying drugs, which exacerbated the condition. Upon seeking treatment again, I administered the aforementioned decoction for two doses. Later, adjusting the prescription twice, all symptoms subsided. He was then given Jinyinhua San (Honeysuckle Powder) plus Lqiao Fructus Forsythiae (Liqiao) and Zhizi Gardenia Fruit (Zhizi) for four doses, leading to pus discharge and resolution.

Luo Qianfu treated the father of Clerk Jia (see "Fabei" case).

A male patient developed a carbuncle, drank alcohol after ulceration, and suffered pain and fever. Two doses of Huanglian Jiedu Tang (Coptis Decoction for Detoxification) stopped the symptoms, and he was subsequently cured with Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder).

Chang treated patients with painful sores accompanied by constipation and a full pulse using Qingliang Yin (Cooling Drink).

[Luo Qianfu] In the Renwu year of the Zhiyuan era, a man named Wang Bolu, aged 57, presented with severe swelling of the right arm extending from the shoulder to the fingers, with color changes in the skin and coldness of the skin. The six pulses were deep, fine, and faint. Both pulse and symptoms indicated cold. Surgeon Yanhe examined him and said: This is Gujue Yong (Bone-Adhering Carbuncle), detected too late. He applied fire cautery. The pus was clear and thin. He advised waiting before incision again. However, the patient developed persistent hiccups. Yanhe prescribed Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) for two doses, providing slight relief. When seen again, the hiccups worsened significantly, accompanied by spontaneous diarrhea, cold pain in the umbilical and abdominal region, abdominal distension, reduced food intake, and occasional syncope. Seventeen moxa cones were applied at the point where black discoloration ended under the left breast. A prescription of Ganjiang Dried Ginger (Ganjiang), Fuzi Prepared Aconite Root (Fuzi), Muxiang Aucklandia Root (Muxiang), Chenxiang Aquilaria Wood (Chenxiang), Huixiang Fennel Fruit (Huixiang), and Qianghuo Notopterygium Rhizome (Qianghuo) was prepared, chopped to 1.5 qian, and intended for administration. Someone asked: "All pain, itching, and sores belong to Heart Fire. Moreover, it is midsummer. Is it appropriate to use Ganjiang and Fuzi?" I replied: "It is logically necessary and unavoidable. The *Neijing* states: Fine pulse, cold skin, diarrhea of both bowels, and inability to eat constitute 'Five Deficiencies.' Hiccups indicate extreme deficiency of Stomach Qi. Although it is a general principle that all swellings and sores belong to Heart Fire, this case presents contradictory internal and external signs. One must disregard the season and treat the syndrome. Without urgent treatment using large doses of acrid-hot medicines, recovery is impossible." Thus, the medicine was administered. All symptoms disappeared, food intake resumed, the sore became warm, and the pus color normalized. Yanhe then administered Wuxiang Tang (Five Fragrances Decoction) several times, and the patient recovered after more than a month. Alas! Adhering to convention is the view of the masses; knowing how to adapt is the task of the superior person. Many fail due to small matters because they know the constant but not the variable, let alone in medicine. Can adhering to convention be compared with knowing how to adapt? (See the case of Chancellor Chen's mother for "Naoju").

Tuoli Wenzhong Tang (Interior-Supporting and Middle-Warming Decoction): Treats sores that have collapsed inward due to cold transformation. Symptoms include clear and thin pus, cold skin, epigastric stuffiness and fullness, borborygmus with cutting pain, slightly loose stools, vomiting and shortness of breath after eating, persistent hiccups, inability to lie down peacefully, and occasional syncope.

Ingredients: Dingxiang Flos Caryophylli (Dingxiang), Chenxiang Lignum Aquilariae Resinatum (Chenxiang), Huixiang Fructus Foeniculi (Huixiang), Yizhiren Semen Alpiniae Oxyphyllae (Yizhiren), Chenpi Pericarpium Citri Reticulatae (Chenpi) (each 1 qian); Muxiang Radix Aucklandiae (Muxiang) (1.5 qian each); Qianghuo Rhizoma et Radix Notopterygii (Qianghuo), Ganjiang Rhizoma Zingiberis Recens (prepared) (each 3 qian); Gancao Radix Glycyrrhizae (prepared with honey) (2 qian); Heifuzi Radix Aconiti Lateralis Preparata (prepared, peeled, de-navel) (4 qian).

The *Neijing* states: "When cold invades internally, treat with acrid-hot substances, assisted by bitter-warm ones." Using Fuzi and Ganjiang, which are greatly acrid and hot, to warm the interior and exterior, allowing Yang Qi to move from the interior to the exterior, serves as the Sovereign drug. Qianghuo, bitter and acrid-warm, penetrates the joints; Gancao (prepared), sweet and warm, tonifies the Spleen and Stomach, unblocks meridians, and unifies blood vessels. Since Stomach cold causes vomiting and hiccups with inability to eat, Yizhiren, Dingxiang, and Chenxiang, being greatly acrid and hot, serve as Assistant drugs to dispel cold. Because pathogenic qi of the sore attacks inward, causing Qi stagnation and fullness, Muxiang, Huixiang, and Chenpi, bitter and acrid-warm, treat stuffiness and dissipate fullness, serving as Envoy drugs.

Chop the above ingredients into one dose. Add three cups of water and five slices of Shengjiang Fresh Ginger (Shengjiang). Decoct until one cup remains, then strain. Take warm at any time. Avoid all cold foods.