五香连翘汤 治诸疮肿,初觉一二日,便厥逆咽喉塞,发寒热。
沉香 木香 麝香 丁香(各一两) 乳香(二两) 连翘 射干 升麻 独活 桑寄生
甘草(炙,各一两), 大黄(一两半) 木通(二两)
上 咀。每服五钱,水一盏半,煎七分,温服取利。
按∶丹溪曰,《精要》第一论云,不问痈疽疮疖,虚实冷热,先与内托散、五香连
翘汤、沉麝汤等诸方,不冷不热,不问老幼少壮,阴阳虚实冷热,多服为妙。夫痈疽疮
疖,脏腑阴阳,有浅深、虚实、冷热,用药有补泻、温凉,老幼、少壮,其禀受浓薄,形
志苦乐,随年岁而增损。奈何?欲以不冷不热,四五方而通治之,又以多服为妙,此不
能无疑也,学人当审经络,察病机而处治,岂可仗此为通治之法乎!
千金漏芦汤 治痈疽、丹 、恶肉,时行热毒赤肿。
漏芦 连翘 黄芩 白蔹 枳壳 升麻 粉草 麻黄 朴硝(各一两) 大黄(一两半)
上除硝外,每服二钱。水一盏,姜三片,薄荷三叶同煎。温服,取利为度。
防风通圣散 治时毒热毒,便秘热燥。若时毒饥馑之后,胃气亏损者,须当审察,非
大满、大实,不用。
防风 当归 川芎 芍药 大黄 芒硝 连翘 薄荷 麻黄 桔梗 石膏 黄芩(各一两) 白术
山栀 荆芥(各二钱五分) 甘草(二两) 滑石(一两)
上水煎服,或为末、白汤调下,仍量人虚实。
按∶此表里气血之药也,治一切风毒,积热疮肿,脉候弦洪,实数浮紧,气血实盛者,
不可缺此。见近有秘传外科家方,以是药加人参、赤茯苓、黄 、苍术、金银花,名消
肿托里散。虽以参 为主,复云人参无亦可。盖使人不能无疑而难用也。且临证加减须较
表里之法,如表证多者,当从此方,以辛甘为主散之也,里证多者,方可从变,故此分
辛温、辛平、辛凉之异。
升麻和气饮 治疮肿疖疥痒痛。(此与前条方,大黄有多少之异,故两列之。)
升麻 桔梗 苍术 干葛 甘草 大黄(煨,各一钱) 陈皮(二钱) 当归 半夏 茯苓
白芷 干姜 枳壳(各五分) 芍药(一钱半)
上作一服,水二盅,煎至一盅,食远服。
Wuxiang Liaoqiao Decoction (Five-Aromatic Forsythia Decoction): Treats various sores and swellings. It is indicated for cases in the early stage (one or two days after onset) presenting with cold extremities, a sensation of obstruction in the throat, and alternating chills and fever.
Ingredients: Chenxiang (Aquilariae Lignum Resinatum), Muxiang (Aucklandiae Radix), Shexiang (Moschus), Dingxiang (Caryophylli Flos) (each 1 liang); Ruxiang (Olibanum) (2 liang); Liaoqiao (Forsythiae Fructus), Shegan (Belamcandae Rhizoma), Shengma (Bupleuri Radix), Duhuo (Angelicae Pubescentis Radix), Sangjisheng (Taxilli Herba), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 1 liang); Dahuang (Rhei Radix et Rhizoma) (1.5 liang); Mutong (Akebiae Caulis) (2 liang).
Preparation and Administration: Coarsely crush the herbs. For each dose, use 5 qian, add 1.5 sheng of water, decoct until 0.7 sheng remains, and take warm. The goal is to achieve bowel movement.
Commentary: Zhu Danxi stated in the first treatise of *Jingyao*: "Regardless of whether it is carbuncle, ulcer, sore, or boil, and regardless of deficiency or excess, cold or heat patterns, initially administer formulas such as Neituo San, Wuxiang Liaoqiao Tang, and ChenShe Tang. These formulas are neither cold nor hot. Regardless of age, strength, yin/yang, deficiency/excess, or cold/heat patterns, taking them in large quantities is considered optimal." However, carbuncles, ulcers, sores, and boils involve the zang-fu organs and yin-yang, with variations in depth, deficiency/excess, and cold/heat. Medication should employ tonification or purgation, warming or cooling strategies accordingly. Furthermore, individuals of different ages and constitutions vary in their innate endowment, physical condition, and emotional state, which change with age. Why rely on four or five formulas that are neither cold nor hot to treat all conditions universally, and consider excessive dosage as ideal? This raises doubts. Practitioners must examine the meridians and investigate the pathogenesis before treatment; one cannot rely on these as universal methods.
Qianjin Loulu Tang (Thousand-Gold Rhapontic Decoction): Treats carbuncles, ulcers, erysipelas, necrotic tissue, and red swelling caused by epidemic heat-toxin.
Ingredients: Loulu (Rhapontici Radix), Liaoqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Bailian (Pseudostellariae Radix), Zhiqiao (Aurantii Fructus), Shengma (Bupleuri Radix), Fencǎo (Glycyrrhizae Radix et Rhizoma), Mahuang (Ephedrae Herba), Puxiao (Natrii Sulfas) (each 1 liang); Dahuang (Rhei Radix et Rhizoma) (1.5 liang).
Preparation and Administration: Exclude Puxiao. For each dose, use 2 qian of the remaining herbs. Add 1 sheng of water, 3 slices of fresh ginger, and 3 leaves of bohe (Menthae Haplocalycis Herba). Decoct together. Take warm. Stop when bowel movement is achieved.
Fangfeng Tongsheng San (Saposhnikovia Universal Relief Powder): Treats epidemic toxins and heat-toxins manifesting as constipation and internal dryness-heat. If the epidemic toxin occurs after a famine leading to stomach qi deficiency, careful examination is required; do not use this formula unless there is significant fullness and solid excess.
Ingredients: Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Liaoqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Mahuang (Ephedrae Herba), Jiegeng (Platycodonis Radix), Shigao (Gypsum Fibrosum), Huangqin (Scutellariae Radix) (each 1 liang); Baizhu (Atractylodis Macrocephalae Rhizoma), Shanzhi (Gardeniae Fructus), Jingjie (Schizonepetae Spica) (each 2.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang); Huashi (Talcum) (1 liang).
Preparation and Administration: Decoct in water and take orally, or grind into powder and mix with warm water. Dosage must be adjusted according to the patient's deficiency or excess status.
Commentary: This formula regulates the exterior and interior and harmonizes qi and blood. It treats all wind-toxins and accumulated heat causing sores and swellings, particularly when the pulse is wiry, surging, solid, rapid, floating, or tight, indicating abundant qi and blood excess. It is indispensable for such cases. Recently, some surgeons have a secret prescription based on this formula, adding Renshen (Ginseng Radix et Rhizoma), Chi Fuling (Poria cum Radix), Huangqi (Astragali Radix), Cangzhu (Atractylodis Rhizoma), and Jinyinhua (Lonicerae Japonicae Flos), named Xiaozhong Tuoli San (Swelling-Reducing Interior-Supporting Powder). Although it emphasizes Renshen, it also states that Renshen can be omitted if unavailable, causing confusion and hesitation in usage. Clinical modifications must follow the principles of distinguishing exterior and interior syndromes. If exterior symptoms predominate, adhere to this formula using acrid-sweet herbs to disperse; if interior symptoms predominate, modifications are permitted, hence the distinction between acrid-warm, acrid-neutral, and acrid-cool properties.
Shengma Heqi Yin (Primula Harmonizing Qi Infusion): Treats sores, swellings, boils, and itching/pain from scabies. (This formula differs from the previous one only in the dosage of Dahuang, hence listed separately.)
Ingredients: Shengma (Bupleuri Radix), Jiegeng (Platycodonis Radix), Cangzhu (Atractylodis Rhizoma), Gange (Puerariae Lobatae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma, stir-baked) (each 1 qian); Chenpi (Citri Reticulatae Pericarpium) (2 qian); Danggui (Angelicae Sinensis Radix), Banxia (Pinelliae Rhizoma), Fuling (Poria), Baizhi (Angelicae Dahuricae Radix), Ganjiang (Zingiberis Rhizoma), Zhiqiao (Aurantii Fructus) (each 5 fen); Shaoyao (Paeoniae Radix Alba) (1.5 qian).
Preparation and Administration: Prepare as one dose. Add 2 zhong of water, decoct until 1 zhong remains. Take well after meals.