丹溪云∶环跳穴痛，防生附骨疽，以苍术佐黄柏之辛，行以青皮、冬加桂枝，夏加
黄芩，体虚加杜牛膝，以生甘草为使，大料煎入生姜汁，食前饮之。痛甚者，恐十数帖
发不动，少加麻黄一二帖又不动，恐疽将成。急掘地成坎，以火 红，沃以小便。赤体坐
其中，以席围下体，使热气熏蒸，腠理开，气血畅而愈。 或问∶附骨疽，何以别之？曰∶
凡患流注，表未尽则余毒附骨而为疽。在股外属足太阳、阳明经，在股内属足厥阴、足
少阴经。又云∶风湿折热，热结而附骨成疽。盖骨者肾之余，肾虚则骨冷而遂附着于骨也，
骨冷则气愈滞而血愈积，但能为肿不能为脓。流注者伤寒之余毒，骨疽者，流注之坏证也。
流注非伤寒之罪，乃医者表之未尽也，骨疽非流注之过，乃庸医凉药之误也，又云∶久
得浓味及醉后涉水；或履冰霜雪，寒入髀枢，积痰瘀血相搏而成疽，初时暂痛无时，乍寒
乍热而无汗，久则痛深，入骨而不移处，按之痛不止者是也。初觉即隔蒜灸之，以多为
上。宜胜金丹、乌金散汗之。壮实者，一粒金丹下之，或八阵散。久则极阴生阳，寒化
为热，肉腐而成脓，脓成则宜烙，十全大补汤加牛膝、木瓜补之。有久溃毒结，留连展
转，经岁不已，腐出朽骨者，骨虽出而不愈，有终身之咎。视其白脓清稀者，碎骨初脱，肉
深难取。脓白而稠者，碎骨将出，肉浅可取。大抵久腐出骨，不论强弱老幼，必须补益，使
气血和畅，正气渐复，邪气渐退，自然收敛，十全大补汤、人参养荣汤，在所当用。未成
脓者，以冲和膏贴之。盖有独活能动汤气血也。已溃者，宜服何首乌散，此药能调和阴
阳也。
〔薛〕 附骨疽有因露卧，风寒深袭于骨者，有因形气损伤，不能起发者，有因克伐
之剂，亏损元气，不能发出者，有因外敷寒药，血凝结于内者，凡此皆宜灸熨患处，解
散毒瓦斯，补接阳气，温补脾胃为主。若饮食如常，先用仙方活命饮，解毒散郁，随着六
君子汤，补托荣气。若体倦食少。但用前汤，培养诸脏，使邪不得胜正。若脓已成即针之，
使毒不得内侵，带生用针亦无妨。如用火针亦不痛，且使易敛，其隔蒜灸，能解毒行气。
葱熨法能助阳气，行壅滞，此虽不见于方书，余常用之大效，其功是不能尽述，唯气血虚
脱者不应。 一女髀枢穴，生附骨疽，在外侧廉少阳经分，始末用五香汤、十宣散，一
日恶寒发热，膈满犹大，服五香汤，一夕喘死。此升散太过，孤阳发热于上也。 一人
年逾四十，夏患附骨痈。予以火针刺去瘀血，更服托里药而愈。至秋忽不饮食，痰气壅盛，
劳则口舌生疮，服寒药腹痛，彼疑为疮。脾胃脉轻取似大，按之无力，此真气不足，虚
火炎上也，治以八味丸。彼不信，自服二陈、四物汤，几殆，复请予。仍以前丸治之而愈。
一人附骨痈，畏针不开，臀膝通溃，脉数发渴，烦躁时嗽，饮食少思。齐氏曰∶疮疡
烦躁时嗽，腹痛渴甚。或泄利无度，或小便如淋，此恶证也，脓出之后，若脉洪数难治，
微涩迟缓易治。刺之，脓出四五碗，即服参、 、归、术大剂，翌日脉稍敛，更服八珍汤
加五味子、麦门、肉桂、白蔹，三十余帖脉缓脓稠，三月乃愈。 一老，腿患附骨疽肿
硬，大按方痛，口干脉弱，肿聚不溃，饮食少思。予谓∶肿下而坚者，发于筋骨；肉色
不变者，发于骨髓。遂托以参 等药三十余剂，脓虽熟不穿。予谓∶药力难达，必须针
刺。不听，至旬日方刺，涌出清脓五六碗，然衰老气血不足，养毒又久，竟不救。大抵疮
疽旬日不退，宜托之，有脓刺之，有腐肉取之，虚则补之，此十全之功也。 一人患贴
骨疽，腿细短软，疮口不合，以十全大补汤，外灸附子饼，贴补药膏，调护得宜，百帖而
愈。 一人环跳穴患附骨疽。彼谓小疮，服败毒药，外以寒药敷帖，因痛极针之，脓瘀
大泄，方知为痈请治。其脉右关浮大，此胃气已伤，故疮口开张，肉紫下陷，扪之不热，
彼谓疮内更觉微冷，自谓必成漏矣。灸以豆豉饼，饮六君子加藿香、砂仁、炮姜，数剂
胃气渐醒，饮食渐进，患处渐暖，肌肉渐生，更以十全大补汤而愈。 一人亦患此，内痛
如锥，外色不变，势不可消，喜其未用寒剂，只因痛伤胃气而不思食，以前药去炮姜治之，
饮食稍进，更以十全大补汤二十余剂，脓成针去，仍以大补汤倍加参、 、芎、归，脓
久不止，更加麦门、五味、贝母、远志，数服渐止，疮亦寻愈。 二证盖因湿热滞于肉
理，真气不能运化，其始宜除湿热，实脾土，和气血，则湿自消散，若脓未成，以隔蒜灸
之立效。 一妇四十余，近环跳生疽，尺脉沉紧，腿不能伸。经曰∶脾移寒于肝，壅肿
筋挛。盖脾主肉，肝主筋，肉温则筋舒，肉冷则筋急，遂与乳香定痛丸少愈，更以助胃
壮气血药，二十余剂而消。 一人因痢骤涩，环跳穴作痛，与四物汤加桃仁、酒黄芩、红
花、苍术、枳壳、黄柏、柴胡、青皮、生姜，十余剂稍可，更刺委中，出黑血而愈。 一
后生，HT 骨痛，以风药饮酒一年，予以防风通圣散去硝黄，加生犀角、浮萍百余帖，成
一疽，近皮革脓出而愈。后五六年，其处再痛。予曰∶旧病作，无能为矣。盖发于新娶
之后，多得香辣肉味，若能茹淡，远房劳，犹可生也。出脓血四五年，延及腰背皆空，又
三年而死，此纯乎病热者。 一少年，天寒极劳，HT 骨痛，两月后生疽，深入骨边，卧
二年，取剩骨而安。此寒搏热者也。（取久疽及痔漏中朽骨，用乌骨鸡胫骨，以砒实之，盐泥固济，
火红，地上出火毒，去泥用骨，研细饭丸，如粟米大，以纸捻送入窍内，更以膏贴之。） 万历乙亥，
予方闭关作举子业，适姻家虞懋庵，股内侧痛久矣，医作痛风治月余不效，脓熟肉浓，不
得穿穴出，因溃入腹，精神昏愦，粥药不入，医不能措手，请教于余。余特破例为诊之，脉
细如蛛丝，气息奄奄欲绝，曰∶无伤也，可以破针刺其腹，脓大泄数升，然皆清如水，疮
口若蟹吐沫，医疑其透膜不可治。余曰∶无伤也，可以参、 、附子，加厥阴引经药，大
剂饮之，为制八味丸，食前辄吞百丸，食大进，日啖饭升余，肉数脔，旬日而平。所以
知可治者，溃疡之脉，洪实者死，微细者生，今脉微细，形病相合，知其受补，故云可治
也。所以刺其腹者，脓不泄，必有内攻之患。且按之而知其创深，即刺之无苦也。所以信
其不透膜，即透膜无损者，无恶候也。所以服八味丸者，八味丸补肾，肾气旺而上升，则
胃口开而纳食，故食大进也。泄脓即多，刀圭之药。其何能济。迁延迟久且变生。故进
开胃之药，使多食粱肉以补之，肌乃速生。此治溃疡之大法也。
黄狗下颏方 治肚痈、少腹痈、及腿上贴骨痈，神效。又云可治发背，大抵此方，治
下部痈疽妙。
用黄狗下颏，连舌、连皮毛、劈下，入罐盐泥封固，铁盏盖口， 一炷香，觉烟清
即止，务宜存性，不可过，过则无用矣。视其骨灰，正黑色者为妙，若带白色，其性已
过勿用，（用时，研极细） 白蔹末 豌豆粉（俗名水寒豆，又名小寒豆。生用）
上三味等分，以各五钱为率，酒调空腹服外，又以三味等分，为敷药，香油调敷患
处。其验以服药后出臭汗，及熟睡为准。史鹤亭太史，亲见顾天宇室人验过。（宜于屠家取
己杀者，制以备用。若生取特杀，反招不祥。）
按∶此方世多用之。《万氏家抄》，亦已收载。然但知其可为敷药，散肿止痛，而不
知其可以内服，为下部痈疽内消之圣药也。予有轿夫，环跳穴痛甚，如鸡啄火灼，适制有
药，以酒调三钱饮之未愈，更进一服，霍然如失，明日舁轿如故。了无苦矣
三生散 治诸疮大痛，不辨肉色漫肿光色，名附骨痈，如神。
露蜂房 蛇蜕 头发（洗净，各等分）
上烧灰存性，研细，酒下三钱。
内托黄 柴胡汤 治附骨痈。
黄 （二钱） 柴胡 土瓜根（酒洗，各一钱） 羌活（半钱） 连翘（一钱三分） 官桂 黄柏 生
地黄（各二分） 当归（七分半）
上 咀作一服。水三盏，酒一盏，同煎至一盏，去滓。热服，宿食消尽服。一服而
愈。昔贾德茂男，年十岁，丁未四月十一日，于左腿近膝股内，出附骨痈，不辩肉色漫肿，
皮泽木硬，疮势甚大，其左脚乃肝之脾土也，更在足厥阴肝经之分，少侵足太阴脾之分，其
脉左三部细而弦，按之缓而微有力，为制此方主治。一方，无黄柏。
内托黄 酒煎汤
黄 当归尾（各二钱） 柴胡（一钱半） 升麻（七分） 连翘 肉桂 黍粘子（炒，各一钱） 黄
柏炙甘草（各半钱）
上 咀。好糯米酒一盏半，水一大盏半，同煎至一大盏，去滓。空心宿食消尽温服，待
少时，早膳压之，使不令大热上攻中上二焦也。丁未季春，薄度主老，年七十，因寒湿
地气，得附骨疽于左腿外侧，足少阳胆经之分，微侵足阳明分，阔六七寸，长一尺，坚
硬漫肿，不辨肉色，皮泽深，但行步作痛，以指按至骨大痛，与药一服立止，再服坚硬肿
消。
当归散 治附骨痈，及一切恶疮。
当归（半两） 甘草（一两） 山栀子（十二枚） 木鳖子（一枚，去壳）
上为细末。每服三钱，冷酒调服。
漏芦汤 治附骨疽。
漏芦（去芦） 升麻 连翘 麻黄（去根节，各一两） 防己 木香 白蔹 沉香（各半两） 大
黄（锉炒，一两半）
上锉碎。每服五钱，水一盏半，入竹叶七片，煎至七分，入芒硝一钱，搅匀，去滓。
空心温服，取利三二行，未利再服。
应痛丸 治走注疼痛，疑是附骨疽者。
苍术（去皮） 当归 黑牵牛 草乌头（炮，各一两）
上为细末，醋糊为丸，如小豆大。每服三十丸，空心醋汤下。
贯众汤 治附骨痈，生股上伏肉间，淋渫。
地骨皮 谷精草 枇杷叶（拭去毛，刷炙） 荆芥（去梗） 蜀椒（去目并合口者，以上各一两）
上捣筛。以水三升，煮取二升，和滓淋渫，蘸布帛拓之。
密陀僧散
密陀僧 自然铜（各半两） 杏仁（去皮尖、双仁，二七枚）
上用苦竹筒一枚，入药在内，纸封筒口，慢火煨，候筒黄色。取出研极细。看疮大小，
用药以新汲水调匀，用鸡翎扫涂痈上，甚者不过二七日效。
Zhu Danxi said: Pain in the Huantiao acupoint (GB30) warns of the potential development of Gujuzhong (Bone-attached Abscess). Use Cangzhu (Atractylodis Rhizoma) to assist Huangbai (Phellodendri Cortex) for its pungency, combined with Qingpi (Citri Reticulatae Pericarpium Viride); add Guizhi (Cinnamomi Ramulus) in winter and Huangqin (Scutellariae Radix) in summer; for those with weak constitutions, add Dunniuxi (Achyranthis Bidentatae Radix); use Sheng Gancao (Glycyrrhizae Radix et Rhizoma) as a guiding agent. Decoct in large quantities, add Jiangzhi (Zingiberis Recens Juice), and drink before meals. For severe pain, if ten or more doses fail to induce sweating, and adding Mahuang (Ephedrae Herba) for one or two doses also fails, it is feared that the abscess is about to form. Urgently dig a pit in the ground, heat it red with fire, and pour urine into it. Sit naked in it, surround the lower body with mats, allowing the hot steam to penetrate, opening the Couli (skin pores and interstices), promoting smooth Qi and Blood flow, leading to recovery. Someone asked: How to distinguish Gujuzhong? The answer is: In cases of Liuzhu (Flowing Tubercles), if the exterior syndrome is not fully resolved, residual toxins attach to the bones forming an abscess. Lesions on the lateral aspect of the thigh belong to the Foot-Taiyang Bladder Channel and Foot-Yangming Stomach Channel; lesions on the medial aspect belong to the Foot-Jueyin Liver Channel and Foot-Shaoyin Kidney Channel. It is also said: Wind-dampness obstructs heat, which condenses and attaches to the bone to form an abscess. Bones are the surplus of the Kidneys; when Kidney deficiency occurs, the bones become cold and subsequently attach to the bone. Bone cold causes Qi to stagnate further and Blood to accumulate, resulting in swelling but no suppuration. Liuzhu is the residual toxin of Shanghan (Cold Damage disease), while Gujuzhong is the deteriorated stage of Liuzhu. Liuzhu is not the fault of Shanghan, but of physicians failing to resolve the exterior sufficiently; Gujuzhong is not the fault of Liuzhu, but of incompetent physicians mistakenly using cooling herbs. It is also said: Long-term consumption of rich flavors and wading in water after drunkenness; or walking on ice, frost, and snow, allowing cold to enter the Bitshu (hip joint), where accumulated phlegm and blood stasis struggle to form an abscess. Initially, there is temporary, intermittent pain, alternating chills and fever without sweat. Over time, the pain becomes deep, fixed in the bone, and pressing exacerbates the pain. Upon initial sensation, apply Moganjiu (Garlic-Separated Moxibustion) to the affected area, preferably with multiple applications. It is suitable to use Shengjin Dan (Winning Gold Pill) or Wujin San (Black Gold Powder) to induce sweating. For robust individuals, use Yili Jin Dan (One-Pill Golden Pill) to purge, or Bazhen San (Eight-Array Powder). After a long duration, extreme Yin generates Yang, cold transforms into heat, flesh rots and forms pus. Once pus is formed, cauterization is appropriate; supplement with Shiquan Dabu Tang (Complete Great Tonifying Decoction) plus Nixi (Achyranthis Bidentatae Radix) and Mugua (Chaenomelis Fructus). In cases of chronic ulceration with toxic accumulation lingering for over a year, expelling necrotic bone, even if the bone is expelled, the wound may not heal, causing lifelong regret. If the pus is white and thin, it indicates the beginning of fragment expulsion, and the tissue is deep, making removal difficult. If the pus is white and thick, the fragments are about to be expelled, and the tissue is shallow, making removal feasible. Generally, for chronic bone exposure, regardless of age or strength, tonification is essential to harmonize Qi and Blood, restore healthy Qi, and eliminate pathogenic factors, leading to natural contraction. Shiquan Dabu Tang (Complete Great Tonifying Decoction) and Renshen Yangrong Tang (Ginseng Nourishing Nutritive Decoction) should be used. For unformed pus, apply Chonghe Gao (Harmonizing Ointment), as Duohuo (Angelicae Pubescentis Radix) can mobilize the Qi and Blood of the decoction. For ulcerated cases, consume Heshouwu San (Polygoni Multiflori Powder), which harmonizes Yin and Yang.
Xue Ji stated: Gujuzhong may arise from sleeping outdoors, allowing wind-cold to deeply invade the bones; from damage to physical constitution and Yuan Qi, preventing eruption; from purgative agents damaging Yuan Qi, preventing emergence; or from external application of cold herbs causing blood coagulation internally. All such cases require moxibustion and warming compresses on the affected area to dissipate toxic vapors, replenish Yang Qi, and primarily warm and tonify the Spleen and Stomach. If appetite is normal, first use Xianfang Huoming Yin (Immortal Formula Life-Saving Decoction) to detoxify and disperse stagnation, followed by Liujunzi Tang (Six Gentlemen Decoction) to support Ying Qi. If fatigue and poor appetite prevail, use only the aforementioned decoction to nourish the Zang organs, preventing pathogens from overcoming healthy Qi. If pus has formed, puncture it to prevent internal invasion; using a needle without prior heating is acceptable. Fire needles cause less pain and facilitate closure. Moganjiu (Garlic-Separated Moxibustion) detoxifies and moves Qi. Congwei (Green Onion Compress) boosts Yang Qi and resolves stagnation; though not recorded in classic texts, I use it frequently with great effect, except in cases of Qi and Blood collapse. A woman developed Gujuzhong at the Huantiao acupoint (GB30) on the lateral Shaoyang channel. She was treated continuously with Wuxiang Tang (Five Fragrances Decoction) and Shixuan San (Ten Acupoints Powder). One day she experienced chills, fever, and severe chest fullness. After taking Wuxiang Tang, she died of asthma overnight. This was due to excessive ascending and dispersing actions, causing solitary Yang to flare upwards. A man over forty developed a Gujuyong (Bone-attached Carbuncle) in summer. I used fire needles to remove blood stasis and prescribed interior-supporting herbs, leading to recovery. In autumn, he suddenly lost his appetite, had abundant phlegm-Qi obstruction, developed mouth ulcers upon exertion, and suffered abdominal pain from cold herbs. He suspected it was related to the sore. His Spleen and Stomach pulse felt large on light pressure but weak on deep pressure, indicating insufficient True Qi and flaming deficient fire. I treated him with Bawei Wan (Eight-Ingredient Pill). He did not believe me, self-medicated with Erchen Tang (Two-Aged Decoction) and Siwu Tang (Four Substances Decoction), nearly dying, then sought my help again. I continued with the same pill, and he recovered. Another man with Gujuyong refused needle drainage. His buttocks and knees ulcerated extensively. He had a rapid pulse, thirst, irritability, occasional cough, and poor appetite. Qi Shi stated: Irritability, cough, abdominal pain, extreme thirst, profuse diarrhea, or dysuria-like symptoms in sores indicate a malignant condition. After pus discharge, a surging and rapid pulse is hard to treat, while a faint, choppy, slow, or delayed pulse is easier. After puncturing and draining four to five bowls of pus, administer a large dose of Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma). The next day, the pulse stabilized slightly. Continue with Bazhen Tang (Eight Treasures Decoction) plus Wuweizi (Schisandrae Fructus), Maidong (Ophiopogonis Radix), Rougui (Cinnamomi Cortex), and Bailian (Trollii Radix). After thirty-plus doses, the pulse slowed, pus thickened, and he recovered in three months. An elderly man had a hard, swollen Gujuzhong on his leg, painful on deep pressure, with dry mouth and weak pulse. The swelling did not ulcerate, and appetite was poor. I said: Hardness below the swelling indicates origin in sinews and bones; unchanged skin color indicates origin in bone marrow. I used Renshen and Huangqi to support the interior for thirty doses. Although the pus matured, it did not rupture. I advised that herbal power was insufficient and needle drainage was necessary. He refused. Ten days later, he allowed drainage, releasing five to six bowls of clear pus. However, due to old age, insufficient Qi and Blood, and prolonged toxicity, he could not be saved. Generally, sores and carbuncles persisting for ten days require interior support; those with pus need drainage; necrotic flesh must be removed; deficiency requires tonification. This achieves perfection. A man with Tieguju (Bone-adhering Abscess) had thin, short, soft legs and non-healing wounds. He used Shiquan Dabu Tang (Complete Great Tonifying Decoction), external moxibustion with Fuzi Bing (Aconite Cake), and tonic ointments. With proper care, he recovered after over a hundred doses. Another man had Gujuzhong at Huantiao (GB30). He considered it a minor sore, took detoxifying herbs, and applied cold external medicines. Due to extreme pain, he was needled, releasing large amounts of pus and blood stasis. Only then did he realize it was a carbuncle and seek treatment. His Right Guan pulse was floating and large, indicating damaged Stomach Qi. The wound opened, flesh was purple and sunken, and cool to touch. He felt internal cold and feared a fistula. I applied Douchi Bing (Fermented Soybean Cake) moxibustion and prescribed Liujunzi Tang (Six Gentlemen Decoction) plus Huoxiang (Pogostemonis Herba), Sharen (Amomi Fructus), and Paojiang (Prepared Ginger). After several doses, Stomach Qi revived, appetite improved, the lesion warmed, and flesh regenerated. He finally recovered with Shiquan Dabu Tang (Complete Great Tonifying Decoction). Another patient had similar symptoms: internal pain like needle pricks, unchanged external color, irreducible swelling. Fortunately, he had not used cold herbs. The pain had damaged Stomach Qi, causing anorexia. I used the previous formula minus Paojiang (Prepared Ginger). Appetite improved slightly. Then, twenty doses of Shiquan Dabu Tang (Complete Great Tonifying Decoction) were given. Pus formed and was drained. The major tonifying decoction was doubled with Renshen (Ginseng Radix), Huangqi (Astragali Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix). For persistent pus, Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Beimu (Fritillariae Cirrhosae Bulbus), and Yuanzhi (Polygalae Radix) were added. After several doses, pus stopped, and the wound healed quickly. These two cases were likely due to damp-heat stagnating in the Couli (interstices), preventing True Qi transformation. Initially, damp-heat should be cleared, Spleen Earth strengthened, and Qi-Blood harmonized, causing dampness to dissipate naturally. If pus has not formed, Moganjiu (Garlic-Separated Moxibustion) is immediately effective. A woman in her forties developed an abscess near Huantiao (GB30). Her Chi pulse was deep and tight, and her leg could not extend. The Classic states: "Spleen transmits cold to the Liver, causing swelling and tendon spasm." The Spleen governs flesh, the Liver governs tendons. Warm flesh relaxes tendons; cold flesh contracts them. I prescribed RuXiang Dingtong Wan (Frankincense Pain-Stopping Pill) for slight relief, followed by herbs to boost Stomach Qi and strengthen Qi and Blood. After twenty doses, it resolved. A man with sudden onset of dysentery experienced pain at Huantiao (GB30). I prescribed Siwu Tang (Four Substances Decoction) plus Taoren (Persicae Semen), Jiu Huangqin (Scutellariae Radix prepared with wine), Honghua (Carthami Flos), Cangzhu (Atractylodis Rhizoma), Zhike (Aurantii Fructus), Huangbai (Phellodendri Cortex), Chaihu (Bupleuri Radix), Qingpi (Citri Reticulatae Pericarpium Viride), and Shengjiang (Zingiberis Recens Rhizoma). After ten doses, he improved. Puncturing Weizhong (BL40) released black blood, leading to cure. A young man suffered Bitong (hip/thigh bone pain) for a year using wind-dispelling herbs and alcohol. I prescribed Fangfeng Tongsheng San (Saposhnikovia Unblocking and Releasing Powder) minus Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma), plus Sheng Xijiao (Rhinocerotis Cornu - substitute available) and Fuping (Urticae Herba) for over a hundred doses. A carbuncle formed near the skin surface, discharged pus, and healed. Five or six years later, pain recurred. I said: Old disease returning, powerless to help. It likely started after marriage, exacerbated by spicy and meat-rich foods. If he ate bland food and avoided sexual excess, he might survive. He discharged pus and blood for four to five years, extending to emptying the waist and back, and died three years later. This was purely a heat disease. A youth, exhausted in extreme cold, suffered hip bone pain. Two months later, an abscess formed deep near the bone. He lay bedridden for two years until remaining bone fragments were extracted, bringing peace. This was cold contending with heat. (To extract necrotic bone from chronic abscesses or hemorrhoidal fistulas, use Tibia of Black-bone Hen, fill with Ashi (Arsenic Trioxide), seal with salt mud, fire until red, extinguish fire toxicity on ground, remove mud, grind bone finely, make rice pills sized like millet seeds, insert via paper twist, and apply ointment.) In the Yi Hai year of Wanli, I was secluded preparing for imperial examinations. My relative Yu Maonan had long-standing pain in the medial thigh. Doctors treated it as gout for over a month without effect. The pus matured and rotted but failed to drain through a pore, instead rupturing into the abdomen. He became delirious, unable to take food or medicine, and doctors were helpless. They consulted me. I broke protocol to examine him. His pulse was fine as a spider's thread, breath faint and near extinction. I said: No danger. Puncture the abdomen with a broken needle. Several liters of clear, watery pus drained. The wound looked like crab bubbles. Doctors doubted perforation of the membrane deemed it incurable. I said: No danger. Administer a large dose of Renshen (Ginseng Radix), Huangqi (Astragali Radix), Fuzi (Aconiti Lateralis Radix Praeparata), plus Jueyin channel-guiding herbs. Prepare Bawei Wan (Eight-Ingredient Pill). Swallow one hundred pills before meals. Appetite increased greatly, consuming over a liter of rice and several pieces of meat daily. Recovered in ten days. Why curable? In ulcers, surging/full pulses indicate death, faint/fine pulses indicate life. Current faint pulse matches the condition, indicating tolerance for tonification. Why puncture abdomen? Undrained pus risks internal attack. Palpation confirmed deep wound, ensuring minimal pain during puncture. Why confident no membrane perforation? Even if perforated, absence of malignant signs suggests safety. Why Bawei Wan (Eight-Ingredient Pill)? It tonifies Kidneys. Strengthened Kidney Qi ascends, opening Stomach appetite, hence increased intake. Massive pus drainage renders small medicinal doses ineffective. Delay invites complications. Thus, open Stomach appetite, encourage grain/meat intake to tonify, accelerating flesh regeneration. This is the major principle for treating ulcers.
Yellow Dog Mandible Formula: Treats abdominal carbuncles, lower abdominal carbuncles, and thigh tie-gu carbuncles with miraculous effect. Also said to treat Back Carbuncles. Generally excellent for lower body abscesses.
Take the mandible of a yellow dog, including tongue and skin/hair. Split it, place in a jar, seal with salt mud, cover with an iron lid. Burn one incense stick's worth of time. Stop when smoke clears. Must preserve nature, do not overcook, or it becomes useless. Ash should be pure black; white indicates overcooking, discard. (Grind extremely fine before use.)
Bailian End (Trollii Radix powder)
Wandou Fen (Vicia Sativa L. flour, common name Shuihandou/Xiaohandou. Raw)
Mix these three in equal parts, typically 5 qian each. Take with wine on an empty stomach. Also mix equal parts for external paste, blend with sesame oil, apply to lesion. Efficacy verified by foul sweat and deep sleep after ingestion. Historian Shi Heting witnessed Mrs. Gu Tianyu verify this. (Obtain from slaughterhouses after killing. Killing specifically for this brings bad luck.)
Note: Widely used in the world. Wan Family Secret Copy also records it. But people only know it as an external paste for reducing swelling and pain, unaware it can be taken internally as a holy medicine for resolving lower body abscesses. I had a sedan chair bearer with severe Huantiao (GB30) pain, like chicken pecking or fire burning. I had just made this medicine. Mixed 3 qian with wine and drank. Not cured. Took another dose. Suddenly cured. Next day carried sedan as usual. No suffering.
Sansheng San (Three Lives Powder): Treats severe pain in all sores, indistinguishable flesh color, diffuse swelling, named Fujie Yong (Bone-attached Carbuncle). Miraculous.
Lufengfang (Apiis Alveolus)
Shetui (Serpent Skin)
Toufa (Human Hair, washed clean, equal parts)
Burn to ash preserving nature, grind fine. Take 3 qian with wine.
Neituo Huangqi Chaihu Tang (Interior-Supporting Astragalus and Bupleurum Decoction): Treats Fujie Yong (Bone-attached Carbuncle).
Huangqi (Astragali Radix, 2 qian)
Chaihu (Bupleuri Radix, 1 qian)
Tugua Gen (Trichosanthes Thunbergiana Radix, wine-washed, 1 qian)
Qianghuo (Notopterygii Rhizoma et Radix, 0.5 qian)
Lianqiao (Forsythiae Fructus, 1.3 qian)
Guangui (Cinnamomi Cortex, amount unspecified in source text context implies small dose)
Huangbai (Phellodendri Cortex, amount unspecified)
Sheng Dihuang (Rehmanniae Radix Recens, 0.2 qian)
Danggui (Angelicae Sinensis Radix, 0.75 qian)
Cut into pieces for one dose. Decoct with 3 cups water and 1 cup wine until 1 cup remains. Strain. Drink hot after宿食 (overnight food) is digested. Cured in one dose. Formerly, Jia Demao's son, age 10, on April 11, Dingwei year, developed Fujie Yong on inner left thigh near knee. Indistinguishable flesh color, diffuse swelling, shiny and woody hard skin, severe condition. Left foot corresponds to Liver's Spleen Earth, involving Foot-Jueyin Liver Channel, slightly invading Foot-Taiyin Spleen Channel. Pulse left three positions fine and wiry, slow and slightly forceful on pressure. Prescribed this formula. Alternative version excludes Huangbai (Phellodendri Cortex).
Neituo Huangqi Wine-Decoction Soup
Huangqi (Astragali Radix, 2 qian)
Danggui Wei (Angelicae Sinensis Radix tail, 2 qian)
Chaihu (Bupleuri Radix, 1.5 qian)
Shengma ( Cimicifugae Rhizoma, 0.7 qian)
Lianqiao (Forsythiae Fructus, 1 qian)
Rougui (Cinnamomi Cortex, 1 qian)
Shuniu Zi (Arctii Fructus, stir-fried, 1 qian)
Huangbai (Phellodendri Cortex, 0.5 qian)
Zhigancao (Glycyrrhizae Radix et Rhizoma Prepared, 0.5 qian)
Cut into pieces. Decoct with 1.5 cups good glutinous rice wine and 1.5 cups water until 1 cup remains. Strain. Drink warm on empty stomach after宿食 digestion. Wait a moment, then eat breakfast to suppress heat from attacking Middle/Upper Jiao. In late spring of Dingwei year, an old master Bodu, age 70, contracted Fujie Ju (Bone-attached Abscess) on outer left leg due to cold-damp earth qi, involving Foot-Shaoyang Gallbladder Channel, slightly invading Foot-Yangming Stomach Channel. Width 6-7 cun, length 1 chi. Hard, diffuse swelling, indistinguishable flesh color, dark shiny skin. Pain on walking, severe pain on pressing to bone. One dose stopped pain immediately. Second dose reduced hardness and swelling.
Danggui San (Angelica Powder): Treats Fujie Yong (Bone-attached Carbuncle) and all malignant sores.
Danggui (Angelicae Sinensis Radix, 0.5 liang)
Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang)
Shanzhizi (Gardeniae Fructus, 12 fruits)
Mubiezi (Momordicae Semen, 1 fruit, shell removed)
Grind to fine powder. Take 3 qian per dose, mixed with cold wine.
Loulu Tang (Rhaponticum Decoction): Treats Fujie Ju (Bone-attached Abscess).
Loulu (Rhapontici Rhizoma, remove rhizome base)
Shengma (Cimicifugae Rhizoma)
Lianqiao (Forsythiae Fructus)
Mahuang (Ephedrae Herba, remove roots/joints, 1 liang each)
Fangji (Stephaniae Tetrandrae Radix)
Muxiang (Aucklandiae Radix)
Bailian (Trollii Radix)
Chenxiang (Aquilariae Lignum Resinatum, 0.5 liang each)
Dahuang (Rhei Radix et Rhizoma, cut and stir-fried, 1.5 liang)
Cut into pieces. Take 5 qian per dose. Decoct with 1.5 cups water and 7 bamboo leaves until 0.7 cups remain. Add Mangxiao (Natrii Sulfas, 1 qian), mix well, strain. Drink warm on empty stomach. Aim for 2-3 bowel movements. If not achieved, repeat dose.
Yingtong Wan (Pain-Relieving Pill): Treats migrating pain, suspected Fujie Ju (Bone-attached Abscess).
Cangzhu (Atractylodis Rhizoma, peeled)
Danggui (Angelicae Sinensis Radix)
Heiqianniu (Brassicae Semen Nigrum)
Caowutou (Aconiti Radix Preparata, processed, 1 liang each)
Grind to fine powder. Make pills with vinegar paste, size of small beans. Take 30 pills per dose, with vinegar soup on empty stomach.
Guanzhong Tang (Cyatheae Decoction): Treats Fujie Yong (Bone-attached Carbuncle) growing in deep flesh of upper thigh, wash/rinse application.
Digupi (Lycii Cortex)
Gujingcao (Eriocauli Flos)
Pipaye (Loquat Leaf, wipe off hairs, brush-roasted)
Jingjie (Schizonepetae Spica, remove stems)
Shujiao (Zanthoxyli Fructus, remove eyes and closed ones, 1 liang each above)
Pound and sieve. Boil 3 sheng water down to 2 sheng. Mix dregs. Rinse/wash lesion, dip cloth, apply compress.
Mituo seng San (Lead Monoxide Powder)
Mituo seng (Lithargyri)
Ziran tong (Pyritum, 0.5 liang each)
Xingren (Armeniacae Semen Amarum, peel tip, double kernels, 14 fruits)
Place medicine in a bitter bamboo tube. Seal mouth with paper. Slow-fire roast until tube turns yellow. Remove, grind extremely fine. Apply according to sore size, mix with fresh water, sweep onto carbuncle with chicken feather. Severe cases effective within 2-7 days.