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In the Gengwu year, upon my return from the Autumn Provincial Examination (Xiukui), I found that my deceased sister was already ill. Since July, her breasts had been swollen and painful without subsiding. In August, a physician used fire needles to drain pus and administered Shiquan Dabu Tang (Ten Complete Tonifying Decoction) along with external application of Tiegu San (Iron Hoop Powder), but these treatments were ineffective. Her condition worsened, developing wheezing and chest oppression. In September, after giving birth to a daughter, the ulceration intensified; both breasts completely rotted, spreading to the chest and axillae. The pus was thick and sticky, with nearly six or seven sheng (a traditional unit of volume) discharged, showing no signs of healing. It was not until November that she returned home for medical care. The physician switched to a mild formula for detoxification and harmonizing the middle jiao, externally applying Shengji San (Flesh-Generating Powder), Longgu (Dragon Bone), Hanshuishi (Calcitum), etc., yet the pus continued to flow profusely. Wherever it splashed, new swellings formed and ulcerated. The skin on both sides turned purple-black, with over ten open sores. The chest and axillae were swollen and ulcerated, making it impossible to turn or lie on either side; the situation was terrifying.

I reasoned that postpartum pathogenic toxins had flared up due to deficiency. She should have taken large doses of Huangqi (Astragali Radix) to resolve toxicity, nourish blood, tonify qi, and generate flesh. However, fearing previous treatment failures, the physician dared not use it. After mid-December, the condition deteriorated further, with over twenty sores appearing. All other medicines had failed. Only then did they adopt my prescription. At that time, the pus was foul and viscous. I washed the affected area with decocted Zhiye (Broussonetia papyrifera leaves) and pig trotter soup, which provided immediate relief. I then formulated a prescription named Huangqi Tuoli Tang (Astragalus Support-the-Interior Decoction). Huangqi is sweet and warm; as the sovereign drug (Jun), it expels pus, tonifies qi, and generates flesh. Gancao (Licorice Root) tonifies stomach qi and resolves toxicity; Danggui Shen (Angelica Sinensis Root Heart) harmonizes and generates blood; these serve as minister drugs (Chen). Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), and Loulu (Euphorbiae Humifusae Herba) are herbs belonging to the Foot-Yangming Stomach meridian. Lianqiao (Forsythiae Fructus) and Fangfeng (Saposhnikoviae Radix) disperse nodules and unblock meridians. Gualou Ren (Trichosanthis Semen) and Shuniuzi (Arctii Fructus) resolve toxicity and reduce swelling. Zaogao Ci (Gleditsiae Spina) guides the medicine to the ulcerated site. Baizhi (Angelicae Dahuricae Radix) enters the Yangming meridian, eliminates foul pus, and promotes tissue regeneration. Additionally, Chuanxiong (Ligustici Chuanxiong Rhizoma) in small dosage, and Rougui (Cinnamomi Cortex) stir-fried with Baicao (Phellodendri Cortex), served as guiding agents. Each dose was taken with one cup of wine, followed by Baiyu Shuang Wan (White Jade Frost Pills) to vent pus, resolve toxicity, and clear heat. Since the pus was thick and the disease vigorous,收敛 (astringent) drugs like Longgu should not be used hastily. Instead, the principle of "chasing" (expelling) toxins was applied. Thus, I prepared Qingxia San (Blue Cloud Powder) for external application. The next day, the pus became thin, pain ceased, and foulness resolved, indicating a trend toward recovery. By the first month of the Xinwei year, new flesh had grown over the lesions. For areas with purple swelling, Congyun Fa (Scallion Moxibustion) was applied, resulting in rapid resolution. However, the area near the axilla involving the Foot-Shaoyang Gallbladder meridian had not yet healed. Therefore, Chaihu (Bupleuri Radix) and Qingpi (Citri Reticulatae Pericarpium Viride) were added, and Chuanxiong dosage was doubled. For areas where pus had completely drained, Daifen San (Dusting Powder) was applied. After the Lantern Festival, full recovery was achieved.

In treating carbuncles and ulcers, one must examine the specific meridian and anatomical region. My sister’s illness primarily involved the Foot-Yangming Stomach meridian, slightly encroaching on the Foot-Shaoyang Gallbladder meridian. Quack physicians failed to differentiate, using indiscriminate medications without guiding agents, leading to failure. This is truly lamentable. Recently, someone suffering severely, similar to my late sister, sought a prescription from a friend who asked me. Due to busy schedules, I could not respond immediately, and the surgeons eventually stood by helplessly while the patient died. Deeply saddened, I decided to publish this formula, unwilling to keep it secret. Recorded on the ninth day of the ninth lunar month in the Xinwei year of Longqing.

Ancient famous physicians understood the root cause upon seeing the disease. They necessarily examined the meridian regions before prescribing, ensuring efficacy. However, modern customs have declined. Unskilled practitioners exploit patients for profit, and patients willingly suffer deception. For serious conditions, they remain helpless. Xin Cun, a man from Jintan, compassionate towards suffering, specifically published this secret formula for widespread dissemination.

Qingxia San: Treats ulcerated carbuncles and sores with excessive pus that fails to heal. First wash the area with Zhiye and pig trotter soup, then apply this powder.
Ingredients: Fei Qingdai (Prepared Indigo Naturalis) 2 qian, Rushiang (Frankincense) 1.5 qian, Moyao (Myrrh) 1.5 qian, Shaofen (Kaolin) 1 qian, Haipiaoxiao (Sepiae Endoconcha) 1 qian, Kufan (Alumen Exsiccatum) 1 qian, Bailian (Ampelopsis Radix) 1 qian, Hanshuishi (Calcitum) 1 qian, Bingpian (Borneolum Syntheticum) 0.3 qian, Hongfenshuang (Red Mercury Oxide Powder) separately ground extremely fine and mixed evenly, then incorporated at 1 qian. Xingren (Prunus Armeniaca Seed), peeled and de-husked, 24 pieces. If necrotic tissue is present, add Baidingxiang (Viverrae Moschiferae Faeces) 0.5 qian. For large, severely ulcerated sores with much putrid matter, add Tonglv (Verdigris) 1.5 qian.
This formula specializes in treating ulcers. Because blood heat causes flesh to rot and transform into pus, Qingdai is used as the sovereign drug to cool blood and resolve toxicity, preventing further flesh corruption. Rushiang and Moyao invigorate blood, relieve pain, and reduce swelling as minister drugs. The cold nature of Hanshuishi assists Qingdai in cooling blood and preserving flesh. Kufan’s astringent property drains pus and pursues toxins. Shaofen and Haipiaoxiao absorb dampness, stop excessive pus discharge without causing dryness. Hongfenshuang extracts toxins. Bailian consolidates wounds. Bingpian penetrates muscles, serving as assistant and guide drugs. Since most herbs are drying, Xingren’s oily nature provides lubrication. This constitutes the rationale of the prescription.