Library

The prescriptions recorded in this book are quite comprehensive and complete. However, those who wish to use these medicines must not fail to understand their principles. If one can carefully ponder each item, elaborate on and deeply reflect upon the intention behind the medication, and apply medicines according to the sequence of symptoms at the time of treatment, there will be no case that fails to respond. Recently, a relative or old friend suffered from this disease and was confused by incompetent physicians. Some used sovereign-minister drug combinations, while others used herbal remedies, resulting in more complications and increasing pain day by day. Only then did they change their minds, reject other doctors, and adopt my prescriptions. Occasionally asked for advice, I simply indicated three or five prescriptions for them to take, and none failed to recover. Herein, I briefly outline the essentials of medication and their chronological order, listed below.

1. When the back carbuncle (Back Carbuncle) is first perceived, immediately administer Neituo San (Internal Support Powder). This prevents later transformation syndromes and ensures no sores appear in the mouth or tongue. This medicine should only be taken for about ten doses before stopping.
Neituo San (Internal Support Powder): Greatly alleviates pain. If the lesion has not ulcerated, puncture it to drain pus (This prescription was originally missing; now supplemented from *Huiji Baoshu*).
Radix Aconiti Lateralis Preparata (Chuanwu, 1 liang, processed and soaked) Poria (Fuling, 3 fen) Bupleuri Radix (Kuzhi, 0.5 liang) Angelicae Pubescentis Radix (Duhuo) Angelicae Dahuricae Radix (Baizhi) Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 1 liang each)
Grind the above into powder. Take 2 qian per dose, mixed with wine, three times daily.

2. Immediately follow with Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction). If bowel movements become loose and internal heat subsides after taking this medicine, stop administration. If constipation recurs after one or two days, resume administration until toxic factors are completely purged, then stop. Also assess the patient's deficiency or excess syndrome and adjust the dosage accordingly based on severity.
Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction)
Aquariæ Lignum (Muxiang, 3 fen, not roasted) Aquariæ Lignum (Chenxiang, 3 fen, not roasted) Forsythiae Fructus (Lianqiao, whole, calyx removed, 3 fen) Cimicifugae Rhizoma (Shengma, 3 fen) Scutellariae Radix (Huangqin, 3 fen, select those without branching, raw use) Tetrapanacis Medulla (Mutong, 3 fen, nodes removed) Glycyrrhizae Radix et Rhizoma (Gancao, 0.5 liang, raw use) Myristicae Semen (Dingxiang, 0.5 liang, remove stems, not roasted) Boswelliae Resina (Ruxiang, 0.5 liang, separately ground) Rhei Radix et Rhizoma (Dahuang, lightly roasted, 0.5 liang, sliced) Moschus (Moxiang, genuine, 1.5 qian, separately ground) Taxilli Herba (Sangjisheng, 3 fen; genuine source is hard to obtain, omission is acceptable) Angelicae Pubescentis Radix (Duhuo, 3 fen; purchase aged Qianghuo instead, as current market Duhuo is often Tu Danggui, which is unsuitable)
Grind the above into coarse powder and mix evenly. Take 3 da qian per dose, decocted in 1 sheng of water until reduced to 0.7 sheng, strain and drink. Retain the dregs for a second decoction with 2 sheng of water to yield one dose. Accumulate dregs from four separate decoctions, add 3 sheng of water, decoct again to yield one dose, then discard the dregs. The prescription specifies using a silver vessel for decoction; if unavailable, add a piece of silver during decoction. Among these, Sangjisheng (Taxilli Herba) is most effective for treating the disease but is hard to obtain genuinely. If unavailable, substitute with Shengma (Cimicifugae Rhizoma). Since Shengma has already been added, if genuine Sangjisheng is lacking, double the dosage of Shengma.

3. Subsequently, advise frequent intake of Hongshi Paimao Neibu San (Hong’s Pus-Draining Internal-Nourishing Powder). If there is no nausea or vomiting, administer with good wine; if nausea or vomiting is present, administer with Muxiang Tang (Aquarius Decoction). This medicine should accompany the treatment of carbuncles and sores throughout, without interruption.
Huadu Paimao Neibu Shixuan San (Toxin-Detoxifying Pus-Draining Internal-Nourishing Ten-Exhaustive Powder) (Also known as Tuoli Shibu San (Interior-Supporting Ten-Nourishing Powder))
Treats all types of carbuncles, ulcers, boils, and sores. Promotes rapid suppuration of unformed lesions, allows foul pus to discharge spontaneously without manual squeezing, eliminates necrotic tissue naturally without surgical incision. Reduces pain after administration, with miraculous efficacy (This prescription was originally missing; now supplemented from *Heji Jufang*).
Astragali Radix (Huangqi, superior quality comes from绵 Lai; shaped like an arrow shaft, 2-3 chi long, branched at the top. Wash clean, cut into cun-length pieces, crush, tear open, moisten thoroughly with salt water, steam over a tea pot for one cooking duration, dry roast, grind together with other herbs into fine powder) Ginseng Radix et Rhizoma (Renshen, Korean origin is best. Select compact, heavy, moist ones, wash clean, remove rhizome, slice thinly, dry and grind) Angelicae Sinensis Radix (Danggui, Sichuan origin preferred. Select large slices resembling horse tails, moist, sweet-spicy, fragrant, wash with warm water, slice thinly, dry roast, 1 liang each) Magnoliae Officinalis Cortex (Houpo, Zizhou origin preferred. Thick flesh, purple color, exudes oil when pinched. Remove rough bark, slice, marinate in ginger juice overnight, cook, dry roast. Do not use Du Pu) Platycodonis Radix (Jiegeng, genuine ones have a heart and bitter taste; those without a heart and sweet taste are Shepherd’s Purse, which detoxifies drugs, do not mistake them. Clean mud, remove head and tail, slice thinly, dry roast) Cinnamomi Cortex (Guixin, select thin curled pieces. Ancient method: for every 1 liang of cinnamon with bark, take only 2.5 qian. To get 1 liang, buy 4 liang. After processing other herbs, grind separately, avoid fire exposure) Ligustici Chuanxiong Rhizoma (Chuanxiong, Sichuan origin preferred, currently mostly Fuxiong. Large chunks, wash clean, slice, dry roast) Saposhnikoviae Radix (Fangfeng, select fresh and fragrant. Wash clean, slice, dry roast) Glycyrrhizae Radix et Rhizoma (Gancao, raw use) Angelicae Dahuricae Radix (Baizhi, 1 liang each)
Of the above ten ingredients, select high-quality herbs, ensure purity, sun-dry and dry-roast thoroughly before weighing. Except for Guixin (Cinnamomi Cortex), grind all together, sieve into fine powder, then add Guixin and mix evenly. Dosage starts at 3 qian and increases to 5 qian, mixed with hot wine, taken several times day and night, more is better. Continue taking even after the wound closes for optimal results, to repair previous damage and prevent future complications. Non-drinkers should take with thickly decocted Muxiang Tang (Aquarius Decoction), though wine is superior. Those who drink little may occasionally mix wine with Muxiang Tang, which maintains efficacy comparable to pure wine. Generally, carbuncles and sores arise from stagnation of blood and qi, and accumulation of wind-toxin. Delayed treatment leads to external muscle destruction and internal organ attack, causing great harm. Administer immediately upon perception, doubling the dosage; intoxication-like effects accelerate efficacy. Disperses wind-toxin, promotes circulation in collaterals, drains pus, relieves pain, generates flesh, and nourishes tissue. The medicinal nature is mild, suitable for elderly, children, women, and unmarried girls.
Muxiang Tang (Aquarius Decoction): Treats initial formation of carbuncles/sores, headache, chills and fever, shortness of breath (This prescription was originally missing; now supplemented from *Shengji Zonglu*).
Aquariæ Lignum (Muxiang) Pogostemonis Herba (Huoxiangye) Aquariæ Lignum (Chenxiang) Frankincense (Xunluzhe) Myristicae Semen (Dingxiang) (1 liang each)
Coarsely grind and sieve the above five ingredients. Take 5 qian per dose, decoct in 1.5 sheng of salt water until reduced to 0.8 sheng, strain, take warm on an empty stomach, apply dregs to the shoulder. Twice daily.

4. Nausea and vomiting present two syndromes: One syndrome occurs when Neituo San (Internal Support Powder) was not taken at onset, leaving latent heat in the Heart; the other syndrome involves Qi deficiency, with improper Spleen Qi causing vomiting. Carefully examine the symptoms and consult appropriate medications. If vomiting is due to heat, accompanied by restlessness, body heat, and carbuncle pain, this indicates latent heat in the Heart. Administer Neituo San (Internal Support Powder) for three doses and stop; do not overuse. If vomiting is due to Qi deficiency, characterized by no mental restlessness or heat, early morning vomiting, or vomiting upon smelling foul odors, administer Jiahe San (Jiahar Powder) in the morning. If chills and fever are present, administer family-prescribed Zhengqi San (Righteous Qi Powder). At dawn, take Shanyao Wan (Chinese Yam Pill) to tonify the Kidney.

5. Although patients with Back Carbuncle (Fa Bei) are said to have heat, none develop this condition without underlying Kidney deficiency. After the carbuncle disease subsides by five parts, follow the previous method: take one dose of Shanyao Wan (Chinese Yam Pill) at dawn.
Jiahe San (Jiahar Powder) (Note: Original prescription missing).