治小儿脐疮。 牡蛎、大黄各三钱，朴硝一钱，共研极细，用活螺蛳五个，洗净，以清
水一碗养一夜，将螺放出，取水调敷数次。
治小儿阴肿。赤小豆、枳壳、赤芍、商陆、朴硝等分，勿见火，晒燥，研极细，柏叶煎
汤，日常调服。
治小儿脱肛。干地蟠龙一两（带土焙燥），朴硝二钱。共研极细，水调，鸡翎蘸搽数次，
肛肿干燥，用葱汤洗净，麻油调涂。蚯蚓一名地龙，味咸性寒，无毒。白颈者良，取用须盐
水洗净。
又方∶乌龟头或鳖头烧灰存性，麻油调搽。
又方∶吊扬尘和干鼠粪烧烟放桶中，坐上熏之。
治痘风疮烂。陀僧、滑石各二两，白芷五钱，共研极细。湿则撒之，干则蜜水调搽。
治风湿溃疮、善甚浸淫者。松香末二两，硫黄末二两，麻油拌温，摊放青布条上，卷作
筒子，以线缝定，再浸油中，取起刮去余油，铁钳夹住，点燃一头，下用碗接其膏液，须陆
续剪去布灰，冷水浸膏听用。
斑蝥五钱（去头足），黑牵牛一钱五分，昆布三钱（去净耖土，炒），海藻二钱（去净砂
土
诸
个
拔
凡治初起之毒，顺手医去，便易见效。如毒患已久及被人医得反复者，必须究其初起何
因及一向所服何药？且何药见效，何药不见效，仔细问明，看清阴阳，兼诊脉之虚实，方好
用药。凡治毒，必须按经加引经药，方能奏效。
正气盛者，消毒为主，正气虚者，扶正为主，消毒佐之。上身之毒，当归、川芎常用，
脚下之毒，用当归不用川芎。足下之毒，十有八九，初起以湿热论，久后以气虚论。发背
不宜用白术。上身之毒，总不宜用白术，恐燥肾闭气，排脓作痛。脐以下可用，并可重用。
委中毒不可用黄 ，用则足不能伸。伤寒时毒，不可用 、术。开口之毒，不宜用皂刺，恐
其翻口。
阳毒初起，通用加减消毒散。冬天有外感，加前胡、防风、苏叶、夏天有暑气，加香茹
、扁豆。
阴毒初起血虚者，通用阳和汤。此方不必加减，惟初起略加银花、甘草。或贫士无力，
买好玉桂换用当归二钱亦可。气虚者通用加味四妙汤。通经络用山甲，清热解毒用元参、赤
芍、银花、甘草，消阳毒坚肿用蒲公英，此乃阳明经主药，阳明之毒有坚肿者，可以重用。
消阴毒坚肿用续断。
散寒湿用防风、前胡。头脑上引经茏用 本，手上用桂枝，胸前口上用桔梗，腰上用杜
仲，脚上用牛膝，耳内用菖蒲，耳后用柴胡、夏枯，鼻孔用辛夷、桔梗，颧骨用公英，唇口
用山栀、白果。颈背侧膀胱经用羌活，乳房用公英，有儿吃乳者宜加漏芦以通乳窍，或山甲
亦可。腰眼用独活。
湿热毒不宜用丹，脚上初起忌用轻粉并升丹，火毒不宜用丹，对口忌用丹，下疳初起忌
用丹，颧口疽忌用丹，龟蛇初开口不宜用丹。鱼口是空处不宜用降，脑项上不宜用追毒散，
腹上不宜用降，恐其伤膜。脚上湿热毒不宜用膏药，贴用则热气闭寒，从内横走四边起吻，
久后则可用。乳房不宜用针，恐其伤络。毒瓦斯未清，不宜用生肌散，面上不宜用生肌散，耳
后不可上药线。
发背阳毒易治，阴毒居多。初起连服阳和汤数贴，自可消散，即或不消，亦易溃脓而收
功也。万不可服真人活命饮，此方多剥削脾胃。凡患阴背发者，多由肾气亏损，盖先天既坏
，复用连翘、花粉，剥削脾肾，安得不死。
凡毒肉满毒尽，久不收口而色白者，多是肌肉寒冷，用姜炭、玉桂末掺之方能收口。凡
毒鲜红者多痛。凡毒不可单用水洗，必须煎药，恐其伤湿。凡服大黄，小便必红而浊，须向
病定说清，恐其惊惶。
麻黄、荆芥，祛风散热，大头瘟症，可用此煎水冲。人中黄、大头瘟要药。气闭作痛者
用追毒散，脓闭作痛者，用冰翠散。
上牙属肾，下牙属大肠，牙肉亦然。交牙亦属胃，上 属脾，舌下属心。
疮口久后变黑无脓，乃气血大败之候，不治。
阴毒误事，多因妄用降丹点头。盖阴毒初起，宜温经通络，以图内消。日久宜用补剂托
里，使其转阳溃脓，不可妄行点降开刀。气薄者不宜重用银花，恐其伤气发汗。
凡遇毒头在上者，未出之时，先用降丹点于垂正处，向下顺出，方不至成倒胎，脓难尽
出。
服凉药而呃逆者，脾胃败也。服暖药而呃逆者，火毒攻也。暖药中用荆芥必须炒黑，取
其和腠理之血。
凡患毒最忌热食、火酒，犯之则红肿 痛。银花不可洗毒，洗则变烂。
腿、牙、头患毒，彻骨痛者以肾经为主；天柱痛者以肝经为主；漫肿者，以脾经为主。
又有咬骨疽，生鱼口下些，此症疼痛彻骨。凡欲追散毒瓦斯，不论阴阳，服药内必须加山甲、
皂刺。
解降丹毒，用蚱行同冰片捣烂敷，并能解诸火毒。
葱捣蜜，乃相反之药，头颈上不宜用，别处寒毒可敷。肺痈服白芨，须晒干研末，候药
水略温，再放下搅匀即服，不可久停，恐粘成膏。
无论各处疮毒，有黄脓痂者，皆是有痒之症，或用消毒散刷。
凡毒无论已溃未溃，忽切牙寒战，系气虚不能胜毒，毒陷攻里之兆。或溃后脓水忽多忽
少，疮口如蟹吐沫者，系内膜已透，俱为逆症。
初起疮口变黑者，或上坏升丹，或遇用黄丹，常有此弊。疮口如猪肝色者，多是过用黄
丹所致。出桐油水者，气血大虚，宜参归鹿茸汤补之。疮口深而有肿硬流桐油水者必有管。
久毒口细而深，无肿硬，流桐油水者必是漏。浮皮烂流桐油水者是湿气。坚肿出南瓜水结成
珠者亦是湿气。久毒疮头流血，乃肝气将败之候，宜重剂补药加五味子收之。
阳毒通用凉药，则变为半阴半阳，但比纯阴毒更易转身，培补正气，即转为阳。
天庭中心虽属督脉，但此处又是离宫，用药必须带住心经。人中患毒以阳明为主。鼻梁
内外以肺为主。玉茎属肝，马口属小肠，囊属肝，子属肾，子之系属肝。
凡毒生空处，最易生管成漏。凡寒症，先酸息而后经肿，湿热毒，红肿坚紧，按之有纳
，纯湿者皮色不变。气虚者，不红紫不作紧，按之有纳，国中益气汤主之，腿上患毒，贫苦
者多是风湿，富者多有肝肾虚，但风湿之症，多有寒热作体。三阴经患毒，虽是阳症，仍宜
调理血分。
口内有白色，用硼砂末搽之。口内腐烂亦见白色，宜用柳花散搽之。
冬天亦有暑毒，晕红作烧，如暑天一样，不会作寒。
口内生疔，仍有痒有头起得暴。治法，先针疔头，用降丹点之，俟脓头 ，用柳花散
收功。
凡毒麻木，有湿痹、血痹、气虚之分。重坠有纳者是气虚，手足初起者多湿痹，血热者
多作痛，血虚者下午更甚，亦有纳。
伤寒狐惑，嘴唇腐烂，不论虫之食脏食肛，小儿总以泻积热为主。如胡连、臭夷、谷虫
、芦荟等药，皆可酌用。
用太极黑铜膏，须避灯火，敷之更验。
凡手足叉龟湿热毒，虽脓腐尽时，不宜用生肌散，恐其复肿而痛，光膏贴之可也。
凡阳毒初溃、坚硬有腐者，宜用化管丸提之，以结其毒，听其自脱，后用乌云散盖膏，
徐即收功。
肛门患毒，服药内须入枳壳方效。
凡毒坐久而痛，血不行也。行而痛者，气血虚也。下午痛者，血虚也。溃后仍痛者，气
血亏也。初起痛者，凡寒湿热客于肉里而作脓也。
凡毒痒有湿痒、有风痒、有虚痒，血行亦作痒。
凡毒内作寒者，乃阴寒之毒，补药内须加鹿茸、玉桂。身上作寒兼有头痛者，乃外感风
寒之候，宜疏表之。
空处及多筋骨处，降丹宜少用。腹上不可轻用降丹。
凡刺毒，须要脓透时方可刺，开刀太早，则泄气反痛。
毒有臭气，须用洗药。阳毒多有臭气，阴毒有臭气必流血，乃气血大败，多不治。阳毒
有臭而生蛆者，须用生猪油捣寒水石末贴之。或用清油调杏仁末刷亦可。
凡毒起萝圈塍，有上坏丹药而起者，多紫黑作紧，乃闭住瘀血故也，宜用线针刺去紫血
，再按症用药。有过服补涩药而起者，内外清解，即可平复。若起浅白塍者无妨。
疮口出血不止∶有肝败而流血者，有气血亏而流血者，俱宜用重剂归脾汤治之。有未熟
误针而出血者，宜用托里散治之。
疮口无脓，有气血虚而无脓者，有风湿痹而无脓者，有误服白术闭住毒瓦斯而无脓者，四
边必坚硬，宜用清热泻火通窍之药治之。
疮口紫黑，有上坏丑丹而然者，须换好丹、盖膏自转红活。有上多黄丹而然者，换药刷
之自转。有气血大虚而然者，多难治，治之则宜大补。
凡疮毒有腐肉，须用冰翠散，重者宜用降丹点之。久后结成腐骨者，宜用托管丸治之。
凡毒 肉多，因开刀太早，伤其好肉所致。亦有毒将愈时，未避风水，新肉强出，只须
用膏盖护，可以平复。
凡久毒成漏，宜内服大补气血之药，外用川乌洗净蒸干，切片二分浓，用口涎润湿贴毒
口上，用艾圆灸之，令毒口温暖，稍稍觉痛，即住手勿灸，须用八宝丹盖膏。灸法须用五七
日为止。
久毒成管，先用化管丸纳入，盖膏六七日，方可 去，换用拔毒散，以消余毒，内服托
里散治之。如五六日后肿未消，则管未离岩，再照法用化管丸一次，断无不起，如无化管丸
，或用降丹线插入，盖膏，但不如化管丸能入弯曲之处。
凡刺毒须认有脓无脓，皮色绉黄，用手按之，手起而即复者有脓，手起而不复者无脓。
重按乃痛，脓之深也。轻按即痛，脓之浅也。至于用刀手法，刀口勿嫌阔大，深则深开，浅
则浅开，如开鱼口、便毒、背痈、脐痈、腹痈，宜浅开之。若遇肉浓处宜深开之。
凡毒用药，当分初、中、末之异。初宜散热、解毒、通经为主，以图消散；中宜排托为
主，以图逐毒成脓；末宜温补为主，以图易于收功，此大法也。若纯阴之毒，始终概宜温补
调理，一切清凉寒凝之药，不可轻投，并不可外敷寒凉末药，冰寒气血，不能消散。
Treats infantile umbilical ulcer (Umbilical Ulcer in Infants). Take Oyster Shell (Muli, 牡蛎) and Rhubarb (Dahuang, 大黄), each three qian, and Mirabilite (Puxiao, 朴硝) one qian. Grind them together into an extremely fine powder. Use five live snails, wash them clean, and keep them in a bowl of clear water overnight. Release the snails, collect the water, mix it with the powder, and apply to the affected area multiple times.
Treats infantile scrotal swelling (Scrotal Edema in Infants). Take Red Bean (Chixiaodou, 赤小豆), Bitter Orange (Zhiqiao, 枳壳), Red Peony Root (Chishao, 赤芍), Phytolacca Root (Shanglu, 商陆), and Mirabilite (Puxiao, 朴硝) in equal amounts. Avoid heat, dry them in the sun, and grind into an extremely fine powder. Decoct Cypresses Leaf (Baiye, 柏叶) in water, and take the mixture daily.
Treats infantile rectal prolapse (Rectal Prolapse in Infants). Take dried Earthworm (Di Long, 地龙) one liang (roasted with soil until dry) and Mirabilite (Puxiao, 朴硝) two qian. Grind together into an extremely fine powder, mix with water, dip a chicken feather in the solution, and apply to the anus several times. If the anus is swollen and dry, wash it with Scallion Decoction, then apply Sesame Oil (Mazhi, 麻油). The earthworm, also known as Di Long, has a salty taste and cold nature, and is non-toxic. Those with white necks are superior; wash them thoroughly with salt water before use.
Another prescription: Burn turtle head or softshell turtle head to ash while retaining their medicinal properties, mix with Sesame Oil (Mazhi, 麻油), and apply.
Another prescription: Collect dust from hanging places and dry mouse feces, burn them to produce smoke, place inside a bucket, and sit on the bucket to fumigate.
Treats varicella wind sores with ulceration. Take Tuo Seng (likely a specific mineral or prepared substance, often associated with realgar or similar minerals in historical contexts, here kept as Tuo Seng) and Talcum (Huashi, 滑石), each two liang, and Angelica Dahurica (Baizhi, 白芷) five qian. Grind together into an extremely fine powder. If the lesion is moist, sprinkle the powder directly; if dry, mix with honey water and apply.
Treats rheumatic ulcers that are severe and spreading/oozing. Take Pine Resin (Songxiang, 松香) powder two liang and Sulfur (Liuhuang, 硫黄) powder two liang. Mix with warm Sesame Oil (Mazhi, 麻油), spread on a strip of green cloth, roll into a cylinder, sew securely with thread, soak in oil again, remove, scrape off excess oil, hold with iron tongs, ignite one end, and catch the ointment liquid in a bowl below. Continuously cut away the burnt cloth ash. Soak the resulting ointment in cold water for later use.
Mylabris (Banmao, 斑蝥) five qian (remove head and feet), Black Morning Glory Seed (Hei Qianniu, 黑牵牛) one qian five fen, Kelp (Kunbu, 昆布) three qian (cleaned of sand and dirt, stir-fried), Seaweed (Haizao, 海藻) two qian (cleaned of sand and dirt...). [Text incomplete].
Generally, treating early-stage toxic sores allows for easy efficacy if treated promptly. If the sore has persisted for a long time or has been mismanaged by other physicians causing recurrence, one must investigate the initial cause and all medications previously taken. Determine which medications were effective and which were not, ask carefully, observe Yin and Yang patterns, and examine the pulse for deficiency or excess before prescribing. When treating toxic sores, meridian-guiding herbs must be added according to the affected meridian to ensure efficacy.
When Zheng Qi (Vital Energy) is robust, prioritize detoxification; when Zheng Qi (Vital Energy) is deficient, prioritize supporting Zheng Qi (Vital Energy) with adjunctive detoxification. For sores on the upper body, Dang Gui (Angelica Sinensis) and Chuan Xiong (Sichuan Lovage Rhizome) are commonly used. For sores on the lower limbs, use Dang Gui (Angelica Sinensis) but not Chuan Xiong (Sichuan Lovage Rhizome). Sores on the feet are mostly damp-heat in the early stage and Qi deficiency in the late stage. Fa Bei (Back Carbuncle) should not use Bai Zhu (Atractylodes Macrocephala Rhizome). Sores on the upper body generally should not use Bai Zhu (Atractylodes Macrocephala Rhizome) as it may dry out the Kidneys and obstruct Qi, causing pain during pus discharge. It can be used and heavily dosed below the navel. Wei Zhong Duzhong (Carbuncle at Weizhong Acupoint) should not use Huang Qi (Astragalus Root), as it may prevent leg extension. Shang Han Shi Du (Cold Damage Seasonal Toxins) should not use Huang Qi (Astragalus Root) or Bai Zhu (Atractylodes Macrocephala Rhizome). Open sores should not use Zao Ci (Gleditsia Sinensis Spine) as it may cause the sore to evert.
For early-stage Yang Du (Yang Toxin), use Jiajian Xiaodu San (Modified Detoxification Powder) universally. In winter with external contraction, add Qian Hu (Peucedani Radix), Fang Feng (Saposhnikovia Root), and Su Ye (Perilla Leaf). In summer with summerheat, add Xiang Ru (Mosla Herb) and Bian Dou (Lablab Bean).
For early-stage Yin Du (Yin Toxin) with Blood deficiency, use Yang He Tang (Warming Yang Decoction) universally. This formula need not be modified, except adding a little Jin Yin Hua (Honeysuckle Flower) and Gan Cao (Licorice Root) in the early stage. If poor patients cannot afford good Yu Gui (Cinnamon Twig), using two qian of Dang Gui (Angelica Sinensis) is acceptable. For Qi deficiency, use Jiawei Simiao Tang (Added-Ingredient Four Marvels Decoction) universally. To unblock meridians, use Shan Jia (Pangolin Scale); to clear heat and detoxify, use Yuan Shen (Scrophularia Root), Chi Shao (Red Peony Root), Jin Yin Hua (Honeysuckle Flower), and Gan Cao (Licorice Root); to dissipate Yang Du (Yang Toxin) hard swelling, use Pu Gong Ying (Dandelion), which is a principal herb for the Yangming Meridian. For Yangming Meridian toxins with hard swelling, heavy dosage is appropriate. To dissipate Yin Du (Yin Toxin) hard swelling, use Xu Duan (Teasel Root).
To disperse cold-dampness, use Fang Feng (Saposhnikovia Root) and Qian Hu (Peucedani Radix). For the head, use Gao Ben (Ligusticum Wallichii Rhizome) as a guiding herb; for the hands, Gui Zhi (Cinnamon Twig); for the chest and mouth, Jie Geng (Platycodon Root); for the waist, Du Zhong (Eucommia Bark); for the feet, Niu Xi (Achyranthes Root); for the ears, Chang Pu (Acorus Rhizome); behind the ears, Chai Hu (Bupleurum Root) and Xia Ku Cao (Prunella Spike); for the nostrils, Xin Yi (Magnolia Flower) and Jie Geng (Platycodon Root); for the cheekbones, Pu Gong Ying (Dandelion); for the lips and mouth, Shan Zhi (Gardenia Fruit) and Bai Guo (Ginkgo Seed). For the bladder meridian on the neck and back, use Qiang Huo (Notopterygium Rhizome); for the breasts, Pu Gong Ying (Dandelion); for nursing mothers, add Lou Lu (Euphorbia Fissurana Root) to unblock milk ducts, or Shan Jia (Pangolin Scale) is also suitable. For the lumbar region, use Du Huo (Angelica Pubescens Root).
Damp-heat toxins should not use Dan (Mineral Pills/Powders). Early-stage foot sores contraindicate Qing Fen (Calomel) and Sheng Dan (Rising Pill). Fire toxins contraindicate Dan (Mineral Pills/Powders). Dui Kou Ju (Opposite Mouth Carbuncle) contraindicates Dan (Mineral Pills/Powders). Xia Gang (Chancre) early stage contraindicates Dan (Mineral Pills/Powders). Quan Kou Ju (Cheek-Mouth Carbuncle) contraindicates Dan (Mineral Pills/Powders). Gui She Chu Kai Kou (Turtle-Snake Early Opening Sore) contraindicates Dan (Mineral Pills/Powders). Yu Kou (Fish Mouth) is a hollow area and contraindicates Jiang Dan (Descending Pill). Brain and nape contraindicate Zhui Du San (Toxin-Chasing Powder). Abdomen contraindicates Jiang Dan (Descending Pill) as it may damage membranes. Foot damp-heat toxins contraindicate Plasters, as applying them traps heat and cold, causing internal spread and cracking; they can be used only after a long time. Breasts contraindicate needle drainage to avoid damaging collaterals. When toxin qi is not cleared, Sheng Ji San (Flesh-Generating Powder) is contraindicated. Face contraindicates Sheng Ji San (Flesh-Generating Powder). Behind the ears, do not insert medicinal threads.
Fa Bei (Back Carbuncle) Yang Du (Yang Toxin) is easy to treat; Yin Du (Yin Toxin) is more common. Early stage, continuously taking Yang He Tang (Warming Yang Decoction) will naturally dissipate it. Even if it does not dissipate, it easily suppurates and heals. Never use Zhen Ren Huo Ming Yin (Immortal Life Decoction), as this formula depletes Spleen and Stomach. Yin Back Carbuncles are mostly due to Kidney Qi deficiency. Since congenital essence is already damaged, using Lian Qiao (Forsythia Fruit) and Hua Fen (Trichosanthes Root) further depletes Spleen and Kidney, leading to death.
When toxic flesh is full and toxin exhausted, but the sore does not close and appears white, it is mostly cold muscle. Use Jiang Tan (Charred Ginger) and Yu Gui (Cinnamon Twig) powder to promote closure. Fresh red sores are mostly painful. Sores should not be washed with plain water alone; decoctions must be used to avoid injuring dampness. Taking Da Huang (Rhubarb) causes red and turbid urine; explain this to the patient to prevent panic.
Ma Huang (Ephedra Stem) and Jing Jie (Schizonepeta Spike) dispel wind and clear heat. They can be decocted in water for Tou Da Wen (Big Head Plague). Ren Zhong Huang (Human Waste Charcoal) is a key herb for Tou Da Wen (Big Head Plague). For pain due to Qi obstruction, use Zhui Du San (Toxin-Chasing Powder); for pain due to Pus obstruction, use Bing Cui San (Ice Jade Powder).
Upper teeth belong to Kidney, lower teeth to Large Intestine, and gum tissue similarly. Interlocking teeth belong to Stomach, upper palate to Spleen, tongue root to Heart.
Sores turning black without pus after a long time indicate severe depletion of Qi and Blood, which is untreatable.
Yin Du (Yin Toxin) errors often result from reckless use of Jiang Dan (Descending Pill) puncture. Early-stage Yin Du (Yin Toxin) should use warming meridians and unblocking collaterals to seek internal dissipation. In later stages, tonics should be used to support interior and transform Yang to suppurate. Do not recklessly puncture, descend, or incise. Those with thin Qi should not heavily use Jin Yin Hua (Honeysuckle Flower) to avoid injuring Qi and inducing sweating.
For sores with heads on the upper body, before emergence, first use Jiang Dan (Descending Pill) at the lowest point to guide downward, preventing inverted fetus formation and ensuring complete pus discharge.
Hiccups after taking cooling medicines indicate Spleen-Stomach failure. Hiccups after taking warming medicines indicate Fire Toxin attack. Jing Jie (Schizonepeta Spike) in warming medicines must be charred black to harmonize collateral blood.
Hot food and strong wine are strictly forbidden for sores; violation causes redness, swelling, and pain. Jin Yin Hua (Honeysuckle Flower) should not be used to wash sores, as it causes rotting.
Leg, tooth, and head sores with bone-deep pain primarily involve Kidney Meridian. Tian Zhu (Occipital) pain primarily involves Liver Meridian. Diffuse swelling primarily involves Spleen Meridian.
Ya Gu Ju (Bone-Biting Carbuncle) occurs slightly below Yu Kou (Fish Mouth), causing bone-deep pain. To chase and scatter toxin qi, regardless of Yin or Yang, Shan Jia (Pangolin Scale) and Zao Ci (Gleditsia Sinensis Spine) must be added to oral medications.
To resolve Jiang Dan (Descending Pill) toxicity, crush Locusta (Zha Xing, 蚱蜢) with Bing Pian (Borneol) and apply externally; it also resolves various fire toxins.
Scallion mixed with Honey is a contradictory combination, unsuitable for head and neck, but applicable for cold toxins elsewhere. For Lung Abscess, Bai Ji (Bletilla Rhizome) must be dried, powdered, mixed with slightly warm decoction, stirred well, and taken immediately to avoid becoming paste-like.
Any sore with yellow purulent crust indicates itching; use Xiaodu San (Detoxification Powder) to brush/clean.
Any sore, whether opened or not, suddenly presenting with clenched teeth and chills indicates Qi deficiency unable to overcome toxin, a sign of toxin sinking inward. Or, if pus flow fluctuates greatly after opening, and the sore looks like crab spitting foam, it indicates perforation of inner membrane; both are adverse signs.
Early-stage sores turning black are often due to improper use of Sheng Dan (Rising Pill) or Huang Dan (Yellow Mineral Pill). Sores resembling pig liver color are mostly caused by excessive use of Huang Dan (Yellow Mineral Tong). Discharge of tung oil indicates severe Qi and Blood deficiency; treat with Shen Gui Lu Rong Tang (Ginseng, Angelica, and Deer Antler Decoction). Deep sores with hard swelling discharging tung oil contain a sinus tract. Long-standing sores that are narrow and deep without hard swelling but discharging tung oil are fistulas. Superficial skin rot discharging tung oil is dampness. Hard swelling discharging pumpkin-water-like fluid forming beads is also dampness. Bleeding from the head of a long-standing sore indicates impending Liver Qi failure; treat with heavy tonics plus Wu Wei Zi (Schisandra Berry) to astringe.
Yang Du (Yang Toxin) generally uses cooling medicines, transforming into semi-Yin semi-Yang. This is easier to reverse than pure Yin Toxin; supporting Zheng Qi (Vital Energy) transforms it back to Yang.
Tian Ting center belongs to Du Mai (Governor Vessel), but is also Li Gong (Fire Palace); medications must address Heart Meridian. Ren Zhong (Philtrum) sores primarily involve Yangming Meridian. Nasal bridge内外 (inside and out) primarily involve Lung. Yu Jing (Penis) belongs to Liver, Ma Kou (Meatus) to Small Intestine, Nang (Scrotum) to Liver, Zi (Testicles) to Kidney, and Zi Zhi Xi (Spermatic Cord) to Liver.
Sores in hollow areas easily form sinuses and fistulas. Cold patterns present with acid sensation followed by meridian swelling. Damp-heat toxins present with red, swollen, hard, tight skin with pitting edema. Pure dampness shows no skin color change. Qi deficiency presents with non-red/non-purple, non-tight skin with pitting edema; treat with Guo Zhong Yi Qi Tang (National Middle Qi-Supporting Decoction). Leg sores in the poor are often wind-damp; in the rich, often Liver-Kidney deficiency. Wind-damp patterns often have alternating chills and fever. Toxins in Three Yin Meridians, though Yang patterns, still require blood regulation.
White patches in the mouth: apply Peng Sha (Borax) powder. Mouth rot with whiteness: apply Liu Hua San (Willow Flower Powder).
Winter also has summerheat toxin, presenting with redness and burning like summer, without chills.
Oral Ding (Hard Carbuncle) starts violently with itching and a head. Treatment: puncture the head first, apply Jiang Dan (Descending Pill), wait for pus head to mature, then use Liu Hua San (Willow Flower Powder) to conclude treatment.
Sore numbness distinguishes between Damp Bi (Obstruction), Blood Bi (Obstruction), and Qi deficiency. Heavy sensation with pitting is Qi deficiency. Early hand/foot onset is often Damp Bi. Blood heat causes pain. Blood deficiency worsens in afternoon, also with pitting.
Shang Han Hu Huo (Cold Damage Hu Huo Syndrome) with lip rot: regardless of worms eating viscera or anus, infants primarily focus on draining accumulated heat. Hu Lian (Coptis Rhizome), Chou Yi (Styrax Benzoin - likely error for another herb, possibly Chou Wutong), Gu Chong (Grub), and Lu Hui (Aloe) can be酌情 (discretionarily) used.
Tai Ji Hei Tong Gao (Tai Ji Black Copper Ointment) must avoid fire/light; application is more effective.
Hand/foot fork-crack damp-heat toxins: even when pus and rot are gone, Sheng Ji San (Flesh-Generating Powder) is contraindicated to avoid recurrent swelling/pain; use smooth plaster instead.
Early-stage Yang Du (Yang Toxin) open sores with hardness and rot: use Hua Guan Wan (Sinus-Unblocking Pill) to extract, consolidate toxin, allow natural shedding, then cover with Wu Yun San (Black Cloud Powder) and plaster for gradual healing.
Anal sores: Zhi Qiao (Bitter Orange) must be added to oral medication for efficacy.
Sore pain after sitting still indicates stagnant blood. Pain upon movement indicates Qi and Blood deficiency. Afternoon pain indicates Blood deficiency. Persistent pain after opening indicates Qi and Blood deficit. Early pain indicates cold, damp, heat pathogens in flesh generating pus.
Sore itching distinguishes Damp itch, Wind itch, Deficiency itch, and Blood circulation itch.
Internal cold in sores indicates Yin-Cold Toxin; add Lu Rong (Deer Antler) and Yu Gui (Cinnamon Twig) to tonics. Body chills with headache indicate external Wind-Cold; release the exterior.
Jiang Dan (Descending Pill) should be sparingly used in hollow and bony areas. Do not lightly use Jiang Dan (Descending Pill) on abdomen.
Incision for toxic sores must wait until pus penetrates. Incising too early leaks Qi and causes pain.
Smelly sores require washing decoctions. Yang Du (Yang Toxin) often smells; Yin Du (Yin Toxin) with smell and bleeding indicates severe Qi/Blood depletion, mostly untreatable. Smelly Yang Du (Yang Toxin) with maggots: apply raw pork fat mixed with Han Shui Shi (Halloysitum) powder, or clear oil mixed with Almond powder.
Sores with ring-shaped edges caused by bad mineral pills are often purple-black and tight due to trapped stasis; prick with thread needle to drain purple blood, then medicate based on pattern. Sores from overuse of astringent tonics: clear internally and externally to recover. Light white edges are harmless.
Unstopping sore bleeding: Liver failure bleeding or Qi/Blood deficiency bleeding both treat with heavy dose Gui Pi Tang (Restore the Spleen Decoction). Unripe mistaken puncture bleeding treats with Tuo Li San (Interior-Supporting Powder).
Sore without pus: Qi/Blood deficiency, Wind-Damp Bi, or mistaken Bai Zhu (Atractylodes Macrocephala Rhizome) usage blocking toxin qi (hard edges) treat with clearing heat, purging fire, and opening orifices.
Purple-black sores: Caused by bad Chou Dan (Bad Mineral Pill) requires changing to good pill and covering with plaster to turn red/vibrant. Caused by excessive Huang Dan (Yellow Mineral Pill) requires changing medicine and brushing to turn. Caused by severe Qi/Blood deficiency is difficult to treat; requires major tonification.
Sores with rotting flesh: use Bing Cui San (Ice Jade Powder). Severe cases puncture with Jiang Dan (Descending Pill). Late-stage rotten bone: use Tuo Guan Wan (Sinus-Supporting Pill).
Excessive rotting flesh results from early incision damaging healthy flesh. Or, near healing, exposure to wind/water causes premature new flesh growth; cover with plaster to recover.
Long-standing sores becoming fistulas: internal major Qi/Blood tonics. External: Wash and steam Chuan Wu (Aconite Root), slice thickly, moisten with saliva, apply to sore, moxa with Ai Yuan (Moxa Cone) until warm and slightly painful, then stop. Cover with Ba Bao Dan (Eight Treasures Pill). Moxibustion lasts 5-7 days.
Long-standing sores becoming sinuses: Insert Hua Guan Wan (Sinus-Unblocking Pill), cover with plaster for 6-7 days, then remove. Change to Ba Du San (Toxin-Extracting Powder) to eliminate residual toxin, internal Tuo Li San (Interior-Supporting Powder). If swelling persists after 5-6 days, sinus hasn't detached; repeat Hua Guan Wan (Sinus-Unblocking Pill). Without Hua Guan Wan (Sinus-Unblocking Pill), use Jiang Dan (Descending Pill) thread insertion, but less effective in curved areas.
Assess pus presence: Wrinkled yellow skin, press with hand. Immediate rebound indicates pus; no rebound indicates no pus. Deep pain on heavy pressure indicates deep pus; light pain indicates shallow pus. Incision technique: Don't fear wide cuts. Deep cuts for deep sores, shallow for shallow. Fish mouth, Bian Du (Groin Abscess), Back Carbuncle, Umbilical Carbuncle, Abdominal Carbuncle: shallow incision. Thick flesh areas: deep incision.
Medication for sores differs by early, middle, and late stages. Early: Clear heat, detoxify, unblock meridians to dissipate. Middle: Drain and support to drive out toxin and form pus. Late: Warm and tonify to facilitate healing. This is the general principle. Pure Yin Toxin always requires warming and tonifying; avoid cooling/cold-congealing medicines and external cold powders that freeze Qi/Blood and prevent dissipation.