（又名通顺散，又名何首乌散。）
何首乌（不犯铁） 当归 木通（去皮节） 赤芍药（炒） 白芷 茴香（炒） 土乌药（炒）
陈枳壳（麸炒。若恶心，姜汁炒） 甘草
上方只此九味各等分，水、酒、汤使随证用之，水酒相半亦可。惟流注加独活。每服四钱。
病在上，食后服；病在下，食前服。
此一药，流注、痈疽、发背、伤折，非此不能效。至于救坏病、活死肌，弭患于未萌之
前，
拔根于既愈之后，中间君臣佐使，如四时五行更相迭旺，真神仙妙剂，随证加减，其效无穷
。何则？此药大能顺气匀血故也。夫气阳也，血阴也。阳动则阴随，气运则血行；阳滞则阴
凝，气弱则血死；血死则肌死，肌死则病未有不死者矣，必调其阳，和其阴，然后气血匀，
二者不可偏废。只调阳不和阴，则气耗而血凝，肌必不活，如五香连翘之类是已。只和阴不
调阳，则血旺而气弱，疾必再作，如内补十宣之类是已。然二药亦须参用之，不可执一为妙
。此药扶植胃本，不伤元气，荡涤邪秽，自然顺通，不生变证，真仙剂也。用法开具于后∶
一、发背既久不愈，乃前医用凉药过也。凉药内伤其脾，外冰其血。脾主肌肉，脾土受伤，
饮食必减，颜色痿瘁，肌肉不生；血为脉络，血一受冰，则气不旺，肌肉糜烂。故必理脾，
脾健，肉自生。宜于此方中去木通，少用当归，倍加浓朴、陈皮。盛则用家传对金饮子，又
盛则加白豆蔻之类为妙。
一、凡治流注，可加独活。流注者，气血凝滞，故气流而滞，则血注而凝。加此药者，
可以动荡一身血脉，血脉既动，岂复有流注乎。
一、流注起于伤寒，伤寒表未尽，余毒流于四肢，经络涩于所滞，而后为流注也。如病
尚有
潮热，则里有寒邪未尽散。此方中可加升麻、苏叶。如服此而热不退，可加干葛。如有头疼
加川芎，并用姜水煎。如无潮热，可用水酒相半煎，酒大能行血生气故也。气生血行，病愈
可必然。流注须表者何也？所以推其因究其源，不忘病之根本也。寒邪既尽，表之太过则为
冷流注，尤为难治，故宜略表为妙。表后第二节，宜服温平之药，乃十宣内补是已。如不效
，第三节宜加附子，或服四桂散数服即止。温药亦不可多用，恐增痛苦，反成脓血不干。第
四节仍归本方收效。然表未尽，则余毒附骨而为骨痈。夫流注者，伤寒之余毒。骨痈者，又
流注之败证也。流注非伤寒之罪，乃医者表之未尽也。骨痈非流注之过，又庸医凉药之过也
。庸医无识，心盲志聋，妄犹明见，虽知为骨痈，而治之无法，又复投之凉药，烈之毒刃，
则毒瓦斯滞，凉药触铁器，则愈附骨而不能愈矣。不然，则人之骨何以有痈。骨而成痈，非药
所治，故名附骨疽，又名白虎飞尸。留连周期，辗转数岁，冷毒朽骨，出尽自愈。其不愈者
，至于终身有之，此皆失于初也。其骨腐者，多为副骨，尤或可痊。正骨腐则终身废疾。故
脓白而清者，碎骨初脱，肉深难取；脓黄而浓者，碎骨将出，肉浅可取，宜以利刀取之。详
在后章。此不过治骨痈之概耳。
又有病经数月，伤于刀刃，羸弱、拳挛、咳嗽、脓血、坏肉阴烂者，此皆冷极。阳弱阴
盛，不可以唾红为热，宜以好附子加减治之。
又有毒自手脚头面而起，疼痛遍身，上至颈项经络所系去处，如疡 贯珠者，此为风湿
流气之证，宜以加减小续命汤及独活寄生汤，与此方参错用之。
又有两膝痛起，以至遍身骨节皆痛，妇人类血风，男子类软风，此名风湿痹，又名 节
，宜以附子八物汤加减用之。
又有痈肿在项、腋、两乳旁，两胯软肉处，名为 痈。此冷证无热，宜以内补十宣散
，与
此方参用。小儿不可轻用附子，恐生惊痫。切不可更犯针刀，薄血无脓， 肉难合，宜以温
热药贴散内消。倘犯针刀，生 肉，亦以此药收功。倘用药微疼，略有惊痫，宜用全蝎观音
散加减用之。惊定，药如故事。又有小儿亦患宿痰失道者，痈肿见于颈项、臂膊、胸背等处
，是为冷极，全在热药敷贴之功，（留口。）病须再作为佳，治法在后。
又有流注，大如匏瓠覆碗，见于胸背，其证类发而甚恶，用药之后，情势一有微动，即
非发
矣。宜以内补十宣，与此方随证通变用之，可以内消。大抵诸证，皆原于冷，故为痛者，骨
痛也。骨者肾之余，肾虚则骨冷，骨冷所以痛。所谓骨疽，皆起肾者，亦以其根于此也。故
补肾必须大附子，方能作效。肾实则骨有生气，疽不附骨矣。凡用药不可执一，贵乎通变。
一、凡痈疽初萌，必气血凝滞所成，为日既久，则血积于所滞，而后盛作。故病患气血
盛者
，此方中减当归，多则生血，发于他所，再结痈肿，生生不绝。斯乃秘传，医者少知也。
一、凡痈疽生痰有二证∶一胃寒生痰，此方中加半夏健脾化痰。二热郁而成风痰，此方
中加桔梗以化咽膈之痰，并用生姜，和水酒煎。
一、凡脑发背发在上者，此方中可去木通，恐导虚下元，为上盛下虚之病，难于用药。
老人虚弱者，尤宜去之。
一、凡病患有泻者，不可便用此方。宜先用止泻药，白矾生用为末，溶开黄蜡为丸米饮
下三
十丸，俟泻止方用此药。盖人身以血气为主，病痈之人，气血潮聚一处为脓，若脏腑不固，
必元气泄而血愈寒难愈。此药大能顺气故也。大抵气顺则血行，气耗则血寒，气寒则血死，
血死则肌肉不生。投之热药，则肌肉无元气，不足以当之，徒增苦。投之凉药，则无是理。
是方虽仙授，要在用之得当，不然，则有刻舟之患矣。至于流注，又不可一概论也。若凉药
耗散元气虚败，有用三建取效者，其疾多缘于冷故也。尤当审其脉、辩其证的出于冷，而然
后用之。亦不可过，过亦有害。但阳脉回，肿处红活，骨有生气，寒气不能相附为疽，即归
功本方以取效。此万全妙法。
一、此药，丸、散、末皆可水、酒、汤使，临时裁度用之。贵人加木香为衣。病者有热
痰、咳嗽，富沉香、贫苏叶汤皆可下，丸用蜜为丸。
一、此方，非但治痈疽、发背、伤折，至于男子妇人疝气、血气皆可用，屡获效矣。有
一妇
人患气疾五年，发时只是块痛、呕逆，水浆不下，一发便死。用此药为丸，木香汤下，一服
呕止，再服痰气顺遂愈。
一、凡伤折，皆不脱此方，但加减有差，详见伤折类中。如寻常打破伤损，或伤心胞，
并皆
治之。在头上则去木通、枳壳，加川芎、陈皮；常用加丁皮、苏叶能活血；加破故纸、五灵
脂能破宿血。水煎熟了，却用浓酒一盏浸入；侯再沸，却入大黄末，空心服之。如通顺，药
只四服，先二服中入大黄末，后二服不必用，只是催发便下。如不通，用枳壳汤一向催；如
若不通，即不可治。不可坐视人死而不知也，补血十宣散之类。
一、凡伤折，常用此方，可去木通，名何首乌散。盖首乌能扶血故也。如刀刃伤，有潮
热，
面肿气喘，乃破伤风证，可服索血散、葛根汤数服，姜葱煎发散∶或败毒散三、四服，外用敷
贴药，根据法治之，无不愈者矣。
一、经年腰痛，加萆 、玄胡索，以酒煎服。
一、香港脚，加槟榔、木瓜、穿山甲，水煎服之。
一、宿痰失道，非惟人不识，自仙授以来，惟余一派知之。人身有痰，润滑一身，犹鱼
之有
涎。痰居胃中，不动则无病，动则百病生，或喘、或咳、或呕、或晕，头痛睛疼，遍身拘急
，骨节痹疼，皆外来新益之痰，乃血气败浊凝结而成也。何则？脏腑气逆郁结生痰，当汗不
汗，蓄积生痰，饮食过伤，津液不行，聚而生痰。其常道，则自胃脘达肺脘而出；其失道，
自胃脘而流散冷肌肉皮毛之间。脾主肌肉，肺主皮毛。故凡胸背、头项、腋胯、腰腿、手足
，结聚肿硬，或痛、或不痛，按之无血潮；虽或有微红，亦淡薄不热；坚如石，破之无脓，
或有薄血，或清水，或如乳汁；又有坏肉如破絮；又恐如瘰 ，在皮肉之间，如鸡卵浮浴于
水中，可移动，软活不硬，破之亦无脓血，针口 肉突出，惟觉咽喉痰实结塞，作寒作热，
即
皆其证。急于此方中加南星、半夏等药，以治其内；外用玉龙热药，以拔其毒，便成脓破为
良。其轻无脓者，必自内消。如热极痰壅，则用控涎丹∶紫大戟、甘遂、白芥子等分为末，
米糊为丸。如遍身肿硬，块大如杯盂，生于喉项要处者，尤为难治。夫血气和畅，自无他病
；气行不顺，血化为痰；痰复失道，则血气衰败，不能为脓，但能为肿硬，理必然也。此证
阳少阴多，随证用药，回阳生气，补血控涎。外则用后法，作起一身气血引散冷块。万一肿
不消，不作痛，不为热，体气实无他证，肉块与好肉无异，此又一证也。切不可轻用针刀自
戕，如草医曾用针灸，阴烂其肉；或用毒药点脱，使人憎寒壮热。法当通顺其气血，于此方
中加升麻，以除其寒邪。用敛口结痂之药以安之，使为疣赘而已。万一病自作臭秽糜烂，不
免动刀，则有妙剂，可以代刀，不可轻泄，即白矾枯朴硝二味为末敷之。
一、肚肠内痈，宜服十宣散，与此方相间用之，并加忍冬藤。此药最治内痈，但当审其
虚实
，或通或补。补须用附子，通则用大黄。如不明虚实，则此方亦自能通顺。十宣自能内补，
可无他变。至于肺痈，初觉饮食有碍，胸膈微痛，即是此证。急须察脉，审其虚实。虚则用
此方，加附子相出入用之。若稍再作，即用十宣散内补之，即自消散。实则用此方加大黄略
通
之，使毒瓦斯下宣为妙。盖肺与大肠相表里故也。如内痈已成，宜以海上方，与此方加减参用
之。喘咳脓血者，肺痈也；大便有脓自脐出者，肚痈也；忍冬藤甘草节煮酒妙。
（此方又名通顺散，又名何首乌散。）
何首乌（注意不可接触铁器） 当归 木通（去除皮和节） 赤芍药（炒制） 白芷 茴香（炒制） 土乌药（炒制）
陈枳壳（用麦麸炒。如果患者有恶心症状，用姜汁炒） 甘草
以上九味药各取等量，煎煮时根据病情选择用水、酒或汤剂送服，水和酒各半也可以。如果是流注病，需加独活。每次服用四钱。
病位在上部的，饭后服用；病位在下部的，饭前服用。
这一种药物，对于流注、痈疽、发背、跌打损伤，非此药不能见效。至于救治误治导致的坏病、挽救坏死的肌肉，在祸患尚未萌发之前消除隐患，在疾病痊愈之后拔除病根，其中君臣佐使的配伍，如同四季五行更替旺盛一样，真是神仙般的妙剂，随证加减，疗效无穷无尽。为什么呢？因为此药大能理顺气机、调和血液。气属阳，血属阴。阳气动则阴血随之运行，气机运转则血液流通；阳气阻滞则阴血凝滞，气虚则血液停滞；血液停滞则肌肉坏死，肌肉坏死则疾病没有不致命的，必须调理阳气、调和阴血，然后气血才能均匀，这两者不可偏废。只调阳不和阴，则气耗散而血凝滞，肌肉必然无法复活，就像五香连翘汤之类的方子。只和阴不调阳，则血旺而气弱，疾病必定复发，就像内补十宣散之类的方子。然而这两类方药也应当参合使用，不可固执一端为妙。此药扶持胃气根本，不伤元气，荡涤邪秽，自然顺畅通达，不生变证，真是仙家之剂。用法如下：
一、发背疮疡日久不愈，是因为之前医生用药过于寒凉所致。寒凉药物内伤脾胃，外冰血脉。脾主肌肉，脾土受伤，饮食必然减少，面色萎黄憔悴，肌肉不生；血行脉络，血液一旦受寒凝滞，则气机不旺，肌肉腐烂糜烂。所以必须调理脾胃，脾胃健运，肌肉自然生长。宜在此方中去掉木通，少量使用当归，加倍加入厚朴、陈皮。病情严重的，使用家传的对金饮子，更加严重的，加入白豆蔻之类更为巧妙。
二、凡是治疗流注，可以加入独活。流注病，是气血凝滞所致，所以气流动而血停滞，导致血注而凝。加入此药，可以动荡全身血脉，血脉既已活动，哪里还会有流注呢。
三、流注起于伤寒，伤寒表证未解，余毒流窜于四肢，经络涩滞于所停之处，而后形成流注。如果病症还有潮热，说明里有寒邪未尽散。此方中可加升麻、苏叶。如果服用此药后热不退，可加干葛（葛根）。如果有头痛，加川芎，并用姜水煎服。如果没有潮热，可用水和酒各半煎服，因为酒大能行血生气。气生血行，病愈是必然的。为什么流注需要发表呢？是为了推究病因根源，不忘疾病的根本。寒邪既然已尽，发表太过则变成冷流注，尤为难治，所以适宜略微发表为妙。发表后的第二阶段，宜服用温平的药物，就是十宣内补散。如果无效，第三阶段宜加附子，或者服用四桂散几服即可停止。温药也不可用太多，恐怕增加痛苦，反而导致脓血不干。第四阶段仍回归本方以收效。然而表邪未尽，则余毒附着骨骼成为骨痈。所谓流注，是伤寒的余毒。骨痈，又是流注的败坏证候。流注不是伤寒的罪过，而是医生发表未尽的缘故。骨痈不是流注的过错，又是庸医滥用寒凉药的过错。庸医无见识，心盲志聋，妄自尊明，虽然知道是骨痈，但治疗无法，又再次投以寒凉药，猛烈如毒刃，则毒瓦斯滞留，寒凉药触碰铁器（比喻性质极寒），则更加附着骨骼而不能治愈了。不然的话，人的骨头怎么会有痈肿。骨头成痈，不是药物所能治疗的，所以名叫附骨疽，又名白虎飞尸。拖延周期，辗转数年，冷毒腐蚀朽骨，排出后自愈。不能自愈的，甚至终身如此，这都是起初失治造成的。如果是副骨腐败，或许还可以痊愈。正骨腐败则终身残疾。所以脓液白而清的，是碎骨初脱，肉深难取；脓液黄而浓的，是碎骨将出，肉浅可取，宜用利刀取出。详细见后章。这不过是治疗骨痈的大概情况罢了。
又有病症经过数月，被刀刃所伤，身体羸弱、拳挛、咳嗽、脓血、坏肉阴烂的，这都是寒气极盛。阳弱阴盛，不可以咳唾红色痰液认为是热证，宜用好附子加减治疗。
又有毒气从手脚头面而起，疼痛遍及全身，上至颈项经络所系之处，像溃疡贯穿珠子一样的，这是风湿流气证，宜用加减小续命汤及独活寄生汤，与此方参差错杂使用。
又有两膝疼痛发起，以至遍身骨节皆痛，妇女类似血风，男子类似软风，这叫风湿痹，又名历节风，宜用附子八物汤加减使用。
又有痈肿在颈部、腋下、两乳旁、两胯软肉处，名叫腤痈。此证属冷证无热，宜用内补十宣散，与此方参合使用。小儿不可轻用附子，恐怕引发惊痫。切不可再犯针刀，否则血薄无脓，肌肉难以愈合，宜用温热药贴敷消散。倘若犯了针刀，长出息肉，也用此药收功。倘若用药微疼，略有惊痫，宜用全蝎观音散加减使用。惊定后，用药照旧。又有小儿也患宿痰失道的，痈肿见于颈项、臂膊、胸背等处，这是寒气极盛，全赖热药敷贴之功。（留口待用。）病情须再次发作为佳，治法在后文。
又有流注，大如匏瓠覆碗，见于胸背，其证类似发背而甚恶，用药之后，情势一有微动，就非发背了。宜用内补十宣，与此方随证通变使用，可以内消。大抵各种病症，都源于寒冷，所以疼痛的，是骨痛。骨是肾之余，肾虚则骨冷，骨冷所以痛。所谓骨疽，都起于肾，也是因为根在此处。所以补肾必须用大附子，才能生效。肾实则骨有生气，疽就不附着骨骼了。凡用药不可固执一端，贵在通变。
一、凡是痈疽初萌，必由气血凝滞而成，日子久了，则血积于所滞之处，而后盛大发作。所以病患气血盛的，此方中减去当归，多了则生血，发于他处，再结痈肿，生生不绝。这是秘传之法，医者少有人知。
一、凡是痈疽生痰有两种证候：一是胃寒生痰，此方中加半夏健脾化痰。二是热郁而成风痰，此方中加桔梗以化咽膈之痰，并用生姜，和水酒煎服。
一、凡是脑发、背发在上部的，此方中可去木通，恐怕引导虚气下元，造成上盛下虚的病，难于用药。老人虚弱者，尤其适宜去掉。
一、凡是患有腹泻的病人，不可立即用此方。宜先用止泻药，白矾生用为末，溶开黄蜡做成丸，米饮送下三十丸，等到泻止才用此药。盖人身以血气为主，患痈的人，气血潮聚一处化为脓，若脏腑不固，必元气泄而血愈寒难愈。此药大能顺气。大抵气顺则血行，气耗则血寒，气寒则血死，血死则肌肉不生。投以热药，则肌肉无元气，不足以承受，徒增痛苦。投以凉药，则没有这个道理。此方虽是仙授，关键在于用得得当，不然，则有刻舟求剑之患。至于流注，又不可一概而论。若凉药耗散元气虚败，有用三建汤取效的，其疾多缘于寒冷。尤当审其脉、辩其证出于寒冷，然后使用。也不可用过量，过量也有害。只要阳脉回，肿处红活，骨有生气，寒气不能相附为疽，即归功于本方以取效。这是万全妙法。
一、此药，丸剂、散剂、末剂皆可用水、酒、汤剂送服，临时裁度使用。贵人加木香为衣。病人有热痰、咳嗽，富人可用沉香，穷人可用苏叶汤送下，丸药用蜜为丸。
一、此方，不仅治痈疽、发背、跌打损伤，至于男女疝气、血气也都可用，屡获效验。有一个妇人患气疾五年，发作时只是块痛、呕逆，水浆不下，一发便死。用此药做成丸，木香汤送下，一服呕止，再服痰气顺遂痊愈。
一、凡是跌打损伤，都不脱离此方，但加减有差异，详见伤折类中。如寻常打破伤损，或伤心胞，都治之。在头上则去木通、枳壳，加川芎、陈皮；常用加丁香皮、苏叶能活血；加破故纸、五灵脂能破宿血。水煎熟后，却用浓酒一盏浸入；待再沸，却入大黄末，空腹服之。如通畅，药只服四服，先二服中加入大黄末，后二服不必用，只是催发便下。如不通，用枳壳汤一直催下；如若不通，即不可治。不可坐视人死而不知也，用补血十宣散之类。
一、凡是跌打损伤，常用此方，可去木通，名何首乌散。因为首乌能扶血。如刀刃伤，有潮热，面肿气喘，乃破伤风证，可服索血散、葛根汤数服，姜葱煎发散；或败毒散三、四服，外用敷贴药，根据法治之，无不愈者。
一、宿痰失道，不仅人不识，自仙授以来，只有我这一派知道。人身有痰，润滑一身，犹鱼之有涎。痰居胃中，不动则无病，动则百病生，或喘、或咳、或呕、或晕，头痛睛疼，遍身拘急，骨节痹疼，都是外来新益之痰，乃血气败浊凝结而成。为什么呢？脏腑气逆郁结生痰，当汗不汗，蓄积生痰，饮食过伤，津液不行，聚而生痰。其常道，则自胃脘达肺脘而出；其失道，自胃脘而流散冷肌肉皮毛之间。脾主肌肉，肺主皮毛。故凡胸背、头项、腋胯、腰腿、手足，结聚肿硬，或痛、或不痛，按之无血潮；虽或有微红，亦淡薄不热；坚如石，破之无脓，或有薄血，或清水，或如乳汁；又有坏肉如破絮；又恐如瘰疬，在皮肉之间，如鸡卵浮浴于水中，可移动，软活不硬，破之亦无脓血，针口息肉突出，惟觉咽喉痰实结塞，作寒作热，即皆是其证。急于此方中加南星、半夏等药，以治其内；外用玉龙热药，以拔其毒，便成脓破为良。其轻无脓者，必自内消。如热极痰壅，则用控涎丹：紫大戟、甘遂、白芥子等分为末，米糊为丸。如遍身肿硬，块大如杯盂，生于喉项要处者，尤为难治。夫血气和畅，自无他病；气行不顺，血化为痰；痰复失道，则血气衰败，不能为脓，但能为肿硬，理必然也。此证阳少阴多，随证用药，回阳生气，补血控涎。外则用后法，作起一身气血引散冷块。万一肿不消，不作痛，不为热，体气实无他证，肉块与好肉无异，此又一证也。切不可轻用针刀自戕，如草医曾用针灸，阴烂其肉；或用毒药点脱，使人憎寒壮热。法当通顺其气血，于此方中加升麻，以除其寒邪。用敛口结痂之药以安之，使为疣赘而已。万一病自作臭秽糜烂，不免动刀，则有妙剂，可以代刀，不可轻泄，即白矾枯朴硝二味为末敷之。
一、肚肠内痈，宜服十宣散，与此方相间用之，并加忍冬藤。此药最治内痈，但当审其虚实，或通或补。补须用附子，通则用大黄。如不明虚实，则此方亦自能通顺。十宣自能内补，可无他变。至于肺痈，初觉饮食有碍，胸膈微痛，即是此证。急须察脉，审其虚实。虚则用此方，加附子相出入用之。若稍再作，即用十宣散内补之，即自消散。实则用此方加大黄略通之，使毒瓦斯下宣为妙。盖肺与大肠相表里故也。如内痈已成，宜以海上方，与此方加减参用之。喘咳脓血者，肺痈也；大便有脓自脐出者，肚痈也；忍冬藤甘草节煮酒妙。
(Also known as Tongshun San, also known as Heshouwu San.)
Polygoni Multiflori Preparati Radix (Heshouwu, 何首乌) [Note: Do not contact iron] Angelicae Sinensis Radix (Danggui, 当归) Akebiae Caulis (Mutong, 木通) [Remove skin and nodes] Paeoniae Radix Rubra (Chishao, 赤芍药) [Stir-fried] Angelicae Dahuricae Radix (Baizhi, 白芷) Foeniculi Fructus (Huixiang, 茴香) [Stir-fried] Linderae Radix (Tuwuyao, 土乌药) [Stir-fried] Aurantii Fructus Pericarpium (Chenzhike, 陈枳壳) [Stir-fried with bran. If nausea occurs, stir-fry with ginger juice] Glycyrrhizae Radix et Rhizoma (Gancao, 甘草)
The above nine herbs are taken in equal parts. Decoct with water, wine, or soup according to the condition; half water and half wine is also acceptable. For Liuzhu (Flowing Abscess), add Angelicae Pubescentis Radix (Duhuo, 独活). Take 4 qian per dose.
For diseases located in the upper body, take after meals; for diseases located in the lower body, take before meals.
This single prescription is effective for Liuzhu (Flowing Abscess), Yongju (Carbuncle and Ulcer), Fabei (Back Carbuncle), and trauma; without this medicine, efficacy is unlikely. It can rescue conditions worsened by improper treatment, revive necrotic tissue, eliminate disasters before they arise, and eradicate the root after recovery. The arrangement of Sovereign, Minister, Assistant, and Courier herbs operates like the succession of the Four Seasons and Five Elements, truly a miraculous divine formula. With modifications according to symptoms, its efficacy is infinite. Why? Because this medicine greatly promotes the smooth flow of Qi and harmonizes Blood. Qi belongs to Yang, Blood belongs to Yin. When Yang moves, Yin follows; when Qi circulates, Blood flows; when Yang stagnates, Yin coagulates; when Qi is weak, Blood dies; when Blood dies, Muscle necroses, and disease becomes fatal. One must regulate Yang and harmonize Yin so that Qi and Blood are balanced; neither should be neglected. Regulating Yang without harmonizing Yin leads to Qi consumption and Blood coagulation, causing Muscle to remain inactive, as seen in formulas like Wuxiang Liaoqiao Tang. Harmonizing Yin without regulating Yang leads to excessive Blood and weak Qi, causing disease recurrence, as seen in Neibu Shixuan San. However, these two types of medicines should be used in conjunction; one should not adhere rigidly to one approach. This medicine supports the Stomach's foundation without damaging Yuan Qi, sweeps away pathogenic turbidity, ensures natural smoothness, and prevents complications. It is truly a divine agent. Usage is detailed below:
1. If Fabei (Back Carbuncle) persists for a long time without healing, it is due to previous doctors using too many cold-cooling medicines. Cold medicines damage the Spleen internally and freeze Blood externally. The Spleen governs Muscle; if Spleen Earth is injured, dietary intake decreases, complexion becomes sallow and emaciated, and Muscle fails to regenerate. Blood travels through vessels; once Blood is frozen, Qi becomes weak, leading to muscle rot and erosion. Therefore, one must regulate the Spleen; when the Spleen is strong, Muscle grows naturally. Remove Mutong from this formula, use less Danggui, and double the amount of Houpo and Chenpi. For severe cases, use the family-prescribed Duijin Yinzi; for even more severe cases, adding Bai Doukou is advisable.
2. In treating Liuzhu (Flowing Abscess), Duhuo can be added. Liuzhu results from Qi and Blood stagnation; thus, when Qi flows but stagnates, Blood pours and coagulates. Adding this herb agitates the entire body's blood vessels; once the vessels move, how can Liuzhu persist?
3. Liuzhu originates from Shanghan (Cold Damage). If the exterior syndrome of Shanghan is not fully resolved, residual toxins flow into the limbs, causing meridians to become涩 (obstructed) at the site of stagnation, forming Liuzhu. If tidal fever persists, it indicates residual cold pathogens inside have not dispersed. Add Shengma and Ziyeh to this formula. If fever remains after taking this medicine, add Gegen (Puerariae Radix). If headache occurs, add Chuanxiong, decocting with ginger water. If there is no tidal fever, decoct with half water and half wine, as wine greatly promotes Blood circulation and generates Qi. With generated Qi and circulating Blood, recovery is inevitable. Why treat Liuzhu with exterior-releasing methods? To trace the cause and source, remembering the root of the disease. Once cold pathogens are exhausted, excessive exterior release transforms it into Cold Liuzhu, which is difficult to treat; thus, slight exterior release is best. After the second stage of exterior release, take warm and neutral medicines, such as Shixuan Neibu San. If ineffective, in the third stage, add Fuzi or take Sigui San for a few doses until cessation. Warm medicines should not be overused, lest they increase pain and prevent pus and blood from drying. In the fourth stage, return to the original formula for efficacy. However, if exterior pathogens are not fully released, residual toxins attach to bones, forming Guyong (Bone Carbuncle). Liuzhu is the residual toxin of Shanghan; Guyong is the deteriorated stage of Liuzhu. Liuzhu is not Shanghan's fault, but the doctor's failure to release the exterior sufficiently. Guyong is not Liuzhu's fault, but the quack doctor's misuse of cold medicines. Quacks lack insight, are blind and deaf, yet arrogant. Even knowing it is Guyong, they have no method and again administer cold medicines, fierce as toxic blades. Pathogenic qi stagnates; cold medicines touching iron metaphorically imply extreme coldness, making toxins adhere to bones and preventing healing. Otherwise, why would bones develop carbuncles? Bone carbuncles cannot be treated by medicine alone, hence named Fugu Ju (Bone-Attending Abscess), also known as Baihu Feishi. Lingering for cycles, dragging on for years, cold toxins corrode dead bone; self-healing occurs only after expulsion. Those who do not heal may suffer lifelong disability, all due to initial mismanagement. If accessory bones decay, recovery is possible; if main bones decay, lifelong disability ensues. White, clear pus indicates fresh bone fragments shedding deep in flesh, hard to remove; yellow, thick pus indicates bone fragments near the surface, easy to remove with a sharp knife. Details follow in later chapters. This is merely a general overview of treating Guyong.
There are also cases where illness lasts months, caused by blade wounds, with emaciation, contracture, cough, pus-blood, and necrotic flesh rotting internally. These indicate extreme cold. Yang is weak, Yin is abundant; expectoration of red sputum does not indicate heat. Treat with prepared Fuzi (Aconiti Lateralis Radix Praeparata) modified.
There are also cases where toxicity arises from hands, feet, head, and face, with pain throughout the body, extending up to neck and shoulder meridians, resembling ulcers piercing pearls. This is Wind-Dampness Flowing Qi Syndrome. Use Jiajian Xiao Maitang and Duhuo Jisheng Tang, intermixed with this formula.
There are also cases of knee pain spreading to all joints, similar to Xuefeng in women and Ruanfeng in men. This is called Fengshi Bi (Wind-Dampness Obstruction), also known as Lijie (Joint) syndrome. Use Fuzi Bawu Tang modified.
There are also carbuncles in the neck, armpits, beside breasts, and soft flesh of groins, named An Yong (Deep Carbuncle). This is a cold syndrome without heat. Use Neibu Shixuan San, combined with this formula. Children should not lightly use Fuzi, lest it induce convulsions. Avoid needles and knives; otherwise, blood will be thin with no pus, and flesh will fail to heal. Apply warm-hot medicines topically to dissipate. If needles/knives are used and polyps grow, this medicine still works. If mild pain or slight convulsions occur after medication, use Quanxie Guanyin San modified. Once calm, resume standard treatment. Some children also suffer from retained phlegm off-course, with carbuncles on neck, arms, chest, back. This is extreme cold, relying entirely on hot topical applications. (Reserved for oral use.) Recurrence of symptoms is favorable; treatment follows later.
There are also Liuzhu, large like inverted bowls on chest and back, resembling Fabei but worse. After medication, if symptoms shift slightly, it is no longer Fabei. Use Neibu Shixuan San, varying with this formula, to resolve internally. Generally, all syndromes originate from cold; thus, pain is bone pain. Bones are the surplus of Kidney; Kidney deficiency causes cold bones, hence pain. So-called Guyong (Bone Abscess) stems from Kidney because the root lies there. To tonify Kidney, large doses of Fuzi are required for effect. When Kidney is solid, bones have vital energy, and abscesses do not attach to bones. Medication must not be rigid; flexibility is key.
1. All early-stage Yongju (Carbuncles/Ulcers) form from Qi and Blood stagnation. Over time, Blood accumulates at the stagnation site, leading to vigorous outbreak. For patients with robust Qi and Blood, reduce Danggui in this formula; excess Danggui generates Blood, potentially causing new carbuncles elsewhere, creating endless cycles. This is a secret transmission rarely known by physicians.
2. Phlegm formation in Yongju has two patterns: First, Stomach Cold generating Phlegm; add Banxia (Pinelliae Rhizoma) to strengthen Spleen and transform Phlegm. Second, Heat stagnation transforming into Wind-Phlegm; add Jiegeng (Platycodonis Radix) to transform Phlegm in throat and diaphragm, decocting with Shengjiang (Zingiberis Rhizoma Recens) and water/wine.
3. For Nao Fabei (Brain Carbuncle) and Back Carbuncle located superiorly, remove Mutong to avoid draining deficient Lower Yuan, preventing Upper Excess/Lower Deficiency patterns, which are hard to treat. Especially suitable for frail elderly patients.
4. Patients with diarrhea should not immediately take this formula. First use anti-diarrheal medicine: Raw Baifan (Alumen) powder dissolved in melted Huangla (Beeswax) to make pills, taken with Rice Decoction, 30 pills. Wait until diarrhea stops before using this medicine. The body relies on Qi and Blood; in carbuncle patients, Qi and Blood gather to form pus. If Zang-Fu are unstable, Yuan Qi leaks, Blood becomes colder, and healing is difficult. This medicine promotes Qi smoothness. Generally, smooth Qi leads to flowing Blood; consumed Qi leads to cold Blood; cold Blood leads to dead Blood; dead Blood means no Muscle growth. Hot medicines would leave Muscle lacking Yuan Qi, increasing suffering. Cold medicines are inappropriate. Although this is a divine prescription, proper application is crucial; otherwise, one falls into the error of "marking the boat to find the sword." Liuzhu cannot be generalized. If cold medicines depleted Yuan Qi causing collapse, Sanjian Tang might work, as the disease often stems from cold. Pulse and symptoms must confirm cold origin before use. Do not overdose. If Yang pulse returns, swelling becomes red and vibrant, bones show vitality, and cold pathogens detach, credit the original formula. This is a perfect method.
5. This medicine can be taken as pills, powders, or granules with water, wine, or soup, adjusted as needed. Nobles may add Muxiang (Aucklandiae Radix) as coating. For patients with hot Phlegm/cough, rich patients may use Chenxiang (Aquilariae Lignum Resinatum), poor patients Su Ye (Perillae Folium) decoction. Pills are honey-bound.
6. This formula treats not only Yongju, Fabei, and trauma, but also Hernia (Shanqi) and Blood Qi disorders in men and women, with frequent success. A woman suffered Qi disorder for five years, presenting with mass pain, vomiting, inability to swallow fluids, and near-death upon attacks. Made into pills, taken with Muxiang decoction, vomiting stopped after one dose, Phlegm-Qi smoothed and cured after two doses.
7. Trauma always uses this formula, with variations. See Trauma section. For common cuts/bruises or Heart Pericardium injury, it applies. On the head, remove Mutong and Zhike, add Chuanxiong and Chenpi. Often add Dingpi (Syzygii Aromatisati Flos) and Ziyeh for Blood activation; add Gubuzhi (Psoraleae Fructus) and Wulingzhi (Trogopteri Dung) for resolving old Blood. Decoct in water, soak in strong wine, boil again, add Dahuang (Rhei Radix et Rhizoma) powder, take on empty stomach. If unobstructed, take four doses; first two with Dahuang, last two without, just to promote bowel movement. If obstructed, use Zhike decoction to promote movement; if still obstructed, untreatable. Do not watch people die; use Buchong Shixuan San.
8. For trauma, often use this formula removing Mutong, named Heshouwu San. Because Heshouwu supports Blood. For blade wounds with tidal fever, facial swelling, panting (Po Shang Feng / Broken Injury Wind), take Suoxue San or Gegen Tang several doses, decocted with Jiangcong (Ginger and Scallion) to release exterior; or Baidu San 3-4 doses, plus external paste. Follow standard treatment, all heal.
9. Chronic lower back pain: add Bibai (Dioscoreae Hypoglaucae Rhizoma) and Yuanhusuo (Corydalis Rhizoma), decoct in wine.
10. Hongzhujiao (Foot Qi / Beriberi): add Binglang (Arecae Semen), Mugua (Chaenomelis Fructus), Chuanshanjia (Manis Squama), decoct in water.
11. Retained Phlegm Off-Course: Unknown to most, known only to my lineage since divine transmission. Phlegm lubricates the body like fish mucus. Phlegm in Stomach causes no disease if static; if moving, hundred diseases arise: asthma, cough, vomiting, dizziness, headache, eye pain, body stiffness, joint bi-pain. These are newly acquired Phlegm, formed from turbid Qi and Blood condensation. Why? Organ Qi reversal/stagnation generates Phlegm; failure to sweat when indicated causes accumulation; dietary excess stops Jin-Ye flow, gathering into Phlegm. Normal path: Stomach to Lung exit. Abnormal path: Flows from Stomach to cold Muscle/Skin. Spleen governs Muscle, Lung governs Skin/Hair. Thus, lumps/hardness in chest, back, head, neck, armpits, groin, waist, legs, hands, feet, painful or not, non-flushing on pressure; slight redness is pale and cool; hard as stone, no pus when broken, or thin blood, clear water, or milky fluid; necrotic flesh like torn cotton; or scrofula-like lumps between skin/muscle, movable, soft, no pus/blood when broken, polyp protruding from needle wound, feeling of throat blockage, chills/fever—all are signs. Urgently add Nanxing (Arisaematis Rhizoma Preparatum) and Banxia to this formula internally; externally apply Yulong Re Yao (Jade Dragon Hot Medicine) to draw out toxin, forming pus for rupture is good. Mild cases without pus resolve internally. For extreme heat/phlegm obstruction, use Kongxian Dan: Daye (Euphorbiae Pekinensis Radix), Gansui (Kansui Radix), Baijiezi (Sinapis Semen) equal parts powder, rice paste pills. Whole-body hardness, cup-sized lumps in throat/neck are hardest to treat. Harmonious Qi/Blood prevents other diseases; stagnant Qi turns Blood to Phlegm; lost Phlegm path leads to Qi/Blood decline, unable to form pus, only hardness. This syndrome has little Yang, much Yin. Treat according to symptoms, restore Yang/Qi, tonify Blood, control Phlegm. Externally use following method to raise Qi/Blood and scatter cold masses. If swelling doesn't subside, isn't painful/hot, patient constitution is fine, lump resembles normal flesh—another syndrome. Do not lightly use needles/knives to harm yourself. If folk doctors used acupuncture causing internal rot, or caustics causing chills/high fever, method is to smooth Qi/Blood, add Shengma to this formula to remove cold. Use astringent/scab-forming medicine to settle it, becoming a wart. If foul rotting occurs requiring surgery, there is a miracle agent replacing the knife, not to be leaked casually: dry Baifan and Xiaomiao (Natrii Sulfas) powder applied.
12. Internal abdominal/intestinal carbuncles: Take Shixuan San, alternating with this formula, adding Jinyinheng (Lonicerae Japonicae Caulis). This medicine best treats internal carbuncles, but assess deficiency/excess, use purging or tonifying. Tonify with Fuzi, purge with Dahuang. If unsure, this formula naturally smooths. Shixuan internally tonifies, preventing changes. For Lung Carbuncle, initial difficulty eating, slight chest pain indicates this. Check pulse, assess deficiency/excess. Deficiency: use this formula with Fuzi. If recurring, use Shixuan San to tonify internally, resolving spontaneously. Excess: use this formula with Dahuang to slightly purge, allowing toxin to descend. Lung and Large Intestine are interior-exterior partners. If internal carbuncle formed, use Haishang Fang modified with this formula. Coughing pus-blood is Lung Carbuncle; pus from umbilicus in stool is Abdominal Carbuncle. Jinyinheng and Gancao Jie (Licorice Joint) boiled in wine is excellent.