疮疡之症，齐氏、陈氏有五善七恶之论。又云∶五善见三则瘥，七恶见四则危。窃谓前症各有所属之经，各有所主
之方。盖五善属六腑，气血无亏，人能调摄，不治自愈。七恶乃五脏亏损，失于滋补所致，非疮疡自有也，调治失宜，
必致不起。如动息自宁，饮食知味，乃胃气和平，一善也。便利调匀，乃肠胃调和，二善也。脓溃肿消，水鲜不臭，乃
邪气去，而胃气平复，三善也。神彩精明，语言清亮，乃心肺气血无亏，四善也。体气平和，脾胃无亏，五善也。作渴
发热，或泄泻淋闭者，属胃火内淫，一恶也，竹叶黄 汤；气血俱虚，八珍加黄 、麦门冬、山茱萸；未应，佐以加减
八味丸料。溃而肿痛尤甚，脓色臭败者，属胃虚火炽，二恶
也，人参黄 汤；未应，十全大补汤加麦门冬、五味子。目视不正，黑睛紧小，白睛青赤，瞳子上视者，属肝肾虚火，
三恶也，六味丸料加山栀、麦门冬、五味子；未应，八珍汤加山栀、麦门冬、五味子。喘粗气短，恍惚嗜卧者，属脾肺
虚火，四恶也，六君子加姜枣；未应，用补中益气汤加麦门、五味；若心火刑肺，人参平肺散；阴火伤肺，六味丸料加
五味子煎服。溃后肩背不便，四肢沉重者，属脾胃亏损，五恶也，补中益气汤加山茱萸、山药、五味子；如不应，用十
全大补汤加山茱萸、山药、五味子。食不下咽，服药而呕，食不知味者，属胃气虚弱，六恶也，六君子汤加木香、砂仁；
未应，加附子。声嘶色败，唇鼻青赤，面目浮肿者，脾肺俱虚，七恶也，用补中益气汤加姜，枣；未应，加附子。若腹
痛泄泻，咳逆昏溃者，阳气虚寒之恶症也，用托里温中汤；次以六君子汤加附子、姜、桂。若溃后发热，恶寒作渴，怔
忡惊悸，寤寐不宁，牙关紧急；或头痛目赤，自汗盗汗，寒战切牙，手撒身热，脉洪大，按之微细，浓衣仍寒，此气血
虚极传变之恶症也。若手足逆冷，肚腹疼痛，泄泻肠鸣，饮食不入，吃逆呕吐者，此阳气虚寒之恶症也。若无汗恶寒，
口噤足冷，腰背反张，项颈强直，此血气虚极，传变之恶症也，急用参、 、归、术、附子救之。夫小儿患之，因胃气
虚弱；或脓血出多，虚邪内作；或乳母失调，血气不和，致儿为患，能审其所致之因而主之，亦有复生者，若更与攻毒，
乃促其亡也。
一小儿臂疮，肉腐色紫， 痛作痛，右关脉洪数，此胃火炽盛之恶症，用竹叶黄 汤而痛止，用四君、升麻、连翘、
白芷、金银花而愈。
一小儿流注，吐泻吃逆腹痛，手足并冷，余谓阳气虚寒
之恶症，用六君子、独参汤益甚，遂以人参五钱、附子五分，连服数剂，诸症渐退，用独参汤月余稍愈；后饮食失宜，
寒热发搐，用五味异功散加升麻、柴胡而安。又因劳发热，脉大而虚，面赤作渴，用当归补血汤、十全大补汤而安，用
八珍汤、附子饼而愈。
一小儿腹痈，溃而肿痛益甚，饮食少思，此脾胃复伤之恶症，先用五味益功散加木香，诸症渐愈。乃用异功散加当
归、黄 ，元气渐复，又用八珍汤、托里散而愈。次年毕姻后，寒热往来，患处作痒，用大补汤、地黄丸而愈。
一小儿胁肿一块，敷寒凉之药，益加肿硬，腹中阴冷，余谓肌肉受寒而患处肿硬，脾气受寒而腹中阴冷，当急温补
脾气。不信，仍服前药，加腹痛泄泻，手足并冷，余曰∶变阳气虚寒之恶症。用五味异功散加姜、桂二剂，诸症渐愈，
乃去二味服之，外用葱熨之法，患处微肿色赤，此阴气散而阳气至，遂朝用补中益气汤，夕用异功散而消。
一女子股间结一核，不作痛，不变色，服散坚之剂，患处肿硬，更头晕吐痰，其脉弦数而无力，心脾俱虚。不信，
仍用攻伐，果吐泻腹痛，发搐吃逆，余谓变脾土虚寒之恶症也，先用五味异功散加干姜、肉桂，脾气稍复，乃用异功散、
八珍汤而愈。
一小儿腿痈溃后，作渴饮汤，泻利无度，此脾胃气虚之恶症也，用益气汤、八珍汤而愈。后功课用心，口干作渴，
小便频数，用益气汤加五味及黄 六一汤，各五十余剂而痊。
一小儿腿痈内溃，泄泻自汗，腹痛气喘，余谓脾胃俱虚之恶症，用独参汤，喘汗渐止，用大补汤诸症悉退。后伤食
吐泻，用五味异功散加干姜而愈。次年毕姻后，患腹痈，脓清不敛，朝寒暮热，用益气汤、八珍汤各百余剂而愈。
一小儿患瘰 ，服追毒之药，更恶寒发热，手足并冷，右寸脉浮，按之而虚，用益气汤百余剂而稍愈。彼欲速效，
另服石膏之类，吐泻昏愦，脉浮大，按之微细，乃变阳气虚寒之恶症也，用人参二两、附子一钱，二剂而苏，数剂而安；
更以五味异功散，月余而愈。
一女子十五岁，瘰 发热晡热，左颊赤甚，余谓肝火血虚，用加味逍遥散、五味异功散、九味芦荟丸而痊。后服斑
蝥等药，恶症蜂起，手足并冷，用参附汤二剂、六君、姜、桂四剂，乃朝用益气汤，夕用异功散而愈。
一女子患 疮，肿痛发热，脉洪大而虚，此血虚之恶症也，用当归补血汤，烦热悉止；用补中益气汤，佐以加味逍
遥散及葱熨法而痊。
一女子胁间患痈，色白漫肿，寒热不溃，余谓禀肝脾虚羸之恶症，用补托之药而愈。后因经事过期，误服行血之剂，
发热烦躁，先用当归补血汤，次用逍遥散、八珍汤而愈。
一小儿十五岁，胁痈脓清，晡热盗汗遗精，此元气虚甚之恶症也，用大补汤、地黄丸料，元气渐复。因犯色欲，患
处色黯，昏愦吃逆，手足并冷，用独参汤四剂而苏，用大补汤加干姜六剂，阳气渐复，乃去姜，又二十余剂而痊。
一小儿十四岁，面目多白，足跟肿硬寸许，肉色如常，遇劳肿硬宛若一栗，口干面赤，余谓禀足三阴经虚症。不信，
外敷内服皆败毒之剂，翻如熟榴，烦躁时嗽，腹痛泄泻，小便如淋。余曰∶此脾肺气虚之恶症也。不信，仍服败毒，更
黑睛紧小，白睛青赤，瞳子上看，此肝肾亏损之恶症并矣。余欲救其胃气以滋五脏，又为人所阻，用千金消毒散，更加
喘短气恍惚。余曰∶恶症并臻，其何能为！或问∶恶症既甚，勿乃攻毒之晚耶？余曰∶邪正不并立，一胜一负，理之自
然，胃气虚则邪气实也，其失在于不预补正气，邪气胜则恶症集耳。东垣先生云∶但见肿痛，参之脉症虚弱，便与滋补，
气血无亏，可保终吉。信斯言也。
一小儿臀间肿硬，肉色如故，小便短赤，而频服分利之剂，膝胫骨肿。余曰∶肾主骨，此禀肾虚所致，前药导损肾
阴而骨肿耳，当调补脾肺以生肾水，其骨自消。不信，仍用前药而殁。
一小儿腹痈久不敛，余欲滋其化源，反清热败毒，恶症蜂起而殁。夫肺者肾之母，脾者肺之母，前症既不滋肾以生
肝木，又用寒凉之药复伤胃气，以绝肺肾之化源，不死鲜矣。
一小儿贴骨痈作泻，余欲施调补，不信，反服分利，两手撮空，肝气败也；泄泻无度，肾气败也；痰涎上壅，脾气
败也；喘嗽不止，肺气败也；额间汗出，心气败也；辞不治，果殁。
一小儿腿痈肿痛，自汗盗汗，体倦食少。余用托里之药而脓成，欲针之。或用大黄之类，令脓从大便出，致大泻腹
痛。余谓∶脾胃虚脱之恶症，急服大补之剂。不信，又服前药而死。
一女子十五岁，外股肿硬，连及内股，肉色不变，右关脉缓弱，按之弦数，此脾虚而肝乘之，气血虚而色不变也，
当补脾土为主。不信，另用流气饮、冰黄散，泄泻腹痛，疮口开张而殁。
参附汤
人参（一两） 附子（制，三钱）
上姜枣水煎，不拘时服。
余方见各症。
疮疡类疾病，齐氏和陈氏提出了“五善七恶”的理论。又说：如果表现出五种善证中的三种，病情就会痊愈；如果出现七种恶证中的四种，病情就会危重。我认为上述症状各自归属于不同的经络，各有对应的主治方剂。一般来说，五善属于六腑（主管传化水谷的脏腑），气血没有亏损，只要人体注意调养摄生，即使不治疗也能自愈。七恶则是由于五脏（主管藏精气的神脏）亏损，失去了滋补所致，并非疮疡本身固有的，而是因为调治不当，必然导致死亡。
例如：呼吸平稳安静，饮食知道味道，这是胃气平和的表现，是第一善。大小便调和均匀，这是肠胃功能协调的表现，是第二善。脓液排出后肿胀消退，脓液颜色鲜亮且不臭，这是邪气已去，胃气恢复平静的表现，是第三善。精神光彩精明，语言清晰洪亮，这是心肺的气血没有亏损的表现，是第四善。身体气息平和，脾胃功能没有亏损，是第五善。
出现口渴发热，或者腹泻、小便淋沥闭塞的，属于胃火内盛淫溢，是第一恶，用竹叶石膏汤治疗；如果是气血都虚弱，用八珍汤加黄芪、麦门冬、山茱萸；如果无效，辅助使用加减八味丸的药料。溃烂后肿痛更加严重，脓液颜色臭败的，属于胃虚火旺，是第二恶，用人参黄芪汤治疗；如果无效，用十全大补汤加麦门冬、五味子。
眼睛视物不正，黑眼球紧缩变小，眼白部分呈现青色或赤色，瞳孔向上翻视的，属于肝肾虚火，是第三恶，用六味地黄丸的药料加栀子、麦门冬、五味子；如果无效，用八珍汤加栀子、麦门冬、五味子。气喘粗重、气短，神志恍惚、嗜睡的，属于脾肺虚火，是第四恶，用六君子汤加生姜、大枣；如果无效，用补中益气汤加麦门冬、五味子；如果是心火克制肺金，用人参平肺散；如果是阴火损伤肺脏，用六味地黄丸药料加五味子煎服。
溃烂后肩背活动不便，四肢沉重的，属于脾胃亏损，是第五恶，用补中益气汤加山茱萸、山药、五味子；如果无效，用十全大补汤加山茱萸、山药、五味子。食物咽不下去，服药后呕吐，吃东西不知道味道的，属于胃气虚弱，是第六恶，用六君子汤加木香、砂仁；如果无效，加附子。声音嘶哑、面色败坏，嘴唇和鼻子呈现青赤色，面目浮肿的，是脾肺都虚弱，是第七恶，用补中益气汤加生姜、大枣；如果无效，加附子。
如果是腹痛腹泻，咳嗽气逆，昏迷溃乱，这是阳气虚寒的恶症，用托里温中汤；随后用六君子汤加附子、生姜、肉桂。如果是溃烂后发热，怕冷且口渴，心慌惊悸，睡眠不安稳，牙关紧急；或者是头痛目赤，自汗盗汗，寒战咬牙，手撒肢冷身热，脉象洪大但按之微细，穿着厚衣服仍然觉得寒冷，这是气血极度虚弱导致的传变恶症。
如果是手脚逆冷，肚腹疼痛，腹泻肠鸣，饮食无法进入，呃逆呕吐的，这是阳气虚寒的恶症。如果没有汗、怕冷，口噤脚冷，腰背反张，颈项强直，这是气血极度虚弱导致的传变恶症，急需用人参、黄芪、当归、白术、附子来救治。
小儿患此病，是因为胃气虚弱；或者因为脓血流出过多，虚邪在体内作祟；或者是乳母调养失当，导致气血不和，致使小儿患病。如果能审察其致病的原因并主治，也有能复活的；如果再给予攻毒的药物，那就是加速他的死亡了。
有一个小儿手臂生疮，肌肉腐烂颜色紫暗，跳动性疼痛，右手关脉洪数，这是胃火炽盛的恶症，用竹叶石膏汤治疗后疼痛停止，再用四君子汤加升麻、连翘、白芷、金银花而痊愈。
有一个小儿患流注（一种漫肿无头、皮色不变的痈疽），呕吐腹泻、呃逆腹痛，手脚都冷，我认为这是阳气虚寒的恶症，用了六君子汤和独参汤后病情反而加重，于是改用五钱人参、五分附子，连续服用几剂，各种症状逐渐消退，之后用独参汤服用一个多月稍微好转；后来因为饮食不当，出现寒热抽搐，用五味异功散加升麻、柴胡而安定。又因为劳累发热，脉象大而虚，面红口渴，用当归补血汤、十全大补汤而安定，再用八珍汤、附子饼贴敷而痊愈。
有一个小儿腹部生痈，溃烂后肿痛更加严重，饮食减少不想吃，这是脾胃再次受伤的恶症，先用五味异功散加木香，各种症状逐渐痊愈。接着用异功散加当归、黄芪，元气逐渐恢复，又用八珍汤、托里散而痊愈。第二年结婚后，出现寒热往来，患处发痒，用大补汤、地黄丸而痊愈。
有一个小儿胁部肿起一块，敷用寒凉药物，反而更加肿硬，腹中感觉阴冷，我认为这是肌肉受寒导致患处肿硬，脾气受寒导致腹中阴冷，应当紧急温补脾气。患者不信，仍然服用之前的药，加上腹痛腹泻，手脚都冷，我说：这变成了阳气虚寒的恶症。用五味异功散加生姜、肉桂两剂，各种症状逐渐痊愈，然后去掉这两味药继续服用，外用葱熨法，患处轻微红肿色赤，这是阴气消散而阳气到来，于是早晨用补中益气汤，晚上用异功散而消散。
有一个女子大腿间结成一个核，不痛，不变色，服用散坚的药物，患处肿硬，更出现头晕吐痰，脉象弦数而无力，这是心脾都虚弱。患者不信，仍然用攻伐的药物，果然出现呕吐腹泻腹痛，抽搐呃逆，我说：这变成了脾土虚寒的恶症，先用五味异功散加干姜、肉桂，脾气稍复，然后用异功散、八珍汤而痊愈。
有一个小儿腿部生痈溃烂后，口渴想喝汤，腹泻无度，这是脾胃气虚的恶症，用益气汤、八珍汤而痊愈。后来因为功课用心过度，口干口渴，小便频数，用益气汤加五味子和黄芪六一汤，各服用五十多剂而痊愈。
有一个小儿腿部生痈内部溃烂，腹泻自汗，腹痛气喘，我认为这是脾胃都虚弱的恶症，用独参汤，气喘和出汗逐渐停止，用大补汤各种症状全部消退。后来因伤食导致呕吐腹泻，用五味异功散加干姜而痊愈。第二年结婚后，患腹部生痈，脓液清稀不收敛，早晨怕冷晚上发热，用益气汤、八珍汤各一百多剂而痊愈。
有一个小儿患瘰疬（颈部淋巴结结核），服用追毒的药物，更出现怕冷发热，手脚都冷，右手寸脉浮，按之而虚，用益气汤一百多剂而稍微好转。病人想要快速见效，另外服用石膏之类的药物，出现呕吐腹泻、昏迷不醒，脉象浮大，按之微细，这变成了阳气虚寒的恶症，用人参二两、附子一钱，两剂后苏醒，几剂后安定；再用五味异功散，一个月多月而痊愈。
有一个女子十五岁，患瘰疬发热，午后潮热，左脸颊很红，我认为这是肝火血虚，用加味逍遥散、五味异功散、九味芦荟丸而痊愈。后来服用斑蝥等药物，恶症蜂拥而起，手脚都冷，用参附汤两剂、六君子汤加生姜、肉桂四剂，于是早晨用益气汤，晚上用异功散而痊愈。
有一个女子患疔疮，肿痛发热，脉象洪大而虚，这是血虚的恶症，用当归补血汤，烦热全部停止；用补中益气汤，佐以加味逍遥散及葱熨法而痊愈。
有一个女子胁间患痈，颜色白且漫肿，寒热不退未溃破，我认为这是禀赋肝脾虚弱羸弱的恶症，用补托的药物而痊愈。后来因为月经过期，误服行血药物，出现发热烦躁，先用当归补血汤，次用逍遥散、八珍汤而痊愈。
有一个十五岁的小儿，胁部生痈脓液清稀，午后潮热盗汗遗精，这是元气非常虚弱的恶症，用大补汤、地黄丸药料，元气逐渐恢复。因为犯了色欲，患处颜色暗滞，昏迷不醒呃逆，手脚都冷，用独参汤四剂后苏醒，用大补汤加干姜六剂，阳气逐渐恢复，然后去掉干姜，又二十多剂而痊愈。
有一个十四岁的小儿，面目多白色，足跟肿硬一寸左右，肌肉颜色如常，遇到劳累肿硬像一颗栗子，口干面红，我认为这是禀赋足三阴经虚弱的症状。患者不信，外敷内服都是败毒的药物，疮口翻开像熟透的石榴，烦躁时常咳嗽，腹痛腹泻，小便像淋病一样。我说：这是脾肺气虚的恶症。患者不信，仍然服用败毒药物，更出现黑眼球紧缩变小，眼白青赤，瞳孔向上看，这是肝肾亏损的恶症并发了。我想救他的胃气以滋养五脏，又被别人阻止，用了千金消毒散，更加出现喘促气短神志恍惚。我说：恶症并至，还能有什么办法呢！有人问：恶症既然这么严重，难道不是攻毒太晚了吗？我说：邪气和正气不能并存，一胜一负，这是自然的道理，胃气虚则邪气实，失误在于没有预先补益正气，邪气胜则恶症聚集罢了。东垣先生说：只要见到肿痛，参合脉症虚弱，就给予滋补，气血没有亏损，可以保证最终吉利。相信这句话吧。
有一个小儿臀部肿硬，肌肉颜色如故，小便短赤，却频繁服用分利（利尿）的药物，导致膝胫骨肿。我说：肾主骨，这是禀赋肾虚所致，前面的药引导损耗了肾阴而导致骨肿，应当调补脾肺以滋生肾水，骨头自然会消。患者不信，仍然用前面的药而死。
有一个小儿腹部生痈久不愈合，我想滋养生化的源头，反而清热败毒，恶症蜂拥而起而死。肺是肾的母亲，脾是肺的母亲，前面的病症既不滋肾以生肝木，又用寒凉药物再次损伤胃气，断绝了肺肾的生化的源头，不死就很少见了。
有一个小儿贴骨痈（深部脓肿）导致腹泻，我想施以调补，患者不信，反而服用分利药物，两手撮空，这是肝气败坏；腹泻无度，这是肾气败坏；痰涎上壅，这是脾气败坏；喘嗽不止，这是肺气败坏；额头出汗，这是心气败坏；我推辞不治，果然死亡。
有一个小儿腿部生痈肿痛，自汗盗汗，身体疲倦饮食少。我用托里的药物使脓形成，想要针刺排脓。有人用大黄之类的药物，让脓从大便排出，导致大泻腹痛。我说：这是脾胃虚脱的恶症，急服大补的药物。患者不信，又服用前面的药而死。
有一个女子十五岁，外侧大腿肿硬，连及内侧大腿，肌肉颜色不变，右手关脉缓弱，按之弦数，这是脾虚而肝木乘克，气血虚弱而颜色不变，应当以补脾土为主。患者不信，另用流气饮、冰黄散，出现腹泻腹痛，疮口开张而死。
In diseases of sores and ulcers, Qi Shi and Chen Shi proposed the theory of "Five Good Signs and Seven Bad Signs." It is further stated: if three of the five good signs appear, the condition will heal; if four of the seven bad signs appear, the condition will be critical. I believe that the aforementioned symptoms each belong to specific meridians and have corresponding primary formulas. Generally, the Five Good Signs relate to the Six Fu Organs (organs responsible for digestion and excretion), where qi and blood are not depleted; if the patient maintains proper self-care, the disease may heal spontaneously without treatment. The Seven Bad Signs, however, result from the depletion of the Five Zang Organs (organs responsible for storing essence) due to lack of nourishment, rather than being inherent to the sores themselves; improper management inevitably leads to death.
For instance: calm breathing and appetite indicate harmonious Stomach qi, which is the first good sign. Regular bowel movements and urination indicate harmonious intestinal and stomach functions, which is the second good sign. After pus discharge, swelling subsides, and the exudate is fresh and odorless, indicating the departure of pathogenic factors and the restoration of Stomach qi, which is the third good sign. Bright spirit and clear speech indicate sufficient qi and blood in the Heart and Lungs, which is the fourth good sign. Balanced body constitution and intact Spleen-Stomach function constitute the fifth good sign.
Thirst with fever, or diarrhea and dysuria, belong to internal flooding of Stomach fire, which is the first bad sign; treat with Zhuye Shigao Tang (Leaf of Bambusa and Gypsum Decoction). If both qi and blood are deficient, use Bazhen Tang (Eight Treasure Decoction) added with Huangqi (Astragali Radix), Maimendong (Ophiopogonis Radix), and Shanzhuyu (Corni Fructus); if ineffective, assist with Jiaban Bawei Wan (Modified Eight-Ingredient Pill). If pain and swelling worsen after ulceration, and the pus is foul-smelling, this belongs to Stomach deficiency with blazing fire, which is the second bad sign; treat with Ren Shen Huangqi Tang (Ginseng and Astragalus Decoction); if ineffective, use Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Maimendong and Wuweizi (Schisandrae Fructus).
Misaligned vision, tight and small black pupils, cyanotic or reddish whites of the eyes, and upward deviation of the pupils belong to deficiency fire of the Liver and Kidney, which is the third bad sign; treat with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) material added with Zhizi (Gardeniae Fructus), Maimendong, and Wuweizi; if ineffective, use Bazhen Tang added with Zhizi, Maimendong, and Wuweizi. Rough and short breath, mental confusion, and drowsiness belong to deficiency fire of the Spleen and Lung, which is the fourth bad sign; treat with Liujunzi Tang (Six-Gentleman Decoction) added with Shengjiang (Zingiberis Rhizoma) and Dazao (Jujubae Fructus); if ineffective, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Maimendong and Wuweizi; if Heart fire insults the Lung, use Renshen Pingfei San (Ginseng Lung-Calming Powder); if yin fire damages the Lung, use Liuwei Dihuang Wan material added with Wuweizi decocted for administration.
Inability to move the shoulders and back after ulceration, and heavy limbs, belong to Spleen-Stomach depletion, which is the fifth bad sign; treat with Buzhong Yiqi Tang added with Shanzhuyu, Shanyao (Dioscoreae Rhizoma), and Wuweizi; if ineffective, use Shiquan Dabu Tang added with Shanzhuyu, Shanyao, and Wuweizi. Inability to swallow food, vomiting after taking medicine, and loss of taste belong to weak Stomach qi, which is the sixth bad sign; treat with Liujunzi Tang added with Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus); if ineffective, add Fuzi (Aconiti Lateralis Radix Praeparata). Hoarse voice and deteriorated complexion, cyanotic-reddish lips and nose, and edema of the face and eyes indicate dual deficiency of the Spleen and Lung, which is the seventh bad sign; treat with Buzhong Yiqi Tang added with Shengjiang and Dazao; if ineffective, add Fuzi.
If abdominal pain and diarrhea occur with cough, air reflux, coma, and disarray, this is a bad sign of yang deficiency and cold; treat with Tuoli Wenzhong Tang (Interior-Supporting and Middle-Warming Decoction); subsequently use Liujunzi Tang added with Fuzi, Shengjiang, and Rougui (Cinnamomi Cortex). If fever, aversion to cold, and thirst occur after ulceration, accompanied by palpitations, fright, insomnia, and jaw stiffness; or headache, red eyes, spontaneous sweating, night sweats, chills with teeth grinding, flaccid hands, hot body, surging pulse that feels fine upon pressure, and feeling cold despite thick clothing, this is a bad sign of transmission due to extreme depletion of qi and blood.
If cold extremities, abdominal pain, diarrhea with borborygmus, inability to eat, hiccups, and vomiting occur, this is a bad sign of yang deficiency and cold. If there is no sweat, aversion to cold, locked jaw, cold feet, opisthotonos, and neck rigidity, this is a bad sign of transmission due to extreme depletion of qi and blood; urgently treat with Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi to rescue.
When children suffer from these conditions, it is due to weak Stomach qi; or excessive loss of pus and blood leading to internal action of deficiency pathogens; or improper care by the nursing mother causing disharmony of qi and blood, affecting the child. If the cause can be identified and treated accordingly, recovery is possible; however, administering detoxifying agents would only hasten death.
A child had an arm sore with rotting flesh and purple color, throbbing pain, and a surging-rapid pulse at the right Guan position; this was a bad sign of blazing Stomach fire. Pain ceased after using Zhuye Shigao Tang, and the child recovered using Sijunzi Tang added with Shengma (Cimicifugae Rhizoma), Lianqiao (Forsythiae Fructus), Baizhi (Angelicae Dahuricae Radix), and Jinyinhua (Lonicerae Japonicae Flos).
A child suffered from liuzhu (a type of abscess with diffuse swelling and no head), vomiting, diarrhea, hiccups, abdominal pain, and cold extremities. I diagnosed this as a bad sign of yang deficiency and cold. Treatment with Liujunzi Tang and Dushen Tang (Single Ginseng Decoction) worsened the condition. Subsequently, 5 qian of Renshen and 0.5 fen of Fuzi were administered continuously for several doses, gradually alleviating symptoms. Dushen Tang was continued for over a month, leading to slight improvement. Later, due to dietary indiscretion, alternating chills and fever with convulsions occurred; the condition stabilized using Wuwei Yigong San added with Shengma and Chaihu (Bupleuri Radix). Fever due to fatigue, with a large and empty pulse, red face, and thirst, was resolved using Danggui Buxue Tang (Danggui and Astragalus Decoction) and Shiquan Dabu Tang. Recovery was achieved with Bazhen Tang and Fuzi cake application.
A child had an abdominal carbuncle that, after ulceration, became more swollen and painful with reduced appetite; this was a bad sign of repeated injury to the Spleen and Stomach. Initially, Wuwei Yigong San added with Muxiang gradually improved all symptoms. Then, Yigong San added with Danggui and Huangqi gradually restored yuan qi. Finally, Bazhen Tang and Tuoli San (Interior-Supporting Powder) led to recovery. After marriage the following year, alternating chills and fever with itching at the lesion site occurred; this was cured using Dabu Tang (Great Tonifying Decoction) and Dihuang Wan (Rehmannia Pill).
A child had a lump on the hypochondrium that became harder and more swollen after applying cold-natured medicines, accompanied by a sensation of cold in the abdomen. I reasoned that cold affected the muscles causing hardness at the site, and cold affected the Spleen qi causing abdominal coldness, requiring urgent warming and tonification of Spleen qi. The patient did not believe this and continued previous medications, developing abdominal pain and diarrhea with cold extremities. I stated this had transformed into a bad sign of yang deficiency and cold. Two doses of Wuwei Yigong San added with Shengjiang and Rougui gradually improved symptoms. These two herbs were then removed, and external application of Congyun Fa (Scallion Moxibustion Method) resulted in slight redness and swelling, indicating dissipation of yin and arrival of yang. Morning administration of Buzhong Yiqi Tang and evening administration of Yigong San led to resolution.
A woman had a non-painful, non-discolored nodule in the thigh. After taking hardening-resolving agents, the area became swollen and hard, accompanied by dizziness and phlegm expectoration. The pulse was wiry, rapid, and forceless, indicating dual deficiency of the Heart and Spleen. Ignoring advice and continuing attacking treatments resulted in vomiting, diarrhea, abdominal pain, convulsions, and hiccups. I diagnosed this as a bad sign of Spleen-earth deficiency and cold. Initial treatment with Wuwei Yigong San added with Ganjiang (Zingiberis Rhizoma) and Rougui slightly restored Spleen qi, followed by recovery with Yigong San and Bazhen Tang.
A child had a leg carbuncle that ulcerated, causing thirst for warm drinks and profuse diarrhea; this was a bad sign of Spleen-Stomach qi deficiency. Recovery occurred using Yiqi Tang and Bazhen Tang. Later, mental exertion caused dry mouth and thirst, and frequent urination; treatment with Yiqi Tang added with Wuweizi and Huangqi Liuyi Tang (Astragalus and Zeaxidis Granular Decoction) for over fifty doses each led to cure.
A child had an internally ulcerating leg carbuncle with diarrhea, spontaneous sweating, abdominal pain, and asthma; this was a bad sign of dual Spleen-Lung deficiency. Dushen Tang stopped the asthma and sweating; Dabu Tang resolved all symptoms. Subsequent food stagnation with vomiting and diarrhea was cured using Wuwei Yigong San added with Ganjiang. After marriage the next year, an abdominal carbuncle developed with clear pus and failure to heal, morning chills, and evening fever; recovery took over a hundred doses each of Yiqi Tang and Bazhen Tang.
A child with luoli (scrofula) took toxic-expelling drugs, worsening chills, fever, and cold extremities. The right Cun pulse was floating and empty upon pressure. Over a hundred doses of Yiqi Tang brought slight improvement. Seeking quick results, the patient took Shigao (Gypsum Fibrosum), leading to vomiting, diarrhea, coma, and a floating-large pulse that felt fine upon pressure, transforming into a bad sign of yang deficiency and cold. Two doses of 2 liang Renshen and 1 qian Fuzi revived the patient, followed by stabilization. Wuwei Yigong San taken for over a month completed the cure.
A fifteen-year-old girl with luoli, afternoon tidal fever, and severe redness on the left cheek was diagnosed with Liver fire and blood deficiency. She recovered using Jiawei Xiaoyao San (Modified Free Wanderer Powder), Wuwei Yigong San, and Jiwei Lujian Wan (Nine-Ingredient Aloe Pill). Taking Banmao (Mylabris) later caused multiple bad signs including cold extremities. Two doses of Shenfu Tang (Ginseng and Aconite Decoction) and four doses of Liujunzi Tang added with Shengjiang and Rougui, followed by morning Yiqi Tang and evening Yigong San, led to recovery.
A woman with dingchuang (carbuncle) presented with swelling, pain, fever, and a surging-empty pulse, indicating a bad sign of blood deficiency. Danggui Buxue Tang stopped the irritability and heat; Buzhong Yiqi Tang assisted with Jiawei Xiaoyao San and Congyun Fa led to recovery.
A woman with a hypochondriac carbuncle showing white, diffuse swelling, chills, fever, and non-ulceration was diagnosed as having innate Liver-Spleen deficiency and weakness. Interior-supporting medicines led to recovery. Later, delayed menstruation and mistaken use of blood-moving agents caused fever and irritability. Initial treatment with Danggui Buxue Tang, followed by Xiaoyao San and Bazhen Tang, resulted in recovery.
A fifteen-year-old boy with a hypochondriac carbuncle had clear pus, afternoon tidal fever, night sweats, and spermatorrhea, indicating severe yuan qi deficiency. Dabu Tang and Dihuang Wan material gradually restored yuan qi. Sexual misconduct caused darkening of the lesion, coma, hiccups, and cold extremities. Four doses of Dushen Tang revived him; six doses of Dabu Tang added with Ganjiang gradually restored yang qi. Removing Ganjiang and continuing for twenty doses led to recovery.
A fourteen-year-old boy with pale features, one-cun hard swelling at the heels, normal muscle color, and labor-induced swelling resembling a chestnut, along with dry mouth and red face, was diagnosed with innate deficiency of the Three Yin Meridians of the Foot. Rejecting advice and using detoxifying agents externally and internally caused the wound to open like a ripe pomegranate, irritability, occasional cough, abdominal pain, diarrhea, and dysuria-like urination. I diagnosed this as a bad sign of Spleen-Lung qi deficiency. Continued use of detoxifying agents led to tight pupils, cyanotic-reddish whites, and upward-deviating pupils, indicating concurrent Liver-Kidney depletion. Attempting to save Stomach qi to nourish the Five Zang was blocked; Qianjin Xiaodu San (Thousand Gold Detoxifying Powder) worsened the condition with shortness of breath and mental confusion. I stated that with concurrent bad signs, nothing could be done. When asked if late detoxification was the cause, I replied that evil and righteous qi do not coexist; one wins while the other loses. Stomach qi deficiency leads to evil excess; the error lies in failing to tonify righteous qi beforehand. As Dongyuan said: "Seeing swelling and pain, if pulse and symptoms indicate deficiency, immediately tonify. With un-depleted qi and blood, ultimate auspiciousness is assured." Trust this statement.
A child with buttock swelling and hardness, normal skin color, and scanty red urine frequently used diuretics, leading to knee and shin bone swelling. I explained that the Kidney governs bones; this was innate Kidney deficiency. Previous drugs damaged Kidney yin, causing bone swelling. Regulating and tonifying Spleen-Lung to generate Kidney water should resolve the bone swelling. Ignoring this and continuing previous medications led to death.
A child with a long-healing abdominal carbuncle was intended to be treated by nourishing the source of transformation, but instead received clearing-heat and detoxifying herbs. Multiple bad signs appeared, leading to death. The Lung is the mother of the Kidney, and the Spleen is the mother of the Lung. Failure to nourish the Kidney to generate Liver wood, combined with cold-natured herbs damaging Stomach qi, severed the transformation sources of Lung and Kidney; survival was unlikely.
A child with tiegu yong (deep-seated abscess) developed diarrhea. Intending to regulate and tonify, but the patient refused and used diuretics instead. Empty-handed grasping indicated Liver qi failure; profuse diarrhea indicated Kidney qi failure; phlegm obstruction indicated Spleen qi failure; incessant cough indicated Lung qi failure; forehead sweating indicated Heart qi failure. Declining treatment, the child died.
A child with leg carbuncle swelling, pain, spontaneous and night sweats, fatigue, and poor appetite had pus formed using interior-supporting medicines. Needling was planned, but someone suggested using Dahuang (Rhei Radix et Rhizoma) to expel pus via stool, causing severe diarrhea and abdominal pain. I diagnosed this as a bad sign of Spleen-Stomach collapse and urgently recommended large tonifying agents. Ignoring this and continuing previous medications led to death.
A fifteen-year-old girl had hard swelling in the outer thigh extending to the inner thigh, unchanged skin color, and a slow-weak right Guan pulse that felt wiry-rapid upon pressure. This indicated Spleen deficiency with Liver invasion, and qi-blood deficiency manifesting as unchanged color. Treatment should focus on tonifying Spleen earth. Ignoring this and using Liuqi Yin (Flowing Qi Decoction) and Binghuang San (Ice and Yellow Powder) led to diarrhea, abdominal pain, gaping wound, and death.
Shenfu Tang (Ginseng and Aconite Decoction)
Renshen (1 liang), Fuzi (processed, 3 qian)
Decoct with Shengjiang and Dazao in water; take at any time.
Other formulas are listed under respective symptoms.