肌肉乃脾胃所生，收敛皆气血所主，二者相济以成者也。若肌肉不生而色赤，血热也，用四物、山栀、牡丹皮。晡
热内热者，血虚也，用四君、归、地、牡丹皮。脓水清稀者，气血俱虚也，用十全大补汤。食少体倦者，脾气虚也，用
补中益气汤。烦热作渴，起居如常者，胃热也，用竹叶黄 汤。烦热作渴，小便频数者，肾虚也，用六味地黄丸。肉腐
而不溃者，用乌金膏。若肉溃而不敛者，用六君子汤。秽臭，脉洪大而作渴，乃真气虚而邪气实也，此为难治。大凡疮
疡久而不愈者，皆元气不足，或因邪气凝滞于患处。苟能调补脾胃，则元气自足，元气既足，则邪气自消，死肉自溃，
新肉自生而疮自敛矣。使不保其本而概敷生肌之剂，是反助其邪，后更溃烂耳。
一小儿臂痈久不敛，日晡倦怠，敷追蚀之药，腐坏而不敛，余谓因脾气虚而不能生长肌肉。朝用益气汤，夕用异功
散，月余而痊。
一小儿腿痈色赤，久不生肌，日晡发热，此脾经血虚也，用四君、归、芎、柴胡、牡丹皮，热渐止而肌渐生。后因
停食吐泻疮色变，此脾气虚弱，用益气汤、异功散而痊。
一小儿臀疮久不生肌，余曰∶臀属膀胱乃气血难到之所，此禀肾虚而患者，当调补脾气，滋养阴血。遂用五味异功
散、地黄丸而痊。
一小儿臀痈，溃而不敛，发热作渴，小便频便，仍欲降火，余谓此禀肾经阴虚而火动耳，用补中益气汤、加减八味
丸而愈。毕姻后，臀复患痈，欲速效，服败毒散，溃而发热，脉洪数而无力，肾部为甚，仍用益气汤、八味丸为主，佐
以八珍汤、异功散而愈。
一小儿腿疮，久不生肌，肿痛色赤，此脾胃虚而湿热也，用益气汤加黄柏、防己渐愈；又用四君、柴胡、升麻而痊。
一小儿臀疮，腐而作痛不止，肌肉不生，口干作渴，右关脉洪数，此胃经火盛之恶症，先用竹叶黄 汤二剂而痛止，
又以四君加升麻、白芷而愈。
一小儿臀间肿硬，色不变，面目皎白，余谓禀肾不足，反行败毒，日出清脓而殁。
一小儿颈间肿硬，余谓禀肝肾不足，不信，乃用杂药，后颐间、胸胁、膝骨皆肿，各用火针出水，疮口开张而殁。
补中益气汤 治小儿禀赋不足，荣卫之气短促，寒薄腠理，闭郁而为疮疡；或因疮疡服克伐之剂，气血亏损而
不能消散；或因已溃气血亏损而不能生肌，或恶寒发热，烦躁倦怠，饮食少思等症。
人参 黄 （炒） 白术（炒） 甘草（炒） 当归 陈皮（各五分） 柴胡 升麻（各三分）
上姜枣水煎服。
神效乌金膏 治疮疡肉死不腐，涂之即腐，未死涂之即生。若初起肿痛搽点数处，其毒顿消。若患顽疮，元气
无亏，久不收敛，内有毒根者，以纸捻蘸 之即敛。其方用巴豆仁一味炒黑，研如膏，点于患处，临用修合，庶不干耳。
此方虽不出千方书，余制而用之，良有奇验，故并籍焉。
五味异功散（方见用败毒之药）
四君子汤（方见腹痈）
加减八味丸（即六味丸加五味子四钱，肉桂一钱）
四物汤（方见腋痈）
十全大补汤（方见便痈）
竹叶黄 汤
六味地黄丸（二方见作渴不止）
保和丸（方见发热不止）
肌肉由脾胃化生，收敛功能皆由气血主导，二者相互协调配合才能形成。如果肌肉不生且颜色发红，这是血热所致，使用四物汤、山栀、牡丹皮。午后潮热及内热的症状，是血虚所致，使用四君子汤、当归、地黄、牡丹皮。脓液清稀的，是气血俱虚，使用十全大补汤。饮食减少、身体疲倦的，是脾气虚，使用补中益气汤。烦躁发热且口渴，但起居如常的，是胃热，使用竹叶石膏汤。烦躁发热且口渴，小便频数的，是肾虚，使用六味地黄丸。肌肉腐烂但不溃破排脓的，使用乌金膏。如果肌肉溃破但不愈合收敛的，使用六君子汤。伤口污秽恶臭，脉象洪大而伴有口渴的，是真气虚弱而邪气亢盛，这属于难治之症。大凡疮疡经久不愈的，都是元气不足，或者是因为邪气凝滞于患处。如果能够调补脾胃，那么元气自然充足，元气既然充足，邪气自然消除，死肉自然溃烂脱落，新肉自然生长，疮口自然愈合。如果不顾护根本而一概敷用生肌的药物，反而是助长邪气，导致后来更加溃烂罢了。
有一个小儿手臂痈肿久不愈合，午后倦怠，敷用追蚀腐蚀的药物，腐坏而不愈合，我认为这是因为脾气虚而不能生长肌肉。早晨服用补中益气汤，晚上服用异功散，一个多月后痊愈。
有一个小儿腿部痈肿颜色发红，久不长肉，午后发热，这是脾经血虚所致，使用四君子汤、当归、川芎、柴胡、牡丹皮，热势逐渐停止而肌肉逐渐生长。后来因为停食导致吐泻，疮色改变，这是脾气虚弱，使用补中益气汤、异功散而痊愈。
有一个小儿臀部疮疡久不长肉，我说：臀部属膀胱经，是气血难以到达的地方，这是禀赋肾虚而患病，应当调补脾气，滋养阴血。于是使用五味异功散、地黄丸而痊愈。
有一个小儿臀部痈肿，溃破但不愈合，发热口渴，小便频数，仍然想要降火，我说这是禀受肾经阴虚而虚火妄动，使用补中益气汤、加减八味丸而痊愈。结婚后，臀部再次患痈，想要快速见效，服用败毒散，溃破后发热，脉象洪数但无力，尺部（肾部）尤为明显，仍然以补中益气汤、八味丸为主，辅以八珍汤、异功散而痊愈。
有一个小儿腿部疮疡，久不长肉，肿痛色红，这是脾胃虚弱兼有湿热，使用补中益气汤加黄柏、防己逐渐好转；又用四君子汤、柴胡、升麻而痊愈。
有一个小儿臀部疮疡，腐烂作痛不止，肌肉不生，口干口渴，右关脉洪数，这是胃经火盛的恶症，先用竹叶石膏汤两剂使疼痛停止，又以四君子汤加升麻、白芷而痊愈。
有一个小儿臀部间肿硬，颜色不变，面目苍白，我认为这是禀赋肾不足，反而使用败毒药物，结果日出清脓而死。
有一个小儿颈部肿硬，我认为这是禀赋肝肾不足，患者不信，乃用杂药，后来颐部、胸胁、膝骨皆肿，各用火针出水，疮口开张而死。
补中益气汤 治疗小儿禀赋不足，营卫之气短促，寒邪侵袭腠理，闭郁而为疮疡；或者因为疮疡服用克伐攻伐的药物，气血亏损而不能消散；或者已经溃破后气血亏损而不能生肌，或出现恶寒发热、烦躁倦怠、饮食少思等症状。
人参、黄芪（炒）、白术（炒）、甘草（炒）、当归、陈皮（各五分）、柴胡、升麻（各三分）。
以上药物用生姜、大枣水煎服。
神效乌金膏 治疗疮疡肌肉死而不腐，涂之即腐，未死的肌肉涂之即生。如果初起肿痛，搽涂几处，其毒顿时消除。如果患顽疮，元气没有亏损，久不收敛，内部有毒根的，用纸捻蘸取药膏涂抹即能收敛。此方只用巴豆仁一味，炒黑，研成膏状，点于患处，临用时调制，才不会干结。此方虽然不出自千千方书，但我制作并应用它，确实有奇效，所以一并记录在这里。
五味异功散（方见“用败毒之药”条下）
四君子汤（方见“腹痈”条下）
加减八味丸（即六味地黄丸加五味子四钱，肉桂一钱）
四物汤（方见“腋痈”条下）
十全大补汤（方见“便痈”条下）
竹叶石膏汤
六味地黄丸（二方见“作渴不止”条下）
保和丸（方见“发热不止”条下）
Muscle is generated by the Spleen and Stomach, while its contraction and consolidation are governed by Qi and Blood; these two factors must harmonize to form muscle. If muscle fails to grow and the area appears red, this indicates Heat in the Blood; treat with Siwu Tang (Four Substances Decoction), Gardenia (Gardeniae Fructus), and Moutan Bark (Moutan Cortex). If there is afternoon tidal fever and internal heat, this indicates Deficiency of Blood; treat with Sijunzi Tang (Four Gentlemen Decoction), Angelica Root (Danggui), Rehmannia Root (Dihuang), and Moutan Bark. If pus is clear and thin, this indicates Deficiency of both Qi and Blood; treat with Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). If appetite is poor and the body feels fatigued, this indicates Deficiency of Spleen Qi; treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If there is irritability, fever, and thirst, but daily activities remain normal, this indicates Heat in the Stomach; treat with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). If there is irritability, fever, and thirst accompanied by frequent urination, this indicates Kidney Deficiency; treat with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If flesh rots but does not ulcerate/drain, apply Wujin Gao (Black Gold Ointment). If flesh ulcerates but does not heal/consolidate, use Liujunzi Tang (Six Gentlemen Decoction). If the wound is foul-smelling, the pulse is surging and large, and there is thirst, this indicates Deficiency of True Qi and Excess of Pathogenic Factors; this is difficult to treat. Generally, sores and ulcers that persist for a long time without healing are due to insufficiency of Yuan Qi (Primal Qi), or because pathogenic factors are stagnant at the affected site. If one can regulate and tonify the Spleen and Stomach, Yuan Qi will naturally become sufficient; once Yuan Qi is sufficient, pathogenic factors will naturally dissipate, necrotic tissue will slough off, new flesh will grow, and the sore will naturally heal. If one neglects to protect the root cause and indiscriminately applies flesh-generating agents, one merely assists the pathogen, leading to further ulceration later.
A child had an arm abscess that failed to heal for a long time, with fatigue in the late afternoon. After applying caustic medications, the tissue became necrotic and did not heal. I reasoned that this was due to Deficiency of Spleen Qi preventing muscle growth. In the morning, I administered Yiqi Tang (Qi-Tonifying Decoction, i.e., Buzhong Yiqi Tang), and in the evening, Yigong San (Yi-Gong Powder); after more than a month, he recovered.
A child had a leg abscess that was red and failed to generate muscle for a long time, with afternoon fever. This indicated Blood Deficiency in the Spleen Meridian. I used Sijunzi Tang combined with Danggui, Chuanxiong, Chaihu, and Moutan Bark. The fever gradually subsided, and muscle gradually grew. Later, due to food stagnation causing vomiting and diarrhea, the color of the sore changed. This indicated Weakness of Spleen Qi, which was treated with Buzhong Yiqi Tang and Yigong San, resulting in recovery.
A child had a buttock sore that failed to generate muscle for a long time. I stated: The buttocks belong to the Bladder meridian, an area where Qi and Blood are difficult to reach. This patient suffered from Congenital Kidney Deficiency. Therefore, one should regulate and tonify Spleen Qi and nourish Yin and Blood. I subsequently used Wuwei Yigong San (Five-Ingredient Yi-Gong Powder) and Dihuang Wan (Rehmannia Pill), resulting in recovery.
A child had a buttock abscess that ulcerated but did not heal, accompanied by fever, thirst, and frequent urination. Although there was a desire to clear Fire, I reasoned that this was due to Congenital Yin Deficiency of the Kidney Meridian causing Hyperactive Fire. I used Buzhong Yiqi Tang and Jiaban Bawei Wan (Modified Eight-Ingredient Pill), resulting in recovery. After marriage, the buttock abscess recurred. Desiring a rapid effect, he took Baidu San (Eliminate Toxin Powder), which led to ulceration and fever. The pulse was surging, rapid, and forceless, especially in the Kidney region (Chi position). I again used Buzhong Yiqi Tang and Bawei Wan as the main treatment, assisted by Bazhen Tang (Eight Treasures Decoction) and Yigong San, resulting in recovery.
A child had a leg sore that failed to generate muscle for a long time, with swelling, pain, and redness. This indicated Spleen and Stomach Deficiency with Damp-Heat. I used Buzhong Yiqi Tang added with Huangbai and Fangji, which gradually improved; subsequently, Sijunzi Tang added with Chaihu and Shengma resulted in recovery.
A child had a buttock sore with persistent rotting pain, failure of muscle growth, dry mouth, and thirst. The Right Guan pulse was surging and rapid. This indicated a severe condition of Excessive Fire in the Stomach Meridian. I first used two doses of Zhuye Shigao Tang to stop the pain, then used Sijunzi Tang added with Shengma and Baizhi, resulting in recovery.
A child had swelling and hardness between the buttocks with unchanged skin color and a pale face. I reasoned this was due to insufficient Congenital Kidney Essence. However, toxic-clearing (attacking) drugs were used instead. The child died after discharging clear pus the next day.
A child had swelling and hardness in the neck. I reasoned this was due to insufficient Congenital Liver and Kidney Essence. The parents did not believe me and used miscellaneous drugs. Later, the chin, chest, hypochondrium, and knee bones all swelled. Various acupuncture needles were used to drain fluid, but the wound openings remained wide, and the child died.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Treats children with congenital insufficiency, shortness of Ying and Wei Qi, cold invading the interstices (Couli), closure and depression leading to sores and ulcers; or sores and ulcers where harsh attacking medicines were taken, causing Qi and Blood deficiency preventing resolution; or post-ulceration Qi and Blood deficiency preventing muscle generation; or symptoms such as aversion to cold, fever, irritability, fatigue, and poor appetite.
Ingredients: Ginseng Radix (Renshen), Astragali Radix (Huangqi, stir-fried), Atractylodis Macrocephalae Rhizoma (Baizhu, stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao, stir-fried), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Chenpi) [each 5 fen]; Bupleuri Radix (Chaihu), Cimicifugae Rhizoma (Shengma) [each 3 fen].
Decoct with Ginger and Jujube water and take orally.
Shenxiao Wujin Gao (Divine Efficacy Black Gold Ointment): Treats sores and ulcers where dead flesh does not rot; application causes immediate rotting of necrotic tissue, while application to living tissue promotes regeneration. If applied to a few spots during initial swelling and pain, the toxin is instantly eliminated. For stubborn sores where Yuan Qi is intact but healing is delayed due to deep-seated toxins, dip paper twists in the ointment to apply; this promotes healing. The formula consists solely of Semen Crotonis (Badou Ren), stir-fried until black, ground into a paste, and applied to the affected area. Prepare fresh before use to prevent drying. Although this formula does not appear in standard compendiums, I formulated and used it with remarkable efficacy, hence it is recorded here.
Wuwei Yigong San (Five-Ingredient Yi-Gong Powder) (See formula under "Use of Toxic-Clearing Medicines")
Sijunzi Tang (Four Gentlemen Decoction) (See formula under "Abdominal Abscess")
Jiaban Bawei Wan (Modified Eight-Ingredient Pill) (i.e., Liuwei Dihuang Wan plus Schisandrae Fructus 4 qian, Cinnamomi Cortex 1 qian)
Siwu Tang (Four Substances Decoction) (See formula under "Axillary Abscess")
Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) (See formula under "Perineal Abscess")
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction)
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (See formulas under "Unremitting Thirst")
Baohe Wan (Preserve Harmony Pill) (See formula under "Unremitting Fever")