附: 薛己治疡通方 治一切疮疡, 未成脓者内消,
已成脓者即溃, 又止痛, 消毒之圣药也.
穿山甲 白芷 防风 皂角刺 乳香 没药 当归尾 赤芍 花粉
贝母 陈皮 金银花 甘草 , 右十三味. 用酒一碗. 煎数沸服.
【集注】罗谦甫曰: 此疡门开手攻毒之第一方也. 经云: 营气不从,
逆于肉理. 故痈疽之发, 未有不从营气之郁滞, 因而血结痰滞蕴崇热
毒为患. 治之之法, 妙在通经之结, 行血之滞, 佐之以豁痰理气解毒
.是方穿山甲以攻坚, 皂刺以达毒所, 白芷, 防风, 陈皮通经理气而
疏其滞, 乳香定痛和血, 没药破血散结, 赤芍, 归尾以驱血热而行之
,以破其结. 佐以贝母, 金银花, 甘草, 一以豁痰解郁, 一以散毒和
血,其为溃坚止痛宜矣. 然是方为营卫尚强, 中气不亏者设. 若脾胃
素弱, 营卫不调, 则有托里消毒散之法, 必须斟酌而用. 此薛己所论
千古不易之治也. 因附治疡用方之法于后, 使学者服膺云. 薛己曰 :
治疡之法, 若肿高焮痛者, 先用仙方活命饮解之, 后用托里败毒散.
漫肿微痛者, 用托里散, 如不应加姜, 桂. 若脓出而反痛, 气血虚也
,八珍散. 不作脓不腐溃, 阳气虚也, 四君加归, 耆, 肉桂. 不生肌
,不收敛, 脾气虚也, 四君加芍药, 木香. 恶寒憎寒, 阳气虚也, 十
全大补加姜, 桂. 晡热内热, 阴血虚也, 四物加参, 耆. 欲呕作呕 ,
胃气虚也, 六君加炮姜. 自汗, 盗汗, 五脏虚也, 六味丸料加五味子
.食少体倦, 脾气虚也, 补中益气加茯苓, 半夏. 喘促咳嗽, 脾肺虚
也,前汤加麦冬, 五味. 欲呕少食, 脾胃虚也, 人参理中汤. 腹痛泄
泻,脾胃虚寒也, 附子理中汤. 热渴淋秘, 肾虚阴火也, 加减八味丸
.大凡怯弱之人, 不必分其肿溃, 惟当先补胃气. 盖疮疡之作, 缘阴
阳亏损, 其脓既泄, 气血愈虚, 岂有不宜补者哉! 或疑参, 耆满中 ,
间有用者, 又加发散败毒, 所补不偿所损. 又或以有疾不服补剂, 因
而致误者多矣. 可胜惜哉!
附：薛己治疗疮疡的通治方。用于治疗各种疮疡，脓未形成的通过内服消散，脓已形成的促使溃破，又能止痛、消毒，是治疗此类疾病的圣药。
穿山甲、白芷、防风、皂角刺、乳香、没药、当归尾、赤芍、天花粉、贝母、陈皮、金银花、甘草，以上十三味药。用酒一碗，煎煮数沸后服用。
【集注】罗谦甫说：这是外科门中攻解毒邪的第一张方子。《内经》说：营气运行不畅，逆乱于肌肉纹理之间。所以痈疽的发生，没有不是因为营气郁滞，进而导致血结、痰滞，蕴积化热成毒而致病。治疗的方法，妙在疏通经络的结滞，行散血液的瘀滞，辅以豁痰、理气、解毒。此方中穿山甲用来攻坚散结，皂角刺用来直达毒邪所在之处，白芷、防风、陈皮疏通经络、调理气机以疏解郁滞，乳香定痛和血，没药破血散结，赤芍、当归尾驱除血热并推动血行，以破除结聚。辅以贝母、金银花、甘草，一方面豁痰解郁，一方面散毒和血，这确实是溃坚止痛的有效方剂。然而此方是为营卫之气尚强、中气不亏损的患者设立的。如果脾胃素来虚弱，营卫不调，则应采用托里消毒散的治法，必须斟酌情况使用。这是薛己所论述的千古不变的治法。因此附上治疗疮疡使用方剂的原则在后面，使学习者铭记于心。
薛己说：治疗疮疡的方法，如果肿胀高起、灼热疼痛的，先用仙方活命饮（Immortal Life Elixir for Sores）解除毒邪，后用托里败毒散（Support-the-Interior and Defeat-Toxin Powder）。漫肿无明显隆起、轻微疼痛的，用托里散（Support-the-Interior Powder），如无效加生姜、肉桂。如果脓液排出后反而疼痛，是气血虚弱的表现，用八珍散（Eight-Treasure Powder）。如果不化脓、不溃烂，是阳气虚弱的表现，用四君子汤（Four-Gentlemen Decoction）加当归、黄芪、肉桂。如果不生肌、不收敛伤口，是脾气虚弱的表现，用四君子汤加白芍、木香。恶寒、憎寒，是阳气虚弱的表现，用十全大补汤（Perfectly Complete Great Tonifying Decoction）加生姜、肉桂。午后发热、内部发热，是阴血虚弱的表现，用四物汤（Four-Materials Decoction）加人参、黄芪。想呕吐或已经呕吐，是胃气虚弱的表现，用六君子汤（Six-Gentlemen Decoction）加炮姜。自汗、盗汗，是五脏虚弱的表现，用六味地黄丸料加五味子。食少、身体疲倦，是脾气虚弱的表现，用补中益气汤（Tonify the Middle and Augment the Qi Decoction）加茯苓、半夏。气喘急促、咳嗽，是脾肺虚弱的表现，用前方加麦冬、五味子。想呕吐、进食少，是脾胃虚弱的表现，用人参理中汤（Ginseng Regulate the Middle Decoction）。腹痛腹泻，是脾胃虚寒的表现，用附子理中汤（Aconite Regulate the Middle Decoction）。热渴、小便淋漓涩痛或闭塞，是肾虚相火妄动的表现，用加减八味丸（Modified Eight-Ingredient Pill）。大凡体质怯弱的人，不必区分是否已经肿起或溃破，只应当先补益胃气。因为疮疡的发生，源于阴阳亏损，脓液既已泄出，气血更加虚弱，哪里有不应该补益的道理呢！有人怀疑人参、黄芪充满胸中，间或有使用者，又加入发散败毒的药物，结果补益的不如损耗的多。又有人因为患有疾病就不敢服用补剂，因而导致误诊误治的情况很多了，真是令人惋惜啊！
Appendix: Xue Ji's General Formula for Treating Ulcers. It is used to treat all kinds of sores and ulcers; if pus has not yet formed, it dissipates them internally; if pus has already formed, it promotes suppuration and rupture. It is also a holy medicine for relieving pain and detoxification.
Schistochilae Cortex (Chuan Shan Jia, 穿山甲), Angelicae Dahuricae Radix (Bai Zhi, 白芷), Saposhnikoviae Radix (Fang Feng, 防风), Gleditsiae Sinensis Spina Fructus (Zao Jiao Ci, 皂角刺), Boswelliae Resina (Ru Xiang, 乳香), Myrrhae Resina (Mo Yao, 没药), Cauda Angelicae Sinensis Radix (Dang Gui Wei, 当归尾), Paeliae Radix Rubra (Chi Shao, 赤芍), Trichosanthis Radix (Hua Fen, 花粉), Fritillariae Cirrhosae Bulbus (Bei Mu, 贝母), Citri Reticulatae Pericarpium (Chen Pi, 陈皮), Lonicerae Japonicae Flos (Jin Yin Hua, 金银花), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草). These thirteen ingredients. Use one bowl of wine, boil for several times until boiling, then take orally.
[Collected Notes] Luo Qianfu said: This is the first formula in the department of surgery for attacking and eliminating toxins. The Classic says: When Ying Qi (Nutritive Qi) does not flow smoothly, it reverses into the muscle tissue. Therefore, the onset of carbuncles and sores always stems from the stagnation of Ying Qi, leading to blood coagulation and phlegm retention, which accumulate heat and transform into toxic pathogens. The method of treatment lies in unblocking the knots of the meridians, promoting the circulation of stagnant blood, assisted by resolving phlegm, regulating qi, and detoxifying. In this formula, Schistochilae Cortex breaks down hard accumulations, Gleditsiae Sinensis Spina Fructus reaches the site of the toxin, Angelicae Dahuricae Radix, Saposhnikoviae Radix, and Citri Reticulatae Pericarpium unblock the meridians and regulate qi to disperse stagnation, Boswelliae Resina stabilizes pain and harmonizes blood, Myrrhae Resina breaks blood stasis and dissipates nodules, Paeiliae Radix Rubra and Cauda Angelicae Sinensis Radix drive out blood heat and promote circulation to break up clots. Assisted by Fritillariae Cirrhosae Bulbus, Lonicerae Japonicae Flos, and Glycyrrhizae Radix et Rhizoma, one resolves phlegm and relieves depression, the other dissipates toxins and harmonizes blood. Thus, it is indeed suitable for breaking hardness and relieving pain. However, this formula is designed for patients whose Ying and Wei (Defensive) Qi are still strong and whose Middle Qi is not deficient. If the Spleen and Stomach have been weak since childhood, or Ying and Wei Qi are discordant, the method of Tuoli Xiaodu San (Support-the-Interior and Detoxify Powder) should be adopted, and it must be used with careful consideration. This is the theory of Xue Ji, an unchangeable treatment principle through the ages. Therefore, I append the principles of using formulas for treating ulcers below, so that students may keep them firmly in mind.
Xue Ji said: Regarding the method of treating ulcers, if there is swelling, elevation, burning sensation, and pain, first use Xianfang Huoming Yin (Immortal Life Elixir for Sores) to resolve the pathogen, followed by Tuoli Baidu San (Support-the-Interior and Defeat-Toxin Powder). If there is diffuse swelling without significant elevation and slight pain, use Tuoli San (Support-the-Interior Powder); if ineffective, add Zingiberis Rhizoma Recens (Sheng Jiang, 生姜) and Cinnamomi Cortex (Rou Gui, 肉桂). If pain persists after pus discharge, it indicates deficiency of Qi and Blood; use Bazhen San (Eight-Treasure Powder). If no pus forms and no ulceration occurs, it indicates deficiency of Yang Qi; use Sijunzi Tang (Four-Gentlemen Decoction) plus Dang Gui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), and Rougui (Cinnamomi Cortex). If granulation tissue does not grow and wounds do not contract, it indicates deficiency of Spleen Qi; use Sijunzi Tang plus Shaoyao (Paeoniae Radix Alba, Bai Shao, 白芍) and Muxiang (Aucklandiae Radix, 木香). If aversion to cold and chilliness occur, it indicates deficiency of Yang Qi; use Shiquan Dabu Tang (Perfectly Complete Great Tonifying Decoction) plus Sheng Jiang (Zingiberis Rhizoma Recens, 生姜) and Rougui (Cinnamomi Cortex, 肉桂). If afternoon fever and internal heat occur, it indicates deficiency of Yin and Blood; use Siwu Tang (Four-Materials Decoction) plus Renshen (Ginseng Radix, 人参) and Huangqi (Astragali Radix, 黄芪). If nausea or vomiting occurs, it indicates deficiency of Stomach Qi; use Liujunzi Tang (Six-Gentlemen Decoction) plus Paoshengjiang (Prepared Zingiberis Rhizoma, 炮姜). If spontaneous sweating or night sweats occur, it indicates deficiency of the Five Zang Organs; use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) material plus Wuweizi (Schisandrae Chinensis Fructus, 五味子). If poor appetite and physical fatigue occur, it indicates deficiency of Spleen Qi; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuling (Poria, 茯苓) and Banxia (Pinelliae Rhizoma, 半夏). If panting, shortness of breath, and cough occur, it indicates deficiency of Spleen and Lung; use the previous decoction plus Maidong (Ophiopogonis Radix, 麦冬) and Wuweizi (Schisandrae Chinensis Fructus, 五味子). If nausea and poor appetite occur, it indicates deficiency of Spleen and Stomach; use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction). If abdominal pain and diarrhea occur, it indicates Cold-Deficiency of Spleen and Stomach; use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). If heat, thirst, dysuria, or urinary retention occur, it indicates Kidney Deficiency with Ministerial Fire flaring up; use Jiaban Bawei Wan (Modified Eight-Ingredient Pill). Generally speaking, for those with weak constitutions, regardless of whether swelling or ulceration has occurred, one should first tonify Stomach Qi. For the occurrence of sores and ulcers stems from the depletion of Yin and Yang; once pus is discharged, Qi and Blood become even more deficient. How could it not be appropriate to use tonification! Some doubt that Renshen (Ginseng Radix, 人参) and Huangqi (Astragali Radix, 黄芪) fill the chest and middle jiao; occasionally, when these are used, dispersing and detoxifying herbs are added, resulting in the benefit not compensating for the loss. Others, because they have a disease, refuse to take tonifying agents, leading to many errors and mishaps. Is this not truly regrettable!