【方歌】多骨疽由肾虚源，疮久肿溃复受寒，落草患此胎元结，
名为骨胀治一般。
【注】此证一名剩骨，一名朽骨。无论老少，皆有生者，多在
腮〔月咢〕、牙床、眼胞、颏下、手足、腿膊等处。有
因肾虚之人，生疮久溃，肿硬不退，口不收敛，外被寒
邪袭入，与脓毒凝结，借人之气血化成多骨者；又有初
生落草，身肉之中，按之有如脆骨，由胎元受之，精血
交错而致，迨其人长大后，必于脆骨所生之处，突然发
肿生疽，及溃破后，多骨脱出，其口方收。有多骨出之
不休者，名曰骨胀，难愈。以上二因，治法皆同，俱宜
隔附子饼艾灸，以宣寒凝，令骨速脱。盖骨属肾，遇寒
则凝，故从热治也。若朽骨内含，或出臭脓，或出涎泡
，宜撒黄灵药，陀僧膏盖贴，令朽骨出尽，其口始易敛
也。肾虚微寒者，服六味地黄丸；虚而寒甚者，桂附地
黄丸，常服可愈。由胎元结成者，禀赋身虚，不可强取
多骨，候自破则取之。
又方：附子饼灸法（见首卷灸法）
黄灵药、陀僧膏（俱见溃疡门）
六味地黄丸（见面部雀斑）
桂附地黄丸（见面部颊疡）
【方歌】结核即同果核形，皮里膜外结凝成，或由风火气郁致，
或因怒火湿痰生。
【注】此证生于皮里膜外，结如果核，坚而不痛，由风火气郁
，结聚而生。初发令人寒热往来，有表证者，荆防败毒
散解之；表既解，即服连翘消毒饮。若湿痰气郁凝结者
，宜行气化痰，以五香流气饮、千金指迷丸，辛凉之药
治之，其核自消；若误投苦寒之剂，必至溃破。或服之
而反甚者，其势将溃，不可强消，以耗其气，宜用透脓
散。溃而不愈者，属气虚，宜用补中益气汤平补之。外
治按痈疽肿疡、溃疡门。
方剂：千金指迷丸
组成：半夏（制，四两） 白茯苓
枳壳（麸炒，各三两） 风化硝（三钱）
共研为末，河水煮糊为丸，如梧桐子大。每服二钱
，白滚水送下。
【方歌】千金指迷丸半夏，茯苓枳壳硝同砑，河水煮糊作成丸，
消坚去核结痰化。
又方：荆防败毒散（见项部脑疽）
连翘消毒饮（见背部酒毒发）
五香流气饮（见胫部黄鳅痈）
透脓散（见肿疡门）
补中益气汤（见溃疡门）
【方歌】多骨疽源于肾虚，疮疡久溃后再次受寒，婴儿出生时患此病是胎元凝结所致，
名为骨胀，治疗方法相同。
【注】此证又名剩骨，又名朽骨。无论老少，都有发生的可能，多在腮颊、牙床、眼睑、下巴、手足、手臂等部位。有的因肾虚之人，生疮久溃，肿胀坚硬不退，伤口不收敛，外部寒邪侵入，与脓毒凝结，借助人的气血化成多骨；又有初生婴儿，身体肉中，触摸时有如脆骨，由胎元遗传，精血交错导致，等到此人长大后，必然在脆骨生长的地方，突然发肿生疽，以及溃破后，多骨脱出，伤口才愈合。有多骨不断排出的，名叫骨胀，难以痊愈。以上两种病因，治疗方法都相同，都适宜用隔附子饼艾灸，以宣散寒凝，让骨头快速脱落。因为骨属肾，遇寒则凝结，所以从热治法治疗。如果朽骨内含，或者流出臭脓，或者流出涎泡，适宜撒黄灵药，用陀僧膏覆盖贴敷，让朽骨排尽，伤口才容易收敛。肾虚伴有轻微寒象的，服用六味地黄丸；虚而寒严重的，服用桂附地黄丸，常服可愈。由胎元结成的，禀赋身体虚弱，不可强行取出多骨，等待自然破溃后再取出。
又方：附子饼灸法（见首卷灸法）
黄灵药、陀僧膏（均见溃疡门）
六味地黄丸（见面部雀斑）
桂附地黄丸（见面部颊疡）
【方歌】结核形状如同果核，在皮里膜外凝结而成，可能由风火气郁引起，
也可能因怒火湿痰生成。
【注】此证生于皮里膜外，结块如果核，坚硬但不痛，由风火气郁，结聚而生。初发让人寒热往来，有表证的，用荆防败毒散解表；表证解除后，即服用连翘消毒饮。如果是湿痰气郁凝结的，适宜行气化痰，用五香流气饮、千金指迷丸，辛凉的药物来治疗，其核自消；如果误投苦寒药剂，必然导致溃破。或者服药后反而加重的，其势将要溃破，不可强行消散，以免耗伤正气，适宜用透脓散。溃破后不愈合的，属于气虚，适宜用补中益气汤平和地补益。外治参照痈疽肿疡、溃疡门。
方剂：千金指迷丸
组成：半夏（制，四两） 白茯苓
枳壳（麸炒，各三两） 风化硝（三钱）
共研为末，河水煮糊做成丸，如梧桐子大。每次服用二钱，白开水送下。
【方歌】千金指迷丸含半夏，茯苓枳壳硝同研，河水煮糊作成丸，
消坚去核结痰化。
又方：荆防败毒散（见项部脑疽）
连翘消毒饮（见背部酒毒发）
五香流气饮（见胫部黄鳅痈）
透脓散（见肿疡门）
补中益气汤（见溃疡门）
[Prescription Verse] Duogu Ju (Multiple Bone Abscess) originates from Kidney Deficiency; after a sore has ulcerated for a long time, it is re-exposed to Cold. Infants suffering from this condition have it due to the condensation of the Prenatal Essence (Taiyuan). It is named Gu Zhang (Bone Distension), and the treatment method is the same.
[Annotation] This syndrome is also known as Sheng Gu (Remaining Bone) or Xiu Gu (Rotten Bone). It can occur in people of any age, mostly appearing on the cheeks, gums, eyelids, chin, hands, feet, and arms. In some cases, individuals with Kidney Deficiency develop sores that ulcerate for a long time, remaining swollen and hard without healing. External Cold pathogens invade, condensing with pus and toxins, and utilizing the body's Qi and Blood to transform into multiple bones. In other cases, newborns have brittle bone-like structures within their flesh, caused by the inheritance of the Prenatal Essence and the intermingling of Jing and Blood. When these individuals grow up, swelling and abscesses suddenly appear at the site of the brittle bone. After ulceration, the multiple bones are expelled, and only then does the wound heal. If multiple bones continue to be expelled continuously, it is named Gu Zhang (Bone Distension), which is difficult to cure. For both causes mentioned above, the treatment methods are identical: Moxibustion with Aconite Cake (Gefu Fuzi Jiu) should be used to disperse Cold condensation and facilitate the rapid expulsion of the bone. Since Bones belong to the Kidney and coagulate upon exposure to Cold, heat-based treatments are employed. If rotten bone remains inside, or if foul pus or saliva bubbles are discharged, Huang Ling Yao (Yellow Spirit Medicine) should be sprinkled, and Tuoseng Gao (Lead Monoxide Ointment) applied as a dressing, ensuring all rotten bone is expelled before the wound can easily close. For those with Kidney Deficiency accompanied by mild Cold, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be taken; for severe deficiency with Cold, Guifu Dihuang Wan (Cinnamon Twig and Aconite Rehmannia Pill) should be taken regularly for recovery. For cases formed by Prenatal Essence condensation, where the constitution is weak, one should not forcibly remove the multiple bones but wait for them to break out naturally before removal.
Another Prescription: Moxibustion with Aconite Cake (See Moxibustion Methods in Volume One).
Huang Ling Yao, Tuoseng Gao (See Ulcer Section).
Liuwei Dihuang Wan (See Facial Freckles).
Guifu Dihuang Wan (See Facial Cheek Sores).
[Prescription Verse] Hejie (Tubercles) resemble fruit pits in shape, forming through condensation in the subcutaneous tissue and fascia. They may be caused by Wind-Fire and Qi Stagnation,
or generated by Angry Fire and Damp-Phlegm.
[Annotation] This syndrome arises in the subcutaneous tissue and fascia, forming nodules like fruit pits—hard but painless—resulting from the aggregation of Wind-Fire and Qi Stagnation. Initially, it causes alternating chills and fever; if exterior symptoms are present, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Relieve Toxicity) is used to resolve the exterior. Once the exterior is resolved, Lianqiao Xiaodu Yin (Forsythia Decoction to Eliminate Toxicity) should be taken. If caused by the condensation of Damp-Phlegm and Qi Stagnation, Qi-moving and Phlegm-resolving methods should be employed using Wuxiang Liqi Yin (Five-Aromatic Qi-Circulating Decoction) and Qianjin Zhimi Wan (Thousand-Gold Obscure-Dissipating Pill), treating with acrid-cool herbs until the nodules dissipate. If bitter-cold agents are mistakenly administered, ulceration will inevitably occur. If symptoms worsen after medication, indicating impending ulceration, forced resolution should be avoided to prevent depletion of Qi; instead, Tou Nong San (Pus-Penetrating Powder) should be used. If ulceration fails to heal, it indicates Qi Deficiency, and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used for gentle tonification. External treatment refers to the sections on Carbuncle-Sore Swelling and Ulcers.
Formula: Qianjin Zhimi Wan
Composition: Banxia (Prepared, 4 liang), Baifuling (White Poria), Zhike (Bran-fried, 3 liang each), Fenghuaxiao (Weathered Nitre, 3 qian).
Grind into powder, make pills with paste boiled in river water, size of Sophora seeds. Take 2 qian per dose, washed down with plain boiling water.
[Prescription Verse] Qianjin Zhimi Wan contains Banxia, Fuling, Zhike, and Xiao ground together; boiled in river water to make pills,
it dissolves hardness, removes nodules, and transforms phlegm.
Another Prescription: Jingfang Baidu San (See Occipital Brain Carbuncle).
Lianqiao Xiaodu Yin (See Back Alcohol-Toxin Eruption).
Wuxiang Liqi Yin (See Calf Loach Carbuncle).
Tou Nong San (See Swelling Section).
Buzhong Yiqi Tang (See Ulcer Section).