大凡痈疽溃后，筋糜肉烂，脓血大泄，阳随阴散，或筋脉拘急，恶寒惕搦。甚者舌强口
噤，
之法，当大补气血。若果系风症，亦须以大补气血为本，而兼以治风之药。设若不审是非而
妄药之则误矣。风症治见后方。
治验
司徒边华泉肩患痈，溃而发热，目直或 ，殊类中风。日晡热甚，脉益数，此足三阴气
血亏损
陆大行背疮，内溃出脓二碗许，用托里之剂，痛止肿消停药。忽寒热作渴，头痛自汗，
此元气虚而未能复也。用十全大补加麦门、五味、肉桂，二剂益甚，诊其脉如故。此药力未及，
仍用前药加附子一钱，三剂诸症悉愈，乃去附子，加肉桂数剂而敛。
一儒者患腿痈，深蓄于内，肉色不变，久不穿溃，针出脓瘀五碗许，恶症骈臻，全类中
风，此脾胃虚而变症也。用六君子加当归、炮姜，及圣愈汤，各四剂而安。又劳心不寐，用归脾
一儒者伤寒后，患流注，肿痛潮热，用十宣、败毒等剂，出稀脓五六碗许，发热恶寒，
烦躁作渴，殊类破伤风症而殁。
一男子背疮未痊敛，以膏药剪孔贴之，患破伤风症而殁。此先失于内补，外邪袭其虚耳
。余
以致殁者多矣，可不慎哉！
《内经》云∶形伤痛，气伤肿，先肿而后痛者，形伤气也。先痛而后肿者，气伤形也。
东垣先生谓∶胃为五脏之本源，人身之根蒂。丹溪先生云∶痈疽因积毒在脏腑，宜先助胃壮气以
固其本。夫然则气血凝结者自散；脓瘀已成者自溃；肌肉欲死者自生；肌肉已死者自腐；死
肉已溃者自敛。若独攻其疮，脾胃一虚，七恶蜂起，其不死者，幸矣！大凡前症，须用托里
消毒散为主。若高肿 痛，热毒也，加黄连。漫肿微痛，气虚也，去金银花、连翘二味，加
参、术。头痛发热。邪在表也，本方加川芎、羌活。若外邪在表，而元气实者，暂用人参败
毒散。头痛恶寒，表虚也，去二味，加参、 。发热饮冷，便秘，内热也，去参、 、归、
术，加大黄。发热饮热便秘，内虚也，去二味，加参、 、归、术。寒热饮冷，小便涩滞，
肝热也，去参、 ，加柴胡、山栀。不作脓，脓不溃，气虚也，去二味及白芷，加参、术、
肉桂。如不应，暂用十全大补汤。肿赤作痛，血凝滞也，本方加乳香、没药。如不应，暂用
仙方活命饮。脓出反痛，气血虚也，去三味（即金银花、连翘、白芷，后仿此。）加参、 、
归、地。肉赤而不敛，血虚而有热也，去三味，加熟地、牡丹皮。肉黯而不敛，阳气虚寒也
去三味，加参、 、白蔹、官桂。漫肿不痛，或肉死不溃，脾气虚也，去三味，加人参、白
术。如不应，加姜、桂。更不应，急加附子。肉白而不敛，阳气虚也，去三味，加参、
、归、术。脓多而不敛，气血虚也，去三味，加参、 、归、术、熟地。如不应，暂用十全大
补汤。饮食少思，而不敛，胃气虚也，去三味，加参、 。如不应，暂用补中益气汤。饮食
难化而不敛，脾气虚也，去三味，加参、术。如不应，暂用六君子汤。又不应，佐以八味丸
。脓多而带赤，血虚也，去三味，加归、地、参、术。如不应，暂用八珍汤加牡丹皮。忿怒
晡热而出血，肝火血虚也，去三味，加牡丹皮、熟地、炒黑山栀。如不应，暂用八珍汤送六
味丸。面青胁胀而出血，肝气虚而不能藏血也，去三味，加山茱、山药、五味子。如不应，
兼六味丸。食少体倦而出血，脾气虚而不能摄血也，去三味，加参、 、归、地。兼郁结少
寐，更加远志、酸枣仁、茯神、龙眼肉。如不应，暂用归脾汤。欲呕作呕，或外搽内服寒凉
，或痛甚，或感寒邪秽气而呕，胃气虚也，去三味，加藿香、参、术。饮食少思，肠鸣腹痛
，腹冷泄泻，脾气虚寒也，去三味，加炮姜、木香。手足逆冷，脾血虚寒也，更加附子，煎
送四神丸。饮冷作渴，热毒也，加赤小豆、知母。如不应，暂用竹叶黄 汤。善食作渴，胃
火也，加石膏、山栀。如不应，暂用竹叶石膏汤。脓多而作渴，气血虚也，去三味，加熟地
黄、五味子。如不应，暂用十全大补汤加五味子、麦门冬。口干舌燥，肾气虚也，去三味，
加熟地、山茱、山药。如不应，兼六味丸。又不应，佐以补中益气汤。自汗内热口干，胃气
虚也，去三味，加参、 、归、术。如不应，暂用六君子汤。盗汗内热口干，阴血虚也，去
三味，加熟地、麦门、五味。如不应，暂用当归六黄汤。茎中痛而小便不利，精内败也，去三味，
加山茱、山药、泽泻。如不应，佐以六味丸。愈便则愈痛，愈痛则愈便，精复竭也，去三味
煎送六味丸。食少体倦，口干饮热，小便黄短，脾肺虚热也，去三味，加五味子、山
茱萸。如不应，暂用六味丸。劳役而小便黄，元气下陷也，去三味，加升麻、柴胡。汗后而
小便黄短，肾虚热也，去三味，加升麻、柴胡。如不应，煎送六味丸。口燥作渴，小便频数
，肾水亏也，去三味，加五味子、山茱、山药、熟地。如不应，兼用六味丸。四肢逆冷，肾
气虚寒也，去三味，加桂、附。如不应，佐以八味丸。食少体倦作渴，胃气虚也，去三味，
加参、 、白术。如不应，暂用补中益气汤。体倦头痛，或眩晕，中气虚也，去三味，加柴
胡、升麻。如不应，暂用补中益气汤加蔓荆子。日晡头痛，或眩晕，阴血虚也，去三味，加
熟地黄。如不应，佐以六味丸。梦泄遗精，头晕头痛，或痰喘气促，肾虚不能纳气也，去三
味并川芎，佐以六味丸。如不应，是虚寒也，用八味丸。面目赤色，烦热作渴，脉大而虚，
血脱发躁也，去三味，加黄 、当归。如不应，暂用当归补血汤。身热恶衣，欲投于水，脉
沉微细，气脱发躁也，去三味，加肉桂、附子。如不应，暂用附子理中汤。善思体痛，无寐
盗汗，脾血虚也，去三味，加茯苓、远志、酸枣仁、圆眼肉。如不应，暂用归脾汤。寝寐而
汗出，肾气虚也，去三味，加五味子，煎送六味丸。饮食而出汗，胃气虚也，去三味，加参
、、归、术、五味子。如不应，暂用六君子汤。睡觉饱而出盗汗，宿食也，去三味，加参
、术、半夏。如不应，暂用六君子汤。胸满多痰，脾气虚也，去三味，加桔梗、半夏。如不
应，暂用六君子汤加桔梗、枳壳。晡热多痰，脾血虚也，去三味，加归、地、参、术。如不
应，暂用六君子汤，加芎、归、熟地。
咳嗽唾痰，肾亏津液泛上也，去三味，加山茱、山药、熟地。
如不应，佐以六味丸。忿怒胸痞，肝气滞也，去三味
，加桔梗、山栀。如不应，暂用补中益气汤，加桔梗、枳壳。倦怠胸痞，中气虚也，去三味
，加参、术、茯苓。如不应，暂用八珍汤加柴胡。口苦，寒热往来，肝火血虚也，去三味，
加熟地、柴胡。因怒，寒热往来，肝火血虚也，加柴胡、黄芩。如不应，暂用八珍汤，加炒
山栀、炒酸枣仁、酒炒黑胆草。体倦寒热往来，肝脾气滞也，去三味，加参、 、归、术。
如不应，暂用补中益气汤。内热晡热，或寒热往来，阴血虚也，去三味，加芎、归、牡丹皮
、柴胡。如不应，暂用八珍汤加牡丹皮。畏寒或寒热往来，胃气虚也，去三味，加参、苓、
白术、升麻。如不应，暂用补中益气汤。胁痛痞满，或寒热往来，肝气滞也，去三味，加青
皮、木香。如不应，属气血虚也，更加芎、归、参、术。若妇人劳役恚怒，或适经行，发热
谵语，或夜间热甚，在血分也，去三味，加生地、丹皮、柴胡。如不应，暂用加味四物汤
。若误服克伐，或脓血大泄，或因吐泻，或误而入房，或劳损元气，或梦泄遗精，或外邪乘入
，以致发热头痛，小便淋涩，或滑数便血，目赤烦喘，气短头晕，体倦热渴，意欲投水，身
热恶衣，扬手掷足，腰背反张，郑声自汗，此阳气脱陷之假热症也。若畏寒头痛，咳逆呕吐
，耳聩目朦，小便自遗，泻利肠鸣，里急腹痛，玉茎短缩，齿浮痛，肢体麻痹，或厥冷身痛，
或咬舌啮唇，此阳气脱陷之真寒症也。凡此危候，勿论其脉，勿问其症，但见有其一二，亦
去三味，急加桂、附补之，庶有复生之理。大抵用药之法，当分元气虚实，标本缓急。若病
急而元气实者，先治其标。病缓而元气虚者，先治其本。若病急而元气又虚者，当治其本为
主，而兼以治标。东垣先生云∶形气有余，病气有余，当泻不当补。形气不足，病气不足，
当补不当泻。丹溪先生云∶但见肿痛，参之脉症虚弱，便与滋补，气血无亏，可保终吉。治
大凡痈疽（化脓性感染）溃破之后，筋肉腐烂，脓血大量流失，阳气随着阴液耗散而外越，或者出现筋脉拘挛紧急、怕冷且身体颤抖的症状。严重的会出现舌体僵硬、口噤不开。治疗的方法，应当以大补气血为主。如果确实是风邪引起的病症，也必须以大补气血为根本，同时兼用治风的药物。如果不审察病情是非而胡乱用药，就会造成误治。风症的治疗方法见后文方剂。
治验记录：
司徒边华泉肩部患痈，溃破后发热，眼睛直视或斜视，症状极像中风。下午申时（3-5点）发热加重，脉搏更加快速，这是足三阴经的气血亏损所致。
陆大行背部生疮，内部溃烂流出约两碗脓液，使用托里透脓的药剂，疼痛停止、肿胀消退后停药。忽然出现寒热交替、口渴、头痛、自汗，这是元气虚弱且未能恢复的表现。使用十全大补汤加麦门冬、五味子、肉桂，服用两剂后症状反而加重，诊察其脉象如故。这是因为药力尚未到达病所，仍然使用前面的药方，加入一钱附子，服用三剂后所有症状全部痊愈，于是去掉附子，加入肉桂继续服用数剂，伤口得以收敛愈合。
一位读书人患腿部痈肿，毒邪深蓄于内，皮肤颜色没有变化，长时间不穿溃排脓，针刺放出约五碗脓血瘀滞物，各种恶症接踵而至，完全像中风一样，这是脾胃虚弱导致的变症。使用六君子汤加当归、炮姜，以及圣愈汤，各服用四剂后病情安定。后来因为劳心导致失眠，使用归脾汤调理。
一位读书人在伤寒之后，患流注（一种多发性的深部脓肿），肿痛伴有潮热，使用十宣散、败毒散等药剂，排出稀脓五六碗左右，出现发热恶寒、烦躁口渴，症状极像破伤风症，最终死亡。
一名男子背部的疮疡尚未痊愈收敛，用膏药剪孔贴敷患处，结果患上破伤风症而死。这是因为先前失于内服补益药物，外邪乘虚侵袭所致。我见到因此致死的病例很多，能不谨慎吗！
《内经》说：形体受伤则痛，气受伤则肿。先肿后痛的，是形伤及气；先痛后肿的，是气伤及形。
东垣先生认为：胃是五脏的本源，人体的根基。丹溪先生说：痈疽是因为积毒在脏腑，应当先助胃壮气以巩固根本。既然这样，那么气血凝结的自然会消散；脓瘀已经形成的自然会溃破；想要死亡的肌肉自然会生长；已经死亡的肌肉自然会腐坏；死肉已经溃破的自然会收敛。如果只攻伐疮疡，导致脾胃虚弱，七恶证（危重征象）蜂拥而起，不死的人，只是侥幸罢了！大凡上述前症，必须用托里消毒散作为主方。如果高肿疼痛，是热毒，加黄连。漫肿微痛，是气虚，去掉金银花、连翘两味药，加人参、白术。头痛发热，邪气在表，本方加川芎、羌活。如果外邪在表，而元气充实者，暂时用人参败毒散。头痛恶寒，是表虚，去掉前两味药，加人参、[缺字，推测为黄芪]。发热想喝冷水，便秘，是内热，去掉人参、[缺字]、当归、白术，加大黄。发热想喝热水，便秘，是内虚，去掉前两味药，加人参、[缺字]、当归、白术。寒热想喝冷水，小便涩滞，是肝热，去掉人参、[缺字]，加柴胡、山栀。不化脓，脓不溃破，是气虚，去掉前两味药及白芷，加人参、白术、肉桂。如果无效，暂时用十全大补汤。红肿疼痛，是血凝滞，本方加乳香、没药。如果无效，暂时用仙方活命饮。脓出反而疼痛，是气血虚，去掉三味药（即金银花、连翘、白芷，后文仿此例），加人参、[缺字]、当归、熟地。肉色红而不收敛，是血虚而有热，去掉三味药，加熟地、牡丹皮。肉色暗而不收敛，是阳气虚寒，去掉三味药，加人参、[缺字]、白蔹、官桂。漫肿不痛，或者肉死而不溃破，是脾气虚，去掉三味药，加人参、白术。如果无效，加姜、桂。更无效，急加附子。肉色白而不收敛，是阳气虚，去掉三味药，加人参、[缺字]、当归、白术。脓多而不收敛，是气血虚，去掉三味药，加人参、[缺字]、当归、白术、熟地。如果无效，暂时用十全大补汤。饮食少思，而不收敛，是胃气虚，去掉三味药，加人参、[缺字]。如果无效，暂时用补中益气汤。饮食难消化而不收敛，是脾气虚，去掉三味药，加人参、白术。如果无效，暂时用六君子汤。再无效，佐以八味丸。脓多而带血色，是血虚，去掉三味药，加当归、熟地、人参、白术。如果无效，暂时用八珍汤加牡丹皮。愤怒、下午发热而出血，是肝火血虚，去掉三味药，加牡丹皮、熟地、炒黑山栀。如果无效，暂时用八珍汤送服六味丸。面青胁胀而出血，是肝气虚而不能藏血，去掉三味药，加山茱萸、山药、五味子。如果无效，兼服六味丸。食少体倦而出血，是脾气虚而不能摄血，去掉三味药，加人参、[缺字]、当归、熟地。兼有郁结少寐，再加远志、酸枣仁、茯神、龙眼肉。如果无效，暂时用归脾汤。想呕吐或已呕吐，或者外搽内服寒凉药，或者痛甚，或者感寒邪秽气而呕，是胃气虚，去掉三味药，加藿香、人参、白术。饮食少思，肠鸣腹痛，腹冷泄泻，是脾气虚寒，去掉三味药，加炮姜、木香。手足逆冷，是脾血虚寒，再加附子，煎汤送服四神丸。喝冷水作渴，是热毒，加赤小豆、知母。如果无效，暂时用竹叶石膏汤。食欲好作渴，是胃火，加石膏、山栀。如果无效，暂时用竹叶石膏汤。脓多而作渴，是气血虚，去掉三味药，加熟地黄、五味子。如果无效，暂时用十全大补汤加五味子、麦门冬。口干舌燥，是肾气虚，去掉三味药，加熟地、山茱萸、山药。如果无效，兼服六味丸。再无效，佐以补中益气汤。自汗内热口干，是胃气虚，去掉三味药，加人参、[缺字]、当归、白术。如果无效，暂时用六君子汤。盗汗内热口干，是阴血虚，去掉三味药，加熟地、麦门冬、五味子。如果无效，暂时用当归六黄汤。尿道痛而小便不利，是精液内败，去掉三味药，加山茱萸、山药、泽泻。如果无效，佐以六味丸。愈排便则愈痛，愈痛则愈排便，是精气复竭，去掉三味药，煎汤送服六味丸。食少体倦，口干想喝热水，小便黄短，是脾肺虚热，去掉三味药，加五味子、山茱萸。如果无效，暂时用六味丸。劳累过度而小便黄，是元气下陷，去掉三味药，加升麻、柴胡。发汗后而小便黄短，是肾虚热，去掉三味药，加升麻、柴胡。如果无效，煎汤送服六味丸。口燥作渴，小便频数，是肾水亏，去掉三味药，加五味子、山茱萸、山药、熟地。如果无效，兼用六味丸。四肢逆冷，是肾气虚寒，去掉三味药，加肉桂、附子。如果无效，佐以八味丸。食少体倦作渴，是胃气虚，去掉三味药，加人参、[缺字]、白术。如果无效，暂时用补中益气汤。体倦头痛，或眩晕，是中气虚，去掉三味药，加柴胡、升麻。如果无效，暂时用补中益气汤加蔓荆子。下午头痛，或眩晕，是阴血虚，去掉三味药，加熟地黄。如果无效，佐以六味丸。梦遗滑精，头晕头痛，或痰喘气促，是肾虚不能纳气，去掉三味药并川芎，佐以六味丸。如果无效，是虚寒，用八味丸。面目赤色，烦热作渴，脉大而虚，是血脱发躁，去掉三味药，加黄芪、当归。如果无效，暂时用当归补血汤。身热讨厌穿衣，想投入水中，脉沉微细，是气脱发躁，去掉三味药，加肉桂、附子。如果无效，暂时用附子理中汤。善思体痛，无寐盗汗，是脾血虚，去掉三味药，加茯苓、远志、酸枣仁、圆眼肉。如果无效，暂时用归脾汤。睡觉时汗出，是肾气虚，去掉三味药，加五味子，煎汤送服六味丸。吃饭时出汗，是胃气虚，去掉三味药，加人参、[缺字]、当归、白术、五味子。如果无效，暂时用六君子汤。睡醒饱食而出盗汗，是宿食，去掉三味药，加人参、白术、半夏。如果无效，暂时用六君子汤。胸满多痰，是脾气虚，去掉三味药，加桔梗、半夏。如果无效，暂时用六君子汤加桔梗、枳壳。下午发热多痰，是脾血虚，去掉三味药，加当归、熟地、人参、白术。如果无效，暂时用六君子汤，加川芎、当归、熟地。
咳嗽吐痰，是肾亏津液泛上，去掉三味药，加山茱萸、山药、熟地。
如果无效，佐以六味丸。愤怒胸痞，是肝气滞，去掉三味药，加桔梗、山栀。如果无效，暂时用补中益气汤，加桔梗、枳壳。倦怠胸痞，是中气虚，去掉三味药，加人参、白术、茯苓。如果无效，暂时用八珍汤加柴胡。口苦，寒热往来，是肝火血虚，去掉三味药，加熟地、柴胡。因怒，寒热往来，是肝火血虚，加柴胡、黄芩。如果无效，暂时用八珍汤，加炒山栀、炒酸枣仁、酒炒黑胆草。体倦寒热往来，是肝脾气滞，去掉三味药，加人参、[缺字]、当归、白术。如果无效，暂时用补中益气汤。内热下午发热，或寒热往来，是阴血虚，去掉三味药，加川芎、当归、牡丹皮、柴胡。如果无效，暂时用八珍汤加牡丹皮。畏寒或寒热往来，是胃气虚，去掉三味药，加人参、茯苓、白术、升麻。如果无效，暂时用补中益气汤。胁痛痞满，或寒热往来，是肝气滞，去掉三味药，加青皮、木香。如果无效，属气血虚，再加川芎、当归、人参、白术。若妇人劳累恚怒，或正值经期，发热谵语，或夜间热甚，在血分，去掉三味药，加生地、丹皮、柴胡。如果无效，暂时用加味四物汤。若误服克伐药，或脓血大泄，或因吐泻，或误入房事，或劳损元气，或梦泄遗精，或外邪乘入，以致发热头痛，小便淋涩，或滑数便血，目赤烦喘，气短头晕，体倦热渴，意欲投水，身热恶衣，扬手掷足，腰背反张，郑声自汗，这是阳气脱陷的假热症。若畏寒头痛，咳逆呕吐，耳聩目朦，小便自遗，泻利肠鸣，里急腹痛，玉茎短缩，齿浮痛，肢体麻痹，或厥冷身痛，或咬舌啮唇，这是阳气脱陷的真寒症。凡是这些危候，不论其脉象，不问其症状，只要见到其中一二种，也去掉三味药，急加肉桂、附子补益，或许有复生的道理。大抵用药的方法，应当分清元气虚实，标本缓急。如果病急而元气实者，先治其标。病缓而元气虚者，先治其本。如果病急而元气又虚者，应当以治其本为主，兼以治标。东垣先生说：形气有余，病气有余，当泻不当补。形气不足，病气不足，当补不当泻。丹溪先生说：但见肿痛，参之脉症虚弱，便与滋补，气血无亏，可保终吉。治疗
Generally, after the ulceration of a carbuncle or furuncle (purulent infection), the tendons and flesh rot, and pus and blood are discharged in large quantities. Yang Qi dissipates along with the Yin fluids, leading to tendon and vessel spasms, aversion to cold, and tremors. In severe cases, there is tongue stiffness and lockjaw. The treatment method should be to greatly tonify Qi and Blood. If it is indeed a wind syndrome, one must still take tonifying Qi and Blood as the root, while simultaneously using herbs that treat wind. If one does not examine the nature of the disease and prescribes recklessly, it will lead to error. The treatment for wind syndromes is described in the formulas later.
Clinical Cases:
Bian Huaquan, a Sima (an official title), developed a carbuncle on his shoulder. After it ulcerated, he had fever, eyes staring straight or deviated, symptoms very similar to stroke (Zhong Feng). His fever intensified at Shen hour (3-5 PM), and his pulse became more rapid. This was due to the deficiency of Qi and Blood in the three Yin meridians of the foot.
Lu Daxing had a back sore that internally ulcerated, discharging about two bowls of pus. He used a formula to support the interior and promote pus discharge. After the pain stopped and swelling subsided, he stopped medication. Suddenly, he experienced alternating chills and fever, thirst, headache, and spontaneous sweating. This indicated that Yuan Qi (Original Qi) was deficient and had not yet recovered. He used Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification) plus Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), and Rougui (Cinnamomi Cortex). After two doses, symptoms worsened. Palpation revealed the pulse remained unchanged. This was because the medicinal force had not yet reached the pathology. He continued with the previous prescription but added 1 qian of Fuzi (Aconiti Lateralis Radix Praeparata). After three doses, all symptoms resolved. Then, Fuzi was removed, and Rougui was added for several more doses until the wound healed and closed.
A scholar suffered from a leg carbuncle. The toxin accumulated deeply inside, with no change in skin color, and it failed to ulcerate for a long time. Needling released about five bowls of pus and blood stasis. Various malignant symptoms appeared sequentially, resembling stroke completely. This was a transformation syndrome caused by Spleen and Stomach deficiency. He used Liujunzi Tang (Six Gentlemen Decoction) plus Danggui (Angelicae Sinensis Radix) and Paojiang (Zingiberis Rhizoma Preparatum), as well as Shengyu Tang (Sage Preservation Decoction), each for four doses, after which he stabilized. Later, due to mental exertion causing insomnia, he used Guipi Tang (Restore the Spleen Decoction).
Another scholar, after contracting Shanghan (Cold Damage), developed Liuzhu (flowing deposits/deep abscesses), presenting with swelling, pain, and tidal fever. He used Shixuan San (Ten Acupoints Powder) and Baidu San (Defeat Toxin Powder), discharging five to six bowls of thin pus. He then developed fever, aversion to cold, irritability, and thirst, symptoms extremely similar to Poshe Feng (Tetanus/Trismus), and he died.
A man’s back sore had not yet healed and closed. He applied a plaster with a hole cut in it over the lesion. He subsequently contracted Poshe Feng (Tetanus/Trismus) and died. This was because internal tonification was neglected initially, allowing external pathogens to invade the deficiency. I have seen many deaths resulting from this; how can one not be cautious!
The *Neijing* states: Injury to form causes pain; injury to Qi causes swelling. Swelling preceding pain indicates form injuring Qi; pain preceding swelling indicates Qi injuring form.
Mr. Dongyuan stated: The Stomach is the source of the five Zang organs and the root of the human body. Mr. Danxi stated: Carbuncles and furuncles arise from accumulated toxins in the Zang and Fu organs; one should first assist the Stomach and strengthen Qi to consolidate the root. With this approach, coagulated Qi and Blood will naturally disperse; formed pus and stasis will naturally ulcerate; dying muscle will naturally regenerate; necrotic muscle will naturally slough off; and opened necrotic tissue will naturally heal. If one only attacks the sore, causing Spleen and Stomach deficiency, the Seven Evils (critical signs) will arise like bees. Those who do not die are merely fortunate! Generally, for the aforementioned conditions, Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder) should be used as the primary formula. If there is high swelling and pain, it is Heat-Toxin; add Huanglian (Coptidis Rhizoma). If there is diffuse swelling and slight pain, it is Qi deficiency; remove Jinyinhua (Lonicerae Japonicae Flos) and Lianqiao (Forsythiae Fructus), and add Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). Headache and fever indicate pathogen in the exterior; add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Qianghuo (Notopterygii Rhizoma et Radix) to the base formula. If external pathogen is in the exterior and Yuan Qi is substantial, temporarily use Renshen Baidu San (Ginseng Defeat Toxin Powder). Headache and aversion to cold indicate exterior deficiency; remove the first two herbs, add Renshen and [missing character, likely Huangqi]. Fever and desire for cold drinks with constipation indicate internal heat; remove Renshen, [missing character], Danggui, and Baizhu, and add Dahuang (Rhei Radix et Rhizoma). Fever and desire for hot drinks with constipation indicate internal deficiency; remove the first two herbs, add Renshen, [missing character], Danggui, and Baizhu. Chills and fever with desire for cold drinks and astringent urination indicate Liver Heat; remove Renshen and [missing character], add Chaihu (Bupleuri Radix) and Shanzhi (Gardeniae Fructus). Failure to form pus or failure of pus to drain indicates Qi deficiency; remove the first two herbs and Baizhi (Angelicae Dahuricae Radix), add Renshen, Baizhu, and Rougui. If ineffective, temporarily use Shiquan Dabu Tang. Redness, swelling, and pain indicate Blood stagnation; add Rushi (Frankincense) and Moyao (Myrrh) to the base formula. If ineffective, temporarily use Xianfang Huoming Yin (Immortal Life Elixir). Pain upon pus discharge indicates Qi and Blood deficiency; remove three herbs (Jinyinhua, Lianqiao, Baizhi; subsequent references follow this pattern), add Renshen, [missing character], Danggui, and Shudi (Rehmanniae Radix Preparata). Flesh red but not healing indicates Blood deficiency with Heat; remove three herbs, add Shudi and Mudanpi (Moutan Cortex). Flesh dark but not healing indicates Yang Qi deficiency and Cold; remove three herbs, add Renshen, [missing character], Bailian (Houttuyniae Herba), and Guanzi Gui (Cinnamomi Cortex). Diffuse swelling without pain, or dead flesh not ulcerating, indicates Spleen Qi deficiency; remove three herbs, add Renshen and Baizhu. If ineffective, add Jiang (Ginger) and Gui (Cinnamon). If still ineffective, urgently add Fuzi. White flesh not healing indicates Yang Qi deficiency; remove three herbs, add Renshen, [missing character], Danggui, and Baizhu. Excessive pus with non-healing indicates Qi and Blood deficiency; remove three herbs, add Renshen, [missing character], Danggui, Baizhu, and Shudi. If ineffective, temporarily use Shiquan Dabu Tang. Poor appetite and non-healing indicate Stomach Qi deficiency; remove three herbs, add Renshen and [missing character]. If ineffective, temporarily use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Difficulty digesting food and non-healing indicates Spleen Qi deficiency; remove three herbs, add Renshen and Baizhu. If ineffective, temporarily use Liujunzi Tang. If still ineffective, supplement with Bawei Wan (Eight Immortals Pill). Pus mixed with blood indicates Blood deficiency; remove three herbs, add Danggui, Shudi, Renshen, and Baizhu. If ineffective, temporarily use Bazhen Tang (Eight Treasures Decoction) plus Mudanpi. Anger, afternoon fever, and bleeding indicate Liver Fire and Blood deficiency; remove three herbs, add Mudanpi, Shudi, and Chaohei Shanzhi (Stir-fried Black Gardeniae Fructus). If ineffective, temporarily administer Bazhen Tang with Liuwei Wan (Six Flavor Pill). Greenish face, distended hypochondrium, and bleeding indicate Liver Qi deficiency failing to store Blood; remove three herbs, add Shanzhuyu (Corni Fructus), Shanyao (Dioscoreae Rhizoma), and Wuweizi. If ineffective, concurrently use Liuwei Wan. Poor appetite, fatigue, and bleeding indicate Spleen Qi deficiency failing to control Blood; remove three herbs, add Renshen, [missing character], Danggui, and Shudi. With accompanying depression and insomnia, add Yuanzhi (Polygalae Radix), Suanzaoren (Ziziphi Spinosae Semen), Fushen (Poria with Hostwood), and Longyanrou (Longan Arillus). If ineffective, temporarily use Guipi Tang. Nausea or vomiting, or vomiting induced by topical/internal cooling herbs, severe pain, or exposure to cold/filthy qi indicates Stomach Qi deficiency; remove three herbs, add Huoxiang (Agastaches Herba), Renshen, and Baizhu. Poor appetite, borborygmus, abdominal pain, cold abdomen, and diarrhea indicate Spleen Qi deficiency and Cold; remove three herbs, add Paojiang and Muxiang (Aucklandiae Radix). Cold extremities indicate Spleen Blood deficiency and Cold; add Fuzi, decocted to send Si Shen Wan (Four Spirits Pill). Desire for cold drinks and thirst indicate Heat-Toxin; add Chixiaodou (Vigna Angularis Semina) and Zhimu (Anemarrhenae Rhizoma). If ineffective, temporarily use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Good appetite with thirst indicates Stomach Fire; add Shigao (Gypsum Fibrosum) and Shanzhi. If ineffective, temporarily use Zhuye Shigao Tang. Excessive pus with thirst indicates Qi and Blood deficiency; remove three herbs, add Shudihuang and Wuweizi. If ineffective, temporarily use Shiquan Dabu Tang plus Wuweizi and Maidong. Dry mouth and tongue indicate Kidney Qi deficiency; remove three herbs, add Shudi, Shanzhuyu, and Shanyao. If ineffective, concurrently use Liuwei Wan. If still ineffective, supplement with Buzhong Yiqi Tang. Spontaneous sweating, internal heat, and dry mouth indicate Stomach Qi deficiency; remove three herbs, add Renshen, [missing character], Danggui, and Baizhu. If ineffective, temporarily use Liujunzi Tang. Night sweats, internal heat, and dry mouth indicate Yin Blood deficiency; remove three herbs, add Shudi, Maidong, and Wuweizi. If ineffective, temporarily use Danggui Liuhuang Tang (Angelica Six-Yellow Decoction). Pain in the urethra with difficult urination indicates essence corruption internally; remove three herbs, add Shanzhuyu, Shanyao, and Zexie (Alismatis Rhizoma). If ineffective, supplement with Liuwei Wan. Urination worsening pain, and pain worsening urination, indicates essence exhaustion; remove three herbs, decoct to send Liuwei Wan. Poor appetite, fatigue, dry mouth desiring hot drinks, and scanty yellow urine indicate Spleen and Lung deficiency heat; remove three herbs, add Wuweizi and Shanzhuyu. If ineffective, temporarily use Liuwei Wan. Fatigue-induced yellow urine indicates sinking of Yuan Qi; remove three herbs, add Shengma (Cimicifugae Rhizoma) and Chaihu. Yellow and scanty urine after sweating indicates Kidney deficiency heat; remove three herbs, add Shengma and Chaihu. If ineffective, decoct to send Liuwei Wan. Dry mouth with thirst and frequent urination indicate Kidney Water deficiency; remove three herbs, add Wuweizi, Shanzhuyu, Shanyao, and Shudi. If ineffective, concurrently use Liuwei Wan. Cold extremities indicate Kidney Qi deficiency and Cold; remove three herbs, add Rougui and Fuzi. If ineffective, supplement with Bawei Wan. Poor appetite, fatigue, and thirst indicate Stomach Qi deficiency; remove three herbs, add Renshen, [missing character], and Baizhu. If ineffective, temporarily use Buzhong Yiqi Tang. Fatigue, headache, or dizziness indicate Middle Qi deficiency; remove three herbs, add Chaihu and Shengma. If ineffective, temporarily use Buzhong Yiqi Tang plus Manjingzi (Viticis Fructus). Afternoon headache or dizziness indicates Yin Blood deficiency; remove three herbs, add Shudihuang. If ineffective, supplement with Liuwei Wan. Nocturnal emission, dizziness, headache, phlegm-panting, or shortness of breath indicate Kidney deficiency failing to grasp Qi; remove three herbs and Chuanxiong, supplement with Liuwei Wan. If ineffective, it is deficiency-cold; use Bawei Wan. Red face and eyes, irritability, thirst, and large-deficient pulse indicate Hair loss and agitation due to Blood deficiency; remove three herbs, add Huangqi (Astragali Radix) and Danggui. If ineffective, temporarily use Danggui Buxue Tang (Angelica Tonify Blood Decoction). Body heat, aversion to clothing, desire to throw oneself into water, and deep-thin-slow pulse indicate Hair loss and agitation due to Qi deficiency; remove three herbs, add Rougui and Fuzi. If ineffective, temporarily use Fuzi Lizhong Tang (Aconite Regulate Middle Decoction). Overthinking, body pain, insomnia, and night sweats indicate Spleen Blood deficiency; remove three herbs, add Fuling (Poria), Yuanzhi, Suanzaoren, and Yuanyanrou (Longan Arillus). If ineffective, temporarily use Guipi Tang. Sweating during sleep indicates Kidney Qi deficiency; remove three herbs, add Wuweizi, decocted to send Liuwei Wan. Sweating during eating indicates Stomach Qi deficiency; remove three herbs, add Renshen, [missing character], Danggui, Baizhu, and Wuweizi. If ineffective, temporarily use Liujunzi Tang. Night sweats after waking up full indicates retained food; remove three herbs, add Renshen, Baizhu, and Banxia (Pinelliae Rhizoma). If ineffective, temporarily use Liujunzi Tang. Chest fullness and much phlegm indicate Spleen Qi deficiency; remove three herbs, add Jiegeng (Platycodonis Radix) and Banxia. If ineffective, temporarily use Liujunzi Tang plus Jiegeng and Zhike (Aurantii Fructus). Afternoon fever and much phlegm indicate Spleen Blood deficiency; remove three herbs, add Danggui, Shudi, Renshen, and Baizhu. If ineffective, temporarily use Liujunzi Tang plus Chuanxiong, Danggui, and Shudi.
Cough with sputum indicates Kidney deficiency with fluid flooding upward; remove three herbs, add Shanzhuyu, Shanyao, and Shudi.
If ineffective, supplement with Liuwei Wan. Anger with chest stuffiness indicates Liver Qi stagnation; remove three herbs, add Jiegeng and Shanzhi. If ineffective, temporarily use Buzhong Yiqi Tang plus Jiegeng and Zhike. Fatigue with chest stuffiness indicates Middle Qi deficiency; remove three herbs, add Renshen, Baizhu, and Fuling. If ineffective, temporarily use Bazhen Tang plus Chaihu. Bitter taste, alternating chills and fever indicate Liver Fire and Blood deficiency; remove three herbs, add Shudi and Chaihu. Anger-induced alternating chills and fever indicate Liver Fire and Blood deficiency; add Chaihu and Huangqin (Scutellariae Radix). If ineffective, temporarily use Bazhen Tang plus Chao Shanzhi, Chao Suanzaoren, and Jiuhao Heidancao (Wine-fried Black Scrophulariae Radix). Fatigue with alternating chills and fever indicates Liver and Spleen Qi stagnation; remove three herbs, add Renshen, [missing character], Danggui, and Baizhu. If ineffective, temporarily use Buzhong Yiqi Tang. Internal heat, afternoon fever, or alternating chills and fever indicate Yin Blood deficiency; remove three herbs, add Chuanxiong, Danggui, Mudanpi, and Chaihu. If ineffective, temporarily use Bazhen Tang plus Mudanpi. Aversion to cold or alternating chills and fever indicate Stomach Qi deficiency; remove three herbs, add Renshen, Fuling, Baizhu, and Shengma. If ineffective, temporarily use Buzhong Yiqi Tang. Hypochondriac pain, fullness, or alternating chills and fever indicate Liver Qi stagnation; remove three herbs, add Qingpi (Citri Reticulatae Pericarpium Viride) and Muxiang. If ineffective, it belongs to Qi and Blood deficiency; add Chuanxiong, Danggui, Renshen, and Baizhu. If a woman suffers from labor and anger, or menstruation, with fever, delirium, or intense night fever, it is in the Blood level; remove three herbs, add Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), and Chaihu. If ineffective, temporarily use Jiawei Siwu Tang (Modified Four Substances Decoction). If mistakenly taken astringents/clearing herbs, or massive pus/blood loss, or due to vomiting/diarrhea, or intercourse, or Yuan Qi damage, or nocturnal emission, or external pathogen invasion, leading to fever, headache, dysuria, slippery-rapid bloody stool, red eyes, irritability, panting, shortness of breath, dizziness, fatigue, heat-thirst, desire to throw oneself into water, body heat with aversion to clothing, flailing limbs, opisthotonos, murmuring speech, and spontaneous sweating, this is a false heat syndrome due to collapse and sinking of Yang Qi. If there is aversion to cold, headache, cough/reverse flow, vomiting, deafness, blurred vision, urinary incontinence, diarrhea with borborygmus, tenesmus, abdominal pain, shortened penis, floating/painful teeth, limb numbness, cold extremities with body pain, biting tongue/lips, this is a true cold syndrome due to collapse and sinking of Yang Qi. For these critical conditions, regardless of pulse or specific symptoms, if one or two are present, also remove the three herbs, urgently add Rougui and Fuzi to tonify, so there may be a chance of recovery. Generally, the method of medication should distinguish between the deficiency/excess of Yuan Qi and the priority of root vs. branch. If the disease is acute and Yuan Qi is substantial, treat the branch first. If the disease is chronic and Yuan Qi is deficient, treat the root first. If the disease is acute and Yuan Qi is also deficient, treat the root primarily, while simultaneously treating the branch. Mr. Dongyuan stated: If Form-Qi and Disease-Qi are both sufficient, purge rather than tonify. If Form-Qi and Disease-Qi are both insufficient, tonify rather than purge. Mr. Danxi stated: Upon seeing swelling and pain, if pulse and symptoms indicate weakness, immediately provide tonification. If Qi and Blood are not depleted, one can ensure ultimate auspiciousness. Treatment