（男妇同用）
鬓疽∶属肝胆二经怒火，或风热血虚所致。若发热作渴者，用柴胡清肝散。肿 痛甚者
，用仙方活命饮。若大势已退，余毒未散，用参、 、归、术为主，佐以川芎、白芷、金银花，
以速其脓。脓成，仍用参、 之类，托而溃之。若欲其生肌收敛，肾虚者六味丸；血虚者，
四物加参、 ；或血燥，或水不能生木者，用四物汤、六味地黄丸；气虚者，用补中益气汤
。皆当滋其化源为善。
治验
侍御朱南皋，患前症。肿痛发热，日晡尤甚，此肝胆二经，血虚火燥也，用四物汤加玄
参、柴胡、桔梗、炙草，治之而愈。又因劳役发热，畏寒，作渴，自汗，用补中益气汤去柴、升
，加五味、麦门、炮姜而瘥。
州守胡廷器年七十，患前症。肿 作痛，头目俱胀，此肾水不足，肝胆火盛而血燥也。
用六味丸料，四剂疮头出水而愈。后因调养失宜，仍肿痛发热喘渴，脉洪大而虚，此脾胃之气伤
也，用补中益气，以补脾胃；用六味地黄丸，以补肝肾而痊。
（妇人症见《妇人良方》，小儿症见《保婴粹要》）
夫瘰 之病，属三焦肝、胆二经怒火风热血燥，或肝肾二经精血亏损，虚火内动，或恚
怒气逆
候多生于耳前后项腋间，结聚成核，初觉憎寒恶热，咽项强痛。若寒热 痛者，此肝火风热
而气病也，用小柴胡汤，以清肝火；并服加味四物汤，以养肝血。若寒热既止，而核不消散
者，此肝经火燥而血病也，用加味逍遥散，以清肝火；六味地黄丸，以生肾水。若肿高而稍软，面
色
水淋漓，肌体羸瘦者，必纯补之剂，庶可收敛，否则变为九 。《内经》曰∶陷脉为 ，
留连肉腠。即此病也。外用豆豉饼、琥珀膏，以驱散寒邪，补接阳气；内服补中益气汤、六味
丸，以滋肾水，培肝木，健脾土，亦有可愈者。大抵肝胆部分结核，不问大小，其脉左关弦
紧，左尺洪数者，乃肾水不能生肝木，以致肝火燥而筋挛。须用前药，以滋化源，是治其本
也。《外台秘要》云∶肝肾虚热则生 。《病机》云∶瘰 不系膏粱丹毒火热之变，因虚
劳气郁所致。止宜补形气，调经脉，其疮自消散，盖不待汗之下之而已也。其不详脉证、经
络受病之异者，下之则犯经禁、病禁、虚虚之祸，如指诸掌。若脉洪大，元气虚败，为不治
。若面 白为金克木，亦不治。若眼内赤脉贯瞳人，见几条则几年死，使不从本而治，妄用
伐肝之剂，则误矣。盖伐肝则脾土先伤，脾伤则损五脏之源矣。可不慎哉！
治验
阁老杨石斋子年十七，发热作渴，日晡颊赤，左关赤脉大而浮。此肝肾阴虚，用补阴八
珍汤
主，佐以芍药、熟地、麦门、五味，脓水稠而肌肉生；更服必效散一剂， 毒去而疮口敛
容台张美之善怒，孟春患此，或用伐肝之剂，不愈。余以为肝血不足，用六味地黄丸、
补中益气汤，以滋化源，至季冬而愈。
一儒者愈后，体瘦发热，昼夜无定。此足三阴气血俱虚，用八珍加麦门、五味，二十余
剂；又用补中益气加麦门、五味，及六味丸而愈。
儒者杨泽之，缺盆间结一核。余谓∶此肝火血燥而筋挛，法当滋肾水，生肝血。彼反用
行气化痰，外敷南星、商陆，益大如碗。余用补中益气汤、六味地黄丸，以滋肾水；间用芦荟丸
，以清肝火。年余，元气复而消。
儒者张子容，素善怒，患此久而不愈。疮出鲜血，左关弦洪，重按如无，此肝火动而血
妄行，症属气血俱虚。用补中益气汤，以补脾肺，用六味丸，以滋肝肾而愈。
一男子颈间结核大溃。一妇人左眉及发际结核。并用栀子清肝散、海藻散坚丸，以清肝
火养肝血益元气而愈。此症亦有大如升斗者，亦治以前药可愈。
陆子温两耳下肿硬，用伐肝软坚之剂益甚。其脉左关弦紧，左尺洪数，此肾水亏损而筋
挛也，当生肺金，滋肾水，则肝得血而筋自舒矣。彼不悟，仍服前药，竟致不起。
（男女通用）
鬓疽：归属于肝胆二经的怒火，或由风热与血虚所致。若出现发热、口渴症状，使用柴胡清肝散。肿胀疼痛严重者，使用仙方活命饮。若大势已退，但余毒未散，以人参、[白]术、当归、[白]术为主药，佐以川芎、白芷、金银花，以加速脓液形成。脓成之后，仍用人参、[白]术之类，托毒外出使其溃破。若想促进生肌收敛，肾虚者用六味丸；血虚者，四物汤加人参、[白]术；或是血燥，或水不能生木者，用四物汤、六味地黄丸；气虚者，用补中益气汤。这些都应当滋养其化源为妙。
治验记录
侍御朱南皋，患上述病症。肿痛发热，傍晚时分尤为严重，这是肝胆二经血虚火燥的表现，使用四物汤加玄参、柴胡、桔梗、炙甘草治疗而痊愈。后来又因劳累过度导致发热，畏寒，口渴，自汗，使用补中益气汤去掉柴胡、升麻，加五味子、麦门冬、炮姜而病愈。
州守胡廷器七十岁，患上述病症。肿胀作痛，头目俱胀，这是肾水不足，肝胆火盛而血燥。使用六味丸料，服用四剂后疮头出水而痊愈。后来因为调养不当，再次出现肿痛发热喘渴，脉象洪大而虚，这是脾胃之气受损，使用补中益气汤以补脾胃；使用六味地黄丸以补肝肾而痊愈。
（妇人症状见《妇人良方》，小儿症状见《保婴粹要》）
瘰疬之病，属于三焦、肝、胆二经的怒火、风热、血燥，或肝肾二经精血亏损，虚火内动，或因愤怒气逆所致。症状多生于耳前后、项部、腋间，结聚成核，初起时憎寒恶热，咽喉颈部强痛。若伴有寒热疼痛，这是肝火风热而气分受病，用小柴胡汤以清肝火；并服用加味四物汤以养肝血。若寒热既止，而结节不消散，这是肝经火燥而血分受病，用加味逍遥散以清肝火；六味地黄丸以生肾水。若肿块高突且稍软，面色㿠白如水淋漓，身体羸瘦者，必须用纯补之剂，才可能收敛，否则变为九漏。《内经》说：邪气陷入脉络为漏，留连于肌肉腠理之间。即指此病。外用豆豉饼、琥珀膏，以驱散寒邪，补接阳气；内服补中益气汤、六味丸，以滋肾水，培肝木，健脾土，也有可治愈的。大抵肝胆部位的结核，不论大小，若脉象左关弦紧，左尺洪数，乃是肾水不能生肝木，以致肝火燥而筋挛。须用前述药物，以滋化源，这是治本的方法。《外台秘要》说：肝肾虚热则生瘰疬。《病机》说：瘰疬并非由于膏粱厚味、丹毒火热变化所致，而是因虚劳气郁引起。只宜补益形气，调和经脉，疮疡自然消散，大概不需要发汗或攻下即可。那些不详察脉证、经络受病差异的人，若用攻下法，就会犯经禁、病禁、虚虚之祸，如同看手掌一样清楚。若脉象洪大，元气虚败，为不治之症。若面色㿠白为金克木，也是不治。若眼内赤脉贯瞳人，见几条则几年后死，如果不从本论治，妄用伐肝之剂，那就错了。因为伐肝则脾土先伤，脾伤则损五脏之源了。能不谨慎吗！
治验记录
阁老杨石斋之子十七岁，发热口渴，傍晚脸颊红，左关脉赤大而浮。这是肝肾阴虚，用补阴八珍汤主方，佐以芍药、熟地、麦门冬、五味子，脓水稠厚而肌肉生长；再服必效散一剂，毒去而疮口收敛。
容台张美之性情易怒，孟春时节患此病，有人用伐肝之剂，未愈。我认为他是肝血不足，用六味地黄丸、补中益气汤，以滋化源，到季冬而痊愈。
一位儒者病愈后，体瘦发热，昼夜不定。这是足三阴气血俱虚，用八珍汤加麦门冬、五味子，二十余剂；又用补中益气汤加麦门冬、五味子，以及六味丸而痊愈。
儒者杨泽之，缺盆间结成一核。我说：这是肝火血燥而筋挛，法当滋肾水，生肝血。他却反用行气化痰，外敷南星、商陆，肿块增大如碗。我用补中益气汤、六味地黄丸，以滋肾水；间用芦荟丸，以清肝火。年余，元气恢复而消散。
儒者张子容，素来易怒，患此病久而不愈。疮出鲜血，左关脉弦洪，重按如无，这是肝火动而血妄行，症属气血俱虚。用补中益气汤以补脾肺，用六味丸以滋肝肾而痊愈。
一男子颈间结核大溃。一妇人左眉及发际结核。均用栀子清肝散、海藻散坚丸，以清肝火养肝血益元气而痊愈。此症也有大如升斗者，也用前述药物可愈。
陆子温两耳下肿硬，用伐肝软坚之剂反而加重。其脉左关弦紧，左尺洪数，这是肾水亏损而筋挛也，应当生肺金，滋肾水，则肝得血而筋自舒矣。他不醒悟，仍服前药，最终致死。
(Normal use for both men and women)
Bing Ju (Malar Abscess): Belongs to the fire of anger in the Liver and Gallbladder meridians, or is caused by Wind-Heat and Blood Deficiency. If fever and thirst occur, Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder) is used. If swelling and pain are severe, Xian Fang Huo Ming Yin (Immortal Recipe for Activating Life and Resolving Toxicity) is used. If the major pathogenic factors have subsided but residual toxins remain, Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), and Bai Zhu (Atractylodes Rhizome) are used as principal herbs, assisted by Chuan Xiong (Ligusticum Rhizome), Bai Zhi (Angelica Dahurica Root), and Jin Yin Hua (Honeysuckle Flower) to hasten suppuration. Once pus forms, Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) etc. are still used to support the body's resistance and promote ulceration. To promote tissue regeneration and contraction, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) is used for Kidney Deficiency; Si Wu Tang (Four-Substance Decoction) plus Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) is used for Blood Deficiency; or if there is Blood Dryness, or Water fails to generate Wood, Si Wu Tang (Four-Substance Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) are used; for Qi Deficiency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used. In all cases, it is advisable to nourish the source of transformation.
Case Record 1
Zhu Nangao, a Censor, suffered from the aforementioned condition. Swelling, pain, and fever were present, worsening significantly in the late afternoon. This indicated Blood Deficiency and Fire Dryness in the Liver and Gallbladder meridians. Si Wu Tang (Four-Substance Decoction) was administered with added Xuan Shen (Scrophularia Root), Chai Hu (Bupleurum Root), Jie Geng (Platycodon Root), and Zhi Cao (Prepared Licorice Root). He recovered. Later, due to overexertion, he experienced fever, aversion to cold, thirst, and spontaneous sweating. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, with Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome) removed, and added Wu Wei Zi (Schisandra Fruit), Mai Men Dong (Ophiopogon Tuber), and Pao Jiang (Prepared Ginger). He recovered.
Hu Tingqi, Prefect, aged seventy, suffered from the aforementioned condition. Swelling and pain were present, with distension of the head and eyes. This indicated insufficient Kidney Water, excessive Fire in the Liver and Gallbladder, and Blood Dryness. Liu Wei Wan (Six-Ingredient Pill with Rehmannia) material was used. After four doses, fluid drained from the abscess head, and he recovered. Later, due to improper convalescence, swelling, pain, fever, panting, and thirst recurred. The pulse was flooding and large yet empty, indicating injury to Spleen and Stomach Qi. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used to tonify the Spleen and Stomach; Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) was used to tonify the Liver and Kidneys. He recovered.
(For women's symptoms, see *Fu Ren Liang Fang* [Good Advice for Women]; for children's symptoms, see *Bao Ying Cui Yao* [Essentials for Protecting Infants].)
The disease of Luo Li (Scrofula) belongs to the Fire of Anger, Wind-Heat, and Blood Dryness in the San Jiao, Liver, and Gallbladder meridians; or to Essence and Blood deficiency in the Liver and Kidney meridians with internal movement of Deficient Fire; or is caused by resentment and rebellious Qi. Symptoms often appear around the ears, posterior neck, and axillae, gathering into nodules. Initially, there is aversion to cold and fear of heat, with stiffness and pain in the throat and neck. If accompanied by alternating chills and fever with pain, this indicates Liver Fire and Wind-Heat affecting the Qi level; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used to clear Liver Fire, along with Jia Wei Si Wu Tang (Modified Four-Substance Decoction) to nourish Liver Blood. If chills and fever cease but the nodules do not dissipate, this indicates Liver Meridian Fire Dryness affecting the Blood level; Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is used to clear Liver Fire; Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is used to generate Kidney Water. If the swelling is high and slightly soft, the complexion is pale white like dripping water, and the body is emaciated, pure tonifying agents must be used for it to contract; otherwise, it will transform into Jiu Lou (Nine Types of Fistula). *Nei Jing* states: "When pathogens sink into the vessels, they become Fistulas, lingering in the muscle layers." This refers to this disease. Externally, Dou Chi Bing (Fermented Soybean Cake) and Hu Po Gao (Amber Plaster) are used to dispel Cold Evil and supplement Yang Qi; internally, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Wan (Six-Ingredient Pill with Rehmannia) are used to nourish Kidney Water, cultivate Liver Wood, and strengthen Spleen Earth. There are cases of recovery. Generally, for nodules in the Liver and Gallbladder regions, regardless of size, if the Left Guan pulse is wiry and tight, and the Left Chi pulse is flooding and rapid, it indicates that Kidney Water fails to generate Liver Wood, leading to Liver Fire Dryness and tendon contraction. The aforementioned medicines should be used to nourish the source of transformation, which treats the root. *Wai Tai Mi Yao* states: "Deficient Heat in the Liver and Kidney generates Luo Li." *Bing Ji* states: "Luo Li is not a change caused by rich foods, Dan Du (erysipelas), or Fire Toxins, but is caused by Consumption and Qi Stagnation." It is appropriate only to tonify the physical constitution and regulate the meridians, so that the sores naturally dissipate, without needing sweating or purging methods. Those who fail to examine the pulse, symptoms, and differences in meridian pathology, and use purging methods, will violate the prohibitions of the meridians and diseases, causing the disaster of "deficiency inducing deficiency," clearly visible as in looking at one's palm. If the pulse is flooding and large, and Yuan Qi (Original Qi) is exhausted and ruined, it is incurable. If the complexion is pale white, indicating Metal overcoming Wood, it is also incurable. If red vessels in the eyes extend through the pupil, the number of vessels indicates the number of years until death. If treatment does not address the root, and liver-subduing agents are recklessly used, it is an error. Subduing the Liver first injures Spleen Earth; injuring the Spleen damages the source of the Five Zang Organs. How can one not be cautious!
Case Record 2
The son of Grand Secretary Yang Shizhai, aged seventeen, had fever, thirst, and red cheeks in the late afternoon. The Left Guan pulse was red, large, and floating. This indicated Yin Deficiency of the Liver and Kidney. Bu Yin Ba Zhen Tang (Yin-Tonifying Eight-Treasure Decoction) was used as the main formula, assisted by Shao Yao (Peony Root), Shu Di (Prepared Rehmannia Root), Mai Men Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Fruit). The pus became thick, and muscle tissue grew; after taking Bi Xiao San (Extremely Effective Powder) once, the toxin was eliminated, and the wound closed.
Zhang Meizhi, a Court Attendant, had a irritable temperament. He contracted this disease in early spring. Someone used liver-subduing agents, but he did not recover. I believed his Liver Blood was insufficient and used Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish the source of transformation. He recovered by late winter.
A scholar, after recovering, had emaciation and fever with no fixed time during day or night. This indicated Qi and Blood deficiency in the three Foot Yin meridians. Ba Zhen Tang (Eight-Treasure Decoction) was used with added Mai Men Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Fruit) for more than twenty doses; then Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Mai Men Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Fruit), along with Liu Wei Wan (Six-Ingredient Pill with Rehmannia), were used. He recovered.
Yang Zezhi, a scholar, had a nodule formed between the collarbones. I stated: "This is Liver Fire and Blood Dryness causing tendon contraction; the method should be to nourish Kidney Water and generate Liver Blood." He instead used Qi-moving and Phlegm-resolving agents, and applied Nan Xing (Arisaema Rhizome) and Shang Lu (Phytolacca Root) externally, causing the swelling to enlarge to the size of a bowl. I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Water; occasionally using Lu Hui Wan (Aloe Pill) to clear Liver Fire. After more than a year, his Original Qi recovered, and the nodule dissipated.
Zhang Zirong, a scholar, was prone to anger and suffered from this disease for a long time without recovery. The sore bled fresh blood. The Left Guan pulse was wiry and flooding, but empty upon heavy pressure. This indicated Liver Fire moving and reckless bleeding, with the syndrome belonging to Qi and Blood deficiency. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used to tonify the Spleen and Lung; Liu Wei Wan (Six-Ingredient Pill with Rehmannia) was used to nourish the Liver and Kidneys. He recovered.
A man had a large ulcerated nodule on his neck. A woman had nodules on her left eyebrow and hairline. Both were treated with Zhi Zi Qing Gan San (Gardenia Liver-Clearing Powder) and Hai Zao San Jian Wan (Kelp Hardness-Resolving Pill) to clear Liver Fire, nourish Liver Blood, and benefit Original Qi. They recovered. This disease can also present with nodules as large as a sheng or dou measure, and can be cured with the aforementioned medicines.
Lu Ziwen had swelling and hardness under both ears. He used liver-subduing and hardness-resolving agents, which worsened the condition. His pulse was Left Guan wiry and tight, Left Chi flooding and rapid. This indicated Kidney Water deficiency causing tendon contraction. One should generate Lung Metal and nourish Kidney Water, so that when the Liver receives Blood, the tendons relax naturally. He did not understand, continued taking the previous medicines, and ultimately died.