李氏云∶痈疽已安之后，或未安之际，口舌燥黄如鸡内金者，乃肾水枯竭，心火上炎，
此症最恶。古人云，玉华池竭七朝亡。若误投以丹药，祸在反掌，急用加减八味丸，桑枝煎五味
子汤，以滋补之。
愚按∶前症若不慎房事，亏损真阴，而虚火上炎，亦多患此。若发热作渴，或口舌生
疮，或小便频数，或茎中作痛，亦宜用前药（详见附录用药关键）。
桑枝方 大治口渴。取嫩桑枝细切一升炒，以水三升煎一升，日服五七剂，更多尤妙。
抱朴子云∶疗风痹干燥，臂痛香港脚，四肢拘挛，上气眩晕。久服补肺消食，利小便，轻身聪
明，令人光泽，其功不能尽述。
愚按∶桑枝补血气，生津液，轻身明目，补肺肾之良剂也。
五味子汤 治肾水枯涸，口燥舌干。
五味子（一两） 黄 （炒三两） 人参（二两） 麦门冬（一两） 粉草（炙五钱）
上每服五钱，水煎，日夜服五七剂。
愚按∶前药乃六一散、生脉散之复方，滋化源之良剂，若肾水既涸，虚火上炎，而口燥
作渴者，须佐以加减八味丸（详见附录用药关键）。
李氏曰∶一发背之热，未有不自肾虚而得之者，必须五更服加减八味丸。
愚按∶前论诚为启发后人，垂惠永久。盖发背脑疽，皆由肾经湿热，虚火上炎，中传恶
症；若非加减八味丸滋肾水以制心火，补中益气以生化源，欲望其生，难矣。启玄子云∶大
寒而甚，热之不热，是无火也，当助其心。大热而甚，寒之不寒，是无水也，当益其肾。夫
寒之不寒，责其无水，热之不热，责其无火；热之不久，责心之虚，寒之不久，责水之少。
窃谓无火者，当用八味丸以益其心；无水者，当用六味丸以滋其肾（治验见前四十二论）。
李氏说：痈疽病情已经稳定之后，或者尚未稳定的时候，如果口舌干燥、发黄，颜色像鸡内金一样，这是肾水枯竭、心火上炎的症状，这种病症最为凶险。古人说，玉华池（指口中津液）枯竭七天后就会死亡。如果误用丹药治疗，灾祸就在顷刻之间，必须紧急使用加减八味丸，以及桑枝煎五味子汤来滋补身体。
我按语认为：前面的病症如果不小心节制房事，导致真阴亏损，虚火上炎，也很容易患上此症。如果出现发热、口渴，或者口舌生疮，或者小便频繁，或者尿道疼痛，也适宜使用前文提到的药物（详见附录用药关键）。
桑枝方 主治严重口渴。取嫩桑枝细切一升并炒制，用水三升煎煮至一升，每天服用五到七次，服得更多效果尤其好。
抱朴子说：治疗风痹引起的干燥、手臂疼痛、脚气病、四肢拘挛、气逆眩晕。长期服用可以补肺、助消化、利小便，使身体轻便、耳聪目明，让人面色光泽，其功效无法全部述尽。
我按语认为：桑枝能补血气、生津液，使身体轻便、明目，是补益肺肾的良药。
五味子汤 治疗肾水枯涸、口燥舌干。
五味子（一两） 黄芪（炒三两） 人参（二两） 麦门冬（一两） 粉草（炙五钱）
以上药材每次服用五钱，用水煎煮，日夜服用五到七次。
我按语认为：上述药物是六一散和生脉散的复方，是滋养化源（脾胃生化之源）的良剂。如果肾水已经枯竭，虚火上炎，导致口燥口渴，必须配合使用加减八味丸（详见附录用药关键）。
李氏说：发背疮的热证，没有不是由于肾虚而得的，必须在五更天服用加减八味丸。
我按语认为：前面的论述确实能够启发后人，造福长久。大概发背疮和脑疽，都是由肾经湿热、虚火上炎，向内传变而成恶症；如果不是用加减八味丸滋补肾水以制约心火，补中益气以生化源，想要治愈，很难做到。启玄子说：极度寒冷且用热药治疗无效不回暖的，是无火（命门火衰），应当助心阳。极度炎热且用寒药治疗无效不退热的，是无水（肾阴亏虚），应当益肾阴。治疗寒冷而不退寒，责任在于无水；治疗炎热而不退热，责任在于无火；用热药治疗但热度不久即复，责任在心之虚；用寒药治疗但寒气不久即复，责任在水之少。
Li stated: After the carbuncle and ulcer (Yong Ju) has stabilized, or while it is still unstable, if the mouth and tongue are dry and yellow like chicken gizzard lining, this indicates exhaustion of Kidney Water and flaming up of Heart Fire. This condition is most malignant. The ancients said, "When the Jade Flower Pool (referring to oral fluids) dries up, death occurs in seven days." If mistakenly administered with elixirs (Dan Yao), disaster will strike in an instant. One must urgently use Modified Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) and a decoction of Mulberry Twig and Schisandra Berry to nourish and tonify.
My commentary: Regarding the aforementioned symptoms, if one fails to exercise caution regarding sexual activity, depleting True Yin, and causing Deficient Fire to flare upward, this condition is also frequently observed. If accompanied by fever and thirst, sores on the mouth and tongue, frequent urination, or pain in the urethra, the aforementioned medicines should also be used (see Appendix for Key Principles of Medication).
Mulberry Twig Formula: Greatly treats thirst. Take fresh tender Mulberry Twig, finely cut one sheng, stir-fry it, add three sheng of water, and decoct until one sheng remains. Take five to seven doses daily; taking more is even better.
Baopuzi stated: It treats wind-bi dryness, arm pain, beriberi, limb spasms, rebellious Qi, and vertigo. Long-term consumption tonifies the Lung, aids digestion, promotes urination, lightens the body, sharpens hearing and vision, gives luster to the skin, and its merits cannot be fully described.
My commentary: Mulberry Twig nourishes Blood and Qi, generates body fluids, lightens the body, improves vision, and is an excellent agent for tonifying the Lung and Kidney.
Schisandra Berry Decoction: Treats exhaustion of Kidney Water, dry mouth, and parched tongue.
Schisandra Berry (Wuweizi) (1 liang)
Astragalus Root (Huangqi) (stir-fried, 3 liang)
Ginseng Root (Renshen) (2 liang)
Ophiopogon Tuber (Maimendong) (1 liang)
Licorice Root (Fencao) (roasted, 5 qian)
Take 5 qian of the above herbs per dose, decoct in water, and take five to seven doses day and night.
My commentary: The aforementioned medicine is a compound formula of Liu Yi San (Six-to-One Powder) and Sheng Mai San (Generate the Pulse Powder), which is an excellent agent for nourishing the source of transformation and generation (Spleen/Stomach). If Kidney Water is exhausted and Deficient Fire flares upward, causing dry mouth and thirst, it is necessary to assist with Modified Ba Wei Wan (see Appendix for Key Principles of Medication).
Li stated: The heat associated with Back Carbuncle (Fa Bei) invariably originates from Kidney Deficiency; therefore, Modified Ba Wei Wan must be taken at wu geng (between 3 am and 5 am).
My commentary: The preceding discussion indeed enlightens future generations and benefits them permanently. Generally, Back Carbuncle and Brain Ulcer (Nao Ju) arise from Damp-Heat in the Kidney Meridian and Deficient Fire flaming upward, transmitting inward to become malignant syndromes. Unless one uses Modified Ba Wei Wan to nourish Kidney Water to control Heart Fire, and tonifies Middle Qi to generate the source of transformation, hoping for survival would be difficult. Qixuanzi stated: "Extreme cold that does not warm up despite heat therapy indicates absence of Fire (Mingmen Fire Decline); one should assist Heart Yang. Extreme heat that does not cool down despite cold therapy indicates absence of Water (Kidney Yin Deficiency); one should benefit Kidney Yin." Failure to resolve cold is attributed to lack of Water; failure to resolve heat is attributed to lack of Fire. If heat resolves only briefly, the fault lies in Heart Deficiency; if cold resolves only briefly, the fault lies in insufficient Water.
I propose: For those with "absence of Fire," one should use Ba Wei Wan to benefit Heart and Kidney Fire; for those with "absence of Water," one should use Liu Wei Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Yin (clinical cases seen in Discussion 42).