李氏云∶麦饭石膏，治发背痈疽神妙，惜世罕知。有患者，因脓不溃，以毒药罨之，其
势益甚，毒延咽喉、脚膝，皆为不治。余用此膏，一夕顿溃，凡疽得脓，其毒始解。或有不
溃者，须用此膏。故录之，俾精择修合，以取十全之功也。
愚按∶前症属腑属阳，而气血未损者，用前膏敷之，固无不愈。然亦有属脏属阴，而气
血有亏者，当审其因，而调治其内，可也。大凡疮阳之作，由胃气不从，疮疡之溃，由胃气
腐化，疮疡之敛，由胃气营养。余尝治初结未成脓者，托而散之，已成欲作脓者，托而腐
之，脓成未溃者，托而开之，脓已溃者，托而敛之。东垣先生云∶胃气乃生发之源，为人身
之本。丹溪先生亦谓∶治疮当助胃壮气，使根本坚固，厥有旨哉（详见附录用药加减之法）。
麦饭石膏
白麦饭石（炭火 醋淬数次研极细二两） 鹿角（生取带脑骨者断之用炭火烧烟尽研极细四两）
上用米醋调和，入砂器煎，以竹片不住手搅熬成膏。先以猪蹄汤洗净，以鹅翎拂涂四
围，干则以醋润之。若腐烂用布帛摊贴之。
凡疽症先以麦饭石膏涂之，俟疮根渐收，却敷神异膏敛之。夫痈疽之发有浅深，故收敛
之功有迟速，断不可早用收口之药，恐毒瓦斯未尽，后必复发，为患匪轻。但麦饭膏难于修
合，用神异膏亦效。
愚按∶前症若毒已解而不生肌收敛者，元气虚也。用六君子汤壮其脾胃，则肌肉自生，
设有余毒，亦能自解。（详见附录用药关键）。
神异膏
露蜂虏（蜂儿多者一两） 玄参（五钱） 蛇蜕（盐水洗一两） 黄丹（水飞炒五两） 麻油
（一斤） 乱发（男子者如鸡子大） 杏仁（一两）
上先将麻油入砂器煎发熔尽，下杏仁更煎黑，入蜂房、蛇蜕仍煎黑，滤去，入黄丹急
搅，试软硬得中，即成膏矣。其丹不必拘定前数。凡膏药用日久必老硬，煎时预取嫩膏少
许，如硬，量和之。
愚按∶神异膏乃解毒生肌之良剂。若毒既解而肌不生，当治其内，不可泥为有余之症，
率用攻伐，以致毒在内者不能发散，在外者不能收敛，其为祸不浅。夫有余者热毒也、虚火
也；不足者阴虚也、营气也。疮毒特其形耳∶
家藏神验血竭膏
当归（酒洗） 白芷 大黄（生用） 黄连 黄 木鳖子（去壳） 皂角 杏仁 露蜂房（各
一两） 乳香 没药 血竭（各三两） 乱发（男子者一两） 黄丹（水飞细者炒晒） 麻油
上除乳、没、血竭，余入油煎焦，去 入发，熔化下丹，将柳枝不住手搅，候软硬得
中，入乳香等搅匀，即成膏矣。
愚按∶血竭膏，取其以毒攻毒也。若瘀恶已去，毒瓦斯既消，宜用神效当归膏，以其生肌
续筋也。
厌热神白膏
大黄 白蔹 黄柏（生用） 南星 赤小豆 黑蛤粉（各一两）
上为末，用芭蕉汁调涂，如干仍以汁润之。
愚按∶神白膏药味多寒，而南星之性辛温，佐之有效，加草乌尤妙。
牡蛎地黄膏
大黄（一两为末） 牡蛎（用盐泥封固 赤出大毒研细二两） 生地黄（水浸）
上研生地黄汁调涂患处，如干更用汁润之。
愚按∶前膏苦寒咸寒之剂，症属纯阳，用之殊效。然此症亦有属纯阴者，亦有属半阴半
阳者（治法见附录用药关键）。
李氏云∶疽疾既成，先服取毒之药，外敷麦饭石膏。五七日后，病渐减，合用川乌、二
乌丸以活血气，生肌肉，排宿脓，祛风邪，后服内补十宣散。
川乌丸 治发背，活经络。
大川乌（去皮尖） 木鳖子（去壳） 当归 赤芍药 苏木独活 羌活（各一两） 没药（另研）
五灵脂（去砂微炒） 穿山甲（蛤粉炒各一两）
上各另为末，酒糊丸桐子大，每服三十丸，温酒下。
二乌丸 治发背，托里定痛，祛风凉血。
羌活 薄荷叶（各三两） 川芎 玄参 地榆 麻黄（去根节） 蔓荆子 旋复花 荆芥穗
防风 天麻 白芷 白僵蚕（直者去丝足嘴炒用） 牛蒡子（炒） 甘菊花（各二两） 大川乌（去皮
尖炮） 何首乌（不见铁器） 粉草（炙各四两） 蝉蜕（洗去土足半两）
上为末，炼蜜丸弹子大，每服一丸，细嚼，茶酒任下。
愚按∶前二丸，用之对症固善，然病有多端，而所因不同，恐不可概施也，治者审之。
李氏说：麦饭石膏治疗发背痈疽（生于背部的严重化脓性感染）效果神妙，可惜世人很少知晓。曾有患者，因为脓液不能溃破，用毒药敷贴，病情反而更加严重，毒邪蔓延至咽喉、脚膝，都成了无法治愈的病症。我使用这种膏药，一夜之间脓液全部溃破，凡是痈疽得到脓液排出，毒邪才开始解除。如果有不溃破的情况，必须使用这种膏药。因此记录下来，使人们精心选择并配制，以取得十全十美的疗效。
我认为：上述症状属于腑病、阳证，且气血尚未受损的，使用前文所述的膏药外敷，确实没有不愈的。然而也有属于脏病、阴证，且气血亏损的，应当审察病因，对内调治，就可以了。大凡疮疡属阳证的发作，是由于胃气不和；疮疡的溃破，是由于胃气的腐化作用；疮疡的愈合收敛，是由于胃气的营养作用。我曾经治疗初起结块尚未成脓的，用托法使其消散；已经成形即将成脓的，用托法使其腐熟；脓已成但未溃破的，用托法使其开泄；脓已溃破的，用托法使其收敛。东垣先生说：胃气是生发的源头，是人身的根本。丹溪先生也说：治疗疮疡应当助益胃气、壮大元气，使根本坚固，这很有深意啊（详见附录用药加减之法）。
麦饭石膏
白麦饭石（在炭火中烧红后用醋淬炼数次，研成极细粉末，二两） 鹿角（新鲜取带脑骨的，折断后在炭火烧至烟尽，研成极细粉末，四两）
以上药物用米醋调和，放入砂锅中煎煮，用竹片不停地搅拌熬制成膏。先用猪蹄汤洗净患处，用鹅毛笔涂抹周围，干了就用醋润湿。如果腐烂则用布帛摊贴。
凡是疽症，先涂麦饭石膏，等到疮根逐渐收敛，再敷神异膏来促进愈合。痈疽的发生有浅有深，所以收敛的功效有快有慢，绝对不可以过早使用收口药物，恐怕毒气未尽，日后必然复发，造成不小的祸患。只是麦饭膏难以配制，使用神异膏也有效。
我认为：上述症状如果毒邪已解但不生肌收敛的，是元气虚弱。使用六君子汤强壮脾胃，肌肉自然生长，即使有余毒，也能自行解除。（详见附录用药关键）。
神异膏
露蜂房（蜂儿多的，一两） 玄参（五钱） 蛇蜕（盐水洗，一两） 黄丹（水飞炒，五两） 麻油（一斤） 乱发（男子的，如鸡蛋大小） 杏仁（一两）
先将麻油放入砂锅中煎，待头发熔化尽后，加入杏仁继续煎至黑色，再加入蜂房、蛇蜕煎至黑色，过滤去除药渣，加入黄丹急搅，试软硬适中，即成为膏药。其中的黄丹不必拘泥于前面的数量。凡是膏药用久了必定变老硬，煎制时预先取少许嫩膏，如果太硬，就混合调和它。
我认为：神异膏是解毒生肌的良好药剂。如果毒邪已解但肌肉不生，应当内治，不可固执认为是有余之症，轻易使用攻伐药物，导致在内之毒不能发散，在外之疮不能收敛，其祸害不浅。所谓有余的是热毒、虚火；不足的是阴虚、营气。疮毒只是外在的表现罢了：
家藏神验血竭膏
当归（酒洗） 白芷 大黄（生用） 黄连 黄芩 木鳖子（去壳） 皂角 杏仁 露蜂房（各一两） 乳香 没药 血竭（各三两） 乱发（男子的，一两） 黄丹（水飞细者炒晒） 麻油
除了乳香、没药、血竭外，其余药物放入油中煎至焦黑，滤去药渣，加入头发，熔化后加入黄丹，用柳枝不停地搅拌，候软硬适中，加入乳香等药搅匀，即成为膏药。
我认为：血竭膏，取其以毒攻毒的作用。如果瘀血恶肉已去，毒气已消，宜用神效当归膏，因为它能生肌续筋。
厌热神白膏
大黄 白蔹 黄柏（生用） 南星 赤小豆 黑蛤粉（各一两）
以上药物研为粉末，用芭蕉汁调匀涂抹，干了仍以汁液润湿。
我认为：神白膏药味多寒凉，而南星的性质辛温，配合使用有效，加草乌尤其奇妙。
牡蛎地黄膏
大黄（一两研末） 牡蛎（用盐泥封固煅烧至红色，大毒，研细，二两） 生地黄（水浸）
将生地黄研出汁液调涂患处，干了再用汁液润湿。
我认为：前一种膏药是苦寒咸寒的药剂，症状属于纯阳证，使用它特别有效。然而此症也有属于纯阴的，也有属于半阴半阳的（治法见附录用药关键）。
李氏说：疽疾形成后，先服用排毒的药物，外敷麦饭石膏。五七日后，病情逐渐减轻，合用川乌、二乌丸来活血气，生肌肉，排宿脓，祛风邪，之后服用内补十宣散。
川乌丸 治疗发背，疏通经络。
大川乌（去皮尖） 木鳖子（去壳） 当归 赤芍药 苏木 独活 羌活（各一两） 没药（另研） 五灵脂（去砂微炒） 穿山甲（蛤粉炒，各一两）
以上药物分别研为粉末，用酒糊做成梧桐子大小的丸药，每次服用三十丸，温酒送下。
二乌丸 治疗发背，托里定痛，祛风凉血。
羌活 薄荷叶（各三两） 川芎 玄参 地榆 麻黄（去根节） 蔓荆子 旋复花 荆芥穗 防风 天麻 白芷 白僵蚕（直的，去丝足嘴炒用） 牛蒡子（炒） 甘菊花（各二两） 大川乌（去皮尖炮制） 何首乌（不见铁器） 粉草（炙，各四两） 蝉蜕（洗去土足，半两）
以上药物研为粉末，炼蜜做成弹子大小的丸药，每次服用一丸，细细咀嚼，茶或酒任便送下。
我认为：前两种丸药，用之对症固然好，然而疾病有多种多样，病因不同，恐怕不能一概施用，医者需审慎判断。
Li said: Maifan Shi Gao (Maifan Stone Plaster) is miraculous in treating Fabei Yongju (severe suppurative infections on the back), yet it is rarely known by the world. There was a patient whose pus failed to discharge, and after applying toxic drugs as a poultice, the condition worsened significantly, with the toxin spreading to the throat, feet, and knees, becoming incurable. I used this plaster, and within one night, the pus discharged completely. Once pus discharges from any Yongju (carbuncle and furuncle), the toxin begins to resolve. If there are cases that do not discharge, this plaster must be used. Therefore, I recorded it so that people may carefully select and prepare it to achieve perfect therapeutic results.
I observe: The aforementioned conditions belong to the Fu organs and Yang patterns, where Qi and Blood have not yet been depleted; applying the aforementioned plaster externally will indeed ensure recovery. However, there are also cases belonging to the Zang organs and Yin patterns, where Qi and Blood are deficient. In such cases, one should examine the etiology and treat internally, which is appropriate. Generally, the onset of Yang-type sores is due to the stomach Qi failing to follow its proper course; the ulceration of sores is due to the rotting and transforming action of stomach Qi; and the healing and contraction of sores are due to the nourishing function of stomach Qi. I once treated early-stage nodules that had not yet formed pus, using the Tuo method (supporting the healthy Qi to expel pathogens) to dissipate them; for those already formed and about to form pus, using the Tuo method to promote suppuration; for those with formed pus but not yet ulcerated, using the Tuo method to open them; and for those already ulcerated, using the Tuo method to promote healing. Mr. Dongyuan stated: Stomach Qi is the source of growth and development, and the root of the human body. Mr. Danxi also said: When treating sores, one should assist the stomach Qi and strengthen the Yuan Qi (Original Qi) to solidify the root, which holds profound significance (see Appendix for methods of adding and subtracting herbs).
Maifan Shi Gao (Maifan Stone Plaster)
Baifanshi (White Maifan Stone, roasted over charcoal and quenched with vinegar several times, ground to an extremely fine powder, 2 liang) Lujiao (Deer Antler, fresh taken with brain bone, broken and burned over charcoal until smoke ceases, ground to an extremely fine powder, 4 liang)
Mix the above ingredients with rice vinegar, place in a clay pot, boil, and stir constantly with a bamboo strip until a plaster is formed. First, wash the affected area with pig trotter soup, apply around the periphery with a goose feather brush, and moisten with vinegar if it dries. If there is putrefaction, apply using cloth.
For all Ju diseases (chronic ulcers), first apply Maifan Shi Gao. Wait until the base of the sore gradually recedes, then apply Shenyi Gao (Miraculous Plaster) to promote healing. The onset of Yongju has varying depths, thus the speed of healing varies. One must absolutely avoid using astringent agents too early, lest the toxin qi remain incomplete, leading to inevitable recurrence and significant harm later. However, since Maifan Gao is difficult to prepare, using Shenyi Gao is also effective.
I observe: If the aforementioned condition has resolved the toxin but fails to generate muscle tissue and heal, it is due to deficiency of Yuan Qi. Using Liujunzi Tang (Six Gentlemen Decoction) to strengthen the Spleen and Stomach will naturally generate muscle tissue; even if residual toxin remains, it will resolve spontaneously. (See Appendix for key points on medication).
Shenyi Gao (Miraculous Plaster)
Lufengfang (Honeycomb, preferably with many larvae, 1 liang) Xuanshen (Scrophulariae Radix, 5 qian) Shetui (Ophichthys Skin, washed in salt water, 1 liang) Huangdan (Lead Monoxide, water-ground and fried, 5 liang) Mayou (Sesame Oil, 1 jin) Luafa (Tangled Hair, from men, size of a chicken egg) Xingren (Apricot Seed, 1 liang)
First, melt the tangled hair in sesame oil in a clay pot. Add Xingren and continue frying until black. Add honeycomb and Ophichthys Skin, fry until black, filter out the dregs, add Huangdan, and stir vigorously. Test for appropriate consistency to form the plaster. The amount of Huangdan need not strictly adhere to the previous quantity. Plasters become hard and old after long-term use; when preparing, mix in a small amount of fresh, soft plaster if the current batch is too hard.
I observe: Shenyi Gao is an excellent agent for resolving toxins and generating muscle tissue. If the toxin is resolved but muscle does not grow, internal treatment is necessary. One must not stubbornly treat it as an excess syndrome and recklessly use attacking methods, which would prevent internal toxins from dispersing and external sores from healing, causing severe harm. Excess refers to heat toxin and deficient fire; deficiency refers to Yin deficiency and Ying Qi (Nutritive Qi) deficiency. Sores and toxins are merely their physical manifestations:
Jiacang Shenyan Xuejie Gao (Family-Stored Miraculous Xuejie Plaster)
Danggui (Angelicae Sinensis Radix, washed with wine) Baizhi (Angelicae Dahuricae Radix) Dahuang (Rhei Radix et Rhizoma, raw) Huanglian (Coptidis Rhizoma) Huangqin (Scutellariae Radix) Mubiezi (Strychni Semen, shell removed) Zaojiao (Gleditsiae Fructus) Xingren (Armeniacae Semen Amarum) Lufengfang (Honeycomb, each 1 liang) Ruxiang (Boswelliae Resin) Moyao (Commiphora Resin) Xuejie (Dracaena Sangue, each 3 liang) Luafa (Tangled Hair, from men, 1 liang) Huangdan (Lead Monoxide, finely water-ground, fried and dried) Mayou (Sesame Oil)
Except for Ruxiang, Moyao, and Xuejie, place the remaining ingredients in oil and fry until charred. Remove dregs, add tangled hair, melt, add Huangdan, and stir constantly with a willow branch until the consistency is appropriate. Add Ruxiang, Moyao, etc., and stir evenly to form the plaster.
I observe: Xuejie Gao utilizes the principle of using toxicity to combat toxicity. Once stasis and foul matter are removed and toxin qi is eliminated, one should use Shenxiao Danggui Gao (Miraculous Danggui Plaster) because it generates muscle tissue and reconnects tendons.
Yanre Shenbai Gao (Heat-Aversion Shenbai Plaster)
Dahuang (Rhei Radix et Rhizoma) Bailian (Pseudostellariae Radix) Huangbo (Phellodendri Cortex, raw) Nanxing (Arisaematis Rhizoma) Chixiaodou (Adzuki Bean) Heigafen (Black Clam Powder, each 1 liang)
Grind the above into powder, mix with Banana Juice (Musa Sapientis Juice) for application. If it dries, moisten again with juice.
I observe: Shenbai Gao consists mostly of cold herbs, while Nanxing is acrid and warm; combining them is effective, and adding Caowu (Aconiti Radix Lateralis Preparata) is particularly excellent.
Moli Dihuang Gao (Oyster and Rehmannia Plaster)
Dahuang (Rhei Radix et Rhizoma, 1 liang, powdered) Moli (Ostreae Concha, sealed with salt mud and calcined to red, highly toxic, ground fine, 2 liang) Shengdihuang (Rehmanniae Radix, soaked in water)
Grind Shengdihuang to extract juice, mix with powder, and apply to the affected area. If it dries, moisten again with juice.
I observe: The aforementioned plaster is bitter-cold and salty-cold, and is particularly effective for pure Yang patterns. However, this condition can also present as pure Yin or half-Yin half-Yang patterns (treatment methods see Appendix for key points on medication).
Li said: Once a Ju disease is established, first administer drugs to extract toxins, and externally apply Maifan Shi Gao. After five to seven days, as the condition gradually subsides, combine with Chuanwu Wan (Chuanwu Pill) and Erwu Wan (Erwu Pill) to invigorate Qi and Blood, generate muscle tissue, drain old pus, and dispel wind pathogens. Afterwards, take Neibu Shixuan San (Internal Tonification Ten-Vitality Powder).
Chuanwu Wan (Chuanwu Pill) Treats Fabei, unblocks meridians.
Da Chuanwu (Aconiti Radix Lateralis Preparata, skin and tip removed) Mubiezi (Strychni Semen, shell removed) Danggui (Angelicae Sinensis Radix) Chishao (Paeoniae Radix Rubra) Sumu (Sappan Lignum) Duhuo (Angelicae Pubescentis Radix) Qianghuo (Notopterygii Rhizoma et Radix, each 1 liang) Moyao (Commiphora Resin, separately ground) Wulingzhi (Trogopterori Faeces, sand removed, lightly fried) Chuanshanjia (Manis Squama, fried with clam powder, each 1 liang)
Grind each ingredient separately into powder, make pills with wine paste the size of tung seeds. Take 30 pills per dose, washed down with warm wine.
Erwu Wan (Erwu Pill) Treats Fabei, supports the interior, relieves pain, dispels wind, and cools blood.
Qianghuo (Notopterygii Rhizoma et Radix) Boheye (Menthae Haplocalycis Folium, each 3 liang) Chuanxiong (Ligustici Chuanxiong Rhizoma) Xuanshen (Scrophulariae Radix) Diyü (Sanguisorbae Radix) Mahuang (Ephedrae Herba, roots and joints removed) Manjingzi (Vittadiniae Fructus) Xuanjinhua (Inulae Flos) Jingjiesui (Schizonepetae Spica) Fangfeng (Saposhnikoviae Radix) Tianma (Gastrodiae Rhizoma) Baizhi (Angelicae Dahuricae Radix) Baijiangcan (Bombyx Batryticatus, straight ones, remove silk feet, mouthparts, and fry) Niubangzi (Arctii Fructus, fried) Gan Juhua (Chrysanthemi Flos, each 2 liang) Da Chuanwu (Aconiti Radix Lateralis Preparata, skin and tip removed, processed) Heshouwu (Polygoni Multiflori Radix, avoid iron vessels) Fencǎo (Glycyrrhizae Radix et Rhizoma Preparata, each 4 liang) Chantui (Cryptotympanae Pergamen, washed to remove soil and feet, 0.5 liang)
Grind the above into powder, make pills with refined honey the size of quince fruits. Take one pill per dose, chew thoroughly, and swallow with tea or wine as preferred.
I observe: The aforementioned two pills are beneficial if they match the syndrome. However, diseases are manifold and etiologies differ; therefore, they cannot be applied universally. Practitioners must exercise caution.