〔薛〕便痈因肝火、肝疳，或禀肝经热毒。若初起肿硬作痛者，先用龙胆泻肝汤一
二剂。肿痛不减，用仙方活命饮二剂。五七日不减，肿尚硬，亦用前二药各一剂。
如不消，或更痛，欲成脓也，用活命饮一剂，却用托里消毒散加柴胡、山栀，一二
剂。若脓已成而不溃者，血气虚也，用托里消毒散一二剂。脓已溃而痛不止者，
毒瓦斯不解也，用活命饮一剂。若脓已出而反痛者，血气虚也，用内补黄 汤。脓已
溃而发热烦躁者，气虚血脱也，用当归补血汤。脓已溃而恶寒发热者，血气俱虚也，
用十全大补汤。脓已溃而恶寒者，元气虚也，用补中益气汤。脓已溃而不生肌者，
脾气虚也，用六君子汤。若禀赋怯弱，或因饮食劳倦而为患者，恒用补中益气汤加
射干自消。设使不分经络，不别虚实，概行攻伐，亏损气血，则轻者难治，重者必
变瘵证，甚至不起。
龙胆泻肝汤（疝） 仙方活命饮（见前） 托里消毒散（见前）
内补黄 汤（薛制） 治溃疡脓水出多，或过服败毒之剂，致气虚血弱，发热无寐，或
兼盗汗内热，或不生肌。
黄 （炒，二钱） 人参 白术（炒） 茯苓 陈皮 当归（各一钱半） 酸枣仁（炒，一钱） 五味子（杵）
甘草（炒。各五分）
上，水煎，徐徐服。
当归补血汤（虚热） 清心莲子饮（淋） 补中益气汤（虚热） 十全大补汤（汗）
【薛己按语】便痈（生于会阴部的痈肿）是由于肝经火盛、肝经疳积，或者先天禀赋中带有肝经热毒所致。如果在初起阶段出现肿胀坚硬且疼痛的症状，先用龙胆泻肝汤服用一到两剂。如果肿痛没有减轻，改用仙方活命饮服用两剂。经过五到七天后症状仍未减退，肿块依然坚硬，也使用前面提到的两种药物各一剂。如果肿块仍未消散，或者疼痛加剧，说明即将化脓，此时用仙方活命饮一剂，随后改用托里消毒散加入柴胡、山栀，服用一到两剂。如果脓液已经形成但未能溃破，这是气血虚弱的表现，使用托里消毒散服用一到两剂。脓液已经溃破但疼痛不止，说明毒邪未解，使用仙方活命饮一剂。如果脓液已排出但反而疼痛，这是气血虚弱的表现，使用内补黄芪汤。脓液溃破后出现发热烦躁，这是气虚血脱的表现，使用当归补血汤。脓液溃破后出现恶寒发热，这是气血俱虚的表现，使用十全大补汤。脓液溃破后仅见恶寒，这是元气虚弱的表现，使用补中益气汤。脓液溃破后伤口不长肌肉，这是脾气虚弱的表现，使用六君子汤。如果是先天体质怯弱，或者因为饮食不节、劳累过度而患病的人，常常使用补中益气汤加入射干，可以使疾病自行消除。假使不分辨经络归属，不辨别虚实性质，一概采用攻伐之法，导致气血亏损，那么轻症难以治愈，重症必然转变为劳损之证（瘵证），甚至导致死亡。
龙胆泻肝汤（治疗疝气） 仙方活命饮（见前文） 托里消毒散（见前文）
内补黄芪汤（薛己制方） 治疗溃疡脓水流出过多，或过服败毒药物，导致气虚血弱，发热失眠，或者兼有盗汗和内热，或者伤口不生肌。
黄芪（炒，二钱） 人参 白术（炒） 茯苓 陈皮 当归（各一钱半） 酸枣仁（炒，一钱） 五味子（捣碎） 甘草（炒，各五分）
以上药材，加水煎煮，慢慢服用。
当归补血汤（治疗虚热） 清心莲子饮（治疗淋证） 补中益气汤（治疗虚热） 十全大补汤（治疗汗证）
[Xue Ji's Commentary] Bianyong (abscess occurring in the perineal region) is caused by Liver Fire, Liver Gan accumulation, or innate heat-toxin in the Liver meridian. If swelling, hardness, and pain are present at the initial stage, administer Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) for one to two doses. If swelling and pain do not subside, administer Xianfang Huoming Yin (Immortal Life Elixir) for two doses. If after five to seven days there is no improvement and the swelling remains hard, use each of the aforementioned two prescriptions for one dose. If the swelling does not resolve or pain increases, indicating suppuration is impending, administer Xianfang Huoming Yin for one dose, followed by Tuoli Xiaodu San (Decoction to Support the Interior and Eliminate Toxins) with added Chaihu (Bupleuri Radix) and Shanzhi (Gardeniae Fructus) for one to two doses. If pus has formed but has not ulcerated, this indicates deficiency of Blood and Qi; administer Tuoli Xiaodu San for one to two doses. If pus has ulcerated but pain persists, it signifies that the pathogenic toxin has not been resolved; administer Xianfang Huoming Yin for one dose. If pain worsens after pus discharge, this indicates deficiency of Blood and Qi; administer Neibu Huangqi Tang (Internal Supplementing Decoction with Astragalus). If fever and irritability occur after ulceration, this indicates Qi deficiency and Blood exhaustion; administer Danggui Buxue Tang (Angelica Sinensis Decoction to Tonify Blood). If chills and fever occur after ulceration, this indicates simultaneous deficiency of Blood and Qi; administer Shiquan Dabu Tang (Great Ten Tonifying Decoction). If only chills occur after ulceration, this indicates deficiency of Yuan Qi (Original Qi); administer Buzhong Yiqi Tang (Decoction to Augment the Middle and Benefit Qi). If granulation tissue fails to grow after ulceration, this indicates Spleen Qi deficiency; administer Liujunzi Tang (Six Gentlemen Decoction). For individuals with innate frailty or those who fall ill due to improper diet and overexertion, Buzhong Yiqi Tang with added Shegan (Belamcandae Rhizoma) can often cause the disease to resolve spontaneously. If one fails to differentiate the meridians involved and does not distinguish between excess and deficiency, indiscriminately employing purgative methods will damage Qi and Blood. Consequently, mild cases will become difficult to treat, severe cases will transform into Zhai syndrome (chronic wasting disease), and death may even ensue.
Longdan Xiegan Tang (for Hernia) Xianfang Huoming Yin (see previous text) Tuoli Xiaodu San (see previous text)
Neibu Huangqi Tang (formulated by Xue Ji) Treats excessive discharge of pus from ulcers, or Qi and Blood weakness resulting from overuse of detoxifying agents, manifesting as fever, insomnia, or accompanied by night sweats, internal heat, or failure of granulation.
Huangqi (Astragali Radix, stir-fried, 2 qian) Renshen (Ginseng Radix) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried) Fuling (Poria) Chenpi (Citri Reticulatae Pericarpium) Danggui (Angelicae Sinensis Radix) (each 1.5 qian) Suanzaoren (Ziziphi Spinosae Semen, stir-fried, 1 qian) Wuweizi (Schisandrae Chinensis Fructus, crushed) Gancao (Glycyrrhizae Radix et Rhizoma, stir-fried) (each 0.5 qian)
Boil the above ingredients in water and take slowly.
Danggui Buxue Tang (for Deficiency Heat) Qingxin Lianzi Yin (for Lin Syndrome) Buzhong Yiqi Tang (for Deficiency Heat) Shiquan Dabu Tang (for Sweating)