（附论）
夫发背者。热毒之气发于背俞。为痈疽是也。此内本于五脏。外传诸腑。热气攻发。必
生于府俞之间。得之乳石发动。及肥甘滋味之过。脏腑壅热。经络为之不通。毒瓦斯凝滞。必
因俞穴而出。是以服石之人。于居处衣食。嗜欲喜怒。尤宜节慎。一有过举。则毒瓦斯乘隙而
发。初如芥粟。治之稍缓。则盈尺寸而难图。故始觉热搏于分肉。痛伤于经络。宜速治之。
盖其脉不通。则肿毒增甚。经所谓营气不从。逆于肉理。乃生痈肿是也。血败肉腐。为患不
一。实则为痈。浮则为肿。深则为疽。然发于背者两胛间。初起甚微。或痒或痛。往往忽之。
数日遂致不救者。治之始则度其肿之正中而灸之。壮数逾百。使恶气外出。次以药疏利腑脏
。决其邪毒。则有可治之理。
凡发背皆因服食五石。寒食更生散所致。亦有单服钟乳而发者。又有平生不服。而自发
者。此是上代有服之者。其候率多于背两胛间起。初如粟米大。或痛或痒。仍作赤色。人皆
初不为事。日渐长大。不过十日。遂至于死。其临困之时。已阔三寸。高一寸。疮有数十孔。
以手按之。诸孔中皆脓出。寻时大困。所以养生者。小觉背上痒痛有异。即火急取净土水和
为泥。捻作饼子。浓二分。阔一寸半。以粗艾火作炷。灸泥饼上。贴着疮上灸之。一炷一易
饼子。若粟米大时。可灸七饼子即瘥。如榆荚大。灸七七饼炷即瘥。如钱大。可日夜灸之。
不限炷数。仍服五香连翘汤。及铁浆诸药。攻之乃愈。又法诸发背未作大脓。可以冷水射之。
浸石令冷熨之。日夜莫住。瘥乃止。此病忌面酒五辛等。亦有当两肩上发者。
凡服石人。皆须劳役四体。无令自安。如其不尔者。多有发动。亦不得逐。便恣意取暖。
称已适情。必须遗欲以取寒冻。虽当时不宁。于后在身。多有所益。终无发动之虑耳。
凡肿起背胛间。头白如黍粟。四边相连肿赤黑。令人闷乱。即名发背也。禁房室酒蒜肉
面。若不灸治。即入内杀人。若灸当疮上。七八百壮。有人不识。多作杂肿治者、皆死。
背疽其原有五。天行一。瘦弱气滞二。怒气三。肾气虚四。饮火酒。食炙爆物。服丹药。热
毒五。盖治背疽。不可一概将为热毒。其治之难易。当自一而至五。
病有至甚而生。有微而至死。病证难辨。死生何从决乎。盖发背透膜者死不治。（此言
肝俞以上） 未溃肉陷、面青、唇黑、便污者死。（此言坏藏便下瘀血） 溃喉者不治。阴
入
腹者不治。入囊者死。鬓深及数月不治。（谓如及寸余者） 在颐后一寸三分。毒锐者不治。
无此者生。流注虽多。疗之必愈。
发背之人。虽云有热。未有不自肾虚而得之者。若疽疾减退五分之后。便合根据法五更初。
服山药丸。或加减八味丸。
背疽呕逆。乃是毒瓦斯冲心。非脾胃之冷。当服内托散。杨氏家藏方云。有人因鼻衄初愈。
不曾表汗。余毒在经络。背发大疽。自肩下连腰胁肿甚。坚如石。色极紫黑。医以凉药服之。
中夜大呕。乃连进此药。三四服呕遂止。既而疮溃。出赤水淋漓。四十日而愈。又有患瘰
者。痛过即呕。服此药呕亦止。近见有人病疽。医者不肯用此药。为恐伤脾胃。愚故引杨氏
之言。以解世人之惑。
凡发背疽之后。不曾服内托散。致使热毒冲于心经。必使后来咽喉口舌生疮。甚至黑烂。
合先服犀角散。以解散其毒。免有此证。
凡有背疽之人。难于隐几。但用绿豆十斗。作一大袋隐伏。则自然心凉身体安稳。饮食
居处。根据法戒忌。已安后。半年间血气未定。犹当谨之。不废药饵。方能保全。外科精要云。
氏叙源幼时学举业。全不知医药。甲申年自太学归省。国医常颖土器之。适在府下。求为母
氏一诊。云。有蓄热必渴。时母氏所饮。大略喜水。又云但防作疮。觉疮便着艾于上。热盛
则五花灸之。谓中及四旁。随赤到处灸。非方停也。切记。至辛巳年六月望日。母氏忽言背
胛间微痒。视之有赤半寸许方。有白粒如黍粟。记器之言。乃急着艾。其赤随消。至二十
七壮而止。信宿复觉微痛。视之有赤下流。长二寸。阔如韭叶。举家不悉。皆以前灸为悔。
亲戚交责。谓赤热如何用火。有诋器之者。遂呼外医用药膏覆之益引。一日夜增一晕。至二
十二日。衡斜约六七寸。痛楚不胜。间一呻吟。听之心碎。仓皇询告。或云等慈寺老智全者
。前病疮甚大。得灸而愈。奔问之。全云。剧时昏不知。但小师辈言。范八奉议守定。灸
八百余壮方苏。约艾一筛。尔亟归白之。见从。始以银杏作炷其上十数。殊不觉。乃截四旁
赤引。其炷减四之三。皆觉痛。七壮后觉痒。每一炷烬。则赤随缩入。灸至三十余壮。赤晕
方退。病者信。遂以艾作团。梅杏大。灸其上。渐加至鸡黄大。约四十团方觉痛。视火焦处
已寸余。盖灸之迟。而初发处肉已坏。攘盛隔至好肉方痛耳。四旁知痛者。肉未坏也。又有
言一番殿直居城南。施疮药每效。叙源即再拜邀请。时已熏黑。火 满背。番以手扪疮五六
寸许。试之云。疮高阜而热。不妨。且云只怕不高而热气少者。病者食粥讫。安寝。前此六
夜不寝。至晓视之。疮如覆一瓯。突然高三四寸。上有百数小窍。色正黑。以千金所说。与
潘氏高阜之言求之。突然高者。毒瓦斯出外而聚也。百数小窍者。毒未聚而浮攻皮肤也。色正
黑者。皮与肉俱坏也。非艾火出其毒于坏肉之里。则五脏毕矣。至是方悟明堂图与烟萝子所
画五脏。在背如悬挂然。今毒行分肉间。待其外穿溃。则内虚。外实则易入。内实则难出。
皎然可见。而听庸医用寻常赤肿敷贴凉冷药。以消散之。此借寇兵也。源痛自咎。为人子不
知医。致亲疾危甚。荷神明扶佑。于仓皇间问知艾灸。已危而获安。
医学类证论曰。治发背、发脑、发鬓、疔疮、鬼箭、射工、鱼脐等。一切恶疮。无不灵
验。方才觉有患。便用蒜横切作片子。如两重纸浓。贴在疮上。以绿豆火艾丸子灸之。待痛
稍可忍。即渐大作丸灸。痛又可忍。便除蒜灸之。若是正发背。二日内灸者。十得十愈。四
日内灸者。十得七八。六日内灸者十得五六。八日内灸者。十得一二愈。十日以后灸即不得
力。若得力者。即是热毒疮。非发背也。凡发背者。灸无多少定数。但初痛候不痛即住。若
初不痛候痛即住。然则大约如此。若住火后。又肿及痛者。即须更灸。候不肿不痛即住。火
每患一个疮。或灸三百圆。或灸五百圆。或一千圆。或二千圆。以差为度。若患三个五个疮。
直须各各用前法灸之。候不肿不痛。然后用膏，药贴之。或问曰。何以知是正发背与热毒疮。
愚应之曰。若有患者。待请人识认得是正发背。或者热毒疮。即已迟也。何异咨丈人而后救
火者哉。古人云。面无好靥。头无恶骨。背无好疮。但根据此灸之。又何须识别者。或问曰。
前言医一切恶疮后。但灸发背而已何也。愚应之曰。疮中人言医不得者。发背也。令若早灸。
无有不验。则其余不言可知也。或曰。忽遇春夏。火正旺相。得行灸乎。若灸多得无火毒入
心乎。愚又应之曰。此是未知灸法之人也。千万勿信。
本事方云。元 三年。夏四月。官京师。疽发于背。召国医治之。逾月势益甚。得徐州
萧县人张生。以艾火加疮上。自旦及暮。凡一百五十壮。知痛乃已。明日镊去黑痂。脓血尽
溃。肤里皆红。亦不复痛。始别以药敷之。日一易焉。易时旋剪去黑烂恶肉。月许疮乃平。
是岁夏间。京师士大夫病疽者七人。余独生。此虽司命事。然固有料理不知其方。遂至不幸
者。以人意论之。可为慨然。
儒门事亲云。一富家女子十余岁。好食紫樱。每食即二三斤。岁岁如此。至十余年。一
日潮热。如热劳。戴人诊其两手脉。皆洪大而有力。谓之曰。他日必作恶疮肿毒。热上攻目。
阳盛阴脱之证。其家大怒。不肯服解毒之药。不一二年。患一背疽如盘。痛不可忍。其女忽
思戴人曾有是言。再三悔。过请戴人。戴人以 针绕疽晕刺数百针。去血一斗。如此三次。
渐渐痛减肿消。微出脓而敛将作痂时。使服十补内托散乃痊。终身忌口。然目亦昏。终身无
子。
凡背疮初发。便可用藏用丸、玉烛散。大作剂料。下脏腑一二行。次用 针于肿 处。
循红晕周匝内。密刺三层出血尽。以湿软帛拭去血。甚者百会、委中皆出血。后用阳起散敷
之。不可便服十味内托散。其中犯官桂。更用酒煎。男子以背为阳。更以热投热。无乃太热
乎。
方
二乌丸（一名万灵丸）治发背托里定痛。驱风毒。凉血脉。
羌活（去苗） 薄荷叶（各三两） 川芎（三味不见火） 玄参 地榆 麻黄（去根节）
蔓荆
子（去蒂白膜） 旋复花（去萼蒂） 荆芥穗（各二两） 防风（去叉芦） 天麻 白芷（不
见火）
白僵蚕（直者去丝足口炒） 牛蒡子（炒各二两） 甘菊花（三两） 大川乌（去皮尖炮） 何
首乌
（各四两） 粉草（炙四两半） 蝉蜕（洗去土前足半两） 上为细末。炼蜜丸如弹子大。
每服
一丸。食后。细嚼茶酒任下。
大黄膏 治发背疼痛。日夜不可忍。涂敷。
大黄（锉） 雄黄（研） 芎 黄连（去须） 白芷 槟榔（锉） 当归（切焙） 木
香桂
（去粗皮） 黄柏（去粗皮） 芍药 附子（去皮脐） 乳香（研） 麒麟竭（各半两） 鸡
舌香
麝香（各一分） 猪脂（一斤） 上为末拌匀。先于银器内熬猪脂。令沸。去筋膜。下诸药
末。
调成膏。涂患处。日三上。以瘥为度。
竹叶黄 汤 疗动散肿。已自利。虚热不除宜服。
竹叶（切三升） 黄 （四两） 小麦（一升） 芍药（三两） 甘草（一两炙） 石
膏（二两研）
人参（二两） 升麻（一两） 茯苓（二两一用七分） 桂心（六分一用三分） 当归（三
两） 干枣
（十四枚） 五味子（三两） 生姜（三两） 干地黄（一两） 麦门冬（三两去心） 知
母（一两）
上切。以水一斗二升。煮竹叶小麦取九升。去滓内药。煮取三升。温分四服。
千金托里散（出儒门事亲书）治一切发背疔疮。
连翘（二两二钱） 黄 （一两半） 浓朴 防风 桔梗（各一两） 川芎 白芷 芍
药官
桂甘草（各一两） 木香 没药（各三钱） 乳香（三钱半） 当归 人参（各半两） 上
为细
末。每服三钱。用酒一大盏。煎三沸。和滓温服。
地黄丸 常服令人终身不患发背。
熟地黄（五两） 苁蓉（酒浸） 天门冬 石斛 当归 防风 白茯苓 川芎（各三两）
远
志黄 甘草（炙） 芍药（各二两） 人参 细辛 巴戟（各一两） 上为末。炼蜜为
丸。如
梧桐子大。每服三十丸。荆芥汤下。
莽草膏 疗发背痈肿。牢核成脓。
莽草 芎 当归 细辛 附子（炮） 黄芩 乌头（炮） 牛膝 踯躅 野葛 茯苓 防
风杜蘅（各一两） 猪脂（半斤） 上切。用猪脂合煎。去滓敷疮上。日再。忌猪肉、冷
水、
生菜、大酢。
神仙万灵散 专治发背疔疮。一切恶疮。
金银花（一两半） 皂角针 穿山甲 白芷 天花粉 甘草节 当归尾 防风 藿香 赤
芍药（各半两） 乳香（别研） 没药（各三钱另研） 上 咀。每服一两重。水一碗。无
灰好酒
一碗。砂石器内顿放。瓷盘盖口。纸条糊缝。文武火煎至重车行十里远。药香为度。热服。
仍饮好酒数杯。浓衣被汗出为效。滓再煎服。病重者不过三服。合煎服时。并忌鸡犬妇人见。
老病气衰者。加黄 半两。
连翘散 治发背肿。痈疽恶风结脓血。
连翘子 独活（去芦头） 木香 射干（各三分） 甘草（炙锉） 桑寄生（锉） 升
麻鸡舌
香沉香 乳香（研） 大黄（锉炒一两一分） 麝香（研一分） 上粗捣筛。每服五钱。
水一盏
半。煎至八分。入淡竹沥半合。去滓。空心温服。快利三五行为度。未利再服。
排脓内补铁屑散 疗痈发背。
当归 人参 细辛 甘草（炙） 苁蓉 黄 桂心 防风 黄芩 铁屑 芎 芍药
（各等分） 上为散。服方寸匕。忌海藻、菘菜、生葱、酢物等。
玄参散 治热毒瓦斯攻冲背上。初觉疼痛。心神烦闷。
玄参 黄芩 当归 赤芍药 麦门冬（去心） 犀角屑 甘草（生锉） 远志（去心） 生
干
地黄（各一两） 赤茯苓 川升麻 人参（去芦头各一两半） 上为散。每服四钱。水一中
盏。
入竹叶二七片。小麦五十粒。煎至六分。去滓。不计时候温服。
犀角散 治初觉皮肤及头背有疮疖。恐成痈疽。兼脏腑壅涩。或寒热口干心烦。
犀角屑（一两） 知母（三分） 木通（一两锉） 赤芍药 川升麻 荠 葳蕤 黄
芩甘
草（生各三分） 麦门冬（去心） 马牙硝 川大黄（锉碎微炒各一两） 上为粗散。每服
四钱。
（附论）
发背病，是热毒之气在背部俞穴发作，形成痈疽。此病内在根源在于五脏，外在传变涉及诸腑。热气攻冲发作，必然产生于脏腑俞穴之间。其成因多因服用石药（五石散等矿物药）引发，以及过食肥甘厚味所致。这导致脏腑壅滞积热，经络运行不畅，毒气凝滞，最终必然通过俞穴向外发散。因此，服用石药的人，在居住、饮食、情欲及喜怒情绪方面，尤其应当节制谨慎。一旦有过失举动，毒气便会乘虚而入而发作。初期症状如同芥子或粟米大小，若治疗稍显迟缓，则肿块会迅速扩大至尺寸大小而难以救治。所以，当刚开始感觉热气搏结于肌肉纹理之间，疼痛损伤经络时，应当迅速治疗。因为经脉不通，会导致肿毒加剧，正如《内经》所说：“营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。”血液败坏、肌肉腐烂，引发的祸患各不相同：实证表现为痈，浮浅表现为肿，深部表现为疽。然而，发于背部两肩胛之间的，初期非常微小，有时发痒有时疼痛，人们往往忽视它。几天后便可能导致无法挽救的后果。治疗开始时，应测量肿头的正中位置进行艾灸，灸的壮数超过一百壮，使恶气向外排出；随后用药疏通利导脏腑，决断邪毒，这样就有治愈的道理。
凡是发背病，大多因服用五石散、寒食更生散所致。也有单服钟乳石而发病的。还有平生从未服药，却自发疾病的。这是上代有人服用石药遗留的影响。其症状多在背部两肩胛间起病，初起如粟米大，或痛或痒，呈现赤色。人们起初都不在意，日子久了逐渐长大，不过十天，便会导致死亡。临终时，疮口已宽三寸，高一寸，有数十个孔洞，用手按压，各孔中都有脓流出，随即病情极度危重。所以养生之人，只要觉得背上痒痛异常，就应立即取洁净的泥土和水调成泥，捏成饼状，厚度二分，直径一寸半，用粗艾绒做艾炷，在泥饼上施灸，将泥饼贴在疮上灸治。一炷艾烧完更换一个泥饼。如果像粟米大小时，可灸七个泥饼即可痊愈。如果像榆荚大小时，需灸四十九个泥饼（七七之数）即可痊愈。如果像铜钱大小时，可日夜不停地灸，不限艾炷数量。同时服用五香连翘汤及铁浆等药物，攻逐邪毒才能痊愈。另一种方法是：对于尚未化大脓的发背，可以用冷水喷洒，浸湿石头使其变冷后熨敷患处，日夜不停，直到痊愈才停止。此病忌食面食、酒类及五辛（葱、蒜、韭、薤、兴渠）等。也有发生在两肩上部的。
凡是服用石药的人，都必须让四肢劳作役使，不能让自己安逸。如果不这样做，多有疾病发动。也不能立刻放纵自己贪图温暖舒适，自称适合性情。必须克制欲望以寻求寒冷冰冻的环境，虽然当时身体不安宁，但过后对身体多有益处，最终没有疾病发动的忧虑。
凡是肿胀隆起在背部肩胛间，顶端白色如黍粟，四周相连红肿发黑，令人胸闷烦乱，这就名叫发背病。禁止房事、饮酒、吃蒜、肉、面。如果不进行艾灸治疗，毒气内陷入里会致人死亡。如果施灸，应在疮口上灸七八百壮。有人不认识此病，多当作普通杂肿治疗，结果都死了。
背疽的病因原有五种：一是天行疫气；二是瘦弱气滞；三是怒气郁结；四是肾气虚弱；五是饮用火酒、食用炙烤爆炒食物、服用丹药导致的内热毒。大概治疗背疽，不可一概视为热毒。治疗的难易程度，应从第一种情况到第五种情况依次判断。
病症有因极重而生，也有因轻微而死，病证难以辨别，生死如何决断呢？大概发背病穿透膜原的，死症难治。（这里指肝俞以上的部位）未溃破且肌肉下陷、面色青、嘴唇黑、大便污浊的，死症。（这里指脏腑败坏，大便下瘀血）溃烂至咽喉的，不治。毒气内陷入腹的，不治。毒入阴囊的，死症。鬓角深处及数月不愈的（指深度达一寸多的），不治。位于颐后一寸三分处，毒势锐利的，不治。没有上述情况的，可生。流注病虽然多发，治疗必能痊愈。
发背病患者，虽然说有热象，但没有不是从肾虚而得的。如果疽疾减退五分之后，就应当依法在五更初，服用山药丸，或者加减八味丸。
背疽出现呕逆，乃是毒气冲击心脏，并非脾胃虚冷，应当服用内托散。杨氏家藏方记载：有人因鼻衄刚愈，未曾发汗，余毒留在经络，背部发出大疽，从肩部向下连及腰胁，肿胀严重，坚硬如石，颜色极紫黑。医生用凉药服用，半夜大呕，于是连续进服此药，三四服后呕吐停止。随后疮溃破，流出赤水淋漓，四十日痊愈。又有患瘰疬者，疼痛剧烈时即呕吐，服用此药呕吐也停止。近来见有人患疽病，医者不肯用此药，担心伤害脾胃。我故引用杨氏的话，来解开世人的疑惑。
凡是发背疽之后，不曾服用内托散，致使热毒冲击心经，必然导致后来咽喉口舌生疮，甚至黑烂。应当先服用犀角散，以解散其毒，避免发生这种证候。
凡是有背疽的人，难以倚靠几案休息。只需用绿豆十斗，做成一个大袋子让人倚伏其上，则自然心凉身体安稳。饮食起居，依法戒忌。安定之后，半年内血气未定，仍应当谨慎，不废除药物治疗，方能保全生命。《外科精要》记载：程叙源幼年学习科举学业，完全不懂医药。甲申年从太学回家省亲，国医常颖土器之正好在府下，请求他为母亲诊脉。说：有蓄热必定口渴，当时母亲所饮用的，大致喜欢水。又说：只需防备长疮，觉得长疮就立即在上面施灸，热盛则用五花灸法（灸中央及四周），随红晕所在处施灸，不是固定穴位。切记。到了辛巳年六月十五日，母亲忽然说背部肩胛间微痒，视之有一块约半寸见方的红斑，上面有白色颗粒如黍粟。想起土器之的话，于是急忙施灸，红斑随之消退，灸了二十七壮停止。隔了两个晚上又觉得微痛，视之有红色条索向下流，长二寸，宽如韭菜叶。全家都不知道，都后悔之前的灸法。亲戚纷纷指责，认为赤热为何用火。有人诋毁土器之。于是请外医用药膏覆盖，反而更加引邪深入。一天一夜增加一圈红晕，到了二十二天，纵横约六七寸，痛苦不堪，间歇呻吟，听之心碎。仓皇询问告知，有人说等慈寺老僧智全，前次患疮很大，得灸而愈。奔去询问，智全说：剧痛时昏迷不知人，只是小和尚们说，范八奉议坚守，灸了八百多壮才苏醒。大约用艾一筛。你赶快回去照办。见到同意，才开始用银杏核做艾炷在其上灸十多个，特别不觉痛。然后截断四周红晕，艾炷减少四分之三，都觉得痛。七壮后觉得痒。每一炷艾烧完，红晕就随之收缩进入。灸到三十多壮，红晕才退。病人相信，于是用艾做成团，梅杏大小，灸其上，逐渐加到鸡黄大小，约四十团才觉得痛。视之火焦处已有一寸多。大概是灸得迟，而初发处肉已坏死，阻隔旺盛直到好肉才痛耳。四周知痛的，肉未坏死。又有说法称一位殿直居住在城南，施用疮药每每有效。叙源再次拜请邀请。此时疮已熏黑，火焰布满背部。番用手摸疮口五六寸许，试探说：疮高突而热，不要紧。还说只怕不高而热气少的。病人吃完粥，安睡。此前六夜未睡。到早晨看，疮如倒扣的一个瓯，突然高三四寸，上面有数百个小孔，颜色正黑。用《千金方》所说的，与潘氏高突的说法对照来看。突然高起的，是毒气向外聚结；数百个小孔的，是毒未聚结而浮泛攻于皮肤；颜色正黑的，是皮与肉都坏死。如果不是艾火将毒从坏死肉中引出，则五脏都完了。至此才明白明堂图与烟萝子所画的五脏，在背部如同悬挂一般。现在毒行走在分肉之间，等待其外部穿溃，则内部空虚，外部实邪容易侵入，内部实邪难以排出。皎然可见。而听信庸医用寻常赤肿敷贴凉冷药来消散，这是借寇兵资盗粮。我痛恨自责，作为儿子不懂医，致使亲人病情危重。承蒙神明扶佑，在仓皇间问知艾灸之法，已危而获安。
《医学类证论》说：治疗发背、发脑、发鬓、疔疮、鬼箭、射工、鱼脐等一切恶疮，无不灵验。方才觉得有病患，就用蒜横切作片，如两层纸厚，贴在疮上，用绿豆大小的艾丸灸之。待痛稍微可以忍受，就逐渐加大艾丸灸治。痛又可以忍受，就除去蒜直接灸。如果是正发背，二日内施灸的，十人得十愈；四日内施灸的，十人得七八愈；六日内施灸的，十人得五六愈；八日内施灸的，十人得一二人愈。十日以后施灸就不得力了。如果得力，那就是热毒疮，不是发背。凡是发背，灸没有固定的多少壮数。只要初痛时不痛就停，初不痛时痛就停。大概如此。如果停火后，又肿又痛的，就必须再灸。等到不肿不痛就停。每患一个疮，或灸三百壮，或五百壮，或一千壮，或二千壮，以痊愈为度。如果患三个五个疮，必须各自用前面的方法灸治。等到不肿不痛，然后用膏药贴之。有人问：怎么知道是正发背还是热毒疮？我回答：如果有患者，等人识别出是正发背或者是热毒疮，就已经晚了。这何不同于咨询老人后再去救火呢？古人说：脸上没有好的靥（酒窝），头上没有恶骨，背上没有好的疮。只要根据这个原则施灸，又何须识别呢？有人问：前面说医治一切恶疮后，为什么只提灸发背呢？我回答：疮中人言“医不得”（无法医治/忌讳医治）的，就是发背。如果早灸，没有不灵的，那么其余的不说也就知道了。有人说：忽然遇到春夏，火气正旺，可行灸吗？如果灸得多，不会有火毒入心吗？我又回答：这是不知道灸法的人。千万不要相信。
《本事方》记载：元祐三年，夏四月，我在京城做官，背部长疽，召国医治疗，过了一个月形势更严重。得到徐州萧县人张生，用艾火加在疮上，从早到晚，共一百五十壮，知道痛才停止。第二天镊去黑痂，脓血全部溃出，皮下皆红，也不再痛。开始另外用药敷之，每天更换一次。更换时随即剪去黑烂恶肉，一个月左右疮平复。这一年夏天，京城的士大夫患疽病的有七人，唯独我幸存。这虽然是司命之事，然而本来就有料理不当不知方法的，遂至不幸。凭人之常理推断，可为感慨。
《儒门事亲》记载：一个富家女子十多岁，喜欢吃紫樱，每次吃二三斤，年年如此，持续十多年。一天潮热，像热劳病。戴人诊其两手脉，皆洪大而有力，对他说：日后必作恶疮肿毒，热上攻目，阳盛阴脱的证候。其家人大怒，不肯服解毒药。不到一两年，患一背疽如盘大，痛不可忍。其女忽然想起戴人曾有此言，再三后悔，过去请戴人。戴人以针绕疽晕刺数百针，去血一斗，如此三次，渐渐痛减肿消，微出脓而敛将作痂时，令服十补内托散乃痊愈。终身忌口，然而眼睛也昏花，终身无子。
凡是背疮初发，就可以用藏用丸、玉烛散，大作剂料，通下脏腑一二行。其次用针在肿处，沿红晕周匝内，密刺三层出血尽，用湿软帛拭去血。严重的在百会、委中皆出血。后用阳起散敷之。不可立即服用十味内托散，其中犯官桂，再用酒煎。男子以背为阳，再以热投热，岂不是太热了吗？
方剂：
二乌丸（一名万灵丸）：治疗发背，托里定痛，驱风毒，凉血脉。
羌活（去苗）、薄荷叶（各三两）、川芎（三味不见火）、玄参、地榆、麻黄（去根节）、蔓荆子（去蒂白膜）、旋复花（去萼蒂）、荆芥穗（各二两）、防风（去叉芦）、天麻、白芷（不见火）、白僵蚕（直者去丝足口炒）、牛蒡子（炒各二两）、甘菊花（三两）、大川乌（去皮尖炮）、何首乌（各四两）、粉草（炙四两半）、蝉蜕（洗去土前足半两）。上为细末，炼蜜丸如弹子大。每服一丸，食后，细嚼茶酒任下。
大黄膏：治疗发背疼痛，日夜不可忍，涂敷。
大黄（锉）、雄黄（研）、川芎、黄连（去须）、白芷、槟榔（锉）、当归（切焙）、木香、官桂（去粗皮）、黄柏（去粗皮）、芍药、附子（去皮脐）、乳香（研）、麒麟竭（各半两）、鸡舌香、麝香（各一分）、猪脂（一斤）。上为末拌匀，先在银器内熬猪脂，令沸，去筋膜，下诸药末，调成膏，涂患处，日三上，以瘥为度。
竹叶黄芪汤：疗动散肿，已自利，虚热不除宜服。
竹叶（切三升）、黄芪（四两）、小麦（一升）、芍药（三两）、甘草（一两炙）、石膏（二两研）、人参（二两）、升麻（一两）、茯苓（二两一用七分）、桂心（六分一用三分）、当归（三两）、干枣（十四枚）、五味子（三两）、生姜（三两）、干地黄（一两）、麦门冬（三两去心）、知母（一两）。上切，以水一斗二升，煮竹叶小麦取九升，去滓内药，煮取三升，温分四服。
千金托里散（出《儒门事亲》书）：治一切发背疔疮。
连翘（二两二钱）、黄芪（一两半）、浓朴、防风、桔梗（各一两）、川芎、白芷、芍药、官桂、甘草（各一两）、木香、没药（各三钱）、乳香（三钱半）、当归、人参（各半两）。上为细末，每服三钱，用酒一大盏，煎三沸，和滓温服。
地黄丸：常服令人终身不患发背。
熟地黄（五两）、苁蓉（酒浸）、天门冬、石斛、当归、防风、白茯苓、川芎（各三两）、远志、黄芪、甘草（炙）、芍药（各二两）、人参、细辛、巴戟（各一两）。上为末，炼蜜为丸，如梧桐子大。每服三十丸，荆芥汤下。
莽草膏：疗发背痈肿，牢核成脓。
莽草、川芎、当归、细辛、附子（炮）、黄芩、乌头（炮）、牛膝、踯躅、野葛、茯苓、防风、杜蘅（各一两）、猪脂（半斤）。上切，用猪脂合煎，去滓敷疮上，日再。忌猪肉、冷水、生菜、大酢。
神仙万灵散：专治发背疔疮，一切恶疮。
金银花（一两半）、皂角针、穿山甲、白芷、天花粉、甘草节、当归尾、防风、藿香、赤芍药（各半两）、乳香（别研）、没药（各三钱另研）。上咀，每服一两重，水一碗，无灰好酒一碗，砂石器内顿放，瓷盘盖口，纸条糊缝，文武火煎至重车行十里远，药香为度，热服。仍饮好酒数杯，浓衣被汗出为效。滓再煎服。病重者不过三服。合煎服时，并忌鸡犬妇人见。老病气衰者，加黄芪半两。
连翘散：治发背肿，痈疽恶风结脓血。
连翘子、独活（去芦头）、木香、射干（各三分）、甘草（炙锉）、桑寄生（锉）、升麻、鸡舌香、沉香、乳香（研）、大黄（锉炒一两一分）、麝香（研一分）。上粗捣筛，每服五钱，水一盏半，煎至八分，入淡竹沥半合，去滓，空心温服，快利三五行为度。未利再服。
排脓内补铁屑散：疗痈发背。
当归、人参、细辛、甘草（炙）、苁蓉、黄芪、桂心、防风、黄芩、铁屑、川芎、芍药（各等分）。上为散，服方寸匕。忌海藻、菘菜、生葱、酢物等。
玄参散：治热毒瓦斯攻冲背上，初觉疼痛，心神烦闷。
玄参、黄芩、当归、赤芍药、麦门冬（去心）、犀角屑、甘草（生锉）、远志（去心）、生干地黄（各一两）、赤茯苓、川升麻、人参（去芦头各一两半）。上为散，每服四钱，水一中盏，入竹叶二七片，小麦五十粒，煎至六分，去滓，不计时候温服。
犀角散：治初觉皮肤及头背有疮疖，恐成痈疽，兼脏腑壅涩，或寒热口干心烦。
犀角屑（一两）、知母（三分）、木通（一两锉）、赤芍药、川升麻、荠、葳蕤、黄芩、甘草（生各三分）、麦门冬（去心）、马牙硝、川大黄（锉碎微炒各一两）。上为粗散，每服四钱。
(Attached Discussion)
Fa Bei (Back Carbuncle) is a condition where heat-toxin qi erupts at the Back-Shu points, manifesting as an abscess or ulcer. Internally, its root lies in the Zang organs, and externally it spreads to the Fu organs. The attacking heat must arise between the organ Shu points. It is caused by the activation of Stone Drugs (mineral pills such as Wushi San), and excessive consumption of rich, sweet, and greasy foods. This leads to stagnation and heat accumulation in the Zang-Fu organs, causing blockage in the meridians. Toxic vapors condense and stagnate, eventually exiting through the Shu points. Therefore, those taking Stone Drugs must be especially cautious and restrained regarding their residence, diet, desires, and emotions. Any lapse can allow toxic vapors to exploit the opening and erupt. Initially, it appears like a mustard seed or millet grain. If treatment is slightly delayed, it will expand to inches in size and become difficult to manage. Thus, when one first feels heat clashing in the muscle layers and pain damaging the meridians, immediate treatment is required. Because if the meridians are blocked, the swelling and toxicity will worsen, as stated in the Classics: "When Ying Qi does not follow its course and reverses into the muscle texture, abscesses and swellings occur." Blood failure and flesh corruption lead to various disasters: excess manifests as Yang abscesses (Yong), superficiality manifests as swelling (Zhong), and depth manifests as Yin ulcers (Ju). However, Fa Bei occurring between the two scapulae starts very subtly, sometimes with itching or pain, which people often ignore. After a few days, it may become incurable. Treatment should begin by measuring the center of the swelling and applying moxibustion, exceeding 100 moxa cones, to expel evil qi outward. Subsequently, use herbs to unblock and purify the Zang-Fu organs and resolve the pathogenic toxin, thereby offering a chance for cure.
All cases of Fa Bei are caused by taking Wushi San or Hanshi Gengsheng San. Some arise from taking only Zhuru (Galactodendron Resin). Others develop spontaneously despite never having taken medicine, due to residual effects from ancestors who took Stone Drugs. The symptoms usually start between the two scapulae on the back, initially the size of a millet grain, painful or itchy, and red. People initially disregard it. Over days, it grows larger, leading to death within ten days. At the time of death, the sore is three cun wide and one cun high, with dozens of holes. Pressing with hands causes pus to flow from all holes, followed by extreme exhaustion. Therefore, those practicing health preservation should, upon feeling unusual itching or pain on the back, immediately take clean earth mixed with water to form mud, shape it into cakes two fen thick and one-and-a-half cun wide. Use coarse moxa wool as cones, burn them on the mud cake placed directly on the sore. Replace the cake after each cone. If the size is like a millet grain, seven cakes suffice for recovery. If like a elm seed, forty-nine cakes are needed. If the size of a coin, moxa can be applied day and night without limit on the number of cones. Simultaneously, drink Wuxiang Lianqiao Tang and Tiejiang (Iron Slag Decoction) to attack the toxin until cured. Another method: for Fa Bei not yet suppurated, spray cold water on it, soak a stone to make it cold, and apply it as a compress day and night until healed. This disease forbids noodles, alcohol, and Five Pungent Spices. Some also occur on the upper shoulders.
Those taking Stone Drugs must engage in physical labor to avoid comfort. Otherwise, diseases are likely to erupt. One must not indulge in warmth and comfort, claiming it suits one's nature. One must restrain desires and seek cold environments. Although uncomfortable initially, it benefits the body later, eliminating the fear of future eruptions.
Whenever swelling rises between the back scapulae, white-headed like millet grains, surrounded by connected red, swollen, and black areas, causing chest oppression and confusion, it is named Fa Bei. Sexual intercourse, alcohol, garlic, meat, and noodles are forbidden. Without moxibustion treatment, internal invasion kills. If moxibustion is used, apply 700-800 cones on the sore. Those who do not recognize this disease and treat it as ordinary miscellaneous swellings all die.
The origins of Back Ju (Back Ulcer) are fivefold: 1. Epidemic qi; 2. Emaciation and Qi stagnation; 3. Anger; 4. Kidney Qi deficiency; 5. Drinking fire wine, eating roasted/fried foods, and taking elixirs causing heat toxin. Treating Back Ju cannot be uniformly treated as heat toxin. The difficulty of treatment varies from the first to the fifth cause.
Diseases range from severe onset to mild onset leading to death. Disease patterns are hard to distinguish, so how to decide life and death? Generally, Fa Bei penetrating the membrane is fatal and untreatable (referring to above Liver Shu). Unruptured with sunken flesh, blue face, black lips, and foul stool indicates death (indicating damaged organs and bloody stool). Rupture to the throat is untreatable. Internal invasion to the abdomen is untreatable. Invasion to the scrotum is fatal. Deep involvement in the temples lasting months (over one cun deep) is untreatable. Sharp toxicity at one inch and three fen behind the chin is untreatable. Absence of these signs indicates survival. Liu Zhu (Flowing Injection)虽多 (though multiple), treatment ensures recovery.
Patients with Fa Bei, though said to have heat, invariably derive from Kidney deficiency. After the ulcer reduces by five parts, one should take Shanyao Wan or Jiajian Bawei Wan at dawn according to the method.
Vomiting and reversal in Back Ju is due to toxic vapors rushing to the Heart, not Spleen-Stomach cold. One should take Neituo San. Yang Shi Jiacang Fang records: A person whose epistaxis had just healed, without sweating out residual toxins in the meridians, developed a large Back Ju extending from the shoulder to the waist and hypochondrium, severely swollen, hard as stone, extremely purple-black. The doctor administered cooling herbs, causing severe vomiting at midnight. Continuous administration of this medicine stopped the vomiting after three to four doses. The sore then ruptured, draining crimson fluid for forty days until healed. Another patient with Scrofula vomited when pain was severe; this medicine stopped the vomiting. Recently, a doctor refused to use this medicine for a carbuncle patient, fearing damage to the Spleen-Stomach. I cite Yang Shi to dispel worldly doubts.
After Fa Bei Ju, failing to take Neituo San allows heat toxin to rush to the Heart Meridian, inevitably causing sores in the throat and tongue later, even blackening and rotting. One should first take Xijiao San to dissipate the toxin and prevent this syndrome.
Patients with Back Ju find it difficult to lean on a table. Using ten dou of mung beans made into a large bag for leaning naturally cools the heart and stabilizes the body. Diet and living habits must follow taboos. After stabilization, for half a year while Qi and Blood are unsettled, caution is still needed, and medication should not be abandoned to ensure preservation. *Waike Jingyao* records: Cheng Xuyuan learned literature but knew no medicine in his youth. In the Jiashen year, returning from the Imperial Academy to visit home, State Physician Chang Ying Tuziqi was present. He requested a diagnosis for his mother. Chang said: "Heat retention causes thirst. Your mother prefers drinking water. Beware of sores. Apply moxa immediately upon sensation. For intense heat, use Five-Flower Moxibustion (center and surroundings) wherever redness appears, not fixed points. Remember this." In the Xinsi year, June 15th, his mother felt slight itching in the back scapulae. A red patch half-cun square with white millet-like grains appeared. Recalling Tuziqi's words, he urgently applied moxa, and the redness subsided, stopping at 27 cones. Two nights later, slight pain returned. A red streak flowed downward, two cun long and broad as a leek leaf. The family was confused and regretted the previous moxa. Relatives blamed them, asking why fire was used for red heat. Someone slandered Tuziqi. An external doctor was called to apply ointment, which only exacerbated the spread. Within a day and night, a new ring expanded. By the 22nd day, it spanned six or seven cun horizontally and vertically. Pain was unbearable, with intermittent groaning. Desperately seeking advice, someone mentioned Old Monk Zhiquan of Dengci Temple, who cured a large sore with moxa. They rushed to ask. Zhiquan said: "During severe stages, patients are unconscious. Novice monks told me Fan Bayi Yi held firm, moxa-ing over 800 cones until revival, using about one sieve of moxa. You must return and do so." Upon agreement, they started with ginkgo nut-sized moxa cones, numbering over ten, feeling little pain. Then they cut the peripheral redness, reducing cone size by three-quarters, causing pain. After seven cones, itching began. With each burnt cone, redness receded inward. After over thirty cones, the red halo faded. The patient believed, so moxa balls plum-apricot sized were applied, gradually increasing to chicken-yolk sized, totaling about forty balls before pain was felt. The burned area was over one cun deep. This was because moxa was late, and the initial tissue was necrotic; only when reaching healthy flesh did pain occur. Peripheral pain indicated viable tissue. Another account mentions a Dianzhi living south of the city effective with wound medicines. Xuyuan invited him. The sore was blackened, fire covering the back. The Dianzhi touched the five-six cun sore and said: "High and hot is fine. Only fear low height and less heat." After the patient ate porridge and slept (having not slept for six nights), morning inspection showed the sore raised like an inverted bowl, suddenly three-four cun high, with hundreds of small pores, jet black. Comparing with *Qianjin Fang* and Pan Shi's theory of elevation: sudden elevation indicates toxin gathering outward; hundreds of pores indicate toxin floating on skin without gathering; jet black color indicates skin and flesh necrosis. Without moxa fire extracting toxin from necrotic flesh, the Five Zang would perish. Only then did he understand that the Mingtang Chart and Yanluozi's drawings of the Five Zang on the back hang like suspended objects. Now toxin moves between muscle layers; waiting for external rupture makes the interior empty and exterior solid, making entry easy and exit difficult. This is clear. Listening to quacks using common cooling pastes for red swelling is lending weapons to bandits. Xuyuan blamed himself bitterly for not knowing medicine as a son, causing parental peril. Thanks to divine protection, finding moxa knowledge in desperation saved him from danger.
*Yixue Leizheng Lun* states: Treating Fa Bei, Fa Nao, Fa Bin, Ding Chuang, Gui Jian, She Gong, Yu Qi, and all malignant sores is invariably effective. As soon as a lesion is felt, slice garlic transversely to the thickness of two papers, apply to the sore, and moxa with mung-bean-sized moxa balls. When pain becomes bearable, increase ball size. When pain is again bearable, remove garlic and moxa directly. For true Fa Bei, moxa within two days yields 100% cure; within four days, 70-80%; within six days, 50-60%; within eight days, 10-20%. After ten days, moxa is ineffective. If effective, it is a heat-toxin sore, not Fa Bei. For Fa Bei, there is no fixed number of cones. Stop if initial pain ceases; stop if initial non-pain becomes painful. Generally, if swelling and pain return after stopping fire, resume moxa until swelling and pain cease. Each sore requires 300, 500, 1000, or 2000 cones, depending on recovery. For three or five sores, treat each individually. Once swelling and pain cease, apply paste. Question: How to distinguish true Fa Bei from heat-toxin sores? Answer: Waiting for identification is too late, like consulting elders before fighting a fire. Ancients said: No good dimples on the face, no bad bones on the head, no good sores on the back. Just moxa according to this principle; no need for identification. Question: Why mention all malignant sores but only specify moxa for Fa Bei? Answer: Among sores, Fa Bei is the one deemed "untreatable" by laymen. Early moxa ensures efficacy; thus others are implied. Question: What about spring/summer when fire is strong? Will excessive moxa cause fire toxin to enter the Heart? Answer: This shows ignorance of moxa technique. Do not believe it.
*Benshi Fang* records: In the third year of Yuanyou, April, summer, I was in the capital. A Back Ju erupted. State physicians treated it for a month, worsening. Zhang Sheng from Xiao County, Xuzhou, applied moxa to the sore from dawn to dusk, 150 cones, stopping when pain was felt. Next day, black crusts were removed, pus and blood drained completely, subcutaneous tissue turned red, pain ceased. Topical medicine was applied daily, trimming necrotic flesh. The sore flattened in a month. That summer, seven officials in the capital died of Ju; I alone survived. Though fate plays a part, poor management leads to misfortune. This is lamentable.
*Rumen Shiqin* records: A wealthy girl in her teens loved eating purple cherries, consuming two-three jin daily for over ten years. One day, tidal fever resembling consumptive fever arose. Dairen diagnosed her pulse as full, large, and forceless on both sides, saying: "You will develop malignant sores and swelling, heat attacking the eyes, a syndrome of Excess Yang and Deficient Yin." Her family was furious and refused detoxifying herbs. Within a year or two, she developed a plate-sized Back Ju, unbearable pain. Remembering Dairen's prediction, she repented and summoned him. Dairen pricked around the sore halo hundreds of times with needles, draining one dou of blood, repeated three times. Pain and swelling gradually decreased. Pus emerged slightly, and scabs formed. She took Shibu Neituo San and recovered. Lifelong dietary restrictions followed. Eyes became dim, and she remained childless.
For initial Back Sores, use Cangyong Wan and Yuzhu San in large doses to purge the Zang-Fu one or two times. Then, use needles to prick densely in three layers within the red halo until bleeding stops. Wipe blood with wet soft cloth. Severe cases bleed from Baihui and Weizhong. Apply Yangqi San afterwards. Do not immediately take Shiwei Neituo San, which contains Guirui (Cinnamon Twig). Brewing with wine adds heat. Since the back is Yang for men, adding heat to heat is excessively hot.
Formulas:
Er Wu Wan (also known as Wan Ling Wan): Treats Fa Bei, supports the interior, relieves pain, expels wind-toxin, cools blood vessels.
Qiang Huo (root removed), Bohe Ye (leaves) (each 3 liang), Chuan Xiong (these three not exposed to fire), Xuanshen, Diyu, Mahuang (roots and joints removed), Manjing Zi (pedicels and white membranes removed), Xuanfuhua (calyx and pedicels removed), Jingjie Sui (each 2 liang), Fangfeng (forks and reeds removed), Tianma, Baizhi (not exposed to fire), Bai Jiangcan (straight ones, silk feet and mouth removed, stir-fried), Niubang Zi (stir-fried, each 2 liang), Gan Juhua (3 liang), Da Chuanwu (skin and tips removed, processed), Heshouwu (each 4 liang), Fencacao (roasted 4.5 liang), Chantui (washed, soil and front legs removed, 0.5 liang). Pulverize into fine powder. Refine honey to make pills the size of bullet seeds. Take one pill after meals, chewed finely with tea or wine as desired.
Dahuang Gao: Treats Fa Bei pain, unbearable day and night. Apply externally.
Dahuang (chopped), Xionghuang (ground), Chuanxiong, Huanglian (whiskers removed), Baizhi, Binglang (chopped), Danggui (sliced and baked), Muxiang, Guirui (bark removed), Huangbai (bark removed), Shaoyao, Fuzi (skin and navel removed), Ruxiang (ground), Qilinjie (each 0.5 liang), Jishe Xiang, Shexiang (each 1 fen), Zhuzhi (pig lard, 1 jin). Mix powders. Boil pig lard in a silver vessel until bubbling, remove fascia, add herb powders, mix into a paste. Apply to affected area, three times daily, until healed.
Zhuye Huangqi Tang: Moves and disperses swelling, suitable for self-diarrhea with persistent deficient heat.
Zhuye (sliced 3 sheng), Huangqi (4 liang), Xiaomai (1 sheng), Shaoyao (3 liang), Gancao (roasted 1 liang), Shigao (ground 2 liang), Renshen (2 liang), Shengma (1 liang), Fuling (2 liang, or 0.7 liang), Guixin (0.6 liang, or 0.3 liang), Danggui (3 liang), Ganzao (dried dates, 14 pieces), Wuweizi (3 liang), Shengjiang (3 liang), Dihuang (dried, 1 liang), Maidong (heart removed, 3 liang), Zhimu (1 liang). Cut ingredients. Boil Zhuye and Xiaomai in 12 sheng of water to obtain 9 sheng. Strain, add remaining herbs, boil to obtain 3 sheng. Divide into four warm doses.
Qianjin Tuoli San (from *Rumen Shinqin*): Treats all Fa Bei and Ding Chuang.
Lianqiao (2.2 qian), Huangqi (1.5 liang), Houpo, Fangfeng, Jiegeng (each 1 liang), Chuanxiong, Baizhi, Shaoyao, Guirui, Gancao (each 1 liang), Muxiang, Moyao (each 3 qian), Ruxiang (3.5 qian), Danggui, Renshen (each 0.5 liang). Pulverize into fine powder. Take 3 qian per dose, decoct in one large cup of wine for three boils, drink warm with dregs.
Dihuang Wan: Regular use prevents Fa Bei for life.
Shudihuang (5 liang), Rongrong (soaked in wine), Tiandong, Shihu, Danggui, Fangfeng, Baifuling, Chuanxiong (each 3 liang), Yuanzhi, Huangqi, Gancao (roasted), Shaoyao (each 2 liang), Renshen, Xixin, Bajitian (each 1 liang). Pulverize, refine honey to make pills the size of paulownia seeds. Take 30 pills per dose, washed down with Jingjie decoction.
Mangcao Gao: Treats Fa Bei abscesses, firm nodules forming pus.
Mangcao, Chuanxiong, Danggui, Xixin, Fuzi (processed), Huangqin, Wutou (processed), Niuxi, Zhizhu, Yegen, Fuling, Fangfeng, Duoheng (each 1 liang), Zhuzhi (half jin). Cut ingredients. Decoct in pig lard, strain, apply to sore twice daily. Avoid pork, cold water, raw vegetables, and strong vinegar.
Shenxian Wanling San: Specifically treats Fa Bei Ding Chuang and all malignant sores.
Jinyinhua (1.5 liang), Zaojiaozhen, Chuanshanjia, Baizhi, Tianhuafen, Gancao Jie, Danggui Wei, Fangfeng, Huoxiang, Chi Shaoyao (each 0.5 liang), Ruxiang (separately ground), Moyao (each 3 qian, separately ground). Coarsely chop. Take 1 liang per dose, with one bowl of water and one bowl of good non-intoxicating wine. Place in sandstone vessel, cover with porcelain plate, seal seams with paper strip. Decoct with gentle fire until equivalent to a heavy cart traveling ten li, until medicinal aroma is reached. Drink hot. Follow with several cups of good wine. Sweating under thick clothing indicates efficacy. Decoct dregs again for second dose. Severe cases require no more than three doses. During preparation, avoid seeing chickens, dogs, or women. For elderly or weak patients, add Huangqi 0.5 liang.
Lianqiao San: Treats Fa Bei swelling, abscesses, aversion to wind, congealed pus and blood.
Lianqiao Zi, Duhuo (rhizome removed), Muxiang, Shegan (each 3 fen), Gancao (roasted and chopped), Sangjisheng (chopped), Shengma, Jishe Xiang, Chenxiang, Ruxiang (ground), Dahuang (chopped and stir-fried 1.1 liang), Shexiang (ground 1 fen). Coarsely grind and sieve. Take 5 qian per dose, with 1.5 cups of water, decoct to 0.8 cup. Add 0.5 he of Danzhuli (bamboo juice), strain, drink warm on an empty stomach. Aim for 3-5 loose stools. If not loose, repeat dose.
Painong Neibu Tiexie San: Treats abscesses and Fa Bei.
Danggui, Renshen, Xixin, Gancao (roasted), Rongrong, Huangqi, Guixin, Fangfeng, Huangqin, Tiexie, Chuanxiong, Shaoyao (equal parts). Make into powder. Take one fangcun bi (measure). Avoid Haizao, Songcai, raw scallions, and sour substances.
Xuanshen San: Treats heat-toxin vapors rushing to the back, initial pain, mental restlessness.
Xuanshen, Huangqin, Danggui, Chi Shaoyao, Maidong (heart removed), Xijiao Xie, Gancao (raw and chopped), Yuanzhi (heart removed), Sheng Gan Dihuang (each 1 liang), Chi Fuling, Chuan Shengma, Renshen (rhizome removed, each 1.5 liang). Make into powder. Take 4 qian per dose, with one medium cup of water, add 14 slices of Zhuye and 50 grains of Xiaomai. Decoct to 0.6 cup, strain, drink warm anytime.
Xijiao San: Treats initial skin sores on head and back, fearing progression to abscess/ulcer, combined with Zang-Fu obstruction, or chills/fever, dry mouth, irritability.
Xijiao Xie (1 liang), Zhimu (3 fen), Mutong (chopped 1 liang), Chi Shaoyao, Chuan Shengma, Qi, Weirui, Huangqin, Gancao (raw, each 3 fen), Maidong (heart removed), Mayaxiao, Chuan Dahuang (chopped, slightly stir-fried, each 1 liang). Make into coarse powder. Take 4 qian per dose.