（附论）
夫漏者。诸 之溃漏也。野狼 、鼠 、蝼蛄 、蜂 、蚍蜉 、蛴螬 、瘰 、转脉
、浮疽 、所谓九 也。野狼 者。由大怒伤阴。气上而不下所致也。鼠 者。由饮食之间。
有虫鼠余毒所致也。蝼蛄 者。因食果瓜虫啖之所致也。蜂 者。因喜饮水即得蜂毒所致也。
蚍蜉 者。因中寒毒腹中胪胀所致也。蛴螬 者。恐惧忧思哭泣不止所致也。浮疽 者。恚
结驰思往返变化所致也。转脉 者。大醉惊呕转侧失枕所致也。瘰 者。则瘰 诸证论
之为详。三因方云。野狼 根于肝。得之忧怒。鼠 根于胃。得之食鼠毒。蝼蛄 根于大肠。
得之食果。蜂 根于脾。得之饮流水有蜂毒。蚍蜉 根于肾。得之食中有蚍蜉毒。蛴螬 根
于心。得之喜怒哭泣。浮疽 根于胆。得之思虑。瘰 漏根于肾。得之新沐发。转脉 根于
小肠。得之惊卧失枕。此等因证。文义不明。未知所始。若以理例较之。怒根在肝。鼠毒在
胃。食瓜果在大肠。蜂水在脾。姑且通俗易晓。如转脉 因惊。根当在胆。却云在小肠。浮
疽因思虑。根当在脾。却云在胆。瘰 因沐发。亦不当在肾。名义不通。似难考据。又况
哭泣得蛴螬之名。思虑得浮疽之名。此尤不可晓也。其外更有风 、冷 、蝎 、蚁 、蜣
螂、蚯蚓 、虾蟆 等。名状不一。谅皆出于土俗。随象命名耳。难以考据。治法观其未
着于肌肉。而外为脓血者。从本引末。可使衰去。针之、灸之、敷之、角之。从其所因。宣
通本脏。皆有成法。甲乙针经寒热瘰 论黄帝问曰。寒热瘰 在于颈腋者。皆何气所生。岐
伯对曰。此皆鼠 寒热之气也。稽留于脉而不去者。鼠 之本。皆在于脏。其末上于颈腋之
间。其浮于脉中。未着于肌肉。而外为脓血者去易。问曰。去之奈何。对曰。请从其末引其
本。可使衰去而绝其寒热。审安其道以予之。徐往徐来以去之。其小如麦者。一刺知。三刺
而已。决其生死法。反其人目视之。其中有赤脉。从上下贯瞳子。见一脉。一岁死。见一脉
半。一岁半死。见二脉。二岁死。见二脉半。二岁半死。见三脉。三岁死。此赤脉不下贯瞳
子者可疗。大抵外伤四气。内窘七情。与夫饮食乖常。染触蠢动含灵之毒。未有不变为 疮。
穿孔一深。脓汁不尽。得冷而风邪并之。于是涓涓而成 矣。漏喜发于项腋。亦喜发于阴僻
肛门之间。疗治失时。即生寒热。不特 能为漏。凡痈疽诸发。随所在处。苟有宿脓败肉朽
骨。停蓄其间。皆一切漏疮之萌 也。圣惠云。 病初发之由不同。至 成于状亦异。病源
所载。复有三十六种。经方不根据次第显其名目也。又有蜣螂、蚯蚓等诸 。非九 之名。
此即应是三十六种 之数也。但 病之生。或因寒暑不调。故血气壅结所作。或因饮食不节
。野狼鼠之精。入于脏腑。毒流筋脉。变化而生。皆能使血脉结聚。寒热相交。久则成脓而溃
漏也。其生身体皮肉者。亦始有结肿。与石疖相似。所可异者。其肿之中。按之垒垒者有数
。核喜发于颈边。或两边俱起。便是瘰证也。亦发两腋下。及两颞 之间。初作喜不痛不热
。若不早治。即生寒热也。所发之处。有轻重。重者有二。一则发口上 。有结核。大小无
定。或如桃李大。此虫之窠止在中。发口下无有核结。而穿成疮。又虫毒之居。或纵横无定。
故发身体。亦有数处。其相应通者多死。治法用祛寒湿。散风冷为急。收水次之。生肌又
次之。藿香、浓朴、半夏、橘皮、苍术、细辛、川芎、白芷。以官桂、干姜一半佐之。此足
以祛寒湿。散风冷矣。然近年漏者。色则淡红。或带微肿。或留小核。久则上而槁白。内而
黑烂。淫虫恶臭生焉。近者不过前药数品。而久者复其元阳。亦当以数品加减而用之。如其
不当用而轻用。又恐热气乘虚。变移结核。夤缘相通。而孔窍为尤甚。若夫收水一节。盖水
属肾也。肾虚不能传道。而后水溢于肾。水溢则渗漉于漏疮。行肾之水。无如黑牵牛。取米
入猪肾。慢火煨熟。随以温酒下之。则借肾入肾。一纵一擒。两得其便。恶水既泄。不复淋
漓。继以当归、黄芩、川芎、官桂、川续断、葫芦巴等。修治细末。佐以发灰。空心温酒调
下。仍以安肾丸、山药丸。兼而济之。庶几肾得所养。真元凝合。夫然后以龙骨、牡蛎、人
齿、犬牙。加之血竭、乳麝发灰。内外相维。生肌必矣。然新肉方生。又当以 肉、猪蹄、
米饭为养。不维滋味益肾。而阳明之生肌肉。亦藉谷气以充之。此则自本自根之论也。
凡项边腋下先作瘰 者。欲作 也。宜禁五辛酒面。及诸热食。凡 者似石痈。瘰 累
然作。 子有核。在两颈及腋下。不痛不热。治者皆炼石散敷其外。内服五香连翘汤下之。
已溃者如治痈法。诸 结核未破。火针针之结核中。无不瘥也。内经云。陷脉为 。留连肉
腠。脉得寒即下陷。凝滞肌肉。故曰留连肉腠。肉冷亦能为脓血。故为冷 。须用温药。陷
脉散。专治 疮。及二三十年瘿瘤。或大或小。如杯盂。经久不瘥。致有漏溃。令人骨肉消
尽。或坚或软或溃。令人惊惕。寐卧不安。体中掣痛。愈而复作者。宜用之。济生方云。稽
云疮当探其深浅。渠在北地时。有一人害 疮于胁间。稽以榆皮细枝刮去皮。取线以绵裹
其尖。以线牢系之。以榆皮探疮中之穴。乃自胁而达于腰。在皮肤之间。遂于病者腰间。
以针决破。用追毒丹三粒。纳于疮中。三日即溃。而胁间之漏遂止。其脓悉自腰间针孔中出。
脓尽则肌肉遂愈。即服狗宝丸。敷乌龙膏、乳香膏、生肌散。并如治痈疽法。
方
皮散（出圣济总录）治诸漏。
皮（半枚炙焦） 蜀椒（去闭口者去子炒出汗） 当归（切焙） 露蜂房（炙焦） 地
榆（醋
炙各三分） 斑蝥（去足翅糯米炒黄） 蛇蜕（锉炒） 乌贼骨（去甲） 葛上亭长（去头
足翅糯米
拌炒各半两） 鲮鲤甲（炙焦四两） 茹（一两） 细辛（去苗叶半两） 樗鸡（四枚四
两） 蜈
蚣（去黄足炒一枚） 蜥蜴（去头足炙一枚） 薏苡仁 干漆（炒烟出用） 蒺藜子（炒去
角） 桂
（去粗皮） 漏芦（去芦头） 木通（锉） 附子（炮制去皮脐） 牡丹皮 龙胆 土瓜根
（各三分）
鹤骨（酒炙） 狸骨（酒炙） 雄黄（研细） 蛇床子 大黄（锉炒） 苦参（各一两半） 上
为细末
。每服二钱半。空心温酒调下日晓再服渐加至三钱半。
治九 方。（出千金方）
皮（半枚） 鲮鲤甲 樗鸡（各四枚） 蜥蜴 蜈蚣（各一枚） 蜀椒 附子 当归 蜂
房
地榆 桂心 通草 干漆 牡丹 薏苡仁 蒺藜子 漏芦（一作 芦） 龙胆（一作龙骨）
土瓜（各二分） 斑蝥（四分） 蛇床子 苦参 大黄 雄黄 蛇蜕 茹 细辛（各二分）
鹤
骨（六分） 上为末。每服五分。温酒调下。以知为度。日二服。
治九 方。（出千金方）
空青 商陆 知母 狸骨 桔梗 防风 荏子 矾石 黄芩 白芷 芍药 甘草（生）
雄黄 白术 矾石 地胆 斑蝥 雌黄（各等分） 上为末。炼蜜丸如豆大。每服三丸。三
十
日知。四十日愈。六十日平复。百日内戒房事。一方为散。醋调服一刀圭。日三。老少减半
服。
续断散（出仁斋直指方）治漏活血。益肾气。续筋脉。
藤子（去积麻炙） 当归 川芎 川续断（洗晒） 黄 （微炙） 葫芦巴（ ） 紫
荆皮
生干地黄（洗晒） 牡蛎粉（各半两） 木香 辣桂（各三钱） 甘草（炙二钱） 上为末。
每服二
钱。空心温酒调下。或加发灰佐之。
温解散（出仁斋直指方）治湿散漏疮风冷。
藿香 浓朴（制） 半夏 橘皮 苍术 细辛 川芎 白芷（各二分） 辣桂 川白姜
（生） 甘草（炙各一分） 上为散。每服三钱。水一盏。生姜枣子煎服。
肝膏（出圣济总录）治诸 瘿遍肿坚硬。或溃。脓血不绝。
皮（炙熟二两） 芍药 芎 细辛（去叶各半两） 牛脂（五钱） 当归（切焙） 蜡
黄
连（去须） 黄芩（去黑心） 松脂（各一两） 上除牛脂、蜡、松脂外。捣为细末。先熬
脂令
沸。下蜡、松脂。销熔。即下诸药末。搅令匀。以瓷合盛。涂疮上。日三度换。
陷脉散（出三因方）治漏疮及三二十年瘿瘤。或大如杯盂。久而不瘥。致有漏
溃。令人骨肉消尽。或坚或软或溃。令人惊惕。寐卧不安。体中掣痛。愈而复作。
干姜（炮） 琥珀（研） 大黄 附子（炮去皮各一两） 丹参（三钱） 石硫黄（研）
白石英
钟乳粉（研） 乌贼鱼骨（研各半两） 上为末。贮以瓷合。韦囊勿令泄气。若疮湿即敷。
无汁
即煎猪脂和敷之。以干为度。或死肌不消。加芒硝二两益佳。一法用胡燕屎一枚。
芫青丸（出千金方）治一切 。
斑蝥（四十枚） 豉（四十九枚） 芫青（二十枚） 生大豆黄 地胆（各十枚） 蜈
蚣（一条
半） 犀角 牛黄（各枣核大） 上为末。炼蜜和丸如桐子大。每服二丸。须臾多作酸浆粥。
冷冻饮料之。病从小便出。尿盆中相视如有虫形状。又似胶汁。此病出也。间日一服。饮粥如常。
小弱者隔三四日。候无虫出。疮渐瘥。特忌油腻。一切器物。皆须灰洗。乃作食。一方以温
酒服之。一方虚闷者可煮食蔓菜羹。后仍作二十日将息。便不须服。
麝香散 治漏疮。
麝香（研） 突厥白 蜣螂 密陀僧（研） 锻石（研） 青蒿心 腻粉 硫黄（研各
半两）
上捣研拌匀。先以盐浆水洗疮。用散子填满疮口。以帛缚定。三两日。若有恶物除去。根据前
换药。如无不用换。不过三两次即瘥。
葛上亭长丸（出圣济总录）治诸漏。
葛上亭长 地胆 斑蝥（三味并去头足翅糯米炒各二十枚） 鼠妇（六十枚炙） 衣中
白鱼
（四十枚） 真珠（研各一分） 槟榔（锉二枚） 雄黄（研） 上为末。炼蜜为丸如桐子
大。每服
三钱。空心温酒下。日晚再服。渐加五丸。
芫青散（出圣惠方）治 有九种。虽久不瘥。不过此方。
芫青（四十枚去头足翅熬） 海藻 昆布（各八分并洗） 雄黄（研八分） 狸骨（炙
三分）
牡蛎（ 四分） 地胆（二十枚熬） 青木香（三分） 上为细末。酒服一钱匕。日二服。
病从小
便出如烂筋。忌生冷面食。猪肉陈臭等物。
桂附丸（出三因方）治气 冷 诸疮。
附子（炮制米醋中浸再炮淬三五次去皮脐） 桂心 浓朴（姜制） 粉草（炙） 白术
（各一
两） 木香（一分） 乳香（二钱别研） 上为细末。炼蜜为丸如桐子大。空腹米饮下二三
十丸。
青金锭子（出外科精要）治诸恶疮脓出不快。及多年疳 疮。愈而复发。
白丁香 铜青 硼砂 粉霜（各五分） 轻粉（一匙） 龙脑（一匙） 麝香（一匙） 上
为细
末。面糊为丸。捻作锭子。每用 入疮口中。脓水出之甚快。
治漏疮。
滑石 轻粉 赤石脂 海螵蛸 腻粉 乳香 明矾 上各等分研细末。以筒子吹药入漏
孔内。一夜再用耳镊子取出孔内败肉。再用荆芥汤洗净。仍复如前用药。
天灵盖膏（出圣惠方）治一切 疮。
天灵盖（一分净洗涂酥炙黄） 虎下颔骨（一分炙黄） 腊月猪脂（四两） 附子（一
分炮
炙去皮脐） 人参（一两去芦头） 铁精（一分） 川乌头（一两炮制去皮脐） 上为细末。
用猪
脂和令稀稠得所。四畔涂之。不得侵疮口。
麝香丸 治漏疮 疮。
麝香（研） 石胆（研） 腻粉（研） 杏仁（去皮尖双仁炒各一分） 香鼠（一枚去
肠胃洗净
炙干） 巴豆（一粒去皮心膜出油尽） 上为末。用面糊和丸如黍米大。 在疮内。一日一
二
次。
通治诸 方。
斑蝥（一枚一方云三分去头足翅） 杜蘅 枳壳根 酸枣根 虎蓟根 猫蓟根（各一把）
上捣细末蜜和丸。每日一服。加枣一枚。以丸着疮口中。
漏疮方。
真龙骨 蜂房（炙黄各三钱） 黄丹（ ） 降真节 五倍子 枯骸骨（瓦 各一钱） 上
为
细末敷之。凡恶核漏疮。并戒怒气。不然。核大而漏。则水多也。
安息膏（出存仁方）治脓水不绝。骨中疼痛成漏。
安息香 花乳石（火 红） 血竭 乳香（各半钱） 麝香（减半） 上为细末。用蜡
少许。
入麻油些小同熔开。将药捻作米粒大。根据前方看大小深浅逐件屑入药于疮孔中。以满为度。
药透内。从内生肉。一二日。退出一粒。渐生肉渐退出。出尽则疮中自然平复。其功效如神。
如疮口冷痛浅阔。只用少许干敷。
治漏疮。
木香 丁香 乳香 麝香（研各三钱） 黑牵牛（头末） 上分作十服。每服乌鸡子一
个。
去其黄。用白调药。再入鸡子壳内。用顶盖头纸糊定。于饭甑上蒸熟。取出细嚼。温酒下之。
（附论）
所谓“漏”，是指各种疮疡溃破后长期流脓流水的病症。野狼瘘、鼠瘘、蝼蛄瘘、蜂瘘、蚍蜉瘘、蛴螬瘘、瘰疬瘘、转脉瘘、浮疽瘘，这被称为“九瘘”。
野狼瘘，是由大怒伤及阴气，导致气机上逆而不能下行所引起。
鼠瘘，是由于饮食过程中，受到老鼠残留毒素的影响所致。
蝼蛄瘘，是因为食用了被虫啃食的瓜果而引发。
蜂瘘，是因为喜欢喝生水，摄入了水中蜜蜂的毒素所致。
蚍蜉瘘，是因为感受寒毒，导致腹部胀满所致。
蛴螬瘘，是由于恐惧、忧思、哭泣不止所致。
浮疽瘘，是由于愤怒郁结、思虑往返变化所致。
转脉瘘，是因为大醉后惊恐呕吐，翻身时失枕所致。
瘰疬瘘，关于瘰疬的各种证候论述已经非常详细。《三因方》说：野狼瘘根源于肝，由忧怒引起；鼠瘘根源于胃，由食用鼠毒引起；蝼蛄瘘根源于大肠，由食果引起；蜂瘘根源于脾，由饮用含有蜂毒的流水引起；蚍蜉瘘根源于肾，由食物中含有蚍蜉毒引起；蛴螬瘘根源于心，由喜怒哭泣引起；浮疽瘘根源于胆，由思虑引起；瘰疬瘘根源于肾，由刚洗完头受风引起；转脉瘘根源于小肠，由惊恐卧睡失枕引起。这些病因和证候的描述，文义不明确，不知始于何处。如果按医理推究，怒伤肝，鼠毒在胃，食瓜果在大肠，蜂水在脾，尚且通俗易懂。但如转脉瘘因惊恐，病根应当在胆，却说在小肠；浮疽瘘因思虑，病根应当在脾，却说在胆；瘰疬瘘因洗头受风，也不应当在肾。名义不通，似乎难以考证。更何况因为哭泣得名蛴螬瘘，因为思虑得名浮疽瘘，这更加令人不解。此外还有风瘘、冷瘘、蝎瘘、蚁瘘、蜣螂瘘、蚯蚓瘘、虾蟆瘘等，名称形状不一，估计都出于民间习俗，随形象命名罢了，难以考证。治疗方法观察那些尚未深入肌肉，而在外部表现为脓血的，从本源引导至末梢，可以使病情衰退消退。用针刺、艾灸、外敷、角法治疗，针对其病因，宣通本脏，都有成熟的方法。
《甲乙经·寒热瘰疬论》记载：黄帝问：颈腋部发生的寒热瘰疬，是什么气引起的？岐伯回答：这都是鼠瘘的寒热之气。稽留于经脉而不散去，鼠瘘的根本都在内脏，其末梢上行到颈腋之间。那些浮在脉中，尚未附着在肌肉，而在外部化为脓血的，容易去除。问：如何去除？答：请从末梢引导本源，可以使病情衰退并断绝寒热。仔细安定其道给予治疗，缓慢进针缓慢出针以去除病邪。小的如麦粒大小，刺一次见效，刺三次痊愈。判断生死的法则：观察患者的眼睛，如果有赤色的脉络从上向下贯穿瞳孔，见一条脉，一年死；见一条半脉，一年半死；见两条脉，两年死；见两条半脉，两年半死；见三条脉，三年死。这些赤色脉络不向下贯穿瞳孔的可以治疗。
大抵外伤四时不正之气，内受七情困扰，以及饮食失常，感染虫兽有毒生物的毒素，没有不变成瘘疮的。穿孔一旦深，脓汁排不尽，遇到寒冷和风邪夹杂，于是涓涓不绝而成漏症。漏症喜欢发于颈部腋下，也喜欢发于阴部肛门之间。治疗不及时，就会发生寒热。不仅仅是鼠瘘能成漏，凡是痈疽各种发作，随所在之处，如果有宿存的脓液、败肉、朽骨，停蓄在其中，都是各种漏疮的萌芽。
《圣惠方》说：瘘病初发的原因不同，等到形成瘘后的症状也各异。《病源》记载有三十六种，经方不按次序显明其名目。又有蜣螂、蚯蚓等各种瘘，不属于九瘘之名，这应该就是三十六种瘘的数量。但是瘘病的产生，或因寒暑不调，导致气血壅结所作；或因饮食不节，野狼鼠的精气进入脏腑，毒流筋脉，变化而生，都能使血脉结聚，寒热相交，久了化脓而溃漏。发生在身体皮肉的，起初也有结肿，与石疖相似。不同的是，肿块中间按压感觉累累有核，喜欢发在颈边，或者两边都起，就是瘰疬证。也发在两腋下及两太阳穴之间。初起喜欢不痛不热，如果不早治，就会发生寒热。发病的地方有轻重之分，重的有两种。一种是发在口上，有结核，大小不定，有的像桃李大，这是虫的巢穴只在中焦；发在口下没有核结，而是穿成疮。另外虫毒居住的地方，或纵横不定，所以发在身体各处，也有多处。相互对应的多会死亡。治疗方法以祛寒湿、散风冷为急，收敛渗水次之，生肌又次之。用药如藿香、厚朴、半夏、橘皮、苍术、细辛、川芎、白芷，用官桂、干姜一半作为佐药。这足以祛寒湿、散风冷了。然而近年来的漏症，颜色淡红，或带微肿，或留有小结节，久了上面干枯发白，里面黑烂，生出淫虫恶臭。近期的不过用前面几种药，久病的恢复元阳，也应当用几味药加减使用。如果不当用而轻用，又恐热气乘虚而入，改变移易结核，蔓延相通，孔窍尤为严重。至于收敛渗水这一节，水属肾，肾虚不能传导，而后水溢于肾。水溢则渗漏于漏疮。行肾之水，没有比黑牵牛更好的。取米放入猪肾，慢火煨熟，随即用温酒送下，则是借肾入肾，一纵一擒，两得其便。恶水既已泄出，不再淋漓。继以当归、黄芩、川芎、官桂、川续断、葫芦巴等，修治成细末，佐以头发灰，空腹温酒调下。仍以安肾丸、山药丸，兼而补益。这样肾得到滋养，真元凝合。然后以龙骨、牡蛎、人齿、犬牙，加上血竭、乳香、麝香、发灰，内外相维，生肌必然成功。然而新肉刚刚生长，又应当以羊肉、猪蹄、米饭来调养，不仅滋味益肾，而且阳明经生成肌肉，也借助谷气来充实它。这是自本自根的理论。
凡是颈边腋下先作瘰疬的，想要成为瘘症。应当禁忌五辛、酒面以及各种热食。凡瘘症似石痈，瘰疬累累发作，瘘子有核，在两颈及腋下，不痛不热。治疗者都炼石散敷在外面，内服五香连翘汤攻下。已经溃破的像治疗痈的方法。各种瘘结核未破的，用火针针刺结核中心，无不痊愈。《内经》说：陷脉为瘘，留连于肉腠。脉得寒邪即下陷，凝滞肌肉，所以说留连肉腠。肉冷也能化为脓血，所以叫冷瘘。必须用温药。陷脉散专门治疗瘘疮，以及二三十年的瘿瘤，或大或小，如杯盂，经久不愈，导致有漏溃，使人骨肉消尽，或坚或软或溃，使人惊惕，睡眠不安，体内掣痛，好了又复发的，适宜使用。
《济生方》说：稽云疮应当探查其深浅。他在北方时，有一人在胁间患瘘疮，稽云用榆皮细枝刮去皮，取线裹住尖端，用线牢固系住，以榆皮探查疮中的穴位，竟然从胁间直达腰部，在皮肤之间。于是在患者腰间，用针决破，用追毒丹三粒，纳入疮中，三天就溃破，而胁间的漏症就停止了。脓液全部从腰间针孔中流出，脓尽则肌肉遂愈。随即服用狗宝丸，敷乌龙膏、乳香膏、生肌散，都像治疗痈疽的方法。
方剂：
皮散（出自《圣济总录》）治疗各种漏症。
皮（半枚，炙焦）、蜀椒（去闭口者，去子，炒出汗）、当归（切，焙）、露蜂房（炙焦）、地榆（醋炙，各三分）、斑蝥（去足翅，糯米炒黄）、蛇蜕（锉，炒）、乌贼骨（去甲）、葛上亭长（去头足翅，糯米拌炒，各半两）、鲮鲤甲（炙焦，四两）、茹（一两）、细辛（去苗叶，半两）、樗鸡（四枚，四两）、蜈蚣（去黄足，炒，一枚）、蜥蜴（去头足，炙，一枚）、薏苡仁、干漆（炒烟出用）、蒺藜子（炒去角）、桂（去粗皮）、漏芦（去芦头）、木通（锉）、附子（炮制，去皮脐）、牡丹皮、龙胆、土瓜根（各三分）、鹤骨（酒炙）、狸骨（酒炙）、雄黄（研细）、蛇床子、大黄（锉炒）、苦参（各一两半）。以上为细末。每服二钱半，空腹温酒调下，早晨再服，逐渐加至三钱半。
治九瘘方（出自《千金方》）：
皮（半枚）、鲮鲤甲、樗鸡（各四枚）、蜥蜴、蜈蚣（各一枚）、蜀椒、附子、当归、蜂房、地榆、桂心、通草、干漆、牡丹、薏苡仁、蒺藜子、漏芦（一作芦）、龙胆（一作龙骨）、土瓜（各二分）、斑蝥（四分）、蛇床子、苦参、大黄、雄黄、蛇蜕、茹、细辛（各二分）、鹤骨（六分）。以上为末。每服五分，温酒调下，以见效为度，日服两次。
治九瘘方（出自《千金方》）：
空青、商陆、知母、狸骨、桔梗、防风、荏子、矾石、黄芩、白芷、芍药、甘草（生）、雄黄、白术、矾石、地胆、斑蝥、雌黄（各等分）。以上为末，炼蜜丸如豆大。每服三丸，三十天见效，四十天痊愈，六十天平复。百日内戒房事。一方为散，醋调服一刀圭，日服三次，老少减半服。
续断散（出自《仁斋直指方》）治疗漏症活血，益肾气，续筋脉。
藤子（去积麻，炙）、当归、川芎、川续断（洗晒）、黄芪（微炙）、葫芦巴（炒）、紫荆皮、生干地黄（洗晒）、牡蛎粉（各半两）、木香、辣桂（各三钱）、甘草（炙二钱）。以上为末。每服二钱，空腹温酒调下。或加发灰佐之。
温解散（出自《仁斋直指方》）治疗湿散漏疮风冷。
藿香、厚朴（制）、半夏、橘皮、苍术、细辛、川芎、白芷（各二分）、辣桂、川白姜（生）、甘草（炙，各一分）。以上为散。每服三钱，水一盏，生姜枣子煎服。
肝膏（出自《圣济总录》）治疗各种瘘瘿遍肿坚硬，或溃破，脓血不绝。
皮（炙熟，二两）、芍药、川芎、细辛（去叶，各半两）、牛脂（五钱）、当归（切，焙）、黄连（去须）、黄芩（去黑心）、松脂（各一两）。除牛脂、蜡、松脂外，捣为细末。先熬脂令沸，下蜡、松脂，销熔，即下诸药末，搅令匀。以瓷盒盛，涂疮上，日换三次。
陷脉散（出自《三因方》）治疗漏疮及三二十年瘿瘤，或大如杯盂，久而不愈，导致有漏溃，使人骨肉消尽，或坚或软或溃，使人惊惕，睡眠不安，体内掣痛，好了又复发的。
干姜（炮）、琥珀（研）、大黄、附子（炮，去皮，各一两）、丹参（三钱）、石硫黄（研）、白石英、钟乳粉（研）、乌贼鱼骨（研，各半两）。以上为末，贮以瓷盒，韦囊包裹勿令泄气。若疮湿即敷，无汁即煎猪脂和敷之，以干为度。或死肌不消，加芒硝二两更佳。一法用胡燕屎一枚。
芫青丸（出自《千金方》）治疗一切瘘。
斑蝥（四十枚）、豉（四十九枚）、芫青（二十枚）、生大豆黄、地胆（各十枚）、蜈蚣（一条半）、犀角、牛黄（各枣核大）。以上为末，炼蜜和丸如桐子大。每服二丸，须臾多作酸浆粥，冷冻饮料之。病从小便出，尿盆中相视如有虫形状，又似胶汁，此病出也。间日一服，饮粥如常。小弱者隔三四日，候无虫出，疮渐愈。特忌油腻，一切器物，皆须灰洗，乃作食。一方以温酒服之，一方虚闷者可煮食蔓菜羹，后仍作二十日将息，便不须服。
麝香散 治疗漏疮。
麝香（研）、突厥白、蜣螂、密陀僧（研）、锻石（研）、青蒿心、腻粉、硫黄（研，各半两）。以上捣研拌匀。先以盐浆水洗疮，用散子填满疮口，以帛缚定。三两日，若有恶物除去，根据前换药。如无不用换。不过三两次即愈。
葛上亭长丸（出自《圣济总录》）治疗各种漏症。
葛上亭长、地胆、斑蝥（三味并去头足翅，糯米炒，各二十枚）、鼠妇（六十枚，炙）、衣中白鱼（四十枚）、真珠（研，各一分）、槟榔（锉，二枚）、雄黄（研）。以上为末，炼蜜为丸如桐子大。每服三钱，空腹温酒下，日晚再服，渐加五丸。
芫青散（出自《圣惠方》）治疗瘘有九种，虽久不愈，不过此方。
芫青（四十枚，去头足翅，熬）、海藻、昆布（各八分，并洗）、雄黄（研，八分）、狸骨（炙，三分）、牡蛎（煅，四分）、地胆（二十枚，熬）、青木香（三分）。以上为细末，酒服一钱匕，日二服。病从小便出如烂筋，忌生冷面食、猪肉陈臭等物。
桂附丸（出自《三因方》）治疗气瘘冷瘘诸疮。
附子（炮制，米醋中浸再炮淬三五次，去皮脐）、桂心、厚朴（姜制）、粉草（炙）、白术（各一两）、木香（一分）、乳香（二钱，别研）。以上为细末，炼蜜为丸如桐子大。空腹米饮下二三十丸。
青金锭子（出自《外科精要》）治疗各种恶疮脓出不快，及多年疳漏疮，愈而复发。
白丁香、铜青、硼砂、粉霜（各五分）、轻粉（一匙）、龙脑（一匙）、麝香（一匙）。以上为细末，面糊为丸，捻作锭子。每用纳入疮口中，脓水出之甚快。
治漏疮。
滑石、轻粉、赤石脂、海螵蛸、腻粉、乳香、明矾。以上各等分研细末，以筒子吹药入漏孔内。一夜再用耳镊子取出孔内败肉，再用荆芥汤洗净，仍复如前用药。
天灵盖膏（出自《圣惠方》）治疗一切瘘疮。
天灵盖（一分，净洗涂酥炙黄）、虎下颔骨（一分，炙黄）、腊月猪脂（四两）、附子（一分，炮炙，去皮脐）、人参（一两，去芦头）、铁精（一分）、川乌头（一两，炮制，去皮脐）。以上为细末，用猪脂和令稀稠得所，四畔涂之，不得侵疮口。
麝香丸 治疗漏疮瘘疮。
麝香（研）、石胆（研）、腻粉（研）、杏仁（去皮尖双仁炒，各一分）、香鼠（一枚，去肠胃洗净，炙干）、巴豆（一粒，去皮心膜出油尽）。以上为末，用面糊和丸如黍米大，纳入疮内，一日一二次。
通治诸瘘方。
斑蝥（一枚，一方云三分，去头足翅）、杜蘅、枳壳根、酸枣根、虎蓟根、猫蓟根（各一把）。以上捣细末，蜜和丸。每日一服，加枣一枚，以丸着疮口中。
漏疮方。
真龙骨、蜂房（炙黄，各三钱）、黄丹（煅）、降真节、五倍子、枯骸骨（瓦煅，各一钱）。以上为细末敷之。凡恶核漏疮，并戒怒气，不然，核大而漏，则水多也。
安息膏（出自《存仁方》）治疗脓水不绝，骨中疼痛成漏。
安息香、花乳石（火煅红）、血竭、乳香（各半钱）、麝香（减半）。以上为细末，用蜡少许，入麻油些小同熔开，将药捻作米粒大，根据前方看大小深浅逐件屑入药于疮孔中，以满为度。药透内，从内生肉，一二日，退出一粒，渐生肉渐退出，出尽则疮中自然平复，其功效如神。如疮口冷痛浅阔，只用少许干敷。
治漏疮。
木香、丁香、乳香、麝香（研，各三钱）、黑牵牛（头末）。以上分作十服，每服乌鸡子一个，去其黄，用白调药，再入鸡子壳内，用顶盖头纸糊定，于饭甑上蒸熟，取出细嚼，温酒下之。
(Attached Discussion)
The term "Lou" (Fistula/Draining Sinus) refers to various sores that have ulcerated and continuously discharge pus and fluid. The Wild Wolf Lou, Rat Lou, Mole Cricket Lou, Bee Lou, Ant Lou, White Ant Lou, Scrofula Lou, Turning Pulse Lou, and Floating Carbuncle Lou are collectively known as the "Nine Lous."
Wild Wolf Lou is caused by severe anger injuring Yin, leading to Qi ascending without descending.
Rat Lou is caused by exposure to residual toxins from rats during eating.
Mole Cricket Lou results from consuming fruits or melons bitten by insects.
Bee Lou occurs due to a preference for drinking water contaminated with bee venom.
Ant Lou arises from contracting cold pathogens causing abdominal distension.
White Ant Lou is caused by excessive fear, worry, and incessant weeping.
Floating Carbuncle Lou stems from anger accumulation and fluctuating thoughts.
Turning Pulse Lou is induced by drunkenness, shock, vomiting, turning over, and losing proper pillow support.
Scrofula Lou: Discussions on various syndromes of Scrofula are already detailed. *San Yin Fang* states: Wild Wolf Lou originates in the Liver, caused by sorrow and anger; Rat Lou originates in the Stomach, caused by rat toxin; Mole Cricket Lou originates in the Large Intestine, caused by eating fruit; Bee Lou originates in the Spleen, caused by drinking flowing water with bee toxin; Ant Lou originates in the Kidney, caused by ant toxin in food; White Ant Lou originates in the Heart, caused by joy, anger, and weeping; Floating Carbuncle Lou originates in the Gallbladder, caused by rumination; Scrofula Lou originates in the Kidney, caused by washing hair recently; Turning Pulse Lou originates in the Small Intestine, caused by shock while sleeping without a pillow. These etiological descriptions are unclear in meaning and origin. Applying medical logic, anger affects the Liver, rat toxin affects the Stomach, eating fruit affects the Large Intestine, and bee water affects the Spleen, which are understandable. However, Turning Pulse Lou due to shock should root in the Gallbladder, yet it is said to be in the Small Intestine; Floating Carbuncle Lou due to rumination should root in the Spleen, yet it is said to be in the Gallbladder; Scrofula Lou due to washing hair should not be in the Kidney. The nomenclature is inconsistent and difficult to verify. Furthermore, naming White Ant Lou after weeping and Floating Carbuncle Lou after rumination is particularly inexplicable. Additionally, there are Wind Lou, Cold Lou, Scorpion Lou, Ant Lou, Dung Beetle Lou, Earthworm Lou, Toad Lou, etc., with varied names and shapes, likely originating from local customs and named after their appearances, making verification difficult. Treatment methods: For those not yet penetrating the muscle but presenting externally as pus and blood, guide from the root to the branch to reduce the condition. Use acupuncture, moxibustion, topical application, and cupping therapies. Address the cause and promote circulation in the affected Zang-Fu organ, following established protocols.
*Jia Yi Zhen Jing* (Systematic Classic of Acupuncture and Moxibustion), Chapter on Cold-Heat Scrofula: The Yellow Emperor asked, "What Qi generates cold-heat scrofula in the neck and axilla?" Qibo replied, "These are all cold-heat Qi of Rat Lou. When it lingers in the meridians without dispersing, the root lies within the Zang organs, and the branch ascends to the neck and axilla. Those floating in the vessels, not yet adhering to muscles but externalizing as pus and blood, are easy to remove." Asked how to remove them, he answered, "Guide from the branch to the root to make it decline and cut off the cold-heat. Carefully stabilize its pathway and treat it. Enter and withdraw the needle slowly to dispel the pathogen. For small nodules like wheat grains, one insertion brings improvement, three insertions cure. The method for determining life and death: Observe the patient's eyes. If red vessels penetrate the pupil vertically from top to bottom, seeing one vessel indicates death in one year; one and a half vessels, one and a half years; two vessels, two years; two and a half vessels, two and a half years; three vessels, three years. Red vessels not penetrating the pupil can be treated."
Generally, external injury from the Four Qi (seasonal pathogens), internal distress from the Seven Emotions, irregular diet, and infection with toxins from insects or animals will inevitably transform into Fistula Sores. Once the perforation is deep and pus is not fully discharged, combined with cold and wind pathogens, it becomes a chronic draining sinus. Fistulas often occur in the neck and axilla, and also between the genitals and anus. Delayed treatment leads to chills and fever. Not only Rat Lou can become a fistula; any abscess or carbuncle, wherever located, if retaining old pus, necrotic flesh, or rotten bone, serves as the germ of all fistula sores.
*Sheng Hui Fang* states: The initial causes of fistula vary, and the resulting manifestations differ. *Bing Yuan* records thirty-six types, but classical formulas do not list them sequentially. There are also Dung Beetle, Earthworm, and other fistulas, not part of the Nine Lous, totaling the thirty-six types. Fistulas arise from imbalance of cold and heat causing Qi and Blood stagnation, or irregular diet allowing essences of wild wolves or rats to enter the Zang-Fu, spreading toxicity through sinews and vessels, transforming into disease. This causes blood vessel aggregation and cold-heat interaction, eventually suppurating and ulcerating. Those appearing on skin and flesh initially present as nodular swelling similar to Stone Boils. The difference is the presence of multiple hard nodules upon pressure, commonly found on the sides of the neck or bilaterally, indicating Scrofula syndrome. It also appears in the axillae and temples. Initially painless and non-febrile; if untreated, chills and fever develop. Severity varies. Severe cases include two types: one appears above the mouth with nodules of varying sizes, sometimes like plums or peaches, where the insect nest remains central; below the mouth, no nodules form, but ulcers develop. Insect toxins may spread纵横 (crisscross), affecting multiple body sites. Corresponding bilateral lesions often result in death. Treatment prioritizes dispelling cold-dampness and wind-cold, followed by drying dampness, then generating flesh. Herbs include Huo Xiang (Agastache Rhizome), Hou Po (Magnolia Bark), Ban Xia (Pinellia Tuber), Ju Pi (Citrus Peel), Cang Zhu (Atractylodes Rhizome), Xi Xin (Asarum Root), Chuan Xiong (Ligusticum Rhizome), Bai Zhi (Angelica Dahurica Root), assisted by Guan Gui (Cinnamon Twig) and Gan Jiang (Dried Ginger). This sufficiently dispels cold-dampness and wind-cold. However, recent fistulas appear pale red, slightly swollen, or retain small nodules, eventually becoming dry white externally and blackened internally with foul-smelling parasites. Recent cases use the aforementioned herbs; chronic cases restore Yuan Yang using modified prescriptions. Improper use may allow Heat Qi to invade deficiency, altering nodules and spreading through channels, worsening orifices. Regarding drying dampness: Water belongs to the Kidney. Kidney deficiency fails to transport fluids, causing water overflow. Overflowing water seeps into fistulas. To move Kidney water, Hei Qian Niu (Black Morning Glory Seed) is best. Mix rice with Pig Kidney, slow-cook, and take with warm wine. This enters the Kidney via the Kidney, balancing retention and release. Once evil water drains, dripping stops. Follow with Dang Gui (Angelica Sinensis Root), Huang Qin (Scutellaria Root), Chuan Xiong, Guan Gui, Chuan Xu Duan (Dipsacus Root), Hu Lu Ba (Trigonella Foenum-Graecum Seed), processed into fine powder, aided by Fa Hui (Hair Ash), taken with warm wine on an empty stomach. Also combine An Shen Wan (Calming Kidney Pill) and Shan Yao Wan (Dioscorea Pill) to nourish the Kidney and consolidate True Yuan. Then use Long Gu (Fossilized Bone), Mu Li (Oyster Shell), Ren Chi (Human Tooth), Quan Ya (Dog Tooth), mixed with Xue Jie (Dragon's Blood), Ru Xiang (Frankincense), She Xiang (Musk), and Fa Hui, coordinating internal and external effects to generate flesh. As new flesh grows, nourish with Lamb Meat, Pig Trotters, and Rice. This not only benefits the Kidney through taste but also supports the Yangming channel's flesh generation via grain Qi. This is the theory of rooting in the source.
For Scrofula first appearing in the neck or axilla, intending to become a fistula, prohibit Five Pungent Spices, alcohol, wheat products, and hot foods. Fistulas resemble Stone Abscesses; Scrofula nodules appear bilaterally in the neck and axillae, painless and non-febrile. Treat externally with Lian Shi San (Refined Stone Powder) and internally with Wu Xiang Lian Qiao Tang (Five-Spice Forsythia Decoction) to purge. Ulcerated cases follow abscess treatment protocols. Unruptured nodules are punctured with fire needles, ensuring recovery. *Nei Jing* states: Depressed meridians form fistulas, lingering in muscle tissue. Meridians sinking due to cold stagnate in muscles, hence "lingering in muscle tissue." Cold flesh generates pus and blood, termed Cold Fistula. Warm herbs are required. Xian Mai San (Depressed Meridian Powder) treats fistulas and Goiters lasting decades, varying in size like cups, unhealed, causing emaciation, hardness, softness, or ulceration, palpitations, insomnia, and twitching pain, recurring after healing.
*Ji Sheng Fang* notes: Ji Yun Chuores require depth assessment. In the North, a patient had a fistula between ribs. Ji Yun used elm bark twigs, scraped clean, wrapped thread around the tip, tied securely, and probed the wound from rib to waist subcutaneously. Punctured the waist with a needle, inserted three pills of Zhui Du Dan (Poison-Chasing Pill). Ulcerated in three days, stopping the fistula. Pus drained entirely from the waist puncture; muscles healed upon pus cessation. Administer Gou Bao Wan (Dog Gallstone Pill), apply Wu Long Gao (Black Dragon Ointment), Ru Xiang Gao (Frankincense Ointment), and Sheng Ji San (Flesh-Generating Powder), following abscess protocols.
Formulas:
Pi San (Skin Powder, from *Sheng Ji Zong Lu*) treats various fistulas.
Pi (Half piece, scorched), Shu Jiao (Sichuan Pepper, remove closed ones, remove seeds, stir-fry until sweat appears), Dang Gui (Cut, baked), Lu Feng Fang (Honeycomb, scorched), Di Yu (Sedge Root, vinegar-fried, each 3 fen), Ban Mao (Blister Beetle, remove feet/wings, stir-fry with glutinous rice until yellow), She Tui (Snake Slough, crushed, fried), Ou Ze Gu (Cuttlefish Bone, remove shell), Ge Shang Ting Zhang (Tortoise Beetle, remove head/feet/wings, stir-fry with glutinous rice, each 0.5 liang), Ling Li Jia (Pangolin Scale, scorched, 4 liang), Ru (1 liang), Xi Xin (Remove seedlings/leaves, 0.5 liang), Chu Ji (4 pieces, 4 liang), Wu Gong (Centipede, remove yellow feet, fried, 1 piece), Xi Yi (Lizard, remove head/feet, roasted, 1 piece), Yi Yi Ren (Coix Seed), Gan Qi (Dry Resin, stir-fry until smoke appears), Ji Li Zi (Tribulus Fruit, stir-fry remove spines), Gui (Cinnamon, remove rough bark), Lou Lu (Euphorbia Root, remove rhizome), Mu Tong (Akebia Stem, crushed), Fu Zi (Aconite Root, processed, remove skin/navel), Mu Dan Pi (Moutan Cortex), Long Dan (Gentian Root), Tu Gua Gen (Trichosanthes Root, each 3 fen), He Gu (Crane Bone, wine-roasted), Li Gu (Fox Bone, wine-roasted), Xiong Huang (Realgar, finely ground), She Chuang Zi (Cnidium Fruit), Da Huang (Rhubarb Root, crushed/fried), Ku Shen (Sophora Root, each 1.5 liang). Process into fine powder. Take 2.5 qian with warm wine on an empty stomach, repeat in the morning, gradually increase to 3.5 qian.
Treating Nine Lous Formula (from *Qian Jin Fang*):
Pi (Half piece), Ling Li Jia, Chu Ji (4 pieces each), Xi Yi, Wu Gong (1 piece each), Shu Jiao, Fu Zi, Dang Gui, Feng Fang, Di Yu, Gui Xin (Cinnamon Heart), Tong Cao (Tetrapanax Pith), Gan Qi, Mu Dan (Peony Root Bark), Yi Yi Ren, Ji Li Zi, Lou Lu (or Lu Lu), Long Dan (or Long Gu/Fossilized Bone), Tu Gua (each 2 fen), Ban Mao (4 fen), She Chuang Zi, Ku Shen, Da Huang, Xiong Huang, She Tui, Ru, Xi Xin (each 2 fen), He Gu (6 fen). Process into powder. Take 5 fen with warm wine, until effective, twice daily.
Another Treating Nine Lous Formula (from *Qian Jin Fang*):
Kong Qing (Azurite), Shang Lu (Phytolacca Root), Zhi Mu (Anemarrhena Rhizome), Li Gu, Jie Geng (Platycodon Root), Fang Feng (Saposhnikovia Root), Ren Zi (Perilla Seed), Fan Shi (Alum), Huang Qin, Bai Zhi, Shao Yao (Peony Root), Gan Cao (Licorice Root, raw), Xiong Huang, Bai Zhu (Atractylodes Macrocephala Rhizome), Fan Shi, Di Dan (Ground Beetle), Ban Mao, Ci Huang (Orpiment, equal parts). Process into powder, honey-pilulate like bean seeds. Take 3 pills, effective in 30 days, cured in 40 days, recovered in 60 days. Abstain from sexual activity for 100 days. Alternative: Powder form, mix with vinegar, take one Dao Gui, three times daily, half dose for elderly/children.
Xu Duan San (Teasel Root Powder, from *Ren Zhai Zhi Zhi Fang*) treats fistulas, invigorates blood, tonifies Kidney Qi, reconnects sinews and vessels.
Teng Zi (Vine Seed, remove impurities, roast), Dang Gui, Chuan Xiong, Chuan Xu Duan (Wash/Dry), Huang Qi (Astragalus Root, lightly roasted), Hu Lu Ba (Roasted), Zi Jing Pi (Bauhinia Bark), Sheng Gan Di Huang (Rehmannia Root, Wash/Dry), Mu Li Fen (Oyster Shell Powder, each 0.5 liang), Mu Xiang (Costus Root), La Gui (Cinnamon Twig, each 3 qian), Gan Cao (Licorice Root, roasted, 2 qian). Process into powder. Take 2 qian with warm wine on an empty stomach. Optionally add Fa Hui.
Wen Jie San (Warm Dispersion Powder, from *Ren Zhai Zhi Zhi Fang*) treats dampness, dissipates wind-cold in fistula sores.
Huo Xiang, Hou Po (Processed), Ban Xia, Ju Pi, Cang Zhu, Xi Xin, Chuan Xiong, Bai Zhi (each 2 fen), La Gui, Chuan Bai Jiang (Raw Ginger), Gan Cao (Roasted, each 1 fen). Process into powder. Take 3 qian with one bowl of water, decoct with Fresh Ginger and Jujube.
Gan Gao (Liver Ointment, from *Sheng Ji Zong Lu*) treats various fistulas/goiters with diffuse swelling, hardness, or ulceration with continuous pus/blood.
Pi (Roasted cooked, 2 liang), Shao Yao, Xiong (Chuan Xiong), Xi Xin (Remove leaves, each 0.5 liang), Niu Zhi (Cow Fat, 5 qian), Dang Gui (Cut/Baked), Huang Lian (Coptis Rhizome, remove stamens), Huang Qin, Song Zhi (Pine Rosin, each 1 liang). Except for Cow Fat, Beeswax, and Pine Rosin, process into fine powder. Boil fat, melt wax and rosin, add herb powders, mix well. Store in porcelain jar, apply to sore, change three times daily.
Xian Mai San (Depressed Meridian Powder, from *San Yin Fang*) treats fistulas and goiters lasting 20-30 years, large as cups, unhealed, causing ulceration, emaciation, hardness/softness/ulceration, palpitations, insomnia, twitching pain, recurrence.
Gan Jiang (Dried Ginger, processed), Hu Po (Amber, ground), Da Huang, Fu Zi (Processed, remove skin/navel, each 1 liang), Dan Shen (Salvia Root, 3 qian), Shi Liu Huang (Flower Sulfur, ground), Bai Shi Ying (Quartz), Zhong Ru Fen (Stalactite Powder, ground), Ou Ze Yu Gu (Cuttlefish Bone, ground, each 0.5 liang). Process into powder, store in porcelain jar, wrap in leather to prevent air leakage. Apply if wet; if dry, mix with boiled pig fat and apply until dry. If dead flesh persists, add Mang Xiao (Mirabilite, 2 liang) for better effect. Alternative: Use one Hu Yan Shi (Swallow Droppings).
Yuan Qing Wan (Blister Beetle Pill, from *Qian Jin Fang*) treats all fistulas.
Ban Mao (40 pieces), Chi (Fermented Soybean, 49 pieces), Yuan Qing (Blister Beetle, 20 pieces), Sheng Da Dou Huang (Yellow Soybean Hull), Di Dan (Ground Beetle, each 10 pieces), Wu Gong (Centipede, 1.5 pieces), Xi Jiao (Rhinoceros Horn), Niu Huang (Calculus Bovis, each pit-sized). Process into powder, mix with honey, pill like sesame seeds. Take 2 pills, soon after drink cold sour porridge soup. Pathogen exits via urine; observe urine basin for worm-like shapes or glue-like fluid, indicating disease exit. Take every other day, drink porridge normally. For weak patients, wait 3-4 days until no worms exit, sores heal. Strictly avoid greasy food; wash all utensils with ash before cooking. Alternative: Take with warm wine; for deficiency/distress, cook Man Cai Geng (Malva Soup); rest for 20 days, no need to continue medication.
She Xiang San (Musk Powder) treats fistula sores.
She Xiang (Musk, ground), Tu Jue Bai (White Rabbit Fur?), Chang Lang (Dung Beetle), Mi Duo Seng (Litharge, ground), Duan Shi (Calcined Iron Ore, ground), Qing Hao Xin (Artemisia Heart), Ni Fen (Calomel), Liu Huang (Sulfur, ground, each 0.5 liang). Grind and mix evenly. First wash sore with salt water, fill sore with powder, bind with cloth. After 2-3 days, if foul matter removed, replace medicine as before. If none, no need to replace. Cure in 2-3 applications.
Ge Shang Ting Zhang Wan (Tortoise Beetle Pill, from *Sheng Ji Zong Lu*) treats various fistulas.
Ge Shang Ting Zhang, Di Dan, Ban Mao (Three items remove head/feet/wings, stir-fry with glutinous rice, each 20 pieces), Shu Fu (Mouse Crab, 60 pieces, roasted), Yi Zhong Bai Yu (Clothes Moth Larva, 40 pieces), Zhen Zhu (Pearl, ground, each 1 fen), Bing Lang (Betel Nut, crushed, 2 pieces), Xiong Huang (Realgar, ground). Process into powder, honey-pill like sesame seeds. Take 3 qian with warm wine on empty stomach, repeat in evening, gradually increase to 5 pills.
Yuan Qing San (Blister Beetle Powder, from *Sheng Hui Fang*) treats nine types of fistulas, even if chronic, this formula suffices.
Yuan Qing (40 pieces, remove head/feet/wings, roast), Hai Zao (Seaweed), Kun Bu (Kelp, each 8 fen, wash), Xiong Huang (Realgar, ground, 8 fen), Li Gu (Fox Bone, roasted, 3 fen), Mu Li (Oyster Shell, calcined, 4 fen), Di Dan (Ground Beetle, 20 pieces, roast), Qing Mu Xiang (Aquilaria Wood, 3 fen). Process into fine powder, take 1 Qian Bi with wine, twice daily. Disease exits via urine like rotten sinew. Avoid cold/raw foods, wheat products, stale pork.
Gui Fu Wan (Cinnamon-Aconite Pill, from *San Yin Fang*) treats Qi fistulas, Cold fistulas, and various sores.
Fu Zi (Aconite Root, processed, soak in rice vinegar, process again 3-5 times, remove skin/navel), Gui Xin (Cinnamon Heart), Hou Po (Ginger-processed), Fen Cao (Licorice Root, roasted), Bai Zhu (each 1 liang), Mu Xiang (1 fen), Ru Xiang (Frankincense, 2 qian, separately ground). Process into fine powder, honey-pill like sesame seeds. Take 20-30 pills with rice water on empty stomach.
Qing Jin Ding Zi (Blue Gold锭) (from *Wai Ke Jing Yao*) treats various malignant sores with slow pus discharge, and chronic Chan fistula sores recurring after healing.
Bai Ding Xiang (White Stinkhorn Spore Mass), Tong Qing (Verdigris), Peng Sha (Borax), Fen Shuang (Sublimated Mercury), Qing Fen (Calomel, 1 spoon), Long Nao (Borneol, 1 spoon), She Xiang (Musk, 1 spoon). Process into fine powder, paste with flour dough, shape into锭 (candles). Insert into sore, rapidly discharges pus/water.
Treating Fistula Sores.
Hua Shi (Talcum), Qing Fen, Chi Shi Zhi (Red Halloysite), Hai Piao Xiao (Cuttlefish Bone), Ni Fen, Ru Xiang, Ming Fan (Alum). Equal parts, finely ground. Blow powder into fistula hole with tube. Next night, use ear tweezers to remove necrotic flesh, wash with Schizonepeta Decoction, reapply medicine.
Tian Ling Gai Gao (Heavenly Spirit Cover Ointment, from *Sheng Hui Fang*) treats all fistula sores.
Tian Ling Gai (Human Skull Cap, 1 fen, clean wash, coat with butter, roast yellow), Hu Xia Han Gu (Tiger Lower Jaw Bone, 1 fen, roast yellow), La Yue Zhu Zhi (December Pig Fat, 4 liang), Fu Zi (Aconite Root, 1 fen, process/roast, remove skin/navel), Ren Shen (Ginseng Root, 1 liang, remove rhizome), Tie Jing (Iron Essence, 1 fen), Chuan Wu Tou (Sichuan Aconite Root, 1 liang, process, remove skin/navel). Process into fine powder, mix with pig fat to appropriate consistency. Apply around edges, avoid entering sore.
She Xiang Wan (Musk Pill) treats fistula/Chan sores.
She Xiang (Musk, ground), Shi Dan (Stone胆/Chalcanthite, ground), Ni Fen (Calomel, ground), Xing Ren (Apricot Kernel, remove skin/spikes/double-kernel, fried, each 1 fen), Xiang Shu (Muskrat, 1 piece, remove gut/clean, roast dry), Ba Dou (Croton Seed, 1 piece, remove skin/core/membrane, press out oil). Process into powder, mix with flour dough, pill like millet seeds. Insert into sore, 1-2 times daily.
General Formula for Various Fistulas.
Ban Mao (Blister Beetle, 1 piece, alternative says 3 fen, remove head/feet/wings), Du Heng (Duzhong Vine?), Zhi Ke Gen (Citrus Aurantium Root Bark), Suan Zao Gen (Ziziphus Spinosa Root), Hu Ji Gen (Hawkweed Root), Mao Ji Gen (Cat-tail Root? Context implies specific roots, each one bunch). Process into fine powder, mix with honey, pill. Take once daily, add one jujube, place pill in sore.
Fistula Formula.
Zhen Long Gu (True Fossilized Bone), Feng Fang (Honeycomb, roasted yellow, each 3 qian), Huang Dan (Lead Monoxide, calcined), Jiang Zhen Jie (Liquidambar Branch), Wu Bei Zi (Gallnut), Ku Hai Gu (Burnt Bone, kiln-fired, each 1 qian). Process into fine powder, apply externally. For malignant nodules and fistulas, avoid anger; otherwise, nodules enlarge and leak more fluid.
An Xi Gao (Peaceful Rest Ointment, from *Cun Ren Fang*) treats continuous pus/water, bone pain forming fistulas.
An Xi Xiang (Benzoin), Hua Ru Shi (Flower Milk Stone/Pyrite, fire-roasted red), Xue Jie (Dragon's Blood), Ru Xiang (Frankincense, each 0.5 qian), She Xiang (Musk, half dose). Process into fine powder, melt with small amount of beeswax and sesame oil. Shape medicine into rice-grain sized pellets. Based on previous method, judge size/depth, insert granules into sore holes until full. Medicine penetrates, generating flesh internally. After 1-2 days, expel one pellet. As flesh grows, pellets are expelled. Complete expulsion leads to natural flattening/healing, miraculous efficacy. For cold/painful/shallow/wide sores, use small amount for dry application.
Treating Fistula Sores.
Mu Xiang (Costus Root), Ding Xiang (Clove), Ru Xiang (Frankincense), She Xiang (Musk, ground, each 3 qian), Hei Qian Niu (Black Morning Glory Seed, first flush powder). Divide into ten doses. Each dose uses one Black Chicken Egg, remove yolk, mix white with medicine, return to eggshell, seal top with paper, steam in rice cooker until cooked. Chew finely, take with warm wine.