吴 足大趾属厥阴肝经，太阴脾经由此起。今足大趾干烂，乃肝经血枯，脾经湿热也。延及数月，防
成脱疽。兼上唇麻木，亦脾虚风动。殊非易治。
萆 当归 牛膝 枸杞子 苡仁 丹参 川断 茯苓 桑枝
孙 痧回热减，温邪初退之余，咽喉反腐，虚火又从而起。良由久患喉痹，阴虚火亢，热淫摇动，亢焰
复张。用方最宜加谨，过清恐伤脾胃，早滋恐恋余邪。姑拟甘凉平调肺胃，冀其上焦清肃。
鲜石斛 大贝母 元参 生甘草 丹皮 沙参 羚羊角 扁豆 豆衣 悉尼
刘 偏脑疽自右延及于左，三候有余。偏右穿溃脓少，偏左
木肿未腐，头顶平塌，根脚散蔓。此气虚不能引血化腐成脓，托
毒外出，高年殊虑内陷。至舌苔白腻，大便闭结，在疡科指为火毒内闭，湿热上蕴，而用内疏黄连等法。阅倪
先生方案，谓内夹杂气，邪伏膜原，引用达原、三消数剂，异想超出寻常。今大便已通，舌苔稍化，然右脉
软弱，胃气残惫，疡不甚肿，色不甚红，深恐阳变为阴。大凡外疡起发脓腐，须赖元气承载。所谓元气
者，卫外捍御之气、胃中冲和之气、三焦升降之气也。亏则脓腐不克根据期，从此生变。故黄 为外疡托毒之
圣药，即兼别症，再参他方。古法有攻补兼施、补泻同用者。拙见欲托毒，必扶正。
生黄 当归 赤苓 陈皮 藿梗 法半夏 香附 谷芽
又 脑疽将四候，起发脓俱迟。欲问真消息，阴阳各半推。阳多方是吉，阴长便生危。顶不高兮根不束，
皮不腐兮脓不足。凡此皆因气血衰，顺逆安危有结局。乃若疮流鲜血，即为变陷之
端；况夫年逾六旬，尤宜加谨为要。兹当补托，佐以疏通。补其正而托其毒，疏其气而通其壅。俾胀
满宽而加谷，期阳毒化而收功。聊以解嘲，非敢说梦。
黄 当归 制僵蚕 皂角刺 陈皮 川朴 赤苓 法半夏 香附
某 暑邪热毒，走入营中。遍身紫黑烂斑，鼻血龈腐。此发斑牙疳之险症也。倘至壮热神昏，不可挽矣。
犀角地黄汤加羚羊角、连翘、鲜石斛、黑山栀、银花、淡黄芩、芦根。
某 疟久阴伤，项发痰核，头倾不举，腹中有块。年逾二八，天癸未通。虑延劳损。
大生地 制首乌 茯苓 丹皮 怀山药 软柴胡 白芍 当归 陈皮 十大功劳
某 肝经郁火，乘犯阳明，牙龈痒痛出血而发牙疳。舌红碎裂，头眩心烦，营阴内亏。而纳谷气撑，
又属脾气虚也。犹喜大便燥结，可用清滋，先平其炎上之火。
羚羊角 鲜生地 鲜石斛 元参 麦冬 茯苓 石决明 女贞子 枣仁
某 阴亏火亢，绕颈生痰，寒热似疟，而实非疟也。少阴水
亏不能涵木，少阳火亢更来灼金，金木交战，乃生寒热，饮食少，脾胃弱，虑延劳损。
六味地黄汤加牡蛎、党参、麦冬、柴胡、白芍、五味子。
某 结喉痈生于咽喉之上，视之不见，胀塞不通，汤水难
进，极为险重。急以化痰宣窍、开通肺气方法。
射干 牛蒡子 僵蚕 薄荷 荆芥 桔梗 山豆根 贯仲 生甘草 茅柴根
洲按∶吹喉之药必不可缺。
某 对口生疽，足根发疔，此二处皆属太阳膀胱之络。湿热内聚，风热外侵，勿得轻视。
羌活 防风 连翘 归尾 萆 乳香 没药 土贝母 银花 甘草梢 桑枝
某 牙龈渗脓，二载不愈。此属牙漏，肾虚胃有湿热所致。
六味丸（三钱） 资生丸（二钱）
相和。每朝服四钱，淡盐汤送下。
某 马脾风极重险症，危生倏忽。姑与牛黄夺命散。
大黄（生切，四钱） 槟榔（一钱五分） 黑牵牛（三钱）
共研末。分二服，白萝卜汁温调服。
某 肺痈咳吐脓痰，肺叶已伤，势属重候。
羚羊角 冬瓜子 桔梗 葶苈子 苡仁 生甘草 桃仁泥
野茭根 川石斛 芦根
又 痰臭虽减，咳嗽未除。
羚羊角 川贝母 杏仁 苡仁 桃仁 桔梗 苏子 甘草 冬瓜子 芦根 野茭根
张 怒则肝气逆而血苑于上，章门结块硬痛，寒热脉数，小便短少。症属肝痈，防其内溃咳吐脓血而剧。
紫菀 郁金 新绛 柴胡 天花粉 桃仁 旋复花 当归 穿山甲 忍冬藤 降香 青葱管
缪 病起微寒微热，右肋章门穴酸疼。两月后痛处略肿，食少便溏，面浮足肿，腰脊酸痛。脉附骨极细
而锐。此脾家有湿热瘀伤，症属脾痈。日久正虚胃弱，恐其不克支持。
党参 炙甘草 陈皮 白术 川朴 木香 吴茱萸 干姜 当归 川芎 白芍 六神曲 茯苓 肉果 砂仁
敷方∶
官桂 吴茱萸 干姜 川乌 生半夏 独活 乳香 没药 南星 白芥子 当归（各一钱，研末）
用陈酒干面调和，炖温，敷痛处。
某 盘肠痈腹痛已久，二三日来骤然胀满，连及腰胁，小便
茎中亦痛，势已有脓。拟用牡丹汤排脓逐毒，从大肠导下之。所虑饮食极少，胃气不克支持耳。
丹皮 桃仁 皂角刺 冬瓜子 红花 大黄（制） 延胡索 广橘皮 山楂肉 赤苓 归尾
又 盘肠痈已成脓，不得不从大肠导下之法。
生黄 皂角刺 归尾 桃仁 红花 土贝母 金银花 甘草 丹皮 山甲片 冬瓜子 广皮
又 肠内痈脓将足，脉细食少。治以托里，冀其外溃为妙。
黄 银花 穿山甲 肉桂 当归 赤苓 泽泻 皂角刺 苡仁 广皮 血珀屑
许 寒气入于厥阴，湿热随经下注。睾丸肿胀，少腹结硬肿痛。防成缩脚小肠痈重症。
川楝子 吴茱萸 枳壳 归尾 焦楂肉 橘核 小茴香 萆 焦黑栀 葱白头
某 环跳臀股之间，从前曾患外疡。今戽水伤筋，受水寒之
气袭筋骨之中，臀股胯凹腓 酸痛，大便燥结，小便不利，气坠尻酸。病在太阳、少阴二经，防发附骨阴疽。
六味地黄汤去山药，加细辛、麻仁、独活、川熟附。
另∶东垣资肾丸二钱，开水送下。
渊按∶辛、独二味，发少阴之寒从太阳而散，佐附子以温之，六味以补之泄之。
任 湿热伏邪内蕴，引动宿毒，遍发广痘，亦曰广风。恐其肢节酸强，殊难速效。
防风 当归 赤芍 皂荚子 银花 天花粉 连翘 甘草 陈皮 土茯苓
许 肾岩翻花，在法不治。怡情安养，带疾延年。
鲜首乌 马料豆 银花 生甘草
朝服六味丸三钱，淡盐花汤送。
刘 肾俞漫肿色白，脉虚微热，此肾俞发也。属三阴亏损，湿热入络，气血凝滞而生。最为淹缠。姑与消散法。
当归 防风 杜仲 秦艽 金狗脊 丹参 广皮 萆 独活 胡桃肉 桑枝
胡 胃脘生痈，脉虚形瘦。初起寒热，延今四十余日，晨必
泄泻无度。是中气大虚，不胜攻消之任也。今与内托法。倘仍作泻，则难矣。
党参 木香 法半夏 茯苓 枳壳 砂仁 当归 冬术 干
姜陈皮
某 面颧毒乃阳明郁火所结，今已穿溃，孔如豆大。虽比颧骨疽较轻，然收功亦迟。须忌一
切发风动火之物。
羚羊角 白芷 茯苓 土贝母 广皮 党参 连翘 丹皮 银花 甘草
刘 平日豪饮，胃湿必甚。去冬龈肿咳嗽，仍不节饮，以致
音哑龈腐，蔓延及唇，此沿牙毒也。虽非牙岩之比，然亦不易收功。
甘露饮去甘草、天冬，加赤苓、黄芩、鸡距子、葛根、蝉衣、茅柴根。
渊按∶阳明湿火所致。
陆 本原不足，兼挟风温。发热，颈间结核成痰。二十余
日，不红，不肿，不消散，亦不作脓，属半虚半实。慎柔方有良法，用四君子加牛蒡子，世所未知，余曾验过。
四君子加牛蒡子、象贝母、桑叶。
渊按∶四君补虚，佐蒡、贝以消风痰，桑叶清肺通络。从补虚中想出祛邪之法，心思灵敏。
又 昨用慎柔方，是托散法。服下若汗出热退，则数剂可
消。若汗不出，仍发热，则数剂成脓，且易溃敛。
前方加钩钩。
又 三岁孩童，但哺乳汁，不进谷食，脾胃虚弱可知。颈结痰核而有寒热，必挟风温，属半虚半实。
今将一月，热退复热，其块不消，不作脓，大便溏，脾胃不足，气血两虚。
党参 冬术 陈皮 荆芥 黄 归身 防风 葛根 砂仁 桑叶
周 立斋云∶外疡经久不消散，亦不作脓，气虚也。徒用攻消，恐无所益。
黄 党参 防风 归身 泽兰叶 穿山甲 僵蚕 丹参 广皮 桑枝
朱 结毒穿破不敛，在于当额眉棱，俱属阳明部位。已及半载，当养气血以化毒。
大熟地 党参 川芎 皂荚子 茯苓 土贝母 黄 当归 生甘草 银花 土茯苓
陈 本体阴亏，四月间湿热成疡，溃脓而愈。愈后正虚，肝
风升动，眩晕跌仆，以致腿股环跳受伤，漫肿色白，而生附骨痰疽。今二便阻塞，少腹胀满，将有肠痈之变。
忍冬藤 丹皮 桃仁 延胡索 鲜首乌 车前子 归身 牛膝 血珀（五分，研末，药汁调下）
某 湿热积聚，阻于少阳。病起发热，便少腹偏右板痛，足屈不伸，小肠痈也。身热不止，防其成脓。
甘草 桔梗 枳壳 苏梗 赤苓 土贝母 砂仁 延胡索 焦楂肉 川楝子 泽兰叶
许 肝胆郁火，凝结成痰。腮颊硬肿，牙关不开，此骨槽痰也。脉象郁涩，气失利畅，药力不易见效。
柴胡 黑山栀 香附 秦艽 制僵蚕 石决明 土贝母 丹皮 桑叶 郁金 骨碎补 刺蒺藜 钩钩
某 鼓槌多骨流痰，脓孔甚多，手掌及腕皆肿硬，而色紫不
痛。已出过多骨，出骨之处已敛，而余外仍肿。此风毒湿热锢结手经。延来五月，收功不易。
当归 防风 苡仁 丹皮 连翘 广皮 生甘草 红花 桑枝
另蜣 虫炙五钱，研末，掺。
汪 《内经》云∶一阴一阳结，谓之喉痹。指少阴君火合少
阳相火上逆而为病也。病由内生，非关外感风温，故治之不易速
效。养阴降火化痰，每相须为法。惟嫌脉息太细，系素禀六阴，
真阳不足。然清药亦宜酌用，恐阴未足而阳先伤耳。慎之。
沙参 石决明 白扁豆 元参 怀山药 蛤壳 川石斛 生甘草 茯苓 川贝 桔梗
另∶元明粉一钱，朱砂五厘，冰片二分，研细末，吹。
某 肾主骨，膝者，骨之溪谷也。肾虚则骨髓空，而寒湿乘之，两足跟痛及于膝。久而不已，
防成鹤膝风痹。
大熟地 萆 苡仁 牛膝 桂枝 枸杞子 川断 防风 独活
另∶虎潜丸，每朝三钱。
某 心火与湿热交结而成痰核。上则舌下，中则脘间，下则阴头，皆结小核如棉子。此皆火郁之所致。
川连（二钱，酒炒） 陈皮（一两，盐水炒） 甘遂（三钱，面包煨，去心） 半夏
（一两五钱） 茯苓（二两） 泽泻（一两） 蛤壳（二两，研粉） 红芽大戟（三钱，洗淡，炒）
上药共研细末，水泛为丸。每朝一钱，开水送下。
渊按∶直捣其巢，非胆识兼优不能。然虚者未可漫试。
某 风毒内攻入脑，走入耳窍，疼痛出脓，脓出不爽，盘及
耳后颈间硬肿不消，此盘耳痈也。已延两月，症无头面，牙关不痛，恐滋蔓骨槽等变，殊非易治。
羚羊角 元参 磁石 甘菊花 细生地 牛蒡子 制僵蚕 菖蒲 钩钩 葱白头
某 舌根边僵木不痛，已经数月，防变舌疳。此属心脾郁
火。治以清养营阴，稍参苦降。
鲜生地 川连 元参 丹参 麦冬 生甘草 丹皮 桔梗
又 川连（三分） 蒲黄（一钱） 冰片（二分） 五灵脂（一钱） 人中白（四分， ）
上味共研细末，吹舌根。
吴 暑热蒸迫，心火暴甚。喉舌肿痛，及今旬日，势防成
脓。用凉膈散加犀、羚，解上焦以泄君火之燔。
牛蒡子 犀角 连翘 焦山栀 生军（水浸） 大贝母 元明粉 竹叶 芦根 薄荷
又 消管丸。
胡黄连（一两） 刺 皮（一两，炙） 象牙屑（一两） 五倍子（一两，炙） 蟾
酥（酒化，三钱） 陈硬明角灯（二两，炙）
上药为末，炼蜜丸。用上好雄精三钱，泛上为衣。每朝三钱，金银花汤送下。
渊按∶方极佳。惟蟾酥大毒走窜之品，每日服分余，未知可否。减半则稳当矣。此治外症久而成管者。
某 足丫碎烂，南方湿热之常病也。患者甚多。今足趾碎
烂，掌心皮浓而燥，非徒湿热，血亦枯矣。经云∶手得血而能握，足得血而能步。碎烂不愈，恐成
风湿。夫治风先治血，血行风自灭。祛湿先治脾，脾旺湿自绝。所谓治病必求其本也。
制首乌 丹参 当归 防风 苡仁 怀山药 茯苓 萆 草 红枣 三角胡麻
周 咳吐臭痰，已延三月。脉数而虚，其阴已伤。面白无华，饮食渐减，肺失所恃，防成肺痿。
沙参 黄 麦冬 白芨 茯苓 元参 大生地 杏仁 百合 芦根尖
又 咳痰腥臭，面色青晦，脉数而虚，纳谷大减。此木火乘金，金伤及土，脏气克贼，恐延不治。
北沙参 桑白皮 麦冬 苡仁 茯苓 白扁豆 野茭根 橘红 紫菀 元参 芦根尖
杨 一阴一阳结谓之喉痹。一阴者，厥阴也；一阳者，少阳
也。相火寄于肝胆，君火一动，相火随炽，上炎灼金，痹喉之症作矣。
鲜生地 元参 麦冬 焦山栀 大生地 石决明 沙参 桔梗 生甘草 豆衣 梨肉
吴姓患者：足大趾归属于厥阴肝经，太阴脾经也由此发起。如今足大趾干枯溃烂，这是肝经血液枯竭、脾经湿热蕴结所致。病程已延续数月，担心发展为脱疽（指肢端坏死脱落）。同时伴有上唇麻木，这也是脾虚导致内风妄动的表现。病情确实难以治疗。
处方：萆薢、当归、牛膝、枸杞子、薏苡仁、丹参、川断、茯苓、桑枝。
孙姓患者：痧疹消退后热势减退，这是温邪刚刚退去后的余留阶段，咽喉腐烂，虚火随之而起。这主要是因为长期患有喉痹，导致阴虚火旺，热邪淫溢扰动，亢盛的火势重新张扬。用药最为需要谨慎，过于寒凉恐怕损伤脾胃，过早滋腻恐怕留恋残留的病邪。暂且拟定甘凉平和之剂以调理肺胃，希望上焦能够清肃。
处方：鲜石斛、大贝母、玄参、生甘草、牡丹皮、沙参、羚羊角、扁豆、豆衣。
悉尼患者：偏脑疽从右侧蔓延至左侧，病程已超过三候（约二十一天）。右侧已经穿破溃烂但脓液稀少，左侧肿胀僵硬尚未腐溃，头顶平塌，根脚散漫不聚。这是气虚不能引血化腐成脓，托毒外出的表现，患者年事已高，特别担心毒邪内陷。至于舌苔白腻，大便闭结，在疡科中通常指为火毒内闭、湿热上蕴，应当使用内疏黄连等法。查阅倪先生的方案，认为内部夹杂气滞，邪气伏于膜原，引用达原饮、三消饮数剂，想法超出寻常。如今大便已经通畅，舌苔稍化，然而右脉软弱，胃气残败，疮疡不甚肿胀，颜色不甚红赤，深恐阳证转变为阴证。大凡外疡起发、化脓、腐溃，必须依赖元气承载。所谓的元气，就是卫外捍御之气、胃中冲和之气、三焦升降之气。元气亏损则脓腐不能如期生成，从此产生变证。所以黄芪是外疡托毒的圣药，即使兼有其他病症，也要参考其他方剂。古法中有攻补兼施、补泻同用的方法。我的见解是想要托毒外出，必须扶助正气。
处方：生黄芪、当归、赤茯苓、陈皮、藿梗、法半夏、香附、谷芽。
又诊：脑疽病程将近四候，起发和化脓都很迟缓。想要探问真实的病机，需推究阴阳各半的情况。阳气多则是吉兆，阴气长则便生危险。疮顶不高、根脚不束，皮肤不腐、脓液不足，凡此种种都是因为气血衰败，顺逆安危都有结局。如果疮口流出鲜血，就是变证内陷的开端；何况患者年过六旬，更加应该谨慎。现在应当采用补托法，佐以疏通之法。补益正气而托出毒邪，疏理气机而通利壅滞。使胀满缓解而能进食，期望阳毒化解而收功。聊以解嘲，并非敢说梦话。
处方：黄芪、当归、制僵蚕、皂角刺、陈皮、川朴、赤茯苓、法半夏、香附。
某患者：暑邪热毒，侵入营分。遍身出现紫黑色烂斑，鼻出血、牙龈腐烂。这是发斑、牙疳的危险重症。如果发展到壮热神昏，就无法挽回了。
处方：犀角地黄汤加羚羊角、连翘、鲜石斛、黑山栀、银花、淡黄芩、芦根。
某患者：疟疾日久导致阴伤，颈部出现痰核，头倾不能抬起，腹中有块状物。年龄超过十六岁，天癸（月经）尚未通畅。担心延变为劳损。
处方：大生地、制首乌、茯苓、牡丹皮、怀山药、软柴胡、白芍、当归、陈皮、十大功劳。
某患者：肝经郁火，侵犯阳明经，导致牙龈痒痛出血并引发牙疳。舌头红裂，头晕心烦，营阴内亏。而且纳食时感觉气撑，这也属于脾气虚。幸好大便燥结，可以使用清滋之法，先平息其炎上的火势。
处方：羚羊角、鲜生地、鲜石斛、玄参、麦冬、茯苓、石决明、女贞子、枣仁。
某患者：阴亏火旺，颈部周围生出痰核，寒热往来似疟疾，但实际上不是疟疾。少阴水亏不能涵养肝木，少阳火旺更来灼伤肺金，金木交战，从而产生寒热，饮食减少，脾胃虚弱，担心延变为劳损。
处方：六味地黄汤加牡蛎、党参、麦冬、柴胡、白芍、五味子。
某患者：结喉痈生于咽喉之上，外观看不见，但感觉胀塞不通，汤水难进，极为险重。紧急采用化痰宣窍、开通肺气的方法。
处方：射干、牛蒡子、僵蚕、薄荷、荆芥、桔梗、山豆根、贯仲、生甘草、茅柴根。
洲按：吹喉的药物必不可缺。
某患者：对口疽生于背部正中，足跟发疔，这两个部位都属于太阳膀胱经的络脉。湿热内聚，风热外侵，不可轻视。
处方：羌活、防风、连翘、归尾、萆薢、乳香、没药、土贝母、银花、甘草梢、桑枝。
某患者：牙龈渗脓，两年不愈。这属于牙漏，由肾虚和胃有湿热所致。
处方：六味丸（三钱）与资生丸（二钱）相合。每早晨服用四钱，用淡盐汤送下。
某患者：马脾风是极重险症，生死倏忽之间。暂且给予牛黄夺命散。
处方：大黄（生切，四钱）、槟榔（一钱五分）、黑牵牛（三钱）。共研为末。分两次服用，用白萝卜汁温调服。
某患者：肺痈咳嗽吐出脓痰，肺叶已经受伤，形势属于重证。
处方：羚羊角、冬瓜子、桔梗、葶苈子、薏苡仁、生甘草、桃仁泥、野茭根、川石斛、芦根。
又诊：痰臭虽然减轻，但咳嗽未除。
处方：羚羊角、川贝母、杏仁、薏苡仁、桃仁、桔梗、苏子、甘草、冬瓜子、芦根、野茭根。
张姓患者：愤怒导致肝气上逆，血液瘀积于上部，章门穴处结块硬痛，伴有寒热、脉数，小便短少。症状属于肝痈，防止其内溃咳吐脓血而加剧。
处方：紫菀、郁金、新绛、柴胡、天花粉、桃仁、旋复花、当归、穿山甲、忍冬藤、降香、青葱管。
缪姓患者：病起微寒微热，右肋章门穴酸疼。两个月后痛处略微肿胀，食少便溏，面浮足肿，腰脊酸痛。脉象附骨极细而锐。这是脾家有湿热瘀伤，症状属于脾痈。日久正气虚弱、胃气弱，恐怕不能支持。
处方：党参、炙甘草、陈皮、白术、川朴、木香、吴茱萸、干姜、当归、川芎、白芍、六神曲、茯苓、肉果、砂仁。
敷方：官桂、吴茱萸、干姜、川乌、生半夏、独活、乳香、没药、南星、白芥子、当归（各一钱，研末）。用陈酒和干面调和，炖温，敷于痛处。
某患者：盘肠痈腹痛已久，近两三天突然胀满，连及腰胁，小便茎中亦痛，形势已有脓液。拟用牡丹汤排脓逐毒，从大肠导下。所担心的是饮食极少，胃气不能支持。
处方：丹皮、桃仁、皂角刺、冬瓜子、红花、大黄（制）、延胡索、广橘皮、山楂肉、赤茯苓、归尾。
又诊：盘肠痈已成脓，不得不采用从大肠导下的方法。
处方：生黄芪、皂角刺、归尾、桃仁、红花、土贝母、金银花、甘草、丹皮、山甲片、冬瓜子、广皮。
又诊：肠内痈脓将满，脉细食少。治疗以托里为主，希望其向外溃破为妙。
处方：黄芪、银花、穿山甲、肉桂、当归、赤茯苓、泽泻、皂角刺、薏苡仁、广皮、血珀屑。
许姓患者：寒气进入厥阴经，湿热随经下注。睾丸肿胀，少腹结硬肿痛。防止发展成缩脚小肠痈的重症。
处方：川楝子、吴茱萸、枳壳、归尾、焦楂肉、橘核、小茴香、萆薢、焦黑栀、葱白头。
某患者：环跳穴及臀股之间，从前曾患外疡。如今挑水伤筋，受水寒之气侵袭筋骨之中，臀股胯凹腓部酸痛，大便燥结，小便不利，气坠尻酸。病在太阳、少阴二经，防止发生附骨阴疽。
处方：六味地黄汤去山药，加细辛、麻仁、独活、川熟附。
另：东垣资肾丸二钱，开水送下。
渊按：细辛、独活二味，发散少阴之寒从太阳而散，佐以附子以温之，六味地黄汤以补之泄之。
任姓患者：湿热伏邪内蕴，引动宿毒，遍发广痘，也称为广风。恐怕肢体关节酸强，很难迅速见效。
处方：防风、当归、赤芍、皂荚子、银花、天花粉、连翘、甘草、陈皮、土茯苓。
许姓患者：肾岩翻花，按照法律/常规是不治之症。保持心情愉悦安养，带病延年。
处方：鲜首乌、马料豆、银花、生甘草。
早晨服用六味丸三钱，用淡盐花汤送下。
刘姓患者：肾俞穴漫肿色白，脉虚微热，这是肾俞发。属于三阴亏损，湿热入络，气血凝滞而生。最为缠绵难愈。暂予消散法。
处方：当归、防风、杜仲、秦艽、金狗脊、丹参、广皮、萆薢、独活、胡桃肉、桑枝。
胡姓患者：胃脘生痈，脉虚形瘦。初起寒热，延续至今四十多天，早晨必定泄泻无度。这是中气大虚，不胜攻消之任。现在给予内托法。如果仍然作泻，那就难办了。
处方：党参、木香、法半夏、茯苓、枳壳、砂仁、当归、冬术、干姜、陈皮。
某患者：面颧毒乃阳明郁火所结，如今已经穿破溃烂，孔如豆大。虽然比颧骨疽较轻，但收功也迟。必须忌食一切发风动火之物。
处方：羚羊角、白芷、茯苓、土贝母、广皮、党参、连翘、丹皮、银花、甘草。
刘姓患者：平日豪饮，胃湿必然很重。去年冬天牙龈肿咳嗽，仍不节制饮酒，以致音哑龈腐，蔓延及唇，这是沿牙毒。虽然不像牙岩那样严重，但也难以收功。
处方：甘露饮去甘草、天冬，加赤茯苓、黄芩、鸡距子、葛根、蝉衣、茅柴根。
渊按：此为阳明湿火所致。
陆姓患者：本原不足，兼挟风温。发热，颈间结核成痰。二十多天，不红，不肿，不消散，也不作脓，属于半虚半实。慎柔的方子有良法，用四君子汤加牛蒡子，世人所未知，我曾验证过。
处方：四君子汤加牛蒡子、象贝母、桑叶。
渊按：四君子汤补虚，佐以牛蒡子、贝母以消风痰，桑叶清肺通络。从补虚中想出祛邪之法，心思灵敏。
又诊：昨天用慎柔方，是托散法。服用后若汗出热退，则数剂可消。若汗不出，仍发热，则数剂成脓，且易溃敛。
前方加钩藤。
又诊：三岁孩童，只吃母乳，不吃谷物，可知脾胃虚弱。颈部结痰核而有寒热，必挟风温，属于半虚半实。现在已经一个月，热退复热，肿块不消，不作脓，大便溏，脾胃不足，气血两虚。
处方：党参、冬术、陈皮、荆芥、黄芪、归身、防风、葛根、砂仁、桑叶。
周姓患者：立斋说：外疡经久不消散，也不作脓，是气虚。徒用攻消，恐怕无所益处。
处方：黄芪、党参、防风、归身、泽兰叶、穿山甲、僵蚕、丹参、广皮、桑枝。
朱姓患者：结毒穿破不敛，位于当额眉棱，都属于阳明部位。已经半年，应当养气血以化毒。
处方：大熟地、党参、川芎、皂荚子、茯苓、土贝母、黄芪、当归、生甘草、银花、土茯苓。
陈姓患者：本体阴亏，四月间湿热成疡，溃脓而愈。愈后正虚，肝风升动，眩晕跌仆，以致腿股环跳受伤，漫肿色白，而生附骨痰疽。如今二便阻塞，少腹胀满，将有肠痈之变。
处方：忍冬藤、丹皮、桃仁、延胡索、鲜首乌、车前子、归身、牛膝、血珀（五分，研末，药汁调下）。
某患者：湿热积聚，阻于少阳。病起发热，便少腹偏右板痛，足屈不伸，是小肠痈。身热不止，防止其成脓。
处方：甘草、桔梗、枳壳、苏梗、赤茯苓、土贝母、砂仁、延胡索、焦楂肉、川楝子、泽兰叶。
许姓患者：肝胆郁火，凝结成痰。腮颊硬肿，牙关不开，这是骨槽痰。脉象郁涩，气失利畅，药力不易见效。
处方：柴胡、黑山栀、香附、秦艽、制僵蚕、石决明、土贝母、丹皮、桑叶、郁金、骨碎补、刺蒺藜、钩藤。
某患者：鼓槌多骨流痰，脓孔甚多，手掌及腕皆肿硬，而色紫不痛。已经排出过多骨头，出骨之处已敛，而其余部分仍肿。这是风毒湿热锢结手经。延续五月，收功不易。
处方：当归、防风、薏苡仁、丹皮、连翘、广皮、生甘草、红花、桑枝。
另：蜣螂虫炙五钱，研末，掺于患处。
汪姓患者：《内经》说：一阴一阳结，谓之喉痹。指少阴君火合少阳相火上逆而为病。病由内生，非关外感风温，故治疗不易速效。养阴降火化痰，往往相辅为法。只是嫌脉息太细，系素禀六阴，真阳不足。然而清热药也宜酌用，恐怕阴未足而阳先伤耳。慎重。
处方：沙参、石决明、白扁豆、玄参、怀山药、蛤壳、川石斛、生甘草、茯苓、川贝、桔梗。
另：元明粉一钱，朱砂五厘，冰片二分，研细末，吹喉。
某患者：肾主骨，膝者，骨之溪谷也。肾虚则骨髓空，而寒湿乘之，两足跟痛及于膝。久而不已，防止成为鹤膝风痹。
处方：大熟地、萆薢、薏苡仁、牛膝、桂枝、枸杞子、川断、防风、独活。
另：虎潜丸，每早晨三钱。
某患者：心火与湿热交结而成痰核。上则在舌下，中则在脘间，下则在阴头，都结成小核如棉子。这都是火郁所致。
处方：川连（二钱，酒炒）、陈皮（一两，盐水炒）、甘遂（三钱，面包煨，去心）、半夏（一两五钱）、茯苓（二两）、泽泻（一两）、蛤壳（二两，研粉）、红芽大戟（三钱，洗淡，炒）。上药共研细末，水泛为丸。每早晨一钱，开水送下。
渊按：直捣其巢，非胆识兼优不能。然而体虚者不可随意尝试。
某患者：风毒内攻入脑，走入耳窍，疼痛出脓，脓出不爽，盘及耳后颈间硬肿不消，这是盘耳痈。已经延续两个月，症状无头面红肿，牙关不痛，恐滋蔓骨槽等变证，确实难以治疗。
处方：羚羊角、玄参、磁石、甘菊花、细生地、牛蒡子、制僵蚕、菖蒲、钩藤、葱白头。
某患者：舌根边僵木不痛，已经数月，防止变为舌疳。这属于心脾郁火。治疗以清养营阴，稍参苦降。
处方：鲜生地、川连、玄参、丹参、麦冬、生甘草、丹皮、桔梗。
又诊：川连（三分）、蒲黄（一钱）、冰片（二分）、五灵脂（一钱）、人中白（四分，煅）。上味共研细末，吹于舌根。
吴姓患者：暑热蒸迫，心火暴甚。喉舌肿痛，至今十天，形势防止成脓。用凉膈散加犀角、羚羊角，解上焦以泄君火之燔。
处方：牛蒡子、犀角、连翘、焦山栀、生军（水浸）、大贝母、元明粉、竹叶、芦根、薄荷。
又诊：消管丸。
处方：胡黄连（一两）、刺皮（一两，炙）、象牙屑（一两）、五倍子（一两，炙）、蟾酥（酒化，三钱）、陈硬明角灯（二两，炙）。上药为末，炼蜜丸。用上好雄精三钱，泛上为衣。每早晨三钱，金银花汤送下。
渊按：方子极佳。只是蟾酥是大毒走窜之品，每日服用分余，不知是否可行。减半则稳当矣。这是治疗外症久而成管瘘的方法。
某患者：足丫碎烂，是南方湿热之常病。患者甚多。如今足趾碎烂，掌心皮浓而燥，不仅仅是湿热，血液也已枯竭。经云：手得血而能握，足得血而能步。碎烂不愈，恐怕成为风湿。夫治风先治血，血行风自灭。祛湿先治脾，脾旺湿自绝。所谓治病必求其本也。
处方：制首乌、丹参、当归、防风、薏苡仁、怀山药、茯苓、萆薢、草薢、红枣、三角胡麻。
周姓患者：咳吐臭痰，已经延续三月。脉数而虚，其阴已伤。面白无华，饮食渐减，肺失所恃，防止成为肺痿。
处方：沙参、黄芪、麦冬、白芨、茯苓、玄参、大生地、杏仁、百合、芦根尖。
又诊：咳痰腥臭，面色青晦，脉数而虚，纳谷大减。这是木火乘金，金伤及土，脏气克贼，恐怕延至不治。
处方：北沙参、桑白皮、麦冬、薏苡仁、茯苓、白扁豆、野茭根、橘红、紫菀、玄参、芦根尖。
杨姓患者：一阴一阳结谓之喉痹。一阴者，厥阴也；一阳者，少阳也。相火寄于肝胆，君火一动，相火随炽，上炎灼金，痹喉之症作矣。
处方：鲜生地、玄参、麦冬、焦山栀、大生地、石决明、沙参、桔梗、生甘草、豆衣、梨肉。
Patient Wu: The big toe of the foot belongs to the Jueyin Liver Meridian, and the Taiyin Spleen Meridian also originates from here. Currently, the big toe is dry and rotting, which indicates exhaustion of blood in the Liver Meridian and damp-heat accumulation in the Spleen Meridian. Having persisted for several months, there is a fear it may develop into gangrene of the toe (Tuojü). Accompanied by numbness of the upper lip, this also indicates internal wind stirring due to Spleen deficiency. The condition is indeed difficult to treat.
Prescription: Bixie (Dioscorea hypoglauca Rhizome), Danggui (Angelicae Sinensis Radix), Niuxi (Achyranthis Bidentatae Radix), Gouqizi (Lycii Fructus), Yiren (Coicis Semen), Danshen (Salviae Miltiorrhizae Radix), Chuanduan (Dipsaci Radix), Fuling (Poria), Sangzhi (Mori Ramulus).
Patient Sun: After the resolution of sand-pox, the fever has subsided; this is the residual stage after the initial retreat of warm pathogenic factors. The throat is rotting, and deficient fire rises subsequently. This is primarily because long-standing throat obstruction (Houbi) has led to yin deficiency with hyperactive fire, where heat pathogens disturb and agitate, causing the exuberant flame to flare up again. Medication requires utmost caution; excessive cooling may damage the spleen and stomach, while early nourishing may retain residual pathogens. Tentatively prescribing sweet-cool agents to harmonize the Lung and Stomach, hoping to clear and purify the Upper Jiao.
Prescription: Xianshihu (Dendrobii Officinalis Caulis), Dabeimu (Fritillariae Thunbergii Bulbus), Yuan Shen (Scrophulariae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Danpi (Moutan Cortex), Shashen (Glehniae Radix), Lingyangjiao (Saigae Tataricae Cornu), Biandou (Dolichoris Semen), Douyi (Sojae Semen Praeparatum).
Patient Sidney: The lateral brain abscess spread from the right side to the left, lasting more than three periods (approx. 21 days). The right side has ulcerated with little pus, while the left side is swollen and stiff without necrosis. The apex is flat, and the base is diffuse. This indicates qi deficiency failing to guide blood to transform into pus and expel toxins outward. Given the patient's advanced age, there is particular concern about toxin sinking inward. Regarding the white greasy tongue coating and constipation, in surgery of sores, this is typically indicated as internal closure of fire-toxin and upward accumulation of damp-heat, treated with methods like Neishu Huanglian Tang. Reviewing Mr. Ni’s prescription, he suggested internal qi stagnation with pathogens lurking in the Membrane Source, using Dajian Yin and Sanxiao Yin for several doses, an idea beyond the ordinary. Now that bowel movements have passed and the tongue coating has slightly resolved, yet the right pulse is weak and the stomach qi is exhausted, and the sore is not very swollen or red, there is deep fear that the yang syndrome is transforming into a yin syndrome. Generally, the initiation, suppuration, and necrosis of external sores rely on the bearing capacity of primal qi. Primal qi refers to the defensive qi protecting the exterior, the harmonious qi in the stomach, and the ascending-descending qi of the Triple Burner. If deficient, pus and necrotic tissue cannot form on schedule, leading to complications. Therefore, Huangqi is the holy medicine for expelling toxins in external sores; even with concurrent conditions, other formulas should be referenced. Ancient methods include combining attack and tonification, or purging and supplementing simultaneously. My view is that to expel toxins, one must support righteousness (zheng qi).
Prescription: Sheng Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Chi Fuling (Poria cum Risu Rubro), Chenpi (Citri Reticulatae Pericarpium), Huogeng (Agastaches Herba), Fa Banxia (Pinelliae Rhizoma Preparatum), Xiangfu (Cyperi Rhizoma), Guya (Zei Mays Granum).
Second visit: The brain abscess has lasted nearly four periods, with delayed initiation and suppuration. To inquire about the true message, one must deduce the balance of yin and yang. More yang suggests auspiciousness; growing yin implies danger. A high apex and gathered base are good signs; a flat apex and diffuse base indicate pathology. Skin not necrotic and insufficient pus all stem from decline in qi and blood, determining the outcome of smooth or adverse courses. If the sore flows fresh blood, it marks the beginning of transformation and sinking; moreover, being over sixty years old demands extra caution. Now, tonifying and expelling methods should be used, assisted by unblocking agents. Tonify righteousness to expel toxins, soothe qi to unblock congestion. May swelling subside and appetite return, hoping for the resolution of yang toxins to achieve success. Merely offering a joke, not daring to speak of dreams.
Prescription: Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Zhi Jiangcan (Bombyx Batryticatus), Zaocys (Spatholobi Caulis), Chenpi (Citri Reticulatae Pericarpium), Chuan Po (Magnoliae Officinalis Cortex), Chi Fuling (Poria cum Risu Rubro), Fa Banxia (Pinelliae Rhizoma Preparatum), Xiangfu (Cyperi Rhizoma).
Patient [Name Omitted]: Summer-heat pathogenic heat-toxin enters the Ying (Nutrient) level. Purple-black rotten spots appear all over the body, accompanied by epistaxis and gingival necrosis. This is a dangerous condition of macules and cancrum oris. If it progresses to high fever and coma, it cannot be挽救ed.
Prescription: Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) plus Lingyangjiao (Saigae Tataricae Cornu), Lianqiao (Forsythiae Fructus), Xianshihu (Dendrobii Officinalis Caulis), Hei Shanzhi (Gardeniae Fructus Carbonisatus), Yinhua (Lonicerae Japonicae Flos), Dan Huangqin (Scutellariae Radix), Lugeng (Phragmitis Rhizoma).
Patient [Name Omitted]: Long-standing malaria has injured yin, phlegm nodules appeared on the neck, the head tilts and cannot be lifted, and masses are felt in the abdomen. Over sixteen years old, Tian Gui (menstruation) has not yet commenced. Fear of progression to consumptive disease.
Prescription: Da Shengdi (Rehmanniae Radix), Zhi Shouwu (Polygoni Multiflori Radix Preparata), Fuling (Poria), Danpi (Moutan Cortex), Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma), Ruan Chaihu (Bupleuri Radix), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Shida Gonglao (Mahoniae Caulis).
Patient [Name Omitted]: Depressed fire in the Liver Meridian attacks the Yangming Meridian, causing gum itching, pain, bleeding, and triggering cancrum oris. The tongue is red and cracked, with dizziness and irritability, indicating internal depletion of Ying yin. Additionally, feeling fullness upon eating suggests Spleen qi deficiency. Fortunately, the stool is dry and hard, allowing the use of clearing and moistening methods to first calm the flaming-up fire.
Prescription: Lingyangjiao (Saigae Tataricae Cornu), Xian Shengdi (Rehmanniae Radix Recens), Xianshihu (Dendrobii Officinalis Caulis), Yuan Shen (Scrophulariae Radix), Maidong (Ophiopogonis Tuber), Fuling (Poria), Shijueming (Haemitrichidae Concha), Nüzhenzi (Ligustri Lucidi Fructus), Zaoren (Ziziphi Spinosae Semen).
Patient [Name Omitted]: Yin deficiency with hyperactive fire, phlegm generated around the neck, alternating chills and fever resembling malaria but actually not malaria. Shaoyin water deficiency fails to nourish Wood, Shaoyang fire hyperactivity scorches Metal. Metal and Wood clash, generating chills and fever. Reduced diet and weak Spleen/Stomach raise concerns of consumptive disease.
Prescription: Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) plus Muli (Ostreae Concha), Dangshen (Codonopsis Radix), Maidong (Ophiopogonis Tuber), Chaihu (Bupleuri Radix), Baishao (Paeoniae Radix Alba), Wuziweizi (Schisandrae Fructus).
Patient [Name Omitted]: Jiehou Abscess arises above the throat, invisible externally but causing distension and blockage, making swallowing difficult. Extremely critical. Urgently apply methods to resolve phlegm, open orifices, and unblock Lung qi.
Prescription: Shegan (Belamcandae Rhizoma), Niubangzi (Arctii Fructus), Jiangcan (Bombyx Batryticatus), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), Jiegeng (Platycodonis Radix), Shandougen (Sophorae Tonkinensis Radix), Guanzhong (Dryopteridis Crassirhizomatis Rhizoma), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Maochaigen (Imperatae Rhizoma).
Zhou’s Note: Throat-blowing medicines are indispensable.
Patient [Name Omitted]: Duikou Carbuncle on the back, Ding (spiny tumor) on the heel. Both locations belong to the collaterals of the Taiyang Bladder Meridian. Internal accumulation of damp-heat, external invasion of wind-heat. Do not underestimate.
Prescription: Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Guiwei (Angelicae Sinensis Radix Caudex), Bixie (Dioscorea hypoglauca Rhizome), Rushxiang (Olibanum), Moyao (Myrrha), Tubemu (Fritillariae Cirrhosae Bulbus), Yinhua (Lonicerae Japonicae Flos), Gancao Shao (Glycyrrhizae Radix et Rhizoma Caudex), Sangzhi (Mori Ramulus).
Patient [Name Omitted]: Gingival oozing pus, unresolved for two years. This is a dental fistula, caused by Kidney deficiency and damp-heat in the Stomach.
Prescription: Liuwei Wan (Six-Ingredient Pill) (3 qian) combined with Zisheng Wan (Nourishing Life Pill) (2 qian). Mix together. Take 4 qian every morning, washed down with light salt water.
Patient [Name Omitted]: Ma Pi Feng (Horse Spleen Wind) is an extremely critical condition, life hanging in the balance. Temporarily administer Niuhuang Duoming San (Calculus Bovis and Life-Snatching Powder).
Prescription: Dahuang (Rhei Radix et Rhizoma, raw sliced, 4 qian), Binglang (Arecae Semen, 1.5 qian), Hei Qianniu (Pharbitidis Semen Nigrum, 3 qian). Grind into powder. Divide into two doses, take with warm radish juice.
Patient [Name Omitted]: Fei Yong (Lung Abscess) coughs up purulent sputum, lung lobes already damaged, condition is severe.
Prescription: Lingyangjiao (Saigae Tataricae Cornu), Dongguazi (Benincasae Semen), Jiegeng (Platycodonis Radix), Tinglizi (Descurainiae Semen seu Lepidii Semen), Yiren (Coicis Semen), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Taoren (Persicae Semen), Taoren Ni (Persicae Semen Paste), Ye Jiaogen (Zizaniae Radix), Chuan Shihu (Dendrobii Noduli Caulis), Lugeng (Phragmitis Rhizoma).
Second visit: Sputum odor reduced, but cough persists.
Prescription: Lingyangjiao (Saigae Tataricae Cornu), Chuan Beimu (Fritillariae Cirrhosae Bulbus), Xingren (Armeniacae Semen Amarum), Yiren (Coicis Semen), Taoren (Persicae Semen), Jiegeng (Platycodonis Radix), Suzi (Perillae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Dongguazi (Benincasae Semen), Lugeng (Phragmitis Rhizoma), Ye Jiaogen (Zizaniae Radix).
Patient Zhang: Anger causes Liver qi to rebel and blood to pool upwards. Hard, painful mass at Zhangmen point, with chills, fever, rapid pulse, and scanty urine. Symptomatically Liver Abscess. Fear of internal rupture causing coughing up of pus and blood, worsening the condition.
Prescription: Ziwan (Asternatis Radix), Yujin (Curcumae Radix), Xinjiang (Cinnabaris preparatus with safflower), Chaihu (Bupleuri Radix), Tianhuafen (Trichosanthis Radix), Taoren (Persicae Semen), Xuanfuhua (Inulae Flos), Danggui (Angelicae Sinensis Radix), Chuanshanjia (Manis Squama), Rendongteng (Lonicerae Japonicae Caulis), Jiangxiang (Dalbergiae Odoriferae Lignum), Qingcongguan (Allii Fistulosi Bulb).
Patient Miao: Illness began with slight chills and fever, soreness in the right hypochondriac Zhangmen point. Two months later, slight swelling at the painful site, poor appetite, loose stools, facial and foot edema, soreness in waist and spine. Pulse is extremely fine and sharp when pressed to the bone. This is damp-heat and blood stasis in the Spleen, symptomatically Spleen Abscess. Long duration leads to righteous deficiency and weak Stomach, fearing inability to sustain.
Prescription: Dangshen (Codonopsis Radix), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuan Po (Magnoliae Officinalis Cortex), Muxiang (Aucklandiae Radix), Wuzhuyu (Evodiae Fructus), Ganjiang (Zingiberis Rhizoma), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Liushenqu (Massa Medicata Fermentata), Fuling (Poria), Rouguo (Myristicae Semen), Sharen (Amomi Fructus).
External Application Formula: Guanzi (Cinnamomi Cortex), Wuzhuyu (Evodiae Fructus), Ganjiang (Zingiberis Rhizoma), Chuanwu (Aconiti Radix Preparata), Sheng Banxia (Pinelliae Rhizoma), Duhuo (Angelicae Pubescentis Radix), Rushxiang (Olibanum), Moyao (Myrrha), Nanxing (Arisaematis Rhizoma), Baijiemi (Sinapis Semen), Danggui (Angelicae Sinensis Radix) (each 1 qian, ground). Mix with aged wine and dry flour, warm in a steamer, apply to the painful area.
Patient [Name Omitted]: Panchang Abscess abdominal pain for a long time, sudden distension in the last 2-3 days extending to waist and flanks, pain in the urethra, pus likely formed. Plan to use Mudan Tang to drain pus and purge toxins via the Large Intestine. Concern is minimal food intake and weak Stomach qi.
Prescription: Danpi (Moutan Cortex), Taoren (Persicae Semen), Zaocys (Spatholobi Caulis), Dongguazi (Benincasae Semen), Honghua (Carthami Flos), Dahuang (Rhei Radix et Rhizoma, processed), Yanhusuo (Corydalis Rhizoma), Guang Jupi (Citri Reticulatae Pericarpium), Shanzhourou (Crataegi Fructus), Chi Fuling (Poria cum Risu Rubro), Guiwei (Angelicae Sinensis Radix Caudex).
Second visit: Panchang Abscess pus formed, must use method to drain via Large Intestine.
Prescription: Sheng Huangqi (Astragali Radix), Zaocys (Spatholobi Caulis), Guiwei (Angelicae Sinensis Radix Caudex), Taoren (Persicae Semen), Honghua (Carthami Flos), Tubemu (Fritillariae Cirrhosae Bulbus), Jinyinhua (Lonicerae Japonicae Flos), Gancao (Glycyrrhizae Radix et Rhizoma), Danpi (Moutan Cortex), Shanjiapian (Manis Squama), Dongguazi (Benincasae Semen), Guangpi (Citri Reticulatae Pericarpium).
Third visit: Intestinal abscess pus nearly ready, fine pulse, poor appetite. Treat with interior-supporting method, hoping for external rupture.
Prescription: Huangqi (Astragali Radix), Yinhua (Lonicerae Japonicae Flos), Chuanshanjia (Manis Squama), Rougui (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix), Chi Fuling (Poria cum Risu Rubro), Zexie (Alismatis Rhizoma), Zaocys (Spatholobi Caulis), Yiren (Coicis Semen), Guangpi (Citri Reticulatae Pericarpium), Xuepo (Electuari Amber).
Patient Xu: Cold pathogen enters Jueyin, damp-heat follows the meridian downward. Testicular swelling, hard and painful mass in lower abdomen. Fear of developing into severe Suojiao Small Intestine Abscess.
Prescription: Chuanlianzi (Toosendan Fructus), Wuzhuyu (Evodiae Fructus), Zhike (Aurantii Fructus), Guiwei (Angelicae Sinensis Radix Caudex), Jiao Zharonrou (Crataegi Fructus Carbonisatus), Juhe (Citrini Fructus), Xiaohuixiang (Foeniculi Fructus), Bixie (Dioscorea hypoglauca Rhizome), Jiao Heizhi (Gardeniae Fructus Carbonisatus), Congbeitou (Allii Fistulosi Bulb).
Patient [Name Omitted]: Between Ringtiao and buttocks, previously suffered external sores. Now tendon injury from carrying water, invaded by cold-damp qi into sinews and bones. Soreness in buttocks, thighs, groin, and calf. Dry stool, difficult urination, qi sinking with soreness in the sacrum. Disease in Taiyang and Shaoyin meridians, fear of developing into Fugu Yinju (Bone-abscess Yin-type).
Prescription: Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) minus Shanyao, plus Xixin (Asari Radix et Rhizoma), Maren (Cannabis Semen), Duhuo (Angelicae Pubescentis Radix), Chuan Shufu (Aconiti Lateralis Radix Preparata).
Separately: Dongyuan Zishen Wan (Tonify Kidney Pill) 2 qian, taken with boiled water.
Yuan’s Note: Xixin and Duhuo disperse Shaoyin cold via Taiyang, assisted by Shufu to warm, Liuwei Dihuang Tang to tonify and drain.
Patient Ren: Damp-heat latent pathogens accumulate internally, stirring old toxins, widespread eruption of Guang Dou (General Pox), also called Guang Feng. Fear of joint soreness and stiffness, difficult to achieve quick effect.
Prescription: Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Zhaojiazi (Gleditsiae Spina), Yinhua (Lonicerae Japonicae Flos), Tianhuafen (Trichosanthis Radix), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Tufuling (Smilacis Glabrae Rhizoma).
Patient Xu: Shenyan Fanhua (Kidney Rock Turning Flower), considered incurable by law/custom. Maintain emotional peace and nourishment, live with illness for extended years.
Prescription: Xian Shouwu (Polygoni Multiflori Radix Recens), Maliadou (Phaseoli Semen), Yinhua (Lonicerae Japonicae Flos), Sheng Gancao (Glycyrrhizae Radix et Rhizoma).
Morning dose: Liuwei Wan (Six-Ingredient Pill) 3 qian, taken with light salt flower water.
Patient Liu: Manous swelling at Shenshu point, white color, fine pulse with slight fever. This is Shenshu Fa (Abscess at Shenshu). Belongs to Three Yin deficiency, damp-heat entering collaterals, qi and blood stagnation. Most lingering. Temporarily apply dispersing method.
Prescription: Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Duzhong (Eucommiae Cortex), Qinjiao (Gentianae Macrophyllae Radix), Jin Gouji (Drynariae Rhizoma), Danshen (Salviae Miltiorrhizae Radix), Guangpi (Citri Reticulatae Pericarpium), Bixie (Dioscorea hypoglauca Rhizome), Duhuo (Angelicae Pubescentis Radix), Hutao Rou (Juglandis Semen), Sangzhi (Mori Ramulus).
Patient Hu: Stomach Epigastrium Abscess, fine pulse, thin body. Initial chills and fever, persisting for over 40 days, morning diarrhea without limit. This is severe Middle Qi deficiency, unable to withstand attacking and dissipating methods. Now apply interior-supporting method. If diarrhea continues, it will be difficult.
Prescription: Dangshen (Codonopsis Radix), Muxiang (Aucklandiae Radix), Fa Banxia (Pinelliae Rhizoma Preparatum), Fuling (Poria), Zhike (Aurantii Fructus), Sharen (Amomi Fructus), Danggui (Angelicae Sinensis Radix), Dongzhu (Atractylodis Rhizoma), Ganjiang (Zingiberis Rhizoma), Chenpi (Citri Reticulatae Pericarpium).
Patient [Name Omitted]: Face and cheek toxin formed by Yangming depressed fire. Now ulcerated, hole size of a bean. Although milder than cheekbone abscess, healing is slow. Must avoid all wind-stirring and fire-moving foods.
Prescription: Lingyangjiao (Saigae Tataricae Cornu), Baizhi (Angelicae Dahuricae Radix), Fuling (Poria), Tubemu (Fritillariae Cirrhosae Bulbus), Guangpi (Citri Reticulatae Pericarpium), Dangshen (Codonopsis Radix), Lianqiao (Forsythiae Fructus), Danpi (Moutan Cortex), Yinhua (Lonicerae Japonicae Flos), Gancao (Glycyrrhizae Radix et Rhizoma).
Patient Liu: Habitual heavy drinking, severe Stomach dampness. Last winter gum swelling and cough, continued drinking, resulting in hoarseness, gingival necrosis spreading to lips. This is Yanya Du (Toxicity along teeth). Not as severe as Yayan (Rock of Teeth), but difficult to heal.
Prescription: Ganlu Yin (Sweet Dew Decoction) minus Gancao and Tiandong, plus Chi Fuling (Poria cum Risu Rubro), Huangqin (Scutellariae Radix), Jiju Zi (Berberidis Fructus), Gegen (Puerariae Lobatae Radix), Chan Yi (Bombyx Batryticatus), Maochaigen (Imperatae Rhizoma).
Yuan’s Note: Caused by Yangming damp-fire.
Patient Lu: Constitutional insufficiency, complicated by wind-warmth. Fever, phlegm nodules in neck. For over 20 days, no redness, swelling, resolution, or suppuration. Half-deficient, half-excess. Shen Rou’s formula has good methods: Si Junzi Tang plus Niubangzi. Unknown to the world, I have verified it.
Prescription: Si Junzi Tang (Four Gentlemen Decoction) plus Niubangzi (Arctii Fructus), Xiang Beimu (Fritillariae Thunbergii Bulbus), Sangye (Mori Folium).
Yuan’s Note: Si Junzi tonifies deficiency, assisted by Niubangzi and Beimu to dissipate wind-phlegm, Sangye clears Lung and unblocks collaterals. Deriving evil-expelling method from tonifying deficiency shows agile thinking.
Second visit: Yesterday used Shen Rou’s formula, a supporting and dispersing method. If sweating and fever reduction occur after taking, several doses can resolve it. If no sweat and fever persist, several doses will form pus, facilitating rupture and healing.
Add Gouteng (Uncariae Ramulus cum Uncis) to previous formula.
Third visit: Three-year-old child, only breast milk, no solid food, indicating weak Spleen/Stomach. Neck phlegm nodules with chills and fever, must involve wind-warmth, half-deficient half-excess. One month now, fever subsides then returns, lump does not resolve, no pus, loose stool, Spleen/Stomach insufficiency, dual deficiency of qi and blood.
Prescription: Dangshen (Codonopsis Radix), Dongzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Jingjie (Schizonepetae Spica), Huangqi (Astragali Radix), Guishen (Angelicae Sinensis Radix Radix), Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), Sharen (Amomi Fructus), Sangye (Mori Folium).
Patient Zhou: Lizhai said: External sores persisting without resolution or suppuration indicate qi deficiency. Merely using attacking/dissipating methods yields no benefit.
Prescription: Huangqi (Astragali Radix), Dangshen (Codonopsis Radix), Fangfeng (Saposhnikoviae Radix), Guishen (Angelicae Sinensis Radix Radix), Zelan Ye (Lycopus Herba), Chuanshanjia (Manis Squama), Jiangcan (Bombyx Batryticatus), Danshen (Salviae Miltiorrhizae Radix), Guangpi (Citri Reticulatae Pericarpium), Sangzhi (Mori Ramulus).
Patient Zhu: Jiedu (Condyloma/Lymphatic swelling) ruptured and does not heal, located on forehead and brow ridge, both Yangming areas. Half a year passed, must nourish qi and blood to transform toxin.
Prescription: Da Shudi (Rehmanniae Radix Preparata), Dangshen (Codonopsis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhaojiazi (Gleditsiae Spina), Fuling (Poria), Tubemu (Fritillariae Cirrhosae Bulbus), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Yinhua (Lonicerae Japonicae Flos), Tufuling (Smilacis Glabrae Rhizoma).
Patient Chen: Constitutionally yin deficient. In April, damp-heat formed sore, ulcerated and healed. Post-healing righteous deficiency, Liver wind stirring, vertigo and falling, injuring thigh/Ringtiao area. Manous white swelling, forming Fugu Tanju (Bone-abscess Phlegm-type). Now urinary/fecal obstruction, lower abdominal distension, fear of Chang Yong (Intestinal Abscess) transformation.
Prescription: Rendongteng (Lonicerae Japonicae Caulis), Danpi (Moutan Cortex), Taoren (Persicae Semen), Yanhusuo (Corydalis Rhizoma), Xian Shouwu (Polygoni Multiflori Radix Recens), Cheqianzi (Plantaginis Semen), Guishen (Angelicae Sinensis Radix Radix), Niuxi (Achyranthis Bidentatae Radix), Xuepo (Electuari Amber) (0.5 qian, ground, mixed with decoction).
Patient [Name Omitted]: Damp-heat accumulation blocking Shaoyang. Onset with fever, scanty urine, right lower abdominal board-like pain, leg flexion inability. Small Intestine Abscess. Persistent fever, fear of suppuration.
Prescription: Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus), Sugeng (Perillae Caulis), Chi Fuling (Poria cum Risu Rubro), Tubemu (Fritillariae Cirrhosae Bulbus), Sharen (Amomi Fructus), Yanhusuo (Corydalis Rhizoma), Jiao Zharonrou (Crataegi Fructus Carbonisatus), Chuanlianzi (Toosendan Fructus), Zelan Ye (Lycopus Herba).
Patient Xu: Liver/Gallbladder depressed fire, condensing into phlegm. Hard swelling of cheeks, trismus. This is Gucao Tan (Bone-gutter Phlegm). Pulse is depressed and choppy, qi flow obstructed, medication efficacy difficult.
Prescription: Chaihu (Bupleuri Radix), Hei Shanzhi (Gardeniae Fructus Carbonisatus), Xiangfu (Cyperi Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Zhi Jiangcan (Bombyx Batryticatus), Shijueming (Haemitrichidae Concha), Tubemu (Fritillariae Cirrhosae Bulbus), Danpi (Moutan Cortex), Sangye (Mori Folium), Yujin (Curcumae Radix), Gusui Bu (Drynariae Rhizoma), Cili Li (Tribuli Fructus), Gouteng (Uncariae Ramulus cum Uncis).
Patient [Name Omitted]: Drumstick multi-bone flowing phlegm, many pus holes, palm and wrist swollen and hard, purple color but painless. Many bones expelled, exit sites healed, remaining parts still swollen. Wind-toxin and damp-heat knotted in Hand meridians. Five months duration, difficult to heal.
Prescription: Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Yiren (Coicis Semen), Danpi (Moutan Cortex), Lianqiao (Forsythiae Fructus), Guangpi (Citri Reticulatae Pericarpium), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Honghua (Carthami Flos), Sangzhi (Mori Ramulus).
Separately: Qiangchang Chong (Dynastes Heracles) roasted 5 qian, ground, applied topically.
Patient Wang: "Neijing" states: One Yin and One Yang knotting is called Hou Bi (Throat Obstruction). Refers to Shaoyin Minister Fire combining with Shaoyang Minister Fire rebelling upward. Disease arises internally, not related to external wind-warmth, thus difficult to cure quickly. Nourishing yin, descending fire, resolving phlegm are often used together. Only worry about the pulse being too fine, indicating innate Six Yin constitution with insufficient True Yang. However, clearing medicines should be used cautiously, fearing yang injury before yin is sufficient. Be careful.
Prescription: Shashen (Glehniae Radix), Shijueming (Haemitrichidae Concha), Baibian Dou (Dolichoris Semen), Yuan Shen (Scrophulariae Radix), Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma), Haqiao (Meretrix Concha), Chuan Shihu (Dendrobii Noduli Caulis), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria), Chuan Bei (Fritillariae Cirrhosae Bulbus), Jiegeng (Platycodonis Radix).
Separately: Yuanming Fen (Mirabilite) 1 qian, Zhusha (Cinnabar) 0.5 li, Bingpian (Borneolum Syntheticum) 2 fen, ground fine, blown into throat.
Patient [Name Omitted]: Kidney governs bones, knees are valleys of bones. Kidney deficiency leads to empty marrow, cold-damp takes advantage. Pain in both heels extending to knees. If prolonged, fear development of He Xi Feng Bi (Crane-Knee Wind Bi).
Prescription: Da Shudi (Rehmanniae Radix Preparata), Bixie (Dioscorea hypoglauca Rhizome), Yiren (Coicis Semen), Niuxi (Achyranthis Bidentatae Radix), Guizhi (Cinnamomi Ramulus), Gouqizi (Lycii Fructus), Chuanduan (Dipsaci Radix), Fangfeng (Saposhnikoviae Radix), Duhuo (Angelicae Pubescentis Radix).
Separately: Huqian Wan (Tiger-Hiding Pill), 3 qian every morning.
Patient [Name Omitted]: Heart fire and damp-heat combine to form phlegm nodules. Above at sublingual area, middle at epigastrium, below at glans penis, all forming small knots like cotton seeds. All caused by fire depression.
Prescription: Chuan Lian (Coptidis Rhizoma) (2 qian, wine-fried), Chenpi (Citri Reticulatae Pericarpium) (1 liang, salt-water fried), Gansui (Kansui Radix) (3 qian, bread-baked, heart removed), Banxia (Pinelliae Rhizoma) (1.5 liang), Fuling (Poria) (2 liang), Zexie (Alismatis Rhizoma) (1 liang), Haqiao (Meretrix Concha) (2 liang, ground), Hongya Daji (Euphorbiae Pekinensis Radix) (3 qian, washed lightly, fried). Grind all into fine powder, make pills with water. Take 1 qian every morning, washed down with boiled water.
Yuan’s Note: Striking directly at the nest requires both courage and insight. However, do not try casually on deficient patients.
Patient [Name Omitted]: Wind-toxin attacks inward to brain, enters ear orifice, pain with pus discharge, pus not smooth, swelling extends behind ear and neck, hard swelling does not resolve. This is Pan Er Yong (Ear-Ring Abscess). Persisted two months, symptoms lack head/face involvement, jaw not painful, fear spreading to Bone-Gutter changes, truly difficult to treat.
Prescription: Lingyangjiao (Saigae Tataricae Cornu), Yuan Shen (Scrophulariae Radix), Cishi (Magnetitum), Gan Juhua (Chrysanthemi Indici Flos), Xi Shengdi (Rehmanniae Radix Recens), Niubangzi (Arctii Fructus), Zhi Jiangcan (Bombyx Batryticatus), Changpu (Acori Tatarinowii Rhizoma), Gouteng (Uncariae Ramulus cum Uncis), Congbeitou (Allii Fistulosi Bulb).
Patient [Name Omitted]: Root of tongue stiff and numb, painless for months, fear transformation into She Gan (Tongue Cancri). Belongs to Heart/Spleen depressed fire. Treat by clearing and nourishing Ying yin, slightly adding bitter descent.
Prescription: Xian Shengdi (Rehmanniae Radix Recens), Chuan Lian (Coptidis Rhizoma), Yuan Shen (Scrophulariae Radix), Danshen (Salviae Miltiorrhizae Radix), Maidong (Ophiopogonis Tuber), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Danpi (Moutan Cortex), Jiegeng (Platycodonis Radix).
Second visit: Chuan Lian (0.3 fen), Puhuang (Lygodii Pollen) (1 qian), Bingpian (Borneolum Syntheticum) (2 fen), Wulingzhi (Trogopterori Faeces) (1 qian), Renzhongbai (Humanis Alumen) (4 fen, calcined). Grind all into fine powder, blow onto root of tongue.
Patient Wu: Summer-heat steaming and pressing, Heart fire violently excessive. Throat and tongue swelling/pain for ten days, fear suppuration. Use Liangge San (Cooling the Chest Powder) plus Xijiao (Rhino Horn) and Lingyangjiao (Saiga Horn), clearing Upper Jiao to vent Sovereign Fire blazing.
Prescription: Niubangzi (Arctii Fructus), Xijiao (Rhinocerotis Cornu), Lianqiao (Forsythiae Fructus), Jiao Shanzhi (Gardeniae Fructus Carbonisatus), Sheng Jun (Rhei Radix et Rhizoma, water-soaked), Dabeimu (Fritillariae Thunbergii Bulbus), Yuanming Fen (Mirabilite), Zhuye (Phyllostachidis Folium), Lugeng (Phragmitis Rhizoma), Bohe (Menthae Haplocalycis Herba).
Second visit: Xiaoguan Wan (Draining Tube Pill).
Prescription: Huhuanglian (Coptidis Chinensis Rhizoma) (1 liang), Ci Pi (Zanthoxyli Pericarpium) (1 liang, roasted), Xiangya Xie (Eleodontis Dentium Fragmentum) (1 liang), Wubeizi (Myrobalani Fructus) (1 liang, roasted), Chansu (Bufonis Venenum) (dissolved in wine, 3 qian), Chen Ying Ming Jiaodeng (Old Deer Antler Lamp Core) (2 liang, roasted). Grind into powder, refine honey to make pills. Coat with 3 qian of high-quality Xiongjing (Realgar). Take 3 qian every morning, washed down with Jinyinhua Tang (Honeysuckle Decoction).
Yuan’s Note: Excellent formula. However, Chansu is highly toxic and moving. Taking fractions daily is questionable. Halving the dose would be safer. This treats external lesions becoming chronic tubes/fistulas.
Patient [Name Omitted]: Toe web rotting, common disease of southern damp-heat. Many patients suffer. Now toe webs rotting, palm skin thick and dry, not just damp-heat, blood is also exhausted. Classic says: Hands grasp when receiving blood, feet walk when receiving blood. If rotting doesn't heal, fear becoming Wind-Damp. Treating wind first treats blood; when blood moves, wind extinguishes. Resolving damp first treats Spleen; when Spleen prospers, damp cuts off. This is seeking the root in treating disease.
Prescription: Zhi Shouwu (Polygoni Multiflori Radix Preparata), Danshen (Salviae Miltiorrhizae Radix), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Yiren (Coicis Semen), Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma), Fuling (Poria), Bixie (Dioscorea hypoglauca Rhizome), Cao Ben (Ligustici Chuanxiong Rhizoma - *Note: Text says 'Cao Cao', likely typo for Cao Ben or similar, interpreted as damp-resolving herb contextually or generic grass root, but strictly 'Cao' usually implies licorice or generic. Given context of damp/blood, likely referring to specific damp herb. I will translate literally as Grass Root/Cao*), Hongzao (Jujubae Fructus), Sanjiao Huma (Sesamum Indicum Fructum Triangular).
Patient Zhou: Coughing foul-smelling sputum for three months. Rapid and deficient pulse, yin injured. Pale face without luster, decreasing appetite, Lung losing support, fear developing into Fei Wei (Lung Atrophy).
Prescription: Shashen (Glehniae Radix), Huangqi (Astragali Radix), Maidong (Ophiopogonis Tuber), Baiji (Bletillae Rhizoma), Fuling (Poria), Yuan Shen (Scrophulariae Radix), Da Shengdi (Rehmanniae Radix Recens), Xingren (Armeniacae Semen Amarum), Baihe (Lilii Bulbus), Lugeng Jian (Phragmitis Rhizoma Tip).
Second visit: Sputum fishy and foul, dark complexion, rapid and deficient pulse, greatly decreased appetite. Wood/Fire attacking Metal, Metal injuring Earth, organ qi overcoming each other, fear progressing to untreatable.
Prescription: Beisha Shen (Glehniae Radix), Sangbaipi (Mori Cortex), Maidong (Ophiopogonis Tuber), Yiren (Coicis Semen), Fuling (Poria), Baibian Dou (Dolichoris Semen), Ye Jiaogen (Zizaniae Radix), Juhong (Citri Reticulatae Pericarpium Flavum), Ziwan (Asternatis Radix), Yuan Shen (Scrophulariae Radix), Lugeng Jian (Phragmitis Rhizoma Tip).
Patient Yang: One Yin and One Yang knotting is called Hou Bi. One Yin is Jueyin; One Yang is Shaoyang. Minister Fire resides in Liver/Gallbladder. When Sovereign Fire moves, Minister Fire blazes, flaming upward scorching Metal, causing Throat Obstruction symptoms.
Prescription: Xian Shengdi (Rehmanniae Radix Recens), Yuan Shen (Scrophulariae Radix), Maidong (Ophiopogonis Tuber), Jiao Shanzhi (Gardeniae Fructus Carbonisatus), Da Shengdi (Rehmanniae Radix Recens), Shijueming (Haemitrichidae Concha), Shashen (Glehniae Radix), Jiegeng (Platycodonis Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Douyi (Sojae Semen Praeparatum), Li Rou (Pyrus Fructus).