（精要论背疽，其源有五∶一天行，二瘦弱，三怒气，四肾气虚，五饮冷酒、食炙爆、服丹药。）
元末，嘉兴桐乡县后朱村徐通判，素慕洞宾，朝夕供礼。一日疽发于背，势垂危，犹扶起礼之如
昔。偶见净水盂下白纸，视之有诗云∶纷纷墓土黄金盾，片片花飞白玉芝，君主一斤臣四两，调和服
下即平夷。意其仙方，然不知何物为黄金白玉，乃召仙以大黄白芷为问。仙曰∶然。服之果验。后以
之医人，无不效。徐无子，方竟传婿沈氏，至今沈以此治生，数百里来货药者无虚日。族大而分数十
家，惟嫡枝居大椿树下者药乃验。沈子尝从吾友俞院判学，尝闻其药，今加穿山甲、当归须、金银花
矣。然大黄既多，以下为主，不问阴阳之毒而投之，恐亦有害者。然源源往医，又独于椿树下者验，
岂非天固与之乎。（《七修类编》）
京师万胜门生员王超，忽觉背上如有疮隐，倩人看之，已如盏大，其头无数。或教往梁门里外科
金龟儿张家买药。张视颦眉曰∶此疮甚恶，非药所能治，只有灼艾一法，庶可冀望万分，然恐费力。
乃撮艾与之曰∶且归试灸疮上，只怕不疼，直待灸疼方可疗耳。灼火十余，殊不知痛，妻守之而哭。
至第十三壮始大痛，四旁恶肉卷烂，随手堕地，即以稍愈。再诣张谢，张付药数帖日安。则知痈疽发
于背胁，其捷法莫如灸也。（《类编》）
王敏诊一人，发背不起。医言起则治矣。敏曰∶是击指脉，即起亦不治。众劫以艾，疽起如粟。
众曰∶无伤矣。竟三日死。（《姑苏志》）
治发背脑疽，一切恶疮初觉时，采独科苍耳一根，连叶带子，细锉不犯铁器，用砂锅熬水二大碗，
熬及一半，疮在上，徐徐饭后服之。吐出，候吐定再服，以尽为度。疮在下，空心服，疮自破出脓，
更不溃烂，疮上
别以膏药敷之。此方京兆张伯玉家榜不传人，后昆仲皆登第，人谓善报。（元遗山《续夷坚志》）
大凡石类，多主痈疽，世传麦饭石膏，治发背疮甚效，乃中岳山人吕子华秘方。裴员外啖之以名第，
河南尹胁之以重刑，吕宁绝荣望，守死不传。其方取此石碎如棋子，炭火烧赤，投米醋中浸之，如此
十次，研末筛细入乳钵内，用数人更碾五七日，要细腻如面四两；鹿角一具，要生取连脑骨者，其自
脱者不堪用，每二三寸截之，炭火烧令烟尽即止，为末研细二两；白蔹生研末二两。用三年米醋入银
石器内，煎令鱼目沸旋，旋入药在内，竹杖子不住搅，熬一二时久，稀稠得所，倾在盆内待冷，以纸
盖收，勿令尘入。用时以鹅翎拂膏于肿上，四围赤处尽涂之，中留钱大泄气。如未有脓即内消，已作
头即撮小，已溃即排脓如湍水。如病久肌肉烂落，见出筋骨者，即涂细布上贴之，干即易，逐日疮口
收敛。但中膈不穴者，即无不瘥。已溃者用药时，先以猪蹄汤洗去脓血，用帛挹干乃用药。其疮切忌
手触动嫩肉，仍不可以口气吹风及腋气月经有孕人见之，合药亦忌此等。初时一日一洗一换，十日后
二日一换。此药拯细方有效，若不细涂之，即极痛也。此方《千金》月令已有之，但不及此详细耳。
（《本草纲目》）
冯楚瞻治蒋司农，向来脉气寸强尺弱，故服八味丸已有年矣。（此等脉多阴虚火
上炎之候，服八味丸者，多贻后患。）然过劳，药力不能胜其妄动之火，鼻衄大作，调理虽愈，而口渴
殊甚，饮汤水如甘露然，即数十杯不足满其欲也。（此即消渴久成痈疽。）劝服大剂壮水，佐以引火
归原之饵，则水升火降，消渴自除，变症可弭。乃忽之，虽服数剂，渴略减，药即停。至初夏，背上
忽隐隐痛痒，渐甚而肉硬，半月余痛极重。及诊之，当脊少偏半寸外不肿，肉分坚实如碗大矣。曰∶
久渴不治，阴水日亏，阴火日炽，书所以有脑疽背疽之兆也。亟为托出阳分，使毒瓦斯勿致逗遛内陷为
要。乃外用大黄二两，芙蓉叶、赤芍各一两，白蔹、白芨各五钱，为末，鸡子清调敷毒四围。内则重
滋阴水，加熟地、山药、土贝、角刺、天虫、甲片、生甘草、连翘、金银花之类。及肿既成，乃早吞
八味丸五六钱，以培先天之水火；食远服参、 、归、芍、术、草、银花、甲片、天虫、角刺、白芷
之类，以助后天之气血；外以太乙膏加男发、蓖麻子、乳香、没药，煎膏贴之，以呼毒瓦斯外出。不旬
日红肿消，痛重减，疮
已高，已有脓势。乃一外科改弦易辙，几至内溃。再亟治，仍用前法煎药，加肉桂钱许，仍高肿红
活，竟如些小之毒，溃脓而愈。
高鼓峰治一乡人，患发背，上距风府，下连肾俞，通块肿起，肌肉青冷，坚硬如铁，饮食俱废，
不省人事，医犹用解毒药。脉之，六部细数，气血大亏，毒将内陷矣。急用养荣汤加附子、炮姜，三
大帖而胃气开，十剂而坚硬者散去十之八九，只左边如茶钟大， 红作肿。戒之曰∶切莫箍药及刀针，
气血温和，毒当自出，箍则反迟，非时而刺，收口难矣。彼以不任痛，竟受刺出血。曰∶当倍前药急
服，以收口为度。仍戒以节嗜欲，慎饮食，兼服还少丹、八味丸而愈。
朱丹溪曰∶予见吴兄浓味气郁，而形实性重，年近六十，患背疽，医与他药皆不行，惟香附末饮
之甚快，始终只此一味，肿溃恃此以安。此等体实千百而一见者也。（名独胜散，惟气滞血凝实症宜
之。）
楼氏妇早寡，善饮啖，形肥伟，性沉毒，年六十六，七月间生背疽近正脊，医遂横直裂开取血，
杂以五香、十宣散，与酒饮之。月余未尝议其寡居之郁，酒肉之毒，执着之滞，时令之热，迨至于平
陷，淹延两三月而不救。
江陵府紫极观，掘得石碑载此∶凡人发背，欲结未结，赤红肿痛，先以湿纸覆其上，立视候其纸
先干处，则是结痈头也。取大蒜切成片，如当三钱浓，安头上，用大艾炷灸之，三壮即换一蒜片，痛
者灸至不痛时住，不痛者灸至痛时方住，早觉早灸为上。（如有头似麻豆大者，不须用湿纸覆法。）
若有十数头，聚而在一处生者，即用大蒜头捣膏作薄饼，铺头上，聚艾于饼上烧之。（一二日十灸十
活，三四日六七活，五六日三四活。）
王蘧《发背方》序云∶元 三年夏四月，官京师，疽发于背，召国医治之，逾日势益甚。得徐州
萧县人张生，以艾火加疮上，自旦及暮，凡一百五十壮，知痛方已。明日镊去黑痂，脓尽溃，肉里皆
红，亦不复痛，始别以膏药贴之，日一易焉。易时旋剪去黑烂肉许，疮乃平。是岁秋夏间，京师士大
夫病疽者七人，余独生。此虽司命自然固有定数，不知其方，遂至不幸者，以人意论之，可为慨然。
于是撰次前后所得方，模板以施，
庶几古人济众之意。（此即当头灸法，但不用蒜耳。）
史源母氏，背胛间微痒，视之有赤半寸许，方有白粒如粟黍，乃急着艾灸，其赤随消，二七壮而
止。信宿，复觉微痛。视之有赤下流长二寸，阔如韭叶，举家皆以前灸为悔。或云等慈寺尼智全者，
前病疮甚大，得灸而愈。奔问之，全曰∶剧时昏不知，但小师辈言，范八奉议守定，灸八百余壮方苏，
约艾一筛耳。亟归白之，见从，始以艾作炷如银杏大，灸其上十数，殊不知痛。乃截四旁赤引，其炷
减四之三，皆觉痛，七壮后觉痒。每一壮烬，则赤随缩入，灸至二十余壮，赤晕收退。病者不惮，遂
以艾作团大灸其上，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，
坏肉成隔，直至好肉方痛。四旁知痛，肉未坏也。病者六夜不寐，至是食粥安寐。至晚视之，疮如覆
一甑，突高三西寸，上有百数小窍，色正黑。突然高者，毒瓦斯出外而聚也。百数小窍，毒未聚而浮攻
肌肤也。色正黑者，皮与肉俱坏也。非灸火出其毒于坏肉之里，则五脏逼矣。
薛立斋治王通府，患背发十余日，势危脉大，先与槐花酒二服，杀退其势。更以败毒散二剂，再
以托里药数剂渐渍。又用桑柴燃灸患处，每日灸良久，仍以膏药贴之。灸至数次，脓溃腐脱，以托里
药加白术、陈皮，月余而愈。
刘大尹发背六七日，满背肿痛，势甚危，与隔蒜灸百壮，饮槐花酒二碗即睡。觉与托里消毒药，
十去五六。令以桑枝灸患处而溃，数日愈。凡灸及饮槐花酒，则托里之效甚速。
一园丁患发背甚危，令取金银藤五六两捣烂，入热酒一钟，绞取酒汁温服，渣罨患处，四五服而
平。彼用此药治疮，足以养家，弃园业。诸书云∶金银花治疮疡，未成者即散，已成者即溃，有回生
之功。
太监刘关患发背，肿痛色紫。诊其脉息沉数。陈良甫云∶脉数发热而痛者，发于阳也。且疮疡赤
甚则紫，即火极似水也。询之尝服丹药半载，乃积温成热所致耳。遂以内疏黄连汤，再服消平。更用
排脓消毒药及猪蹄汤、太乙膏而愈。经曰∶色与脉当相参应，治之者在明亢害承制之理，阴阳变化之
机焉耳。
一男子年逾五十，患发背，色紫肿痛，外皮将溃，寐食不安，神思甚疲，用桑柴灸患处，出黑血
即鼾睡，觉而诸症如失。服仙方活命饮二帖，又灸一次，脓血皆出。更进二剂，肿痛大退。又服托里
消毒散，数帖而敛。夫疮毒炽甚，未宜峻剂攻之，但年老血气衰弱，况又发在肌表。若专于攻毒，则
胃先损，必反误事。
吴江申佥宪患背疽，坚硬，脉沉实，乃毒在内，用宣毒散∶大黄五钱，煨，白芷五钱，水煎，食
前服。一剂大小便下污物，再服而消。此方乃宣通攻毒之剂，脉沉实便秘者，其功甚大。
（ 按∶即首条黄金白玉方，薛用之而不详其出处。）
大尹陈国信素阴虚，患背疽，用参、 大补而不敛，内热发热，舌燥唇裂，小便少，频数，口干
饮汤，呕吐泻利，耳闭目盲，仰首眩晕，脉浮大而数。薛曰∶疮口不敛，脾土败也；舌燥唇裂，肾水
枯也；小便频数，肺气衰也；内热发热，虚火上炎也；口干饮汤，真寒之象也；呕吐泻利，真火衰败
也；耳闭目盲，肝木枯散也；仰首眩晕，肾气绝也。辞不治，后果殁。
（ 按∶不拘内外病，凡阴虚者，服参、 诸气分药，非惟无益，而反害之。据此症，纯属三阴
亏竭，若初时解用二地、二冬、杞子、归、芍之辈，犹可挽也。）
吴庠史邦直之内，仲夏患背疽，死肉不溃，发热痛甚，作呕少食，口干饮汤，脉洪大，按之如无，
此内真寒而外假热，当舍时从症。先用六君加炮姜、肉桂，四剂饮食顿进。复用十全大补汤，仍加姜、
桂之类，五十余帖而死肉溃，又五十余剂而新肉生。斯人血气充盛，而疮易起易敛。使医者逆知，预
为托里，必无此患。（雄按∶十全大补，必毒火尽除而后可用。）
南仪部贺朝卿，升山西少参，别时见其唇鼻青黑，且时搔背。问其故，曰∶有小疮耳。与视之，
果疽也。此脾胃败坏，为不治之症。薛素与善，悲其途次不便殡殓，遂托其僚友张东沙辈强留之，勉
与大补，但出紫血，虚极也。或谓毒炽不能为脓，乃服攻毒药一钟，以致呕逆脉脱，果卒于南都。
京兆柴黼庵，仲夏背发，色黯微肿，发热烦躁，痰涎自出，小腹阴实，手足逆冷，右关浮涩，两
尺微细，
曰∶此虚寒之症也。王太仆云，大热而不热，是无火也。决不能起。恳求治之，用大温补药一帖，流
涎虽止，患处不起，终不能效。
宪副屠九峰，孟春患此，色黯漫肿，作渴便数，尺脉洪数。此肾水干涸，当殁于火旺之际。不信，
更用苦寒之药，复伤元气，以促其殁。
一男子不慎房劳，背胛肿高三寸许，阔经尺余，自汗盗汗，内热发热，口干饮汤，脉浮大，按之
弱涩，此阴虚气节为患。用十全大补加五味、麦冬、山萸、山药，四剂诸症悉退。后乃别用流气饮一
帖，虚症悉具，肿硬如石，仍以前药六剂，始得愈。
一儒者背肿一块，按之则软，肉色如故，饮食如常，劳则吐痰体倦，此脾气虚而痰滞。用补中益
气加茯苓、半夏，少加羌活，外用阴阳散，以姜汁调搽而消。后因劳，头晕作呕，仍以前药去羌活，
加生姜、蔓荆子而愈。
节推王器之，背患疽，疮头如黍， 痛背重，脉沉而实，此毒在内。服黄连内疏汤，二剂少退。
更与仙方活命饮而愈。
举人刘华甫， 肿作痛，脉浮而数，此毒蓄于经络。用内托复煎散二剂，而 肿作痛。用仙方活
命饮四剂，而肿痛止。更用托里药而愈。
一儒者患背疽，肿 痛甚，此热毒蕴结而炽盛。用隔蒜灸而痛止。服仙方活命饮而肿消。更与托
里药而溃愈。
一男子患背疽，腐肉虽溃而新肉不生，此毒瓦斯解而脾胃之气虚也。用六君子加芎、归、五味、黄
渐愈。用十全大补汤全愈。
一男子背患疽，肿痛，赤晕尺余，背如负石。其势当峻攻，其脉又不宜，遂用针砭赤处，出紫血
碗许，肿痛顿退。更用神功散及仙方活命饮二剂，疮口及砭处出血水而消。
一男子背患疽，肉腐脓清，肌肉不生，此邪去而气血俱虚也。用十全大补汤，月余而敛。
【精要论述背疽，其病因有五种：一是时行疫气，二是身体瘦弱，三是怒气郁结，四是肾气虚弱，五是饮用冷酒、食用烤爆食物、服用丹药。】
元朝末年，嘉兴桐乡县后朱村的徐通判，一向仰慕吕洞宾，早晚供奉礼拜。一天背部发疽，病情垂危，他仍然扶起身体像往常一样行礼。偶然看到净水盂下的白纸，上面有一首诗写道：“纷纷墓土黄金盾，片片花飞白玉芝，君主一斤臣四两，调和服下即平夷。”他以为是仙方，但不知道什么是黄金白玉，于是向仙人请教，以大黄、白芷作为对应。仙人说：“是的。”服用后果然有效。后来他用此方医治他人，没有不有效的。徐通判没有儿子，最终将此方传给了女婿沈氏，至今沈家以此谋生，几百里外来买药的人络绎不绝。家族庞大，分为几十家，只有居住在老椿树下的那一支，药效才灵验。沈家的儿子曾跟随我的朋友俞院判学习，曾经听他说这个药方，现在加入了穿山甲、当归须、金银花。但是大黄用量很多，以下泄为主，不分阴阳毒邪而投用，恐怕也有害处。然而源源不断去治病，又唯独在椿树下的一支灵验，这难道不是上天本来就赐予的吗？（出自《七修类编》）
京师万胜门的学生王超，忽然觉得背上好像有隐痛如疮，请人查看，已经像盏口那么大，头数无数。有人教他去梁门里的外科医生金龟儿张家买药。张医生皱眉看后说：“这个疮很恶毒，不是药物能治好的，只有灼烧艾灸这一法，或许还有一线希望，但恐怕费力。”于是撮了一些艾草给他：“先回去试着灸疮上，只怕不疼，直到灸到疼才能治疗。”烧灼了十几壮，竟然不知道痛，妻子守着哭。到了第十三壮才大痛，四周坏肉卷曲腐烂，随手掉在地上，随即稍微好转。再次去感谢张医生，张医生给几帖药，日子安稳了。由此可知痈疽发于背胁，快捷的方法莫过于艾灸。（出自《类编》）
王敏诊治一个人，发背不起发。医生说起了发就能治了。王敏说：“这是击指脉，即使起发也不能治。”众人强迫用艾草灸，疽起发像粟米大小。众人说：“没危险了。”结果三天后死了。（出自《姑苏志》）
治疗发背脑疽，一切恶疮刚感觉时，采摘独杆苍耳一根，连叶带子，细细切碎不接触铁器，用砂锅熬水两大碗，熬到一半，疮在上部，慢慢饭后服用。吐出来，等吐定后再服，以喝完为度。疮在下部，空腹服用，疮自然破出脓，不再溃烂，疮上另外敷膏药。此方是京兆张伯玉家秘不外传的，后来他的兄弟都考中进士，人们说是善报。（出自元好问《续夷坚志》）
大凡石类药物，多主治痈疽，世间流传麦饭石膏，治疗发背疮非常有效，是中岳山人吕子华的秘方。裴员外用功名收买，河南尹用重刑威胁，吕宁断绝荣华期望，坚守死也不传授。此方取这种石头碎如棋子，炭火烧红，投入米醋中浸泡，如此十次，研末筛细放入乳钵内，用几个人轮流碾五七天，要细腻如面粉四两；鹿角一具，要生取连脑骨的，自然脱落的不能用，每二三寸截断，炭火烧至烟尽为止，研细末二两；白蔹生研末二两。用三年陈米醋放入银石器内，煎至鱼目沸旋，随即入药在内，竹杖子不停搅拌，熬一两个时辰，稀稠得当，倒在盆内待冷，用纸盖收，不要让灰尘进入。用时用鹅毛拂膏在肿上，四周赤处全涂之，中间留铜钱大透气。如果没有化脓就内消，已经成头就撮小，已经溃破就排脓如湍水。如果病久肌肉烂落，露出筋骨，就涂在细布上贴之，干了就换，每天疮口收敛。只要中间膈膜没有穿孔，就没有不痊愈的。已经溃破用药时，先用猪蹄汤洗去脓血，用帛擦干再用药。此疮切忌手触动嫩肉，也不可以用口气吹风及腋气月经有孕人看见，配药也忌讳这些。初时一日一洗一换，十日后二日一换。此药拯救细微之处方有效，如果不仔细涂抹，就会极痛。此方《千金月令》已有记载，但不如此详细。（出自《本草纲目》）
冯楚瞻治疗蒋司农，向来脉象寸强尺弱，所以服用八味丸已有多年。（这种脉象多是阴虚火上炎的征候，服用八味丸的，多会留下后患。）然而过度劳累，药力不能胜其妄动之火，鼻出血大作，调理虽然好了，但口渴非常严重，喝汤水像甘露一样，即使几十杯也不足以满足欲望。（这就是消渴久成痈疽。）劝他服用大剂量的壮水药，佐以引火归原的药饵，则水升火降，消渴自除，变症可消除。但他忽视了，虽然服了几剂，口渴略减，药就停了。到初夏，背上忽然隐隐痛痒，渐重而肉硬，半月多痛极重。等到诊察，当脊柱稍偏半寸外不肿，肉分坚实如碗大。说：“久渴不治，阴水日亏，阴火日炽，书上有脑疽背疽的征兆。”急忙托出阳分，使毒瓦斯不要滞留内陷为要。于是外用大黄二两，芙蓉叶、赤芍各一两，白蔹、白芨各五钱，研末，鸡子清调敷毒四周。内则重滋阴水，加熟地、山药、土贝、角刺、天虫、甲片、生甘草、连翘、金银花之类。等到肿既成，就早上吞服八味丸五六钱，以培补先天水火；食远服参、芪、归、芍、术、草、银花、甲片、天虫、角刺、白芷之类，以助后天气血；外以太乙膏加男发、蓖麻子、乳香、没药，煎膏贴之，以呼出毒瓦斯。不到十天红肿消，痛重减，疮已高，已有脓势。然后一个外科医生改弦易辙，几乎导致内溃。再次紧急治疗，仍用前法煎药，加肉桂一钱许，仍高肿红活，竟像小的毒疮，溃脓而愈。
高鼓峰治疗一个乡人，患发背，上距风府，下连肾俞，通块肿起，肌肉青冷，坚硬如铁，饮食俱废，不省人事，医生还用解毒药。诊脉，六部细数，气血大亏，毒将内陷。急用养荣汤加附子、炮姜，三大帖而胃气开，十剂而坚硬者散去十之八九，只左边如茶钟大，发红作肿。告诫他说：“切莫箍药及刀针，气血温和，毒当自出，箍则反迟，非时而刺，收口难矣。”他因为忍受不了痛，竟然受刺出血。说：“应当加倍前药急服，以收口为度。”仍告诫节制嗜欲，慎饮食，兼服还少丹、八味丸而愈。
朱丹溪说：“我看见吴兄浓味气郁，而形实性重，年近六十，患背疽，医生给他其他药都不行，只有香附末饮之很快，始终只此一味，肿溃恃此以安。这种体质结实千百而一见的人。”（名独胜散，只有气滞血凝实症适宜用。）
楼氏妇女早寡，善饮酒吃肉，形体肥伟，性情沉毒，年六十六，七月间生背疽靠近正脊，医生于是横直裂开取血，杂以五香、十宣散，与酒饮之。一个多月未曾议论她的寡居之郁，酒肉之毒，执着之滞，时令之热，等到平陷，拖延两三个月而不救。
江陵府紫极观，掘得石碑记载此方：“凡人发背，欲结未结，赤红肿痛，先以湿纸覆其上，立视候其纸先干处，则是结痈头也。取大蒜切成片，如当三钱厚，安头上，用大艾炷灸之，三壮即换一蒜片，痛者灸至不痛时住，不痛者灸至痛时方住，早觉早灸为上。（如有头似麻豆大者，不须用湿纸覆法。）若有十数头，聚而在一处生者，即用大蒜头捣膏作薄饼，铺头上，聚艾于饼上烧之。（一二日十灸十活，三四日六七活，五六日三四活。）”
王蘧《发背方》序云：“元某三年夏四月，官京师，疽发于背，召国医治之，逾日势益甚。得徐州萧县人张生，以艾火加疮上，自旦及暮，凡一百五十壮，知痛方已。明日镊去黑痂，脓尽溃，肉里皆红，亦不复痛，始别以膏药贴之，日一易焉。易时旋剪去黑烂肉许，疮乃平。是岁秋夏间，京师士大夫病疽者七人，余独生。此虽司命自然固有定数，不知其方，遂至不幸者，以人意论之，可为慨然。于是撰次前后所得方，模板以施，庶几古人济众之意。”（这就是当头灸法，只是不用蒜罢了。）
史源的母亲，背胛间微痒，看之有赤半寸许，方有白粒如粟黍，于是急着艾灸，其赤随消，十四壮而止。隔两夜，又觉微痛。看之有赤下流长二寸，阔如韭叶，举家都以前灸为悔。有人说等慈寺尼智全者，前病疮甚大，得灸而愈。奔问之，全说：“剧时昏不知，但小师辈言，范八奉议守定，灸八百余壮方苏，约艾一筛耳。”急忙回家禀告，见从，开始以艾作炷如银杏大，灸其上十数，殊不知痛。于是截四旁赤引，其炷减四之三，皆觉痛，七壮后觉痒。每一壮烬，则赤随缩入，灸至二十余壮，赤晕收退。病者不惮，遂以艾作团大灸其上，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，坏肉成隔，直至好肉方痛。四旁知痛，肉未坏也。病者六夜不寐，至此食粥安寐。至晚看之，疮如覆一甑，突高三西寸，上有百数小窍，色正黑。突然高者，毒瓦斯出外而聚也。百数小窍，毒未聚而浮攻肌肤也。色正黑者，皮与肉俱坏也。非灸火出其毒于坏肉之里，则五脏逼矣。
薛立斋治疗王通府，患背发十余日，势危脉大，先与槐花酒二服，杀退其势。更以败毒散二剂，再以托里药数剂渐渍。又用桑柴燃灸患处，每日灸良久，仍以膏药贴之。灸至数次，脓溃腐脱，以托里药加白术、陈皮，月余而愈。
刘大尹发背六七日，满背肿痛，势甚危，与隔蒜灸百壮，饮槐花酒二碗即睡。觉与托里消毒药，十去五六。令以桑枝灸患处而溃，数日愈。凡灸及饮槐花酒，则托里之效甚速。
一个园丁患发背很危急，让人取金银藤五六两捣烂，入热酒一钟，绞取酒汁温服，渣罨患处，四五服而平。他用此药治疮，足以养家，弃园业。诸书云：“金银花治疮疡，未成者即散，已成者即溃，有回生之功。”
太监刘关患发背，肿痛色紫。诊其脉息沉数。陈良甫说：“脉数发热而痛者，发于阳也。且疮疡赤甚则紫，即火极似水也。”询问之曾服丹药半年，乃是积温成热所致耳。遂以内疏黄连汤，再服消平。更用排脓消毒药及猪蹄汤、太乙膏而愈。经曰：“色与脉当相参应，治之者在明亢害承制之理，阴阳变化之机焉耳。”
一个男子年过五十，患发背，色紫肿痛，外皮将溃，寐食不安，神思甚疲，用桑柴灸患处，出黑血即鼾睡，觉而诸症如失。服仙方活命饮二帖，又灸一次，脓血皆出。更进二剂，肿痛大退。又服托里消毒散，数帖而敛。夫疮毒炽甚，未宜峻剂攻之，但年老血气衰弱，况又发在肌表。若专于攻毒，则胃先损，必反误事。
吴江申佥宪患背疽，坚硬，脉沉实，乃是毒在内，用宣毒散：大黄五钱，煨，白芷五钱，水煎，食前服。一剂大小便下污物，再服而消。此方乃宣通攻毒之剂，脉沉实便秘者，其功甚大。（按：即首条黄金白玉方，薛用之而不详其出处。）
大尹陈国信素阴虚，患背疽，用参、芪大补而不敛，内热发热，舌燥唇裂，小便少，频数，口干饮汤，呕吐泻利，耳闭目盲，仰首眩晕，脉浮大而数。薛说：“疮口不敛，脾土败也；舌燥唇裂，肾水枯也；小便频数，肺气衰也；内热发热，虚火上炎也；口干饮汤，真寒之象也；呕吐泻利，真火衰败也；耳闭目盲，肝木枯散也；仰首眩晕，肾气绝也。”辞不治，后果殁。（按：不拘内外病，凡阴虚者，服参、芪诸气分药，非惟无益，而反害之。据此症，纯属三阴亏竭，若初时解用二地、二冬、杞子、归、芍之辈，犹可挽也。）
吴庠史邦直的内人，仲夏患背疽，死肉不溃，发热痛甚，作呕少食，口干饮汤，脉洪大，按之如无，此内真寒而外假热，当舍时从症。先用六君加炮姜、肉桂，四剂饮食顿进。复用十全大补汤，仍加姜、桂之类，五十余帖而死肉溃，又五十余剂而新肉生。斯人血气充盛，而疮易起易敛。使医者逆知，预为托里，必无此患。（雄按：十全大补，必毒火尽除而后可用。）
南仪部贺朝卿，升山西少参，别时见其唇鼻青黑，且时搔背。问其故，说：“有小疮耳。”与视之，果疽也。此脾胃败坏，为不治之症。薛素与善，悲其途次不便殡殓，遂托其僚友张东沙辈强留之，勉与大补，但出紫血，虚极也。或谓毒炽不能为脓，乃服攻毒药一钟，以致呕逆脉脱，果卒于南都。
京兆柴黼庵，仲夏背发，色黯微肿，发热烦躁，痰涎自出，小腹阴实，手足逆冷，右关浮涩，两尺微细，说：“此虚寒之症也。”王太仆说，大热而不热，是无火也。决不能起。恳求治之，用大温补药一帖，流涎虽止，患处不起，终不能效。
宪副屠九峰，孟春患此，色黯漫肿，作渴便数，尺脉洪数。此肾水干涸，当殁于火旺之际。不信，更用苦寒之药，复伤元气，以促其殁。
一个男子不慎房劳，背胛肿高三寸许，阔经尺余，自汗盗汗，内热发热，口干饮汤，脉浮大，按之弱涩，此阴虚气节为患。用十全大补加五味、麦冬、山萸、山药，四剂诸症悉退。后乃别用流气饮一帖，虚症悉具，肿硬如石，仍以前药六剂，始得愈。
一个儒者背肿一块，按之则软，肉色如故，饮食如常，劳则吐痰体倦，此脾气虚而痰滞。用补中益气加茯苓、半夏，少加羌活，外用阴阳散，以姜汁调搽而消。后因劳，头晕作呕，仍以前药去羌活，加生姜、蔓荆子而愈。
节推王器之，背患疽，疮头如黍，痛背重，脉沉而实，此毒在内。服黄连内疏汤，二剂少退。更与仙方活命饮而愈。
举人刘华甫，肿作痛，脉浮而数，此毒蓄于经络。用内托复煎散二剂，而肿作痛。用仙方活命饮四剂，而肿痛止。更用托里药而愈。
一个儒者患背疽，肿疼痛甚，此热毒蕴结而炽盛。用隔蒜灸而痛止。服仙方活命饮而肿消。更与托里药而溃愈。
一个男子患背疽，腐肉虽溃而新肉不生，此毒瓦斯解而脾胃之气虚也。用六君子加芎、归、五味、黄芪渐愈。用十全大补汤全愈。
一个男子背患疽，肿痛，赤晕尺余，背如负石。其势当峻攻，其脉又不宜，遂用针砭赤处，出紫血碗许，肿痛顿退。更用神功散及仙方活命饮二剂，疮口及砭处出血水而消。
一个男子背患疽，肉腐脓清，肌肉不生，此邪去而气血俱虚也。用十全大补汤，月余而敛。
[Essential Discussion on Back Carbuncle, its etiology has five sources: one is epidemic qi, two is emaciation and weakness, three is anger stagnation, four is kidney qi deficiency, five is drinking cold wine, eating roasted or fried foods, and taking elixirs.]
At the end of the Yuan Dynasty, Xu Tongpan from Houzhu Village, Tongxiang County, Jiaxing, admired Lü Dongbin and offered worship morning and night. One day, a carbuncle erupted on his back, and although his condition was critical, he still propped himself up to bow as usual. He accidentally saw a piece of white paper under a water basin, on which was written a poem: "Heap upon heap of grave soil like golden shields, Flakes of flowers flying like white jade mushrooms, The ruler weighs one jin, the minister four liang, Mix and take them, and peace will be restored." He thought it was an immortal prescription but did not know what "golden" and "white jade" referred to, so he consulted the immortal, asking if Da Huang (Rhei Radix et Rhizoma) and Bai Zhi (Angelicae Dahuricae Radix) corresponded. The immortal said, "Yes." Taking it proved effective. Later, he used this prescription to treat others, with no failure. Xu had no sons, so he eventually passed the prescription to his son-in-law, the Shen family. To this day, the Shens make their living by selling this medicine, with people coming from hundreds of miles away to buy it daily. The clan is large, divided into dozens of branches, but only those living under the old Chinese chestnut tree (Cinnamomum camphora) find it effective. Shen's son once studied with my friend Yu Yuanpan and mentioned that the prescription now includes Shan Jia Pian (Squama Manis), Dang Gui Xu (Radix Angelicae Sinensis Cauda), and Jin Yin Hua (Flos Lonicerae Japonicae). However, since Da Huang is used in large quantities, acting primarily as a purgative, using it indiscriminately regardless of yin or yang toxicity may cause harm. Yet, it works continuously for many, yet only proves effective for the branch under the chestnut tree. Is this not heaven's gift? (From *Qi Xiu Lei Bian*)
Wang Chao, a student at Wansheng Gate in the capital, suddenly felt a hidden pain on his back as if from a sore. Upon inspection, it was already the size of a cup mouth, with countless heads. Someone advised him to buy medicine from Zhang Jiagou'er, a surgeon in Liangmen. Doctor Zhang frowned and said, "This sore is very malignant; medicines cannot cure it. Only moxibustion offers a slim hope, though it is laborious." He gave him some mugwort and said, "Go home and try moxibustion on the sore. You likely won't feel pain; only when it hurts can treatment proceed." After more than ten moxa cones, he felt no pain, while his wife watched and cried. It was only at the thirteenth cone that severe pain occurred. The necrotic flesh around the edges curled and rotted, falling off easily, and he improved slightly. He thanked Doctor Zhang again, who gave him several doses of medicine, after which he remained stable. Thus, we know that for carbuncles erupting on the back or flanks, the quickest method is moxibustion. (From *Lei Bian*)
Wang Min treated a patient with a back carbuncle that failed to suppurate. The doctor said that once it suppurates, it can be treated. Wang Min said, "This is a 'finger-striking' pulse; even if it suppurates, it cannot be cured." The crowd forced moxibustion, and the carbuncle rose like millet grains. The crowd said, "No danger." Three days later, he died. (From *Gusu Zhi*)
To treat back carbuncles, brain carbuncles, and all malignant sores at the initial stage, harvest a single-stemmed Xian Er Cao (Asteris Tatarici Herba), including leaves and seeds. Finely chop without touching iron. Boil in two large bowls of water in a clay pot until reduced by half. If the sore is on the upper body, take slowly after meals. Wait for vomiting to subside, then continue until finished. If the sore is on the lower body, take on an empty stomach. The sore will naturally rupture and discharge pus, preventing further spreading. Apply ointment separately. This prescription was kept secret by Zhang Boyu of Jingzhao; later, his brothers passed the imperial examinations, and people attributed this to good karma. (From Yuan Haowen's *Xu Yijian Zhi*)
Generally, stone-type herbs often treat carbuncles. The world-transmitted Maifan Shi Gao (Kaolinite) is very effective for back carbuncles; it is a secret formula of Lü Zihua, a hermit from Mount Zhong. Pei Yuanwai tried to buy it with official rank, and the Henan Prefect threatened him with heavy punishment, but Lü Ning refused all glory and chose death over transmission. The method involves crushing the stone like chess pieces, heating it red in charcoal, and soaking it in rice vinegar. Repeat ten times, then grind into fine powder. Take four taels of this powder. Use one deer antler (Lu Rong), preferably fresh with the skull bone attached; naturally shed ones are unusable. Cut into 2-3 inch pieces, burn in charcoal until smoke ceases, and grind into two taels of fine powder. Add two taels of raw Bai Lian (Ampelopsis Radix). Place three-year-old rice vinegar in a silver or earthenware vessel, boil until bubbles resemble fish eyes, then add the medicine. Stir constantly with a bamboo stick for one to two hours until the consistency is appropriate. Pour into a basin to cool, cover with paper to prevent dust. When using, apply the ointment with a goose feather to the swelling, covering all red areas but leaving a coin-sized hole in the center for ventilation. If no pus has formed, it will resolve internally; if a head has formed, it will shrink; if ulcerated, it will drain pus rapidly. If muscles have rotted exposing bone, apply to fine cloth and patch; change when dry, promoting daily contraction. As long as the diaphragm is not perforated, recovery is certain. For ulcerated sores, wash with pig trotter soup to remove pus and blood, dry with cloth, then apply. Avoid touching tender flesh with hands, blowing on it, or letting menstruating or pregnant women see it during preparation. Initially, wash and change daily; after ten days, change every two days. This medicine is effective only if applied meticulously; otherwise, it causes extreme pain. This prescription appears in *Qianjin Yue Ling* but lacks such detail. (From *Bencao Gangmu*)
Feng Chuzhan treated Jiang Sinong, whose pulse was strong at the cun position and weak at the chi position, so he had taken Ba Wei Wan (Eight-Ingredient Pill with Rehmannia Root) for years. (Such pulses often indicate yin deficiency with flaming fire; taking Ba Wei Wan may cause future complications.) However, due to overwork, the medicine could not control the erratic fire, leading to severe epistaxis. Although调理 (regulation) helped, thirst became extreme; he drank soups and water as if they were ambrosia, yet dozens of cups were insufficient. (This is xiao ke [wasting-thirst] becoming carbuncles over time.) He was advised to take large doses of yin-nourishing medicine assisted by fire-guiding agents, so that water rises and fire descends, eliminating thirst and preventing complications. He ignored this; although a few doses reduced thirst slightly, he stopped the medicine. By early summer, his back suddenly ached and itched, progressing to hardness. After half a month, pain was severe. Examination showed a bowl-sized hard mass half a cun lateral to the spine. Feng said, "Untreated chronic thirst depletes yin water daily and intensifies yin fire; texts warn of brain and back carbuncles as signs." Urgently, he aimed to expel toxins to the exterior to prevent internal collapse. Externally, he used Da Huang (two liang), Fu Rong Ye (Lotus Leaf, one liang each), Chi Shao (Red Peony Root, one liang), Bai Lian (two qian each), and Bai Ji (Bletilla Rhizome, two qian), ground to powder, mixed with egg white, and applied around the toxin. Internally, he heavily nourished yin water with Shu Di Huang (Prepared Rehmannia Root), Shan Yao (Dioscorea Rhizome), Tu Bei Mu (Fritillaria Thunbergii Bulb), Ci Jia (Spina Gleditsiae), Tian Chong (Beetle), Jia Pian (Manis Scale), Sheng Gan Cao (Raw Licorice Root), Lian Qiao (Forsythia Fruit), and Jin Yin Hua (Honeysuckle Flower). Once swelling matured, he took Ba Wei Wan (5-6 qian) in the morning to tonify primordial water and fire. Far from meals, he took Ren Shen (Ginseng), Huang Qi (Astragalus Root), Dang Gui (Angelica Root), Bai Shao (White Peony Root), Bai Zhu (Atractylodes Rhizome), Gan Cao (Licorice Root), Jin Yin Hua, Jia Pian, Tian Chong, Ci Jia, and Bai Zhi to support post-heaven qi and blood. Externally, Tai Yi Gao (Great One Ointment) with human hair, Bi Ma Zi (Castor Seed), Ru Xiang (Frankincense), and Mo Yao (Myrrh) was boiled and applied to draw out toxins. Within ten days, redness and swelling subsided, pain decreased, the sore elevated, and pus formed. Then, a surgeon changed tactics, nearly causing internal collapse. Emergency treatment resumed the previous decoction with added Rou Gui (Cinnamon Bark, approx. one qian). Swelling remained high, red, and active, resembling a minor sore, which eventually ruptured and healed.
Gao Gufeng treated a villager with a back carbuncle extending from Fengfu (GV16) to Shenshu (BL23). The entire area swelled, muscles were cyanotic and cold, hard as iron, with loss of appetite and consciousness. Doctors continued using detoxifying herbs. Pulse was fine and rapid in all six positions, indicating severe qi and blood deficiency with impending internal collapse. Urgently, he used Yang Rong Tang (Nourish the Blood Decoction) with Fu Zi (Aconite Root) and Pao Jiang (Prepared Ginger). After three large doses, stomach qi opened; after ten doses, hardness resolved by 80-90%, leaving only a tea-cup-sized red swelling on the left. He warned, "Do not use binding drugs or knives/needles. With gentle qi and blood, toxins will exit naturally. Binding delays it; puncturing out of season makes healing difficult." Unable to bear pain, he allowed puncture bleeding. Gao said, "Double the previous medicine urgently to promote healing." He also advised restraining desires, careful diet, and taking Huan Shao Dan (Restore Youth Pill) and Ba Wei Wan. He recovered.
Zhu Danxi said: "I saw Brother Wu, who consumed rich foods and had qi stagnation, with a solid constitution and heavy temperament, near sixty years old, suffering from a back carbuncle. Other medicines failed; only Xiang Fu Mo (Cyperi Rhizoma Powder) drunk quickly brought relief. He relied solely on this one herb throughout swelling and ulceration for safety. Such solid constitutions are rare in thousands." (Named Du Sheng San, suitable only for qi stagnation and blood stasis excess syndromes.)
Lady Lou, widowed early, enjoyed drinking and eating, was fat and robust, with a dark and toxic nature. At sixty-six, in July, she developed a back carbuncle near the spine. Doctors lanced it horizontally and vertically to drain blood, mixing it with Wu Xiang San (Five Fragrances Powder) and Shi Xuan San (Ten Acupoints Powder), given with wine. For over a month, no one discussed her widowhood depression, the toxicity of alcohol and meat, stagnation from attachment, or seasonal heat. Eventually, it sank flat, dragging on for two to three months without rescue.
In Zijiguan, Jiangling Prefecture, a stone tablet was unearthed recording: "For anyone with a back carbuncle, before it knots, with red, swollen, hot pain, first cover with wet paper. Stand and watch where the paper dries first; that is the carbuncle head. Slice garlic, about three qian thick, place on the head, and moxa with large cones. Change garlic after three cones. If painful, moxa until pain stops; if painless, moxa until pain starts. Early detection and moxa are best. (If heads are small like hemp seeds, skip the wet paper method.) If there are ten or more heads clustered together, crush garlic head into paste, make thin cakes, place on heads, and pile moxa on cakes to burn. (Moxa ten times in 1-2 days, ten survive; 3-4 days, six or seven survive; 5-6 days, three or four survive.)"
Wang Qu's preface to *Fa Bei Fang* says: "In the fourth month of summer in the third year of Yuan [era], I was an official in the capital. A carbuncle erupted on my back. National doctors treated me, but the condition worsened the next day. I met Zhang Sheng from Xiao County, Xuzhou, who applied moxa to the sore from dawn to dusk, totaling 150 cones, stopping only when I felt pain. The next day, black scabs were removed with tweezers, pus drained completely, flesh inside turned red, and pain ceased. Then, ointment was applied separately, changed daily. During changes, black rotting flesh was trimmed, and the sore flattened. That autumn and summer, seven scholar-officials in the capital died of carbuncles; I alone survived. Although fate has its fixed numbers, those who do not know the methods meet misfortune. Considering human effort, this is lamentable. Thus, I compiled the prescriptions obtained before and after, modeled them for distribution, hoping to fulfill the ancients' intent to save the multitude." (This is the 'Head Moxa' method, just without garlic.)
Shi Yuan's mother felt slight itching between her shoulder blades. Inspection showed a half-cun red patch with millet-like white grains. She urgently applied moxa, and the redness vanished. After fourteen cones, she stopped. Two nights later, she felt slight pain. Inspection showed redness flowing down two cun long, as wide as a leek leaf. The whole family regretted the earlier moxa. Someone mentioned Nun Zhiquan from Dengci Temple, who was cured of a large sore by moxa. They rushed to ask. Zhiquan said, "During severe stages, I was unconscious. Young nuns said Fan Bayi Fenyi persisted, moxa-ing over 800 cones before I woke, using about one sieve of mugwort." They hurried home, agreed, and started moxa with cones the size of ginkgo nuts. Ten or more cones caused no pain. They cut the red extension at the sides, reducing cone size by three-quarters. All felt pain. After seven cones, itching began. With each cone burning out, redness receded. After twenty-plus cones, the red halo faded. The patient endured it. Cones were increased to the size of a chicken egg, then quail egg, totaling about forty cones before pain was felt. The burnt area was over an cun deep. Because moxa was delayed, the initial flesh had necrosed, forming a barrier; only healthy flesh felt pain. Sides felt pain because flesh wasn't necrosed yet. The patient slept poorly for six nights, then ate congee and slept peacefully. Evening inspection showed the sore like an overturned steamer, protruding three cun high, with hundreds of small pores, jet black. Protrusion indicated toxins gathering externally. Pores indicated toxins floating in skin/muscle without gathering. Jet black color meant skin and flesh necrosis. Without moxa drawing toxins from within the necrotic flesh, the five zang organs would be compromised.
Xue Lizhai treated Wang Tongfu, who had a back eruption for over ten days, critical condition, large pulse. First, two doses of Huai Hua Jiu (Sophora Flower Wine) reduced the severity. Then, two doses of Bai Du San (Defeat Toxin Powder), followed by several doses of Tuo Li Yao (Support Interior Medicine) to gradually soak. Also, moxa with mulberry wood on the affected area for long periods daily, plus ointment patches. After several moxa sessions, pus discharged, rot fell off. Tuo Li Yao with Bai Zhu (Atractylodes Macrocephala Rhizome) and Chen Pi (Tangerine Peel) led to recovery in over a month.
Grand Magistrate Liu had a back carbuncle for six to seven days, full back swelling and pain, critical condition. He received 100 garlic-separated moxa cones and drank two bowls of Huai Hua Jiu, then slept. Upon waking, he took Tuo Li Xiao Du Yao (Support Interior and Detoxify Medicine); ten parts disappeared, six remaining. Mulberry branch moxa caused ulceration; he healed in a few days. Whenever moxa and Huai Hua Jiu were used, the effect of supporting interior was very rapid.
A gardener had a critical back carbuncle. He was told to take 5-6 liang of Jin Yin Teng (Lonicerae Japonicae Caulis), crush it, mix with one cup of hot wine, squeeze out juice, and drink warm. Dregs were applied to the site. After 4-5 doses, it flattened. Using this medicine to treat sores was enough to support his family, allowing him to abandon gardening. Books say: "Jin Yin Hua treats sores; unformed ones disperse, formed ones ulcerate, having life-restoring power."
Eunuch Liu Guan had a back carbuncle, swelling, pain, purple color. Pulse was deep and rapid. Chen Liangfu said: "Rapid pulse, fever, and pain indicate yang eruption. Moreover, severe redness turning purple indicates extreme fire resembling water." Inquiry revealed he had taken elixirs for half a year, causing accumulated warmth turning to heat. He took Nei Shu Huang Lian Tang (Internal Purging Coptis Decoction), taking two doses to calm. More Pai Nong Xiao Du Yao (Drain Pus and Detoxify Medicine), Zhu Ti Tang (Pig Trotter Soup), and Tai Yi Gao led to recovery. The Classic says: "Color and pulse should correspond; treatment lies in understanding excessive harm and controlling mechanisms, and the dynamics of yin and yang transformation."
A man over fifty had a back carbuncle, purple color, swelling, pain, outer skin about to ulcerate, restless sleep and appetite, mental fatigue. Moxa with mulberry wood on the site; black blood came out, followed by snoring sleep. Upon waking, symptoms vanished. He took Xian Fang Huo Ming Yin (Immortal Life-Preserving Decoction) for two doses, moxa again, pus and blood discharged. Two more doses greatly reduced swelling and pain. Then, Tuo Li Xiao Du San (Support Interior and Detoxify Powder) for several doses promoted closure. When carbuncle toxins are intense, harsh purgatives are not suitable initially. But for an elderly person with weak qi and blood, especially with surface eruptions, focusing solely on detoxification damages the stomach first, causing mistakes.
Shen Qianxian of Wujiang had a back carbuncle, hard, deep and solid pulse, indicating toxin inside. He used Xuan Du San (Disperse Toxin Powder): Da Huang (five qian, baked), Bai Zhi (five qian), decocted in water, taken before meals. One dose expelled filth via stool and urine; two doses cleared it. This is a dispersing and attacking toxin formula; for deep, solid pulses with constipation, its merit is great. (Note: This is the 'Golden White Jade' formula from the beginning; Xue used it without detailing its source.)
Grand Magistrate Chen Guoxin had inherent yin deficiency. He developed a back carbuncle. Using Ren Shen (Ginseng) and Huang Qi (Astragalus) for major tonification failed to close the wound. Internal heat, fever, dry tongue, cracked lips, scanty frequent urination, dry mouth desiring soup, vomiting, diarrhea, deafness, blindness, dizziness looking up, floating-large-rapid pulse. Xue said: "Wound not closing indicates spleen earth failure; dry tongue/cracked lips indicate kidney water exhaustion; frequent urination indicates lung qi decline; internal heat/fever indicates deficient fire flaming upward; dry mouth/desire for soup indicates true cold; vomiting/diarrhea indicates true fire decay; deafness/blindness indicates liver wood withering; dizziness indicates kidney qi extinction." He declined treatment; the patient subsequently died. (Note: Regardless of internal/external disease, for yin deficiency patients, taking Ren Shen/Huang Qi and qi-moving herbs is not only useless but harmful. Based on these symptoms, it is pure triple-yin depletion. If initially treated with Di Huang, Mai Dong, Gou Qi, Dang Gui, Bai Shao, it might have been saved.)
Wu Xiang Shi Bangzhi's wife, in mid-summer, had a back carbuncle. Dead flesh did not ulcerate, severe fever/pain, vomiting, poor appetite, dry mouth desiring soup, large pulse, empty on pressure. This is true cold inside, false heat outside; discard season, follow symptoms. First, Liu Jun Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Ginger) and Rou Gui (Cinnamon Bark). Four doses improved diet immediately. Then, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with ginger/cinnamon. Over fifty doses, dead flesh ulcerated; another fifty doses, new flesh grew. This person had abundant qi/blood, so sores rose and closed easily. If doctors anticipated this and prepared interior-supporting measures beforehand, this trouble would be avoided. (Xiong notes: Shi Quan Da Bu Tang must only be used after toxin-fire is completely cleared.)
He Zhaoqing, Southern Ministry of Rites official, promoted to Vice Minister of Shanxi. At parting, his lips/nose were cyanotic-black, scratching back occasionally. Asked why, he said, "Small sore." Inspected, indeed a carbuncle. This is spleen/stomach failure, incurable. Xue was friends with him, pitying the difficulty of funeral arrangements en route, asked colleagues like Zhang Dongsha to keep him, forcing major tonification. Only purple blood came out, indicating extreme deficiency. Some said intense toxin couldn't form pus, so he took attacking toxin medicine, leading to vomiting, reverse flow, and pulse disappearance. He indeed died in Nanjing.
Chai Fuan'an of Jingzhao, mid-summer back eruption, dark color, slight swelling, fever, irritability, spontaneous saliva, cold lower abdomen, cold extremities, floating-choppy right guan, fine two chi pulses. Said: "This is deficiency-cold syndrome." Wang Tapu said, "Great heat without heat means no fire." Determined it wouldn't recover. Begged for treatment. One dose of major warming-tonifying medicine stopped salivation, but the lesion didn't rise; ultimately ineffective.
Tu Jiufeng, Vice Commissioner, contracted this in early spring. Dark color, diffuse swelling, thirst, frequent urination, large-rapid chi pulse. Kidney water dried up; destined to die during peak fire. Disbelieved, took bitter-cold medicine, further damaging yuan qi, hastening death.
A man neglected sexual activity. Shoulder blade swelling three cun high, over a chi wide. Spontaneous and night sweats, internal heat/fever, dry mouth desiring soup, floating-large pulse, weak-choppy on pressure. Yin deficiency with qi stagnation. Used Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with Wu Wei Zi (Schisandra), Mai Dong (Ophiopogon), Shan Yu (Cornus), Shan Yao (Dioscorea). Four doses, all symptoms retreated. Later, used Liu Qi Yin (Flowing Qi Decoction) for one dose; deficiency symptoms appeared fully, swelling/hardness like stone. Returned to previous medicine for six doses, finally healed.
A scholar had a back swelling. Soft on pressure, normal flesh color, normal diet. Fatigue/phlegm upon work. Spleen qi deficiency with phlegm stagnation. Used Bu Zhong Yi Qi Tang (Tonify Middle and Augment Qi Decoction) with Fu Ling (Poria), Ban Xia (Pinellia), slight Qiang Huo (Notopterygium). Externally, Yin Yang San (Yin-Yang Powder) mixed with ginger juice applied and resolved. Later, due to fatigue, dizziness/vomiting. Same medicine minus Qiang Huo, added Sheng Jiang (Fresh Ginger), Man Jing Zi (Vittex Seed). Healed.
Wang Qizhi, Judicial Officer, back carbuncle. Head like millet, painful, heavy back, deep-solid pulse. Toxin inside. Took Huang Lian Nei Shu Tang (Coptis Internal Purging Decoction). Two doses, slight improvement. Then Xian Fang Huo Ming Yin healed him.
Liu Huafu, Graduate Student, swelling/pain, floating-rapid pulse. Toxin stored in meridians. Used Nei Tuo Fu Jian San (Internal Support Re-decoction Powder) for two doses, swelling/pain occurred. Xian Fang Huo Ming Yin for four doses, swelling/pain stopped. Tuo Li Yao healed him.
A scholar had back carbuncle, severe swelling/pain. Heat-toxin accumulation intense. Garlic-separated moxa stopped pain. Xian Fang Huo Ming Yin reduced swelling. Tuo Li Yao caused ulceration/healing.
A man had back carbuncle. Necrotic flesh ulcerated but new flesh didn't grow. Toxin resolved but spleen/stomach qi deficient. Liu Jun Zi Tang (Six Gentlemen Decoction) with Xiong (Ligusticum), Gui (Angelica), Wu Wei Zi, Huang Qi (Astragalus) gradually improved. Shi Quan Da Bu Tang fully healed.
A man had back carbuncle, swelling/pain, red halo over a chi, back felt like carrying a stone. Condition demanded harsh attack, but pulse contraindicated. Pricked red area, draining a bowl of purple blood. Swelling/pain instantly retreated. Shen Gong San (Divine Merit Powder) and Xian Fang Huo Ming Yin for two doses, wound and pricked sites bled fluid and cleared.
A man had back carbuncle. Flesh rotted, pus clear, muscle didn't grow. Evil gone, qi/blood both deficient. Shi Quan Da Bu Tang, healed in over a month.