不寒不热，半阴半阳者，宜之。
良方升麻和气饮 治疮肿、疖疥、痒痛。
甘草 陈皮（各一两半） 芍药（七钱半） 大黄（半两，煨） 干葛 苍术 桔梗 升麻（各一两）
当归 茯苓 白芷（各二两） 干姜 枳壳（各半钱） 《三因方》有浓朴（半钱）
上 咀，每服一两，水煎。
按∶此手足太阴、阳明经药也，五积散加减法，世俗多用之，故收入。盖欲燥脾胃
胜湿和气，为治疮之剂，然临证而不通变，恐未合宜也。
加味当归饮子（见前）
圣济总录金针散 治发背，诸疮肿。
皂角针（春取一半新，采一半黑者）
上一味不拘多少，晒干为末。食后，酒调二三钱服。
按∶丹溪曰∶此药治痈疽，已破未破皆用，直领到溃处，谓当入群队中用也。
脉无力而缓者，秋冬者，宜之。
精要十宣散
人参 当归 黄 （各二两） 川芎 防风 浓朴 桔梗 官桂 甘草 白芷（各一两）
上为细末，每服二钱，加至六钱止。热酒调下，日数服以多为妙。不饮酒者，用木
香浓煎汤下，然不若酒力之胜也。许学士云∶此方得于都下异人，济苦者不可胜数。陈无
择谓∶此药在第四节服者非也，早服中病者，必消散。
《卫生宝鉴》曰∶诸痛痒疮疡，皆属心火，
言其常也。如疮盛形赢，邪高痛下，始热终寒，此反常也，固当察时下之宜而权治。故
曰，经者常也，法者用也，医者意也，随其
宜治之，可收十全之功矣。故此方用之于痈疽初发，或已发，或内托。然疮证脉缓涩，或
身倦恶寒热少，脉弦或紧细者，宜用之，散风寒助阳之剂也，表里气血之药。若施之于
积热 毒，更不分经络、时宜，不能无误也。
丹溪曰∶《精要》谓，排脓内补十宣散，治未成者速散，已成者速溃，诚哉是言也。若
用之于些小痈疮，与冬月时令，尽收内托之功；若于冬月肿疡用之，亦可转重就轻，移
深为浅。若溃疡于夏月用之，其桂朴之温散，佐以防风、白芷，吾恐虽有参 ，难为倚仗。
比见世人用此者，不分痈疽、冬夏，无经络，无前后，如盲人骑瞎马，夜半临深池，危哉。
十六味流气饮 治无名恶肿，痈疽等证。
川芎 当归 芍药 防风 人参 木香 黄 官桂 桔梗 白芷 槟榔 浓朴
乌药 甘草 紫苏 枳壳
上 咀，水煎服。
按∶此表里气血药也，复以疏风助阳之剂，世俗多用之，故收入。非脉之洪缓、沉
迟、紧细者，不宜用此。每见外科诸家载此，往往不分经络、脉证，不具时宜，但云化毒
消肿。有云不退者，加以补气血之药。盖又使入不能无疑也，用者当触类而长之。
凡治疮疡，不审元气虚实，病在表里，便服败毒、流气等药，必有失误。盖败毒散发
表药也，果有表症，止宜一二服，多则元气损，毒愈盛，虽有人参亦莫能补。流气饮耗
血药也，果气结胸满，只宜二三服，多则血反致败，虽有芎归亦难倚仗。丹溪曰∶此不
系膏粱丹毒之变，因虚劳气郁所致也。
千金托里散 治一切疮肿、发背、疔疮。
黄 （一两半） 浓朴 防风 桔梗（各二两） 连翘（二两二钱） 木香 没药（各三钱） 乳香（二
钱） 当归（半两） 川芎 白芷 芍药 官桂 人参 甘草（各一两）
上为细末。每服三钱，酒一大盏，煎三二沸，和滓温服。
没有寒热症状，属于半阴半阳证候的，适宜使用此法。
良方升麻和气饮：治疗疮肿、疖子、疥癣以及瘙痒疼痛。
药材及剂量：甘草、陈皮（各一两半），芍药（七钱半），大黄（半两，煨制），干葛（即葛根）、苍术、桔梗、升麻（各一两），当归、茯苓、白芷（各二两），干姜、枳壳（各半钱）。《三因方》中还有浓朴（半钱）。
制法与用法：将上述药材切碎，每次服用一两，加水煎煮后服用。
按语：这是作用于手足太阴经和阳明经的药物，是五积散的加减方，世俗多使用它，所以收录于此。大概是想通过燥湿健脾、胜湿和气，作为治疗疮疡的方剂，然而临证时如果不灵活变通，恐怕未必合适。
加味当归饮子（见前文）
圣济总录金针散：治疗发背疽及其他各种疮肿。
药材：皂角针（春季取一半新鲜的，采一半黑色的）。
制法与用法：以上一味药不拘多少，晒干后研成粉末。饭后，用酒调服二三钱。
按语：丹溪说：此药治疗痈疽，无论已破或未破均可使用，能直达溃烂之处，意思是应当将其加入其他药物队伍中配合使用。
脉象无力而迟缓的，在秋冬季节发病的，适宜使用此法。
精要十宣散
药材及剂量：人参、当归、黄（即黄芪，各二两），川芎、防风、浓朴、桔梗、官桂、甘草、白芷（各一两）。
制法与用法：制成细末，每次服用二钱，最多增至六钱。用热酒调服，每日多次服用，以多为妙。不饮酒的人，用木香浓煎汤送服，但这不如酒力强劲有效。许学士说：此方得自京城中的异人，救助苦难者不可胜数。陈无择认为：此药在第四节服用是不对的，早期服用且中病者，必然消散。
《卫生宝鉴》说：各种疼痛、瘙痒、疮疡，都属于心火，这是指一般常理而言。如果疮势盛大而形体消瘦，邪气高位而疼痛低位，起初发热最终转寒，这是反常情况，确实应当观察当下时令的适宜性而权衡治疗。所以说，经书讲的是常理，法则是应用，医者的关键在于意会，根据适宜的情况治疗，可以收到十全的效果。因此此方用于痈疽初发，或已发，或用于内托法。但是，如果疮证脉象缓涩，或者身体疲倦、恶寒、发热少，脉象弦或紧细的，适宜使用此方，因为它是疏散风寒、助阳的药剂，也是调理表里气血的药物。如果施用于积热毒邪，又不分经络、时令适宜，就不能不产生误治。
丹溪说：《精要》中说，排脓内补十宣散，对于未形成的疮疡能迅速消散，对于已形成的能迅速溃破，这确实是真知灼见。如果用于小的痈疮，以及在冬季时令使用，能收尽内托之功；如果在冬季用于肿疡（未溃之疮），也可以使病情由重转轻，由深变浅。如果在夏季用于溃疡（已溃之疮），其中桂枝、厚朴的温散作用，佐以防风、白芷，我担心即使有人参、黄芪，也难以倚仗其效。
近来见到世人使用此方，不分痈疽类型、冬夏季节，不顾经络先后，就像盲人骑瞎马，半夜面临深渊池水，非常危险。
十六味流气饮：治疗无名恶肿、痈疽等证候。
药材：川芎、当归、芍药、防风、人参、木香、黄（即黄芪）、官桂、桔梗、白芷、槟榔、浓朴、乌药、甘草、紫苏、枳壳。
制法与用法：将上述药材切碎，加水煎煮后服用。
按语：这是调理表里气血的药物，又加上疏风助阳的药剂，世俗多使用它，所以收录于此。如果不是脉象洪缓、沉迟、紧细者，不宜使用此方。常见外科各家记载此方，往往不分经络、脉证，不具备时令适宜性，只说能化毒消肿。有的说不能消退的，就加上补气血的药。这又让人产生疑惑，使用者应当触类旁通，灵活运用。
凡是治疗疮疡，不审察元气虚实，不明确病在表里，就服用败毒、流气等药，必定会有失误。因为败毒散发表药，果真有表症，只宜服用一二剂，多了则损伤元气，毒邪更盛，即使有人参也无法补救。流气饮是耗血药，果真有气结胸满，只宜服用二三剂，多了则血液反而败坏，即使有川芎、当归也难以倚仗。丹溪说：这不是膏粱厚味导致的丹毒变化，而是因虚劳气郁所致。
千金托里散：治疗一切疮肿、发背、疔疮。
药材及剂量：黄（即黄芪，一两半），浓朴、防风、桔梗（各二两），连翘（二两二钱），木香、没药（各三钱），乳香（二钱），当归（半两），川芎、白芷、芍药、官桂、人参、甘草（各一两）。
制法与用法：制成细末。每次服用三钱，用一大盏酒，煎煮两三沸，连同药渣一起温服。
When there is neither chills nor fever, indicating a syndrome of half-Yin and half-Yang, this method is suitable.
Liangfang Shengma Heqi Yin (Shengma Harmonizing Qi Decoction from Excellent Formulas): Treats carbuncles, boils, scabies, itching, and pain.
Ingredients: Radix Glycyrrhizae (Gancao) and Pericarpium Citri Reticulatae (Chenpi) (each 1.5 liang), Radix Paeoniae Alba (Shaoyao) (0.75 liang), Radix Polygoni Cuspidati (Dahuang) (0.5 liang, roasted), Rhizoma Bupleuri (Gange), Rhizoma Atractylodis Macrocephalae (Cangzhu), Radix Platycodi (Jiegeng), and Radix Cimicifugae (Shengma) (each 1 liang), Radix Angelicae Sinensis (Danggui), Poria (Fuling), and Radix Angelicae Dahuricae (Baizhi) (each 2 liang), Rhizoma Zingiberis Recens (Ganjiang) and Fructus Aurantii (Zhiqiao) (each 0.05 liang). *San Yin Fang* also includes Cortex Magnoliae Officinalis (Houpo) (0.05 liang).
Preparation and Administration: Cut the herbs into small pieces. For each dose of 1 liang, decoct in water.
Commentary: These are herbs belonging to the Foot-Taiyin, Hand-Taiyin, and Yangming meridians. This is a modification of Wujisan (Five Accumulations Decoction), widely used by common practitioners, hence it is included here. The intention is likely to dry dampness, strengthen the spleen and stomach, overcome dampness, and harmonize Qi, serving as a formula for treating sores. However, without flexibility in clinical application, it may not be entirely appropriate.
Jiawei Danggui Yin (Modified Danggui Drink) (see previous text)
Shengji Zonglu Jinzhen San (Golden Needle Powder from General Records of Sage Assistance): Treats back carbuncles and various swelling sores.
Ingredients: Spina Gleditsiae Sinensis (Zaojiaoren) (In spring, take half fresh-picked and half black ones).
Preparation and Administration: Take the above single herb in any quantity, dry it in the sun, and grind it into powder. After meals, mix 2-3 qian with wine and take orally.
Commentary: Danxi stated: This medicine treats carbuncles and ulcers; it can be used whether they have ruptured or not, reaching directly to the ulcerated area. It implies that it should be used within a compound prescription.
When the pulse is weak and slow, or when the disease occurs in autumn and winter, this method is suitable.
Jingyao Shixuan San (Essential Ten-Accumulation Dispersion)
Ingredients: Radix Ginseng (Renshen), Radix Angelicae Sinensis (Danggui), and Radix Astragali Membranacei (Huangqi) (each 2 liang), Radix Chuanxiong (Chuanxiong), Radix Saposhnikoviae (Fangfeng), Cortex Magnoliae Officinalis (Houpo), Radix Platycodi (Jiegeng), Ramulus Cinnamomi Cassiae (Guangui), Radix Glycyrrhizae (Gancao), and Radix Angelicae Dahuricae (Baizhi) (each 1 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, increasing up to 6 qian if necessary. Mix with hot wine and take orally. Taking multiple doses daily is preferable. For those who do not drink alcohol, decoct Radix Aucklandiae (Muxiang) strongly and take orally with the decoction, though this is less effective than wine. Xu Xueshi said: This formula was obtained from an extraordinary person in the capital, saving countless sufferers. Chen Wuze stated: It is incorrect to administer this medicine at the fourth stage; if taken early and matching the pathology, the condition will surely dissipate.
*Weisheng Baojian* states: Various painful, itchy sores and ulcers belong to Heart Fire, which refers to the general rule. If the sore is severe while the body is emaciated, the pathogen is high but pain is low, starting with heat and ending with cold, this is an abnormal situation. One must indeed observe the appropriateness of the current season and weigh the treatment accordingly. Thus, it is said that classics state the constant principles, methods denote application, and the physician's skill lies in discernment. Treating according to appropriateness can achieve perfect results. Therefore, this formula is used for the initial onset of carbuncles and ulcers, or for internal support therapy. However, if the sore presents with a slow and choppy pulse, or if the patient is fatigued, aversed to cold, has minimal chills/fever, or has a string-taut, tight, or thin pulse, this formula is suitable. It is a formula to disperse wind-cold and assist Yang, regulating the exterior-interior and Qi-Blood. If applied to accumulated heat and toxic pathogens without distinguishing meridians and seasonal appropriateness, errors are inevitable.
Danxi said: *Jingyao* states that Paiong Neibu Shixuan San (Draining Pus and Internal-Nourishing Ten-Accumulation Dispersion) causes unformed sores to dissipate quickly and formed sores to suppurate quickly. This is indeed true. If used for minor sores or in winter, it achieves the full effect of internal support; if used in winter for swelling sores (unruptured), it can turn heavy conditions light and deep conditions superficial. However, if used in summer for ulcerated sores (ruptured), the warming and dispersing nature of Cinnamon Twig and Magnolia Bark, assisted by Saposhnikovia Root and Angelica Dahurica Root, makes me fear that even with Ginseng and Astragalus, reliance on them would be difficult. Recently, I have seen people using this formula indiscriminately regarding the type of carbuncle, season (winter/summer), meridians, and progression, like a blind man riding a blind horse facing a deep pool at midnight—this is perilous.
Shiliuwei Liuqi Yin (Sixteen-Ingredient Flowing-Qi Decoction): Treats nameless malignant swellings, carbuncles, and other conditions.
Ingredients: Radix Chuanxiong, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Saposhnikoviae, Radix Ginseng, Radix Aucklandiae, Radix Astragali Membranacei, Ramulus Cinnamomi Cassiae, Radix Platycodi, Radix Angelicae Dahuricae, Areca Seed (Binglang), Cortex Magnoliae Officinalis, Rhizoma Linderae (Wuyao), Radix Glycyrrhizae, Folium Perillae (Zisu), and Fructus Aurantii (Zhiqiao).
Preparation and Administration: Cut the herbs and decoct in water for oral administration.
Commentary: These are herbs regulating the exterior-interior and Qi-Blood, combined with formulas to disperse wind and assist Yang. Widely used by common practitioners, hence included. It is not suitable unless the pulse is surging-slow, deep-slow, tight, or thin. I often see surgical texts citing this formula without distinguishing meridians, pulse signs, or seasonal appropriateness, merely claiming it resolves toxins and reduces swelling. When ineffective, tonifying Qi and Blood herbs are added, causing further doubt. Users should apply this principle flexibly.
Generally, treating sores without assessing the deficiency or excess of Yuan Qi (Original Qi) and the location of the disease (exterior or interior), and immediately administering Baidu or Liuqi formulas, will inevitably lead to mistakes. Baodu San is an exterior-releasing formula; if there is truly an exterior syndrome, only one or two doses are appropriate. Excessive use damages Yuan Qi and intensifies toxicity; even with Ginseng, it cannot be replenished. Liuqi Yin consumes Blood; if there is truly Qi stagnation and chest fullness, only two or three doses are appropriate. Excessive use ruins Blood; even with Chuanxiong and Danggui, reliance is futile. Danxi stated: This is not a transformation caused by rich food and toxin, but due to deficiency-labor and Qi depression.
Qianjin Tuoli San (Thousand-Gold Supporting-Interior Powder): Treats all swelling sores, back carbuncles, and carbuncles (Dingchuang).
Ingredients: Radix Astragali Membranacei (Huangqi) (1.5 liang), Cortex Magnoliae Officinalis, Radix Saposhnikoviae, Radix Platycodi (each 2 liang), Fructus Forsythiae (Lianqiao) (2.2 qian), Radix Aucklandiae, Myrrha (Moyao) (each 3 qian), Olibanum (Ruxiang) (2 qian), Radix Angelicae Sinensis (Danggui) (0.5 liang), Radix Chuanxiong, Radix Angelicae Dahuricae, Radix Paeoniae Alba, Ramulus Cinnamomi Cassiae, Radix Ginseng, and Radix Glycyrrhizae (each 1 liang).
Preparation and Administration: Grind into fine powder. Take 3 qian per dose, decoct with one large cup of wine for two or three boils, and take warm including the dregs.