关格之症原有上下之分一上格之而不得入一下关之而不得出也上下既有相殊治法亦宜各
异大
约上格之而不得入者当治肝下关之而不得出者当治脾然而开郁行气则上下皆同也上格之症水
食俱不可下一得水食则吐出两胁饱胀气逆拂抑而觉气不能通初起之时以逍遥散和解之何致
成不
可救药之症惟其不与此汤也则肝木终无解时又加另服他药则愈加胀闷吾今定一方缓缓呷之自
然重门渐开转输有路矣下关之症大小便俱不能出上食水谷觉胀闷欲死气急而息粗初起之时
亦以逍遥散和之亦随手奏功而无如人之不识也则脾气转燥而肝木来凌大小肠火势阻遏而不能
下达其势甚急然而较上格之症实少轻也盖邪在上难于发泄邪在下易于推荡也用四物汤加大黄
柴胡于补中兼下而散之则火郁可开关门中启矣谁谓关格之症可不分上下以治之乎
增补逍遥汤
白芍（三钱） 白术（一钱） 枳壳（一钱） 当归（三钱） 柴胡（一钱） 香附（一钱） 甘草（五分）
川芎（一钱） 炒栀子（一钱） 茯苓（三钱） 陈皮（五分） 天花粉（一钱） 竹沥（五匙）水煎服
痈疽之宜辨真假也少若辨之不清杀人多矣痈疽之毒结于脏腑之中发于皮肤之外往往现假
象以
欺人本是热而假作寒本是阴而假作阳其问辨明之法尤宜亟讲如痈疽之初生也身必重而口必渴
此现真象以示人也及见疮口也或现高突而作疼止有一点黄头露形者此真象也或疮口作痒现无
数小头无高突之形止现圆圆一线之红影者此假象也及其头破出脓也脓出红黄而作痛者此真象
也脓出而不多或现紫黑疮口作黯澹之状不疼不痒者此假象也及其将收口也云蒸雾起肉拥皮绉
虽有脓而黄红中有脓而旁无脓者真象也坎陷色滞脓少而血多两旁之皮全无润泽之气或外边皮
肉生满而中央仍复作疼或中不满而作痒旁反痛者皆假象也大约真者皆火毒也宜用散火以凉之
假者皆虚寒也宜用补剂以温之而少加解毒之药余今定二方一治真症一治假症无不神效治真者
名为散真
汤此方散毒而又能祛火未破者能消已破者能收自生毒之初至出脓之后皆可服之收功不论前后
而
均宜也治假者名为救假汤此方大补气血而又能散毒凡遇阴症不论初起已破已溃已坏以此方投
之即能起死为生转祸为福又何至有夭人性命之忧哉倘遇人贫家窘无参亦可服但加黄 当归可
也
散真汤
金银花（一两） 蒲公英（五钱） 生甘草（五钱） 荆芥（二钱） 当归（一两）水煎服
救假汤
金银花（三两） 人参（三两） 生黄 （五两） 肉桂（二钱） 当归（三两）水煎服
关格这一病症，原本就有上部和下部的区别：上部表现为“格”，即食物无法进入；下部表现为“关”，即二便无法排出。既然上下病情不同，治疗方法也应当各异。大致来说，上部因“格”而不得入的，应当治疗肝脏；下部因“关”而不得出的，应当治疗脾脏。然而，疏解郁结、行气导滞的方法，对于上下两部是相同的。
上部“格”的症状，饮食水液都不可咽下，一喝水或进食就会吐出，两胁部位饱胀，气机上逆，感到憋闷压抑，觉得气机不能通畅。在初起之时，用逍遥散来和解肝气，怎么会发展到不可救治的地步呢？只是因为不服用这种汤药，导致肝木之气始终无法舒缓，如果再另外服用其他药物，只会更加胀闷。我现在制定一方，缓缓饮用，自然能层层开通，使气机转输有路。
下部“关”的症状，大小便都不能排出，进食饮水后感觉胀闷欲死，气息急促且粗重。在初起之时，也用逍遥散来调和，也能随手奏效。无奈人们不懂此法，导致脾气转燥，肝木来克制脾土，大小肠的火势被阻遏而不能下达，病势非常急迫。然而，比起上部“格”的症状，确实要轻一些。因为邪气在上部，难以发泄；邪气在下部，易于推荡排除。使用四物汤加大黄、柴胡，在补益的同时兼以攻下和疏散，那么火郁之邪就可以解开，如同打开门户一样畅通了。谁说关格这一病症可以不区分上下而统一治疗呢？
增补逍遥汤
白芍（三钱） 白术（一钱） 枳壳（一钱） 当归（三钱） 柴胡（一钱） 香附（一钱） 甘草（五分）
川芎（一钱） 炒栀子（一钱） 茯苓（三钱） 陈皮（五分） 天花粉（一钱） 竹沥（五匙） 水煎服。
痈疽应当辨别真假，如果辨别不清，往往会导致大量死亡。痈疽的毒邪结聚于脏腑之中，发作于皮肤之外，常常出现假象来欺骗人：本是热证却假装寒象，本是阴证却假装阳象。其中辨别真伪的方法尤其需要急切讲解。例如痈疽刚生成时，身体必然沉重且口必口渴，这是显现真象来示人。等到看到疮口时，有的高突并疼痛，仅有一点黄头显露形状，这是真象；有的疮口发痒，呈现无数小头，没有高突的形状，只现出一圈圆圆的红影，这是假象。等到疮头破溃出脓时，脓液呈红黄色且伴有疼痛，这是真象；脓液流出不多，或者呈现紫黑色，疮口颜色黯淡，不疼不痒，这是假象。等到即将收口时，若见如云蒸雾起般肉芽隆起、皮肤皱褶，虽有脓但黄红色中夹杂脓液，旁边无脓，这是真象；若见凹陷色滞，脓少血多，旁边的皮肤完全没有润泽之气，或者外部皮肉生满而中央仍然疼痛，或者中间不满而发痒旁边反而疼痛，这些都是假象。
大约真证都是火毒所致，宜用散火凉血的方法治疗；假证都是虚寒所致，宜用补剂温补，并稍加解毒药物。我现在制定两个方子，一个治真证，一个治假证，无不神效。治疗真证的名为“散真汤”，此方既能散毒又能祛火，未破溃者能消散，已破溃者能收敛，从毒邪初起到出脓之后皆可服用，无论病程前后均适宜。治疗假证的名为“救假汤”，此方大补气血又能散毒，凡遇到阴证，不论初起、已破、已溃还是已坏，以此方投之，就能起死回生，转祸为福，又何至于有夭折性命的担忧呢？如果遇到贫穷人家窘迫无参的情况，也可以服用，只需加入黄芪、当归即可。
The syndrome of Guan Ge (Obstruction and Repletion) originally has distinctions between the upper and lower parts: the upper part manifests as "Ge" (Rejection), where food cannot enter; the lower part manifests as "Guan" (Closure), where urination and defecation cannot exit. Since the conditions of the upper and lower parts differ, the treatment methods should also vary. Generally speaking, for the upper part where "Ge" prevents entry, treatment should focus on the Liver; for the lower part where "Guan" prevents exit, treatment should focus on the Spleen. However, methods to resolve stagnation and promote Qi movement are the same for both upper and lower parts.
In the upper "Ge" syndrome, neither water nor food can be swallowed; upon intake, vomiting occurs, accompanied by fullness in the hypochondriac regions, rebellious Qi, a feeling of oppression and stifling, and a sensation that Qi cannot flow freely. At the initial stage, Xiaoyao San (Free and Easy Wanderer Powder) should be used to harmonize the Liver. How could it develop into an incurable condition? It is only because this decoction was not taken, causing the Wood of the Liver to remain unresolved indefinitely. Furthermore, taking other medications additionally would only exacerbate the distension and stifling. I have now formulated a prescription to be sipped slowly; naturally, layers of obstruction will gradually open, and the transport mechanism will regain its pathway.
In the lower "Guan" syndrome, both urination and defecation are blocked. After eating or drinking, there is a sensation of severe distension and stifling, rapid and coarse breathing. At the initial stage, Xiaoyao San (Free and Easy Wanderer Powder) is also used to harmonize, yielding immediate results. Unfortunately, people fail to recognize this, leading to dryness of the Spleen Qi and encroachment by Liver Wood. The Fire in the Large and Small Intestines is obstructed and cannot descend, creating an urgent situation. However, compared to the upper "Ge" syndrome, it is actually less severe. This is because pathogenic factors in the upper part are difficult to vent, whereas those in the lower part are easier to push out and eliminate. Using Siwu Tang (Four Substances Decoction) augmented with Dahuang (Rhubarb Rhizome) and Chaihu (Bupleurum Root), combining tonification with purgation and dispersal, allows the stagnant Fire to be resolved, opening the gates like unlocking a door. Who says the syndrome of Guan Ge can be treated without distinguishing between upper and lower?
Supplemented Xiaoyao Decoction
Baishao (White Peony Root, 3 qian) Baizhu (Atractylodes Macrocephala Rhizome, 1 qian) Zhike (Immature Bitter Orange, 1 qian) Danggui (Angelica Sinensis Radix, 3 qian) Chaihu (Bupleurum Root, 1 qian) Xiangfu (Cyperus Rotundus Rhizome, 1 qian) Gancao (Licorice Root, 5 fen)
Chuanxiong (Sichuan Lovage Rhizome, 1 qian) Chao Zhizi (Fried Gardenia Fruit, 1 qian) Fuling (Poria, 3 qian) Chenpi (Tangerine Peel, 5 fen) Tianhuafen (Trichosanthes Root, 1 qian) Zhuli (Bamboo Sap, 5 spoons) Decoct in water and take orally.
Yong Ju (Carbuncles and Ulcers) must be distinguished as true or false; if not clearly differentiated, many lives are lost. The toxicity of Yong Ju accumulates within the Zang-Fu organs and erupts on the skin, often presenting false images to deceive people: heat syndromes masquerading as cold, and Yin syndromes masquerading as Yang. The method of differentiation requires urgent attention. For example, when a carbuncle first appears, the body is necessarily heavy and the mouth thirsty; this presents the true image. When observing the sore, if it protrudes high and hurts, showing only one yellow head, this is the true image; if the sore itches, showing numerous small heads without protrusion, presenting only a circular red shadow, this is the false image. When the head breaks and pus discharges, if the pus is red-yellow and painful, this is the true image; if the pus discharge is scanty, or purple-black, with a dull sore surface, painless and itchless, this is the false image. When approaching healing, if the tissue rises like mist and clouds, with flesh bulging and skin wrinkling, containing yellow-red pus but no pus on the sides, this is the true image; if there is depression with stagnant color, scanty pus and abundant blood, lacking luster on the surrounding skin, or if the outer flesh grows fully while the center remains painful, or if the center is incomplete and itchy while the sides hurt, these are all false images.
Generally, true syndromes are caused by Fire-Toxin and should be treated by dissipating Fire and cooling; false syndromes are caused by Deficiency-Cold and should be treated with tonifying agents to warm, supplemented slightly with detoxifying herbs. I have now formulated two prescriptions: one for true syndromes and one for false syndromes, both highly effective. The one for true syndromes is named Sanzhen Tang (Disperse True Toxin Decoction). This formula dissipates toxin and clears Fire; it can resolve unbroken sores and consolidate broken ones. It can be taken from the initial onset of toxin until after pus discharge, suitable regardless of the stage. The one for false syndromes is named Jiujia Tang (Save Falsehood Decoction). This formula greatly tonifies Qi and Blood while dissipating toxin. Whenever a Yin syndrome is encountered, whether at the initial stage, broken, ulcerated, or necrotic, administering this formula can bring the dying back to life and turn disaster into fortune, eliminating the fear of premature death. If treating poor families who lack Ginseng, it can still be taken by adding Huangqi (Astragalus Root) and Danggui (Angelica Sinensis Radix).
Sanzhen Tang
Jinyinhua (Honeysuckle Flower, 1 liang) Gongying (Dandelion Herb, 5 qian) Sheng Gancao (Raw Licorice Root, 5 qian) Jingjie (Schizonepeta Spike, 2 qian) Danggui (Angelica Sinensis Radix, 1 liang) Decoct in water and take orally.
Jiujia Tang
Jinyinhua (Honeysuckle Flower, 3 liang) Renshen (Ginseng Root, 3 liang) Sheng Huangqi (Raw Astragalus Root, 5 liang) Rougui (Cinnamon Bark, 2 qian) Danggui (Angelica Sinensis Radix, 3 liang) Decoct in water and take orally.