（两手）诸（部。俱见）浮数（之）脉。（浮主表。数主热。若表邪）应当发热。
（今不发热。）而反洒淅恶寒。（必其气血凝滞。即经所谓营气不从。逆于肉理。乃生
痈肿。阳气有余。营气不行。乃发为痈是也。）若有痛处。（更明明可验。然而痈者。
壅也。欲通其壅。）当（以麻黄荆芥之类。透）发其（凝滞之）痈。师曰。诸痈肿。欲
知有脓无脓。以手掩肿上。热者（毒已聚。）为有脓。不热者。（毒不聚。）为无脓。
此言痈之所由成。而并辨有脓无脓也。言外见痈之已成者。欲其溃。未成者。 之
起也。
内外原不分科。分之者。以针砭刀割熏洗等法。另有传习谙练之人。士君子置而弗道。
然而大证。断非外科之专门者。所能治也。薛氏医按。论之最详。然以六味丸八味丸补
中益气汤十全大补汤归脾汤六君子汤异功汤逍遥散等剂。出入加减。若溃后虚证颇宜。
其实是笼统套法。于大证难以成功。金匮谓浮数脉。当发热而反恶寒者。以卫气有所遏
而不出。卫有所遏。责在荣之过实。止此数语寥廖。已寓痈肿之绝大治法。再参六经之
见证。六经之部位。用六经之的方。无有不效。外科之专门。不足恃也。
肠痈之为病。（气血为内痈所夺。不得外荣肌肤。故）其身（枯皱。如鳞）甲（之交）错。腹皮（虽
）急。（而）按之（则）濡。（其外虽）如肿状。（而其）腹（则）无积聚。（其）
身（虽）无热。（而其）脉（则似表邪之）数。此为（营郁成热。）肠内有痈脓。（以）
薏苡附子败酱散主之。（此痈之在于小肠也。）
此为小肠痈而出其方治也。败酱一名苦菜。多生土墙及屋瓦上。闽人误为蒲公英。
薏苡附子败酱散方
薏苡仁（十分） 附子（二分） 败酱（五分）
上三味。杵为散。取方寸匕。以水二升。煎减半。顿服。小盒饭下。
（痈之在于大肠者。何如。大肠居于小肠之下。若）肿（高而）痈（甚）者。（逼
处膀胱。致）少腹肿痞。按之即痛如淋。（而实非膀胱为害。故）小便（仍见）自调。
（小肠为心之合。而气通于血脉。大肠为肺之合。而气通于皮毛。故彼脉数身无热。而
此则）时时发热自汗出。复恶寒。（再因其证而辨其脉。若）其脉迟紧者。（邪暴遏而营
未变。为）脓未成。可下之。（令其消散。若其）脉洪数者（毒已聚而营气腐。为）脓
已成。（虽下之。亦不能消。故）不可下也。（若）大黄牡丹汤（不论痈之已成未成。
皆可）主之。
此为大肠痈而出其方治也。
大黄牡丹汤方
大黄（四两） 牡丹（一两） 桃仁（五十个） 冬瓜仁（半升） 芒硝（三合）
上五味。以水六升。煮取一升。去滓。内芒硝。再煎沸。顿服之。有脓当下。如无
脓。当下血。
问曰。寸口脉浮微而涩。法当亡血。若汗出。设不汗出者。云何。曰、（血与汗。
皆阴也。微为阳弱。涩为血少。）若身有疮。被刀斧所伤。（而）亡血（血亡而气亦无
辅。此脉微而又涩之）故也。（且夺血者无汗。此脉浮而不汗出之故也。）
此为金疮亡血辨其脉也。
（凡一切）病金疮。（统以）王不留行散主之。
此为金疮出其总治之方也。
徐忠可云、此非上文伤久无汗之金疮方。乃概治金疮方也。故曰、病金疮。王不留
行散主之。盖王不留行。性苦平。能通利血脉。故反能止金疮血。逐痛。蒴 亦通利气
血。尤善开痹。周身肌肉肺主之。桑根白皮最利肺气。东南根向阳。生气尤全。以复肌
肉之生气。故以此三物甚多为君。甘草解毒和荣。尤多为臣。椒姜以养其胸中之阳。浓
朴以疏其内结之气。芩芍以清其阴分之热为佐。若有风寒。此属经络客邪。桑皮止利肺
气。不能逐外邪。故勿取。（孙男心兰按。金疮亡血者忌发汗。以阴伤故也。若偶感风
邪。其人不省。仍宜以破伤风论治。勿泥于亡血之禁。）
王不留行散方
王不留行（十分八月八日采） 蒴 细叶（十分七月七日采） 桑东南根（白皮十
分三月三日采） 甘草（十八分） 黄芩（二分） 川椒（三分） 浓朴（二分） 干姜（二分） 芍药（二分）
上九味。王不留行蒴 桑皮三味。烧灰存性。各别杵筛。合治之为散。服方寸匕。小
疮即粉之。大疮但服之。产后亦可服。
排脓散方
枳实（十六枚） 芍药（六分） 桔梗（二分）
上三味。杵为散。取鸡子黄一枚。以药散与鸡黄相等。揉和令相得。饮和服之。日
一服。
枳实得阳明金气以制风。禀少阴水气以清热。又合芍药以通血。合桔梗以利气。而
尤赖鸡子黄之养心和脾。取有情之物。助火土之脏阴。以为排脓化毒之本也。
排脓汤方
甘草（二两） 桔梗（三两） 生姜（一两） 大枣（十枚）
上四味。以水三升。煮取一升。温服五合。日再服。
此亦行气血和营卫之剂。
浸淫疮。（留流不已。俗名棉花疮杨梅疮恶疠之类。）从口起。流向四肢者。可治。
（以其从内走外也。）从四肢流来入口者。不可治。（以其从外走内也。）浸淫疮。
（以）黄连粉主之。（方未见）
此为浸淫疮出其方治也。方未见。疑即黄连一味为粉。外敷之。甚者亦内服之。
诸疮痛痒。皆属心火。黄连苦寒泻心火。所以主之。余因悟一方。治杨梅疮棉花等疮甚
效。连翘蒺藜黄 金银花各三钱。当归甘草苦参荆芥防风各二钱。另用土茯苓二两。以
水煮汤去滓。将此汤煮药。空心服之。十日可愈。若系房欲传染者。其毒乘肾气之虚。
从精孔深入中肾。散于冲任督脉。难愈。宜加龟板入任。生鹿角末入督。黄柏入冲等药。
并先用黑牵牛制末。作小丸。和烧 散。以土茯苓汤送下。令黑粪大下后。再加前汤
如神。
（两手）寸关尺各部脉象都呈现浮数之脉。（浮脉主表证，数脉主热证。如果是表邪侵袭）应当出现发热症状。
（现在却不发热。）反而感到像被冷水洒身般的恶寒。（这必定是气血凝滞所致，正如《内经》所说：营气运行不畅，逆乱于肌肉纹理之间，就会发生痈肿。阳气偏盛有余，营气运行受阻，就会发为痈疽。）如果有疼痛的部位。（这就更加明显可以验证了。然而“痈”的意思是壅塞不通。）应当（用麻黄、荆芥之类的药物，透达）发散其（凝滞的）痈肿。老师说：各种痈肿，想要知道里面是否有脓，用手覆盖在肿胀处，感觉发热的，（说明毒邪已经聚结。）是有脓；不热的，（说明毒邪未聚结。）是无脓。这段话说明了痈形成的原因，并且同时辨别有脓和无脓的情况。言外之意是，对于已经形成的痈，希望它溃破；尚未形成的，希望它起发消散。
内外外科原本不分科，后来分开，是因为针砭、刀割、熏洗等方法，另有专门传承练习的人，士大夫阶层不屑于谈论这些。然而重大的病证，绝对非外科专科医生所能治愈。薛己的《薛氏医按》，论述得非常详细，但是使用六味丸、八味丸、补中益气汤、十全大补汤、归脾汤、六君子汤、异功散、逍遥散等方剂，进行加减出入。如果用于溃后虚证颇为适宜，但这其实是笼统的套路方法，对于重大病证难以成功。《金匮要略》说浮数脉，应当发热却反而恶寒的，是因为卫气受到遏制而不能外出，卫气受遏制，责任在于营分邪气过实。仅仅这几句简短的话，已经蕴含了治疗痈肿的绝大法则。再参考六经的见证，六经的部位，运用六经的对症方药，没有不有效的。外科专科医生的技术，不足以依赖。
肠痈这种病。（气血被内痈所掠夺，不能外荣肌肤，所以）身体（干枯起皱，像鱼鳞一样交叠交错），腹部皮肤（虽然）紧张，（但）按压时却柔软。（外表虽然）像肿胀的样子，（但腹内）没有积聚包块，身体（虽然）没有发热，（但）脉象却像表邪一样的数脉。这是因为（营气郁结化热。）肠道内有痈脓。（用薏苡附子败酱散主治。）（这是针对小肠痈提出的方治。）
这是针对小肠痈而给出的方治。败酱又名苦菜，多生长在土墙和屋瓦上。福建人误将其当作蒲公英。
薏苡附子败酱散方
薏苡仁（十分） 附子（二分） 败酱（五分）
以上三味药，捣碎成散剂。取一方寸匕的药量，用水二升，煎煮至减半，一次性服用。小便会像饭粒一样排出（指脓液随小便排出）。
（痈位于大肠的情况，是怎样的呢？大肠位于小肠之下，如果）肿胀（高突且）痈肿严重，（逼迫邻近膀胱，导致）少腹部肿胀痞硬，按压就疼痛如同淋病，（但实际上并非膀胱受害，所以）小便（仍然）正常通畅。（小肠与心相合，气通于血脉；大肠与肺相合，气通于皮毛，所以前者脉数身无热，而这里则）时常发热、自汗出，又伴有恶寒。（再根据症状来辨别脉象，如果）脉象迟紧的，（说明邪气暴烈遏制而营血尚未变化，属于）脓未形成，可以用攻下法。（使其消散。如果脉象洪数的，（说明毒邪已聚结而营气腐败，属于）脓已形成。（即使使用攻下法，也不能消除，所以）不可再用攻下法。（若用）大黄牡丹汤（不论痈肿已成或未成，皆可）主治。
这是针对大肠痈而给出的方治。
大黄牡丹汤方
大黄（四两） 牡丹皮（一两） 桃仁（五十个） 冬瓜仁（半升） 芒硝（三合）
以上五味药，用水六升，煮取一升药液，去渣，加入芒硝，再次煮沸，一次性服用。有脓则会排出脓液，如无脓，则会排出瘀血。
问：寸口脉象浮微而涩，按照常理应当是失血或汗出过多。假设没有汗出的情况，是怎么回事？回答说：（血与汗，都属于阴液。微脉表示阳气虚弱，涩脉表示血少。）如果身上有疮疡，被刀斧所伤，（导致）失血（血亡而气也失去依附，这就是脉微而又涩的）原因。（而且夺血者无汗，这就是脉浮而不汗出的原因。）
这是针对金创失血辨别脉象的内容。
（凡是一切）金创疾病，（统一用）王不留行散主治。
这是针对金创给出总治方的内容。
徐忠可说：这不是上文所述伤久无汗的金创方，而是概括治疗金创的方子。所以说：患金创病，用王不留行散主治。盖因王不留行，性味苦平，能通利血脉，所以反而能止住金创出血，驱逐疼痛。蒴藋细叶也能通利气血，尤其善于开通痹阻。周身肌肉由肺所主，桑根白皮最利于肺气，东南方向的根向阳生长，生气尤为完备，用以恢复肌肉的生气，所以这三样药用量很大作为君药。甘草解毒调和营血，用量也多作为臣药。花椒、干姜用来温养胸中之阳，厚朴用来疏解内部结滞之气，黄芩、芍药用来清泄阴分之热作为佐药。如果有风寒，这属于经络中的客邪，桑白皮只利于肺气，不能驱逐外邪，所以不要选用。（孙思邈之孙孙心兰按语：金创失血者忌用发汗法，因为阴液受损的缘故。如果偶然感受风邪，患者神志不清，仍宜按照破伤风论治，不要拘泥于亡血禁汗的规定。）
王不留行散方
王不留行（十分，八月八日采集） 蒴藋细叶（十分，七月七日采集） 桑树东南根（白皮十分，三月三日采集） 甘草（十八分） 黄芩（二分） 川椒（三分） 厚朴（二分） 干姜（二分） 芍药（二分）
以上九味药，王不留行、蒴藋、桑皮三味药，烧成灰存性，分别捣碎筛粉，混合制成散剂。每次服用一方寸匕。小疮直接撒粉在外，大疮仅内服。产后也可以服用。
排脓散方
枳实（十六枚） 芍药（六分） 桔梗（二分）
以上三味药，捣碎成散剂。取鸡蛋黄一枚，用药散与蛋黄相等，揉和使两者融合。用水送服，每日一服。
枳实得阳明金气以制约风邪，禀受少阴水气以清热，又配合芍药以通血脉，配合桔梗以利气机，尤其依赖鸡蛋黄的滋养心脾作用，取有情之物，辅助火土脏器的阴液，作为排脓化毒的根本。
排脓汤方
甘草（二两） 桔梗（三两） 生姜（一两） 大枣（十枚）
以上四味药，用水三升，煮取一升药液，温服五合，每日两次服用。
这也是调和气血、调和营卫的方剂。
浸淫疮。（流注不止，俗称棉花疮、杨梅疮、恶疠之类。）从口部开始，流向四肢的，可治。（因为其从体内走向体表。）从四肢流来进入口部的，不可治。（因为其从体表走向体内。）浸淫疮，（用）黄连粉主治。（原方未见）
这是针对浸淫疮给出的方治。原方未见，怀疑即黄连一味药研成粉，外敷。严重的也内服。
各种疮疡疼痛瘙痒，都属于心火。黄连苦寒泻心火，所以用它主治。我因此悟出一个方子，治疗杨梅疮、棉花疮等非常有效：连翘、蒺藜、黄柏、金银花各三钱，当归、甘草、苦参、荆芥、防风各二钱。另外用土茯苓二两，用水煮汤去渣，用此汤煎煮上述药物，空腹服用。十日可愈。如果是房事传染的，其毒邪乘肾气之虚，从精孔深入肾脏，散布于冲任督脉，难愈。宜加龟板入任脉，生鹿角末入督脉，黄柏入冲脉等药。并先用黑牵牛制末，做成小丸，配合烧过的灰烬散剂，用土茯苓汤送下，令黑色大便大量排出后，再加前述汤药如神效。
The pulse at the cun, guan, and chi positions on both hands presents as floating and rapid. (A floating pulse indicates an exterior syndrome, and a rapid pulse indicates heat. If it is due to exterior pathogenic factors,) fever should occur.
(However, there is no fever now.) Instead, there is a sensation of chills as if being sprinkled with cold water. (This must be due to stagnation of qi and blood, as stated in the *Neijing*: when Ying Qi does not flow smoothly and reverses within the muscle tissue, carbuncles and swellings arise. When Yang Qi is excessive and Ying Qi fails to circulate, carbuncles develop.) If there is a painful area, (this is even more clearly verifiable. However, "carbuncle" implies obstruction.) one should (use herbs such as Ephedrae Herba [Mahuang] and Schizonepetae Spica [Jingjie] to) diffuse and disperse the (stagnant) carbuncle. The Master said: Regarding various carbuncles and swellings, to determine whether pus has formed, place the hand over the swelling. If it feels hot, (the toxin has gathered,) there is pus; if not hot, (the toxin has not gathered,) there is no pus. This passage explains the origin of carbuncles and simultaneously distinguishes between cases with and without pus. The implied meaning is that for established carbuncles, the goal is suppuration and rupture; for unestablished ones, the goal is resolution and dispersal.
Internal and external medicine were originally not separated into different departments. They were later separated because techniques such as acupuncture, stone knives, surgical incision, fumigation, and washing required specialized transmission and practice, which scholars tended to disregard. However, major syndromes are absolutely beyond the capability of specialists in external surgery alone. Xue Ji's *Xue Shi Yi An* discusses this in great detail, but relying on formulas such as Liuwei Wan, Bawei Wan, Buzhong Yiqi Tang, Shiquan Dabu Tang, Guipi Tang, Liujunzi Tang, Yigong San, and Xiaoyao San, with modifications, is suitable mainly for deficiency syndromes after ulceration. In reality, this is a generalized routine method and difficult to succeed in treating major syndromes. The *Jinkui Yaolue* states that a floating and rapid pulse should present with fever, yet if chills occur instead, it is because Wei Qi is restrained and cannot exit. The restraint of Wei Qi is attributed to excess in the Ying level. These few concise sentences already contain the supreme treatment principles for carbuncles and swellings. By referring to the manifestations of the Six Channels, their anatomical locations, and applying the specific formulas of the Six Channels, efficacy is assured. Relying solely on external surgical expertise is insufficient.
Intestinal carbuncle is characterized by... (qi and blood are depleted by the internal carbuncle and cannot nourish the skin and muscles externally, so the body appears) dry and wrinkled, like overlapping scales. The abdominal wall is (tense, but) soft upon palpation. Although the exterior looks swollen, there are no accumulations in the abdomen. Although the body has no fever, the pulse is rapid, resembling an exterior pathogen. This is due to (Ying Qi stagnation transforming into heat.) Pus forms within the intestines. (Treat with Yiyi Fuzi Baijiang San.) (This addresses small intestinal carbuncle.)
This provides the formula and treatment for small intestinal carbuncle. Baijiang Cao (Patriniae Herba), also known as Kucai, grows abundantly on earthen walls and roof tiles. People in Fujian mistakenly identify it as Taraxaci Herba (Dandelion).
Formula for Yiyi Fuzi Baijiang San
Coicis Semen (Yiyiren) - 10 parts
Aconiti Lateralis Radix Praeparata (Fuzi) - 2 parts
Patriniae Herba (Baijiangcao) - 5 parts
Grind these three ingredients into a powder. Take a measure equivalent to a square inch spoonful (fangcun bi). Add two sheng of water, decoct until reduced by half, and take in one dose. Small amounts of stool resembling rice grains will be passed (indicating discharge of pus via urine/stool).
(What about carbuncles located in the large intestine? The large intestine lies below the small intestine. If the swelling is high and the carbuncle severe, it presses against the bladder, causing) distension and hardness in the lower abdomen. Palpation causes pain resembling strangury (lin syndrome), (but this is not due to bladder pathology, so urination remains normal.) (Since the small intestine pairs with the Heart and its qi connects to the blood vessels, while the large intestine pairs with the Lung and its qi connects to the skin and hair, the former presents with rapid pulse and no fever, whereas here there is) intermittent fever, spontaneous sweating, and aversion to cold. (Further distinguishing by pulse based on symptoms: if the pulse is slow and tight, the pathogen is violently obstructing and the Ying blood has not yet changed, indicating pus has not formed. Purging may be used to resolve it. If the pulse is surging and rapid, the toxin has gathered and the Ying qi has腐rified, indicating pus has formed. Even purging cannot eliminate it, so purging is contraindicated. Use Dahuang Mudan Tang regardless of whether the carbuncle is formed or not.)
This provides the formula and treatment for large intestinal carbuncle.
Formula for Dahuang Mudan Tang
Rhei Radix et Rhizoma (Dahuang) - 4 liang
Moutan Cortex (Mudanpi) - 1 liang
Persicae Semen (Taoren) - 50 seeds
Benincasae Semen (Dongguaren) - 0.5 sheng
Natrii Sulfas (Mangxiao) - 3 he
Decoct the five ingredients in six sheng of water until one sheng remains. Strain, add Mangxiao, boil again, and take in one dose. If pus exists, it will be discharged; if no pus, blood clots will be discharged.
Question: The pulse at the cunkou position is floating, faint, and choppy. According to standard theory, this indicates blood loss or excessive sweating. If there is no sweating, what is the explanation? Answer: Blood and sweat both belong to Yin fluids. A faint pulse indicates weak Yang, and a choppy pulse indicates blood deficiency. If there is a wound on the body caused by knife or axe injury, resulting in blood loss (where the loss of blood leads to loss of Qi support, hence the faint and choppy pulse), and since those who lose blood do not sweat (explaining the floating pulse without sweating)...
This section distinguishes the pulse in cases of metallic wound blood loss.
For all types of metallic wounds (Jinchuang), Wangbuliuxing San is the primary treatment.
This provides the general treatment formula for metallic wounds.
Xu Zhongke stated: This is not the formula for metallic wounds from earlier in the text where long-standing injuries cause lack of sweating, but rather a general formula for treating metallic wounds. Hence it says: For metallic wounds, use Wangbuliuxing San. Wangbuliuxing Seed (Vaccariae Semen) is bitter and neutral in nature, capable of promoting blood circulation and unblocking collaterals, thus stopping bleeding from wounds and relieving pain. Desmodii Caulis (Shuodai) also promotes qi and blood circulation and is particularly effective in opening obstructions. Since the muscles are governed by the Lung, Mulberry Root Bark (Sangbaipiku) benefits Lung qi best. Roots facing southeast absorb sunlight and possess abundant vital energy, helping restore the vitality of muscles. Therefore, these three herbs are used in large quantities as sovereign drugs. Glycyrrhizae Radix et Rhizoma (Gancao) detoxifies and harmonizes Ying Qi, used in larger quantity as ministerial drug. Zanthoxyli Pericarpium (Chuanjiao) and Zingiberis Rhizoma (Ganjiang) warm and nourish Yang in the chest. Magnoliae Officinalis Cortex (Houpo) relieves internal stagnation. Scutellariae Radix (Huangqin) and Paeoniae Radix Alba (Shaoyao) clear heat in the Yin aspect as adjunctive drugs. If wind-cold is present, this belongs to external pathogens in the meridians. Sangbaipiku only benefits Lung qi and cannot expel external pathogens, so it should not be selected. (Sun Xinlan, grandson of Sun Simiao, noted: Patients with metallic wounds and blood loss should avoid diaphoresis because Yin is damaged. If they accidentally contract wind pathogen and become unconscious, they should still be treated as broken-wind-sickness (tetanus), not strictly adhering to the prohibition of sweating due to blood loss.)
Formula for Wangbuliuxing San
Vaccariae Semen (Wangbuliuxing) - 10 parts (harvested on the 8th day of the 8th lunar month)
Desmodii Caulis (Shuodai Xiye) - 10 parts (harvested on the 7th day of the 7th lunar month)
Mori Radix Cortex (Sanggen Dianangun Baipi) - 10 parts (harvested on the 3rd day of the 3rd lunar month)
Glycyrrhizae Radix et Rhizoma (Gancao) - 18 parts
Scutellariae Radix (Huangqin) - 2 parts
Zanthoxyli Pericarpium (Chuanjiao) - 3 parts
Magnoliae Officinalis Cortex (Houpo) - 2 parts
Zingiberis Rhizoma (Ganjiang) - 2 parts
Paeoniae Radix Alba (Shaoyao) - 2 parts
Burn the first three ingredients (Wangbuliuxing, Shuodai, Sangbaipiku) to ash while preserving their properties. Grind and sieve each separately, then mix into a powder. Take one fangcun bi per dose. For minor wounds, apply powder topically; for major wounds, take orally. It can also be taken postpartum.
Formula for Painong San
Immature Tangerine Peel (Zhishi) - 16 pieces
Paeoniae Radix Alba (Shaoyao) - 6 fen
Platycodonis Radix (Jiegeng) - 2 fen
Grind the three ingredients into a powder. Take one chicken egg yolk. Mix the powder with an equal amount of egg yolk, knead until well combined, and take with water once daily.
Zhishi obtains Metal Qi from the Yangming channel to control wind, and Water Qi from the Shaoyin channel to clear heat. Combined with Shaoyao to unblock blood, and Jiegeng to promote qi movement. It relies especially on the chicken egg yolk to nourish the Heart and Spleen. Using substances with life force assists the Yin of the Fire and Earth organs, serving as the foundation for draining pus and resolving toxins.
Formula for Painong Tang
Glycyrrhizae Radix et Rhizoma (Gancao) - 2 liang
Platycodonis Radix (Jiegeng) - 3 liang
Zingiberis Rhizoma Recens (Shengjiang) - 1 liang
Jujubae Fructus (Dazao) - 10 pieces
Decoct the four ingredients in three sheng of water until one sheng remains. Take five he of the warm decoction twice daily.
This is also a formula to regulate qi and blood and harmonize Ying and Wei.
Jinyin Chuang (Exudative dermatitis/weeping sores)... (flows continuously, commonly known as cotton sore, syphilis sore, or malignant leprosy-like lesions). If it starts from the mouth and flows toward the limbs, it is treatable (because it moves from interior to exterior). If it starts from the limbs and flows into the mouth, it is untreatable (because it moves from exterior to interior). Jinyin Chuang is treated with Huanglian Fen (Coptidis Rhizoma Powder). (Original formula not seen.)
This provides the treatment for Jinyin Chuang. The original formula is missing; it is suspected to be simply Coptidis Rhizoma (Huanglian) ground into powder for topical application. Severe cases may also take it internally.
All sores with pain and itching belong to Heart Fire. Huanglian is bitter and cold, clearing Heart Fire, hence it is used. From this, I deduced a formula that is very effective for treating syphilis sores, cotton sores, etc.: Lonicerae Japonicae Flos (Lianqiao), Tribuli Fructus (Jili), Phellodendri Cortex (Huangbai), and Lonicerae Japonicae Flos (Jinyinhua) each 3 qian; Angelicae Sinensis Radix (Danggui), Glycyrrhizae Radix et Rhizoma (Gancao), Sophorae Flavescentis Radix (Kushen), Schizonepetae Spica (Jingjie), and Saposhnikoviae Radix (Fangfeng) each 2 qian. Additionally, use Smilacis Glabrae Rhizoma (Tufuling) 2 liang, decoct in water, strain, and use this liquid to decoct the other herbs. Take on an empty stomach. Cure expected in ten days. If contracted through sexual intercourse, the toxin enters deeply into the Kidney via the essence aperture, exploiting Kidney Qi deficiency, and spreads through the Chong, Ren, and Du vessels, making it difficult to cure. Add Tortoise Plastron (Guiban) to enter the Ren vessel, raw Deer Antler Powder (Luji) to enter the Du vessel, and Phellodendri Cortex (Huangbai) to enter the Chong vessel. First, prepare black Bindweed Seed (Heiqianniu) powder into small pills, combine with burnt ash powder, and swallow with Tufuling decoction. After significant black stool discharge, resume the previous decoction for miraculous results.