此书所着方颇为周备，但欲使用药者，不可不知之尔。然人能逐一玩味，详说深思用药
之意，临时看其病证次第用药，无有不效。近时有亲旧得此病，为愚医所惑，或用君臣药，
或用草药，其病益多，痛楚日增，然后回心，杜绝众医，用愚方，间蒙下问，但指示三五方与
之服饵，无有不安者。今略书用药要领与夫先后之序，画一于后。
一、初觉时背疽之疾，便令服内托散，后来不生变证，口舌无疮。此药但可服十数服而
止。
内托散 大止疼痛. 如未破，即点破有脓（此方原缺，今从《惠济宝书》补入）。
川乌(一两，泡） 茯苓（三分） 苦杖（半两） 独活 白芷 甘草（炙，各一两）
上为末。每服二钱，酒调下，日三服。
一、即令继服五香连翘汤。服此药如大便宽快、内热既省，即令住服。若一二日之后大
便再闭，须令再服，要取利毒瓦斯至尽，然后住服。亦合看病患虚实，量其轻重而进药。
五香连翘汤
木香（三分，不见火） 沉香（三分，不见火） 连翘（全者去蒂，三分） 升麻（三分） 黄 （三分，
拣无叉附者，生用） 木通（三分，去节） 甘草（半两，生用） 丁香（半两，拣去枝杖，不见火）
乳香（半两，别研） 大黄（微炒，半两，锉） 麝（真者，一钱半，别研） 桑寄生（三分，难得真
者，缺之亦可） 独活（三分，买老羌活用，今铺家所卖独活，乃是土当归，不堪用）
上为粗末，和匀。每服三大钱，水一盏，煎至七分，去滓服；留滓二服，用水二盏再煎作
一服；积四散滓，用水三盏，又再煎作一服，然后不用其滓。方用银器煎药，如无银器，入银
一片同煎。内桑寄生一味，最能疗病，但难得真者，如缺，用升麻代。今已加升麻，若无真桑
寄生，则升麻分两当倍用。
一、次令多服洪氏排脓内补散。无呕逆之证，用好酒下；有呕逆之证，合用木香汤下。此
一药，合与痈疽相为，终始服饵，不可辍。
化毒排脓内补十宣散（亦名托里十补散）
治一切痈疽疖疮。未成者速溃，败脓自出，无用手挤，恶肉自去，不犯刃。使服药后，疼痛
减，其效如神（此方原缺，今从《和剂局方》补入）。
黄 （以绵上来者为胜。状如箭竿，长二三尺，头上叉者。洗净，寸截，捶破撕擘，以盐
汤润透，用盏盛汤瓶上一炊久，焙燥，随众药入研，即成细末） 人参（以新罗者为上。择团
结、重实、滋润，洗净，去芦，薄切，干搏用） 当归（取川中来者。择大片如马尾状，滋润、甜
辣、芬香者，温水洗，薄切，焙干用，各一两） 浓朴（用梓州者。肉浓而色紫，掐之油出。去粗
皮，切，姜汁窨一宿， 熟，焙燥。不用杜朴） 桔梗（以有心、味苦者为真，无心、味甘者荠
也，主解药毒，切勿误用。泥净，去头、尾，薄切，焙燥） 桂心（用卷薄者。古法，带皮桂
每两止取二钱半。合用一两，当买四两。候众药罢，别研，不得见火） 芎 （以川中来者为
上，今多抚芎。大块者，洗净，切，焙） 防风（择新香者。洗净，切，焙） 甘草（生用） 白
芷（各一两）
上十味，选药贵精，皆取净，晒、焙极燥方秤。除桂心外，一处捣，罗为细末。入桂令匀。
每服，自三钱加至五钱，热酒调下，日夜各数服，以多为妙。服至疮口合，更服犹佳，所以补
前损、杜后患也。不饮酒人，浓煎木香汤下，然不若酒力之胜也；或饮酒不多，能勉强间用酒
调，并以木香汤用酒，功效当不减于酒也。大抵痈疽之作，皆血气凝滞，风毒壅结所致。治
之不早，则外坏肌肉，内攻脏腑，其害甚大。才觉便服，倍加服数，服之醉则其效速。发散风
毒，流行经络，排脓止痛，生肌长肉，药性平和，老人、小儿、妇人、室女皆可服之。
木香汤 治痈肿（一作疽）初结，头痛寒热，气急方（此方原缺，今从《圣济总录》补
入）。
木香 藿香叶 沉香 薰陆者 丁香（各一两）
上五味，粗捣筛。每服五钱，盐水一盏半，煎至八分，去滓，空心温服，取滓敷膊上。日二。
一、呕逆有二证∶一证谓其初发时，不曾服内托散，伏热在心；一证有气虚，脾气不正
而呕。合仔细看病证，参酌用药。若是因热而呕，外证心烦、身热、痈作痛，此即是伏热在
心，合将内托散服三两服而止，不可多服；若是气虚而呕，其证心不烦热，遇早便呕，或闻
秽气亦呕，早晨合服嘉禾散。如有寒热，合服家传正气散。五更初，当服山药丸以补其肾。
一、发背人虽云有热，未有不至肾虚而得之者。若疽疾减退五分之后，便合如前法，五
更初服山药丸一服。
嘉禾散（案∶原方缺）。
这本书所记载的方剂相当周全完备，但想要使用这些药物的人，不能不了解其中的道理。然而，人们若能逐一细细品味，详细说明并深思用药的意图，在临证时根据病证的先后次序来用药，没有不奏效的。近来有亲友得了这种病，被庸医迷惑，有的用君臣配伍的药物，有的用草药，结果病情更加复杂，痛苦日益加重，然后才回心转意，拒绝其他医生，采用我的方子，偶尔蒙受询问，我只指示三五张方子给他们服用，没有不安康的。现在简要书写用药的要领以及先后的次序，一一列在下面。
一、初觉背疽疾病时，便令服用内托散，后来就不会产生变证，口舌也不会生疮。此药只可服用十几次就停止。
内托散 能大止疼痛。如果未破溃，即点破排脓（此方原缺，今从《惠济宝书》补入）。
川乌（一两，炮制后浸泡） 茯苓（三分） 苦杖（半两） 独活 白芷 甘草（炙，各一两）
以上药材研为细末。每次服用二钱，用酒调服，每日三次。
一、随即令继服五香连翘汤。服用此药如大便通畅、内热既已消退，便令停止服用。若一二日之后大便再次闭塞，须令再服，要取利毒瓦斯至尽，然后停止服用。也要查看病患虚实，衡量其轻重而进药。
五香连翘汤
木香（三分，不经过火炒） 沉香（三分，不经过火炒） 连翘（完整的去蒂，三分） 升麻（三分） 黄芩（三分，拣选无叉附者，生用） 木通（三分，去节） 甘草（半两，生用） 丁香（半两，拣去枝杖，不经过火炒） 乳香（半两，另研） 大黄（微炒，半两，锉碎） 麝香（真品，一钱半，另研） 桑寄生（三分，难得真品，缺之亦可） 独活（三分，买老羌活代替使用，如今药铺所卖的独活，乃是土当归，不堪使用）
以上药材研为粗末，和匀。每次服用三大钱，水一盏，煎至七分，去渣服用；留药渣二次，用水二盏再煎作一服；积存四次散渣，用水三盏，又再煎作一服，然后不再用其渣。方中规定用银器煎药，如无银器，放入银一片同煎。其中桑寄生一味，最能疗病，但难得真品，如缺，用升麻代替。现在已经加入升麻，若无真桑寄生，则升麻的分量应当加倍使用。
一、其次令多服洪氏排脓内补散。没有呕逆之证，用好酒送下；有呕逆之证，合用木香汤送下。这一种药，合与痈疽相伴，始终服用，不可停止。
化毒排脓内补十宣散（亦名托里十补散）
治疗一切痈疽疖疮。未成脓者速溃，败脓自出，不用手挤，恶肉自去，不犯刀刃。使服药后，疼痛减轻，其效如神（此方原缺，今从《和剂局方》补入）。
黄芪（以绵上来者为胜。状如箭竿，长二三尺，头上有叉者。洗净，寸截，捶破撕擘，以盐汤润透，用盏盛汤瓶上一炊久，焙燥，随众药入研，即成细末） 人参（以新罗者为上。择团结、重实、滋润，洗净，去芦，薄切，干搏用） 当归（取川中来者。择大片如马尾状，滋润、甜辣、芬香者，温水洗，薄切，焙干用，各一两） 浓朴（用梓州者。肉浓而色紫，掐之油出。去粗皮，切，姜汁窨一宿，熟，焙燥。不用杜朴） 桔梗（以有心、味苦者为真，无心、味甘者荠也，主解药毒，切勿误用。泥净，去头、尾，薄切，焙燥） 桂心（用卷薄者。古法，带皮桂每两止取二钱半。合用一两，当买四两。候众药罢，别研，不得见火） 川芎（以川中来者为上，今多抚芎。大块者，洗净，切，焙） 防风（择新香者。洗净，切，焙） 甘草（生用） 白芷（各一两）
以上十味药，选药贵精，皆取净，晒、焙极燥方秤。除桂心外，一处捣，罗为细末。入桂令匀。每次服用，自三钱加至五钱，热酒调下，日夜各数服，以多为妙。服至疮口愈合，更服犹佳，所以补前损、杜后患也。不饮酒人，浓煎木香汤送下，然不若酒力之胜也；或饮酒不多，能勉强间用酒调，并以木香汤用酒，功效当不减于酒也。大抵痈疽之作，皆血气凝滞，风毒壅结所致。治之不早，则外坏肌肉，内攻脏腑，其害甚大。才觉便服，倍加服数，服之醉则其效速。发散风毒，流行经络，排脓止痛，生肌长肉，药性平和，老人、小儿、妇人、室女皆可服之。
木香汤 治疗痈肿（一作疽）初结，头痛寒热，气急方（此方原缺，今从《圣济总录》补入）。
木香 藿香叶 沉香 薰陆者 丁香（各一两）
以上五味药，粗捣筛。每次服用五钱，盐水一盏半，煎至八分，去渣，空心温服，取渣敷膊上。每日两次。
一、呕逆有二证：一证谓其初发时，不曾服内托散，伏热在心；一证有气虚，脾气不正而呕。合仔细看病证，参酌用药。若是因热而呕，外证心烦、身热、痈作痛，此即是伏热在心，合将内托散服三两服而止，不可多服；若是气虚而呕，其证心不烦热，遇早便呕，或闻秽气亦呕，早晨合服嘉禾散。如有寒热，合服家传正气散。五更初，当服山药丸以补其肾。
The prescriptions recorded in this book are quite comprehensive and complete. However, those who wish to use these medicines must not fail to understand their principles. If one can carefully ponder each item, elaborate on and deeply reflect upon the intention behind the medication, and apply medicines according to the sequence of symptoms at the time of treatment, there will be no case that fails to respond. Recently, a relative or old friend suffered from this disease and was confused by incompetent physicians. Some used sovereign-minister drug combinations, while others used herbal remedies, resulting in more complications and increasing pain day by day. Only then did they change their minds, reject other doctors, and adopt my prescriptions. Occasionally asked for advice, I simply indicated three or five prescriptions for them to take, and none failed to recover. Herein, I briefly outline the essentials of medication and their chronological order, listed below.
1. When the back carbuncle (Back Carbuncle) is first perceived, immediately administer Neituo San (Internal Support Powder). This prevents later transformation syndromes and ensures no sores appear in the mouth or tongue. This medicine should only be taken for about ten doses before stopping.
Neituo San (Internal Support Powder): Greatly alleviates pain. If the lesion has not ulcerated, puncture it to drain pus (This prescription was originally missing; now supplemented from *Huiji Baoshu*).
Radix Aconiti Lateralis Preparata (Chuanwu, 1 liang, processed and soaked) Poria (Fuling, 3 fen) Bupleuri Radix (Kuzhi, 0.5 liang) Angelicae Pubescentis Radix (Duhuo) Angelicae Dahuricae Radix (Baizhi) Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 1 liang each)
Grind the above into powder. Take 2 qian per dose, mixed with wine, three times daily.
2. Immediately follow with Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction). If bowel movements become loose and internal heat subsides after taking this medicine, stop administration. If constipation recurs after one or two days, resume administration until toxic factors are completely purged, then stop. Also assess the patient's deficiency or excess syndrome and adjust the dosage accordingly based on severity.
Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction)
Aquariæ Lignum (Muxiang, 3 fen, not roasted) Aquariæ Lignum (Chenxiang, 3 fen, not roasted) Forsythiae Fructus (Lianqiao, whole, calyx removed, 3 fen) Cimicifugae Rhizoma (Shengma, 3 fen) Scutellariae Radix (Huangqin, 3 fen, select those without branching, raw use) Tetrapanacis Medulla (Mutong, 3 fen, nodes removed) Glycyrrhizae Radix et Rhizoma (Gancao, 0.5 liang, raw use) Myristicae Semen (Dingxiang, 0.5 liang, remove stems, not roasted) Boswelliae Resina (Ruxiang, 0.5 liang, separately ground) Rhei Radix et Rhizoma (Dahuang, lightly roasted, 0.5 liang, sliced) Moschus (Moxiang, genuine, 1.5 qian, separately ground) Taxilli Herba (Sangjisheng, 3 fen; genuine source is hard to obtain, omission is acceptable) Angelicae Pubescentis Radix (Duhuo, 3 fen; purchase aged Qianghuo instead, as current market Duhuo is often Tu Danggui, which is unsuitable)
Grind the above into coarse powder and mix evenly. Take 3 da qian per dose, decocted in 1 sheng of water until reduced to 0.7 sheng, strain and drink. Retain the dregs for a second decoction with 2 sheng of water to yield one dose. Accumulate dregs from four separate decoctions, add 3 sheng of water, decoct again to yield one dose, then discard the dregs. The prescription specifies using a silver vessel for decoction; if unavailable, add a piece of silver during decoction. Among these, Sangjisheng (Taxilli Herba) is most effective for treating the disease but is hard to obtain genuinely. If unavailable, substitute with Shengma (Cimicifugae Rhizoma). Since Shengma has already been added, if genuine Sangjisheng is lacking, double the dosage of Shengma.
3. Subsequently, advise frequent intake of Hongshi Paimao Neibu San (Hong’s Pus-Draining Internal-Nourishing Powder). If there is no nausea or vomiting, administer with good wine; if nausea or vomiting is present, administer with Muxiang Tang (Aquarius Decoction). This medicine should accompany the treatment of carbuncles and sores throughout, without interruption.
Huadu Paimao Neibu Shixuan San (Toxin-Detoxifying Pus-Draining Internal-Nourishing Ten-Exhaustive Powder) (Also known as Tuoli Shibu San (Interior-Supporting Ten-Nourishing Powder))
Treats all types of carbuncles, ulcers, boils, and sores. Promotes rapid suppuration of unformed lesions, allows foul pus to discharge spontaneously without manual squeezing, eliminates necrotic tissue naturally without surgical incision. Reduces pain after administration, with miraculous efficacy (This prescription was originally missing; now supplemented from *Heji Jufang*).
Astragali Radix (Huangqi, superior quality comes from绵 Lai; shaped like an arrow shaft, 2-3 chi long, branched at the top. Wash clean, cut into cun-length pieces, crush, tear open, moisten thoroughly with salt water, steam over a tea pot for one cooking duration, dry roast, grind together with other herbs into fine powder) Ginseng Radix et Rhizoma (Renshen, Korean origin is best. Select compact, heavy, moist ones, wash clean, remove rhizome, slice thinly, dry and grind) Angelicae Sinensis Radix (Danggui, Sichuan origin preferred. Select large slices resembling horse tails, moist, sweet-spicy, fragrant, wash with warm water, slice thinly, dry roast, 1 liang each) Magnoliae Officinalis Cortex (Houpo, Zizhou origin preferred. Thick flesh, purple color, exudes oil when pinched. Remove rough bark, slice, marinate in ginger juice overnight, cook, dry roast. Do not use Du Pu) Platycodonis Radix (Jiegeng, genuine ones have a heart and bitter taste; those without a heart and sweet taste are Shepherd’s Purse, which detoxifies drugs, do not mistake them. Clean mud, remove head and tail, slice thinly, dry roast) Cinnamomi Cortex (Guixin, select thin curled pieces. Ancient method: for every 1 liang of cinnamon with bark, take only 2.5 qian. To get 1 liang, buy 4 liang. After processing other herbs, grind separately, avoid fire exposure) Ligustici Chuanxiong Rhizoma (Chuanxiong, Sichuan origin preferred, currently mostly Fuxiong. Large chunks, wash clean, slice, dry roast) Saposhnikoviae Radix (Fangfeng, select fresh and fragrant. Wash clean, slice, dry roast) Glycyrrhizae Radix et Rhizoma (Gancao, raw use) Angelicae Dahuricae Radix (Baizhi, 1 liang each)
Of the above ten ingredients, select high-quality herbs, ensure purity, sun-dry and dry-roast thoroughly before weighing. Except for Guixin (Cinnamomi Cortex), grind all together, sieve into fine powder, then add Guixin and mix evenly. Dosage starts at 3 qian and increases to 5 qian, mixed with hot wine, taken several times day and night, more is better. Continue taking even after the wound closes for optimal results, to repair previous damage and prevent future complications. Non-drinkers should take with thickly decocted Muxiang Tang (Aquarius Decoction), though wine is superior. Those who drink little may occasionally mix wine with Muxiang Tang, which maintains efficacy comparable to pure wine. Generally, carbuncles and sores arise from stagnation of blood and qi, and accumulation of wind-toxin. Delayed treatment leads to external muscle destruction and internal organ attack, causing great harm. Administer immediately upon perception, doubling the dosage; intoxication-like effects accelerate efficacy. Disperses wind-toxin, promotes circulation in collaterals, drains pus, relieves pain, generates flesh, and nourishes tissue. The medicinal nature is mild, suitable for elderly, children, women, and unmarried girls.
Muxiang Tang (Aquarius Decoction): Treats initial formation of carbuncles/sores, headache, chills and fever, shortness of breath (This prescription was originally missing; now supplemented from *Shengji Zonglu*).
Aquariæ Lignum (Muxiang) Pogostemonis Herba (Huoxiangye) Aquariæ Lignum (Chenxiang) Frankincense (Xunluzhe) Myristicae Semen (Dingxiang) (1 liang each)
Coarsely grind and sieve the above five ingredients. Take 5 qian per dose, decoct in 1.5 sheng of salt water until reduced to 0.8 sheng, strain, take warm on an empty stomach, apply dregs to the shoulder. Twice daily.
4. Nausea and vomiting present two syndromes: One syndrome occurs when Neituo San (Internal Support Powder) was not taken at onset, leaving latent heat in the Heart; the other syndrome involves Qi deficiency, with improper Spleen Qi causing vomiting. Carefully examine the symptoms and consult appropriate medications. If vomiting is due to heat, accompanied by restlessness, body heat, and carbuncle pain, this indicates latent heat in the Heart. Administer Neituo San (Internal Support Powder) for three doses and stop; do not overuse. If vomiting is due to Qi deficiency, characterized by no mental restlessness or heat, early morning vomiting, or vomiting upon smelling foul odors, administer Jiahe San (Jiahar Powder) in the morning. If chills and fever are present, administer family-prescribed Zhengqi San (Righteous Qi Powder). At dawn, take Shanyao Wan (Chinese Yam Pill) to tonify the Kidney.
5. Although patients with Back Carbuncle (Fa Bei) are said to have heat, none develop this condition without underlying Kidney deficiency. After the carbuncle disease subsides by five parts, follow the previous method: take one dose of Shanyao Wan (Chinese Yam Pill) at dawn.
Jiahe San (Jiahar Powder) (Note: Original prescription missing).