《仙传外科集验方》Vol. 2

Use rhubarb, gardenia, and Asian morning glory root in the formula. If the illness affects the feet, add papaya.

Chop all the herbs. Use five qian per dose. Take one dose and add a small amount of Eupatorium leaves, along with one liang each of honeysuckle and ginger. Pound them together, then mix with a suitable amount of good wine and drink while hot. For those who do not drink alcohol, decocting the mixture in water is more suitable. Afterward, decoct the herbs with one and a half cups each of wine and water and ten slices of ginger. When hot, drink it and continue until sweating occurs. Once the illness has eased, add two qian of rhubarb and decoct it, to promote one or two bowel movements and expel the remaining toxins.

Judging by the ingredients alone, this formula may seem ordinary, but it is said to work quickly and to have proved effective on repeated use.

If other symptoms arise afterward, adjust the herbs according to the specific symptoms to seek the fastest effect.

For restlessness and vomiting, add one qian of licorice node, and take it with bean powder washed down with sour rice-washing water.

For vomiting and nausea, add frankincense and take bean powder with licorice decoction. Then mix purple river cart and aged ginger with rice vinegar and swallow it in one gulp.

Restlessness and vomiting are called “summerheat lodged within”; use Cinnabar Five-Ingredient Powder.

For vomiting and nausea, add mother clove and lotus seed. If the symptoms still do not stop, use Gold-Without-Exchange Rectifying-Qi Powder, with ginseng and costus root added.

Unrelenting vomiting is called “drinking water.” If the hands and feet are also cold, swallow Coptis and Mosla Powder and Summer-Heat-Dispelling Pills.

For vomiting and nausea in the hands, add mother clove and lotus seed. If the symptoms still do not stop, use Gold-Without-Exchange Rectifying-Qi Powder, with ginseng and costus root added.

Unrelenting vomiting is called “drinking water.” If the hands and feet are also cold, swallow Coptis and Mosla Powder and Summer-Heat-Dispelling Pills.

For cold hands and feet, add Sichuan papaya and Asian morning glory root.

For restlessness, add Ophiopogon, red peony, gardenia, and rush pith.

For tidal fever, add northern bupleurum, Scutellaria, light bamboo leaves, and cogongrass root.

For blurred vision, add cinnabar, realgar, and a little musk.

For abdominal distension, add Job’s tears and Glauber’s stone.

For diarrhea, add white atractylodes, white poria, nutmeg, and poppy shell.

For persistent abdominal pain, add southern costus root and frankincense.

For panting and coughing, add Anemarrhena, fritillaria, and a little honey.

When there is a headache, add Sichuan lovage rhizome, angelica dahurica, and the white part of a scallion. If the pain still does not stop, pound radish seeds, Sichuan lovage rhizome, and scallion white together and apply them to the temples; this is said to relieve the pain.

When there is a lot of phlegm, add fresh young mugwort leaves. Pound them with rice vinegar to extract the juice, then swallow it to help bring up the phlegm.

For a sore throat, add subprostrate sophora root, lingxiao root, gardenia, lophatherum leaves, mugwort leaves, and rush pith.

For constipation, add red peony root prepared with ginger, bitter orange, and areca peel. For difficulty urinating, add red peony root, red poria, akebia stem, plantain seeds, and rush pith. If there is blood in the urine, add raw rehmannia root and plantain seeds. For a nosebleed, add wild safflower, raw rehmannia root, lotus node, and ginger peel; use all these herbs fresh.

If a sore or ulcer does not hurt and its head does not rise, apply moxibustion for three cones of mugwort (each cone means one application, made by burning a section of mugwort). If it still does not hurt after moxibustion, it is considered difficult to treat.

For steaming-bone disorder, an ancient term for illnesses in which heat seems to steam up from within the bones, add cogongrass root. If the pulse cannot be felt, take the Twenty-Four-Ingredient Flowing Qi Decoction.

Add Ye Su Xiao Nei Xiao to the secret formula as well. It is said to disperse sores and ulcers quickly and is a prescription worth using throughout one’s life.

Flying Dragon Seizes Life Pill is specifically used to treat furuncles, sores on the back, deep sores on the head, breast abscesses, deep sores near the bone, and all kinds of swellings without a visible head. The text says that after taking the medicine, a head will form on the sore; those that did not hurt will begin to hurt; and those that have already filled with pus will heal quickly. The scripture describes these as severe illnesses and regards this pill as an exceptionally precious remedy, claiming that it takes effect as soon as it is taken in an emergency, works rapidly, and almost never fails. It also says the formula is a family secret that is not readily passed on.

The ingredients are two qian of toad secretion, one qian of dried dragon’s blood resin, two qian each of frankincense and myrrh, three qian of realgar, half a qian of calomel, one qian of blue vitriol, half a qian of musk, two qian of verdigris, one qian of gypsum, and one qian of cinnabar. Also take half a qian of borneol; if it is unavailable, it may be omitted. Use twenty-one snails, shells and all, and one centipede, soaked and then roasted until yellow; remove its head and legs. Grind all the ingredients above into a fine powder. Pound the snails into a paste, mix it with the powder, and form pills the size of mung beans. If the mixture is too difficult to shape, add flour paste mixed with wine to make the pills.

Take two pills per dose. First have the patient chew a three-inch piece of the white part of a scallion and spit it into the palm of the hand: men should use the left hand, women the right. Wrap the pills in the chewed scallion and swallow them with three or four cups of hot wine, without adding water. After taking them, stay out of the wind and cover yourself with clothes and bedding. After about as long as it takes to walk five li, drink several more cups of hot wine to help the medicine take effect. The intended result is a hot sweat.

Take two pills as soon as the illness is noticed; the symptoms will usually subside. If there is no sweating and the illness is severe, take another two pills. The text says that once sweating begins, the medicine will work. For severe cases, take another two pills after three to five days; the text claims this will bring a cure. If the poison of a furuncle spreads—a condition described as “the toxin turning yellow and reaching the heart”—the case is difficult to save. Becoming chilled while sweating is also considered a dangerous sign. If the patient cannot chew scallion, pound it instead, wrap the pills in it, and swallow them with hot wine. For sores on the upper body, take the medicine after eating; for sores on the lower body, take it before eating.

After taking the medicine, avoid cold water, cucumbers, eggplants, oil, pork offal, fish and meat, moist noodles, and foods that the text says may provoke wind disorders or sores and toxins. It also specifically prohibits women from washing or changing their fox-odor garments. The text concludes by claiming that this medicine is exceptionally effective and can save lives quickly.

Song Verses

Grind blood scorpion, toad venom, light powder, realgar, copper rust, cinnabar, alum, and gypsum finely, then add musk, notoginseng, and sea sheep, and mix them together. This formula is specifically for treating furuncles and other severe, poisonous sores; it may also be used for carbuncles of the head and sores on the back, and is said to be highly effective. Take two pills, each the size of a mung bean, chew them thoroughly, and swallow them with scallion and wine. Cover yourself with clothing and bedding, and let the body sweat. The verses say this medicine can bring the dead back to life. It is the “life-restoring Golden Elixir” that immortals passed down to the world, and is beyond all price.

This formula is used for furuncles, carbuncles, and other toxic sores and boils. It is said to disperse the toxins, make the affected area recede from within, and turn them into black water that is passed in the urine. The scripture calls its efficacy “reliable in ten thousand cases without a single failure” and cautions that the formula must not be disclosed carelessly, but kept carefully.

Frankincense, anemarrhena, pinellia, and trichosanthes root; optionally add fritillaria, pangolin scales, bletilla, gleditsia, and honeysuckle, one qian of each.

Cut the above ingredients into small pieces; together they should weigh eight qian. Simmer them in one bowl of ash-free wine—a wine to which no ash has been added—until reduced to half a bowl. Strain out the dregs and drink the liquid warm, once; do not increase or decrease the quantities. Pound the dregs into a fine powder, add one liang of hibiscus leaves gathered after autumn begins, and mix with honey. Then stir in well water drawn at dawn until smooth, and apply it to the opening of the sore. When the medicine dries, moisten it again with honey water. According to the formula, the sore will recede on its own overnight, and there is no need to take a second dose.

Realgar Pills: Promote bowel movements and dispel accumulated toxins.

Half a liang each of turmeric and realgar; one liang each of euphorbia and mirabilite; and forty croton seeds, shelled but with their oil retained.

Grind all the ingredients into a fine powder and use flour paste to form pills the size of mung beans. Take seven to nine pills at a time, grinding half a croton seed and swallowing it with cold boiled water. To dispel phlegm, simmer mulberry root bark and apricot kernels in water, let it cool, and use it to swallow the pills; the medicine is said to take effect accordingly.

Another formula: Grind euphorbia into a fine powder. Take three to four qian at a time, mixed with cold boiled water. To dispel phlegm, simmer mulberry root bark and apricot kernels in water, let it cool, and use it to swallow the powder; the medicine is said to take effect accordingly.

Another prescription calls for grinding Chinese rhubarb root (Daji) into a fine powder. Take three to four qian each time, mix it with clear tea, and swallow; it will induce a bowel movement.

Another prescription for clearing accumulated stagnation:

Twenty-one croton seeds; equal parts costus root, clove, and peach kernels.

Grind the ingredients into a fine powder and use flour paste to form pills the size of mung beans. Take with warm boiled water. Once the medicine takes effect, it will induce a bowel movement.

One liang of croton seeds and one liang of fermented black beans.

Grind the ingredients into a fine powder and use flour paste to make pills. Take seven or nine pills at a time with plain boiled water. Avoid hot soups and hot foods while taking the medicine. Once it takes effect, drink warm thin rice porridge or rice water to help restore the body.

A medicine for drawing out yellow fluid: make pills the size of parasol tree seeds from toad secretion (chan su) and finely sifted flour (fei luo mian). Place one pill beneath the front of the tongue, and yellow fluid will soon flow out.

The “Hundred-Twenty Powder,” also called “Heart-Protecting Powder,” is used when a boil causes agitation and restlessness, loss of sensation in the hands and feet, or mental derangement. Take it immediately.

Equal parts licorice nodes, mung bean powder, and cinnabar.

Grind the ingredients into a fine powder. In severe cases, mix it with water and take it.

The “Soul-Returning Elixir”: a little musk, two qian of realgar, one zi of toad secretion (a traditional unit of medicinal weight), and seven croton seeds. Shell the seeds, then heat them over a lamp flame until their medicinal properties are preserved but they are not completely reduced to ash.

Grind the ingredients into a fine powder and mix with clarified butter. Divide it into three portions, place them on the tongue one at a time, let them dissolve, and swallow. It is said to make the boil rupture on its own. Do not use iron utensils.

This concludes juan six of Secret Prescriptions for External Medicine from Immortal Transmission.

Volume Seven of Secret Formulas of the Immortal’s External Medicine

Compiled by Zhao Yizhen, Master Yuanyang of Junyi.

A Remarkably Effective Method for Treating Scrofula

For scrofula—a condition involving lumps in the neck’s lymph nodes—regardless of how long it has been present, first apply a constricting medicinal paste over the affected area. Then, starting at the lowest point, cauterize each spot in turn with moxa, moving upward; stop when you reach the root of the lesion. Place a slice of garlic over each spot before cauterizing it, and apply five to seven moxa cones there. After treating each spot, apply a medicated plaster. At first, replace it once a day. The method is said to bring results quickly.

Secretly Transmitted Medicated Plaster

Take two and a half liang of genuine green powder and dry-fry it in an iron pan until yellow; it should be thoroughly dry. Add half a liang each of frankincense and sandalwood, first dry-roasting the sandalwood; half a liang of xiangjie, also called xiangjie, a fragrant medicinal substance; and half a liang of myrrh. If there is pain, half a liang of genuine bile vitriol may be added. Once the poison is thought to have been drawn out and new flesh needs to grow, omit the bile vitriol. Calomel and a medicinal substance called xiazi may also be used, but only in small amounts. Southern snake gall may be left out if unavailable. Use only damaged musk, and do not use it when moxa treatment first begins.

Grind each ingredient separately into a fine powder. For each half liang of the powder, add five liang of bean flour and mix with rice vinegar to make a paste. Spread it on oiled paper and apply it to the affected area. If new flesh does not grow over the wound, add a flesh-regenerating medicine; the wound should then heal.

Five-Fragrance Forsythia Powder

This formula is used to treat various forms of accumulated heat, as well as lumps, scrofula, abscesses, malignant sores, and boils. It contains equal parts of agarwood, forsythia (stems removed), frankincense, cimicifuga, rhubarb (steamed to promote purging, though it may also be used raw), mistletoe, cloves (stems removed), musk, pubescent angelica, akebia, notopterygium, licorice, musk (use damaged musk), and green woody fragrance.

Another formula: frankincense, Cimicifuga, and rhubarb (use the raw form, which has a purgative effect). Mulberry mistletoe and Cimicifuga may also be used. Remove the stems from the cloves, then combine them with musk, dried Chinese angelica, akebia stem, Notopterygium root, licorice, and Aristolochia root in equal amounts. Damaged Aristolochia root may also be used medicinally.

Another formula may include raw astragalus.

Coarsely chop the ingredients above. For each dose, take four qian and decoct in two bowls of water until the liquid is about four-fifths full. Drink it hot after a meal, continuing until the harmful toxins have been expelled. The original formula also used bamboo sap and mirabilite; adjust their amounts according to the severity of the heat signs. Decoction the residue again and use the liquid to wash the affected area; the sores and swelling should then improve.

The powder for treating scrofula is also called Six-to-One Powder or Beneficial Origin Powder. It is said to relieve symptoms when taken at the onset of the illness.

One liang of talc and two qian of licorice.

Grind the ingredients into a fine powder. Take one and a half qian at a time, mixed with rice water. Take one dose before bed and another at midnight.

Another formula: four qian each of Japanese catnip flower spikes, stiff silkworm, and black morning glory seed; and twenty-eight cantharides, with the heads, legs, and wings removed. Stir-fry the cantharides with glutinous rice until the rice turns yellow, then pick out the cantharides and set the rice aside for later use.

Grind the ingredients together into a fine powder. Take one qian at a time, mixed with warm wine at dawn, in the fifth watch. Wait for the harmful toxins to be expelled in the urine. If they are not expelled, take another dose the next day. If they still have not been expelled, first eat thin porridge made with white glutinous rice on the morning of the third day, then take another dose. Afterward, decoct rush pith in water, mix the liquid with one qian of powdered amber, and drink it. The formula is said to prevent recurrence if the harmful toxins are expelled in the urine.

If abdominal pain continues and harmful toxins keep being discharged, drink cold tea to ease it. If the pain still does not stop, crush Saposhnikovia root, extract its juice, and take it. Do not take too much of the preceding medicine.

Arctium Seed Pills are used to treat lumps formed by wind-toxin, as well as painful scrofula that does not let up.

One liang of slightly toasted Arctium seed; one liang of fleeceflower root; two liang of dried mint; two liang of realgar; two qian of bezoar; two qian of musk; and seven pods of soap pod. Add two sheng of water, pound and extract the juice, then boil it down to a paste.

Grind the medicines listed above into a fine powder, then use soap pod paste to form pills about the size of a parasol tree seed. Take twenty pills each time, washed down with a decoction of Astragalus.

Four Sages Powder: For patients with scrofula (a condition involving tuberculous swellings of the lymph nodes in the neck), take this formula to restore and nourish the body after taking medicines that promote drainage.

Use equal parts of Sargassum, abalone shell, Notopterygium root, and the flowering spikes of Dianthus.

Grind all the ingredients together into a fine powder. Take two qian each time, mixed with rice water.

Four Sages Powder: For patients with scrofula, take this formula to restore and nourish the body after taking medicines that promote drainage.

Use equal parts of Sargassum, abalone shell, Notopterygium root, and the flowering spikes of Dianthus.

Grind all the ingredients together into a fine powder. Take two qian each time, mixed with rice water.

Empirical Formulas for Throat Diseases

The throat is an important part of the body. It connects to the stomach and serves as a passage for breathing in and out. If toxic heat accumulates between the chest and diaphragm, triggering pathogenic Wind and obstructing the movement of Qi, it may cause throat disease. Sores may form inside the throat, sometimes making the tissue appear rotten. The throat may become swollen, painful, and blocked, making it difficult to swallow or spit. In severe cases, there may also be a “double tongue,” in which swelling beneath the tongue makes it appear thickened or doubled. Treatment should first dispel pathogenic Wind and phlegm, clearing the throat and chest, and then clear the toxic heat. Delayed treatment may be dangerous.

In another condition, toxic heat surges upward to the palate and causes sores, a condition called “suspended abscess” (swelling or sores around the uvula). Deficiency and cold in the bowel organs can also make swallowing difficult. In such cases, carefully identify the pattern before choosing a treatment.

Toxicity-Transforming and Supportive Powder: Used for acute throat swelling and blockage caused by Wind-Heat rising upward, as well as swelling and pain in the cheeks. It may also be used for bilateral or unilateral tonsil swelling and pain, throat nodules, a double tongue, and a stiff, immobile tongue. Its effectiveness is shown by the resulting evacuation.

Scrophularia root, Akebia stem, raw rhubarb, light bamboo leaves, gardenia fruit, fresh rehmannia root, and rush pith.

Coarsely chop the ingredients. Take a suitable amount, boil it in water, and drink warm.

Emergency Method for Inducing Coughing by Irrigation

Mix soap pod powder with water and cooking oil, then swallow it. Alternatively, swallow plant soot—the black ash left after burning plants.

Shandougen Decoction

This is used to treat swelling, obstruction, and pain in the throat. Holding the decoction in the mouth and rinsing the throat with it can help bring up phlegm. Then, hold it in the mouth and swallow it slowly; the original text says this will bring about a cure.

The formula contains shandougen, jieduling, xiaogen, shengji, shanzhizi, danzhuye, mugwort leaves, and rush pith. Coarsely chop the ingredients and boil them. Those who usually drink alcohol may prepare the decoction with wine; those who do not drink alcohol may use water. Pregnant women must not take it. For people with sores in the throat, the original text says that taking five or six doses after recovery can prevent the sores from returning.

Wind-Dispelling Powder for Blowing into the Throat

This is used to treat sores, swelling, and pain in the throat, as well as chanhoufeng (a condition involving sudden swelling and obstruction of the throat), single or double “tonsils” (swelling and pain on one or both sides of the throat), throat swelling, acute throat wind, a “flying thread” entering the throat, a swollen tongue, and a stiff tongue.

The formula contains alum, yazi, brain (an aromatic medicinal substance), bixue, stir-fried silkworms with their filaments removed, kudingxiang (that is, muskmelon stems; it should not be used in large amounts), rush pith, and rice paste. If the condition does not improve, add realgar, pig’s-tusk soap pod with the skin removed and roasted until yellow, saltpeter, and veratrum with the skin and core removed. Grind all the ingredients into a fine powder, then blow a small amount into the throat. The original text says that swellings that have not yet formed can be made to disperse quickly; those that have already formed will rupture and then improve. For severe cases, the powder may be blown into the nose.

If there is a lot of phlegm, immediately take the fresh tips of mugwort leaves, pound them with rice vinegar to extract the juice, and hold the juice in the mouth to rinse and swallow, helping to expel the phlegm.

Another Formula

Take a pig’s gallbladder from the twelfth lunar month. Grind alum into a fine powder, put it into the gallbladder, and hang it in a well-ventilated place to dry. Remove it, grind it finely, and blow it into the throat; the original text says it works quickly. For people whose condition recurs every year, moxibustion may be used to prevent attacks.

For locked jaws: Take Jiulongchuan, also known as Jinchai grass; a single-stemmed plant is preferred. Peel the root, crush it, wrap it in cotton, and bind it to the teeth. Rub the jaw five or six times, and the jaws will open; accumulated phlegm and saliva in the throat will also be expelled in five or six bouts. Then grind calcined alum into powder. Dab cotton in the powder and rub the affected area, and the condition will be cured.

If the condition returns after eating, crush fresh ginger and combine it with roasted Gleditsia pod and calcined alum, ground to a powder. Wrap the ginger in cotton, dip it in salt and Gleditsia powder, and rub the affected area repeatedly five or six times; this should cure it.

For acute, severe throat obstruction: Pound rice vinegar and fresh ginger together and administer by pouring it into the throat. This is effective for breaking open sores in the throat.

Drumstick grass and Chinese ox-knee root, used with lindera root, work well together. Pound the herbs fresh and extract their juice, mix it with vinegar, and administer by pouring it down the throat. In severe cases, pour it into the nostrils. Once the phlegm has been vomited out, the patient will recover. The dried herbs may also be ground into powder and taken after simmering in rice vinegar.

The “As Sacred as a Sage” Powder treats acute, seasonal throat wind: the illness gradually worsens, the throat closes, water and food cannot be swallowed, the jaws lock, and the patient loses consciousness.

The ingredients are realgar, Chinese bulrush, raw alum, peeled and roasted Gleditsia pod, and seven cuttlefish bones. Grind all the ingredients together into a fine powder. Take one zi (an ancient unit for a very small amount) at a time and blow it into the nostrils to expel stubborn phlegm; the illness will then be cured.

Another prescription: Simmer white medicine with Vietnamese sophora root. Hold it in the mouth, then gargle the throat with the liquid to dispel phlegm, and swallow one or two mouthfuls afterward.

The final heading, “A Proven Remedy for a Mad Dog Bite,” introduces the next prescription.

When someone has just been bitten by a rabid dog, they should immediately drink half a cup of clarified oil; this is said to calm the mind and spirit. Then quickly stir-fry “spotted cat” (a name for a traditional medicine, usually referring to cantharides) with realgar. Remove the spotted cat’s head, wings, and legs, grind it into a fine powder, and take one insect each day. Alternatively, mix the realgar with wine and take it for forty-nine days, using one insect each day. A little clarified oil may also be added, and the mixture washed down with cold water. Continue until urination is unobstructed and the so-called “malignant toxin” has been expelled. If urination does not resume, take another dose. If the lower abdomen hurts after taking the medicine, immediately mix indigo paste (a blue pigment or medicinal substance) with cold water and drink it as an antidote; decoction of coptis root may also be taken. Do not eat hot food immediately after taking the medicine; this is said to eradicate the illness completely. Do not wait for the wound to heal on its own. If it has not opened, use moxibustion to make it open and let the blood flow, so the toxic Qi can escape and the illness will not break out. The original text states that if there is blood in the urine, the person cannot be saved and will die.

If someone dies after being bitten by a rabid dog, whether the illness breaks out a year after the bite or within a hundred days, they are considered dead; yet as long as the area over the heart remains warm, they are said to be treatable. Quickly take one pound of sophora flowers, add two large bowls of wine and water, and boil until one and a half bowls remain. While the person is still warm, pry open their mouth with an instrument and pour the liquid down their throat. If the person wakes after a while, wait another two hours, then give them warm thin rice porridge; they are said to recover. Otherwise, boil the medicinal residue again and give it to them. Do not give them cold water or mutton, which is considered to aggravate wind toxin; these foods must be avoided.

Another formula is said to be highly effective when the illness relapses and no other medicine can treat it: five qian of pure realgar and five qian of musk.

Grind the above ingredients separately into a fine powder, then mix them together. Stir the mixture into two cups of wine and have the patient drink it. If the patient refuses, hold his nose and pour it down his throat. He will certainly fall asleep after taking the medicine. Do not wake him; let him come to naturally. Once he has passed the foul matter, give him another dose of the medicine above, and it will take effect.

Another empirical remedy: Grind together peeled, blanched almonds and malan root into a fine powder. First wash the affected area with water boiled with scallions, then apply the powder. The peeled, blanched almonds may also be used alone.

Another prescription: Take fifty castor beans, remove their shells, and grind them with well water drawn at dawn until they form a paste. First wash the affected area with plain water, then apply the medicine.

Another prescription: Rub tiger-bone oil on the affected area; it will take effect quickly.

Secret Formulas for External Medicine Transmitted by Immortals, fascicle seven

A highly effective treatment for scrofula: Grind the medicine into a paste. First wash the affected area with plain water, then apply it.

Another prescription: Rub tiger-bone oil on the affected area; it will take effect quickly.

Secret Formulas for External Medicine Transmitted by Immortals, fascicle eight

Compiled by Zhao Yizhen, Master Yuanyang of Junyi.

Formulas and discussions for various abscesses and sores: A physician’s use of medicine is like a commander’s deployment of troops. As the saying goes, an army of a thousand is easy to find, but a capable commander is hard to come by. Victory or defeat is decided by an excellent commander; successful treatment depends on a skilled physician.

A doctor’s use of medicine is like a general’s use of troops. As the saying goes, “An army is easy to find; a good general is hard to find.” Victory depends on an able general, just as effective treatment depends on a skilled doctor. The outcome of a battle hinges on how the general commands; whether a patient survives likewise depends on the doctor’s examination and diagnosis. Even with three armies, a force without a good general will struggle to win. Even with hundreds or thousands of prescriptions, medicines without a good doctor to use them will have little effect. A capable general knows how to deploy the troops; a skilled doctor knows how to choose the right medicines. A general’s skill lies in using unexpected tactics to secure victory; a doctor’s effectiveness lies in using medicines well to cure illness. Whether commanding troops or prescribing medicines, one must first find the right general or doctor. If the wrong person is chosen, neither troops nor medicines are likely to succeed.

To keep the body free from illness, heed the sound counsel of a skilled doctor.

The Shenghui Formulae says: The scriptures ask how to recognize an abscess or carbuncle—a painful, swollen, pus-forming disease of the skin and flesh. Imbalances in the Five Viscera can give rise to such conditions, and people who have long suffered from wasting-thirst disease, marked chiefly by thirst, excessive drinking, and frequent urination, often develop them as well. Unrestrained eating and drinking, erratic emotions, deficient Yin with excessive Yang, and disharmony between the defensive and nutritive Qi—the Qi that circulates within the body to protect and nourish it—can obstruct the flow of blood. When blood does not flow freely, defensive Qi also has difficulty circulating. Qi and blood then bind with pathogenic heat, giving rise to an abscess or carbuncle and causing a high fever.

In severe cases, the flesh decays and turns to pus. Usually, however, the disease does not sink deeply into the skin and flesh or reach the marrow, causing the marrow to dry up and the Five Viscera to be damaged. If the pathogenic influence penetrates the skin, flesh, and marrow, reaches even the Five Viscera, and depletes Qi and blood, the lesion sinks deep among the sinews and bones and little healthy flesh remains. This is an extremely critical condition.

Abscesses and carbuncles can form either inside the body or on its surface. Internally, they may develop among the organs of the chest and abdomen; externally, they arise in the skin, flesh, or bones. The sites where these two kinds of conditions occur are not fixed, though each has its customary name. Their root cause is blood that has stagnated inside the body and cannot be expelled with sweat, old accumulations that have not been cleared, and pent-up, steaming Qi that cannot disperse outward. Over time, these build up and form a pathological condition caused by pathogenic heat.

A carbuncle or deep abscess—a suppurating swelling that develops in the skin and flesh—does not appear out of nowhere or spring from the earth. It forms through gradual accumulation over time. To preserve one’s life, one should make every effort to regulate the body before it is harmed, guard against illness before its course becomes apparent, and act promptly before the disease takes shape. This means noticing a problem in the morning and addressing it that same day. Yet the causes of illness are many, and the ways harmful influences affect the body differ. They may give rise to sores, boils, furuncles, carbuncles, or deep abscesses. At the onset, their symptoms may differ only slightly, but they still call for close attention. People often dismiss them, and many die as a result of mistreatment.

At first, the symptoms of a carbuncle or deep abscess are very mild, so people often pay them no heed. Treatment should therefore begin as soon as possible. When Heat affects the space between the skin and the flesh, causing a superficial swelling with a small base no more than one or two inches across, it is called a carbuncle. When accumulated Heat in the internal organs spreads outward into the space between the interior and exterior, the onset is sudden and severe; the swollen skin is glossy and soft, and the swelling keeps spreading. This is called a carbuncle or deep abscess. Illness may involve deficiency or excess: deficiency should be tonified, and excess should be drained. Excess Heat is relatively easy to treat, while a pattern of deficiency Cold combined with pathogenic Heat is harder to treat. A hard swelling with thick pus is a pattern of excess; a soft swelling with thin pus is a pattern of deficiency. Without a sound grasp of treatment methods beforehand, one may panic when illness strikes and fail to judge how deeply it has progressed, putting one’s life at risk.

Treating an abscess or carbuncle—a swollen, suppurating lesion between the skin and flesh—requires prompt action, just as one would respond to sudden fainting. If it occurs in a critical area such as the throat, tongue, face, back of the head and neck, shoulders and back, chest, or breasts, it is especially urgent. It should be treated as soon as possible: if discovered in the morning, treatment should be sought by evening, for recovery may then be possible. Without access to a skilled physician, or if one cannot assess the condition oneself, even a cure by an ordinary physician should be considered fortunate. Many people do not regard these lesions as emergencies, but they need treatment without delay. If the condition worsens, it may become impossible to save the patient, and many have died as a result.

Treating such conditions calls for the urgency of putting out a fire, rescuing someone from drowning, pursuing a fugitive, or catching a thief. Failure to act in time is certain to bring great harm. Swellings of this kind generally take three forms: one that rises high and feels soft indicates disease in the blood vessels; one that is lower and hard indicates disease in the bones and flesh; and one that leaves the skin’s color unchanged indicates disease in the bone marrow. Superficial sores usually occur where the flesh is thin, while deep sores are more often found where it is thick.

When pressing the swelling, pain only under firm pressure indicates that the pus is deep; pain under slight pressure indicates that it is near the surface. If the swelling does not spring back after being pressed, there is no pus and fluid may have accumulated. If it springs back immediately, pus is present. A swelling that is soft throughout is a “blood tumor,” not an abscess or carbuncle. A lump that gradually grows without becoming very hot, and that often causes a pulling pain, is an “Qi tumor.” “Pei knot” refers to a swelling that gathers into a lump and does not subside for a long time; it may later develop into an abscess, carbuncle, or furuncle. The original text attributes this to cold Qi: when cold pathogenic influence remains for a long time, Yin reaches its extreme and turns into Yang; the cold changes into heat, and the lump then ruptures. After rupturing, it may form a fistula—a channel connecting the inside and outside that does not heal over time.

The illness may undergo different changes, and its severity may wax and wane. Physicians should keep these possibilities clearly in mind and judge the condition according to how it develops. Good treatment depends on adapting to the circumstances.

The Shenghui says: Carbuncles and deep abscesses (suppurating conditions between the skin and flesh), back abscesses, rapidly developing and severe boils, breast abscesses, and furuncles all show signs of “five good and seven bad” outcomes, which must be examined carefully. If the patient is agitated or coughing, has abdominal pain, or the illness fluctuates in severity, each sign must be assessed with care. Do not draw a conclusion from only one or two symptoms noticed by chance. The physician must judge flexibly according to the patient’s condition and the circumstances.

The seven dangerous signs are: agitation and coughing, or abdominal pain and thirst; in severe cases, unremitting diarrhea or difficult, dribbling urination—this is the first bad sign. A profuse discharge of pus and blood, especially severe swelling, redness, and heat, discolored pus, and unrelenting pain—this is the second. Labored, heavy breathing, shortness of breath, a clouded mind, and drowsiness—this is the third. An unfocused gaze, swollen and reddened irises, and eyes rolling upward—this is the fourth. Difficulty moving the shoulders and neck, and heaviness in the limbs—this is the fifth. Inability to eat or drink, vomiting after taking medicine, and loss of taste—this is the sixth. A hoarse voice, a wan complexion, bluish-purple or red lips and nose, and swelling of the face and limbs—this is the seventh.

The five favorable signs are: pain lessens, the patient gradually becomes calm, and food tastes good—this is the first good sign. Regular, unobstructed bowel movements and urination—this is the second. The abscess subsides on its own, and the affected area is bright in color, with no signs of deterioration—this is the third. The mind is clear, and speech and voice are clear—this is the fourth. The body’s Qi is balanced—this is the fifth. If two of the five good signs appear, the illness may improve; if four of the seven bad signs appear, the condition is dangerous.

However, judgment cannot be based on appearances alone. Some illnesses originally show signs from the seven bad, yet the skin is firm and the patient appears well. Others originally show signs from the five good, yet the skin is slack and weak, making the condition look dangerous. Can an ordinary person really distinguish such cases? When all five good signs appear, the prognosis is best; when all seven bad signs appear, the illness is extremely severe. These signs are recorded here, along with the relevant acupoints, to make the matter clear.

If a faint, deep-seated pain is felt at the corresponding point on the body, it is identified as an “abscess” (ju) of that organ; if the flesh is slightly raised, it is identified as a “swelling” (yong) of that organ. The text lists these correspondences: the Central Fu point corresponds to the lungs, Jueque to the heart, Qimen to the liver, Zhangmen to the spleen, Zhongwan to the stomach, Jingmen to the kidneys, Tianshu to the large intestine, Dantian to the Triple Burner, and Guanyuan to the small intestine. Faint pain at each point indicates an abscess of the corresponding organ, while a slight raising of the flesh indicates a swelling of that organ.

During examination, inspect the corresponding points on the patient’s body and use them to judge how deep the abscess or swelling is. Also determine which organ the illness originated in, learn what mineral medicines the patient has previously taken—substances used in ancient times for health cultivation or treatment—and assess whether Qi is deficient or excessive. Then weigh all these findings together before treating the patient.

The Qianjin says: At the onset of a deep abscess or ulcer, carefully observe it, whether the boil is large or small and whether the pain is mild or severe. At the first sign of anything unusual, take it seriously and treat it as soon as possible. At the same time, avoid all harmful or unsuitable foods to help new flesh grow. Refrain from sexual activity for three months, and take care to avoid cold drafts and injury from overexertion. Resume ordinary activities only after the sinews and vessels, Qi, and blood have returned to a steady state. Without proper recuperation, newly grown flesh is easily injured. Severe injury can cause the wound to break down again; repeated relapses may lead to disaster, so great care is essential.

At the onset of a deep abscess or ulcer, take one of the following formulas as early as possible: Zhiding Duoming Decoction, Huadu Xiaozhong Tuoli Powder, Secretly Transmitted Neituo Qianjin Powder, or Sixteen-Ingredient Liqi Drink. If cold predominates, use Neihan Powder. Apply Jiedu Shengji Powder to the center of the affected area, with Huadu Powder or Xueba Dusan Powder over it. After applying the medicine that detoxifies and promotes flesh growth, dab on Tiedong Badu Gao. If the sore is spreading and difficult to control, dab medicine around its edges and in the center; stop once the skin breaks open. Treating it this way at the onset can help the swelling subside. If pus has already formed, dab this medicine on the area to open it and let the pus drain. If pus remains, heat a suction cup with the medicinal liquid. This device uses negative pressure inside the cup to draw out pus. Use it to remove pus, discharge, and blood, after which the sore can heal.

The terms for these conditions are classified by the extent of the swelling: a raised area one to three inches across is called a “boil”; two to five inches, an “abscess”; five inches to one foot, a “deep abscess”; one to three feet, a “whole-body abscess”; and one the size of a bean, a “small pustule.” Once a deep abscess has filled with pus, if pus drains from all nine openings, wait until it has emptied, then use tweezers to remove the dead flesh until the root of the pus is cleared. Apply medicine to promote new flesh and relieve pain. When new flesh has filled the wound, use a medicated plaster separated from the affected area by a layer of paper.

Another scripture says: When the flow of Qi is obstructed, swelling turns to pus. If pus drains from all nine openings, wait until it has emptied, then use tweezers to remove the dead flesh until the root of the pus is cleared. Apply medicine to promote new flesh and relieve pain. When new flesh has filled the wound, use a medicated plaster separated from the affected area by a layer of paper.

A medical text also says: When pathogenic Qi obstructs the channels and collaterals, Qi and blood cannot flow freely. If they accumulate, they form an abscess or ulcer deep in the flesh. This is not caused by heat alone. An abscess that develops later forms when Yang Qi gathers and cold pathogenic influence remains trapped until it transforms into heat. When the heat grows intense, it causes the flesh to decay and produce pus. The body may already have internal heat and then be attacked by cold; if the vessels and collaterals congeal and become blocked, heat will also become trapped and form an abscess.

If firm pressure is needed to cause pain, the lesion lies deep; if even a light touch hurts, it lies near the surface. If a depression remains after pressing, there is no pus yet; if the skin springs back at once, pus is present. A depression that remains after pressing may resolve on its own. If the area feels taut throughout when pressed, there is usually no pus yet; if part of it feels somewhat soft, pus may be present. Press above and below the lesion by hand: if the area is not hot, there is no pus; if it is distinctly hot, pus may be present. Once pus is confirmed, incise promptly to drain it.

If there is no pus, the swelling is only from Qi. If there is also accumulated blood, take particular care and do not puncture it with a needle. Instead, apply the detoxifying plaster from the Qianjin to disperse the swelling. If the surrounding area is hard and the center soft, pus is usually present; pus may also be present when only one side is soft. If the entire area is hard, it may be a malignant nodule or simply a gathering of Qi. If it is soft throughout, it may be a blood tumor formed by accumulated blood. The key is to distinguish carefully between hardness and softness, and between deficiency and excess.

If a hard abscess persists for a long time, then later becomes hot and develops a soft spot, that spot contains pus; however, it must not be punctured with a needle. A soft abscess should be cared for only by wrapping it in warm clothing. Needling, moxibustion, or puncturing it makes it difficult to cure.

When an abscess has already formed pus, there is no need for worry. If the skin over it is thick, it should be incised promptly to drain the pus. In a bone abscess, a deep swelling near the bone, the skin often shows no change in color. In that case, immediately take Huadu Xiaozhong Tuobao Powder and Zouma Powder, and apply Huadu Badu Powder externally to draw out the toxic influence. Continue applying the medicine until pus and blood drain out. Even if no pus forms, the condition may still heal this way. If blood or pus is discharged, the skin may be opened with a needle inserted about three or four fen deep. To drain pus, do not puncture directly over the abscess; make the incision below it so the pus can drain completely. Once the pus is cleared, new flesh will grow. Then apply a medicine to promote tissue growth, followed by a plaster, and the wound will heal.

It is also said that an abscess in the neck is called a “fatal abscess.” It is large and red-black in color. If not treated promptly, the heat toxin will spread downward into “Yuanye,” an area of acupuncture points near the armpit, damage the Ren Vessel, one of the body’s meridians, and burn inward into the liver and lungs. Death may follow within a little more than ten days. The Jing says that the front of the neck is called the “neck.”

The Weiji Baoshu says that a spot one cun and three fen behind the ear is vital, and illness there is fatal; this is why “acute toxin” is difficult to treat. Acute toxin refers to a severe toxic illness that invades the liver and lungs and may cause death within a little more than ten days. This illness is also called “facial swelling.” Heat rises upward and spreads to the forehead and mouth; if it breaks through the throat, the person will die very soon.

It is also said that in a brain abscess, heat toxin attacks upward into the brain, forming a lump beneath the skin. At first it is about the size of a millet grain, with redness, heat, swelling, and hardness around it, and it spreads to the ears and nape. Chills, fever, and pain accompany it. Without timely treatment, the toxin enters the flesh and blood, which decay into pus and fluid that drain from the head. Qi and blood are depleted, and the person eventually dies.

The Waitai says that abscesses in the jaw, below the cheek, are called “fierce abscesses.” Without timely treatment, the blood turns to pus. If the pus cannot drain and blocks the throat, the person will die. If the blood turns to pus within half a day, even draining the pus will not prevent death three days later, because the person will be unable to eat. Another account says that the patient cannot eat, Yang Qi is greatly exuberant, and the brain is depleted, while the abscess darkens in color. If the nape and neck hurt as though pierced by needles and the person feels agitated, death is inevitable and the condition cannot be treated. The strength or deficiency of Qi and blood must also be assessed, and treatment given only after considering all the signs together.

It is also said: An ulcer that grows on the chest is called a “well carbuncle” (jingju), a type of carbuncle on the chest about the size of a bean. Three or four days after it appears, if it is not treated promptly, the toxic pathogen will descend into the abdomen. If it is still left untreated after entering the abdomen, the patient will die within ten days. The patient will also die if alternating chills and fever persist without subsiding.

It is also said: An ulcer that grows on a toe is called “toe gangrene” (tuoju), a severe carbuncle of the toes. If it is red and black, with no pus or fluid, the prognosis is grave. If left untreated, the toxic pathogen will descend into the abdomen; if still untreated after entering the abdomen, the patient will die within ten days. The patient will also die if chills and fever persist without subsiding.

It is also said: An ulcer that grows on a toe is called “toe gangrene” (tuoju). If it is red and black, with no pus or fluid, the prognosis is grave. If it is not red and black and has pus or fluid, it can be treated. If treatment does not lessen the severity of the illness, the affected part must be amputated at once; only then is there hope of saving the patient’s life. Without amputation, the patient will also die.

The Shenghui, an abbreviation for the Taiping Shenghui Fang, says: If an ulcer’s opening still contains pus or fluid that has not fully drained, and it closes too soon, the surface may appear healed even though the wind toxin has not dispersed. The ulcer will later recur and discharge foul fluid. If the foul fluid drains rapidly, the illness will develop into a fistulous ulcer, one that does not heal for a long time and forms a passage. This advice should be carefully remembered. Specific prescriptions are given below.

One should first take the “Pain-Chasing, Life-Saving Decoction” at once, a prescription said to act quickly. It is recorded later in the text.

The “Toxin-Transforming, Swelling-Reducing, Tissue-Supporting Powder” treats abscesses, carbuncles, back carbuncles, breast abscesses, bone carbuncles, furuncles and toxic swellings, as well as various painful malignant ulcers and sore, swollen throats.

The ingredients and amounts are recorded as follows: six qian each of ginseng, which may be omitted if unavailable, red poria, and white atractylodes; two liang each of talc, platycodon, and honeysuckle; five qian each of schizonepeta spikes and gardenia; and one liang of Chinese angelica. The text also lists Sichuan lovage, astragalus, red peony, atractylodes, ephedra, rhubarb, scutellaria, saposhnikovia, licorice, mint, forsythia, gypsum, and mirabilite, among other ingredients. Some characters are missing at this point in the original; a later note also says that cardamom may be added.

Snake gourd, oyster shell, fritillaria, and costus may also be added as appropriate.

For furuncles, add the herbs listed under “foot lotus, lotus leaf, and cart”; for scrofula and sores associated with wasting disease, add plantain seed, akebia stem, and bamboo leaves; for pain, add frankincense and myrrh; for sore, swollen throats, add rhubarb, gardenia, bamboo leaves, and rush pith; for beriberi, add fresh papaya and areca nut; for cough, add ginger-processed pinellia and decoct it with fresh ginger.

Coarsely chop the ingredients above and decoct five qian for each dose. The later part of the original is repetitive and damaged, so the amount of water and other details of preparation cannot be determined with certainty.

Coarsely chop the above ingredients. For each dose, take five qian, add them to one bowl of water with one white section of scallion, and simmer until hot. Drink it; the dose is sufficient when it brings on sweating. If it also produces three to five bowel movements, the effect is better. In severe cases, three to five doses are enough to disperse the toxic pathogens from the body.

Thousand-Gold Powder for Supporting the Interior treats deep-seated abscesses, sores on the back, carbuncles on the head, breast abscesses, and other severe boils and sores.

Ginseng, Chinese angelica root, astragalus, white peony root, Sichuan lovage rhizome, siler root, official cinnamon bark, platycodon root, dahurian angelica root, licorice root, snakegourd fruit, and honeysuckle flower, in equal parts.

For severe pain, add Chinese angelica root, peony root, frankincense, and myrrh.

Coarsely chop the ingredients. For each dose, take seven or eight qian, add them to two large bowls of water, and boil until reduced to seven-tenths of the original amount. Add half a bowl of good wine, strain out the herbs, and drink warm. Take two or three doses daily. If black blood drains from the sore or the body sweats after taking it, these are signs that the medicine is working. However fierce the illness, take one or two liang, boil in one large bowl of water, and take with wine. A sore that has not yet formed will disperse on its own; one that has formed will rupture.

Secretly Transmitted Sixteen-Ingredient Flowing-Qi Drink, also called Powder for Supporting the Interior, is also known as the Supporting-and-Enveloping Powder made from the first ten ingredients.

Ginseng (remove the reed heads), Chinese angelica root (wash with wine), official cinnamon bark (remove the outer bark), Sichuan lovage rhizome (remove soil), siler root (remove the reed heads), dahurian angelica root, platycodon root (remove the reed heads), tender astragalus (remove the reed heads), licorice root (honey-fried), and magnolia bark (remove the outer bark and prepare with ginger): three qian of each.

Then add these six ingredients: southern costus root, white peony root, areca nut, lindera root, bitter orange, and perilla leaf (dry-fried until fragrant): three qian of each.

If the illness does not improve, add poria, white atractylodes rhizome, and prepared rehmannia root (wash and then dry over low heat).

To improve the appetite, add round cardamom seed and cyperus rhizome.

For pain, add frankincense and myrrh.

If the pus and fluid do not dry up, add fritillaria bulb and anemarrhena rhizome.

If the sore is slow to open, add gleditsia thorn.

For a cough, add dried tangerine peel (with the white inner layer removed), Pinellia (washed seven times in warm water), and apricot kernels, then decoct and take with five slices of fresh ginger.

For constipation, add rhubarb and bitter orange. For difficulty urinating, add dwarf lilyturf, plantain seeds, akebia stem, and rush pith.

The formula described above treats deep-rooted abscesses on the back, breast abscesses, foot pain, and various severe sores and boils. Before a sore has formed fully, it can make it disperse quickly. Once it has formed, it can bring it to a head and make it rupture, allowing pus to drain and dead tissue to slough off. After taking the medicine, pain soon eases. This formula has been used many times with notable results.

Grind all the ingredients above into a fine powder. Take five to six qian each time, washed down with wine. Those who do not drink wine may take it with a decoction of costus root or rice water. Consider the formula’s ingredients carefully: they can disperse Wind-toxin, regulate Qi and Blood, drain pus, relieve pain, or help wounds grow new flesh. Even without understanding the complex combinations of medicinal ingredients, one can achieve good results in surgical treatment. When the movement of Qi is unregulated, give priority to medicines that regulate Qi; when Blood circulation is unregulated, prioritize medicines that regulate Blood.

Cut the ingredients above into pieces and decoct them with one and a half cups of water and one scallion white. When the liquid has reduced to about seven-tenths of its original volume, add a small sip of wine. For illness in the upper part of the body, take it after a meal; for illness in the lower part, take it on an empty stomach. It takes effect quickly.

Internal Support Powder treats various severe sores and boils. After the fever has subsided, if pus and blood continue to drain, or the wound is weak and painful, this formula can drain pus, relieve pain, promote the growth of new flesh, and nourish the body from within.

The ingredients are: ginseng (rootlets removed), Chinese angelica (rootlets removed and soaked in wine), astragalus (soaked in salt water), Sichuan lovage, white stiff silkworm (washed free of dirt), poria (skin removed), saposhnikovia (rootlets removed), and cassia bark, two and a half qian each; platycodon, polygala, licorice, and angelica dahurica, one liang each; amomum, cyperus, and magnolia bark, two liang each; five ge of red beans (soaked in wine); and two aconite roots (skinned and dry-roasted).

For restlessness and thirst, add schisandra, poria, dried tangerine peel, white peony, and prepared rehmannia.

Cut the ingredients into pieces and decoct them with one and a half cups of water and three slices of fresh ginger. When the liquid has reduced to about seven-tenths of its original volume, add wine and take while hot.

“Immortal Formula for Detoxifying, Promoting Flesh Growth, and Relieving Pain” is used for boils, carbuncles, sores on the back, breast abscesses, cuts, wounds from blades, and various abscesses and sores caused by toxins. Take half a bowl of the medicine, add three slices of fresh ginger, and decoct. Reduce the liquid to about seven-tenths of its original volume, then add wine and drink while hot.

The prescription lists one liang of Huanglian, four liang of Huangbo, one liang of Muze, one liang of Fangfeng, and four liang of Kushen, together with Qianghuo and Duhuo. Chop the herbs, place them in a large earthenware jar, add water, and decoct. Take ten jin of Lugan Shi, roast it over charcoal until red-hot, then lift it out with tongs and quench it in the herbal decoction. Quench stones of any size until they become friable and blue inside. If they have not yet become friable, decoct the herb dregs again to obtain more liquid and continue quenching. Then turn an earthenware basin upside down over them on the ground and leave them for a full day and night to disperse the fire toxicity. Remove the stones, let them dry, and grind them into an extremely fine powder. Separately grind twenty jin of gypsum into a fine powder, mix it with the Lugan Shi powder, and set aside.

Separately roast Chishi Zhi and stir-fry Gudan, then mix them with the powder prepared above. Add equal parts of Nanmuxiang, Xuejie, Jiangzhen, Ruxiang, Moyao, Baizhi, Huanglian, Huangbo, and Baixian, and grind them into a fine powder. Roast Longgu and add it, along with cinnabar and Heshouwu. If there are worms in the sore, add Qingfen, Kushen, Baiyaojian, and realgar. If fluid continues to seep from the wound, add peeled Piao Xiao, roasted Wuming Yi, and ash made by burning Meng Ye. Grind each of these ingredients finely, mix them with the powder prepared earlier, and apply the mixture to the center of the affected area.

For the cleansing medicine, decoct the following ingredients in water. Once the liquid is clear, use it to wash the affected area: Fangfeng, Baizhi, Chishao, Kushen, Gancao Jie, Kejie, Aiye, Jinyinhua, Canger Cao, Qianghuo, Duhuo, He Ye Di, Danggui Wei, Yajiao, Baizi, Fengfang, Congbai, and tea leaves left after brewing.

First wash the affected area with a medicinal infusion. Once the liquid has cooled to lukewarm, cleanse the area. Dry it with silk cloth, then mix the previously mentioned Flesh-Growing and Pain-Relieving Powder with clear oil and apply it to the wound. If the wound is moist, sprinkle the powder on dry. When there is no pus, do not leave an opening; change the dressing once a day. If there is pus, leave an opening so that the toxic qi and pus can drain. After applying the medicine, cover it with black paper and wrap it tightly three to five times with a silk band. Change the medicine applied around the affected area every three days. Do not disturb the area in between; it is said to take effect quickly.

To make dead flesh rot and come away, take a live centipede and place it in a bamboo tube filled with oil until it dies. Then calcine it over a fire and grind it into powder. Add a little of this to the previously mentioned dressing and apply it for a full day and night. If the pain still does not stop, wash off this medicine and use the earlier one instead. This will relieve the pain and promote the growth of new flesh.

Apply the medicine around the affected area. The Toxin-Transforming, Blood-Dispersing, and Toxin-Draw-Out Powder is used for various severe sores and foot ailments. Its ingredients are red peony root, Saposhnikovia root, dahurian angelica root, neixiao, jiaolianhe, chebei, and Asarum, three liang each; Chinese angelica tail, stiff silkworm, cicada slough, and five-leaf aralia bark, two liang each.

If the swelling and toxin have not subsided after application, apply the following medicines to help disperse them: Arisaema tuber, fleeceflower root, five-leaf root, fritillaria bulb, violet-flowered Chinese violet (also called sheep’s hoof root), Aconitum kusnezoffii, notopterygium root, angelica pubescens root, and hibiscus leaves. In autumn, red kudzu root may be used when available. Remove the woody part of wild pepper root and use only the bark, then add five-leaf aralia bark. Grind all the ingredients into a fine powder and mix it with fresh ginger juice, including the ginger pulp, and vinegar. To disperse the swelling and toxin quickly, add garlic and apply it at once to draw out the toxic qi; it is said to take effect quickly.

If there is constipation caused by obstruction in the internal organs, add rhubarb, bitter orange (remove the inner white pith and dry-fry it), and hemp seeds for oral use.

When urination is obstructed, add mu tong, che qian zi, deng xin cao, chi shao, and fu ling.

If the condition is predominantly cold, add cao bo and liang jiang.

The formula above is specifically for cold-dampness foot disorders, lesions on the back, and various malignant sores, boils, and swellings caused by toxins. Applied externally, it can disperse lumps and relieve pain. Its medicinal nature is gentle; it can resolve toxic influences and disperse stagnant blood. To prepare it for application, take a large piece of fresh ginger with its skin and an appropriate amount of good wine without added ash. Grind and pound the medicine together into a paste, then apply it while warm. For an illness affecting the upper body, take it after meals; for one affecting the lower body, take it before bed. After one or two doses, the swelling will subside.

Iron-tube toxin-drawing paste: Used to lance various sores and boils. If lanced at the onset, the swelling will disperse.

The ingredients include good, uncalcined lime; glutinous rice smoked with Chinese honeylocust; arisaema; dong quai; red peony root; and sal ammoniac that has been stir-fried. Add sal ammoniac to remove the core of a toxin boil; for other conditions, omit it. The source also contains the words “gu niu ban mao” here, but the medicinal name and method of use are unclear.

Boil the preceding ashes in water, strain off the liquid, then reduce it by boiling until concentrated. Use this liquid to mix the preceding medicinal ingredients.

The ashes consist of genuine charcoal ash, mulberry-wood ash, sesame-stalk ash, three or four pieces of Chinese honeylocust bark, and willow-wood ash. Boil these ashes in water and strain off the liquid. Pour it into a pot and simmer until a white film appears on the surface, then remove from the heat and pour it into a vessel. To use, mix a small amount with the medicinal ingredients and apply it to the affected area. Apply it three to five times. Once the skin breaks and the toxin fluid drains out, the discharge will stop.

Bamboo tube for drawing out toxins: Used for lesions on the back, deep abscesses, toxin boils, and toxic swellings. The bamboo tube draws out pus, blood, and foul fluids. The ingredients are atractylodes, bai lian, Chinese tallow bark, magnolia bark, mugwort leaves, good tea buds, bai ji, and bai ji li, in equal amounts.

Make three, five, or seven small tubes from bitter bamboo, each about one inch long. Leave a bamboo node at one end, shave off the outer green skin, and thin the walls until they are like paper. Choose a tube to fit the size of the sore. Put the tubes into the medicinal decoction prepared earlier and boil for about ten rounds, until the liquid has dried up. While a tube is still hot, press it by hand onto the sore so that it adheres tightly. When pus, blood, and fluid fill the tube, it will fall off by itself. If it does not, pull it off by hand and replace it with another. Repeat this three to five times. Once the toxic pus has been drained, apply a medicine that promotes new flesh. After filling the wound, cover it with a medicated plaster, and it will heal.

The Immortal Formula Paper-Separated Plaster, also called the Spirit-Responsive Plaster, is specifically used for sores on the back, breast abscesses, ulcerating sores on the outer lower leg, and various malignant, toxic sores and boils.

Ingredients: Coptis rhizome, fleeceflower root (peeled), kusnezoff monkshood root (peeled), the tail portion of Chinese angelica root, and Chinese angelica root, each half a tael; Sichuan aconite root (peeled), two and a half qian. Also use one tael of litharge, or two taels in summer; frankincense, myrrh, and dragon’s blood, each half a tael.

Coarsely chop the ingredients, put them in a pot with five taels of sesame oil, and simmer over alternating low and high heat. When the herbs have turned black, strain out the dregs through cloth and return the oil to the pot. Add the litharge and stir continuously with a peach or willow branch. When the oil turns black again, add the finely ground dragon’s blood, frankincense, and myrrh. Stir well and cook briefly. Drop a little of the mixture into water. If it forms a bead and does not disperse, scoop it into an earthenware bowl and soak it in cold water for a full day and night to remove the medicinal fire-toxicity. It is then ready to use and is said to work very well.

The Great One Spirit-Responsive Plaster, also called the Golden-Thread Panacea Plaster or the Myriad-Spirit Plaster, is specifically used for sores on the back, abscesses and carbuncles, injuries from blows with a staff, malignant sores, injuries from falls and impacts, heart pain, beriberi, and lower back pain. It is reputed to be effective for all these conditions.

One qian of Sichuan aconite, half a qian of kusnezoff monkshood, two qian of coptis, one qian of phellodendron bark, one qian each of red peony root and white peony root, one qian of corydalis, one and a half qian of the tail of Chinese angelica root, half a qian of galangal, half a qian of makuwa seed (shelled), one qian of stiff silkworm (with the silk removed), hair in a quantity about the size of an egg (burned to ash), half a qian of purple bark, half a qian of earthworm, half a qian of holly-leaved spicebush vine, half a qian of pangolin scales, and half a qian each of dahurian angelica root, Sichuan lovage root, black bindweed, pagoda tree flowers, Chinese gall, cortex lycii, apricot kernels, Sichuan pepper, fennel, sweet flag, figwort root, cocklebur herb, cinnamon bark, arisaema, Chinese trichosanthes, sophora root, atractylodes, and Siberian ginseng bark. Add one qian of fangfeng, one qian of prepared rehmannia root, one qian of litharge, one qian of clove, one qian of neixiao, one qian of yeben, two and a half qian of fresh rehmannia root, one and a half qian of fleeceflower root, one and a half qian of asarum, twenty-five Jiangzi seeds (shelled), two and a half qian of ginseng, twenty-five castor beans (shelled), half a qian of eclipta, one qian of ink, one and a half qian of fleeceflower root, one and a half qian of asarum, twenty-five Jiangzi seeds (shelled), two and a half qian of ginseng, twenty-five castor beans (shelled), half a qian of eclipta, one qian of ink, one qian of astragalus root, two and a half qian of baiyaojian, one qian of notopterygium root, half a qian of southern costus root, one qian of licorice root nodes, one qian of earth centipede root, and one qian of red rouge.

Chop the above ingredients and soak them in one jin and four liang of clear oil for one or two nights. Then pour the oil and herbs into a pot and simmer, alternating between low and high heat, until the herbs turn black. Strain out the dregs through cloth. Continue heating the strained oil over low heat, then add the following powdered ingredients in order.

Add two and a half qian each of southern costus root, benzoin, and amber; one qian of yunxiang; half a liang each of frankincense, myrrh, and dragon’s blood resin. Fragrant resin knots may be replaced with half a liang of Daizhen wood nodes. Add one qian of Shaofen, one and a half qian of naturally occurring copper that has been quenched in vinegar, and five qian each of mulberry root bark, bletilla rhizome, ampelopsis root, and realgar, all dried over low heat and ground into a fine powder. Add six liang of litharge, increasing this by two liang in summer.

Grind each of the above ingredients separately in a mortar until very fine. Use half a liang each of frankincense, myrrh, dragon’s blood, xiangjie, and Jiangzhenjie; one qian of Shaofen; one and a half qian of natural copper; and five qian each of vinegar-quenched mulberry root bark, Bletilla rhizome, Chinese clematis root, and realgar. Dry the last four ingredients by roasting, then grind them to powder. Use six liang of litharge, adding another two liang in summer.

First pour the medicinal oil into a pot, then add the litharge. Stir constantly with a peach, willow, or locust branch. Add the natural copper, Bletilla rhizome, mulberry root bark, Chinese clematis root, and Shaofen in a second batch. Then add costus root, amber, benzoin, mica, frankincense, dragon’s blood, myrrh, and xiangjie. When the plaster turns black and a drop placed in water forms a bead without dispersing, it is ready. Pour it into an earthenware bowl and leave it in water for two or three days to remove what is traditionally called “fire toxin”—a term in plaster-making for the need to soak the mixture after cooking. It is better still to leave it on the ground for another three to five days. It can then be spread into medicinal plasters as needed.

To make a Golden Silk Plaster, grind all the preceding ingredients into a fine powder. Separately, take one jin of clear pine resin, melt it in a pot, and filter it through palm fiber until clean. Then take four liang of cooking oil and simmer it until ready; add one liang of litharge and cook them together until a drop placed in water forms a bead. Remove the pot from the heat and place the mixture in water, then stir in the medicinal powder to make the plaster. Keep the plaster immersed in water, changing the water daily; in winter, change it every other day.

If a back abscess (a carbuncle on the back) is black and painless, it is a Yin-pattern condition.

Take one jin of mugwort leaves, half a liang of realgar, and half a liang of sulfur. Boil the mugwort leaves with the realgar and sulfur in water for half a day. When the liquid is warm, apply it to the affected area, changing the dressing every other day.

If a back abscess is black and painless, use the method above, boiling fresh mugwort leaves for each application. Change the dressing more than ten times. If pain develops, there may still be a chance of recovery. If it remains painless and black blood flows out, the prognosis is grave.

If the back abscess splits open and is slow to close, or if it appears this way from the outset, immediately apply this medicine as a band around the affected area.

Take equal amounts of white salt and Chinese honey locust fruit. Burn them to ash while retaining their medicinal properties, then grind them into a fine powder. If the sore is not hot, mix the powder with rice vinegar and apply it around the affected area, forming a ring around the opening. Replace the dressing repeatedly so the medicine’s effects do not readily disperse. Adding ginger juice and vinegar to the mixture is even better. If the sore is hot, mix the powder with clear tea and apply it around the affected area; it is said to work quickly.

This works very well for back abscesses, whether they have already ruptured or remain unruptured.

Take two qian each of magnolia bark, ginger-processed dried tangerine peel (prepared with ginger and with the inner white layer removed), and licorice joints, and five qian of roasted atractylodes, soaked in rice-washing water.

Add five qian of sanghuang mushroom to the ingredients above and grind them together into a fine powder. If the sore has ruptured, sprinkle the powder dry over the affected area; this is said to work very well.

Take two qian each of magnolia bark, ginger-processed dried tangerine peel (prepared with ginger and with the inner white layer removed), and licorice joints, and five qian of roasted atractylodes, soaked in rice-washing water.

Add five qian of sanghuang mushroom to the ingredients above and grind them together into a fine powder. If the sore has ruptured, sprinkle the powder on dry. If it has not ruptured, mix the powder with clear oil and apply it.

Internal Fortification and Clear Heart Powder is used for severe sores and ulcers with intense heat, burning pain at the affected site, thirst, and agitation. This formula is used to dispel toxins.

Take equal amounts of cinnabar, poria, ginseng, white cardamom, realgar, mung beans, sodium sulfate, licorice, borneol, musk, and Chinese honey locust fruit.

Grind the ingredients together into a fine powder. Take one qian at a time, mixed with honey water.

Pus-Penetrating Powder is used for various abscesses and for bone-adhering abscesses—those close to the bone—that have failed to rupture for a long time. The text says that soon after taking the medicine, the sore will break open on its own, and that repeated use has consistently proved effective.

Use a moth-emerged cocoon: the shell left behind after the moth has emerged from its cocoon.

Burn the shell to ash and take it mixed with wine; it is said to make the sore break open. Do not burn and take two or three shells together. Taking one will open just one sore; taking two or three may cause several openings, so use with caution.

End of Volume Eight of Secret Formulas for External Medicine from the Immortals.

A carbuncle or ulcer may develop on the back, extending to a span of one foot and reaching about one foot deep. Even if it rots down to the bone, it will not be fatal as long as it has not pierced the membrane.

This condition arises when overeating leaves the body vulnerable to toxic influences, which then lodge between the spleen and stomach. The toxins in the spleen and stomach should be treated promptly with medicine, applying treatment both internally and externally. Since this area is prone to foul decay, medicine must be taken at once. At the onset, use “Decoction for Pursuing and Expelling the Toxin,” which disperses the pathogenic influence from within; the formula appears at the end of the text. One may also take “Powder to Transform Toxins, Reduce Swelling, and Support the Lesion” and “Thousand-Gold Powder for Internal Support.” Apply medicines that detoxify, promote tissue growth, and relieve pain to the center of the affected area, and apply toxin-drawing powder around its edges. Finally, use a tissue-regenerating medicinal plaster; this will usually bring results.

Take the medicine immediately. At the very beginning of the illness, use “Zhui Ding Duo Ming Decoction” (a formula for treating boils) to disperse the toxin from within; the prescription appears at the end of the book. Then use “Hua Du Xiao Zhong Tuo Guo Powder” or “Nei Tuo Qian Jin Powder” to draw out the toxin and reduce swelling. Apply medicine that detoxifies, promotes tissue growth, and relieves pain to the center of the affected area, and apply toxin-drawing powder around its edges. Finally, use a tissue-regenerating plaster to close the wound. Treatment in this way should be effective.

Lotus-Seed Eruption

This illness develops on the right side. The author believes that toxin in the Spleen may spread into the Heart and cause the fire to blaze fiercely. Medicine should therefore be taken to disperse the toxin, with topical and spot treatments applied to stop the illness from advancing and prevent it from invading the Heart. If the swelling spreads across the entire back, the condition is difficult to treat; if it recedes, treatment may still succeed.

The author believes that pain and itching in sores of all kinds are related to the Heart, because the Heart governs the blood and drives the circulation of Qi and blood. If pain from this kind of sore moves from place to place, apply a fire needle to the affected area, inserting it three or four times. Fire needling involves heating a needle before inserting it into the affected area. Then use the previously mentioned “Hua Du Xiao Zhong Tuo Guo Powder,” adding Nan Xing, Cao Wu, Mu Bie, Bei Mu, garlic, and ginger. Mix the ingredients with rice vinegar and apply them, leaving the opening of the sore uncovered. Keep the poultice on for two or three days and nights; the author says the swelling and toxin will then disperse. While it is on, moisten the poultice frequently with vinegar.

Beehive Eruption

In this illness, the heads of the sores point upward. It is especially difficult to treat and is considered an abnormal pattern of disease progression, but medicine must still be used cautiously. It is called “Beehive Eruption.” Treatment depends on taking medicine and using remedies to draw out the toxin, promote tissue growth, relieve pain, and disperse stagnant blood. The author fears that the toxic Qi may attack the Heart and invade its inner membranes, at which point the condition will be difficult to treat. This is attributed to Heart Fire that has not yet subsided.

Spreading, Wandering Eruption

This illness is commonly known as “Turtle Shadow.” The author points out that medical prescriptions make no mention of “Turtle Shadow.” The claim that the back looks like a turtle’s shadow, or like a turtle laying eggs, does not describe what is actually happening. In reality, the toxin is influenced by wind and heat and wanders from place to place.

This illness arises when strong wind generates heat. The heat becomes so intense that Qi follows it and disperses in all directions. Wind should be dispelled and heat cleared as quickly as possible so that the Qi settles. The author compares the use of medicine to deploying troops and arranging battle formations, and holds that if the illness spreads to the hands, feet, or legs, death is certain.

This condition arises from exposure to dampness, anger, and drinking hot wine. The pathogenic influence injures the area between the internal kidneys, and the toxic Qi flows to Shenshu (the acupoint on the back corresponding to the kidneys). Apply medicine externally and take it internally at once to disperse the toxins in the internal kidneys, then use tissue-regenerating medicine to treat the condition from both within and without. If a Yin pattern develops and damages the kidney membrane, the condition is very difficult to treat. Anger and sexual intercourse must be avoided. Even a slight violation may make the condition incurable, so great care is essential.

Simultaneous Sores on Both Shenshu Points and Spleen Abscess

When sores develop on both sides of Shenshu at the same time, the cause is often having sexual intercourse after drinking hot wine, along with anger and exposure to dampness. If the lesion appears on the body’s surface and is a Yang pattern, it can still be treated. But if it is a phlegm pattern or a Yin pattern, the kidney membrane has already been damaged. Thin pus indicates that the body’s vital Qi is weak, making the condition difficult to treat and potentially fatal.

A spleen abscess develops between the left arm and shoulder. At the onset, apply moxibustion with a lamp flame to the affected area, then take Zhuding Decoction to induce sweating; the condition will then subside.

Right Shoulder-Connecting Sores

The lesion develops above the bone of the right shoulder. Because the shoulder moves frequently, the condition can be treated but is difficult to stabilize. If it spreads to the left shoulder, it is difficult to treat. Apply or sprinkle medicine according to the prescription for left shoulder-connecting sores given below.

Left Shoulder-Connecting Sores

The lesion develops above the bone of the left shoulder. Because the shoulder moves frequently, the condition can be treated but is difficult to stabilize. If it spreads to the right shoulder, it is difficult to treat. Dry chicken-yellow skin and down by roasting them, then grind them into powder. If the affected area is moist, sprinkle the powder on directly; if it is dry, mix it with clear oil and apply it.

Sores Opposite the Heart

This condition develops on the chest directly opposite the heart. The ancients attributed it to excessive Heart Fire and heat gathering in this area. If the toxins continue to worsen and spread, promptly treat them with medicine that clears and guides out Heart Fire. Then use tissue-regenerating medicine to help the affected area heal.

Beehive Sores

This kind of illness occurs between the breasts and is called “beehive eruption,” a swollen sore shaped like a honeycomb. It is caused by an excess of Heart Fire. It can be treated by promptly using the medicines mentioned earlier to disperse Heart Fire. If treatment is delayed even slightly, the heat toxin may attack the Heart and endanger life.

Beehive Eruption at the Back of the Head

This kind of illness occurs at the back of the head. If the swelling is honeycomb-shaped, treat it immediately. If there is only localized redness, heat, swelling, and pain, it is usually easier to treat. If phlegm symptoms appear, it is difficult to cure. Take internal medicine and apply medicine externally without delay, or the illness may become life-threatening.

Beehive Eruption at the Back of the Head

This kind of illness occurs at the back of the head. If the swelling is honeycomb-shaped, treat it immediately. If there is only localized redness, heat, swelling, and pain, it is usually easier to treat. If phlegm symptoms appear, it is difficult to cure, so take medicine internally and apply it externally at once. If the illness spreads to both shoulders, it cannot be cured.

Sores on the Back, Narrow at Both Ends

These sores on the back are narrow at both ends and spread outward. They are caused by disordered eating. Food and the movement of Qi influence one another; when the body is weak, illness may arise. Qi deficiency can also cause the sores to spread outward, widening their openings. Take internal medicine promptly to disperse the sore’s toxin, and also replenish Yang Qi as appropriate.

Carbuncles and Ulcers Beneath Both Flanks

This illness consists of carbuncles and ulcers forming beneath both flanks and is associated with bodily weakness and Qi deficiency. Do not take medicines that tonify Yang. Since the illness has arisen amid weakness, the body cannot tolerate warming medicines. If hot-natured medicines are used, deficient heat will intensify and may damage the periosteum, so great care is essential.

Eruption Along Both Sides of the Hairline

This illness occurs on both sides at the back of the neck, along the hairline at the temples. Apply medicine externally at once. If the sore forms a hard lump, remove its root as soon as possible. If it is at the center of the head, heat surges upward into the brain and the illness can progress rapidly, making damage to the periosteum more likely. Handle it with great care.

Eruption Along Both Sides of the Hairline

This illness occurs on both sides at the back of the neck, along the hairline at the temples. Apply medicine externally at once. If it forms a hard lump, remove its root as soon as possible. If it is at the center of the head, heat surges upward, and the surrounding skin becomes red, swollen, and hard. The illness may spread to the ears and neck, accompanied by chills, fever, and pain. Without prompt treatment, the toxin may enter the blood, and large areas of muscle may decay and suppurate, with pus and blood draining from the head. If Qi deficiency and phlegm symptoms also appear, the illness is difficult to cure and may be fatal.

Eruption at the Back of the Head

This kind of illness is called “premature abscess” (yaoju). The swelling is large and purplish-black. If it is not treated at once, the toxic heat will invade deep into the armpit, first damaging the Conception Vessel, then scorching the liver and lungs from within. Death may follow after a little more than ten days. Immediately use the previously mentioned Powder for Resolving Toxins, Reducing Swelling, and Supporting the Lesion, the Internal Support Powder of a Thousand Gold Pieces, and medicines that promote tissue growth and relieve pain, in hopes of obtaining a response.

Abscess Behind the Ear

This illness occurs about one cun and three fen behind the ear. The ancients believed this area was vital to life and that an outbreak there would cause death. They therefore called this sharp, fierce toxic abscess a hard-to-treat “acute toxin.” The term refers to a toxin that is firm and violent in force. The illness is also called “swelling of the jaw,” meaning that toxic heat steams upward and reaches the lower jaw, sometimes even breaking through into the mouth. The original text holds that if the toxin breaks through the throat, it will cause death. The method of treatment is given below.

Abscess Behind the Ear

This illness occurs about one cun and three fen behind the ear. The ancients believed this area was vital to life and that an outbreak there would cause death. They therefore called this sharp, fierce toxic abscess a hard-to-treat “acute toxin.” The term refers to a toxin that is firm and violent in force. The illness is also called “swelling of the jaw,” meaning that toxic heat steams upward and reaches the lower jaw, sometimes even breaking through into the mouth. The original text holds that if the toxin breaks through the throat, it will cause death. The method of treatment is described below.

Powder for Breaking Stagnation

This formula is specifically for stone goiter, qi goiter, sinew goiter, blood goiter, and related conditions. Take this medicine promptly, together with the external application described later.

Three qian each of seaweed, washed gentian, sea clam shell, and menispermum vine; three qian each of washed kelp, calcined alum, and pine lichen; one qian each of wheat flour and pinellia.

Grind all the ingredients together into a fine powder. Take about one qian per dose, mixed with warm southern wine. During treatment, avoid all foods considered toxic, as well as licorice, chicken, fish, spicy foods, cold or raw foods, and fruit, for the formula to take effect.

Arisaema Paste

This formula is specifically for sores and lumps that grow on the skin, neck, or face. Some are as large as a fist, others as small as millet; some are soft and others hard. They are usually neither painful nor itchy. Use this medicine, and do not casually puncture with a needle or apply moxibustion. Instead, open the lesion in keeping with its condition, taking great care.

Use one large arisaema tuber and grind it finely into a thick paste. The original text is damaged in the instructions that follow for preparing the paste.

Grind a large piece of arisaema very finely and mix it into a fairly thick paste, then add a little good-quality vinegar and blend well. If fresh arisaema is unavailable, dried arisaema may also be used: grind it into powder and mix it with vinegar to make a paste. First, gently prick the affected area to let the Qi escape. Spread the medicinal paste on paper to about the size of the swelling, then apply it to the area. If it itches, do not scratch or disturb it. Replace the paste often, and it should take effect. When the paste on the paper dries, replace it with a freshly prepared, moist application.

Chest Sores

A sore swelling that forms on the chest is called a “well abscess.” It is about the size of a soybean and develops over three or four days. Without prompt treatment, the illness may spread downward into the abdomen; if it remains untreated there, the patient will die in about ten days. The patient should quickly take the “Powder for Strengthening the Interior and Clearing the Heart” listed above. A sore that develops on the body’s surface can be treated. If it begins internally and damages the membranes within the chest or abdomen, it is considered difficult to save.

The Nine Outbreaks

These abscesses include lung abscess, heart abscess, liver abscess, kidney carbuncle, spleen abscess, and stomach abscess. Those that develop on the body’s surface can be treated. If they begin internally and damage the inner membranes, they are considered difficult to save.

The Nine Outbreaks

These abscesses include lung abscess, heart abscess, liver abscess, kidney carbuncle, spleen abscess, stomach abscess, large-intestine abscess, Triple Burner abscess (in Chinese medicine, the upper, middle, and lower burners), and small-intestine carbuncle. Examine the affected area to determine how deep the abscess is and which organ it originated in. Also find out whether the patient has previously taken mineral medicines, and assess whether the Qi is deficient or abundant. An abscess that breaks through and drains pus outward can be treated. One that develops inside the body and damages the inner membranes, or whose pus is discharged with the stool, is considered difficult to treat. Take all these signs into account before treating the patient.

Breast Abscesses in Women

A breast abscess in a nursing woman is called “external milk obstruction”; in a pregnant woman, it is called “internal milk obstruction.” Treat the condition promptly at its onset and apply medicine to disperse the swelling. If it has already suppurated and begun to drain, use medicine to promote tissue growth and relieve pain, following the prescribed formula.

Powder That Takes Effect at Once

Use equal parts of angelica root and fritillaria bulb, with the central core removed from the fritillaria. Grind them into a fine powder and take it mixed with Shaoxing wine. If the milk does not flow, add vaccaria seeds, decoct them in wine, and take the preparation mixed with the wine; this is said to promote the flow of milk.

Treating Breast Problems at Their Onset and Internal or External Milk Obstruction

For external application, use one spoonful of fermented dough starter and five qian of flour. Fry them, mash them, and apply the mixture once the starter has risen. If the milk does not flow, add vaccaria seeds, decoct them in wine, and take the preparation mixed with the wine; this is said to promote the flow of milk.

For newly developed breast abscesses, and for painful swelling inside or outside the breast caused by stagnant milk, a fermented-dough poultice may be used. Take one spoonful of yeast starter and five qian of flour, stir-fry them until cooked, and grind them. Let the dough ferment until it rises and becomes honeycombed; it does not matter if it overferments and the surface turns green. Dry it by heating, grind it into powder, and mix it with well water to apply. When the poultice dries, moisten it with water day and night. If the lump still does not subside, add powdered angelica root and fritillaria bulb; if there is pain, add powdered frankincense and myrrh. The source says this brings rapid results.

For breast abscesses and breast carbuncles—two conditions involving lumps and pain or swelling in the breast—if an internal lump does not disperse, take Rejuvenating and Qi-Activating Powder urgently, together with the poultice described above and external applications that resolve or draw out toxins. Also take Life-Saving Decoction, continuing until sweating occurs.

Rejuvenating and Qi-Activating Powder is used for breast abscesses, breast carbuncles, and various toxic swellings. The prescription lists equal parts of costus root, fennel, green tangerine peel, fried and crisped pangolin scales, aged tangerine peel, angelica root, and licorice. Add fritillaria bulb, with its core removed and prepared with ginger, and Chinese bellflower. Grind to a fine powder and take it mixed with southern wine (wine produced in southern China). The source also says the ingredients may be chopped and decocted in water, then taken with wine.

Another prescription lists one liang each of green tangerine peel, aged tangerine peel, and licorice; three liang each of fried and crisped pangolin scales and roasted trichosanthes root; and one liang each of forsythia and honeysuckle. Grind to a fine powder and take it mixed with hot wine. The earlier ingredient names and dosages contain repetitions and disorder; the identifiable content is reproduced here as given.

Breast Lao—a category of chronic breast disease involving ulceration—should not be treated with acupuncture. The source warns that needling may damage the tissue spaces of the breast and cause death. In diagnosis, if the wound is open and its edges are wide apart, this is taken to indicate that the breast tissue has been damaged and has died; medicine should be taken urgently and an external application used. If new flesh does not grow over the wound, it is difficult to cure. One may take Secretly Transmitted Qi-Circulating Drink and Supportive Ten-Ingredient Powder; at the same time, apply Detoxifying, Flesh-Regenerating, and Pain-Relieving Powder to the affected area, and apply the poultice described earlier for nipple inflammation around the wound.

The source says that breast swelling caused by fanhua and pomegranate cannot be cured. Those aged thirty-two or thirty-three may still be treated, while those over forty should take internal medicine and apply external remedies as early as possible. If new flesh still does not grow over the wound, apply the medicine around the affected area.

The original text considers the conditions called “fan-flower breast discharge” and “pomegranate breast discharge” incurable. Patients around thirty-two or thirty-three years old may still be treated. Those over forty should begin treatment as soon as possible, using both internal medicine and external applications. If new flesh still does not grow over the wound, the condition is difficult to treat and may be life-threatening.

Human-Face Sores

The original text attributes human-face sores to grievances from past lives and says they can be resolved by doing good deeds. One must first repent sincerely before using medicine. Take Liqi Drink, a formula for regulating the flow of Qi. If the condition does not improve after prolonged treatment, take Kushen Pills, made with Sophora root and other ingredients, which the original text says can replenish Kidney Water. Apply Jiedu Shengji Dingtong Powder externally to detoxify, promote the growth of new flesh, and relieve pain; the original text says it works quickly. Then apply a medicinal plaster and pack the sore with medicine that promotes new flesh.

Kushen Pills

The formula lists four liang of Sophora root, along with Saposhnikovia root, schizonepeta, dahurian angelica root, raw Sichuan aconite with the skin removed, red peony root, fleeceflower root, Sichuan lovage root, Chinese gardenia, Chinese honeylocust thorn, Vitex fruit, poria, Chinese yam, tribulus, stir-fried aconite root, astragalus, notopterygium root, and white aconite, among other ingredients. The original text repeats and scrambles some ingredients and dosages. It also mentions “Four Raw Ingredients Powder” and specifies three qian of aconite root in that formula. The information is insufficient to reconstruct a complete, reliable prescription.

Grind the ingredients into a fine powder and use water-cooked flour paste to form pills the size of Chinese parasol tree seeds. Take thirty to fifty pills two or three times a day on an empty stomach, washed down with southern Chinese wine. Those who do not drink alcohol may take them with good-quality tea. The original text says this formula can replenish Kidney Water.

External Leg Ulcers

External leg ulcers—ulcers on the outer side of the lower leg that do not heal for a long time—are attributed in the original text chiefly to weakened Kidney Water and pathogenic factors descending into the lower body. They may also be associated with the Spleen’s failure and the leakage of damp fluids. Take Kushen Pills and apply Jiedu Shengji Dingtong Powder externally, then use a paper-separated medicinal plaster. This is a plaster applied with a layer of paper between the ointment and the wound.

Secretly Transmitted Paper-Separated Plaster

This formula is used for leg ulcers that have not healed for years. Its ingredients include aged pine resin, camphor, stir-fried gū dān, “water-dragon bone” (also called chuán hóng), lime, and calomel. If the ulcer still does not heal, add dahurian angelica root, Sichuan lovage root, and cuttlebone. Grind the ingredients into a fine powder, then melt the pine resin to make a plaster. The latter half of the original text repeats the ingredients and does not give complete instructions for preparing the plaster.

Grind the above medicinal ingredients together into a fine powder. Melt the pine resin, then add a small amount of cooking oil and mix well. Make an oilpaper pouch sized to fit the wound and place the medicine inside. First wash the wound with water, then bind the pouch over it. Secure it firmly after two days, and change the medicine every four days. Washing the wound with a decoction made from only three ingredients—Angelica dahurica, Sichuan lovage rhizome, and cuttlebone—is also effective.

Abdominal Carbuncles and Blood-Wind Sores

In these two conditions, carbuncles that form on the abdomen, where the muscles are thick, are difficult to treat if they are near the openings for urination and defecation; those on areas with thick muscle are more stable. Blood-wind sores on the feet of men or women are usually easy to treat. If a sore spreads upward from the foot and reaches the hand, however, it is difficult to treat.

Dorsal Foot Sores

This condition is associated with wasting-thirst disease, a group of disorders characterized by excessive drinking, eating, and urination. A sore on a toe is called a toe gangrene sore, a necrotic sore affecting the extremities. If the affected area turns red and black, the prognosis is grave and treatment is difficult; if it has not turned red and black, it may still be treated. If the condition does not improve with treatment, the affected part should be amputated promptly, which may save the patient’s life. Without amputation, redness and blackening of the area can become life-threatening.

The condition can still be treated when it first appears. Patients with wasting-thirst disease may take Flowing Qi Drink, Sophora Root Pill, and medicines that clear toxins and promote tissue growth; treatment should begin as soon as possible. Another method specifically for this condition is to boil tung oil with nameless mineral, a mineral medicine, add a spoonful of Sichuan pepper, then cut a piece of smartweed leaf to fit the wound and add it to the mixture. Boil and soak it for seven days. Then apply that leaf alone to the sore; it is said to bring a cure. The same method is used for sores on the fingers.

Kidney Yin Sores

A kidney carbuncle is also called a suspended carbuncle. Swelling and pain of the scrotum occur when cold and damp pathogenic influences invade the Bladder and Kidney channels and lodge in the portion of the Kidney channel that runs through the genital area. This obstructs the flow of Qi and blood, while the cold and dampness remain unresolved, producing the condition. The patient may take the previously mentioned Supporting and Enveloping Powder, with plantain seed, akebia stem, light bamboo leaf, morning glory seed, fleeceflower root, and a plant called “foot lotus” added. The patient should also take Internal Dissolving Powder, apply Tissue-Regenerating and Pain-Relieving Powder externally, cover it with a medicated plaster, and take the previously mentioned Secret Flowing Qi Drink.

Lower Sores□

A character is missing here in the original text. The “Secret One-Ingredient Thousand-Gold Powder” mentioned afterward is specifically for treating [missing text]; it is said to take effect immediately.

Take one black spider, preferably one large enough to cross a river, and grind it to a pulp in a bowl. While it is still hot, pour in southern wine (wine produced in the south) and mix well. Drink the entire contents of the bowl. Lie on the side corresponding to the side of the body where the affected area is located. If the condition does not improve, use one more spider; this should bring relief.

Poultices

First, heat the white part of a scallion and apply it hot to the affected area. When it cools, heat it again and repeat the warming treatment three or four times, then apply the medicine. Use the detoxifying and swelling-reducing medicine mentioned earlier, and lie on the side corresponding to the affected area. If the condition does not improve, use another spider.

First, heat the white part of a scallion and apply it hot to the affected area. When it cools, heat it again and repeat this three or four times, then apply the medicine. Use the detoxifying and swelling-reducing medicine mentioned earlier, adding garlic, Semen Momordicae, Arisaema, and Aconitum kusnezoffii for external application. If the affected area has already broken open, use the wound-healing and pain-relieving medicine mentioned earlier.

Medicine to promote drainage

Take it three to five times, stopping when the discharge has been expelled.

Take equal amounts of Pharbitis seed, realgar, Melia fruit, rhubarb, licorice nodes, trichosanthes root, bitter orange, and fritillaria bulb.

Grind these ingredients into powder. Take on an empty stomach, mixed with southern wine. Once the pus has drained, the swelling and pain will subside.

Another formula

Asarum, Coptis, pangolin scales, frankincense, myrrh, forsythia, the tip of the angelica root, rhubarb, gardenia, honeysuckle, oyster shell, plantain seed, saposhnikovia root, licorice, and oil-treated walnut.

Chop the ingredients and simmer them in water. Add southern wine and drink warm at the fifth watch, before dawn.

Formula for unilateral swelling of the scrotum

For unilateral swelling and pain of the scrotum or testicle, this formula is said to work quickly. First take Wuling Powder, a formula that promotes urination and drains dampness, adding capillaris, rush pith, akebia stem, atractylodes, polyporus, alisma, red poria, cinnamon bark, and plantain seed.

Chop the ingredients and simmer them in clean water. Take on an empty stomach, then apply moxibustion as described later.

Afterward, take pills: use one packet of Qingmuxiang Pills, add a large blister beetle, and heat them together with the pills. Remove the beetle, then swallow the pills with warm southern wine. If the condition does not improve, take another one or two doses.

Another formula uses chestnut-tree root, simmered in southern wine and taken as a drink. It is said to work quickly.

Medicine to rub on chancres

Take equal amounts of Coptis and phellodendron bark.

First take the bile from two pig gallbladders and use it to moisten the two medicines. Then heat a piece of roof tile or brick over a fire until it is red hot, place the medicines on it, and dry them. Add frankincense, myrrh, sodium sulfate, calcined alum, nameless mineral, Baiyaojian, dragon’s blood, and Sophora root, then grind everything into a fine powder. If the affected area is dry, mix the powder with sesame oil and apply it. If the area is moist, sprinkle the powder on directly. If the swelling still does not subside, decoct Yiyuan Powder with Saposhnikovia root, Schizonepeta, and fleeceflower root, and wash the affected area while the liquid is warm.

If a chancre in the genital area remains swollen, decoct equal amounts of Saposhnikovia root, Schizonepeta, Caulis Spatholobi, and Achyranthes root. Fumigate and wash the affected area with the decoction; the swelling will subside.

Another formula for treating a genital ulcer known as “gnawing chancre” is to grind litharge, Coptis root, Phellodendron bark, and calomel into a fine powder and sprinkle it on the affected area. Then wash the area with a decoction of salt and mugwort leaves.

To take the medicine internally, pound together red kudzu root and a piece of fresh ginger. Mix them with warm wine and drink, taking enough to induce sweating. Apply the leftover medicinal pulp to the ulcer.

For unilateral swelling of the scrotum, grind Phellodendron bark and calomel into a fine powder and apply it to the affected area. Then wash the area with a decoction of salt and mugwort leaves. To take medicine internally, pound together red kudzu root and a piece of fresh ginger, mix them with warm wine, and drink enough to induce sweating. Apply the leftover pulp to the affected area.

For unilateral scrotal swelling, one may also use the patient’s own mouth width as a measure and apply moxibustion above the navel, warming the point with burning mugwort. If the swelling is on the left, apply moxibustion on the right; if it is on the right, apply it on the left. Then take one dose each of Zouma Fennel Pill and Evodia Internal-Dispersing Pill, swallowing them on an empty stomach with a small amount of wine mixed with a little salt.

The Secret Formula for Pursuing and Subduing Foul Sores is said to work quickly and make internal swelling subside. This formula has already appeared in the earlier Immortal’s Transmission of External Medicine. Because the author was concerned that it might be inconvenient to look up, it is listed here again.

Use equal amounts of notopterygium root, angelica pubescens, tangerine peel, Saposhnikovia root (in a larger quantity), Coptis root, red peony root, asarum, licorice nodes, cicada slough, stiff silkworm, and lotus-foot herb. Add placenta, Indian madder, and honeysuckle. If there is pus, add fleeceflower root and angelica dahurica. To promote bowel movements, add green costus root, rhubarb, gardenia, and morning glory seed. If the illness is in the foot, add Chinese quince.

Coarsely chop the medicines listed above. For each dose, take five qian. Set aside one dose, add one qian each of eupatorium leaves and honeysuckle flowers, along with one liang of fresh ginger, and pound them together. Take the mixture with warm, good-quality wine. Those who do not drink alcohol may decoct the medicines in water, then add a little wine before taking it; this also works well. Afterward, decoct one and a half cups each of wine and water with ten slices of fresh ginger. Drink it hot, then cover yourself well with clothing and bedding and stay covered until you sweat. Once the illness has eased, add two qian of rhubarb to the earlier prescription, decoct it, and drink it hot. If this brings about one or two bowel movements, it can help expel the remaining pathogenic toxins. Judging by its ingredients, this prescription may not seem well suited to the illness, but repeated use has shown it to be effective. If other symptoms arise afterward, adjust the medicines according to the circumstances.

Irritability and vomiting: Add one qian of licorice nodes. Take with bean flour and sour fermented liquid. Grind the medicines listed above separately into powder.

Vomiting and nausea: Add frankincense and take with a decoction of bean flour and licorice.

Another option is to grind ziheche and aged ginger with rice vinegar and take the mixture.

Irritability with vomiting, called “latent summerheat” (summerheat lodged within the body): Use Cinnabar Powder of the Five Ingredients.

Persistent vomiting: Add mother cloves and lotus seeds, and decoct them with the previous medicines. If vomiting still does not stop, take the Powder for Harmonizing the Qi, with aged ginger ground in a little rice vinegar.

Irritability with vomiting, called “latent summerheat”: Use Cinnabar Powder of the Five Ingredients.

Persistent vomiting: Add mother cloves and lotus seeds, and decoct them with the previous medicines. If vomiting still does not stop, decoct the Powder for Harmonizing the Qi with ginseng and costus root.

Persistent vomiting with cold hands and feet, called “water ingestion”: Take Coptis and Elsholtzia Powder, and swallow Summerheat-Dispelling Pills.

Cold hands and feet: Add xuan papaya and qianniu.

Irritability: Add mai men dong, red peony root, gardenia, and rush pith.

Tidal fever: Add northern bupleurum, scutellaria, pale green bamboo, and cogongrass root.

Blurred vision: Add cinnabar, realgar, and a little musk.

Abdominal distension: Add coix seed and hanshuishi.

Diarrhea: Add atractylodes, poria, nutmeg, and poppy husk.

Unrelenting abdominal pain: Add southern costus root and frankincense.

Wheezing and cough: Add anemarrhena, fritillaria, and a little honey.

For headache, add Sichuan lovage rhizome, Dahurian angelica root, and the white part of a scallion.

If the pain still does not stop, crush radish seeds, Sichuan lovage rhizome, and the white part of a scallion together, and apply the mixture to the temples.

When there is a great deal of phlegm and saliva, pound the tips of fresh mugwort leaves with rice vinegar to extract the juice. Gargle with it and spit it out; this can help bring up the phlegm and saliva by coughing.

For a sore throat, boil thinleaf sophora root, lingxiao root, gardenia fruit, lophatherum leaves, mugwort leaves, and rush pith in water. Gargle with the liquid and spit it out.

For constipation, pound the herbs with vinegar to extract their juice. Gargle with it and spit it out to help clear phlegm. (The original does not specify which herbs to use here.)

For constipation, use red peony root (prepared with ginger), root bark (stir-fried with wheat bran), and areca peel.

For inability to urinate, use red peony root, red poria, akebia stem, plantain seed, and rush pith.

For blood in the urine, use raw rehmannia root and plantain seed.

For nosebleeds, use wild safflower, raw rehmannia root, lotus node, and fresh ginger peel, all raw.

If a sore is swollen but painless and has not come to a head, apply moxibustion with three cones of mugwort (light and burn three moxa cones). If it still does not hurt, it will be difficult to treat.

For steaming-bone fever (a feeling of heat deep within the bones, often used to describe deficiency heat), add cogongrass root to the formula.

If the pulse cannot be felt, take Twenty-Four-Ingredient Flowing Qi Drink.

Flying Dragon Life-Taking Elixir is specifically used to treat boils, sores on the back, carbuncles on the head, breast abscesses, bone-attached abscesses, and various severe ulcerous swellings that have no head of pus. The text claims that after taking it, the swelling will develop a head of pus; sores that were painless will begin to hurt, and those that have already formed pus will heal quickly. The original describes this medicine as a precious remedy for severe sores, says it may be taken even when the condition is critical, and especially cautions against underestimating it.

Ingredients: two qian of dried toad venom; one qian of dragon’s blood dissolved in aged wine; two qian each of frankincense and myrrh; three qian of realgar; half a qian of calomel; one qian of copper sulfate; half a qian of musk; two qian of verdigris; one qian of gypsum; two qian of cinnabar, for the outer coating; twenty-one sea snails (that is, snails, used with their shells); one centipede, roasted yellow in wine with its head and legs removed; and half a qian of borneol (also called “brain,” and optional).

First grind the medicinal ingredients listed above into a fine powder. Pound the sea snail (a type of marine mollusk) into a paste and mix it with the powder to form pills, each about the size of a mung bean. If the powder does not bind well, use flour paste cooked with wine to hold it together. Take only two pills at a time.

Before taking the medicine, prepare a three-inch piece of the white part of a scallion. Have the patient chew it thoroughly and spit it into the palm of the hand. A man should use the left hand, and a woman the right. Wrap the pills in the chewed scallion, then swallow them with three or four cups of hot wine free of ash. Afterward, go somewhere sheltered from the wind and cover the patient with bedding. Wait about as long as it takes to walk five li, then drink several cups of hot wine to help the medicine take effect and disperse. Continue until the patient develops a fever and sweats heavily. If there is no sweating and the illness is severe, take two more pills; sweating is then regarded as a sign that the treatment has worked. If the illness has just begun, two pills should suffice; in severe cases, two more may be taken. A furuncle whose poison has spread and attacked the heart is difficult to save; cold sweats are also considered life-threatening. If the patient cannot chew scallion, pound it, wrap the pills in it, and swallow them with wine. For a sore on the upper body, take the medicine after eating; for one on the lower body, take it before eating.

After taking the medicine, avoid cold water, cucumber, eggplant, oily foods and wheat-flour dishes, pork and lamb offal, fish, and foods that the scripture says may provoke wind disorders or sores. Women should also avoid bathing and changing clothes, and should not handle substances associated with body odor.

Back Sores

Blood-seeing-sorrow herb, one liang; ground cherry, half a liang; Chinese angelica, two qian and five fen; frankincense, one qian and two fen and five li; myrrh, one qian and two fen and five li.

Dry the ingredients by roasting and grind them into powder. Take seven qian at a time, mixed with hot wine. If fresh herbs are available, pound them and take them with hot wine, keeping the remaining herb pulp to apply to the sore.

Lower Back Pain

Heat black beans in a pan, wrap them in silk or cloth, and bind them around the waist. Then pound fresh ginger, mix it with hot wine, and drink until sweating begins. If there is no sweating, repeat the procedure two or three times. The scripture says this will have a marked effect.

Wounds from Beatings with a Staff

White lead, one liang; red bole, one qian; raw mercury, one fen. First heat the ingredients, then pound all three with sesame oil to make a paste. Apply it to the injured area until oily sweat seeps out. If no oily sweat appears, repeat the procedure two or three times.

These are traditional treatments and medicinal claims recorded in the scripture.

Sores Caused by Beatings

Take one liang of water powder, one qian of red ochre, and one fen of raw mercury. First decoct the ingredients, then pound all three with sesame oil into a paste. Spread the paste on umbrella paper, apply it to the affected area, and bind it tightly. If the flesh at the wound is sunken, fill the hollow with the paste and cover it. The remedy is said to work quickly. It may also be used for hemorrhoids and severe ringworm.

Boils

Take arsenic-based medicine, licorice, and alum, and grind each into a fine powder. Prepare a bowl and layer the powders in this order: arsenic-based powder, licorice powder, then alum powder. Heat the bowl over a fire to calcine the ingredients. Repeat the layering and calcining in the same order until they have been calcined three times. Sweep up the powder, let it cool, then mix it with cold water and apply it to the boil. It will cause some pain when applied. Have the patient drink until drunk; after one night, the boil is said to fall off by itself.

Drawing Out a Boil

If the boil cannot be drawn out, take half a shelled croton seed and powdered lodestone. Mix them with onion juice and honey into a paste, and apply it to the boil. The boil is said to draw out by itself.

Swellings and Toxic Sores

Take ginger paste, made from ground fresh ginger, and earth that has fallen from the eastern roof beam of a house. Draw a circle at the place where the earth is collected: on a yang day draw a round circle, and on a yin day draw a square one. Dip fresh ginger in good rice vinegar and rub it over the earth inside the circle. Scrape the earth into a bowl, add powdered rhubarb and powdered mirabilite, and grind them finely together with the ginger. Apply the mixture to the swelling, leaving the sore’s opening uncovered so that the pus and toxins can drain.

Eroding Sores

Mix calomel and Shao powder, a powdered medicine, and sprinkle the mixture over the affected area.

Scabies

This remedy may also be used for mild ringworm. Take Chinese croton, Coptis rhizome, licorice, oil walnut, elm bark, Sichuan pepper, calomel, alum, snakebed seed that is half raw and half cooked, and well spring stone. Grind each into a fine powder, then add an appropriate amount of oil walnut and pound everything together into a paste. Shape the paste into balls about the size of a pellet. Wrap a ball in coarse cloth and rub it over itchy areas; press it onto painful areas. The remedy is said to take effect as soon as it is applied.

Infantile Milk Rash

Rub licorice over the affected area, then apply oil and soy sauce.

In critical cases, shape the medicine into a ball the size of a marble and wrap it in coarse cloth. Rub it over the itchy area, and press it against painful spots. The medicine takes effect quickly once it touches the affected area.

Infantile Milk Ringworm (ringworm sores on the chests of infants and young children)

Rub the affected area with Shuai Fen Cao, then apply oil paste.

Acute and Chronic Convulsions in Children

Take a mouthful of fecal-green water from a cold pit and give it to the child to drink. It is said to bring a cure.

End of Volume Nine of Secret Prescriptions from the Immortal Tradition on External Medicine

Textual notes:

1. The original text had the two characters “ji yan” in place of “mi”; this has been corrected to conform to the book’s conventions.

2. For “yu,” Secretly Transmitted External Medicine Prescriptions has “yin.”

3. For “kou,” the manuscript has “yi.”

4. For “fa,” Secretly Transmitted External Medicine Prescriptions has “chuang.”

5. The original text had “qu” in place of “ou”; this has been corrected according to the manuscript.

6. The original text had “lei” in place of “mo”; this has been corrected according to the manuscript.

Volume Ten of Secret Prescriptions from the Immortal Tradition on External Medicine

Compiled by Zhao Yizhen, the Original Yangzi of Junyi

Treatments for Various Miscellaneous Ailments

Rescuing a Person Who Has Been Hanged

A person may still be revived from morning until evening, even if their body has already grown cold. If the area over the heart is slightly warm, they may still be revived even after more than a day. Quickly lift the person, loosen the rope, and remove it from the neck, but do not cut the rope. Then gently straighten the throat, lay the person flat, and cover them with a quilt. Immediately use bamboo tubes to blow air into both ears. One person should keep hold of the person’s hair, while another presses down on both shoulders with their feet. A third should massage the chest and bend, stretch, and rub the hands and feet. If the person begins breathing again, give them some rice water to drink. The book says this method has never failed to bring someone back to life.

Rescuing a Drowning Person

When someone is drowning, first use a knife to pry open their mouth and place a chopstick across it for them to bite down on, so water can drain from the mouth. You can also lay the person face down over an overturned urn or an upright rice steamer, with their head hanging down, so the water flows out. If there is no urn or steamer, lay their abdomen across a log. Once the water has drained, have a strong person bend the drowning person’s legs over their shoulders, carry them upside down back to back, and walk around to help drain the remaining water from the body.

Next, dig up a clod of earth from a wall and lay the drowning person on their back on the ground. Cover their body with the earth, leaving only the mouth and eyes exposed. The scripture says that in this way the Qi of the earth will naturally be drawn into the body. If the person shows signs of waking, quickly take turns blowing through a bamboo tube into their mouth, ears, nose, navel, and anus, so that the Qi in the upper and lower parts of the body can circulate. Then blow a little powdered pinellia into the nose. If the person shows even slight signs of life, give them some thin rice porridge.

Another method for rescuing a drowning person, passed down by Master Sun (Sun Simiao), is to quickly loosen their clothing and apply moxibustion to the center of the navel; this can revive them.

Treating someone who has fallen into cold water in winter and become stiff

If the person’s limbs are cold and they cannot speak, but still have a faint breath, do not warm them over a fire right away. Put hot ashes in a cloth bag and place it over the chest, replacing them with fresh hot ashes as they cool. Once the person opens their eyes, give them some warm wine or rice soup.

Treating someone who has fainted from heatstroke

Do not let the person’s body get cold, as this will make the danger worse. Keep wiping the chest and abdomen with warm water. If the situation is urgent and you are on the road, place hot earth from the roadside over the abdomen and navel, then have someone urinate into the person’s navel. The scripture says this can revive them.

Treating someone who has fainted from heatstroke and is thirsty

Pound equal amounts of hot earth from the roadside and garlic together, mix with water, strain out the solids, and give the liquid to the person to drink. The scripture says they will wake soon after drinking it.

Treating someone who suddenly suffers a stroke and falls unconscious

The scripture holds that this condition is often caused by phlegm and saliva obstructing the body. Take two qian of alum, grind it raw into powder, and mix it with fresh ginger juice. Pry open the patient’s mouth and pour it in. The phlegm and saliva may be vomited out or swallowed; afterward, the person will wake.

If someone suddenly suffers a stroke and falls unconscious, the cause is often phlegm and drool obstructing the passages. Take two qian of alum, grind it raw into a powder, and mix it with fresh ginger juice. Pry open the person’s mouth and pour it in. Once the phlegm and drool have been expelled or swallowed, the person will wake.

If someone suddenly becomes unconscious after being struck by an evil influence, pound Chinese chives to extract their juice and pour it into the nostrils.

If someone suddenly becomes unconscious while asleep, drip Chinese chive juice into the nostrils. In winter, pound the chives with their roots and pour in the juice.

After a fall from a height, if stagnant blood surges into the chest and heart area and the person appears to be dying, take a large bowl of fermented black beans, add two bowls of water, and boil the mixture three times. Strain out the beans and have the person drink the liquid. If their breath is already faint and they cannot speak, and there is no time to fetch medicine, pry open the mouth and pour in hot urine.

Those crushed beneath heavy objects, hanged, drowned, or overcome by a nightmare, as well as women who faint and stop breathing after childbirth, are said to suffer from the “Five Extinctions.” Grind pinellia into powder, take an amount the size of a bean, and blow it into the nostrils. The person will soon regain consciousness.

The divine physician Hua Tuo said:

There are ten kinds of critical illness that come on as suddenly as wind and rain. For this reason, these effective prescriptions have been selected for emergency treatment.

The first critical condition is cholera with vomiting and diarrhea. It may result from drinking cold beverages, exposure to cold, prolonged hunger, intense anger, or jolting the stomach’s Qi while traveling by cart or boat. The symptoms include persistent vomiting and diarrhea, dizziness and blurred vision, cramping in the hands and feet, and cold limbs. The prescription is as follows:

Half a liang each of evodia, Chinese quince, and salt.

Fry the three ingredients together until golden brown. First, fill an earthenware bottle with three sheng of water and boil it for a hundred rolling boils. Then add the three fried ingredients and continue boiling until two sheng remain. Strain out the dregs and drink the liquid in several portions.

Another prescription: Grind dried alum into powder. Take one large qian at a time and dissolve it in boiling water.

Another prescription: Take a pinch of salt and one zhan of vinegar. Boil until seven-tenths of the liquid remains, then drink it warm. Salty and sour foods such as salted plums may also be boiled and taken.

Second dangerous condition: An attack of chanhoufeng, an acute illness in which the throat suddenly swells shut and becomes painful, with cold hands and feet and breathing about to stop. Take three pieces of gleditsia pod, rub them in water, and give one cup of the liquid to drink. It is said to work immediately.

Another remedy: Grind one gleditsia pod and one qian of bai caoshuang, a medicinal substance made from the soot of grasses and trees, into a fine powder. Mix it with cold water, add a few drops of clear oil, and give it to drink.

Another remedy: Chop four liang of cimicifuga, add four bowls of water, and simmer until reduced to one bowl. Give it to drink. It is said to work immediately.

Third dangerous condition: Vomiting. Add a few drops of clear oil and give it to drink.

Another remedy: Chop four liang of cimicifuga, add four bowls of water, and simmer until reduced to one bowl. Give it to drink. It is said to work immediately.

Third dangerous condition: Vomiting blood, which results from internal injury. It may also occur when excessive drinking or sexual activity injures the heart and lungs, disrupting the movement of Qi and blood and causing blood to gush from both the mouth and nose.

Take a handful of Japanese catnip and burn it to ash. Spread it on the ground to disperse its fire toxin, then grind it finely. For each dose, take three qian and mix with old rice water.

Another remedy: Grind bai caoshuang finely. For each dose, take three qian and mix with thick rice water. Take three doses in succession; this is said to be highly effective.

Fourth dangerous condition: After mistakenly ingesting poisonous mineral sand, the person becomes agitated and restless, suffers severe cramping pain in the chest and abdomen, feels dizzy and faint, wants to vomit but cannot, turns bluish-black in the face, and has cold limbs.

Grind a handful of indigo plant finely, mix it with well water to make one bowl, and give it to drink.

Another remedy: Give two sheng of sesame oil to drink.

Another remedy: Give three bowls of thick earth-slurry water. To make earth-slurry water, dig into yellow earth, pour in clear water, stir until muddy, and use the liquid.

Fifth dangerous condition: Shijue, a sudden collapse in which the person appears dead and loses consciousness, with Qi surging through the abdomen and making a thunderous rumbling sound.

Mix half a cup of fresh ginger juice with one cup of wine. Bring it to a boil several times, then give it to drink. At the same time, apply moxibustion to points including the Dantian, Baihui, and Qihai, warming them with burning mugwort.

Sixth dangerous condition: Being struck by ghost Qi, an old term for unusual illnesses such as sudden collapse. The person suddenly falls to the ground, with cold limbs, clenched fists, and bleeding from the nose and mouth.

Grind about one qian of realgar into a fine powder and mix it with peach-leaf decoction.

Another remedy: Use an old undershirt or other garment that has been worn and has absorbed foul odors. For a man, use a woman’s garment, and place it over the Qihai point.

Sixth dangerous condition: Being struck by ghost Qi, with sudden collapse, cold limbs, clenched fists, and bleeding from the nose and mouth.

Take realgar, grind it into a fine powder—about one qian—and mix it with a decoction of peach leaves before taking it.

Another formula: Take a worn undershirt, or grime that has accumulated on clothing worn close to the body for a long time. For a man, use a woman’s clothing; for a woman, use a man’s. Burn it to ash. Each time, take two qian and mix with water that has been boiled seven times. “Contact clothing” here means underwear worn next to the skin.

The seventh critical condition: Loss of Yang. Symptoms include gripping pain in the lower abdomen, contraction in the kidney region, a darkened complexion, shortness of breath, and incessant cold sweats.

Take three scallion whites with their roots, pound them in a sand basin, and add five sheng of wine. Boil until two sheng remain, then divide into two doses. At the same time, heat salt in a pan and apply it as a warm compress below the navel, over the Qihai point (an acupuncture point in the lower abdomen). Keep the area from getting cold.

The eighth critical condition: Ghost oppression or ghost assault. It seems as though someone in the room has been struck by a ghost; the person makes sounds and cries out, yet is not conscious of what is happening.

Break up and grind to powder the hearth earth from near the fire inside the stove. Take two qian at a time, mixed with freshly drawn water. Then blow a little of the powder, about the size of half a fingernail, into the nostrils. Also apply moxibustion at the patches of hair at the base of each big toe, twenty-one moxa cones at each spot.

Another formula: Take three lengths each of peach and willow branches that grow toward the east, boil them to make three cups of decoction, let it cool until warm, and administer it.

The ninth critical condition: The fetus presents in the breech position.

Grind seven seeds from the pagoda tree to a fine powder and swallow them with freshly drawn running water.

Another formula: Boil a decoction to make three cups, let it cool until warm, and administer it.

The ninth critical condition: The fetus presents in the breech position.

Grind seven seeds from the pagoda tree to a fine powder and swallow them with freshly drawn running water.

Another formula: Take one shed snake skin from a black snake, fourteen cicada shells, and a bundle of hair. Burn them together to ash, mix with warm wine, and take in three doses. Lie on your back for a short while; the fetus is said to be delivered afterward.

Another formula: With a fine silk needle, prick the soles of the baby’s feet three to five times each. Immediately rub salt over the punctures; the fetus is said to turn into the proper position for birth.

The tenth critical condition: The placenta does not descend. Bad blood surges toward the heart, leaving the woman drowsy and distressed; the placenta may even rise upward.

Toast one sheng of adzuki beans, add three sheng of water, and boil until two sheng remain. Strain out the beans, let the liquid cool until warm, and drink it. The placenta is said to be expelled soon afterward.

Another method: Burn the woman’s own fingernails and toenails to ash and mix them with wine for a single dose. Then have a strong woman lift the mother, and use a bamboo tube to guide downward from the area over her heart; this is said to work better.

There are also formulas for childbirth.

Burn the laboring woman’s own fingernails and toenails to ash, mix the ash with wine, and have her take one dose. Then have a strong woman lift her up and use a bamboo tube to guide downward from her chest; this is said to work better.

A Prescription for Childbirth

When a woman is nearing her due date and begins to feel pain in her lower back and abdomen, she should not immediately take a childbirth-inducing talisman or medicine, nor should she at once sit on the birthing bed and prepare to deliver. She should walk or stand regularly and remain calm. If the fetus is still within the fetal membranes, it will emerge naturally once the mother has sufficient strength. If medicine is used to induce labor before the due date, the fetus may lie crosswise or come out feet first, among other difficult births. If this leads to death, it is truly something she has brought about herself. The following are several tested prescriptions.

Perilla Drink

Perilla Drink treats various ailments during pregnancy. It can both protect the fetus and help ensure an easy delivery; its effects in protecting the fetus and regulating Qi (vital energy) are pronounced.

One liang of perilla leaves; one liang of dried, baked areca peel; half a liang each of ginseng stir-fried with fresh ginger juice and aged tangerine peel, with the white pith removed from the tangerine peel; eight qian of Sichuan lovage rhizome; half a liang of roasted licorice root; four qian of northern white peony root, lightly stir-fried; and one liang of Sichuan angelica root.

Coarsely chop the ingredients. For each dose, take three qian and add three slices of fresh ginger and three cun of scallion white. Simmer in water and drink on an empty stomach. At seven or eight months of pregnancy, add half a liang of bitter orange, soaked in rice water, with the pith removed, and stir-fried; also add three qian of stir-fried round cardamom. Take once a day. During labor, simmer the prescription in water from a flowing stream and drink it.

If labor brings pain that comes in waves through the lower back and abdomen, take a piece of good-quality frankincense about the size of the little fingertip. Grind it finely, dissolve it in one ge of water, warm it, and drink it. Take medicine to induce labor only after the waters have broken.

A Childbirth-Inducing Prescription

Take a handful of fresh oak branches about one chi long and wash them. Add five cun of licorice root and chop them together. Put the ingredients in a clay jar with seven bowls of water and seal it tightly with paper. Simmer over low heat until the water is reduced by half. When the woman’s abdominal pain becomes severe, have her drink one warm cup. After one or two doses, she will feel the fetus descend and will give birth.

The text also recommends this prescription for the conditions it describes as crosswise or feet-first presentation, and for a dead fetus that has decomposed and swollen while remaining undelivered for many days. It says the prescription has often proved effective.

One prescription: Take equal amounts of Baicao Shuang (soot from the bottom of a pot or stove) and Bai Zhi, grind them into a fine powder, and mix with a boy’s urine and a little vinegar to make a paste. Take it with hot water.

Another prescription: Use wood shavings from the place where a wooden wedge fits into an axe head. This remedy is also used for transverse or breech births, and when a stillborn fetus has decomposed and swollen but remains undelivered after many days. The text says it has worked repeatedly.

One prescription: Take equal amounts of Baicao Shuang and Bai Zhi, grind them into a fine powder, and mix with a boy’s urine and a little vinegar to make a paste. Take it with hot water.

Another prescription: Take wood shavings from the place where a wooden wedge fits into an axe head. Burn them to ash while preserving their medicinal properties, grind them into a fine powder, and take with fast-flowing water.

When the fetus is obstructing the chest and cannot be delivered:

Burn snakeskin to ash, grind it finely with a little musk, and take it mixed with warm wine. It is said to bring on a rapid delivery.

When the placenta is slow to descend:

Take the whites of three eggs, discard the yolks, mix the whites with one he of sour vinegar, and drink. The text says the placenta will then be expelled.

Another method: Have the woman in labor put the tips of her own hair in her mouth to induce vomiting. The text says this will cause the placenta to descend.

Another prescription: Take fourteen castor beans, remove their shells, grind them, and apply the paste to the soles of both feet. The text says the placenta will then be expelled, after which the medicine can be washed off. If the placenta has not descended, the intestines may prolapse. In that case, apply the medicine to the crown of the head; it is said to make the prolapsed intestines retract. The text says a larger dose is also acceptable. Once the intestines have retracted, wash off the medicine; the remedy is said to be effective.

When postpartum stagnant blood rises upward, causing faintness and possibly becoming life-threatening, boil aged mugwort in water, add vinegar, and drink.

For profuse vaginal bleeding in women:

Grind Huang Qin into a fine powder and take two qian at a time. First place a red-hot iron steelyard weight in wine. Once the wine has boiled and then settled, mix the powdered medicine with it and drink.

Another prescription: Burn dried lotus receptacles to ash while preserving their medicinal properties. Take two qian at a time mixed with wine. The text says it is effective.

Another prescription: Burn together high-quality cotton, palm fiber, and hair to ash while preserving their medicinal properties. Then grind them with Baicao Shuang into a fine powder and take it mixed with undiluted wine.

Jiyin Dan, used to treat various illnesses in women.

Use four liang each of cyperus rhizome, black beans, ginger, and atractylodes. Soak them in yellow rice vinegar for fourteen days, except for the atractylodes, which should be soaked for only seven days. Remove them and slice them, then soak them for another seven days. Afterward, remove the black beans and stir-fry them. Pound the cyperus rhizome, add one liang of Chinese angelica and half a liang of Sichuan pepper, cook them in vinegar, then dry them together over low heat and grind them into powder. Make pills with glutinous rice paste, each about the size of a parasol tree seed. Take twenty or thirty pills on an empty stomach with warm wine or vinegar broth. They treat the same conditions as those described in the Taiping Imperial Grace Formulary.

Remedies for poisoning, cold damage, miscellaneous illnesses, and other conditions

Remedies for all kinds of poison and food poisoning

Use two liang of raw licorice, chopped. Add three cups of water and simmer until the liquid is reduced by half. Strain out the herb residue and let the liquid cool. Take half a cup at a time, sipping it slowly. If it has no effect, take another dose; vomiting afterward is also acceptable.

Another formula: Add soybeans and simmer them together; this is especially effective.

Remedies for all kinds of poison, including the peach-born golden silkworm Gu poison of Fujian and Guangdong

Take forty-nine stalks of licorice, each seven inches long, and soak them in a latrine pit for forty-nine days. Wash them clean, grind them into powder, and form pills with honey. Store them in a bottle. When poisoned, chew and swallow a pill to counteract the poison.

Remedy for bi poison

Burn early-rice straw to ash. Pour freshly drawn water through the ash to collect the lye, then strain it through silk and let it cool. Drink one bowl. If the poison is expelled through diarrhea, the condition will improve.

Another formula: Mix powdered white hyacinth beans with freshly drawn water and drink.

Another formula: Boil indigo, licorice, and black beans in water, simmering until three bowls remain, and drink. Fermented black beans may also be simmered into a strong broth and administered. Another method is to rub a tin vessel against a coarse stone, collect the resulting water, and drink it; water produced by rubbing a tin vessel is said to be especially effective. Alternatively, simmer only Chinese bayberry bark into a decoction for two…