《急救仙方》Vol. 8

The eighth volume of Ji Jiu Xian Fang (Emergency Immortal Prescriptions) records methods for treating furuncles. In their initial stage, these lesions often go unnoticed. They may appear anywhere on the body—head, face, hands, feet, abdomen, waist, or legs. Within one or two days, the patient will invariably develop malaria-like symptoms of alternating chills and fever, accompanied by severe headaches and generalized body pain. This distinctive pain differentiates it from ordinary ailments. Careful examination of the entire body is required; any small lesion with unusual characteristics indicates a furuncle.

Furuncles manifest in various forms according to their causes: "Pig Furuncles" appear as small circular lesions with greasy interiors; "Sheep Furuncles" are elongated and white; "Ox Furuncles" are round but without greasy discharge; "Dog Furuncles" present as elongated or pointed red lesions; while "Donkey-Horse Furuncles" are triangular with black dots at the apex and red bases. Notably, these lesions aren't exclusively caused by animal toxins—stagnant unclean water may produce "Water Furuncles," tofu contaminated with human sweat induces "Tofu Furuncles," along with "Qi Furuncles" and "Ghost Furuncles." Though their shapes differ, the treatment remains consistent.

Color progression indicates severity: On the first day, the lesion's apex turns white; by the second day, the whiteness expands; the third day brings slight purple discoloration; deepening to dark purple on the fourth day—indicating relatively slow progression. If the lesion appears bluish and tense on the fifth day, turns dark blue with increased tension by the sixth, and blackens resembling fish-belly or scalding by the seventh day, this signals critical danger.

Prognostic signs: If satellite lesions ("responsive lesions") surround the primary furuncle, they may be lanced. A "starry sky" pattern—where multiple small lesions emerge amid surrounding redness and swelling—coupled with normal appetite, headache, fever, yet warm extremities, signifies favorable outcome. Conversely, absence of satellite lesions, lack of surrounding redness, unquenchable thirst, loss of appetite, vertigo, prostration, fixed gaze, cyanotic lips/tongue, severe abdominal pain—particularly when accompanied by cold extremities, labored breathing, and faint pulse indicating internal furuncles—portends grave danger.

The text concludes with the prescription "Peach Blossom Powder" (Tao Hong San), noting its efficacy even for moribund patients exhibiting all critical symptoms and undetectable pulses.

This passage documents an ancient surgical prescription and procedure for treating boils (acute suppurative infections), primarily using a combination of animal toxins and mineral medicines. The specific steps are as follows:

First, prepare several toxic medicinal ingredients: toad venom (secretions from toad poison glands), arsenic, cicada slough (with legs and wings removed), blister beetles (three specimens with legs and wings removed), centipede head (one piece), and minium (lead tetroxide, five qian). Place one liang of weathered lime in an earthenware pot and calcine it over charcoal fire for two hours before removal. Grind all ingredients into extremely fine powder.

For treatment, first puncture the boil about half an inch deep using a heye needle (ancient fine needle). Boils typically present with red streaks—puncture obliquely along these streaks: downward slant for boils above the chest, upward slant for those below, as the toxin tends to spread toward the heart. After puncturing, thoroughly squeeze out pus and blood, then insert a wheat-grain-sized portion of toad venom deep into the wound using the needle.

Next, mix the medicinal powder with mucus from the inner skin of scallion stalks and apply it to the wound (avoiding healthy skin), covering with twenty to thirty layers of cold-water-soaked paper as a seal. If heat is felt from morning to evening application, remove the dressing, cleanse the wound, and switch to Yuhong Powder (another topical medicine). In subsequent days, the wound will swell painfully—persist with Yuhong Powder applications, washing daily with scallion broth.

Special note: Though boils are dangerous, this method of puncturing, inserting toad venom, and sealing with Taohong Powder can preserve life. Severe pain indicates the toad venom is corroding the infected tissue—a normal reaction. Apply crushed hibiscus or mulberry leaves around the wound to disperse stagnation, changing dressings daily after cleansing.

For early-stage boils with chills and fever (indicating surface toxins), induce sweating with "self-boiling decoction" (containing five qian of alum and three qian of indigo naturalis) to expel toxins. However, this is contraindicated for the elderly, physically weak individuals, and pregnant women—they should only use Taohong Powder to draw out toxins.

This passage describes several methods for treating ding sores (acute suppurative infections). The first approach involves grinding medicinal ingredients like dry lime into fine powder, mixing it with well water for oral administration, followed by sweating under thick blankets. If the ding sore isn't recognized early and the sweating treatment window is missed—allowing toxins to penetrate deeper—then Realgar Pills (Xionghuang Wan) should be used to purge and eliminate toxins through bowel movements.

The Realgar Pill formula contains realgar, curcuma root, and croton seeds, with additional herbs tailored to symptoms: for scrofula, add arsenic trioxide (pre-boiled in vegetable oil); for throat swelling, add refined mirabilite. These ingredients are ground into powder, mixed with flour paste, and formed into mung bean-sized pills. Take seven pills per dose with cold tea until bowel movement occurs.

The subsequent Jade Red Powder (Yuhong San), made from calcite and mercurous chloride, is applied externally to the sore, with dressing changes twice daily after cleansing. The text cautions that potent medicines like Toad Venom Ointment or Peach Red Powder may cause pain and require Jade Red Powder as an antidote.

As an alternative when these medicines are unavailable, Li Shi'an's Angelica Powder (Danggui San) is recommended. Composed of over ten herbs including angelica root, ligusticum, kudzu root, and schizonepeta spike, this formula promotes blood circulation and dispels wind with notable efficacy.

(Note: Arsenic trioxide, blister beetles mentioned herein are toxic substances, and mercurous chloride is rarely used in modern clinics. These historical formulas are provided for reference only—actual medical use requires professional guidance.)

For painful sores, add five qian each of frankincense, myrrh, and angelica dahurica. If the sore remains feverish, include small amounts of lophatherum and gardenia seeds. For constipation, add one liang of bitter orange, and for restlessness, ten pieces of rush pith and one piece of bamboo shavings. Thirst requires one liang of trichosanthes root, while swelling needs half a liang each of licorice nodes and dalbergia odorifera nodes. Dizziness calls for chuanxiong rhizome, angelica dahurica, schizonepeta, and saposhnikovia root. If both thirst and dysuria are present, add one liang of talcum.

Preparation: Finely chop the ingredients. Take five qian per dose with a dozen rush pith strands and ten black soybeans, decocted in one and a half bowls of water until reduced to 80%. For upper-body ailments, take after meals; for lower-body conditions, take before meals. Continuous use yields rapid results.

For untreated furuncles where initial diaphoresis was neglected, if superficial symptoms disappear after days but swelling appears in the abdomen, flanks, or axillae—indicating inward toxin penetration—apply the "Thunderbolt Fire" method. If angelica powder fails to resolve external symptoms, immediately use Thunderbolt Fire for dispersion.

Thunderbolt Fire protocol: Heat cobblestones until red-hot in charcoal. Prepare a large wooden barrel containing a bamboo chair with a spoon beneath. The patient sits naked on the chair. Mix one bowl of sour rice vinegar with schizonepeta powder. Place glowing stones in the spoon and douse with the vinegar mixture. Control heat intensity to prevent burns. If sweating remains insufficient after heat diminishes, replenish charcoal and vinegar. Cover the barrel opening with quilts, leaving only the patient's nose and mouth exposed. Full-body sweating including the face ensures recovery. This method proves remarkably effective, though contraindicated for the frail elderly and pregnant women—for them, lance the sore, apply seahorse toxin-drawing powder, and take xanthium sibiricum decoction in wine instead.

For internal toxin penetration requiring Thunderbolt Fire, omit the barrel. Use a small bucket with the red-hot stone and vinegar steam method described above.

When an abscess appears on the body, position the affected area above the medicinal steaming bucket while lying on one side, surrounding the area with blankets to contain the heat. Maintain this posture until the swollen area begins to sweat. If sweating is insufficient, increase the heat to continue the fumigation—the key is to induce perspiration specifically at the abscess site, without requiring full-body sweating.

If a toxic sore develops between the ribs, this signals a dangerous condition where the toxic Qi (vital energy) may attack the heart. Immediately apply moxibustion (Ai jiu therapy) with mugwort wool at the highest point of the affected area for three to five cones. Additionally, perform minor bloodletting with acupuncture needles before and after the moxibustion site. The appearance of blisters around the moxibustion area is auspicious, while their absence is inauspicious. For sores in fleshy or loose areas unsuitable for acupuncture or moxibustion, use the pine needle interception method: sever the red streaks (paths of toxin diffusion in the body) with pine needles.

If the sore appears near the hips, intercept the red streaks at their endpoints on both sides with pine needles to prevent the toxic Qi from attacking the kidneys. For facial sores, intercept the red streaks at their termination point on the neck. Even if the red streaks are faint, an experienced practitioner should still judge their path and sever them with pine needles.

The pine needle method is primarily used when red streaks are indistinct. Select soft areas such as the jaw, armpits, or hips for needling to block the toxic Qi from attacking the heart or kidneys. For this procedure, use stiff pine needles from trees grown facing north, trimmed neatly and tightly bundled. Insert the needles slowly along the toxin’s path in soft tissue until blood appears. Moisten the skin with alcohol beforehand—though painful, the patient must endure it. Administer a medicinal wine containing realgar and musk before needling.

If surface symptoms disappear but the toxin penetrates deeper, take realgar pills. If limbs turn cold and the pulse vanishes entirely, this indicates deep toxin penetration obstructing Qi and blood. Continuously administer Muxiang Liuqi Decoction to restore circulation, then proceed with targeted treatment once the pulse returns.

Haima Badu Powder is highly effective for boils and also treats severe sores and back carbuncles. Note that during treatment: if the toxin ascends, vomiting occurs; if it descends, diarrhea follows—both signs that the medicine is working. Avoid cold water, meat, and greasy foods during treatment, and maintain dietary restrictions for a hundred days after healing. This remedy is contraindicated for pregnant women, and sexual activity is strictly prohibited during treatment.

This scripture records ancient medicinal formulas and treatments for furuncles (acute suppurative infections). The primary formula consists of seahorse (one piece, roasted), pangolin scales (fried with yellow earth), mercury, cinnabar (two qian each), realgar (three qian), calomel (one qian), with small amounts of borneol and musk. The preparation method involves grinding all ingredients except mercury into powder, mixing them thoroughly, then incorporating the mercury until fully blended. For application, the furuncle is pierced with a needle, and the medicinal powder is applied directly to the affected area once daily, reportedly with excellent efficacy.

The text explains that internal furuncles (occurring in visceral regions) and external furuncles share similar symptoms—both manifest chills, fever, headaches, and generalized pain—though internal furuncles initially show no visible lesion. After several days, sudden swelling appears on the chest, back, abdomen, face, or extremities, marking the eruption site of the internal furuncle. Immediate treatment with the "Thunderbolt Fire" method (a sweat-inducing detoxification therapy) should be applied to the swollen area. If chills and fever occur without visible swelling, but with severe abdominal pain, it should still be treated as an internal furuncle without delay.

Another remedy involves toad venom (dried secretion of toads). For mild cases, one pellet is used; for severe cases, two pellets are placed under the patient’s tongue to dissolve slowly. After complete dissolution, the mouth is rinsed with well water, followed by ingestion of seven realgar pills with cool tea. This induces several bouts of diarrhea, leading to rapid recovery.

Lastly, the text mentions that when collecting toad venom, mulberry leaves (about the size of a copper coin) can be added. The mixture is kneaded together and rolled into bead-sized pills, then dried in shade for storage. These methods are compiled in the eighth volume of the Emergency Immortal Formulas (Jijiuxian Fang).