《仙傳外科祕方》Vol. 2

This scripture records an external medicinal formula called "Chonghe Immortal Ointment" (also known as Yellow Cloud Ointment or Immortal Ointment), specifically designed to treat abscesses, ulcers, and toxic swellings of ambiguous hot-cold nature. The formula comprises five medicinal ingredients: Sichuan redbud bark (five liang, stir-fried), red peony root (two liang, stir-fried), angelica pubescens (three liang, stir-fried), dahurian angelica root (one liang, must avoid fire processing), and calamus (also called stone acorus). These ingredients should be ground into fine powder, and can be mixed with either tea or wine during application depending on symptoms.

The author explains the formula's principle: all abscesses, ulcers, and toxic swellings result from congealed Qi and blood. Warmth promotes vitality while cold induces death. This formula maintains balanced warmth, with each ingredient serving specific functions: redbud bark contains Wood-phase essence (Mu) that unblocks Qi-blood circulation and reduces swelling; angelica pubescens contains Earth-phase essence (Tu) that dispels wind, activates blood, knits bones, and counteracts toxins; red peony root contains Fire-phase essence (Huo) that generates blood and alleviates pain; calamus contains Water-phase essence (Shui) that activates blood and reduces swelling; dahurian angelica root contains Metal-phase essence (Jin) that dispels wind and promotes tissue regeneration. The five ingredients work synergistically through blood activation, pain relief, wind dispelling, and nodule dissipation.

Application notes: For severe heat-toxicity, increase redbud bark and calamus quantities; for pronounced cold patterns, slightly increase red peony root and angelica pubescens. During extreme heat-toxicity manifestations, never use wine as the mixing medium—instead use scallion broth, as scallions disperse Qi and hot compresses enhance medicinal efficacy. Only after heat symptoms subside may wine be used for mixing.

This passage explains the application methods and precautions for external medicinal preparations in treating ulcers and abscesses:

Regarding medicinal wine's functions: Wine promotes blood generation, with warmer preparations being more effective. It also enhances blood circulation, particularly when taken warm.

When treating blood blisters on ulcerated surfaces, avoid using Muxi (a certain medicinal resin) as its adhesive quality interferes with dressing changes. First apply a four-herb base poultice, then use Muxi only around the periphery to restrict blood flow. Apply the poultice while hot—when it dries, moisten it with the original decoction to allow the medicinal properties to activate through warm vaporization.

If the ulcer appears darkened and bloodless, this indicates prior overuse of cold-natured medicines. In such cases, don't apply Yulong Ointment directly. First add Rougui (cinnamon) and Danggui (angelica) to activate blood circulation, then resume the original formula after blood coloration returns.

For unbearable pain, dissolve Ruxiang (frankincense) and Moyao (myrrh) in wine, heat the mixture, and apply externally as an analgesic. For tendon contractions and inflexibility, add extra Ruxiang to relax the sinews.

Protruding red granulation tissue indicates three possible causes: water exposure, wind invasion, or knife wound inversion. Add small amounts of Nanxing (Arisaema rhizome) to dispel wind, applying with ginger-juice wine. If protrusions persist—possibly due to prior improper treatment—avoid heating medicines. Instead use Baifan (alum) and Poxiao (mirabilite) compresses externally, supplemented with Liuhuang (sulfur) dusting, while taking Rongwei Jiaduiyin internally.

For severe heat syndromes, never apply cold medicines alone as this causes Qi-blood stagnation. Combine warming and cooling agents, applying Hongbao Dan with scallion broth.

The text emphasizes this formula as the primary treatment for dorsal carbuncles and deep abscesses (liuzhu), urging medical practitioners to master these essential application techniques.

This passage discusses a unique medical technique for treating "flowing stagnation" (流注), a stubborn condition caused by lingering toxins from cold damage disorders. The key lies in distinguishing between hot-natured and cold-natured flowing stagnation treatments.

A skilled physician adapts treatment according to the dynamic manifestations of internal and external symptoms, maintaining complete control over the disease progression. For severe back carbuncles (malignant boils) where life hangs in the balance, our formulas prove most reliable—consistently effective without risk of exacerbation. While minor cases might be handled by ordinary physicians, complications often arise, especially when yin syndromes (cold-natured disorders) manifest, leaving conventional practitioners helpless. Our prescriptions uniquely regulate both yin and yang, demonstrating miraculous efficacy that seems to harness the creative forces of heaven and earth.

Though not immediately fatal, flowing stagnation causes disability in eight or nine out of ten cases, with prolonged disability eventually proving lethal. Even when cured through conventional means, recovery takes at least six months to a year, with only one in a hundred patients regaining full health—most remain constitutionally weakened. Only our immortal-class formulas produce rapid, fail-safe results with truly resurrection-level efficacy.

Flowing stagnation essentially represents residual toxins from unresolved cold damage disorders. If surface pathogens aren't fully dispersed, these toxins linger in the meridians, obstructing qi and blood flow to form hot-natured flowing stagnation—still treatable at this stage. However, excessive diaphoresis that weakens qi and blood allows toxins to penetrate deeper between muscles, forming cold-natured flowing stagnation—the most challenging to treat. Unresolved cold damage not only generates heat syndromes but more frequently causes cold syndromes due to kidney deficiency, leading to bone gangrene (骨疽). Cold congeals qi and blood, causing swelling without suppuration. Misapplying cold-natured herbs compounds cold with cold, allowing toxins to erode bones into osteomyelitis (骨痈), resulting in permanent disability. Thus bone gangrene develops from mismanaged flowing stagnation—the fault lying not with the disease itself but with the physician's erroneous use of cold-natured medications.

The term "flowing stagnation" (流注) reveals its mechanism: "flowing" (流) refers to qi movement, while "stagnation" (注) indicates blood stasis. Qi belongs to yang, blood to yin—where yang qi circulates, yin blood follows. Our method's success in dispersing flowing stagnation relies precisely on this principle: when qi mobilization is properly activated, blood naturally follows its movement—how could stagnation possibly remain?

This passage discusses surgical methods for treating abscesses (suppurative inflammation) and knife wounds, primarily introducing the "toxin relocation technique" and the application skills of several medicinal formulas.

Regarding the herb duhuo (Angelica pubescens), because it promotes the movement of Qi (vital energy) and blood, it is used to guide the relocation of toxins. When Qi and blood circulation are activated, Yin-Yang balance is restored, allowing the toxins to dissipate naturally without suppuration. This method is particularly suitable for treating abscesses in critical areas like the back, shoulders, waist, and legs. The specific procedure involves grinding duhuo into powder, mixing it with warm wine, and applying it to the affected area. Then, the "Jade Dragon" formula is applied at the endpoint of toxin migration to redirect Qi and blood flow toward less vital areas, where the toxins either form pus or dissipate completely.

If suppuration has already occurred and relocation isn't feasible, medicinal formulas should be used immediately to extract toxic Qi and prevent progression to bone infection (osteomyelitis). The text criticizes incompetent physicians who indiscriminately use cooling medicines or invasive procedures like knives and needles, which may lead to bone suppuration (pyogenic osteomyelitis). In such cases, recovery can only occur after all necrotic bone fragments are expelled. For those hesitant to use needles or knives, the "Jade Dragon" therapy is recommended.

Several practical formulas are recorded:

1. "First Victory Ointment": Made with baizhi (Angelica dahurica) and zijingpi (Cercis chinensis bark) mixed with wine, effective for eliminating newly formed abscesses.

2. "Third Victory Ointment": Prepared with chishao (red peony root), mula (resin), and zijingpi, used as a perimeter application (applied around the affected area).

3. Method for reattaching severed tongues: Wrap the severed tongue with the soft inner membrane of an egg white, apply poxuedan (blood-breaking elixir) mixed with honey to the tongue base to stop bleeding, then cover the egg membrane with a beeswax-based ointment. The tongue reattaches within three days and fully heals in seven.

A crucial warning: When treating abscesses, avoid applying "Crimson Treasure Elixir" to the apex before suppuration occurs, as cooling medicines may cause blood coagulation and subsequent tissue necrosis. The correct approach is to first apply the primary formula. If promoting suppuration is desired, use "Jade Dragon" to dry the apex while applying the primary formula beneath it, then surround the area with "Crimson Treasure Elixir" to prevent spreading.

Finally, the text emphasizes the importance of flexible treatment strategies. If these methods show slow results, they can be combined with trauma medicines for enhanced efficacy.

This passage describes treatment methods for several external ailments, primarily using topical herbal applications. When the condition isn't too severe, the cooling Jade Dragon Ointment (Yulong Gao) can be used alone without requiring additional formulas. For newly formed back sores that haven't fully erupted, simply grinding purple bark (Zijingpi) into powder and mixing it with wine to apply around the affected area will naturally contain the sore and prevent spreading.

For rabid dog bites, use gromwell root (Zicao) mixed with sugar as a poultice, but leave the wound itself uncovered. Simultaneously, chewing and holding bitter almonds in the mouth counteracts toxins. Adding arisaema rhizome (Nanxing) and aconite (Caowu) to the formula, then mixing with heated wine for application, enhances effectiveness—particularly for stubborn, long-unhealed injuries.

For early-stage rickets in children, add dried ginger to this formula and apply with wine. At the very onset, simply using the wine-mixed formula until suppuration occurs suffices. If purple bark and wax are mixed with wine during initial symptoms, swelling will certainly reduce—but crucially avoid using Crimson Treasure Elixir (Hongbao Dan) at this stage.

Heart Fire Carbuncle (Xinhuo Ju), caused by excessive heart fire, manifests as blood-red blisters. Though externally small, it carries intense internal heat toxins. When appearing near the heart, it's nearly untreatable; on palms or soles it's manageable if caught early. Delay allows toxins to attack the heart, becoming fatal beyond even divine intervention. For palm sores, apply Crimson Treasure Elixir around the periphery to block toxic blood flow, then use Harmonizing Paste (Chonghe Gao) on the sore itself to complete treatment. For sole sores, apply Crimson Treasure Elixir around the ankle joint within a one-to-two-inch radius, concluding similarly with Harmonizing Paste.