《仙傳外科祕方》Vol. 8

This scripture conveys two main teachings: first, the importance of skilled physicians being like capable generals, and second, the pathological mechanisms underlying abscesses (suppurative infections).

The text begins with a military analogy, comparing physicians using medicine to generals commanding troops. As the saying goes, "A thousand soldiers are easily found, but a true general is hard to come by." Just as battles are won by capable commanders, healing depends on skilled doctors. An army without a good general cannot achieve victory, just as medicine cannot be effective without a competent physician. Excellent generals win through unconventional tactics, while exceptional doctors heal with extraordinary prescriptions. Therefore, the first step in treatment is finding a true healer—without one, even the finest medicines prove useless.

The text then elaborates on abscess pathogenesis: when the Five Organs malfunction, particularly in cases of chronic wasting-thirst syndrome (equivalent to modern diabetes), combined with dietary excesses or emotional turbulence, the body's Yin-Yang balance becomes disrupted. This causes Qi and blood stagnation, where accumulated heat transforms into abscesses. Mild cases manifest as superficial suppuration in muscle tissue, while severe cases penetrate to the bone marrow and damage internal organs. Abscesses are categorized as internal (developing in thoracic/abdominal viscera) or external (forming in skin and muscles).

Finally, the text emphasizes that suppuration doesn't arise spontaneously but results from accumulated internal toxins. Those truly versed in preserving life consult physicians for prevention when illness first manifests—addressing warning signs by evening if detected at dawn represents the superior approach.

(Note: The original author Zhao Yizhen, Daoist name Yuanyangzi, was a renowned Yuan Dynasty Daoist from Junyi. The term "abscess" refers to traditional Chinese medicine's classification of suppurative infections, while "wasting-thirst syndrome" corresponds to modern diabetes.)

This passage discusses the diagnosis and key treatment principles for abscesses (suppurative infections). It first notes that skin infections initially present with very mild symptoms, but will worsen if not promptly treated. The distinction between superficial abscesses (yong) and deep abscesses (ju) lies in their nature: yong are infections of the epidermis with localized swelling, while ju result from internal heat accumulation erupting outward, characterized by extensive swelling and rapid progression.

Abscesses are categorized into excess (shi) and deficiency (xu) types: excess conditions manifest as hard masses with thick pus, being easier to treat; deficiency conditions present as soft masses with thin pus, proving more difficult to cure. Many cases deteriorate due to delayed treatment from failing to recognize the infection's depth.

Particular emphasis is placed on infections occurring in critical areas like the throat, face, brain, shoulders/back, and chest/breasts—these require emergency intervention, with treatment needed immediately upon discovery (morning to evening). Any delay may prove fatal. Managing such acute conditions demands urgency comparable to firefighting or chasing thieves.

Three diagnostic methods are specified:

1) Swellings that are elevated and soft indicate blood vessel disorders

2) Swellings that are sunken and hard suggest bone/muscle issues

3) Unchanged skin coloration points to bone marrow involvement

Superficial ulcers mostly occur in thin-skinned areas, while deep ulcers develop in thick-skinned regions.

Pus detection techniques:

• Deep pain upon firm pressure indicates deep pus accumulation
• Superficial pain upon light pressure suggests shallow pus
• Non-rebounding swelling signifies edema, while rebounding swelling confirms pus presence

If the entire mass feels soft, it may be a hemangioma (blood tumor) rather than an abscess. Slowly enlarging masses without fever but with intermittent pulling pain may indicate qi stagnation tumors; if persistent, these can transform into abscesses or boils.

This scripture primarily discusses the pathological progression of cold-induced diseases and the diagnostic criteria for distinguishing favorable from malignant manifestations of abscesses (suppurative infections).

When cold pathogens accumulate in the body over time, extreme cold transforms into heat, eventually leading to suppuration and ulceration that often forms fistulas. The disease manifests with varying degrees of severity, requiring physicians to make flexible judgments based on specific conditions.

The Shenghui Fang records that suppurative conditions like abscesses, dorsal carbuncles, furuncles, and breast abscesses exhibit diagnostic patterns known as the "Five Favorable Signs and Seven Malignant Symptoms," which must be carefully differentiated:

The seven dangerous manifestations (Seven Malignant Symptoms) include: 1. Restlessness with cough, abdominal pain with thirst, severe diarrhea or dysuria; 2. Profuse discharge of pus and blood, severe swelling with fever, abnormal pus coloration with unrelenting pain; 3. Labored breathing, mental confusion, and somnolence; 4. Strabismus with reddened scleral swelling and upward-turned pupils; 5. Restricted neck and shoulder movement with heavy limbs; 6. Inability to eat, vomiting after medication, and loss of taste sensation; 7. Hoarse voice, pallid complexion, cyanotic lips and nose, with facial and limb edema.

The five positive indicators (Five Favorable Signs) comprise: 1. Pain relief with normal appetite; 2. Regular bowel and urinary function; 3. Spontaneous abscess resolution with normal pus characteristics; 4. Mental clarity and coherent speech; 5. General physical comfort.

The appearance of two favorable signs indicates improvement, while four malignant symptoms signal critical danger. However, disease manifestations can be complex—sometimes favorable signs mask malignant conditions and vice versa—requiring exceptional diagnostic acumen.

The text further specifies pain locations for visceral abscesses: lung abscess manifests as chest pain; heart abscess at the Juque point (lower sternum); liver abscess at the Qimen point (below nipple); spleen abscess at the Zhangmen point (lateral abdomen); stomach abscess at the Zhongwan point (above navel); kidney abscess at the Jingmen point (lumbar region); and intestinal abscess at the Tianshu points (flanking the navel). Dull pain or subtle swelling at these locations indicates corresponding visceral abscess formation.

This medical text explains methods for diagnosing and treating abscesses (suppurative infections). It first teaches how to determine the origin of the condition by examining the location of pain and characteristics of the swelling: a slight bulge above the navel indicates intestinal abscess (dachang yong), while dull pain in the Dantian (lower abdomen) suggests triple burner ulcer (sanjiao ju); dull pain at the Guanyuan point (three inches below the navel) signifies small intestine ulcer, and slight protrusion of the skin there indicates small intestine abscess.

Diagnosis requires comprehensive observation: noting where the patient feels pain, the characteristics of the swelling, whether they previously took mineral-based medicines like "milk stones" (an ancient mineral drug), and assessing the patient's Qi and blood deficiency or excess. Only after considering all factors should treatment begin.

The text emphasizes that upon first detecting an abscess, regardless of the swelling's size or pain severity, immediate attention is crucial—any abnormality should be treated promptly. During treatment, patients must avoid toxic foods and abstain from sexual activity for three months while preventing exposure to cold and overexertion. Normal activities may resume only after Qi and blood are restored. Otherwise, newly formed tissue may ulcerate again, worsening the condition.

Treatment follows specific steps: first, internal remedies like Zhuiding Duoming Decoction and Tuoli Powder to reduce swelling; external application of Jiedu Shengji Powder; when suppuration occurs, pierce with an iron tube to drain pus, using medicated suction tubes if drainage is incomplete. Conditions are classified by size: 1-3 inches is termed "boil" (jie), 2-5 inches "abscess" (yong), 5 inches to 1 foot "ulcer" (ju), and over 1 foot "whole-body ulcer" (jingti ju). After complete pus drainage, remove necrotic tissue and apply flesh-regenerating pain-relief medicine.

Finally, the etiology is explained: abscesses form when stagnant Qi and congealed blood block meridians. Though heat symptoms may not appear initially, later suppuration manifests as trapped Yang energy. Treatment requires tailored prescriptions—such as Sixteen-Ingredient Qi-Flowing Decoction (for Qi stagnation) or Internal Cold-Dispersing Powder (for cold syndromes)—based on specific conditions.

This passage primarily discusses the diagnosis and treatment of abscesses (known in Chinese medicine as purulent infections).

When the human body is exposed to cold that transforms into heat, excessive heat toxins can cause muscle decay and pus formation. This occurs due to internal heat pathogens obstructed by cold, leading to congealed and stagnant blood vessels where accumulated heat forms abscesses. Deep pain upon pressure indicates severe illness, while shallow pain suggests mild condition. If the pressed area remains depressed without rebounding, there's no pus; if it rebounds, pus is present. Uniform hardness upon palpation indicates no pus formation, while localized softness suggests pus. Areas that don't feel warm when pressed up and down contain no pus, whereas significant warmth indicates pus presence. When pus is detected, immediate incision for drainage is necessary; for mere qi-swelling without pus, caution must be exercised to avoid reckless needling. The Qianjin Antitoxin Ointment can be applied externally for treatment.

Diagnostic points to note: Hard surrounding tissue with soft center indicates pus; one-sided softness may also suggest pus; uniform hardness might signify malignant tumors or qi-swelling; complete softness could indicate hemangiomas. For chronic hard abscesses showing localized softening, never needle the softened area. Soft abscesses require warmth maintenance with cloth wrapping - mistaken needling makes recovery difficult.

When treating abscesses, don't worry about thick skin - timely incision for pus drainage is crucial. For bone abscesses (osteomyelitis) without skin discoloration, administer internally the Antitoxin Swelling-Reducing Tuoli Powder and Walking Horse Powder, while applying externally the Antitoxin-Drawing Powder. For pus drainage: insert needles 3-4 fen deep (about 1-1.3cm), avoiding direct top puncture - proper drainage follows the principle of creating an opening below. After complete pus discharge, new flesh will grow - first apply flesh-generating medicine, then ointment for full recovery.

Special mention is made of "fatal abscesses" (yao ju) occurring on the neck: Manifesting as large, red-black lesions, untreated cases allow heat toxins to descend to the Yuanye point (3 cun below armpit), damaging the Conception Vessel anteriorly and attacking liver/lung internally, causing death within ten days. The medical text Weiji Baoshu records: 1.3 cun behind the ear is a fatal location - abscesses here are invariably lethal. "Acute toxins" (indicating extreme virulence) are extremely difficult to treat, also called "fa yi" (mumps-like swelling). If heat toxins ascend to forehead and oral cavity, throat perforation causes immediate death.

This passage describes the symptoms and treatments for several severe types of abscesses (suppurative infections), emphasizing the critical importance of timely intervention.

A cerebral abscess (nao ju) forms when heat energy rises to the head. Initially appearing millet-sized with surrounding redness, swelling and hardness, it spreads to the ears and neck accompanied by alternating chills/fever and pain. Without prompt treatment, the toxic qi penetrates flesh and blood, causing putrefaction and pus formation. When pus and blood drain from the head, the patient eventually dies from exhaustion of qi and blood.

A fierce abscess (meng ju) in the throat proves fatal within three days if untreated. Within half a day, the blood transforms into pus that blocks the throat, preventing eating. Poor complexion, stabbing neck pain, and mental agitation indicate a hopeless prognosis.

A well abscess (jing ju) on the chest, initially bean-sized, spreads to the abdomen within three to four days without treatment, causing death within ten days. Persistent chills and fever also prove fatal.

For gangrenous abscess (tuo ju) on toes: dark red-black lesions without pus signify certain death, while pus indicates treatable cases. If treatment fails, immediate amputation becomes necessary to preserve life.

The Sheng Hui Fang warns that premature healing of wounds with residual pus, though superficially recovered, allows retained toxins to reactivate as fistulas. Such cases require special attention.

Recommended treatments include emergency administration of "Life-Saving Boil-Chasing Decoction" (formula provided later), plus "Toxin-Resolving Swelling-Reducing Internal Support Powder" specifically for various abscesses, back carbuncles, breast abscesses, bone abscesses, malignant sores, and throat swellings. The formula contains over twenty ingredients including ginseng, red poria, white atractylodes, talcum, platycodon, and honeysuckle, with modifications according to symptoms. For boils, additional herbs like lotus rhizome and chelidonium should be added.

This records several traditional Chinese surgical prescriptions and their modifications. For different symptoms, specific herbs are added to the base formula:

For treating ulcerative sores (skin ulceration), add Plantago seeds, Akebia stem, and Bamboo leaves; for severe pain, add Frankincense and Myrrh; for throat swelling, add Rhubarb, Gardenia, and Rush pith; for beriberi, add Chaenomeles fruit and Areca nut; for cough, add ginger-processed Pinellia or decoct with fresh ginger. Take five qian (15g) of powdered herbs, decoct with one bowl of water and one spring onion until sweating occurs after ingestion – three to five bowel movements indicate better efficacy, with severe cases showing results after three to five doses.

The Internal Support Thousand-Gold Powder specifically treats carbuncles (purulent inflammation), back abscesses, mastitis, and other malignant sores. The base formula contains equal parts of Ginseng, Chinese Angelica, Astragalus, White Peony, Chuanxiong, Saposhnikovia root, Cinnamon bark, Platycodon root, Dahurian Angelica, Licorice, Trichosanthes fruit, and Honeysuckle. For intense pain, increase Chinese Angelica and Peony or add Frankincense and Myrrh. Decoct seven to eight qian (21-24g) in two bowls of water until reduced by 30%, then mix with half bowl of warm wine – take two to three times daily. Efficacy is marked by dark blood discharge from sores or sweating; critical cases may require increased dosage.

The Secret Sixteen-Ingredient Qi-Streaming Decoction (also called Internal Tonifying Powder) contains: Ginseng, wine-washed Chinese Angelica, peeled Cinnamon bark, Chuanxiong, Saposhnikovia root, Dahurian Angelica, Platycodon root, Astragalus, honey-fried Licorice, and ginger-processed Magnolia bark (3 qian each), plus Costus root, White Peony, Areca peel, Lindera root, Bitter Orange peel, and fried Perilla leaf (3 qian each). If symptoms persist, add Poria, White Atractylodes, or Prepared Rehmannia; for poor appetite add Amomum fruit and Cyperus rhizome; for pain add Frankincense and Myrrh; for unhealed wounds add Fritillaria bulb and Anemarrhena rhizome; for unruptured abscesses add Gleditsia spine.

These formulas address various surgical conditions through tailored herb combinations, emphasizing flexible modifications based on symptoms. Therapeutic efficacy is judged by detoxification responses (sweating, pus/blood discharge).

This scripture records several traditional Chinese medicinal formulas for treating abscesses, carbuncles, and suppurative skin infections, along with their modified applications.

The first prescription treats various malignant sores including back carbuncles, breast abscesses, and foot infections. When the toxic swelling hasn't fully formed, it can quickly disperse the inflammation; for already formed lesions, it promotes suppuration and pus drainage. Pain relief is immediate after taking the medicine, with remarkably potent effects. The preparation involves grinding the ingredients into fine powder—take five to six qian (about 15-18g) per dose with wine. Non-drinkers may substitute Muxiang decoction or rice water. This formula uniquely combines wind-toxin dispersion with Qi-blood regulation, exhibiting pus-expelling, pain-relieving, and tissue-regenerating properties.

Modifications based on symptoms include: for cough, add aged tangerine peel, pinellia, and apricot kernel; for constipation, add rhubarb and bitter orange; for difficult urination, add ophiopogon, plantago seeds, akebia, and rush pith. When decocting, add one spring onion stalk, boil until reduced to 70% liquid volume, then mix in a sip of wine. Take after meals for upper-body ailments, on empty stomach for lower-body conditions.

The second formula, called Internal Blockage-Dispersing Powder, treats various malignant abscesses by reducing fever, stopping pus-blood discharge, draining suppuration, stabilizing pain, and promoting tissue regeneration. Primary ingredients include ginseng, angelica, astragalus, and chuanxiong rhizome. For excessive thirst, add schisandra, poria, or aged tangerine peel. Decoct with three slices of fresh ginger and take warm with wine.

The third prescription, named Immortal Formula Toxin-Resolving Tissue-Regenerating Pain-Stabilizing Powder, specifically addresses back carbuncles, breast abscesses, facial ulcers, leg ulcers, and weapon-inflicted wounds with swelling and pain.

This passage documents an ancient surgical treatment protocol consisting primarily of external applications and medicinal washes.

The main ingredient for the external poultice is calcined stone (ten pounds), which must first be repeatedly tempered in a medicinal decoction until the stone's surface turns bluish-green. The decoction is prepared by boiling herbs such as huanglian (Coptis), huangbai (Phellodendron), muze (Alisma), fangfeng (Saposhnikovia), and kushen (Sophora). The tempered stone is then ground into a fine powder and mixed with gypsum powder in a 1:2 ratio. Additional ingredients include calcined minerals like red halloysite and gudan (processed grain-based mineral), as well as powdered herbs such as nanmuxiang (Aucklandia), xuejie (Dragon’s Blood resin), jiangzhenxiang (Dalbergia), ruxiang (Frankincense), moyao (Myrrh), and baizhi (Angelica dahurica). Supplementary ingredients are adjusted based on symptoms: for parasitic infections, qingfen (calomel) and kushen are added; for non-healing wounds, piaoxiao (cuttlebone) and wumingyi (pyrolusite) are included.

The medicinal wash is prepared by decocting more than twenty herbs, including fangfeng, baizhi, and chishao (red peony root). The affected area is first exposed to the steam of the decoction, followed by washing once the temperature becomes tolerable. After drying, the wound is treated either with an oil-mixed poultice or direct powder application: non-suppurating wounds require daily dressing changes, while pus-filled wounds must be left partially open for drainage. The final step involves covering the wound with black paper and securing it with a silk bandage. For lower leg injuries, dressings are changed every three days.

A notable method for removing necrotic tissue involves soaking live centipedes in oil until they perish, then calcining and grinding them into powder to blend into the poultice. The treatment emphasizes keeping the dressing undisturbed, as this is believed to ensure efficacy.

This scripture presents methods for treating various malignant sores, foot qi (a type of foot disorder), and toxic swellings through both external applications and internal remedies.

The external poultice consists of multiple medicinal ingredients, including red peony root (Chishao), saposhnikovia root (Fangfeng), angelica dahurica (Baizhi), asarum root (Xixin), Chinese angelica tail (Dangguiwei), silkworm (Jiangcan), cicada slough (Chantui), and acanthopanax bark (Wujiapi). If symptoms persist after application, additional herbs such as arisaema rhizome (Nanxing), fleeceflower root (Heshouwu), five-leaf root (Wuyegen), fritillaria bulb (Beimu), and viola herb (Zihuadiding) can be incorporated. The preparation involves grinding these ingredients into a fine powder, then mixing them with ginger juice and vinegar to form a paste for external application. To accelerate the expulsion of toxins, crushed garlic can be added to the mixture.

For internal blockages in the organs, remedies such as rhubarb (Dahuang), bitter orange (Zhiqiao), and hemp seed (Huomazi) can be taken internally. If urinary obstruction occurs, additional herbs like akebia stem (Mutong), plantago seed (Cheqianzi), rush stem (Dengcao), and red poria (Chifuling) are recommended. For those experiencing chills, long pepper (Bibo) and galangal (Liangjiang) can be included.

This formula is particularly effective for treating cold-damp foot qi, back carbuncles, and various malignant sores and abscesses. Externally, it reduces swelling and alleviates pain, while internal consumption gently detoxifies, promotes blood circulation, and resolves stasis. When taken internally, the medicine should be mashed with fresh ginger (with skin intact) and fine liquor, then consumed while warm. For ailments in the upper body, take after meals; for lower-body conditions, take before sleep. Typically, one or two doses yield noticeable results.

Additionally, the scripture introduces a "Toxic-Drawing Iron Tube Ointment" (Tietong Badu Gao) for treating newly formed sores and abscesses. Its primary ingredients include lime, glutinous rice, and borax. The preparation involves first boiling mulberry wood ash, sesame ash, and soapberry pod ash into a decoction, then using this ash-infused liquid to blend the medicinal components.

This passage describes ancient surgical methods for treating toxic sores. The first technique involves using small bamboo tubes to extract pus: take three to five one-inch sections of bitter bamboo, keeping one end sealed with its natural node while shaving the other end paper-thin. Boil the tubes ten times with medicinal herbs like atractylodes (Cangzhu), ampelopsis root (Bailian), and sapium bark (Wujiupi), then press them hot against the infected wound to draw out pus and blood. Replace each tube when full, repeating the process three to five times until all toxins are expelled, then apply flesh-regenerating medicine.

Two specialized medicinal plasters are then introduced: The first, called Transcendent Formula Paper-Layered Plaster (also known as Divine Response Plaster), combines ingredients like coptis root (Huanglian), fleeceflower root (Heshouwu), and aconite (Caowu) ground into powder. These are simmered with clear oil over alternating high and low heat until blackened, filtered, mixed with yellow lead oxide (Huangdan), then blended with powdered dragon's blood resin (Xuejie), frankincense (Ruxiang), and myrrh (Moyao). Before use, the plaster must be soaked in cold water for a day to neutralize its fiery toxicity.

The second plaster, Supreme Unity Divine Response Plaster (also called Golden Thread Universal Plaster), specifically treats severe conditions like back carbuncles and flogging injuries, while also being effective for lumbar pain and leg qi (beriberi). Its primary ingredients include Sichuan aconite (Chuanwu), aconite (Caowu), and coptis root (Huanglian), prepared similarly to the previous method. Both approaches emphasize external application after toxin removal, with careful attention to pressing while hot and timely replacement of tools during the procedure.

This prescription lists thirty-nine medicinal herbs with their dosages (the ancient measurement unit "qian" is approximately equal to 3 grams). The main ingredients include: Phellodendron bark (Huangbai), red and white peony root (Chishao/Baishao) 1 qian each, corydalis rhizome (Xuanhuosuo) and Chinese angelica root tip (Dangguiwei) 1.5 qian each, galangal rhizome (Liangjiang) 0.5 qian, shelled coix seed (Mubiezi) 0.5 qian, silkworm larva without silk (Jiangcan) 1 qian, a ball of burned human hair (the size of an egg), as well as lagerstroemia bark (Zijingpi), earthworm (Dilong), and piper vine (Shinanteng) 0.5 qian each.

Additional ingredients include pangolin scales (Chuanshanjia), angelica root (Baizhi), Sichuan lovage rhizome (Chuanxiong), morning glory seed (Qianniuzi), pagoda tree flower (Huaihua), Chinese gall (Wubeizi), wolfberry root bark (Digupi), apricot kernel (Xingren), and prickly ash peel (Huajiao) 0.5 qian each, along with musk (Shexiang), lemongrass (Maoxiang), figwort root (Xuanshen), cocklebur herb (Cang'ercao), cinnamon bark (Rougui), arisaema rhizome (Tiannanxing), trichosanthes fruit (Gualou), sophora root (Kushen), and atractylodes rhizome (Cangzhu). Other additions are acanthopanax bark (Wujiapi), ledebouriella root (Fangfeng), and prepared rehmannia root (Shudihuang) 1 qian each, litharge (Mituoseng), clove (Dingxiang), Neixiao (an internal dissolving agent), and ligusticum root (Gaoben) 1 qian each, fresh rehmannia root (Shengdihuang) 2.5 qian, fleeceflower root (Heshouwu) and asarum root (Xixin) 1.5 qian each, 25 shelled croton seeds (Jiangzi), ginseng (Renshen) 2.5 qian, 25 shelled castor seeds (Bimazi), eclipta herb (Hanliancao) 0.5 qian, astragalus root (Huangqi) 1 qian, gallnut extract (Baiyaojian) 2.5 qian, notopterygium root (Qianghuo) 1 qian, southern costus root (Nanmuxiang) 0.5 qian, licorice node (Gancaojie) 1 qian, centipede root (Dixiongwugen) 1 qian, and large rouge (Dayanzhi) 1 qian.

Preparation method: First, finely chop these herbs and soak them in 1 jin 4 liang (approximately 750 grams) of clear oil for one or two days. Then place them in a pot and simmer over medium heat until the herbs turn black, filtering out the residue with cloth. Afterward, reduce to low heat and gradually add the remaining powdered herbs in sequence. This is a typical processing method in ancient Daoist medical prescriptions for treating external injuries, extracting the active medicinal components through oil infusion and decoction.

This passage documents ancient external medical treatments for "back boils" (abscesses and toxic sores on the back), divided into two parts: medicinal plaster preparation and moxibustion therapy.

To prepare the Golden Sore Plaster, various medicinal ingredients are required: 2.5 qian each of southern costus root (Nanmuxiang), benzoin (Anxixiang), and amber (Hupo); 1 qian of frankincense (Yunxiang); half a tael each of frankincense (Ruxiang) and myrrh (Moyao); half a tael of dragon’s blood resin (Xuejie); half a tael of fragrant knots (Xiangjie, or Jiangzhen knots as an alternative); 1 qian of Shao powder (Shaofen); 1.5 qian of natural copper (Zirantong, tempered with vinegar); 5 qian each of mulberry root bark (Sangbaipi), bletilla rhizome (Baiji), ampelopsis root (Bailian), and realgar (Xionghuang, roasted and powdered); and 6 taels of yellow lead oxide (Huangdan, with an extra 2 taels added in summer). All ingredients must be ground into fine powder.

During preparation, first heat the medicinal oil, then gradually add the yellow lead oxide and other ingredients while stirring continuously. When the mixture turns black and forms pearls that do not disperse when dripped into water, pour it into an earthenware bowl. Soak it in water for two or three days to remove fire toxins, then let it rest on the ground for another three to five days for enhanced efficacy.

Another method for making Golden Silk Plaster involves grinding all the above ingredients into fine powder, melting and filtering 1 jin of transparent pine resin (Songxiang), adding 4 taels of refined oil (Qingyou) and heating until cooked, then mixing in 1 tael of yellow lead oxide and boiling until the mixture forms pearls in water. After cooling, the plaster is ready. Before use, soak the plaster in water, changing the water daily (every three days in winter).

For dark, painless sores (yin syndrome): Take 1 jin of mugwort leaves (Aiye), half a tael of realgar (Xionghuang), and half a tael of sulfur (Liuhuang), boil the mugwort for half a day, and apply it warm to the affected area. Repeat the process with fresh mugwort over ten times. If pain occurs after application, it indicates a treatable condition; if there is no pain and black blood oozes, the prognosis is poor.

For early-stage back sores that are difficult to close: Burn white salted plums (Baiyanmei) and soapberry pods (Zaojiao) to ash while preserving their medicinal properties, then grind them into powder. For non-feverish sores, mix with rice vinegar and apply around the wound to stabilize it (adding ginger juice enhances the effect). For feverish sores, mix with tea water—this provides immediate relief. Frequent replacement of the plaster is necessary to prevent the sore from spreading.

Here are several secret surgical formulas for treating toxic sores, particularly effective for back abscesses (发背) whether ulcerated or not. The first prescription uses two qian of ginger-processed Magnolia officinalis bark, white-peel-removed tangerine peel, two qian of roasted licorice nodes, combined with five qian of rice-washed Atractylodes rhizome, all ground into fine powder with five qian of Sanghuang mushroom (Phellinus igniarius). For ulcerated sores, apply the powder directly; for unbroken abscesses, mix with clear oil before topical application.

The second formula, Internal Fortification Heart-Clearing Powder, specifically treats malignant sores with fever, intense redness and swelling, severe pain, thirst, and irritability, demonstrating remarkable detoxification effects. It contains equal parts of cinnabar (辰砂), poria (茯苓), ginseng (人参), cardamom (白豆蔻), realgar (雄黄), mung beans (绿豆), crude mirabilite (朴硝), licorice (甘草), borneol (冰片), musk (麝香), and皂角 (Gleditsia sinensis), all pulverized into fine powder. Take one qian per dose with honey water.

The third formula, Pus-Penetrating Powder, specifically addresses various carbuncles, particularly deep periosteal abscesses (boneside suppuration). Remarkably, this formula can induce spontaneous rupture without surgery. The method involves burning silkworm cocoons that have already released moths into ash, taken with wine. Crucial note: Use only one cocoon's worth of ash per dose—using two or three may cause excessive ulceration openings, so extreme caution is required. This formula's efficacy has been repeatedly verified.