Zhang Jingyue's Lianqiao Guiwei Jian for Abscesses and Carbuncles

In the Ming-dynasty physician Zhang Jingyue's Complete Writings with Jingyue (Jingyue Quanshu) there is a formula called "Lianqiao Guiwei Jian". Its composition is: Lianqiao (Forsythiae Fructus) 7-8 qian (21-24 g), Dangguiwei (Angelicae Sinensis Radix tail) 3 qian (9 g), Gancao (Glycyrrhizae Radix) 1 qian (3 g), Jinyinhua (Lonicerae Flos) and Hongteng (Sargentodoxae Caulis) each 4-5 qian (12-15 g). Decoct in 500 ml of good wine (usually Shaoxing yellow wine) down to 250 ml. Take warm, twice daily, and lie warm for a while after dosing.

This formula clears heat and resolves toxin, activates blood and lowers fire. It is indicated for all unnamed abscess-toxins, erysipelas, and deep abscesses (liu zhu) with fire.

In this formula, Lianqiao and Jinyinhua clear heat and resolve toxin, dissipate abscesses and boils; both are key herbs for sores. Dangguiwei and Hongteng activate blood and reduce swelling; Gancao (in this formula use raw Gancao, not honey-fried Gancao) is expert at resolving toxin and also harmonizes the other herbs. The composition is refined, the herbs are focused, and the effect is marked. Used to treat abscesses or swellings of the fire-toxin type, it produces immediate results.

Typically such abscesses present with redness, swelling, heat, and pain, and swell rapidly, sometimes growing noticeably overnight. I used to think this was mostly due to infectious disease, but in recent years I have also observed the phenomenon in cancer patients. In some tumor patients the mass may grow rapidly over one or two days to about a week, with heat and pain at the site. Treating such patients requires large doses of heat-clearing, toxin-resolving herbs to clear their "fire-toxin." Zhang Jingyue's compositional logic is worth drawing on.