Inner Support and Qi Boosting Decoction

A qi-and-blood supplement built on the Eight Substances frame — ginseng, atractylodes, poria and licorice for the qi, angelica, peony and prepared rehmannia for the blood — with the 地黃 half left thin and atractylodes doubled, so the weight falls on the spleen. Fritillaria and platycodon are the two additions that make it a 癰疽 formula rather than a general tonic: both open and lift, and platycodon in particular is the chapter's standard drug for carrying something upward to a surface. 肉色不變 is the diagnostic point. A swelling under skin of normal colour is one that has not come to the surface, and the chapter reads that as the body lacking the force to push it up rather than as a mild case. 托裏, supporting from within, is the answer to that reading, and it is the exact opposite of the draining approach taken in 內疏黃連湯 and 五利大黃湯 earlier in the chapter; the two halves of 癰疽 treatment are meant to be read against each other, and which one applies turns on whether the patient has reserves left. The modern counterpart is real enough. A wound that will not granulate, an abscess that keeps reopening, an infection that stays smouldering instead of declaring itself — these track with poor nutrition, diabetes, steroids and immunosuppression, and nutritional and glycaemic support genuinely changes wound outcomes. What they also need is source control. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.