Tou Nong San透脓散
Powder to Bring Out Pus
Ingredients5 herbs
Indications
Abscess with pus formed but no strength to expel it: the swelling is flat rather than raised, its base spreads without a clear margin, the colour is dull, and the patient is tired and pale. Right qi is insufficient to push the toxin out, so the formula supports rather than attacks.
Clinical Manifestations
- A mature abscess that stays flat and will not break open
- Chronic boils and deep abscesses in a depleted patient
- Sores with diffuse margins and thin discharge
- Slow-maturing abscess alongside surgical drainage
Health Categories
Modern Applications
Common adjustments
- Marked qi deficiency — increase Huang Qi 黄芪 and add Ren Shen 人参
- Heat toxin still evident with redness and fever — add Jin Yin Hua 金银花 and Lian Qiao 连翘 — supporting alone would retain the toxin
- in the classical composition — not used — substitute a larger dose of Zao Jiao Ci 皂角刺 or Wang Bu Liu Xing Zi 王不留行子, for both legal and conservation reasons
- Sore has already broken and is discharging — the task changes to closing it — move to a supporting, flesh-generating formula such as Nei Bu Huang Qi Tang 内补黄芪汤
Contraindications
first: the pangolin is critically endangered and listed under CITES Appendix I, its scales were removed from the Chinese Pharmacopoeia in 2020, and possessing or trading them is a criminal offence in many countries. The classical composition is recorded here for completeness; it is not to be filled as written. Beyond that, the formula's risk is one of timing rather than toxicity. Using it before pus has formed, while the sore is red, hot and rising, encourages suppuration where dispersing was still possible; using it while heat toxin is strong without adding heat-clearing herbs supports the body and the toxin together. Zao Jiao Ci is traditionally contraindicated in pregnancy and is avoided once a sore has ruptured. Chuan Xiong and Dang Gui move blood, so caution applies alongside anticoagulants and around surgery. Huang Qi is warming and unsuitable where heat signs dominate. Clinically, a mature abscess needs drainage: incision and drainage is the definitive treatment, and no herbal formula replaces it. Spreading redness, fever, rigors, red streaking, a rapidly enlarging swelling, or an abscess on the face, hand or perineum needs prompt medical care, and diabetes or immunosuppression lowers the threshold further.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Not used in pregnancy. Zao Jiao Ci is traditionally forbidden in pregnancy, and Chuan Xiong with Dang Gui move the blood. An abscess in pregnancy should be assessed and drained medically.
References
Source Wai Ke Zheng Zong 《外科正宗》 · Ming
- Classical source named in the source fields (pre-1900, public domain).
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— chapter placement, 功用 and pattern analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.