张左 正脑疽两候,疮口虽大,而深陷不起,疮根散漫不收,色红疼痛,舌质光红,脉象濡缓。气虚血亏,
不能托毒外出,痰湿蕴结,营卫不从,症势重险!再拟益气托毒,和营化湿,冀其疮顶高起,根脚收缩,始有出
险之幸。
生黄 (八钱) 全当归(三钱) 抱茯神(三钱) 生首乌(四钱) 生潞党参(三钱) 京赤芍(二钱)
炙远志肉(一钱) 白茄蒂(一钱) 生草节(八分) 紫丹参(三钱) 鹿角霜(三钱) 陈广皮(一钱)
大贝母(三钱)
外用黑虎丹、九黄丹、补天丹,阳和膏。
钱左 脑疽三日,红肿寒热,外邪客于风府,蕴热上乘,邪热相搏,血瘀停凝。法当疏散。
荆芥穗(一钱五分) 青防风(一钱) 全当归(二钱) 京赤芍(二钱) 大贝母(三钱) 炙僵蚕(三钱)
羌活(一钱) 大川芎(八分) 香白芷(八分)
外用金箍散、冲和膏,陈醋、白蜜调,炖温敷。
二诊 投剂后,得大汗,热退肿减,再用和解。
全当归(二钱) 京赤芍(二钱) 大川芎(八分) 生草节(八分) 苦桔梗(一钱) 大贝母(三钱)
炙僵蚕(三钱) 晚蚕砂(包,三钱) 丝瓜络(二钱) 香白芷(六分) 万灵丹(入煎,一粒)
仍用金箍散、冲和膏。
柯左 脑旁属太阳,为寒水之府,其体冷,其质沉,其脉上贯巅顶,两旁顺流而下。花甲之年,气血已亏,
加之体丰多湿,湿郁生痰,风寒侵于外,七情动于中,与痰湿互阻于太阳之络,营卫不从,疽遂成矣。所喜红肿
高活,尚属佳象,起居调摄,尤当自慎。
生黄 (三钱) 青防风(一钱) 生草节(八分) 苦桔梗(一钱) 陈广皮(一钱) 仙半夏(二钱) 大川
芎(八分) 大贝母(三钱) 炙僵蚕(三钱) 羌活(一钱) 小金丹(陈酒化服,一粒)
外用金箍散,金黄散、冲和膏,陈醋、白蜜调,炖
温敷。
二诊 脑疽偏者较正者难治,前方连服三剂,根盘略收。疮顶高突,有溃脓之势。今症位虽偏,情势尚
佳,所喜疮顶起发,胃纳健旺,人以胃气为本,有胃则生,书有明文。再拟消托兼施法。
生黄 (三钱) 全当归(二钱) 京赤芍(二钱) 陈广皮(一钱) 仙半夏(三钱) 生草节(八分)
大贝母(三钱) 苦桔梗(一钱) 炙甲片(一钱五分) 皂角针(一钱五分) 笋尖(三钱) 炙僵蚕(三钱)
香白芷(八分)
外用金箍散、金黄散、冲和膏。
三诊 叠进提托之剂,得脓甚畅,四围根盘渐收,调养得宜,生机有庆。
生黄 (三钱) 全当归(二钱) 京赤芍(二钱) 紫丹参(二钱) 陈广皮(一钱) 仙半夏(三钱)
云茯苓(三钱) 制首乌(三钱) 生草节(八分) 红枣(二枚)
外用九黄丹、海浮散、阳和膏。
张姓患者,左侧。脑疽(生于后脑正中的痈疽)病程已两候(约十四天),疮口虽然较大,但深陷不起,疮根散漫不收束,颜色红且疼痛,舌质光红,脉象濡缓。此为气虚血亏,不能托毒外出,痰湿蕴结,营卫不和,病情危重险恶!再拟定益气托毒,和营化湿之法,希望疮顶高起,根脚收缩,始有转危为安的希望。
生黄芪(八钱) 全当归(三钱) 抱茯神(三钱) 制何首乌(四钱) 潞党参(三钱) 赤芍药(二钱)
炙远志肉(一钱) 白茄蒂(一钱) 生甘草节(八分) 紫丹参(三钱) 鹿角霜(三钱) 陈皮(一钱)
大贝母(三钱)
外用黑虎丹、九黄丹、补天丹,阳和膏。
钱姓患者,左侧。脑疽三日,红肿伴寒热,外邪客于风府穴,蕴热上乘,邪热相搏,血瘀停凝。治法当疏散。
荆芥穗(一钱五分) 防风(一钱) 全当归(二钱) 赤芍药(二钱) 大贝母(三钱) 炙僵蚕(三钱)
羌活(一钱) 川芎(八分) 白芷(八分)
外用金箍散、冲和膏,用陈醋、白蜜调和,炖温后敷贴。
二诊 服药后,得大汗出,热退肿减,再用和解之法。
全当归(二钱) 赤芍药(二钱) 川芎(八分) 生甘草节(八分) 桔梗(一钱) 大贝母(三钱)
炙僵蚕(三钱) 晚蚕砂(包煎,三钱) 丝瓜络(二钱) 白芷(六分) 万灵丹(入煎,一粒)
仍用金箍散、冲和膏。
柯姓患者,左侧。脑旁属太阳经,为寒水之府,其体冷,其质沉,其脉上贯巅顶,两旁顺流而下。年过花甲(六十岁),气血已亏,加之身体丰腴多湿,湿郁生痰,风寒侵于外,七情动于中,与痰湿互阻于太阳之络,营卫不和,疽遂成矣。所庆幸的是红肿高活,尚属佳象,起居调摄,尤当自慎。
生黄芪(三钱) 防风(一钱) 生甘草节(八分) 桔梗(一钱) 陈皮(一钱) 半夏(二钱) 川芎(八分)
大贝母(三钱) 炙僵蚕(三钱) 羌活(一钱) 小金丹(陈酒化服,一粒)
外用金箍散,金黄散、冲和膏,用陈醋、白蜜调和,炖温后敷贴。
二诊 偏侧脑疽较正中者难治,前方连服三剂,根盘略收。疮顶高突,有溃脓之势。今症位虽偏,情势尚佳,所庆幸的是疮顶起发,胃纳健旺,人以胃气为本,有胃则生,书有明文。再拟消托兼施法。
生黄芪(三钱) 全当归(二钱) 赤芍药(二钱) 陈皮(一钱) 半夏(三钱) 生甘草节(八分)
大贝母(三钱) 桔梗(一钱) 炙穿山甲片(一钱五分) 皂角针(一钱五分) 笋尖(三钱) 炙僵蚕(三钱)
白芷(八分)
外用金箍散、金黄散、冲和膏。
三诊 叠进提托之剂,得脓甚畅,四围根盘渐收,调养得宜,生机有庆。
生黄芪(三钱) 全当归(二钱) 赤芍药(二钱) 紫丹参(二钱) 陈皮(一钱) 半夏(三钱)
云茯苓(三钱) 制何首乌(三钱) 生甘草节(八分) 红枣(二枚)
外用九黄丹、海浮散、阳和膏。
Patient Zhang, left side. Brain carbuncle (a severe abscess on the back of the head) has persisted for two periods (approximately fourteen days). Although the wound is large, it is deeply sunken and not rising; the base of the lesion is diffuse and unconsolidated, with redness and pain. The tongue body is bare and red, and the pulse is soggy and slow. This indicates Qi deficiency and Blood depletion, unable to expel the toxin outward, with phlegm-dampness accumulation and disharmony of Ying and Wei nutrients. The condition is critical and dangerous! I further prescribe a method to tonify Qi and expel toxins, harmonize Ying and resolve dampness, hoping that the top of the sore will rise and the base will contract, thereby offering a chance of recovery from danger.
Raw Huangqi (Radix Astragali) (8 qian)
Quan Danggui (Radix Angelicae Sinensis) (3 qian)
Bao Fushen (Poria with Hostwood) (3 qian)
Sheng Shouwu (Prepared Rhizoma Polygoni Multiflori) (4 qian)
Sheng Luedangshen (Radix Codonopsis Pilosae) (3 qian)
Jing Chishao (Radix Paeoniae Rubra) (2 qian)
Zhi Yuanzhi (Radix Polygalae Tenuifoliae) (1 qian)
Baiqiedi (Pedicel of Solanum Melongena) (1 qian)
Sheng Caojie (Node of Radix Glycyrrhizae Uralensis) (0.8 qian)
Zi Danshen (Radix Salviae Miltiorrhizae) (3 qian)
Lujiaoshuang (Cornu Cervi Pantotrichum Preparatum) (3 qian)
Chen Guangpi (Pericarpium Citri Reticulatae) (1 qian)
Da Beimu (Bulbus Fritillariae Thunbergii) (3 qian)
External use: Heihu Dan (Black Tiger Pill), Jiu Huang Dan (Nine Yellow Pill), Buntian Dan (Heaven-Replenishing Pill), Yanghe Gao (Yanghe Ointment).
Patient Qian, left side. Brain carbuncle for three days, with redness, swelling, aversion to cold, and fever. External pathogens have lodged in Fengfu (GV16), accumulating heat and ascending, where pathogenic heat clashes, causing blood stasis and stagnation. The treatment method should be dispersing and releasing.
Jingjie Sui (Cacumen Schizonepetae) (1.5 qian)
Qing Fangfeng (Radix Saposhnikoviae) (1 qian)
Quan Danggui (Radix Angelicae Sinensis) (2 qian)
Jing Chishao (Radix Paeoniae Rubra) (2 qian)
Da Beimu (Bulbus Fritillariae Thunbergii) (3 qian)
Zhi Jiangcan (Bombyx Batryticatus) (3 qian)
Qianghuo (Rhizoma et Radix Notopterygii) (1 qian)
Dachuanxiong (Rhizoma Chuanxiong) (0.8 qian)
Xiang Baizhi (Radix Angelicae Dahuricae) (0.8 qian)
External use: Jingu San (Golden Hoop Powder), Chonghe Gao (Chonghe Ointment), mixed with aged vinegar and white honey, warmed and applied as a compress.
Second visit: After taking the prescription, profuse sweating occurred, fever subsided, and swelling reduced. Use a harmonizing method again.
Quan Danggui (Radix Angelicae Sinensis) (2 qian)
Jing Chishao (Radix Paeoniae Rubra) (2 qian)
Dachuanxiong (Rhizoma Chuanxiong) (0.8 qian)
Sheng Caojie (Node of Radix Glycyrrhizae Uralensis) (0.8 qian)
Ku Jiegeng (Radix Platycodonis Grandiflori) (1 qian)
Da Beimu (Bulbus Fritillariae Thunbergii) (3 qian)
Zhi Jiangcan (Bombyx Batryticatus) (3 qian)
Wancansha (Semen Bombyx) (wrapped, 3 qian)
Sigualuo (Retinervus Trichosanthis) (2 qian)
Xiang Baizhi (Radix Angelicae Dahuricae) (0.6 qian)
Wanling Dan (Ten Thousand Spirit Pill) (decocted, 1 pill)
Continue using Jingu San (Golden Hoop Powder) and Chonghe Gao (Chonghe Ointment).
Patient Ke, left side. The area beside the brain belongs to the Taiyang channel, which is the residence of cold water. Its nature is cold, its substance is heavy, and its pulse ascends to the vertex and flows down along both sides. At an age past sixty, Qi and Blood are already depleted. Furthermore, the patient is corpulent and prone to dampness; dampness stagnates to generate phlegm. Wind-cold invades externally, while Seven Emotions stir internally. These obstruct the Taiyang collaterals together with phlegm-dampness, leading to disharmony of Ying and Wei nutrients, thus forming the carbuncle. Fortunately, the redness and swelling are high and active, which is still a favorable sign. Care in daily life and diet must be strictly observed.
Raw Huangqi (Radix Astragali) (3 qian)
Qing Fangfeng (Radix Saposhnikoviae) (1 qian)
Sheng Caojie (Node of Radix Glycyrrhizae Uralensis) (0.8 qian)
Ku Jiegeng (Radix Platycodonis Grandiflori) (1 qian)
Chen Guangpi (Pericarpium Citri Reticulatae) (1 qian)
Xian Banxia (Rhizoma Pinelliae Ternatae) (2 qian)
Dachuanxiong (Rhizoma Chuanxiong) (0.8 qian)
Da Beimu (Bulbus Fritillariae Thunbergii) (3 qian)
Zhi Jiangcan (Bombyx Batryticatus) (3 qian)
Qianghuo (Rhizoma et Radix Notopterygii) (1 qian)
Xiao Jin Dan (Little Gold Pill) (dissolved in aged rice wine, 1 pill)
External use: Jingu San (Golden Hoop Powder), Jinhuang San (Golden Yellow Powder), Chonghe Gao (Chonghe Ointment), mixed with aged vinegar and white honey, warmed and applied as a compress.
Second visit: Oblique brain carbuncles are more difficult to treat than central ones. After taking the previous prescription for three doses, the base has slightly consolidated. The top of the sore is prominent, showing signs of impending suppuration. Although the location is oblique, the condition is still favorable. Fortunately, the top of the sore has risen, and appetite is robust. Humans rely on Stomach Qi as their foundation; where there is Stomach Qi, there is life, as explicitly stated in medical texts. I further prescribe a method combining resolution and expulsion.
Raw Huangqi (Radix Astragali) (3 qian)
Quan Danggui (Radix Angelicae Sinensis) (2 qian)
Jing Chishao (Radix Paeoniae Rubra) (2 qian)
Chen Guangpi (Pericarpium Citri Reticulatae) (1 qian)
Xian Banxia (Rhizoma Pinelliae Ternatae) (3 qian)
Sheng Caojie (Node of Radix Glycyrrhizae Uralensis) (0.8 qian)
Da Beimu (Bulbus Fritillariae Thunbergii) (3 qian)
Ku Jiegeng (Radix Platycodonis Grandiflori) (1 qian)
Zhi Jiapian (Scuta Testudinis et Carapax Trionycis) (1.5 qian)
Zaojiaozhen (Spina Gleditsiae Sinensis) (1.5 qian)
Sunjian (Bamboo Shoot Tip) (3 qian)
Zhi Jiangcan (Bombyx Batryticatus) (3 qian)
Xiang Baizhi (Radix Angelicae Dahuricae) (0.8 qian)
External use: Jingu San (Golden Hoop Powder), Jinhuang San (Golden Yellow Powder), Chonghe Gao (Chonghe Ointment).
Third visit: Repeatedly administering lifting and expelling agents resulted in abundant pus discharge. The surrounding base gradually consolidates. With proper recuperation, vitality is promising.
Raw Huangqi (Radix Astragali) (3 qian)
Quan Danggui (Radix Angelicae Sinensis) (2 qian)
Jing Chishao (Radix Paeoniae Rubra) (2 qian)
Zi Danshen (Radix Salviae Miltiorrhizae) (2 qian)
Chen Guangpi (Pericarpium Citri Reticulatae) (1 qian)
Xian Banxia (Rhizoma Pinelliae Ternatae) (3 qian)
Yun Fuling (Poria) (3 qian)
Zhi Shouwu (Prepared Rhizoma Polygoni Multiflori) (3 qian)
Sheng Caojie (Node of Radix Glycyrrhizae Uralensis) (0.8 qian)
Hongzao (Fructus Jujubae) (2 pieces)
External use: Jiu Huang Dan (Nine Yellow Pill), Haifu San (Sea Floating Powder), Yanghe Gao (Yanghe Ointment).