治膀胱蕴热,风湿相乘,阴 肿胀,大小便不利。
白牵牛(略炒,二两) 白术(半两) 桑白皮 陈皮 木通(各半两)
上为末。每服二钱,姜汤调下,空腹服,初进一服未觉,再进。此药不损脏气,只导利
留滞。疝方大率多用热药,此方唯壅热证宜服之。
治阴狐 气,偏有小大,时时上下,胀人。
蜘蛛(十四个,熬焦) 桂心(半两)
上为末,蜜丸,梧子大。米饮下十丸。
治 偏大,胀不能动,坐卧不安。
牡丹皮 防风(等分)
上为末。酒服方寸匕。《短剧》有桂枝、豉、铁精共五味。婴儿以乳汁调一字许。
治 胀。
香附子(不拘多少)
上为末。每用酒一盏,煎海藻一钱重,至半盏,先捞海藻,嚼细,用所煎酒调香附末二钱服。
治阴肿大如斗,核痛,人所不能治。
雄黄(一两,研) 矾(二两,研) 甘草(生,半两)
上为锉散。以水五升煎,洗之。
发背痈疽者,该三因而有之。论云∶痈疽瘰 ,不问虚实寒热,皆由气郁而成。《经》
亦云∶气宿于经络,与血俱涩而不行,壅结为痈疽。不言热之所作而后成痈者,此乃因喜
怒忧思有所郁而成也。又论云∶身有热,被风冷搏之,血脉凝泣不行,热气壅结而成;亦有
阴虚阳气凑袭,寒化为热,热成则肉腐为脓者,此乃外因寒热风湿所伤而成也。又服丹石,
及炙爆、酒面,温床浓被所致;又尽力房室,精虚气节所致者,此乃因不内外所伤而成也
,故知三因备矣。又论云∶疖者,节也;痈者,壅也;疽者,沮也。如是但阴阳不平,有所
壅节,皆成痈疽。又曰∶阴滞于阳,则发痈;阳滞于阴,则发疽。而此二毒,发无定处,当
以脉别之,浮洪滑数则为阳,微沉缓涩则为阴。阴则热治,阳则冷治。治之之要,虽有四节
八事,所谓初觉,则宣热拔毒;已溃,则排脓止痛;脓尽,则消肌内塞,恶肉尽;则长肌敷痂
。次序固明,若不别其因,施治亦昧。故治法中,有用远志宣热者,得非内因乎;至于外因
,则用大黄;不内外因,则用甘草。世医但泥方书,多用五香连翘与漏芦二汤,更不知三因
所自,其可守一法而普攻之。既得其因,又须观病浅深,与证候吉凶,寒则温之,热则清之
,虚则补之,实则泻之,导以针石,灼以艾炷,破毒溃坚,以平为期,各有成法。近胡丞得
一方,甚宝秘之,持以献洪丞相,丞相与之作序,言重于世,已遍行矣。其方乃《千金》内
补散添黄 加人参减桂。间有轻者,服之稍效,若真痈疽,为害反甚。内补散当用在第四节
,当前服内消等药,俟脓尽,方得投。苟专用之,亦所谓守一法也。孔子不尝未达之药者,
良有旨哉。士夫当深味斯言,无轻信医方,误天下后世。谨之谨之。
治疗膀胱蕴积热邪,风湿二气相互侵袭,导致阴部肿胀,大小便不通畅。
白牵牛(略炒,二两) 白术(半两) 桑白皮 陈皮 木通(各半两)
以上药物研为细末。每次服用二钱,用姜汤调服,空腹服用,初次服用后若未见效,可再服用一次。此药不损伤脏腑之气,仅引导并利导体内留滞之邪。治疗疝气的方剂大多多用热性药物,此方唯独适用于壅塞热证的患者服用。
治疗阴狐疝气,表现为阴囊偏大偏小,时时上下移动,胀满不适。
蜘蛛(十四个,熬至焦黑) 桂心(半两)
以上药物研为细末,用蜂蜜制成梧桐子大小的丸剂。用米饮送服十丸。
治疗一侧阴囊肿大,胀得不能活动,坐卧不安。
牡丹皮 防风(等分)
以上药物研为细末。用酒送服一方寸匕的量。《短剧》中有桂枝、豆豉、铁精共五味药。婴儿可用乳汁调和少许服用。
治疗阴囊肿胀。
香附子(不拘多少)
以上药物研为细末。每次取酒一盏,煎煮海藻一钱重,煎至半盏时,先捞出海藻,嚼碎,再用所煎的酒调服香附末二钱。
治疗阴囊肿大如斗,睾丸疼痛,这是常人难以治愈的病症。
雄黄(一两,研细) 矾(二两,研细) 甘草(生用,半两)
以上药物锉成散剂。用水五升煎煮,用来外洗患处。
发背痈疽的发生,涵盖了三种病因。论述说:痈疽瘰疬,不论虚实寒热,都是由气机郁结而成。《内经》也说:气停留于经络,与血液一起涩滞而不运行,壅塞结聚形成痈疽。这里没有提及因热邪所作而后形成痈疽,这是因为因喜怒忧思等情志有所郁结而造成的。又论述说:身体发热,被风冷邪气搏击,血脉凝涩不行,热气壅结而成;也有阴虚阳气凑袭,寒邪化为热邪,热盛则肌肉腐败化为脓液的情况,这是由外因中的寒热风湿所伤而形成的。又有服用丹石类药物,以及食用炙烤爆炒食物、酒类面食,睡温床盖厚被所致;还有尽力房事,精虚气竭所致者,这是由不内外因所伤而形成的。因此知道三因具备了。又论述说:疖,是节点的意思;痈,是壅塞的意思;疽,是阻塞的意思。像这样只要阴阳不平衡,有所壅塞阻滞,都会形成痈疽。又说:阴气滞留于阳分,则发为痈;阳气滞留于阴分,则发为疽。而这两种毒邪,发病没有固定位置,应当通过脉象来辨别,脉浮洪滑数则为阳证,脉微沉缓涩则为阴证。阴证用热法治疗,阳证用冷法治疗。治疗的要点,虽然有初起、已溃、脓尽、腐肉尽这四个阶段八件事,所谓初起时,要宣散热毒拔除毒邪;已经溃破,要排脓止痛;脓液排尽,要消除肌内空隙堵塞,恶肉排尽,要生长肌肉敷上痂皮。次序固然明确,如果不辨别病因,施治也会盲目。所以在治法中,有用远志来宣散热邪的,这难道不是针对内因吗?至于外因,则用大黄;不内外因,则用甘草。世间的医生只拘泥于方书,多用五香连翘汤和漏芦汤,更不知道三因的来源,怎么能固守一种方法去普遍攻治呢?既然找到了病因,还必须观察病情的浅深,以及证候的吉凶,寒证则温之,热证则清之,虚证则补之,实证则泻之,用针石导引,用艾炷灼灸,破除毒邪溃散坚结,以平复为准则,各有固定的法则。近来胡丞得到一个方子,非常珍视保密,拿着献给洪丞相,丞相为他作序,言论重于世间,已经广泛流传了。这个方子是《千金》内补散添加黄芩加入人参减去桂枝。间或有轻症患者,服用后稍见效果,如果是真正的痈疽,危害反而更严重。内补散应当用在第四阶段,当前应服用内消等药物,等到脓液排尽,才能投用。如果专用它,也叫做固守一种方法。孔子不曾尝试未曾通达其理的药物,确实是有深意的啊。士大夫应当深刻体味这句话,不要轻信医方,误天下后世。谨慎啊,谨慎啊。
To treat heat accumulation in the Bladder (Bladder), with Wind-Dampness (Wind-Dampness) attacking mutually, causing swelling of the Yin organs and difficulty in urination and defecation.
Bai Qianniu (Semen Pharbitidis, slightly stir-fried, 2 liang), Baizhu (Rhizoma Atractylodis Macrocephalae, 0.5 liang), Sangbaipi (Cortex Mori Radicis), Chenpi (Pericarpium Citri Reticulatae), Mutong (Caulis Akebiae, each 0.5 liang).
Grind the above into powder. Take 2 qian per dose, mixed with Ginger Decoction (Ginger juice/water), taken on an empty stomach. If no effect is felt after the first dose, take another. This medicine does not damage Zang-Fu Qi (Vital energy of the internal organs), but only guides and promotes the discharge of stagnation. Formulas for treating Hernia (Hernia) generally use more warming herbs; this formula is suitable only for patients with Obstructive Heat Syndrome (Syndrome of heat obstruction).
To treat Yin Hu Hernia (Yin Fox Hernia), characterized by one side of the scrotum being larger or smaller than the other, moving up and down frequently, causing distension and discomfort.
Spider (14 pieces, roasted until charred), Guixin (Cortex Cinnamomi, 0.5 liang).
Grind the above into powder, make pills with honey, sized like wutong seeds. Take 10 pills with Rice Drink (Rice water).
To treat unilateral scrotal swelling, so distended that movement is impossible, causing restlessness in sitting and lying.
Mudanpi (Cortex Moutan Radicis), Fangfeng (Radix Saposhnikoviae, equal parts).
Grind the above into powder. Take one fangcun bi (a square-inch measure) with wine. *Duanju* mentions adding Guizhi (Ramulus Cinnamomi), Chi (Fermented Soybean), and Tiejing (Iron filings), totaling five ingredients. For infants, mix a small amount with breast milk.
To treat scrotal swelling.
Xiangfu Zi (Rhizoma Cyperi Rotundi, any amount).
Grind the above into powder. For each use, take one zhan of wine, decoct Haizao (Thallus Sargassii, 1 qian weight) until reduced to half a zhan. First remove the seaweed, chew it thoroughly, then use the decocted wine to mix with 2 qian of Xiangfu powder and take orally.
To treat massive scrotal swelling like a dou (a unit of volume), with testicular pain, a condition difficult for ordinary people to cure.
Xionghuang (Realgar, 1 liang, ground), Fan (Alumen, 2 liang, ground), Gancao (Radix Glycyrrhizae, raw, 0.5 liang).
Cut the above into coarse pieces for a powder. Decoct in 5 sheng of water, and wash the affected area.
Fa Bei Yong Ju (Back Carbuncle and Ulcer) arises from all three causes. The discussion states: Carbuncles, ulcers, and scrofula, regardless of deficiency/excess or cold/heat, are all caused by Qi Stagnation (Stagnation of Qi). The *Classic* also says: When Qi lodges in the meridians and flows sluggishly together with Blood, it obstructs and knots to form carbuncles and ulcers. It does not mention that heat alone creates these conditions, because they are formed due to emotional depression such as joy, anger, worry, and thought. Another discussion states: When the body has heat and is struck by Wind-Cold, the blood vessels become congealed and stagnant, and heat accumulates to form the condition; or when Yin deficiency allows Yang Qi to invade, Cold transforms into Heat, and excessive Heat rots flesh into pus. This is caused by external factors of Cold, Heat, Wind, and Dampness. Furthermore, taking Dan-Shi (Elixir stones), eating roasted/fried foods, alcohol, wheat products, sleeping on warm beds, and covering with thick quilts cause it; or exhausting oneself in sexual activity, leading to Essence deficiency and Qi depletion, is caused by non-internal and non-external factors. Thus, the Three Causes are complete. Another discussion states: Jie (Boil) means node; Yong (Carbuncle) means obstruction; Ju (Ulcer/Gangrene) means blockage. As long as Yin and Yang are unbalanced and there is obstruction/stagnation, carbuncles and ulcers will form. It is also said: When Yin stagnates in Yang, a Carbuncle develops; when Yang stagnates in Yin, an Ulcer develops. These two toxins have no fixed location for onset and should be distinguished by pulse. Floating, surging, slippery, and rapid pulses indicate Yang patterns; fine, deep, slow, and choppy pulses indicate Yin patterns. Yin patterns are treated with heat methods; Yang patterns are treated with cold methods. The key to treatment involves four stages and eight matters: at the initial stage, disperse heat and extract toxins; once ulcerated, drain pus and relieve pain; when pus is exhausted, eliminate internal gaps and fill defects; when foul tissue is gone, promote muscle growth and apply scabs. Although the sequence is clear, if the cause is not distinguished, treatment will be blind. Therefore, in treatment methods, using Yuanzhi (Radix Polygalae) to disperse heat addresses the Internal Cause; for External Causes, Dahuang (Radix et Rhizoma Rhei) is used; for Non-Internal/External Causes, Gancao (Radix Glycyrrhizae) is used. Physicians today merely stick to medical texts, mostly using Wuxiang Liaoqiao Tang (Five-Aroma Liaoqiao Decoction) and Loulu Tang (Loulu Decoction), without understanding the origin of the Three Causes. How can one adhere to a single method for universal application? Once the cause is identified, one must observe the depth of the disease and the auspiciousness/malevolence of the symptoms. Treat cold with warmth, heat with clearing, deficiency with tonification, excess with purging. Guide with needles and stones, cauterize with moxa cones, break toxicity and soften hardness, aiming for balance. Each has established methods. Recently, Official Hu obtained a formula, which he treasured and kept secret, presenting it to Chancellor Hong. The Chancellor wrote a preface, giving it great weight in the world, and it has now circulated widely. This formula is Qianjin Neibu San (Thousand Gold Internal Tonifying Powder) with Huang Qin (Radix Scutellariae) added, Renshen (Radix Ginseng) added, and Guizhi (Ramulus Cinnamomi) removed. In mild cases, taking it yields slight improvement; however, for true carbuncles and ulcers, the harm may be even greater. Neibu San should be used in the fourth stage; currently, one should take internal resolving medicines first, and only administer it after pus is exhausted. If used exclusively, it is called adhering to a single method. Confucius did not try medicines whose principles he had not fully understood, which is indeed profound. Scholars should deeply ponder these words, do not lightly trust medical prescriptions, and avoid misleading the world and future generations. Be cautious, be cautious.