拔疔散
番卤砂 白丁香 蟾酥(酒化) 轻粉 大蜈蚣 全蝎(酒漂) 朱砂 雄黄(各一钱) 金顶砒
(五分) 射香(三分) 乳香(六分)
共为细末,取活穿山甲,或甲中油,杵成
膏,如麦粒大,针透疔根,插入一粒,候四边裂缝,是疔根摇动,可拔去,若刺针无血,插药干
枯,脓汁不变,终无生理。
德按∶如无穿山甲鲜血,拟用炙甲片一钱代之。一方用金顶砒、大蜈蚣、人指甲、水乡陈
年久烂阴霉所剩旧木桥梁老杉木节 为炭各等分研末,薄贴盖之,其疔拨出即愈。
疔毒在肉如丁着木,必藉此毒烈之性方可拔出,此药当预备以应急用。
许氏橡村曰∶疔毒当服解毒之剂,外以银针挑破,口含清水吸去恶血,才可敷药,重者
须用拔疔散,解毒之剂如连翘牛蒡子银花甘草 黑豆之类必加蒲公英、白菊花根二味,蒲
公英化肌肉之毒,野白菊花治疔毒之圣药也。
上编曰∶方论
喻氏嘉言曰∶盖凡人当感后身中之元气已虚,身中之邪热未净,于此而补虚则热不可
除,于此而清热则虚不能任,即一半补虚,一半清热,终属模糊不得要领。然舍补虚清热,
外更无别法。当细辨之。补虚有二法一补脾,一补胃。如疟痢后脾气衰弱饮食不能运化,宜
补其脾。如伤寒后胃中津液久耗,新者未生,宜补其胃。二者有霄壤之殊也。清热亦有二
法∶初病时热为实热,宜用苦寒药清之,大病后之热为虚热宜用甘寒药清之。二者亦霄壤
之殊也。人身天真之气全在胃口,津液不足即是虚,生津液即是补虚,故以生津之药合甘寒
清热之药而治感后之虚热,如麦门冬生地黄牡丹皮人参梨汁竹沥之属,皆为合法。河间每
用天水散以清虚热,正取滑石甘草一甘一寒之义也。设误投参 苓术补脾之药为补,宁不
并邪热而补之乎。至于饮食之补,但取其气不取其味,如五谷之气以养之,五菜之气以充
之,每食之间便觉津津汗透,将身中蕴蓄之邪热以渐运出于毛孔何其快哉。人皆不知此理,
急于用肥甘之味以补之,不思油腻阻滞经络,邪热不能外出,久久充养完固,愈无出期矣。
前哲有鉴于斯,宁食淡茹蔬使体暂虚,而邪易出乃为贵耳。
德按∶《内经》曰∶饮食自倍,肠胃乃伤。《物理论》云∶谷气胜元气,其人肥而不寿。养
生之术,常令谷气少,则病不生。谷气且然,况
五味餍饫为五内之害乎。
龙集庚寅十二月望十六日辛亥写成。
拔疔散
番卤砂、白丁香、蟾酥(用酒化开)、轻粉、大蜈蚣、全蝎(用酒漂洗)、朱砂、雄黄(各一钱)、金顶砒(五分)、射香(三分)、乳香(六分)。
以上药物共同研磨成细末,取活穿山甲,或者取穿山甲鳞片中的油脂,捣烂成膏状,大小如麦粒。用针刺透疔疮的根部,插入一粒药膏,等待四周出现裂缝,这是疔根松动摇动的表现,可以将其拔出。如果针刺时无血流出,插入的药物干枯,脓汁没有变化,最终就没有生机了。
德按:如果没有穿山甲的鲜血,拟用炙过的甲片一钱来代替。另一方法是用金顶砒、大蜈蚣、人指甲、水乡陈年久烂阴霉所剩旧木桥梁老杉木节烧成的炭,各等分研成末,薄贴覆盖在上面,其疔毒拨出即愈。
疔毒在肉中如同钉子钉入木头,必须借助这种药性猛烈之性才能拔出,此药应当预备以应急使用。
许氏橡村说:疔毒应当服用解毒的药剂,外用银针挑破,口中含清水吸去恶血,才可以敷药,病情重的必须用拔疔散,解毒的药剂如连翘、牛蒡子、金银花、甘草、黑豆之类,必须加上蒲公英、白菊花根两味药,蒲公英能化解肌肉中的毒,野白菊花是治疗疔毒的圣药。
上编说:方论
喻氏嘉言说:大概凡人在感受病邪之后,身体中的元气已经虚弱,身体中的邪热尚未清除干净,在这个时候补虚则热不能去除,在这个时候清热则虚弱不能承受,即使一半补虚,一半清热,终究属于模糊不得要领。然而除了补虚清热之外,更没有其他办法。应当仔细辨别。补虚有两种方法:一是补脾,一是补胃。如疟疾、痢疾后脾气衰弱,饮食不能运化,适宜补其脾。如伤寒后胃中津液长久耗损,新的津液尚未生成,适宜补其胃。这两者有着天壤之别。清热也有两种方法:初病时热为实热,适宜用苦寒药清解它,大病后的热为虚热,适宜用甘寒药清解它。这两者也有着天壤之别。人身上的天真之气全在胃口,津液不足即是虚,生津液即是补虚,所以用生津的药合甘寒清热的药来治疗感邪后的虚热,如麦门冬、生地黄、牡丹皮、人参、梨汁、竹沥之类的,都是合法的方法。河间每用天水散来清虚热,正是取滑石、甘草一甘一寒的含义。如果误投人参、茯苓、白术补脾的药作为补益,难道不是连同邪热一起补了吗?至于饮食的补益,只取其气不取其味,如五谷的气来滋养它,五菜的气来充实它,每次进食之间便觉得津津汗透,将身体中蕴蓄的邪热逐渐运出于毛孔,何其痛快啊。人们都不知道这个道理,急于用肥甘的味道来补益,不考虑油腻阻滞经络,邪热不能外出,久而久之充养完固,更加没有排出的时期了。前哲对此有鉴于此,宁愿吃淡茹蔬使身体暂时虚弱,而邪气容易排出,这才是珍贵的。
德按:《内经》说:饮食自倍,肠胃乃伤。《物理论》说:谷气胜元气,其人肥而不寿。养生的方法,常令谷气少,则病不生。谷气尚且如此,何况五味饱食对五脏的危害呢。
龙集庚寅十二月望十六日辛亥写成。
Bading San (Callosity-Extracting Powder)
Fanlusha (Fenugreek Seed), Baidingxiang (White Stinkhorn Spore), Chansu (Toad Venom, dissolved in wine), Qingfen (Calomel), Da Wugong (Large Centipede), Quanxie (Whole Scorpion, washed in wine), Zhusha (Cinnabar), Xionghuang (Realgar, each 1 qian), Jindingpi (Golden-tipped Arsenic Trioxide, 0.5 qian), Shexiang (Musk, 3 fen), Ruxiang (Frankincense, 6 fen).
Grind all the above herbs into a fine powder. Take a live Pangolin scales or the oil from the scales, pound them into a paste, forming pills the size of wheat grains. Pierce through the root of the carbuncle with a needle, insert one pill, and wait for cracks to appear around the edges; this indicates that the root is loosened and can be extracted. If no blood flows when pierced, the inserted medicine dries up, and the pus remains unchanged, there is ultimately no hope for survival.
De's Note: If fresh pangolin blood is unavailable, use 1 qian of calcined pangolin scales as a substitute. Another prescription uses equal parts of Jindingpi, Da Wugong, human fingernails, and charcoal made from old fir wood knots from old wooden bridges in water regions that have rotted and molded over many years. Grind these into powder, apply thinly to cover the lesion, and the carbuncle will be extracted and cured.
The toxin of a carbuncle in the flesh is like a nail driven into wood; only by relying on the fierce nature of this medicine can it be extracted. This medicine should be prepared for emergency use.
Xu Shicun said: For carbuncle toxins, one should take detoxifying decoctions externally puncture with silver needles, hold clear water in the mouth to suck out foul blood, and then apply external medicines. For severe cases, Bading San must be used. Detoxifying decoctions such as Liaoqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Yinhua (Lonicerae Japonicae Flos), Gancao (Glycyrrhizae Radix et Rhizoma), and Heidou (Sojae Semen Nigrum) must be added with Pugongying (Taraxaci Herba) and Baijuhuagen (Wild Chrysanthemi Indici Radix). Pugongying resolves toxins in the muscles, and wild Baijuhuagen is the sacred medicine for treating carbuncle toxins.
Volume One states: Discussion on Prescriptions.
Yu Jiayan said: Generally, after contracting an illness, the vital energy (Yuanqi) within the body is already deficient, and the pathogenic heat within the body has not yet been cleared. At this time, tonifying deficiency will not remove the heat, and clearing heat will not be tolerated by the deficiency. Even if one half-tonifies deficiency and half-clears heat, it ultimately remains vague and misses the key point. However, apart from tonifying deficiency and clearing heat, there is no other method. It must be carefully differentiated. There are two methods for tonifying deficiency: one is tonifying the Spleen, and the other is tonifying the Stomach. After malaria or dysentery, if Spleen Qi is weak and cannot transform food and drink, it is appropriate to tonify the Spleen. After typhoid fever, if Stomach fluids have been long consumed and new fluids have not yet generated, it is appropriate to tonify the Stomach. These two differ as much as heaven and earth. There are also two methods for clearing heat: when heat is excess heat at the beginning of the disease, bitter-cold herbs should be used to clear it; after severe illness, when heat is deficient heat, sweet-cold herbs should be used to clear it. These two also differ as much as heaven and earth. The innate true Qi of the human body resides entirely in the Stomach appetite. Insufficiency of fluids constitutes deficiency; generating fluids constitutes tonifying deficiency. Therefore, using fluid-generating herbs combined with sweet-cold heat-clearing herbs to treat post-infection deficient heat, such as Maimendong (Ophiopogonis Radix), Shengdihuang (Rehmanniae Radix), Mudanpi (Moutan Cortex), Renshen (Ginseng Radix et Rhizoma), Lizhi (Pear Juice), Zhuli (Bamboo Sap), are all correct methods. Hejian often used Tianshui San (Heavenly Water Powder) to clear deficient heat, precisely taking the meaning of Shihui (Talcum) and Gancao being one sweet and one cold. If one mistakenly administers Renshen, Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) to tonify the Spleen as tonification, would it not be tonifying along with the pathogenic heat? As for dietary tonification, one should only utilize their Qi, not their flavor. Use the Qi of the five grains to nourish, and the Qi of the five vegetables to fill. During each meal, one feels sweat permeating gently, gradually transporting the accumulated pathogenic heat out through the pores, how delightful! People do not understand this principle; they are eager to use rich and sweet flavors to tonify, failing to consider that greasy foods obstruct the meridians, preventing pathogenic heat from exiting. Over time, nourishment becomes complete and solidified, making expulsion even more impossible. Former sages, having seen this, preferred eating bland vegetables, allowing the body to be temporarily deficient so that pathogens could easily exit, which is precious.
De's Note: The *Neijing* says: "If food and drink double in quantity, the intestines and stomach are injured." The *Wulun* says: "When Grain Qi exceeds Yuan Qi, the person becomes fat but does not enjoy longevity." The art of health preservation involves keeping Grain Qi low, so that illness does not arise. If Grain Qi is thus, how much more so is the harm of saturating the Five Flavors to the Five Viscera?
Written on the 16th day of the twelfth month of the Gengyin year, on a Xinhai day.