须斟酌而用。此薛己所论千古不易之治也。因附治疡用方之法于后,使学人服膺云。
薛己曰∶治疡之法,若肿高 痛者,先用仙方活命饮解之,后用托里败毒散。漫肿
微痛者,用托里散,如不应,加姜、桂。若脓出而反痛,气血虚也,八珍散。不作脓不
腐溃,阳气虚也,四君加归、 、肉桂。不生肌、不收敛,脾气虚也,四君加芍药、木
香。恶寒僧寒,阳气虚也,十全大补加姜、桂。晡热内热,阴血虚也,四物加参、 。欲呕
作呕,胃气虚也,六君加炮姜。自汗、盗汗,五脏虚也,六味九料加五味子。食少体倦,脾
气虚也,补中益气加茯苓、半夏。喘促咳嗽,脾肺虚也,前汤加麦冬、五味。欲呕少食,脾
胃虚也,人参理中汤。腹痛泄泻,脾胃虚寒也,附子理中汤,热渴淋秘,肾虚阴火也,加
减八味丸。大凡怯弱之人,不必分其肿溃,惟当先补胃气。盖疮疡之作,缘阴阳亏损,其
脓既泄,气血愈虚,岂有不宜补者哉!或疑参、 满中,间有用者,又加发散败毒,所
补不偿所损。又或以有疾不服补剂,因而致误者多矣。可胜惜哉!
托里消毒散
人参 黄 白术 茯苓 当归 川芎 白芍 金银花 白芷 甘草 连翘
水煎服。
【注】参、 、术、苓、草以益气分,归、芎、芍以滋血分,银花、白芷、连翘以解毒。
必须仔细斟酌后使用。这是薛己所论述的千古不变的治法。因此附上治疗疮疡使用方剂的方法在后面,使学习的人铭记于心。
薛己说:治疗疮疡的方法,如果肿势高突且疼痛的,先用仙方活命饮来消散它,后用托里败毒散。如果肿势平漫且微痛的,用托里散,如果无效,加入干姜、肉桂。如果脓液排出后反而疼痛,是气血虚弱,用八珍散。如果不化脓、不溃烂,是阳气虚弱,用四君子汤加当归、黄芪、肉桂。如果不生肌肉、不收敛伤口,是脾气虚弱,用四君子汤加白芍、木香。怕冷或自觉寒冷,是阳气虚弱,用十全大补汤加干姜、肉桂。傍晚发热或内部发热,是阴血虚弱,用四物汤加人参、黄芪。想呕吐或呕吐,是胃气虚弱,用六君子汤加炮姜。自汗、盗汗,是五脏虚弱,用六味地黄丸加五味子。饮食减少、身体疲倦,是脾气虚弱,用补中益气汤加茯苓、半夏。气喘急促、咳嗽,是脾肺虚弱,用前面的汤剂(指补中益气汤)加麦冬、五味子。想呕吐、进食少,是脾胃虚弱,用人参理中汤。腹痛泄泻,是脾胃虚寒,用附子理中汤。热渴、小便淋漓涩痛或闭塞,是肾虚阴火,用加减八味丸。大凡怯弱之人,不必区分是否已经肿胀或溃破,只应当先补益胃气。大概疮疡的发生,源于阴阳亏损,脓液既然已经排泄,气血更加虚弱,哪里有不应该补益的呢!有人怀疑人参、黄芪充满胸腹(导致胀满),偶尔有使用的,又加上发散败毒的药物,所补益的不抵所损耗的。又有些人因为有疾病不服用补益药剂,因而导致误事的很多了。这难道不可惜吗!
It must be carefully considered before use. This is the treatment method discussed by Xue Ji, which remains unchangeable through the ages. Therefore, the methods for using formulas in treating sores and ulcers are appended below, so that students may keep them firmly in mind.
Xue Ji said: In the treatment of sores and ulcers, if the swelling is high and painful, first use Xianfang Huoming Yin (Immortal Life Elixir) to resolve it, followed by Tuoli Baidu San (Supporting Interior and Resolving Toxin Powder). If the swelling is flat and spreading with slight pain, use Tuoli San (Supporting Interior Powder); if there is no response, add Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark). If pain persists after pus discharge, it indicates a deficiency of Qi and Blood; use Bazhen San (Eight Treasure Powder). If there is no suppuration or ulceration, it indicates a deficiency of Yang Qi; use Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelica Sinensis), Huangqi (Astragalus Root), and Rougui (Cinnamon Bark). If granulation tissue does not grow and the wound does not close, it indicates a deficiency of Spleen Qi; use Sijunzi Tang (Four Gentlemen Decoction) added with Shaoyao (Peony Root) and Muxiang (Aucklandiae Radix). If aversion to cold or feeling cold occurs, it indicates a deficiency of Yang Qi; use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) added with Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark). If afternoon fever or internal heat occurs, it indicates a deficiency of Yin Blood; use Siwu Tang (Four Substance Decoction) added with Renshen (Ginseng Root) and Huangqi (Astragalus Root). If there is nausea or vomiting, it indicates a deficiency of Stomach Qi; use Liujunzi Tang (Six Gentlemen Decoction) added with Paojiang (Prepared Ginger). If spontaneous sweating or night sweats occur, it indicates a deficiency of the Five Zang Organs; use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Wuweizi (Schisandra Fruit). If food intake is decreased and the body feels fatigued, it indicates a deficiency of Spleen Qi; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinellia Tuber). If panting, shortness of breath, and cough occur, it indicates a deficiency of the Spleen and Lung; use the aforementioned decoction (referring to Buzhong Yiqi Tang) added with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit). If there is nausea and reduced food intake, it indicates a deficiency of the Spleen and Stomach; use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction). If abdominal pain and diarrhea occur due to deficiency-cold of the Spleen and Stomach, use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). If heat, thirst, dysuria, or urinary retention occur due to Kidney deficiency and defaming fire, use Jianba Bawei Wan (Modified Eight-Ingredient Pill). Generally, for individuals who are weak and frail, one need not distinguish whether the sore has swollen or ulcerated; one should first tonify Stomach Qi. The occurrence of sores and ulcers stems from the depletion of Yin and Yang. Since the pus has been discharged, the Qi and Blood become even more deficient. How could it be inappropriate to tonify? Some suspect that Renshen (Ginseng Root) and Huangqi (Astragalus Root) cause fullness in the chest and abdomen. Occasionally, some are used, but dispersing and detoxifying agents are added as well, such that the benefit of tonification does not compensate for the damage caused. Furthermore, many have erred because they refused to take tonifying formulas while suffering from illness. Is this not lamentable!
Tuoli Xiaodu San (Supporting Interior and Resolving Toxin Powder)
Renshen (Ginseng Root), Huangqi (Astragalus Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Jinyinhua (Lonicerae Japonicae Flos), Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Lianqiao (Forsythiae Fructus).
Decoct in water and take orally.
[Note] Renshen (Ginseng Root), Huangqi (Astragalus Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), and Gancao (Glycyrrhizae Radix et Rhizoma) are used to tonify Qi in the Qi aspect; Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), and Baishao (Paeoniae Radix Alba) are used to nourish Blood in the Blood aspect; Jinyinhua (Lonicerae Japonicae Flos), Baizhi (Angelicae Dahuricae Radix), and Lianqiao (Forsythiae Fructus) are used to resolve toxins.