窃恐淋洗有一时之快,少顷恐病体自觉疲惫,有不耐烦之意,非虚而何?可不先议补接乎。(补接,
即参、 、归、术之类是也。)
〔苏〕乱发、蜂房、蛇蜕皮,各烧灰存性,每味取一钱匕,酒调服,治疮久不合,神验。
(丹溪云∶发补阴之功甚捷。)
〔丹〕 收敛疮口,止有柳皮、白蔹煎汤饮之。
〔《灵》〕 眼白青,黑眼小,是一逆也。纳药而呕者,是二逆也。腹痛渴甚,是三逆也。
肩项中不便,是四逆也。音嘶色脱,是五逆也。除此五者,为顺矣。(玉版篇)
〔《精》〕 痈疽破溃之后,其形候有逆有顺。眼白青黑而紧小,一恶也。不能下食,纳药而
呕,食不知味,二恶也。腹痛渴甚,三恶也。肩背不便,四肢沉重,四恶也。声嘶色脱,唇鼻
青黑,面目四肢浮肿,五恶也。烦躁时嗽,腹痛渴甚,泄利无度,小便如淋,六恶也。脓血大泄,
痛尤甚,脓色败臭,气不可近,七恶也。喘粗短气,恍惚嗜卧,八恶也。未溃先黑久陷,面青
唇黯便污者,九恶也。更有气噫痞塞,咳嗽身冷,自汗无
时,瞪目耳聋,恍惚惊悸,语言颠错,皆是恶证。动息自宁,饮食知味,一善也。便利调匀,
二善也。神彩精明,语声清朗,三善也。脓清肿消,色鲜不臭,四善也。体气和平,五善也。五
善见三则吉,诸恶见四必危。
我担心冲洗(淋洗)虽然能带来一时的舒适,但过了一会儿恐怕患者身体会感到疲惫,产生难以忍受的感觉,这难道不是正气虚弱吗?怎能不预先考虑使用补益接续之法呢?(所谓“补接”,即人参、[白术]、当归、白术之类的药物。)
〔苏〕将乱发、蜂房、蛇蜕皮分别烧成炭存性,每味取一钱匕的量,用酒调服,治疗疮疡久不愈合,效果神奇。
〔《灵枢》〕眼白泛青,黑睛缩小,这是一逆证。用药后发生呕吐,是二逆证。腹痛且极度口渴,是三逆证。肩项部活动不便,是四逆证。声音嘶哑、面色枯槁,是五逆证。除去这五种情况,其余为顺证。(出自《玉版篇》)
〔《精要》〕痈疽破溃之后,其形态征候有逆证和顺证之分。眼白泛青黑且紧缩变小,是一恶证。不能进食,用药后呕吐,饮食不知滋味,是二恶证。腹痛且极度口渴,是三恶证。肩背活动不便,四肢沉重,是四恶证。声音嘶哑、面色枯槁、唇鼻呈青黑色、面目及四肢浮肿,是五恶证。烦躁不安、时常咳嗽、腹痛且极度口渴、泄泻无度、小便像淋证一样涩痛,是六恶证。脓血大量流出,疼痛更加剧烈,脓液颜色败坏且有臭味,气息令人无法靠近,是七恶证。呼吸急促短气,神志恍惚嗜睡,是八恶证。未溃烂前局部先变黑且深陷,面色青、嘴唇暗、大便污秽的,是九恶证。更有嗳气痞塞、咳嗽、身体寒冷、不时自汗、瞪眼耳聋、神志恍惚惊悸、言语错乱颠倒,这些都是恶证。动静自然安宁,饮食知味,是一善证。大小便调匀,是二善证。神采精明,语声清朗,是三善证。脓液清澈、肿胀消退、色泽鲜红且不臭,是四善证。体质气息平和,是五善证。出现五种善证中的三种则预后吉利,出现各种恶证中的四种则必然危险。
I fear that although washing (lín xǐ) provides momentary relief, the patient may soon feel physically exhausted and develop a sense of intolerance. Is this not indicative of deficiency? How can one fail to consider beforehand the use of tonification and replenishment methods? ("Tonification and replenishment" refers to herbs such as Renshen [Ginseng Radix et Rhizoma], Baizhu [Atractylodis Macrocephalae Rhizoma], Danggui [Angelicae Sinensis Radix], and Baizhu [Atractylodis Macrocephalae Rhizoma].)
[Su] Charred human hair (Fà), honeycomb (Fēngfáng), and snake skin (Shé tuì pí), each processed by burning to retain their properties, taken in doses of one qian bi (a small spoonful) mixed with wine, treats chronic non-healing sores with miraculous efficacy.
(Danxi stated: Hair has a very rapid effect in nourishing Yin.)
[Dan] To converge the sore opening, there is only one method: decocting willow bark (Liupi) and Bai Lian [Akebiae Caulis or Puerariae Radix depending on context, here likely Akebiae Caulis/Bai Lian] for drinking.
[Lingshu] If the whites of the eyes appear greenish and the black part of the eye is small, this is the first reverse syndrome (nì zhèng). Vomiting after administering medication is the second reverse syndrome. Abdominal pain with extreme thirst is the third reverse syndrome. Inconvenience in movement of the shoulders and neck is the fourth reverse syndrome. Hoarseness of voice and depletion of complexion is the fifth reverse syndrome. Excluding these five conditions, the rest are considered favorable (shùn). (From "Yu Ban Pian")
[Jing Yao] After the ulceration of carbuncles and sores, the clinical manifestations can be either reverse (nì) or favorable (shùn).
1. The whites of the eyes appear greenish-black, tight, and small; this is the first evil sign (è zhèng).
2. Inability to eat, vomiting after taking medicine, and loss of taste for food; this is the second evil sign.
3. Abdominal pain with extreme thirst; this is the third evil sign.
4. Inconvenience in the shoulders and back, heaviness in the four limbs; this is the fourth evil sign.
5. Hoarseness, depletion of complexion, cyanosis of lips and nose, and edema of the face, eyes, and four limbs; this is the fifth evil sign.
6. Restlessness, frequent coughing, abdominal pain with extreme thirst, uncontrolled diarrhea, and dysuria resembling strangury; this is the sixth evil sign.
7. Massive discharge of pus and blood, intensified pain, foul-smelling and discolored pus, and an odor that repels others; this is the seventh evil sign.
8. Rapid and coarse breathing, shortness of breath, mental confusion, and excessive drowsiness; this is the eighth evil sign.
9. Prior to ulceration, local tissue turns black and sinks deeply, accompanied by a greenish face, dark lips, and fecal impurity; this is the ninth evil sign.
Additionally, belching with chest fullness, coughing, cold body, spontaneous sweating at any time, staring eyes with deafness, mental confusion with palpitations, and erratic speech are all evil signs.
Conversely:
1. Natural calmness in movement and rest, and appetite for food; this is the first good sign (shàn zhèng).
2. Regular and balanced bowel movements and urination; this is the second good sign.
3. Bright spirit and clear mind, clear and resonant voice; this is the third good sign.
4. Clear pus, subsided swelling, fresh color without odor; this is the fourth good sign.
5. Harmonious constitution and peaceful qi; this is the fifth good sign.
If three of the five good signs appear, the prognosis is auspicious. If four of the various evil signs appear, the condition is critical.