〔涓〕热毒方盛,或发大渴,此是毒攻心脏,令舌干烦渴也。但以补心气药,内补即止。
〔罗〕竹叶黄 汤治发背发渴,通治诸疮大渴。
淡竹叶(二两) 生地(八两) 黄 麦门冬(去心) 当归 川芎 甘草 黄芩 芍药
人参 半夏(汤洗) 石膏(各三两)
上为粗末,每服五钱,水一盏半,竹叶五七片,同煎至一盏,去渣,温服无时。(虚渴者
忌用石膏、半夏、黄芩。)
金银花散
金银花(四两,去土) 甘草(一两,炒)
上为细末,每服四钱,水酒各一盏,同煎至一盏,去渣热服。
〔丹〕《外科精要》云∶疽向安后发渴,与加减八味丸。夫当此时血气两虚,当用参、 补气,当
归、地黄养血,渴当自止。何必泽泻、茯苓导水,佐以肉桂?若忍冬丸、黄 六一汤等方,切
当。忍冬养血,黄 补气,渴何由作。
〔《精》〕忍冬丸大能止渴,及疗渴疾,既愈之后,须预防外痈疽,大宜服此。
忍冬草(不以多少,根茎花叶皆可用)
上入瓶内,以无灰好酒浸,以糠火煨一宿,取出晒干,入甘草少许,研为细末,以所浸酒
打面糊丸,如桐子大,每服五十丸至百丸,无时酒饮任下。
黄 六一汤大治渴疾,补虚乏,常服此药,终身可免痈疽之疾。
绵黄 (去芦,六两,一半生用,一半盐水润蒸,三次焙干) 粉草(一两,一半生,
一半炙黄用)
上为细末,每服二钱,早晨日午,以白汤点服。若饮初杯,用酒调尤妙。
桑枝汤大治口干。
取桑枝一小升,细切炒香,以水三大升,煎取二升。一日服尽。
五味子汤大治口燥舌干,此是肾水竭也。
五味 黄 (去芦,生用) 人参(去芦) 麦门冬(去心) 粉草(炙,半两)
上 咀,每服半两,水一盏半,煎至八分,去渣温服,无时候,一日二夜五七服妙。
〔丹〕《外科精要》云∶呕逆有二证,一证谓初发时,不曾服内托散,伏热在心。一证谓
气虚脾气不正而呕,伏热在心,与内托散三两帖,气虚而呕,宜嘉禾散。有寒热,宜家传正气散,
兼与山药丸以补肾。谨按病机,诸逆冲上呕越,皆属于火。其内托散性凉,固有降火之理,若
嘉禾散群队以为补虚之剂,补力已少,徒有温暖助火耳。山药丸补肾以壮下焦之阴,粗为近理。
然治呕,须分先后,肿疡时,当作毒瓦斯上攻治之。溃疡后,当作阴虚补之。若年老因疽溃发呕不
食者,宜用参 白术膏峻补取效。佐药随时随证加减,恐用山药丸,缓急未易得力。河间谓诸病
疮疡如呕者,湿气侵于胃也,药中宜倍加白术。
丹溪治一老人,背疽呕逆,用补药效。方见溃疡门。予治一男子肿疡呕,诸药不止,用独
参汤一服,呕即愈。
〔《精》〕犀角膏治咽喉口舌生疮。
昔有一贵人,因疽而生此证,医者以为心脏绝尽,皆辞退。愚进此药,一日而安。
真琥珀(研) 生犀角(各一钱) 辰砂(研) 茯神(去木。各二钱) 真脑子(研,一字)
人参(去芦) 酸枣仁(去皮研。各二钱)
上人参、茯神、犀角为细末,入乳钵内,别研药味和匀,用炼蜜搜为膏子。以瓷瓶收贮,
俟其疾作,每服一弹子大,以麦门冬去心,浓煎汤化服,一日连服五服,取效。(此方溃疡不宜用。)
〔涓〕治发背痈疽,脓溃后气虚,脾脏滑泄,并四肢逆冷,宜用和气散。
苍术(四两,米泔浸三日,洗净,晒干,再以米醋炒令香黄色) 甘草(炙) 青皮(去穣。
各一两) 良姜(炒) 肉桂 干姜(炮。各半两) 陈粟(半升)
上七味,为末,每服一钱,用炒茴香末半钱,相和温酒调下,不拘时。
〔垣〕圣愈汤 治诸恶疮血出不止,以寒水石细末掺之,立止。或疮时间作黑色,不可溃也,
药力去尽却红和。如血出多而心烦不安,不得眠睡,此亡血也。此汤主之。
熟地 生地(各三钱) 归身(一钱半) 川芎(二钱) 黄 (五分) 人参(三分)
上 咀,如麻豆大,都作一服,水盏半,煎至一盏,去渣,稍热服无时。
〔梅〕治背疮肉长疾,皮不及裹,见风即成僵。以寒水石烧研为细末,敷疮上,再用铜绿细末
上之,肉即不作僵矣。
〔《图经》〕古方疗恶疮痈肿,或连阴髀间疼痛,急挛牵入小腹不可忍,一宿则杀人者。用
茴香苗叶捣取汁一升,服之,日三四,用其滓以贴肿上,冬中根亦可用。此外国方,永嘉以来用之,
起死神效。
【涓】热毒正盛时,如果出现极度口渴,这是毒邪攻心,导致舌干、心烦、口渴。只需使用补益心气的药物,内里得到补益后症状即可停止。
【罗】竹叶石膏汤治疗发背疽引发的口渴,通用治疗各种疮疡引起的严重口渴。
淡竹叶(二两) 生地黄(八两) 黄芪 麦门冬(去心) 当归 川芎 甘草 黄芩 芍药
人参 半夏(汤洗) 石膏(各三两)
以上药材捣成粗末,每次服用五钱,加水一盏半,放入五到七片竹叶,同煎至一盏量,滤去药渣,随时温服。(虚证口渴者忌用石膏、半夏、黄芩。)
金银花散
金银花(四两,去土) 甘草(一两,炒制)
以上药材研为细末,每次服用四钱,用水和酒各一盏,同煎至一盏量,滤去药渣,趁热服用。
【丹】《外科精要》说:疽病在趋向痊愈后出现口渴,应用加减八味丸。此时气血两虚,应当用人参、黄芪补气,当归、地黄养血,口渴自然停止。何必用泽泻、茯苓利水,佐以肉桂?像忍冬丸、黄芪六一汤等方剂,非常恰当。忍冬养血,黄芪补气,口渴从何而来?
【《精》】忍冬丸大有止渴功效,以及治疗消渴病,病愈之后,必须预防外发痈疽,非常适合服用此药。
忍冬草(不限多少,根、茎、花、叶均可使用)
以上药材放入瓶内,用无灰好酒浸泡,用糠火煨烤一夜,取出晒干,加入少许甘草,研为细末,用浸泡过的酒打面糊制成丸药,如梧桐子大,每次服用五十丸至一百丸,随时可用酒送服。
黄芪六一汤大力治疗消渴病,补益虚弱乏力,常服此药,终身可免除痈疽之疾。
绵黄芪(去芦头,六两,一半生用,一半用盐水润湿蒸制,三次焙干) 粉甘草(一两,一半生用,一半炙黄用)
以上药材研为细末,每次服用二钱,早晨和中午,用白开水冲服。如果刚开始喝,用酒调服尤其妙。
桑枝汤大力治疗口干。
取桑枝一小升,切碎炒香,用水三大升,煎取二升。一天服完。
五味子汤大力治疗口燥舌干,这是肾水枯竭所致。
五味子 黄芪(去芦头,生用) 人参(去芦头) 麦门冬(去心) 粉甘草(炙,半两)
以上药材切碎,每次服用半两,加水一盏半,煎至八分,滤去药渣温服,不分时候,一天夜间服用五到七次效果更佳。
【丹】《外科精要》说:呕吐逆乱有两种证候,一种证候是说初发时,未曾服用内托散,伏热在心。另一种证候是说气虚脾气不正而呕吐,伏热在心,给予内托散三帖;气虚而呕吐,宜用嘉禾散。有寒热症状的,宜用家传正气散,兼用山药丸以补肾。谨按病机,各种上逆冲上的呕吐,都属于火。内托散性凉,确实有降火的道理;若嘉禾散作为补虚的药剂,补力已经很少,徒有温暖助长火势的作用。山药丸补肾以壮下焦之阴,粗略看比较接近事理。然而治疗呕吐,必须分清先后,肿疡阶段,当作毒瓦斯上攻来治疗。溃疡后期,当作阴虚来补益。如果年老因疽疮溃烂引发呕吐不进食的,宜用人参、白术膏峻猛补益以求见效。辅助药物随时间随证候加减,恐怕使用山药丸,缓急之间不易得力。河间认为各种疮疡如呕吐者,是湿气侵扰胃腑,药物中应加倍加入白术。
丹溪治疗一位老人,背疽呕吐逆乱,用补益药有效。方剂见溃疡门。我治疗一名男子,肿疡期呕吐,诸药不止,用独参汤一服,呕吐即愈。
【《精》】犀角膏治疗咽喉口舌生疮。
过去有一位贵人,因疽疮而产生此证,医生认为心脏元气已绝,都辞退不治。我进献此药,一天就安定了。
真琥珀(研碎) 生犀角(各一钱) 辰砂(研碎) 茯神(去木心,各二钱) 真脑子(研碎,一字)
人参(去芦头) 酸枣仁(去皮研碎,各二钱)
以上人参、茯神、犀角研为细末,放入乳钵内,将其他药味分别研碎混合均匀,用炼蜜调和成膏状。用瓷瓶收贮,等到疾病发作时,每次服用一弹子大小,用麦门冬去心,浓煎汤化开服下,一天连续服用五次,可取效。(此方溃疡期不宜使用。)
【涓】治疗发背痈疽,脓液溃破后气虚,脾脏滑泄,并伴有四肢逆冷,宜用和气散。
苍术(四两,米泔水浸泡三日,洗净,晒干,再用米醋炒至香黄色) 甘草(炙制) 青皮(去瓤,各一两) 良姜(炒制) 肉桂 干姜(炮制,各半两) 陈粟米(半升)
以上七味药,研为末,每次服用一钱,用炒茴香末半钱,混合后用温酒调下,不拘时间。
【垣】圣愈汤治疗各种恶疮出血不止,用寒水石细末撒敷,立即止血。或者疮口间歇出现黑色,无法溃破,药力去除尽后却变红柔和。如果出血多且心烦不安,无法睡眠,这是亡血。此汤主治。
熟地黄 生地黄(各三钱) 归身(一钱半) 川芎(二钱) 黄芪(五分) 人参(三分)
以上药材切碎,如麻豆大小,全部作为一服,加水一盏半,煎至一盏,滤去药渣,稍热时随时服用。
【梅】治疗背疮肌肉生长过速,皮肤不足以包裹,见风即变成僵硬。用寒水石烧后研为细末,敷在疮上,再用铜绿细末覆盖其上,肌肉就不会变僵硬了。
【《图经》】古方治疗恶疮痈肿,或者牵连阴部和大腿间疼痛,紧急痉挛牵引入小腹不可忍受,一宿则杀人者。用茴香苗叶捣取汁液一升,服用,每天三四次,用其药渣贴敷在肿处,冬天也可以用根。这是外国方剂,永嘉以来使用,起死回生效果显著。
[Juan] When heat-toxin is flourishing, if extreme thirst occurs, this is toxin attacking the Heart, causing dry tongue, restlessness, and thirst. Simply use herbs to tonify Heart Qi; once internally tonified, the symptoms will cease.
[Luo] Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction) treats thirst caused by back carbuncles and is generally used for severe thirst in various sores.
Dan Zhu Ye (Lophatheri Herba, Bamboo Leaf) (2 liang), Sheng Di Huang (Rehmanniae Radix, Raw Rehmannia Root) (8 liang), Huang Qi (Astragali Radix, Astragalus Root), Mai Men Dong (Ophiopogonis Tuber, Ophiopogon Tuber), Dang Gui (Angelicae Sinensis Radix, Angelica Root), Chuan Xiong (Chuanxiong Rhizoma, Szechwan Lovage Rhizome), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root), Huang Qin (Scutellariae Radix, Scutellaria Root), Shao Yao (Paeoniae Radix, Peony Root), Ren Shen (Ginseng Radix, Ginseng Root), Ban Xia (Pinelliae Tuber, Pinellia Tuber), Shi Gao (Gypsum Fibrosum, Gypsum) (each 3 liang).
Grind the above into coarse powder. Take 5 qian per dose, add 1.5 sheng of water and 5-7 slices of bamboo leaf, decoct until 1 sheng remains, strain, and take warm at any time. (Contraindicated for deficiency-type thirst: avoid Shi Gao, Ban Xia, Huang Qin.)
Jinyinhua San (Honeysuckle Powder)
Jin Yin Hua (Lonicerae Japonicae Flos, Honeysuckle Flower) (4 liang, cleaned), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (1 liang, stir-fried).
Grind the above into fine powder. Take 4 qian per dose, add 1 sheng of water and 1 sheng of wine, decoct until 1 sheng remains, strain, and take hot.
[Dan] *Waike Jingyao* (Essentials of Surgery) states: If thirst occurs after a carbuncle begins to heal, use Ji Jian Ba Wei Wan (Modified Eight-Ingredient Pill with Rehmannia). At this stage, both Qi and Blood are deficient. One should use Ren Shen (Ginseng Radix, Ginseng Root) and Huang Qi (Astragali Radix, Astragalus Root) to tonify Qi, and Dang Gui (Angelicae Sinensis Radix, Angelica Root) and Di Huang (Rehmanniae Radix, Rehmannia Root) to nourish Blood; thirst will stop naturally. Why use Ze Xie (Alismatis Rhizoma, Water Plantain Rhizome) and Fu Ling (Poria, Poria Cocos) to drain dampness, assisted by Rou Gui (Cinnamomi Cortex, Cinnamon Bark)? Formulas such as Rendong Wan (Honeysuckle Pill) and Huang Qi Liu Yi Tang (Astragalus Six-to-One Decoction) are highly appropriate. Rendong Cao (Lonicerae Japonicae Caulis et Flos, Honeysuckle Stem and Flower) nourishes Blood, Huang Qi (Astragali Radix, Astragalus Root) tonifies Qi; how can thirst arise?
[*Jing*] Rendong Wan (Honeysuckle Pill) greatly stops thirst and treats xiao ke disease (wasting-thirst syndrome). After recovery, one must prevent external carbuncles and furuncles; it is highly suitable to take this medicine.
Rendong Cao (Lonicerae Japonicae Caulis et Flos, Honeysuckle Stem and Flower) (any amount, root, stem, flower, and leaves all usable).
Place the above in a bottle, soak in good unadulterated wine, simmer over chaff fire overnight, take out, dry, add a little Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root), grind into fine powder, make pills using the soaking wine and flour paste, size of paulownia seeds. Take 50-100 pills at any time, washed down with wine.
Huang Qi Liu Yi Tang (Astragalus Six-to-One Decoction) greatly treats xiao ke disease (wasting-thirst syndrome), tonifies deficiency and fatigue. Regular use of this medicine can prevent carbuncles and furuncles for life.
Mian Huang Qi (Astragali Radix, Astragalus Root) (remove rhizome, 6 liang, half raw, half steamed with salt water, dried three times), Fen Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (1 liang, half raw, half honey-fried).
Grind the above into fine powder. Take 2 qian per dose, morning and noon, taken with plain boiled water. Mixing with wine at the beginning of drinking is especially excellent.
Sang Zhi Tang (Mulberry Twig Decoction) greatly treats dry mouth.
Take 1 sheng of Sang Zhi (Mori Ramulus, Mulberry Twig), cut finely, stir-fry until fragrant, add 3 sheng of water, decoct to obtain 2 sheng. Consume within one day.
Wu Wei Zi Tang (Schisandra Decoction) greatly treats dry mouth and tongue, which is due to exhaustion of Kidney Water.
Wu Wei Zi (Schisandrae Chinensis Fructus, Schisandra Fruit), Huang Qi (Astragali Radix, Astragalus Root) (remove rhizome, raw), Ren Shen (Ginseng Radix, Ginseng Root) (remove rhizome), Mai Men Dong (Ophiopogonis Tuber, Ophiopogon Tuber) (remove heart), Fen Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (honey-fried, 0.5 liang).
Cut the above into pieces. Take 0.5 liang per dose, add 1.5 sheng of water, decoct to 0.8 sheng, strain, and take warm at any time. Taking it 5-7 times during the day and night is optimal.
[Dan] *Waike Jingyao* (Essentials of Surgery) states: There are two types of vomiting and regurgitation. One type occurs when initially developing, without having taken Neituo San (Internal Support Powder), where latent heat resides in the Heart. The other type is vomiting due to Qi deficiency and abnormal Spleen Qi, with latent heat in the Heart. For latent heat in the Heart, administer 3 doses of Neituo San (Internal Support Powder); for Qi deficiency vomiting, use Jiahe San (Harmonizing Grain Powder). If there are alternating chills and fever, use Jiachuan Zhengqi San (Family-Transmitted Upright Qi Powder), combined with Shanyao Wan (Dioscorea Pill) to tonify the Kidney. Carefully analyzing the pathogenesis, all upward rushing and vomiting belong to Fire. Neituo San (Internal Support Powder) is cool in nature and indeed has the principle of descending Fire. However, Jiahe San (Harmonizing Grain Powder) as a group of tonifying deficiency agents has little tonifying power and merely provides warmth that aids Fire. Shanyao Wan (Dioscorea Pill) tonifies the Kidney to strengthen the Yin of the Lower Jiao, which is roughly close to reason. However, treating vomiting requires distinguishing stages. During the ulceration stage (swelling/abscess formation), treat it as toxic vapors attacking upwards. After ulceration, treat it as Yin deficiency and tonify. If an elderly person develops vomiting and loss of appetite due to ulcerated carbuncles, use Renshen Baizhu Gao (Ginseng and Atractylodes Paste) for vigorous tonification to achieve effect. Auxiliary medicines should be adjusted according to time and syndrome. It is feared that using Shanyao Wan (Dioscorea Pill) may not be effective in urgent situations. Hejian stated that various sores and ulcers accompanied by vomiting are caused by Dampness invading the Stomach; in medication, Bai Zhu (Atractylodis Macrocephalae Rhizoma, Large-headed Atractylodes Rhizome) should be doubled.
Danxi treated an elderly man with back carbuncle and vomiting/regurgitation, using tonifying medicines with effect. See the Ulceration Section for the formula. I treated a male patient with swelling-stage ulcer and vomiting; various medicines failed to stop it. After one dose of Dushen Tang (Single Ginseng Decoction), the vomiting ceased immediately.
[*Jing*] Xijiao Gao (Rhinoceros Horn Paste) treats sores in the throat, mouth, and tongue.
In the past, a nobleman developed this condition due to a carbuncle. Physicians believed his Heart Qi was exhausted and dismissed him. I administered this medicine, and he was stabilized in one day.
Zhen Hu Po (Amber, Succinite Lapis) (ground), Sheng Xi Jiao (Rhinocerotis Cornu, Rhino Horn) (each 1 qian), Chen Sha (Cinnabar, Cinabrum, Cinnabar), Fu Shen (Poria cum Risus, Poria with Hostwood) (remove wood, each 2 qian), Zhen Nao Zi (Borneolum Syntheticum, Borneol) (ground, 1 zi), Ren Shen (Ginseng Radix, Ginseng Root) (remove rhizome), Suan Zao Ren (Ziziphi Spinosae Semen, Jujube Seed) (skin removed, ground, each 2 qian).
Grind Ren Shen (Ginseng Radix, Ginseng Root), Fu Shen (Poria cum Risus, Poria with Hostwood), and Xi Jiao (Rhinocerotis Cornu, Rhino Horn) into fine powder. Place in a mortar, grind other medicines separately, mix evenly, knead with refined honey into a paste. Store in a porcelain bottle. When the disease strikes, take a pill the size of a bullet, dissolve in strong decoction of Mai Men Dong (Ophiopogonis Tuber, Ophiopogon Tuber) (heart removed), and take. Take five doses continuously in one day for effect. (This formula is contraindicated for ulceration stage.)
[Juan] To treat back carbuncles and furuncles, after pus has drained, if there is Qi deficiency, Spleen deficiency with slippery diarrhea, and cold extremities, use Heqi San (Harmonizing Qi Powder).
Cang Zhu (Atractylodis Rhizoma, Atractylodes Rhizome) (4 liang, soaked in rice wash water for 3 days, washed clean, dried, then stir-fried with rice vinegar until fragrant and yellow), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (honey-fried), Qing Pi (Citri Reticulatae Pericarpium Viride, Green Tangerine Peel) (remove pith, each 1 liang), Liang Jiang (Alpiniae Officinarum Rhizoma, Galangal Rhizome) (stir-fried), Rou Gui (Cinnamomi Cortex, Cinnamon Bark), Gan Jiang (Zingiberis Rhizoma, Dried Ginger) (processed, each 0.5 liang), Chen Su Mi (Setaria Italica, Foxtail Millet) (0.5 sheng).
Grind the above seven ingredients into powder. Take 1 qian per dose, mix with 0.5 qian of stir-fried Huixiang powder (Foeniculi Fructus, Fennel Fruit), and take with warm wine at any time.
[Yuan] Shengyu Tang (Sustaining Life Decoction) treats various malignant sores with continuous bleeding. Sprinkle fine powder of Hanshui Shi (Halloysitum Rubrum, Red Halloysite) on the wound to stop bleeding immediately. Or if the sore intermittently turns black and cannot ulcerate, remove all medicinal force until it becomes red and soft. If excessive bleeding causes restlessness and insomnia, this is blood loss. This decoction is indicated.
Shu Di Huang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root), Sheng Di Huang (Rehmanniae Radix, Raw Rehmannia Root) (each 3 qian), Gui Shen (Angelicae Sinensis Radix, Angelica Root tip) (1.5 qian), Chuan Xiong (Chuanxiong Rhizoma, Szechwan Lovage Rhizome) (2 qian), Huang Qi (Astragali Radix, Astragalus Root) (0.5 fen), Ren Shen (Ginseng Radix, Ginseng Root) (0.3 fen).
Cut the above into pieces the size of hemp or beans. Combine as one dose, add 1.5 sheng of water, decoct to 1 sheng, strain, and take slightly warm at any time.
[Mei] To treat back sores where flesh grows excessively, skin fails to cover, and exposure to wind causes stiffness, burn Hanshui Shi (Halloysitum Rubrum, Red Halloysite) and grind into fine powder, apply to the sore. Then cover with Tong Lv (Malachite, Malachite) fine powder, and the flesh will not become stiff.
[*Tu Jing*] Ancient formulas treat malignant sores and carbuncles, or pain connecting to the groin and thigh, with urgent spasms pulling into the lower abdomen unbearable, which kills within one night. Use Huixiang Miao Ye (Foeniculi Herba, Fennel Herb) juice extracted by pounding, 1 sheng, taken orally, 3-4 times daily. Apply the dregs to the swelling. In winter, roots can also be used. This is a foreign formula, used since the Yongjia era, with miraculous effects bringing the dead back to life.