【方歌】上水鱼生委中旁,折纹两梢疼埂昂,长若鱼形瘀热结,
外施砭血敷二黄。
【注】此证生委中折纹两梢,肿如高埂,长若鱼形,色紫作痛
。由血热遇外寒稽留,则血瘀凝结而成。外用砭法,向
肿埂上砭出恶血,兼用二黄散香油调敷,甚效。
方剂:二黄散(即颠倒散,见鼻部肺风粉刺)
歌诀;膝肘疮生如人面,自古传来系孽因,流气苦参敷贝母,
从善改恶自察心。
【注】此证自古传来,乃奇病也。多生两膝或生两肘,肿类人
形,眉目口鼻皆具。《本事方》云:疮口能饮食,施治
诸药,绝无所苦,惟敷贝母,其疮皱眉闭口,自此日用
贝母末和水敷灌,数日疮消结痂而愈。又诸书皆以为素
积冤谴,须自清心忏悔。初宜服流气饮,日久宜用大苦
参丸。今据所用之药,俱系辛热疏散之品,其证或因风
、寒、湿三气,凝合之所化,亦未必尽由冤谴之所致也
,根据古施治,谅可奏效。
方剂:大苦参丸
组成;苦参(二两) 蔓荆子
赤茯苓 山药
白芷 荆芥
防风 白附子
川芎 山栀(生)
何首乌 白蒺藜
皂角 川乌(炮)
黄耆 赤芍
独活 羌活(各五钱)
草乌(炮,一钱五分)
上为细末,面糊和丸,如梧桐子大。每服五、七十
丸,空心黄酒送下,不饮酒者,以茶代之。
【方歌】大苦参丸人面疮,蔓苓山药芷荆防,白附芎栀何蒺皂,
川草乌耆芍独羌。
又方:流气饮(见背部痰注发)
御纂医宗金鉴卷十一编辑外科
心法要诀胫部
【方歌】上水鱼生于委中穴旁,在腘窝横纹的两端出现疼痛的硬结隆起,形状像鱼,这是瘀热互结所致。
外用砭石放血,并敷贴二黄散。
【注】这种病症生长在委中穴处的腘窝横纹两端,肿胀如同高高的土埂,长度呈鱼形,颜色紫暗且伴有疼痛。
这是由于血分有热,又遭遇外寒滞留,导致血液瘀滞凝结而形成的。
治疗时采用外用的砭法,在肿胀的硬结处用砭石刺破放出恶血,同时配合使用二黄散,用香油调匀后敷贴,效果很好。
方剂:二黄散(即颠倒散,参见鼻部肺风粉刺章节)
歌诀:膝肘部的疮疡长得像人面,自古以来流传认为是宿世孽缘所致,可用流气饮和苦参,外敷贝母,通过向善改过来自我反省内心。
【注】这种病症自古就有记载,属于奇异的疾病。
多生长于双膝或双肘部位,肿胀形状类似人形,具备眉毛、眼睛、嘴巴和鼻子等特征。
《本事方》记载:疮口能够进食,施用各种药物,疮口毫无痛苦反应,只有敷上贝母粉,疮口才会皱眉闭口。
从此每天用贝母粉末加水调和后敷灌,数日后疮疡消退、结痂而痊愈。
另外,许多医书都认为这是平素积累冤仇报应所致,必须自我清理内心、忏悔过错。
初期适宜服用流气饮,病程日久则适宜使用大苦参丸。
如今根据所使用的药物分析,都是辛温发散、疏散风邪的药物,此证或许是由风、寒、湿三种邪气凝合转化而成,也未必完全由冤仇报应所导致。
依据古人的治疗方法,想必可以取得疗效。
方剂:大苦参丸
组成:苦参(二两)、蔓荆子、赤茯苓、山药、白芷、荆芥、防风、白附子、川芎、山栀(生用)、何首乌、白蒺藜、皂角、川乌(炮制)、黄耆、赤芍、独活、羌活(各五钱)、草乌(炮制,一钱五分)。
以上药材研为细末,用面糊调和制成丸药,大小如梧桐子。
每次服用五七十丸,空腹时用黄酒送服,不饮酒的人,以茶代替。
【方歌】大苦参丸治疗人面疮,包含蔓荆、茯苓、山药、白芷、荆芥、防风,还有白附子、川芎、山栀、何首乌、白蒺藜、皂角,以及川乌、草乌、黄耆、赤芍、独活、羌活。
另一个方剂:流气饮(参见背部痰注发章节)
御纂医宗金鉴卷十一 编辑外科心法要诀 胫部
[Formula Song] The Shangshuiyu (Fish-like Ulcer) grows beside the Weizhong point, presenting as painful, raised hard knots at both ends of the popliteal crease. Its shape resembles a fish, indicating a binding of blood stasis and heat.
Externally apply bloodletting with a bi stone, and apply Erhuang San (Two-Yellow Powder).
[Annotation] This condition arises at both ends of the popliteal crease at the Weizhong point. It swells like a high ridge, is elongated in the shape of a fish, appears purple in color, and is painful.
It is caused by blood-heat encountering external cold stagnation, leading to blood stasis and coagulation.
Treatment involves the external application of the bi method: using a bi stone to puncture the swollen ridge to release foul blood, combined with applying Erhuang San mixed with sesame oil. This yields excellent results.
Formula: Erhuang San (also known as Diandao San; see section on Acne Rosacea/Papulopustular Acne of the Lung for details).
Song Verse: Ulcers on the knees or elbows resembling human faces have been passed down since ancient times, attributed to karmic retribution. Use Liqi Yin (Flowing Qi Decoction) and Kushen (Sophora Root), and externally apply Beimu (Fritillaria Bulb). One must turn from evil to good and examine one's heart.
[Annotation] This condition has been recorded since ancient times and is considered a rare disease.
It commonly occurs on both knees or both elbows. The swelling resembles a human form, complete with eyebrows, eyes, mouth, and nose.
The *Ben Shi Fang* records that the ulcer opening can "eat"; when various medicines are applied, the ulcer shows no distress. However, when Beimu powder is applied, the ulcer frowns and closes its mouth.
From then on, daily application and irrigation with Beimu powder mixed with water will cause the ulcer to subside and scab over within a few days, leading to recovery.
Furthermore, many medical texts attribute this to accumulated grievances and retribution from past lives, requiring self-purification of the mind and repentance.
Initially, it is suitable to take Liqi Yin (Flowing Qi Decoction); for long-standing cases, Dakushen Wan (Major Sophora Pill) is appropriate.
Based on the ingredients used, which are all acrid-warm dispersing agents, this condition may be transformed by the confluence of Wind, Cold, and Dampness pathogens, and is not necessarily entirely caused by karmic retribution.
Following ancient treatment methods should yield effective results.
Formula: Dakushen Wan (Major Sophora Pill)
Composition: Kushen (Sophorae Radix, 2 liang), Manjingzi (Vitex Fructus), Chifuling (Poria Cocos with Red Host), Shanyao (Dioscoreae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Baifuzi (Aconiti Kusnezoffii Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shanzhi (Gardeniae Fructus, raw), Heshouwu (Polygoni Multiflori Radix), Baijili (Tribuli Fructus), Zaojiao (Gleditsiae Sinensis Spina), Chuanwu (Aconiti Radix Praeparata), Huangqi (Astragali Radix), Chishao (Paeoniae Radix Rubra), Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygii Rhizoma et Radix, each 5 qian), Caowu (Aconiti Radix Praeparata, 1.5 qian).
Grind the above into a fine powder, mix with flour paste to form pills the size of sophora seeds.
Take 50–70 pills per dose, administered orally on an empty stomach with yellow wine. For those who do not drink alcohol, tea may be used as a substitute.
[Formula Song] Dakushen Wan treats the Human-Face Ulcer, containing Manjing, Ling, Shanyao, Zhij, Jing, Fang, Baifu, Chuanxiong, Zhizi, Heshouwu, Biji, Zao, Chuanwu, Caowu, Huangqi, Chishao, Duhuo, and Qianghuo.
Another Formula: Liqi Yin (Flowing Qi Decoction; see section on Phlegm-Nodule Abscess of the Back for details).
Imperial Compilation of Medical Essentials, Volume XI, Edited Surgical Methods Essential Verses, Tibia Region