条文:114
倒靥浆清陷不红,痘壳皮皱痂不成,速用加味保元剂,气血充足痘收功。
[注]
倒靥者,装色清稀不足 根脚淡白无晕,遍体形如痘壳,
疮皮皱而似结非结,至收靥时,终不成痂,
此因气血两虚,乏领载之力也,
宜加味保元汤治之。
(加味保元汤) 人参 黄耆蜜炙 甘草炙 全当归酒洗 白芍酒炒
木香煨 白术土炒官桂 引用老米水煎服。
(方歌)
加味保元治倒靥,人参黄耆甘草协,当归白芍广木香,白术官桂效更捷。
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条文:115
痘疔枭毒乱正疮,色紫黑黯形坚强,先出先长妨诸痘,针刺随贴四圣良。
[注]
痘疔之成,由枭毒蕴伏,锢蔽于肌肉之间,
痘未出疔先出,痘未长疔先长,
其色紫黑其形坚强,五藏各有所见,
心疔色赤,起于颧阜胸乳之处,
肝疔色紫,起于左太阳,左胁眼胞,两臀阜之处,
脾疔色先黄后黑,起于腮颊,中庭,口角,肚腹,手足之处,
肺疔色先灰后黑,起于右太阳,右胁,颈项,喉突之处,
肾疔色黑,起于地合后,颈耳窖,背窬,腰脊,阳茎之处,
见时急用银针刺破,以泄毒血,刺后用四圣膏贴患处,
若迟延不治,能使痘当发不发,当胀不胀,当灌不灌,而百变生矣。
(四圣膏) 菉豆四十九粒 豌豆四十九粒俱烧灰存性 珍珠一分煆
头发一分烧灰 以上为细末,以棉燕脂水调和成膏,
将银针拨开疮头,然后涂之。
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条文:114
痘疹浆液清稀、塌陷且颜色不红,痘壳皮肤皱缩、结痂不成形,应迅速使用加味保元剂,使气血充足以完成痘疹收功。
[注]
所谓倒靥(痘疹后期因气血虚弱导致痘疮不能正常结痂而反陷),是指痘色清稀不足、根部淡白无红晕,全身形态如同空壳,疮皮皱缩似结非结,到了收靥阶段,最终无法结成痂皮。这是因为气血两虚,缺乏承载托举之力所致,适宜用加味保元汤治疗。
(加味保元汤) 人参、黄耆蜜炙、甘草炙、全当归酒洗、白芍酒炒、木香煨、白术土炒、官桂,引用老米水煎服。
(方歌)
加味保元治倒靥,人参黄耆甘草协,当归白芍广木香,白术官桂效更捷。
条文:115
痘疔(生于痘疮中的毒疔)如枭鸟之毒扰乱正疮,颜色紫黑黯沉、形状坚硬,往往先于其他痘疹出现并生长,妨碍诸痘发育,需用针刺破后随即贴上四圣膏疗效良好。
[注]
痘疔的形成,是由于枭毒蕴藏潜伏,固闭于肌肉之间。痘疹尚未发出时疔已先出,痘疹尚未长大时疔已先长。其颜色紫黑,形状坚硬,五脏各有对应的表现:
心疔颜色赤红,起于颧骨隆起处、胸部和乳房部位;
肝疔颜色紫暗,起于左侧太阳穴、左胁部、眼睑及两侧臀部隆起处;
脾疔颜色先黄后黑,起于腮颊、中庭(胸骨剑突下)、口角、腹部及手足部位;
肺疔颜色先灰后黑,起于右侧太阳穴、右胁部、颈项、喉结突出处;
肾疔颜色黑,起于地合后(尾闾附近)、颈耳后方、背部腰臀、腰脊及阳茎部位。
发现时急用银针刺破,以泄出毒血,刺后用四圣膏贴敷患处。若拖延不治,会导致痘疹该发不发、该胀不胀、该灌浆不灌浆,从而产生各种变证。
(四圣膏) 菉豆四十九粒、豌豆四十九粒,均烧灰存性;珍珠一分,煅制;头发一分,烧灰。以上研为细末,用棉燕脂水调和成膏。将银针拨开疮头,然后涂敷。
Article 114
When the pustular fluid of variola (smallpox) is clear and thin, the lesions are sunken and lack redness, and the scab skin is wrinkled with incomplete crusting, Jia Wei Bao Yuan Ji (Modified Formula for Preserving Vitality) should be administered promptly to replenish Qi and Blood, thereby facilitating the completion of the healing process.
[Note]
Dao Ye (Reversed Crusting) refers to a condition where the lesion color is clear and insufficient, the root base is pale white without a surrounding halo, and the entire body resembles empty shells. The sore skin is wrinkled, appearing as if forming a crust but not actually doing so. By the time of the crusting stage, it ultimately fails to form a scab. This is due to deficiency in both Qi and Blood, lacking the strength to support and lift the toxin outward. It is suitable for treatment with Jia Wei Bao Yuan Tang (Modified Decoction for Preserving Vitality).
(Jia Wei Bao Yuan Tang) Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix) honey-fried, Gan Cao (Licorice Radix et Rhizoma) fried, Quan Dang Gui (Angelicae Sinensis Radix) wine-washed, Bai Shao (Paeoniae Radix Alba) wine-stir-fried, Mu Xiang (Aucklandiae Radix) baked, Bai Zhu (Atractylodis Macrocephalae Rhizoma) soil-stir-fried, Guan Gui (Cinnamomi Cortex), decocted with water from old rice.
(Verse)
Jia Wei Bao Yuan treats reversed crusting, Ginseng, Astragalus, and Licorice cooperate; Angelica, White Peony, and Costus root follow, Atractylodes and Cinnamon make the effect more swift.
Article 115
Dou Ding (Smallpox Carbuncle), harboring venomous toxicity that disrupts normal lesions, appears purple-black and dark, with a hard and firm shape. It often emerges and grows before other smallpox lesions, hindering their development. It should be pricked with a needle and immediately covered with Si Sheng Gao (Four Sages Plaster) for good efficacy.
[Note]
The formation of Dou Ding results from the accumulation and latent hiding of venomous toxins, which are sealed within the muscles. The carbuncle appears before the smallpox erupts and grows before the smallpox matures. Its color is purple-black, and its shape is hard and firm. Each Zang organ has specific manifestations:
Xin Ding (Heart Carbuncle) is red in color and arises on the malar eminence, chest, and breast areas;
Gan Ding (Liver Carbuncle) is purple in color and arises at the left Taiyang point, left hypochondrium, eyelids, and bilateral gluteal eminences;
Pi Ding (Spleen Carbuncle) is initially yellow then turns black, arising at the cheeks, Zhongting (below the xiphoid process), corners of the mouth, abdomen, and hands/feet;
Fei Ding (Lung Carbuncle) is initially gray then turns black, arising at the right Taiyang point, right hypochondrium, neck, and laryngeal prominence;
Shen Ding (Kidney Carbuncle) is black in color, arising at the Dihe posterior (near the tailbone), behind the ears and neck, back and buttocks, lumbar spine, and penis.
Upon discovery, silver needles should urgently be used to pierce the lesion to drain toxic blood, followed by the application of Si Sheng Gao (Four Sages Plaster) to the affected area. If treatment is delayed, it may cause the smallpox to fail to erupt, swell, or suppurate as expected, leading to various complications.
(Si Sheng Gao) Lv Dou (Vigna Radiata Seed) 49 grains, Wan Dou (Pisum Sativum Seed) 49 grains, both burnt to ash while retaining their properties; Zhen Zhu (Margarita) 1 fen, calcined; Tou Fa (Capilli Humanii) 1 fen, burnt to ash. Grind the above into fine powder, mix with Mian Yan Zhi Shui (water prepared from cotton rouge) to form a paste. Use a silver needle to open the head of the sore, then apply the paste.