诸疮久患成 ,常有脓水不绝,其脓不臭,内无歹肉,须先服参 归术大剂,托里
为主,或服以丸,尤宜
用附子浸透,切作片,浓二三分,于疮上着艾灸之,仍服前托里之药,隔三日再灸,不五
七次,肌肉自长满矣。又有脓水恶物渐溃根深者,用面、硫黄、大蒜三物一处捣烂,看疮
大小,捻作饼子,浓三分,安疮上,用艾炷炙二十一壮,每壮一易。后隔四五日,方
用翠霞锭子并信效锭子护用 入疮内,歹肉尽去,好肉长平,然贴收敛之药,内服应
病之剂,调理瘥。
罗谦甫云∶一人病头目赤肿,耳前热甚,疼痛不可忍,发热恶寒,牙关紧急,涕唾稠
粘,饮食难下,不得安卧,一疡医于坚硬上砭之,数四五百余针,肿赤不减,其痛益甚,
不知所由,诊其脉浮紧,按之洪缓,此寒覆皮毛,郁遏经络,热不得升,聚而赤肿。经云∶
天寒地冻则水冰,人气在中,皮肤致密,腠理闭塞,汗不出,血气强,内坚满。当是之时,
而善行水者不能往水,善穿地者不能凿冻,善用针者亦不能取四厥,必待天温,冰释
冻解,而水可行,地可穿,人脉亦由是也。又云∶冬月闭藏,水冰地坼,故用药而多针
石也。宜以苦温之剂温经散寒致胜理,少苦发之,少辛散之也。麻黄,苦温发之者也,防
风,辛温散之者也,升麻苦辛,葛根、甘草解肌出汗,专治阳明经中之邪,故以为臣。血
流而不行则痛,少加白芷辛温,当归以和血散滞;湿热则肿,以苍术苦甘,能泄皮肤腠理
之湿热,人参、甘草甘温,白芍药酸寒,调中益气使补其里也,故以为佐。如法煎服,薄衣
覆其首,浓被覆其身,卧暖则经血温,腠理开,寒乃散,阳气升,而其肿减去八九。再服,
去麻黄、防风,加连翘、鼠粘子而痛悉去。经云∶汗之则疮已,信哉。
各种疮疡长期患病形成溃疡,常常脓水淋漓不止,但脓液没有臭味,内部也没有坏死的腐肉。此时必须先服用大剂量的参、归、术(人参、当归、白术)组成的方剂,以托毒外出、补益正气为主要治疗原则;或者服用丸药,尤其适宜使用经过浸透处理的附子,切成厚约二三分的薄片,敷在疮口上,再用艾绒进行艾灸,同时继续服用前面提到的托里药物。每隔三天再灸一次,不超过五到七次,肌肉自然就会生长填满伤口。
又有那种脓水和恶臭物质逐渐溃烂、病位较深的情况,使用面粉、硫黄、大蒜这三种材料一起捣烂,根据疮口的大小,捏成饼状,厚度约为三分,放置在疮口上,用艾炷灸二十一壮,每灸完一壮就更换一个新的药饼。之后间隔四五日,才使用翠霞锭子和信效锭子护用(一种外用制剂)放入疮内,待坏死组织完全去除,健康肌肉长平后,再贴上具有收敛作用的药物,内服针对病症的药物,进行调理直至痊愈。
罗谦甫说:有一人头部和眼睛红肿,耳前发热严重,疼痛难以忍受,伴有发热、怕冷,牙关紧闭,鼻涕和唾液粘稠,饮食难以下咽,无法安睡。一位外科医生在患处坚硬的地方用砭石针刺,扎了几百针,但红肿并未消退,疼痛反而加剧,不知原因所在。诊察其脉象浮紧,重按则洪缓,这是寒邪覆盖皮毛,郁结阻滞经络,导致热气无法上升,聚集而引发红肿。《内经》说:天气寒冷大地冻结时,人体气血潜藏于内,皮肤致密,腠理闭塞,不出汗,血气强盛,体内坚实饱满。在这个时候,即使是善于治水的人也无法疏通水流,善于挖掘的人也无法凿开冻土,善于用针的人也无法治疗四肢厥逆之症,必须等到天气温暖,冰消雪融,水流才能通行,土地才能挖掘,人的经脉气血也是如此。又说:冬季是闭藏的季节,水结冰地裂开,所以用药时多配合针石疗法。应当使用苦温的药剂来温通经络、散除寒邪,使胜气(正气)得以确立,稍加苦味药发散,稍加辛味药疏散。麻黄,是苦温发散的药材;防风,是辛温疏散的药材;升麻苦辛,葛根、甘草解肌发表出汗,专门治疗阳明经中的邪气,所以作为臣药。血液流动但不通畅则产生疼痛,稍加辛温的白芷、当归来调和血液、消散瘀滞;湿热则导致肿胀,苍术苦甘,能泄除皮肤腠理的湿热;人参、甘草甘温,白芍药酸寒,调和中焦、益气,使补益作用深入体内,所以作为佐药。按照方法煎服,用薄衣覆盖头部,用厚被覆盖身体,卧处温暖则经脉血液温热,腠理开放,寒邪散去,阳气升发,红肿消退八九成。再次服药时,去掉麻黄、防风,加入连翘、牛蒡子,疼痛便全部消除。《内经》说:发汗则疮疡自愈,确实如此。
Various chronic sores that have persisted for a long time often present with continuous discharge of pus and fluid. The pus is not foul-smelling, and there is no necrotic tissue inside. In such cases, one must first administer a large dose of a formula containing Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), and Bai Zhu (Atractylodes Macrocephala) to primarily support the interior and expel toxins, or take it in pill form. It is particularly suitable to use Fu Zi (Aconite Lateralis Radix Praeparata) that has been thoroughly soaked, sliced into pieces approximately 2-3 fen thick, placed on the sore, and moxibusted. Continue taking the aforementioned interior-supporting medicine. Moxibustion should be performed every three days; after five to seven sessions, the muscle tissue will naturally grow to fill the wound.
In cases where pus and foul matter gradually ulcerate with a deep root, mix flour, Liu Huang (Sulfur), and Da Suan (Garlic Bulb) together until mashed. Shape the mixture into a cake approximately 3 fen thick, according to the size of the sore, place it on the lesion, and apply moxa cones for twenty-one burns (zhuang), replacing the cake after each burn. After four to five days, insert Cuixia Dingzi (Emerald Cloud Pill) and Xinxiao Dingzi (Trustworthy Effect Pill) into the sore. Once all necrotic tissue is removed and healthy flesh grows flat, apply astringent medicines externally and administer internal remedies tailored to the disease, regulating the patient until recovery.
Luo Qianfu stated: A patient suffered from redness and swelling of the head and eyes, severe heat in front of the ears, unbearable pain, fever, aversion to cold, trismus (lockjaw), thick and sticky sputum and nasal discharge, difficulty swallowing, and inability to sleep peacefully. A surgeon used Bian Shi (Bian Stone) to puncture the hardened area, inserting several hundred needles, yet the redness and swelling did not decrease, and the pain intensified. The cause was unknown. Upon palpation, the pulse was floating and tight, but forceful pressure revealed a surging and slow quality. This indicates cold covering the skin and hair, stagnating and blocking the meridians, preventing heat from ascending, leading to accumulation and resulting in redness and swelling. The Classic states: When heaven is cold and earth frozen, water turns to ice; human qi resides within, the skin is dense, pores are closed, sweat does not emerge, blood and qi are strong, and the interior is firm and full. At this time, even those skilled in managing water cannot flow it, those skilled in digging cannot pierce the frozen ground, and those skilled in acupuncture cannot treat tetraplegia (Si Jue). One must wait for warm weather, when ice melts and frost dissolves, allowing water to flow and earth to be dug; similarly, human meridians follow this principle. It is also said: In winter, storage is closed, water freezes, and earth cracks; therefore, when using medicine, needle and stone therapies are frequently employed. One should use bitter-warm agents to warm the meridians and scatter cold, establishing the winning qi (healthy qi), slightly using bitter herbs to vent, and slightly using acrid herbs to disperse. Ma Huang (Ephedrae Herba) is a bitter-warm herb for venting; Fang Feng (Saposhnikoviae Radix) is an acrid-warm herb for dispersing; Sheng Ma (Cimicifugae Rhizoma) is bitter and acrid; Ge Gen (Puerariae Lobatae Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) resolve the muscle layer and induce sweating, specifically treating pathogens in the Yangming Meridian, thus serving as Deputy Ministers. When blood flows but does not circulate smoothly, pain occurs; therefore, add small amounts of Bai Zhi (Angelicae Dahuricae Radix), which is acrid and warm, and Dang Gui (Angelicae Sinensis Radix) to harmonize blood and dissipate stasis. Damp-heat causes swelling; Cang Zhu (Atractylodis Rhizoma), being bitter and sweet, can drain damp-heat from the skin and pores. Ren Shen (Ginseng Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) are sweet and warm; Bai Shao Yao (Paeoniae Radix Alba) is sour and cold; together they harmonize the middle, boost qi, and tonify the interior, thus serving as Assistants. Decoct and administer according to method: cover the head with thin clothing and the body with thick blankets. If the sleeping environment is warm, the meridian blood becomes warm, pores open, cold scatters, yang qi ascends, and the swelling reduces by eight or nine tenths. For the second administration, remove Ma Huang (Ephedrae Herba) and Fang Feng (Saposhnikoviae Radix), add Lian Qiao (Forsythiae Fructus) and Niu Bang Zi (Arctii Fructus), and the pain will completely cease. The Classic states: "Inducing sweating cures sores," which is indeed true.