方
苏葛汤 初热未见点,发表之药,暂用分两,量儿大小服之。
紫苏(二钱) 葛根(二钱) 甘草(二钱) 白芍药(一钱半) 陈皮(五分) 砂仁(五分)
上锉,葱白、生姜煎服。
加味升麻汤 治小儿麻疹表药,或邻家已有疹证,预服。
升麻(五钱) 玄参(五钱) 柴胡(五钱) 黄芩(五钱) 干葛(四钱) 赤芍(四钱)
独活(一钱) 甘草(二钱)
每锉三四钱,水煎服。
治疹后咳嗽喘急,烦躁腹胀,泄泻声哑,唇口青黑。
黄连 黄芩 连翘 玄参 知母 桔梗 白芍 杏仁 麻黄
干葛 陈皮 浓朴 甘草 牛蒡子(各等分,水煎服)
小儿疹后赤白痢疾。
黄连 甘草 杏仁 桔梗 木通 浓朴 泽泻(各等分)
上锉,灯草水煎服。如下坠,加枳壳。
脉
凡诸脉浮数,应当发热。其不发热而反洒淅恶寒,若有痛处,必发痈疽。脉微而迟,反发热;弱
而数,反振寒,当发痈疽。脉浮而数,身体无热,形默默,胸中微燥不知痛之所在,其人必发痈疽。
证
《内经》曰∶诸痛痒疮疡,皆属心火。又云∶膏粱之变,足生大疔。盖心主血而行气,气血凝滞而为
痈疽也。痈者,壅也。大而高起,属乎阳,六腑之气所生也,其脉浮数。疽者,沮也。平而内
发,属乎阴,五脏之气所成也,其脉沉数。
凡人初生疮之时,便觉壮热恶寒,拘急头痛,精神不宁。烦躁饮冷者,其患疮疽
必深也。若人须患疮疽,起居平和,饮食如故,其疮浮浅也。
凡外敷贴药,亦发表之意。一方谓贴冷药有神效。夫气得热则散,得冷则敛,何谓神效?经曰,发表。
凡肿疡用手按之,热则有脓,不热则无脓。重按乃痛,脓之深也;轻按即痛,脓之浅也;按之不
甚痛者,未成脓也。若按之即复者,有脓也;不复者,无脓,必是水也。
凡痈疽未破,毒攻脏腑,一毫热药不敢用。若已破溃,脏腑既亏,饮食少进,一毫冷药不敢用也。
凡脓出而反痛者,此为虚也,宜补之。亦有秽气所触而作痛者,宜和解之。风冷所逼者,宜温养之。
凡疽发深而不痛者,胃气大虚,必死肉多而不知痛也。
凡肿疡时呕者,当作毒瓦斯上攻治之,溃后当作阴虚补之。若年
老溃后,发呕不食,宜参 白术膏峻补。河间谓疮疡呕者,湿气侵于胃,宜倍白术。
凡痈疽发渴,乃血气两虚,用参、 以补气,当归、地黄以养血。
凡痈疽有实热者,易疗;虚寒邪热者,难治。肿起坚硬,脓稠
者为实;肿下软漫,脓稀者为虚。败脓不去,加白芷则去,不可用白术,盖白术能生脓故也。
凡痈疽始发,即以艾多灸之,可使轻浅。或以骑竹马灸法最妙,盖火畅达,拔引郁毒,此从治之意。
惟头为诸阳所聚,艾炷宜小而少。若其身必痛,灸至不痛,不痛灸至痛。
方
连翘败毒散
治痈疽发背,疔疮乳痈,一切无名肿毒,初起憎寒壮热,甚则头痛拘急,状似伤寒,一日至四五日者,
二三剂以解其毒,轻者则内自消散,若至六七日不消,宜服真人活命饮,后服托里消毒散调理。
柴胡 羌活 桔梗 金银花 连翘 防风 荆芥 薄荷叶 川芎 独活 前胡 白茯苓 甘草 枳壳
上锉,生姜煎。如疮在上,食后服;在下,食前服。如热甚
并痛甚,加黄连、黄芩。如大便不通,加大黄,芒硝下之。
真人活命饮
治一切痈疽疔肿,不问阴阳虚实,善恶肿溃,太痛或不痛,然当服于未溃之
先与初溃之时,如毒已大溃,更不宜服。初用此剂,大势已退,然后随证调理,其功甚捷,诚仙方也。
乳香 没药 贝母 甘草节 白芷 花粉 赤芍药 当归梢(各一钱) 防风(七分) 陈皮(一钱
半) 皂角刺(五分) 金银花(三钱) 穿山甲(三六片,切碎,以蛤粉炒黄色)
上锉一剂,用醇酒一钟半,以纸密封罐口,勿令泄气,煎至一钟,随疮上下,以分饥饱温服。能饮酒
者,服后再饮三五杯,忌酸薄酒、铁器。服后倒卧,觉痛定回生,神功浩大,不可臆度,再
看证加减。在背俞倍皂角刺。在腹募倍白芷。在胸次加栝蒌仁(二钱) 在四肢倍金银花。
槐花酒
治背发一切疔疮肿毒,不问已成未成,俱 痛者宜用。未成者一二服即消,已成者三四服即愈。
槐花四五两微炒黄,乘热入酒二钟,煎十余沸,去渣热服。
〔批〕(按上方治痈疽初起,已成或未成未溃之先宜之)
金银花酒
治一切痈疽、发背、疔疮、乳痈、便毒,及喉痹乳鹅,不问已溃未溃者。
金银花连茎叶捣烂,取汁半钟,和热酒半钟,温服,可保无虞。如秋冬无鲜者,水煎和酒服。
追风通气散
治痈疽、发背、流注、肿毒、脑疽、打破伤折、疝气、血瘕、香港脚、诸气痞塞、块痛、腰痛、一
切痰饮为患。此药大能顺气匀血,扶植胃本,不伤元气,荡涤邪秽,自然通顺,不生变证,真仙
剂也。
气血逆于腠理,故令壅结痈疽,调和营卫实堪,宜赤芍、木通、白芷、何首乌同枳壳、茴香、乌药、
当归,更加国老等无疑,酒水同煎济世。
一痈疽生痰有二∶一则胃寒生痰,加半夏以健脾化痰;一则郁热而成风痰,加桔梗,并用生姜水酒煎。
一发背因服寒凉之药,过伤脾胃,饮食少进,颜色憔悴,肌肉不生,去木通,少用当归,倍浓朴、陈皮。
流注,加独活。脑发背发,去木通;打破伤折在头上,去木通,加川芎、陈皮。经年腰痛,加萆 、玄胡索
酒煎。香港脚,加槟榔、木瓜、穿山甲水煎。痰饮为患,或喘,或咳,或晕,头痛睛疼,遍身拘急,骨节痹疼,
胸背、颈项、腋胯、腰腿、手足聚结肿硬,或痛或不痛,按之无血潮,虽或微红,亦淡薄不热,坚如石,
破之无脓,或有薄血,或清水,或如乳汁,又有坏肉如破絮,又如瘰 ,在皮肉之间,如鸡卵可移动,软活不
硬,破之亦无脓血,针口 肉突出,惟觉咽喉痰实结塞,作寒作热,加南星、半夏。肿毒坚硬不穿,加川
芎、独活、麻黄、连须葱煎,热服。
托里消毒散
治一切痈疽,六七日未消者,服此药,疮未成即消,已成即消。能壮气血,固脾胃,使毒瓦斯不得内攻,
脓毒易溃,肌肉易生。切不可早用生肌之药,恐毒瓦斯未尽,反增溃烂。如有疮口,便贴膏
药,以御风入,至疮口闭合,如不用贴,此守成之方也。
黄 (盐水炒) 花粉(各二钱) 防风 当归(酒洗) 川芎 白芷 桔梗(炒)
浓朴(姜制) 穿山甲(炒) 皂角刺(炒,各一钱) 金银花 陈皮(各三钱)
上用水、酒各一钟,煎至七分。疮在上食后服,在下空心服,二帖后,只用水煎。
千金内托散
治痈疽疮疖,未成者速散,已成者速溃。败脓自出,无用手挤,恶肉自去,不用针刀,服药后疼
痛顿减。此药活血匀气,谓胃补虚,祛风邪,辟秽气,王道之剂,宜多服之,神效。
黄 (蜜炙) 人参(去芦) 当归(各二钱) 川芎 防风(去芦) 桔梗(去芦) 白
芷浓朴(姜炒) 薄桂 甘草(生用,各一钱) 加金银花亦可
上为末,每服三钱,无灰酒调下。不饮酒,木香汤调下亦可。或都作一剂,用酒煎服尤佳。痈
疽肿痛,用白芷;不肿痛,倍官桂。不进饮食,加砂仁、香附。痛,加乳香、没药。水不干,加知母、
贝母。疮不穿,加皂角刺。咳,加陈皮、半夏(烫泡七次)、杏仁、姜五片煎。大便闭,加大黄、枳壳。小便
涩,加麦门冬、车前子、木通、灯心。
〔批〕(按上方治痈疽已溃,托里消毒败脓之剂)
神仙蜡矾丸
治痈疽及肠痈,消毒,固脏腑,止疼痛,扩膜止泻,化脓,痈疽溃后宜服。
黄蜡二两,生白矾三两,为末,熔蜡为丸,如梧桐子大。每服二三十丸,酒下。不饮酒者,熟水
下。一日服三次。肺痈,蜜水下;咳嗽,姜汤下。
二仙散(黄宾江传)
治发背痈疽,已成未成,已溃未溃,痛不可忍者。
白芷(未溃者用一两,已溃者用五钱) 贝母(未溃者用五钱,已溃者用一两)
上锉,好酒煎服。
〔批〕(按上方治诸痈疼痛及不破者宜之)
透脓散 治诸痈疽,及贴骨痈不破者,不用针刀,一服不移时而自透,神效。
蛾口茧一个,烧灰存性,用酒调服,即透。切不可用三两个,
服之即生三两头。
芙蓉膏(张秀峰传)
治发背痈疽,痛如锥剜不可忍,登时痛止如神。
芙蓉叶 黄荆子(为末,各等分)
上二味,入石臼内捣极烂,用鸡子清调搽患处,留顶,如烟雾起,立瘥。此方用在未溃之先,或将溃之际。
三神膏(张贡士传) 治痈疽发背。
蓖麻子(去壳,四十九枚) 陈醋(一碗半) 好盐(一撮)
上三味,置锅中,用文武火熬之,槐枝搅成膏。先将米泔水洗
净疮,搽上药,留顶,未成脓者即散,已成脓者即溃。忌一切发物并酒。
神妙生肌散(敏所兄传)
治痈疽发背,诸般疮毒,溃烂疼痛。
乳香(一钱) 没药(二钱,二味用灯草同研) 孩儿茶(一钱) 血竭(一钱)
赤石脂(一钱) 海螵蛸(一钱) 轻粉(三分) 龟板(炒,一钱) 鳖甲(炒,一钱)
硼砂(二钱,生肌全在此味) 水银(一钱) 黑铅(一钱) 初起加黄柏一钱。作痒加白芷一钱。
上将银、铅同煎化,将前药各为末,入银铅于内,研极细,糁疮上,神效。
铁桶膏(泽川酉府传)
治痈疽、发背、疔疮、瘰 、痔疮、粉瘤。
荞麦秆灰淋汁二碗,熬至一碗,下 血竭 乳香 没药(各三分,为末) 入汁内,再熬去半碗,取
下待冷,入 黄丹(八分) 雄黄(八分) 朱砂(八分) 好锻石(八钱) 为极细末,共一处,
放药汁内搅匀成膏,瓷器收贮,用三棱针刺破,将药入内,直深入到底,不三四次痊愈。
玉容膏(秘传)
治发背痈疽溃烂,用此生肌,止痛,外护。
香油(二两) 黄蜡(一两) 二味化开,入黄丹末(一钱) 寒水石(火 ,一两) 为细末,
熔化为膏,纸摊贴患处。
〔批〕(按上方治痈疽外治之剂)
水云膏(阐传) 治发背。
干姜(炒) 皂角(炙,去皮弦) 五倍子(炒) 川芎(各一两) 孩儿茶 乳香
没药(各三钱) 枯矾 槐花(各一钱)
上为末,苦胆汁调涂,神效。又方,醋炒五倍子,入猪脑髓同捣如膏贴之,如疮在左,用左边脑。
附 肠痈、肚痈
千金内消散 治肠痈便毒,初起即消,已肿即溃,脓血从大便中出。
大黄(三钱) 赤芍药 白芷 木鳖子(去壳) 乳香 没药 皂角刺
白僵蚕 栝蒌仁 天花粉(各一钱) 归尾(酒洗,一钱半) 穿山甲(三大片,蛤
粉炒黄色,杵碎) 金银花(三钱) 甘草(五分)
上锉一剂,水酒煎,空心服。红点加芒硝。
内消沃雪汤(陈恕轩传) 治肚内生痈及痈疽,神效。
当归身 白芍药 黄 甘草节 金银花 天花粉 连翘 香白芷
穿山甲 皂角刺 贝母 乳香(研) 木香 青皮 广陈皮
甚者加大黄,水酒煎服立消,是世所奇。
方剂
苏葛汤:用于麻疹初期,发热但尚未出现皮疹时。作为发表透疹的药物,需根据患儿年龄大小斟酌剂量服用。
紫苏(二钱) 葛根(二钱) 甘草(二钱) 白芍药(一钱半) 陈皮(五分) 砂仁(五分)
以上药材切碎,加入葱白、生姜煎煮后服用。
加味升麻汤:治疗小儿麻疹的表证药物。如果邻居家已有出疹病例,可预先服用以预防。
升麻(五钱) 玄参(五钱) 柴胡(五钱) 黄芩(五钱) 干葛(四钱) 赤芍(四钱)
独活(一钱) 甘草(二钱)
每次取三至四钱药材,加水煎煮服用。
治疗麻疹后出现的咳嗽气喘急促、烦躁不安、腹胀、腹泻、声音嘶哑、嘴唇和口唇发青发黑等症状。
黄连 黄芩 连翘 玄参 知母 桔梗 白芍 杏仁 麻黄
干葛 陈皮 浓朴 甘草 牛蒡子(各等分,加水煎煮服用)
治疗小儿麻疹后出现的赤白痢疾。
黄连 甘草 杏仁 桔梗 木通 浓朴 泽泻(各等分)
以上药材切碎,用灯心草水煎煮服用。如果出现肛门下坠感,加入枳壳。
脉象
凡是各种脉象浮而数,应当伴有发热症状。如果不发热反而感到洒淅恶寒(如冷水浇身般的怕冷),如果有疼痛的部位,必定会发展为痈疽。脉象微细而迟,却反而发热;脉象弱而数,却反而发生寒战,这都预示着将发生痈疽。脉象浮而数,身体却没有热度,神情沉默不语,心中轻微燥热但不知道疼痛的具体位置,这个人必定会发生痈疽。
证候
《黄帝内经》说:所有的疼痛、瘙痒、疮疡,都属于心火。又说:饮食肥甘厚味的变化,足以导致大疔的发生。因为心主血并运行气,气血凝滞就会形成痈疽。痈,就是壅塞的意思。肿块大而高起,属于阳证,由六腑之气所生,其脉象浮数。疽,就是阻塞败坏的意思。肿块平坦且向内深陷,属于阴证,由五脏之气所成,其脉象沉数。
凡人在初生疮疡的时候,就会觉得壮热恶寒,肢体拘急头痛,精神不宁。如果烦躁想喝冷饮,说明患疮疽的病位一定很深。如果人将要患疮疽,但起居平和,饮食如常,说明疮疡病位较浅。
凡是外敷贴的药,也有发表的意思。有一方说贴冷药有神奇效果。但是气受热则散开,遇冷则收敛,怎么能说是神效呢?经书说,应该发表(发散邪气)。
凡是肿疡用手按压,感觉热的就有脓,不热的就没有脓。重按才痛,说明脓在深处;轻按就痛,说明脓在浅处;按压时不太痛的,说明还没有成脓。如果按压后凹陷立即弹起的,是有脓;不能立即弹起的,没有脓,一定是水肿。
凡是痈疽未破溃时,毒气攻冲脏腑,一丝一毫的热性药物都不敢使用。如果已经破溃,脏腑已经亏损,饮食减少,一丝一毫的寒凉药物都不敢使用。
凡是脓液流出后反而疼痛的,这是虚证,适宜用补法。也有被秽气触动而作痛的,适宜用和解法。受风冷逼迫的,适宜用温养法。
凡是疽发于深处而不痛的,是胃气大虚,必然导致肌肉腐烂而不知疼痛,预后不良。
凡是肿疡时常呕吐的,应当当作毒瓦斯上攻来治疗;溃烂后应当当作阴虚来补益。如果年老体弱者溃烂后,发生呕吐且不进食,适宜用参术膏峻补。河间(刘完素)认为疮疡呕吐,是湿气侵入胃部,适宜加倍使用白术。
凡是痈疽发作口渴,是气血两虚,用人参、黄芪以补气,当归、地黄以养血。
凡是痈疽有实热的,容易治疗;虚寒兼邪热的,难治。肿胀坚硬,脓液稠厚的为实证;肿胀下部软漫,脓液稀薄的为虚证。败脓不去除,加入白芷即可去除,不可用白术,因为白术能生脓的缘故。
凡是痈疽刚开始发作,就用艾条多灸,可以使病情减轻变浅。或者用骑竹马灸法最好,因为火气畅达,能拔引郁结的毒气,这是从治(反治)的意思。只有头部是诸阳经汇聚之处,艾炷宜小且少。如果身上某处必痛,灸到不痛为止;如果不痛,灸到有痛感为止。
方剂
连翘败毒散
治疗痈疽发背、疔疮、乳痈,一切无名肿毒。初起时憎寒壮热,严重时头痛拘急,症状像伤寒,持续一至四天者,服用二三剂以解除毒素,轻症则内部自然消散。如果到了六七天还不消退,适宜服用真人活命饮,之后服用托里消毒散调理。
柴胡 羌活 桔梗 金银花 连翘 防风 荆芥 薄荷叶 川芎 独活 前胡 白茯苓 甘草 枳壳
以上药材切碎,用生姜煎煮。如果疮在上部,饭后服用;在下部,饭前服用。如果热势很盛并且疼痛剧烈,加入黄连、黄芩。如果大便不通,加入大黄、芒硝通便泄热。
真人活命饮
治疗一切痈疽疔肿,不论阴阳虚实、善恶肿溃,无论剧痛或不痛,应当在未溃破之前与刚溃破之时服用。如果毒气已经严重溃烂,更不宜服用。初次使用此方,大势已退,然后随证调理,功效非常迅速,真是仙方。
乳香 没药 贝母 甘草节 白芷 花粉 赤芍药 当归梢(各一钱) 防风(七分) 陈皮(一钱半) 皂角刺(五分) 金银花(三钱) 穿山甲(三至六片,切碎,用蛤粉炒至黄色)
以上药材切碎一剂,用醇酒一钟半,用纸密封罐口,不让漏气,煎至一钟,根据疮的位置上下,结合饥饱情况温服。能喝酒的人,服药后再喝三五杯,忌食酸味、薄酒及使用铁器。服药后倒卧,感觉疼痛停止即能回生,神功浩大,不可随意揣测,再根据证候加减。如果在背部俞穴部位,加倍皂角刺。如果在腹部募穴部位,加倍白芷。如果在胸部,加入栝蒌仁(二钱)。如果在四肢,加倍金银花。
槐花酒
治疗背部发生的一切疔疮肿毒,不论已成或未成,凡是疼痛的都适宜使用。未成的服用一二剂即消散,已成的服用三四剂即痊愈。
槐花四五两微炒黄,趁热加入酒二钟,煎煮十余沸,去渣热服。
〔批注〕(按上方治疗痈疽初起,已成或未成未溃之先适宜使用)
金银花酒
治疗一切痈疽、发背、疔疮、乳痈、便毒,以及喉痹乳鹅,不论已溃未溃者。
金银花连茎叶捣烂,取汁半钟,和热酒半钟,温服,可以保无虞。如果秋冬没有新鲜的,用水煎煮和酒服用。
追风通气散
治疗痈疽、发背、流注、肿毒、脑疽、打破伤折、疝气、血瘕、香港脚(脚气)、诸气痞塞、块痛、腰痛、一切痰饮为患。此药大能顺气匀血,扶植胃本,不伤元气,荡涤邪秽,自然通顺,不生变证,真是仙剂。
气血逆乱于腠理,所以导致壅结痈疽,调和营卫确实值得推崇,适宜用赤芍、木通、白芷、何首乌同枳壳、茴香、乌药、当归,再加上国老(甘草)等无疑,酒水同煎济世。
一、痈疽生痰有两种:一是胃寒生痰,加入半夏以健脾化痰;二是郁热而成风痰,加入桔梗,并用生姜水酒煎煮。
二、发背因服用寒凉药物,过度损伤脾胃,饮食减少,面色憔悴,肌肉不生,去掉木通,少量使用当归,加倍浓朴、陈皮。
三、流注,加入独活。脑发背发,去掉木通;打破伤折在头上,去掉木通,加入川芎、陈皮。经年腰痛,加入萆薢、玄胡索酒煎。香港脚,加入槟榔、木瓜、穿山甲水煎。痰饮为患,或喘,或咳,或晕,头痛睛疼,遍身拘急,骨节痹疼,胸背、颈项、腋胯、腰腿、手足聚结肿硬,或痛或不痛,按之无血潮,虽或微红,亦淡薄不热,坚如石,破之无脓,或有薄血,或清水,或如乳汁,又有坏肉如破絮,又如瘰疬,在皮肉之间,如鸡卵可移动,软活不硬,破之亦无脓血,针口息肉突出,惟觉咽喉痰实结塞,作寒作热,加入南星、半夏。肿毒坚硬不穿,加入川芎、独活、麻黄、连须葱煎,热服。
托里消毒散
治疗一切痈疽,六七天未消退者,服用此药,疮未成即消,已成即消。能壮气血,固脾胃,使毒瓦斯不得内攻,脓毒易溃,肌肉易生。切不可早用生肌之药,恐毒瓦斯未尽,反增溃烂。如有疮口,便贴膏药,以御风入,至疮口闭合,如不用贴,此守成之方也。
黄 (盐水炒) 花粉(各二钱) 防风 当归(酒洗) 川芎 白芷 桔梗(炒)
浓朴(姜制) 穿山甲(炒) 皂角刺(炒,各一钱) 金银花 陈皮(各三钱)
以上用水、酒各一钟,煎至七分。疮在上食后服,在下空心服,二帖后,只用水煎。
千金内托散
治疗痈疽疮疖,未成的速散,已成的速溃。败脓自出,无用手挤,恶肉自去,不用针刀,服药后疼痛顿减。此药活血匀气,谓胃补虚,祛风邪,辟秽气,王道之剂,宜多服之,神效。
黄 (蜜炙) 人参(去芦) 当归(各二钱) 川芎 防风(去芦) 桔梗(去芦) 白
芷浓朴(姜炒) 薄桂 甘草(生用,各一钱) 加金银花亦可
以上为末,每服三钱,无灰酒调下。不饮酒,木香汤调下亦可。或都作一剂,用酒煎服尤佳。痈
疽肿痛,用白芷;不肿痛,倍官桂。不进饮食,加砂仁、香附。痛,加乳香、没药。水不干,加知母、
贝母。疮不穿,加皂角刺。咳,加陈皮、半夏(烫泡七次)、杏仁、姜五片煎。大便闭,加大黄、枳壳。小便
涩,加麦门冬、车前子、木通、灯心。
〔批注〕(按上方治疗痈疽已溃,托里消毒败脓之剂)
神仙蜡矾丸
治疗痈疽及肠痈,消毒,固脏腑,止疼痛,扩膜止泻,化脓,痈疽溃后宜服。
黄蜡二两,生白矾三两,为末,熔蜡为丸,如梧桐子大。每服二三十丸,酒下。不饮酒者,熟水
下。一日服三次。肺痈,蜜水下;咳嗽,姜汤下。
二仙散(黄宾江传)
治疗发背痈疽,已成未成,已溃未溃,痛不可忍者。
白芷(未溃者用一两,已溃者用五钱) 贝母(未溃者用五钱,已溃者用一两)
以上切碎,好酒煎服。
〔批注〕(按上方治疗诸痈疼痛及不破者适宜使用)
透脓散 治疗诸痈疽,及贴骨痈不破者,不用针刀,一服不移时而自透,神效。
蛾口茧一个,烧灰存性,用酒调服,即透。切不可用三两个,
服之即生三两头。
芙蓉膏(张秀峰传)
治疗发背痈疽,痛如锥剜不可忍,登时痛止如神。
芙蓉叶 黄荆子(为末,各等分)
以上二味,入石臼内捣极烂,用鸡子清调搽患处,留顶,如烟雾起,立瘥。此方用在未溃之先,或将溃之际。
三神膏(张贡士传) 治疗痈疽发背。
蓖麻子(去壳,四十九枚) 陈醋(一碗半) 好盐(一撮)
以上三味,置锅中,用文武火熬之,槐枝搅成膏。先将米泔水洗
净疮,搽上药,留顶,未成脓者即散,已成脓者即溃。忌一切发物并酒。
神妙生肌散(敏所兄传)
治疗痈疽发背,诸般疮毒,溃烂疼痛。
乳香(一钱) 没药(二钱,二味用灯草同研) 孩儿茶(一钱) 血竭(一钱)
赤石脂(一钱) 海螵蛸(一钱) 轻粉(三分) 龟板(炒,一钱) 鳖甲(炒,一钱)
硼砂(二钱,生肌全在此味) 水银(一钱) 黑铅(一钱) 初起加黄柏一钱。作痒加白芷一钱。
以上将银、铅同煎化,将前药各为末,入银铅于内,研极细,糁疮上,神效。
铁桶膏(泽川酉府传)
治疗痈疽、发背、疔疮、瘰疬、痔疮、粉瘤。
荞麦秆灰淋汁二碗,熬至一碗,下 血竭 乳香 没药(各三分,为末) 入汁内,再熬去半碗,取
下待冷,入 黄丹(八分) 雄黄(八分) 朱砂(八分) 好锻石(八钱) 为极细末,共一处,
放药汁内搅匀成膏,瓷器收贮,用三棱针刺破,将药入内,直深入到底,不三四次痊愈。
玉容膏(秘传)
治疗发背痈疽溃烂,用此生肌,止痛,外护。
香油(二两) 黄蜡(一两) 二味化开,入黄丹末(一钱) 寒水石(火 ,一两) 为细末,
熔化为膏,纸摊贴患处。
〔批注〕(按上方治疗痈疽外治之剂)
水云膏(阐传) 治疗发背。
干姜(炒) 皂角(炙,去皮弦) 五倍子(炒) 川芎(各一两) 孩儿茶 乳香
没药(各三钱) 枯矾 槐花(各一钱)
以上为末,苦胆汁调涂,神效。又方,醋炒五倍子,入猪脑髓同捣如膏贴之,如疮在左,用左边脑。
千金内消散 治疗肠痈便毒,初起即消,已肿即溃,脓血从大便中出。
大黄(三钱) 赤芍药 白芷 木鳖子(去壳) 乳香 没药 皂角刺
白僵蚕 栝蒌仁 天花粉(各一钱) 归尾(酒洗,一钱半) 穿山甲(三大片,蛤
粉炒黄色,杵碎) 金银花(三钱) 甘草(五分)
以上切碎一剂,水酒煎,空心服。红点加芒硝。
内消沃雪汤(陈恕轩传) 治疗肚内生痈及痈疽,神效。
当归身 白芍药 黄 甘草节 金银花 天花粉 连翘 香白芷
穿山甲 皂角刺 贝母 乳香(研) 木香 青皮 广陈皮
甚者加大黄,水酒煎服立消,是世所奇。
Formulas
Sugu Tang (Perilla and Kudzu Decoction): Used in the early stage of measles when fever is present but rash has not yet appeared. As a formula to release the exterior and vent the rash, the dosage should be adjusted according to the child's age and size.
Perillae Folium (2 qian) Puerariae Radix (2 qian) Glycyrrhizae Radix et Rhizoma (2 qian) Paeoniae Radix Alba (1.5 qian) Citri Reticulatae Pericarpium (0.5 fen) Amomi Fructus (0.5 fen)
Crush the above herbs, decoct with Scallion White (Congbai) and Zingiberis Rhizoma Recens (Shengjiang), and take orally.
Jiawei Shengma Tang (Modified Cinnamon Twig and Cimicifugae Decoction): A formula for treating the exterior syndrome of pediatric measles. If neighbors have cases of measles, it can be taken prophylactically.
Cimicifugae Rhizoma (5 qian) Scrophulariae Radix (5 qian) Bupleuri Radix (5 qian) Scutellariae Radix (5 qian) Puerariae Radix (4 qian) Paeoniae Radix Rubra (4 qian)
Angelicae Pubescentis Radix (1 qian) Glycyrrhizae Radix et Rhizoma (2 qian)
Take 3-4 qian per dose, decoct in water, and take orally.
For cough, wheezing, irritability, abdominal distension, diarrhea, hoarseness, and cyanosis of lips and mouth after measles:
Coptidis Rhizoma Scutellariae Radix Forsythiae Fructus Scrophulariae Radix Anemarrhenae Rhizoma Platycodonis Radix Paeoniae Radix Alba Armeniacae Semen Amarum Puerariae Radix Citri Reticulatae Pericarpium Magnoliae Officinalis Cortex Bischofiae Fructus (Equal parts, decoct in water and take orally)
For red and white dysentery in children after measles:
Coptidis Rhizoma Glycyrrhizae Radix et Rhizoma Armeniacae Semen Amarum Platycodonis Radix Akebiae Caulis Magnoliae Officinalis Cortex Alismatis Rhizoma (Equal parts)
Crush the above herbs, decoct with Junci Medulla (Dengcao) water, and take orally. If there is a sensation of rectal tenesmus, add Aurantii Fructus Immaturus (Zhiqiao).
Pulse Diagnosis
When pulses are floating and rapid, fever should be present. If there is no fever but instead a sensation of chilliness (as if splashed by cold water), and there is a painful area, carbuncles or sores (Yongju) will likely develop. If pulses are faint and slow but accompanied by fever; or weak and rapid but accompanied by chills, this indicates the impending development of carbuncles or sores. If pulses are floating and rapid, yet the body has no heat, the person is taciturn, feels slight internal dryness without knowing the exact location of pain, they will surely develop carbuncles or sores.
Syndrome Differentiation
The *Neijing* states: "All pain, itching, and sores belong to Heart Fire." It also says: "Changes from rich and greasy foods can give rise to large Ding (hard boils)." The Heart governs blood and moves Qi. When Qi and Blood stagnate, carbuncles and sores form.
"Yong" (Carbuncle) means obstruction. The swelling is large and elevated, belongs to Yang, arises from the Qi of the Six Fu organs, and presents with floating and rapid pulses.
"Ju" (Deep Abscess/Sore) means blockage and decay. The swelling is flat and deep-seated, belongs to Yin, arises from the Qi of the Five Zang organs, and presents with deep and rapid pulses.
When a sore first appears, the patient typically experiences high fever, aversion to cold, stiffness, headache, and mental restlessness. If the patient is irritable and desires cold drinks, the lesion is likely deep. If the patient's daily routine and diet remain normal despite the onset of a sore, the lesion is likely superficial.
External applications also aim to release the exterior. Some claim that applying cold medicines is miraculous. However, Qi disperses with heat and contracts with cold; thus, claiming cold application is miraculous contradicts this principle. The classics state that one should release the exterior.
To determine suppuration in a swelling: Press with the hand. If hot, pus is present; if not hot, no pus. Deep pressure causing pain indicates deep pus; light pressure causing pain indicates shallow pus; minimal pain upon pressure indicates no pus formation yet. If depression rebounds immediately, pus is present; if it does not rebound, there is no pus, likely edema.
Before an abscess ruptures, toxic heat attacks the Zang-Fu organs; absolutely avoid hot/warm-natured herbs. After rupture, the Zang-Fu are deficient and appetite is poor; absolutely avoid cold/cool-natured herbs.
If pain persists after pus discharge, it is a deficiency pattern; tonification is indicated. If pain is caused by foul pathogens, harmonization is indicated. If forced by wind-cold, warming and nourishing are indicated.
If a deep Ju develops without pain, it indicates severe deficiency of Stomach Qi, leading to necrosis without pain, which is fatal.
If vomiting occurs during the swelling stage, treat as toxic heat attacking upward. After ulceration, treat as Yin deficiency. In elderly patients with post-ulcerative vomiting and anorexia, use Shen Zhu Gao (Ginseng and Atractylodes Paste) for strong tonification. Hejian (Liu Wansu) stated that vomiting in sores is due to dampness invading the Stomach; double the dose of Atractylodis Macrocephali Rhizoma (Baizhu).
Thirst in carbuncles and sores indicates dual deficiency of Qi and Blood. Use Ginseng and Astragalus to tonify Qi, and Angelica and Rehmannia to nourish Blood.
Carbuncles with excess heat are easy to treat; those with deficiency-cold and pathogenic heat are difficult. Hard swelling with thick pus indicates excess; soft, spreading swelling with thin pus indicates deficiency. To remove rotten pus, add Angelicae Dahuricae Radix (Baizhu); do not use Atractylodis Macrocephali Rhizoma (Baizhu) because it promotes pus generation.
At the initial stage of carbuncles, moxibustion with Mugwort (Aiye) can lighten and shallow the condition. The "Bamboo Horse Moxibustion" method is excellent as fire promotes circulation and draws out stagnant toxins (treating contrary to symptoms). For the head, where all Yang meridians converge, use small and few moxa cones. If a specific area hurts, moxibustion until pain stops; if not painful, moxibustion until pain starts.
Formulas
Lianqiao Baidu San (Forsythia and Detoxifying Powder)
Treats carbuncles, back sores, Ding sores, mastitis, and all unnamed swellings. Early stage with aversion to cold and high fever, severe headache and stiffness resembling Typhoid fever (Shanghan), lasting 1-4 days. Take 2-3 doses to resolve toxicity; mild cases dissipate internally. If unresolved after 6-7 days, take Zhenren Huoming Yin, followed by Tuoli Xiaodu San for regulation.
Bupleuri Radix Qianghuo Platycodonis Radix Chrysanthemi Indici Flos Forsythiae Fructus Saposhnikoviae Radix Schizonepetae Spica Menthae Haplocalycis Cacumen Chuanxiong Rhizoma Angelicae Pubescentis Radix Peucedani Radix Poria Coos Glycyrrhizae Radix et Rhizoma Aurantii Fructus Immaturus
Crush, decoct with Zingiberis Rhizoma Recens (Shengjiang). If the sore is upper body, take after meals; lower body, before meals. If heat and pain are severe, add Coptidis Rhizoma and Scutellariae Radix. If constipated, add Rhei Radix et Rhizoma and Natrii Sulfas to purge.
Zhenren Huoming Yin (True Person's Life-Preserving Decoction)
Treats all carbuncles, sores, and Ding. Regardless of Yin/Yang, excess/deficiency, or severity. Take before ulceration or at initial ulceration. Do not take if already severely ulcerated. This formula rapidly reduces major symptoms, followed by syndrome-specific regulation. It is a miraculous formula.
Boswelliae Resina Myrrhae Resina Farfarae Flos Glycyrrhizae Radix et Rhizoma (Segmented) Angelicae Dahuricae Radix Trichosanthis Radix Paeoniae Radix Rubra Cauda Angelicae Sinensis (Each 1 qian) Saposhnikoviae Radix (0.7 fen) Citri Reticulatae Pericarpium (1.5 qian) Gleditsiae Sinensis Spina (0.5 fen) Chrysanthemi Indici Flos (3 qian) Manis Squama (3-6 slices, chopped, fried with Tritonischloris Pulvis to yellow)
Crush one dose. Add 1.5 zhong of strong wine, seal tightly with paper to prevent evaporation. Decoct to 1 zhong. Take warm based on hunger/fullness and sore location. Drinkers may take 3-5 more cups after. Avoid sour/thin wine and ironware. Lie down after taking; if pain ceases, life is preserved. Adjust based on syndrome: Double Gleditsiae Sinensis Spina for Back Shu points; double Angelicae Dahuricae Radix for Abdomen Mu points; add Benincasae Semen (2 qian) for Chest; double Chrysanthemi Indici Flos for Limbs.
Huaihua Jiu (Sophora Flower Wine)
Treats all Ding sores and swellings on the back, whether formed or unformed, painful. Unformed: 1-2 doses dissipate. Formed: 3-4 doses heal.
Sophorae Flavescentis Flos (4-5 liang, lightly fried yellow). Add while hot to 2 zhong of wine. Boil 10+ times. Strain and take hot.
[Note: Suitable for early-stage carbuncles/sores, before ulceration.]
Jinyinhua Jiu (Honeysuckle Wine)
Treats all carbuncles, back sores, Ding, mastitis, groin abscesses, throat bi, and tonsillar hypertrophy, whether ulcerated or not.
Lonicerae Japonicae Flos with stems and leaves, pounded to pulp. Extract half zhong of juice, mix with half zhong of hot wine. Take warm. Safe even in winter/autumn if fresh is unavailable; decoct with water and mix with wine.
Zhuifeng Tongqi San (Wind-Chasing and Qi-Unblocking Powder)
Treats carbuncles, back sores, flowing abscesses, swellings, brain neck sores, traumatic fractures, hernia, blood masses, gout, Qi stagnation, masses, waist pain, and phlegm-fluid disorders. This formula regulates Qi and Blood, supports the Stomach root, preserves Yuan Qi, clears turbidity, ensures smooth flow, prevents complications, and is truly a celestial formula.
Qi and Blood reversal in the interstices causes obstruction and carbuncles. Harmonizing Ying and Wei is essential. Use Paeoniae Radix Rubra, Akebiae Caulis, Angelicae Dahuricae Radix, Polygoni Multiflori Caulis, Aurantii Fructus Immaturus, Foeniculi Fructus, Linderae Radix, and Angelicae Sinensis Radix, plus Guolao (Glycyrrhiza). Decoct with wine and water.
Two types of phlegm in carbuncles: 1. Stomach cold generating phlegm, add Pinelliae Rhizoma to strengthen Spleen and transform phlegm. 2. Stagnant heat generating wind-phlegm, add Platycodonis Radix, decoct with Ginger and wine.
Back sores caused by excessive cold/cool herbs damaging Spleen/Stomach, leading to poor appetite and emaciation: Remove Akebiae Caulis, reduce Angelicae Sinensis Radix, double Magnoliae Officinalis Cortex and Citri Reticulatae Pericarpium.
Flowing abscesses: Add Angelicae Pubescentis Radix. Brain/Back sores: Remove Akebiae Caulis. Head trauma: Remove Akebiae Caulis, add Chuanxiong Rhizoma and Citri Reticulatae Pericarpium. Chronic waist pain: Add Dioscoreae Hypoglaucae Rhizoma and Cyperi Rhizoma, decoct with wine. Gout: Add Arecae Semen and Chaenomelis Fructus, decoct with Manis Squama. Phlegm-fluid disorders causing asthma, cough, dizziness, headache, eye pain, body stiffness, joint bi pain, hard swelling in chest/back/neck/armpits/groin/limbs (painful or not, no blood rush on pressure, pale/red but cool, stone-hard, no pus or only thin blood/water/milk-like fluid, necrotic tissue like broken cotton, or scrofula-like movable lumps between skin/flesh, soft but not hard, no pus/blood on puncture, polypoid protrusion from needle wound, sensation of phlegm blocking throat, alternating chills/fever): Add Arisaematis Rhizoma and Pinelliae Rhizoma. Hard swellings not penetrating: Add Chuanxiong Rhizoma, Angelicae Pubescentis Radix, Ephedrae Herba, and Scallion White with roots, decoct and take hot.
Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder)
Treats all carbuncles/sores unresolved after 6-7 days. Prevents formation or resolves existing ones. Strengthens Qi/Blood, stabilizes Spleen/Stomach, prevents internal attack of toxins, facilitates pus discharge, and promotes flesh regeneration. Do not use flesh-generating drugs early lest residual toxins worsen ulceration. Apply plaster to cover wounds against wind until closed. This is a formula for maintaining victory.
Astragali Radix (Salt-water fried) Trichosanthis Radix (Each 2 qian) Saposhnikoviae Radix Angelicae Sinensis Radix (Wine-washed) Chuanxiong Rhizoma Angelicae Dahuricae Radix Platycodonis Radix (Fried)
Magnoliae Officinalis Cortex (Ginger-processed) Manis Squama (Fried) Gleditsiae Sinensis Spina (Fried, each 1 qian) Lonicerae Japonicae Flos Citri Reticulatae Pericarpium (Each 3 qian)
Decoct with 1 zhong water and 1 zhong wine to 70%. Upper sores: take after meals. Lower sores: take on empty stomach. After two doses, use water only.
Qianjin Neituo San (Thousand-Gene Internal-Pushing Powder)
Treats carbuncles, sores, and boils. Rapidly dissipates unformed ones, rapidly ulcerates formed ones. Pus drains spontaneously without squeezing; necrotic tissue falls off without needles/knives. Pain reduces significantly after taking. This formula invigorates Blood, regulates Qi, tonifies Stomach deficiency, expels wind-pathogens, and clears foul qi. It is a kingly formula; take frequently for miraculous effects.
Astragali Radix (Honey-fried) Ginseng Radix (De-radicle) Angelicae Sinensis Radix (Each 2 qian) Chuanxiong Rhizoma Saposhnikoviae Radix (De-radicle) Platycodonis Radix (De-radicle) Angelicae Dahuricae Radix Magnoliae Officinalis Cortex (Ginger-fried) Cinnamomi Ramulus (Thin) Glycyrrhizae Radix et Rhizoma (Raw, each 1 qian) Add Lonicerae Japonicae Flos optionally.
Grind to powder. Take 3 qian mixed with clear wine. Non-drinkers may use Aucklandiae Decursus Decoction. Alternatively, decoct whole dose in wine for best results. For painful swelling, use Angelicae Dahuricae Radix; for non-painful, double Cinnamomi Ramulus. For anorexia, add Amomi Fructus and Cyperi Rhizoma. For pain, add Boswelliae Resina and Myrrhae Resina. For non-drying exudate, add Anemarrhenae Rhizoma and Farfarae Flos. For non-penetrating sores, add Gleditsiae Sinensis Spina. For cough, add Citri Reticulatae Pericarpium, Pinelliae Rhizoma (scalded 7 times), Armeniacae Semen Amarum, and 5 slices of Ginger. For constipation, add Rhei Radix et Rhizoma and Aurantii Fructus Immaturus. For difficult urination, add Ophiopogonis Radix, Plantaginis Semen, Akebiae Caulis, and Junci Medulla.
[Note: For ulcerated carbuncles, supporting interior and detoxifying rotten pus.]
Shenxian Lafan Wan (Celestial Wax-Alum Pill)
Treats carbuncles, sores, and intestinal abscesses. Detoxifies, stabilizes Zang-Fu, stops pain, expands membranes, stops diarrhea, and transforms pus. Take after ulceration.
Beeswax (2 liang), Raw Alum (3 liang). Grind to powder, melt wax to form pills the size of Sophora seeds. Take 20-30 pills with wine. Non-drinkers take with boiled water. Three times daily. For lung abscess, take with honey water; for cough, with ginger soup.
Er Xian San (Two Immortals Powder - Transmitted by Huang Binjiang)
Treats back sores/carbuncles, formed/unformed, ulcerated/not ulcerated, unbearable pain.
Angelicae Dahuricae Radix (1 liang if unformed, 5 qian if formed) Farfarae Flos (5 qian if unformed, 1 liang if formed)
Crush, decoct in good wine, and take.
[Note: Suitable for painful carbuncles and non-penetrating sores.]
Tounong San (Pus-Penetrating Powder)
Treats all carbuncles/sores and subcutaneous abscesses not penetrating. No need for needles/knives; penetrates naturally within moments after one dose. Miraculous.
One moth cocoon, burned to ash retaining nature. Mix with wine and take orally to penetrate. Do not use 3-2, as it may cause multiple openings.
Furong Gao (Hibiscus Ointment - Transmitted by Zhang Xiufeng)
Treats back sores/carbuncles with piercing pain. Stops pain instantly like magic.
Hibisci Mutabilis Folium Vitexis Trifoliae Fructus (Grind to powder, equal parts)
Pound in mortar until extremely fine. Mix with Egg White (Jizi Qing) and apply to affected area, leaving the top open. If smoke rises, healing occurs immediately. Use before ulceration or at the verge of ulceration.
Sanshen Gao (Three Gods Ointment - Transmitted by Zhang Gongshi)
Treats carbuncles and back sores.
Ricini Semen (Shelled, 49 pieces) Aged Vinegar (1.5 bowls) Good Salt (A pinch)
Place in pot, simmer with medium-low heat, stir with Locust Branch until paste forms. Wash sore with rice wash water, apply ointment, leave top open. Unformed pus dissipates; formed pus ulcerates. Avoid all stimulating foods and alcohol.
Shenmiao Shengji San (Divine Flesh-Generating Powder - Transmitted by Min's Brother)
Treats carbuncles, back sores, various sores, ulceration, and pain.
Boswelliae Resina (1 qian) Myrrhae Resina (2 qian, ground together with Junci Medulla) Camelliae Seed Tea (1 qian) Draco Sanguis (1 qian)
Halloysit Rubrum (1 qian) Sepiae Endoconcha (1 qian) Calomelas (0.3 fen) Testudinis Carapax et Plastrum (Fried, 1 qian) Trionycis Carapax (Fried, 1 qian) Borax (2 qian, key for flesh generation) Mercury (1 qian) Black Lead (1 qian) Add Phellodendri Cortex (1 qian) at onset. Add Angelicae Dahuricae Radix (1 qian) for itching.
Melt Silver and Lead together. Grind other herbs to powder, mix with melted silver/lead, grind extremely fine, and sprinkle on sore. Miraculous.
Tietong Gao (Iron Bucket Ointment - Transmitted by Ze Chuan Youfu)
Treats carbuncles, back sores, Ding sores, scrofula, hemorrhoids, and sebaceous cysts.
Buckwheat Straw Ash Lixivium (2 bowls), boil down to 1 bowl. Add Draco Sanguis, Boswelliae Resina, Myrrhae Resina (Each 0.3 fen, powdered). Stir into liquid, boil down another half bowl. Remove, cool. Add Lithargyrum (0.8 fen), Realgar (0.8 fen), Cinnabaris (0.8 fen), Calcined Lime (8 qian). Grind to fine powder, mix with liquid to form ointment. Store in porcelain. Pierce with three-edged needle, insert ointment deeply to bottom. Heal in 3-4 applications.
Yurong Gao (Jade Face Ointment - Secret Recipe)
Treats ulcerated back sores/carbuncles. Generates flesh, stops pain, protects externally.
Sesame Oil (2 liang) Beeswax (1 liang) Melt together. Add Lithargyrum Powder (1 qian) and Halloysitum Album (Calcined, 1 liang). Grind to fine powder, melt into ointment. Spread on paper and apply to sore.
[Note: External treatment formulas for carbuncles/sores.]
Shuiyun Gao (Water Cloud Ointment - Transmitted by Chan)
Treats back sores.
Zingiberis Rhizoma (Fried) Gleditsiae Sinensis Fructus (Roasted, de-rind/seeds) Myrobalani Fructus (Fried) Chuanxiong Rhizoma (Each 1 liang) Camelliae Seed Tea Boswelliae Resina Myrrhae Resina (Each 3 qian) Calcined Alum Sophorae Flavescentis Flos (Each 1 qian)
Grind to powder. Mix with Gallus gallus domesticus bile and apply. Miraculous. Another method: Vinegar-fried Myrobalani Fructus mixed with Pig Brain Marrow, pounded to paste, applied to sore. If sore is on left, use left brain.
Appendix: Intestinal Abscess, Abdominal Abscess
Qianjin Neixiao San (Thousand-Gene Internal-Dissolving Powder)
Treats intestinal abscess and groin abscess. Dissipates at onset, ulcerates when swollen. Pus and blood exit via stool.
Rhei Radix et Rhizoma (3 qian) Paeoniae Radix Rubra Angelicae Dahuricae Radix Momordicae Semen (De-shelled) Boswelliae Resina Myrrhae Resina Gleditsiae Sinensis Spina
Bombyx Batryticatus Benincasae Semen Trichosanthis Radix (Each 1 qian) Cauda Angelicae Sinensis (Wine-washed, 1.5 qian) Manis Squama (3 large slices, fried with Tritonischloris Pulvis to yellow, crushed) Lonicerae Japonicae Flos (3 qian) Glycyrrhizae Radix et Rhizoma (0.5 fen)
Crush one dose, decoct with water and wine, take on empty stomach. Add Natrii Sulfas if red spots appear.
Neixiao Woxue Tang (Internal-Dissolving Snow-Melting Decoction - Transmitted by Chen Shuxuan)
Treats internal abdominal abscesses and carbuncles. Miraculous.
Angelicae Sinensis Radix Corpus Paeoniae Radix Alba Astragali Radix Glycyrrhizae Radix et Rhizoma (Segmented) Lonicerae Japonicae Flos Trichosanthis Radix Forsythiae Fructus Angelicae Dahuricae Radix
Manis Squama Gleditsiae Sinensis Spina Farfarae Flos Boswelliae Resina (Ground) Aucklandiae Decursus Quinine Peel Citri Reticulatae Pericarpium
Severe cases: Add Rhei Radix et Rhizoma. Decoct with water and wine. Rapid resolution is rare in the world.