论曰恶脉之病,其状赤络忽起, 而聚,若死蚯蚓之状,又若水在脉中,长短随络脉
所生,得之春冬恶风,入于络脉而不散,则血脉瘀结而成是疾,久不治,则结脉变为 病。
不除。五香汤加茱萸犀角汤方
木香 藿香叶 沉香 熏陆香 鸡舌香 吴茱萸(汤洗微炒) 犀角(镑各一两)
上七味。粗捣筛,每服五钱匕。水二盏,煎至一盏,去滓空心温服,日晚再服,其滓热
拓肿上,冷即易之。
治恶脉毒肿。升麻汤方
升麻(一两) 乌梅肉(二两) 山栀子仁(二十枚)
上三味。粗捣筛,每服五钱匕。水二盏,煎至一盏,去滓空心温服,日晚再服,余滓热
拓患上。
治恶脉肿毒,木香汤方
木香 吴茱萸(洗焙微炒) 升麻 熏陆香 鸡舌香 雄黄 甘草(炙) 鳖甲(醋浸
炙去
上九味。粗捣筛,每服五钱匕。水二盏,煎至一盏,去滓空心温服,日晚再服。
治恶脉毒肿。黄耆散涂敷方
黄耆(细锉四两)
上一味,捣罗为细散,水调敷上,日三五度。
又方
漆头( 茹二两)
上一味,捣罗为细散,水调敷上,日三五度。
论曰痈肿若寒多及毒深,外证虽结聚 硬不消,疼痛难任,未能溃化,或已穿穴,经久
不瘥,在外者须以药蚀,在里者须以药 ,令毒瓦斯发泄,荣卫流通,则痈疽得瘥矣。所以有
追引蚀痈之方。
治痈疽肿未有头,疼痛不可忍。透肌丸方
砂(研) 斑蝥(去翅足米炒) 乌头尖
上三味等分,捣研为末,醋煮面糊,丸如小豆大,捻令扁,贴在疮上,却用膏药花子盖
,以透为度,如恶物出尽,次用后方生肌散合疮口。
生肌散方
白矾(烧令汁尽一两) 黄连末(一分) 轻粉(一钱)
上三味同研细,不拘多少,掺疮口上,候生肉、脓水尽,疮口干,即止。
治痈肿疖毒,出脓疼痛。追脓散方
湿生虫(五十枚瓦上爆干) 小麦(五十粒) 麝香(研半钱匕)
上三味,捣研为末,每用一字, 在疮内。
治肿毒未成头热痛方
蛴螬(不计多少)
上一味生研细,入少面,并醋三两滴,调摊纸花子上,中剪一眼子,帖时以水润,觉药
力尽再用,候痒揭去,自然脓出。
治痈疽已溃,蚀恶肉。追毒丸方
巴豆(去皮心膜十四枚) 白丁香(二十一枚) 豆豉(二十一粒) 屁盘虫(七枚)
上四味同研细,滴水丸捻如雀粪大, 疮内,追汁尽即止。
治疮疖痈疽等无头者。通关膏方
乳香 轻粉(各等分)
上二味研匀,津唾调,涂肿处,以纸贴之。
治痈疽疮疖未有头。射疮坏脓丸方
砒霜(半钱) 白矾 铅丹(各一字)
上三味同研细,以面糊丸,如麻子大,先于毒处安药一丸,外以膏药花子掩定,微觉痒
痛即脓出。
治一切痈疮未破。败毒丸方
巴豆(去皮心膜三枚) 铅丹(少许)
上二味同研,入生面少许,再研匀,丸如麻子大,每以一丸安疮口外,以膏药贴之,脓
即出。
治痈疖多日不熟无头者。栝蒌酒方
栝蒌(一枚) 甘草(二寸)
上二味锉碎,用酒一盏,水一盏,量人虚实,入腻粉少许,煎三五沸去滓,临卧温服
夜半疏动一行,其疮自消。
治痈未有头,使必穴。方
茅锥(十枚尖正全具者)
上一味,以水煎十数沸,服之立溃,若两茎即生两孔,或断折一锥为二,亦两孔。
治痈疽发背,热毒攻 ,肌肉赤色,疼痛欲成脓,令速溃。丁香散方
丁香 赤小豆(各半两) 寒水石(二两) 羊桃根 硝石(研) 大黄(各一两) 木
香白
上一十味,捣罗为散,先以雄雀屎七粒,乳香一小块细研,以醋调和,涂疮头上,以醋
调药末如糊,摊故帛上贴之,干则易。
治发背痈疽,一切疮肿未溃,疼痛寒热,渴躁不食,解毒。犀角散方
犀角(镑一分) 人参 甘草(炙) 栝蒌实 大黄(炒各半两) 芎 (一两) 赤
茯苓(去
上一十味,捣罗为散,每服二钱匕,粥饮调下,以差为度。
治肿毒,及痈疖不穴。葱香涂敷方
煨葱(一茎) 乳香(如枣核大一粒)
上二味,烂研涂肿上即溃。
治痈疖无头。咽葵子方
葵子(一合)
上以津咽三五粒,多咽即头出多,假令咽一粒,即穿一穴也,随痈疖大小,不可过多。
治痈肿速穿坏。雀粪涂敷方
雄雀粪(二十一枚)
上用醋研和如糊,涂敷肿上,脓便出,未穴再涂,即破。
治热痈肿结热振 ,欲作脓。地黄膏涂贴方
生地黄(三斤细切捣绞取汁)
上一味,于铜器内慢火煎搅成膏,取敷肿处,以故帛涂贴之,亦得,日三五次易,即溃
【论述】恶脉这种病,其症状表现为红色的络脉突然突起,聚集在一起,形状像死去的蚯蚓,又像是水在脉管中流动。它的长短随着所发生的络脉而定。如果在春冬季节感受了恶风之邪,邪气侵入络脉而不能消散,就会导致血脉瘀结从而形成这种疾病。如果长期不治疗,瘀结的脉络就会演变成严重的病症而难以消除。
五香汤加茱萸犀角汤方
木香、藿香叶、沉香、熏陆香(乳香)、鸡舌香(丁子香)、吴茱萸(用汤水洗过并微炒)、犀角(镑成薄片,各一两)
以上七味药。粗捣筛碎,每次服用五钱匕。加水两盏,煎煮至一盏,滤去药渣,空腹温服,晚上再服一次。剩下的药渣加热后敷贴在肿胀处,变冷后即更换。
主治恶脉毒肿。
升麻汤方
升麻(一两)、乌梅肉(二两)、山栀子仁(二十枚)
以上三味药。粗捣筛碎,每次服用五钱匕。加水两盏,煎煮至一盏,滤去药渣,空腹温服,晚上再服一次。剩下的药渣加热后敷贴患处。
主治恶脉毒肿。
木香汤方
木香、吴茱萸(洗后焙干并微炒)、升麻、熏陆香、鸡舌香、雄黄、甘草(炙)、鳖甲(醋浸后炙烤去裙边,原文此处缺重量,依例推测为等分或适量,但按原文只列名)
以上九味药。粗捣筛碎,每次服用五钱匕。加水两盏,煎煮至一盏,滤去药渣,空腹温服,晚上再服一次。
主治恶脉肿毒。
黄耆散涂敷方
黄耆(细锉四两)
以上一味药,捣碎过筛成为细散,用水调匀敷在患处,每天三到五次。
又一方
漆姑草(茹二两,原文“漆头”疑为漆姑草之误,“ 茹”疑为衍文或特定部位,此处依常见外治法理解为漆姑草)
以上一味药,捣碎过筛成为细散,用水调匀敷在患处,每天三到五次。
【论述】痈肿如果寒邪较多且毒邪深重,外部症状虽然结聚坚硬且不消退,疼痛难以忍受,不能溃破化脓,或者已经穿孔,经久不愈,在外部的必须用药腐蚀,在内部的必须用药引出,使毒气发泄,营卫之气流通,那么痈疽就能痊愈了。所以有追引腐蚀痈肿的方剂。
透肌丸方
砂(研碎)、斑蝥(去掉翅膀和足,用米炒制)、乌头尖
以上三味药等量,捣碎研磨成粉末,用醋煮面糊,制成如小豆大小的丸子,捻扁,贴在疮上,再用膏药花子覆盖,以透出脓液为度。如果恶物排尽,接着使用后面的生肌散合拢疮口。
生肌散方
白矾(烧至汁液流尽,一两)、黄连末(一分)、轻粉(一钱)
以上三味药共同研细,不拘多少,撒在疮口上,等到新肉生长、脓水流尽,疮口干爽时,即停止使用。
追脓散方
湿生虫(五十枚,在瓦上爆干)、小麦(五十粒)、麝香(研碎半钱匕)
以上三味药,捣碎研磨成粉末,每次取一字量的药粉,纳入疮内。
主治痈肿疖毒,出脓疼痛。
蛴螬方
蛴螬(数量不限)
以上一味药生研细,加入少量面粉和三滴醋,调和摊在纸花子上,中间剪一个眼,贴敷时用水润湿,感觉药力尽了再换,等到发痒时揭去,脓液自然会流出。
主治肿毒未成头且热痛。
追毒丸方
巴豆(去皮心膜十四枚)、白丁香(二十一枚)、豆豉(二十一粒)、屁盘虫(七枚)
以上四味药共同研细,滴水制成如雀粪大小的丸子,纳入疮内,直到追出的汁液排尽即止。
主治痈疽已溃,腐蚀恶肉。
通关膏方
乳香、轻粉(各等分)
以上两味药研匀,用唾液调和,涂在肿胀处,用纸贴住。
主治疮疖痈疽等没有脓头的情况。
射疮坏脓丸方
砒霜(半钱)、白矾、铅丹(各一字)
以上三味药共同研细,用面糊制成如麻子大小的丸子,先在毒处安放一丸药,外面用膏药花子掩住固定,微微感到痒痛时脓液就会流出。
主治痈疽疮疖没有脓头。
败毒丸方
巴豆(去皮心膜三枚)、铅丹(少许)
以上两味药共同研细,加入少量生面,再研匀,制成如麻子大小的丸子,每次取一丸放在疮口外,用膏药贴住,脓液就会流出。
主治一切痈疮未破。
栝蒌酒方
栝蒌(一枚)、甘草(二寸)
以上两味药锉碎,用酒一盏、水一盏,根据病人的虚实情况,加入少许腻粉,煎煮三五沸后滤去药渣,临睡前温服。半夜会通畅排便一行,疮肿自然消退。
主治痈疖多日不熟、没有脓头的情况。
茅锥方
茅锥(十枚,尖端端正完整的)
以上一味药,用水煎煮十几沸,服用后立即溃破。如果是两根茎就生出两个孔,或者折断一根茅锥为二,也会生出两个孔。
主治痈未有头,使其必定穿孔。
丁香散方
丁香、赤小豆(各半两)、寒水石(二两)、羊桃根、硝石(研碎)、大黄(各一两)、木香、白(原文此处缺字,可能为白芷或其他,依上下文补全逻辑,但提取时仅取可见词)
以上十味药,捣碎过筛成为散剂。先用雄麻雀屎七粒、一小块乳香细研,用醋调和,涂在疮头上;再用醋将药末调成糊状,摊在旧布上贴敷,干了就更换。
主治痈疽发背,热毒攻注,肌肉赤色,疼痛欲成脓,促使快速溃破。
犀角散方
犀角(镑一分)、人参、甘草(炙)、栝蒌实、大黄(炒,各半两)、芎 (一两)、赤茯苓(去...原文截断)
以上十味药,捣碎过筛成为散剂,每次服用二钱匕,用粥饮调下,以病愈为度。
主治发背痈疽,一切疮肿未溃,疼痛寒热,口渴烦躁不食,解毒。
葱香涂敷方
煨葱(一茎)、乳香(如枣核大一粒)
以上两味药,烂研后涂在肿胀处即可溃破。
主治肿毒,及痈疖不穿孔。
咽葵子方
葵子(一合)
以上药,用唾液吞咽三到五粒,多吞咽则脓头多出。假如吞咽一粒,就会穿通一个孔。根据痈疖的大小,不可过多。
主治痈疖无头。
雀粪涂敷方
雄雀粪(二十一枚)
以上药用醋研和如糊状,涂敷在肿胀处,脓液就会流出。如果没有穿孔再涂,就会破溃。
主治痈肿速穿坏。
地黄膏涂贴方
生地黄(三斤,细切捣绞取汁)
以上一味药,在铜器内用慢火煎搅成膏,取来敷在肿胀处,用旧布涂贴也可以,每天三到五次更换,即可溃破。
主治热痈肿结热振栗,欲作脓。
[Discussion] The disease of "E Mai" (Evil Veins) presents with symptoms where red collaterals suddenly protrude and gather, resembling dead earthworms, or as if water is flowing within the vessels. Its length varies according to the collateral where it arises. Contracted from exposure to malignant wind in spring and winter, when the pathogen enters the collaterals and fails to dissipate, blood stasis forms, resulting in this ailment. If left untreated for a long time, the knotted vessels will transform into severe, intractable conditions.
Wu Xiang Tang Jia Zhu Yu Xi Jiao Tang (Five-Aromatic Decoction plus Cornus and Rhinoceros Horn Formula)
Mu Xiang (Aucklandiae Radix), Huo Xiang Ye (Pogostemonis Leaf), Chen Xiang (Aquilariae Lignum Resinatum), Xun Lu Xiang (Boswelliae Resina), Ji She Xiang (Caryophylli Flos), Wu Zhu Yu (Evodiae Fructus [washed with decoction and lightly stir-fried], each 1 liang), Xi Jiao (Rhinocerotis Cornu [sliced]).
The above seven herbs are coarsely crushed and sifted. Each dose consists of 5 qian bi. Add two zhan of water, boil down to one zhan, remove the dregs, and take warm on an empty stomach. Take again in the evening. Apply the hot dregs to the swelling; replace when cool.
Indicated for E Mai toxic swelling.
Sheng Ma Tang ( Cimicifugae Decoction)
Sheng Ma (Cimicifugae Rhizoma, 1 liang), Wu Mei Rou (Mume Fructus Flesh, 2 liang), Shan Zhi Zi Ren (Gardeniae Semen, 20 pieces).
The above three herbs are coarsely crushed and sifted. Each dose consists of 5 qian bi. Add two zhan of water, boil down to one zhan, remove the dregs, and take warm on an empty stomach. Take again in the evening. Apply the remaining dregs hot to the affected area.
Indicated for E Mai toxic swelling.
Mu Xiang Tang (Aucklandiae Decoction)
Mu Xiang (Aucklandiae Radix), Wu Zhu Yu (Evodiae Fructus [washed, dried, and lightly stir-fried]), Sheng Ma (Cimicifugae Rhizoma), Xun Lu Xiang (Boswelliae Resina), Ji She Xiang (Caryophylli Flos), Xiong Huang (Realgar), Gan Cao (Glycyrrhizae Radix et Rhizoma [roasted]), Bie Jia (Testudinis Carapax et Plastrum [soaked in vinegar, roasted, and skirt removed]).
The above nine herbs are coarsely crushed and sifted. Each dose consists of 5 qian bi. Add two zhan of water, boil down to one zhan, remove the dregs, and take warm on an empty stomach. Take again in the evening.
Indicated for E Mai swelling and toxin.
Huang Qi San Tu Fu Fang (Astragalus Powder for External Application)
Huang Qi (Astragali Radix [finely cut, 4 liang]).
The above single herb is crushed, sifted into a fine powder, mixed with water, and applied to the lesion 3-5 times daily.
Another Prescription
Qi Gu Cao (Lysimachiae Herba [2 liang]).
The above single herb is crushed, sifted into a fine powder, mixed with water, and applied to the lesion 3-5 times daily.
[Discussion] For carbuncles and swellings where cold is predominant and the toxin is deep, although external signs show induration that does not resolve and pain is unbearable, preventing suppuration, or if perforation has occurred but healing is delayed over a long period, external lesions require caustic agents, while internal ones require agents to draw out toxins. This allows the toxic qi to vent and Ying-Wei circulation to flow freely, leading to the cure of the carbuncle and ulcer. Hence, there are formulas for drawing out and cauterizing carbuncles.
Tou Ji Wan (Penetrating Muscle Pills)
Sha (Arsenolite [ground]), Ban Mao (Mylabris [wings and feet removed, stir-fried with rice]), Wu Tou Jian (Aconiti Lateralis Radix Prematura Apex).
Equal parts of the above three herbs are crushed and ground into powder. A paste made from vinegar and flour dough is used to form pills the size of small beans, flattened, and applied to the sore, covered with a plaster patch. Stop when pus penetrates. If all foul matter is expelled, subsequently apply the following Sheng Ji San to promote granulation and close the wound.
Sheng Ji San (Flesh-Generating Powder)
Bai Fan (Alumen [calcined until liquid runs out, 1 liang]), Huang Lian Mo (Coptidis Rhizoma powder, 1 fen), Qing Fen (Calomelas, 1 qian).
The above three herbs are finely ground together. Sprinkle an appropriate amount onto the wound. Stop when new flesh grows, pus ceases, and the wound becomes dry.
Zhui Nong San (Pus-Drawing Powder)
Shi Sheng Chong (Diptera Larvae [50 pieces, dried by popping on tile)], Xiao Mai (Tritici Semen, 50 grains), She Xiang (Moschus [ground, half qian bi]).
The above three herbs are crushed and ground into powder. Use one zi amount per application, inserted into the wound.
Indicated for carbuncles, furuncles, and toxic swellings with pus discharge and pain.
Qi Lao Fang (Ground Beetle Paste)
Qi Lao (Silphidae Larva [quantity unspecified]).
Fresh Qi Lao is finely ground, mixed with a little flour and three drops of vinegar, spread on a paper patch with a central hole, and applied moistened to the lesion. Replace when the medicinal effect wanes. Remove when itching occurs; pus will naturally drain.
Indicated for toxic swelling without a head, presenting with heat and pain.
Zhui Du Wan (Toxin-Expelling Pills)
Ba Dou (Crotonis Fructus [skin, core, and membrane removed, 14 seeds]), Bai Ding Xiang (Stercus Muscae Domesticae, 21 pieces), Dou Chi (Sojae Semen Praeparatum, 21 grains), Pi Pan Chong (Sarcophagidae Larva [7 pieces]).
The above four herbs are finely ground together. Form pills the size of sparrow droppings using water drops. Insert into the wound. Stop when the drawn fluid is exhausted.
Indicated for ruptured carbuncles and ulcers, for cauterizing foul flesh.
Tong Guan Gao (Passing Through Ointment)
Ru Xiang (Boswelliae Resina), Qing Fen (Calomelas) [equal parts].
The above two herbs are uniformly ground, mixed with saliva, applied to the swelling, and covered with paper.
Indicated for carbuncles, furuncles, and ulcers without heads.
She Chuang Huai Nong Wan (Piercing Sore and Expelling Bad Pus Pills)
Pi Shuang (Realgar Orpiment mixture/Arsenic Trioxide [half qian]), Bai Fan (Alumen), Qian Dan (Minii Oxidum) [each one zi].
The above three herbs are finely ground together. Form pills the size of hemp seeds using flour paste. Place one pill on the toxic area first, cover externally with a plaster patch. When slight itching and pain are felt, pus will emerge.
Indicated for carbuncles, ulcers, and furuncles without heads.
Bai Du Wan (Resolving Toxin Pills)
Ba Dou (Crotonis Fructus [skin, core, and membrane removed, 3 seeds]), Qian Dan (Minii Oxidum [a small amount]).
The above two herbs are ground together, mixed with a little raw flour, and ground evenly. Form pills the size of hemp seeds. Place one pill outside the wound opening each time, cover with a plaster. Pus will emerge.
Indicated for all carbuncles and sores not yet broken.
Gua Lou Jiu (Trichosanthes Wine)
Gua Lou (Trichosanthis Fructus, 1 piece), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 cun).
The above two herbs are cut up. Use one zhan of wine and one zhan of water. Add a small amount of Ni Fen (Calomelas) according to the patient's deficiency or excess. Boil for three to five boils, remove dregs, and take warm before sleep. A loose stool will occur at midnight, and the sore will subside naturally.
Indicated for carbuncles and furuncles that have persisted for many days without ripening or forming a head.
Mao Zhui Fang (Thatch Spike Decoction)
Mao Zhui (Thatch Spike [10 pieces, with complete and upright tips]).
Boil the above single herb in water for more than ten boils and drink. It will cause immediate rupture. Two stems produce two holes; breaking one spike in two also produces two holes.
Indicated for carbuncles without heads, to ensure perforation.
Ding Xiang San (Clove Powder)
Ding Xiang (Caryophylli Flos), Chi Xiao Dou (Phaseoli Semen Rubrum) [each half liang], Han Shui Shi (Halloysitum, 2 liang), Yang Tao Gen (Pruni Trilobae Radix), Xiao Shi (Natrii Nitras [ground]), Da Huang (Rhei Radix et Rhizoma) [each 1 liang], Mu Xiang (Aucklandiae Radix), Bai [Character missing in source, likely Bai Zhi or similar].
The above ten herbs are crushed and sifted into powder. First, grind seven grains of male sparrow droppings and a small piece of Ru Xiang finely, mix with vinegar, and apply to the head of the sore. Then, mix the herb powder with vinegar to form a paste, spread on old cloth, and apply to the wound. Change when dry.
Indicated for back carbuncles and ulcers where heat-toxin attacks, muscles are red, pain suggests impending suppuration, promoting rapid rupture.
Xi Jiao San (Rhinoceros Horn Powder)
Xi Jiao (Rhinocerotis Cornu [sliced, 1 fen]), Ren Shen (Ginseng Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma [roasted]), Gua Lou Shi (Trichosanthis Fructus), Da Huang (Rhei Radix et Rhizoma [stir-fried]) [each half liang], Xiong [Qiong] (Ligustici Chuanxiong Rhizoma, 1 liang), Chi Fu Ling (Poria Cocos [red part, removed... text cuts off]).
The above ten herbs are crushed and sifted into powder. Take 2 qian bi per dose, administered with millet broth. Continue until recovery.
Indicated for back carbuncles and ulcers, all sores not yet ruptured, with pain, chills, fever, thirst, restlessness, loss of appetite, for detoxification.
Cong Xiang Tu Fu Fang (Scallion and Aromatic External Application)
Wei Cong (Roasted Scallium, 1 stem), Ru Xiang (Boswelliae Resina [size of a jujube pit]).
The above two herbs are mashed and applied to the swelling to induce rupture.
Indicated for toxic swelling, and carbuncles/furuncles not perforating.
Yan Kui Zi Fang (Swallowing Abelmoschus Seeds Method)
Kui Zi (Abelmoschi Semen, 1 he).
Swallow 3-5 seeds with saliva. Swallowing more results in more heads appearing. Swallowing one seed pierces one hole. Do not use excessively depending on the size of the carbuncle/furuncle.
Indicated for carbuncles and furuncles without heads.
Que Fen Tu Fu Fang (Sparrow Dropping External Application)
Xiong Que Fen (Male Sparrow Dropping, 21 pieces).
Grind with vinegar to a paste consistency and apply to the swelling. Pus will drain. If not perforated, reapply to break it open.
Indicated for rapid rupture of hot toxic swelling.
Di Huang Gao Tu Tie Fang (Rehmannia Paste Application)
Sheng Di Huang (Rehmanniae Radix Recens [3 jin, finely cut, crushed, and juice extracted]).
The above single herb is slowly boiled and stirred in a copper vessel until it becomes a paste. Apply to the swelling and cover with old cloth. Change 3-5 times daily. Rupture will occur.
Indicated for hot carbuncles with knotting, heat, and chills, impending suppuration.