论曰痈疽发背,病为急切,然五脏 皆在背,发于何部,宜精详之,其作也邪毒内鼓,
寒热交攻,气血壅滞,阴阳相干,故令人身热而恶寒也,当以疗痈疽之法治之。
治痈疽发背,时作寒热,疼痛不食。解毒地黄丸方
生干地黄(焙二两) 黄 (锉) 栝蒌根 黄芩(去黑心) 麦门冬(去心焙各一两
半) 桑
螵蛸(十五枚锉炒) 大黄(锉炒) 人参 栀子仁 肉苁蓉(焙) 前胡(去芦头) 升
麻芍药
知
五枚汤浸
去
上一十九味,捣罗十八味为末,入枣膏和丸,如梧桐子大,每服三十丸,加至
五十丸,空心米饮下,日晚再服。
治痈肿初结,头痛寒热气急。木香汤方
木香 藿香叶 沉香 薰陆香 丁香(各一两)
上五味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓空心温服,取滓敷肿上,日
二。
治痈疽始作便败坏,发寒热疼痛。羊髓膏方
羊髓 甘草(锉捣各二两) 胡粉(研) 大黄(锉捣各一两) 猪脂(半斤)
上五味,先熬脂髓令沸,下甘草大黄,煎候甘草黑色,绵滤去滓,入胡粉,以柳篦搅匀
,瓷合盛,每日三五度涂敷疮上,以瘥为度。
治发背痈疽,一切疮肿乳痈,口干脚冷,发作寒热,头痛呕哕不下食。葛根汤方
葛根(锉) 麦门冬(去心焙各一两) 犀角(镑半两) 葳蕤 荠 芍药 甘草(炙
锉)
芦根(锉各三分) 石膏(一两半)
上九味,粗捣筛,每服五钱匕,水一盏半,煎至八分,下竹沥半合,红雪一分,更煎三
两沸,去滓空心日晚温服。
治痈疽始作,坚硬皮色紫赤,恶寒壮热,一二日未成脓者。升麻汤方
升麻 连翘 大黄(锉炒) 生地黄(切焙) 木香(各一两) 白蔹 玄参(各三分)
上七味,粗捣筛,每服五钱匕,水二盏,煎至一盏,入芒硝末半钱匕,去滓空心温服,
取利为度,未利再服。
治发背痈疽,一切疮肿未穴时,攻刺疼痛,或发寒热渴躁不食,解毒匀气。犀角散方
犀角(镑一分) 人参 大黄(锉炒) 栝蒌实(焙) 甘草(炙锉各半两) 葛根(锉)
赤茯苓(去黑皮) 槟榔(锉) 木香(各三分) 芎 (一两)
上一十味,捣罗为散,每服二钱匕,空心晚间粥饮调下,以瘥为度。
治发背未成脓,身体寒热。人参散方
人参 当归(焙) 密陀僧( ) 没药(研) 雄黄(研各半两) 丹砂(研一钱) 栝
蒌实(
二枚去瓤取皮子生用)
上七味,捣研为细散,每服二钱匕,用甘草煎汤放温调下,日三。
治发背未溃,身体寒热。黄柏散方
黄柏 烟熏壁土(多年者各二两)
上二味为细散,每服二钱匕,茅根煎汤调下,仍用生姜汁调药敷之。
治发背作寒热。车螯酒方
车螯(紫色光浓者以黄泥固济 赤候冷为末取三钱匕) 腻粉(一钱匕) 甘草末(二
钱匕)
栝蒌实(一枚锉)
上四味,先将前三味和匀,次将栝蒌用酒二盏,煎至一盏,去滓调下前药三钱匕,取下
恶物瘥。
治发背未溃,身体寒热。苦茄散方
苦茄种 甘草(炙各一两)
上二味为细散,每服二钱匕,甘草汤调下。
治热毒痈肿血不散,初觉憎寒干渴,四肢烦闷,能令速消。柴胡煎方
柴胡(去苗一两) 知母(焙一两) 木通(一两半) 淡竹叶(一百片) 瞿麦穗(一
两) 连
翘(一两) 防己(二两) 大黄(生二两细锉) 生麦门冬(汁三合汤成下) 生藕汁(三
合汤成
下)
上一十一味,先将八味锉如麻豆大,以水三升,煮取一升半,去滓下甜硝令散,次入麦
门冬藕汁等,共分为八服,空腹两服,以溏利为度,余药食后缓缓服之。
治痈疽发脑发背,肿 寒热疼痛。忍冬饮方
忍冬嫩苗一握(叶尖圆蔓生茎叶皆有毛生田野篱落间多有之两叶对生春夏新叶稍尖而色
嫩绿柔
数日变
似薜荔
上二味,烂研忍冬同甘草,入酒一升半,沙瓶中塞口,煮两食顷温服,一日服尽,若仓
卒求不获,只用干叶为散,每服三方寸匕,甘草方寸匕,酒煮服之亦可,但不及生者耳。
论述说:痈疽发背,病情急迫凶险。然而五脏都位于背部,发病的具体部位不同,治疗时必须精细详察。其发作机理是邪毒在体内鼓动,寒热之邪相互攻冲,导致气血壅滞,阴阳失调,因此使人出现身体发热且恶寒的症状,应当用治疗痈疽的方法来施治。
治疗痈疽发背,时常发作寒热,疼痛且不能进食的方剂:解毒地黄丸方。
生干地黄(焙干,二两) 黄芩(切碎) 栝蒌根 黄芩(去除黑心部分) 麦门冬(去心,焙干,各一两半) 桑螵蛸(十五枚,切碎炒制) 大黄(切碎炒制) 人参 栀子仁 肉苁蓉(焙干) 前胡(去除芦头) 升麻 芍药 知母 甘草(炙,切,各三两) 大枣(五枚,汤浸,去皮核)。
以上十九味药,将除大枣外的十八味捣碎过筛成细末,加入枣膏调和制成丸药,大小如梧桐子。每次服用三十丸,可加至五十丸,空腹时用米汤送服,晚上再服一次。
治疗痈肿初起结聚,头痛、寒热、气急的方剂:木香汤方。
木香 藿香叶 沉香 薰陆香(乳香) 丁香(各一两)。
以上五味药,粗捣后过筛,每次服用五钱匕,加水一盏半,煎至八分,去渣,空腹温服。取药渣敷在肿处,每日两次。
治疗痈疽刚开始发作就已败坏,出现寒热疼痛的方剂:羊髓膏方。
羊髓 甘草(切碎捣烂,各二两) 胡粉(研细) 大黄(切碎捣烂,各一两) 猪脂(半斤)。
以上五味药,先将猪脂和羊髓熬煮至沸腾,放入甘草和大黄,煎煮直到甘草变黑,用绵布过滤去渣,加入胡粉,用柳枝搅拌均匀,装入瓷盒中。每天涂抹疮口三到五次,以痊愈为度。
治疗发背痈疽,一切疮肿及乳痈,口干脚冷,发作寒热,头痛呕吐呃逆不能进食的方剂:葛根汤方。
葛根(切碎) 麦门冬(去心,焙干,各一两) 犀角(镑片,半两) 葳蕤(玉竹) 荠(此处疑为“荠”或通“薤”,依原文保留) 芍药 甘草(炙,切碎) 芦根(切碎,各三分) 石膏(一两半)。
以上九味药,粗捣后过筛,每次服用五钱匕,加水一盏半,煎至八分,加入竹沥半合,红雪一分,再煎三沸,去渣,空腹及晚间温服。
治疗痈疽刚开始发作,局部坚硬,皮色紫赤,恶寒壮热,一二日内尚未化脓的方剂:升麻汤方。
升麻 连翘 大黄(切碎炒制) 生地黄(切片焙干) 木香(各一两) 白蔹 玄参(各三分)。
以上七味药,粗捣后过筛,每次服用五钱匕,加水二盏,煎至一盏,加入芒硝末半钱匕,去渣,空腹温服,以大便通畅为度,若未通便则再服。
治疗发背痈疽,一切疮肿在未溃破时,攻刺样疼痛,或发作寒热、口渴烦躁、不能进食,旨在解毒调气的方剂:犀角散方。
犀角(镑片,一分) 人参 大黄(切碎炒制) 栝蒌实(焙干) 甘草(炙,切碎,各半两) 葛根(切碎) 赤茯苓(去除黑皮) 槟榔(切碎) 木香(各三分) 川芎(一两)。
以上十味药,捣碎过筛成散剂,每次服用二钱匕,空腹及晚间用粥饮调服,以痊愈为度。
治疗发背未成脓,身体寒热的方剂:人参散方。
人参 当归(焙干) 密陀僧 没药(研细) 雄黄(研细,各半两) 丹砂(研细,一钱) 栝蒌实(二枚,去瓤,取皮和子生用)。
以上七味药,捣研成细散,每次服用二钱匕,用甘草煎汤放温后调服,每日三次。
治疗发背未溃破,身体寒热的方剂:黄柏散方。
黄柏 烟熏壁土(多年的,各二两)。
以上两味药,研成细散,每次服用二钱匕,用茅根煎汤调服,同时用生姜汁调药外敷患处。
治疗发背发作寒热的方剂:车螯酒方。
车螯(紫色光泽浓重的,用黄泥密封煅烧至红透,冷却后研成末,取三钱匕) 腻粉(一钱匕) 甘草末(二钱匕) 栝蒌实(一枚,切碎)。
以上四味药,先将前三味混合均匀,然后将栝蒌用酒二盏,煎至一盏,去渣,调入前述药末三钱匕,服用后排出恶物即可痊愈。
治疗发背未溃破,身体寒热的方剂:苦茄散方。
苦茄种 甘草(炙,各一两)。
以上两味药,研成细散,每次服用二钱匕,用甘草汤调服。
治疗热毒痈肿,血瘀不散,初觉憎寒干渴,四肢烦闷,能使肿块迅速消散的方剂:柴胡煎方。
柴胡(去苗,一两) 知母(焙干,一两) 木通(一两半) 淡竹叶(一百片) 瞿麦穗(一两) 连翘(一两) 防己(二两) 大黄(生用,二两,细切) 生麦门冬(榨汁三合,汤成时下) 生藕汁(三合,汤成时下)。
以上十一味药,先将前八味切成芝麻豆大小,用水三升,煮取一升半,去渣,加入甜硝使其溶解,然后加入麦门冬汁、藕汁等,共分为八份服用。空腹时服两份,以大便溏泄为度,其余药物在饭后缓缓服下。
治疗痈疽发脑、发背,肿胀、寒热、疼痛的方剂:忍冬饮方。
忍冬嫩苗一握(叶尖圆,蔓生,茎叶皆有毛,生于田野篱落间,多有之,两叶对生,春夏新叶稍尖而色嫩绿柔,数日变似薜荔……此处原文有缺漏或描述性文字混杂,依文意理解为忍冬藤/叶),甘草(二两)。
以上两味药,将忍冬与甘草烂研,加入酒一升半,用沙瓶塞口,煮约一顿饭的时间,温服,一日服完。如果仓促间没有鲜品,只用干叶研成散,每次服用三方寸匕,甘草一方寸匕,用酒煮服也可以,只是效果不如鲜品好。
Commentary states: Carbuncle and furuncle on the back (Yong Ju Fa Bei) present with urgent and critical conditions. Since all five zang organs are located in the back, one must carefully examine the specific site of onset to determine the appropriate treatment. The pathogenesis involves internal agitation of evil pathogens, mutual attack of cold and heat, stagnation of qi and blood, and interference between yin and yang, resulting in fever and aversion to cold. Treatment should follow the methods for managing carbuncles and furuncles.
Formula for treating carbuncle and furuncle on the back with intermittent chills and fever, pain, and anorexia: Jiedu Dihuang Wan (Detoxifying Rehmannia Pill).
Sheng Gan Di Huang (Baked Dried Rehmanniae Radix, 2 liang), Huang Qin (Chopped Scutellariae Radix), Gua Lou Gen (Trichosanthis Radix), Huang Qin (Scutellariae Radix with black heart removed), Mai Men Dong (Pulpless and Baked Ophiopogonis Tuber, each 1.5 liang), Sang Piao Xiao (Mashed and Stir-fried Mantis Egg-case, 15 pieces), Da Huang (Chopped and Stir-fried Rheum Palmati Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Zhi Zi Ren (Gardeniae Semen), Rou Cong Rong (Baked Cistanches Herba), Qian Hu (Anthocarpus Root with rhizome removed), Sheng Ma (Cimicifugae Rhizoma), Shao Yao (Paeoniae Radix), Zhi Mu (Anemarrhenae Rhizoma), Gan Cao (Honey-fried and Chopped Glycyrrhizae Radix et Rhizoma), Da Zao (Five dates, soaked in water, skin and pits removed).
Process eighteen of the nineteen ingredients into a fine powder. Mix with jujube paste to form pills the size of wutong seeds. Take 30 pills per dose, increasing to 50 if necessary, with rice decoction on an empty stomach, and again in the evening.
Formula for treating early-stage swelling with headache, chills and fever, and rapid breathing: Muxiang Tang (Costus Decoction).
Mu Xiang (Aucklandiae Radix), Huo Xiang Ye (Agastachis Folium), Chen Xiang (Aquilariae Lignum Resinatum), Xun Lu Xiang (Frankincense), Ding Xiang (Caryophylli Flos, each 1 liang).
Coarsely crush and sieve the five ingredients. Take 5 qian bi per dose with 1.5 cups of water, boil down to 0.8 cup, strain, and take warm on an empty stomach. Apply the residue topically to the swelling twice daily.
Formula for treating carbuncle and furuncle at initial stage with deterioration, chills, fever, and pain: Yang Sui Gao (Sheep Marrow Ointment).
Yang Sui (Ovis Medulla), Gan Cao (Chopped and Pounded Glycyrrhizae Radix et Rhizoma, each 2 liang), Hu Fen (Lead Carbonate), Da Huang (Chopped and Pounded Rheum Palmati Radix et Rhizoma, each 1 liang), Zhu Zhi (Suis Adeps, 0.5 jin).
Boil the lard and marrow until boiling. Add Gan Cao and Da Huang, simmer until Gan Cao turns black. Strain through silk cloth, add Hu Fen, and stir evenly with a willow stick. Store in a porcelain jar. Apply to the sore 3-5 times daily until healed.
Formula for treating fa bei carbuncle, all sores and breast abscesses, dry mouth, cold feet, chills and fever, headache, vomiting, retching, and inability to eat: Gegen Tang (Kudzu Decoction).
Ge Gen (Chopped Puerariae Lobatae Radix), Mai Men Dong (Pulpless and Baked Ophiopogonis Tuber, each 1 liang), Xi Jiao (Slivered Rhinocerotis Cornu, 0.5 liang), Wei Rui (Polygonati Odorati Rhizoma), Qi (Herba Siegesbeckiae or similar, kept as original text), Shao Yao (Paeoniae Radix), Gan Cao (Honey-fried and Chopped Glycyrrhizae Radix et Rhizoma), Lu Gen (Chopped Phragmitis Rhizoma, each 3 fen), Shi Gao (Gypsum Fibrosum, 1.5 liang).
Coarsely crush and sieve the nine ingredients. Take 5 qian bi per dose with 1.5 cups of water, boil down to 0.8 cup. Add Ban Xia Li (Zhu Ru juice, 0.5 he) and Hong Xue (Red Snow, 1 fen). Boil three more times, strain, and take warm on an empty stomach and in the evening.
Formula for treating early-stage carbuncle and furuncle characterized by hardness, purple-red skin, severe aversion to cold and high fever, before suppuration occurs within 1-2 days: Shengma Tang (Cimicifugae Decoction).
Sheng Ma (Cimicifugae Rhizoma), Lian Qiao (Forsythiae Fructus), Da Huang (Chopped and Stir-fried Rheum Palmati Radix et Rhizoma), Sheng Di Huang (Sliced and Baked Rehmanniae Radix), Mu Xiang (Aucklandiae Radix, each 1 liang), Bai Lian (Bai Lian Rhizoma), Xuan Shen (Scrophulariae Radix, each 3 fen).
Coarsely crush and sieve the seven ingredients. Take 5 qian bi per dose with 2 cups of water, boil down to 1 cup. Add Mang Xiao (Natrii Sulfas) powder 0.5 qian bi. Strain and take warm on an empty stomach. Stop when bowel movement is achieved; repeat if necessary.
Formula for treating fa bei carbuncle and all sores before ulceration, with stabbing pain, chills and fever, thirst, restlessness, and anorexia, aimed at detoxification and qi regulation: Xijiao San (Rhinoceros Horn Powder).
Xi Jiao (Slivered Rhinocerotis Cornu, 1 fen), Ren Shen (Ginseng Radix et Rhizoma), Da Huang (Chopped and Stir-fried Rheum Palmati Radix et Rhizoma), Gua Lou Shi (Baked Trichosanthis Fructus), Gan Cao (Honey-fried and Chopped Glycyrrhizae Radix et Rhizoma, each 0.5 liang), Ge Gen (Chopped Puerariae Lobatae Radix), Chi Fu Ling (Poria with Black Skin Removed), Bing Lang (Arecae Semen, chopped, each 3 fen), Mu Xiang (Aucklandiae Radix, 1 liang), Xiong (Ligustici Chuanxiong Rhizoma).
Grind the ten ingredients into a powder. Take 2 qian bi per dose with congee drink on an empty stomach and in the evening until healed.
Formula for treating fa bei before suppuration with body chills and fever: Renshen San (Ginseng Powder).
Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Baked Angelicae Sinensis Radix), Mi Tuo Seng (Lithargyrum), Mo Yao (Myrrha), Xiong Huang (Realgar, ground, each 0.5 liang), Dan Sha (Cinnabar, ground, 1 qian), Gua Lou Shi (Two fruits, pulp removed, peel and seeds used raw).
Grind the seven ingredients into a fine powder. Take 2 qian bi per dose mixed with warm decoction of Gan Cao. Take three times daily.
Formula for treating fa bei without ulceration with body chills and fever: Huangbai San (Phellodendri Powder).
Huang Bai (Phellodendri Cortex), Yan Xun Bi Tu (Wall Soil Smoked by Kitchen Smoke for Many Years, each 2 liang).
Grind into a fine powder. Take 2 qian bi per dose mixed with decoction of Mao Gen (Imperatae Rhizoma). Also apply medicine mixed with Jiang Su (Zingiberis Recens Juice) externally.
Formula for treating fa bei with chills and fever: Che Ao Jiu (Vegetable Clam Wine).
Che Ao (Purple, glossy specimens sealed with yellow mud, calcined until red, cooled, and powdered; take 3 qian bi), Ni Fen (Calomelas, 1 qian bi), Gan Cao Mo (Glycyrrhizae Powder, 2 qian bi), Gua Lou Shi (One fruit, chopped).
Mix the first three ingredients. Decoct the Gua Lou Shi in 2 cups of wine until reduced to 1 cup. Strain and mix with the 3 qian bi of the previous powder. Ingest to expel foul matter and achieve cure.
Formula for treating fa bei without ulceration with body chills and fever: Ku Qie San (Bitter Eggplant Seed Powder).
Ku Qie Zhong (Solanum Melongena Seed), Gan Cao (Honey-fried, each 1 liang).
Grind into a fine powder. Take 2 qian bi per dose mixed with Gan Cao decoction.
Formula for treating heat-toxin carbuncle with blood stasis, initial aversion to cold, dryness, thirst, and limb oppression, promoting rapid resolution: Chaihu Jian (Bupleurum Decoction).
Chai Hu (De-stalked Bupleuri Radix, 1 liang), Zhi Mu (Baked Anemarrhenae Rhizoma, 1 liang), Mu Tong (Akebiae Caulis, 1.5 liang), Dan Zhu Ye (Lophatheri Folium, 100 leaves), Qu Mai Sui (Dianthi Spica, 1 liang), Lian Qiao (Forsythiae Fructus, 1 liang), Fang Ji (Stephaniae Tetrandrae Radix, 2 liang), Da Huang (Raw Rheum Palmati Radix et Rhizoma, finely chopped, 2 liang), Sheng Mai Men Dong (Fresh Ophiopogonis Tuber juice, 3 he, added when soup is ready), Sheng Ou Zhi (Fresh Nelumbinis Rhizomatis Juice, 3 he, added when soup is ready).
Chop the first eight ingredients like hemp seeds. Boil in 3 sheng of water until reduced to 1.5 sheng. Strain, dissolve Tian Xiao (Sal Nitratis) in the liquid, then add Mai Men Dong and Ou Zhi. Divide into 8 doses. Take 2 doses on an empty stomach until loose stools occur. Take remaining doses slowly after meals.
Formula for treating carbuncle/furuncle on head or back with swelling, chills, fever, and pain: Rendong Yin (Lonicera Drink).
Rendong Nen Miao (One handful of fresh Lonicera japonica tender shoots), Gan Cao (2 liang).
Mash the Lonicera and Gan Cao together. Add 1.5 sheng of wine, seal in a clay pot, and simmer for the duration of a meal. Take warm, consuming the entire dose in one day. If fresh material is unavailable, use dried leaves as powder: take 3 fang cun bi of leaf powder and 1 fang cun bi of Gan Cao powder, boiled in wine. Fresh material is superior.