瘰 为疡科中最难治之一种顽固症候,其症之成也,往往三五成群,牵藤成串,故有
串之称,亦有窜胸窜胁者,种种现象不一而足,溃后则脓水常流,终岁穷年,缠绵不
愈,名虽有五,治法则一。在初起时可用紫背天葵草服之,或以紫花地丁草服之,间有愈
者,如不愈而反扩大时,则当以顺气行痰、开郁软坚之方(顺气消痰饮)主之,方如次∶
石燕(一对入锅炭火 红醋淬七次为末) 陈皮 半夏 茯苓(各五钱) 广香(三钱) 海藻 海带
昆布(各一两) 槟榔(五钱) 防风(三钱) 川芎 枳实 白芷 夏枯草(各五钱) 黄连
黄芩 栀子(各一钱) 赤芍 桔梗(各三钱)
或水煎服,或成丸服均可,或兼服金蚣丸更妙。
如系男子,则加入知母、黄柏各八分;如系女子,则加入当归、地黄、川芎、白芍各
八分。如有孕者,则忌金蚣丸,恐其伤胎。
此方久服之后,消散者有之;如不消时,则有落核一法,内服中九丸兼金蚣丸,如未穿
颈者,以化肉膏贴于头上,俟肉变黑色而不疼痛时,用针剥开一孔,插入药线,一日一插,
至七日后,核必自行落出(凡上药线,当以鸡蛋油搽于孔部,以减少其疼痛,然后以解毒膏
掩盖之)。用熏洗汤洗净污浊后,用加味天然散加细药,生肌平口,须忌发物,免碍药效。加味天然散
乳香 没药 儿茶 血竭(各一钱) 赤石脂(三钱) 海螵蛸(三钱) 冰片(一分)
如系冬月则加龙骨、象皮各三钱。
上共研细末,加入天然散中用之,约一月久可愈。
大药方(能消百毒,去腐烂,即药线方)
白砒(三钱) 明矾(七钱)
先将矾末铺入锅内,次将砒放在矾中心,滴清油五、六滴,候烟消尽,取出听用。如
疮口烂大时,用清油、白蜡煎溶,入大药在内,以油纸敷贴。
小药方(能缩血,干脓水)
蚊蛤一个,开一口,灌入明矾末于内,用皮纸封固,火中烧至内部呈黑色时,取起研
为细末,入生肌散用。
脱茧风凉膏(上大药后,以此方润茧,其核自落)
煮鸡蛋五个,去白留黄,同麻油久煎去渣,倾入碗内,加雄黄五钱为末,入油内搅匀,敷搽患处。
瘰疬是外科中最难治疗的一种顽固性病症。其发病特点往往是三五成群,像藤蔓一样串联成串,因此被称为“串疮”。也有蔓延至胸部和胁肋部的,各种现象不一而足。溃破后脓水常流,终年缠绵不愈。虽然病名有五种(指不同阶段或形态),但治疗法则是一致的。在初起阶段,可以服用紫背天葵草,或者服用紫花地丁草,偶尔有痊愈的病例。如果服药后病情未愈反而扩大,则应当采用顺气行痰、开郁软坚的方剂(顺气消痰饮)为主进行治疗。方剂组成如下:
石燕(一对,放入锅中用炭火煅烧至红,用醋淬炼七次后研为粉末) 陈皮 半夏 茯苓(各五钱) 广香(三钱) 海藻 海带 昆布(各一两) 槟榔(五钱) 防风(三钱) 川芎 枳实 白芷 夏枯草(各五钱) 黄连 黄芩 栀子(各一钱) 赤芍 桔梗(各三钱)
以上药物可以水煎服用,也可以制成丸药服用,如果同时服用金蚣丸效果更好。
如果是男性患者,则加入知母、黄柏各八分;如果是女性患者,则加入当归、地黄、川芎、白芍各八分。如果有身孕者,则忌服金蚣丸,恐怕会损伤胎儿。
此方长期服用后,有的肿块会消散;如果肿块不消散,则采用“落核”的方法:内服中九丸并兼服金蚣丸。如果颈部尚未溃破,以化肉膏贴敷于肿块顶部,等到局部组织变黑且不感到疼痛时,用针挑开一个小孔,插入药线,每天插入一次,七天之后,肿块核团必会自行脱落(凡是在药线上涂抹鸡蛋油,涂在孔部,以减少疼痛,然后用解毒膏覆盖)。用熏洗汤洗净污浊后,使用加味天然散加细药,促进生肌和平复创口,必须忌食发物,以免妨碍药效。加味天然散组成:乳香 没药 儿茶 血竭(各一钱) 赤石脂(三钱) 海螵蛸(三钱) 冰片(一分)。如果是冬季,则加入龙骨、象皮各三钱。
以上药物共同研成细末,加入天然散中使用,大约一个月即可痊愈。
大药方(能消除百毒,去除腐烂组织,即制作药线的方子)
白砒(三钱) 明矾(七钱)
先将明矾粉末铺入锅内,然后将白砒放在明矾中心,滴入清油五到六滴,等待烟雾消散尽后,取出备用。如果疮口腐烂较大,用清油和白蜡煎融化,将大药放入其中,用油纸敷贴。
小药方(能收缩血管,使脓水干燥)
取一个蚊蛤,开一个小口,灌入明矾粉末于内,用皮纸封固,在火中烧至内部呈黑色时,取出研为细末,加入生肌散中使用。
脱茧风凉膏(在使用大药之后,以此方润湿硬结,其核团自然脱落)
煮五个鸡蛋,去掉蛋白只留蛋黄,同麻油长时间煎煮去渣,倒入碗内,加入雄黄五钱研成的粉末,混入油中搅匀,敷搽患处。
Scrofula (Luo Li) is one of the most difficult stubborn syndromes to treat in surgery. Its formation often presents as clusters of three or five, linking together like vines, hence it is also called "Chuan Chuang" (String Sores). There are also cases where it spreads to the chest and hypochondrium, with various manifestations. After ulceration, pus and fluid flow continuously, lingering throughout the year without healing. Although there are five names for this condition, the treatment principles remain consistent. In the early stage, one may take Zi Bei Tian Kui Cao (Rhizoma et Radix Tripterygii Hypoglauci) orally, or take Zi Hua Di Ding Cao (Viola Yedoensis Herb); occasionally, cures occur. If the condition does not improve but instead expands, a formula that regulates qi, moves phlegm, opens depression, and softens hardness (Shun Qi Xiao Tan Yin, Regulating-Qi and Resolving-Phlegm Decoction) should be used as the main treatment. The formula is as follows:
Shi Yan (One pair, calcined in a pot over charcoal fire until red, quenched seven times in vinegar, then ground into powder) Chen Pi (Exocarpium Citri Reticulatae), Ban Xia (Rhizoma Pinelliae), Fu Ling (Poria) (each 5 qian), Guang Xiang (Radix Aucklandiae), Hai Zao (Thallus Laminariae), Hai Dai (Thallus Eckloniae), Kun Bu (Thallus Eckloniae) (each 1 liang), Bing Lang (Arecae Semen), Fang Feng (Radix Saposhnikoviae) (each 3 qian), Chuan Xiong (Rhizoma Chuanxiong), Zhi Shi (Fructus Aurantii Immaturus), Bai Zhi (Radix Angelicae Dahuricae), Xia Ku Cao (Spica Prunellae) (each 5 qian), Huang Lian (Rhizoma Coptidis), Huang Qin (Radix Scutellariae), Zhi Zi (Fructus Gardeniae) (each 1 qian), Chi Shao (Radix Paeoniae Rubra), Jie Geng (Radix Platycodonis) (each 3 qian).
These herbs can be decocted in water for oral administration, or prepared into pills. Taking Jin Gong Wan (Golden Centipede Pill) concurrently is even better.
For male patients, add Zhi Mu (Rhizoma Anemarrhenae) and Huang Bo (Cortex Phellodendri) each 8 fen; for female patients, add Dang Gui (Radix Angelicae Sinensis), Di Huang (Radix Rehmanniae), Chuan Xiong (Rhizoma Chuanxiong), and Bai Shao (Radix Paeoniae Alba) each 8 fen. For pregnant women, Jin Gong Wan is contraindicated to avoid harming the fetus.
After long-term use of this formula, some nodules will dissipate; if they do not dissipate, the "Luoke" (Nodule Expulsion) method is employed: internally administer Zhong Jiu Wan (Central Nine Pills) along with Jin Gong Wan. If the neck has not yet perforated, apply Hua Rou Gao (Flesh-Melting Ointment) to the top of the nodule. Wait until the tissue turns black and becomes painless, then puncture a small hole with a needle, insert a medicinal thread once a day. After seven days, the nodule core will naturally fall out (When applying the medicinal thread, apply egg yolk oil to the hole area to reduce pain, then cover with Du Ji Gao (Detoxifying Ointment)). After cleaning the dirt with the Fumigation and Washing Decoction, use Jia Wei Tian Ran San (Modified Natural Powder) with fine herbs to promote flesh regeneration and level the wound surface. Avoid "Fa Wu" (stimulating foods) to prevent hindering the efficacy. Jia Wei Tian Ran San composition: Ru Xiang (Resina Acaciae Cathartae), Mo Yao (Resina Boswelliae), Er Cha (Catechu), Xue Jie (Santalum Album Lignum) (each 1 qian), Chi Shi Zhi (Halloysitum Rubrum) (3 qian), Hai Piao Xiao (Endoconcha Sepiae), Bing Pian (Borneolum Syntheticum) (1 fen). In winter months, add Long Gu (Os Dinosauri) and Xiang Pi (Corium Elephantis) each 3 qian.
Grind all ingredients into a fine powder and mix with Tian Ran San for use. Healing can be expected in about one month.
Da Yao Fang (Great Medicine Formula - capable of eliminating hundred toxins and removing rotting tissue, i.e., the medicinal thread formula):
Bai Pi (Arsenicum Rubrum) (3 qian), Ming Fan (Alumen) (7 qian).
First, spread the powdered Alumen into the pot, then place the Arsenicum Rubrum in the center of the Alumen. Add five to six drops of clear oil. Wait until the smoke dissipates completely, then remove and set aside. If the sore is large and rotten, melt clear oil and white wax, add the Great Medicine inside, and apply using oiled paper.
Xiao Yao Fang (Small Medicine Formula - capable of contracting blood vessels and drying pus/fluid):
Take one Wen Ge (likely referring to a specific insect or shell, contextually ambiguous, literal translation: Mosquito Shell), make a small opening, pour powdered Alumen inside, seal tightly with skin paper, and burn in fire until the interior turns black. Remove, grind into fine powder, and add to Sheng Ji San (Flesh-Regenerating Powder).
Tuo Jian Feng Liang Gao (Peeling Callus Wind-Cool Ointment - after applying the Great Medicine, use this formula to moisten the callus so the core falls off naturally):
Boil five eggs, remove whites and keep yolks. Simmer with Sesame Oil (Ma You) for a long time, strain the residue, pour into a bowl. Add Xiong Huang (Realgar) 5 qian ground into powder, mix evenly into the oil, and apply to the affected area.