凡疔疮取治。其法不一。当先看其缓急。如缓者一日疮 白色而小。二日色白微大。三日色微紫。
四日色真紫。此候之缓也。急者五日色青紧小。六日色深青大紧。七日色黑如火灸疮之状。此最急之候。假
如身上生一疮。而他处再生一小疮。为之应候。用针挑破小疮。则泄其毒。谓之可治。不可治者他处
无小疮。谓之无应候。毒之甚。故不可治也。大抵疔疮四围有赤 肿。名曰有护汤。如四围不赤肿。
即是不护汤。亦不可治也。疔之生者则身热头疼。手足温暖。饮食如常是也。疔之危者。睛不转。大
渴而喘。唇面青。不进食。五心肿。无有脉。四肢冷。不起床。不精神。腹痛甚于常。是有内疔也。
当详内疔条。如治外疔。虽有三十四种之分。而其治法不无少异。当知禁忌。不可误犯。犯之者恐难
治也。
大凡痈疽等毒。虽属君火。而经络壅滞。感受亦有阴有阳。阳痈则赤肿 痛。脉浮数。发热而渴。
或大便秘。小便赤。疮亦紫赤。皆热之过极。宜服内疏黄连汤。外以洪宝膏敷贴自愈。如阴毒初起。
肿痛肉不变色而少热。其脉沉实。恶寒喜饮暖。五七日则疮面凹
而阴黑。腐烂溃而不速。久则开而不敛。宜服补中益气加温暖药。外敷玉龙膏。待阴气散而阳气回。
则疮赤而肌肉渐长。痛减如失。人亦得生矣。若不知此。而误以败毒等剂。多致不救。学人参之。
凡治疗疔疮,方法多种多样。应当首先观察病情的缓急。如果是缓证,第一天疮面白色且小;第二天颜色白而稍大;第三天颜色微紫;第四天颜色真紫。这是病情缓和的征象。如果是急证,第五天颜色青紧而小;第六天颜色深青、大而紧;第七天颜色黑得像火灸过的疮一样。这是最危急的征象。假如身上生了一个疮,而在其他部位又生出一个小疮,这称为“应候”。用针挑破这个小疮,就能泄出毒气,这就叫做可治。不可治的情况是其他部位没有小疮,这称为无“应候”,说明毒气极盛,所以不可治。大抵疔疮四周有红肿,名叫“护场”(指疮周有红晕保护,不致内陷)。如果四周不红肿,就是无“护场”,也不可治。疔疮轻生的表现是身体发热、头痛、手足温暖、饮食如常。疔疮危重的表现是眼球转动不灵、极度口渴且气喘、嘴唇和面色发青、不能进食、五心(两手心、两足心及心口)肿胀、无脉象、四肢冰冷、不能起床、精神萎靡、腹痛比平时剧烈,这是出现了“内疔”。应当详细参考内疔的条文。至于治疗外疔,虽然有三十四种分类,但其治疗方法没有太大差异。应当知晓禁忌,不可误犯,一旦误犯恐怕难以治愈。
大凡痈疽等毒邪,虽然属于君火范畴,但经络壅滞,感受邪气也有阴证和阳证之分。阳痈表现为红肿疼痛,脉象浮数,发热且口渴,或者大便秘结,小便赤黄,疮色紫赤,这都是热毒过极所致。适宜服用内疏黄连汤,外用洪宝膏敷贴即可自愈。如果是阴毒初起,肿痛但肌肉不变色且热度不高,脉象沉实,恶寒喜欢喝热水。到了第五七天,疮面凹陷且呈阴黑色,腐烂溃破但不迅速愈合,时间久了疮口敞开而不收敛。适宜服用补中益气汤加入温性药物,外用玉龙膏敷贴。等到阴气消散、阳气回复,则疮色变红,肌肉逐渐生长,疼痛消失,人也能存活了。如果不懂这个道理,而错误地使用败毒等寒凉药剂,大多导致无法救治。学习的人应当以此为戒。
In the treatment of Ding sores (fixed, deep-rooted skin infections), various methods are employed. One must first assess the urgency of the condition. In mild cases, on the first day, the sore is white and small; on the second day, it remains white but slightly larger; on the third day, the color becomes slightly purplish; on the fourth day, it turns truly purple. This indicates a mild presentation. In acute cases, on the fifth day, the color is cyanotic, tight, and small; on the sixth day, it is deeply cyanotic, large, and tight; on the seventh day, it appears black, resembling a burn from moxibustion. This represents the most critical presentation. If a sore appears on the body and another smaller sore emerges elsewhere, this is termed an "Ying Hou" (responsive sign). Puncturing the smaller sore with a needle allows the release of toxicity, indicating that the condition is treatable. Untreatable conditions occur when no such smaller sore appears elsewhere, termed "no Ying Hou," indicating extreme toxicity, thus rendering the condition untreatable. Generally, if the four sides of a Ding sore exhibit redness and swelling, it is called having a "Hu Chang" (protective field/barrier). If there is no redness or swelling around the four sides, it lacks a protective field and is considered untreatable. Mild Ding sores present with fever, headache, warm hands and feet, and normal appetite. Critical Ding sores present with immobility of the eyeballs, extreme thirst accompanied by panting, cyanosis of the lips and face, inability to eat, swelling of the five centers (palms, soles, and chest), absence of pulse, cold limbs, inability to rise from bed, lethargy, abdominal pain more severe than usual, indicating the presence of "Nei Ding" (internal Ding). Refer to the section on internal Ding for details. Regarding the treatment of external Ding sores, although classified into thirty-four types, the therapeutic methods do not differ significantly. One must be aware of contraindications and avoid violating them, as doing so may make the condition difficult to treat.
Generally speaking, toxins such as Yong (abscesses) and Ju (carbuncles), although belonging to the category of Sovereign Fire, involve stagnation of the meridians and collaterals, and the pathogenic invasion can be either Yin or Yang. Yang Yong presents with redness, swelling, and pain, a floating and rapid pulse, fever, thirst, constipation, dark urine, and a purplish-red sore color, all resulting from extreme heat toxicity. It is appropriate to administer Nei Shu Huang Lian Tang (Internal Draining Coptis Decoction) internally and apply Hong Bao Gao (Hongbao Ointment) externally for self-healing. If Yin Du (Yin toxin) occurs initially, there is swelling and pain without discoloration of the flesh and little heat sensation; the pulse is deep and solid; the patient fears cold and prefers warm drinks. By the fifth to seventh day, the sore surface becomes concave and darkly cyanotic; it rots and ulcerates slowly and fails to close over time. It is appropriate to administer Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) combined with warming herbs, and apply Yu Long Gao (Jade Dragon Ointment) externally. Once the Yin qi dissipates and Yang qi returns, the sore will turn red, muscles will gradually regenerate, pain will vanish, and the patient will survive. Failure to understand this principle and mistakenly using detoxifying agents (typically cold/cool in nature) often leads to fatal outcomes. Practitioners should take this as a warning.