疮脓已溃已破。因脓塞阻之不通。富贵骄奢及女体不便。皆不能挤其脓。故阻而肿 。如此当用
竹筒吸法。自吸去其脓。乃泄其毒也。亦有用口吮其脓。令不痛而毒自安。此疮医之仁矣。古云。医
家有割股之心。罕矣哉。
凡疮之为患。必有大痛。皆因感之所作是也。风寒暑湿之邪。皆能为痛。经云。寒者温之。热者
清之。湿者燥之。燥者润之。虚者补之。实者泄之。闭者通之。通者止之。风者散之。蚀者引之。荣
卫不和者调
之。皆在药之五气五味。性之温凉。对症之机。止痛如神。岂专于乳没乎。
疮之一症。非同小可。生死之端。危险之际。最宜谨慎。不可轻忽。当保其性命。忌之宣瞑。慎
之七情。禁之口味。净之心神。守之恬淡。妨之色欲。避之十恶之气者。是孝产体气新婚酒麝香腥臊
膻秽之气动之。奔劳喊叫接之。友鄙亲狂友之。恭礼趋退牵之。情怀谈之。胡方乱药感之。是非啖之。
异禽兽有毒之物当食麋粥菜蔬。如此之守岂不安乎。
消者灭也。灭其形症也。经云。诸痛痒疮疡皆属心火。火者离卦也。离者外阳而内阴。内阴壅滞。
必然外攻。治当内消。使绝其源而清其内。不令外发。故云内消。乃初起微觉之时。即以汤液内用黄连
大黄芒硝甘草节类疏其源。绝其毒也。如形症已成。不可此法也。
疮疡的脓液已经溃破。但因为脓液堵塞导致排出不畅,加上富贵人家骄奢淫逸以及女性身体不便等原因,都无法挤压排出脓液,因此导致毒气阻滞而肿胀。在这种情况下应当使用竹筒吸脓法,从内部吸出脓液,这是为了泄出体内的毒邪。也有用口吮吸脓液的方法,让患者不感到疼痛而毒气自然安定,这是疮科医生的仁德之举。古话说:“医生有割下自己大腿肉给病人吃的孝心”,这种境界太罕见了。
凡是疮疡发病,必然伴有剧烈疼痛,这都是因为感受外邪所致。风寒暑湿等邪气,都能引起疼痛。医经说:寒证要用温法治疗,热证要用清法治疗,湿证要用燥法治疗,燥证要用润法治疗,虚证要补益,实证要攻泻,闭阻的要通利,滑脱的要固涩,风邪的要疏散,蚀烂的要提引,营卫不和的要调和。这些都在于药物的五气五味、性味的温凉,关键在于对症施治,止痛效果如神,难道仅仅依靠乳香和没药吗?
疮疡这一病症,非同小可,关乎生死存亡,处于危险境地,最宜谨慎,不可轻视疏忽。应当保全性命,忌讳宣露和昏暗环境,谨慎对待七情(喜怒忧思悲恐惊),禁忌口腹之欲,净化心神,保持恬淡心境,妨碍色欲,避开十恶之气(指秽浊不正之气)。这些气包括产妇体气、新婚夫妇之气、酒麝香腥臊膻秽等气味触动它;奔跑劳累、喊叫接应触动它;卑鄙亲友的狂态触动它;恭敬礼仪中的进退牵拉触动它;情怀谈论触动它;胡乱服用方药触动它;是非口舌触动它。异类禽兽有毒之物,应当食用糜粥菜蔬。如此坚守调护,难道不能安宁吗?
“消”就是灭除的意思,灭除其形态症状。医经说:“各种疼痛、瘙痒、疮疡都归属于心火。”火对应八卦中的离卦。离卦的特点是外阳而内阴,内阴壅滞,必然向外攻发。治疗应当采用内消法,断绝病源并清理内部,不让毒邪向外发散,所以称为“内消”。这是在初起阶段微微感觉不适时,立即使用汤剂内服,如黄连、大黄、芒硝、甘草节等药物疏通源头,断绝毒邪。如果形态症状已经完全形成,就不能再用这种方法了。
The pus of the carbuncle has already ulcerated and broken. However, due to blockage by accumulated pus preventing smooth discharge, combined with the luxurious lifestyle of the wealthy and physical inconveniences of women, squeezing out the pus is impossible. Consequently, the pathogenic factor stagnates, causing swelling. In such cases, the bamboo tube suction method should be employed to suck out the pus from within, thereby draining the toxicity. There are also instances where the pus is sucked out orally, relieving pain and allowing the toxicity to settle naturally; this demonstrates the benevolence of surgeons. As the ancients said, "A physician's heart to cut flesh from one's own thigh for the patient" is extremely rare.
Whenever a carbuncle manifests, it inevitably involves severe pain, which arises from external pathogenic influences. Pathogens such as wind, cold, summerheat, and dampness can all cause pain. The Classics state: Cold patterns require warming; heat patterns require clearing; damp patterns require drying; dryness patterns require moistening; deficiency patterns require tonifying; excess patterns require purging; obstruction patterns require unblocking; incontinence patterns require astringing; wind patterns require dispersing; erosion patterns require guiding out; and disharmony of Ying and Wei requires regulating. All these depend on the Five Flavors and Five Qi of herbs, their warm or cool properties, and the critical point of symptomatic treatment. Pain relief can be miraculous; does it rely solely on Frankincense (Ruxiang) and Myrrh (Moyao)?
The condition of carbuncles is no trivial matter; it marks the boundary between life and death and is a dangerous situation requiring utmost caution and never being taken lightly. One must preserve life, avoid exposure and dim environments, be cautious regarding the Seven Emotions (joy, anger, worry, overthinking, grief, fear, and fright), forbid dietary indulgences, purify the mind and spirit, maintain tranquility and simplicity, restrain sexual desire, and avoid ten types of foul airs. These include the qi of childbirth, newlywed couples, wine, musk, fishy smells, mutton odor, and other turbid odors that provoke the condition; running, labor, shouting, and responding that provoke it; the wild behavior of base relatives and friends that provoke it; the pulling and traction during respectful etiquette and movements that provoke it; emotional discussions that provoke it; indiscriminate use of prescriptions and drugs that provoke it; and disputes and gossip that provoke it. Regarding toxic substances from exotic birds and beasts, one should consume millet porridge and vegetables. Such strict adherence to care would surely ensure peace.
"Xiao" (Dissolution) means extinguishing, i.e., eliminating the morphological symptoms. The Classics state: "All pain, itching, carbuncles, and sores belong to Heart Fire." Fire corresponds to the Li Trigram in the Eight Trigrams. Li is characterized by Yang on the outside and Yin on the inside. Internal Yin stagnation inevitably attacks outward. Treatment should employ internal dissolution to cut off the source and clear the interior, preventing outward eruption; hence it is called "internal dissolution." This method is applied when symptoms are just beginning and slightly felt. Immediately, decoctions should be taken internally, using herbs such as Coptidis Rhizoma (Huanglian), Rhei Radix et Rhizoma (Dahuang), Natrii Sulfas (Mangxiao), and Glycyrrhizae Radix et Rhizoma cum Stimulis (Gancao Jie) to dredge the source and cut off the toxicity. If the morphological symptoms have fully formed, this method cannot be used.