小儿初生。旬日。脐忽虚浮赤肿者。用大黄 牡蛎(等分) 朴硝(不拘)
为末。用田螺浸水调敷。小便下白。即愈。
一用荆芥煎汤洗之。以煨葱伏地气贴之。即消。
脐风湿肿。用蜂房烧灰掺之。
脐湿。用当归烧灰为末掺之。或青蛤散。(见三卷面部)
经络 腋下中间。属手厥阴心包络及足厥阴肝经。腋前属足太阴脾经。腋后属足少阳胆经。下六寸
又属脾之大络也。
腋痈 生于腋。一名夹痈。初起皮色不变。漫肿无头。日久方疼。乃生寒热。此患难消。终必作
脓。多由性躁所致。初宜柴胡清肝汤。加味逍遥散。脉虚病虚者。补中益气汤加羌活。俟少可去之。脓成胀痛者
针之。已溃者八珍汤加黄 、陈皮、香附。此以性情治症。不待专于攻毒也。始终忌用寒凉。亦不宜大
热。惟宜温补。灸少海穴七壮。或灸间使穴。
米疽 灵枢云。发于腋下赤而坚者为米疽。砭之勿裹。若坚而不溃者。为挟瘿马刀及 疡 也。宜各
随本门治之。
黯疔 生腋下。坚硬无头。四肢拘急。寒热大作。异于常症者暗疔也。(治见疔门)
腋气 俗名狐臭。受秉于未形之初。腋内有窍。浊气由此而出。诸药鲜能除根。故治法不立。
经络 腋直下髀骨。属足少阳足厥阴二经相火之司也。二经之气不平则风火内搏。荣逆血郁。热聚
为肿。痈之所由而生也。(肋胁骨也。肋者助也。有骨曰肋。无骨曰胁。)
肋疽 一名夹荧疽。两肋发肿。甚则连及肩肘。其症在左。痛应于右。其患在右。痛应于左。急宜针砭。庶
免内攻。脓多可治。无脓不治。肿赤痛甚。烦躁脉实而呕者。为有余。当下之。肿硬不溃。脉弱而呕
者。为胃虚。宜六君子汤加砂仁、藿香补之。亦有痛伤胃气而呕者。外感寒邪及秽气而呕者。虽肿
时尤宜助胃壮气。盖肿时作呕。因毒瓦斯内侵者十有一二。湿气内伤者十有八九。二十日不穴者死。
胁疽 初生如李。渐大如杯。灵枢云。发于胁者名曰败 。败 者女子之病也。灸之。由足厥阴肝经
郁怒所致。初宜柴胡清肝汤。解郁泻火。已成者托里消毒散。加香附、青皮。脓成者针之。勿伤内膜。已
溃者八珍汤。加山萸丹皮、泽泻。兼滋肾水。是症。肥胖内实者鲜有是症。惟虚劳者患之。如破流臭
败稀脓。补托不应者死。大抵脓血大泻。气血俱虚。法当峻补。虽有他症。当末治之。盖元气一复。诸症
自退也。宜灸冲门穴二七壮。
一误作痰痞。治之罔效。数月大如盎。高如 。坚如石。微红漫肿。不甚疼痛者。即此症也。失治。则攻击
成脓。形如鼓胀。但其肚无青筋。而脐不突为异耳。
渊疽 生胁下。初起不红坚硬。久则破溃而有声。如婴儿啼状。用膏盖之。则声止。去膏则声作。宜灸阳
陵泉穴二七壮。其声即止。疮即愈。
内发丹毒 生胁下。及腰胯间。肿痛。色赤如霞。急宜砭去血。内服贵金丸之类汗之。如无汗。及呕哕腹
胀。神昏便闭。遍身青紫者。不治。
小儿出生后十日左右,如果脐部突然虚浮、发红肿胀,可用大黄、牡蛎(等量)、朴硝(适量)研成细末,用田螺浸泡的水调匀后外敷。若小便排出白色分泌物,即可痊愈。
另一种方法是用荆芥煎汤清洗患处,再用煨热的葱贴敷于地面吸附地气后贴于脐部,肿胀即可消退。
脐部风湿肿胀,用蜂房烧成灰后撒在患处。
脐部湿烂,用当归烧成灰研末撒在患处。或者使用青蛤散。(见第三卷面部章节)
经络:腋下中间部位,归属于手厥阴心包经和足厥阴肝经。腋前侧归属于足太阴脾经。腋后侧归属于足少阳胆经。向下六寸处又属于脾的大络脉。
腋痈:生于腋下,又名夹痈。初起时皮肤颜色不变,弥漫性肿胀且无脓头,日久才出现疼痛,并伴有寒热症状。此病难以消除,最终必然化脓。多由性情急躁所致。初期宜用柴胡清肝汤或加味逍遥散。若脉象虚弱、病症属虚者,用补中益气汤加羌活。待病情稍缓即停用。若脓已成且胀痛,则进行针刺排脓。已溃破者用八珍汤加黄芪、陈皮、香附。这是根据患者性情来治疗病症,不专门依赖攻毒药物。全程忌用寒凉药,也不宜用大热药,只宜温补。可灸少海穴七壮,或灸间使穴。
米疽:《灵枢》记载,发于腋下且红肿坚硬的称为米疽。用砭石刺破后不要包扎。如果坚硬而不溃破的,属于挟瘿、马刀及瘘疮一类,应各自按照相应门类的方法治疗。
黯疔:生于腋下,坚硬无头,四肢拘挛紧急,寒热剧烈发作,不同于一般症状的,即为暗疔。(治疗方法见疔疮门)
腋气:俗称狐臭。禀受于胎儿未成形之初,腋内有窍道,浊气由此排出。各种药物很少能除根,因此没有设立专门的治疗方法。
经络:腋下直下至髀骨部位,归属于足少阳经和足厥阴经相火的管辖范围。这两条经脉的气机不平衡,则风火在内搏结,营血逆乱郁滞,热邪聚集形成肿胀,这就是痈产生的原因。(肋指肋骨,胁指肋下的软肉部分。有骨头的叫肋,没骨头的叫胁。)
肋疽:又名夹荧疽。两侧肋骨部位发生肿胀,严重时牵连到肩部和肘部。病变在左侧,疼痛反映在右侧;病变在右侧,疼痛反映在左侧。急需针刺放血,以免毒邪内攻入里。脓多者可治,无脓者难治。若红肿疼痛剧烈,烦躁不安,脉象实大而呕吐的,属于实证有余,应当攻下。若肿硬不溃破,脉象微弱而呕吐的,属于胃气虚弱,宜用六君子汤加砂仁、藿香以补益。也有因疼痛损伤胃气而呕吐的,或因外感寒邪及秽浊之气而呕吐的,即使在肿胀时期也特别需要助胃壮气。大概肿胀时期作呕,因毒瓦斯内侵的占十分之一二,因湿气内伤的占十分之八九。二十天不出脓的会死亡。
胁疽:初生时像李子大小,逐渐增大如杯口大。《灵枢》说,发于胁部的名叫败疵。败疵是女子的疾病。通过艾灸治疗,由足厥阴肝经郁怒所致。初期宜用柴胡清肝汤,解郁泻火。已成形的用托里消毒散,加香附、青皮。脓成的进行针刺,勿伤及内膜。已溃破的用八珍汤,加山茱萸、丹皮、泽泻,兼以滋补肾水。此症,肥胖体内充实的人很少有患此病的,只有虚劳之人容易患病。如果破溃流出臭败稀薄的脓液,用补托法无效的会死亡。大抵脓血大量流失,气血俱虚,治法应当峻补。即使有其他症状,也应放在次要位置处理。因为元气一旦恢复,其他症状自然消退。宜灸冲门穴十四壮。
有一种误认为是痰痞的情况,治疗无效,数月后大如盆盎,高如山丘,坚硬如石头,微红弥漫肿胀,不太疼痛的,就是此症。失治的话,会攻击化脓,形状像鼓胀,只是腹部没有青筋暴露,且肚脐不突出作为区别罢了。
渊疽:生于胁下,初起不红且坚硬,久则破溃并发出声音,像婴儿啼哭的样子。用膏药覆盖它,声音就停止;去掉膏药声音就出现。宜灸阳陵泉穴十四壮,声音随即停止,疮疡即愈。
内发丹毒:生于胁下及腰胯之间,肿痛,颜色赤红如霞。急需砭石刺去瘀血,内服贵金丸之类发汗。如果没有汗,且出现呕吐呃逆、腹胀、神志昏迷、大便闭塞、遍身青紫的,无法治愈。
When a newborn infant is about ten days old, if the umbilicus suddenly becomes flaccid, swollen, red, and inflamed, use Rhizoma Polygoni Cuspidati (Dahuang) and Concha Ostreae (Muli) in equal parts, along with Natrii Sulfas (Puxiao) as needed, grind them into powder, mix with water in which a river snail has been soaked, and apply externally. If white discharge appears in the urine, it will heal.
Alternatively, wash the area with a decoction of Herba Schizonepetae (Jingjie), then apply baked green onion stalks that have been placed on the ground to absorb earth qi; the swelling will subside.
For wind-dampness swelling of the umbilicus, burn honeycomb to ash and sprinkle it on the lesion.
For dampness at the umbilicus, burn Radix Angelicae Sinensis (Danggui) to ash, grind into powder, and sprinkle on the lesion. Or use Qingha San (Green Clam Powder). (See Volume 3, Face section.)
Meridians: The middle of the axilla belongs to the Pericardium Meridian of Hand-Jueyin and the Liver Meridian of Foot-Jueyin. The anterior aspect of the axilla belongs to the Spleen Meridian of Foot-Taiyin. The posterior aspect belongs to the Gallbladder Meridian of Foot-Shaoyang. Six cun below this point also belongs to the Great Luo Vessel of the Spleen.
Axillary Carbuncle (Yexong): Arises in the axilla, also known as Jia Yong. Initially, the skin color remains unchanged, with diffuse swelling and no head. Pain develops only after some time, accompanied by aversion to cold and fever. This condition is difficult to resolve and will eventually suppurate. It is often caused by an irritable temperament. In the early stage, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) or Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) are suitable. For those with a deficient pulse and deficiency syndrome, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Radix Notopterygii (Qianghuo) should be used. Discontinue when the condition slightly improves. If pus has formed causing distending pain, puncture with a needle. For already ulcerated cases, Shazhen Tang (Eight Treasures Decoction) plus Radix Astragali (Huangqi), Pericarpium Citri Reticulatae (Chenpi), and Rhizoma Cyperi (Xiangfu) is indicated. This treatment addresses symptoms based on temperament rather than focusing solely on detoxification. Cold and cooling herbs are strictly contraindicated throughout, as are excessively hot herbs; only warm tonification is appropriate. Moxibustion may be applied to Shaohai (HT3) for seven moxa cones, or to Jianshi (PC5).
Rice Carbuncle (Miju): As stated in *Ling Shu*, a red and hard swelling arising in the axilla is called Rice Carbuncle. It should be pricked with a bi stone and not bandaged. If it remains hard without suppuration, it belongs to categories such as Xie Ying, Ma Dao, or Liu Yang, and should be treated according to their respective sections.
Dark Ding (An Ding): Arises in the axilla, hard and without a head, accompanied by stiffness and urgency in the four limbs, and severe alternating chills and fever. These symptoms differ from common conditions and indicate Dark Ding. (Treatment is found in the Ding section.)
Axillary Odor (Yexi): Commonly known as fox odor. It is inherited from the pre-natal stage. There are pores in the axilla through which turbid qi exits. Few medicines can eradicate the root cause, so no specific treatment method is established.
Meridians: The area directly below the axilla down to the femoral bone is governed by the Ministerial Fire of the Gallbladder Meridian of Foot-Shaoyang and the Liver Meridian of Foot-Jueyin. Imbalance in the qi of these two meridians leads to internal struggle between wind and fire, counterflow of nutritive blood, blood stasis, and heat accumulation forming swelling, which is the origin of carbuncles. (The ribs refer to the bony structure; 'Lei' refers to ribs with bone, while 'Xie' refers to the soft tissue under the ribs without bone.)
Intercostal Carbuncle (Leiju): Also known as Jia Ying Ju. Swelling occurs in both intercostal regions, potentially extending to the shoulders and elbows. Lesions on the left side manifest pain on the right, and lesions on the right manifest pain on the left. Immediate pricking and bleeding are required to prevent internal invasion. Cases with abundant pus are treatable; those without pus are not. If there is severe redness, swelling, and pain, restlessness, a full pulse, and vomiting, it indicates excess; purgation is indicated. If the swelling is hard and does not suppurate, with a weak pulse and vomiting, it indicates stomach deficiency; Liujunzi Tang (Six Gentlemen Decoction) plus Fructus Amomi (Sharen) and Rhizoma Zingiberis Veri (Huoxiang) should be used to tonify. Vomiting may also result from pain damaging stomach qi, or from external cold pathogenic factors and foul qi. Even during the swelling phase, strengthening stomach qi is crucial. Approximately 10-20% of vomiting during swelling is due to internal invasion of toxic vapors, while 80-90% is due to internal injury from dampness. Death occurs if no pus forms within twenty days.
Costal Carbuncle (Xieju): Initially the size of a plum, gradually enlarging to the size of a cup. *Ling Shu* states that swelling arising in the costal region is named Bai Ci. Bai Ci is a disease affecting women. It is treated with moxibustion and caused by depression and anger stagnating in the Liver Meridian of Foot-Jueyin. Early stage: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) to resolve depression and drain fire. Formed stage: Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder) plus Rhizoma Cyperi (Xiangfu) and Exocarpium Citri Grandis (Qingpi). When pus forms, puncture carefully to avoid injuring the inner membrane. Ulcerated stage: Shazhen Tang (Eight Treasures Decoction) plus Fructus Corni (Shanzhuyu), Cortex Moutan (Danpi), and Radix Alismatis (Zexie) to nourish Kidney yin. This condition rarely affects obese individuals with robust constitution but is common in those with consumptive diseases. If rupture discharges foul, thin pus and tonifying support fails, death ensues. Generally, massive loss of pus and blood leads to dual deficiency of qi and blood; vigorous tonification is required. Other symptoms should be treated secondarily, as recovery of primordial qi will cause other symptoms to recede. Moxibustion may be applied to Chongmen (SP12) for fourteen moxa cones.
One misdiagnosis is phlegm obstruction; treatment is ineffective, and after months, the swelling becomes large like a basin, high like a mound, hard as stone, slightly red and diffusely swollen, with little pain. If neglected, it attacks and suppurates, resembling abdominal distension, distinguished by the absence of visible abdominal veins and non-protruding umbilicus.
Abyss Carbuncle (Yuanju): Arises below the costal margin, initially non-red and hard. Later it ulcerates and emits sounds resembling an infant crying. Applying plaster stops the sound; removing it restarts the sound. Moxibustion on Yanglingquan (GB34) for fourteen moxa cones will stop the sound and heal the wound.
Internal Erysipelas (Neifa Dandu): Arises in the hypochondrium and between the waist and hip, presenting with swelling, pain, and redness like rosy clouds. Immediate pricking to remove blood is required, followed by internal administration of Guijin Wan (Precious Metal Pill) to induce sweating. If there is no sweat, accompanied by vomiting, hiccups, abdominal distension, coma, constipation, and generalized cyanosis, the condition is incurable.