(附∶瓜藤缠)
湿毒流注腿胫生,顶如牛眼漫肿形,紫轻黑重脓水渍,寒湿暑热在腠凝。
【注】此证生于腿胫,流行不定,或发一二处,疮顶形似牛眼,根脚漫肿,轻则色紫,
重则色黑,溃破脓水浸渍,好肉破烂,日久不敛。由暴风疾雨,寒湿暑火,侵在腠理,而
肌肉为病也。初觉急服防风通圣散,加木瓜、牛膝、防己、苍术消之;若腿胫至晚发热者,
宜服当归拈痛汤,加牛膝。外治初搽三妙散,肿痛全消,换搽轻粉散敛之即效。若绕胫而
发,即名瓜藤缠,结核数枚,日久肿痛,腐烂不已,亦属湿热下注而成,治法同前。
\r湿毒流注图\p04-34a210.bmp\r
轻粉散
轻粉(一钱五分) 黄丹 黄柏 密陀僧 高末茶 乳香(各三钱) 麝香(五分)
共研末,先用葱熬汤洗患处,再搽此药。
【方歌】轻粉黄丹柏陀僧,末茶乳麝共研成,湿毒流注 疮证,化腐除湿又止疼。
防风通圣散(见头部秃疮)
当归拈痛汤(见股部腿游见)
三妙散(见腹部脐痈)
肾气游风腿肚生,红肿如云火烘疼,证由肾火蕴于内,膀胱气滞外受风。
【注】此证多生于肾虚之人。腿肚红肿,形如云片,游走不定,痛如火烘,由肾火内
蕴,外受风邪,膀胱气滞而成也。初服紫苏
流气饮,次服槟榔丸;外用豆腐研调黄柏末,贴敷之,甚效。
\r肾气游风图\p04-34a211.bmp\r
紫苏流气饮
紫苏 黄柏 木瓜 槟榔 香附 陈皮 川芎 浓朴(姜炒) 白芷 苍术(米泔水浸,炒)
乌药 荆芥 防风 甘草 独活 枳壳(麸炒)
等分,姜三片,枣一枚,水煎服。
【方歌】紫苏流气柏瓜榔,香附陈芎浓芷苍,乌药荆防甘独枳,肾气游风服最昌。
槟榔丸
槟榔 枳壳(麸炒各二两) 木瓜(一两五钱) 木香(一两) 大黄(四两)
共研细末,炼蜜为丸,如梧桐子大。每服三十丸,空心白滚汤送下,黄酒送下亦可。
【方歌】槟榔枳壳木瓜研,木香大黄炼蜜丸,肾气游风红肿痛,空心水送自然痊。
【附注:瓜藤缠】
湿毒流注病发于小腿胫骨部位,疮顶形状像牛眼,周围弥漫性肿胀。颜色紫者病情较轻,颜色黑者病情较重,溃破后脓水浸渍皮肤。此病由寒、湿、暑、热邪气凝结在腠理(皮肤与肌肉之间的间隙)所致。
【注释】这种病症发生在大腿和小腿部位,病势游走不定,有时发作于一两处。疮顶形状像牛眼,根部漫肿,轻则颜色发紫,重则颜色发黑,溃破后脓水浸渍,导致好肉腐烂,日久难以愈合。这是由于暴风疾雨、寒湿暑火等邪气侵入腠理,导致肌肉发病。初起时应立即服用防风通圣散,加入木瓜、牛膝、防己、苍术以消除病邪;如果小腿到傍晚时发热,适宜服用当归拈痛汤,加入牛膝。外治法初期涂抹三妙散,待肿痛完全消退后,更换涂抹轻粉散以促进收敛,即可见效。如果环绕小腿发作,即称为“瓜藤缠”,出现数个结节,日久肿痛,不断腐烂,这也属于湿热下注而成,治疗方法同上。
轻粉散
配方:轻粉(一钱五分)、黄丹、黄柏、密陀僧、高末茶、乳香(各三钱)、麝香(五分)。
制法:共同研磨成粉末。先用葱熬汤清洗患处,再涂抹此药。
【方歌】轻粉黄丹柏陀僧,末茶乳麝共研成,湿毒流注疮证,化腐除湿又止疼。
防风通圣散(见头部秃疮章节)
当归拈痛汤(见股部腿游风章节)
三妙散(见腹部脐痈章节)
肾气游风病生于小腿肚,红肿如云片状,如火烤般疼痛。病因是肾火蕴结于内,膀胱气机阻滞,外部感受风邪所致。
【注释】这种病症多发生于肾虚之人。小腿肚红肿,形状像云片,游走不定,疼痛如火烤,是由于肾火内蕴,外受风邪,膀胱气滞而形成的。初期服用紫苏流气饮,随后服用槟榔丸;外用豆腐研磨调匀黄柏末,贴敷患处,效果显著。
紫苏流气饮
配方:紫苏、黄柏、木瓜、槟榔、香附、陈皮、川芎、浓朴(姜炒)、白芷、苍术(米泔水浸泡,炒)、乌药、荆芥、防风、甘草、独活、枳壳(麸炒)。
用法:以上药材等分,加生姜三片、大枣一枚,水煎服。
【方歌】紫苏流气柏瓜榔,香附陈芎浓芷苍,乌药荆防甘独枳,肾气游风服最昌。
槟榔丸
配方:槟榔、枳壳(麸炒,各二两)、木瓜(一两五钱)、木香(一两)、大黄(四两)。
制法:共同研磨成细末,用炼蜜制成丸药,大小如梧桐子。每次服用三十丸,空腹时用温开水送服,用黄酒送服也可以。
【方歌】槟榔枳壳木瓜研,木香大黄炼蜜丸,肾气游风红肿痛,空心水送自然痊。
[Appendix: Vine-like Entanglement (Gua Teng Chan)]
Damp-toxin Liuzhu (Flowing Abscess) arises on the lower leg and shin. The ulcer's apex resembles a cow's eye, surrounded by diffuse swelling. A purple hue indicates mild severity, while a black hue indicates severe severity; upon ulceration, pus exudate soaks the skin. This condition is caused by the condensation of cold-dampness, summerheat, and heat pathogens in the Couli (interstitial spaces between skin and muscle).
[Commentary] This syndrome occurs in the thigh and calf regions, with a migratory nature, sometimes manifesting in one or two locations. The ulcer apex resembles a cow's eye, with diffuse root swelling. Mild cases present with a purple color, severe cases with a black color. Upon ulceration, pus exudate causes healthy tissue to rot, leading to chronic non-healing wounds over time. It results from pathogenic factors such as violent wind and rain, cold-dampness, summerheat, and fire invading the Couli, causing disease in the muscles. At the initial stage, immediately administer Fangfeng Tongsheng San (Windproof Unimpeded Powder), added with Mugua (Chaenomeles Fruit), Niuxi (Achyranthes Root), Fangji (Stephania Root), and Cangzhu (Atractylodes Rhizome) to eliminate the pathogen. If the lower legs become hot in the evening, Danggui Niantong Tang (Angelica Joint-Pain Decoction) added with Niuxi (Achyranthes Root) is suitable. For external treatment, initially apply Sanmiao San (Three Marvels Powder); once swelling and pain completely subside, switch to applying Qingfen San (Calomel Powder) to promote healing, which yields effective results. If the condition wraps around the shin, it is named "Vine-like Entanglement" (Gua Teng Chan), presenting with several nodules. Over time, swelling and pain persist, and tissue continues to rot. This also belongs to damp-heat pouring downward, and the treatment method is the same as above.
Qingfen San (Calomel Powder)
Ingredients: Qingfen (Calomel, 1.5 qian), Huangdan (Lead Tetroxide), Huangbai (Phellodendron Bark), Mituosen (Litharge), Gaomo Cha (High-grade Tea Leaves), Ruxiang (Frankincense) (each 3 qian), Shexiang (Musk, 0.5 fen).
Preparation: Grind all ingredients into powder together. First, wash the affected area with decoction made from scallions, then apply this medicine.
[Prescription Verse] Calomel, Lead Tetroxide, Phellodendron, and Litharge, Mixed with tea leaves, frankincense, and musk ground fine; For damp-toxin flowing abscesses, it resolves decay, removes dampness, and stops pain.
Fangfeng Tongsheng San (See section on Scalp Alopecia Areata)
Danggui Niantong Tang (See section on Migratory Leg Pain in the Thigh Region)
Sanmiao San (See section on Umbilical Carbuncle in the Abdomen)
Shenqi Youfeng (Kidney-Energy Wandering Wind) arises in the calf muscle. It presents with redness and swelling like cloud patches, accompanied by burning pain. The etiology involves Kidney Fire accumulating internally, Qi stagnation in the Bladder, and external invasion of Wind pathogens.
[Commentary] This syndrome often occurs in individuals with Kidney Deficiency. The calf exhibits redness and swelling resembling cloud patches, migrating without fixed location, with pain feeling like burning fire. It is formed by internal accumulation of Kidney Fire, external invasion of Wind pathogens, and Qi stagnation in the Bladder. Initially administer Zisu Liuqi Yin (Perilla Qi-Circulating Decoction), followed by Binglang Wan (Areca Nut Pill). Externally, grind tofu and mix with Huangbai (Phellodendron Bark) powder, then apply as a poultice; this is highly effective.
Zisu Liuqi Yin (Perilla Qi-Circulating Decoction)
Ingredients: Zisu (Perilla Leaf), Huangbai (Phellodendron Bark), Mugua (Chaenomeles Fruit), Binglang (Areca Seed), Xiangfu (Cyperus Rhizome), Chenpi (Citrus Peel), Chuanxiong (Ligusticum Rhizome), Nongpo (Magnolia Bark, stir-fried with ginger), Baizhi (Angelica Dahurica Root), Cangzhu (Atractylodes Rhizome, soaked in rice water, stir-fried), Wuyao (Litsea Root), Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Gancao (Licorice Root), Duhuo (Angelica Pubescens Root), Zhike (Bitter Orange, bran-stir-fried).
Usage: Equal parts of the above herbs, add three slices of ginger and one jujube, decoct in water and take orally.
[Prescription Verse] Perilla, Qi-circulating agents, Phellodendron, Chaenomeles, Areca, Cyperus, Citrus, Ligusticum, Magnolia, Angelica, Atractylodes, Litsea, Schizonepeta, Saposhnikovia, Licorice, Angelica Pubescens, Bitter Orange; For Kidney-Energy Wandering Wind, taking this is most auspicious.
Binglang Wan (Areca Nut Pill)
Ingredients: Binglang (Areca Seed), Zhike (Bitter Orange, bran-stir-fried, each 2 liang), Mugua (Chaenomeles Fruit, 1.5 liang), Muxiang (Vladimiria Root, 1 liang), Dahuang (Rhubarb Root, 4 liang).
Preparation: Grind finely into powder, bind with refined honey to form pills the size of Chinese quince seeds. Take 30 pills per dose, swallowed with warm boiled water on an empty stomach; swallowing with yellow wine is also acceptable.
[Prescription Verse] Areca nut, bitter orange, chaenomeles ground fine, Vladimiria root and rhubarb bound with honey pill; For kidney-energy wandering wind with redness, swelling, and pain, taken on an empty stomach with water, recovery comes naturally.