黄瓜痈在背旁生,脾火色红黄瓜形,肿高寸余长尺许,四肢麻木引心疼。
【注】此证生于背旁,一名肉龟,由脾火积毒而成。皮肉色红,状若黄瓜,肿高寸余,
长可尺许,四肢麻木,疼痛引心。红活速溃者顺;紫陷脉微,自汗谵语,坚硬溃迟者逆。
初起宜服仙方活命饮,加羌活、柴胡或夺命丹治之。其余内外治法,俱按痈疽肿疡、溃疡门。
\r黄瓜痈图\p04-34a86.bmp\r
仙方活命饮(见肿疡门)
夺命丹(见阴阳二气疽)
肾俞发生肾俞穴,单者酒色兼湿热,房劳怒火则双生,红活黑陷顺逆别。
【注】此证生肾俞穴,在腰骨两旁陷肉处,有单有双。单者由酒色湿热而成,双者由房
劳怒火而发。若疮形红活高肿,十四日生脓属顺;若疮形紫黑,干枯坚硬,应期无脓属
逆。或脓稀伤膜者,系真阳血气大亏,初宜服人参养荣汤,或加减八味丸以救其源。其
顺逆内外治法,俱按痈疽肿疡、溃疡门。
\r肾俞发图\p04-34a87.bmp\r
人参养荣汤 加减八味丸(俱见溃疡门)
石疽寒凝瘀血聚,生于腰胯最缠绵,坚硬如石皮不变,时觉木痛消溃难。
【注】此证由寒气瘀血凝结,生于腰胯之间,缠绵难以收功。其疽时觉木痛,难消难
溃,坚硬如石,皮色不变。初宜内服没药丸,外用鲜商陆捣烂,贴于患处治之,随用艾壮
当顶灸之,以软为度。溃后按痈疽溃疡治法。
\r中石疽图\p04-34a88.bmp\r
没药丸
桃仁(炒,一两) 乳香 没药 川芎 川椒(去目及合口者) 当归 赤芍(各五钱) 自然铜
(火烧醋淬七次,二钱五分)
共研细末,用黄蜡二两,火化开入药末,不住手搅匀,丸如弹子大。每用一丸,以好
酒一盅,将药化开,煎至五分,乘热服下。
【方歌】没药丸治中石疽,乳没桃芎归芍宜,川椒自然铜黄蜡,用酒服之行血瘀。
黄瓜痈生于背部两侧,因脾经火毒蕴结所致,疮面颜色红赤,形状如同黄瓜,肿胀高度超过一寸,长度可达一尺左右,伴有四肢麻木及牵引性心痛。
【注】此证候发生于背部两侧,又名“肉龟”,由脾经火毒积聚而成。皮肤肌肉呈现红色,形态类似黄瓜,肿胀高耸约一寸余,长度大约一尺,出现四肢麻木,疼痛放射至心部。若疮色红活且迅速溃破者属顺证;若疮色紫暗下陷、脉象微弱、自汗出并伴有胡言乱语,或疮体坚硬、溃破迟缓者属逆证。初起阶段适宜服用仙方活命饮,加入羌活、柴胡,或者使用夺命丹进行治疗。其余内治与外治方法,均参照痈疽肿疡门和溃疡门的相关记载执行。
肾俞发发生于肾俞穴部位,单侧发病多因饮酒过度、房事不节兼夹湿热所致,双侧发病则多因房劳过度及怒火伤肝引起,需根据疮形红活或黑陷来辨别顺逆。
【注】此证候发生于肾俞穴,位于腰部骨骼两侧的肌肉凹陷处,有单侧和双侧之分。单侧发病由酒色过度及湿热内蕴引起,双侧发病由房劳过度和怒火引发。若疮形红活且高肿,十四天左右化脓者属顺证;若疮形紫黑,干枯坚硬,到期不能化脓者属逆证。若脓液稀薄损伤筋膜者,系真阳与血气严重亏损,初期适宜服用人参养荣汤,或者加减八味丸以固本救源。其顺逆证的内外治疗方法,均参照痈疽肿疡门和溃疡门的相关记载执行。
中石疽由寒气与瘀血凝结而成,好发于腰胯之间,病程缠绵难愈,疮体坚硬如石头而皮色不变,时常感觉木痛,难以消散和溃破。
【注】此证候由寒邪与瘀血凝结所致,发生于腰胯之间,病情缠绵难以治愈。该疽症时常感觉麻木疼痛,难以消散和溃破,质地坚硬如石,皮肤颜色无变化。初期适宜内服没药丸,外用鲜商陆捣烂敷贴于患处治疗,随后用艾炷在病灶顶部施灸,以患处变软为度。溃破后按照痈疽溃疡的治疗方法处理。
没药丸配方:桃仁(炒制,一两)、乳香、没药、川芎、川椒(去除椒目及闭合部分)、当归、赤芍(各五钱)、自然铜(火烧后醋淬七次,二钱五分)。
将上述药材共研为细末,取黄蜡二两,加热熔化后加入药末,不停搅拌混合均匀,制成如弹子大小的药丸。每次服用一丸,用好酒一杯,将药丸溶化,煎煮至剩余五分量,趁热服用。
Cucumber Carbuncle (Huanggua Yong) arises on the lateral aspects of the back. It is caused by Spleen Fire (Spleen heat-toxin accumulation), presenting with a red color resembling a cucumber. The swelling exceeds one cun in height and may reach approximately one chi in length, accompanied by numbness in the four limbs and radiating heart pain.
[Note] This condition occurs on the lateral back, also known as "Rou Gui" (Flesh Turtle). It results from the accumulation of Spleen Fire toxin. The skin and flesh are red, shaped like a cucumber, with swelling rising over one cun and lengthening to about one chi. Symptoms include limb numbness and pain radiating to the heart. A favorable prognosis (Shun) is indicated if the lesion is bright red and ulcerates rapidly; an unfavorable prognosis (Ni) is indicated if the lesion is purple and depressed, pulse is faint, spontaneous sweating occurs, delirium appears, or if the mass is hard and ulceration is delayed. At the initial stage, Xian Fang Huo Ming Yin (Immortal Life Elixir Decoction) should be taken, added with Qiang Huo (Notopterygii Rhizoma et Radix) and Chai Hu (Bupleuri Radix), or Du Ming Dan (Life-Snatching Pill) may be used. All other internal and external treatment methods follow the protocols for Carbuncles and Ulcers (Zhong Yang Men) and Ulcerated Sores (Kui Yang Men).
Shensu Fa (Eruption at Shenshu Acupoint) occurs at the Shenshu (BL23) acupoint. Unilateral cases result from excessive alcohol consumption, sexual indulgence, and damp-heat accumulation. Bilateral cases arise from sexual exhaustion and liver fire due to anger. Prognosis is determined by whether the sore is bright red (favorable) or black/depressed (unfavorable).
[Note] This condition manifests at the Shenshu (BL23) acupoint, located in the muscular depressions on both sides of the lumbar vertebrae. It can occur unilaterally or bilaterally. Unilateral onset is caused by alcohol, sexual excess, and damp-heat. Bilateral onset is triggered by sexual fatigue and anger-induced fire. If the sore is bright red, high, and swollen, suppuration occurring around the 14th day indicates a favorable course (Shun). If the sore is purple-black, dry, hard, and fails to suppurate when expected, it indicates an unfavorable course (Ni). If the pus is thin and damages the fascia, it signifies a severe deficiency of True Yang and Qi-Blood. Initially, Ren Shen Yang Rong Tang (Ginseng Nourishing Qi and Blood Decoction) or Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) should be administered to restore the root. Internal and external treatments for favorable and unfavorable courses follow the protocols for Carbuncles and Ulcers (Zhong Yang Men) and Ulcerated Sores (Kui Yang Men).
Zhong Shi Ju (Middle Stone Abscess) is caused by the coagulation of Cold Qi and Blood Stasis. It typically arises in the waist and hip region, is persistent and difficult to resolve. The mass is hard as stone with unchanged skin color, often causing numbness and pain, and is difficult to dissipate or ulcerate.
[Note] This condition results from the concretion of Cold Pathogens and Blood Stasis, occurring between the waist and hips, leading to a lingering course that is hard to cure. The abscess presents with numbness and pain, resisting resolution and ulceration, feeling hard as stone with normal skin color. Initially, Mei Yao Wan (Myrrh Pill) should be taken internally. Externally, fresh Shang Lu (Phytolaccae Radix) should be mashed and applied to the affected area. Subsequently, Moxibustion (Ai Zhuang) should be applied directly on top of the lesion until the area softens. After ulceration, treat according to the protocols for Ulcerated Sores.
Mei Yao Wan (Myrrh Pill) Formula: Tao Ren (Persicae Semen, stir-fried, 1 liang), Ru Xiang (Olibanum), Mo Yao (Myrrha), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chuan Jiao (Zanthoxyli Pericarpium, remove seeds and closed parts), Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra, each 5 qian), Zi Ran Tong (Pyritum, calcined in vinegar seven times, 2.5 qian).
Grind all ingredients into fine powder. Melt 2 liang of Huang La (Beeswax) over fire, mix thoroughly with the powder while stirring continuously, and form pills the size of bullet seeds. Take one pill per dose. Dissolve the pill in one cup of good wine, boil until reduced to five fen, and drink hot.
[Prescription Verse] Mei Yao Wan treats Middle Stone Abscess; Olibanum, Myrrha, Peach Seed, Ligusticum, Angelica, and Red Peony Root are suitable. Combined with Zanthoxylum, Pyrite, and Beeswax, taken with wine to invigorate blood and resolve stasis.