多骨疽者,由疮疡久溃,气血不能营于患处,邪气陷袭,久则烂筋腐骨而脱出,属足三
阴亏
阳气虚寒者,佐以八味丸,益火之源,以消阴翳。外以附子饼、葱熨法,祛散寒邪,补接荣
气,则骨自脱,疮自敛也。夫肾主骨,若肾气亏损,其骨渐肿,荏苒岁月,溃而出骨,亦用
前法。若投以克伐之剂,复伤真气,鲜有不误者。
治验
举人于廷器,腿患流注,年余出腐骨少许。午前畏寒,午后发热,口干痰唾,小便频数
。余
用豆豉饼,诸症渐愈。又以十全大补之类,喜其慎疾而愈。
一儒者患附骨疽,失于调补,疮口不敛,日出清脓少许,已而常出三腐骨。其脉但数而
无邪,此气血虚,疮结脓管,而不能愈。 以乌金膏,日服十全大补汤而愈。
上舍王廷璋,患前症,三年未愈。肢体消瘦,饮食难化,手足并冷,大便不通,手足阴
冷。余谓∶此阳气虚寒。用补中益气、八味丸,及灸其患处,而痊。
一男子上 肿硬,年余方溃,内热作渴,肢体消瘦,六脉洪大,左手尤甚。用补中益气
汤、六味丸,出腐骨一块。仍服前药,诸症悉去,疮口亦敛。
一男子十六岁,间足肿黯,溃而露骨,体瘦盗汗,发热口干。用十全大补汤、六味地黄
丸,各五十余剂而愈。不然,多变瘵症,或沥尽气血而亡。
一妇人年三十余素弱,左手背渐肿,一年后溃出清脓,肿黯连臂,内热晡热,自汗盗汗
,经水
愈,疮出腐骨。仍服前药,前后共三百余剂得痊。
多骨疽,是由于疮疡长期溃烂,气血无法滋养患处,邪气乘虚深入侵袭,日久导致筋脉腐烂、骨骼坏死并脱落排出,此证归属于足三阴经亏虚。若伴有阳气虚弱、寒象明显者,可配合使用八味丸(即金匮肾气丸),通过补益命门之火以消散阴寒之邪。外用附子饼敷贴或葱熨法,以驱散寒邪,补充和接续营卫之气,则坏死的骨骼自然脱落,疮口自行愈合。肾主司骨骼,若肾气亏损,骨骼逐渐肿胀,经过漫长岁月后溃破流出骨骼,也采用上述方法治疗。如果误用攻伐克削的药物,再次损伤人体真气,很少有不误事的。
治验记录:
举人于廷器,腿部患有流注病,一年多后排出少量腐骨。午前感到畏寒,午后发热,口干且有痰唾,小便频数。我使用豆豉饼外敷,诸症逐渐痊愈。随后又服用十全大补汤之类的方剂,因其谨慎调养疾病而最终康复。
一位儒生患有附骨疽,因未能及时调补,疮口不收敛,每天流出少许清稀脓液,不久后经常排出三块腐骨。其脉象仅见数脉而无实邪之象,这是气血虚弱,疮口结成脓管,因而难以愈合。使用乌金膏外敷,每日内服十全大补汤,最终痊愈。
上舍王廷璋,患前述病症,三年未愈。肢体消瘦,饮食难以消化,手足冰冷,大便不通,手足阴部寒冷。我认为这是阳气虚弱兼有寒象。使用补中益气汤、八味丸,并艾灸患处,得以痊愈。
一名男子大腿肿胀坚硬,一年多才溃破,伴有内热、口渴,肢体消瘦,六脉洪大,左手脉象尤为明显。使用补中益气汤、六味地黄丸,排出一块腐骨。继续服用前药,诸症全部消除,疮口亦愈合。
一名十六岁男子,两足肿胀色暗,溃破后露出骨骼,身体消瘦且有盗汗,发热口干。使用十全大补汤、六味地黄丸,各服用五十余剂后痊愈。否则,病情多变成为痨瘵症,或耗竭气血而死亡。
一名三十多岁的妇人素来体弱,左手背逐渐肿胀,一年后溃破流出清稀脓液,肿胀色暗蔓延至手臂,伴有内热、傍晚发热,自汗与盗汗,月经停止,疮口排出腐骨。仍服用前述药物,前后共服用三百余剂得以痊愈。
Duogu Ju (Bone-Exuding Abscess) arises from chronic ulceration where Qi and Blood fail to nourish the affected area, allowing pathogenic factors to sink and invade. Over time, this leads to the rotting of tendons and necrosis of bones, which eventually detach and discharge. This condition is attributed to deficiency in the Foot Three Yin meridians. In cases accompanied by Yang Qi deficiency and cold syndromes, it should be assisted with Bawei Wan (Eight-Ingredient Pill), tonifying the source of Fire to dissipate shadows of Yin. Externally, Fuzi Bing (Aconite Cake) application or Congyi method (scallion moxibustion/warming) is used to dispel cold pathogens and replenish Ying and Wei Qi; thus, the necrotic bone will naturally detach, and the sore will heal spontaneously. The Kidney governs the bones; if Kidney Qi is deficient, the bones gradually swell. After a long period, they ulcerate and discharge bone, treated with the aforementioned methods. If harsh draining or attacking agents are administered, further injuring True Qi, few cases will not result in error.
Case Records:
Yu Tingqi, a Juren (degree holder), suffered from Liuzhu (Flowing Abscess) in the leg for over a year before expelling a small amount of necrotic bone. He experienced chills before noon, fever after noon, dry mouth with phlegm-saliva, and frequent urination. I applied Douchi Bing (Fermented Soybean Cake) externally, and his symptoms gradually improved. Subsequently, he took formulas similar to Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction); due to his prudent management of his illness, he recovered.
A scholar suffered from Fugu Ju (Bone-Adhering Abscess). Due to lack of timely regulation and tonification, the sore did not close, discharging a small amount of clear pus daily, followed by the regular expulsion of three pieces of necrotic bone. His pulse was merely rapid without signs of excess pathogens, indicating Qi and Blood deficiency with a sinus tract formation at the sore, preventing healing. He was treated with Wujin Gao (Black Gold Ointment) externally and Shiquan Dabu Tang internally on a daily basis, resulting in recovery.
Wang Tingzhang, a Shangshe (student of the Imperial Academy), suffered from the aforementioned condition for three years without cure. His limbs were emaciated, digestion was poor, hands and feet were cold, and bowel movements were obstructed with coldness in the Yin regions of the extremities. I diagnosed this as Yang Qi deficiency with cold. He was treated with Buzhong Yiqi Tang (Middle-Boosting and Qi-Enriching Decoction), Bawei Wan, and moxibustion applied to the affected area, leading to recovery.
A male patient presented with swelling and hardness in the thigh, which ulcerated only after more than a year. He had internal heat, thirst, emaciation, and a surging pulse in all six positions, particularly pronounced on the left hand. He was treated with Buzhong Yiqi Tang and Liuwei Wan (Six-Ingredient Pill with Rehmannia), expelling a piece of necrotic bone. Continuing the previous medications, all symptoms disappeared, and the sore healed.
A sixteen-year-old male presented with swollen, darkened feet that ulcerated exposing bone. He was emaciated, suffered from night sweats, fever, and dry mouth. He was treated with Shiquan Dabu Tang and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), taking more than fifty doses of each, resulting in recovery. Otherwise, the condition might have transformed into Zhai Syndrome (Consumptive Disease) or led to death due to exhaustion of Qi and Blood.
A female patient in her thirties, constitutionally weak, developed gradual swelling on the dorsum of her left hand. After one year, it ulcerated, discharging clear pus, with dark swelling spreading to the arm. She experienced internal heat, afternoon fever, spontaneous sweating, and night sweats. Her menstruation ceased, and the sore discharged necrotic bone. She continued taking the aforementioned medicines, taking over three hundred doses in total, and recovered.