(妇人症见《女科撮要》、《妇人良方)
疮生于两 ,初起赤肿,久而腐溃或津淫搔痒,破而脓水淋漓。盖因饮食起居,亏损
肝肾
初起恶寒壮热,肿 作痛者,属湿热,用槟苏败毒散。若漫肿作痛,或不肿不痛者,属阴虚
,用补阴八珍汤。若脓水淋漓,体倦食少,内热口干者,属脾虚,用补中益气加茯苓、酒炒
白芍药。若午后热,或作痛,头目不清者,属阴火,前汤加酒炒黑黄柏,及六味地黄丸。若
午后发热,至子时分方止,是血虚,前汤加芎、归、熟地。若郁结伤脾而甚,用归脾汤加柴胡
、山栀。若怒动肝火而甚,用补中益气汤加川芎、山栀、黄芩。内热口干,肢体倦怠,或痰涎
上升,或口舌生疮,属脾肾虚热,用六味地黄丸、补中益气汤。若患处黑黯,肢体畏寒,饮
食少思,属脾肾虚败,用八味地黄丸。若误用攻伐,复损胃气,绝其化源,治亦难矣。
治验
鸿胪翟少溪,两 生疮,渐至遍身,发热吐痰,口燥咽干,盗汗心烦,溺赤足热,日晡
益甚,形体日瘦,此肾经虚火也。用六味丸,一月诸症悉退,三月元气平复。
一男子左腿肿,肉色如故,寒热恶心,饮食少思,此脾气不足,而为外邪所感也。用六
君,加藿香、桔梗、川芎,而寒热止;又用补中益气汤,而肿痛消。
陈湖陆懋诚,素因阴虚过饮入房,发热腿痛似 疮。用发表之剂,两腿肿黯,热气如雾
,欲
补加山药、山茱萸、附子一剂,脉症顿退;却去附子,又二剂,痊愈。
一男子先于两 ,后及遍身生疮,似疥非疥,时或脓水淋漓,两腿为甚,肢体倦怠,作
痒烦热,年余不愈。余作肾经虚火,用加减八味丸而愈。
一男子腿患痈,服克伐之药,亏损元气,不能成脓。余为托里而溃,大补而敛,但大便
结燥,用十全大补汤加麦门、五味而润,月余仍结,自服润肠丸,而泻不止。余用补中益气汤,
送四神丸,数服而愈。
(妇人相关病症详见《女科撮要》、《妇人良方》)
疮疡生于两胁,初起时红肿,日久则腐烂溃破,或渗出津液、瘙痒难耐,破溃后脓水淋漓不断。这通常是因为饮食起居不当,导致肝肾亏损所致。
初起时若见恶寒壮热,肿胀疼痛者,属于湿热证,使用槟苏败毒散。若漫肿疼痛,或不肿也不痛者,属于阴虚证,使用补阴八珍汤。若脓水淋漓,身体疲倦、食欲减退,伴有内热口干者,属于脾虚证,使用补中益气汤加茯苓、酒炒白芍药。若午后发热,或伴有疼痛,头目昏沉不清爽者,属于阴火证,在前述汤剂基础上加酒炒黑黄柏,并配合服用六味地黄丸。若午后发热,直到子时才停止,这是血虚证,在前述汤剂基础上加川芎、当归、熟地黄。若因郁结损伤脾胃且病情严重,使用归脾汤加柴胡、山栀。若因发怒引动肝火且病情严重,使用补中益气汤加川芎、山栀、黄芩。若出现内热口干,肢体倦怠,或痰涎上涌,或口舌生疮,属于脾肾虚热证,使用六味地黄丸、补中益气汤。若患处颜色黑黯,肢体畏寒,饮食减少缺乏胃口,属于脾肾虚败证,使用八味地黄丸。若误用攻伐药物,再次损伤胃气,断绝了生化之源,治疗也就困难了。
治验案例:
鸿胪寺官员翟少溪,两胁生疮,逐渐蔓延至全身,发热吐痰,口燥咽干,盗汗心烦,小便赤黄,足部发热,傍晚时分症状加重,身体日渐消瘦,这是肾经虚火所致。使用六味地黄丸,一个月后所有症状全部消退,三个月后元气恢复平稳。
一名男子左腿肿胀,皮肤颜色如常,伴有寒热往来、恶心、食欲减退,这是脾气不足,受到外邪侵袭所致。使用六君子汤,加藿香、桔梗、川芎,寒热症状停止;又使用补中益气汤,肿痛消除。
陈湖人陆懋诚,素来因阴虚而过度饮酒行房,出现发热、腿痛类似疔疮的症状。医生使用发表解表之剂,导致两腿肿胀色黯,热气蒸腾如雾状。欲采用补法,加入山药、山茱萸、附子一剂,脉象和症状顿时减退;随后去掉附子,再服两剂,痊愈。
一名男子先在两胁部位,随后遍及全身生疮,似疥非疥,有时脓水淋漓,以两腿最为严重,肢体倦怠,发作时瘙痒烦热,一年多未愈。我判断为肾经虚火,使用加减八味丸而治愈。
一名男子腿部患痈疽,服用克伐攻邪的药物,导致元气亏损,无法化脓。我为其使用托里透脓之法使其溃破,再用大补之法促进收敛。但患者大便干结,使用十全大补汤加麦门冬、五味子以润燥,一个月后依然干结,自行服用润肠丸,导致腹泻不止。我使用补中益气汤,送服四神丸,数服后痊愈。
(For conditions in women, see *Nuke Cuyao* [Essentials of Gynecology] and *Furen Liangfang* [Good Prescriptions for Women].)
A carbuncle arising on both hypochondria initially presents with redness and swelling. Over time, it may become necrotic and ulcerate, or exude fluid accompanied by itching. Upon rupture, pus and water flow continuously. This is generally caused by improper diet and lifestyle, leading to a deficiency of the Liver and Kidney.
If chills and high fever occur at the onset, accompanied by swollen and painful areas, this belongs to Damp-Heat syndrome; use *Bingsu Baidu San* (Betel Nut and Perilla Decoction for Resolving Toxins). If there is diffuse swelling with pain, or no swelling and no pain, this belongs to Yin Deficiency syndrome; use *Buyin Bazhen Tang* (Yin-Nourishing Eight Treasure Decoction). If pus flows continuously, accompanied by fatigue, poor appetite, internal heat, and dry mouth, this belongs to Spleen Deficiency syndrome; use *Buzhong Yiqi Tang* (Decoction to Supplement the Middle and Augment the Qi) with added Poria (*Fu Ling*) and White Peony Root (*Baishao*) stir-fried with wine. If fever occurs in the afternoon, or pain arises, accompanied by a heavy and unclear head and eyes, this belongs to Deficient Fire syndrome; add Blackened Cinnamon Bark (*Huangbai*) stir-fried with wine to the aforementioned decoction, and administer concurrently with *Liuwei Dihuang Wan* (Six-Ingredient Pill with Rehmannia). If fever occurs in the afternoon and ceases only around the Zi hour (11:00 PM–1:00 AM), this indicates Blood Deficiency; add Ligusticum Chuanxiong Rhizome (*Chuanxiong*), Angelica Sinensis Radix (*Danggui*), and Prepared Rehmannia Root (*Shudihuang*) to the aforementioned decoction. If emotional constraint severely injures the Spleen, use *Guipi Tang* (Restore the Spleen Decoction) with added Bupleurum Root (*Chaihu*) and Gardenia Fruit (*Shanzhi*). If anger stirs up Liver Fire severely, use *Buzhong Yiqi Tang* with added Ligusticum Chuanxiong Rhizome (*Chuanxiong*), Gardenia Fruit (*Shanzhi*), and Scutellaria Root (*Huangqin*). If internal heat, dry mouth, limb fatigue, rising phlegm-saliva, or sores in the mouth and tongue are present, this belongs to Spleen and Kidney Deficient Heat syndrome; use *Liuwei Dihuang Wan* and *Buzhong Yiqi Tang*. If the affected area appears dark black, limbs feel cold, and appetite is diminished, this belongs to Spleen and Kidney Exhaustion syndrome; use *Bawei Dihuang Wan* (Eight-Ingredient Pill with Rehmannia). If attacking and purging drugs are mistakenly used, further damaging Stomach Qi and severing the source of transformation, treatment becomes difficult.
Case Records:
Zhai Shaoxi, an official at the Court of State Ceremonial, developed carbuncles on both hypochondria that gradually spread over the whole body. He presented with fever, expectoration, dry mouth and throat, night sweats, irritability, dark urine, hot feet, worsening symptoms in the late afternoon, and emaciation. This was diagnosed as Deficient Fire of the Kidney Meridian. He was treated with *Liuwei Dihuang Wan*; after one month, all symptoms subsided, and after three months, his Yuan Qi (Original Qi) recovered.
A man suffered from swelling in his left leg, with normal skin color, accompanied by alternating chills and fever, nausea, and poor appetite. This was due to insufficient Spleen Qi invaded by external pathogens. He was treated with *Liujunzi Tang* (Six Gentlemen Decoction) plus Agastache Rhizome (*Huoxiang), Platycodon Root (*Jiegeng*), and Ligusticum Chuanxiong Rhizome (*Chuanxiong*), which stopped the chills and fever. Subsequently, *Buzhong Yiqi Tang* was used, resolving the swelling and pain.
Lu Maocheng from Chen Lake, who had a history of Yin deficiency exacerbated by excessive alcohol consumption and sexual activity, presented with fever and leg pain resembling a carbuncle. After being treated with diaphoretic agents, his legs became swollen and dark, with heat radiating like fog. The physician intended to tonify, adding Chinese Yam (*Shanyao*), Cornus Fruit (*Shanzhuyu*), and Aconite Root (*Fuzi*) in one dose, which immediately alleviated the pulse and symptoms. The Aconite Root was then removed, and two more doses were administered, resulting in a cure.
A man first developed sores on both hypochondria, which later spread over the entire body. The lesions resembled scabies but were not scabies, sometimes oozing pus and water, most severely on the legs. He experienced limb fatigue, itching, and irritability, lasting for over a year without healing. I diagnosed this as Deficient Fire of the Kidney Meridian and cured him with *Jianji Bawei Wan* (Modified Eight-Ingredient Pill).
A man suffered from a carbuncle on his leg. After taking harsh purgative drugs, his Yuan Qi was depleted, preventing suppuration. I employed methods to support the interior and promote drainage until it ulcerated, followed by strong tonification to promote healing. However, he suffered from constipation. I used *Shiquan Dabu Tang* (Complete Great Tonifying Decoction) with added Ophiopogon Tuber (*Maimendong*) and Schisandra Berry (*Wuweizi*) to moisten the intestines. After a month, constipation persisted. He self-medicated with *Runchang Wan* (Intestine-Moistening Pill), leading to unceasing diarrhea. I treated him with *Buzhong Yiqi Tang*, administering *Sishen Wan* (Four Spirit Pill) with the decoction. After several doses, he recovered.