夫流注者,流者行也,乃气血之壮,自无停息之机;注者住也,因气血之衰,是以凝滞之患。故行者由其
自然,住者由其瘀壅。其形漫肿无头,皮色不变,所发毋论穴道,随处可生。凡得此者,多生于体虚之人,勤
劳之辈,不慎调燮,夏秋露卧,纵意取凉,热体当风,图身快爽;或中风邪,发散未尽,或欲后阴虚,外寒所
侵。又或恼怒伤肝,郁结伤脾,荣气不从,逆于肉里;又或跌打损伤,瘀血凝滞;或产后恶露未尽,流缩经络。
此等种种,皆成斯疾也。既成之后,当分表里、寒热、虚实、邪正、新久而治之。初因风寒相中,表症发散未
尽者,人参败毒散散之。房欲之后,体虚寒气外侵者,五积散加附子温之。劳伤郁怒,思虑伤脾而成者,归脾
汤加香附、青皮散之。跌扑伤损,瘀血凝滞而成者,复元活血汤逐之。产后恶露未尽,流注经络而成,木香流
气饮导之。此皆初起将成之法,一服至三、四服皆可;外俱用琥珀膏敷贴,其中亦有可消者,十中五、六。如
服前药不得内消者,法当大养气血,培助脾胃,温暖经络,通行关节,木香流气饮、十全大补汤俱加熟附子、
香附培助根本;此则未成者自消,已成者自溃,已溃者自敛,而终无残败破漏不敛之症。且如有脓宜急开之。
患者又当慎起居,戒七情,远寒就温,俱可保全;若误用寒凉克伐、内消等药,终至不救者多矣。
所谓“流注”,“流”意为运行,指气血旺盛时,本应无停息之机;“注”意为停留,指因气血衰弱,从而产生凝滞之患。因此,正常运行源于自然状态,而停滞则源于瘀血壅塞。其症状表现为漫肿而无脓头,皮肤颜色不变,发病部位不论穴位,随处皆可发生。凡是患上此病的人,多生于体质虚弱之人、从事繁重劳动之辈,不慎调养,夏季秋季露天睡觉,放纵心意贪图凉快,身体发热时当风,只求身体爽快;或者感受风邪,发散未尽;或者房事后阴虚,外寒侵袭。又或者恼怒伤肝,郁结伤脾,营气不顺,逆乱于肌肉之中;又或者跌打损伤,瘀血凝滞;或者产后恶露未尽,流入收缩经络。这些种种情况,都导致形成这种疾病。既然已经形成,应当区分表里、寒热、虚实、邪正、新久来治疗。初起因风寒相中,表证发散未尽者,用人参败毒散发散它。房事之后,体虚寒气外侵者,用五积散加附子温补它。劳伤郁怒,思虑伤脾而成者,用归脾汤加香附、青皮消散它。跌扑伤损,瘀血凝滞而成者,用复元活血汤驱逐它。产后恶露未尽,流注经络而成,用木香流气饮疏导它。这些都是初起将成阶段的方法,服用一至四服即可;外部均使用琥珀膏敷贴,其中也有可以消除的,十人中能治愈五到六人。如果服用前面的药物不能从内部消除,法则应当大补气血,培助脾胃,温暖经络,通行关节,木香流气饮、十全大补汤均加熟附子、香附以培助根本;这样未成的自然会消散,已成的自然会溃破,已溃破的自然会收敛,最终没有残败破漏不收敛的症状。而且如果有脓应当立即切开排脓。患者又应当谨慎起居,戒除七情,远离寒冷接近温暖,都可以保全性命;如果误用寒凉克伐、内消等药物,最终导致无法救治的情况很多了。
Jinye Wutu Dan (see section on Gangrene of the Extremities).
The term "Liuzhu" (Flowing Abscess) consists of two characters: "Liu" (Flow) means movement, indicating that when Qi and Blood are vigorous, there should be no stagnation; "Zhu" (Stationary) means staying, indicating that due to the decline of Qi and Blood, stagnation occurs. Therefore, normal flow arises from natural conditions, while stagnation arises from blood stasis and obstruction. The manifestation is a diffuse swelling without a head, with unchanged skin color, and it can occur anywhere, regardless of acupoints. Those who contract this disease are mostly individuals with weak constitutions or those engaged in hard labor, who fail to care for themselves properly. They may sleep outdoors in summer and autumn, indulge in seeking coolness, expose their hot bodies to wind for comfort, or suffer from incomplete dispersion of wind-cold pathogenic factors. Alternatively, they may experience Yin deficiency after sexual intercourse, allowing external cold to invade. Anger may injure the Liver, and emotional constraint may damage the Spleen, causing Ying Qi (Nutritive Qi) to become disordered and reverse into the muscles. Traumatic injuries may cause blood stasis and stagnation, or postpartum lochia may not have been fully discharged, flowing into and obstructing the meridians. All these various causes lead to this disease. Once established, treatment must differentiate between exterior/interior, cold/heat, deficiency/excess, pathogenic factor/righteous Qi, and acute/chronic stages. For initial cases where wind-cold has invaded and exterior symptoms remain undispersed, Renshen Baidu San (Ginseng Detoxification Powder) is used to disperse them. After sexual activity, when weakness allows external cold to invade, Wuji San (Five Accumulations Powder) with Fuzi (Prepared Aconite Root) is used to warm them. For cases caused by overwork, depression, anger, and excessive thinking damaging the Spleen, Guipi Tang (Restore the Spleen Decoction) with Xiangfu (Cyperus Rhizome) and Qingpi (Aurantium Peel) is used to dissipate them. For traumatic injuries causing blood stasis, Fuyuan Huoxue Tang (Restore Vitality and Invigorate Blood Decoction) is used to drive out the stasis. For postpartum lochia obstructing the meridians, Muxiang Liqi Yin (Costus Qi-Regulating Infusion) is used to guide and drain it. These are methods for the early stage before full formation; one to four doses are sufficient. Externally, Hupo Gao (Amber Plaster) is applied, which can resolve about 50-60% of cases. If internal resolution fails with the above prescriptions, the method requires substantial tonification of Qi and Blood, strengthening the Spleen and Stomach, warming the meridians, and unblocking the joints. Muxiang Liqi Yin and Shiquan Dabu Tang (Perfect Ten Tonifying Decoction) are both modified with Shu Fuzi (Prepared Aconite Root) and Xiangfu to strengthen the root. In this manner, unformed abscesses will dissipate, formed ones will suppurate, and ruptured ones will heal, avoiding persistent non-healing ulcers. If pus has formed, it should be incised promptly. Patients must also regulate their daily life, restrain the Seven Emotions, avoid cold and seek warmth, which ensures preservation of health. However, many cases become incurable due to the mistaken use of cold-cooling, purgative, or internal-resolving drugs.