活血散瘀汤
活血散瘀汤枳壳 芎归苏木角红花
连翘花粉防风等 大黄赤芍一齐加
治臀痈初起,红赤肿痛,坠重如石及大便秘涩。
川芎 当归 防风 赤芍 苏木 连翘 天花粉 皂角针 红花 黄芩 枳壳(各一钱) 大黄(二钱)
水二钟,煎八分,食前服。便通者,去大黄加乳香。
黄 内托散
黄 内托散堪夸 山甲芎归皂刺加
金银花与甘草节 臀痈诸肿乐无涯
治臀痈已成,服前药势定者,欲其溃脓宜服之。
黄 (二钱) 当归 川芎 金银花 皂角针 穿山甲 甘草节(各一钱)
水二钟,煎八分,入酒一杯,食前服。
内消沃雪汤 如意金黄散 人参败毒散 托里消毒散 透脓散(俱见肿疡门)
蟾酥条(见疔疮门)
十全大补汤(见溃疡门)
夫杨梅疮者,以其形似杨梅;又名时疮,因时气乖变,邪气凑袭;又名绵花疮,自期绵绵难绝。有此三者
之称,总由湿热邪火之化,但气化传染者轻,精化欲染者重。故气化乃脾肺受毒,其患先从上部见之,皮肤作
痒,筋骨不疼,其形小而且干;精化乃肝肾受毒,其患先从下部见之,筋骨多疼,小水涩淋,其形大而且硬。
如气化者,毒在皮肤,未经入里,宜服万灵丹洗浴发汗,解散皮肤之毒。精化者,毒在骨髓,未透肌肤,宜服
九龙丹通利大小二便以泻骨中之毒,甚者二服皆可。行散之后,体实者升麻解毒汤,体弱者归灵内托散。服至
筋骨不疼,疮根淡白,内毒已解,方用点药,轻者半年,重则一载,始方得愈。如患者不遵此法,欲其速愈,
妄用熏条、擦药、哈吸等法,往往致成后患者多矣。患者熟思之。
方剂组成:枳壳、川芎、当归、苏木、角红花(即红花)、连翘、天花粉、防风,以及大黄、赤芍一并加入。
主治:治疗臀痈初起阶段,患处红肿热痛,感觉沉重如石块,并伴有大便秘结不通。
药物剂量与用法:川芎、当归、防风、赤芍、苏木、连翘、天花粉、皂角针、红花、黄芩、枳壳各一钱;大黄二钱。加水两钟,煎至八分,饭前服用。若大便通畅者,去掉大黄,加入乳香。
方剂组成:黄芪、穿山甲、川芎、当归、皂角刺,加上金银花和甘草节。
主治:治疗臀痈已经成脓,服用前述活血散瘀汤后病情稳定者,为了促使脓液溃破排出,适宜服用此方。
药物剂量与用法:黄芪二钱;当归、川芎、金银花、皂角针、穿山甲、甘草节各一钱。加水两钟,煎至八分,加入酒一杯,饭前服用。
以下方剂详见相关章节:
内消沃雪汤、如意金黄散、人参败毒散、托里消毒散、透脓散(均见于“肿疡门”)
蟾酥条(见于“疔疮门”)
十全大补汤(见于“溃疡门”)
关于杨梅疮的论述:
这种病之所以叫杨梅疮,是因为其形态像杨梅;又名叫时疮,是因为因时令气候异常变化,邪气侵袭所致;还名叫绵花疮,因为病程绵延难绝。拥有这三种名称,总归是由湿热邪火转化而成。其中,通过气化传染的病情较轻,通过精液接触感染的病情较重。因此,气化型是脾肺受毒,病症首先出现在上部,皮肤瘙痒,筋骨不疼痛,疮形小而干燥;精化型是肝肾受毒,病症首先出现在下部,筋骨多疼痛,小便涩滞淋沥,疮形大而坚硬。如果是气化型,毒邪在皮肤,未深入体内,适宜服用万灵丹洗浴以发汗,解散皮肤之毒。如果是精化型,毒邪在骨髓,未透出肌肤,适宜服用九龙丹通利大小便以泻除骨中之毒,严重的两种方法都可以使用。行散排毒之后,体质强壮者服用升麻解毒汤,体质虚弱者服用归灵内托散。服药直到筋骨不疼,疮根颜色淡白,内部毒素已解,才使用点药外治。轻者半年,重者一年,才能痊愈。如果患者不遵循这种方法,想要快速痊愈,胡乱使用熏条、擦药、哈吸等方法,往往导致成为后遗症的患者很多。患者应深思熟虑。
Huoxue Saiyu Decoction (Blood-Activating and Stasis-Resolving Decoction)
Formula Composition: Zhiqiao (Fructus Aurantii), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis), Sumu (Lignum Sappan), Honghua (Flos Carthami), Lianqiao (Fructus Forsythiae), Tianhuafen (Radix Trichosanthis), Fangfeng (Radix Saposhnikoviae), along with Dahuang (Radix et Rhizoma Rhei) and Chishao (Radix Paeoniae Rubra).
Indications: Treats early-stage Buttock Carbuncle (Pterygium of the Buttocks), characterized by redness, swelling, heat, pain, a sensation of heaviness like a stone, and constipation.
Dosage and Administration: Chuanxiong, Danggui, Fangfeng, Chishao, Sumu, Lianqiao, Tianhuafen, Zaocia Spina (Spina Gleditsiae Sinensis), Honghua, Huangqin (Radix Scutellariae), Zhike (Pericarpium Citri Reticulatae) each 1 qian; Dahuang 2 qian. Add two zhong of water, decoct until reduced to eight fen, take before meals. If bowel movements are unobstructed, remove Dahuang and add Ruxiang (Olibanum).
Huangqi Neituo San (Astragalus Internal-Supporting Powder)
Formula Composition: Huangqi (Radix Astragali), Chuanshanjia (Squama Manis), Chuanxiong, Danggui, Zaocia Spina, plus Jinyinhua (Flos Lonicerae) and Gancao Jie (Cortex Glycyrrhizae Uralensis Node).
Indications: Treats Buttock Carbuncle that has already formed pus. After the condition stabilizes following the administration of the previous Huoxue Saiyu Decoction, this formula is suitable to promote suppuration and drainage.
Dosage and Administration: Huangqi 2 qian; Danggui, Chuanxiong, Jinyinhua, Zaocia Spina, Chuanshanjia, Gancao Jie each 1 qian. Add two zhong of water, decoct until reduced to eight fen, add one cup of wine, take before meals.
The following formulas are detailed in their respective sections:
Neixiao Woxue Tang (Internal-Resolving Snow-Melting Decoction), Ruyi Jinhuang San (Ruyi Golden-Yellow Powder), Renshen Baidu San (Ginseng Detoxification Powder), Tuoli Xiaodu San (Supporting-Interior and Detoxifying Powder), Tou Nong San (Pus-Penetrating Powder) (all see "Swelling Ulcer Section").
Chansu Tiao (Toad Venom Strip) (see "Carbuncle Section").
Shiquan Dabu Tang (Ten Complete Tonifying Decoction) (see "Ulcer Section").
Discussion on Yangmei Chuang (Syphilis/Chancre):
This disease is called Yangmei Chuang because its appearance resembles bayberries; it is also named Shichuang (Seasonal Chancre) because it arises from abnormal seasonal climate changes where pathogenic factors invade; it is further named Mianhuachuang (Cotton-Flower Chancre) because its course is lingering and difficult to eradicate. These three names all stem from transformation by damp-heat and pathogenic fire. Among them, transmission via qi (airborne/environmental) is mild, while transmission via essence (sexual contact) is severe. Therefore, the qi-transmission type involves toxicity affecting the Spleen and Lung, with symptoms appearing first in the upper body: skin itching without bone or tendon pain, and lesions that are small and dry. The essence-transmission type involves toxicity affecting the Liver and Kidney, with symptoms appearing first in the lower body: frequent bone and tendon pain, dysuria with dribbling, and lesions that are large and hard. For qi-transmission cases, where the toxin remains in the skin and has not entered the interior, it is appropriate to bathe with Wanling Dan (Myriad Spirits Pill) to induce sweating and dissipate the cutaneous toxin. For essence-transmission cases, where the toxin resides in the marrow and has not penetrated the skin, it is appropriate to administer Jiulong Dan (Nine Dragons Pill) to promote urination and defecation to drain the marrow toxin; in severe cases, both methods may be used. After dispersing and draining, those with strong constitutions should take Shengma Jiedu Tang (Cimicifuga Detoxifying Decoction), while those with weak constitutions should take Guiling Neituo San (Guiling Internal-Supporting Powder). Continue medication until bone and tendon pain cease, the base of the chancre becomes pale white, and internal toxins are resolved, then apply topical medicaments. Mild cases resolve in half a year, severe cases in one year. If patients do not follow this method but seek rapid cure, recklessly using fumigation strips, rubbing medicines, or inhalation methods often leads to many cases of sequelae. Patients should reflect deeply on this.