肿痛脉浮数者。祛风清热。
脉涩者。补血为主。
脉弱者。补气为主。
肿硬不溃者。补血气为主。
郁抑所致者。解郁结。调气血。
溃后不敛者。属气血俱虚。宜大补。
虚劳所致者。补之。
因有核而不敛者。腐而补之。
脉实而不敛。或不消者。下之。
瘰 者。结核是也。或在耳后。耳前。或在耳下。连及颐颔。或在颈下。连缺盆。皆谓
之瘰 。或在胸及胸之侧。或在两胁。皆谓之马刀。手足少阳主之。
瘰 必起于少阳一经。不守禁忌。延及阳明。大抵食物之浓。郁气之积。曰毒。曰风。
。皆此三端。拓引变换。须分虚实。实者易治。虚者可虑。以其属胆经。主决断。有相火。
且气多血少。妇人见此。若月经不调。寒热变生。稍久转为潮热。危矣。自非断欲。神仙不
救苦化坚汤 瘰 。马刀。挟瘿。从耳下。或耳后。下颈至肩。或入缺盆。乃手足少阳经
分。其在颏下或颊车。乃足阳明经分。受心脾之邪而作。宜将二症合而治之。
升麻(一钱) 葛根(半钱) 真漏芦 三味俱足。阳明本经药。连翘(一钱。能散诸血。
聚疮之神药。十二经疮药不可无。) 归身(三分) 熟 (二分) 牡丹皮(三分。去肠胃中留
血、滞血、三味。诸经中和血、生血、凉血药也) 黄 (一钱。枯皮毛。实腠理。补表之元
气。 反活血脉、生血。亦疮家圣药。) 白芍药(三分。味酸气寒。补中益肺。气散而不收
。故用酸寒以收散气。腹痛必用。夏月倍之。冬寒下用酸寒故也。又治腹中不和。) 肉
桂(三分。大辛热。能散结积疮症。属阳。须少用之。寒因热用也。又寒覆其疮。以大辛热
消浮冻之气。或躁烦者去之。) 麦芽(一钱。治腹中缩急。兼能消食神胃。) 柴胡(八分。
说同连翘) 鼠粘子(当肿不用。若当马刀挟瘿。不在少阳经矣。去此二味。) 羌活(一钱)
独活(半钱。) 防风(半钱。三味乃手足太阳经药。脊痛项强。不可回顾。腰似拆。项似拔
者用之。或只用防风一味亦可。疮在膈以上。虽为手足太阳经症。亦当用之。为能散结。去
上部风病。身拘急者。风也。诸疮见此症亦用。) 曲末(炒黄二分。为消化食。) 昆布(二
分。味大咸酸。能 坚。疮坚硬者用之。) 黄连(去毛三分。治烦闷。) 广术(三分。煨。
)三棱(二分。煨。坚者削之。疮坚硬甚者用之。不甚勿用。) 人参(三分。补肺气。如气
短气喘。气不调加之。) 浓朴(姜制一钱二分。腹时见胀加之。) 益智仁(二分。唾多者胃
不和也。或吐沫吐食。胃上寒者加之。) 黄柏(炒三分。有热或脚膝无力。加之。或燥烦欲
去衣者。肾中伏火者。亦加之。) 甘草(炙五分。或二分。调中益胃。泄火和诸药。分两不
定者。疮宜泻营气。而甘入脾胃。生湿助疮邪故也。)
上为细末。汤浸蒸饼。和作饼子。日干。捣如米粒。每服二钱。或三钱。白汤下。量病
人虚实。无令药多。妨其饮食。此治之大法也。
如在少阳经分。为马刀、挟瘿者。去独活、漏芦、升麻、葛根。加瞿麦。(三分)
顺加橘皮甚者加木香。(少许)人素气弱。若病来气盛不短促者。不可拘其平素。只作气盛治
之。而从病变之权。邪在上焦加黄芩。(一半酒制。一半生用。)在中焦加黄连。(一半酒制
。一半生用。)在下焦加黄柏、知母、防己。皆酒制选用之、大便不通。滋其邪盛。急加酒
大黄以利之。
如血燥不行。加桃仁、酒大黄。如风结燥不行。加麻仁、大黄。风涩不行。加煨皂角仁
艽、大黄。如脉涩觉身气滞不行。加郁李仁、大黄、以除气燥。如阴寒秘结不行。以局方半
硫丸。或加附子、干姜。冰冷与之。
大抵诸病素气弱者。当去苦寒之药。多加参、 、甘草之类。泄火而补元气。少佐寒
散肿溃坚汤 治马刀坚硬如石。在耳下至缺盆。或肩上。或胁下。皆手足少阳经分。
或颏。或颊车。坚硬如石。在足阳明经分。或二经疮已破。流脓。并皆治之。
柴胡(四钱) 升麻(三钱) 甘草(炙) 归尾 葛根
白芍(各二钱) 黄连(一钱) 三棱(酒制微炒) 连翘(各三钱) 昆布(去土)
知母(酒制) 黄柏(酒制) 土瓜根(切碎酒制) 草龙胆(酒制炒四次)
桔梗(各半两) 黄芩(八钱酒制一半生用一半) 广术(酒制微炒)
上锉。每服五钱。或七钱。水二盏八分。浸大半日。煎至一盏。热服。卧宜去枕。头低
。每噙一口。作十次咽。留一口送下后项丸药。服毕。卧如常。取药在膈上。停留故也。若
能食。粪硬者。旋加作七八钱。止可秤半料作末。炼蜜丸如绿豆大。每服百丸或二百丸。此
制之缓也。一方 海藻 昆布 二味洗净。焙干为末。何首乌木臼捣末。皂角刺炒黄色。公
蛇蜕一条。树上墙上者是。
上五味为末。用猪项下刀口肉。烧熟醮药末吃。食后向患处一边侧卧一伏时。每核上
灸七壮。烟从口中出为度。脓尽即安。
连翘散坚汤 治耳下或肩上及缺盆疮硬如石。动之无根。或生两胁。或已脓流作疮未破
。此手足少阳经分也。
柴胡(一两二钱) 归尾(酒制) 黄芩(生) 广术(酒炒) 三棱(酒炒) 连翘 芍药(各
半两) 黄连(酒炒二次) 苍术(各二钱) 土瓜根(一两酒炒)
草龙胆(一两酒制四次) 黄芩(酒炒二次七钱) 甘草(三钱炙)
上秤一半蜜丸。一半锉。煎如前法。服。
柴胡连翘汤 治男妇马刀疮。
黄芩(炒) 知母(酒制) 连翘 柴胡(各半两) 中桂(三分) 甘草(炙) 黄柏(酒制)
生(各三钱) 归尾(钱半) 瞿麦穗(六钱) 鼠粘子(二钱)
锉如麻豆。每服五钱或三钱。水二盏。煎一盏。食后稍热时服之。
柴胡通经汤 治小儿项侧有疮坚而不溃。名曰马刀。
柴胡 归尾 桔梗 甘草(生) 连翘 三棱 鼠粘子 黄芩(各二分) 红花(少许) 黄
连(五分) 锉。作一服。水二大盏。煎一盏。食后稍热服。忌苦药泄大便。
项上瘰 、马刀。将初生者用四棱铁环按定作口子。以油纸捻 之。勿令合了。以绝其
疮之源。其效至速。如瘰不破。或畏破。以龙泉粉涂。
龙泉粉(炒半润湿另研) 瓦粉(各半两) 昆布(去土三钱或五钱) 广术(酒制) 三棱(
炒各半两) 上细末。熟水调涂之。用此去疾尤速。一二日一易。龙泉粉。即磨刀水脓汁。
青石者佳。
瘰 、马刀血少肚泄。
四物汤加芍药(炒)、牡蛎、(细研)陈皮、柴胡、甘草、黄连、玄参、神曲(炒)、及桑椹
桑椹膏取极熟黑色者二斗。以布滤取自然汁。砂器属性武火慢熬成薄膏。每日白汤点一匙
。食后日三服。
夏枯草。本草言大治瘰 。散结气。有补养厥阴血脉之功。而经不言。观其能退寒热。
虚者可仗。实者以行散之药佐之。外以艾灸。亦渐取效。
一妇患瘰 。延至胸腋。脓水淋漓。日久五心烦热。肢体疼痛。头目昏重。心忪颊赤。
咽燥。发热盗汗。食少嗜卧。月水不调。脐腹作痛。予谓血虚而然。非 故也。服逍遥散(
二三)月余少可。更服八珍汤(十四)。加牡丹皮、香附子。又月余而经通。再加黄 、白蔹
。两月余而愈。(此凭症也。)
一妇久患瘰 不消。自汗恶寒。此血气俱虚。服十全大补汤(十三)月余而溃。然坚核虽
取。疮口不敛。灸以豆豉饼(四三)仍与前药。加香附、乌药两月而愈。(此凭症也。)
一人劳倦。耳下 肿。恶寒发热。头痛作渴。右脉大而软。当服补中益气汤。彼自用药
发表。遂致呕吐。始信予用六君子汤。(二)更服补中益气汤(十六)而愈。(此凭症也。)
大抵内伤。荣卫失守。皮肤间无气滋养。则不任风寒。胃气下陷。则阴火上冲。气喘发
头痛脉大。此不足证也。误作外感。表实而反泻之。宁免虚虚之祸。东垣云。内伤右脉大。
外感左脉大。当以此别之。
机按左脉大属外感。此亦难凭。必须察形观色。审症参之以脉。乃得不误。丹溪治一老
饥寒作劳。患头痛。发热恶寒。骨节疼。无汗妄语。脉洪数而左甚。治以参、 、归、术
皮、甘草。每贴加附一片。五贴而愈。又一少年。九月间发热头痛。妄语大渴。形肥脉数大
左甚。以参、术、君、茯苓、臣。 、佐。附一片使。盖人肥而脉左大于右。事急矣。非附则
参、 无捷效。五十贴大汗而愈。此皆左脉大。丹溪悉以内伤治之。若根据东垣认作外感。宁
一妇年二十。耳下结核。经每过期。午后头痛。服头痛药愈甚。治以八珍汤。(十四)加
柴胡、地骨皮二十余贴。愈。(此凭症也。)
一妇 溃后。发热烦躁作渴。脉大无力。此血虚也。以当归补血汤六剂顿退。又。以圣
愈汤数剂少健。加以八珍汤。加贝母、远志三十余剂而敛。(此凭脉也。)
一 妇四肢倦怠类痿症。以养气血健脾胃而愈。(此凭症也。)
一人素弱。溃后核将不腐。此气血皆虚。用托里养荣汤。气血复。核尚在。以簪挺拨去
。又服前药月余而痊。(此凭症也。)
一人患之痰盛。胸膈痞闷。脾胃脉弦。此脾土虚。肝木乘之也。当实脾土。伐肝木为主
以治痰为先。乃服苦寒化痰药。不应。又加破气药。病愈甚。始用六君子汤加芎归。数剂。
饮食少思。以补中益气汤。倍加白术。月余中气少健。又以益气养荣汤。四月肿消而血气亦
复矣。夫右关脉弦。弦属木。乃木盛而克脾土。为贼邪也。虚而用苦寒之剂。是虚虚也。况
痰之为病。其因不一。主治之法不同。凡治痰利药过多。则脾气愈虚。虚则痰愈易生。如中
气不足。必用参术之类为主。佐以痰药。(此凭症与脉也。)
一人久而不敛。神思困倦。脉虚。予欲投以托里。彼以为迂。乃服散肿溃坚汤。半月余
果发热。饮食愈少。复求治。投益气养荣汤三月。喜其谨守。得以收救。(此凭症脉也。)
齐氏曰。结核瘰 。初觉宜内消之。如经久不除。气血渐衰。肌寒肉冷。或脓汁清稀。
不出。疮口不合。聚肿不赤。结核无脓。外症不明者。并宜托里。脓未成者。使脓早成。脓
已溃者。使新肉早生。血气虚者。托里补之。阴阳不和。托里调之。大抵托里之法。使疮无
变坏之症。所以宜用也。
一人久而不敛。脓出更清。面黄羸瘦。每侵晨作泻。与二神丸数服。泄止。更以六君子
加芎归。月余肌体渐复。灸以豆豉饼。及用补剂作膏药贴之。三月余而愈。(此凭症也。)
一妇溃后核不腐。以益气养荣汤三十余剂。更敷针头散腐之。再与前汤三十余剂而敛。
(此凭症也。)
一人患而肿硬。久而不消。亦不作脓。服散坚毒药不应令。灸肘尖看尖二穴。更服益气
养荣汤。月余而消。(此凭症也。)
一人尚硬。亦灸前穴。饮前药。脓成针之而敛。
一妇久溃发热。月经过期且少。用逍遥散兼前汤。两月余气血复而疮亦愈。但一口不收
。敷针头散。更灸前穴而痊。
常治二三年不愈者。连灸三次。兼用托里药即愈。(前二条俱凭症。)
一人患此肿痛。发寒热。大便秘。以射干连翘散六剂。热退大半。以仙方活命饮(六一)
四剂而消。(此凭症也。)
一妇肝经积热。患而作痛。脉沉数。以射干连翘汤四剂少愈。更用散肿溃坚丸月余而消
。(此凭脉也。)
一妇耳下肿痛。发寒热。与荆防败毒散四剂。表症悉退。以散肿溃坚汤数剂。肿消大半
。再以神效栝蒌散(五一)四剂而平。(此凭症也。)
一人肝经风热。耳下肿痛发热。脉浮数。以薄荷丹治之而消。(此凭脉也。)
一人年二十。耳下患 痛。左关脉数。此肝经风热所致。以荆防败毒散(七)。三贴。
表症悉退。再与散肿溃坚丸(五十)。月余平复。(此凭脉也。)
一妇因怒耳下肿痛。以荆防败毒散(七)加连翘黄芩。四剂而愈。(此无脉症而用发表。
必有所见也。)
尝治此旬日不消者。以益气血药。及饮远志酒(二十)。并效。无脓自消。有脓自溃。
一妇因怒。耳下 痛。头痛寒热。以荆防败毒散(七)加黄芩。表证悉退。但饮食少思。
发热。东垣云。虽有虚热。不可大攻。热去则寒起。遂以小柴胡加地骨皮、芎、归、芩、术
、陈皮十余贴而愈。次年春复肿坚不溃。用八珍汤(十四)加香附、柴胡、地骨皮、桔梗。服
至六七贴以为延缓。仍服人参败毒散。势愈盛。又服流气饮。则盗汗发热口干食少。至秋复
求诊视。气血虚极。辞之。果没。(此凭症也。)
一人每怒。耳下肿。或胁作痛。以小柴胡汤加青皮、红花、桃仁。四剂而愈。(此凭症
一人肿硬不作脓。脉弦而数。以小柴胡汤兼神效栝蒌散(五三)各数剂。及隔蒜灸数次。
月余而消。(此凭脉与症也。)
一妇颈痛不消。与神效栝蒌散(五三)六剂。少退。更以小柴胡加青皮、枳壳、贝母数剂
。痛肿减大半。再以四物对小柴胡数剂而平。(此凭症也。)
肿胀疼痛且脉象浮数的,采用祛风清热法。
脉象涩滞的,以补血为主。
脉象虚弱的,以补气为主。
肿块坚硬且不溃破的,以补益气血为主。
由情志抑郁导致的,需解郁结,调理气血。
溃破后伤口不愈合的,属于气血俱虚,宜大补。
因虚劳导致的,予以补益。
因为有硬核而不愈合的,先腐去死肉再行补益。
脉象实大而伤口不愈合,或肿块不消退的,用攻下法。
瘰疬,就是结核一类病症。有的在耳后、耳前,有的在耳下,连及面颊和下颌;有的在颈部下方,连及锁骨上窝(缺盆),都称为瘰疬。有的在胸部及胸侧,有的在两侧胁肋,都称为马刀。这些病症主要与手少阳三焦经和足少阳胆经有关。
瘰疬必定起于少阳一经。若不遵守禁忌,会延及阳明经。大致而言,饮食过于浓腻、郁积之气,称为毒、风等,皆属这三端,相互牵引变化,必须分辨虚实。实证容易治疗,虚证令人担忧。因为该病属胆经,胆主决断,内有相火,且胆经气多血少。妇女患此病,若月经不调,寒热交替产生,稍久转为潮热,就危险了。除非断绝房事,否则神仙也难以救治。
苦化坚汤:治疗瘰疬、马刀、挟瘿。病灶从耳下或耳后,沿颈至肩,或入缺盆,这是手足少阳经的分野。若在颏下或颊车穴处,则是足阳明经的分野,受心脾之邪而发病。适宜将这两种症状合并治疗。
药物组成:升麻(一钱)、葛根(半钱)、真漏芦。这三味是阳明本经的药物。连翘(一钱,能散诸血聚疮的神药,十二经疮疡药不可无)。当归身(三分)。熟地黄(二分)。牡丹皮(三分,去除肠胃中留血、滞血,这三味是各经中和血、生血、凉血的药)。黄芪(一钱,枯皮毛,实腠理,补表之元气,反活血脉、生血,也是疮家圣药)。白芍药(三分,味酸气寒,补中益肺,气散而不收,故用酸寒以收敛散气,腹痛必用,夏季加倍,冬季寒冷时下部使用酸寒药的原因。又治腹中不和)。肉桂(三分,大辛热,能散结积疮症,属阳,须少量使用,即“寒因热用”。又若寒邪覆盖疮口,用大辛热消除浮冻之气,若有躁烦者去掉此药)。麦芽(一钱,治腹中缩急,兼能消食神胃)。柴胡(八分,功效同连翘)。鼠粘子(牛蒡子)(当肿胀时不用,若属马刀挟瘿,不在少阳经则去掉这两味)。羌活(一钱)。独活(半钱)。防风(半钱,这三味是手足太阳经药,用于脊痛项强,不能回顾,腰似折断,项似拔出的情况。或只用防风一味也可。疮在膈以上,虽为手足太阳经症,也应当使用,因为它能散结,去除上部风病。身体拘急者是风邪所致,各种疮疡见此症也用)。曲末(炒黄二分,用于消化食物)。昆布(二分,味大咸酸,能软坚,疮坚硬者用之)。黄连(去毛三分,治烦闷)。莪术(三分,煨制)。三棱(二分,煨制,坚硬者削之,疮坚硬甚者用之,不坚硬勿用)。人参(三分,补肺气,如气短气喘、气不调时加入)。厚朴(姜制一钱二分,腹部时常胀满时加入)。益智仁(二分,唾多者胃不和,或吐沫吐食,胃上有寒时加入)。黄柏(炒三分,有热或脚膝无力时加入,或燥烦欲去衣者,肾中伏火者,也加入)。甘草(炙五分或二分,调中益胃,泄火和诸药,分量不定,疮宜泻营气,而甘入脾胃,生湿助疮邪的缘故)。
以上研为细末,用汤浸蒸饼,和作饼子,日晒干燥,捣如米粒大小。每服二钱或三钱,白开水送下。根据病人虚实情况,不要让药量过多,妨碍饮食。这是治疗的大法。
若在少阳经分野,为马刀、挟瘿者,去掉独活、漏芦、升麻、葛根。加瞿麦(三分)。顺加橘皮,甚者加木香(少许)。人素来气弱,若病来气盛不短促者,不可拘泥其平素体质,只按气盛治疗,而从病变之权变。邪在上焦加黄芩(一半酒制,一半生用)。在中焦加黄连(一半酒制,一半生用)。在下焦加黄柏、知母、防己,皆酒制选用。大便不通,滋其邪盛,急加酒大黄以利之。
如血燥不行,加桃仁、酒大黄。如风结燥不行,加麻仁、大黄。风涩不行,加煨皂角仁、秦艽、大黄。如脉涩觉身气滞不行,加郁李仁、大黄,以除气燥。如阴寒秘结不行,用局方半硫丸,或加附子、干姜,冰冷与之。
大致诸病素来气弱者,应当去掉苦寒之药,多加参、芪、甘草之类,泄火而补元气。
散肿溃坚汤:治疗马刀坚硬如石。在耳下至缺盆,或肩上,或胁下,皆手足少阳经分野。或颏下,或颊车,坚硬如石,在足阳明经分野。或两经疮已破,流脓,并皆治之。
药物组成:柴胡(四钱)、升麻(三钱)、甘草(炙)、归尾、葛根、白芍(各二钱)、黄连(一钱)、三棱(酒制微炒)、连翘(各三钱)、昆布(去土)、知母(酒制)、黄柏(酒制)、土瓜根(切碎酒制)、草龙胆(酒制炒四次)、桔梗(各半两)、黄芩(八钱,酒制一半生用一半)、莪术(酒制微炒)。
以上锉碎,每服五钱或七钱,水二盏八分,浸泡大半日,煎至一盏,热服。卧时宜去枕,头低。每噙一口,分十次咽下,留一口送下后项丸药。服毕,卧如常。取药在膈上停留的缘故。若能食,粪硬者,旋加作七八钱。止可秤半料作末,炼蜜丸如绿豆大。每服百丸或二百丸。此为制之缓也。一方:海藻、昆布,二味洗净,焙干为末。何首乌木臼捣末。皂角刺炒黄色。公蛇蜕一条,树上墙上者是。
以上五味为末,用猪项下刀口肉,烧熟蘸药末吃。食后向患处一边侧卧一时辰。每核上灸七壮,烟从口中出为度。脓尽即安。
连翘散坚汤:治疗耳下或肩上及缺盆疮硬如石,动之无根。或生两胁,或已脓流作疮未破。此手足少阳经分野。
药物组成:柴胡(一两二钱)、归尾(酒制)、黄芩(生)、莪术(酒炒)、三棱(酒炒)、连翘、芍药(各半两)、黄连(酒炒二次)、苍术(各二钱)、土瓜根(一两酒炒)、草龙胆(一两酒制四次)、黄芩(酒炒二次七钱)、甘草(三钱炙)。
以上秤一半蜜丸,一半锉,煎如前法,服。
柴胡连翘汤:治疗男妇马刀疮。
药物组成:黄芩(炒)、知母(酒制)、连翘、柴胡(各半两)、肉桂(三分)、甘草(炙)、黄柏(酒制)、生姜(各三钱)、归尾(钱半)、瞿麦穗(六钱)、鼠粘子(二钱)。
锉如麻豆,每服五钱或三钱,水二盏,煎一盏,食后稍热时服之。
柴胡通经汤:治疗小儿项侧有疮坚而不溃,名曰马刀。
药物组成:柴胡、归尾、桔梗、甘草(生)、连翘、三棱、鼠粘子、黄芩(各二分)、红花(少许)、黄连(五分)。
锉,作一服,水二大盏,煎一盏,食后稍热服。忌苦药泄大便。
项上瘰疬、马刀,将初生者用四棱铁环按定作口子,以油纸捻塞之,勿令合了,以绝其疮之源,其效至速。如瘰疬不破,或畏破,以龙泉粉涂。
龙泉粉(炒半润湿另研)、瓦粉(各半两)、昆布(去土三钱或五钱)、莪术(酒制)、三棱(炒各半两)。上细末,熟水调涂之。用此去疾尤速,一二日一易。龙泉粉,即磨刀水脓汁,青石者佳。
瘰疬、马刀血少肚泄。
四物汤加芍药(炒)、牡蛎(细研)、陈皮、柴胡、甘草、黄连、玄参、神曲(炒)、及桑椹。
桑椹膏取极熟黑色者二斗,以布滤取自然汁,砂器属性武火慢熬成薄膏。每日白汤点一匙,食后日三服。
夏枯草,本草言大治瘰疬,散结气,有补养厥阴血脉之功,而经不言。观其能退寒热,虚者可仗。实者以行散之药佐之。外以艾灸,亦渐取效。
一妇患瘰疬,延至胸腋,脓水淋漓,日久五心烦热,肢体疼痛,头目昏重,心忪颊赤,咽燥,发热盗汗,食少嗜卧,月水不调,脐腹作痛。予谓血虚而然,非痨故也。服逍遥散(二三)月余少可。更服八珍汤(十四),加牡丹皮、香附子。又月余而经通。再加黄芪、白蔹,两月余而愈。(此凭症也。)
一妇久患瘰疬不消,自汗恶寒,此血气俱虚。服十全大补汤(十三)月余而溃。然坚核虽取,疮口不敛,灸以豆豉饼(四三)仍与前药,加香附、乌药两月而愈。(此凭症也。)
一人劳倦,耳下肿,恶寒发热,头痛作渴,右脉大而软,当服补中益气汤。彼自用药发表,遂致呕吐。始信予用六君子汤。(二)更服补中益气汤(十六)而愈。(此凭症也。)
大抵内伤,荣卫失守,皮肤间无气滋养,则不任风寒。胃气下陷,则阴火上冲,气喘发头痛脉大,此不足证也。误作外感,表实而反泻之,宁免虚虚之祸。东垣云,内伤右脉大,外感左脉大,当以此别之。
机按:左脉大属外感,此亦难凭。必须察形观色,审症参之以脉,乃得不误。丹溪治一老饥寒作劳,患头痛,发热恶寒,骨节疼,无汗妄语,脉洪数而左甚,治以参、芪、归、术、皮、甘草,每贴加附一片,五贴而愈。又一少年,九月间发热头痛,妄语大渴,形肥脉数大左甚,以参、术、君、茯苓、臣、佐、附一片使。盖人肥而脉左大于右,事急矣,非附则参、芪无捷效。五十贴大汗而愈。此皆左脉大,丹溪悉以内伤治之。若根据东垣认作外感,宁...(原文此处似有脱漏或语意未完,依文意推测为“宁有误治”之意,但严格翻译原文)...一妇年二十,耳下结核,经每过期,午后头痛,服头痛药愈甚,治以八珍汤(十四)加柴胡、地骨皮二十余贴,愈。(此凭症也。)
一妇溃后,发热烦躁作渴,脉大无力,此血虚也。以当归补血汤六剂顿退。又,以圣愈汤数剂少健,加以八珍汤,加贝母、远志三十余剂而敛。(此凭脉也。)
一人素弱,溃后核将不腐,此气血皆虚。用托里养荣汤,气血复,核尚在,以簪挺拨去。又服前药月余而痊。(此凭症也。)
一人患之痰盛,胸膈痞闷,脾胃脉弦,此脾土虚,肝木乘之也。当实脾土,伐肝木为主,以治痰为先,乃服苦寒化痰药,不应。又加破气药,病愈甚。始用六君子汤加芎归,数剂。饮食少思,以补中益气汤,倍加白术,月余中气少健,又以益气养荣汤,四月肿消而血气亦复矣。夫右关脉弦,弦属木,乃木盛而克脾土,为贼邪也。虚而用苦寒之剂,是虚虚也。况痰之为病,其因不一,主治之法不同。凡治痰利药过多,则脾气愈虚,虚则痰愈易生。如中气不足,必用参术之类为主,佐以痰药。(此凭症与脉也。)
一人久而不敛,神思困倦,脉虚,予欲投以托里,彼以为迂,乃服散肿溃坚汤。半月余果发热,饮食愈少,复求治,投益气养荣汤三月,喜其谨守,得以收救。(此凭症脉也。)
齐氏曰:结核瘰疬,初觉宜内消之。如经久不除,气血渐衰,肌寒肉冷,或脓汁清稀不出,疮口不合,聚肿不赤,结核无脓,外症不明者,并宜托里。脓未成者,使脓早成。脓已溃者,使新肉早生。血气虚者,托里补之。阴阳不和,托里调之。大抵托里之法,使疮无变坏之症,所以宜用也。
一人久而不敛,脓出更清,面黄羸瘦,每侵晨作泻,与二神丸数服,泄止。更以六君子加芎归,月余肌体渐复,灸以豆豉饼,及用补剂作膏药贴之,三月余而愈。(此凭症也。)
一妇溃后核不腐,以益气养荣汤三十余剂,更敷针头散腐之,再与前汤三十余剂而敛。(此凭症也。)
一人患而肿硬,久而不消,亦不作脓,服散坚毒药不应,令灸肘尖看尖二穴,更服益气养荣汤,月余而消。(此凭症也。)
一人尚硬,亦灸前穴,饮前药,脓成针之而敛。
一妇久溃发热,月经过期且少,用逍遥散兼前汤,两月余气血复而疮亦愈。但一口不收,敷针头散,更灸前穴而痊。
常治二三年不愈者,连灸三次,兼用托里药即愈。(前二条俱凭症。)
一人患此肿痛,发寒热,大便秘,以射干连翘散六剂,热退大半,以仙方活命饮(六一)四剂而消。(此凭症也。)
一妇肝经积热,患而作痛,脉沉数,以射干连翘汤四剂少愈,更用散肿溃坚丸月余而消。(此凭脉也。)
一妇耳下肿痛,发寒热,与荆防败毒散四剂,表症悉退,以散肿溃坚汤数剂,肿消大半,再以神效栝蒌散(五一)四剂而平。(此凭症也。)
一人肝经风热,耳下肿痛发热,脉浮数,以薄荷丹治之而消。(此凭脉也。)
一人年二十,耳下患痛,左关脉数,此肝经风热所致,以荆防败毒散(七),三贴,表症悉退,再与散肿溃坚丸(五十),月余平复。(此凭脉也。)
一妇因怒耳下肿痛,以荆防败毒散(七)加连翘黄芩,四剂而愈。(此无脉症而用发表,必有所见也。)
尝治此旬日不消者,以益气血药,及饮远志酒(二十),并效。无脓自消,有脓自溃。
一妇因怒,耳下痛,头痛寒热,以荆防败毒散(七)加黄芩,表证悉退,但饮食少思,发热。东垣云,虽有虚热,不可大攻,热去则寒起,遂以小柴胡加地骨皮、芎、归、芩、术、陈皮十余贴而愈。次年春复肿坚不溃,用八珍汤(十四)加香附、柴胡、地骨皮、桔梗,服至六七贴以为延缓,仍服人参败毒散,势愈盛,又服流气饮,则盗汗发热口干食少,至秋复求诊视,气血虚极,辞之,果没。(此凭症也。)
一人每怒,耳下肿,或胁作痛,以小柴胡汤加青皮、红花、桃仁,四剂而愈。(此凭症)
一人肿硬不作脓,脉弦而数,以小柴胡汤兼神效栝蒌散(五三)各数剂,及隔蒜灸数次,月余而消。(此凭脉与症也。)
一妇颈痛不消,与神效栝蒌散(五三)六剂,少退,更以小柴胡加青皮、枳壳、贝母数剂,痛肿减大半,再以四物对小柴胡数剂而平。(此凭症也。)
Swelling and pain with a floating and rapid pulse: Dispel wind and clear heat.
A choppy pulse: Primarily nourish blood.
A weak pulse: Primarily tonify qi.
Hard swelling that does not ulcerate: Primarily tonify qi and blood.
Caused by emotional depression: Resolve depression and regulate qi and blood.
Ulceration that fails to heal: Belongs to deficiency of both qi and blood; suitable for strong tonification.
Caused by consumptive disease (Xu Lao): Apply tonification.
Presence of nodules preventing healing: First promote suppuration/debridement, then apply tonification.
Excess pulse with non-healing or non-resolving swelling: Apply purgation.
Luoli (Scrofula) refers to tubercles. They may occur behind the ear, in front of the ear, below the ear, extending to the jaw and chin; or below the neck, extending to the supraclavicular fossa (Quepen). All are termed Luoli. They may also occur on the chest and its sides, or in the two hypochondriac regions, all termed Machdao (Marine Knife). These conditions are primarily governed by the Hand-Shaoyang Sanjiao Meridian and Foot-Shaoyang Gallbladder Meridian.
Luoli must originate from the Shaoyang meridian. Failure to observe dietary and lifestyle taboos allows it to extend to the Yangming meridian. Generally speaking, rich food and accumulated stagnant qi constitute poison and wind. These three factors interact and transform. One must distinguish between excess and deficiency. Excess patterns are easy to treat; deficiency patterns are concerning because they belong to the Gallbladder Meridian, which governs decision-making, contains Ministerial Fire, and has abundant qi but scarce blood. In women, if menstruation is irregular, alternating chills and fever arise, and after a short time turns into tidal fever, the condition is critical. Unless sexual abstinence is practiced, even immortals cannot save them.
Kuhua Jian Tang (Bitter Decoction to Harden and Dissipate): Treats Luoli, Machdao, and Jiaying (Goiter accompanying scrofula). Lesions from below the ear or behind the ear, down the neck to the shoulder, or entering the supraclavicular fossa belong to the Hand and Foot Shaoyang meridians. If located below the chin or at Jiache acupoint, they belong to the Foot-Yangming meridian, caused by pathogenic factors affecting the Heart and Spleen. It is appropriate to treat these two conditions together.
Ingredients: Shengma (Cimicifugae Rhizoma, 1 qian), Gegen (Puerariae Radix, 0.5 qian), Zhen Loulu (Euphorbiae Humifusae Herba). These three are herbs of the Yangming primary meridian. Lianqiao (Forsythiae Fructum, 1 qian, a divine herb for dispersing blood stasis and gathering sores, indispensable in formulas for sores of the twelve meridians). Danggui Shen (Radix Angelicae Sinensis, root portion, 3 fen). Shu Dihuang (Prepared Rehmanniae Radix, 2 fen). Mudanpi (Moutan Cortex, 3 fen, removes retained and stagnant blood in the intestines and stomach; these three harmonize, generate, and cool blood in various meridians). Huangqi (Astragali Radix, 1 qian, nourishes skin and hair, consolidates the exterior, tonifies primordial qi of the exterior, invigorates blood vessels, generates blood, and is a sacred herb for sore practitioners). Baishao Yao (White Peony Root, 3 fen, sour taste and cold nature, tonifies middle and benefits lungs; as qi scatters without gathering, sour-cold herbs are used to gather scattered qi; essential for abdominal pain, doubled in summer, used in winter/cold for lower body reasons; also treats disharmony in the abdomen). Rougui (Cinnamon Bark, 3 fen, greatly pungent and hot, dissipates nodules and accumulations in sores; belongs to yang, use sparingly, i.e., "treat cold with heat"; also uses great pungent-hot herbs to dispel frozen qi when cold covers the sore; remove if irritability is present). Maiya (Hordei Fructus Germinatus, 1 qian, treats abdominal contraction/tightness, aids digestion and stomach spirit). Chaihu (Bupleuri Radix, 8 fen, effects similar to Lianqiao). Shi Niu Zi (Arctii Fructum, do not use when swollen; if Machdao/Jiaying, not in Shaoyang meridian, remove these two). Qianghuo (Notopterygii Rhizoma et Radix, 1 qian). Duhuo (Angelicae Pubescentis Radix, 0.5 qian). Fangfeng (Saposhnikoviae Radix, 0.5 qian; these three are herbs of Hand and Foot Taiyang meridians, used for back pain and stiff neck, inability to look back, waist feeling like breaking, neck feeling like pulling; or use only Fangfeng alone. Even if sores are above the diaphragm and belong to Taiyang, use them as they disperse nodules and remove upper-body wind diseases. Body stiffness is due to wind; used in various sores presenting this symptom). Qu Mo (Stellariae Semen Fermentatum, stir-fried yellow 2 fen, aids digestion). Kunbu (Eckloniae Thallus, 2 fen, greatly salty and sour, softens hardness, used for hard sores). Huanglian (Coptidis Rhizoma, de-haired 3 fen, treats irritability). Ezhu (Curcumae Rhizoma, 3 fen, roasted). Sanleng (Sparganii Rhizoma, 2 fen, roasted, cuts away hardness, used for very hard sores, avoid if not hard). Renshen (Ginseng Radix, 3 fen, tonifies lung qi, add if shortness of breath, panting, or qi dysregulation). Houpo (Magnoliae Officinalis Cortex, ginger-processed 1.2 qian, add if frequent abdominal distension). Yizhi Ren (Alpiniae Oxyphyllae Fructus, 2 fen, excessive saliva indicates stomach disharmony, or spitting foam/food, cold in stomach, add it). Huangbai (Phellodendri Cortex, stir-fried 3 fen, add if heat or weakness in legs/knees, or irritability wanting to remove clothes, indicating latent fire in kidney). Gancao (Licorice Root, honey-fried 5 fen or 2 fen, harmonizes middle and benefits stomach, drains fire and harmonizes other herbs; dosage varies because sores should drain Ying qi, and sweet enters spleen/stomach, generating dampness and aiding pathogenic factors in sores).
Process the above into fine powder. Soak in decoction, mix with steamed dough cakes, form into small cakes, sun-dry, crush to rice-grain size. Take 2 qian or 3 qian per dose, washed down with plain warm water. Adjust according to patient's excess/deficiency; do not let the dosage be too high to interfere with diet. This is the general principle of treatment.
If in the Shaoyang meridian field, for Machdao/Jiaying, remove Duhuo, Loulu, Shengma, Gegen. Add Qumai (Dianthi Herba, 3 fen). Add Ju Pi (Citri Reticulatae Pericarpium); if severe, add Mu Xiang (Aucklandiae Radix, a little). For patients with inherently weak qi, if the disease presents with excess qi and no shortness of breath, do not adhere to their usual constitution; treat as excess qi, adapting to the change of pathology. Pathogen in Upper Jiao: add Huangqin (Scutellariae Radix, half wine-processed, half raw). Pathogen in Middle Jiao: add Huanglian (half wine-processed, half raw). Pathogen in Lower Jiao: add Huangbai, Zhimu (Anemarrhenae Rhizoma), Fangji (Stephaniae Tetrandrae Radix), all wine-processed and selected. Constipation with exacerbating pathogen: urgently add Jiu Dahuang (Rhei Radix et Rhizoma processed with wine) to promote bowel movement.
For dry blood stagnation: add Taoren (Persicae Semen), Jiu Dahuang. For wind-induced dryness constipation: add Huma (Cannabis Semen), Dahuang. For wind-dryness stagnation: add Wei Zaorouren (Gleditsiae Sinensis Fructus processed), Qinjiao (Gentianae Macrophyllae Radix), Dahuang. For choppy pulse with sensation of qi stagnation: add Yuziren (Prunus Semen), Dahuang to remove qi dryness. For yin-cold constipation: use Ju Fang Banshen Wan (Half-Sulfur Pill from Standard Formulas), or add Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), serve cold.
Generally, for diseases in patients with inherently weak qi, remove bitter-cold herbs, increase Renshen, Huangqi, Gancao, etc., to drain fire and tonify primordial qi.
Sanzhong Kuijian Tang (Decoction to Disperse Swelling, Harden, and Dissipate): Treats Machdao hard as stone. From below ear to supraclavicular fossa, or shoulder, or hypochondrium, belonging to Hand and Foot Shaoyang meridians. Or chin/jaw, hard as stone, belonging to Foot-Yangming meridian. Also treats broken sores from either meridian with pus discharge.
Ingredients: Chaihu (4 qian), Shengma (3 qian), Gancao (honey-fried), Guiwei (Angelicae Sinensis Radix, tail portion), Gegen, Baishao (each 2 qian), Huanglian (1 qian), Sanleng (wine-processed, lightly stir-fried), Lianqiao (each 3 qian), Kunbu (cleaned of soil), Zhimu (wine-processed), Huangbai (wine-processed), Tugua Gen (Trichosanthes Kirilowii Radix, chopped wine-processed), Caolongdan (Gentianae Scabrae Radix, wine-processed stir-fried four times), Jiegeng (Platycodonis Radix, each half liang), Huangqin (8 qian, half wine-processed half raw), Ezhu (wine-processed, lightly stir-fried).
Cut into pieces. Take 5 qian or 7 qian per dose. Soak in 2 zhan 8 fen of water for most of the day. Decoct to 1 zhan. Take hot. When lying down, remove pillow, keep head low. Hold one mouthful in mouth, swallow in ten portions. Save one mouthful to wash down the posterior neck pill medicine afterwards. After taking, lie normally. This is because the medicine stays above the diaphragm. If appetite is good and stool is hard, add up to 7-8 qian. Alternatively, take half the material, grind to powder, refine honey into pills the size of mung beans. Take 100 or 200 pills per dose. This is a slow preparation method. Another formula: Haizao (Sargassum Thallus), Kunbu. Cleanse, bake dry, grind to powder. He Shouwu (Polygoni Multiflori Radix) pounded in wooden mortar to powder. Zaojiaoci (Gleditsiae Sinensis Spina, stir-fried yellow). Gong Shetui (Ophichthus Skin from tree/wall).
Grind the above five ingredients to powder. Use pork meat from under the pig's neck, roast until cooked, dip in powder and eat. After eating, lie on side towards affected area for one shichen (two hours). Moxibustion seven moxa cones on each nodule, until smoke exits from mouth. When pus is exhausted, peace ensues.
Lianqiao Sanjian Tang (Powder/Decoction of Forsythia to Dissipate Hardness): Treats sores below ear, shoulder, or supraclavicular fossa hard as stone, moving without root. Or arising in hypochondrium, or already suppurated but unbroken. Belongs to Hand and Foot Shaoyang meridians.
Ingredients: Chaihu (1.2 liang), Guiwei (wine-processed), Huangqin (raw), Ezhu (wine-stir-fried), Sanleng (wine-stir-fried), Lianqiao, Shaoyao (each half liang), Huanglian (wine-stir-fried twice), Cangzhu (each 2 qian), Tugua Gen (1 liang wine-stir-fried), Caolongdan (1 liang wine-processed four times), Huangqin (wine-stir-fried twice, 7 qian), Gancao (3 qian honey-fried).
Weigh half for honey pills, half for cutting. Decoct as before, take.
Chaihu Lianqiao Tang (Decoction of Bupleurum and Forsythia): Treats Machdao sores in men and women.
Ingredients: Huangqin (stir-fried), Zhimu (wine-processed), Lianqiao, Chaihu (each half liang), Zhonggui (Cinnamomi Ramulus, 3 fen), Gancao (honey-fried), Huangbai (wine-processed), Shengjiang (Fresh Ginger, each 3 qian), Guiwei (1.5 qian), Qumai Sui (Dianthi Herba, tip portion, 6 qian), Shi Niu Zi (2 qian).
Cut like hemp seeds. Take 5 qian or 3 qian per dose. Water 2 zhan, decoct to 1 zhan. Take slightly warm after meals.
Chaihu Tongjing Tang (Decoction of Bupleurum to Unblock Meridians): Treats children with hard, non-ulcerated sores on side of neck, named Machdao.
Ingredients: Chaihu, Guiwei, Jiegeng, Gancao (raw), Lianqiao, Sanleng, Shi Niu Zi, Huangqin (each 2 fen), Honghua (Carthami Flos, a little), Huanglian (5 fen).
Cut. Prepare as one dose. Water 2 large zhan, decoct to 1 zhan. Take slightly warm after meals. Avoid bitter drugs that purge bowels.
For initial Luoli/Machdao on neck: Press firmly with a square iron ring to make an opening. Insert oil-paper wick, do not let it close, to cut off the source of the sore. Effect is very fast. If Luoli does not break or fear breaking, apply Longquan Fen.
Longquan Fen (Stir-fried half, moistened, ground separately), Wafen (Tile powder, each half liang), Kunbu (Cleaned of soil 3 qian or 5 qian), Ezhu (Wine-processed), Sanleng (Stir-fried, each half liang). Grind to fine powder. Mix with boiled water and apply. Removes disease quickly. Change every 1-2 days. Longquan Fen is grinding stone slurry/pus juice; bluestone is best.
Luoli/Machdao with scant blood and diarrhea.
Siwu Tang (Four Substances Decoction) plus Shaoyao (stir-fried), Muli (Ostreae Concha, finely ground), Chenpi (Citri Reticulatae Pericarpium), Chaihu, Gancao, Huanglian, Xuanshen (Scrophulariae Radix), Shenqu (Massa Medicata Fermentata, stir-fried), and Sangshen (Mori Fructus).
Sangshen Gao (Mulberry Paste): Take 2 dou of fully ripe black mulberries. Filter through cloth to get natural juice. Slowly boil in clay vessel over moderate fire to thin paste. Take one spoonful daily with warm water, three times after meals.
Xiaku Cao (Prunellae Spica): Materia Medica says it greatly treats Luoli, dissipates nodular qi, has benefit to Jueyin blood vessels. Scripture does not mention this. Observing its ability to resolve chills and fever, deficiency types can rely on it. Excess types should be assisted with dispersing drugs. External moxibustion also gradually takes effect.
Case 1: A woman suffered Luoli extending to chest and axilla, dripping pus. Long duration caused five-palm heat, limb pain, heavy head/eyes, palpitations, red cheeks, dry throat, fever, night sweats, poor appetite, lethargy, irregular menstruation, umbilical/abdominal pain. I diagnosed blood deficiency, not tuberculosis. Took Xiaoyao San (Dispersing Wander Powder) for over a month, slightly improved. Then took Bazhen Tang (Eight Treasures Decoction) plus Mudanpi, Xiangfu (Cyperi Rhizoma). Over another month, menstruation regulated. Added Huangqi, Bailian (Lilii Bulbus). Cured in over two months. (Based on symptoms.)
Case 2: A woman had long-standing Luoli not resolving, spontaneous sweating, aversion to cold. Blood and qi both deficient. Took Shiquan Dabu Tang (Ten Thousand Great Tonifying Decoction) for over a month, then ulcerated. Although hard nodules removed, wound did not heal. Moxibustion with Douchi Bing (Fermented Soybean Cake) still gave previous medicine, added Xiangfu, Wuyao (Linderae Radix). Cured in two months. (Based on symptoms.)
Case 3: A man fatigued, swelling below ear, aversion to cold/fever, headache/thirst, right pulse large and soft. Should have taken Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction). He self-medicated with exterior-releasing drugs, causing vomiting. Finally believed me, used Liujunzi Tang (Six Gentlemen Decoction). Then took Buzhong Yiqi Tang. Cured. (Based on symptoms.)
Generally, internal injury causes loss of defense of Ying and Wei. Without qi nourishment in skin, it cannot withstand wind-cold. Stomach qi sinking causes Yin fire to rush upward, causing panting, headache, large pulse. This is insufficiency syndrome. Mistaking it for external contraction, treating excess exterior with purgatives invites disaster of double deficiency. Dongyuan said: Internal injury shows large right pulse; external contraction shows large left pulse. Distinguish by this.
Ji notes: Large left pulse belonging to external contraction is also hard to rely on. Must examine form and color, assess symptoms combined with pulse to avoid error. Danxi treated an old man hungry/cold/laboring, headache, fever/chills, bone/joint pain, no sweat, delirium, large-rapid pulse especially on left. Treated with Renshen, Huangqi, Danggui, Baizhu, Pifu (likely Chenpi/Cortex Aurantii), Gancao. Added one slice of Fuzi per packet. Cured in five packets. Another youth, September fever/headache, delirium/thirst, fat body, large-rapid pulse especially on left. Used Renshen, Baizhu as Sovereign, Fuling as Minister, Huangqi as Assistant, one slice Fuzi as Envoy. Fat person with left pulse larger than right is critical; without Fuzi, Renshen/Huangqi have no quick effect. Fifty packets caused profuse sweat, cured. All these left-large pulses, Danxi treated as internal injury. If following Dongyuan as external contraction... [Text fragment] ... A woman age 20, tubercle below ear, menstruation delayed, afternoon headache, headache medicines worsened it. Treated with Bazhen Tang plus Chaihu, Digupi (Lycii Cortex). Over twenty packets, cured. (Based on symptoms.)
Case 4: Woman post-ulceration, fever, irritability, thirst, large powerless pulse. Blood deficiency. Danggui Buxue Tang (Tang-kuei Decoction for Tonifying Blood) six packets rapidly reduced symptoms. Then Shengyu Tang (Holy Recovery Decoction) several packets slightly strengthened. Added Bazhen Tang, Beimu (Fritillariae Cirrhosae Bulbus), Yuanzhi (Polygalae Radix). Over thirty packets, healed. (Based on pulse.)
Case 5: Woman limbs fatigue resembling paralysis. Cured by nourishing qi/blood, strengthening spleen/stomach. (Based on symptoms.)
Case 6: Man inherently weak, post-ulceration nodules not rotting. Qi and blood both deficient. Used Tuoli Yangrong Tang (Support Interior and Nourish Spirit Decoction). Qi/blood recovered, nodules remained. Removed with needle probe. Took previous medicine over a month, cured. (Based on symptoms.)
Case 7: Patient with excessive phlegm, chest/diaphragm fullness, spleen/stomach pulse wiry. Spleen earth deficient, Liver wood invading. Should strengthen spleen earth, suppress liver wood, treat phlegm first. Took bitter-cold phlegm-resolving drugs, ineffective. Added qi-breaking drugs, disease worsened. Finally used Liujunzi Tang plus Xiong/gui (Chuanxiong/Danggui). Several packets. Poor appetite, used Buzhong Yiqi Tang, doubled Baizhu. Over a month middle qi slightly recovered. Then Yiqi Yangrong Tang. Four months swelling subsided, qi/blood recovered. Right Guan pulse wiry, wiry belongs to wood, wood excess conquers spleen earth, is thief evil. Using bitter-cold on deficiency is double deficiency. Phlegm causes vary, methods differ. Too many phlegm-draining drugs further weaken spleen qi; weakness makes phlegm easier to generate. If middle qi insufficient, must use Renshen/Baizhu as main, assist with phlegm drugs. (Based on symptoms and pulse.)
Case 8: Long-term non-healing, mental fatigue, empty pulse. I wanted to use interior-supporting drugs. He thought it slow, took Sanzhong Kuijian Tang. Half month later fever, less appetite. Sought treatment again. Given Yiqi Yangrong Tang for three months. Glad he adhered, could rescue. (Based on symptoms/pulse.)
Qi Shi said: Tubercles/Luoli, initially should be internally resolved. If long-standing not removed, qi/blood decline, muscle cold/flesh cold, or thin pus not coming out, wound not closing, swollen but not red, tubercles without pus, unclear external symptoms, all should use interior support. Pus not formed: make it form early. Pus already ulcerated: make new flesh grow early. Qi/blood deficient: support interior and tonify. Yin/Yang disharmony: support interior and harmonize. Generally, interior support prevents bad changes in sores, hence suitable.
Case 9: Long-term non-healing, clearer pus, sallow emaciation, morning diarrhea. Given Ershen Wan (Two Spirits Pill) several doses, diarrhea stopped. Then Liujunzi Tang plus Xiong/gui. Over a month body recovered. Moxibustion with Douchi Bing, plus tonifying plaster. Over three months cured. (Based on symptoms.)
Case 10: Woman post-ulceration nodules not rotting. Yiqi Yangrong Tang over thirty packets. Applied Zhentou San (Needle Head Powder) to promote rotting. Then previous soup over thirty packets to heal. (Based on symptoms.)
Case 11: Patient swollen/hard, long-term not resolving, no pus formation. Hard-dissipating toxic drugs ineffective. Ordered moxibustion on Zhijian/Kanjian two acupoints. Then Yiqi Yangrong Tang. Over a month resolved. (Based on symptoms.)
Case 12: Still hard. Moxibustion on previous points. Drank previous medicine. Pus formed, pricked, healed.
Case 13: Woman long-term ulceration fever, menstruation delayed/scanty. Xiaoyao San combined with previous soup. Over two months qi/blood recovered, sore healed. But one opening not closing. Applied Zhentou San, moxibustion on previous points, cured.
Commonly treating those not healing for 2-3 years: Continuous moxibustion three times, combined with interior-supporting drugs, cures. (Previous two items based on symptoms.)
Case 14: Patient swelling/pain, chills/fever, constipation. Shegan Lianqiao San (Belamcanda and Forsythia Powder) six doses, heat largely subsided. Xianfang Huoming Yin (Immortal Formula Life-Saving Decoction) four doses, resolved. (Based on symptoms.)
Case 15: Woman Liver meridian accumulated heat, painful sore, deep-rapid pulse. Shegan Lianqiao Tang four doses slightly better. Then Sanzhong Kuijian Wan over a month, resolved. (Based on pulse.)
Case 16: Woman below ear swelling/pain, chills/fever. Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) four doses, exterior symptoms retreated. Sanzhong Kuijian Tang several doses, swelling largely subsided. Shenxiao Gualou San (Miraculous Trichosanthes Powder) four doses, flattened. (Based on symptoms.)
Case 17: Man Liver meridian wind-heat, below ear swelling/pain/fever, floating-rapid pulse. Bohe Dan (Mint Pills) treated, resolved. (Based on pulse.)
Case 18: Man age 20, below ear pain, left Guan pulse rapid. Liver meridian wind-heat. Jingfang Baidu San three packets, exterior symptoms retreated. Then Sanzhong Kuijian Wan over a month, recovered. (Based on pulse.)
Case 19: Woman anger-induced below ear swelling/pain. Jingfang Baidu San plus Lianqiao, Huangqin. Four doses cured. (No pulse/symptoms, used exterior release, must have seen something.)
I once treated cases not resolving in ten days with qi/blood-nourishing drugs and Yuanzhi Jiu (Polygala Wine), both effective. No pus resolves spontaneously, pus ulcerates spontaneously.
Case 20: Woman anger-induced below ear pain, headache/chills/fever. Jingfang Baidu San plus Huangqin, exterior symptoms retreated. Poor appetite, fever. Dongyuan said: Even with deficiency heat, do not attack heavily; heat gone then cold rises. Thus Xiao Chaihu Tang plus Digupi, Xiong, Gui, Qin, Zhu, Chenpi over ten packets cured. Next spring recurrence, hard swelling not ulcerating. Bazhen Tang plus Xiangfu, Chaihu, Digupi, Jiegeng. Took 6-7 packets thinking it slow, still took Renshen Baidu San, condition worsened. Then Liuqi Yin, night sweats/fever/dry mouth/poor appetite. Autumn sought diagnosis again, qi/blood extremely deficient, declined treatment. Indeed died. (Based on symptoms.)
Case 21: Man anger-induced below ear swelling or hypochondriac pain. Xiao Chaihu Tang plus Qingpi (Citri Reticulatae Pericarpium Viride), Honghua, Taoren. Four doses cured. (Based on symptoms.)
Case 22: Man swollen/hard no pus, wiry-rapid pulse. Xiao Chaihu Tang combined with Shenxiao Gualou San several doses each, plus garlic-separated moxibustion several times. Over a month resolved. (Based on pulse/symptoms.)
Case 23: Woman neck pain not resolving. Shenxiao Gualou San six doses, slightly retreated. Then Xiao Chaihu plus Qingpi, Zhike (Aurantii Fructus), Beimu several doses, pain/swelling largely reduced. Then Siwu Tang combined with Xiao Chaihu several doses, flattened. (Based on symptoms.)