白蜡禀收敛坚凝之气。外科要药。生肌止痛。接骨续筋。补虚用合欢树皮。同入长肉膏
。有神效。但未试其可服否。合欢皮尝服之验矣。
(附皂角刺 神异膏 麦饭石膏)
蓖麻子性善收。能追脓取毒。亦要药也。皂角刺治痈疽未破已破。能钻引至渍处。神异
说膏药方甚多。神效无出于此。麦饭石膏脓溃后围疮口。一说内冷恶寒不(注∶“不”下疑
夫气血凝滞。多因营卫之气弱。不能运散。岂可复用流气饮以益其虚。况各经气血多少
。心包络、膀胱、小肠、肝经。多血少气。三焦、胆、肾、心、脾、肺。少血多气。人年四
十以上。阴血日衰。若于血少经分而病痈肿。或脉症不足。当以补接为主。
丹溪曰。肿疡内外皆壅。宜托里表散为主。乃补气血药而加之以行散之剂。非专攻之谓
或者肿 痛甚。烦躁脉大。其辛热之剂。不但肿疡不可用。虽溃疡亦不可用也。凡患者须分
经络、血气、地部远近、年岁老幼、禀气虚实。及七情所感、时令所宜而治之。常见以流气
、十宣散二药。概治结肿之症。以致取败者多矣。
大抵症有主末。治有权宜。治其主则末病自退。用其权则不拘于时。泥于守常。必致
危甚。况杂用攻剂。动扰各经。故丹溪云。凡疮发于一经。只当求责本经。不可干扰余经
白蜡禀受收敛、坚凝的气性,是外科的重要药物。它能生肌止痛,接骨续筋。若用于补虚,可配合合欢树皮一同入药制成“长肉膏”,具有神效。但尚未尝试过单独服用是否可行,而合欢皮我曾服用过且有效。
蓖麻子性质善于收敛,能追出脓液、引出毒邪,也是重要药物。皂角刺用于治疗痈疽,无论未破还是已破,都能钻透引导脓毒至溃烂处。“神异”所说的膏药方剂很多,其神效没有超过这个的。
至于气血凝滞,多因营卫之气虚弱,不能运行消散,岂可再复用流气饮来增加其虚损?况且各经络的气血多少不同:心包络、膀胱、小肠、肝经,是多血少气;三焦、胆、肾、心、脾、肺,是少血多气。人到了四十岁以上,阴血日渐衰退。如果在血少的经络发生痈肿,或者脉象症状不足,应当以补益接续为主。
朱丹溪说:肿疡内外都壅塞,应当以托里透表发散为主,即使用补气血的药加上行散的药物,而不是专门攻伐。如果肿痛剧烈,烦躁不安,脉象洪大,那么辛热性质的药剂,不仅肿疡不可用,即使是溃疡也不可再用。凡是患者,必须分辨经络、气血、部位远近、年龄老幼、体质虚实,以及七情所感、时令适宜等因素来治疗。常见有人用流气饮、十宣散两种药,一概治疗结肿病症,导致失败者很多。
大体上病症有主次,治疗有权宜变通。治其主则末病自然消退,运用权变则不拘泥于常规。拘泥于守常,必定导致危险严重。何况杂用攻伐药剂,会扰动各条经络。所以丹溪说:凡疮发于一经,只应当追究本经的原因,不可干扰其他经络。
Bai La (White Beeswax) possesses the nature of astringency and firmness, serving as an essential herb in external medicine. It promotes tissue regeneration, alleviates pain, knits bones, and reconnects tendons. For tonifying deficiency, it is combined with Cortex Albiziae (Hehuan Pi) to prepare Changrou Gao (Flesh-Growing Ointment), which yields miraculous effects. However, its efficacy when taken orally alone remains untested, whereas Cortex Albiziae has been proven effective through personal use.
(Attached: Spina Gleditsiae (Zaociao Ci), Shenyi Gao (Miraculous Ointment), Maifan Shi Gao (Maifan Stone Powder))
Ricini Semen (Banshenzi) has a strong astringent nature; it can draw out pus and expel toxins, making it another essential herb. Spina Gleditsiae treats carbuncles and sores, whether unruptured or ruptured, by penetrating and guiding pus to the ulcerated area. Among the various ointment formulas described in "Shenyi," none surpass this one in efficacy.
Regarding Qi and Blood stagnation, it often stems from weakness in Ying Wei (Defensive and Nutritive Qi), which fails to circulate and dissipate. How can Liqi Yin (Qi-Flowing Decoction) be reused, thereby exacerbating deficiency? Furthermore, the quantity of Qi and Blood varies among meridians: the Pericardium, Bladder, Small Intestine, and Liver meridians are rich in Blood but deficient in Qi; the Sanjiao (Triple Burner), Gallbladder, Kidney, Heart, Spleen, and Lung meridians are deficient in Blood but rich in Qi. After the age of forty, Yin Blood declines daily. If abscesses occur in meridians deficient in Blood, or if pulse and symptom manifestations are insufficient, treatment should primarily focus on tonification and restoration.
Zhu Danxi stated: In Swelling Ulcers (Zhongyang), where both interior and exterior are obstructed, the primary approach should be Tuo Li Biao San (Supporting the Interior and Dispersing the Exterior)—that is, using Qi- and Blood-tonifying herbs combined with moving and dispersing agents, rather than purely attacking methods. If swelling and pain are severe, accompanied by irritability and a large pulse, acrid-warm agents should not be used for swelling ulcers, nor even for ulcerated wounds. For every patient, one must differentiate the meridian involved, the state of Qi and Blood, the distance of the location, the age of the patient, the constitution's deficiency or excess, the influence of Seven Emotions, and seasonal appropriateness. It is common to see practitioners indiscriminately using Liqi Yin and Shixuan San (Ten-Accumulations Powder) to treat all nodular swellings, leading to frequent failures.
Generally, diseases have primary and secondary aspects, and treatment requires flexibility. Treating the primary aspect causes secondary symptoms to recede naturally; employing flexibility allows one to transcend rigid conventions. Adhering strictly to routine practices inevitably leads to critical danger. Moreover, indiscriminately using attacking agents disturbs the various meridians. Therefore, Danxi said: When a sore originates in a specific meridian, one should seek the cause within that meridian alone and avoid disturbing other meridians.