典藏书目

Diseases of sores and carbuncles have various treatment methods. Generally speaking, each method has its appropriate application. Tonification (Bu), purgation (Xia), washing (Lin), as well as applications, dressings, acupuncture, bloodletting with stone lancets (Bianlian), moxibustion (Jiu), and cauterization (Lao) are all used. The key to their use lies in understanding the underlying principles. If one grasps these principles, treatments will invariably be effective; if one is ignorant of the rationale, there will inevitably be pros and cons.

It is commonly said throughout ancient and modern times that cold-natured remedies treat heat syndromes, and hot-natured remedies treat cold syndromes. However, some individuals consult medical formulas to treat diseases, arbitrarily adding or subtracting ingredients, making decisions based on personal speculation, believing themselves to be correct. They fail to realize that diseases have patterns of compliance and opposition (Ni Cong), treatments have urgency and slackness, therapeutic laws include standard and flexible approaches (Zheng Quan), prescriptions consist of odd and even combinations (Qi Ou), and medication dosages vary in weight and lightness.

The physician's art relies on mental comprehension; only by grasping the essence can one achieve flexibility and adaptation. Those who master adaptability comprehend the Dao of medicine and reflect upon its principles, thereby finding resources everywhere they turn. Although I lack talent, I briefly present my humble insights. I have observed cases where treating cold with heat exacerbates the cold, and treating heat with cold intensifies the heat. Why is this? It stems from a failure to understand that the Five Viscera (Wu Zang) possess yin and yang natures, and treatment should follow their specific characteristics.

For instance, if Heart excess generates heat, one should tonify the Kidney. Once Kidney water is nourished, the heat will naturally dissipate. If Kidney water deficiency generates cold, one should tonify the Heart. Once Heart fire descends, the cold will naturally resolve. This is what is meant by "when cooling fails to resolve heat, seek it in Yin; when heating fails to resolve cold, seek it in Yang." Furthermore, "treating cold by utilizing heat, and treating heat by utilizing cold" depends entirely on comprehending these logical categories.

I have also heard that mild conditions are treated by counteracting them (Ni Zhi), while severe conditions are treated by following/complying with them (Cong Zhi). What does this mean? Generally, when using hot medicines to treat cold, one must administer them with cool guides; when using cold medicines to treat heat, one must administer them with warm guides. This is done to achieve harmony. What distinguishes standard treatment (Zheng) from flexible treatment (Quan)? Diseases vary in severity. Treating mild conditions by counteraction is the standard principle; treating severe conditions by compliance is the flexible principle.

However, in the field of surgery, how can one neglect ignorance of the principles of tonification and purgation, sweating and purging, root and branch, counteraction and compliance, and standard and flexible approaches? The essential method for treating sores and carbuncles is stated as follows: When heat toxin initially manifests with fever, leading to the formation of sores and carbuncles due to stagnation, within one or two days, one should first administer Wuli Tang (Five Benefits Decoction) to purge evil qi, unblock the viscera, and cause internal resolution.

Ancient and modern decoction methods involve chopping herbs into pieces the size of hemp seeds, boiling them rapidly over high heat without overcooking, aiming for swift efficacy. Next come pills and powders, which promote blood circulation and gradually dissolve the pathogen, allowing for slow dispersion. Washing therapies assist in harmonizing Ying and Wei (Nutritive and Defensive Qi) and promoting flow through the meridians. Additionally, ointments should be used for moistening and warming nourishment, combined with grinding applications and peripheral pastes to adhere to yin-yang dynamics. Methods such as escharosis, interior-supporting, sweating, and purging must be applied according to circumstances; the depth and urgency of treatment have their own gradations; distinctions between men and women, nobility and commoners, must also be considered separately.

Chu Cheng, Minister of Personnel of the Jin Dynasty, stated: Widows and nuns differ from married women's natal families; although they suffer no sexual exhaustion, they endure the bitterness of worry and thought. This reflects a deep understanding of human emotions. Zhang Zhongjing said: Substances possess rigid or soft natures, and dietary habits and living environments also vary, necessitating different treatments. Thus, when Huangdi inquired about the four directions, Qibo enumerated the capabilities of four types of treatment. How much more so for diseases that are new or old, and for patients whose physical forms and emotional states range from joy to suffering? How can one stick to fixed formulas without adapting to circumstances, hoping to cure the disease?

There are also cases of sore and carbuncle swelling and pain, appearing for one or two days, where the pulse is deep and fine accompanied by vexation and oppression, the viscera are weak, the skin is cold, the evil toxin is fierce and violent, the spirit is unsettled and agitated, and external signs are profound and severe. In such cases, Tuoli San (Support Interior Powder) or Zengsun Fuling Tang (Modified Poria Decoction) should be used immediately, employing hot and warm agents to apply the compliant treatment method.