伍氏云∶痈疽发热大渴,毒瓦斯炽盛,急用神仙追毒丸驱下恶毒,次以清膻汤、万金散、
五香连翘汤、六味车螫散、千金漏芦汤选用之。渴不止,用秘传金粉散、人参黄 散、内补
散之类,以补津液,生血气,其渴自止。
愚按∶前症若脉沉实,大便秘结,宜用前药驱逐积毒。若发热作渴,饮食如故,大便如
常,属胃经实热,用竹叶石膏汤以清胃热,生津液。若发热作渴,饮食少思,大便不实,属
胃经虚热,用竹叶黄 汤以补胃气,生津液。若发热恶寒,若内热晡热,口干作渴,属气血
不足,用八珍、麦门、五味以补肝脾,生精血(余见附录用药关键)。
李氏云∶凡疽愈后忽发渴,而不救者十有八九。或先渴而患疽者,尤为难治。急用加减
八味丸,可免前患,如能久服,永不作渴,亦无疽症,且气血皆壮,真神剂也。
愚按∶前症属肾水枯涸,虚火上炎。口干作渴,饮水无度。或舌黄作裂,小便顿数;或
痰气上壅,烦躁不宁;或二三年先作渴饮水;或口舌生疮,两足发热,痰气上壅;或疮愈三
四年而口干作渴,小便频数,急用前药,多有复生者。能逆知其因,预服前丸,可免此患。
若兼手足厥冷,真阳虚也,宜服八味丸。大凡疮后,审其肾水不足,用加减八味丸;中气虚
弱,用补中益气汤;气血虚弱,用十全大补汤,阳气虚寒加姜、桂,如不应,用八味丸。
加减八味丸
地黄(酒拌九蒸九晒八两杵膏) 干山药 山茱萸(去核) 五味子(炒各四两) 肉桂(一两)
牡丹皮 白茯苓(各三两) 泽泻(切片蒸五次焙三两)
上各另为末,入地黄膏,加炼蜜丸桐子大,每服七八十丸,五更初未言语前,白汤下。
李氏云∶一贵人病疽未安而渴,日饮水数升。余用前方,诸医云∶此药若能止渴,我辈
当不复业医矣。仍用木瓜乌梅等味,渴愈甚。用前方,三日渴止,久服气血益壮,饮食加倍。
愚按∶前方非特可治前症。夫人之生,以肾为主,凡病多由肾虚而致。此方乃天一生水
之剂,最宜用之。
忍冬丸 治渴疾既愈,预防发疽。先将忍冬草入瓶内,后入无灰酒,微火煨一宿,取出
晒干,少加甘草,俱为末,又以所浸余酒调丸桐子大,每服六七十丸,温酒下,又能治五痔诸瘿。
黄 六一散 常服,终身可免痈疽,实治渴补虚之剂也。
绵黄 (六两用淡盐水润饭上蒸) 粉草(一两半生半炙)
上为末,每服二钱,侵晨日午,白汤调下。不应,作大剂,水煎服。古人号黄 为羊
肉,可见其能补也。
愚按∶忍冬丸,解热毒消渴之药也。六一汤,补气虚作渴之药,用之无有不验。
伍氏说:痈疽患者出现发热和大渴,是因为毒气炽盛,应立即使用神仙追毒丸来驱除体内的恶毒,随后根据情况选用清膻汤、万金散、五香连翘汤、六味车螯散、千金漏芦汤中的一种。如果口渴不止,可以使用秘传金粉散、人参黄芪散、内补散等方剂,以补充津液,生养血气,口渴自然就会停止。
我认为:上述症状如果脉象沉实,大便秘结,适宜使用前药来驱逐积聚的毒素。如果发热且口渴,但饮食正常,大便如常,这属于胃经实热,应使用竹叶石膏汤来清泻胃热,生津止渴。如果发热且口渴,但食欲不振,大便稀溏不成形,这属于胃经虚热,应使用竹叶黄芪汤来补益胃气,生津止渴。如果发热并伴有恶寒,或者午后潮热,口干口渴,这属于气血不足,应使用八珍汤、麦门冬汤、五味子汤等来补益肝脾,化生精血(其余内容见附录用药关键)。
李氏说:凡是疽疮愈合后突然发生口渴,如果不及时救治,十有八九会死亡。或者是先出现口渴症状而后患疽疮的,尤其难以治疗。应立即使用加减八味丸,可以避免前述祸患,如果能长期服用,将永不口渴,也不会再发疽疮,而且气血都会强壮,这真是神效的药剂。
我认为:上述症状属于肾水枯竭,虚火上炎。表现为口干口渴,饮水无度。或者舌苔黄且出现裂纹,小便频数;或者痰气上壅,烦躁不安;或者两三年前就开始口渴多饮;或者口舌生疮,双足发热,痰气上壅;或者疮疡愈合三四年后出现口干口渴,小便频数,紧急使用前药,大多能起死回生。若能预先知晓病因,提前服用前丸,可避免此祸患。如果兼有手足厥冷,这是真阳虚衰,适宜服用八味丸。大凡疮疡之后,若审察为肾水不足,用加减八味丸;中气虚弱,用补中益气汤;气血虚弱,用十全大补汤;阳气虚寒加生姜、肉桂,如果无效,再用八味丸。
加减八味丸
地黄(用酒拌,九蒸九晒至八两,捣成膏) 干山药 山茱萸(去核) 五味子(炒,各四两) 肉桂(一两)
牡丹皮 白茯苓(各三两) 泽泻(切片,蒸五次后焙干,三两)
以上各药分别研为细末,加入地黄膏,再加炼蜜制成梧桐子大小的丸药,每次服用七八十丸,在五更初未说话之前,用白开水送服。
李氏说:有一位权贵患疽疮尚未痊愈却感到口渴,每天饮水数升。我使用前方,其他医生说:“如果这药能止渴,我们就不必再行医了。”他们仍然使用木瓜、乌梅等药物,导致口渴更加严重。改用我的前方,三天后口渴停止,长期服用后气血更加强壮,饮食量加倍。
我认为:前方不仅可治疗上述症状。人的生存以肾为主,大多数疾病都由肾虚引起。此方是“天一生水”的药剂,最适合使用。
忍冬丸:治疗消渴病痊愈后,预防疽疮复发。先将忍冬草放入瓶中,然后倒入无灰酒,用微火煨烤一夜,取出晒干,少加甘草,全部研为细末,又用浸泡剩下的酒调制成梧桐子大小的丸药,每次服用六七十丸,温酒送服,又能治疗五痔和各种瘿瘤。
黄芪六一散:经常服用,终身可免除痈疽,这确实是治疗口渴、补虚的药剂。
绵黄芪(六两,用淡盐水润湿,放在饭上蒸制) 粉甘草(一两半,一半生用,一半炙用)
以上研为细末,每次服用二钱,在清晨和中午,用白开水调服。如果效果不明显,加大剂量,用水煎服。古人称黄芪为羊肉,可见其补益作用之强。
Wu stated: When a patient with carbuncle and furuncle (Yong Ju, 痈疽) presents with fever and intense thirst, it indicates that the pathogenic toxins are blazing. One should urgently use Shenxian Zhuidu Wan (Divine Immortal Pursuing-Toxin Pill) to purge the malignant toxins from below. Subsequently, select one of the following formulas based on the condition: Qingdan Tang (Clear Diaphragm Decoction), Wanjing San (Ten-Thousand-Gold Powder), Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction), Liuwei Cheshi San (Six-Shell Clam Powder), or Qianjin Loulu Tang (Thousand-Gold Rhapontic Decoction). If the thirst persists, use formulas such as Michuan Jinfen San (Secretly Transmitted Gold-Dust Powder), Renshen Huangqi San (Ginseng and Astragalus Powder), or Neibu San (Internal Nourishing Powder) to replenish body fluids, generate blood and qi, and the thirst will cease naturally.
I observe: For the aforementioned symptoms, if the pulse is deep and excess, and there is constipation, it is appropriate to use the preceding medicines to expel accumulated toxins. If there is fever accompanied by thirst, but appetite remains normal and bowel movements are regular, this belongs to Excess Heat in the Stomach Meridian; use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) to clear Stomach heat and generate fluids. If there is fever and thirst, but poor appetite and loose stools, this belongs to Deficiency Heat in the Stomach Meridian; use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction) to tonify Stomach qi and generate fluids. If there is fever with aversion to cold, or afternoon tidal fever, dry mouth and thirst, this belongs to Qi and Blood deficiency; use Bazhen Tang (Eight-Treasure Decoction), Maidong Tang (Ophiopogon Decoction), or Wuweizi Tang (Schisandra Decoction) to tonify the Liver and Spleen, and generate essence and blood (for further details, see Appendix on Key Principles of Medication).
Li stated: In cases where thirst suddenly appears after the healing of a carbuncle or furuncle, eight or nine out of ten patients will die if not treated promptly. Conversely, if thirst precedes the onset of the carbuncle or furuncle, it is particularly difficult to treat. Urgently use Jiaban Bawei Wan (Modified Eight-Ingredient Pill) to prevent such complications. If taken for a long time, one will never experience thirst again, nor suffer from carbuncles or furuncles, and both qi and blood will become robust; this is truly a miraculous formula.
I observe: The aforementioned symptoms belong to the depletion of Kidney Water with floating Deficient Fire. Symptoms include dry mouth and thirst with excessive water intake. Alternatively, there may be yellow tongue coating with cracks, or frequent urination; or phlegm and qi obstructing upward causing restlessness and irritability; or a history of thirst and excessive drinking for two or three years; or sores in the mouth and tongue, heat in the feet, and upward obstruction of phlegm and qi; or dry mouth and thirst with frequent urination appearing three to four years after the wound heals. Urgently using the preceding medicine often results in recovery. If the cause can be anticipated beforehand and the pill taken prophylactically, this misfortune can be avoided. If accompanied by cold limbs, this indicates Deficiency of True Yang, and Bawei Wan (Eight-Ingredient Pill) is suitable. Generally, after a sore heals, if Kidney Water insufficiency is diagnosed, use Jiaban Bawei Wan; if Middle Qi is weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if Qi and Blood are deficient, use Shiquan Dabu Tang (Perfect Great Tonifying Decoction); if Yang Qi is deficient and cold, add Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark); if ineffective, then use Bawei Wan.
Jiaban Bawei Wan (Modified Eight-Ingredient Pill)
Dihuang (Rehmanniae Radix Praeparata, mixed with wine, steamed and sun-dried nine times, eight liang, pounded into paste)
Shanyao (Dioscoreae Rhizoma)
Shanzhuyu (Corni Fructus, pitted)
Wuweizi (Schisandrae Fructus, stir-fried, each four liang)
Rougui (Cinnamomi Cortex, one liang)
Mudanpi (Moutan Cortex)
Baifuling (Poria, each three liang)
Zexie (Alismatis Rhizoma, sliced, steamed five times, dried, three liang)
Grind each ingredient separately into fine powder, mix with the Dihuang paste, add refined honey, and make pills the size of paulownia seeds. Take seventy to eighty pills each time, before dawn before speaking, washed down with plain warm water.
Li stated: A nobleman suffered from an unhealed carbuncle accompanied by thirst, drinking several sheng of water daily. I used the aforementioned formula. Other physicians said, "If this medicine can stop thirst, we shall no longer practice medicine." They continued using Quamu (Papaveris Fructus) and Wumei (Mume Fructus), which exacerbated the thirst. Upon switching to my formula, the thirst ceased in three days. Long-term consumption led to stronger qi and blood and doubled food intake.
I observe: The aforementioned formula is not only effective for the previous symptoms. Human life is centered on the Kidney; most diseases arise from Kidney deficiency. This formula is a "Heaven Generates One Water" agent, making it highly suitable for use.
Rendong Wan (Honeysuckle Pill): Treats thirst disease (Xiao Ke, 消渴) after cure, preventing the recurrence of carbuncles. First, place Rendong Cao (Lonicerae Japonicae Caulis et Flos) in a bottle, then add non-ash wine, simmer over low fire overnight, take out and dry. Add a small amount of Gancao (Licorice Root), grind all into powder. Use the remaining soaking wine to form pills the size of paulownia seeds. Take sixty to seventy pills with warm wine. It also treats hemorrhoids and various goiters.
Huangqi Liuyi San (Astragalus Six-to-One Powder): Regular consumption can prevent carbuncles and furuncles for life; it is indeed a formula for treating thirst and tonifying deficiency.
Mian Huangqi (Astragali Radix, six liang, moistened with light salt water, steamed over rice)
Fen Gancao (Glycyrrhizae Radix et Rhizoma, one and a half liang, half raw, half honey-fried)
Grind into powder. Take two qian each time, in the early morning and at noon, mixed with plain warm water. If ineffective, increase the dose and decoct in water. Ancient people referred to Huangqi as "lamb meat," indicating its strong tonifying properties.
I observe: Rendong Wan is a medicine for resolving heat toxins and treating thirst. Liuyi Tang (Six-to-One Decoction) is a medicine for treating thirst caused by Qi deficiency; its efficacy is invariably verified.