阳症变而为阴者,草医凉药之过也。于十一日之前未有脓时,投温中健脾之药,如不应,为纯阴
不治。至十五日之后,已出脓时,投托里温中汤,及十二味异功散。轻者十全大补汤,倍加参 桂附
以救之,须得疮热作痛脓出,食进身温脉起为吉,所为原本于阳者,故生。
阴症变而为阳者,大方热药之骤也。虽得微肿微红,微痛微脓,终不似真阳红活,亦
不得稠浓黄脓,其疮不久复归阴矣,所为原本于阴者,故死。
肿疡初溃,或已开针,恐针口易合,随用绵纸的捻蘸元珠膏插之,或用黄蜡化开。入香油少许,
作捻如钉,须裹线一条为心,将蜡捻插入针口内,留线头在外,以膏盖之,次日换插如前。
疮口腐肉不出者,用线纸做捻,取捻毛头于腐上绞之,绞住瘀肉,徐徐拔出,如未
净,再取之。次涂元珠膏,如腐已净,涂绛
珠膏,四围肿处,贴绀珠膏。瘀脓壅肿不出,捣大蒜调松香末敷之。
疮已溃烂,中有黑疔,突兀如箸头,坚痛不可忍者,用紫绛真香锉豆大,炒焦黑为
末,掺疔上。其四围溃处,用兰雪散掺之,黑膏盖之。三二次,则疔尽去,次换生肌药。
顽腐不去,壮实者,用生南星末,加冰片掺之。膏盖过宿,去腐如井,随换生肌等
药。虚弱者,用人参末掺之,过宿洗之。三二次,腐肉自脱,且易收敛。
阳证转变为阴证的,是草医滥用寒凉药物造成的过错。在发病十一日之前、尚未化脓时,投用温中健脾的药物;如果无效,则属于纯阴证,难以治愈。到了十五日之后、已经化脓时,投用托里温中汤,以及十二味异功散。病情较轻的,使用十全大补汤,加倍加入人参、桂枝、附子来救治。必须等到疮口发热作痛、脓液排出、食欲增进、身体温暖、脉象恢复为吉兆,这是因为原本源于阳证,所以能够痊愈。
阴证转变为阳证的,是大方使用热性药物过于猛烈造成的。虽然出现轻微肿胀、微红、微痛、微有脓液,但最终不像真正的阳证那样红润鲜活,也得不到稠密浓黄的脓液,疮口不久又会回归阴证,这是因为原本源于阴证,所以会导致死亡。
肿疡初溃破,或者已经切开排脓,担心针孔容易愈合,随即用绵纸做的药捻蘸取元珠膏插入创口,或者将黄蜡熔化后加入少许香油,做成如钉状的药捻,中间必须包裹一根线作为芯,将蜡捻插入针孔内,留出线头在外面,再用药膏覆盖,第二天像之前一样更换插入。
疮口腐肉排不出的,用线纸做成药捻,取药捻的毛头在腐肉上绞动,绞住瘀肉后徐徐拔出,如果未清理干净,再重复操作。随后涂抹元珠膏,如果腐肉已净,涂抹绛珠膏,四周肿胀处,贴敷绀珠膏。瘀脓壅滞肿胀排不出,捣碎大蒜调和松香末外敷。
疮口已经溃烂,里面有黑色疔疮,突起如筷子头大小,坚硬疼痛无法忍受,用紫绛真香锉成豆粒大小,炒至焦黑研为细末,撒在疔疮上。其四周溃烂处,用兰雪散撒布,用黑膏覆盖。经过两三次处理,则疔疮完全去除,随后更换生肌药物。
顽固腐肉不去除,体质壮实的,用生南星粉末,加入冰片撒布。用药膏覆盖过夜,去除腐肉如同挖井一般,随后更换生肌等药物。体质虚弱的,用人参粉末撒布,过一夜后清洗。经过两三次处理,腐肉自然脱落,且容易收敛愈合。
Yang syndromes transforming into Yin syndromes are the fault of unqualified practitioners overusing cooling herbs. Before the eleventh day, when pus has not yet formed, administer warming and spleen-strengthening formulas; if there is no response, it is a pure Yin syndrome that is difficult to cure. After the fifteenth day, when pus has already emerged, administer Tuoli Wenzhong Tang (Support Interior and Warm Middle Decoction) and Shierwei Yigong San (Twelve-Ingredient Extraordinary Efficacy Powder). For mild cases, use Shiquan Dabu Tang (Ten-Absence Great Tonifying Decoction), doubling the dosage of Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamon Twig), and Fuzi (Aconite Lateralis Radix Praeparata) to rescue the patient. Auspicious signs include the wound becoming hot and painful, pus draining, appetite improving, body temperature normalizing, and pulse recovering. This occurs because the condition originally stemmed from Yang, hence survival is possible.
Yin syndromes transforming into Yang syndromes result from the abrupt and excessive use of hot herbs in large prescriptions. Although slight swelling, redness, pain, and pus may appear, they ultimately do not resemble the vibrant redness of true Yang syndromes, nor do they produce thick, dense yellow pus. The wound will soon revert to Yin because it originally stemmed from Yin, leading to death.
When a swelling ulcer first ulcerates or has been lanced, fearing the incision might close prematurely, insert a cotton-paper wick dipped in Yuanzhu Gao (Pearl-like Ointment) into the wound, or melt Huangla (Beeswax) with a small amount of Xiangyou (Sesame Oil) to form a nail-shaped wick. A thread must be wrapped around the center as a core. Insert the wax wick into the incision, leaving the thread end outside, and cover with ointment. Replace the insertion daily as before.
If necrotic tissue does not discharge from the wound, use a paper-thread wick to twist the frayed tip against the necrotic tissue, grasping the dead flesh and slowly pulling it out. If not clean, repeat. Then apply Jiangzhu Gao (Crimson Pearl Ointment); if necrosis is cleared, apply Jiangzhu Gao, and paste Ganzhu Gao (Blue-Green Pearl Plaster) on the surrounding swollen areas. For stagnant pus and swelling that fails to drain, crush fresh garlic and mix with Songxiang powder (Pine Resin) for topical application.
For ulcers that have already broken down, containing a black Ding (carbuncle/furuncle) protruding like a chopstick head, hard and painfully intolerable, grind Zijiang Zhenxiang (Purple Crimson True Agarwood) into bean-sized pieces, stir-fry until charred black, and powder it. Sprinkle this powder onto the Ding. Apply Lanxue San (Orchid Snow Powder) to the surrounding ulcerated areas, and cover with Hei Gao (Black Plaster). After two or three applications, the Ding will completely disappear, then switch to Jiushengji Yao (Flesh-regenerating medicines).
For stubborn necrotic tissue in robust patients, apply Sheng Nanxing powder (Rhizoma Arisaematis) mixed with Bingpian (Borneol). Cover with plaster overnight; the necrotic tissue will fall away like a well-dug cavity, then replace with flesh-regenerating medicines. For weak patients, sprinkle Renshen powder (Ginseng Radix et Rhizoma), wash after one night. After two or three applications, the necrotic tissue will naturally detach, facilitating easy healing and contraction.