经曰∶膏粱之变,足生大疔。此言富贵人也。日食浓味以助其阳,不能走空窍以行阳道,反
行阴道,则脾土湿气大胜;子能令母实,则心火大炽。火土既盛,肾水亏伤,湿热上行,必出于
太阳膀胱之经,为脑疽。为发背等诸最重之证。故患时不宜再食浓味,以助宿积之蕴热也。若贫
家则不然,无过气郁而成。盖诸 补阴,诸肉补阳。素不得 肉之养,再泥以诸毒戒肉,何所赖
以补益乎?故不可一途而论也。
(一贫士患发背,无力买人参补药,日食肉馄饨而愈。)
(附∶预防)
疮疡之证,必因膏粱浓味,或恚怒郁结,致毒火蕴蓄。渐觉心烦躁热,口作大渴,引饮不休
,食已即饥,乃欲发痈疽之候。当急服清火解毒之药而预防之,可免斯患。如患后因脓水泄其津
液,亦至口渴不已,无问初重,溃后作渴,竹叶黄 汤;脉数无力,口干,补中益气汤;便秘,
清凉饮;尺脉洪大,按之无力,用加减八味丸。若口燥舌黄,渴欲饮水,此丸尤妙。渴与口干不
同,若用丹药镇坠,祸不旋踵。惟截嫩桑枝同五味子煎汤饮,可以救阳水。
(隔蒜灸、豆豉饼灸、净土灸)
疮疡用灸,有回生之功。一切痈毒发背初起,赤热肿痛,可拔引郁结滞气,及攻散沉凝留血
,必能取效。老弱元气虚寒者,不灸必至败亡。先以湿纸覆其上,立视纸先干处,即痈头也。取
蒜炙,独蒜犹佳。切片如三文钱浓,安疮头上,用大艾炷灸之,三壮换蒜。痛者灸至不痛,不痛
灸至痛。一、二日,十灸十愈;二、四日,灸六、七愈;五、六日,灸三、四愈;十数日,灸无
功。若有十数头,蒜研成饼,聚艾灸之亦愈。如疮大,日夜灸;若有椒眼一、二十,逐眼灸之,
用蒜并淡豆豉、乳香、捣作饼灸尤效。初起中有一黄粟米头,用独蒜切去两头,安疮上灸十四壮
,多至四十九壮。一人背疽,逾月益甚,艾加疮上,早灸至晚,百五十壮知痛。明日镊去黑痂,
敷药服药即安。如无蒜,用豆豉捣作饼;如俱无,用
净土以众人唾,或加葱汁,或嗽口水,和捏作饼,大小根据疮,浓一、二分。痛则加浓,不大热,
减薄。一壮一换,灸四十九壮,以验为度。
《黄帝内经》中说:“食用肥甘厚味过度,足以导致严重的疔疮。”这是针对富贵之人而言的。他们每日食用浓烈滋味的食物来助长阳气,但阳气不能通达空窍以运行阳道,反而行于阴道,导致脾土的湿气过盛;根据五行相生理论“子能令母实”,心火因此大旺。火与土的气机既已亢盛,肾水就会受到亏损和伤害,湿热之气向上逆行,必然发于太阳膀胱经,形成脑疽、发背等最为严重的病症。因此,患病期间不适宜再食用浓烈滋味的食物,以免助长体内积滞的蕴热。如果是贫苦人家则不然,其病因不过是由于气机郁结所致。一般来说,各种谷物具有补阴的作用,而各种肉类具有补阳的作用。平民百姓平时得不到肉类的滋养,如果再拘泥于各种禁忌而完全不吃肉,那么依靠什么来补充身体所需的营养呢?所以不能一概而论地看待这个问题。
(有一个贫穷的读书人患了发背疮,因为无力购买人参等补药,每天吃肉馄饨而痊愈。)
(附:预防措施)
疮疡这类病症,必定是因为食用肥甘厚味,或者因愤怒、忧郁导致气机郁结,致使毒火蕴蓄体内。逐渐感到心烦意乱、燥热,口中极度口渴,饮水不止,吃完饭后立刻又感到饥饿,这是即将发生痈疽的先兆。应当立即服用清热泻火、解毒的药物进行预防,可以避免这种祸患。如果患病后因为脓水流出耗伤了津液,也会导致口渴不止,无论初期病情轻重,溃烂后出现口渴症状,使用竹叶石膏汤;如果脉象数而无力,口干,使用补中益气汤;如果便秘,使用清凉饮;如果尺脉洪大但重按无力,使用加减八味丸。如果口燥舌苔黄,想喝水,使用加减八味丸尤其巧妙。“渴”与“口干”是不同的概念,如果使用丹药强行镇坠收敛,灾祸很快就会降临。只有截取嫩桑枝同五味子一起煎汤饮用,可以救治因阳虚引起的水液代谢失常导致的口渴。
(隔蒜灸、豆豉饼灸、净土灸)
治疗疮疡使用艾灸,有起死回生的功效。一切痈毒、发背在初起阶段,表现为局部发红、发热、肿胀、疼痛,艾灸可以拔引并疏散郁结的滞气,以及攻散沉积凝滞的瘀血,必定能取得疗效。年老体弱、元气虚寒的人,如果不进行艾灸,必然会走向败亡。先用湿纸覆盖在患处,立即观察纸张哪里先变干,那里就是痈疽的头绪所在。采用隔蒜灸,单独的大蒜效果更佳。将大蒜切成约三文钱厚的片状,放在疮头上,用大的艾炷进行艾灸,灸三壮后更换一片大蒜。感觉疼痛的要灸到不痛为止,不痛的灸到有痛感为止。发病一两天内,灸十次可治愈十次;发病两到四天,灸六到七次可治愈六七次;发病五到六天,灸三到四次可治愈三四次;发病十多天后,艾灸就无效了。如果有十几个疮头,可以将大蒜研碎做成饼,集中艾灸也可以痊愈。如果疮面较大,日夜连续艾灸;如果有花椒眼大小的一二十个疮口,逐个对每个疮口进行艾灸,使用大蒜配合淡豆豉、乳香捣碎做成饼进行艾灸尤为有效。初起时中间有一个像黄粟米大小的头,取独蒜切去两头,放在疮上灸十四壮,多至四十九壮。有一人患背疽,超过一个月病情加重,将艾绒加在疮上,从早上灸到晚上,共一百五十壮才感觉到疼痛。第二天镊去黑色的痂皮,敷药服药后即安稳下来。如果没有大蒜,就用豆豉捣碎做成饼;如果两者都没有,就用净土,加入众人的唾液,或者加入葱汁,或者嗽口水,调和捏成饼,大小依据疮口而定,厚度一至二分。疼痛则增加厚度,不太热的则减薄。每灸一壮更换一次饼,灸四十九壮,以见效为限度。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Excessive consumption of rich and sweet foods is sufficient to generate severe Ding sores (hard, deep-seated infections)." This refers to people of wealth and status. They consume strong-flavored foods daily to augment their Yang Qi, but this Yang Qi fails to navigate the orifices to circulate along the Yang pathways; instead, it moves along the Yin pathways, causing excessive dampness in the Spleen Earth. According to the Five Elements theory where "the child can make the mother full," Heart Fire becomes excessively blazing. With Fire and Earth both flourishing, Kidney Water is depleted and injured. Damp-heat rises upward and inevitably manifests in the Taiyang Bladder Meridian, resulting in severe conditions such as Nao Ju (brain carbuncle) and Fa Bei (back carbuncle). Therefore, during illness, one should not consume rich and strong-flavored foods, as this would aid the accumulated latent heat. For poor families, however, this is not the case; their condition arises merely from Qi stagnation. Generally, grains nourish Yin, while meats tonify Yang. Commoners usually do not receive the nourishment of meat; if they strictly adhere to various taboos against eating meat, what reliance do they have for tonification? Thus, one cannot discuss this through a single perspective.
(A poor scholar suffered from a back carbuncle but lacked the funds to buy Ren Shen (Ginseng) tonics; he recovered by consuming meat wontons daily.)
(Attachment: Prevention)
Sores and ulcers invariably arise from the consumption of rich and sweet foods, or from anger and emotional depression leading to Qi stagnation, causing toxic fire to accumulate within. One gradually feels restless, irritable, and hot, with extreme thirst in the mouth, drinking incessantly, and feeling hungry immediately after eating. These are signs that an abscess or carbuncle is about to erupt. One should urgently take herbs that clear fire and detoxify to prevent this disaster. If, after the onset of the disease, pus discharge depletes body fluids, it also leads to unceasing thirst. Regardless of whether the initial stage was mild or severe, if thirst occurs after ulceration, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); if the pulse is rapid and forceless, and the mouth is dry, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if constipated, use Qingliang Yin (Cooling Drink); if the Chi position pulse is surging and large but forceless upon deep pressure, use Jiaban Bawei Wan (Modified Eight-Ingredient Pill). If the mouth is dry, the tongue coating is yellow, and there is a desire to drink water, this pill is particularly effective. "Thirst" differs from "dry mouth"; using mineral pills to forcibly suppress symptoms will bring disaster swiftly. Only by decocting tender mulberry branches together with Wuweizi (Schisandra Berry) and drinking the soup can one rescue cases of thirst caused by Yang deficiency affecting water metabolism.
(Garlic-Separate Moxibustion, Fermented Soybean Cake Moxibustion, Pure Earth Moxibustion)
Using moxibustion for sores and ulcers has the power to revive the dying. For all types of carbuncles, toxic swellings, and back carbuncles in their early stages, characterized by redness, heat, swelling, and pain, moxibustion can draw out and disperse stagnant Qi, as well as attack and scatter stagnant blood. It will certainly be effective. For the elderly and weak who have deficient and cold Yuan Qi (Original Qi), failure to use moxibustion will lead to demise. First, cover the area with wet paper; immediately observe where the paper dries first, which indicates the head of the carbuncle. Use garlic-separated moxibustion; a single large clove of garlic is preferable. Slice the garlic to a thickness of about three Sanqian coins, place it on the sore, and apply large moxa cones. After three Zhuang (units of moxa burning), replace the garlic. For painful lesions, moxa until the pain ceases; for non-painful lesions, moxa until pain is felt. Within one to two days, ten applications yield ten cures; within two to four days, six to seven applications yield six or seven cures; within five to six days, three to four applications yield three or four cures; after more than ten days, moxibustion is ineffective. If there are ten or more heads, grind the garlic into a cake and apply concentrated moxibustion, which can also cure the condition. If the sore is large, moxa day and night; if there are one or twenty pepper-eye-sized spots, moxa each spot individually. Using garlic combined with Dan Dou Chi (Fermented Soybean) and Xurong (Frankincense) pounded into a cake for moxibustion is particularly effective. In the early stage, if there is a central head resembling a yellow millet grain, take a single garlic clove, cut off both ends, place it on the sore, and moxa fourteen Zhuang, up to forty-nine Zhuang. One person suffered from a back carbuncle that worsened after a month; moxa was applied directly to the sore from morning till evening, totaling 150 Zhuang before pain was perceived. The next day, black scabs were removed with tweezers, and after applying medicine and taking oral medication, the patient stabilized. If no garlic is available, pound Dan Dou Chi into a cake; if neither is available, use pure earth mixed with saliva from many people, or add green onion juice or spit, kneading it into a cake. The size should match the sore, with a thickness of one to two fen. Increase thickness if painful; reduce thickness if not very hot. Replace the cake after each Zhuang, moxa for forty-nine Zhuang, stopping when efficacy is observed.