十仙汤(序班孙双泉传) 治疹后余毒。
柴胡 葛根 玄参 黄连 黄芩 栀子 陈皮 茯苓 枳壳 生地
上锉。生姜煎服。
一小儿疹后。咳嗽腹胀。喘急烦躁。泄泻声哑。唇口青黑。贾农峰传。
黄连 黄芩 连翘 玄参 知母 桔梗 杏仁 白芍 麻黄 牛蒡子 干葛 陈皮 浓
朴甘草
上锉。水煎服。
夫痈疽疮疖者。皆由气血不利。喜怒不时。饮食不节。寒暑不调。使五脏六腑之气。怫郁于
内。以致阴阳乖错。气血凝滞而发也。亦有久服丹石燥热之药。热毒结深。而发为痈疽也。
夫此疾多生于膏粱富贵之人。以其平昔所食肥腻炙爆。安坐不劳。嗜欲无节。以致虚邪热
内攻。煎熬气血而成也。痈者壅也。大而高起属乎阳。六腑之气所生也。其脉数浮。疽者沮
也。平而内发属乎阴。五脏之气所成也。其脉沉数。疮者其总名也。疖者有头小疮也。经
云。诸痛痒疮。皆属心火。盖心主血而行气。若气血凝滞。夹心火之热。而生痈疽之类也。
然所感有浅深。故所发有轻重大小之不同也。六腑积热。腾出于外。肌肉之间。其发暴甚。
皮肿光软。侵表广大者。痈也。五脏风毒积热。攻注于肌肉。其发猛恶。初生一头。如痞
白色焦枯。触之而痛应心者。疽也。热发于皮肤之间。是以浮肿。根小不过二三寸者。疖
也。夫痈生于六腑。若燎原之火。外溃肌肉。疽生于五脏。沉涩难疗。若陶室之燧。内溃骨
髓。痈则易疗。惟难将息而迟瘥。疽则难疗而易痊复。夫诸疮之中。惟背疽疔疮。最为急症
其次莫如脑疽肠痈喉痈之类。亦其急者也。至若瘰 悬痈痔漏诸疮之类。其症可缓而治也
又有疥癣 疮风疳之类。虽云俱属疮类。而其轻重缓急。自有不同。夫痈疽之疾。须要察
其虚实冷热轻重。对症用药。无失先后次序。凡人年四十以上。头顶鬓颐。背膂腰胁。或筋
骨之上。所视不见之处。稍有疮疖。便不可轻易待之。若视之怠慢。以为常疾。每见从微至
显。丧命者多矣。便宜速治。庶几得救。譬之救火。初起则易救。至于燎原之势。不可扑灭
矣。其理亦犹是也。凡疮未破。毒攻脏腑。一毫热药。断不可用。若已破溃。脏腑既亏。饮
食不下。一毫冷药。亦不可用。此先后次序之要诀也。夫疮有五善七恶。不可不辨。若动息
宁。饮食知味。一善也。便利调匀。二善也。脓溃肿消。色鲜不臭。三善也。神彩精明。语
音清朗。四善也。体气和平。五善也。如烦躁时嗽。腹痛渴甚。泄利无度。小便如淋。一恶
也。脓血大泄。 痛尤甚。臭恶难近。二恶也。喘粗短气。恍惚嗜卧。三恶也。未溃先黑入
陷。面青唇黯便污者。四恶也。肩项不便。四肢沉重。五恶也。不能下食。服药而呕。食不
知味。六恶也。声嘶色脱。唇鼻青黑。面目四肢浮肿。七恶也。更有气噫痞塞。咳逆身冷
自汗无时。目眩耳聋。恍惚惊悸。言语颠倒。皆是恶症。五善见三则善。七恶见四必危。五
善并至。则吉而安。七恶全见。必危而死矣。
十仙汤(由序班孙双泉传授):治疗痘疹消退后残留的毒邪。
柴胡、葛根、玄参、黄连、黄芩、栀子、陈皮、茯苓、枳壳、生地黄。
以上药材切碎,加生姜煎煮后服用。
另一个方剂(由贾农峰传授):治疗小儿在痘疹之后,出现咳嗽、腹部胀满、气喘急促、烦躁不安、腹泻、声音嘶哑、嘴唇和口唇呈现青黑色等症状。
黄连、黄芩、连翘、玄参、知母、桔梗、杏仁、白芍、麻黄、牛蒡子、干葛(即葛根)、陈皮、厚朴、甘草。
以上药材切碎,加水煎煮后服用。
所谓痈疽疮疖等病症,都是由气血运行不畅,喜怒情绪调节不当,饮食没有节制,寒暑气候适应失调,导致五脏六腑的气机在内郁结,从而引起阴阳失衡错乱,气血凝滞而引发的。也有因为长期服用丹石类燥热性质的药物,致使热毒深结,进而引发痈疽的情况。
这种疾病多发生在食用精细食物且生活富裕的人身上,因为他们平时食用肥腻、炙烤爆裂的食物,久坐不劳动,欲望没有节制,导致虚邪热毒内攻,煎熬气血而形成。
“痈”的意思是壅塞,体积大且高高隆起,属于阳证,由六腑之气产生。其脉象数而浮;“疽”的意思是阻塞不通,平坦且向内深陷,属于阴证,由五脏之气形成。其脉象沉而数。“疮”是这类疾病的总称;“疖”是有头的小疮。
《内经》说:“各种疼痛、瘙痒、疮疡,都归属于心火。”因为心主血并推动气行,如果气血凝滞,夹杂心火的熱气,就会生成痈疽之类的疾病。
然而,感受病邪有浅深之分,所以发病有轻重大小之不同。六腑积热,腾发于体表肌肉之间,发病突然猛烈,皮肤肿胀光亮柔软,侵犯范围广大的是痈。五脏风毒积热,攻注于肌肉,发病凶猛恶险,初生时有一个头,像痞块一样白色焦枯,触碰时疼痛感应到心脏的是疽。热毒发于皮肤之间,因此浮肿,根部小不超过二三寸的是疖。
痈生于六腑,就像燎原之火,向外溃烂肌肉;疽生于五脏,深沉涩滞难以治疗,就像陶室中的燧石,向内溃烂骨髓。痈容易治疗,只是难护理且痊愈慢;疽难治疗但容易恢复。
在各种疮疡中,只有背疽和疔疮是最为急重的病症,其次莫过于脑疽、肠痈、喉痈等,也是急症。至于瘰疬、悬痈、痔漏等各种疮疡,病情可以缓和地治疗。还有疥癣、疮风、疳疮等,虽然都属于疮类,但其轻重缓急自然有所不同。
对于痈疽这类疾病,必须辨别其虚实、冷热、轻重,对症用药,不要失去先后次序。凡是年龄四十岁以上的人,头顶、鬓角、下巴、背部脊柱、腰部胁肋,或者筋骨之上,以及视线看不见的地方,只要稍有疮疖,就不可以轻易对待。如果看淡怠慢,认为是平常疾病,常常见到从轻微发展到显著,最终丧命的人很多。应当迅速治疗,才有望得救。这就像救火一样,刚起火时容易扑灭,等到形成燎原之势,就无法扑灭了。道理也是一样的。
凡是疮疡未破溃时,毒邪攻伐脏腑,绝对不可使用任何热性药物;如果已经破溃,脏腑已经亏损,饮食不下,也绝对不可使用任何冷性药物。这是掌握先后次序的要诀。
疮疡有五善七恶的症状,不能不辨别。如果呼吸平稳安静,饮食知道味道,是一善;大小便调匀,是二善;脓液排出、肿胀消退,颜色鲜艳且不臭,是三善;神采精明,语音清朗,是四善;身体气息平和,是五善。
如果是烦躁时咳嗽,腹痛口渴严重,腹泻无度,小便像淋证一样短赤,是一恶;脓血大量流出,疼痛更加剧烈,气味恶臭难以靠近,是二恶;气喘粗重短气,神志恍惚嗜睡,是三恶;未破溃前局部先变黑下陷,面色青紫嘴唇暗红,大便失禁,是四恶;肩项活动不便,四肢沉重,是五恶;不能进食,服药后呕吐,吃东西不知道味道,是六恶;声音嘶哑,神色脱败,嘴唇鼻子青黑,面目四肢浮肿,是七恶。
另外还有嗳气痞塞,咳逆身冷,不时自汗,头晕耳聋,神志恍惚惊悸,言语颠倒,这些都是恶症。五善症状出现三个则为吉,七恶症状出现四个必定危险。五善全部出现,则吉利平安;七恶全部出现,必定危险致死。
Shixian Decoction (Ten Immortals Decoction) (transmitted by Sun Shuangquan, a court attendant): Treats residual toxins after smallpox/rubella.
Bupleuri Radix (Chaihu), Puerariae Lobatae Radix (Gegen), Scrophulariae Radix (Xuanshen), Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Gardeniae Fructus (Zhizi), Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling), Aurantii Fructus Immaturus (Zhiqiao), Rehmanniae Radix Recens (Shengdi).
The above herbs are coarsely crushed. Decoct with fresh ginger and take orally.
Another prescription (transmitted by Jia Nongfeng): Treats children who, after recovering from smallpox/rubella, exhibit coughing, abdominal distension, rapid breathing, irritability, diarrhea, hoarseness, and cyanosis of the lips and mouth.
Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Forsythiae Fructus (Lianqiao), Scrophulariae Radix (Xuanshen), Anemarrhenae Rhizoma (Zhimu), Platycodonis Radix (Jiegeng), Armeniacae Semen Amarum (Xingren), Paeoniae Radix Alba (Baishao), Ephedrae Herba (Mahuang), Arctii Fructus (Niubangzi), Puerariae Lobatae Radix (Gange), Citri Reticulatae Pericarpium (Chenpi), Magnoliae Officinalis Cortex (Houpo), Glycyrrhizae Radix et Rhizoma (Gancao).
The above herbs are coarsely crushed. Decoct with water and take orally.
Sores, carbuncles, ulcers, and boils all arise from the obstruction of Qi and Blood, irregular emotions (excessive anger or joy), unregulated diet, and inability to adapt to cold and heat. These factors cause the Qi of the Zang and Fu organs to stagnate internally, leading to a disorder of Yin and Yang and the stasis of Qi and Blood. There are also cases where long-term consumption of hot and dry cinnabar-stone pills causes deep accumulation of heat-toxin, resulting in sores and carbuncles.
This disease mostly occurs in people of wealth who consume rich and fatty foods. Due to their sedentary lifestyle, lack of labor, and unrestrained desires, deficient pathogens and internal heat attack the body, boiling the Qi and Blood to form these lesions.
"Yong" (Carbuncle) means blockage; it is large, elevated, and belongs to the Yang aspect, generated by the Qi of the Fu organs. Its pulse is rapid and floating. "Ju" (Deep Abscess) means obstruction; it is flat, sinks inward, and belongs to the Yin aspect, formed by the Qi of the Zang organs. Its pulse is deep and rapid. "Chuang" (Ulcer/Sore) is the general term for these conditions. "Jie" (Boil) is a small sore with a head.
The Classics state: "All pain, itching, and sores belong to Heart Fire." Because the Heart governs Blood and moves Qi, if Qi and Blood become stagnant and are combined with the heat of Heart Fire, conditions such as carbuncles and deep abscesses arise.
However, the depth of pathogenic invasion varies, so the severity and size of the lesions differ. When accumulated heat in the Fu organs surges outward into the muscles, the onset is sudden and severe, with swollen, shiny, soft skin and a wide area of involvement; this is a Carbuncle (Yong). When wind-toxin and accumulated heat from the Zang organs attack the muscles, the onset is fierce and malignant, starting as a single lesion resembling a nodule, white, scorched, and dry, causing pain that radiates to the heart upon touch; this is a Deep Abscess (Ju). When heat erupts between the skin layers causing swelling, with a small base not exceeding two or three cun; this is a Boil (Jie).
Carbuncles arise in the Fu organs, like a prairie fire spreading outward to ulcerate muscles; deep abscesses arise in the Zang organs, deep and difficult to treat, like embers in a clay oven corroding bones and marrow internally. Carbuncles are easier to treat but heal slowly due to difficult nursing; deep abscesses are harder to treat but recover more easily.
Among all sores, back carbuncles and Ding sores (hard boils) are the most urgent. Next are brain carbuncles, intestinal abscesses, and throat abscesses, which are also emergencies. Conditions such as scrofula, hanging sores, hemorrhoids, and fistulas can be treated with a slower approach. Skin diseases like tinea, leprosy-like sores, and pediatric malnutrition sores, although classified as sores, vary in severity and urgency.
For sores and carbuncles, one must distinguish deficiency/excess, cold/heat, and severity, prescribing medication accordingly without losing the correct sequence. For individuals over forty years old, any sore or boil on the crown, temples, chin, back spine, waist, ribs, or over tendons and bones—even in areas out of direct sight—must not be neglected. If ignored as a trivial ailment, many die as the condition worsens from mild to severe. Immediate treatment is necessary for salvation. This is akin to fighting a fire: it is easy to extinguish when just started, but impossible once it becomes an uncontrollable blaze. The principle is the same.
When a sore has not yet ruptured and toxin attacks the Zang and Fu organs, absolutely no hot-natured medicines should be used. If it has already ruptured and the Zang and Fu organs are depleted, with inability to eat, absolutely no cold-natured medicines should be used. This is the key to mastering the sequence of treatment.
There are Five Good Signs and Seven Bad Signs in sores that must be distinguished.
Five Good Signs:
1. Calm breathing and rest, appetite present.
2. Regular bowel movements and urination.
3. Pus drains, swelling subsides, color is bright and odorless.
4. Clear spirit and bright eyes, clear voice.
5. Harmonious body and breath.
Seven Bad Signs:
1. Irritability with cough, severe abdominal pain and thirst, unlimited diarrhea, urine scanty and burning like strangury.
2. Massive discharge of pus and blood, intensified pain, foul odor repulsive to others.
3. Rapid, coarse breathing and shortness of breath, mental confusion and lethargy.
4. Lesion turns black and sinks before rupture, face blue, lips dark, fecal incontinence.
5. Stiffness in shoulders and neck, heaviness in limbs.
6. Inability to eat, vomiting after taking medicine, loss of taste.
7. Hoarse voice, sallow complexion, cyanosis of lips and nose, edema of face and limbs.
Additional bad signs include belching and chest fullness, coughing with cold limbs, spontaneous sweating at random times, dizziness, deafness, mental confusion, palpitations, and incoherent speech.
If three of the Five Good Signs appear, the prognosis is good. If four of the Seven Bad Signs appear, the condition is critical. If all Five Good Signs are present, the patient will be safe. If all Seven Bad Signs are present, death is inevitable.