〔薛〕《宝鉴》云∶初生芽儿一块血,也无形证也无脉,有惊即系是胎惊,有热
即系是胎热。婴儿实与乳母一体,凡患疮疾,但审乳母肝经有热,用加味小柴胡汤
之类,肝经虚热用加味逍遥散之类。肾水不能生肝用地黄丸。心经积热用柴胡栀子
散。心经虚热用茯苓补心汤。膏粱积热,用东垣清胃散。脾经郁热,用钱氏泻黄散;脾
经虚热,用钱氏异功散。若服犀角丸、化毒丹,外敷寒凉之药,复伤生气,乃促其
危也。
因食膏梁浓味,或乳母七情郁火所致,若肿肾作痛,气血凝滞也,用仙方活命
饮。口渴便秘,热毒内蕴也,用四顺清凉饮,佐以如圣饼。肿硬色赤,热毒凝聚也,
用活命饮,佐以隔蒜灸。肿 不消,欲作脓也,用托里消毒散。不成脓或成脓不溃,
气血虚也,用八珍汤。溃而肉赤不敛,脾血虚也,用四物参术。肉白而不敛,脾气
弱也,用四君芎归。食少体倦而不敛,脾气虚也,用六君当归升麻。凡药对证,无
有不愈,设或妄行攻毒,元气亏损,则变恶证而难治矣。大抵疮疡属腑者易治,元
气无亏者不治自愈。属脏者难治,元气亏损者则变为恶证。误行克伐,元气亏损,
尤难疗理,故切不可用峻厉之剂。观东垣、丹溪云,但见肿痛,参之脉证,虚弱便
与滋补,血气无亏,可保终吉,若用驱逐败毒,不免有虚虚之祸矣。
漏芦散 治小儿痈疮及丹毒疮疖。(见丹毒) 当归散(见潮热)
解表消毒饮 治小儿疮疡,肿高 痛,便利调和,脉浮而洪,有表证者用之。
黄 (上部、酒拌炒,中部、米泔拌炒,下部、盐水炒,一钱半) 葛根 升麻 赤芍药 玄参 牛
蒡子(炒研) 麻黄(去根节) 甘草(各五分) 连翘(一钱) 更看是何经分野,加
引经药∶手少阴加细辛(三分)。足少阴加独活(七分)。手太阴加桔梗、白芷(各五分)。足太阴加苍术(七分)。手
厥阴加柴胡(七分)。足厥阴加柴胡、青皮(各五分)。手太阳加 本(五分)。足太阳加羌
活(七分)。手阳明加白芷(五分)。足阳明加升麻、葛根(各七分)。手足少阳加柴胡(七分)。
水一钟,生姜三片,葱白一根,煎七分,温服,不拘时。
攻里消毒饮 治小儿疮疡,肿硬痛深,大便秘涩,脉沉而实,有里证者用之。
栝蒌(连皮子,细切,三钱) 连翘 牛蒡子(炒,研) 当归 白芍药(各一钱) 川大黄(一钱半)
芒硝(五分) 甘草(七分)
上,用水一钟,煎至七分,大温服。未利,再服。
连翘散 治痈疖等。
连翘(一两) 沉香 黄 (各半两) 白蔹 川朴硝 川大黄(炮) 甘草(各一分)
上,捣为粗散。每服一钱,水一盏,抄入麝香一钱,煎五分,去滓放温,食后服。
寄生散 治毒肿甚者。
桑寄生 独活 川大黄(各一两) 犀角屑 朴硝 甘草(各半两)
上,捣、罗为细末。每服一钱,水一盏,煎五分,去滓放温服,量儿大小加减。
玄参剂 解诸般热,消疮疖。
生地黄 玄参(各一两) 大黄
末之,炼蜜、丸桐子大。每服一丸,灯心、竹叶,煎汤化下,入沙糖少许,亦
可加羌活川芎赤芍连翘防风。
凉膈散 治小儿脏腑积热烦躁,多渴头昏,唇焦咽燥,舌肿喉闭,目赤鼻衄,颔颊
结硬,口舌生疮,痰实不利,涕唾稠粘,睡卧不宁,谵语狂妄,肠胃燥结,便溺
赤涩,一切风肿,并宜服之。
川大黄 朴硝 甘草(炙。各一两) 连翘(二两) 栀子仁 黄芩 薄荷叶(去土。各半两)
上,锉散。每服二钱,水一盏,入竹叶七个,蜜少许,煎四分,食后温服,大
小加减。
四顺清凉饮(发热)
上,解表攻里之药,皆为肿疡挟有内证者设也,溃疡勿拘此例。
托里荣卫汤 治疮疡外无 肿,内亦便利调和,乃邪客经络,宜用此药调理。
黄 (炒) 红花(各一钱) 苍术(米泔浸,炒) 柴胡 连翘 羌活 防风 当归身(酒拌)
甘草(炙) 黄芩 人参(各一钱) 桂枝(七分)
上,用水一钟,酒半钟,煎八分,食远服。
秘方托里散 治一应疮毒,始终常服,不致内攻。
栝蒌(大者一枚,杵) 当归(酒拌) 黄 (如前法制) 白芍药(各一两半) 皂角刺(炒) 金银花
天花粉 熟地黄(各一两)
上为粗末。每服,以三岁儿为率,用药一两,以酒一钟,入瓷器内浓纸封口,
再用油纸重封,重汤煮之,仍覆以盖,煮至药香,取出分服,直至疮愈。
仙方活命饮
金银花 橘皮(各三钱) 皂角刺(炒) 穿山甲(蛤粉同炒) 防风 没药 白芷 乳香
当归(各一) 贝母 天花粉 甘草节(各八分)
上,每服五钱,酒煎服。婴儿每服一两,母子同服。为末酒调服亦可。毒在表
者加麻黄散下毒,在内者加大黄下之,当临时制宜。此解毒回生起死妙剂。
神效解毒散 治一切疮毒初起,肿者即消,已溃仍肿者即散,已溃毒不解者即愈。
金银花(一两) 甘草节(五钱) 黄 皂角刺(炒) 当归(各三钱) 乳香 没药(各二钱)
上为散。每服二钱,酒煎,温酒调服亦可。婴儿病乳母亦服。如疮已溃,肿痛
已止者,去乳没金银花,倍加黄 甘草。
治发背痈疖方
羌活(一两) 穿山甲(炒焦,半两) 生人骨( 存性,半两) 麝香(少许)
上末,煎麻黄、薄荷,酒调。如阴疮,头平向内者服之即突出,其功效不可尽述,
若小儿痘疮黑陷者,只一服而起,万不失一。
玄参丸 治疹痘后余毒不散,遍身生疮不已,大能解毒。
玄参 赤芍药 生地黄 赤茯苓 荆芥 防风 木通 桔梗 黄芩 朱砂 青
黛(各等分)
上为细末,炼蜜丸,芡实大。每服一丸,薄荷汤下,大小加减服之。
五福化毒丹 治热毒蕴积,颊赤咽干,口舌生疮,或头面疮疖,谵语不宁。(方见惊搐)
按∶前方,生血凉血,解毒寒中之剂,形病俱实者殊有良验,但一二丸即止,
不可过多,过多则反伤元气,变证不可言也。
犀角消毒丸 治积热及痘疹后余毒生疮。
生地黄 防风 当归 犀角(镑屑) 荆芥穗(各一两) 牛蒡子(杵,炒) 赤芍药
连翘 桔梗(各七钱) 薄荷 黄芩 甘草(各五钱)
上为末,炼蜜、丸如芡实大。每服一丸,薄荷汤化下。
按∶前二方,善损中气,伤阴血,若大人形病俱实,脾胃健旺者庶可用之,
恐芽儿脏腑脆嫩,不能胜此。经云∶气主嘘之,血主濡之。气者,胃中冲和之元
气,若胃气一伤,不能嘘濡消散,脓已成者不能腐溃,脓已溃者不能生肌收敛,
因而难治,甚致不起,不可不慎也。
托里消毒散 治胃经虚弱,或因克伐,致疮不能溃散。疮未成即消,已成即溃,腐
肉自去,新肉自生。
人参 黄 当归(酒拌) 川芎 芍药(炒) 白术(炒) 茯苓(各一钱) 金银花
白芷 甘草(炙) 连翘(各五分)
上,作二剂,水煎,徐徐服。
托里散 治疮疡因气血虚,不能起发,腐溃收敛,及恶寒发热,宜用此补托之。
人参(气虚倍用) 黄 (炒) 当归(血虚倍用) 白术(倍用) 茯苓 芍药(酒炒。
各五分) 熟地黄(二钱,生者自制)
上,作两三剂,水煎服。
八味茯苓补心汤 治心气不足,血气不和,而患疮证。(薛制)
茯苓 酸枣仁(炒。各二钱) 五味子(炒) 当归(各一钱) 人参(一钱五分) 白术(炒,
一钱) 菖蒲(五分) 远志(去心,六分) 甘草(炒,五分)
上,作二三服,水煎。
〔外治〕
天乌散贴方
天南星 赤小豆 草乌 黄柏
上等分,为末。生姜自然汁调贴患处,用米醋调尤佳。
青露散 治背疽一切恶疮围药不胤开。
白芨 白蔹 白薇 白芷 白藓皮 朴硝 青黛 黄柏 大黄 天花粉 青露叶(即芙蓉叶)
老龙皮(即老松树皮)
上各等分,为细末。生姜自然汁调涂,留小孔,如干,再用生姜汁润。
惊毒掩 治疮疖初发,掩上即退,已成速破。
葱根(七个) 木鳖子(七个) 白芷(三个) 巴豆(十四个) 黄丹(二两) 香油(肆两)
上,先用油入前四味,武火熬,用柳木篦搅,以白芷焦黑为度,用绵滤去滓,再
入铫用文火KT ,却入黄丹,熬令紫黑色成膏为度。治诸般疮疖,去脓收疮口。
惊毒诸般肿痛掩子
蒲黄 大黄 黄柏 连翘 白芷 白芨 白蔹 真粉 牡蛎 丹参(各等分)
上为末。水调涂肿处。
敷药铁箍散 治一切疮疖痈疽。
芙蓉叶 黄柏 大黄 五倍子 白芨
上为末。用水调搽四围。
按∶前方,乃寒凉解热收敛之剂,或有用白蔹、商陆根者,有用寒水石、天
花粉者,有用苍耳、金银花者,有用芭蕉、赤小豆者,有用草乌、白芷、之类者,
皆不分寒热温凉之杂饵。《内经》云∶先肿而后痛者,形伤气也,先痛而后肿者,
气伤形也。又云∶五脏不和,九窍不通,六腑不和,留结为痈。《外科精义》云∶
凡疮肿高而软者,发于血脉,肿下而坚者,发于筋脉,肉色不变,发于骨髓,盖
必有诸中,而后形诸外,故受证之经与所患之位,各有不同,岂宜一概外敷凉药,
惟脾胃无亏,血气不和者,庶几有效。若服化毒之类,脾胃复伤,血气凝滞,亦
不能消矣。至如疔疮之类,正欲宣拔其毒,若复用前药,肌肉受寒,血气凝滞,
必致毒瓦斯入内而不救。治法必察其肿之高漫,色之赤白,痛之微甚,作脓之难易,
出脓之稠薄,生肌之迟速,以别其属阴属阳,或半阴半阳,或纯阴纯阳,而用相
宜之药以凉之、热之、和之。又当审受证之敷变,五脏之相胜,而以调补脾胃为
主,庶不致变恶证也。
神功散 治疮疡初起肿 者,用之可消,加血竭更好,丹毒未砭者亦可用之。
黄柏(炒) 草乌(生用)
上,各另为末,等分。用漱口水调敷,常漱口水润之。
上,敷贴、散肿、排脓、生肌、收口、等方,并见《疡医准绳》,宜于彼中查
之,兹不赘述。
【薛己】《小儿药证直诀》中说:初生的婴儿只是一团血气,没有明显的病形症状,也没有可以切诊的脉象。如果有受惊的表现,就是胎惊;如果有发热的表现,就是胎热。婴儿与乳母在生理上是一体的,凡是婴儿患有疮疡疾病,只要审察乳母的肝经有热,就用加味小柴胡汤之类的方剂治疗;如果是肝经虚热,就用加味逍遥散之类的方剂治疗。如果是肾水不足不能滋养肝木(肝用地黄丸),用六味地黄丸。心经积热,用柴胡栀子散。心经虚热,用茯苓补心汤。因饮食膏粱厚味导致的积热,用李东垣的清胃散。脾经郁热,用钱乙的泻黄散;脾经虚热,用钱乙的异功散。如果服用犀角丸、化毒丹,并在外敷寒凉的药物,反而会损伤人体的生气,从而加速病情危重。
因为食用膏粱厚味,或者由乳母七情郁结化火所致,如果肿块坚硬且疼痛,这是气血凝滞的表现,用仙方活命饮。如果口渴便秘,这是热毒内蕴的表现,用四顺清凉饮,配合如圣饼使用。如果肿块硬而色红,这是热毒凝聚的表现,用仙方活命饮,配合隔蒜灸法。如果肿胀不消退,说明将要化脓,用托里消毒散。如果不能成脓,或者成脓后不溃破,这是气血虚弱的表现,用八珍汤。如果溃破后创面肉色鲜红但不愈合,这是脾血虚弱的表现,用四物汤加人参、白术。如果创面肉色苍白且不愈合,这是脾气虚弱的表现,用四君子汤加川芎、当归。如果食欲减退、身体疲倦且伤口不愈合,这是脾气虚弱的表现,用六君子汤加当归、升麻。凡是药物对症,没有不痊愈的。假如胡乱使用攻伐解毒的药物,导致元气亏损,就会变成恶证而难以治疗。大抵而言,疮疡属于腑病的容易治疗,元气没有亏损的即使不治也能自愈。属于脏病的难治,元气亏损的就会变成恶证。错误地使用克伐(攻下)药物,导致元气亏损,尤其难以调理,所以切不可使用猛烈峻厉的药物。观察李东垣、朱丹溪的说法,只要见到肿痛,参合脉证,如果发现虚弱就给予滋补,只要血气没有亏损,就可以保证最终吉利。如果使用驱逐败毒的药物,不免会有“虚虚”(使虚者更虚)的祸患。
漏芦散:治疗小儿痈疮及丹毒疮疖。(详见丹毒章节)
当归散:(详见潮热章节)
解表消毒饮:治疗小儿疮疡,表现为肿高疼痛,二便调和,脉象浮而洪大,有表证的患者使用。
黄芪(上部病变用酒拌炒,中部病变用米泔水拌炒,下部病变用盐水炒,一钱半) 葛根 升麻 赤芍药 玄参 牛蒡子(炒后研碎) 麻黄(去根节) 甘草(各五分) 连翘(一钱) 再根据是哪一经的病变,加入引经药:手少阴心经加细辛(三分)。足少阴肾经加独活(七分)。手太阴肺经加桔梗、白芷(各五分)。足太阴脾经加苍术(七分)。手厥阴心包经加柴胡(七分)。足厥阴肝经加柴胡、青皮(各五分)。手太阳小肠经加藁本(五分)。足太阳膀胱经加羌活(七分)。手阳明大肠经加白芷(五分)。足阳明胃经加升麻、葛根(各七分)。手足少阳经加柴胡(七分)。
用水一钟,生姜三片,葱白一根,煎至七分,温服,不限时间。
攻里消毒饮:治疗小儿疮疡,表现为肿硬痛深,大便秘结涩滞,脉象沉而实,有里证的患者使用。
栝蒌(带皮和子,细切,三钱) 连翘 牛蒡子(炒,研碎) 当归 白芍药(各一钱) 川大黄(一钱半) 芒硝(五分) 甘草(七分)
以上药物,用水一钟,煎至七分,大温服。如果大便未通利,再服一次。
连翘散:治疗痈疖等症。
连翘(一两) 沉香 黄芪(各半两) 白蔹 川朴硝 川大黄(炮制) 甘草(各一分)
以上药物,捣成粗散。每次服用一钱,用水一盏,加入麝香一钱,煎至五分,去渣放温,饭后服用。
寄生散:治疗毒肿严重的情况。
桑寄生 独活 川大黄(各一两) 犀角屑 朴硝 甘草(各半两)
以上药物,捣碎、过筛为细末。每次服用一钱,用水一盏,煎至五分,去渣放温服用,根据患儿年龄大小增减剂量。
玄参剂:解除各种热邪,消除疮疖。
生地黄 玄参(各一两) 大黄
以上药物研末,用炼蜜制成梧桐子大小的丸药。每次服用一丸,用灯心草、竹叶煎汤送服,可加入少许砂糖,也可以加入羌活、川芎、赤芍、连翘、防风。
凉膈散:治疗小儿脏腑积热烦躁,多渴头昏,嘴唇焦裂咽喉干燥,舌头肿胀喉部闭塞,眼睛发红鼻出血,下巴脸颊结块变硬,口舌生疮,痰涎壅盛不利,鼻涕唾液稠粘,睡眠不安,说胡话狂妄,肠胃燥结,小便短赤涩痛,一切风肿,都适宜服用。
川大黄 朴硝 甘草(炙。各一两) 连翘(二两) 栀子仁 黄芩 薄荷叶(去土。各半两)
以上药物,锉成散剂。每次服用二钱,用水一盏,加入竹叶七个,少许蜂蜜,煎至四分,饭后温服,根据年龄大小增减剂量。
四顺清凉饮:(治疗发热)
以上解表攻里的药物,都是为肿疡兼有内证的情况设立的,溃疡期不要拘泥于这个例子。
托里荣卫汤:治疗疮疡外部没有明显肿胀,内部二便也调和,这是邪气客居经络,适宜用此药调理。
黄芪(炒) 红花(各一钱) 苍术(米泔水浸泡,炒) 柴胡 连翘 羌活 防风 当归身(酒拌) 甘草(炙) 黄芩 人参(各一钱) 桂枝(七分)
以上药物,用水一钟,酒半钟,煎至八分,饭前或饭后较远的时间服用。
秘方托里散:治疗各种疮毒,始终常服,防止毒气内攻。
栝蒌(大者一枚,捣烂) 当归(酒拌) 黄芪(按前述方法炮制) 白芍药(各一两半) 皂角刺(炒) 金银花 天花粉 熟地黄(各一两)
以上药物做成粗末。每次服用,以三岁幼儿为标准,用药一两,用酒一钟,放入瓷器内,用厚纸封口,再用油纸重重封好,隔水炖煮,直到闻到药香,取出分次服用,直到疮愈。
仙方活命饮
金银花 橘皮(各三钱) 皂角刺(炒) 穿山甲(与蛤粉同炒) 防风 没药 白芷 乳香 当归(各一钱) 贝母 天花粉 甘草节(各八分)
以上药物,每次服用五钱,用酒煎服。婴儿每次服用一两,母子同服。也可以研成粉末,用酒调服。毒气在表的加麻黄散送下以排毒,毒气在内的加大黄以下之,应当根据具体情况临时制宜。这是解毒回生、起死回生的妙剂。
神效解毒散:治疗一切疮毒初起,肿的就消散,已经溃破仍然肿的就散开,已经溃破毒气未解的就痊愈。
金银花(一两) 甘草节(五钱) 黄芪 皂角刺(炒) 当归(各三钱) 乳香 没药(各二钱)
以上药物研成散剂。每次服用二钱,用酒煎服,也可以用温酒调服。婴儿患病,乳母也要服用。如果疮已溃破,肿痛已停止,去掉乳香、没药、金银花,加倍使用黄芪、甘草。
治疗发背痈疖的方子
羌活(一两) 穿山甲(炒焦,半两) 生人骨(煅存性,半两) 麝香(少许)
以上研成粉末,用麻黄、薄荷煎汤,调酒服用。如果是阴疮,疮头平陷向内的,服用后即会突出,其功效不可尽述。如果是小儿痘疮黑陷的,只服一次就能起效,万无一失。
玄参丸:治疗疹痘后余毒不散,遍身生疮不止,具有强大的解毒作用。
玄参 赤芍药 生地黄 赤茯苓 荆芥 防风 木通 桔梗 黄芩 朱砂 青黛(各等分)
以上药物研成细末,用炼蜜制成芡实大小的丸药。每次服用一丸,用薄荷汤送下,根据年龄大小调整剂量服用。
五福化毒丹:治疗热毒蕴积,脸颊红赤咽喉干燥,口舌生疮,或者头面疮疖,说胡话不安宁。(方剂见惊搐章节)
按语:前方是生血凉血、解毒寒中的药剂,对于形体和病症都属实证的患者特别有效,但只需服用一二丸即止,不可过多,过多则会反而损伤元气,产生变证,后果不堪设想。
犀角消毒丸:治疗积热及痘疹后余毒生疮。
生地黄 防风 当归 犀角(镑成屑) 荆芥穗(各一两) 牛蒡子(捣碎,炒) 赤芍药 连翘 桔梗(各七钱) 薄荷 黄芩 甘草(各五钱)
以上药物研成粉末,用炼蜜制成芡实大小的丸药。每次服用一丸,用薄荷汤化开送服。
按语:前两个方子,容易损伤中气,伤害阴血,如果是成年人形体和病症都属实,脾胃健旺的或许可以使用,恐怕婴儿脏腑脆嫩,不能承受这些药物。医经说:气主嘘(推动运行),血主濡(滋润濡养)。气,是胃中冲和的元气,如果胃气受伤,就不能推动运行和滋润消散,脓已成形的不能腐溃排出,脓已溃破的不能生肌收敛,因而难以治疗,甚至导致死亡,不可不谨慎啊。
托里消毒散:治疗胃经虚弱,或者因为误用攻伐药物,导致疮疡不能溃散。疮未形成时能使其消散,已形成时能使其溃破,腐肉自然去除,新肉自然生长。
人参 黄芪 当归(酒拌) 川芎 芍药(炒) 白术(炒) 茯苓(各一钱) 金银花 白芷 甘草(炙) 连翘(各五分)
以上药物,分成两剂,水煎,慢慢服用。
托里散:治疗疮疡因为气血虚弱,不能起发、腐溃、收敛,以及伴有恶寒发热,适宜用此药进行补益托毒。
人参(气虚加倍使用) 黄芪(炒) 当归(血虚加倍使用) 白术(加倍使用) 茯苓 芍药(酒炒。各五分) 熟地黄(二钱,生者自制)
以上药物,做成两三剂,水煎服用。
八味茯苓补心汤:治疗心气不足,血气不和,而患疮证。(薛己配制)
茯苓 酸枣仁(炒。各二钱) 五味子(炒) 当归(各一钱) 人参(一钱五分) 白术(炒,一钱) 菖蒲(五分) 远志(去心,六分) 甘草(炒,五分)
以上药物,做成二三服,水煎。
【外治法】
天乌散贴方
天南星 赤小豆 草乌 黄柏
以上药物等分,研成粉末。用生姜自然汁调匀贴敷患处,用米醋调敷效果更好。
青露散:治疗背疽一切恶疮的围药,不让毒气扩散。
白芨 白蔹 白薇 白芷 白鲜皮 朴硝 青黛 黄柏 大黄 天花粉 青露叶(即芙蓉叶) 老龙皮(即老松树皮)
以上药物各等分,研成细末。用生姜自然汁调涂,留出一个小孔,如果干了,再用生姜汁润湿。
惊毒掩:治疗疮疖初发,敷上即可消退,已成脓的迅速破溃。
葱根(七个) 木鳖子(七个) 白芷(三个) 巴豆(十四个) 黄丹(二两) 香油(四两)
以上药物,先用油将前四种药材,用武火熬制,用柳木篦搅拌,以白芷焦黑为度,用棉布滤去药渣,再将药油放入铫子中用文火熬炼,然后加入黄丹,熬至紫黑色成膏为止。治疗各种疮疖,去脓收口。
惊毒诸般肿痛掩子
蒲黄 大黄 黄柏 连翘 白芷 白芨 白蔹 真粉(铅粉) 牡蛎 丹参(各等分)
以上药物研成粉末。用水调涂肿胀处。
敷药铁箍散:治疗一切疮疖痈疽。
芙蓉叶 黄柏 大黄 五倍子 白芨
以上药物研成粉末。用水调搽疮疡四周。
按语:前方,是寒凉解热收敛的药剂,有人有用白蔹、商陆根的,有用寒水石、天花粉的,有用苍耳、金银花的,有用芭蕉、赤小豆的,有用草乌、白芷之类的,这都是不分寒热温凉混杂服用的方法。《内经》说:先肿而后痛的,是形体伤及气;先痛而后肿的,是气伤及形体。又说:五脏不和,九窍不通;六腑不和,留结成为痈。《外科精义》说:凡是疮肿高而软的,发于血脉;肿下而坚硬的,发于筋脉;肉色不变的,发于骨髓。这必定是内部有病,然后表现在外部,所以受证的经脉与患病的位置,各有不同,岂能一概外敷凉药?只有脾胃无亏损,血气不和的,才可能有效。如果服用化毒之类的药物,脾胃再次受伤,血气凝滞,也不能消散了。至于像疔疮这类,正需要宣拔其毒,如果再用前面的药,肌肉受寒,血气凝滞,必然导致毒瓦斯入内而不救。治疗方法必须观察肿的高漫程度,色的赤白,痛的轻重,成脓的难易,出脓的稠薄,生肌的迟速,来辨别其属阴属阳,或半阴半阳,或纯阴纯阳,而使用相宜的药物来凉之、热之、和之。还应当审察受证的演变,五脏的相胜关系,而以调补脾胃为主,这样才不会变成恶证。
神功散:治疗疮疡初起肿胀的,使用它可以消散,加血竭更好,丹毒未砭刺的也可以使用。
黄柏(炒) 草乌(生用)
以上药物,分别另研为末,等分。用漱口水调敷,经常用漱口水润湿。
[Xue Ji] "Xiao'er Yaozheng Zhijue" (Precious Mirror for Children's Disease Management) states: A newborn infant is merely a mass of blood and qi, presenting with no distinct pathological signs or symptoms, and lacking a palpable pulse. If there are signs of fright, it is termed fetal fright (Taijing); if there is fever, it is termed fetal heat (Taire). The infant and the nursing mother are physiologically integrated. Whenever an infant suffers from sores and ulcers, one must examine whether the nursing mother’s Liver Meridian has heat; if so, use formulas such as JiaWei XiaoChaiHu Tang (Modified Minor Bupleurum Decoction). If the Liver Meridian has deficiency-heat, use formulas such as JiaWei Xiaoyao San (Modified Free and Easy Wanderer Powder). If Kidney Water fails to nourish Liver Wood (Liver uses DiHuang Wan), use LiuWei DiHuang Wan (Six-Ingredient Rehmannia Pill). If the Heart Meridian has accumulated heat, use ChaiHu ZhiZi San (Bupleurum and Gardenia Powder). If the Heart Meridian has deficiency-heat, use FuLing BuXin Tang (Poria Tonifying Heart Decoction). For accumulated heat due to rich diet, use Li Dongyuan’s QingWei San (Stomach-Clearing Powder). For Spleen Meridian stagnant heat, use Qian Yi’s XieHuang San (Draining Spleen Heat Powder); for Spleen Meridian deficiency-heat, use Qian Yi’s YiGong San (Extraordinary Skill Powder). If one administers XiJiao Wan (Rhinoceros Horn Pill) or HuaDu Dan (Toxin-Dissolving Pellets), and applies cold-natured medicines externally, it will further damage the body’s vital generating qi, thereby hastening critical danger.
Caused by consuming rich and greasy foods, or by emotional stagnation transforming into fire in the nursing mother: If the swelling is hard and painful, this indicates blood and qi stagnation; use XianFang HuoMing Yin (Immortal Formula for Saving Life Decoction). If there is thirst and constipation, this indicates internal accumulation of heat toxin; use SiShun QingLiang Yin (Four-Obedience Cooling Clearing Decoction), assisted by RuSheng Bing (Like-Sage Cake). If the swelling is hard and red, this indicates congealed heat toxin; use HuoMing Yin, assisted by GeSuan Jiu (Garlic-Separated Moxibustion). If the swelling does not subside, pus is about to form; use TuoLi XiaoDu San (Interior-Supporting Toxin-Resolving Powder). If pus does not form, or forms but does not ulcerate, this indicates deficiency of blood and qi; use BaZhen Tang (Eight-Treasure Decoction). If after ulceration the flesh is red but fails to heal, this indicates Spleen Blood deficiency; use SiWu Tang (Four-Substance Decoction) added with RenShen (Ginseng) and BaiZhu (Atractylodes Macrocephala Rhizome). If the flesh is white and fails to heal, this indicates Spleen Qi weakness; use SiJun Zi Tang (Four-Gentlemen Decoction) added with ChuanXiong (Szechwan Lovage Rhizome) and DangGui (Angelica Sinensis Root). If appetite is poor, the body is fatigued, and the wound fails to heal, this indicates Spleen Qi deficiency; use LiuJun Zi Tang (Six-Gentlemen Decoction) added with DangGui and ShengMa (Cimicifuga Rhizome). When the medicine matches the syndrome, there is no cure that fails. However, if one recklessly employs attacking and detoxifying methods, causing YuanQi (Original Vital Energy) to be depleted, it will transform into a malignant syndrome that is difficult to treat. Generally speaking, sores and ulcers belonging to the Fu organs are easy to treat; those where YuanQi is not depleted may heal spontaneously even without treatment. Those belonging to the Zang organs are difficult to treat; if YuanQi is depleted, they transform into malignant syndromes. Mistakenly using purgative/attacking methods depletes YuanQi, making them particularly difficult to manage; therefore, one must absolutely avoid using harsh and severe agents. Observing the teachings of Li Dongyuan and Zhu Danxi: whenever swelling and pain are seen, combined with pulse and syndrome analysis, if deficiency is present, tonification should be given immediately. As long as blood and qi are not depleted, ultimate auspiciousness can be ensured. Using驱邪 (evil-expelling) and detoxifying agents inevitably risks the disaster of "deficiency inducing deficiency."
LuLu San (Cynanchum Atratum Powder): Treats pediatric carbuncles, sores, and erysipelas sores/furuncles. (See Erysipelas section.)
DangGui San (Angelica Sinensis Powder): (See Tidal Fever section.)
JieBiao XiaoDu Yin (Release Exterior and Resolve Toxin Decoction): Used for pediatric sores and ulcers presenting with high, swollen, painful lesions, normal bowel and bladder functions, floating and surging pulse, and exterior syndromes.
HuangQi (Astragalus Membranaceus Root): Use wine-fried for upper body, rice water-fried for middle body, salt-water-fried for lower body (1.5 qian). GenQian (Kudzu Root). ShengMa (Cimicifuga Rhizome). ChiShaoYao (Red Peony Root). XuanShen (Scrophularia Root). NiuBangZi (Arctium Fruit): fried and ground. MaHuang (Ephedra Herb): roots and joints removed. GanCao (Licorice Root): each 0.5 qian. LianQiao (Forsythia Fruit): 1 qian. Further, add guiding herbs based on the affected meridian: Hand Shaoyin (Heart) add Xi Xin (Asarum Root) (0.3 qian). Foot Shaoyin (Kidney) add Du Huo (Angelica Pubescens Root) (0.7 qian). Hand Taiyin (Lung) add Jie Geng (Platycodon Root) and BaiZhi (Angelica Dahurica Root) (each 0.5 qian). Foot Taiyin (Spleen) add Cang Zhu (Atractylodes Lancea Rhizome) (0.7 qian). Hand Jueyin (Pericardium) add Chai Hu (Bupleurum Root) (0.7 qian). Foot Jueyin (Liver) add Chai Hu and QingPi (Citrus Reticulata Green Peel) (each 0.5 qian). Hand Taiyang (Small Intestine) add Gao Ben (Ligusticum Chuanxiong Rhizome) (0.5 qian). Foot Taiyang (Bladder) add Qiang Huo (Notopterygium Rhizome) (0.7 qian). Hand Yangming (Large Intestine) add BaiZhi (0.5 qian). Foot Yangming (Stomach) add ShengMa and GenQian (each 0.7 qian). Hand/Foot Shaoyang (Sanjiao/Gallbladder) add Chai Hu (0.7 qian).
Decoct one zhong of water with three slices of fresh ginger and one stalk of green onion until reduced to seven-tenths. Take warm, at any time.
GongLi XiaoDu Yin (Attack Interior and Resolve Toxin Decoction): Used for pediatric sores and ulcers presenting with deep, hard, swollen, painful lesions, constipation, sinking and excess pulse, and interior syndromes.
GuaLou (Trichosanthes Fruit): with skin and seeds, finely cut (3 qian). LianQiao. NiuBangZi: fried, ground. DangGui. BaiShaoYao (White Peony Root): each 1 qian. Chuan Da Huang (Rhubarb Root): 1.5 qian. Mang Xiao (Mirabilite): 0.5 qian. GanCao: 0.7 qian.
Decoct one zhong of water until reduced to seven-tenths. Take large dose warm. If bowels do not open, take again.
LianQiao San (Forsythia Powder): Treats carbuncles and furuncles.
LianQiao (1 liang). ChenXiang (Aquilaria Wood). HuangQi: each half liang. BaiLian (Belamcanda Rhizome). Chuan PuXiao (Mirabilite). Chuan Da Huang (prepared). GanCao: each 1 fen.
Grind into coarse powder. Each dose 1 qian, decoct with one zhong of water and 1 qian of SheXiang (Musk), reduce to five-tenths, strain, let cool to warm, take after meals.
JiSheng San (Viscum Powder): Treats severe toxic swelling.
SangJiSheng (Taxillus Stem). Du Huo. Chuan Da Huang: each 1 liang. XiJiao Xie (Rhinoceros Horn Shavings). PuXiao. GanCao: each half liang.
Grind and sieve into fine powder. Each dose 1 qian, decoct with one zhong of water, reduce to five-tenths, strain, let cool to warm, take according to age.
XuanShen Ji (Scrophularia Agent): Resolves various heats, eliminates sores and furuncles.
ShengDiHuang (Rehmannia Root). XuanShen: each 1 liang. Da Huang (Rhubarb Root).
Grind into powder, make pills with refined honey, size of paulownia seeds. Each dose one pill, dissolve in decoction of Deng Xin Cao (Juncus Effusus Pith) and Zhu Ye (Bamboo Leaf), add a little rock sugar. Can also add Qiang Huo, Chuan Xiong, Chi Shao, Lian Qiao, Fang Feng.
LiangGe San (Cool the Diaphragm Powder): Treats pediatric internal organ accumulated heat causing irritability, excessive thirst, dizziness, cracked lips, dry throat, swollen tongue, blocked throat, red eyes, epistaxis, hardness in jaw/cheeks, mouth/tongue sores, phlegm obstruction, thick nasal/salivary discharge, restless sleep, delirium, intestinal dryness/constipation, dark/scanty urination, and all wind-induced swellings.
Chuan Da Huang. PuXiao. GanCao (roasted): each 1 liang. LianQiao (2 liang). ZhiZi Ren (Gardenia Seed). Huang Qin (Scutellaria Root). Bo He Ye (Mint Leaf) (deveined): each half liang.
Cut into pieces. Each dose 2 qian, decoct with one zhong of water, seven leaves of Zhu Ye, and a little honey, reduce to four-tenths, take warm after meals, adjust by age.
SiShun QingLiang Yin (Four-Obedience Cooling Clearing Decoction): (For fever)
The above exterior-releasing and interior-attacking medicines are designed for sores accompanied by interior syndromes; do not rigidly apply this example to ulcerated stages.
TuoLi RongWei Tang (Interior-Supporting Nutritive-Defensive Decoction): Treats sores/ulcers with no external swelling, normal internal bowel/bladder function, indicating pathogen lodging in meridians; suitable for regulation.
HuangQi (fried). HongHua (Safflower Flower): each 1 qian. CangZhu (soaked in rice water, fried). Chai Hu. Lian Qiao. Qiang Huo. Fang Feng. DangGui Shen (Angelica Sinensis Root Body) (wine-mixed). GanCao (roasted). Huang Qin. RenShen (Ginseng): each 1 qian. GuiZhi (Cinnamon Twig): 0.7 qian.
Decoct one zhong of water and half zhong of wine until reduced to eight-tenths. Take far from meals.
MiFang TuoLi San (Secret Recipe Interior-Supporting Powder): Treats all kinds of toxic sores; take continuously from start to finish to prevent internal invasion.
GuaLou (large one, pounded). DangGui (wine-mixed). HuangQi (prepared as before). BaiShaoYao: each 1.5 liang. ZaoJiao Ci (Gleditsia Spine) (fried). JinYinHua (Honeysuckle Flower). Tian Hua Fen (Trichosanthes Root). Shu DiHuang (Prepared Rehmannia Root): each 1 liang.
Make coarse powder. Standard dose for 3-year-old: 1 liang of medicine, one zhong of wine, seal in porcelain jar with thick paper, then oil paper, boil in double boiler until fragrant, take divided doses until healed.
XianFang HuoMing Yin (Immortal Formula for Saving Life Decoction)
JinYinHua (Honeysuckle Flower). JuPi (Tangerine Peel): each 3 qian. ZaoJiao Ci (fried). Chuan Shan Jia (Pangolin Scale) (fried with clam powder). Fang Feng. Mo Yao (Myrrh). BaiZhi. RuXiang (Frankincense). DangGui: each 1 qian. Bei Mu (Fritillaria Bulb). Tian Hua Fen. GanCao Jie (Licorice Joint): each 8 fen.
Each dose 5 qian, decoct with wine. Infants: each dose 1 liang, mother and child take together. Can also be taken as powder mixed with wine. If toxin is in the exterior, add MaHuang San to expel toxin; if in the interior, add Da Huang to purge. Adapt to circumstances. This is a miraculous formula for detoxification, reviving life, and restoring the dead.
ShenXiao JieDu San (Divine Effect Toxin-Resolving Powder): Treats initial stage of all toxic sores; reduces swelling immediately, disperses persistent swelling after ulceration, heals unresolved toxins after ulceration.
JinYinHua (1 liang). GanCao Jie (5 qian). HuangQi. ZaoJiao Ci (fried). DangGui: each 3 qian. RuXiang. Mo Yao: each 2 qian.
Make powder. Each dose 2 qian, decoct with wine, or take with warm wine. If infant is ill, nursing mother also takes. If ulcerated and pain/swelling stopped, remove RuXiang, Mo Yao, JinYinHua, double HuangQi and GanCao.
Formula for Treating Back Carbuncles and Furuncles
Qiang Huo (1 liang). Chuan Shan Jia (charred, half liang). Sheng Ren Gu (Human Bone) (calcined to retain nature, half liang). SheXiang (Musk) (small amount).
Grind to powder, decoct MaHuang and Bo He, mix with wine. For yin sores with flat/inverted heads, taking this causes them to protrude; efficacy is beyond description. For infants with black/depressed smallpox, one dose restores them, infallible.
XuanShen Wan (Scrophularia Pill): Treats residual toxin after rash/smallpox failing to disperse, continuous body sores; strongly detoxifies.
XuanShen. ChiShaoYao. ShengDiHuang. Chi FuLing (Red Poria). JingJie (Schizonepeta). FangFeng. Mu Tong (Akebia Stem). JieGeng. Huang Qin. ZhuSha (Cinnabar). QingDai (Indigo Naturalis): equal parts.
Grind to fine powder, make pills with refined honey, size of euryale seed. Each dose one pill, take with mint tea, adjust by age.
WuFu HuaDu Dan (Five-Fortunes Toxin-Resolving Pellet): Treats accumulated heat toxin, red cheeks, dry throat, mouth/tongue sores, head/face furuncles, delirium/restlessness. (See Convulsions section.)
Note: The above formula generates/cools blood and resolves cold-toxin; highly effective for excess syndromes in both form and disease. Stop after 1-2 pills; excessive use damages YuanQi, causing unpredictable changes.
XiJiao XiaoDu Wan (Rhinoceros Horn Toxin-Resolving Pill): Treats accumulated heat and post-smallpox residual toxin causing sores.
ShengDiHuang. FangFeng. DangGui. XiJiao (shaved shavings). JingJie Sui (Schizonepeta Tip): each 1 liang. NiuBangZi (pounded, fried). ChiShaoYao. LianQiao. JieGeng: each 7 qian. Bo He. Huang Qin. GanCao: each 5 qian.
Grind to powder, make pills with refined honey, size of euryale seed. Each dose one pill, dissolve in mint tea.
Note: The previous two formulas easily damage Middle Qi and Yin-Blood. Suitable only for adults with excess syndromes and robust spleen/stomach. Infant viscera are tender and cannot withstand these. Classics state: Qi leads movement, Blood moistens. Qi is the harmonious original energy in the stomach. If Stomach Qi is injured, it cannot move/moisten/disperse; formed pus cannot ulcerate, ulcerated wounds cannot regenerate tissue/heal, leading to difficulty or death. Must be cautious.
TuoLi XiaoDu San (Interior-Supporting Toxin-Resolving Powder): Treats Stomach Meridian weakness or damage from purgatives, preventing sore ulceration. Prevents formation of unformed sores, promotes ulceration of formed sores, removes necrotic tissue, generates new tissue.
RenShen. HuangQi. DangGui (wine-mixed). ChuanXiong. ShaoYao (fried). BaiZhu (fried). FuLing: each 1 qian. JinYinHua. BaiZhi. GanCao (roasted). LianQiao: each 0.5 qian.
Divide into two doses, decoct in water, take slowly.
TuoLi San (Interior-Supporting Powder): Treats sores/ulcers unable to rise, ulcerate, or heal due to blood/qi deficiency, accompanied by aversion to cold/fever; use this tonifying/supporting method.
RenShen (double for Qi deficiency). HuangQi (fried). DangGui (double for Blood deficiency). BaiZhu (double). FuLing. ShaoYao (wine-fried): each 0.5 qian. ShuDiHuang (2 qian, prepared by self).
Divide into 2-3 doses, decoct in water, take.
BaWei FuLing BuXin Tang (Eight-Ingredient Poria Tonifying Heart Decoction): Treats heart qi insufficiency, disharmony of blood/qi causing sores. (Formulated by Xue.)
FuLing. SuanZaoRen (fried): each 2 qian. WuWeiZi (fried). DangGui: each 1 qian. RenShen (1.5 qian). BaiZhu (fried, 1 qian). ChangPu (Acorus Rhizome) (0.5 qian). YuanZhi (Polygala Root, heart removed) (0.6 qian). GanCao (fried, 0.5 qian).
Divide into 2-3 doses, decoct in water.
[External Treatment]
TianWu San Paste Formula
Tian Nan Xing (Arisaema Rhizome). Chi Xiao Dou (Adzuki Bean). Cao Wu (Aconitum Carmerichaeli Root). Huang Bo (Phellodendron Bark).
Equal parts, grind to powder. Mix with fresh ginger juice to paste on lesion; mixing with rice vinegar is better.
QingLu San: External powder for back carbuncles/all malignant sores to prevent spread.
Bai Ji (Bletilla Rhizome). Bai Lian. Bai Wei (Cynanchum Auriculatum Root). Bai Zhi. Bai Xian Pi (Dictamnus Bark). Pu Xiao. Qing Dai. Huang Bo. Da Huang. Tian Hua Fen. Qing Lu Ye (Hibiscus Leaf). Lao Long Pi (Old Pine Bark).
Equal parts, grind to fine powder. Mix with fresh ginger juice to apply around lesion, leave a small hole open. Reapply ginger juice if dry.
JingDu Yan (Fright-Toxin Cover): Treats initial sores/furuncles; covers to resolve, speeds rupture if formed.
Cong Gen (Green Onion Root): 7. Mu Bie Zi (Momordica Seed): 7. Bai Zhi: 3. Ba Dou (Croton Seed): 14. Huang Dan (Lead Monoxide): 2 liang. Xiang You (Sesame Oil): 4 liang.
First, simmer first four ingredients in oil over high heat, stirring with willow stick, until Bai Zhi is charred black. Strain through cotton. Return oil to pot, simmer over low heat, add Huang Dan, boil until purple-black paste forms. Treats various sores/furuncles, drains pus, closes wound.
JingDu Various Swelling/Pain Cover
Pu Huang (Typha Pollen). Da Huang. Huang Bo. Lian Qiao. Bai Zhi. Bai Ji. Bai Lian. Zhen Fen (Lead White). Mu Li (Oyster Shell). Dan Shen (Salvia Root): equal parts.
Grind to powder. Mix with water, apply to swelling.
Fu Yao TieGu San (Iron Hoop Powder): Treats all sores/furuncles/carbuncles.
Fu Rong Ye (Hibiscus Leaf). Huang Bo. Da Huang. Wu Bei Zi (Galla Chinensis). Bai Ji.
Grind to powder. Mix with water, apply around perimeter.
Note: The above formula is a cold-cooling resolving/astringent agent. Some use Bai Lian, Shang Lu Gen; some use Han Shui Shi, Tian Hua Fen; some use Cang Er Zi, Jin Yin Hua; some use Ba Jiao, Chi Xiao Dou; some use Cao Wu, Bai Zhi, etc. These are indiscriminate mixtures ignoring cold/hot/warm/cool natures. "Neijing" states: Swelling then pain indicates shape injuring qi; pain then swelling indicates qi injuring shape. Also: Five Zang disharmony blocks nine orifices; Six Fu disharmony leads to retention/knotting forming carbuncles. "Waike Jingyi" states: High/soft swelling originates in blood vessels; low/hard swelling originates in sinews; unchanged skin color originates in bone marrow. Internal pathology manifests externally; thus, affected meridians and locations vary. One cannot uniformly apply cold external pastes. Only when spleen/stomach are intact and blood/qi are harmonized will it be effective. Taking toxin-resolving drugs injures spleen/stomach, causing blood/qi stagnation, preventing resolution. For Ding Chuang (hard carbuncle), one must vent toxin; using cold pastes causes muscle coldness and blood/qi stagnation, leading to fatal internal toxin invasion. Treatment must observe swelling height/spread, color red/white, pain severity, pus formation ease, pus thickness, tissue regeneration speed to distinguish yin/yang, half-yin/half-yang, pure-yin/pure-yang, and use appropriate cooling, heating, or harmonizing agents. Also assess meridian evolution and zang organ interactions, prioritizing spleen/stomach tonification to avoid malignant transformation.
ShenGong San: Treats initial swelling of sores/ulcers; resolves swelling, adding Xue Jie (Dragon's Blood) is better; usable for erysipelas before pricking.
Huang Bo (fried). Cao Wu (raw).
Separately grind to powder, equal parts. Apply with mouthwash solution, keep moist with frequent rinsing.
Above pastes, swelling-resolving, pus-draining, tissue-regenerating, wound-closing formulas are detailed in "Yang Yi Zhun Sheng"; consult there, not repeated here.