伍氏曰∶气血闻香则行,闻臭则逆。大抵疮疡多因营气不从,逆于肉理,故郁聚为脓,
得香散药则气流行,故当多服五香连翘汤、万金散、清心内固金粉散。凡疮本腥秽,又闻臭
,浊则愈甚。若毒瓦斯入胃,则为咳逆。古人用此,可谓有理,且如饮食调令香美,则益脾土
,养真元,保其无虞矣。
立斋曰∶今人有疮疡,不审元气虚实,病之表里,病者多喜内消,而医者即用十宣散及
败毒散、流气饮之类。殊不知十宣散,虽有参 ,然防风、白芷、浓朴、桔梗,皆足以耗气
,况不分经络时令气血多少,而概用之乎。败毒散乃发表之药,果有表证,亦止宜一二服,
多则元气反损,其毒愈盛,虽有人参莫能补也,况非表证而用之乎。流气饮乃耗血之剂,果
气结膈满,亦止宜二三服,多则血气愈伤。夫血气凝滞,多因荣卫气弱,不能营运,岂可
用流气饮以益其虚。况诸经气血多寡不同,而流气饮通行十二经,则诸经皆为所损,反为败
证。虽有芎归亦难倚伏。若服之过度,则气虚血耗,何以成脓。苟不察其由,而泛投克伐之
剂,能无危乎。此三药者,其不可轻用亦明矣。河间云∶凡疮止于一经,或兼二经者,止当
求责其经,不可干扰余经也。
槐花,治湿退热之功,最为神速。大抵肿毒,非用蒜灸及槐花酒先去其势。虽用托里诸
药,其效未必甚速,惟胃寒之人,不可过用。
滁洲于侍御,髀胛患毒痛甚,服消毒药其势未减。即以槐花酒一服,势逐大退。再以托
里消毒之药而愈。
王通府,患发背十余日,势危脉大。先以槐花酒二服,杀退其势,更以败毒散二剂,再
以托里药数剂渐溃。又用桑柴燃灸患处,每日灸良久,仍以膏药贴之。灸至数次,脓溃腐脱
,以托里药加白术、陈皮,月余而愈。
刘大尹,发背六七日,满背肿痛,势甚危。与隔蒜灸百壮,饮槐花酒二碗,即睡觉。以
托里消毒药十去五六,令以桑枝灸患处而溃,数日而愈。
一上舍,肩患疽,脉数。以槐花酒一服,势顿退。再与金银花、黄 、甘草,十余服而平。(薛按)
伍氏说:气血闻到香气就会运行通畅,闻到臭气就会逆乱。大抵疮疡大多因为营气不能顺从经脉,逆乱于肌肉纹理之间,所以郁结聚集化为脓液,得到香散药后气机就能流行,所以应当多服用五香连翘汤、万金散、清心内固金粉散。凡是疮本身体味腥秽,如果又闻到臭气,浊气就会更加严重。如果毒瓦斯进入胃中,就会导致咳嗽气逆。古人使用这种方法,可以说是有道理的,况且像饮食调理使之香甜美味,就能补益脾土,滋养真元,保持平安无虞了。
立斋说:现在的人患有疮疡,不审察元气是虚还是实,病邪是在表还是在里,患者大多喜欢内服药物使疮疡消散,而医生就立即使用十宣散以及败毒散、流气饮之类的方剂。殊不知十宣散,虽然含有参(人参),但防风、白芷、浓朴、桔梗这些药材,都足以耗损正气,何况不分经络和时令气血的多少,一概使用呢?败毒散是发表的药物,果真有表证,也只适宜服用一两次,多了则元气反而受损,毒势更加旺盛,即使有人参也难以补益,何况并不是表证却使用它呢?流气饮是耗血的药剂,果真是气结胸膈胀满,也只适宜服用两三次,多了则血气更加受伤。血气凝滞,大多因为营卫之气虚弱,不能正常营运,怎么可以使用流气饮来增加其虚损呢?况且各经的气血多少不同,而流气饮通行十二经,那么各经都会受到损害,反而成为败坏之证。虽然有川芎、当归也难依靠。如果服用过度,则气虚血耗,怎么能化生脓液呢?如果不考察其原因,而泛泛投予克伐的药剂,能不危险吗?这三种药,它们不可轻易使用也是显而易见的了。河间说:凡是疮疡只局限于一经,或者兼及二经的,只应当追究该经的病机,不可干扰其余的经脉。
槐花,在治疗湿热退热方面,功效最为神速。大抵肿毒,不用蒜灸以及槐花酒先去其毒势,即使使用托里诸药,疗效未必很快,只有胃寒的人,不可以过量使用。
滁洲于侍御,大腿和肩胛处患毒痛得很厉害,服用消毒药后毒势没有减退。立即服用一次槐花酒,毒势随即大大消退。再服用托里消毒的药而痊愈。
王通府,患发背十余日,病情危重脉象洪大。先服用两次槐花酒,杀退其毒势,再用败毒散两剂,接着用托里药数剂逐渐溃破。又用桑柴点燃灸患处,每天灸很长时间,仍然用膏药贴敷。灸到数次,脓液溃破腐肉脱落,用托里药加入白术、陈皮,一个多月后痊愈。
刘大尹,患发背六七日,整个背部肿痛,形势非常危急。给予隔蒜灸一百壮,饮用槐花酒两碗,随即睡醒。用托里消毒药去除了五六成的病势,让他用桑枝灸患处使其溃破,几天后痊愈。
一位上舍,肩部患疽,脉象数急。服用一次槐花酒,毒势顿时消退。再给予金银花、黄(黄芪)、甘草,服用十余次后平复。(薛己按语)
Wu stated: Qi and blood move freely when exposed to fragrance, but become reversed when exposed to foul odors. Generally speaking, sores and ulcers often arise because Ying (Nutritive) Qi fails to follow its proper course, reversing within the muscle tissue, thus stagnating and accumulating into pus. Upon receiving aromatic dispersing medicines, Qi circulation is restored; therefore, one should take Wuxiang Liaoqiao Tang (Five-Aromatic Liaoqiao Decoction), Wanjin San (Myriad-Gold Powder), and Qingxin Neigu Jinfen San (Clear-Heart Inner-Solidifying Gold-Dust Powder) frequently. Any sore that inherently has a fishy or foul odor will worsen if exposed to further foul smells, as turbidity increases. If toxic vapors enter the stomach, it leads to coughing and rebellious Qi. The ancients' use of this principle was reasonable; furthermore, adjusting diet to be fragrant and delicious benefits Spleen Earth and nourishes True Yuan, ensuring safety.
Lizhai stated: Nowadays, patients with sores and ulcers do not examine whether their Yuan Qi (Primal Qi) is deficient or excess, nor whether the disease is in the exterior or interior. Patients often prefer internal resolution, and physicians immediately prescribe Shixuan San (Ten-Exterior Dispelling Powder), Baidu San (Resolving-Toxicity Powder), or Liqi Yin (Qi-Circulating Decoction). Little do they know that although Shixuan San contains Renshen (Ginseng Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Houpo (Magnoliae Officinalis Cortex), and Jiegeng (Platycodonis Radix) are all capable of depleting Qi. Moreover, using them indiscriminately without considering meridians, seasons, and the varying amounts of Qi and blood is inappropriate. Baidu San is an exterior-releasing formula; even if there are exterior signs, it should only be taken once or twice. Excessive use damages Yuan Qi, causing toxicity to flourish; even with Renshen, recovery is difficult, especially when no exterior syndrome exists. Liqi Yin is a blood-depleting agent; even for Qi stagnation with chest fullness, it should only be taken two or three times. Overuse injures Qi and blood. Blood and Qi stagnation usually result from weak Ying and Wei (Defensive) Qi failing to circulate properly; how can Liqi Yin be used to exacerbate deficiency? Furthermore, since Qi and blood vary among meridians, Liqi Yin's action across the Twelve Meridians damages all of them, leading to deteriorating conditions. Even with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix), reliance is futile. Excessive intake causes Qi deficiency and blood depletion, preventing pus formation. Without investigating the cause and indiscriminately administering attacking agents, danger is inevitable. It is clear that these three formulas should not be used lightly. Hejian stated: Sores confined to one meridian, or involving two, should be treated by addressing that specific meridian, without disturbing others.
Huaihua (Sophorae Flavescentis Flos) is most effective and rapid in clearing damp-heat and reducing fever. Generally, for swelling and toxicity, if Suanjio (Garlic Moxibustion) and Huaihua Jiu (Sophora Flower Wine) are not used first to subdue the pathogenic force, even with Toli (Supporting-the-Interior) herbs, efficacy may not be swift. Only those with Stomach Cold should avoid excessive use.
Yu Shiyu of Chuzhou suffered severe pain from toxicity in his thigh and scapula. After taking detoxifying herbs without reduction in severity, one dose of Huaihua Jiu caused the condition to recede significantly. Subsequent treatment with Toli detoxifying herbs led to recovery.
Wang Tongfu suffered from Fabei (Back Carbuncle) for over ten days, with critical condition and a large pulse. Two doses of Huaihua Jiu subdued the toxicity. This was followed by two doses of Baidu San, then several doses of Toli herbs until gradual suppuration occurred. Sangchai moxibustion (Moxibustion with Mulberry Wood) was applied to the affected area for long periods daily, along with plaster application. After several sessions, pus drained and necrotic tissue detached. Toli herbs were supplemented with Baizhu (Atractylodis Macrocephalae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium), resulting in recovery after more than a month.
Liu Dayin suffered from Fabei for six or seven days, with widespread back swelling and pain, indicating critical severity. He received 100 moxa cones via Ge Suan Jiu (Garlic-Separated Moxibustion) and drank two bowls of Huaihua Jiu, waking up refreshed. Toli detoxifying herbs reduced the pathology by five or six parts. Sangzhi moxibustion (Moxibustion with Mulberry Twig) was applied to induce suppuration, leading to recovery within days.
A Shangshe (Imperial Student) suffered from Ju (Carbuncle) on the shoulder with a rapid pulse. One dose of Huaihua Jiu caused immediate recession of toxicity. Subsequently, Yinhua (Lonicerae Japonicae Flos), Huangqi (Astragali Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) were administered for over ten doses, leading to resolution. (Commentary by Xue Ji)