疠疡服轻粉之剂,若腹痛去后,兼有脓秽之物,不可用药止之。若口舌肿痛,秽水时流,作渴发热喜冷,
此为上焦热毒,宜用泻黄散。若寒热往来,宜用小柴胡汤加知母。若口齿缝出血,发热而大便秘结,此为热毒
内淫,宜用黄连解毒散。若大便调和,用《济生》犀角地黄汤。若秽水虽尽,
口舌不愈,或发热作渴而不饮冷,此为虚热也,宜用七味白
术散。(同上)
初起麻木不仁,肌肉未死者,宜万灵丹(系荆、防、蝎、乌等大方),洗浴发汗,以散凝滞之风。后服
神应养真丹(系四物汤加天麻、羌活、木瓜、菟丝子、蜜丸),加白花蛇等分,久服自愈。年久肌破肉死者,
先用必胜散疏通脏腑。次服万应丹,每日酒化一丸,通活血脉。服至一月,换服苦参丸(系苦参、大风子等大方
)。轻者半年,重者一载渐愈。或兼服酒药。(《外科正宗》)
其脉初起则洪大而数,数而有力。此时气血未衰,用汗吐下三法,先攻逐郁蒸之疠气,不使虫蚀,继
服凉血补血清热之剂。禁忌疏风发散、辛热劫燥之药,反耗津液,以助烈焰之势。(《证治百问》)
治疠风五法∶一、出汗,用麻黄、荆、防、羌、独、皂角、苦参、全蝎之类,热服覆汗。二、熏浴,先用
黄柏、黄连、薄荷为末,水调涂眼四围。次用荆芥、苦参、风藤、枳壳、苍耳、羌活、桑槐桃柳枝、连根葱,
煎汤熏浴。浴起用木通、石菖蒲、大黄为末,加麝少许,擦患上。三。敷擦,用白矾、川槿皮、五倍子、全
蝎为末,加 蝥少许,香油调敷,野狼油尤妙。燥痒用大枫肉、番木鳖、乌 仁、黑芝麻、
黑豆、杏仁、木棉子,共捣一处,入炀成 内,以铁盏盖上,铁线扎定,铁钉旋紧,糠火中煨一夜,取其药油调
后药。预用胡椒、川椒各二两,枯矾、轻粉各六钱,为细末,入前药油调匀,擦患处,数日如蛇蜕脱下,再
擦二次效。肥人用川乌、草乌、细辛、杏仁、白附子、雄黄、白芥子为末,加麝少许,生姜蘸擦。顽浓者,
加斑蝥、白砒,不时擦之。擦时须觅空房,用纸糊好,勿见风。七日后,又换别静房居之,
以前房便溺臭秽不堪也。七日后,日擦一次,至病痊为度。
如有一处不知痛痒,即是病根,如前但擦其处,日三、五次。四、汤液,用凉膈、双解、消风散之类。五、
丸散,用九龙丸、漆黄丸、希 丸、白花蛇丸、鹅翎散、蜈蚣散选用(按∶六方俱系于驱风之剂,今不取)。
疠风诸药不效,《千金》 婆万病丸,极有神验。(《医通》)
治须推其所因 凡治大风,须推其所因。凡因风寒湿热,劳逸饮食,与夫传染,不可混滥,散寒湿、风
湿,清热,调和气血,颖然不同。若例以泻风药治之,则失其机要矣。昔有一僧得病,状如白癞,卒不成疮,
但每旦起,白皮一升许,如蛇蜕。医者谓多啖炙爆所致,与局方解毒雄黄丸,三四服而愈,岂非得因治之邪。
(《三因》)(按∶解毒雄黄丸,用雄黄、郁金、巴豆,方出《咽喉》中。)
治宜责血分(说见针法中。)
治当知变证类证 疠疡当知有变有类之不同,而治法有汗有下有砭刺攻补之不一。盖兼症当审轻重,变
症当察先后,类证当详真伪,而汗下砭刺攻补之法,又当审其人之虚实,究其病之源委,而施治之。
(《疠疡机要》)
治须分上下 人得之者,须分在上在下。夫在上者,以醉仙散,取臭涎恶血于齿缝中出。在下者,
以通天再造散,取恶物陈虫于谷道中出。所出虽有上下道路之殊,然皆不外乎阳明一经,治此病者,须知此
意。看其疙瘩与疮,若上先见者,上体多者,在上也。若下先见者,下体多者,在下也。上下同得者,在上复
在下也。阳明经,胃与大肠也,无物不受。此风之入人也,气受之则在上多,血受之则在下多。气血俱受者甚
重,自非医者神手,病者铁心,罕有免此。夫或从上,或从下,以渐而来者,皆是可治之病。(《丹溪》)
外内不得分治 盖其风毒之伤,与夫内毒所致,人皆安
得而知之。及其病证显露,方始归咎于此。其于外受之风,内积之毒,岂可得而分治之也。故《内经》刺肌
肉,刺骨髓,以泄荣卫之怫热。《灵枢》以锐针刺肿上,按出恶气恶血。子和用汗吐下出血之法,河间用疏风
泄热之剂,俱不分病之所因,随其病之所在以调之也。(《微义》)(按∶子和治验,括出于下,以备参考。)
阳复张主簿,病癞十余年,眉须皆落,皮肤皴涩如树皮。戴人断之曰∶是有汗者可治之,当大发汗,其
汗出当臭,其涎当腥。乃置燠室中,遍塞风隙,以三圣散吐之(方用防风、瓜蒂、藜芦)。汗出周身,如卧水
中,其汗果粘臭不可闻,痰皆腥如鱼涎,两足心微有汗。次以舟车丸、浚川散,
大下五、七行,如此数次乃瘳。(《十形三疗》)
发表拔毒方法 病家百邪,非汗不彻。疯疾肌肤麻木,递生疙瘩,汗孔多闭,邪益无从而出。邪气
久留血络,血热筋枯,肉顽骨坏,由汗之不早故也。虽经年累月,犹当取汗,汗亦非一次而止。肌肤之顽痹不
仁者,得汗后自然渐渐和活,痛痒减退,肌肉软润,饮食增多,有验无误。人疑体虚,恐汗益虚,殆其
不然。(《疠疡全书》)
浮萍散,治诸风疥癣及癞(原无方名,今从《丹溪心法》录)。
浮萍(一两) 荆芥 川芎 甘草 麻黄(以上各半两)
或加当归、芍药。
上为粗末,每服一两,水一碗,入葱白根,同煎至一半,无时服,汗出为度。(《神效名方》)
治风,眉毛脱落,肌肤拆裂,用防风通圣散,加苦参、天麻、蝉壳,早晚各一服,至百帖必愈,忌
房室、盐酱、荤腥、生冷、油腻。(《卫生易简》)《疠疡机要》治风热炽
盛,大便秘结,发热烦躁,表里俱实者,于原方加白蒺藜、白芷、鼠粘子。《疡科选粹》加减通圣散,大泻恶
毒秽积,于原方去白术,加皂角刺、枳壳、柴胡、黄连、黄柏、羌活、生地黄、熟地黄。
九味羌活汤,治一切外因疮毒。
羌活 防风 苍术(各一钱五分) 川芎 白芷 生地黄 黄芩 甘草(各一钱) 细辛(五分)
上水煎服。(《疠疡机要》)(按∶此本张洁古方。)
清胃散,治热毒在表,以此发散之。
升麻 白芷 防风 白芍药 干葛 甘草 当归 川芎 羌活 麻黄 紫浮萍 木贼草
上各等分,每服五、七钱,水煎。(同上)
透经解挛汤,治风热,筋挛骨痛。
穿山甲(三钱炮) 荆芥 红花 苏木 羌活 当归 防风 蝉蜕(去土) 天麻 甘草(
各七分) 白芷(一钱) 连翘 川芎(各五分)
上水酒各半煎服。(同上)
范汪疗在身白屑虚搔之,或呼作白癞方。
苦参(五斤) 露蜂房(五两炙) 皮(一只炙锉之) 曲(三斤)
上四味切,以水三斗五升合药渍四宿,去滓,炊米二斗,酿如常法。酒熟,食后饮三、五合,渐增之,以
知为度。(《外台》)
仙传搜风酒(至八月后方可煮,近寒酒不坏也),真白蕲蛇一条(有野狼牙佛指甲方胜文者是头,近颈去
三寸,尾去四寸,好腊酒浸一宿,去骨取净肉焙干。如无白花蛇,以二乌蛇代之亦可),净蝉蜕(去头足,水
洗去土)三两,川当归(去芦头)三两,大川芎(去芦)三两,生地黄(去节)
三两,白苦参(去芦)三两,白蒺藜(研去刺净炒)六两,
土胡麻(水洗去土净炒)六两,何首乌(去芦)二两,软防风(去芦)三两,荆芥穗(去梗)三两,牛蒡子
(炒)三两,净连翘(去蒂研碎)二两五钱,川羌活(去芦)二两五钱,粉甘草(去皮节炒)一两,蔓荆子
(去衣)三两。上根据法精制,将蕲蛇肉和匀,分作三袋。取好头生酒二十一壶,净埕装盛。药悬埕下,纸□封
口嘴,入重汤锅内,如常法煮极熟取起,随以湿泥封口嘴,置阴静处窨三、五日,取出药渣再煎,头生好酒十
二壶如前法煮。每日早、中、晚,听饮三、五杯,只以果子咽嗄,勿与肉食混用,饮酒过以听肉食。
(《明辨类函》)(按∶《类函》曰∶癞风最为恶疾,汪副护得仙方以授予云云。凡三首,此其一也。)
治白癞,语声嘶嗄,目视不明,四肢 痹,关节热痛,身体瘾胗,鼻生息肉,白花蛇散方。
白花蛇(酒浸去皮骨炙二两) 天麻 槐子(炒) 羌活(去芦头)
防风(去叉) 晚蚕沙(微炒) 蔓荆实 白藓皮 威灵仙(去土)
枳壳(去穣麸炒各一两) 甘草(炙锉半两)
上一十一味,捣罗为散,每服一钱匕,温酒调下,不计时候。(《圣济》)
桦皮散,治肺脏风毒,遍身疮疥,及瘾疹搔之成疮。
荆芥穗 杏仁(去皮尖,用水一碗,于银铫子内熬,候减水一半已来,急取出,放令干,各二两。) 甘
草(炙半两) 枳壳(去穣,用炭火烧存性,取出,于湿纸上令冷。) 桦皮(烧灰秤各四两)
上件药除杏仁外,余药并捣罗为末,即将杏仁别研令极细,次用诸药末旋旋入研令匀,每服二钱,食后
调下温酒服,日进三服。疮疥甚者,每日频服。(《和剂》)(按∶此方,《保命集》以来,用为治疠之套剂。)
换肌散,治大风,毒瓦斯蕴积,攻冲疡溃。
胡麻子 蔓荆子 枸杞子 牛蒡子(四味各半两并炒熟) 防风(去芦头) 苦参 白蒺藜 栝蒌根
(四味各半两并生用) 轻粉(四钱匕别研)
上件为细末和匀,每服二钱,用淡茶清调下,煎甘草贯众汤漱口,日三服,不拘时候。(《杨氏》)《
宝鉴》名醉仙散,每服一钱,茶清一盏调下,空心日午临卧各一服。服后五、七日,先于牙缝内出臭黄涎,浑
身痛疼。次后便利脓血,病根乃去。丹溪与《宝鉴》同,更曰∶证候重而急者,须先以再造散下之。候补益得
还,复与此药吃。须断盐酱醋、诸般肉腥、椒料水果、煨烧炙爆及茄子等物,只宜淡粥、
煮熟时菜,并乌梢、菜花蛇肉,用淡酒煮熟食之。又曰∶服此药,若有伤齿,则以黄连末揩之,或先固济,
以解银粉之毒。《万应方》治疠风等疮方,于本方去牛蒡子、栝蒌根、轻粉,加细辛、大风子、当归、威灵
仙、天花粉,用老米饭为丸,如梧子大,日三服,每四十丸酒下,四十九日有效。
(《明辨类函》更去枸杞子、细辛、威灵仙、天花粉,加荆芥穗,名遇仙胡麻丸。)
五九散,治癞。
地龙(去土) 蝉壳 白僵蚕 凌霄 全蝎(以上各等九个)
上同为末,只作一服,热酒调下,浴室中汗出粘臭气为效。(《神效名方》)
表汗灵丹,治初起诸疯,眼红鼻赤,内热及乳发阳毒等症。
川当归(酒洗切片焙) 麻黄(去节研碎焙) 番木鳖(水浸去毛。黑枣肉包 ,烟尽力度,连
枣研,入余药各先秤三钱三分。)
上研匀,每服六分,热酒调下,被覆取汗,三日服一次,
三服止。(《疠疡全书》)利疯丹,番木鳖一味,刀刮去皮毛,入麻油内,煎至焦黄色为度,取出为
末,大疯发表用之,每服一分,卧时白汤下,须择无风处出汗,一月方可起身。(《医学要则》)
大麻疯(盛天眷)。
活癞虾蟆一个,用盐泥捣熟做一匣,入虾蟆于内,炭火
烧熟存性,去泥,将虾蟆研为细末,每服三钱,热酒调服发汗,得汗即止后服。(《疡医大全》)
东华玉髓。
枫肉(四两) 乳香 没药 血竭(各二两) 麝香(六分) 牛黄(二钱五分) 阿魏(
一钱) 琥珀 真珠(各三钱) 雄黄(五钱) 片脑(三钱) 地龙(七钱)
上各为末,用枫油入药搅匀,每服一钱,酒下。如便闭,加芒消为末,隔汤煮。内热者,柿饼汤下。内
寒者,花椒汤下。虚怯者,人参汤下。若瘫烂败脱者,非服此药不能愈。(《医学要则》)
治恶疾方。
炼松脂,投冷水中二十遍,蜜丸,服二两,饥便服之,日三。鼻柱断离者,二百日服之瘥。断盐及杂食
房室。(《千金》)(按∶《本草》白字曰∶松脂,味苦温,主疽、恶疮、头疡、白秃、疥瘙、风气。是知
其为拔毒之品。陶隐居曰∶有阴干捣为屑丸服者,人患恶病,服此无不瘥。此真人所本。)
治大风疾神效方。
水银(二两) 硫黄(一两细研) 松脂(炼成者二两末)
上件药同入铫子内,火上结为砂子,以大乌鸦不损者一只,以湿纸裹七重,又以泥裹作球,候干,大火锻令通赤,
候冷取出研,入砂子及松脂末,都研令细,炼蜜和丸,
如梧桐子大,每服空心以温酒下五丸,晚食前再服。(《圣惠》)
换肌丸,治诸癞、大风疾。
苦参(三两) 大风油(一两)
上将苦参为细末,入大风油及少酒,糊为丸,如梧桐子大,每服五十丸,不拘时候,用温酒送下。
仍将苦参煎汤,带热洗之为佳。(《济生续方》)(按∶《丹溪纂要》曰∶近见粗工用药,佐以大风子油,不
知此药性热,有燥痰之功而伤血,至有病将愈而先失明者。此说难信。)
单治麻风癞疾,建德路徐大夫、赣州廉同知服效。
皂角针(三两) 水银(一两)
【背景信息】
书名:杂病广要 作者:日本·丹波元坚撰 朝代:清 章节:疠(2/4) 类别:综合
【待处理原文】
治疗麻风(疠疡)服用含轻粉的药物后,如果腹痛消失且大便通畅,但排泄物中仍夹杂脓液和污秽之物,此时不可使用药物强行止泻。若出现口舌肿痛、秽水不时流出、口渴发热且喜饮冷水的症状,这是上焦热毒所致,适宜使用泻黄散。若出现寒热往来(忽冷忽热),适宜用小柴胡汤加知母。若口齿缝出血,伴有发热和大便秘结,此为热毒内侵,适宜使用黄连解毒散。若大便调和,则使用《济生方》中的犀角地黄汤。若秽水虽已排尽,但口舌溃疡仍未痊愈,或虽有发热口渴却不喜饮冷水,此为虚热,适宜使用七味白术散。(同上)
疾病初起时表现为麻木不仁,肌肉尚未坏死的,适宜服用万灵丹(由荆芥、防风、全蝎、乌梢蛇等大剂量药材组成),通过洗浴发汗,以疏散凝滞的风邪。随后服用神应养真丹(由四物汤加入天麻、羌活、木瓜、菟丝子,制成蜜丸),并加入等分的白花蛇,长期服用可自愈。若病程长久导致肌肤破损、肌肉坏死,先用必胜散疏通脏腑。接着服用万应丹,每日用酒化开一丸服用,以通利活血脉。服药一个月后,换服苦参丸(由苦参、大风子等大剂量药材组成)。轻症者半年,重症者一年,病情逐渐痊愈。或者兼服药酒。(《外科正宗》)
该病的脉象在初起时洪大而数,数而有力。此时气血尚未衰弱,可使用汗法、吐法、下法三种治法,先攻逐郁积蒸腾的疠气,防止虫蚀身体,继服凉血、补血、清热之剂。禁忌使用疏风发散、辛热燥烈之药,以免耗伤津液,反而助长火热之势。(《证治百问》)
治疗麻风有五种方法:第一,发汗,使用麻黄、荆芥、防风、羌活、独活、皂角、苦参、全蝎等药物,热服后覆盖衣被取汗。第二,熏浴,先用黄柏、黄连、薄荷研末,用水调匀涂抹于眼睛四周。其次用荆芥、苦参、海风藤、枳壳、苍耳子、羌活、桑枝、槐枝、桃枝、柳枝、带根葱,煎汤进行熏洗。洗浴后用木通、石菖蒲、大黄研末,加入少许麝香,擦拭患处。第三,敷擦,用白矾、川槿皮、五倍子、全蝎研末,加入少许斑蝥,用香油调匀敷贴,野狼油尤为妙用。若皮肤干燥瘙痒,用大枫子、番木鳖、乌桕仁、黑芝麻、黑豆、杏仁、木棉子,共同捣碎,放入熔化的油脂中,用铁盏盖住,铁丝扎紧,铁钉旋紧,在糠火中煨烤一夜,取其药油调和后续药物。预先准备胡椒、川椒各二两,枯矾、轻粉各六钱,研为细末,加入前述药油调匀,擦拭患处,数日后如蛇蜕皮般脱落,再擦两次即见效。体型肥胖者,用川乌、草乌、细辛、杏仁、白附子、雄黄、白芥子研末,加入少许麝香,蘸生姜汁擦拭。脓液顽固稠厚者,加入斑蝥、白砒,随时擦拭。擦拭时必须寻找空房,用纸糊好缝隙,避免见风。七日后,又更换到另一间静室居住,因为前一间房间因大小便及臭秽之气不堪入目。七日后,每日擦拭一次,直至病愈为止。
若有一处不知痛痒,即是病根所在,像前面那样只擦拭该处,每日三至五次。第四,汤液,使用凉膈散、双解散、消风散之类。第五,丸散,选用九龙丸、漆黄丸、希言丸、白花蛇丸、鹅翎散、蜈蚣散(按:这六个方子都属于驱风药剂,现在不予采用)。
对于各种麻风药物无效的情况,《千金方》中的婆罗门万病丸,极有神效。(《医宗必读》)
治疗必须推求病因。凡是治疗大麻风,必须推究其起因。凡是因为风寒湿热、劳逸饮食,以及传染所致,不可混淆滥治。需分别散寒湿、风湿,清热,调和气血,各自不同。若一概用泻风药治疗,就会失去关键要领。过去有一位僧人患病,症状如同白癞,突然不形成疮疡,只是每天早晨起床时,掉落白皮约一升,如同蛇蜕皮。医生认为是多吃烧烤食物所致,给予局方解毒雄黄丸,服用三四次而痊愈,这难道不是针对病因治疗吗?(《三因极一病证方论》)(按:解毒雄黄丸,由雄黄、郁金、巴豆组成,方出《咽喉备急方》中。)
治疗应当责之于血分(详见针灸疗法中)。
治疗应当了解变证与类证。麻风应当知道有变证和类证的不同,而治疗方法有汗法、下法、砭刺、攻法、补法的不一致。兼症应当审察轻重,变症应当观察先后,类证应当详辨真伪,而汗、下、砭刺、攻、补的方法,又应当审察病人的虚实,探究疾病的源委,然后施治。(《疠疡机要》)
治疗须分上下部位。人得了此病,必须分在上部还是下部。在上部的,用醉仙散,使恶臭的涎水和恶血从齿缝中排出。在下部的,用通天再造散,使恶物和陈旧的虫体从肛门排出。所排出的物质虽然上下路径不同,但都不外乎阳明经。治疗此病的人,必须知晓此意。看其疙瘩与疮疡,若上部先出现,或上部较多,即为病在上。若下部先出现,或下部较多,即为病在下。上下同时得病者,是上部复涉下部。阳明经,指胃与大肠,无所不受。此风邪侵入人体,气受之则病多在上,血受之则病多在下。气血俱受者病情严重,若非医者手法高明,病人意志坚定,很少能免除死亡。或者从上起,或者从下起,逐渐蔓延的,都是可治之病。(《格致余论》)
外感与内伤不得分开治疗。大概风毒的伤害,以及内毒所致,人们怎能预先得知?等到病症显露,才归咎于此。那外受之风邪,内积之毒素,怎么能分开治疗呢?所以《内经》主张刺肌肉、刺骨髓,以泄营卫之郁热。《灵枢》主张用锐针刺肿处,按压排出恶气恶血。张子和用汗、吐、下、出血之法,刘河间用疏风泄热之剂,都不区分病因,而是随病所在之处来调理。(《医学入门》)(按:张子和的治疗验案,概括如下,以备参考。)
阳复张主簿,患麻风十余年,眉毛胡须全部脱落,皮肤皴裂干燥如树皮。戴人诊断说:有汗者可治,应当大发汗,其汗出当臭,其涎当腥。于是置于暖室中,堵塞所有风口,用三圣散催吐(方用防风、瓜蒂、藜芦)。汗出周身,如卧水中,其汗果然粘臭不可闻,痰皆腥如鱼涎,两足心微有汗。接着用舟车丸、浚川散,大下五至七次,如此数次乃痊愈。(《儒门事亲》)
发表拔毒的方法。病患百邪,非汗不能彻底清除。疯疾肌肤麻木,陆续生出疙瘩,汗孔大多闭塞,邪气更无从排出。邪气久留血络,血热筋枯,肉顽骨坏,都是因为发汗不及时造成的。即使经过长年累月,仍应当取汗,发汗也不是一次就能停止的。肌肤顽痹不仁者,得汗后自然渐渐和缓灵活,痛痒减退,肌肉软润,饮食增多,确有疗效无误。有人怀疑体质虚弱,恐怕发汗更加虚弱,这大概是不对的。(《疠疡全书》)
浮萍散,治疗各种风疹疥癣及麻风(原无方名,今从《丹溪心法》录入)。
浮萍(一两) 荆芥 川芎 甘草 麻黄(以上各半两)
也可加当归、芍药。
以上为粗末,每服一两,水一碗,加入葱白根,同煎至一半,随时服用,以出汗为度。(《神效名方》)
治疗风邪,眉毛脱落,肌肤开裂,用防风通圣散,加苦参、天麻、蝉蜕,早晚各一服,至一百帖必愈,忌房事、盐酱、荤腥、生冷、油腻。(《卫生易简方》)《疠疡机要》治风热炽盛,大便秘结,发热烦躁,表里俱实者,在原方加白蒺藜、白芷、牛蒡子。《疡科选粹》加减通圣散,大泻恶毒秽积,在原方去白术,加皂角刺、枳壳、柴胡、黄连、黄柏、羌活、生地黄、熟地黄。
九味羌活汤,治疗一切外因疮毒。
羌活 防风 苍术(各一钱五分) 川芎 白芷 生地黄 黄芩 甘草(各一钱) 细辛(五分)
以上水煎服。(《疠疡机要》)(按:此本张洁古方。)
清胃散,治疗热毒在表,以此发散之。
升麻 白芷 防风 白芍药 干葛 甘草 当归 川芎 羌活 麻黄 紫浮萍 木贼草
以上各等分,每服五至七钱,水煎。(同上)
透经解挛汤,治疗风热,筋挛骨痛。
穿山甲(三钱炮制) 荆芥 红花 苏木 羌活 当归 防风 蝉蜕(去土) 天麻 甘草(各七分) 白芷(一钱) 连翘 川芎(各五分)
以上水酒各半煎服。(同上)
范汪治疗身上白屑虚搔,或呼作白癞的方子。
苦参(五斤) 露蜂房(五两炙) 狗皮(一只炙锉之) 神曲(三斤)
以上四味切碎,用水三斗五升合药浸泡四夜,去渣,煮米二斗,按常法酿酒。酒熟,饭后饮三至五合,逐渐增加,以见效为度。(《外台秘要》)
仙传搜风酒(至八月后方可煮,近寒季节酒不易坏也),真白蕲蛇一条(有野狼牙佛指甲方胜文者是头,距颈三寸,距尾四寸,用好腊酒浸泡一夜,去骨取净肉焙干。如无白花蛇,以两条乌梢蛇替代亦可),净蝉蜕(去头足,水洗去土)三两,川当归(去芦头)三两,大川芎(去芦)三两,生地黄(去节)三两,白苦参(去芦)三两,白蒺藜(研去刺净炒)六两,土胡麻(水洗去土净炒)六两,何首乌(去芦)二两,软防风(去芦)三两,荆芥穗(去梗)三两,牛蒡子(炒)三两,净连翘(去蒂研碎)二两五钱,川羌活(去芦)二两五钱,粉甘草(去皮节炒)一两,蔓荆子(去衣)三两。以上依法精制,将蕲蛇肉和匀,分作三袋。取好头生酒二十一壶,装入净坛。药悬于坛下,纸封口嘴,放入重汤锅内,按常法煮至极熟取出,随即用湿泥封口嘴,置于阴静处窖藏三至五日,取出药渣再煎,头生好酒十二壶按前法煮。每日早、中、晚,随意饮三至五杯,只用果子咽嗄,勿与肉食混用,饮酒过量后可听任吃肉。(《明辨类函》)(按:《类函》曰:麻风最为恶疾,汪副护得仙方授予云云。共三首,此为其中之一。)
治疗白癞,语声嘶哑,视物不明,四肢麻痹,关节热痛,身体瘾疹,鼻生息肉,白花蛇散方。
白花蛇(酒浸去皮骨炙二两) 天麻 槐子(炒) 羌活(去芦头)
防风(去叉) 晚蚕沙(微炒) 蔓荆实 白鲜皮 威灵仙(去土)
枳壳(去穣麸炒各一两) 甘草(炙锉半两)
以上十一味,捣罗为散,每服一钱匕,温酒调下,不计时候。(《圣济总录》)
桦皮散,治疗肺脏风毒,遍身疮疥,及瘾疹搔之成疮。
荆芥穗 杏仁(去皮尖,用水一碗,于银铫子内熬,候减水一半已来,急取出,放令干,各二两。) 甘草(炙半两) 枳壳(去穣,用炭火烧存性,取出,于湿纸上令冷。) 桦皮(烧灰秤各四两)
以上药除杏仁外,余药并捣罗为末,即将杏仁别研令极细,次用诸药末旋旋入研令匀,每服二钱,食后调下温酒服,日进三服。疮疥甚者,每日频服。(《太平惠民和剂局方》)(按:此方,《保命集》以来,用为治疠之套剂。)
换肌散,治疗大风,毒瓦斯蕴积,攻冲疡溃。
胡麻子 蔓荆子 枸杞子 牛蒡子(四味各半两并炒熟) 防风(去芦头) 苦参 白蒺藜 栝蒌根(四味各半两并生用) 轻粉(四钱匕别研)
以上件为细末和匀,每服二钱,用淡茶清调下,煎甘草贯众汤漱口,日三服,不拘时候。(《杨氏家藏方》)《宝鉴》名醉仙散,每服一钱,茶清一盏调下,空心日午临卧各一服。服后五、七日,先于牙缝内出臭黄涎,浑身痛疼。次后便利脓血,病根乃去。丹溪与《宝鉴》同,更曰:证候重而急者,须先以再造散下之。候补益得还,复与此药吃。须断盐酱醋、诸般肉腥、椒料水果、煨烧炙爆及茄子等物,只宜淡粥、煮熟时菜,并乌梢、菜花蛇肉,用淡酒煮熟食之。又曰:服此药,若有伤齿,则以黄连末揩之,或先固济,以解银粉之毒。《万应方》治疠风等疮方,于本方去牛蒡子、栝蒌根、轻粉,加细辛、大风子、当归、威灵仙、天花粉,用老米饭为丸,如梧子大,日三服,每四十丸酒下,四十九日有效。
(《明辨类函》更去枸杞子、细辛、威灵仙、天花粉,加荆芥穗,名遇仙胡麻丸。)
五九散,治疗麻风。
地龙(去土) 蝉壳 白僵蚕 凌霄花 全蝎(以上各等九个)
以上同为末,只作一服,热酒调下,浴室中汗出粘臭气为效。(《神效名方》)
表汗灵丹,治疗初起诸疯,眼红鼻赤,内热及乳发阳毒等症。
川当归(酒洗切片焙) 麻黄(去节研碎焙) 番木鳖(水浸去毛。黑枣肉包 ,烟尽力度,连枣研,入余药各先秤三钱三分。)
以上研匀,每服六分,热酒调下,被覆取汗,三日服一次,三服止。(《疠疡全书》)利疯丹,番木鳖一味,刀刮去皮毛,入麻油内,煎至焦黄色为度,取出为末,大疯发表用之,每服一分,卧时白汤下,须择无风处出汗,一月方可起身。(《医学要则》)
大麻疯(盛天眷)。
活癞虾蟆一个,用盐泥捣熟做一匣,入虾蟆于内,炭火烧熟存性,去泥,将虾蟆研为细末,每服三钱,热酒调服发汗,得汗即止后服。(《疡医大全》)
东华玉髓。
枫肉(四两) 乳香 没药 血竭(各二两) 麝香(六分) 牛黄(二钱五分) 阿魏(一钱) 琥珀 真珠(各三钱) 雄黄(五钱) 片脑(三钱) 地龙(七钱)
以上各为末,用枫油入药搅匀,每服一钱,酒下。如便闭,加芒消为末,隔汤煮。内热者,柿饼汤下。内寒者,花椒汤下。虚怯者,人参汤下。若瘫烂败脱者,非服此药不能愈。(《医学要则》)
治疗恶疾方。
炼松脂,投冷水中二十遍,蜜丸,服二两,饥便服之,日三。鼻柱断离者,二百日服之瘥。断盐及杂食房室。(《千金方》)(按:《本草》白字曰:松脂,味苦温,主疽、恶疮、头疡、白秃、疥瘙、风气。是知其其为拔毒之品。陶隐居曰:有阴干捣为屑丸服者,人患恶病,服此无不瘥。此真人所本。)
治疗大风疾神效方。
水银(二两) 硫黄(一两细研) 松脂(炼成者二两末)
以上件药同入铫子内,火上结为砂子,以大乌鸦不损者一只,以湿纸裹七重,又以泥裹作球,候干,大火锻令通赤,候冷取出研,入砂子及松脂末,都研令细,炼蜜和丸,如梧桐子大,每服空心以温酒下五丸,晚食前再服。(《太平圣惠方》)
换肌丸,治疗诸癞、大风疾。
苦参(三两) 大风油(一两)
上将苦参为细末,入大风油及少酒,糊为丸,如梧桐子大,每服五十丸,不拘时候,用温酒送下。
仍将苦参煎汤,带热洗之为佳。(《济生续方》)(按:《丹溪纂要》曰:近见粗工用药,佐以大风子油,不知此药性热,有燥痰之功而伤血,至有病将愈而先失明者。此说难信。)
[Background Information]
Book: Zabing Guangyao (Comprehensive Requirements for Miscellaneous Diseases)
Author: Danbo Yuanjian (Japan)
Dynasty: Qing
Chapter: Leprosy (2/4)
Category: Comprehensive
[Original Text Processing]
When treating leprosy (ulcerative lesions caused by leprosy) with preparations containing calomel (mercurous chloride), if abdominal pain ceases and bowel movements become free, but the excreta still contain pus and foul matter, one must not use medication to forcibly stop diarrhea. If there are swelling and pain in the mouth and tongue, frequent discharge of foul fluid, thirst, fever, and a preference for cold drinks, this is due to heat-toxin in the Upper Jiao (Upper Burner); Xiehuang San (Drain Yellow Powder) is appropriate. If there is alternating chills and fever, Xiaochaihu Tang (Minor Bupleurum Decoction) with Zhi Mu (Anemarrhena Rhizome) is appropriate. If bleeding occurs from the gum margins, accompanied by fever and constipation, this indicates internal invasion by heat-toxin; Huanglian Jiedu San (Coptis Decoction for Resolving Toxins) is appropriate. If bowel movements are harmonized, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) from *Jisheng Fang* should be used. If the foul fluid has ceased but oral ulcers have not healed, or if there is fever and thirst without a desire for cold drinks, this is deficiency-heat; Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is appropriate. (Ibid.)
In the early stage, when numbness and loss of sensation are present but muscles have not yet necrosed, Wanling Dan (Ten Thousand Spirit Pill) is appropriate. This pill contains large doses of Jingjie (Schizonepeta Twig), Fangfeng (Saposhnikovia Root), Quanxie (Scorpion), and Wushaoshe (Zaocys Snake). It should be taken while bathing to induce sweating, thereby dispersing stagnant wind pathogens. Subsequently, Shenyang Zhen Dan (Divine Response Nourishing True Pill) is administered. This pill consists of Siwu Tang (Four Substance Decoction) added with Tianma (Gastrodia Rhizome), Qianghuo (Notopterygium Rhizome), Mugua (Chaenomeles Fruit), Tusizi (Cuscuta Seed), formed into honey pills. Equal parts of Baihuashe (Bungarus multicinctus snake) are added. Long-term administration leads to spontaneous recovery. If the disease has persisted for years causing skin breakdown and muscle necrosis, Bisheng San (Invincible Powder) is first used to unblock the Zang-Fu organs. Then, Wanying Dan (Universal Response Pill) is taken, one pill dissolved in wine daily, to promote blood circulation. After one month, switch to Kushen Wan (Sophora Pill), which contains large doses of Kushen (Sophora Root) and Dafengzi (Chaulmoogra Seed). Mild cases improve within six months, severe cases within one year. Alternatively, medicinal wine may be taken concurrently. (*Waike Zhengzong*, Standard Treatment for External Diseases)
The pulse at the onset is surging, large, and rapid, forceful upon pressure. At this stage, Qi and Blood are not yet depleted. The three methods of sweating, vomiting, and purging can be employed to first attack and expel the stagnant and steaming leprosy qi, preventing worm-like erosion of the body. This is followed by decoctions that cool the blood, nourish the blood, and clear heat. Medications that disperse wind and release the exterior, as well as pungent-warm desiccants, are contraindicated, as they consume body fluids and exacerbate the blazing fire. (*Zhengzhi Baiwen*, Hundred Questions on Treatment)
There are five methods for treating leprosy:
1. Sweating: Use Mahuang (Ephedra Herb), Jingjie, Fangfeng, Qianghuo, Duhuo (Angelica Pubescens Root), Zaojiao (Gleditsia Sinensis Fruit), Kushen, and Quanxie. Take hot and cover to induce sweating.
2. Fumigation and Bathing: First, apply a paste made of Huangbai (Phellodendron Bark), Huanglian (Coptis Rhizome), and Bohe (Mint Leaf) mixed with water around the eyes. Next, fumigate and bathe using Jingjie, Kushen, Fengteng (Saussurea Stem), Zhike (Aurantii Fructus), Cang'erzi (Xanthium Fruit), Qianghuo, Sangzhi (Mulberry Twig), Huaizhi (Hollyhock Twig), Taozhi (Peach Twig), Liuzhi (Willow Twig), and Conggen (Green Onion Root with bulb). After bathing, rub the affected area with a powder of Mutong (Akebia Stem), Shichangpu (Acorus Rhizome), and Dahuang (Rhubarb Root and Rhizome) mixed with a small amount of Shexiang (Musk).
3. Application and Rubbing: Use Baifan (Alum), Chuanjinpi (Hibiscus Tiliaceus Bark), Wubeizi (Galla Chinensis), and Quanxie powdered together. Add a small amount of Banmao (Mylabris) and mix with sesame oil for application; wild wolf oil is particularly excellent. For dryness and itching, use Dafengrou (Chaulmoogra Flesh), Fanmubie (Strychnos Nux-vomica Seed), Wuren (Tallow Tree Seed), Heihema (Black Sesame Seed), Heidou (Black Soybean), Xingren (Apricot Seed), and Mianmazi (Kapok Seed). Pound them together, place in molten oil, cover with an iron lid secured by wire and nails, and bake in chaff fire overnight. Extract the medicinal oil to mix with subsequent drugs. Prepare Huajiao (Sichuan Pepper) and Chuanjiao (Sichuan Pepper) each two taels, Gufan (Burnt Alum) and Qingfen (Calomel) each six qian, grind into fine powder, mix with the aforementioned medicinal oil, and rub onto the lesion. After several days, the skin will shed like a snake slough; rubbing twice more yields efficacy. For obese individuals, use Chuannwu (Aconitum Carmichaelii Lateral Root), Caowu (Aconitum Kusnezoffii Root), Xixin (Asarum Root), Xingren, Baifuzi (Typhonii Rhizoma), Xionghuang (Realgar), and Baijiezhi (White Mustard Seed) powdered, add a little Shexiang, and rub with ginger juice. For stubborn thick pus, add Banmao and Baipi (Arsenic Trioxide), applying frequently. During rubbing, find an empty room, seal gaps with paper, and avoid drafts. After seven days, move to another quiet room, as the previous one becomes unbearable due to waste and odor. After seven days, rub once daily until cured.
If one area lacks pain and itch sensation, it is the root of the disease; rub only that area as described above, three to five times daily.
4. Decoctions: Use Liangge San (Cool the Diaphragm Powder), Shuangjie San (Double Resolution Powder), or Xiaofeng San (Eliminate Wind Powder).
5. Pills and Powders: Selectively use Jiulong Wan (Nine Dragons Pill), Qihuang Wan (Lac Yellow Pill), Xi Yan Wan, Baihuashe Wan (Baihuashe Pill), Eling San (Goose Feather Powder), or Wugong San (Centipede Powder). (Note: These six formulas are all wind-dispelling agents and are not adopted here.)
For various leprosy medications failing, *Qianjin Fang*'s Poluomen Wanbing Wan (Brahma Myriad Disease Pill) is extremely effective. (*Yitong*, General Treatise on Medicine)
Treatment must deduce the cause. In treating major wind (leprosy), one must investigate the etiology. Whether due to wind-cold-damp-heat, overwork/labor, diet, or contagion, treatments must not be confused. One must scatter cold-damp, dispel wind-damp, clear heat, and harmonize Qi and Blood; these are distinct. Treating uniformly with wind-draining herbs misses the key principle. Once, a monk suffered from a condition resembling white leprosy, suddenly developing no sores, but shedding about one sheng of white skin daily upon waking, like a snake slough. Physicians attributed it to excessive consumption of roasted foods and prescribed Ju Fang Jiedu Xionghuang Wan (Bureau Formula Detoxifying Realgar Pill). Three to four doses resulted in cure. Was this not treatment based on the cause? (*Sanyin*, Causes and Patterns) (Note: Jiedu Xionghuang Wan consists of Xionghuang, Yujin (Curcuma Root), and Badou (Croton Seed), originating from *Yanhou* [Throat and Mouth].)
Treatment should focus on the Blood aspect (see Acupuncture section).
Treatment requires understanding variable syndromes and similar syndromes. Leprosy presents with variations and similarities, requiring diverse methods such as sweating, purging, pricking, attacking, and tonifying. Concurrent symptoms require assessing severity; variable symptoms require observing sequence; similar syndromes require distinguishing truth from falsehood. Methods of sweating, purging, pricking, attacking, and tonifying must be applied according to the patient's deficiency or excess and the origin of the disease. (*Liuyang Jiyao*, Mechanisms and Essentials of Leprosy)
Treatment must distinguish upper and lower locations. Patients must be assessed for involvement in the upper or lower body. For upper involvement, Zuixian San (Intoxicating Immortal Powder) is used to expel foul saliva and bad blood from the gums. For lower involvement, Tongtian Zaizao San (Heaven-Penetrating Rebirth Powder) expels foul matter and old worms via the anus. Although the exit paths differ, both relate to the Yangming Channel (Stomach and Large Intestine Meridians). Practitioners must understand this. Observe nodules and sores: if appearing first or predominantly in the upper body, the disease is upper; if lower, it is lower. Simultaneous involvement implies upper affecting lower. Yangming receives everything. Wind entering the body affects Qi (upper) or Blood (lower). Simultaneous Qi and Blood involvement is severe. Without skilled physicians and resolute patients, survival is rare. Gradual progression from top or bottom is treatable. (*Danxi*, Zhu Zhenheng's Works)
External and internal causes cannot be treated separately. The injury from wind-toxin and internal toxin accumulation is often unknown initially. Only when symptoms manifest do we attribute it to these causes. How can external wind and internal toxins be treated separately? Thus, *Neijing* advises piercing muscles and bone marrow to vent Ying-Wei stagnation and heat. *Lingshu* advises sharp needle pricking of swellings to press out evil qi and blood. Zhang Zihe used sweating, vomiting, purging, and bleeding methods; Liu Wenjian used wind-dispersing and heat-clearing agents. Neither distinguished the cause but adjusted based on the location of the disease. (*Weiyi*, Micro-meanings) (Note: Zhang Zihe's case records are summarized below for reference.)
Yang Fu, Magistrate Zhang, suffered from leprosy for over ten years, losing eyebrows and beard, skin cracking and drying like tree bark. Dairen diagnosed: "Sweating indicates treatability. Profuse sweating is required; sweat will be foul, saliva fishy." He placed him in a warm room, sealed wind gaps, and induced vomiting with Sansheng San (Three Holy Powders: Fangfeng, Gouti (Melon Peduncle), Licui (Veratrum)). Whole-body sweating ensued, feeling like lying in water. Sweat was sticky and foul; phlegm smelled fishy. Slight sweating occurred on soles of feet. Then, Zhouche Wan (Boat Cart Pill) and Junchuan San (River-Dredging Powder) were used for massive purgation, five to seven times, repeated several times until recovery. (*Rumen Shiqin*, Ten Forms and Three Therapies)
Methods for releasing the exterior and extracting toxins. Pathogenic evils in patients are not thoroughly expelled without sweating. Leprosy causes numbness, successive nodules, and closed sweat pores, trapping pathogens. Prolonged pathogen retention in blood collaterals causes blood heat, tendon withering, hard flesh, and rotten bones due to delayed sweating. Even after years, sweating is necessary; it may take multiple sessions. Hardened, numb skin gradually softens and moves after sweating; pain and itch decrease; flesh softens; appetite increases. This is verified. Doubts about weakness fearing further depletion from sweating are unfounded. (*Liuyang Quanshu*, Complete Book of Leprosy)
Fuping San (Lemna Minor Powder), treating various wind, scabies, tinea, and leprosy (Original name missing, recorded from *Danxi Xinfa*).
Fuping (Lemna Minor) (1 liang), Jingjie, Chuanxiong (Ligusticum Chuanxiong Rhizome), Gancao (Licorice Root), Mahuang (1/2 liang each).
May add Danggui (Angelica Sinensis Root) and Shaoyao (Peony Root).
Grind into coarse powder. Take 1 liang per dose, boil with 1 bowl of water and green onion roots until half remains. Take anytime, stopping when sweating occurs. (*Shenxiao Mingfang*, Divine Efficacy Famous Formulas)
Treating wind with eyebrow loss and skin cracking: Use Fangfeng Tongsheng San (Saposhnikovia Protecting the Exterior and Unblocking the Interior Powder), adding Kushen, Tianma, Chanqiao (Cicada Slough). Take morning and evening. Cure expected after 100 doses. Avoid sexual intercourse, salt, soy sauce, meat, raw/cold food, and greasy food. (*Weisheng Yijian Fang*, Simple Formulas for Health Preservation). *Liuyang Jiyao* treats intense wind-heat, constipation, fever, irritability, and excess in both interior and exterior by adding Bijieli (Tribulus Fruit), Baizhi (Angelica Dahurica Root), and Niuzi (Arctium Fruit) to the original formula. *Yangke Xuanhui* modifies Tongsheng San to purge evil toxic accumulation by removing Baizhu (Atractylodes Macrocephala Rhizome) and adding Zaogelaci (Gleditsia Spine), Zhike, Chaihu (Bupleurum Root), Huanglian, Huangbai (Phellodendron Bark), Qianghuo, Shengdihuang (Rehmannia Root), and Shudihuang (Prepared Rehmannia Root).
Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), treating all external toxin sores.
Qianghuo, Fangfeng, Cangzhu (Atractylodes Lancea Rhizome) (1.5 qian each), Chuanxiong, Baizhi, Shengdihuang, Huangqin (Scutellaria Root), Gancao (1 qian each), Xixin (Asarum Root) (0.5 qian).
Decoct in water and take. (*Liuyang Jiyao*) (Note: Originally by Zhang Jiegou.)
Qingwei San (Clear Stomach Powder), treating heat-toxin on the exterior, dispersing it.
Shengma (Cimicifuga Rhizome), Baizhi, Fangfeng, Baishaoyao (White Peony Root), Gange (Pueraria Root), Gancao, Danggui, Chuanxiong, Qianghuo, Mahuang, Ziping (Purple Lemna), Mizhecao (Equisetum Hiemale). Equal parts. Take 5-7 qian per dose, decoct in water. (Ibid.)
Toujing Jiélüan Tang (Penetrating Channels Relieving Spasm Decoction), treating wind-heat, tendon spasm, and bone pain.
Shanjiapia (Pangolin Scale) (3 qian, fried), Jingjie, Honghua (Carthamus Flower), Sumu (Pterocarpus Wood), Qianghuo, Danggui, Fangfeng, Chantui (Cicada Slough, cleaned), Tianma, Gancao (0.7 qian each), Baizhi (1 qian), Lianqiao (Forsythia Fruit), Chuanxiong (0.5 qian each).
Decoct in equal parts water and wine. (Ibid.)
Fan Wang's formula for white scales and itching, also called White Leprosy.
Kushen (5 jin), Lubifang (Beehive), Dog Skin (1 piece, fried and chopped), Qu (Medicated Leaven) (3 jin).
Cut the four ingredients, soak in 3.5 dou of water for four nights. Strain, cook 2 dou of rice, ferment normally. When wine is ready, drink 3-5 he after meals, increasing gradually until effect is seen. (*Waitai Miyao*, Essential Prescriptions from the Golden Cabinet)
Xianchuan Sofeng Jiu (Immortally Transmitted Wind-Searching Wine) (Can only be brewed after August, as near-cold temperatures prevent spoilage). One real Baiqi She (White Water Snake) (Head identified by wild wolf tooth Buddha finger pattern; cut 3 cun from neck, 4 cun from tail). Soak in good aged wine overnight, remove bones, take clean meat, dry by roasting. If Baihuashe is unavailable, substitute two Wushaoshe. Jing Chantui (Cicada Slough, cleaned) (3 liang), Chuan Danggui (3 liang), Da Chuanxiong (3 liang), Shengdihuang (3 liang), Bai Kushen (3 liang), Bai Jili (Tribulus Fruit, ground, thorns removed, stir-fried) (6 liang), Tu Huma (Sesame Seed, washed, stir-fried) (6 liang), Heshouwu (Polygonum Multiflorum Root) (2 liang), Ruan Fangfeng (3 liang), Jingjie Sui (Schizonepeta Spike) (3 liang), Niuzi (Arctium Seed, fried) (3 liang), Jing Lianqiao (Forsythia Fruit, stem removed, ground) (2.5 liang), Chuan Qianghuo (2.5 liang), Fen Gancao (Licorice Root, peeled, stir-fried) (1 liang), Manjingzi (Vittex Seed) (3 liang). Process strictly according to method. Mix Qi She meat evenly, divide into three bags. Take 21 hu of good head-distilled wine, fill clean jars. Hang medicine under jar, seal mouth with paper, place in double-boiler, cook thoroughly. Seal with wet mud, store in cool quiet place for 3-5 days. Remove dregs, decoct again with 12 hu of good wine. Drink 3-5 cups morning, noon, night. Swallow with fruits, avoid meat. May eat meat if wine intake is excessive. (*Mingbian Leihan*, Clarified Classification Encyclopedia) (Note: *Leihan* states leprosy is the most malignant disease. Vice Protector Wang received this immortal prescription...)
Formula for White Leprosy with hoarse voice, blurred vision, limb paralysis, joint heat/pain, body urticaria, nasal polyps. Baihuashe San.
Baihuashe (Soaked in wine, skin/bone removed, fried) (2 liang), Tianma, Huaizi (Sophora Seed, fried), Qianghuo (cleaned), Fangfeng (cleaned), Wancansha (Silkworm Frass, lightly fried), Manjing Shi (Vittex Fruit), Baixianpi (Dictamnus Bark), Weilingxian (Syneilesis Aconitifolia Root), Zhike (Aurantii Fructus, bran removed, wheat-bran fried, 1 liang each), Gancao (fried/chopped, 0.5 liang).
Grind eleven ingredients into powder. Take 1 qian-bi per dose, mix with warm wine, anytime. (*Shengji Zonglu*, General Records of Sage Relief)
Huapi San (Birch Bark Powder), treating lung wind-toxin, body-wide sores/scabies, and urticaria turning into sores upon scratching.
Jingjie Sui, Xingren (Apricot Seed, skin/kernel removed, boiled in 1 bowl water in silver pot until half water remains, take out, dry) (2 liang each), Gancao (fried, 0.5 liang), Zhike (bran removed, charred to retain nature, cooled on wet paper), Huapi (Birch Bark, burned to ash, weighed) (4 liang each).
Except Xingren, grind remaining medicines into powder. Grind Xingren separately to extreme fineness. Mix powders uniformly. Take 2 qian per dose, mix with warm wine after meals, three times daily. For severe sores, take frequently. (*Tai Ping Hui Min He Ji Ju Fang*, Bureau Formulas for Universal Relief) (Note: Since *Baoming Ji*, this formula has been a standard set-formula for leprosy.)
Huanji San (Skin-Replacing Powder), treating major wind, accumulated toxic vapors, attacking and ulcerating sores.
Huma Zi (Sesame Seed), Manjingzi, Gouqizi (Goji Berry), Niuzi (Arctium Seed) (Each 0.5 liang, stir-fried ripe), Fangfeng (cleaned), Kushen, Bai Jili, Gualou Gen (Trichosanthes Root) (Each 0.5 liang, raw), Qingfen (Calomel) (4 qian-bi, separately ground).
Grind finely, mix. Take 2 qian per dose, mix with light tea liquor. Rinse mouth with Gancao Guanzhong Tang (Licorice and Cyathula Decoction). Three times daily, anytime. (*Yangshi Jiancang Fang*, Yang Family Stored Formulas). *Baodian* names it Zuixian San. Take 1 qian, mix with 1 cup tea liquor, fasting, noon, bedtime. After 5-7 days, foul yellow saliva appears from teeth, whole body aches. Then stool contains pus/blood, root of disease removed. Danxi agrees with *Baodian*, adding: For severe/urgent cases, first use Zaizao San to purge. After recovery, resume this drug. Strictly avoid salt, soy sauce, vinegar, meat, spices, fruits, roasted/grilled foods, and eggplant. Eat only light congee, cooked vegetables, and Wushao/Caihua snake meat cooked in light wine. Also: If teeth are damaged, wipe with Huanglian powder, or pre-treat to neutralize mercury toxicity. *Wanying Fang* formula for leprosy sores removes Niuzi, Gualou Gen, Qingfen from this base, adds Xixin, Dafengzi, Danggui, Weilingxian, Tianhuafen (Trichosanthes Root), forms pills with old rice, size of wu zi. Take 40 pills with wine, three times daily. Effective after 49 days. (*Mingbian Leihan* further removes Gouqizi, Xixin, Weilingxian, Tianhuafen, adds Jingjie Sui, names it Yuxian Huma Wan.)
Wuji San (Five-Nine Powder), treating leprosy.
Dilong (Earthworm, cleaned), Chanche (Cicada Slough), Bai Jiangcan (White Silkworm), Lingxiao (Campsis Flower), Quanxie (Scorpion) (Equal amounts, nine of each).
Grind together. Single dose. Mix with hot wine. Effect indicated by sticky, foul-smelling sweat in bathroom. (*Shenxiao Mingfang*)
Biaohan Lingdan (Sweating Spiritual Pill), treating early-stage madness, red eyes/nose, internal heat, and breast carbuncle yang-toxin.
Chuan Danggui (Washed in wine, sliced, dried), Mahuang (Nodes removed, ground, dried), Fanmubie (Strychnos Nux-vomica Seed, soaked, hair removed, wrapped in black date flesh, smoked until smoke ends, pounded with date, weigh 3.3 qian each before mixing with others).
Grind uniformly. Take 6 fen per dose, mix with hot wine, cover to sweat. Take once every three days, stop after three doses. (*Liuyang Quanshu*) Lifeng Dan: Fanmubie alone, scrape skin/hair, fry in sesame oil until焦yellow, grind. Used for major wind exterior-release. Take 1 fen, down with plain water at bedtime. Choose windless place to sweat. Rise after one month. (*Yixue Yaoze*, Essentials of Medicine)
Major Leprosy (Sheng Tianjuan).
One live toad. Make box with salt mud, put toad inside, roast over charcoal until preserved character remains. Remove mud, grind toad to fine powder. Take 3 qian, mix with hot wine to induce sweating. Stop subsequent doses once sweating occurs. (*Yangyi Daquan*, Great Collection of Surgeons' Medicine)
Donghua Yuisui (Eastern Jade Marrow).
Fengrou (Autumn Maple Flesh) (4 liang), Ruxiang (Frankincense), Moyao (Myrrh), Xuexie (Dragon's Blood) (Each 2 liang), Shexiang (Musk) (6 fen), Niuhuang (Calculus Bovis) (2.5 qian),awei (Asafoetida) (1 qian), Hupo (Amber), Zhenzhu (Pearl) (Each 3 qian), Xionghuang (Realgar) (5 qian), Pian Nao (Borneol) (3 qian), Dilong (Earthworm) (7 qian).
Grind each into powder. Mix with Feng You (Maple Oil). Take 1 qian per dose with wine. For constipation, add Mangxiao (Mirabilite) powder, steam. For internal heat, down with persimmon cake soup. For internal cold, down with Sichuan pepper soup. For deficiency/collapse, down with Ginseng soup. For gangrenous/decayed cases, this drug is essential for cure. (*Yixue Yaoze*)
Formula for Malignant Disease.
Refined Pine Resin, dip in cold water twenty times, form honey pills. Take 2 liang, take when hungry, three times daily. If nasal bridge collapses, take for 200 days for cure. Abstain from salt, miscellaneous food, and sexual activity. (*Qianjin Fang*) (Note: *Bencao* states Pine Resin is bitter/warm, treating abscesses, malignant sores, scalp sores, baldness, scabies, wind-damp. Thus it extracts toxins. Tao Hongjing stated: Sun-dried, ground, and taken as pills, it cures malignant diseases. This is the basis.)
Divine Efficacy Formula for Major Wind Disease.
Shuiyin (Mercury) (2 liang), Liuhuang (Sulfur, finely ground) (1 liang), Songzhi (Pine Resin, refined) (2 liang, powdered).
Put medicines in pot, melt on fire into sand. Take one intact crow, wrap in seven layers of wet paper, then mud ball. Dry, roast over high fire until red hot. Cool, grind. Add sand and pine resin powder, grind fine. Mix with refined honey, form pills size of wu zi. Take 5 pills fasting with warm wine, repeat before evening meal. (*Taiping Shenghui Fang*, Holy Benefit Formulas of Taiping Era)
Huanji Wan (Skin-Replacing Pill), treating various leprosy/major wind.
Kushen (3 liang), Dafeng You (Chaulmoogra Oil) (1 liang).
Grind Kushen to fine powder, add Dafeng You and little wine, make paste pills size of wu zi. Take 50 pills anytime with warm wine. Also decoct Kushen, wash affected area while hot. (*Jisheng Xufang*, Continuation of Jisheng Formulas) (Note: *Danxi Zuan Yao* states: Recently seen crude practitioners use Chaulmoogra Oil, unaware its heat nature dries phlegm but damages blood, causing blindness before cure. This claim is hard to believe.)
Single formula for Leprosy, effective for Dr. Xu of Jiande Road and Associate Prefect Lian of Ganzhou.
Zaojiao Zhen (Gleditsia Thorn) (3 liang), Shuiyin (Mercury) (1 liang)