王肯堂曰∶环项发,发于项之周遭,故名。又名落头痈。先看何处肿起,如从后
天柱穴起,是足太阳兼督脉哑门穴下,作寒热,拘倦闷乱,恐怖不食;如连前项俱肿,
乃毒流入足少阳;连耳肿,是流入阳明,当分经络治之。不应者死。(《准绳》)
\r环项发\p04-a41a93.bmp\r
汪省之曰∶颈蝗其毒不红,其形坚硬无脓,一年半载,长久如此,不能穿溃,两
尖锁颈,嗜人脂血,食血一饱,病患即将危矣。毒发之初,先服益气养荣汤十余剂,
即将两患头上用三棱针针住,以艾炷针灸七壮或九壮,次服神效栝蒌散。(方见乳证门。)自消。(《理例》)
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窦汉卿曰∶颈项间忽痛如失枕之状,名曰风热锁喉毒。久则红色绕于肩背,坚硬难治。(《全书》)
申斗垣曰∶无辜疳伤疮,乃因小儿衣物洗濯晒晾,误被雌鸟粪及羽毛落于上,有
虫入于皮毛间,致令小儿脑后项边,有核如弹丸在肉内,推之则动,软而不痛;久
则虫化入于脏腑,令儿羸瘦壮热,便脓血,头骨开缝,肢体生疮。治宜消疳鳖甲丸主之。(《启玄》)
冯鲁瞻曰∶无辜疳者,因浣衣夜露,被无辜落羽所污,小儿服之,令身体发热,日渐黄瘦,便痢脓血是也。
《心鉴》曰∶脑后项边有核如弹,按之转动,软而不痛,其间有虫如米粉,如不
速破而去之,即虫随热气流散,遍体生疮,一入脏腑,便痢脓血。须以银针刺破,贴以膏药可也。
又曰∶更有疳虫,或如发丝,或如马尾,出于头项腹背之间。黄白芨赤者生,紫黑青者死。
\r无辜疳伤疮\p04-a41a95.bmp\r
王肯堂说:环项发,发生在颈部的周围,因此得名。又叫做落头痈。首先要观察哪里开始肿胀,如果从后方的天柱穴发起,这是足太阳膀胱经兼及督脉哑门穴下方受邪,会出现寒热交替、拘挛疲倦、胸闷烦乱、恐惧不安、不想进食的症状;如果连同前颈部都肿胀,那是毒邪流入足少阳胆经;如果连耳朵也肿胀,那是毒邪流入阳明经,应当根据经络分别治疗。如果治疗无效,患者就会死亡。(《医学准绳六要》)
汪省之说:颈蝗这种病,其毒邪表现不红,形状坚硬且没有脓液,一年半载时间长久保持这样状态,不能破溃流脓,两端像锁住脖子一样,嗜食人的脂血,吃血吃饱后,病人就会立即面临危险。毒邪发作初期,先服用益气养荣汤十几天,然后立即用三棱针针刺两个患处头部,再用艾炷灸七壮或九壮,接着服用神效栝蒌散。(方剂见乳证门)。可以使疮疡自行消散。(《外科理例》)
窦汉卿说:颈项间忽然疼痛如同落枕的样子,名叫风热锁喉毒。时间久了,红色环绕肩背,变得坚硬难以治疗。(《疮疡全书》)
申斗垣说:无辜疳伤疮,是因为小儿的衣物洗涤晾晒时,误被雌鸟的粪便及羽毛落在上面,有虫子进入皮毛之间,导致小儿脑后颈部旁边,出现如弹丸大小的核块在肉内,推动它则会移动,柔软且不痛;时间久了,虫子化入脏腑,使孩子消瘦、壮热,大便排出脓血,头骨缝隙张开,肢体生疮。治疗宜以消疳鳖甲丸为主。(《启玄秘旨》)
冯鲁瞻说:无辜疳,是因为洗衣服时夜间露天放置,被无辜鸟落的羽毛污染,小儿接触或服下后,令身体发热,日渐黄瘦,大便痢疾排出脓血。
《心鉴》说:脑后颈部旁边有核块如弹丸大小,按压时转动,柔软且不痛,其中含有如米粉状的虫子,如果不迅速刺破去除,那么虫子会随着热气流散,遍布全身生疮,一旦进入脏腑,就会大便痢疾排出脓血。需要用银针刺破,贴上膏药即可。
又说:更有疳虫,有的像发丝,有的像马尾,出现在头项腹背之间。颜色黄白带红的能活,紫黑青色的会死。
Weng Kentang stated: "Huanxiang Fa (Ring-shaped Neck Carbuncle) arises around the neck, hence its name. It is also known as Luotou Yong (Head-Dropping Abscess). One must first observe where the swelling originates. If it starts from the Tianzhu point (BL10) at the back, this indicates pathogenic invasion of the Foot-Taiyang Bladder Meridian and the Du Meridian below the Yamens point (DU15), presenting with alternating chills and fever, stiffness and fatigue, chest stuffiness and restlessness, fear, and anorexia; if the swelling extends to the anterior neck, it signifies toxic heat flowing into the Foot-Shaoyang Gallbladder Meridian; if the ears are also swollen, it indicates flow into the Yangming Meridian. Treatment should be differentiated according to the meridians involved. If ineffective, death ensues." (*Yixue Zhunsheng*)
Wang Shengzhi stated: "Jinghuang (Neck Locust) presents with toxicity that is not red, the shape is hard without suppuration, persisting for one and a half to two years in this state, unable to rupture or ulcerate. The two ends lock the neck, consuming human fat and blood; once the toxin has fed sufficiently on blood, the patient faces imminent peril. At the initial stage of toxin manifestation, administer Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) for more than ten doses. Subsequently, puncture the heads of both lesions with a three-edged needle, followed by moxibustion using seven or nine moxa cones. Then, administer Shenxiao Gualou San (Miraculous Trichosanthes Powder). This will lead to spontaneous resolution." (*Waike Lili*)
Dou Hanqing stated: "Sudden pain in the neck and nape resembling stiff neck is named Fengre Suohou Du (Wind-Heat Lock-Throat Toxicity). Over time, redness encircles the shoulders and back, becoming hard and difficult to treat." (*Chuangyang Quanshu*)
Shen Douyuan stated: "Wugu Gan Shangchuang (Innocent Malnutrition Injury Sore) occurs when children's laundry, while being washed and dried outdoors, is contaminated by droppings and feathers from female birds. Insects enter the skin and hair follicles, causing nodules like bean-sized pellets to form under the flesh behind the child's head and neck. These nodules move upon pushing and are soft but painless. Prolonged exposure allows insects to transform and enter the zang-fu organs, causing emaciation, high fever, purulent bloody stools, splitting of the cranial sutures, and sores on the limbs. Treatment should prioritize Xiaogan Biejia Wan (Insect-Malnutrition Turtle Shell Pill)." (*Qixuan Mizhi*)
Feng Luzhan stated: "Wugu Gan (Innocent Malnutrition) results from laundry left exposed overnight during washing, contaminated by falling feathers from 'innocent' birds. If ingested or contacted by children, it causes fever, progressive yellowish emaciation, and dysentery with purulent bloody stools."
*Xinjian* states: "Nodules like beans appear behind the head and neck, movable upon pressure, soft and painless, containing insect larvae resembling rice flour. If not rapidly punctured and removed, the insects scatter with the heat qi, causing sores all over the body. Once entering the zang-fu organs, dysentery with purulent bloody stools occurs. It is necessary to puncture with a silver needle and apply plaster."
It further states: "There are also gan insects, some resembling hair strands, others like horse tails, emerging between the head, neck, abdomen, and back. Those that are yellow-white with red hues indicate survival; those that are purple-black or green indicate death."