\r石疽\p04-a41a158.bmp\r
冯鲁瞻曰∶耳下石疽者,不脓不疼是也。大宜养肝血,滋肾水,温补可化。如
少年脉实者,少佐以清肝,然不可轻用行气破血之药。(《锦囊》)
汪省之曰∶石疽多生耳项。(《理例》)
窦汉卿曰∶石疽与石痈同,惟石疽深寒客于经络,血气结聚不散,隐于皮内,坚
肿按之如石;此毒若连颈项之节,内先腐烂,方出皮肤。如脓出颈项者即死。初起
宜艾火灸三四十壮,发于额面者,不可灸也。
又曰∶商陆捣敷石疽最效。
汪省之曰∶项门痈乃阴阳不调,气热
壅上,结在风府之傍,聚而成毒,伤于脑后。此恶候也。治同痈疽法。(《理例》)
\r项门痈\p04-a41a159.bmp\r
《心法》曰∶肉龟疮,即胖人项后发际疽。盖胖人项后发际肉浓而多折纹,其发
反刺疮内,因循日久不瘥,又兼外袭风寒,凝结形如卧瓜,破烂津水,时破时敛,俗
名谓之肉龟。经年不愈,亦无伤害。
项后生疙瘩,肉色不变,不论大小,年深日久者。
生山药(去皮一块) 萆麻仁(十粒)
捣烂。摊帛上贴之,奇验。
\r失荣证\p04-a41a160.bmp\r
陈实功曰∶失荣证得之于先得后失,始富终贫,亦有虽居富贵,其心或因六欲不
遂,损伤中气,郁火相凝,隧痰失道,停结而成。其患多生肩之上,初起微肿,皮
色不变;日久渐大,坚硬如石,推之不移,按之不动。半载一年,方能作痛,气血日
衰,形容瘦削,破烂紫斑,渗流血水,或肿泛如莲,秽气熏蒸,昼夜不歇,平生疙
瘩,愈久愈大,越溃越坚,犯此俱为不治。当以和荣散坚丸、飞龙阿魏化坚膏治之,虽
不能愈,诚缓命之金丹也。治此证与乳岩相似。(《正宗》)
冯鲁瞻说:耳下的石疽,特点是既不化脓也不疼痛。治疗上非常适宜滋养肝血、滋补肾水,通过温补的方法可以使肿块消散。如果是年轻人脉象实有力的,可以少量辅以清肝的药物,但绝不可以轻易使用行气破血的药物。(出自《锦囊》)
窦汉卿说:石疽与石痈是相同的病证,只是石疽是因为深层的寒邪客居于经络之中,导致气血凝结聚积而不得消散,隐藏在皮肤内部,表现为坚硬肿胀,按压起来像石头一样;这种毒邪如果蔓延连及颈项关节部位,内部先发生腐烂,然后才从皮肤表面溃破。如果脓液从颈项部流出,患者就会死亡。初起时适宜用艾火灸三四十壮,但如果发生在额面和头部的,则不可施灸。
汪省之说:项门痈是由于阴阳不调,热气壅滞于上部,结聚在风府穴旁边,聚集而成毒邪,损伤脑后部位。这是恶性的病候。治疗方法同痈疽相同。(出自《理例》)
《心法》说:肉龟疮,就是肥胖之人项后发际处的疽。大概因为肥胖之人项后发际处肉质丰厚且多有褶皱,头发反而刺入疮口内,因循日久不能痊愈,又兼受外袭的风寒侵袭,凝结成形如同卧瓜,破烂流津水,时而破裂时而收敛,俗名叫做肉龟。经年不愈,但也无大害。
项后生疙瘩,肉色不变,不论大小,病程年深日久的。
生山药(去皮一块) 蓖麻仁(十粒)
捣烂。摊在帛布上贴敷,效果奇妙。
陈实功说:失荣证是由于先得后失(指先富裕后贫穷),开始富有最终贫困;也有虽然身处富贵,但内心因为六欲(指眼、耳、鼻、舌、身、意六种欲望)不得满足,损伤中气,郁火相互凝滞,痰浊失去正常通道,停聚结块而形成的。这个病患多生于肩部上方,初起时轻微肿胀,皮色不变;日子久了逐渐变大,坚硬如石头,推之不移,按之不动。半年到一年之后,才会开始疼痛,气血日渐衰败,形体消瘦,皮肤破烂出现紫斑,渗出流血水,或者肿胀泛滥如同莲花,散发秽臭之气,昼夜不停,身上原有的疙瘩,越久越大,越溃破越坚硬,患上此病都属于不治之症。应当用和荣散坚丸、飞龙阿魏化坚膏来治疗,虽然不能痊愈,但这确实是延缓生命的金丹妙药。治疗此证与乳岩相似。(出自《正宗》)
Feng Luzhan stated: Stone abscess (Shiju) under the ear is characterized by neither suppuration nor pain. Treatment should primarily nourish Liver blood and tonify Kidney water; warming and tonifying methods can resolve the mass. In young patients with a solid pulse, a small amount of Liver-clearing herbs may be added, but qi-moving and blood-breaking drugs must never be used lightly. (From *Jinnang*)
Wang Shengzhi stated: Stone abscesses mostly occur in the neck and auricular regions. (From *Lili*)
Dou Hanqing stated: Stone abscess is identical to stone carbuncle (Shiyong), except that in stone abscess, deep cold pathogens invade the meridians, causing Qi and Blood to coagulate and accumulate without dispersing. It hides within the skin, presenting as hard swelling that feels like stone upon palpation. If this toxicity spreads to connect with the cervical joints, internal rotting occurs first before breaking through the skin surface. If pus discharges from the neck region, death ensues. At the initial stage, moxibustion with thirty to forty moxa cones is appropriate; however, if it occurs on the forehead or face, moxibustion is contraindicated.
He further stated: Crushed Phytolacca acinosa root (Shanglu, *Phytolaccae Radix*) applied externally is most effective for treating stone abscess.
Wang Shengzhi stated: Neck gate carbuncle (Xiangmen Yong) results from disharmony of Yin and Yang, with heat Qi stagnating upward, knotting beside the Fengfu point (GV16), accumulating into toxicity and damaging the back of the head. This is a malignant condition. The treatment follows the same principles as for general carbuncles and sores. (From *Lili*)
*Xinfa* states: Flesh turtle sore (Rougui Chuang) refers to a sore occurring at the hairline behind the neck in obese individuals. Because the flesh behind the neck of obese people is thick and has many folds, hairs may penetrate into the sore. Over time, it fails to heal, and when combined with external invasion of Wind-Cold, it condenses into a shape resembling a lying melon. It becomes ulcerated, weeping fluid, alternating between rupturing and healing. Commonly known as "flesh turtle." Though it persists for years, it causes no serious harm.
For lumps arising behind the neck where the skin color remains unchanged, regardless of size, and have persisted for many years:
Raw Chinese Yam (Shanyao, *Dioscoreae Rhizoma*, one piece, peeled) and Castor Seed (Bima Ren, *Ricini Semen*, ten grains).
Pound into a paste. Spread onto silk cloth and apply topically; it yields miraculous results.
Chen Shigong stated: Loss of luster syndrome (Shirong Zheng) arises from a transition from wealth to poverty, or even among those who remain wealthy, due to unfulfilled desires (Six Desires) damaging the Middle Qi. Stagnant fire coagulates, phlegm loses its proper pathway, and stops to form knots. The lesions mostly appear above the shoulders. Initially, there is slight swelling with normal skin color; over time, it gradually enlarges, becoming hard as stone, immovable upon pushing, and fixed upon pressing. Only after half a year to a year does pain begin. Qi and Blood decline daily, the body becomes emaciated, the skin ulcerates revealing purple spots, oozing bloody fluid, or swelling and spreading like a lotus flower, emitting a foul odor day and night. Existing nodules grow larger and harder with time and ulceration. Cases involving this condition are considered incurable. Treatment should employ He Rong San Jian Wan (Harmonize Nutrient and Disperse Hardness Pill) and Feilong Awei Huajian Gao (Flying Dragon Asafoetida Hardness-Resolving Plaster). Although it cannot cure the disease, it is indeed a golden elixir that prolongs life. The treatment of this syndrome is similar to that of breast cancer (Ruyan). (From *Zhengzong*)