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,又闻臭触,则愈甚者,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。
澄曰∶脾喜馨香,药品香燥,固能行气散郁。若真阴不足,虚火上炎,素多痰
火之人,又所当禁。
又曰∶溃后疮疡生肌药中,务须少加冰麝,盖冰麝香窜,多用则走泄真气,反令疮口难敛。
又曰∶溃后忌房内焚烧安息、沉香,烧则疮口燥痒。
又曰∶溃后忌佩香囊、离宫锭等物,不独耗散真气,且恐引动相火遗泄。
薛立斋曰∶夫疮疡之作,由六淫七情所伤而痛也。因气血凝滞所致,假如热毒
在内,便秘而作痛者,内疏黄连汤导之。热毒炽盛, 肿而作痛者,黄连解毒散治之。
不应,仙方活命饮解之。瘀血凝滞而作痛者,乳香定痛散和之。作脓而痛者,托里
消毒散排之。脓胀而痛者,针之。脓溃而痛者,补之。若因气虚而痛,四君加归、 。
血虚而痛,四物加参、 。肾虚而痛,六味地黄丸。口干作渴,小便频数者,加减
八味丸,此皆止痛之法也。丹溪云∶脓出而反痛,此为虚也,宜补之。秽气所触者,
和解之,风寒所逼者,温散之,若泥用乳没,斯执方矣。
李东垣曰∶夫疮疽之证候不同,寒热虚实皆能为痛,止痛之法,殊非一端,世
人皆谓乳没珍宝之药可住疼痛,殊不知临病制宜,自有方法。盖热毒之痛者以寒凉
之剂折其热,则痛自止也。寒邪之痛者,以温热之药,熨其寒,则痛自除矣。因风而
有痛者,除其风,因湿而痛者导其湿,燥而痛者润之,塞而痛者通之,虚而痛者补
之,实而痛者泻之,因脓郁而闭者开之,恶肉浸溃者引之,阴阳不和者调之,经络秘
涩者利之。临机应变,方为上医,不可执方而无权也。(《十书》)
伍氏说:气血闻到香气就会运行,闻到臭味就会逆乱。大抵疮疡大多因为营气不随顺,在肌肉纹理中逆乱,所以郁结聚集化为脓液,得到香散药后气机就能流通,所以应当多服用五香连翘汤、万金散、清心内固金粉散。凡是疮本身体味腥臭秽浊,又受到臭味刺激,就会更加严重的,如果毒瓦斯进入胃中,就会导致咳嗽气逆,古人使用这类方法,可以说是很有道理的。况且如饮食调理得香甜美味,就能补益脾土,滋养真元,保持平安无事了。
顾世澄说:脾脏喜欢馨香的气味,药品气味香燥,固然能够行气疏散郁结。但如果真阴不足,虚火上炎,平素多痰火的人,又是应当禁忌的。
又说:溃破后的疮疡在生肌药物中,务必稍微加入冰片、麝香,因为冰片和麝香香气走窜,如果使用过多则会耗泄真气,反而导致疮口难以收敛。
又说:溃破后忌讳在房中焚烧安息香、沉香,焚烧则会导致疮口干燥发痒。
又说:溃破后忌讳佩戴香囊、离宫锭等物品,不仅会耗散真气,而且恐怕会引动相火导致遗精泄泻。
薛立斋说:疮疡的发生,是由六淫(风、寒、暑、湿、燥、火)和七情(喜、怒、忧、思、悲、恐、惊)所伤而疼痛。这是由于气血凝滞导致的,假如热毒在内,便秘而作痛的,用内疏黄连汤引导它。热毒炽盛,肿胀而作痛的,用黄连解毒散治疗。如果不奏效,用仙方活命饮解除它。瘀血凝滞而作痛的,用乳香定痛散调和它。化脓而作痛的,用托里消毒散排脓。脓胀而作痛的,用针刺排脓。脓溃破而作痛的,用补法。如果因气虚而痛,用四君子汤加当归、黄芪。血虚而痛,用四物汤加人参、黄芪。肾虚而痛,用六味地黄丸。口干口渴,小便频数的,用加减八味丸,这些都是止痛的方法。丹溪说:脓出后反而疼痛,这是虚证,应当用补法。被秽气触犯的,用和解法;被风寒逼迫的,用温散法,如果拘泥于使用乳香、没药,这就是固执于成方了。
李东垣说:疮疽的证候不同,寒、热、虚、实都能引起疼痛,止痛的方法,绝非只有一种,世人都认为乳香、没药是珍宝般的药物可以止住疼痛,却不知道临病制宜,自有方法。大概热毒引起的疼痛,用寒凉药剂折服其热,疼痛自然停止。寒邪引起的疼痛,用温热药物熨散其寒,疼痛自然消除。因风而有疼痛的,祛除其风;因湿而疼痛的,疏导其湿;因燥而疼痛的,滋润它;因闭塞而疼痛的,通利它;因虚而疼痛的,补益它;因实而疼痛的,泻下它;因脓液郁闭的,开泄它;因恶肉浸渍溃烂的,引流它;阴阳不和的,调和它;经络秘涩的,通利它。随机应变,才是上等的医生,不可固执成方而没有变通。(《十书》)
Wu said: Qi and blood flow when exposed to fragrant odors, but move in reverse when exposed to foul odors. Generally speaking, sores and ulcers often occur because Ying-Qi (nutritive energy) does not follow its proper course, reversing within the muscle tissues, thus stagnating and accumulating into pus. Upon receiving aromatic dispersing medicines, the flow of Qi becomes smooth; therefore, one should frequently take Wuxiang Liaoqiao Tang (Five-Aromatic Magnolia Flower Decoction), Wanjin San (Myriad-Gold Powder), and Qingxin Neigu Jinfen San (Clear-Heart Inner-Solidification Gold-Powder Powder). For any sore that is inherently fishy and foul, and worsens upon exposure to foul smells, if toxic vapors enter the stomach, it may cause coughing and rebellious Qi. The ancients' use of these methods can be considered reasonable. Furthermore, if diet is regulated to be fragrant and delicious, it benefits Spleen-Earth (the digestive system's function in Traditional Chinese Medicine) and nourishes True Yuan (original vitality), ensuring safety and well-being.
Cheng stated: The Spleen delights in aromatic scents; medicinal substances that are aromatic and dry can indeed promote Qi movement and dissipate stagnation. However, for those with insufficient True Yin and rising Deficient Fire, or those who habitually have Phlegm-Fire, such aromatics are strictly contraindicated.
It is also said: In flesh-regenerating medicines for ulcerated sores, a small amount of Borneolum Syntheticum (Bingpian, 冰片) and Moschus (Shexiang, 麝香) must be added. Since Borneolum and Moschus have penetrating aromatic properties, excessive use will leak and deplete True Qi, causing the wound to heal poorly.
It is also said: After ulceration, burning Anxi Xiang (Benzoin Resin) and Chenxiang (Aquilaria Wood) in the bedroom is taboo; doing so causes the wound to become dry and itchy.
It is also said: After ulceration, wearing sachets or using Ligong Ding (Palace Pill) is taboo. Not only do these consume and scatter True Qi, but they may also stir up Ministerial Fire, leading to seminal emission.
Xue Lizhai said: The onset of sores and ulcers involves pain caused by damage from the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Thought, Grief, Fear, Fright). This pain results from Qi and Blood stagnation. For example, if internal Heat-Toxiness causes constipation and pain, Neishu Huanglian Tang (Internal-Draining Coptis Decoction) is used to guide it out. If Heat-Toxiness is vigorous, causing swelling and pain, Huanglian Jiedu San (Coptis Detoxification Powder) treats it. If ineffective, Xianfang Huoming Yin (Immortal Formula for Preserving Life Decoction) resolves it. For pain due to Blood stasis stagnation, Ruxiang Dingtong San (Frankincense Pain-Stabilizing Powder) harmonizes it. For pain during suppuration, Tuoli Xiaodu San (Support-Interior Detoxify-Decoction Powder) drains it. For pain due to pus distension, needle drainage is applied. For pain after pus rupture, tonification is used. If pain is due to Qi deficiency, Sijunzi Tang (Four-Gentlemen Decoction) is modified with Danggui (Angelica Sinensis) and Huangqi (Astragalus). If pain is due to Blood deficiency, Siwu Tang (Four-Substance Decoction) is modified with Renshen (Ginseng) and Huangqi (Astragalus). If pain is due to Kidney deficiency, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is used. For dry mouth, thirst, and frequent urination, Jiaban Bawei Wan (Modified Eight-Ingredient Pill) is prescribed. These are all methods for relieving pain. Danxi said: Pain persisting after pus discharge indicates deficiency, requiring tonification. If touched by foul odors, harmonize it; if forced by Wind-Cold, warm and disperse it. To rigidly rely on Ruxiang (Frankincense) and Moya (Myrrh) is to be dogmatic about formulas.
Li Dongyuan said: The manifestations of carbuncles and abscesses differ; Cold, Heat, Deficiency, and Excess can all cause pain. Methods for relieving pain are numerous. People generally believe that Ruxiang (Frankincense) and Moyao (Myrrh) are precious drugs that stop pain, not realizing that treatment must adapt to the specific condition. For pain caused by Heat-Toxiness, cold-natured agents reduce the heat, and pain ceases naturally. For pain caused by Cold pathogen, warm-natured agents dispel the cold, and pain disappears naturally. For pain due to Wind, eliminate the Wind; for pain due to Dampness, drain the Dampness; for pain due to Dryness, moisten it; for pain due to obstruction, unblock it; for pain due to Deficiency, tonify it; for pain due to Excess, purge it; for pain due to pus retention, open it; for pain due to necrotic tissue erosion, draw it out; for disharmony of Yin and Yang, regulate it; for blocked meridians, facilitate flow. Adapting to changes according to circumstances makes one an excellent physician; one must not stick rigidly to formulas without flexibility. (From "Ten Books")