木香 干姜 百草霜(各一两) 肉豆蔻 丁香(各一两五钱) 杏仁(一百四十粒,去皮) 巴豆(七十粒,去
皮膜,熨净油) 共为细末,用好黄蜡四两,清茶油一两,同蜡熔化,重绢滤过,乘热调为丸,绿豆大,每服三十丸,
姜汤
下。
肥疳冷积,久伤脾胃,致休息泻利,欲盲双眼。用此丸而明者,盖丁香、肉蔻、干姜、巴豆破寒宣滞,立使
关格通而阳复;木香、杏仁、草霜、黄蜡,导气和中,自然水谷化而年延。《医贯》谓此方神妙不可言,信乎。
诗曰∶蜡子丸,丁木香,肉蔻杏仁百草霜,巴豆去油黄蜡滤,方中还有白干姜。
黄蜡二两、白矾一两,先将蜡溶化,退火,入矾和匀为丸,赤豆大,朱衣。以金银花五两,甘草一两,醇酒
一升,重汤煮出味。每下十丸、二十丸,加至百丸。酒亦三杯、五六杯、渐饮至尽量,则有效。倘被毒虫蛇犬所
伤,加雄黄五钱,乳香三钱,没药二钱。
一切疮疡觉发,便服此方。得奇效者,盖黄蜡甘温、白矾酸涩,能护膜托里,使毒不内攻。乳香辛温,没药
苦平,能止痛和气,使火不上炎。再有金银花、雄黄清热辟邪。甘草、醇酒扶胃养血。游刃毒所,恢恢乎有余力
矣。
(一方无连翘有桔梗、皂刺,治同)
人参 白术 茯苓 甘草 当归 芎 白芍 黄 连翘 白芷 忍冬花
《机要》曰∶治疮须明托里、疏通脏腑、调和营卫三法。内之外者,其脉沉实,发热烦躁。外无 赤,痛甚
于内,其邪深矣。当疏通脏腑,以绝其源。外之内者,其脉浮数, 肿在外,恐邪极而内行,当先托里。外无
恶之气,内亦脏腑宣通,知其在经,当和营卫。用此三法,虽未必即瘥,决无变症。此方其兼备欤。
外科方症,至为繁杂,且各有专家,未能多识。缘有因毒一款,姑择数方以应缓急。引申触类,属望于后之
学人。
诗曰∶托里消毒饮,四君加归 ,芷芎翘芍忍,五物力相如。
【蜡子丸】
木香、干姜、百草霜(各一两)、肉豆蔻、丁香(各一两五钱)、杏仁(一百四十粒,去皮)、巴豆(七十粒,去皮膜,熨净油)。以上药材共同研磨成细末,取优质黄蜡四两、清茶油一两,与药末一同熔化,用双层丝绸过滤,趁热调和制成丸剂,大小如绿豆。每次服用三十丸,用姜汤送服。
此方主治肥疳冷积(因脾胃虚弱导致的慢性积滞),久伤脾胃,导致休息痢(时发时止的腹泻),甚至可能导致双眼失明。使用此丸后视力恢复者,是因为丁香、肉豆蔻、干姜、巴豆能破除寒邪、宣通滞气,迅速使关格(指上下不通的病证)通畅而阳气回复;木香、杏仁、百草霜、黄蜡能疏导气机、调和脾胃,自然使水谷精微得以化生而延年益寿。《医贯》称此方神妙不可言,确实如此。
诗曰:蜡子丸,丁木香,肉蔻杏仁百草霜,巴豆去油黄蜡滤,方中还有白干姜。
【蜡矾丸】
黄蜡二两、白矾一两。先将黄蜡熔化,退去火气,加入白矾搅拌均匀制成丸剂,大小如赤豆,外用朱砂衣包裹。以金银花五两、甘草一两、醇酒一升,隔水炖煮至出味。每次服用十丸或二十丸,逐渐增加至一百丸。同时饮酒三杯、五六杯,逐渐饮至尽兴,则能见效。如果是被毒虫、蛇、犬咬伤,可加雄黄五钱、乳香三钱、没药二钱。
一切疮疡刚开始发作时,便服用此方。获得奇效的原因在于:黄蜡味甘性温、白矾味酸涩,能够保护黏膜、托毒外出,使毒邪不向内攻陷。乳香味辛性温、没药味苦性平,能够止痛、调和气血,使火气不上炎。再加上金银花、雄黄清热辟邪,甘草、醇酒扶助胃气、滋养血液。在应对毒邪时,游刃有余,绰绰有余。
【托里消毒饮】
人参、白术、茯苓、甘草、当归、川芎、白芍、黄芪、连翘、白芷、忍冬花(金银花)。
《医学机要》说:治疗疮疡必须明白托里、疏通脏腑、调和营卫这三种方法。病由内向外发的,脉象沉实,伴有发热烦躁。体表没有红肿,但疼痛比内部更甚,说明邪气深入。应当疏通脏腑,以断绝病源。病由外向内传的,脉象浮数,肿胀在体表,担心邪气极盛而内行,应当先托里扶正。体表没有恶寒之气,体内脏腑也宣通,知道病在经络,应当调和营卫。运用这三种方法,虽然未必立即痊愈,但决不会产生变证。这个方子是否兼备了这三种功效呢?
外科方的病症非常繁杂,且各有专家擅长,未能广泛识记。因为有毒邪这一类情况,姑且选择几个方子来应对紧急情况。引申触类旁通,希望寄托于后来的学人。
诗曰:托里消毒饮,四君加归芎,芷芎翘芍忍,五物力相如。(注:诗中“四君”指四君子汤,即参术苓草;“归芎”指当归、川芎;“芷芎翘芍忍”指白芷、川芎、连翘、白芍、忍冬花。诗句略有重复或简写,意指该方由补气养血及清热解毒药组成,力量相当。)
[Cizi Wan (Wax Seed Pill)]
Muxiang (Costus Root), Ganjiang (Dried Ginger), Baicaoshuang (Soot from the Chimney) (each 1 liang), Roudoukou (Nutmeg), Dingxiang (Clove) (each 1.5 liang), Xingren (Apricot Seed) (140 grains, skin removed), Badou (Croton Seed) (70 grains, skin and membrane removed, oil pressed out). Grind all ingredients into a fine powder. Take 4 liang of high-quality Huangla (Yellow Beeswax) and 1 liang of Qingchayou (Clear Tea Oil), melt them together with the powder, filter through multiple layers of fine silk, and while hot, mix to form pills the size of mung beans. Take 30 pills per dose, washed down with Shengjiang Tang (Ginger Decoction).
Indicated for Feigan Lengji (emacification due to cold accumulation), where long-term damage to the Spleen and Stomach leads to Xiuxie (intermittent dysentery/diarrhea), potentially causing blindness in both eyes. Those whose vision is restored after using this pill do so because Dingxiang, Roudoukou, Ganjiang, and Badou break up cold and relieve stagnation, quickly unblocking obstruction and restoring Yang Qi; Muxiang, Xingren, Baicaoshuang, and Huangla guide Qi and harmonize the Middle Jiao, allowing natural transformation of food and fluids, thereby extending life. The *Yi Guan* states that this formula is miraculous beyond words, which is true.
Poem: Cizi Wan, Ding and Muxiang, Roudoukou, Xingren, Baicaoshuang, Badou de-oiled and filtered with Huangla, White Ganjiang also in the formula.
[Lafan Wan (Wax and Alum Pill)]
Huangla (Yellow Beeswax) 2 liang, BaiFan (Alum) 1 liang. First melt the beeswax, remove the fire heat, add the alum, mix evenly, and form pills the size of red beans, coated with Zhuyin (Cinnabar coating). Boil 5 liang of Jinyinhua (Honeysuckle Flower), 1 liang of Gancao (Licorice Root), and 1 sheng of Chunjiu (Pure Wine) over water until the flavor is extracted. Take 10 or 20 pills initially, gradually increasing to 100 pills. Simultaneously drink 3 cups, then 5-6 cups of wine, gradually increasing to full capacity for effectiveness. If injured by venomous insects, snakes, or dogs, add Xionghuang (Realgar) 5 qian, Ruxiang (Olibanum/Frankincense) 3 qian, Moyao (Myrrh) 2 qian.
Take this formula at the first sign of any Chuanyang (skin ulcer/abscess). The reason for its remarkable efficacy lies in: Huangla being sweet and warm, and BaiFan being sour and astringent, they can protect the mucous membranes and push toxins outward, preventing internal invasion. Ruxiang being pungent and warm, and Moyao being bitter and neutral, they can alleviate pain and harmonize Qi and Blood, preventing Fire from flaring upward. Additionally, Jinyinhua and Xionghuang clear heat and dispel evil pathogens. Gancao and Chunjiu support the Stomach and nourish Blood. In dealing with toxins, one has ample room to maneuver and strength to spare.
(Another version excludes Lianqiao but includes Jiegeng and Zaoci, with identical effects.)
[Tuoli Xiaodu Yin (Support the Interior and Disinfect Toxin Decoction)]
Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Fuling (Poria), Gancao (Licorice Root), Danggui (Angelica Sinensis), Xiong (Chuanxiong Rhizome), Baishao (White Peony Root), Huangqi (Astragalus Root), Lianqiao (Forsythia Fruit), Baizhi (Angelica Dahurica), Rendonghua (Lonicera Japonica Flower/Honeysuckle).
The *Jiyao* states: Treating Chuanyang requires understanding three methods: Tuoli (Supporting the Interior), Shutong Zangfu (Unblocking and Regulating the Zang-Fu Organs), and Tiaohé Yingwei (Harmonizing Ying and Wei Qi). When pathogenic factors move from exterior to interior, the pulse is deep and solid, accompanied by fever and irritability. There is no external redness, but pain is more severe internally, indicating deep-seated pathogens. One should unblock and regulate the Zang-Fu organs to cut off the source. When pathogens move from interior to exterior, the pulse is floating and rapid, swelling is on the surface, and there is fear that extreme pathogens will move inward; one should first use Tuoli methods. If there is no aversion to cold externally, and the internal Zang-Fu are unblocked, knowing the pathogen is in the meridians, one should harmonize Ying and Wei Qi. Using these three methods, although immediate cure is not guaranteed, complications will certainly be avoided. Does this formula encompass all three?
External surgical formulas and syndromes are extremely complex, each having its own specialists, making it difficult to memorize many. Since this concerns toxic conditions, I have tentatively selected a few formulas to address emergencies. By analogy and extension, I place my hopes on future scholars.
Poem: Tuoli Xiaodu Yin, Si Jun Zi Tang plus Danggui and Chuanxiong, Baizhi, Chuanxiong, Lianqiao, Baishao, Rendonghua, five forces acting in harmony.