【因治】 属表者,因风挟热痰。通经微汗之,下之亦可。
属里者,因胃热,助手少阴心火,入于手太阴肺也。故红点如斑,生于皮毛之间耳。白
虎、泻心,调胃承气,从长而用之。
【因】 热与痰、血热也。夫斑、痘、疹、丹,皆恶毒血热蕴蓄于命门,遇相火
合起则发也。
外有赤游风、天蛇漠、丹疹、瘾斑,其状不同,因则一也。
【治】 张归之少阳相火。如遇热之时,以通经辛凉解之;如在寒之时,以葛根
、升麻,辛
温解之。如遇疮痈黑陷,腹内喘满者,热而气虚也,急以白虎解之。热加参,参主喘也。主
之,全以凉膈调之。
消毒汤 升麻根 羌活 本 细辛 柴胡 葛根 黄芩(酒炒) 生地黄 黄连
黄柏 连翘 红花 当归 苏木 白术 苍术 陈皮 吴茱萸 防风 甘草
又方 紫草 红花子 白芍 胡荽 当归
附方 剪刀草汁调原蚕砂,敷之。
龙脑丸 治斑疮倒靥。
猪心血调脑子成膏,以紫茸汤化,无脑用辰砂。
(附油火刀犬等伤)
【脉】 金疮出血太多,脉沉细者生,浮数实大者死。
【治】 没药散 治刀箭伤,止血住痛。
定粉 风化灰(各一两) 枯白矾(三钱) 乳香(五分,另研) 没药一字,(即二
分半也,一铜钱有四字之故。)另研和匀糁之。
圣愈汤 治出血太多。
四物汤 人参 黄
煎服。
金疮刀伤见血方 降真香末细贴之;锻石和人血作饼,旋干贴之;煨大黄、石膏
,细研,桐油二分,水一分,拌,抹上;又淹灰搽敷亦良。
救苦散 治热油、刀斧伤、火伤、犬咬伤。
寒水石
油调涂上
【病因与治疗】
属于表证的,是因为风邪挟带热痰。应当通过疏通经络使其微微出汗来治疗,使用泻下法也可以。
属于里证的,是因为胃中有热,助长手少阴心经的火气,进而传入手太阴肺经。所以皮肤上出现如斑疹般的红点,生长在皮毛之间。可以使用白虎汤、泻心汤、调胃承气汤,根据病情轻重缓急依次选用。
【病因】
主要是热邪、痰浊和血热所致。大凡斑、痘、疹、丹毒,都是恶毒的血热蕴结蓄积在命门,遇到相火(指寄居于肝肾的阳气,具有激发和推动脏腑功能的作用)一起发作而显现出来。
外部有赤游风、天蛇头(一种急性感染性皮肤病)、丹疹、瘾斑等,虽然症状表现不同,但病因是一致的。
【治疗】
归属于少阳相火的范畴。如果遇到热证的时候,用辛凉性质的药物疏通经络以解表;如果遇到寒证的时候,用葛根、升麻等辛温性质的药物解表。如果遇到疮疡黑陷、腹部胀满气喘的情况,这是热盛而气虚的表现,急需使用白虎汤来清热。若热势加重且伴有气喘,加入人参,因为人参主治气喘。整体治疗全凭凉膈散来调理。
消毒汤:升麻根、羌活、藁本、细辛、柴胡、葛根、黄芩(酒炒)、生地黄、黄连、黄柏、连翘、红花、当归、苏木、白术、苍术、陈皮、吴茱萸、防风、甘草。
又一方:紫草、红花子、白芍、胡荽、当归。
附方:剪刀草汁调和原蚕砂(即家蚕的粪便),外敷患处。
龙脑丸:治疗斑疮倒靥(痘疮塌陷不起)。
猪心血调和冰片成膏状,用紫茸汤化开服用,若无冰片可用辰砂代替。
(附带油烫、火烧、刀伤、犬咬等外伤)
【脉象】
金疮(金属利器造成的创伤)出血过多,脉象沉细的预后良好,脉象浮数实大的预后不良(主死)。
【治疗】
没药散:治疗刀箭创伤,止血止痛。
定粉:风化石灰(各一两)、枯白矾(三钱)、乳香(五分,单独研磨)、没药一字(即二分半,因一铜钱大小可刻四字,故一字为二分半,单独研磨),将上述药物混合均匀后撒在伤口上。
圣愈汤:治疗出血过多的情况。
四物汤加人参、黄芪煎服。
金疮刀伤见血方:降真香研成细末贴敷;锻石与人血制成饼状,随干随贴;煨大黄、石膏,研成细末,用桐油两份、水一份拌匀,涂抹患处;另外,草木灰搽敷也效果良好。
救苦散:治疗热油烫伤、刀斧切割伤、火烧伤、狗咬伤。
寒水石:用油调匀后涂抹。
[Pathogenesis and Treatment]
Cases belonging to the exterior are caused by wind pathogens carrying heat-phlegm. The treatment should involve unblocking the meridians to induce slight sweating; purgation is also permissible.
Cases belonging to the interior are caused by stomach heat, which assists the fire of the Hand-Shaoyin Heart meridian and transmits into the Hand-Taiyin Lung meridian. Consequently, red spots resembling macules appear between the skin and hair follicles. Baihu Tang (White Tiger Decoction), Xiexin Tang (Drain the Epigastrium Decoction), and Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Purgative Decoction) should be used sequentially according to the severity and progression of the condition.
[Etiology]
The primary causes are heat, phlegm, and blood-heat. Generally speaking, macules (ban), smallpox (dou), rashes (zhen), and erysipelas-like conditions (dan) all result from toxic blood-heat accumulating in the Mingmen (Gate of Life). They manifest when combined with Xianghuo (Ministerial Fire, referring to the physiological fire residing in the Liver and Kidney that stimulates organ functions).
External conditions such as Chiyoufeng (Red Roaming Wind), Tianshemao (Heavenly Snake Head, a type of acute dermatological infection), Danzhen (Erythematous Rash), and Yinban (Itchy Macules) present with different symptoms but share the same etiology.
[Treatment]
These conditions are attributed to Shaoyang Xianghuo (Shaoyang Ministerial Fire). In cases of heat, use acrid-cool herbs to unblock the meridians and resolve the exterior; in cases of cold, use acrid-warm herbs like Gegen (Puerariae Radix) and Shengma (Cimicifugae Rhizoma) to resolve the exterior. If sores appear black and sunken with abdominal distension and wheezing, this indicates excess heat with Qi deficiency. Urgently treat with Baihu Tang (White Tiger Decoction). If heat intensifies accompanied by wheezing, add Renshen (Ginseng Radix et Rhizoma), as Ginseng treats wheezing. Overall regulation is achieved primarily using Liangge San (Cool the Diaphragm Powder).
Xiaodu Tang (Detoxification Decoction): Shengmaggen (Cimicifugae Rhizoma Root), Qianghuo (Notopterygii Rhizoma et Radix), Bencao (Ligustici Rhizoma), Xixin (Asari Radix et Rhizoma), Chaihu (Bupleuri Radix), Gegen (Puerariae Radix), Huangqin (Scutellariae Radix, stir-fried with wine), Shengdihuang (Rehmanniae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Lianqiao (Forsythiae Fructus), Honghua (Carthami Flos), Danggui (Angelicae Sinensis Radix), Sumu (Sappan Lignum), Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Wuzhuyu (Evodiae Fructus), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Another Prescription: Zicao (Arnebiae Radix seu Lithospermi Radix), Honghuazi (Carthami Semen), Baishao (Paeoniae Radix Alba), Huxu (Coriandri Fructus), Danggui (Angelicae Sinensis Radix).
Supplementary Prescription: Mix juice of Jiandaocao (Isolepis sp.) with Yuancansha (Bombyx Batryticatus, dried excrement of silkworms) and apply externally.
Longnao Wan (Borneol Pill): Treats inverted or depressed macules/rashes.
Mix pig heart blood with Naobing (Borneolum Syntheticum) to form a paste, dissolve with Zirong Tang (Purple Velvet Decoction); if Borneol is unavailable, use Zhensha (Cinnabaris).
(Attached: Injuries from oil, fire, knives, dogs, etc.)
[Pulse Diagnosis]
In Jinchuang (metal weapon injuries) with excessive bleeding, a deep and fine pulse indicates survival, whereas a floating, rapid, full, and large pulse indicates death.
[Treatment]
Moyao San (Myrrh Powder): Treats knife and arrow wounds, stops bleeding and relieves pain.
Dingfen (Stabilizing Powder): Fenghuahui (Weathered Lime, 1 liang each), Kubaijian (Calcined Alum, 3 qian), Rushen (Olibanum, 5 fen, ground separately), Moyao (Myrrha, 1 zi [approx. 2.5 fen], ground separately). Grind all ingredients evenly and dust onto the wound.
Shengyu Tang (Sage Preservation Decoction): Treats excessive bleeding.
Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix), decocted and taken orally.
Jinchuang Dao Shang Jian Xue Fang (Formula for Bleeding Knife Wounds): Apply finely powdered Jiangzhenxiang (Daemonorops Spatha) directly; mix Duanshi (Ferrum Oxidatum) with human blood to make cakes, applying fresh as they dry; roast Dahuang (Rhei Radix et Rhizoma) and Shigao (Gypsum Fibrosum), grind finely, mix with two parts Tongyou (Camellia Seed Oil) and one part water, and smear on the area; alternatively, applying plant ash is also effective.
Jiuku San (Distress Salvation Powder): Treats hot oil burns, knife/axe cuts, fire burns, and dog bites.
Hanshuishi (Halloysitum Rubrum): Mix with oil and apply topically.