运气∶阴疮皆属寒。经云∶太阳之胜,阴中乃疡,隐曲不利,治以苦热是也。
仲景云∶少阴脉滑而数者,阴中即生疮。阴中蚀烂者,野狼牙汤洗之。用野狼牙二两,以
水四升,煮取半升。以绵缠箸如茧,浸汤沥阴中,日三遍。
洗拓散 (《大全》) 治阴蚀疮。
甘草 干漆(各一两) 黄芩 当归 地黄 芍药(各二两) 龟甲(五两)
上细切。以水七升,煮取一半,去渣。以绵帛纳汤中,用拓疮处,良久即易,日二度。
每拓汤可作十里许,即挹干。捻取甘湿散,薄敷疮上使遍,可经半日;又以汤拓,拓讫如
前敷药。
甘湿散
蚺蛇胆(真者) 青木香 石硫黄 铁精麝香(各四分。临时入用,缘麝辟蛇毒,若先相和胆,
即无力)
上各等分为末,更研细。有患取如三棋子大,和井花水,日再服讫,先令便利了。即
以后方桃枝,先熏部讫。然后取药如棋子,安竹管里,纳下部中,日再度,老少量减。其
熏法,每日一度,不用再。
桃枝熏法 取东南桃枝五七枝,轻打头使散,以绵缠之;又捣石硫黄为末,将此绵
缠桃枝捻转之,令末少浓。又截一竹筒,先纳下部中;仍以所捻药,桃枝烧着熏之。
蛇床子散 湿阴中主药。
用蛇床子仁一味末之,以白粉少许,和令相得如枣大,绵裹纳之,自然湿散。
〔补遗〕 治阴疮,捣新桃叶,绵裹纳阴中,日三两易。
余详女科前阴诸疾。
运气学说认为:阴疮(女性外阴部的溃疡性病变)都属于寒证。《内经》说:“太阳之气偏胜时,阴部会发生溃疡,导致隐蔽部位的功能障碍,治疗应用苦热性质的药物。”说的就是这个道理。
张仲景说:“少阴脉象滑而数的,阴中就会生疮。如果阴中有腐蚀溃烂的情况,用野狼牙汤清洗。取野狼牙二两,用水四升,煮取半升药液。用棉絮包裹筷子头如蚕茧大小,蘸取药液滴入阴中,每天三次。”
洗拓散(出自《妇人大全良方》):治疗阴部蚀烂疮疡。
药材:甘草、干漆(各一两);黄芩、当归、地黄、芍药(各二两);龟甲(五两)。
以上药材切碎。用水七升,煮取一半药液,去渣。将棉帛浸入药液中,用来敷贴疮处,停留较长时间后更换,每天两次。每次敷贴的药液大约可使用十里路程的时间,之后需擦干。捻取甘湿散,薄薄地敷在疮面上使其覆盖均匀,可维持半天;然后再用药液敷贴,敷贴结束后再像前面那样敷药。
甘湿散
药材:蚺蛇胆(真品)、青木香、石硫黄、铁精、麝香(各四分。临时加入使用,因为麝香会排斥蛇毒,如果预先与胆汁混合,药效就会减弱)。
以上药材等分为末,再研磨细腻。患病者取如三枚棋子大小的药量,用井花水调和,每天服用两次,服药前先令患者排便通畅。然后用下方的桃枝熏法,先熏患处。然后将药如棋子大小,放入竹管中,纳入下部(阴道内),每天两次,年老体弱者酌情减量。熏法,每天一次,不需要重复。
桃枝熏法:取东南方向的桃枝五到七枝,轻打头部使其松散,用棉絮缠绕;再将石硫黄捣成末,用缠有棉絮的桃枝捻转,使药末稍微浓聚。再截取一段竹筒,先纳入下部;仍用捻好药的桃枝点燃进行熏蒸。
蛇床子散:是治疗阴中潮湿的主药。
只用蛇床子仁一味药研成末,加少许白粉,调和得像枣核大小,用棉絮包裹纳入阴中,自然可使潮湿消散。
Fortune and Qi (Yunqi): Yin sores (ulcerative lesions of the female external genitalia) all belong to Cold patterns. The Classic says: "When Taiyang Qi prevails, ulcers occur in the yin region, causing dysfunction in concealed areas; treatment should employ bitter-hot substances." This is what is meant.
Zhang Zhongjing said: "When the Shaoyin pulse is slippery and rapid, sores will arise in the yin region. If there is erosion and ulceration in the yin region, wash it with Yelangya Decoction (Wolf's Tooth Herb Decoction). Use two liang of Yelangya (Acanthopanacis Senticosi Caulis), boil in four sheng of water until half a sheng remains. Wrap cotton around the head of a chopstick like a silkworm cocoon, dip it in the decoction, and drip it into the yin region three times a day."
Xituo San (Washing and Compressing Powder) [from *Daquan*]: Treats yin erosion sores.
Herbs: Gancao (Licorice Root, Glycyrrhizae Radix et Rhizoma), Ganxi (Dried Resin of Toxicodendron Vernicifluum, each one liang); Huangqin (Scutellaria Root, Scutellariae Radix), Danggui (Angelica Sinensis Root, Angelicae Sinensis Radix), Dihuang (Rehmannia Root, Rehmanniae Radix), Shaoyao (Peony Root, Paeoniae Radix, each two liang); Guijia (Tortoise Shell, Testudinis Carapax et Plastrum, five liang).
Finely cut the above. Boil in seven sheng of water until half remains, remove the dregs. Immerse cotton cloth in the decoction, use it to compress the sore area, leave for a long time, then replace; do this twice a day. Each batch of decoction can be used for approximately ten li of walking distance, then wipe dry. Take Gan Shi San (Sweet Moist Powder), apply thinly over the sore to cover it evenly, which can last for half a day; then compress again with the decoction, and after compression, apply the medicine as before.
Gan Shi San (Sweet Moist Powder)
Herbs: Ran She Dan (Bile of Python, Pythonis Fel), Qingmuxiang (Costus Root, Saussureae Radix), Shiliuhuang (Sulfur, Sulfur), Tiejing (Iron Essence, Ferri Oxidatum), Shexiang (Musk, Moschus, each four fen. Add temporarily when using, because Musk repels Snake Poison; if mixed with bile beforehand, its efficacy will be weak).
Grind each herb equally into powder, then grind finely again. For patients, take an amount the size of three chess pieces, mix with Jinghua Water (well water drawn from the surface), take twice a day, after first ensuring the bowels are cleared. Then use the following Tao Zhi Fumigation Method (Peach Twig Fumigation), fumigate the part first. Then take the medicine the size of a chess piece, place it in a bamboo tube, insert it into the lower orifice (vagina), twice a day; reduce the dose slightly for the elderly. The fumigation method: once a day, no need to repeat.
Tao Zhi Fumigation Method (Peach Twig Fumigation): Take five to seven branches of peach wood from the southeast, lightly beat the head to loosen it, wrap with cotton; then crush Shiliuhuang (Sulfur, Sulfur) into powder, roll the cotton-wrapped peach twig in the powder to make it slightly concentrated. Cut a bamboo tube, insert it into the lower orifice first; still use the prepared peach twig, ignite it to fumigate.
Shechuangzi San (Cnidium Seed Powder): The main medicine for treating dampness in the yin region.
Use only Shechuangzi Ren (Cnidium Fruit, Cnidii Fructus) alone, grind into powder, add a small amount of Baifen (White Powder, likely Starch or Lead Carbonate historically, here translated as White Powder), mix to form a ball the size of a jujube, wrap in cotton, and insert into the yin; naturally, the dampness will dissipate.
[Supplementary Material] To treat yin sores, crush fresh Tao Ye (Peach Leaf, Pruni Persicae Folium), wrap in cotton, insert into the yin region, change three to four times a day.
For details, refer to the section on Diseases of the Anterior Genitals in Gynecology.