浸淫疮者,浅搔之,蔓延长不止,搔痒者,初如疥。搔之转生,汁相连着是也。仲
景云∶从口流向四肢者,可治,四肢流来入口者,不可治。运气∶浸淫皆属火。经云∶岁
火太过,甚则身热肤浸淫是也。
升麻汤 治心有风热,生浸淫疮遍体。
升麻大黄(锉,微炒) 黄芩(去黑心) 枳实(面炒) 芍药(各一两) 当归(切,焙) 甘草(炙,
各半两)
上锉碎。每服五钱匕,水一盏半,灯心一握,煎至一盏去滓,空心,温服。
香瓣疮方 治面上、耳边生浸淫疮,有黄水出,久不愈。
羊须 荆芥 干枣(去核,各二钱)
上烧灰存性,研匀,入腻粉半钱,同研极细。每用少许清油调搽。先以温汤净洗拭
干,涂药三二次效。亦治大人、小儿两吻生疮。
鸡冠血涂方 治卒得浸淫疮,不早治则绕身周匝,能杀人。《外台》云∶浸淫疮转广
有汁,多起于心。
上以雄鸡冠上刺血敷之,日三五度。
《简要济众方》浸淫疮,痛不可忍者,发寒热。刺蓟末,水调敷疮上,干即易之。
又方 鲫鱼(一尾,长三寸者) 豆豉(一合)
上杵 如膏涂之,亦疗马鞍疮。
又方 苦瓠(一两),蛇蜕(烧,半两) 露蜂房(微炙,半两) 梁上尘
上为末,油调涂。
又方 伏龙肝(七钱半) 乱发(烧,七钱半)
上为末,猪脂和涂。
又方 以鸡冠血和黄连末涂。煎鲫鱼膏涂。生切鲫鱼片,和盐贴。烧胡燕窠,水和
涂。
山妻年五十。旧患发颐之处,腠理虚疏,每食则汗出成流。一日忽成浸淫疮,脓汁所
至辄皮破肉腐。敷银粉、黄连、黄丹、枯矾之属,皆不验。用猪胆汁调芦荟末涂之,脓
水即干而痊。
〔热汗浸渍成疮〕
玉粉散 七粉散 七宝散(并见热疮、痱子。)
浸淫疮,是指病变部位浅表,轻轻搔抓后,皮损蔓延生长不止;伴有瘙痒症状,初起时形态如同疥疮。因搔抓而转变扩散,渗出汁液相互粘连附着,这就是浸淫疮的特征。张仲景说:如果疮疡从口部向四肢蔓延的,可以治疗;如果从四肢向口部流注的,难以治愈。五运六气理论认为:浸淫疮都属于火邪致病。《内经》记载:岁火太过之年,严重时会出现身体发热、皮肤出现浸淫疮的症状。
升麻汤:治疗心经有风热,导致全身遍发浸淫疮。
处方组成:升麻、大黄(切碎,微炒)、黄芩(去除黑心部分)、枳实(面粉炒)、芍药(各一两)、当归(切片,焙干)、甘草(炙制,各半两)。
制法与用法:将上述药物切碎。每次服用五钱匕,加水一盏半,灯心草一握,煎煮至一盏量,去渣滓,空腹时温服。
香瓣疮方:治疗面部、耳旁生浸淫疮,流出黄色水液,久不愈合。
处方组成:羊须、荆芥、干枣(去核,各二钱)。
制法与用法:将上述药物烧成灰但保留药性,研磨均匀,加入腻粉半钱,共同研磨至极细。每次取少许用清油调和涂抹患处。先用温水洗净擦干,涂药两三次即可见效。此方也治疗成人和儿童嘴角生疮。
鸡冠血涂方:治疗突然患上的浸淫疮,如果不早治疗则会环绕周身,能致人死亡。《外台秘要》说:浸淫疮扩散且有汁液流出,多起于心经。
制法与用法:取雄鸡冠上刺出的血敷于患处,每日三到五次。
《简要济众方》记载:浸淫疮疼痛难忍,伴有寒热症状。取蓟菜末,用水调匀敷在疮上,干了就更换。
又一方:鲫鱼(一条,长约三寸)、豆豉(一合)。
制法与用法:捣烂如膏状涂抹患处,也能治疗马鞍疮(臀部褥疮或类似疮疡)。
又一方:苦瓠(一两)、蛇蜕(烧制,半两)、露蜂房(微炙,半两)、梁上尘。
制法与用法:研为粉末,用油调匀涂抹。
又一方:伏龙肝(七钱半)、乱发(烧制,七钱半)。
制法与用法:研为粉末,用猪脂调和涂抹。
又一方:用鸡冠血调和黄连末涂抹。煎煮鲫鱼膏涂抹。生切鲫鱼片,加盐贴敷。烧胡燕窠(燕子窝),用水调和涂抹。
案例:山妻五十岁。旧病发作颐(腮颊)部位,腠理虚疏,每次进食则汗出如流。一天忽然生出浸淫疮,脓汁所到之处皮肤破裂、肌肉腐烂。使用银粉、黄连、黄丹、枯矾等药物外敷,均无效。改用猪胆汁调和芦荟末涂抹,脓水即干燥而痊愈。
Jinyin Chuang (Exudative Eczema) refers to a condition where the lesion is superficial; slight scratching causes the rash to spread and grow continuously. It is characterized by itching, initially resembling Jie Chuang (Scabies). Due to scratching, it transforms and spreads, with exudate connecting and adhering to surrounding skin. Zhang Zhongjing stated: If the sores spread from the mouth towards the limbs, they are treatable; if they flow from the limbs towards the mouth, they are difficult to treat. According to Yunqi (Five Movements and Six Qi) theory: Jinyin Chuang all belong to Fire pathogen. The Classic of Internal Medicine states: In years of excessive Fire, severe cases manifest as body heat and skin Jinyin Chuang.
Shengma Tang (Cinnamon Twig Decoction): Treats Wind-Heat in the Heart causing widespread Jinyin Chuang over the body.
Ingredients: Shengma (Rhizoma Cimicifugae), Dahuang (Radix et Rhizoma Rhei, chopped and lightly stir-fried), Huangqin (Radix Scutellariae, removing black heart), Zhishi (Fructus Aurantii, flour-stir-fried), Shaoyao (Radix Paeoniae Rubra or Radix Paeoniae Alba, each 1 liang), Danggui (Radix Angelicae Sinensis, sliced and baked), Gancao (Radix Glycyrrhizae Uralensis, honey-fried, each half liang).
Preparation and Administration: Chop the herbs finely. Take 5 qianbi per dose, add 1.5 sheng of water and a handful of Dengxincao (Medulla Junci), decoct until 1 sheng remains, strain, and take warm on an empty stomach.
Xiangban Chuang Fang (Fragrant Petal Sores Formula): Treats Jinyin Chuang on the face and around the ears with yellow exudate that persists for a long time.
Ingredients: Yangxu (Sheep whiskers), Jingjie (Herba Schizonepetae), Ganzao (Fructus Jujubae, pitted, each 2 qian).
Preparation and Administration: Burn the ingredients to ash while preserving their medicinal properties, grind evenly, add Nifen (Calomel, half qian), and grind to an extremely fine powder. Apply a small amount mixed with clear sesame oil to the affected area. Wash thoroughly with warm water and dry before application; two to three applications yield effective results. This formula also treats sores at the corners of the mouth in adults and children.
Jiguan Xue Tu Fang (Rooster Comb Blood Application): Treats sudden onset of Jinyin Chuang. If not treated early, it may encircle the body and be fatal. The Wai Tai Mi Yao states: Jinyin Chuang spreading with exudate often originates from the Heart.
Preparation and Administration: Prick the comb of a male rooster to obtain blood and apply it to the lesion, 3 to 5 times daily.
Jianyao Jizhong Fang records: For Jinyin Chuang with unbearable pain accompanied by chills and fever. Take Jiwei (Spina Gleditsiae or similar thistle end, depending on interpretation, here likely referring to Cirsii Herba or similar herb used topically for sores, literally "Thistle end"), mix with water, apply to the sore, and change when dry.
Another Formula: Jiyu (Cyprinus carpio, one fish, approx. 3 cun long), Douchi (Fermented Soybeans, 1 he).
Preparation and Administration: Pound into a paste and apply. Also treats Ma'an Chuang (Saddle Sores/Pressure Ulcers).
Another Formula: Ku Hu (Bitter Bottle Gourd, 1 liang), She Tui (Ophichthys Skin or Snake Slough, burned, half liang), Lu Feng Fang (Vespa Nest, lightly roasted, half liang), Liang Shang Chen (Dust from ceiling beams).
Preparation and Administration: Grind into powder, mix with oil, and apply.
Another Formula: Fulonggan (Dragon's House Earth/Cooked Clay Hearth Bottom, 7.5 qian), Luanfa (Human Hair, burned, 7.5 qian).
Preparation and Administration: Grind into powder, mix with Pig Fat (Zhuzhi), and apply.
Another Formula: Mix Rooster Comb Blood with Huanglian (Radix Coptidis) powder and apply. Decoct Jiyu paste for application. Slice raw Jiyu, mix with salt, and apply as a patch. Burn Huyan Ke (Swallow's Nest), mix with water, and apply.
Case Study: The author's wife, aged fifty, had a history of issues in the Yiyu (parotid/malar region) area with loose pores, sweating profusely upon eating. One day, she suddenly developed Jinyin Chuang; wherever pus flowed, the skin broke down and flesh rotted. Applications of Yinfen (Silver Powder), Huanglian, Huangdan (Lead Monoxide), and Kufan (Alum) were ineffective. Using Zhu Danzhi (Pig Bile) to mix Luluo (Aloe) powder for topical application dried up the pus and led to recovery.
[Sores Caused by Heat and Sweat Impregnation]
Yufen San (Jade Powder Powder), Qifen San (Seven Powders Powder), Qibao San (Seven Treasures Powder) (See entries under Re Chuang (Heat Sores) and Feizi (Prickly Heat)).