治附骨疽肿热,未破已破,或脓出不愈。
黑色鲫鱼(一个,去肠肚入白盐令满,线缝定)
上铜石器中,煮一盏水尽,鱼干焦,为末。脂油调敷;已破,则干糁,少痛勿怪。
治附骨疽,脓出淋漓,久久不瘥,已破未破,皆可服。
赤术(一斤,米泔浸三宿,取出洗净晒干,再以大麻腐汁浸术上,余二寸许,入川椒二十
一粒、葱白七根,煮黑油出,洗净焙干秤) 破故纸(炒) 川楝(锉炒) 茯苓 舶上茴香(炒
)杜茴香 白芷 桃仁(去皮尖炒,各半斤)
上为末,炼蜜丸,梧子大。每服五十丸,温酒、盐汤任下。
一方 用槲树皮烧灰为末,饮方寸匕。
一方 用蜜陀僧为末,以猪脊骨髓调敷之。兼治痔漏不愈。
世医谓伤寒在诸风之上,痈疽冠杂病之先,言此二病,重大急切。然方论,疔肿又在痈
疽之前,其意谓急切甚矣。但江左少见此病,医者不以为事,病源既有,不可不知,且根据《
千金》类例,具列于后,既不能究其源,亦不敢妄有改作。一曰麻子疔,肉上起头如黍米,
色稍黑,四边微赤,多痒,忌食麻子,及麻衣,并入麻田中行。二曰石疔,皮肉相连,色乌
黑如黑豆,甚硬,刺之不入肉,阴阴微疼,忌瓦砾砖石之属。三曰雄疔, 头黑 ,四
畔仰,疮 浆起,有水出,色黄,大如钱孔,忌房事。四曰雌疔,疮头稍黄,向
里亦似灸疮,四畔 浆起,如钱孔,心凹,色赤,忌房事。五曰火疔,状如汤火
烧灼,疮头黑 ,四边有 浆起,如赤粟米,忌火灸烁。六曰烂疔,色稍黑,有白
斑,疮中溃,溃有脓水流出,疮形大小如匙面,忌沸热食、烂帛物。七曰三十六疔,头黑浮
起,形如黑豆,四畔起大赤色,今日生一,明日生二,三日生三,若满三十六,药所不治,
俗名黑 ,忌嗔怒,蓄积愁恨。八曰蛇眼疔,疮头黑,皮上浮生,形如小豆,状似蛇眼
,大体硬,忌恶眼看之,并嫉妒人见,及毒药。九曰盐肤疔,状如匙面,四边皆赤,有黑粟
粒起,忌咸食。十曰水洗疔,形如钱,或如钱孔大,疮头白,里黑 ,汁出,中硬,
忌饮浆水,水洗,渡河。十一曰刀镰疔,疮阔狭如薤叶大,长一寸,左侧肉黑如烧烁,忌刺
,及刀镰切割,铁刃所伤,可以药治。十二曰浮沤疔,疮体曲圆,少许不合,长而狭,如薤
叶大,内黄外黑,黑处刺不痛,内黄处刺之则痛。十三曰牛拘疔,肉 起,掐不破。此
十三证初发,必先痒后痛,先寒后热,热定则寒,四肢沉重,头痛心惊,眼花;大重者呕逆
,呕逆则难治。麻子疔始末唯痒。所录忌者不得犯,犯即难治。浮呕疔、牛拘疔无忌,纵不
治,亦不杀人。欲知犯触,但脊强,疮痛极,甚不可忍者,是犯之状也。
To treat *fuguju* (deep-seated abscess) characterized by swelling and heat, whether the lesion is unruptured or ruptured, or if pus discharge fails to heal the wound.
Take one black crucian carp (*Carassius auratus*), remove the intestines and viscera, fill with white salt until full, and sew shut with thread. Place in a copper or ceramic vessel, add water equivalent to one cup, and boil until the water is completely evaporated. The fish should become dry and charred, then grind into powder. Mix with lard for external application; if the wound is already ruptured, sprinkle the powder directly onto the lesion. Mild pain is expected, do not be alarmed.
To treat *fuguju* with continuous pus discharge that persists for a long time without healing. This formula can be taken internally regardless of whether the wound is ruptured or not.
Take *Cangzhu* (Rhizoma Atractylodis Chinensis), one jin (approx. 500g). Soak in rice-washing water for three nights, take out, wash clean, and sun-dry. Then soak the *Cangzhu* in the juice of decomposed hemp fibers, leaving only about two cun exposed above the liquid. Add twenty-one fruits of *Chuanjiao* (Fructus Zanthoxyli) and seven stalks of scallion white (*Congbai*). Boil until oil exudes and turns black. Wash clean, bake dry, and weigh. Combine with stir-fried *Poguozhi* (Fructus Psoraleae), chopped and stir-fried *Chuanlian* (Fructus Toosendan), *Fuling* (Poria), stir-fried *Boshang Huixiang* (Fructus Foeniculi), *Duhui Xiang* (Fructus Anisi Stellati), *Baizhi* (Radix Angelicae Dahuricae), and *Taoren* (Semen Persicae, peeled, de-veined, and stir-fried). Each of these latter ingredients should amount to half a jin.
Grind all ingredients into fine powder. Use refined honey to make pills the size of a golden dewberry seed. Take fifty pills per dose, administered with warm wine or salted water, at the patient's preference.
Another prescription: Burn oak bark (*Hupishu*) to ash, grind into powder, and take one *cunfang bi* (approx. 1 cubic inch) with rice soup.
Another prescription: Grind *Miduoseng* (Lithargyrum) into powder, mix with pig spinal marrow, and apply externally. This also treats chronic hemorrhoids and fistulas that fail to heal.
Practicing physicians consider *Shanghan* (Cold Damage) to be paramount among wind diseases, and *Yongju* (carbuncles and sores) to be primary among miscellaneous diseases, citing these two conditions as major and urgent. However, according to formula treatises, *Dingzhong* (malignant carbuncle) ranks even before *Yongju*, implying its urgency is even greater. Since this disease is rare in the Jiangnan region, physicians often neglect it. Yet, since the pathology exists, it must be known. Following the classification of *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), I list them below. As I cannot fully investigate their origins, I dare not arbitrarily modify them.
1. *Mazi Ding* (Hemp Seed Carbuncle): A head rises on the skin like a millet grain, slightly black in color, with slightly red margins, often accompanied by itching. Avoid eating hemp seeds, wearing hemp clothes, and walking in hemp fields.
2. *Shi Ding* (Stone Carbuncle): Connected to skin and flesh, dark black like a black bean, very hard, needle insertion does not penetrate the flesh, with dull mild pain. Avoid contact with tiles, bricks, and stones.
3. *Xiong Ding* (Male Carbuncle): Black head, raised margins, pus forms within, yellow fluid discharges, size like a coin hole. Avoid sexual intercourse.
4. *Ci Ding* (Female Carbuncle): Head slightly yellow, resembling a moxibustion scar internally, raised margins with pus like a coin hole, central depression, red color. Avoid sexual intercourse.
5. *Huo Ding* (Fire Carbuncle): Resembles burn from boiling water or fire, black head, raised margins like red millet grains. Avoid moxibustion or heat therapy.
6. *Lan Ding* (Rotting Carbuncle): Slightly black color with white spots, ulceration with purulent discharge, size like a spoon face. Avoid hot food and rotting fabrics.
7. *San Shi Liu Ding* (Thirty-Six Carbuncles): Black floating head, shape like a black bean, large red margins. One appears today, two tomorrow, three the third day. If thirty-six appear, it is untreatable by medicine. Commonly called *Hei Ding* (Black Carbuncle). Avoid anger and accumulated sorrow/hatred.
8. *Sheyan Ding* (Snake Eye Carbuncle): Black head, superficial blistering, shape like a small bean, resembling a snake eye, generally hard. Avoid being looked at by malicious eyes or jealous people, and avoid toxic substances.
9. *Yanku Ding* (Salt Skin Carbuncle): Shape like a spoon face, all margins red, with black millet-like granules rising. Avoid salty food.
10. *Shuixi Ding* (Water Wash Carbuncle): Shape like a coin or coin hole, white head, black interior, fluid discharge, hard center. Avoid drinking sour water, washing the area with water, and crossing rivers.
11. *Daolian Ding* (Sickle Carbuncle): Width narrow like an onion leaf, length one cun. Left side flesh is blackened as if burned. Avoid needling, cutting with sickles/knives, and injury by iron blades. Can be treated with medicine.
12. *Fou'ou Ding* (Foaming Carbuncle): Curved and round body, slightly open, long and narrow like an onion leaf, yellow inside and black outside. Pricking the black area causes no pain; pricking the yellow area causes pain.
13. *Niuju Ding* (Ovine Contraction Carbuncle): Flesh protrudes, cannot be broken by pinching.
For these thirteen types, initial onset must present as itching before pain, chills before fever, and fever subsiding into chills. Symptoms include heavy limbs, headache, heart palpitations, and blurred vision. In severe cases, vomiting and regurgitation occur, which are difficult to treat. *Mazi Ding* presents only with itching throughout its course. Do not violate the recorded taboos; violation makes treatment difficult. *Fou'ou Ding* and *Niuju Ding* have no taboos; even if untreated, they are not fatal. To know if a taboo has been violated, observe if there is neck stiffness and extreme, unbearable pain in the lesion; these are signs of violation.