书云∶用膏贴顶上,敷药四边围。凡肿毒之大者,将以成脓,用乌金膏贴疮头上,然后
用万全膏贴之,四旁用芙蓉膏敷之。贴膏处取其出脓,敷药处取其消散,并能箍住根脚,不
令展开。其作三层敷围法,第一层,用乌金膏贴疮头,若漫肿无头,以湿纸粘贴,先干处,
是疮头也。第二层,万全膏贴之。第三层,芙蓉膏围之。然予尝用万全膏,遍敷肿处,连根
脚一齐箍住。其中消处自消,溃处自溃,竟收全功。可见膏药之妙矣。
凡治痈疽,口小脓多,则脓不出,或出而不尽,或薄脓可出,硬脓难出,以致瘀不去而
新不生,延绵难愈。法当烂开大口,俾瘀脓尽出为善。其烂药,乌金散最佳,祛瘀肉,不伤
新肉,且不甚掀痛,为至妙也。若有脓管,以棉纸拈裹药纳入,频换数条,即化去耳。亦有
顽梗之极,非乌金散所能去者,则用化腐紫霞膏搽之,然终不若乌金散为至稳。
凡治痈疽最难收口者,由瘀肉夹杂,瘀脓不尽所致。庸工不识,妄用补涩之剂,勉强收
口,恐他日内毒复发,更甚于目前。惟予所用海浮散堪称至宝。以此敷上,瘀肉自脱,不必
用刀,新肉自生,又不藏毒,万举万当也。大法先用防风汤洗之。再上末药。洗时须避风为
主。书云∶频将汤洗,切忌风吹是已。更有体虚不能收口者,须内服补药以助之。
According to ancient texts: Apply a plaster to the top of the lesion and spread medicine around the four sides. For large swellings and toxic sores that are about to suppurate, first apply Wujin Gao (Black Gold Plaster) to the head of the sore, then cover it with Wanquan Gao (Perfect Safety Plaster), and surround it with Furong Gao (Hibiscus Plaster). The area covered by the plaster is intended to promote pus discharge, while the area covered by the medicine is intended to resolve the swelling. This method can also "hoop" or confine the base of the sore, preventing it from spreading. Regarding this three-layer application method: the first layer involves applying Wujin Gao to the head of the sore; if there is diffuse swelling without a distinct head, paste wet paper onto the area—the part that dries first indicates the location of the sore's head. The second layer involves applying Wanquan Gao. The third layer involves surrounding the area with Furong Gao. However, I have often used Wanquan Gao, spreading it over the entire swollen area, thereby confining both the swelling and its base. The parts that should resolve naturally resolve, and the parts that should ulcerate naturally ulcerate, ultimately achieving complete healing. This demonstrates the efficacy of plasters.
In treating carbuncles and ulcers, if the opening is small but there is abundant pus, the pus may not drain, or may not drain completely; thin pus may drain easily, while thick/hard pus is difficult to expel. This leads to stasis remaining while new tissue fails to grow, resulting in a lingering condition that is difficult to heal. The treatment method should be to cauterize/open a larger aperture to ensure the complete expulsion of necrotic tissue and pus. Among cauterizing/removing necrotic agents, Wu Jin San (Black Gold Powder) is the best; it removes necrotic flesh without damaging healthy new tissue and causes minimal pain, making it extremely effective. If a sinus tract exists, wrap the medicine in cotton paper strips, insert them into the tract, and replace them frequently until the obstruction dissolves. In cases of extremely stubborn induration that cannot be removed by Wu Jin San alone, Huafu Zixia Gao (Corrosive Purple Cloud Plaster) may be applied for sloughing, although it is not as safe and stable as Wu Jin San.
The most difficult aspect of treating carbuncles and ulcers regarding wound closure is caused by the intermingling of necrotic tissue and incomplete drainage of purulent exudate. Unskilled practitioners fail to recognize this and recklessly use astringent and tonifying formulas to force wound closure, fearing that internal toxins may recur later, potentially worse than the current state. Only the Haifu San (Sea Float Powder) used by me can be considered a supreme treasure. When applied, necrotic tissue naturally detaches without the need for surgical knife excision, new tissue grows spontaneously, and toxins are not retained, making every application highly successful. The general principle is to first wash the area with Fangfeng Tang (Saposhnikovia Decoction), and then apply the powdered medicine. During washing, avoiding wind exposure is paramount. Ancient texts state: "Frequently wash with decoction, strictly avoid wind exposure," which confirms this approach. For patients with weak constitution who cannot achieve wound closure, internal administration of tonifying medicines is required to assist the process.