消瘰 。
生半夏(一两) 生山甲(三钱) 生甘遂(一钱) 生马钱子(四钱,剪碎) 皂角(三钱) 朱血竭(二钱)
上药前五味,用香油煎枯去渣,加黄丹收膏,火候到时将血竭研细搀膏中熔化和匀,随疮大小摊作膏药。
临用时每药一帖加麝香少许。
友人之女年五岁。项间起瘰 数个,年幼不能服药,为制此药,贴之全愈。
凡膏药中用黄丹,必以火炒过,然后以之熬膏,其胶粘之力始大。而麝香不早加入膏药中者,以麝香忌火也。
治瘰 已溃烂者,用此药擦之。他疮破后者亦可用之。
炉甘石(六钱, ) 乳香(三钱) 没药(三钱) 明雄黄(二钱) 蓬砂(三钱) 砂(二分) 冰片(三分)
共研细,收贮瓶中勿令透气。日擦患处三四次,用此药长肉。将平时收口不速者,可加珍珠一分, 研
细搀入,其 法详护眉神应散后。
治瘰 疮疡破后,气血亏损不能化脓生肌。或其疮数年不愈,外边疮口甚小,里边溃烂甚大,且有串至
他处不能敷药者。
生黄 (四两) 甘草(二两) 生明乳香(一两半) 生明没药(一两半) 生杭芍(二两)
天花粉(三两) 丹参(一两半)
上七味共为细末,开水送服三钱,日三次。若将散剂变作汤剂,须先将花粉改用四两八钱,一剂分作八
次煎服,较散剂生肌尤速。
从来治外科者,于疮疡破后不能化脓生肌者,不用八珍即用十全大补。不知此等药若遇阳分素虚之人服
之犹可,若非阳分素虚或兼有虚热者,连服数剂有不满闷烦热,饮食顿减者乎?夫人之后天,赖水谷以生气血,
赖气血以生肌肉,此自然之理也。而治疮疡者,欲使肌肉速生,先令饮食顿减,斯犹欲树之茂而先戕其根也。
虽疮家阴证,亦可用辛热之品,然林屋山人阳和汤,为治阴证第一妙方,而重用熟地一两以大滋真阴,则热药
自无偏胜之患,故用其方者,连服数十剂而无弊也。如此方重用黄 ,补气分以生肌肉,有丹参以开通之,则
补而不滞,有花粉、芍药以凉润之,则补而不热,又有乳香、没药、甘草化腐解毒,赞助黄 以成生肌之功。
况甘草与芍药并用,甘苦化合味同人参,能双补气血,则生肌之功愈速也。至变散剂为汤剂,花粉必加重者,
诚以黄 煎之则热力增,花粉煎之则凉力减,故必加重而其凉热之力始能平均相济也。至黄 必用生者,因生
用则补中有宣通之力,若炙之则一于温补,固于疮家不宜也。
一人年二十余。因抬物用力过度,腰疼半年不愈。忽于疼处发出一疮,在脊梁之旁,微似红肿,状若复
盂,大径七寸。疡医以为腰疼半年,始现此疮,其根蒂必深而难治。且其内外发热,饮食懒进,舌苔黄浓,脉
象滑数。知其证兼外感实热,投以白虎加人参汤,热退能食。数日,又复虚汗淋漓,昼夜不止,遂用龙骨、牡
蛎(皆不用 )、生杭芍、生山药各一两为方,两剂汗止。继治以清火、消肿、解毒之药,若拙拟消乳汤,去
栝蒌加金线重楼、
三七(冲服)之类,更加鹿角霜钱许,以引经。惟消乳汤以知母为君重八钱,兹则所用不过五六钱。外用五倍
子、三七、枯矾、金线重楼、白芨为末,以束其根;乳香、没药、雄黄、金线重楼、三七为末,以敷其顶,皆
用醋调之。旬日疮消三分之二,其顶甚软。遂以乌金膏(以雄黄炒巴豆仁至黑色研细名乌金膏)调香油敷其软
处。二日,疮破出稠脓若干。将此内托生肌散改作汤剂,投之,外敷拙拟化腐生肌散。七八日间疮口长平,结
痂而愈。
徐灵胎治疮最重围药。以围药束住疮根,不使毒势散漫,又能阻隔周身之热力,不贯注于疮,则疮必易
愈。愚治此疮所用束根之药,实师徐氏之意也。
Xiaoluo Gao (Scrofula-Resolving Plaster).
Raw Banxia (Pinelliae Rhizoma, 1 liang), Raw Shanjia (Manis Squama, 3 qian), Raw Gansui (Radix Euphorbiae Kansui, 1 qian), Raw Maqianzi (Strychni Semen, 4 qian, cut into pieces), Zaojiao (Gleditsiae Sinensis Fructus, 3 qian), Zhuxuejie (Dragon's Blood with Cinnabar, 2 qian).
The first five herbs above are fried in sesame oil until charred, then the dregs are removed. Huangdan (Lithargyrum) is added to form the plaster. When the heat control is appropriate, Xuejie (Dragon's Blood) is ground into fine powder and mixed into the plaster until melted and uniform. It is then spread onto paper according to the size of the sore.
When applying, add a small amount of Shexiang (Moschus) to each plaster.
A friend's daughter, aged five, had several lumps of Luoli (scrofula/tuberculous lymphadenitis) on her neck. Due to her young age, she could not take oral medicine, so this plaster was prepared for external application, resulting in complete recovery.
Whenever Huangdan (Lithargyrum) is used in plasters, it must be roasted over fire before being used to boil the plaster; only then will its adhesive strength be significant. Shexiang (Moschus) is not added early because it fears fire.
For treating ulcerated Luoli (scrofula), apply this medicine by wiping. It can also be used for other sores after they have broken open.
Lu-gan-shi (Calamina, 6 qian, calcined), Ruxiang (Olibanum/Frankincense, 3 qian), Moyao (Myrrha/Myrrh, 3 qian), Ming Xionghuang (Realrealgar, 2 qian), Pengsha (Borax, 3 qian), Naosha (Sal Ammoniac, 2 fen), Bingpian (Borneolum Syntheticum, 3 fen).
Grind all together into fine powder, store in a bottle, and prevent air exposure. Wipe the affected area 3-4 times daily. This medicine promotes flesh growth. For cases where healing is usually slow, add 1 fen of Zhenzhu (Pearl), grind finely, and mix in. The method is detailed after Humei Shenyingsan.
For treating Luoli (scrofula) or sores that have broken open, where Qi and Blood deficiency prevents pus formation and flesh regeneration. Or for sores that do not heal for years, with a very small external opening but large internal ulceration, and spreading to areas where topical medication cannot reach.
Sheng Huangqi (Raw Astragali Radix, 4 liang), Gancao (Licorice Root, 2 liang), Sheng Ming Ruxiang (Raw Olibanum, 1.5 liang), Sheng Ming Moyao (Raw Myrrha, 1.5 liang), Sheng Hangshao (Raw Paeoniae Radix Alba, 2 liang), Tianhuafen (Trichosanthis Radix, 3 liang), Danshen (Salviae Miltiorrhizae Radix et Rhizoma, 1.5 liang).
Grind the seven herbs above into fine powder. Take 3 qian with boiled water, three times a day. If changing the powder to a decoction, change Tianhuafen (Trichosanthis Radix) to 4.8 liang initially. Divide one dose into eight portions for decoction and administration. This generates flesh faster than the powder form.
Historically, surgeons treating sores that fail to generate pus and flesh after breaking open use either Bazhen Tang (Eight-Treasure Decoction) or Shiquan Dabu Tang (Ten Significant Tonifying Decoction). However, if these medicines are taken by someone who is constitutionally deficient in Yang, it may be acceptable. But for those not constitutionally deficient in Yang, or those with concomitant deficiency-heat, taking several doses would likely cause fullness, oppression, irritability, heat, and a sudden decrease in appetite. The post-heaven foundation relies on food and drink to generate Qi and Blood, and relies on Qi and Blood to generate flesh; this is natural law. Surgeons wishing to speed up flesh generation but causing a sudden decrease in appetite are like wanting a tree to flourish while cutting off its roots. Even for Yin syndromes in sores, acrid-hot substances can be used. Linwu Shanren's Yanghe Tang is the premier miraculous formula for Yin syndromes, using heavy doses of Shudi (Rehmanniae Radix Preparata, 1 liang) to greatly nourish True Yin, thus avoiding the risk of excessive heat from hot medicines. Therefore, users of this formula can take dozens of doses without detriment. This formula heavily uses Huangqi (Astragali Radix) to tonify Qi to generate flesh; Danshen (Salviae Miltierhizae Radix et Rhizoma) opens and unblocks it, preventing stagnation from tonification; Tianhuafen (Trichosanthis Radix) and Shaoyao (Paeoniae Radix) cool and moisten it, preventing heat from tonification; Ruxiang (Olibanum), Moyao (Myrrha), and Gancao (Licorice Root) resolve putrefaction and detoxify, assisting Huangqi (Astragali Radix) in generating flesh. Moreover, Gancao (Licorice Root) combined with Shaoyao (Paeoniae Radix) creates a sweet-bitter flavor akin to Renshen (Ginseng Radix et Rhizoma), double-tonifying Qi and Blood, thereby accelerating flesh generation. Regarding changing powder to decoction, Tianhuafen (Trichosanthis Radix) must be increased in dosage because decocting Huangqi (Astragali Radix) increases its heat, while decocting Tianhuafen (Trichosanthis Radix) decreases its cooling power; thus, increasing the dose allows their cooling and heating powers to balance. Huangqi (Astragali Radix) must be used raw because raw use provides unblocking power within tonification; if honey-fried, it becomes purely warm-tonifying, which is unsuitable for sores.
A man in his twenties suffered from waist pain for half a year due to excessive exertion while carrying objects. Suddenly, a sore appeared at the painful spot, beside the spine, slightly red and swollen, shaped like an inverted bowl, with a diameter of seven cun. The surgeon believed that since the sore appeared after half a year of pain, its root must be deep and difficult to treat. The patient had internal and external fever, poor appetite, thick yellow tongue coating, and a slippery, rapid pulse. Recognizing the syndrome involved exterior-contracted excess heat, Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng) was administered. The fever subsided, and appetite returned. A few days later, profuse spontaneous sweating occurred day and night. Longgu (Fossilia Ossis Mastodi, uncalcined) and Muli (Concha Ostreae, uncalcined), each 1 liang, along with Sheng Hangshao (Raw Paeoniae Radix Alba, 1 liang) and Sheng Shanyao (Raw Dioscoreae Rhizoma, 1 liang) were prescribed. After two doses, sweating stopped. Subsequent treatment focused on clearing heat, reducing swelling, and detoxifying, using my proposed Xiaoru Tang (Breast-Reducing Decoction), removing Gualou (Trichosanthis Fructus), adding Jinxian Chonglou (Paris Polyphylla), Sanqi (Notoginseng Radix, taken with decoction), etc., plus a small amount (1 qian) of Lujiaoshuang (Antler Glue Powder) as a guiding herb. In Xiaoru Tang, Zhimu (Anemarrhenae Rhizoma) is the sovereign herb weighing 8 qian; here, only 5-6 qian was used. Externally, Wubeizi (Terminalia Chebula Fruit), Sanqi (Notoginseng Radix), Kufan (Alumen), Jinxian Chonglou (Paris Polyphylla), and Baiji (Bletillae Rhizoma) were ground into powder to bind the root; Ruxiang (Olibanum), Moyao (Myrrha), Xionghuang (Realgar), Jinxian Chonglou (Paris Polyphylla), and Sanqi (Notoginseng Radix) were ground into powder to apply to the top, all mixed with vinegar. Within ten days, two-thirds of the sore resolved, and the top became very soft. Wujin Gao (Black Gold Plaster, made by frying Xionghuang (Realgar) with Badou Ren (Crotonis Semen) until black, then grinding fine) mixed with sesame oil was applied to the soft area. Two days later, the sore broke and discharged thick pus. Neituo Shengji San (Internal-Supporting Flesh-Generating Powder) was changed to a decoction and administered, while Huafu Shengji San (Putrefaction-Resolving Flesh-Generating Powder) was applied externally. Within seven to eight days, the wound healed flat, formed a scab, and recovered.
Xu Lingtai placed great emphasis on Weiyao (Surrounding Medicine) when treating sores. By binding the root of the sore with surrounding medicine, the spread of toxicity is prevented, and the heat of the whole body is blocked from pouring into the sore, making it easier to heal. The root-binding medicine I used for this sore truly follows Xu's intention.