属性:洗有荡涤之功。涤洗则气血自然舒畅,其毒易于溃腐,
而无壅滞也。凡肿在四肢者,〔榻〕渍之;在腰腹脊背
者,淋之;在下部者,浴之,俱以布帛或棉蘸洗,稍温
即易,轻者日洗一次,重者日夜洗二次,每日洗之,不
可间断。凡洗时,冬月要猛火以逼寒气,夏月要明窗以
避风凉。若不慎此,轻则有妨收口,重则恐变纯阴。夫
洗药不一,如初肿与将溃者,俱用葱归〔榻〕肿汤烫洗
。如阴证不起者,俱用艾茸汤敷法。如溃后,俱用猪蹄
汤烫洗。用猪蹄汤者,以肋肉之气而逐腐也。此涤洗之
法,乃疡科之要药也。
方剂:葱归〔榻〕肿汤
主治:此汤治痈疽疮疡,初肿将溃之时,用此汤洗之,以疮内
热痒为度。
组成:独活(三钱) 白芷(三钱)
葱头(七个) 当归(三钱)
甘草(三钱)
上五味,以水三大碗,煎至汤醇,滤去渣,以绢帛
蘸汤热洗,如温再易之。
【方歌】葱归〔榻〕肿洗诸毒,初起将溃用之宜,洗至热痒斯为
度,独芷葱归甘草俱。
又方:艾茸敷法
主治:此膏治阴疮黑陷而不痛者,用之为良。以知痛则生,不
知痛出紫血者死,然必内服大补回阳之剂以助之。
组成:硫黄(五钱) 雄黄(五钱)
艾茸(一斤)
上以硫、雄二味为末,同艾入水煎半日,水将干,取
艾出,捣烂,温敷患处。再煎再易,十余次为度。
【方歌】艾茸敷法治阴疮,黑陷不痛用之良,石硫黄雄同艾煮,
捣成膏敷定能康。
又方:猪蹄汤
主治:此汤治痈疽、诸毒流脓者,熬好洗之,以助肉气,消肿
散风,脱腐止痛,去恶肉,活死肌,润疮口。如腐尽者
,不必用之,当以米泔水热洗之,令疮洁净。不可过洗
,过洗则伤水,皮肤破烂,难生肌肉敛口矣。
组成:黄芩 甘草
当归 赤芍
白芷 蜂房
羌活(各等份)
上七味,共为粗末,看证之大小,定药之多少。先
将〔火贲〕猪前蹄一只,用水六碗,煮蹄软为度,将汁
滤清,吹去汁上油花,即用粗药末一两,投于汁中;再
用微火煎十数沸,滤去渣,候汤微温,即用方盘一个,
靠身于疮下放定,随用软绢蘸汤淋洗疮上,并入孔内,
轻手捺尽内脓,庶败腐宿脓,随汤而出,以净为度;再
以软帛叠七、八重,蘸汤勿令大干,覆于疮上,两手轻
按片时,帛温再换,如此再按四、五次,可以洗通血气
,解毒止痛去瘀也。洗讫用绢帛挹干,即随证以应用之
药贴之。
【方歌】猪蹄汤治痈疽毒,已溃流脓用此方,消肿散风能止痛,
芩甘归芍芷蜂羌。
Washing possesses the efficacy of cleansing and scouring. Through washing, Qi and Blood naturally become smooth and unobstructed; its pathogenic toxins are prone to disperse and putrefy, without causing stagnation or blockage. For swellings located in the four limbs, soaking (Zi) is used; for those in the waist, abdomen, spine, and back, pouring/rinsing (Lin) is used; for those in the lower parts, bathing (Yu) is used. All methods involve dipping cloth or cotton into the medicinal liquid for washing. The cloth should be changed when it becomes slightly cool. For mild cases, wash once a day; for severe cases, wash twice a day (morning and night). Daily washing must not be interrupted. During washing, in winter, strong fire should be used to drive out cold qi; in summer, one should wash near a bright window to avoid wind and chill. If these precautions are not observed, mild cases may hinder wound healing, while severe cases may transform into Pure Yin Syndrome (a critical condition characterized by extreme Yang deficiency). The specific washing medicines vary: for initial swelling and impending ulceration, Cong Gui Zi Zhong Tang (Scallion and Angelica Soaking Swelling Decoction) is used for hot washing. For Yin Syndromes that fail to rise or manifest, Ai Rong Fu Fa (Mugwort Floss Application Method) is used. After ulceration has occurred, Zhu Ti Tang (Pig Trotter Decoction) is used for hot washing. Zhu Ti Tang is used because the qi of pork ribs helps expel putrefied tissue. This method of cleansing and washing is an essential technique in Surgery (Yang Ke).
Formula: Cong Gui Zi Zhong Tang (Scallion and Angelica Soaking Swelling Decoction)
Indications: This decoction treats Carbuncles and Ulcers (Yong Ju Chuang Yang) during the stage of initial swelling and impending ulceration. It is used for washing until a sensation of heat and itching within the wound is felt, which indicates the proper degree.
Composition: Du Huo (Radix Angelicae Pubescentis, 3 qian), Bai Zhi (Radix Angelicae Dahuricae, 3 qian), Cong Tou (Bulbus Allii Cepae, 7 heads), Dang Gui (Radix Angelicae Sinensis, 3 qian), Gan Cao (Radix Glycyrrhizae, 3 qian).
The above five herbs are boiled in three large bowls of water until the decoction becomes rich and concentrated. Filter out the dregs. Dip silk fabric into the hot decoction to wash the affected area. Change with fresh hot decoction as it cools.
[Prescription Verse] Cong Gui Zi Zhong Tang washes various toxins; suitable for use when swelling begins and is about to ulcerate. Wash until heat and itching are felt; this is the limit. Du Huo, Bai Zhi, Cong Tou, Dang Gui, and Gan Cao are all included.
Another Formula: Ai Rong Fu Fa (Mugwort Floss Application Method)
Indications: This plaster is effective for treating Yin Sores (Yin Chuang) that appear black, depressed, and painless. If pain is perceived after application, it indicates vitality; if there is no pain and purple blood flows out, the prognosis is fatal. However, internal administration of major tonifying and Yang-restoring agents is necessary to assist treatment.
Composition: Liu Huang (Sulfur, 5 qian), Xiong Huang (Realgar, 5 qian), Ai Rong (Artemisia argyi floss, 1 jin).
Grind Liu Huang and Xiong Huang into powder. Mix with Ai Rong and boil in water for half a day. When the water is nearly dry, remove the Ai Rong, pound it into a paste, and apply it warm to the affected area. Re-boil and re-apply, repeating more than ten times as a course.
[Prescription Verse] Ai Rong Fu Fa treats Yin Sores; effective for black, depressed, and painless lesions. Boil Shi Liu Huang (Mineral Sulfur) and Xiong Huang with Ai Rong; pound into a paste and apply to ensure recovery.
Another Formula: Zhu Ti Tang (Pig Trotter Decoction)
Indications: This decoction treats Carbuncles, Ulcers, and various toxic sores with purulent discharge. It is boiled and used for washing to promote flesh regeneration, reduce swelling, dissipate wind, relieve pain, remove necrotic tissue, revitalize dead muscle, and moisten the wound edges. If the necrotic tissue has already been completely expelled, this decoction is unnecessary; instead, rinse with hot Mi Gan Shui (Rice Washing Water) to keep the wound clean. Do not over-wash, as excessive washing damages fluids/tissues, causes skin breakdown, and hinders muscle growth and wound closure.
Composition: Huang Qin (Radix Scutellariae), Gan Cao (Radix Glycyrrhizae), Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), Bai Zhi (Radix Angelicae Dahuricae), Feng Fang (Cera Tabulae), Qiang Huo (Rhizoma Notopterygii); all in equal proportions.
Crush the seven herbs into coarse powder. Determine the quantity based on the size of the lesion. First, boil one front pig trotter in six bowls of water until soft. Filter the broth clearly, skim off the oil from the surface. Add one liang of the coarse herb powder to the broth. Simmer over low heat for several boils. Filter out the dregs. Wait until the decoction is slightly warm. Place a square basin close to the body beneath the wound. Dip soft silk into the decoction to pour/wash over the wound and into any cavities. Gently press with hands to exhaust internal pus, allowing necrotic tissue and old pus to exit with the decoction. Continue until clean. Fold soft cloth seven or eight layers, dip in decoction (keep it moist), cover the wound, and gently press with both hands for a moment. Replace the cloth when it cools. Repeat pressing four or five times to unblock Qi and Blood, detoxify, relieve pain, and remove stasis. After washing, dry with silk, then apply appropriate medicaments according to the syndrome.
[Prescription Verse] Zhu Ti Tang treats Carbuncles and Toxic Sores; use this formula for ulcerated wounds with purulent discharge. Reduces swelling, dissipates wind, and relieves pain. Huang Qin, Gan Cao, Dang Gui, Chi Shao, Bai Zhi, Feng Fang, and Qiang Huo are used.