【方歌】脑后发生在督经,热结风府粟肿疼,红活易溃稠脓顺,
紫暗难溃血水凶。
【注】此证属督脉经,枕骨之下风府穴,由积热外受风邪凝结
而成。初如粟米,焮肿作疼,痛引头顶肩项,气粗鼻塞
,渐大如盘如碗。红活速溃出稠脓者顺;紫暗难溃时津
血水者逆。初起内外治法,按玉枕疽。其余内外治法,
俱按痈疽肿溃疡门。
【方歌】脑铄顶后如横木,精涸毒火上乘生,黑如灶烟牛唇硬,
木痛未腐水流清。急施桑艾法至痛,火燎刺痛属阳经,
速服仙方活命饮,若见七恶定然凶。
【注】此证先于督脉经风府穴,由阴粉枯涸,毒火乘之而生。
初起形如椒粒,坚硬紫暗,渐肿如横木,甚则上至巅顶
,下至大椎,色如灶烟,硬若牛唇。未脓皮先腐烂,时
流清水,肌肉冰冷,轻者木痛,重者毒气将陷,全不知
疼。宜急施桑柴烘法,艾壮灸法,以痛为度;速服仙方
活命饮,以舒解其毒。七日之后,不发长不生大脓者,
宜服十全大补汤救之,投补药不应者难治。若初起热如
火燎刺痛,属阳证,速服黄连消毒饮,外敷回阳玉龙膏
。此证若首尾纯见五善之证者,属顺;见七恶之证者,
逆也。其余内外治法,俱按痈疽肿溃疡门。
方剂:桑柴烘法、艾壮灸法(俱见卷首)
仙方活命饮(见肿疡门)
十全大补汤(见溃疡门)
黄连消毒饮(见前百会疽)
回阳玉龙膏(见肿疡门)
[Prescription Verse] Nao Hou Fa (Abscess at the Back of the Head) occurs in the Du Meridian. Heat accumulation at Fengfu (GV16) causes millet-like swelling and pain. Reddish and vibrant lesions that easily suppurate with thick pus indicate a favorable prognosis; purplish-dark lesions that are difficult to suppurate and discharge bloody fluid indicate a ominous prognosis.
[Annotation] This condition belongs to the Du Meridian, located below the occipital bone at Fengfu (GV16). It is caused by the confluence of accumulated internal heat and external wind pathogenic factors. Initially, it resembles a millet grain, presenting with burning swelling and pain, radiating to the vertex, shoulders, and neck, accompanied by coarse breathing and nasal congestion. It gradually enlarges to the size of a plate or bowl. Lesions that are reddish-vibrant and rapidly suppurate with thick pus are considered favorable (Shun); those that are purplish-dark, difficult to suppurate, and continuously discharge serous or bloody fluids are considered unfavorable (Ni). For initial treatment, both internal and external methods should follow the guidelines for Yuzhen Ju (Abscess at the Jade Pillow). All other internal and external treatments should refer to the "Chapters on Carbuncles, Ulcers, Swellings, and Ulcerations."
[Prescription Verse] Nao Shuo (Abscess at the Crown-Back) resembles a horizontal log. It arises from the depletion of essence and blood, allowing toxic fire to ascend. The lesion appears black like soot and hard as ox lips. Before suppuration, clear fluid may flow while the area feels numb and painful. Urgently apply Sangchai Hong (Mulberry Wood Roasting) and Aizhuang Jiu (Moxa Cone Moxibustion), stopping when pain is felt. Burning pain resembling fire indicates involvement of Yang meridians; administer Xianfang Huoming Yin immediately. If Seven Evil signs appear, the prognosis is definitely poor.
[Annotation] This condition initially manifests at Fengfu (GV16) of the Du Meridian, caused by the depletion of Yin essence, allowing toxic fire to invade. Initially, it resembles a pepper grain, being hard and purplish-dark. It gradually swells like a horizontal log, potentially extending up to the vertex and down to Dazhui (GV14). The color resembles soot, and hardness resembles ox lips. Before suppuration, the skin may rot first, discharging clear fluid, with cold muscles. Mild cases present with numbness and pain; severe cases involve toxin sinking inward, resulting in complete loss of sensation. Urgently apply Sangchai Hong (Mulberry Wood Roasting) and Aizhuang Jiu (Moxa Cone Moxibustion), using pain as the indicator. Administer Xianfang Huoming Yin promptly to resolve toxicity. After seven days, if new tissue does not grow and large pus does not form, administer Shiquan Dabu Tang for rescue. If tonifying herbs are ineffective, the condition is difficult to treat. If the onset presents with burning heat and stabbing pain, it is a Yang syndrome; administer Huanglian Xiaodu Yin internally and apply Guiyang Yulong Gao externally. If the Five Good signs persist throughout the course, it is favorable; if the Seven Evil signs appear, it is unfavorable. All other internal and external treatments should refer to the "Chapters on Carbuncles, Ulcers, Swellings, and Ulcerations."
Formulas: Sangchai Hong Method, Aizhuang Jiu Method (see Volume Preface); Xianfang Huoming Yin (see Chapter on Pre-ulcerative Conditions); Shiquan Dabu Tang (see Chapter on Post-ulcerative Conditions); Huanglian Xiaodu Yin (see preceding section on Baihui Ju); Guiyang Yulong Gao (see Chapter on Pre-ulcerative Conditions).