脉浮数者,散之。脉沉实者,下之。表里俱实,解表攻里。
麻木大痛或不痛者,并灸之,更兼攻毒。
疔疮,以其疮形如丁盖之状也,多因肥甘过度,不慎房酒,以致邪毒蓄结,遂生疔疮,
经曰膏粱之变,足生大疔是也。亦有人患多汗滴入肉食而生,亦有误食死牛马而生,不可不慎。
初生,头凹肿痛,赤黄赤黑无复定色,便令烦躁闷乱,或憎寒头痛,或呕吐心逆者是也。急于
艾炷灸之,若不觉痛,针疮四边皆令血出,以回疮锭子从疮口 之,贴以膏药,仍服五香连
翘汤、漏芦汤等疏下之为效。针之不痛多血者,以猛火烧铁针通赤,于疮上烙之,令如焦炭,
取痛为效,亦 前锭子,贴以膏药,经一二日,脓溃根出,服托里散,根据常疗之。如针不痛,
其人眼黑,或见火光者,不可治,此毒已入脏腑也。
一人足患,作脓,恶寒呕吐,时发昏乱,脉浮数,明灸二十余壮,始痛,以夺命丹一服,
肿起,更以荆防败毒散而愈。
一人左手臂患之,是日一臂麻木,次日半体皆然,神思昏溃,遂明灸二十余壮,犹不痛,
至百壮始痛,以夺命丹一服始肿起,更用神异膏及防风败毒散而愈。
一人脚面生疔,形虽如粟,其毒甚大,宜峻利之药攻之,因其怯弱,以隔蒜灸五十余壮,
痒止,再灸片时知痛,更贴膏药,再以人参败毒散一服,渐愈。至阴之下,道远位僻,药力
难达,若用峻剂,则药力未到,胃气先伤,不如灸之为宜。
一人感风毒,面生疔十余枚,肿痛脉数,服荆防败毒散稍愈,尚可畏,更用夺命丹,一服
而愈。
一妇六十,右耳下天容穴间一疔,其头黑靥,四边泡起,黄水时流,浑身麻木,发热谵语,
时时昏沉,六
脉乱洪,用乌金散以汗之,就用铍针刺疮心不痛,周遭再刺十余下,紫黑血出,方知疼痛,
即将寸金锭子 之疮内,外用提疔子放疮上,膏日贴护。次日汗后,精神微爽,却用破棺丹下之,
病即定,其疮溃动,后用守效散贴涂,红玉锭子 之,八日疔出。兹所谓审脉证,汗下之,
间外治,次第如此,殊胜不察脉证,但见发热谵语,便投下药,或兼香窜之药,遂至误人远
矣。(世人多云∶是疮不是疮,且服五香连翘汤。然或中或否,致误者多。盖不审形气虚实,疮
毒浅深,发表攻里,所因不同故也,此药善于驱逐,又以五般香窜佐之,与漏芦相间,大黄为
佐,大黄入阳明、太阳,性能走不守,泄诸实热,以其峻捷,故号将军,虽各有参 、漏芦、
甘草之补药,宁免驱逐之祸乎!)
一人胸患,遍身麻木,脉数而实,急针,出恶血,更明灸数壮,始痛,服防风通圣
散,得利而愈。
一夫人面生疔,肿 痛甚,数日不溃,肺证俱实,治以荆防败毒散,加芩连,稍愈。
彼以为缓,乃服托里散,一剂势盛,痛极始悟。再服用凉膈散,二服痛减肿溃,又与连翘消
毒散,十余剂而愈。
一人唇生疔疮以五日,肿硬脉数,烦躁喜冷,此胃经积热所致。先以凉膈散,一服热
去五六;更与夺命丹,二粒肿退二三;再以荆防败毒散,四剂而愈。
一人患之,发热烦躁脉实,以清凉饮下之而愈。
一郑氏举家生疔,多在四肢,皆食死牛肉所致,刺去恶血,更服紫金丹,悉愈。
一人唇下生疔,脉证俱实,法宜下之,反用托里,故口鼻流脓而死,是谓实实之祸也。
一老妇足大指患疔,甚痛,令灸之不从,专服败毒药,致真气虚而邪气愈实,竟不救。
盖败毒药,虽能表散疮毒,然而感有表里,所发有轻重,体段有上下,所禀有虚实,岂
可一概而用之耶?且至阴之下,药力难到,专假药力,则缓不及事,不若灸之为速,故下部患
疮,皆宜隔蒜灸之,不痛者,宜明灸之,及针疔四舋,去恶血,以夺命丹一粒入疮头孔内,仍
以膏药贴之。若患在手足,红丝攻心腹者,就放丝尽处刺去恶血,宜服荆防败毒散。若丝近
心腹者,宜挑破疮头,去恶水,以膏药贴之。如麻木者,服夺命丹,如
牙关紧急,或喉内患者,并宜噙一二丸。
疔疮,丹溪用磁石为末,苦酒和封之,根即出。
又方 巴豆(十粒) 大半夏(一粒) 大附子(半个) 蜣螂(一枚)
上各为末,用麝和,看疮大小,以纸绳子围疮口,以药泥上,用帛贴敷,时换新药,
以瘥为度,活人甚多。
For a floating and rapid pulse, use dispersing methods. For a deep and excess pulse, use purgative methods. When both exterior and interior manifestations are excess, resolve the exterior and attack the interior simultaneously.
For numbness, severe pain, or absence of pain, apply moxibustion, combined with detoxification therapies.
Ding Chuang (Furuncle/Carbuncle) is named for its shape resembling a nail cap. It often arises from excessive consumption of rich and sweet foods, lack of restraint in sexual activity and alcohol intake, leading to the accumulation and condensation of pathogenic toxins, thereby generating Ding Chuang.
The Classics state: "Changes caused by rich food can produce large Ding," which refers to this condition. Some people contract it when sweat drips into meat, while others contract it from accidentally eating dead cattle or horses; one must be cautious.
Initially, the lesion has a depressed head with swelling and pain, displaying colors such as red-yellow or red-black without fixed hue. The patient subsequently experiences irritability and confusion, aversion to cold and headache, or vomiting and nausea. Urgent application of moxa cones is required. If there is no sensation of pain, prick the four sides of the lesion to induce bleeding, insert the Huichuang Dingzi (Return-to-lesion pellet) into the wound, apply a plaster, and administer formulas such as Wuxiang Lianqiao Tang (Five-Spice Forsythia Decoction) or Loulu Tang (Rhaponticum Decoction) to promote drainage and achieve efficacy. If pricking yields no pain but abundant blood flow, heat an iron needle red-hot in a fierce fire and cauterize the lesion until it resembles charred coal, aiming to elicit pain. Use the aforementioned pellet and apply a plaster. After one or two days, when pus discharges and the root emerges, administer Tuoli San (Support-the-Interior Powder) and treat according to standard protocols for Ding Chuang. If pricking still yields no pain, and the patient exhibits blackening of the eyes or visualizes firelight, the condition is incurable, indicating that the toxin has entered the zang-fu organs.
A case: A patient suffered from Ding Chuang on the foot, with suppuration, aversion to cold, vomiting, and periodic confusion. The pulse was floating and rapid. Direct moxibustion was applied for over twenty moxa cones, after which pain was felt. One dose of Duoming Dan (Life-Restoring Pill) was administered, causing the swelling to subside. The patient was then cured using Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder).
Another case: A patient suffered from the condition on the left arm. On the day of onset, the entire arm was numb; by the next day, half the body was affected, accompanied by mental confusion. Direct moxibustion was applied for over twenty cones, yet no pain was felt. Only after one hundred cones was pain elicited. One dose of Duoming Dan was given, leading to subsidence of swelling. The patient recovered using Shenyi Gao (Miraculous Plaster) and Fangfeng Baidu San (Saposhnikovia Detoxifying Powder).
Another case: A patient developed Ding Chuang on the dorsum of the foot. Although small like a millet grain, the toxicity was severe. Potent purgatives were indicated, but due to the patient's weakness, garlic-separated moxibustion was applied for over fifty cones. Itching ceased, and after further brief moxibustion, pain was felt. A plaster was applied, followed by one dose of Renshen Baidu San (Ginseng Detoxifying Powder), leading to gradual recovery. In the lower yin regions (lower limbs), distant and remote locations make drug delivery difficult. Using potent drugs may damage stomach qi before the drug reaches the site; thus, moxibustion is preferable.
Another case: A patient contracted wind-toxin, developing over ten Ding lesions on the face, with swelling, pain, and a rapid pulse. Slight improvement occurred after taking Jingfang Baidu San, but fear persisted. Duoming Dan was then used, resulting in cure after one dose.
A sixty-year-old female had a Ding lesion between the Tianrong acupoint below the right ear. The head was black and crusted, surrounded by blisters with intermittent yellow discharge. The whole body was numb, with fever, delirium, periodic drowsiness, and chaotic, surging pulses. Wujin San (Golden Metal Powder) was used to induce sweating. A Pi needle was used to prick the center of the lesion (no pain initially), followed by over ten pricks around the periphery, releasing purple-black blood, after which pain was felt. Cunjin Dingzi (Inch-Gold Pellet) was inserted into the wound, and a Tidingzi (Pull-Ding Agent) placed on top externally, protected by daily plaster application. After sweating the next day, mental clarity slightly improved. Pokuan Dan (Coffin-Breaking Pill) was then used to purge, stabilizing the condition. The lesion ulcerated. Shouxiao San (Maintaining-Efficacy Powder) was applied topically, Hongyu Dingzi (Red-Jade Pellet) inserted, and the Ding expelled after eight days. This illustrates examining pulse and symptoms, employing sweating and purging methods, interspersed with external treatments, in proper sequence. This approach far surpasses ignoring pulse and symptoms, merely seeing fever and delirium, and immediately administering purgatives or aromatic-penetrating drugs, which leads to significant error. (People often say: "It is a sore, not a Ding; take Wuxiang Lianqiao Tang." However, results vary, causing many errors. This stems from failing to examine the deficiency or excess of constitution and the depth of toxin, where the causes for resolving the exterior or attacking the interior differ. This drug excels at expelling pathogens, aided by five aromatic substances, alternating with Loulu, assisted by Dahuang (Rhubarb). Dahuang enters the Yangming and Taiyang channels, possessing a moving rather than retaining nature, draining various excess heats. Due to its potency, it is called the "General." Although it contains tonics like Renshen, Loulu, and Gancao, how can it avoid the disaster of excessive expulsion?)
Another case: A patient suffered from chest involvement with generalized numbness, rapid and excess pulse. Emergency pricking released evil blood, followed by direct moxibustion for several cones until pain was felt. Fangfeng Tongsheng San (Saposhnikovia Unblocking-Harmonizing Powder) was administered, leading to recovery upon bowel movement.
A lady developed facial Ding with severe swelling and pain, persisting for several days without ulceration. Lung channel signs were all excess. She was treated with Jingfang Baidu San supplemented with Huangqin (Scutellaria) and Huanglian (Coptis), showing slight improvement.
Believing the effect too slow, she took Tuoli San. After one dose, the condition worsened, and pain became extreme, realizing her mistake. Taking Liangge San (Cooling Diaphragm Powder) for two doses reduced pain and caused ulceration. Lianqiao Xiaodu San (Forsythia Detoxifying Powder) was then given, curing her after more than ten doses.
A patient had a lip Ding for five days, with swelling, hardness, rapid pulse, irritability, and preference for cold. This was caused by accumulated heat in the Stomach channel. Liangge San was first administered, reducing heat by 50-60% after one dose. Two pills of Duoming Dan reduced swelling by 20-30%. Jingfang Baidu San was then given for four doses, resulting in cure.
A patient presented with fever, irritability, and excess pulse. Qingliang Yin (Clearing-Cooling Drink) was used to purge, leading to recovery.
A Zheng family experienced multiple cases of Ding, mostly on the limbs, caused by eating dead beef. Pricking removed evil blood, and Zijin Dan (Purple-Gold Pill) was taken, resulting in complete recovery.
A patient developed a sub-labial Ding. Pulse and signs were all excess, warranting purgation. Instead, Tuoli (Support-the-Interior) methods were used, leading to pus flowing from the mouth and nose and death. This is termed the "exacerbating excess" disaster.
An elderly woman suffered from a painful Ding on the big toe. Refusing moxibustion, she exclusively took detoxifying drugs, depleting true qi and allowing pathogenic qi to become excessively strong, ultimately proving fatal.
Detoxifying drugs, although capable of dispersing surface sores, must consider whether the pathogen is in the exterior or interior, the severity of onset, the location (upper or lower), and the constitution (deficiency or excess). How can they be used uniformly? Moreover, in the lower yin regions, drug efficacy is hard to reach. Relying solely on drugs is too slow; moxibustion is faster. Therefore, for sores in the lower body, garlic-separated moxibustion is suitable. For those without pain, direct moxibustion is appropriate, along with pricking the four corners of the Ding to remove evil blood. Insert one pill of Duoming Dan into the hole of the Ding head, and cover with a plaster. If the lesion is on the hands or feet with red threads attacking the heart and abdomen, prick the end of the thread to release evil blood, and take Jingfang Baidu San. If the thread is close to the heart and abdomen, pierce the Ding head, drain evil fluid, and apply a plaster. For numbness, take Duoming Dan. For trismus or throat involvement, hold one or two pills in the mouth.
Zhu Danxi used magnetite powder mixed with vinegar to seal the lesion, causing the root to emerge.
Another prescription: Radix Crotonis (Badou, 10 grains), Rhizoma Pinelliae Preparatum (Banxia, 1 large grain), Radix Aconiti Lateralis Preparata (Fuzi, half a piece), Scarabaeus (Qianglang, 1 insect).
Grind each into powder, mix with Moschus (Shexiang). Depending on the size of the lesion, draw a circle with paper string around the wound, apply the medicinal mud inside, cover with cloth, and change the medicine frequently until healed. Many lives have been saved this way.