追蚀脓法。使毒瓦斯外泄而不内攻。恶肉易去。好肉易生也。若 其疮。血出不止者未可
但掺追蚀药于疮上。待其熟可 。方 。 之痛应心者。亦不可 。误触其疮。 痛必倍。
必生变症。若疮疖脓成未破者于上薄皮剥起者。当用破头代针之药安其上。以膏贴之。脓出
之后。用搜脓化毒药。若脓血未尽。便用生肌。务其早愈。则毒瓦斯未尽。必再发。
肌肉。脾之所主也。溃后收敛迟速者。乃气血盛衰使然。世人但知生肌用龙竭。止痛用
。予谓不然。生肌之法。当先理脾胃助气血为主。则肌肉自生。岂假龙竭之属。设若脓毒未
尽。就用生肌。反增溃烂。壮者轻者。不过复溃。或迟敛而已。怯者重者。必致内攻。或溃
烂不敛者亦多矣。止痛之法。热者清之。寒者温之。实者损之。虚者补之。脓郁者开之。恶
肉侵蚀者。去之。如是则痛自止。岂特乳没之属。
一人发背。毒瓦斯未尽。早用生肌。竟背溃烂。治以解毒药而愈。又有患此。毒瓦斯始发。
生肌。其毒内攻而死。一人腿痈。因寒作痛。与乳香定痛丸。一妇时毒。因热作痛。与防风
通圣散。一人腿痈脓溃。因虚作痛。与益气养荣汤。一人腹痈。因实作痛。与黄连内疏汤。
一人腿痈。脓成作痛。予为刺之。一妇发背。腐肉不去作痛。予为取之。痛各自止。专用龙
竭生肌。乳没止痛。未之察也。
疮痛不可忍者。苦寒药可施于资禀浓者。若资禀素薄者。宜补中益气汤。加苦寒药。血
。四物汤加黄苓、鼠粘子、连翘。在下加黄柏。若肥人湿热疮痛者。羌活、防风、荆芥、白
芷、取其风能胜湿也。
每见疮作。先发为肿。气血郁积。蒸肉为脓。故痛多在疮始作时。脓溃之后。肿退肌宽
必渐减。而反痛者虚也。宜补参 之属。亦有秽气所触者。宜和解之。乳香、芍药之属。亦
有风寒所逼。宜温散之。羌桂之属。
The method of pursuing and eroding pus aims to allow the pathogenic toxins to discharge externally rather than attack internally. In this way, necrotic flesh is easily removed, and healthy flesh is easily regenerated. If there is unceasing bleeding from the sore, one must not merely sprinkle pursuit-and-erosion medicines on the wound surface. One must wait until the sore has matured and the pus is localized before applying such medicines. If the pain is severe enough to cause palpitations or distress in the heart, these medicines should also not be used. Accidental contact with the sore will double the pain and inevitably lead to complicated syndromes. For furuncles where pus has formed but not yet ruptured, and where the superficial thin skin has peeled up, medicines that "break the head and act as a needle" should be applied on top, covered with a plaster. After the pus discharges, medicines for searching out pus and resolving toxicity should be used. If pus and blood are not yet exhausted, and one hastily uses flesh-regenerating medicines in pursuit of early healing, the remaining toxins will inevitably cause recurrence.
Muscle tissue is governed by the Spleen (Pi). The speed of contraction after ulceration depends on the prosperity or decline of Qi and Blood. People generally believe that Regalite (Xuejie) and Dragon's Blood (Longjie) are used for flesh regeneration, and Frankincense (Ruxiang) and Myrrh (Moyao) for pain relief. I disagree. The method of regenerating flesh should primarily focus on regulating the Spleen and Stomach and assisting Qi and Blood; then flesh will naturally grow. Why rely on substances like Regalite? If pus and toxins are not yet exhausted and flesh-regenerating medicines are used immediately, it will instead increase ulceration. Those with strong constitutions and mild conditions may simply experience re-ulceration or delayed healing. However, those with weak constitutions and severe conditions will inevitably suffer from internal attack of toxins, or many cases of non-healing ulcers will occur. The method for relieving pain involves: clearing heat for heat syndromes, warming for cold syndromes, reducing excess for excess syndromes, tonifying deficiency for deficiency syndromes, opening blockages for stagnant pus, and removing necrotic flesh for erosive lesions. By doing so, pain will cease naturally. It is not limited to using only Frankincense and Myrrh.
One patient suffered from a carbuncle on the back (Fabei). Because flesh-regenerating medicine was used too early while toxins were still present, the back eventually ulcerated extensively. He was cured using detoxifying medicines. Another patient with this condition died because flesh-regenerating medicine was used when the toxin had just begun to emerge, causing the toxin to attack internally. One patient with a thigh abscess experienced pain due to Cold, and was given Ruxiang Dingtong Wan (Frankincense Pain-Relieving Pill). A female patient with a seasonal toxic eruption experienced pain due to Heat, and was given Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking and Purging). One patient with a thigh abscess experienced pain due to Deficiency after pus rupture, and was given Yiqi Yangrong Tang (Qi-Supplementing and Nourishing Blood Decoction). One patient with an abdominal abscess experienced pain due to Excess, and was given Huanglian Neishu Tang (Coptis Internal-Draining Decoction). One patient with a thigh abscess experienced pain due to formed pus; I punctured it to drain the pus. A female patient with a back carbuncle experienced pain due to retained necrotic flesh; I removed the necrotic tissue. The pain stopped in all cases. Specialized use of Regalite for flesh regeneration and Frankincense/Myrrh for pain relief without examining the underlying causes is incorrect.
For unbearable sore pain, bitter-cold medicines can be applied to patients with robust constitutions. For those with inherently weak constitutions, Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) should be used with added bitter-cold medicines. If related to Blood deficiency, Siwu Tang (Four Substances Decoction) with Huangqin (Scutellaria Root), Niubangzi (Arctium Fruit), and Lianqiao (Forsythia Fruit) should be used. Add Huangbai (Phellodendron Bark) if the location is lower body. For obese patients with damp-heat sore pain, Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), and Baizhi (Angelica Dahurica Root) are used, leveraging the principle that wind can overcome dampness.
I often observe that when a sore erupts, swelling appears first. Qi and Blood stagnate, steaming the flesh into pus, so pain is most severe at the beginning of the sore. After pus rupture, as swelling subsides and muscles relax, pain must gradually decrease. If pain increases instead, it indicates Deficiency, and tonics like Ginseng (Renshen) should be used. There are also cases caused by contact with foul odors, which require harmonizing methods, such as Frankincense and Peony. There are also cases forced by Wind-Cold, which require warming and dispersing methods, such as Qianghuo and Guizhi (Cinnamon Twig).