夫瘰 之病,其名甚多。《巢氏病源》载之三十六种,《千金》、《圣惠》所论瘰 九
论,说有风毒、热毒、气毒之异,瘰 、结核、寒热之殊。其本皆由恚怒气逆,忧思过甚,
风热邪气内搏于肝。盖怒伤肝,肝主筋,故令筋蓄结而肿,其候多生于颈腋之间,结聚成核
。初如豆粒,后若梅李,累累相连,大小无定。初觉憎寒壮热,咽项强痛,肿结不消者,当
便服五香连翘汤或牡蛎大黄汤,疏下三两行,于上贴十香膏、乌犀膏及用淋 肿汤、溃毒汤
,时复淋 。如此救疗,即得消散;若未消散,可服内消丸或皂角丸之类,渐以求瘥;若
结深硬,荏苒月日,不能内消者,久必成脓;若肿高而稍软,其人面色萎黄,皮肤壮热上蒸
,脓已成也,可以针决核中,令其溃散,则易愈也。治法如疮法,于疮口中用追毒蚀肉铤
子之,于上用乌犀十香膏等贴之,及托里之剂和之。经久不瘥,或愈而复发,或别处自穴
脓水透出,流津不止,肌体羸瘦者,变成九 。《内经》曰∶陷脉为 ,留连内腠。即此病也
,可用蒜饼子灸之,然后疮口上用紫金散、翠散等,于上 贴膏药求瘥。其将护忌慎,治疗用
法,无造次焉。
夫痔 之候,其名有五∶一曰牝痔,二曰牡痔,三曰气痔,四曰血痔,五曰酒痔。又曰
风痔、脉痔、雌雄痔,皆五痔之别名也。其状初生,悉在肛边,或如鼠乳,或结小核,痒痛
注闷,甚者身热恶寒。诸方论之,皆由房酒过度,久嗜甘肥,不慎醉饱,以合阴阳,劳扰血
脉,肠癖渗漏,冲注下部,肛边生疮,变为痔疾。治法∶始觉痔作,便服通气丸、槐角丸;
热实者,服诸利汤疏利脏腑,及浴洗熏熨以取内消,切忌酒面、辛热、房室、肥腻,稍纵嗜
欲,腐滑脓血,或逗流淫汁,岁月已深,旁穿窍穴,即变痔漏,即须用寸金铤子,三五次全
愈。若能味无味之味,正味足矣;事无事之事,百事备矣;其次服饵调节,谨慎合宜,未有
不瘥者也。
The disease of Luoli (scrofula, lymph node tuberculosis) has many names. *Chao Shi Bing Yuan* (Treatise on the Pathogenesis and Symptoms of Various Diseases) records thirty-six types. The discussions in *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) and *Sheng Hui Fang* (Holy Benefit Formulas) mention nine treatises on Luoli, stating there are differences in wind-toxin, heat-toxin, and qi-toxin, as well as distinctions between Luoli, tubercles, and cold-heat symptoms. The root cause lies in anger causing qi rebellion and excessive worry, allowing wind-heat pathogenic factors to internally clash with the Liver. Anger injures the Liver, and the Liver governs the sinews; thus, it causes the sinews to accumulate and knot, resulting in swelling. This condition mostly occurs between the neck and axilla, gathering into nodules. Initially resembling bean grains, later like plums or dates, they connect in clusters with varying sizes. When initially feeling aversion to cold and high fever, with stiffness and pain in the throat and neck, and unresolved swelling and knots, one should immediately take Wuxiang Liaoqiao Tang (Five-Spice Forsythia Decoction) or Muli Dahuang Tang (Oyster Shell Rhubarb Decoction), promoting purgation two or three times. Simultaneously, apply Shixiang Gao (Ten-Fragrance Plaster) or Wuxi Gao (Black Rhinoceros Horn Plaster) externally, and use Linzhong Tang (Washing Swelling Decoction) and Kuidu Tang (Ulcerating Toxin Decoction) for washing. With such treatment, resolution can be achieved; if not resolved, one may take Neixiao Wan (Internal Resolution Pill) or Zaojiao Wan (Gleditsia Sinensis Pill) to gradually seek recovery. If the knots are deep and hard, lingering for months without internal resolution, pus will inevitably form over time. If the swelling is elevated and slightly soft, with the patient having a sallow complexion and skin feeling hot rising upwards, pus has formed. One can puncture the center of the nodule with a needle to allow it to ulcerate and disperse, facilitating easier healing. The treatment method is similar to that for sores: insert a Zhuodu Shimou Tingzi (Toxin-Pursuing Flesh-Erasing Probe) into the sore, apply Wuxi Shixiang Gao etc. on top, and harmonize with Tuoli agents (Interior-Supporting Formulas). If it does not heal after a long time, recurs after healing, or leaks pus and fluid from other natural openings, leading to continuous discharge and emaciation, it transforms into Jiulou (Nine Types of Fistula). As stated in *Nei Jing* (Inner Canon): "Pathogens sinking into meridians become fistulas, lingering in the interstices." This refers to this disease. Garlic cake moxibustion can be used, followed by applying Zijin San (Purple Gold Powder) or Cuisan (Emerald Powder) to the wound, covered with plaster to seek recovery. Nursing precautions and treatment methods must not be hasty.
The manifestations of Zhiji (hemorrhoids) have five names: first, Nuzhi (Female Hemorrhoid); second, Nanzhi (Male Hemorrhoid); third, Qizhi (Qi Hemorrhoid); fourth, Xuezhij (Blood Hemorrhoid); fifth, Jiuji (Alcohol Hemorrhoid). It is also said that Fengzhi (Wind Hemorrhoid), Maizhi (Vessel Hemorrhoid), and Cixiongzhi (Yin-Yang Hemorrhoids) are all aliases of the Five Hemorrhoids. Their appearance at onset is always around the anus, sometimes resembling mouse teats or forming small nodules, accompanied by itching, pain, and distension. Severe cases present with systemic fever and aversion to cold. Various texts attribute this to excessive sexual activity and alcohol consumption, long-term preference for sweet and fatty foods, improper intercourse while intoxicated or full, disturbing blood vessels, causing intestinal leakage, where pathogens rush to the lower body, generating sores around the anus that transform into hemorrhoidal disease. Treatment: Upon initial sensation of hemorrhoid onset, take Tongqi Wan (Qi-Ventilating Pill) or Huaijiao Wan (Sophora Fruit Pill). For excess-heat patterns, take various Liting (Purgative/Draining Decoctions) to unblock the zang-fu organs, and use bathing, washing, fumigation, and warming to promote internal resolution. Strictly avoid alcohol, wheat products, spicy-hot foods, sexual intercourse, and greasy foods. Slight indulgence in desires leads to putrid, slippery pus and blood, or persistent weeping fluids. After years, lateral perforation of orifices occurs, transforming into Zhilou (Hemorrhoidal Fistula). At this stage, Cunjin Tingzi (Inch-Gold Probe) must be used; three to five treatments can achieve complete cure. If one can appreciate flavorless flavors (bland diet), righteous qi will be sufficient; if one engages in non-action, all matters will be prepared. Secondly, through medication regulation and prudent propriety, no case fails to heal.