用药之法,如执权衡。若大势已退,仍用悍霸之药,为诛伐无过,失《内经》之旨
矣。如败毒散,有表症者宜之,多则损气。流气饮,气结胸满者宜之,多则败血。内补十
宣散,在冬月可助内托之功,能移深居浅,然燥荣泻卫之药太多,在夏月及虚之甚者勿用。
五香散肿疡时用之,似有畅达之理,溃疡时用之,则犯重虚之戒。护心散能解丹石之毒,
若不因此,及老年病深症惫者禁用。蟾酥等丸,皆有砒 之辈,乃取汗之峻剂也。治初
起寒热拘急,疼痛脉沉细者,为毒瓦斯内陷者宜用。若身热脉洪,及已溃者,禁与。玉枢
丹为下毒之药,无取脓之功。而体虚者已成者,勿用。垣云∶一经受病,止责其一经,不
可干扰余经,如流气饮通行十二经,则诸经皆为所损矣,禁之。
肌肉者,脾胃之所主。收敛迟速,由气血之盛衰。惟补脾胃,此内治也。瘀腐不尽,
不可以生肌,如骤用生肌,反增溃烂。务令
毒尽,则肌自生。加生肌药,此外治也。如肌生如榴子红艳,或有白膜为善。若肌白而
平,且无纹理,或脓清气秽,为毒连五脏,气血枯竭也,危。
溃疡验膜,用软薄绵纸封疮口,令患者用意呼吸之,纸不动者,未透膜也,忌用嚏
法,恐鼓破膜不救。
The method of using medication is like holding the beam of a scale; it requires weighing and balancing. If the major pathogenic factors have already receded, yet one still employs harsh and domineering drugs, this constitutes punishing the innocent and violates the principle of the *Huangdi Neijing* (Yellow Emperor's Inner Canon).
For instance, Baidu San (Poison-Resolving Powder) is suitable for patients with exterior syndromes, but excessive use damages Qi. Liuqi Yin (Flowing-Qi Decoction) is suitable for those with Qi stagnation and chest fullness, but excessive use harms the blood. Neibu Shixuan San (Internal-Supplementing Ten-Aperture Powder) can assist in the function of internal support during winter, shifting deep-seated pathogens to superficial layers; however, since it contains too many drying and dispersing herbs that deplete Wei Qi, it should not be used in summer or in cases of severe deficiency. Wuxiang San (Five-Aromatic Powder), when used for initial swelling (swollen ulcer), seems to follow the principle of unblocking and promoting circulation; but when used for ulcers, it violates the taboo of causing double deficiency. Huxin San (Heart-Protecting Powder) can resolve toxicity from mineral drugs (Dan Shi); if not caused by such toxins, or in elderly patients with deep disease and exhausted symptoms, it is contraindicated. Chan Su Wan (Toad Venom Pills) contain substances akin to arsenic (Pi) and are drastic diaphoretic agents. They are suitable for early-stage conditions presenting with chills, fever, stiffness, pain, and a deep-thin pulse, indicating internal sinking of toxic vapors. However, they are contraindicated if there is high fever with a surging pulse, or if the wound has already ulcerated. Yushu Dan (Jade Pivot Pill) is a purgative/toxic drug and lacks the efficacy of draining pus. It should not be used in patients with weak constitution who have already formed an abscess. Yuan stated: "Once a meridian is affected, only that meridian should be addressed; do not interfere with other meridians." Since Liuqi Yin circulates through all twelve meridians, it causes damage to all of them, and thus its use is prohibited.
A tongue that is red, moist, and normal indicates a favorable prognosis. A tongue coating of green, yellow, red, white, or black indicates severe illness. A dry, cracked, and painful tongue indicates a fatal outcome.
If the swelling is initially high, but suddenly becomes flat and sunken after ten days or so, this is a sign of internal attack by the pathogen, and immediate treatment with methods to support the interior and expel pus is required.
Muscles are governed by the Spleen and Stomach. The speed of wound contraction depends on the abundance or decline of Qi and Blood. Only by tonifying the Spleen and Stomach can one achieve internal treatment. If stasis and necrotic tissue are not completely cleared, one must not apply muscle-generating medicines; sudden application will instead increase ulceration. One must ensure that all toxins are exhausted before muscles can naturally regenerate. Adding muscle-generating medicines constitutes external treatment. If the regenerated flesh resembles the bright red pomegranate seeds, or is covered by a white membrane, it is auspicious. If the flesh is pale and flat, lacking texture, or if the pus is clear and foul-smelling, this indicates that the toxin has connected to the five Zang organs and that Qi and Blood are exhausted, which is critical.
To test the membrane in an ulcer, seal the wound opening with soft, thin cotton paper. Instruct the patient to focus their intent while breathing. If the paper does not move, the membrane has not yet perforated. At this stage, sneezing-inducing methods are contraindicated, as forcing a sneeze might rupture the membrane, leading to untreatable complications.