夫痈疽外发。理体已备于前。至于内痈内疽。其疾隐而不见。目既不接。所谓至难。然
五脏六腑。有俞募。虽结固于中。而自形于外。外察其部。则内审其源。定药投分。若拔芒
刺。
小便
嗜睡
重。
肿。
善也
然
知
明
一
一
穴在鸠尾下一寸是)期门隐隐而痛者。肝疽也。上肉微起者。肝痈也。(期门一穴在第二肋
旁
一
名
长
是)
中管隐隐而痛者。胃疽也。上肉微起者。胃痈也。(中管二穴一名太仓在上管下一寸)天枢
隐
隐而痛者。大肠疽也。上肉微起者。大肠痈也。(天枢二穴在脐两旁各二寸陷中是)丹田隐
隐
而痛者。三焦疽也。(上肉微起者三焦痈也)(丹田一名石门一名精室一名命门一穴在脐下二
寸)关元隐隐痛者。小肠疽也。上肉微起者。小肠痈也。(关元一名腋门在脐下三寸)右验
其
人所慕。依据此候审定痈疽浅深。病从何腑脏发。先曾食何乳石。又验其气虚实。参详而疗
之。
凡痈疽疖初生。皆只如粟黍粒许大。微似有痛痒。或触破之即 展。初觉有之。即须速
服犀
四畔
是痈
兼帛
血滞
烂肉
草从风
凡痈疽发背。初生如黍粟粒许大。或痒或痛。觉似有。即用汤水淋射。兼贴药 之。经
一两日不退。须当上灸之一二百壮。如绿豆许大。凡灸后。却似 痛。经一宿乃定。即火气
下微
奇
作
豉饼子若干。更换新者尤佳也。其疮苦痛。即须苦灸。仍壮数唯多为妙。若是疽。即不宜灸
。夫疽初生。形如 。头白焦枯。气本深沉。疗者既不精辨。亦便灸之。以至数壮。或痈
疖成脓之后。亦令灸之。深须将理。莫谩轻生。初灸三壮。不觉痛者为上。肉已夭。其下脓
深。及至数壮之后。 痛必倍。为热气益盛。脓伏内攻之。火灼其外。转增毒甚。物理推之
。事则可验。诸所不宜灸穴。及大妨处。具载之于后。
头维(在额角发际本神旁一寸) 承光(在头上五处穴后二寸是) 神庭(在发际直鼻
上)
承泣(在目下
(在枕骨上强间后一寸半) 风府(在脑后发际一寸大筋旁宛宛中) 喑门(在顶后发际宛
宛
中) 脊中(在第十一椎节中间) 三阳络(在肾上大脉沟上一寸) 下关(在耳前动脉是
也)
耳中耳门(禁灸) 人迎(在颈大脉应手侠结喉旁通五脏气) 石门(在脐下二寸女子禁灸)
伏
兔(二穴在膝上六寸) 地五会(在足小趾次趾后
上件穴。据明堂经。并禁不可灸。或于上出疮疖。亦不得便灸。且以诸方法。及汤水注
射。
经久
灸法。
上用硫黄一块子。随疮口大小安之。别取少许硫黄。于火上烧之。以银钗脚挑之取焰。
点硫黄上。令着三两遍。取脓水。以疮干瘥为度。
The manifestations of carbuncles and sores appearing on the exterior have been fully explained in the preceding text. As for internal carbuncles (Nei Yong) and internal sores (Nei Ju), their pathologies are concealed and invisible; since they cannot be directly observed by the eyes, they are considered extremely difficult to diagnose. However, the five zang organs and six fu organs all have Shu (Transport) and Mu (Alarm) acupoints. Although the lesions may be firmly knotted within the interior, they inevitably manifest externally. By observing the external sites, one can ascertain the internal source. Determining the appropriate herbs and administering them corresponds to the pathology, making treatment as effective as removing a thorn.
[Note: The original text contains severe fragmentation and garbled characters such as "urine," "somnolence," "heaviness," "swelling," etc., which do not form coherent sentences. The translation below reflects the fragmented nature of the source.]
If there is a dull pain at Qimen (LR14, located in the 2nd intercostal space), it indicates Liver Sore (Gan Ju); if the flesh slightly protrudes, it indicates Liver Carbuncle (Gan Yong). If there is a dull pain at Zhongwan (CV12, also known as Taicang, located 1 cun below Shangwan), it indicates Stomach Sore (Wei Ju); if the flesh slightly protrudes, it indicates Stomach Carbuncle (Wei Yong). If there is a dull pain at Tianshu (ST25, located 2 cun lateral to the umbilicus in the depression), it indicates Large Intestine Sore (Dachang Ju); if the flesh slightly protrudes, it indicates Large Intestine Carbuncle (Dachang Yong). If there is a dull pain at Dantian (also known as Shimen, Jing Shi, or Mingmen, CV4, located 2 cun below the umbilicus), it indicates Sanjiao Sore (Sanjiao Ju); if the flesh slightly protrudes, it indicates Sanjiao Carbuncle (Sanjiao Yong). If there is a dull pain at Guanyuan (CV4, located 3 cun below the umbilicus), it indicates Small Intestine Sore (Xiaochang Ju); if the flesh slightly protrudes, it indicates Small Intestine Carbuncle (Xiaochang Yong).
By verifying these signs and considering the patient's preferences, one can determine the depth of the carbuncle or sore and identify which organ system it originates from. One should also inquire about previous consumption of mineral drugs (Rushi) and assess the deficiency or excess of Qi, then treat accordingly after comprehensive analysis.
When a carbuncle, sore, or boil first appears, it is initially the size of a millet seed. It feels slightly painful or itchy. If touched or broken, it may spread rapidly. Upon initial detection, one must immediately administer Rhinoceros Horn (Xijiao) [and other heat-clearing agents] to prevent stagnation of blood and necrosis of tissue.
For back carbuncles (Fa Bei) that have just emerged, initially the size of a millet seed, whether itchy or painful, one should wash and spray the area with hot decoctions and apply medicinal plasters. If it does not recede after one or two days, moxibustion of 100 to 200 moxa cones is required. The moxa cone should be the size of a mung bean. After moxibustion, the pain may temporarily intensify, stabilizing after one night as the fire qi descends. Using several Black Soybean Cakes (Chibingzi) and replacing them with fresh ones is optimal. If the wound causes severe pain, heavy moxibustion is necessary, with more moxa cones being better. However, for sores (Ju), moxibustion is generally contraindicated. Initially, a sore presents with a white, dry, and shriveled head, and the pathological qi is deep-seated. If the practitioner fails to distinguish it carefully and applies moxibustion indiscriminately, causing multiple burns, or if moxibustion is applied after pus has formed in a carbuncle or boil, careful nursing is essential. Do not take it lightly. If there is no pain after three initial moxa cones, it is an excellent sign, indicating necrotic flesh and deep pus below. However, after many cones, the pain will double due to intensified heat, causing the pus to attack internally while the fire burns externally, thereby increasing toxicity. This can be verified by reasoning through natural principles. The following lists acupoints unsuitable for moxibustion and those strictly forbidden:
Touwei (GB8, 1 cun lateral to Ben Shen at the hairline), Chengguang (BL9, 2 cun posterior to Wuchu), Shenting (GV24, straight above the nose at the hairline), Chengqi (ST1, below the eye), Qiangjian (GV18, 1.5 cun posterior to Qiangjian on the occipital bone), Fengfu (GV16, 1 cun above the posterior hairline beside the large tendon in the depression), Yanmen (GV19, in the depression at the posterior hairline of the vertex), Jizhong (GV12, between the spinous processes of the 11th thoracic vertebra), Sanyangluo (TE7, 1 cun above the pulse groove on the kidney region), Xiaguan (ST7, anterior to the ear where the artery beats), Erzhong (SI17), Ermen (TE21, both forbidden for moxibustion), Renying (ST9, on the carotid pulse beside the larynx, connecting to the five zang organs), Shimen (CV5, 2 cun below the umbilicus, forbidden for women), Futu (ST32, bilateral, 6 cun above the knee cap), Diwuhui (BL64, posterior to the second toe). According to the *Mingtang Jing*, all the above acupoints are forbidden for moxibustion. Even if boils appear near these points, moxibustion must not be applied. Instead, use various methods and wash with decoctions.
For chronic non-healing wounds using moxibustion: Place a piece of Realgar (Sulfur/Huang) over the wound according to its size. Take a small amount of sulfur, ignite it on fire, pick up the flame with the tip of a silver needle, and light the sulfur placed on the wound. Repeat this ignition two or three times to draw out pus until the wound dries and heals.