元戎云。凡人初觉发背欲结未结。赤热肿痛。先湿纸覆其上。立视候之。其纸先干处即
是结
灸至不痛。不痛灸至痛时方佳。最要早觉早灸为上。一日二日。十灸七活。三日四日。六七
活。五六日。三四活。过七日。则不可灸。若有十数头作一处生者。即用大蒜研成膏。作薄
饼铺
独蒜切去两头。取中间半寸浓。正安于疮上。着艾灸十四壮。多至四十九壮。又曰。灸而不
痛。痛而后止其灸。灸而不痛者。先及其 。所以不痛。而后及良肉。所以痛也。灸而痛。
不痛而后止其灸。灸而痛者。先及其未 。所以痛。次及将 。所以不痛也。刘氏曰。此谓
痈疽初发。宜灸之也。然诸疮患久成漏者。常有脓水不绝。其脓不臭。内无歹肉。尤宜用附
子浸透。切作大片。浓二三分。于疮上着艾灸之。仍服内托之药。隔三二日再灸之。不五七
次。自然肌肉长满矣。至有脓水恶物渐溃根深者。郭氏治用白面、硫黄、大蒜。三物一处捣
烂。着疮大小。捻作饼子。浓约三分。于疮上用艾炷灸二十一壮。一灸一易。后隔四五日。
方用翠霞锭子并信效锭子。互相用之。 入疮内歹肉尽处。好肉长平。然后外贴收敛之药。
内服应病之剂。调理即瘥矣。盖不止宜灸于疮之始发也。大抵始发宜灸。要汗下补养之药对
证。至灸冷疮。亦须内托之药切当。设有反逆。不唯不愈。恐致转生他病也。元好问记云。素
饮酒。于九月中。患脑之下。项之上。出小疮。后数日。脑项麻木。肿势外掀。疡医遂取五
香连翘。至八日不下。而云不可速疗。十八日得脓。俟脓出。用药或砭刺。三月乃可平。四
月如故。予记医经云。凡疮见脓九死一生。果如其言。则有束手待毙之悔矣。乃请东垣诊视
。且谓膏粱之变。不当投五香。五香已无及。当先用火攻之。然后用药。以大艾炷如两核许
者。攻之至百壮。乃觉痛。次为处方云。是足太阳膀胱之经其病逆。当急治以黄连消毒丸。
身面疣瘤。宝鉴云。艾炷灸十壮。即用醋摩雄黄涂纸上。剪如螺蛳靥大。贴灸处。用膏药重
贴。二日一易。候痒折出。纸如豆粉愈。
Yuanyong stated: Generally, when a person first begins to feel that a back carbuncle (a severe abscess on the back) is about to form but has not yet fully consolidated, with local redness, heat, swelling, and pain, one should first cover the affected area with a wet paper and immediately observe it. The place where the wet paper dries out first indicates the site of consolidation. Moxibustion should be applied to this spot until the patient no longer feels pain; if the patient initially felt no pain, moxibustion should continue until pain arises, which is considered optimal. The most crucial aspect is early detection and early application of moxibustion. If treated within one or two days of onset, seven out of ten cases may survive; three to four days, six or seven out of ten; five to six days, three or four out of ten; after seven days, moxibustion is contraindicated. If multiple carbuncle heads grow clustered together, garlic should be ground into a paste, formed into a thin cake, and placed over the lesion. Take a single garlic clove, cut off both ends, retain the middle section approximately half an cun thick, place it directly on the sore, and apply fourteen moxa cones (Zhuang), up to forty-nine Zhuang. It is also said: If moxibustion causes no pain, continue until pain is felt before stopping. Lack of pain during moxibustion occurs because the healthy tissue is stimulated first (hence no pain), followed by the diseased tissue (which causes pain). Conversely, if pain is felt during moxibustion, stop before the pain subsides. Pain occurs because the unaffected tissue is stimulated first (causing pain), followed by the tissue about to become diseased (which ceases to cause pain). Liu stated: This refers to the initial stage of carbuncles and sores, where moxibustion is appropriate. However, for chronic ulcers that have persisted for a long time and developed sinuses (chronic fistulas), characterized by continuous non-odorous pus discharge without internal necrotic tissue, it is particularly suitable to soak Radix Aconiti Lateralis Preparata (Fuzi, Prepared Lateral Root of Aconite) thoroughly, slice it into large pieces approximately two to three fen thick, place it on the ulcer, and apply moxibustion. Simultaneously administer internal supportive herbs (Neituo, Internal Supportive Therapy), and repeat moxibustion every two to three days. After five to seven sessions, the flesh will naturally regenerate and fill the wound. For cases with deep-rooted infection and gradual溃烂 (ulceration) of foul pus, Guo's treatment method involves pounding together white flour, Realgar (Liu Huang, Arsenic Sulfide), and garlic into a paste. Form this into a cake approximately three fen thick, sized to the ulcer, place it on the lesion, and apply twenty-one moxa cones. Replace the cake after each session. Subsequently, every four to five days, alternate using Cuixia Dingzi (Cuixia Pill) and Xinxiao Dingzi (Xinxiao Pill), inserting them deep into the ulcer until all necrotic tissue is expelled and healthy granulation tissue levels out. Then apply external astringent medicines and internal disease-specific formulas; regulation will lead to recovery. This indicates that moxibustion is not only suitable for the initial stage of sores. Generally, early-stage sores are suitable for moxibustion, provided it is combined with diaphoretic, purgative, or tonic therapies according to syndrome differentiation. For treating cold-type ulcers, appropriate internal supportive therapy is also essential. If adverse reactions occur, not only will the condition fail to heal, but other diseases may arise. Yuan Haowen recorded: An individual who habitually drank wine developed a small sore below the occiput and above the neck in the ninth month. Several days later, numbness spread to the head and neck, with swelling protruding outward. The surgeon prescribed Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction). By the eighth day, pus had not drained, and the surgeon claimed rapid cure was impossible. Pus finally drained on the eighteenth day. After drainage, medication or bloodletting with a stone needle (Bianci, Stone Needle Therapy) was used. It took three months to flatten and four months to return to normal. I recalled from medical classics: "When a sore suppurates, nine die and one survives." If this were true, one would merely wait for death with hands bound. Thus, Li Dongyuan was consulted. He stated: This is a disorder caused by rich food and drink, and Wuxiang (Five-Aromatic) herbs are inappropriate. Since Wuxiang herbs are ineffective at this stage, fire therapy (Huogong, Fire Attack Therapy) should be employed first. Use large moxa cones, size of two kernels, applying up to one hundred Zhuang until pain is perceived. Then, he prescribed: This is a reversal of Qi in the Foot-Taiyang Bladder Meridian (Zu Taiyang Pangguang Jing); urgently treat with Huanglian Xiaodu Wan (Coptis Detoxification Pill). Regarding warts and tumors on the body and face, Baojian records: Apply ten moxa cones, then grind Realgar with vinegar, paint it on paper, cut into shapes resembling snail shells, and apply to the moxibusted area. Cover with a plaster, changing every two days. Wait for itching and scabbing to fall off like bean powder, indicating healing.