结核,或生项侧,在颈、在臂、在身,如肿痛者,多在皮里膜外,多是痰注不散。问其平日好食何物,吐
下后用药散核。又云结核,火气热甚则郁结,核硬如果中核也。不须溃发,但热气散则自消矣。
结核者,风痰郁结也。又云火因痰注而不散也。
消风化痰汤
南星 半夏 赤芍 连翘 天麻 青藤 僵蚕(洗去丝) 苍耳子 金银花 天门冬 桔梗(各七分)
白芷 防风 羌活 皂角(各五分) 全蝎(去毒) 陈皮(各四分) 白附子 淮木通(各一钱) 甘草(二分)
上锉一剂,生姜五片,水煎食后服。忌煎炒热物。
消毒散 治咽喉结核,肿块如桃、坚硬疼痛、颈项不回转,四腋下或有块硬如石。
南星(姜制) 半夏(姜制) 陈皮 枳实 桔梗 柴胡 前胡 黄连 连翘 赤芍 防风 独活 白附子
苏子 莪术 蔓荆子 木通 甘草。
上锉一剂,生姜二片、灯草一团,水煎服。
化凤膏 治咽喉、颈项结核成形及瘰 。用蓖麻子七枚,去壳捻烂,用薄纸卷于中,插入鸡子内,纸
封固,水浸湿,火煨熟,去壳,去内纸条,只食鸡子,以酒一杯送下。每早晨服一枚,十日奏效。
内消散 治梅核、痰核、马刀瘰 。
归尾 连翘 羌活 独活 薄荷 桂枝 赤芍 白芷梢(各一两) 防风(一两半) 荆芥 细辛(各八钱)
本(七钱半) 小川芎 甘草节(各六钱)
上为细末,每服二钱,食后酒调下。
内托白蔹散 治腋下痰核,因酒、怒气发肿痛,溃脓久不合口。
当归(一钱) 赤芍(一钱) 川芎(七分) 白芷(八分) 连翘(一钱) 白蒺藜(四分) 白蔹
(八分) 片芩(酒炒、八分) 防风 桔梗(各五分) 天花粉(七分) 栝蒌仁(八分,另研) 柴胡
(五分) 乳香(七分,另研) 生甘草节(四分)
上锉一剂,水煎,晚间热服。忌一切发物并怒气、房劳。
消核丸 治颈项、耳后结核,三五成簇,不红、不肿、不痛、不成脓者。
橘红(盐水洗略去白,一两) 赤茯苓(一两,去皮) 生甘草节(去皮,四钱) 半夏曲(姜汁拌焙,
七钱) 片芩(酒拌炒,八钱) 僵蚕(水洗炒黄,六钱) 玄参(酒拌焙,七钱) 牡蛎粉(火煨、童便淬、
另研,七钱) 山栀仁(连壳炒焦,八钱) 天花粉(七钱) 栝蒌仁(七钱,另研) 大黄(煨,一两)
桔梗(去芦,七钱) 连翘(去枝梗,一两)
上为末,汤泡蒸饼为丸,如绿豆大,晒干。每服八九十丸,白汤送下。
一妇人项结核,寒热头痛,胁乳胀痛,内热口苦,小便频数,证属肝火血虚。用四物加柴胡、山栀、胆草
而愈。又用加味逍遥散而安。
结核,有时生长在颈部侧面,位于颈部、手臂或身体其他部位,如果伴有肿胀疼痛,多发生在皮肤与筋膜之间,大多是由于痰湿凝聚不散所致。询问患者平时喜欢吃什么食物,在采用吐法或下法之后,再用药消散结节。又说,结核是因为火气过盛导致郁结,结节坚硬如同果核。不需要使其溃破排脓,只要热气消散,结节自然就会消除。
消风化痰汤
南星、半夏、赤芍、连翘、天麻、青藤(即青风藤)、僵蚕(洗净去除丝状物)、苍耳子、金银花、天门冬、桔梗(各七分);
白芷、防风、羌活、皂角(各五分);全蝎(去毒)、陈皮(各四分);白附子、淮木通(即川木通,各一钱);甘草(二分)。
以上药材锉碎为一剂,加生姜五片,水煎煮,饭后服用。忌食煎炒燥热之物。
消毒散:治疗咽喉部的结核,肿块像桃子一样大,坚硬且疼痛,颈项不能转动,腋下也可能有硬如石头的肿块。
南星(姜汁制)、半夏(姜汁制)、陈皮、枳实、桔梗、柴胡、前胡、黄连、连翘、赤芍、防风、独活、白附子、苏子、莪术、蔓荆子、木通、甘草。
以上药材锉碎为一剂,加生姜两片、灯心草一团,水煎服。
化凤膏:治疗咽喉、颈项部结核成形以及瘰疬。用蓖麻子七枚,去掉外壳并捣烂,用薄纸包裹在其中,插入鸡蛋内,用纸封口固定,用水浸湿后,用火煨熟,去掉蛋壳和内层的纸条,只吃鸡蛋,用一杯酒送服。每早晨服用一枚,十天见效。
内消散:治疗梅核气、痰核、马刀瘰疬。
归尾、连翘、羌活、独活、薄荷、桂枝、赤芍、白芷梢(各一两);防风(一两半);荆芥、细辛(各八钱);藁本(七钱半);小川芎、甘草节(各六钱)。
以上研为细末,每次服用二钱,饭后用酒调服。
内托白蔹散:治疗腋下痰核,因饮酒或发怒引发肿痛,溃破流脓后长期不愈合。
当归(一钱)、赤芍(一钱)、川芎(七分)、白芷(八分)、连翘(一钱)、白蒺藜(四分)、白蔹(八分)、片芩(酒炒,八分)、防风、桔梗(各五分)、天花粉(七分)、栝蒌仁(八分,另研)、柴胡(五分)、乳香(七分,另研)、生甘草节(四分)。
以上药材锉碎为一剂,水煎,晚间热服。忌食一切发物,并避免发怒和房劳。
消核丸:治疗颈项、耳后结核,三五成群簇集,不红、不肿、不痛、不成脓者。
橘红(盐水洗略去白色部分,一两)、赤茯苓(一两,去皮)、生甘草节(去皮,四钱)、半夏曲(姜汁拌焙,七钱)、片芩(酒拌炒,八钱)、僵蚕(水洗炒黄,六钱)、玄参(酒拌焙,七钱)、牡蛎粉(火煨、童便淬炼、另研,七钱)、山栀仁(连壳炒焦,八钱)、天花粉(七钱)、栝蒌仁(七钱,另研)、大黄(煨,一两)、桔梗(去芦头,七钱)、连翘(去枝梗,一两)。
以上研为细末,用汤泡蒸饼做丸,如绿豆大小,晒干。每次服用八九十丸,用白开水送服。
有一位妇女颈部患结核,伴有寒热头痛,胁肋和乳房胀痛,体内发热口苦,小便频数,证候属于肝火兼血虚。使用四物汤加入柴胡、山栀、胆草而痊愈。后来又用加味逍遥散调理而安。
Tubercles may occur on the side of the neck, in the neck, arm, or body. If accompanied by swelling and pain, they are mostly located between the skin and fascia, and are generally caused by the stagnation of phlegm-dampness. Inquire about the patient's dietary preferences. After employing emetic or purgative methods, administer medication to dissipate the nodules. It is also stated that tubercles result from the constraint of excessive fire-heat, causing the nodules to become hard like the pit of a fruit. There is no need to induce suppuration; once the heat dissipates, the nodules will resolve spontaneously.
Tubercles refer to the constraint of wind-phlegm. It is also said that fire pathogens fail to dissipate due to phlegm stagnation.
Xiaofeng Huatan Decoction (Wind-Dispersing and Phlegm-Resolving Decoction)
Arisaema Cum Bile (Nanxing), Pinellia Rhizoma Preparatum (Banxia), Paeoniae Radix Rubra (Chishao), Forsythiae Fructus (Lianqiao), Gastrodiae Rhizoma (Tianma), Sinomenii Caulis (Qingteng), Bombyx Batryticatus (Jiangcan) [washed to remove silk], Xanthii Fructus (Cangerzi), Lonicerae Japonicae Flos (Jinyinhua), Asparagi Radix (Tianmendong), Platycodonis Radix (Jiegeng) [each 0.7 qian];
Angelicae Dahuricae Radix (Baizhi), Saposhnikoviae Radix (Fangfeng), Notopterygii Rhizoma et Radix (Qianghuo), Gleditsiae Spina (Zaojiao) [each 0.5 qian]; Scorpion (Quanxie) [remove toxicity], Citri Reticulatae Pericarpium (Chenpi) [each 0.4 qian]; Aconiti Kusnezoffii Radix Praeparata (Baifuzi), Tetrapanacis Medulla (Huaimutong) [each 1 qian]; Glycyrrhizae Radix et Rhizoma (Gancao) [0.2 qian].
Decoct these herbs as one dose with five slices of fresh ginger, take orally after meals. Avoid fried and hot-natured foods.
Xiaodu San: Treats tubercles in the throat, where lumps are peach-sized, hard, painful, with limited neck mobility, and possibly hard-as-stone masses in the axillae.
Arisaema Cum Bile (Nanxing) [processed with ginger juice], Pinellia Rhizoma Preparatum (Banxia) [processed with ginger juice], Citri Reticulatae Pericarpium (Chenpi), Aurantii Fructus Immaturus (Zhishi), Platycodonis Radix (Jiegeng), Bupleuri Radix (Chaihu), Peucedani Radix (Qianhu), Coptidis Rhizoma (Huanglian), Forsythiae Fructus (Lianqiao), Paeoniae Radix Rubra (Chishao), Saposhnikoviae Radix (Fangfeng), Angelicae Pubescentis Radix (Duhuo), Aconiti Kusnezoffii Radix Praeparata (Baifuzi), Perillae Fructus (Suzi), Curcumae Zedoariae Rhizoma (Ezhu), Viticis Fructus (Manjingzi), Akebiae Caulis (Mutong), Glycyrrhizae Radix et Rhizoma (Gancao).
Decoct these herbs as one dose with two slices of fresh ginger and a bundle of Juncus effusus (Dengcao), take orally.
Huafeng Ointment: Treats formed tubercles in the throat and neck, as well as scrofula (Luoli). Take seven seeds of Ricinus Communis (Bimazi), remove shells, mash them, wrap in thin paper, insert into a chicken egg, seal with paper, soak in water, roast over fire until cooked. Remove shell and paper strip, consume only the egg, washed down with a cup of wine. Take one egg every morning; efficacy is expected within ten days.
Neixiao San: Treats plum-pit qi (Meihe), phlegm nodules (Tanhe), and scrofula resembling a knife handle (Madao Luoli).
Angelicae Sinensis Radix (Guiwei), Forsythiae Fructus (Lianqiao), Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Pubescentis Radix (Duhuo), Menthae Haplocalycis Herba (Bohe), Cinnamomi Ramulus (Guizhi), Paeoniae Radix Rubra (Chishao), Angelicae Dahuricae Radix (Baizhi shao) [each 1 liang]; Saposhnikoviae Radix (Fangfeng) [1.5 liang]; Schizonepetae Spica (Jingjie), Asari Radix et Rhizoma (Xixin) [each 8 qian]; Ligustici Wallichii Rhizoma et Radix (Ben) [7.5 qian]; Chuanxiong Rhizoma (Xiaochuanxiong), Glycyrrhizae Radix et Rhizoma (Ganjie) [each 6 qian].
Grind into fine powder. Take 2 qian per dose, mixed with wine and taken after meals.
Neituo Bailian San: Treats phlegm nodules in the axilla caused by alcohol consumption or anger, leading to swelling, pain, suppuration, and non-healing ulcers.
Angelicae Sinensis Radix (Danggui) [1 qian], Paeoniae Radix Rubra (Chishao) [1 qian], Chuanxiong Rhizoma (Chuanxiong) [0.7 qian], Angelicae Dahuricae Radix (Baizhi) [0.8 qian], Forsythiae Fructus (Lianqiao) [1 qian], Tribuli Fructus (Bajili) [0.4 qian], Ampelopsis Radix (Bailian) [0.8 qian], Scutellariae Radix (Pianqin) [wine-fried, 0.8 qian], Saposhnikoviae Radix (Fangfeng), Platycodonis Radix (Jiegeng) [each 0.5 qian], Trichosanthis Radix (Tianhuafen) [0.7 qian], Trichosanthis Semen (Gualouren) [0.8 qian, separately ground], Bupleuri Radix (Chaihu) [0.5 qian], Frankincense (Ruxiang) [0.7 qian, separately ground], Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancaojie) [0.4 qian].
Decoct as one dose, take hot in the evening. Avoid all stimulating foods, anger, and sexual exertion.
Xiaohe Wan: Treats tubercles in the neck and behind the ears, clustered in groups of three to five, without redness, swelling, pain, or suppuration.
Citri Reticulatae Pericarpium (Juhong) [washed in salt water, white pith slightly removed, 1 liang], Red Poria (Chifuling) [peeled, 1 liang], Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancaojie) [peeled, 4 qian], Pinelliae Fermentatum (Banxiaqu) [mixed with ginger juice and baked, 7 qian], Scutellariae Radix (Pianqin) [mixed with wine and fried, 8 qian], Bombyx Batryticatus (Jiangcan) [washed and fried yellow, 6 qian], Scrophulariae Radix (Xuanshen) [mixed with wine and baked, 7 qian], Ostreae Concha (Molifan) [roasted, quenched in child's urine, separately ground, 7 qian], Gardeniae Fructus (Shanzhiren) [fried scorched with shell, 8 qian], Trichosanthis Radix (Tianhuafen) [7 qian], Trichosanthis Semen (Gualouren) [7 qian, separately ground], Rheum Palmatum (Dahuang) [roasted, 1 liang], Platycodonis Radix (Jiegeng) [de-gorged, 7 qian], Forsythiae Fructus (Lianqiao) [de-branched, 1 liang].
Grind into powder, mix with steamed wheat cake soaked in decoction to form pills the size of mung beans, dry them. Take 80-90 pills per dose, washed down with plain boiled water.
A female patient presented with tubercles in the neck, alternating chills and fever, headache, distending pain in the hypochondrium and breasts, internal heat, bitter taste in the mouth, and frequent urination. The pattern was identified as Liver Fire with Blood Deficiency. She was cured using Siwu Tang added with Bupleuri Radix (Chaihu), Gardeniae Fructus (Shanzhi), and Scutellariae Radix (Dancao). Subsequently, she was stabilized with Jiawei Xiaoyao San.