阴发难治。阳发易医。为治之法。或疏散。或消毒。或针烙。或内托。或外消。或泻。
。随其虚实寒热。而调治之。又当辨其五善七恶。如痛息自宁。饮食有味。一善。便利调匀
。二善。脓肿自消。色鲜不臭。三善。神彩光明。声音清朗。四善。体气平和。为之五善。
腹痛而渴。泻利无度。小便如淋。一恶。脓大溃掀肿犹甚。臭败莫近。二恶。喘粗气促。
恍惚嗜卧。三恶。毒瓦斯攻心。药食呕逆。四恶。声嘶色脱。面目如垢。唇青鼻黑。四肢浮肿
小便不通。烦燥时咳。六恶。四肢沉重。未溃先黑陷下为之七恶。
神授卫生汤 治发背。并脑疽对口。诸恶毒。未成者即消。已成者即溃。药性平和。功
羌活 防风 白芷 穿山甲 沉香 红花 连翘 石决明(各六分) 金银花 皂角刺
当归尾 甘草节 天花粉 乳香(各八分) 大黄(酒炒二钱) 水煎食远服。
消肿托里散 治发背。不拘上下左右。并一切痈疽肿毒。
人参 赤茯苓 白术 滑石 桔梗 金银花 荆芥 山栀 当归 川芎 黄 (各一钱)
赤芍 苍术 麻黄(各七分) 大黄(三钱) 黄芩 防风 甘草 薄荷 连翘(各八分) 石膏
芒硝(各一钱五分) 水酒各一钟煎服。
灸法 如发背初起时。背上微有红肿重坠。即是发背。以此法立时消散。屡屡效验。
用河边水中泥。先挖去一尺许。再取一大块。同人粪杵极熟。做一饼。如碗大。顶上以
针通一细孔。放在患处。外用艾火灸之。如痛灸至不痛。不痛要灸至痛住。
熏发背奇方 治发背七日后。未成者自消。已成者自溃。不起发者即发。不腐溃者即腐
。雄黄 朱砂 血竭 没药(各二钱) 麝香(五分)
上为细末每用三分。绵纸裹药为捻。长尺许。以麻油润透。照火离疮半寸许。自外而内
。周遭徐徐照之。初用三条。加至五条。候毒势渐消渐减。
散毒饮 治发背三五日间。身上洒淅恶寒。疼痛急胀。如未成脓即消。已成即溃。调气
血。和脾胃。使毒不攻心。
乳香 没药 天花粉 黄 防风(各一钱) 当归 白芷 桔梗 穿山甲(各一钱二分)
皂角刺 连翘 陈皮 金银花 牡丹皮 川芎(各八分) 水煎食后服。
蜡矾丸 治发背痈疽并一切肿毒服之能护心膜。毒瓦斯不能攻心。
黄蜡(一斤) 明矾(八两研末) 朱砂(八钱研细)
先以蜡熔开。入明矾末。搅和投水中。众手丸如绿豆大。朱砂为衣。每服百丸。白滚汤
生肌丸 治一切发背疽毒。服此长肉收功。
黄蜡(一斤) 乳香(研细) 没药(研细) 血竭(各二两研细) 象牙末(四两)
先用蜡熔化。再入乳没等药和匀投水中。众手丸如绿豆大。每服百丸。一日二服。
吸毒竹筒 治发背痈疽肿毒。以此拔出脓血恶水。
苍术 白蔹 浓朴 艾叶 白芨 乌柏皮 芽茶 白蒺藜(各等分)
如法用竹筒六七个。长二寸。一头留节。削去青。今极薄。随大小用之。以药煮筒十数
煮干为度。乘筒热。按上紧吸疮口。脓水满自脱落。不然用手拔脱。更换别个竹筒。如此三
五次。毒尽消矣。
托里定痛散 治发背。溃后。血虚。余毒未尽作疼。
归身 熟地(各二钱) 乳香 没药 川芎 白芍(各一钱酒炒) 肉桂 粟壳(各一钱五
分泡去筋膜蜜炒) 水煎食后温服。
五宝饮 治发背不肯收口。作疼作痒。服去即收功。
金银 黄 甘草 归身 人参(各二钱) 水二钟。煎八分。食后服。
生肌神秘散 治发背将收功。掺上腐肉即去。新肉即生。
白升药(一两) 轻粉 铅粉(各一两二钱) 银朱 珍珠(豆腐内煮过各四钱) 上为极细
末掺于疮口。
十全大补汤 治发背已溃。寒热往来。或作疼痛脓多。或自汗盗汗。气血两亏。神思倦
怠。疮口不敛。
人参 黄 川芎 白芍 当归 肉桂(各二钱) 熟地 白茯苓 白术 甘草(各一钱
五分) 黑枣五枚。食前煎服。
阴发(生于身体下部或深部的发背)难以治疗。阳发(生于身体上部或浅表的发背)容易医治。治疗的方法,有的采用疏散法,有的采用消毒法,有的采用针烙法,有的采用内托法,有的采用外消法,有的采用泻下法。根据病证的虚实寒热情况,进行调理治疗。还应当辨别五善七恶的预后征象。如疼痛轻微、自然安宁,饮食有味道,这是一善;大小便调匀,是二善;脓肿自行消退,颜色鲜艳且不臭,是三善;神采光明,声音清亮朗润,是四善;体质气息平和,是为五善。腹痛且口渴,腹泻无度,小便像淋证一样涩痛,是一恶;脓液大量溃破,掀肿依然严重,气味臭败令人无法靠近,是二恶;气喘粗重,呼吸急促,神志恍惚,嗜睡懒卧,是三恶;毒瓦斯攻心,服药进食即呕吐逆出,是四恶;声音嘶哑,面色脱失,面目如污垢状,唇青鼻黑,四肢浮肿,小便不通,烦躁不安,时时咳嗽,是六恶;四肢沉重,疮口未溃之前先变黑陷下,是为七恶。
神授卫生汤:治疗发背,以及脑疽、对口疽等各种恶毒疮疡。未成脓者立即消散,已成脓者立即溃破。药性平和,功效显著。药用羌活、防风、白芷、穿山甲、沉香、红花、连翘、石决明(各六分),金银花、皂角刺、当归尾、甘草节、天花粉、乳香(各八分),大黄(酒炒二钱)。用水煎煮,饭后服用。
消肿托里散:治疗发背,不论部位在上、下、左、右,以及一切痈疽肿毒。药用人参、赤茯苓、白术、滑石、桔梗、金银花、荆芥、山栀、当归、川芎、黄芪(各一钱),赤芍、苍术、麻黄(各七分),大黄(三钱),黄芩、防风、甘草、薄荷、连翘(各八分),石膏、芒硝(各一钱五分)。用水和酒各一钟煎服。
灸法:如在发背初起时,背上微微出现红肿沉重坠胀感,这就是发背。用此法可立即消散,屡屡有效。取河边水中的泥,先挖去表层约一尺,再取一大块,与人粪一起捣烂至极熟,做成一个饼,大小如碗。在饼顶用针通一个小孔,放在患处。外用艾火灸之。如果感到疼痛,就灸到不痛为止;如果不痛,要灸到有痛感并停止。
熏发背奇方:治疗发背七日之后,未成脓者自行消散,已成脓者自行溃破,不起发者立即起发,不腐溃者立即腐溃。药用雄黄、朱砂、血竭、没药(各二钱),麝香(五分)。将上述药物研为细末,每次取三分,用绵纸包裹药末做成捻子,长约一尺。用麻油浸透,点燃后离疮口半寸许,从外向内,围绕疮口徐徐熏照。开始用三条捻子,增加到五条,等到毒势逐渐消除减少。
散毒饮:治疗发背三五日间,身上洒淅恶寒,疼痛急胀。如未成脓即消散,已成脓即溃破。能调畅气血,调和脾胃,使毒瓦斯不攻心。药用乳香、没药、天花粉、黄芪、防风(各一钱),当归、白芷、桔梗、穿山甲(各一钱二分),皂角刺、连翘、陈皮、金银花、牡丹皮、川芎(各八分)。用水煎煮,饭后服用。
蜡矾丸:治疗发背痈疽及一切肿毒。服用它能保护心膜,使毒瓦斯不能攻心。药用黄蜡(一斤)、明矾(八两研末)、朱砂(八钱研细)。先将黄蜡熔化,加入明矾末,搅拌混合后投入水中,众人用手搓成如绿豆大的丸子,以朱砂为衣。每次服用一百丸,用白开水送服。
生肌丸:治疗一切发背疽毒。服用此药可使肌肉生长,收功愈合。药用黄蜡(一斤)、乳香(研细)、没药(研细)、血竭(各二两研细)、象牙末(四两)。先用蜡熔化,再加入乳香、没药等药搅拌均匀后投入水中,众人用手搓成如绿豆大的丸子。每次服用一百丸,一日两次。
吸毒竹筒:治疗发背痈疽肿毒。用此法拔出脓血恶水。药用苍术、白蔹、浓朴、艾叶、白芨、乌柏皮、芽茶、白蒺藜(各等分)。依法制作竹筒六七个,长二寸,一头保留竹节,削去青皮,切得极薄,随疮口大小使用。将药与竹筒一起煮十多次,煮干为止。趁竹筒热时,紧按吸附在疮口上,脓水流满后自动脱落。否则用手拔脱,更换另一个竹筒。如此三四五次,毒气尽消。
托里定痛散:治疗发背,溃破后,因血虚、余毒未尽而作痛。药用归身、熟地(各二钱),乳香、没药、川芎、白芍(各一钱酒炒),肉桂、粟壳(各一钱五分泡去筋膜蜜炒)。用水煎煮,饭后温服。
五宝饮:治疗发背不肯收口,作疼作痒。服用后即能收功愈合。药用金银花、黄芪、甘草、归身、人参(各二钱)。水二钟,煎至八分,饭后服用。
生肌神秘散:治疗发背即将收功时。撒在疮口上,腐肉即去,新肉即生。药用白升药(一两)、轻粉、铅粉(各一两二钱)、银朱、珍珠(豆腐内煮过各四钱)。研为极细末,掺于疮口。
十全大补汤:治疗发背已溃破,寒热往来,或作疼痛脓多,或自汗盗汗,气血两亏,神思倦怠,疮口不收敛。药用人参、黄芪、川芎、白芍、当归、肉桂(各二钱),熟地、白茯苓、白术、甘草(各一钱五分),黑枣五枚。饭前煎服。
Yin Fa (Fabei occurring in the lower body or deep tissues) is difficult to treat. Yang Fa (Fabei occurring in the upper body or superficial tissues) is easy to treat. The methods of treatment include: dispersing and diffusing, detoxifying, needle cauterization, internal support (Tuo Li), external resolution, and purging. Treatment should be adjusted according to the deficiency/excess and cold/heat patterns. One must also distinguish between the "Five Good" and "Seven Bad" prognostic signs.
If pain is mild and naturally calm, and appetite is good, this is the First Good. If bowel movements and urination are regular, this is the Second Good. If the abscess subsides spontaneously with fresh color and no foul odor, this is the Third Good. If the spirit is bright and the voice is clear and resonant, this is the Fourth Good. If the physical constitution and qi are peaceful, this constitutes the Five Goods.
Abdominal pain with thirst, uncontrolled diarrhea, and dysuria resembling strangury constitute the First Bad. Profuse ulceration with persistent severe swelling and unbearable foul odor constitute the Second Bad. Rapid, coarse breathing, mental confusion, and lethargy constitute the Third Bad. Toxic heat attacking the Heart, causing vomiting of medicines and food, constitutes the Fourth Bad. Hoarseness, loss of facial luster, a dirty appearance, cyanotic lips, black nose, edema of the four limbs, urinary retention, irritability, and occasional coughing constitute the Sixth Bad. Heaviness of the four limbs, with the lesion turning black and sinking before ulceration, constitutes the Seventh Bad.
Shen Shou Wei Sheng Tang (Divine Grant Health-Preserving Decoction): Treats Fabei, as well as brain carbuncles, neck carbuncles, and other malignant sores. It resolves lesions that have not yet suppurated and promotes drainage of those that have. The medicinal properties are mild, and its efficacy is significant. Ingredients include: Huoxiang (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Chuanshanjia (Manis Squama), Chenxiang (Aquilariae Lignum Resinatum), Honghua (Carthami Flos), Lianqiao (Forsythiae Fructus), Shijueming (Haliotidis Concha), each 6 fen; Jinyinhua (Lonicerae Japonicae Flos), Zaojiaoci (Gleditsiae Sinensis Spina), Dangguiwei (Angelicae Sinensis Radix), Gancaojie (Glycyrrhizae Radix et Rhizoma), Tianhuafen (Trichosanthis Radix), Ruxiang (Olibanum), each 8 fen; Dahuang (Rhei Radix et Rhizoma, stir-fried with wine) 2 qian. Decoct in water and take after meals.
Xiao Zhong Tuo Li San (Swelling-Reducing Internal-Supporting Powder): Treats Fabei, regardless of location (upper, lower, left, right), and all types of carbuncles and toxic swellings. Ingredients include: Renshen (Ginseng Radix), Chi Fuling (Poria with Red Host), Baizhu (Atractylodis Macrocephalae Rhizoma), Huashi (Talcum), Jiegeng (Platycodonis Radix), Jinyinhua, Jingjie (Schizonepetae Herba), Shanzhi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Huangqi (Astragali Radix), each 1 qian; Chishao (Paeoniae Radix Rubra), Cangzhu (Atractylodis Rhizoma), Mahuang (Ephedrae Herba), each 7 fen; Dahuang 3 qian; Huangqin (Scutellariae Radix), Fangfeng, Gancao (Glycyrrhizae Radix et Rhizoma), Bohe (Menthae Haplocalycis Herba), Lianqiao, each 8 fen; Shigao (Gypsum Fibrosum), Xiaoshi (Natrii Sulfas), each 1 qian 5 fen. Decoct in water and wine (one zhong each) and take.
Moxibustion Method: At the initial stage of Fabei, if there is slight redness, swelling, heaviness, and distension on the back, it is identified as Fabei. This method can resolve it immediately and has proven effective repeatedly. Use mud from river water, removing the top layer about one chi first, then taking a large piece. Pounded thoroughly with human feces, form it into a cake the size of a bowl. Pierce a small hole through the top with a needle. Place it on the affected area. Apply moxibustion externally. If painful, moxa until pain ceases; if painless, moxa until pain arises and then stops.
Xun Fabei Qi Fang (Strange Formula for Smoking Fabei): Treats Fabei after seven days. It causes non-suppurated lesions to resolve spontaneously, suppurated ones to drain spontaneously, non-elevated ones to rise, and non-necrotic ones to slough. Ingredients include: Xionghuang (Realgar), Zhusha (Cinnabaris), Xuexie (Draconis Sanguis), Moyao (Myrrha), each 2 qian; Shexiang (Moschus) 5 fen. Grind into fine powder. Take 3 fen per dose, wrap in cotton paper to form a roll about one chi long. Moisten with sesame oil. Ignite and hold about half an chi away from the sore, moving slowly around the lesion from outside to inside. Start with three rolls, increase to five, until the pathogenic factor gradually diminishes.
San Du Yin (Toxin-Dispersing Drink): Treats Fabei within three to five days, characterized by aversion to cold with shivering, acute pain, and distension. It resolves non-suppurated lesions and drains suppurated ones. It regulates qi and blood, harmonizes the Spleen and Stomach, and prevents toxic heat from attacking the Heart. Ingredients include: Ruxiang, Moyao, Tianhuafen, Huangqi, Fangfeng, each 1 qian; Danggui, Baizhi, Jiegeng, Chuanshanjia, each 1 qian 2 fen; Zaojiaoci, Lianqiao, Chenpi (Citri Reticulatae Pericarpium), Jinyinhua, Mudanpi (Moutan Cortex), Chuanxiong, each 8 fen. Decoct in water and take after meals.
La Fan Wan (Beeswax-Alum Pill): Treats Fabei, carbuncles, and all toxic swellings. Ingestion protects the pericardium, preventing toxic heat from attacking the Heart. Ingredients include: Huangla (Beeswax) 1 jin, Mingfan (Alumen) 8 liang (ground), Zhusha 8 qian (ground finely). Melt the beeswax, add alum powder, stir, and pour into water. Roll into pills the size of mung beans by hand. Coat with cinnabar. Take 100 pills per dose with plain boiled water.
Sheng Ji Wan (Flesh-Generating Pill): Treats all Fabei and carbuncle toxins. Ingestion promotes tissue regeneration and healing. Ingredients include: Huangla 1 jin, Ruxiang (ground finely), Moyao (ground finely), Xuexie (each 2 liang, ground finely), Xiangya Mo (Elephant Ivory Powder) 4 liang. Melt the beeswax, mix with frankincense, myrrh, etc., pour into water, and roll into mung-bean-sized pills. Take 100 pills per dose, twice daily.
Xi Du Zhu Tong (Toxin-Absorbing Bamboo Tube): Treats Fabei, carbuncles, and toxic swellings. Used to extract pus, blood, and foul fluids. Ingredients include: Cangzhu, Bailian (Bletillae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Aye (Artemisiae Argyi Folium), Baiji (Bletillae Rhizoma), Wubai Pi (Phyllanthi Niruri Cortex), Yacha (Young Tea Leaves), Bjlili (Tribuli Fructus), equal parts. Prepare six or seven bamboo tubes, two cun long, retaining one node at one end. Remove the green skin and shave thinly. Fit to the sore size. Boil the tubes with herbs until dry. While hot, press tightly onto the sore to suction. When full of pus/fluid, remove manually or let fall off. Replace with another tube. Repeat three to five times until toxins are exhausted.
Tuo Li Ding Tong San (Internal-Supporting Pain-Stopping Powder): Treats Fabei after ulceration, where pain persists due to blood deficiency and residual toxins. Ingredients include: Guishen (Angelicae Sinensis Radix), Shudi (Rehmanniae Radix Praeparata), each 2 qian; Ruxiang, Moyao, Chuanxiong, Baishao (Paeoniae Radix Alba), each 1 qian (stir-fried with wine); Rougui (Cinnamomi Cortex), Sukewu (Papaveris Capsicum), each 1 qian 5 fen (soaked,筋 membrane removed, honey-fried). Decoct in water and take warm after meals.
Wu Bao Yin (Five-Treasure Drink): Treats Fabei that refuses to close, causing pain and itching. Ingestion leads to healing. Ingredients include: Jinyinhua, Huangqi, Gancao, Guishen, Renshen, each 2 qian. Decoct in two zhong of water to yield eight fen. Take after meals.
Sheng Ji Shen Mi San (Mysterious Flesh-Generating Powder): Treats Fabei nearing the healing stage. Applied to the wound, it removes necrotic tissue and generates new flesh. Ingredients include: Baisheng Yao (White Sublimate) 1 liang, Qingfen (Calomelas), Qianfen (Lead Carbonate), each 1 liang 2 qian; Yinzhu (Vermilion), Zhenzhu (Margarita) (boiled in tofu, each 4 qian). Grind into extremely fine powder and apply to the wound.
Shi Quan Da Bu Tang (Complete Great Tonifying Decoction): Treats Fabei after ulceration, presenting with alternating chills and fever, pain with abundant pus, spontaneous sweating, night sweats, dual deficiency of qi and blood, mental fatigue, and non-healing wounds. Ingredients include: Renshen, Huangqi, Chuanxiong, Baishao, Danggui, Rougui, each 2 qian; Shudi, Bai Fuling (Poria cum Mycelium), Baizhu, Gancao, each 1 qian 5 fen; Black dates 5 pieces. Decoct and take before meals.