多骨疽由疮疡久溃,脾胃亏损,气血不能营于患处,邪气陷袭,久而筋烂骨腐,故骨脱出,非禀胎所有也。当补脾
胃壮元气,内用大补汤、地黄丸,外以附子饼、葱熨法,祛散寒邪,补接元气,则骨自脱疮自敛。若用克伐之剂,复伤
真气,鲜有不危。婴儿患之,当调补乳母,外用葱熨,以岁月除之,尤不可用追蚀之药。
一小儿足内患之,日流清脓,恶寒发热,大便去而不了,皆元气虚而下陷也,先用补中益气汤加干姜、肉桂,诸
症渐复,乃用十全大补汤及如圣饼,出碎骨而愈。
一小儿臂患之,时出清脓,恶寒发热,此元气虚也,朝用补中益气汤,夕用四君、归、 ,半载常出细骨一块,又
用六味丸而愈。
一小儿患之目睛白多,饮食难化,手足并冷,此禀命门火衰而脾胃虚寒也,先用八味丸、异功散、如圣饼出碎骨,
乃用六味丸、大补汤而愈。若攻疮邪不固元气,必不活矣。
一小儿十四岁,闪足腕间,用败毒之剂,肿硬色黑,余谓此元气虚而外寒凝滞也,用回阳膏、六君、肉桂十余剂,
肿黯渐消;又用冲和膏、托里散,余毒渐软;又佐以大补汤,针之出清脓甚多,即恶寒发热,此阳随阴散而气虚也,用
六君加肉桂、参、 各二钱,寒热顿止;却用八珍汤、托里散、豆豉饼而愈。
一小儿足跗肿硬,肉色不变,形气倦怠,外敷内服皆败毒耗气之药。余谓∶经云形伤痛,气伤肿。乃禀赋足三阴虚
羸之症也,当滋补元气,若行攻伐,虚虚之祸不免矣。彼以
为迂,仍用前药,足跗变黯肿至脚腕,余用大补汤、异功散各五十剂,以调补脾胃;及葱熨患处,祛散寒邪,补接阳
气,漫肿渐消,疮肉赤色,旬日而溃,此元气渐复之善症也。然固元气充实,瘀肉可腐,新肉可生。又惑于速效之
说,敷追蚀生肌之药,患处复黯,七恶并臻而殁。
十全大补汤(方见腹痈)
补中益气汤(方见肌肉不生)
八珍汤(方见发热不止)
托里散(方见热毒疮疡)
如圣饼
葱熨法
豆豉饼(三方见流注)
冲和膏(一名阴阳散,方见寒凉之药)
八味丸(即六味地黄丸加肉桂、附子各一两,方见作渴)
多骨疽是由于疮疡长期溃烂,导致脾胃功能受损,气血无法滋养患处,邪气乘虚侵入,日久致使筋络腐烂、骨骼腐朽,因此骨头脱落排出,这并非先天禀赋所致。治疗应当补益脾胃、壮大元气,内服大补汤和地黄丸,外用附子饼和葱熨法,以驱散寒邪、补充接续元气,这样骨头自然会脱落,疮口自然愈合。如果使用攻伐损伤的药剂,再次伤害真气,很少有不陷入危境的。婴儿患此病,应当调理补益乳母,外用葱熨法,经过较长时间才能治愈,尤其不可使用腐蚀追蚀的药物。
有一个小儿足部内侧患病,每日流出清稀脓液,伴有恶寒发热,大便溏泄且排不尽,这都是元气虚弱而下陷的表现,先用补中益气汤加入干姜、肉桂,各种症状逐渐恢复,然后改用十全大补汤及如圣饼,排出碎骨而痊愈。
另一个小儿手臂患病,时常流出清稀脓液,伴有恶寒发热,这是元气虚弱的表现,早晨服用补中益气汤,晚上服用四君子汤加当归、地黄(原文缺字,据方义补),半年间常排出细骨一块,后又用六味丸而痊愈。
还有一个小儿患病,表现为眼白部分较多,饮食难以消化,手足冰冷,这是禀受命门火衰且脾胃虚寒所致,先用八味丸、异功散、如圣饼排出碎骨,接着用六味丸、大补汤而痊愈。如果只攻击疮毒而不固护元气,必定无法存活。
一个十四岁的小儿,脚踝扭伤后,使用了败毒的药剂,导致肿胀坚硬、颜色发黑。我认为这是元气虚弱而外寒凝滞所致,使用回阳膏、六君子汤、肉桂十余剂,肿胀黯黑逐渐消退;又用冲和膏、托里散,余毒逐渐变软;再配合大补汤,针刺放出大量清稀脓液,随即出现恶寒发热,这是阳气随阴液消散而气虚的表现,用六君子汤加肉桂、人参、地黄各二钱,寒热症状立刻停止;随后用八珍汤、托里散、豆豉饼而痊愈。
还有一个小儿足背肿胀坚硬,肤色不变,形体疲惫倦怠,外敷和内服的都是败毒耗气的药物。我说:《内经》说“形伤痛,气伤肿”。这是禀赋不足导致的足三阴经虚弱的病症,应当滋补元气,如果进行攻伐,难免犯下“虚虚”的错误。他认为我的话迂腐,仍然使用之前的药物,足背变为黯黑肿胀直至脚踝。我使用大补汤、异功散各五十剂,来调补脾胃;并在患处使用葱熨法,驱散寒邪,补充接续阳气,漫肿逐渐消退,疮肉呈现赤色,十天后溃破,这是元气逐渐恢复的良好征兆。然而若固护元气充实,瘀肉可腐败,新肉可生长。但他又迷信速效的说法,敷用追蚀生肌的药物,患处再次变黯,七恶证候并至而死。
十全大补汤(方剂见腹痈章节)
补中益气汤(方剂见肌肉不生章节)
八珍汤(方剂见发热不止章节)
托里散(方剂见热毒疮疡章节)
如圣饼
葱熨法
豆豉饼(以上三方见流注章节)
冲和膏(又名阴阳散,方剂见寒凉之药章节)
八味丸(即六味地黄丸加肉桂、附子各一两,方剂见作渴章节)
Mogu Ju (Bone-Exuding Abscess) arises from chronic ulceration of sores, leading to damage of the Spleen and Stomach. Qi and Blood fail to nourish the affected area, allowing pathogenic factors to invade deeply. Over time, tendons rot and bones decay, causing bone fragments to detach and discharge; this is not due to congenital endowment. Treatment should tonify the Spleen and Stomach and strengthen Yuan Qi (Original Qi). Internally, use Dabu Tang (Great Tonifying Decoction) and Dihuang Wan (Rehmannia Pill); externally, apply Fuzi Bing (Aconite Cake) and Congyun Fa (Scallion Moxibustion Method) to dispel cold pathogens and replenish Yuan Qi. Consequently, the bone will naturally detach and the sore will heal. If harsh attacking agents are used, further damaging True Qi, danger is inevitable. For infants suffering from this condition, the nursing mother should be regulated and tonified, and external scallion moxibustion should be applied over a prolonged period for cure. It is especially inadvisable to use corrosive or escharotic drugs.
One child suffered from this on the medial aspect of the foot, with daily discharge of clear pus, aversion to cold, fever, and incomplete evacuation of loose stools. These symptoms indicate deficiency of Yuan Qi with sinking. Initially, Buzhong Yiqi Tang (Spleen-Raising Qi-Boosting Decoction) was administered with Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark). As symptoms gradually improved, Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) and Rusheng Bing (Like-Sage Cake) were used to expel bone fragments, resulting in recovery.
Another child suffered from this on the arm, with intermittent discharge of clear pus and aversion to cold accompanied by fever, indicating deficiency of Yuan Qi. In the morning, Buzhong Yiqi Tang was taken; in the evening, Sijunzi Tang (Four Gentlemen Decoction) combined with Danggui (Angelica Sinensis) and Dihuang (Rehmannia Root) was administered. Over half a year, small bone fragments were frequently discharged. The condition was finally cured using Liuwei Wan (Six-Ingredient Pill with Rehmannia).
Yet another child presented with excessive whiteness in the eyes, difficulty in digesting food, and cold hands and feet. This indicates congenital deficiency of Mingmen Fire (Fire of the Gate of Life) and deficiency-cold of the Spleen and Stomach. Initially, Bawei Wan (Eight-Ingredient Pill), Yigong San (Yi-Gong Powder), and Rusheng Bing were used to expel bone fragments, followed by Liuwei Wan and Dabu Tang for recovery. If one attacks the pathogenic factors of the sore without consolidating Yuan Qi, survival is impossible.
A fourteen-year-old child suffered an ankle sprain and was treated with detoxifying agents, resulting in swelling, hardness, and black discoloration. I reasoned that this was due to deficiency of Yuan Qi and stagnation of external cold. Ten doses of Huiyang Gao (Return-Yang Ointment), Liujunzi Tang (Six-Gentlemen Decoction), and Rougui were administered, gradually reducing the swelling and darkening. Chonghe Gao (Harmonizing Ointment) and Tuoli San (Interior-Supporting Powder) were then used to soften residual toxins. Subsequently, Dabu Tang was added, and puncture released a large amount of clear pus. Immediately after, aversion to cold and fever appeared, indicating Yang dissipating with Yin and Qi deficiency. Six Junzi Tang with Rougui, Renshen (Ginseng), and Dihuang, each at 2 qian, stopped the chills and fever abruptly. Finally, Bazhen Tang (Eight-Treasure Decoction), Tuoli San, and Douchi Bing (Fermented Soybean Cake) led to full recovery.
Another child had a swollen and hard dorsum pedis with unchanged skin color, accompanied by physical fatigue and lassitude. Both topical and internal treatments consisted of detoxifying and Qi-depleting drugs. I stated: "The Classic says, 'Form injury causes pain, Qi injury causes swelling.'" This is a syndrome of deficiency and emaciation of the Foot Three Yin Meridians due to constitutional weakness. Tonification of Yuan Qi is required; if attacking methods are employed, the error of "treating deficiency as excess" (Xu Xu) cannot be avoided. He considered my advice pedantic and continued with previous medications. The dorsum pedis became dark and swollen up to the ankle. I prescribed fifty doses each of Dabu Tang and Yigong San to regulate and tonify the Spleen and Stomach, along with external scallion moxibustion to dispel cold and restore Yang Qi. The diffuse swelling gradually subsided, the wound tissue turned red, and it ulcerated within ten days—a favorable sign of recovering Yuan Qi. With sufficient Yuan Qi, necrotic flesh can slough off and new flesh can grow. However, influenced by claims of rapid efficacy, he applied escharotic and flesh-regenerating drugs. The lesion turned dark again, the Seven Evil Syndromes manifested simultaneously, and he died.
Shiquan Dabu Tang (Formula see Abdominal Carbuncle)
Buzhong Yiqi Tang (Formula see Failure of Muscle Regeneration)
Bazhen Tang (Formula see Persistent Fever)
Tuoli San (Formula see Heat-Toxic Sores)
Rusheng Bing
Congyun Fa
Douchi Bing (See Flowing Deposit for these three formulas)
Chonghe Gao (Also known as Yinyang San, Formula see Cold-Cooling Drugs)
Bawei Wan (i.e., Liuwei Dihuang Wan plus Rougui and Fuzi, each 1 liang, Formula see Thirst)