小儿疮疡,多由胎禀遗热,或乳哺积热,或乳母七情致热。经云∶五脏不和,九窍不通。六腑不和,留结为痈。又
云∶气主嘘之,血主濡之。治者当察其经络所因,表里虚实而调和,以固其本。假如肿痛热渴,大便秘结者,邪在内也,
宜疏通之。肿 作痛,寒热头疼者,邪在表也,宜发散之。 肿痛甚者,邪在经络也,宜和解之。漫肿微痛而不溃者,
血气虚弱也,宜补托之。色黯微痛而不溃,或溃而不敛者,
阳气虚寒也,宜温补之。如是,则五脏自和,六腑自调,气血自生,疮毒自解,此即败毒之法也。若概用寒凉之剂,复
损脾胃,则肿者不能消散,溃者不能收敛,诸恶蜂起,多致不救矣。
一小儿臂痈,肿硬色白,寒热倦怠,此因血气虚耳,先用五味异功散加木香、干姜,诸症渐减,去二味,又佐以托
里散、如圣饼,脓溃而愈。
一小儿臂痈,服败毒药,肿硬不消,汗出不止,此脾肺气虚也,用异功散加五味子而汗止,佐以葱熨而脓成;用托
里散而疮愈。
一小儿腿痈,脓水清稀,手足时冷,余谓脾胃虚寒,先用益气汤加干姜而手足温;用异功散、葱熨法而脓稠;用八
珍汤、附子饼而疮愈。
一小儿面生疮,寒热头痛,服大黄等药,连泻数度,手足并冷,疮黯吃逆。余曰∶此邪在表,误攻其里,下多而亡
阴也。后果殁。
一小儿腿痈,服麻黄等药,汗出喘急,手足并冷,余谓此阴虚误汗而亡阳也,后果殁。
五味异功散 治禀赋元气虚弱,肌肉消薄,荣卫短促而患疮疡,不能消散;或脾肺气虚,不能生肌收口。大凡
诸症,因脾气虚而不能愈者,皆宜服之,调补元气,则自愈矣。
人参 茯苓 白术(炒) 甘草(炒) 陈皮(各等分)
上为末,每服二三钱,姜枣水煎。
托里散(方见热毒疮疡)
葱熨法
如圣饼(二方见流注)
八珍汤(方见发热不止)
十全大补汤(方见便痈)
补中益气汤(方见肌肉不生)
附子饼(方见贴骨痈)
小儿疮疡,多由胎禀遗热,或乳哺积热,或乳母七情致热。经云∶五脏不和,九窍不通。六腑不和,留结为痈。又
云∶气主嘘之,血主濡之。治者当察其经络所因,表里虚实而调和,以固其本。假如肿痛热渴,大便秘结者,邪在内也,
宜疏通之。肿 作痛,寒热头疼者,邪在表也,宜发散之。 肿痛甚者,邪在经络也,宜和解之。漫肿微痛而不溃者,
血气虚弱也,宜补托之。色黯微痛而不溃,或溃而不敛者,
阳气虚寒也,宜温补之。如是,则五脏自和,六腑自调,气血自生,疮毒自解,此即败毒之法也。若概用寒凉之剂,复
损脾胃,则肿者不能消散,溃者不能收敛,诸恶蜂起,多致不救矣。
一小儿臂痈,肿硬色白,寒热倦怠,此因血气虚耳,先用五味异功散加木香、干姜,诸症渐减,去二味,又佐以托
里散、如圣饼,脓溃而愈。
一小儿臂痈,服败毒药,肿硬不消,汗出不止,此脾肺气虚也,用异功散加五味子而汗止,佐以葱熨而脓成;用托
里散而疮愈。
一小儿腿痈,脓水清稀,手足时冷,余谓脾胃虚寒,先用益气汤加干姜而手足温;用异功散、葱熨法而脓稠;用八
珍汤、附子饼而疮愈。
一小儿面生疮,寒热头痛,服大黄等药,连泻数度,手足并冷,疮黯吃逆。余曰∶此邪在表,误攻其里,下多而亡
阴也。后果殁。
一小儿腿痈,服麻黄等药,汗出喘急,手足并冷,余谓此阴虚误汗而亡阳也,后果殁。
五味异功散 治禀赋元气虚弱,肌肉消薄,荣卫短促而患疮疡,不能消散;或脾肺气虚,不能生肌收口。大凡
诸症,因脾气虚而不能愈者,皆宜服之,调补元气,则自愈矣。
人参 茯苓 白术(炒) 甘草(炒) 陈皮(各等分)
上为末,每服二三钱,姜枣水煎。
托里散(方见热毒疮疡)
葱熨法
如圣饼(二方见流注)
八珍汤(方见发热不止)
十全大补汤(方见便痈)
补中益气汤(方见肌肉不生)
附子饼(方见贴骨痈)
Pediatric sores and ulcers are mostly caused by heat retained from the fetal constitution, accumulation of heat due to breastfeeding or feeding, or heat generated by the mother's seven emotions. The classics state: "When the five zang organs are disharmonious, the nine orifices become obstructed. When the six fu organs are disharmonious, stagnation and knotting form carbuncles." It is also stated: "Qi primarily warms and moistens, while Blood primarily nourishes." Practitioners should examine the etiology involving the meridians, assess the exterior and interior, deficiency and excess, and harmonize them to consolidate the root. For instance, if there is swelling, pain, fever, thirst, and constipation, the pathogen is in the interior; it is appropriate to unblock and drain it. If there is swelling with pain, aversion to cold, fever, and headache, the pathogen is in the exterior; it is appropriate to disperse and release it. If swelling and pain are severe, the pathogen is in the meridians; it is appropriate to harmonize and resolve it. If there is diffuse swelling with slight pain that does not suppurate, this indicates deficiency and weakness of Qi and Blood; it is appropriate to tonify and support (push out toxins). If the color is dark with slight pain and does not suppurate, or if it suppurates but fails to heal, this indicates deficiency and cold of Yang Qi; it is appropriate to warm and tonify. In this way, the five zang organs will naturally harmonize, the six fu organs will naturally regulate, Qi and Blood will naturally generate, and sore toxins will naturally resolve. This is the method of defeating toxins. However, if cooling agents are generally used, damaging the Spleen and Stomach further, then swollen areas will not dissipate, and ulcerated areas will not converge. Various malignant conditions will arise, often leading to untreatable cases.
A child had a carbuncle on the arm, with swelling, hardness, white color, aversion to cold, fever, and fatigue. This was due to deficiency of Qi and Blood. First, Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Efficacy) was administered with added Muxiang (Aucklandiae Radix) and Ganjiang (Dried Ginger), after which all symptoms gradually decreased. The two added herbs were removed, and Tuoli San (Support-the-Interior Powder) and Rusheng Bing (Rusheng Cake) were assisted, leading to suppuration and recovery.
Another child had a carbuncle on the arm. After taking toxin-defeating medicines, the swelling and hardness did not subside, and sweating continued incessantly. This indicated deficiency of Lung and Spleen Qi. Yigong San (Extraordinary Efficacy Powder) with added Wuweizi (Schisandrae Fructus) was used to stop the sweating, assisted by Congyun (Scallion Moxibustion) to promote suppuration; Tuoli San (Support-the-Interior Powder) was then used to heal the sore.
Another child had a carbuncle on the leg. The pus and water were clear and thin, and the hands and feet were occasionally cold. I considered this to be deficiency-cold of the Spleen and Stomach. First, Yiqi Tang (Tonify-Qi Decoction) with added Ganjiang (Dried Ginger) was used to warm the hands and feet; Yigong San (Extraordinary Efficacy Powder) and the Congyun (Scallion Moxibustion) method were used to thicken the pus; Bazhen Tang (Eight-Treasure Decoction) and Fuzi Bing (Aconite Cake) were used to heal the sore.
Another child developed sores on the face, accompanied by aversion to cold, fever, and headache. After taking Dahuang (Rhei Radix et Rhizoma) and other medicines, diarrhea occurred several times consecutively, the hands and feet became cold, the sores turned dark, and hiccuping occurred. I said: "The pathogen is in the exterior, but the interior was mistakenly attacked. Excessive purging leads to loss of Yin." The child subsequently died.
Another child had a carbuncle on the leg. After taking Mahuang (Ephedrae Herba) and other medicines, sweating occurred with panting and urgency, and the hands and feet became cold. I considered this to be mistaken sweating causing loss of Yang due to Yin deficiency. The child subsequently died.
Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Efficacy) treats congenital deficiency of Yuan Qi (Primal Qi), thinning of muscles, shortness of Ying and Wei (Nutritive and Defensive Qi), and occurrence of sores and ulcers that cannot dissipate; or deficiency of Lung and Spleen Qi, inability to generate flesh and close wounds. Generally, for any condition that fails to heal due to deficiency of Spleen Qi, this formula is suitable. Harmonizing and tonifying Yuan Qi will lead to self-healing.
Ren Shen (Ginseng Radix), Fu Ling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried), Gancao (Licorice Root - stir-fried), Chenpi (Citri Reticulatae Pericarpium) (equal parts).
Grind into powder. Take 2-3 qian per dose, decoct with ginger and jujube water.
Tuoli San (Support-the-Interior Powder) (Formula seen under Heat-Toxin Sores and Ulcers)
Congyun Method (Scallion Moxibustion)
Rusheng Bing (Rusheng Cake) (Two formulas seen under Liuzhu/Flowing Abscess)
Bazhen Tang (Eight-Treasure Decoction) (Formula seen under Unceasing Fever)
Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) (Formula seen under Perineal Carbuncle)
Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) (Formula seen under Failure of Muscle Generation)
Fuzi Bing (Aconite Cake) (Formula seen under Deep-Seated Bone Carbuncle)