治耳下或至缺盆或肩上生疮坚硬如石动之无根名曰马刀从手足少阳经中来也或生两胁或
已流脓作疮未破并皆治之
柴胡(一两二钱) 草龙胆(酒洗四次) 土瓜根(酒制各一两) 黄芩(酒炒二次七钱) 当
归梢
生黄芩 广术 京三棱(同广术酒炒) 连翘 芍药(各五钱) 炙甘草(三钱) 黄连(酒炒
二次) 苍术(各二钱)
上另秤一半为细末炼蜜为丸如绿豆大每服百余丸一半 咀每服五钱水二盏先浸多半日煎
至一盏去渣临卧热服去枕仰卧每口作十次咽之留一口送下丸药服毕卧如常更以后药涂之
龙泉粉(炒) 瓦粉 广术 京三棱(酒洗炒) 昆布(各五钱)
上同为细末煎热水调涂之用此药去疾尤速
治瘰 马刀挟瘿从耳下或耳后下颈至肩上或入缺盆中乃手足少阳之经分其瘰 在颏下或
至颊车乃足阳明之经分受心脾之邪而作也今将二证合而治之
黄 (一钱)
护皮毛实腠理虚及活血脉生血亦疮家圣药也又能补表实元气之弱也
人参(三分)
补肺气之药也如气短不调及喘者加之
炙甘草(五分)
能调中和诸药泻火益胃气亦能去疮邪
真漏芦 升麻(各一钱) 葛根(五分)
此三味俱足阳明本经药也
连翘(一钱)
此一味十二经疮中之药不可无者能散诸血结气聚此疮家之神药也
牡丹皮(三分)
去肠胃中留滞宿血
当归身 生地黄 熟地黄(各三分)
此三味诸经中和血生血凉血药也
白芍药(三分)
如夏月倍之其味酸其气寒能补中益肺之虚弱治腹中痛必用之冬寒则不可用
肉桂(二分)
大辛热能散结积阴证疮疡须当少用之此寒因热用之意又为寒阴覆盖其疮用大辛热以消浮
冻之气如有烦躁者去之
柴胡(八分)
功同连翘如疮不在少阳经则去之
黍粘子(三分)
无肿不用
羌活(一钱) 独活 防风(各五分)
此三味必关手足太阳证脊痛项强不可迥视腰似折项似拔者是也其防风一味辛温若疮在膈
以上虽无手足太阳经证亦当用之为能散结去上部风邪病患身拘急者风也
昆布(二分)
其味大咸若疮坚硬结硬者宜用咸能软坚京三棱(煨二分) 广术(煨三分)
此二味若疮坚硬甚者用之如不坚硬勿用
益智仁(二分)
如唾多者胃不和也或病患吐沫吐食胃上寒者加之无则去之
大麦 面(一钱)
治腹中缩急兼能消食补胃
神曲末(炒黄色二分)
为食不消化故也
黄连(去须三分)
以治烦闷
黄柏(炒三分)
如有热或腿脚无力加如有躁烦欲去衣者肾中伏火也更宜加之无此证勿用
浓朴(三钱二分姜制)
如腹胀者加之无则勿用
上为细末汤浸蒸饼和丸捻作饼子日干捣如米粒大每服三钱白汤下
如气不顺加橘皮甚者加木香少许量病患虚实临时斟酌与之无令药多妨其饮食此治之大法
也
如止在阳明分为瘰 者去柴胡黍粘子二味余皆用之
如在少阳分为马刀挟瘿者去独活漏芦升麻葛根更加瞿麦穗三分
如本人素气弱其病势来时气盛而不短促者不可考其平素宜作气盛而从病变之权也宜加黄
芩黄连黄柏知母防己之类神邪气在上中下三处
假令在上焦加黄芩(一半酒洗一半生用)在中焦加黄连(一半酒洗一半生用)在下焦则加酒
制黄
柏知母防己之类选而用之如本人大便不通而滋其邪盛者加酒制大黄以利如血燥而大便燥干者
加桃仁酒制大黄二味
如风结燥不行者加麻仁大黄
如风涩而大便不行加煨皂角仁大黄秦艽以利之
如脉涩觉身痒气涩而大便不通者加郁李仁大黄以除气燥也
如阴寒之病为寒结闭而大便不通以局方中半硫丸或加煎附子干姜冰冷与之大抵用药之法
不惟
疮疡一说诸疾病量人素气弱者当去苦寒之药多加人参黄 甘草之类泻火而先补其元气余皆仿
此
治疗耳下、或延伸至缺盆(锁骨上窝)、或肩部的疮疡,质地坚硬如石头,推动时感觉无根基,这种病称为“马刀”,病邪来源于手足少阳经。或者生于两胁部,或者已经流脓形成疮口但尚未破溃,这些情况都适用此方。
柴胡(一两二钱),草龙胆(用酒清洗四次),土瓜根(用酒炮制,各一两),黄芩(用酒炒两次,七钱),当归梢,生黄芩,莪术,京三棱(与莪术一同用酒炒),连翘,芍药(各五钱),炙甘草(三钱),黄连(用酒炒两次),苍术(各二钱)。
以上药材另取一半称量,研成细末,用炼蜜制成如绿豆大小的丸剂。每次服用一百多丸;另一半药材切碎,每次取五钱,加水两盏,先浸泡大半日,煎煮至一盏,去渣,睡前热服。服药后去掉枕头仰卧,每口分十次咽下,留一口送服丸药。服毕后像平常一样睡觉,再用以下药物外涂:
龙泉粉(炒),瓦粉,莪术,京三棱(用酒洗并炒),昆布(各五钱)。
以上药材共同研成细末,用热水调匀后涂抹使用。此药祛除疾病尤其迅速。
治疗瘰疬、马刀挟瘿,病位从耳下或耳后沿颈部向下至肩部,或进入缺盆中,这是手足少阳经的分野;若瘰疬生在颏下或至颊车穴部位,则是足阳明经的分野,由心脾之邪所致。现在将这两种证候合并治疗。
黄芪(一钱):能保护皮毛,充实腠理,虚损时活血脉、生血液,也是疮疡家的圣药,还能补益体表元气之虚弱。
真漏芦,升麻(各一钱),葛根(五分):这三味都是足阳明本经的药物。
连翘(一钱):这一味药是十二经疮疡中不可缺少的,能消散各种血结气聚,是疮疡家的神药。
当归身,生地黄,熟地黄(各三分):这三味药是各经中和血、生血、凉血的药物。
白芍药(三分):如在夏季可加倍使用,其味酸,气寒,能补中益肺之虚弱,治疗腹中痛必用之;冬季寒冷则不可用。
肉桂(二分):大辛大热,能散结积阴证疮疡,须当少量使用。这是“寒因热用”的意思,又为寒阴覆盖其疮,用大辛热以消除浮冻之气。如有烦躁者去掉它。
黍粘子(牛蒡子)(三分):没有肿胀时不用。
羌活(一钱),独活,防风(各五分):这三味药必须关联手足太阳证,即脊痛项强、不能回头看、腰似折断、项似拔出的情况。其中防风一味,性辛温,如果疮在膈以上,即使没有手足太阳经证,也应当使用,因为它能散结去上部风邪。病患身体拘急者是风邪所致。
京三棱(煨,二分),莪术(煨,三分):这两味药如果疮非常坚硬严重时使用,如果不坚硬勿用。
益智仁(二分):如果唾液多者,是胃不和;或者病患吐沫、吐食,胃上有寒者加入,没有则去掉。
大麦面(一钱):治疗腹中缩急,兼能消食补胃。
神曲末(炒黄色,二分):因为食物不消化故用。
黄柏(炒,三分):如果有热或腿脚无力加用;如有躁烦欲去衣者,是肾中伏火,更适宜加用;没有此证勿用。
以上药材研成细末,用汤浸蒸饼和丸,搓作饼状,日晒干燥,捣如米粒大小。每次服用三钱,白开水送下。
如果气不顺,加橘皮;严重者加少许木香,根据病患虚实临时斟酌给予,不要让药太多妨碍饮食。这是治疗的大法。
如果在少阳分为马刀挟瘿者,去掉独活、漏芦、升麻、葛根,更加入瞿麦穗三分。
如果本人平时气弱,但病势来时气盛且不短促者,不可考察其平素状态,宜作气盛而从病变之权变处理。宜加黄芩、黄连、黄柏、知母、防己之类,以泻邪气在上、中、下三处。
假令邪气在上焦,加黄芩(一半酒洗,一半生用);在中焦加黄连(一半酒洗,一半生用);在下焦则加酒制黄柏、知母、防己之类,选而用之。如果本人大便不通且滋助邪气盛者,加酒制大黄以利之;如血燥而大便燥干者,加桃仁、酒制大黄两味。
如果是阴寒之病,为寒结闭而大便不通,用局方中的半硫丸,或加煎附子、干姜,冰冷与之。大抵用药之法,不仅限于疮疡一说,其他疾病,根据人平时气弱者,应当去掉苦寒之药,多加人参、黄芪、甘草之类,泻火而先补其元气,其余都仿照此法。
Treatment for sores or ulcers occurring below the ear, extending to the depression above the clavicle (Quepen), or on the shoulder. The lesions are hard as stone and feel unrooted when moved. This condition is called "Madao" (Scrofula of the neck), originating from the Hand-Shaoyang and Foot-Shaoyang meridians. It may also occur in the hypochondriac region, or have already suppurated into an ulcer without breaking open. All these conditions are treated with this formula.
Chaihu (Bupleuri Radix, 1 liang 2 qian), Caolongdan (Gentianae Macrophytae Radix, washed four times with wine), Tugegen (Trichosanthis Radix, prepared with wine, each 1 liang), Huangqin (Scutellariae Radix, fried twice with wine, 7 qian), Danggui Shao (tip of Angelicae Sinensis Radix), Sheng Huangqin (raw Scutellariae Radix), Guangzhu (Curcumae Longae Rhizoma), Jing Sanleng (Sparganii Rhizoma, stir-fried with wine together with Guangzhu), Lianqiao (Forsythiae Fructus), Shaoyao (Paeoniae Radix, each 5 qian), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 3 qian), Huanglian (Coptidis Rhizoma, fried twice with wine), Cangzhu (Atractylodis Rhizoma, each 2 qian).
Take half of the above ingredients by weight, grind into a fine powder, and mix with refined honey to make pills the size of mung beans. Take over one hundred pills per dose. For the remaining half of the ingredients, chop them coarsely, take 5 qian per dose, add two zhan of water, soak for more than half a day, decoct until one zhan remains, strain, and drink hot before retiring. Remove the pillow and lie supine after taking the medicine. Swallow the liquid in ten portions throughout the night, using the last portion to wash down the pills. After finishing, sleep as usual. Then apply the following external preparation:
Longquanfen (Stir-fried), Wafen (Tile powder), Guangzhu (Curcumae Longae Rhizoma), Jing Sanleng (Sparganii Rhizoma, washed and stir-fried with wine), Kunbu (Laminariae Thallus, each 5 qian).
Grind all together into a fine powder. Mix with hot water to form a paste for topical application. This medication removes disease especially quickly.
Treatment for Luoli (Scrofula), Madao, and Jiaying (Goiter associated with scrofula). The pathology extends from below the ear or behind the ear down the neck to the shoulder, or enters the Quepen area; this belongs to the Hand-Shaoyang and Foot-Shaoyang meridians. If Luoli occurs under the chin or at the Jiache point, it belongs to the Foot-Yangming meridian, caused by pathogenic factors from the Heart and Spleen. Here, both syndromes are treated together.
Huangqi (Astragali Radix, 1 qian): Protects the skin and hair, consolidates the Couli (pores and interstices), invigorates blood vessels, and generates blood when deficient. It is a sacred herb for wound healers and can tonify the weakness of Yuan Qi (Original Qi) in the exterior.
Renshen (Ginseng Radix, 3 fen): Tonifies Lung Qi. Add if there is shortness of breath or irregular breathing, and wheezing.
Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 5 fen): Harmonizes other herbs, clears heat, benefits Stomach Qi, and expels pathogenic factors from sores.
Zhen Loulu (Euphorbiae Humifusae Radix), Shengma (Cimicifugae Rhizoma, each 1 qian), Gegen (Puerariae Lobatae Radix, 5 fen): These three herbs belong to the Foot-Yangming meridian.
Lianqiao (Forsythiae Fructus, 1 qian): Indispensable for sores and ulcers in all twelve meridians. It dissipates blood stasis and qi stagnation; it is a divine herb for wound healing.
Mudanpi (Moutan Cortex, 3 fen): Removes stagnant old blood in the intestines and stomach.
Danggui Shen (body of Angelicae Sinensis Radix), Sheng Dihuang (Rehmanniae Radix Recens), Shu Dihuang (Rehmanniae Radix Praeparata, each 3 fen): These three herbs harmonize, invigorate blood, generate blood, and clear heat in various meridians.
Baishaoyao (White Peony Root, 3 fen): In summer, double the dosage. Its flavor is sour and nature cold; it tonifies the middle and benefits Lung deficiency, and is essential for treating abdominal pain. Do not use in winter cold.
Rougui (Cinnamomi Cortex, 2 fen): Greatly pungent and hot; it dissipates nodules and accumulations in Yin-type sores. Use sparingly. This illustrates the principle of "treating cold with heat." It counteracts the floating cold qi covering the sore. Discontinue if irritability is present.
Chaihu (Bupleuri Radix, 8 fen): Efficacy similar to Lianqiao. Remove if the sore is not in the Shaoyang meridian.
Shuniuzi (Arctii Fructus, 3 fen): Do not use if there is no swelling.
Qianghuo (Notopterygii Rhizoma et Radix, 1 qian), Duhuo (Angelicae Pubescentis Radix, Fangfeng (Saposhnikoviae Radix, each 5 fen): These three herbs relate to Hand-Taiyang and Foot-Taiyang syndromes, characterized by back pain, stiff neck, inability to look back, waist feeling like breaking, and neck feeling like pulling. Fangfeng is pungent and warm. Even if there are no Taiyang symptoms, if the sore is above the diaphragm, it should be used to dissipate nodules and remove wind pathogens from the upper body. Physical stiffness in patients indicates wind pathogen.
Kunbu (Laminariae Thallus, 2 fen): Very salty in flavor. Use if the sore is hard and indurated, as salt softens hardness.
Jing Sanleng (Sparganii Rhizoma, roasted, 2 fen), Guangzhu (Curcumae Longae Rhizoma, roasted, 3 fen): Use these two only if the sore is extremely hard and severe. Do not use if not hard.
Yizhiren (Alpiniae Oxyphyllae Fructus, 2 fen): If there is excessive saliva, it indicates Stomach disharmony. Add if the patient spits foam or vomits food due to Cold in the Stomach. Remove if absent.
Damai Mian (Barley Flour, 1 qian): Treats abdominal contraction and urgency; aids digestion and tonifies the Stomach.
Shenqu Mo (Fermented Medicinal Leaven Powder, stir-fried yellow, 2 fen): Used for undigested food.
Huanglian (Coptidis Rhizoma, de-stemmed, 3 fen): Treats restlessness and oppression.
Huangbai (Phellodendri Cortex, stir-fried, 3 fen): Add if there is heat or weakness in the legs and feet. Add if there is irritability and desire to remove clothes, indicating latent fire in the Kidney. Do not use if these signs are absent.
Houpo (Magnoliae Officinalis Cortex, 3 qian 2 fen, processed with ginger): Add if there is abdominal distension. Do not use if absent.
Grind all into a fine powder. Soak in decoction, mix with steamed wheat cake dough, shape into cakes, dry in the sun, and crush to the size of rice grains. Take 3 qian per dose with plain warm water.
If Qi is not smooth, add Chenpi (Citri Reticulatae Pericarpium); if severe, add a small amount of Muxiang (Aucklandiae Radix). Adjust according to the patient's deficiency or excess temporarily. Do not let the medicine interfere too much with diet. This is the general principle of treatment.
If the condition is solely Luoli in the Yangming division, remove Chaihu and Shuniuzi; use the rest.
If the condition is Madao or Jiaying in the Shaoyang division, remove Duhuo, Loulu, Shengma, and Gegen; add Qumai Sui (Setariae Milicae Spica, 3 fen).
If the patient usually has weak Qi, but during the onset of the disease, the Qi appears strong without shortness of breath, do not rely solely on their usual state. Instead, adapt to the apparent excess of the disease. Add Huangqin, Huanglian, Huangbai, Zhimu (Anemarrhenae Rhizoma), and Fangji (Stephaniae Tetrandrae Radix) to drain pathogenic factors in the Upper, Middle, and Lower Jiao.
Assuming the pathogen is in the Upper Jiao, add Huangqin (half wine-washed, half raw). In the Middle Jiao, add Huanglian (half wine-washed, half raw). In the Lower Jiao, add wine-processed Huangbai, Zhimu, and Fangji, selecting as appropriate. If the patient has constipation and the pathogen is abundant, add wine-processed Dahuang (Rhei Radix et Rhizoma) to promote bowel movement. If blood dryness causes dry stool, add Taoren (Persicae Semen) and wine-processed Dahuang.
If wind-induced dryness obstructs bowel movement, add Haren (Cannabis Semen) and Dahuang.
If wind-dryness prevents bowel movement, add roasted Zaorao Ren (Gleditsiae Sinensis Spina Fructus Seed), Dahuang, and Qinjiao (Gentianae Macrophytae Radix) to promote bowel movement.
If the pulse is choppy, the body itches, Qi is stagnant, and there is constipation, add Yuziren (Prunus Armeniaca Semen Amarum) and Dahuang to remove Qi dryness.
If it is a Yin-Cold disease causing constipation due to cold obstruction, use Banshu Wan (Half-Sulfur Pill) from the Ju Fang, or decoct Fuzi (Aconiti Lateralis Radix Praeparata) and Ganjiang (Zingiberis Rhizoma), and administer cold. Generally, the method of medication applies not only to sores and ulcers but to all diseases. For patients with weak constitution, remove bitter-cold herbs and increase Renshen, Huangqi, and Gancao to drain fire and first tonify Yuan Qi. Apply this principle to other cases.