【方歌】冲疽脐上二寸生,心火毒炽入肾红,高肿焮痛速溃吉,
若见七恶定然凶。
【注】此证生于任脉,脐上二寸下脘穴。一名中发疽,又名壅
肾疮。由心火炽盛,流入肾经而成,色赤高肿,应在二
十一日溃破,脓稠受补者顺。初宜疮科流气饮,或仙方
活命饮消之。脓将成时,内外治法,俱按痈疽肿疡、溃
疡门。其证若平塌紫黑,脓水清稀,七恶证见者逆。
方剂:疮科流气散(见背部痰注发)
仙方活命饮(见肿疡门)
【方歌】脐痈毒发在脐中,肿大如瓜突若铃,无红无热宜蒜灸,
稠脓为吉污水凶。
【注】此证由心经火毒,流入大肠、小肠所致。生于脐中,属
任脉经神阙穴,此穴禁针。肿大如瓜,高突若铃,无红
无热,最宜隔蒜灸之。初宜服仙方活命饮加升麻消之;
便结实者,内疏黄连汤通利之;将欲成脓,内外治法,
俱按痈疽肿疡、溃疡门。溃后得稠脓者顺,时出污水臭
秽者逆。亦有脐中不痛、不肿、甚痒,时津黄水,此属
肠胃湿热积久,宜服黄连平胃散,外用二妙散干撒渗湿
即愈。当忌酒、面、生冷、果菜,不致再发。若水出不
止者,亦属逆。
方剂:黄连平胃散
组成:黄连(五钱) 陈皮
厚朴(姜炒,各三钱) 甘草(生,二钱)
苍术(炒,一两)
共研细末,每服三钱,白滚水调服。
【方歌】黄连平胃散陈甘,厚朴苍术共细研,专除湿热兼消积,
能令脐水立时干。
又方:三妙散
组成:槟榔 苍术(生)
黄柏(生,各等分)
共研细末,干撒肚脐,出水津淫成片,止痒渗湿;
又治湿癣,以苏合油调搽甚效。
【方歌】三妙散用槟榔苍,黄柏同研渗湿疮,苏合油调治湿癣,
收干止痒效称强。
又方:隔蒜灸法(见首卷灸法)
仙方活命饮、内疏黄连汤(俱见肿疡门)
【方歌】冲疽生于脐上两寸处,因心火毒邪炽盛侵入肾经而致局部发红,若肿块高起肿胀、灼热疼痛且迅速溃破则预后良好,
若出现“七恶”症状则必然凶险。
【注】此证发生于任脉,具体位置在脐上两寸的下脘穴。该病又名中发疽,又名为壅肾疮。由心火亢盛,流注于肾经所致,表现为颜色红赤、高高肿起,通常在发病后二十一天左右溃破,若脓液稠厚且患者能耐受补益疗法则为顺证。初期宜使用疮科流气饮,或仙方活命饮以消散病灶。当脓液即将形成时,内服与外治方法,均参照痈疽章节中的肿疡和溃疡部分进行处理。若病症表现为平塌不起、颜色紫黑,脓水清稀,并出现“七恶”症状者则为逆证。
方剂:疮科流气散(参见背部痰注发章节)
仙方活命饮(参见肿疡门章节)
【方歌】脐痈毒邪发作于脐部中央,肿胀大如瓜状,突起形似铃铛,若无红肿发热现象适宜采用隔蒜灸法,
若排出稠厚脓液为吉兆,排出污水则为凶兆。
【注】此证由心经火毒,流入大肠和小肠所致。病变位于脐中,属于任脉经的神阙穴,此穴位禁止针刺。患处肿大如瓜,高耸突起如铃,无红肿热痛感,最适合采用隔蒜灸法治疗。初期宜服用仙方活命饮加入升麻以消散病灶;若大便干结坚硬者,服用内疏黄连汤以通利腑气;当脓液即将形成时,内外治法,
均参照痈疽章节中的肿疡和溃疡部分处理。溃破后若流出稠厚脓液为顺证,若时常流出污水且气味臭秽者为逆证。也有脐部不痛、不肿、极度瘙痒,时常渗出黄水的症状,这属于肠胃湿热积滞日久所致,宜服用黄连平胃散,外用二妙散干粉撒敷以渗湿止痒即可痊愈。应当忌食酒、面食、生冷食物及瓜果蔬菜,以免病情复发。若脐部出水不止者,也属于逆证。
方剂:黄连平胃散
组成:黄连(五钱) 陈皮
厚朴(姜炒,各三钱) 甘草(生用,二钱)
苍术(炒制,一两)
共研成细末,每次服用三钱,用白开水调服。
【方歌】黄连平胃散含陈皮与甘草,厚朴苍术共同细细研磨,专门清除湿热兼消除积滞,
能使脐部流水立即干燥。
另一方:三妙散
组成:槟榔 苍术(生用)
黄柏(生用,各等分)
共研成细末,干粉撒于肚脐,用于渗出黄水成片、止痒渗湿;
另外治疗湿癣,用苏合香油调和涂抹效果极佳。
【方歌】三妙散使用槟榔与苍术,黄柏一同研磨以渗除湿疮,用苏合油调和治疗湿癣,
收敛干燥止痒功效显著。
另一法:隔蒜灸法(见首卷灸法章节)
仙方活命饮、内疏黄连汤(均见肿疡门章节)
[Prescription Verse] Chongju (Pulse Abscess) arises two cun above the umbilicus, caused by excessive heart fire toxin invading the Kidney meridian leading to redness; if the swelling is high and distended with burning pain and it suppurates rapidly, the prognosis is auspicious.
If the "Seven Evils" symptoms appear, the outcome is inevitably ominous.
[Annotation] This condition occurs on the Ren Mai (Conception Vessel), specifically at the Xiawan (CV10) acupoint, two cun above the umbilicus. It is also known as Zhongfa Ju (Central Hair Abscess) or Yong Shen Chuang (Obstructing Kidney Sore). It results from hyperactive Heart Fire flowing into the Kidney Meridian, presenting with red coloration and high swelling. It typically suppurates around the twenty-first day; if the pus is thick and the patient can tolerate tonification, it is a favorable course (Shun). Initially, treat with Chuang Ke Liu Qi Yin (Wound Department Flowing Qi Decoction) or Xian Fang Huo Ming Yin (Immortal Life-Activating Decoction) to dissipate the lesion. When pus is about to form, internal and external treatments should follow the protocols for Swelling Ulcer (Zhongyang) and Ulcerated Ulcer (Kuyang) sections in the Carbuncle and Ulcer chapters. If the lesion appears flat and sunken with purple-black discoloration, with thin pus water and the appearance of the "Seven Evils," it is an unfavorable course (Ni).
Formulas: Chuang Ke Liu Qi San (See Back部的 Tan Zhu Fa section)
Xian Fang Huo Ming Yin (See Zhongyang Men section)
[Prescription Verse] Qiyong (Umbilical Abscess) toxin erupts in the center of the umbilicus, swelling large like a melon and protruding like a bell; if there is no redness or heat, Garlic-partitioned Moxibustion is suitable.
Thick pus indicates a good omen, while turbid water indicates a bad omen.
[Annotation] This condition is caused by Heart Meridian Fire Toxin flowing into the Large Intestine and Small Intestine. The lesion is located in the umbilicus, belonging to the Shenque (CV8) acupoint of the Ren Mai (Conception Vessel); this acupoint is contraindicated for acupuncture. The area swells like a melon and protrudes high like a bell, without redness, heat, or pain, making it most suitable for Garlic-partitioned Moxibustion. Initially, administer Xian Fang Huo Ming Yin (Immortal Life-Activating Decoction) added with Sheng Ma (Cimicifugae Rhizoma) to dissipate the lesion; if stool is dry and hard, administer Nei Shu Huang Lian Tang (Internal Draining Coptis Decoction) to unblock and purge. When pus is about to form, internal and external treatments should follow the protocols for Swelling Ulcer and Ulcerated Ulcer sections in the Carbuncle and Ulcer chapters. After ulceration, the discharge of thick pus is a favorable course (Shun), while frequent discharge of turbid water with foul odor is an unfavorable course (Ni). There are also cases where the umbilicus is not painful or swollen but extremely itchy, with occasional exudation of yellow fluid; this belongs to long-standing accumulation of Damp-Heat in the Stomach and Intestines. Treat internally with Huang Lian Ping Wei San (Coptis Harmonizing the Stomach Powder) and externally apply Er Miao San (Two Marvels Powder) as a dry dusting to drain dampness, which will lead to recovery. Alcohol, wheat products, raw/cold foods, and fruits/vegetables must be avoided to prevent recurrence. If umbilical discharge does not stop, it is also considered an unfavorable course (Ni).
Formula: Huang Lian Ping Wei San
Composition: Huang Lian (Coptidis Rhizoma) (5 qian), Chen Pi (Citri Reticulatae Pericarpium)
Hou Po (Magnoliae Officinalis Cortex, stir-fried with ginger juice, 3 qian each), Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 2 qian)
Cang Zhu (Atractylodis Rhizoma, fried, 1 liang)
Grind into fine powder. Take 3 qian per dose, mixed with boiling water.
[Prescription Verse] Huang Lian Ping Wei San contains Chen Pi and Gan Cao, Hou Po and Cang Zhu ground finely together; it specializes in draining Damp-Heat and eliminating stagnation,
making umbilical discharge dry immediately.
Another Formula: San Miao San (Three Marvels Powder)
Composition: Bing Lang (Arecae Semen), Cang Zhu (Atractylodis Rhizoma, raw)
Huang Bo (Phellodendri Cortex, raw, equal parts)
Grind into fine powder. Apply as a dry dusting to the umbilicus to treat weeping sores, stop itching, and drain dampness;
Also treats Damp Tinea (Shi Xuan); mixing with Su He You (Styrax Oil) for topical application is very effective.
[Prescription Verse] San Miao San uses Bing Lang and Cang Zhu, Huang Bo ground together to drain damp sores; mixed with Su He Oil to treat damp tinea,
its ability to dry up lesions and stop itching is strongly praised.
Another Method: Garlic-partitioned Moxibustion (See First Volume, Moxibustion Methods section)
Xian Fang Huo Ming Yin, Nei Shu Huang Lian Tang (Both see Zhongyang Men section)