属性:洗有荡涤之功。涤洗则气血自然舒畅,其毒易于溃腐,
而无壅滞也。凡肿在四肢者,〔榻〕渍之;在腰腹脊背
者,淋之;在下部者,浴之,俱以布帛或棉蘸洗,稍温
即易,轻者日洗一次,重者日夜洗二次,每日洗之,不
可间断。凡洗时,冬月要猛火以逼寒气,夏月要明窗以
避风凉。若不慎此,轻则有妨收口,重则恐变纯阴。夫
洗药不一,如初肿与将溃者,俱用葱归〔榻〕肿汤烫洗
。如阴证不起者,俱用艾茸汤敷法。如溃后,俱用猪蹄
汤烫洗。用猪蹄汤者,以肋肉之气而逐腐也。此涤洗之
法,乃疡科之要药也。
方剂:葱归〔榻〕肿汤
主治:此汤治痈疽疮疡,初肿将溃之时,用此汤洗之,以疮内
热痒为度。
组成:独活(三钱) 白芷(三钱)
葱头(七个) 当归(三钱)
甘草(三钱)
上五味,以水三大碗,煎至汤醇,滤去渣,以绢帛
蘸汤热洗,如温再易之。
【方歌】葱归〔榻〕肿洗诸毒,初起将溃用之宜,洗至热痒斯为
度,独芷葱归甘草俱。
又方:艾茸敷法
主治:此膏治阴疮黑陷而不痛者,用之为良。以知痛则生,不
知痛出紫血者死,然必内服大补回阳之剂以助之。
组成:硫黄(五钱) 雄黄(五钱)
艾茸(一斤)
上以硫、雄二味为末,同艾入水煎半日,水将干,取
艾出,捣烂,温敷患处。再煎再易,十余次为度。
【方歌】艾茸敷法治阴疮,黑陷不痛用之良,石硫黄雄同艾煮,
捣成膏敷定能康。
又方:猪蹄汤
主治:此汤治痈疽、诸毒流脓者,熬好洗之,以助肉气,消肿
散风,脱腐止痛,去恶肉,活死肌,润疮口。如腐尽者
,不必用之,当以米泔水热洗之,令疮洁净。不可过洗
,过洗则伤水,皮肤破烂,难生肌肉敛口矣。
组成:黄芩 甘草
当归 赤芍
白芷 蜂房
羌活(各等份)
上七味,共为粗末,看证之大小,定药之多少。先
将〔火贲〕猪前蹄一只,用水六碗,煮蹄软为度,将汁
滤清,吹去汁上油花,即用粗药末一两,投于汁中;再
用微火煎十数沸,滤去渣,候汤微温,即用方盘一个,
靠身于疮下放定,随用软绢蘸汤淋洗疮上,并入孔内,
轻手捺尽内脓,庶败腐宿脓,随汤而出,以净为度;再
以软帛叠七、八重,蘸汤勿令大干,覆于疮上,两手轻
按片时,帛温再换,如此再按四、五次,可以洗通血气
,解毒止痛去瘀也。洗讫用绢帛挹干,即随证以应用之
药贴之。
【方歌】猪蹄汤治痈疽毒,已溃流脓用此方,消肿散风能止痛,
芩甘归芍芷蜂羌。
洗涤具有荡涤清除的功效。通过涤洗,气血自然能够通畅舒展,病邪毒气容易溃散腐化,而不会产生壅滞阻塞的情况。凡是肿胀在四肢部位的,用浸泡法;在腰腹、脊背部位的,用淋洗法;在下部部位的,用洗浴法,都用布帛或棉絮蘸取药液进行清洗,稍微变凉就更换,病情轻的每天清洗一次,病情重的早晚各清洗一次,每天都要清洗,不可间断。凡是清洗时,冬季要用猛火加热以驱逼寒气,夏季要在明亮的窗边进行以避免风凉侵袭。如果不谨慎注意这些细节,轻则妨碍疮口愈合,重则恐怕转变为纯阴证(危重证候)。至于使用的洗药并不固定,如初起肿胀和即将溃破的,都使用葱归渍肿汤烫洗。如果是阴证不起发的,都使用艾茸敷法。如果已经溃破后,都使用猪蹄汤烫洗。使用猪蹄汤的原因,是利用猪肋肉的气味来驱逐腐肉。这种涤洗的方法,是外科治疗的重要方法之一。
方剂:葱归渍肿汤
主治:此汤治疗痈疽疮疡,在初起肿胀即将溃破的时候,用此汤清洗,以感觉到疮内发热发痒为适度。
组成:独活(三钱) 白芷(三钱)
葱头(七个) 当归(三钱)
甘草(三钱)
以上五味药,用水三大碗,煎煮至汤汁浓醇,过滤去掉药渣,用绢帛蘸取药汤热洗,如果温度降低就再更换热的。
【方歌】葱归渍肿汤洗治各种毒疮,初起将溃时使用适宜,洗到感觉热痒就是适度,独活、白芷、葱头、当归、甘草各味俱全。
又一方:艾茸敷法
主治:此膏药治疗阴疮颜色黑陷且不疼痛的,使用它效果良好。如果用药后感到疼痛说明有生机,如果不痛且流出紫黑色血液的预后不良(死亡),但必须内服大补元气、回阳救逆的药物来辅助治疗。
组成:硫黄(五钱) 雄黄(五钱)
艾茸(一斤)
以上将硫黄、雄黄两味药研成粉末,同艾草一起放入水中煎煮半天,水快干时,取出艾草,捣烂,温热地敷在患处。再次煎煮再次更换,重复十余次为限度。
【方歌】艾茸敷法治疗阴疮,黑陷不痛的使用效果好,硫黄、雄黄同艾草一起煮,捣成膏状敷上定能康复。
又一方:猪蹄汤
主治:此汤治疗痈疽、各种毒疮流脓的情况,熬制好后清洗,以助长肌肉之气,消肿散风,去除腐肉止痛,清除恶肉,活化死肌,滋润疮口。如果腐肉已经排尽,不必使用此汤,应当用米泔水(淘米水)热洗,使疮面洁净。不可过度清洗,过度清洗会损伤水分(津液/组织),导致皮肤破烂,难以生长肌肉收敛疮口。
组成:黄芩 甘草
当归 赤芍
白芷 蜂房
羌活(各等份)
以上七味药,共同捣碎成粗末,根据病症的大小,确定药物的多少。先将一只前猪蹄,用六碗水煮至猪蹄软烂为度,将汁液过滤澄清,吹去汁面上的油花,就用一两粗药末,投入汁液中;再用微火煎煮十几滚,过滤掉药渣,等候药汤稍微温热,就用一个方盘,靠近身体放在疮口下方固定好,随即用软绢蘸取药汤淋洗疮面,并伸入孔洞内,用手轻轻按压排尽内部脓液,这样败坏的腐肉和积存的脓液,就会随着药汤排出,以排净为限度;再用软帛折叠七八层,蘸取药汤不要让它太干,覆盖在疮面上,双手轻轻按压片刻,帛巾变温后再更换,如此再按压四五次,可以疏通气血,解毒止痛祛瘀。洗完后用绢帛擦干,随即根据证候贴上应用的药物。
【方歌】猪蹄汤治疗痈疽毒疮,已经溃破流脓的使用此方,消肿散风能止痛,黄芩、甘草、当归、赤芍、白芷、蜂房、羌活。
Washing possesses the efficacy of cleansing and scouring. Through washing, Qi and Blood naturally become smooth and unobstructed; its pathogenic toxins are prone to disperse and putrefy, without causing stagnation or blockage. For swellings located in the four limbs, soaking (Zi) is used; for those in the waist, abdomen, spine, and back, pouring/rinsing (Lin) is used; for those in the lower parts, bathing (Yu) is used. All methods involve dipping cloth or cotton into the medicinal liquid for washing. The cloth should be changed when it becomes slightly cool. For mild cases, wash once a day; for severe cases, wash twice a day (morning and night). Daily washing must not be interrupted. During washing, in winter, strong fire should be used to drive out cold qi; in summer, one should wash near a bright window to avoid wind and chill. If these precautions are not observed, mild cases may hinder wound healing, while severe cases may transform into Pure Yin Syndrome (a critical condition characterized by extreme Yang deficiency). The specific washing medicines vary: for initial swelling and impending ulceration, Cong Gui Zi Zhong Tang (Scallion and Angelica Soaking Swelling Decoction) is used for hot washing. For Yin Syndromes that fail to rise or manifest, Ai Rong Fu Fa (Mugwort Floss Application Method) is used. After ulceration has occurred, Zhu Ti Tang (Pig Trotter Decoction) is used for hot washing. Zhu Ti Tang is used because the qi of pork ribs helps expel putrefied tissue. This method of cleansing and washing is an essential technique in Surgery (Yang Ke).
Formula: Cong Gui Zi Zhong Tang (Scallion and Angelica Soaking Swelling Decoction)
Indications: This decoction treats Carbuncles and Ulcers (Yong Ju Chuang Yang) during the stage of initial swelling and impending ulceration. It is used for washing until a sensation of heat and itching within the wound is felt, which indicates the proper degree.
Composition: Du Huo (Radix Angelicae Pubescentis, 3 qian), Bai Zhi (Radix Angelicae Dahuricae, 3 qian), Cong Tou (Bulbus Allii Cepae, 7 heads), Dang Gui (Radix Angelicae Sinensis, 3 qian), Gan Cao (Radix Glycyrrhizae, 3 qian).
The above five herbs are boiled in three large bowls of water until the decoction becomes rich and concentrated. Filter out the dregs. Dip silk fabric into the hot decoction to wash the affected area. Change with fresh hot decoction as it cools.
[Prescription Verse] Cong Gui Zi Zhong Tang washes various toxins; suitable for use when swelling begins and is about to ulcerate. Wash until heat and itching are felt; this is the limit. Du Huo, Bai Zhi, Cong Tou, Dang Gui, and Gan Cao are all included.
Another Formula: Ai Rong Fu Fa (Mugwort Floss Application Method)
Indications: This plaster is effective for treating Yin Sores (Yin Chuang) that appear black, depressed, and painless. If pain is perceived after application, it indicates vitality; if there is no pain and purple blood flows out, the prognosis is fatal. However, internal administration of major tonifying and Yang-restoring agents is necessary to assist treatment.
Composition: Liu Huang (Sulfur, 5 qian), Xiong Huang (Realgar, 5 qian), Ai Rong (Artemisia argyi floss, 1 jin).
Grind Liu Huang and Xiong Huang into powder. Mix with Ai Rong and boil in water for half a day. When the water is nearly dry, remove the Ai Rong, pound it into a paste, and apply it warm to the affected area. Re-boil and re-apply, repeating more than ten times as a course.
[Prescription Verse] Ai Rong Fu Fa treats Yin Sores; effective for black, depressed, and painless lesions. Boil Shi Liu Huang (Mineral Sulfur) and Xiong Huang with Ai Rong; pound into a paste and apply to ensure recovery.
Another Formula: Zhu Ti Tang (Pig Trotter Decoction)
Indications: This decoction treats Carbuncles, Ulcers, and various toxic sores with purulent discharge. It is boiled and used for washing to promote flesh regeneration, reduce swelling, dissipate wind, relieve pain, remove necrotic tissue, revitalize dead muscle, and moisten the wound edges. If the necrotic tissue has already been completely expelled, this decoction is unnecessary; instead, rinse with hot Mi Gan Shui (Rice Washing Water) to keep the wound clean. Do not over-wash, as excessive washing damages fluids/tissues, causes skin breakdown, and hinders muscle growth and wound closure.
Composition: Huang Qin (Radix Scutellariae), Gan Cao (Radix Glycyrrhizae), Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), Bai Zhi (Radix Angelicae Dahuricae), Feng Fang (Cera Tabulae), Qiang Huo (Rhizoma Notopterygii); all in equal proportions.
Crush the seven herbs into coarse powder. Determine the quantity based on the size of the lesion. First, boil one front pig trotter in six bowls of water until soft. Filter the broth clearly, skim off the oil from the surface. Add one liang of the coarse herb powder to the broth. Simmer over low heat for several boils. Filter out the dregs. Wait until the decoction is slightly warm. Place a square basin close to the body beneath the wound. Dip soft silk into the decoction to pour/wash over the wound and into any cavities. Gently press with hands to exhaust internal pus, allowing necrotic tissue and old pus to exit with the decoction. Continue until clean. Fold soft cloth seven or eight layers, dip in decoction (keep it moist), cover the wound, and gently press with both hands for a moment. Replace the cloth when it cools. Repeat pressing four or five times to unblock Qi and Blood, detoxify, relieve pain, and remove stasis. After washing, dry with silk, then apply appropriate medicaments according to the syndrome.
[Prescription Verse] Zhu Ti Tang treats Carbuncles and Toxic Sores; use this formula for ulcerated wounds with purulent discharge. Reduces swelling, dissipates wind, and relieves pain. Huang Qin, Gan Cao, Dang Gui, Chi Shao, Bai Zhi, Feng Fang, and Qiang Huo are used.