论曰∶痈疽诸疮,气血虚微,肌寒肉冷,脓汁清稀,毒瓦斯不出,疮久不合,或聚肿不赤
,结硬无脓,外证不见者,并宜托里,邪气外散,脓汁早成,毒有所泄而不内攻也。
治痈疽诸疮,溃后脓出,多内虚。托里黄 汤方
黄 (细锉) 白茯苓(去黑皮) 桂(去粗皮) 麦门冬(去心焙) 当归(切焙) 人
参甘
草(炙) 远志(去心各一两) 五味子(一两半)
上九味,粗捣筛,每服四钱匕,水一盏半,煎取一盏,去滓温服,不计时候,日二。
治发背痈疽,久冷不瘥,托里生肌。芎 散方
芎(二两) 黄 (细锉一两) 白芷(半两) 赤芍药(一两) 桂(去粗皮三分) 人
参
丁香 当归(切焙各半两)
上八味,捣罗为细散,每服二钱匕,粥饮调下,空心日晚再服,以瘥为度。
治痈疽发背,脓血穿溃疼痛,托里止痛。当归汤方
当归(切焙) 黄 (细锉) 人参(各一两) 桂(去粗皮) 赤芍药 甘草(炙锉)
生干地
黄(焙各三分)
上七味,粗捣筛,每服五钱匕,以水一盏半,煎取一盏,去滓温服,不拘时候,日二夜
一。
治发背痈疽,一切疮肿,托里排脓。木香散方
木香 黄 (细锉) 白蔹 木占斯 芎 当归(切焙) 细辛(去苗叶) 桔梗(炒)
赤
芍药 槟榔(生锉) 败酱 甘草(炙) 桂(去粗皮) 羌活(去芦头) 白芷(各一两)
上十五味,捣罗为细散,每服二钱匕,甘草煎酒调下,空心午时日晚各一服,以瘥为度
治一切疮。内托散方
甘草(炒) 人参 甘菊花(一半生一半炒) 玄参(各一两)
上四味,捣罗为细散,每服二钱匕,煎绿豆汤调下。
治诸疮,热退脓不止,托里内补。防风散方
防风(去叉) 白茯苓(去黑皮) 白芷 桔梗(炒) 远志(去心) 甘草(炙) 人
参芎
当归(切焙) 黄 (锉各一两) 附子(炮裂去皮脐二枚) 浓朴(去粗皮姜汁炙透二
两) 赤
小豆
上十四味,捣罗为细散,每服一钱匕,温酒调下,日二夜一。
治痈疽溃后,脓血太多,托里除虚热。黄 茯苓汤方
黄 (细锉) 麦门冬(去心焙各三两) 芎 白茯苓(去黑皮) 桂(去粗皮各二
两) 五
上六味,粗捣筛,每服三钱匕,以水一盏,入生姜枣,煎取七分,去滓温服,不拘时候
治痈疽托里。六倍散方
黄 (细锉一两一分脓多倍之) 赤小豆(三分口干倍之) 芎 (半两若绞肉生倍之)
白
蔹(三分疮口不合倍之) 栝蒌(去皮三分小便不利倍之) 当归(切焙一两若疼倍之)
上六味,捣罗为细散,温酒服方寸匕,日三夜二,凡痈疽大坚者未有脓,半坚半有脓,
当上
火针
熟也
治痈疽内攻五脏,烦闷不安,排毒托里。五香散方
沉香(锉) 乳香(研) 丁香 木香 藿香(各一两)
上五味,以四味捣罗为细散,入乳香和匀,先以清酒五升,黄 五两,寸截,瓶内封闭
,浸一宿,旋取一盏,微温调下一钱匕,日三夜二,不可犯铁器。
治痈疽日渐 长。内塞散方
熟干地黄(焙) 续断 人参 芍药 附子(炮裂去皮脐) 枳壳(去瓤麸炒) 甘草
(炙锉)
芎
切焙各二两) 蜀椒(去目并合口者炒出汗半两) 肉苁蓉(酒浸切焙三分)
上十五味,捣罗为散,每服三钱匕,空心温酒调下,日再服。
治诸痈疽疏转后宜。补虚助气饮方
黄 (锉二两) 人参 白茯苓(去黑皮) 甘草(炙锉) 五味子 芎 独活(去
芦头)
桂(去粗皮) 青橘皮(汤浸去白焙各一两) 麦门冬(去心焙) 当归(切焙) 杏仁(去
皮尖双
仁炒
上十三味,粗捣筛,每服五钱匕,水一盏半,生姜三片,大枣二枚去核,煎至八分,去
滓不拘时温服。
治痈肿疮疖,排脓。连翘饮方
连翘 防风(去叉) 玄参 白芍药 荠 黄芩(去黑心各二两) 桑根白皮(锉炒
二两
半) 前胡(去芦头) 人参 甘草(炙锉) 桔梗(锉炒) 白茯苓(去黑皮各一两) 黄
(锉四
两)
上十三味,粗捣筛,每服五钱匕,以水一盏半,煎取八分,去滓温服,日二。
论述说:痈疽等各类疮疡,若出现气血虚弱微小、肌肉寒冷、脓汁清稀、毒邪无法排出、疮口经久不愈合,或者肿胀聚集但不发红、结块坚硬无脓、外部症状不明显等情况,都适宜采用托里法治疗。通过托里法使邪气向外消散,促使脓液早日形成,让毒邪有所排泄而不向内攻陷脏腑。
治疗痈疽各类疮疡,溃破后脓液流出,多伴有内部虚损。使用托里黄芪汤方:
黄芪(细切),白茯苓(去掉黑皮),桂枝(去掉粗皮),麦门冬(去掉心并焙干),当归(切片焙干),人参,甘草(炙),远志(去掉心,各一两),五味子(一两半)。
以上九味药,粗捣筛过,每次服用四钱匕,用水一盏半,煎取一盏,去渣温服,不限时间,每日两次。
治疗发背痈疽,久治不愈且伴有虚冷症状,采用托里生肌法。使用芎䓖散方:
川芎(二两),黄芪(细切一两),白芷(半两),赤芍药(一两),桂枝(去掉粗皮三分),人参,丁香,当归(切片焙干,各半两)。
以上八味药,捣碎过罗成细散,每次服用二钱匕,用粥饮调下,空腹及傍晚再服一次,以痊愈为度。
治疗痈疽发背,脓血穿溃疼痛,采用托里止痛法。使用当归汤方:
当归(切片焙干),黄芪(细切),人参(各一两),桂枝(去掉粗皮),赤芍药,甘草(炙切),生干地黄(焙干,各三分)。
以上七味药,粗捣筛过,每次服用五钱匕,用水一盏半,煎取一盏,去渣温服,不限时间,每日两次,夜间一次。
治疗发背痈疽,一切疮肿,采用托里排脓法。使用木香散方:
木香,黄芪(细切),白蔹,木占斯,川芎,当归(切片焙干),细辛(去掉苗叶),桔梗(炒),赤芍药,槟榔(生切),败酱草,甘草(炙),桂枝(去掉粗皮),羌活(去掉芦头),白芷(各一两)。
以上十五味药,捣碎过罗成细散,每次服用二钱匕,用甘草煎酒调下,空腹、午时、傍晚各服一次,以痊愈为度。
治疗一切疮疡。使用内托散方:
甘草(炒),人参,甘菊花(一半生用一半炒),玄参(各一两)。
以上四味药,捣碎过罗成细散,每次服用二钱匕,用绿豆汤调下。
治疗各类疮疡,热退但脓液不止,采用托里内补法。使用防风散方:
防风(去掉叉枝),白茯苓(去掉黑皮),白芷,桔梗(炒),远志(去掉心),甘草(炙),人参,川芎,当归(切片焙干),黄芪(切,各一两),附子(炮裂去皮脐,两枚),浓朴(去掉粗皮,姜汁炙透,二两),赤小豆。
以上十四味药,捣碎过罗成细散,每次服用一钱匕,用温酒调下,每日两次,夜间一次。
治疗痈疽溃破后,脓血过多,采用托里清除虚热法。使用黄芪茯苓汤方:
黄芪(细切),麦门冬(去掉心焙干,各三两),川芎,白茯苓(去掉黑皮),桂枝(去掉粗皮,各二两),五味子。
以上六味药,粗捣筛过,每次服用三钱匕,用水一盏,加入生姜、大枣,煎取七分,去渣温服,不限时间。
治疗痈疽托里。使用六倍散方:
黄芪(细切一两一分,脓多者加倍),赤小豆(三分,口干者加倍),川芎(半两,若腐肉生长则加倍),白蔹(三分,疮口不合者加倍),栝蒌(去皮三分,小便不利者加倍),当归(切片焙干一两,若疼痛则加倍)。
以上六味药,捣碎过罗成细散,用温酒送服方寸匕,每日三次,夜间两次。凡是痈疽坚硬大的尚未化脓,或半坚半有脓的,应当使用火针烧熟后刺入。
治疗痈疽毒邪内攻五脏,烦闷不安,采用排毒托里法。使用五香散方:
沉香(切),乳香(研),丁香,木香,藿香(各一两)。
以上五味药,将前四味捣碎过罗成细散,加入乳香混合均匀。先用清酒五升,黄芪五两,切成寸段,放入瓶中密封,浸泡一夜,随即取出一盏,微温调下一钱匕,每日三次,夜间两次,不可接触铁器。
治疗痈疽日渐生长。使用内塞散方:
熟干地黄(焙干),续断,人参,芍药,附子(炮裂去皮脐),枳壳(去掉瓤麸炒),甘草(炙切),川芎(切片焙干,各二两),蜀椒(去掉目和合口的,炒出汗,半两),肉苁蓉(酒浸切片焙干,三分)。
以上十五味药,捣碎过罗成散,每次服用三钱匕,空腹用温酒调下,每日两次。
治疗各类痈疽疏通转运后宜用的。使用补虚助气饮方:
黄芪(切二两),人参,白茯苓(去掉黑皮),甘草(炙切),五味子,川芎,独活(去掉芦头),桂枝(去掉粗皮),青橘皮(汤浸去掉白焙干,各一两),麦门冬(去掉心焙干),当归(切片焙干),杏仁(去皮尖双仁炒)。
以上十三味药,粗捣筛过,每次服用五钱匕,用水一盏半,生姜三片,大枣二枚去核,煎至八分,去渣不拘时间温服。
治疗痈肿疮疖,排脓。使用连翘饮方:
连翘,防风(去掉叉枝),玄参,白芍药,荠苨,黄芩(去掉黑心,各二两),桑根白皮(切炒,二两半),前胡(去掉芦头),人参,甘草(炙切),桔梗(切炒),白茯苓(去掉黑皮,各一两),黄芪(切,四两)。
以上十三味药,粗捣筛过,每次服用五钱匕,用水一盏半,煎取八分,去渣温服,每日两次。
It is stated that for various sores and ulcers (yongju), if there is deficiency and weakness of Qi and Blood, cold muscles and flesh, thin purulent discharge, inability to expel toxic factors, failure of the sore to heal over a long period, or swelling without redness, induration without pus, and absence of external symptoms, it is appropriate to employ the method of supporting the interior (tuoli). This method disperses pathogenic factors outward, promotes early formation of pus, allows toxins to be discharged, and prevents internal invasion.
For treating sores and ulcers where pus has drained after ulceration, indicating internal deficiency, use the Tuoli Huangqi Decoction:
Huangqi (Astragali Radix, finely cut), Baifuling (Poria, black skin removed), Guizhi (Cinnamomi Ramulus, coarse bark removed), Maimendong (Ophiopogonis Radix, heart removed and roasted), Danggui (Angelicae Sinensis Radix, sliced and roasted), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Yuanzhi (Polygalae Radix, heart removed), Wuweizi (Schisandrae Fructus). Each of the first eight herbs is one qianliang; Wuweizi is one and a half qianliang.
Crush and sieve these nine ingredients coarsely. Take four qianbi per dose, with one and a half sheng of water, decoct until one sheng remains, remove dregs, and take warm at any time, twice daily.
To treat back carbuncles (fabei) and ulcers that have persisted with chronic cold and failed to heal, employing the method of supporting the interior and generating flesh, use the Xiong San Powder:
Xiongfeng (Ligustici Chuanxiong Rhizoma, two qianliang), Huangqi (Astragali Radix, finely cut, one qianliang), Baizhi (Angelicae Dahuricae Radix, half qianliang), Chishao (Paeoniae Radix Rubra, one qianliang), Guizhi (Cinnamomi Ramulus, coarse bark removed, three fen), Renshen (Ginseng Radix et Rhizoma), Dingxiang (Caryophylli Flos), Danggui (Angelicae Sinensis Radix, sliced and roasted, each half qianliang).
Grind these eight ingredients into a fine powder. Take two qianbi per dose, mixed with gruel beverage. Take on an empty stomach and again in the evening, until healed.
To treat sores, ulcers, and back carbuncles with pain due to rupture of pus and blood, employing the method of supporting the interior and relieving pain, use the Danggui Tang Decoction:
Danggui (Angelicae Sinensis Radix, sliced and roasted), Huangqi (Astragali Radix, finely cut), Renshen (Ginseng Radix et Rhizoma, each one qianliang), Guizhi (Cinnamomi Ramulus, coarse bark removed), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Shenggan Dihuang (Rehmanniae Radix Preparata, roasted, each three fen).
Crush and sieve these seven ingredients coarsely. Take five qianbi per dose, with one and a half sheng of water, decoct until one sheng remains, remove dregs, and take warm at any time, twice daily and once at night.
To treat back carbuncles and all types of swollen sores, employing the method of supporting the interior and discharging pus, use the Muxiang San Powder:
Muxiang (Aucklandiae Radix), Huangqi (Astragali Radix, finely cut), Bailian (Trollii Radix), Mozanshi (Stemonae Radix), Xiongfeng (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix, sliced and roasted), Xixin (Asari Radix et Rhizoma, seedlings and leaves removed), Jiegeng (Platycodonis Radix, stir-baked), Chishao (Paeoniae Radix Rubra), Binglang (Arecae Semen, raw cut), Baijiangcao (Patriniae Herba), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Guizhi (Cinnamomi Ramulus, coarse bark removed), Qianghuo (Notopterygii Rhizoma et Radix, rhizome removed), Baizhi (Angelicae Dahuricae Radix, each one qianliang).
Grind these fifteen ingredients into a fine powder. Take two qianbi per dose, mixed with wine decocted with Gancao. Take on an empty stomach, at noon, and in the evening, until healed.
To treat all types of sores, use the Neituo San Powder:
Gancao (Glycyrrhizae Radix et Rhizoma, stir-baked), Renshen (Ginseng Radix et Rhizoma), Ganjuhua (Chrysanthemi Flos, half raw and half stir-baked), Xuanshen (Scrophulariae Radix, each one qianliang).
Grind these four ingredients into a fine powder. Take two qianbi per dose, mixed with mung bean soup.
To treat various sores where heat subsides but pus continues to drain, employing the method of supporting the interior and tonifying internally, use the Fangfeng San Powder:
Fangfeng (Saposhnikoviae Radix, forked parts removed), Baifuling (Poria, black skin removed), Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix, stir-baked), Yuanzhi (Polygalae Radix, heart removed), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Renshen (Ginseng Radix et Rhizoma), Xiongfeng (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix, sliced and roasted), Huangqi (Astragali Radix, cut, each one qianliang), Fuzi (Aconiti Lateralis Radix Preparata, cracked, skin and umbilicus removed, two pieces), Houpo (Magnoliae Officinalis Cortex, coarse bark removed, ginger juice-roasted thoroughly, two qianliang), Chixiaodou (Vigna Angularis Semen).
Grind these fourteen ingredients into a fine powder. Take one qianbi per dose, mixed with warm wine, twice daily and once at night.
To treat sores and ulcers after ulceration where excessive pus and blood are lost, employing the method of supporting the interior and clearing deficient heat, use the Huangqi Fuling Tang Decoction:
Huangqi (Astragali Radix, finely cut), Maimendong (Ophiopogonis Radix, heart removed and roasted, each three qianliang), Xiongfeng (Ligustici Chuanxiong Rhizoma), Baifuling (Poria, black skin removed), Guizhi (Cinnamomi Ramulus, coarse bark removed, each two qianliang), Wuweizi (Schisandrae Fructus).
Crush and sieve these six ingredients coarsely. Take three qianbi per dose, with one sheng of water, add fresh ginger and jujubes, decoct until seven-tenths remain, remove dregs, and take warm at any time.
To support the interior for sores and ulcers, use the Liubei San Powder:
Huangqi (Astragali Radix, finely cut, one qianliang and one fen; double if pus is abundant), Chixiaodou (Vigna Angularis Semen, three fen; double if mouth is dry), Xiongfeng (Ligustici Chuanxiong Rhizoma, half qianliang; double if necrotic tissue grows), Bailian (Trollii Radix, three fen; double if wound does not close), Gualou (Trichosanthis Fructus, skin removed, three fen; double if urination is difficult), Danggui (Angelicae Sinensis Radix, sliced and roasted, one qianliang; double if painful).
Grind these six ingredients into a fine powder. Take one fangcunbi per dose with warm wine, three times daily and twice at night. For large, hard sores without pus, or those half-hard with some pus, apply heated fire needles.
To treat sores and ulcers where toxins invade the five zang organs, causing restlessness and oppression, employing the method of detoxifying and supporting the interior, use the Wuxiang San Powder:
Chenxiang (Aquilariae Lignum Resinatum, cut), Ruxiang (Olibanum, ground), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Huoxiang (Agastaches Herba, each one qianliang).
Grind the first four ingredients into a fine powder, mix with Ruxiang. Soak five liang of Huangqi (Astragali Radix), cut into inch-length pieces, in five sheng of clear wine overnight in a sealed bottle. Take one sheng, slightly warmed, mixed with one qianbi of powder, three times daily and twice at night. Avoid iron vessels.
To treat progressively growing sores and ulcers, use the Naisai San Powder:
Shugan Dihuang (Rehmanniae Radix Preparata, roasted), Xuduan (Dipsaci Radix), Renshen (Ginseng Radix et Rhizoma), Shaoyao (Paeoniae Radix), Fuzi (Aconiti Lateralis Radix Preparata, cracked, skin and umbilicus removed), Zhike (Aurantii Fructus, pith removed, bran-roasted), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Xiongfeng (Ligustici Chuanxiong Rhizoma, sliced and roasted, each two qianliang), Shujiao (Zanthoxyli Pericarpium, remove eyes and closed ones, stir-fry until sweat appears, half qianliang), Roubingrongsu (Cistanches Herba, wine-soaked, sliced and roasted, three fen).
Grind these fifteen ingredients into a powder. Take three qianbi per dose on an empty stomach with warm wine, twice daily.
After draining and transforming sores and ulcers, to tonify deficiency and assist Qi, use the Buxu Zhuqi Yin Decoction:
Huangqi (Astragali Radix, cut, two qianliang), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria, black skin removed), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Wuweizi (Schisandrae Fructus), Xiongfeng (Ligustici Chuanxiong Rhizoma), Duohuo (Notopterygii Rhizoma et Radix, rhizome removed), Guizhi (Cinnamomi Ramulus, coarse bark removed), Qingjupi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, roasted, each one qianliang), Maimendong (Ophiopogonis Radix, heart removed and roasted), Danggui (Angelicae Sinensis Radix, sliced and roasted), Xingren (Armeniacae Semen Amarum, skin and tip removed, twin kernels stir-fried).
Crush and sieve these thirteen ingredients coarsely. Take five qianbi per dose, with one and a half sheng of water, three slices of fresh ginger, and two pitted jujubes. Decoct until eight-tenths remain, remove dregs, and take warm at any time.
To discharge pus from swellings, boils, and furuncles, use the Lianqiao Yin Decoction:
Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix, forked parts removed), Xuanshen (Scrophulariae Radix), Baishaoyao (Paeoniae Radix Alba), Qini (Bupleuri Radix? Note: Text says 荠, likely Qini or similar, here translated as Herb of Shepherd's Purse or specific local herb, context implies clearing heat), Huangqin (Scutellariae Radix, remove black heart, each two qianliang), Sangbaipipi (Mori Cortex, cut and stir-baked, two and a half qianliang), Qianhu (Peucedani Radix, rhizome removed), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut), Jiegeng (Platycodonis Radix, cut and stir-baked), Baifuling (Poria, black skin removed, each one qianliang), Huangqi (Astragali Radix, cut, four qianliang).
Crush and sieve these thirteen ingredients coarsely. Take five qianbi per dose, with one and a half sheng of water, decoct until eight-tenths remain, remove dregs, and take warm, twice daily.