余自幼闻痈疽有不可治之症,名曰阴发。五六岁时,舅氏子京先生以骨槽风亡,问之长
老,
云∶久则成痨瘵也。甲午岁,子仁丈患骨槽风,始甚剧,后按《外科症治全生》法,治辄愈
。余取其书观之,乃知阳为痈,阴为疽,骨槽风亦阴疽类,非由瘵发。由发后服凉药,
延久成瘵耳。世人知阴发之名,而不达阴发之治,良可概也。适秦君立甫元其家藏别本,余
因据以参校,互有得失。其字之显讹者改正之,间有改而义仍未明,及疑者有疑而未改者。
如大痈溃后,治法两本并云体虚年老者,投参、 、草皆炙也。夫托毒忌炙,上已详之,而
此忽云炙,盖承上痛息毒散肿退色转红活而言,即体虚年老者,亦必至是而后可用炙,断断
不可早用。今改云体虚年老者,始投参、 、草更用炙,勿仍误谓虚者初起即当用灸也。瘰
治法第四条云∶即在手下之脚骨。别本云∶即在手下突出之骨,脚骨足跗外高骨也。突出
之骨,掌后之锐骨也。患系喉间,手为近,故从别本。然足阳明脉,亦循喉咙,下循 外廉
,下足跗。拔疔散、六和散两方,并有瓜蝎,而他方或作瓜蝎,或作血蝎。考古方书,有作
瓜儿血蝎者,知此蝎为蝎误。第如雄黄之名腰黄,后集申之,瓜竭则无文,本补亦无瓜竭之
名,今并改血竭。轻粉无毒,而于黄连则云解轻粉毒,文歧出,考《本草》亦云无毒,而注
云有毒、黄连解,今改无为有,庶免眩惑。牛膝治茎痛。茎,别本或改作胫。按∶茎中痛,
水道中痛也。第曰茎,似非茎中矣。而《本草》主治列茎中痛,此其脱中字乎?痈疽方诀,
归芩花粉节煎,或麻黄青蒿甘草,皆有用节者,此其甘草节乎?锁喉方药诀甘草各一钱,别
本作二钱。《本草》当归,全者活血,而是书云定血,此俱未敢臆断。表弟时清甫于吴门买
是书,即立甫所藏本。清甫又于书肆旧书中见是书,与吴门所买本异,欲买之以示余,则即
子仁先生藏本也。重刻者不外此二本,辗转淆讹,益不足据矣。原本刻于乾隆五年,子仁先
生藏本则重刻于嘉庆五年,立甫藏本不知其刻于何年。是书流传已百余年,而疡医都若未见
,何哉?胡氏孤女所患久治不效,案是书法治乃效。既效,欲刻余所校本,以广其传。爰更
取二本,严勘付梓。而序其始末,并识其疑,以质世之精于医者。
道光二十有一年辛丑七月朔日王浩荆门氏撰
我自幼便听说痈疽病中有不可治愈的症候,名为“阴发”。五六岁时,舅舅家的儿子京先生因骨槽风去世,我问长辈,他们说:病程久了就会变成虚劳(痨瘵)。甲午年,子仁丈人患骨槽风,起初病情非常严重,后来按照《外科症治全生》的方法治疗,随即痊愈。我借阅这本书阅读,才知道阳证为痈,阴证为疽,骨槽风也属于阴疽一类,并非由虚劳(痨瘵)引发。是因为发病后服用寒凉药物,拖延日久才演变成虚劳罢了。世人只知道“阴发”这个名称,却不明白“阴发”的治疗方法,实在令人感慨。恰逢秦君立甫家中藏有该书的另一个版本,我便据此进行参校,两个版本各有优劣。其中文字明显错误的予以改正;偶尔有改了之后文义仍不明确,以及有疑问而未改动的地方。例如大痈溃破后,两种版本的治法都写着“体虚年老者”,投用人参、[此处原文缺字,推测为黄芪或类似补气药]、甘草,且都注明是炙过的。但是托毒外出应当忌讳炙烤,上文已经详细说明,而这里忽然说用炙过的,大概是承接上文“痛止、毒消、肿退、色转红活”而言,即即使是体虚年老者,也必须到了这个阶段后才可用炙过的药,绝对不可以早期使用。现在改为“体虚年老者,开始投用人参、[缺字]、甘草时更要用炙过的”,不要仍然错误地认为虚证初起就应当用炙药。关于瘰疬(颈部淋巴结结核)治法第四条写道:“即在手下之脚骨。”别本写道:“即在手下突出之骨”,脚骨是指足跗外侧的高骨。“突出之骨”是指手掌后方锐利的骨头。患病部位在喉间,手部较近,所以采纳别本的说法。然而足阳明胃经,也循行于喉咙,向下沿小腿外侧前缘,下行至足背。拔疔散、六和散两个方剂中,都有“瓜蝎”,而其他方剂有的写作“瓜蝎”,有的写作“血蝎”。考证古代方书,有写作“瓜儿血蝎”的,知道这里的“蝎”字是误写。只是像雄黄又名腰黄,我在后集中申述过,“瓜竭”则没有文献依据,原本补注也没有“瓜竭”之名,现在一并改为“血竭”。轻粉无毒,但在黄连条下却说能解轻粉毒,文义矛盾,考证《本草》也说无毒,但注释又说有毒,黄连可解,现在将“无”改为“有”,以免使人困惑。牛膝治疗茎痛。“茎”,别本有的改为“胫”。按:茎中痛,是指尿道中痛。如果只说“茎”,似乎不是指“茎中”了。但《本草》主治列表中列有“茎中痛”,这难道是脱漏了“中”字吗?痈疽方诀中,“归芩花粉节煎”,或者“麻黄青蒿甘草”,都有用到“节”的,这难道是甘草节吗?锁喉方药诀中甘草各一钱,别本作二钱。《本草》记载当归,全株活血,而本书说定血,这些都不敢妄加推断。表弟时清甫在吴门购买了这本书,就是立甫所藏的原本。清甫又在书肆旧书中见到这本书,与在吴门买的版本不同,想买来给我看,结果就是子仁先生所藏的原本。重刻的大概不外乎这两个版本,辗转传抄讹误,更加不足以作为依据了。原本刻于乾隆五年,子仁先生藏本则重刻于嘉庆五年,立甫藏本不知刻于何年。这本书流传已一百多年,而疡医们却好像没见过,为什么呢?胡氏孤女所患之病久治不效,按照本书的方法治疗才见效。既然有效,想要刻印我所校订的版本,以广泛传播。于是再次取这两个版本,严格勘校后交付雕版印刷。并写下始末,同时记录其中的疑问,以此请教世间精通医术的人。
道光二十一年辛丑七月初一日,王浩荆门氏撰写
I have heard since childhood that there are incurable conditions among carbuncles and sores, named "Yin Fa" (Yin Eruption). When I was five or six years old, my uncle's son, Mr. Zijing, died from "Gu Cao Feng" (Bone Trough Wind, a type of mandibular osteomyelitis). When I asked the elders, they said: "If prolonged, it becomes Lao Zhai" (Consumption/Tuberculosis). In the year Jiawu, Mr. Ziren suffered from Gu Cao Feng. Initially, the condition was very severe, but later, following the methods in *Waike Zhengzhi Quansheng* (Complete Treatment of Surgical Diseases), he recovered promptly. I borrowed this book to read it and came to know that Yang manifestations are Carbuncles (Hong Zhong), while Yin manifestations are Sores (Du Ju). Gu Cao Feng also belongs to the category of Yin Sores and is not caused by Consumption. It became Consumption only because cooling medicines were taken after onset, prolonging the illness. People in the world know the name "Yin Fa" but do not understand its treatment, which is indeed lamentable.
Just then, Mr. Qin Lipu had another version of the book in his family collection. I used it for comparative collation; both versions had their merits and demerits. Obvious textual errors were corrected. Occasionally, some corrections still left the meaning unclear, and some doubts remained uncorrected. For example, regarding the treatment after the rupture of a large Carbuncle, both texts state: "For those with weak constitutions and advanced age, administer Ginseng Radix et Rhizoma Rubra [Renshen], Astragali Radix [Huangqi], and Glycyrrhizae Radix et Rhizoma [Gancao], all honey-fried." However, promoting toxin expulsion should avoid honey-frying, as detailed earlier. The sudden mention here likely follows the context of "pain ceased, toxin dispersed, swelling subsided, color turned red and vibrant." That is, even for those with weak constitutions and advanced age, honey-fried herbs can only be used at this stage, never early on. Now it is revised to: "For those with weak constitutions and advanced age, initially administer Renshen, Huangqi, and Gancao, and subsequently use honey-fried ones," so as not to mistakenly believe that deficiency patterns at the initial stage should use honey-fried herbs.
Regarding item 4 of the treatment method for Scrofula (Luo Li): "It is exactly the 'foot bone' under the hand." The other version states: "It is exactly the protruding bone under the hand." The "foot bone" refers to the high bone on the outer side of the dorsum of the foot. The "protruding bone" refers to the sharp bone behind the palm. Since the disease site is in the throat and the hand is closer, we follow the other version. However, the Foot-Yangming Stomach Meridian also runs along the throat, descends along the anterior lateral aspect of the lower leg, and reaches the dorsum of the foot. Both formulas, Dingling San (Calabash and Scorpion Powder) and Liuhe San (Six Harmonies Powder), contain "Gua Xie," while other formulas write either "Gua Xie" or "Xue Xie." Consulting ancient medical books, some write "Gua'er Xue Xie," indicating that "Xie" here is a typo for "Jie." Just as Realgar is also known as Yao Huang, and later collections clarify this, "Gua Jie" has no textual basis, nor does the original supplement mention "Gua Jie." Therefore, it is now uniformly changed to "Xue Jie" (Draconis Sanguis). Calomelas (Qing Fen) is non-toxic, yet under the entry for Coptidis Rhizoma (Huanglian), it says it resolves Calomelas toxicity, creating a contradiction. Consulting the *Bencao* (Materia Medica), it also states non-toxic, but notes it is toxic and resolvable by Huanglian. Thus, "non-toxic" is changed to "toxic" to avoid confusion. Achyranthis Bidentatae Radix (Niuxi) treats pain in the Jing (urethra). In the other version, "Jing" is sometimes changed to "Jing" (tibia). According to analysis: Pain in the Jingzhong refers to pain in the urinary tract. Saying only "Jing" seems not to refer to "Jingzhong." Yet the *Bencao* lists "pain in Jingzhong" among its indications; could the character "Zhong" have been omitted? In surgical formula rhymes, "Gui Xin Hua Fen Jie Jian" (Angelica Sinensis, Scutellaria Baicalensis, Angelicae Dahuricae Radix, Poria, and Licorice Nodes Decoction), or "Mahuang Qinghao Gancao" (Ephedra Herba, Artemisia Annua Herba, and Glycyrrhiza), all mention using "Jie" (nodes); is this referring to Gancao Jie (Licorice Nodes)? In the Lock-Throat Formula Rhyme, Glycyrrhiza is one qian each, while the other version says two qian. The *Bencao* states Danggui (whole root) invigorates blood, while this book says it stabilizes blood. These matters are not dared to be arbitrarily inferred.
My cousin, Shi Qingfu, purchased this book in Wu Men (Suzhou), which was the copy collected by Mr. Lipu. Qingfu also found this book in old books at a bookstore, different from the Wu Men copy, and wanted to buy it to show me; it turned out to be the copy collected by Mr. Ziren. Reprints are based on these two copies. With repeated copying and transmission, errors increased, making them less reliable. The original edition was printed in the 5th year of Qianlong. Mr. Ziren's copy was reprinted in the 5th year of Jiaqing. Mr. Lipu's copy's printing year is unknown. This book has circulated for over a hundred years, yet surgeons have never seen it, why? A girl surnamed Hu suffered from a long-standing illness that failed to respond to treatment. Following the methods of this book, she recovered. Since it was effective, there was a desire to print my collated version to spread it widely. Therefore, I took the two copies again, strictly proofread them, and sent them to press. I record the beginning and end here, along with my doubts, to consult with experts in medicine.
Written by Wang Hao, styled Mingjin, on the first day of the seventh month in the Xin Chou year, the 21st year of Daoguang.