痰核者其核亦成串,三、五不等,多生于左右二颊下,或左右二颏,有气、血、风、
痰、酒之五种,名虽有五,而其根则一,惟治法当分别虚实,不可笼统。男子在未患痰核
之先,原患火症者,则为火盛生痰;妇人在未患痰核之先,先患火症,如子午潮烧,体质
虚弱,而后生痰核者(即腺痨),可照瘰 方法治之,以落其核。惜乎十有九皆不可治,
事前当使病家知道,免致医治不愈时,召来毁誉。其治疗法与瘰 同,服中九丸,贴解毒
膏,落核之后,亦以熏洗汤洗之,再用加味天然散收功。
凡寒痰凝结者,最忌贴凉膏,服凉药,治法服中九丸或阳和汤为妙。
鬓疔生于太阳下,左右形一样,头尖如疖,坚硬如石,起初顶上如粟米大,起白泡,
或痒或痛,色红者吉,紫黑者凶,治法内服中九丸,兼服千金内托散(即十宣散)。方如下∶
川芎 当归 生地(各八分) 赤芍 白芷 防风(各三钱) 黄 (一钱) 栀子 连翘
荆芥 白术 黄芩(各八分) 茯苓 银花 人参 甘草(各三分)
上煎服。有脓者可治,无脓者难治,故可以预决生死。
外治法∶或贴麻凉膏,或涂太岁墨以止其痛,兼用熏洗汤洗之,俟六、七日后,红色
或乌色回弦,起白浆泡产脓,头顶上不硬而棉软,饮食如常者,是为可治之症。若痛不
止,乌黑如前,又不成脓者,其症危矣。当辨五善、七恶,以决生死存亡;如成脓之症,
已经溃烂化脓者,可以清油、黄蜡、隔纸膏等贴之∶
隔纸膏方
乳香 没药 血竭(各一钱) 轻粉(二钱) 银朱(二钱) 铅粉(三钱) 朱砂(二钱)
冰片(一分) 石钟乳(三钱 过)
上共为末,用清油四两,黄蜡四两,入锅熔化取起,瓷碗贮之,候冷定,入药在内搅
匀,以棉纸摊膏,贴于患处,一日两换。贴去腐肉后,视其肉色如石榴尖样时,用熏洗汤
洗净,贴解毒膏,掺加味天然散,生肌、平口。
痰核表现为肿块呈串珠状排列,数量有三五个不等,多生长在左右两侧脸颊下方或下巴处。其病因分为气、血、风、痰、酒五种类型,虽然名称有五种不同,但病根是一致的,治疗时必须区分虚实,不能一概而论。男子在患痰核之前,原本患有火症(实热证)的,属于火盛生痰;妇女在患痰核之前,先患有火症,如子午时潮热、体质虚弱,而后生成痰核的(即淋巴结核),可以按照治疗瘰疬的方法进行处理,以使肿块消散。可惜其中十之八九都无法治愈,事前应当让患者家属知晓,以免在治疗无效时招致非议。其治疗方法与瘰疬相同,服用中九丸,外贴解毒膏,肿块消退后,再用熏洗汤清洗,最后使用加味天然散来收功。
凡是寒痰凝结的情况,最忌讳贴敷凉性膏药和服用凉性药物,治疗时服用中九丸或阳和汤最为适宜。
鬓疔生长于耳前太阳穴下方,左右两侧形态相似,顶端尖锐如同疖肿,质地坚硬如石头。起初顶部如粟米大小,出现白色水泡,或者发痒或者疼痛,颜色发红为吉兆,紫黑色为凶兆。治疗方法是内服中九丸,兼服千金内托散(即十宣散)。方剂如下:川芎、当归、生地(各八分)、赤芍、白芷、防风(各三钱)、黄芪(一钱)、栀子、连翘、荆芥、白术、黄芩(各八分)、茯苓、银花、人参、甘草(各三分)。以上药材煎煮后服用。如果有脓液形成则可以治愈,没有脓液则难以治愈,因此可以预先判断生死。
外治法:或者贴敷麻凉膏,或者涂抹太岁墨以止痛,同时用熏洗汤清洗。等到六七天之后,红色或乌色消退,边缘收缩,出现白色浆泡并化脓,头顶部位不再坚硬而是变得柔软如棉,饮食正常,这是可治的症状。如果疼痛不止,颜色依然乌黑,且不化脓,病情就非常危险了。此时应当辨别五善、七恶症状,以决断生死存亡;如果已经溃烂化脓,可以用清油、黄蜡、隔纸膏等贴敷:
隔纸膏方剂组成:乳香、没药、血竭(各一钱)、轻粉(二钱)、银朱(二钱)、铅粉(三钱)、朱砂(二钱)、冰片(一分)、石钟乳(三钱,需过筛)。以上共研为细末,用清油四两、黄蜡四两,放入锅中熔化后取出,存入瓷碗中,待冷却凝固后,加入药粉搅拌均匀,用棉纸摊成膏药,贴敷于患处,每天更换两次。贴敷去除腐肉后,观察伤口肉色如石榴尖般红润时,用熏洗汤洗净,再贴解毒膏,掺入加味天然散,以促进生肌和平复疮口。
Tan He (Phlegm Nodules) present as nodules arranged in a string of beads, varying in number from three to five, mostly occurring below the cheeks on both sides or under the chin. Their etiology is categorized into five types: Qi (Vital Energy), Blood, Wind, Phlegm, and Alcohol. Although there are five distinct names, their root cause is singular; treatment must differentiate between deficiency and excess patterns and cannot be generalized. In men who suffered from Huo Zheng (Fire Syndromes/Excess Heat) prior to developing Tan He, the condition arises from excessive Fire generating Phlegm. In women who first experienced Fire Syndromes, such as tidal fever at Zi and Wu hours (midnight and noon), with a weak constitution, before developing Tan He (which refers to Scrofula/Lymphatic Tuberculosis), it should be treated according to the methods for Luo Li (Scrofula) to resolve the nodules. Regrettably, nine out of ten cases are incurable; patients' families should be informed beforehand to avoid criticism when treatment fails. The therapeutic method is the same as for Luo Li: take Zhong Jiu Wan (Nine-Pill Formula), apply Jie Du Gao (Detoxifying Plaster), after the nodules subside, wash with Xun Xi Tang (Fumigation and Washing Decoction), and finally use Jia Wei Tian Ran San (Modified Natural Powder) to conclude treatment.
For cases of Cold-Phlegm coagulation, applying cooling plasters and taking cooling medicines are strictly contraindicated. It is advisable to treat by taking Zhong Jiu Wan or Yang He Tang (Yang-Harmonizing Decoction).
Bin Ding (Sideburn Carbuncle) occurs below the Taiyang point (Temple area), with symmetrical morphology on both sides. The head is pointed like a boil and hard as stone. Initially, the top is millet-sized, forming white blisters, accompanied by itching or pain. A red color indicates a favorable prognosis, while purple-black indicates an unfavorable one. The treatment involves internal administration of Zhong Jiu Wan combined with Qian Jin Nei Tuo San (Thousand-Gold Internal Support Powder, also known as Shi Xuan San). The formula is as follows: Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix Preparata (Shengdi) (each 8 fen); Paeoniae Radix Rubra (Chishao), Angelicae Dahuricae Radix (Baizhi), Saposhnikoviae Radix (Fangfeng) (each 3 qian); Astragali Membranacei Radix (Huangqi) (1 qian); Gardeniae Fructus (Zhizi), Forsythiae Fructus (Lianqiao), Schizonepetae Spica (Jingjie), Atractylodis Macrocephalae Rhizoma (Baizhu), Scutellariae Radix (Huangqin) (each 8 fen); Poria (Fuling), Lonicerae Japonicae Flos (Yinhua), Ginseng Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao) (each 3 fen). Decoct and take orally. If pus forms, it is treatable; if no pus forms, it is difficult to treat, allowing for a preliminary determination of life or death.
External treatment: Apply Ma Liang Gao (Hemp-Cooling Plaster) or smear Tai Sui Mo (Tai Sui Ink) to relieve pain, and simultaneously wash with Xun Xi Tang. After six or seven days, if the redness or blackness recedes, the edges contract, white serous blisters appear, and pus is produced, and the crown becomes soft like cotton rather than hard, with normal diet, this indicates a treatable condition. If pain persists, the color remains black, and no pus forms, the condition is critical. One must distinguish between the Five Good Signs and Seven Bad Signs to determine survival. For cases that have ulcerated and suppurred, apply Ge Zhi Gao (Paper-Separating Plaster) made with refined sesame oil, yellow beeswax, etc.:
Ge Zhi Gao Formula: Boswelliae Carterii Resina (Ruxiang), Myrrhae Resina (Moyao), Draconis Sanguis (Xuejie) (each 1 qian); Calomelas (Qingfen), Cinnabar (Yinzhu) (each 2 qian); Cerussa (Qianfen) (3 qian); Cinnabar (Zhusha) (2 qian); Borax (Bingpian) (1 fen); Arsenicum Album (Shizhongru) (3 qian, sieved). Grind all ingredients into fine powder. Melt four liang of refined sesame oil and four liang of yellow beeswax in a pot, remove from heat, store in a porcelain bowl, and let cool until solidified. Add the medicinal powder and mix evenly. Spread onto cotton paper to make plasters, apply to the affected area, and change twice daily. After the plaster removes necrotic tissue, when the granulation tissue resembles the tip of a pomegranate (healthy pink/red), wash clean with Xun Xi Tang, apply Jie Du Gao, and sprinkle Jia Wei Tian Ran San to promote flesh regeneration and flatten the wound margin.