大凡妇女生产之后。气血大虚之际。而感受七情六淫。致令荣卫不行。逆于肉理。乃生痈肿。况
元气不足。岂能禁于巴 暴悍之剂。只宜大补气血。大托里之药。八珍汤丸内少加温暖药。使荣卫通
行。毒瓦斯消散。无不安乎。不然。恐致虚损。疮亦败坏。溃而不敛。多致不救矣。
婴孩之辈。乃气血未克。筋骨未坚。脾胃尚脆。凡有痈疽。多是胎毒。或母不慎调护。致令血气
壅滞。多生疮肿。止宜内托内疏汤剂。和缓之药。不可用大猛峻之剂。有伤胃气。外有无辜疳毒。岂
同大人治之。宜消疳大补之剂即安矣。
凡师尼寡妇室女。虽云牝体。乃异于妻外家乎。然无房室。常有忧思之苦。欲心蒙而不遂。有失交
欢。气血欠和。阴阳乖戾。凡有疮疡。治法亦异。虽内托补中之剂不殊。而调经舒郁安神之药不缺。
随症治之神矣。
夫宦官富贵人者。性自骄奢。膏粱浓味。受享不同。形志苦乐亦异。及年老衰弱。酗酒劳房。多
令阳胜阴亏。凡有痈疽。势不可缓。内疏内托。必用大剂攻之。方得其宜。然性贪不忌口。略少苦即
难禁。此其常也。
夫贫贱之人。饥寒劳苦。风霜有之。志虑居处奔驰有之。致令荣卫不通。血脉凝注。逆于肉理乃
生痈肿。非膏粱之变。形苦志乐之所生乎。既受享不足则血气不克。形骸瘦弱。痈肿初起。必大补内
托为先。已溃之后。宜补中益气加减。令气血冲和。不致 羸颓败。医术之玄妙在斯矣。
大凡妇女在生产之后,正处于气血极度虚弱的阶段,此时若感受七情(喜、怒、忧、思、悲、恐、惊)和六淫(风、寒、暑、燥、湿、火)等外邪,会导致营卫之气运行不畅,逆乱于肌肉纹理之间,从而产生痈肿。况且元气本就不足,哪里能承受得住猛烈峻急的药物呢?只应当使用大补气血、大力托毒外出的药物。在八珍汤丸中少量加入温性药物,使营卫之气通行,毒邪消散,没有不痊愈的。否则,恐怕会导致虚损,疮疡也会败坏,溃烂后不能收敛,大多导致无法救治。
婴幼儿这类人群,气血尚未充盈,筋骨尚未坚固,脾胃尚且脆弱。凡是患有痈疽,多半是胎毒所致,或者是母亲在孕期不慎调护,导致血气壅滞,从而多生疮肿。只适宜使用内托内疏汤等和缓的药物,不可使用过于猛烈峻急的药物,以免损伤胃气。此外,还有无辜疳毒(一种小儿颈部淋巴结结核或类似病症),其治法岂能同大人一样?宜用消疳大补的药物即可安愈。
凡是尼姑、寡妇及未婚女子,虽然说是女性身体,难道不同于已婚妇女吗?然而她们没有性生活,常常有忧愁思虑的痛苦,欲望被压抑而不能实现,失去了正常的阴阳交合欢愉,导致气血不和,阴阳失调。凡是患有疮疡,治疗方法也与众不同。虽然内托补中的方剂没有不同,但调理月经、舒展郁结、安神定志的药物不可或缺。根据症状进行治疗,效果神奇。
至于宦官和富贵人家的人,本性自然骄横奢侈,食用肥甘厚味的食物,享受的生活不同,形体与精神的苦乐也不同。等到年老体衰时,又酗酒、房劳过度,多导致阳气偏胜、阴液亏损。凡是患有痈疽,病势不可迟缓,必须使用内疏内托的大剂量攻伐药物,才能得当。然而他们性格贪婪,不注意忌口,稍微吃点苦味或清淡的食物就难以忍受,这是他们的常态。
至于贫贱之人,遭受饥寒劳累之苦,经受风霜雨雪,志向思绪和居住环境奔波劳碌,导致营卫之气不通,血脉凝滞,逆乱于肌肉纹理之间从而产生痈肿。这难道不是因生活贫困、形体受苦而精神相对安逸(指劳作后的休息或心态上的无奈接受,此处原文“形苦志乐”可能有特定语境,通常指体力劳动虽苦但心神无过多忧虑,或指相对于富贵人的精神焦虑而言)所导致的吗?既然享受不足,则气血不充,形体瘦弱。痈肿初起时,必须以大力补益气血、内托毒邪为先;已经溃破之后,适宜使用补中益气汤加减,使气血冲和,不至于消瘦颓败。医术的玄妙之处就在这里了。
Generally speaking, after childbirth, women are in a state of severe deficiency of Qi and Blood. If they contract the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) and Six Exogenous Pathogens (Wind, Cold, Summer-heat, Dryness, Dampness, Fire), it causes the Ying (Nutritive) and Wei (Defensive) Qi to fail to circulate properly, reversing within the muscle tissues, thereby generating carbuncles and swellings. Moreover, since the Yuan (Original) Qi is insufficient, how can the body tolerate harsh and violent medicinal agents? One should only use medicines that greatly tonify Qi and Blood and strongly promote the expulsion of toxins outward. By adding a small amount of warming herbs to Bazhen Tang Wan (Eight Treasures Pill), the Ying and Wei Qi will circulate, and the toxic pathogens will dissipate, leading to recovery without exception. Otherwise, one risks causing deficiency damage, where the sores may deteriorate, ulcerate but fail to heal, often resulting in untreatable conditions.
Infants and young children have Qi and Blood that are not yet fully developed, bones and sinews that are not yet firm, and spleen and stomach that are still fragile. Any carbuncles or ulcers they suffer from are mostly due to fetal toxins, or caused by improper care during pregnancy leading to stagnation of Qi and Blood, resulting in various sores and swellings. Treatment should be limited to gentle formulas such as Neituo Neshu Tang (Internal Support and Dispersal Decoction). Harsh and drastic agents must be avoided to prevent damaging Stomach Qi. Furthermore, conditions like Wugu Gandu (Innocent Phagedenic Toxin, often referring to pediatric cervical lymphadenitis or similar tuberculous conditions) differ significantly from adult treatments; appropriate anti-phagedenic and tonifying agents will bring relief.
Nuns, widows, and unmarried women, although female, are distinct from married women in their lifestyle. Lacking sexual intercourse, they often endure suffering from worry and overthinking. Their desires are suppressed and unfulfilled, and they miss the harmony of yin-yang union. This leads to disharmony of Qi and Blood and deviation of Yin and Yang. Therefore, the treatment for their sores and ulcers differs. Although internal support and middle-tonifying formulas remain similar, herbs for regulating menstruation, relieving depression, and calming the spirit are indispensable. Treating according to specific symptoms yields miraculous results.
As for eunuchs and wealthy individuals, their nature tends toward arrogance and luxury. They consume rich and greasy foods and enjoy different lifestyles, experiencing distinct physical and mental hardships or pleasures. As they age and weaken, excessive alcohol consumption and sexual indulgence often lead to excess Yang and deficient Yin. When carbuncles or ulcers arise, the condition cannot be delayed. Strong doses of internal dispersing and supporting formulas are necessary to address the issue appropriately. However, due to their greed and lack of dietary restraint, they find even slight bitterness or blandness difficult to endure; this is their common trait.
Regarding people of low status and poverty, they suffer from hunger, cold, and labor, exposed to wind, frost, rain, and snow. Their lives involve奔波 (rushing about) in both ambition and residence, causing blockage of Ying and Wei Qi and coagulation of blood vessels, which reverses in the muscle tissues to generate carbuncles and swellings. Is this not the result of poor living conditions and physical hardship? Since their material enjoyment is insufficient, their Qi and Blood are inadequate, and their bodies are emaciated. At the initial stage of a carbuncle or swelling, the priority must be strong tonification and internal support. After ulceration, modifications of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to harmonize Qi and Blood, preventing emaciation and collapse. The profound mystery of medical art lies here.