羌活散 治手发背。及手掌毒。
羌活 独活 前胡 桔梗 乌药 荆芥 当归 升麻 薄桂 威灵仙 甘草
用水、酒各一钟。煎一钟。食远服。
代指膏 治代指。
雄黄 朴硝(等分)
用猪胆汁。少加香油调涂。
藜芦膏 治 疮痒痛。黄水浸淫。
藜芦 苦参(各一两) 猪脂(半斤)
浸七日。煎十数沸。去渣。入松香一两化。离火。入雄黄末、枯矾末各一两。搅匀涂之。以瘥为度。
二矾散 鹅掌风皮肤枯浓。破裂作痛。越重越妙。
白矾(四两) 皂矾(四两) 儿茶(五钱) 侧柏叶(半斤)
水十碗。煎数滚听用。先以桐油搽患处。次以纸捻蘸桐油。点着向患处熏之。片时。次用前汤乘热贮
净桶内。手架上用布盖。以汤气熏之。勿令泄气。特微热倾入盆内。蘸洗良久。一次可愈。七日不可见
水。
一用妇人经布。滚水洗下。炸患处。效。
二油膏 鹅掌风及血风等疮。
油 牛油 香油(各一两) 黄蜡(一两) 银朱(一两) 铅粉(二钱) 麝香(二钱)
成膏。搽患处。火烘之。以油干为度。
绀珠丹 内疏黄连汤 阳燧锭子 离宫锭子(俱见首卷) 蟾酥丸 拔疔散(俱见疔门)
股部(足三阳之脉在外曰髀足三阴之脉在内曰股)
(足三阳之脉在外曰髀足三阴之脉在内曰股)
经络 前廉足阳明胃经。后廉足太阳膀胱经。外廉足少阳胆经。内廉足厥阴肝经。内前廉足太阴脾
经。内后廉足少阴肾经。
股阴疽 生股内阴囊之侧。形长微赤痛甚。膝曲难伸。上发下。易治。下发上。难医。灸商丘穴七壮。或灸
膝下外廉横骨尽处。
阴疽 生夹缝之下三寸。在左。漫肿。痛连阴子。上及小腹。下及大腿。灸中都穴二七壮。
玄疽 生夹缝之下。在右。灸蠡沟穴三七壮。
伏兔 生胯下五六寸寒热。 肿无头。疼痛彻心。
肚门痈 生于大腿肚。
箕门痈 生股内近膝。
股阳疽 生股外侧。灵枢云。肿不变色。内薄于骨。
环跳疽 生环跳穴。漫肿隐痛。尺脉沉紧。腿不能伸。
按上症。初起红肿 痛者。神授卫生散。漫肿大痛者。内托黄 汤。痛而筋挛。脉弦而紧者。绀珠丹汗
之。痛止。易以神应养真丹。遍身走痛。两日后脚面结肿。腿股结块。脉浮轻重缓者。由寒邪外袭也。绀
珠丹汗之。痛止。则宜托里。倍加参、术、归、 。 肿便闭。烦躁饮冷。脉数者。热淫于内也。内疏黄连汤、贵
金丸下之。肿痛寒热。发渴。脉洪数而有力。饮食如常者。由足三阳之湿热壅滞也。槟苏败毒散。肿痛
寒热止。易以逍遥散。肿痛色不变。寒热。食少体倦者。由脾虚湿痰下注也。补中益气汤加茯苓、半夏、
芍药。患此入房。肿硬二便不通者。六味丸料加牛膝、车前。二便利仍用补中汤。
溃而脓清者。十全大补汤加牛膝。外以豆豉饼灸之。再疮口紫陷者。再加大附子。外以附子饼灸之。
食少者胃弱也。诸虚皆禀于胃。宜六君子汤加藿香、当归。俟食进。更以十全大补。脓出。恶寒不食。脉
细如丝者。用人参一两。附子三钱。姜、枣煎服。溃而反痛。气血虚也。峻补之。补之则气化。气化则痛自
除。
再环跳疽者。由脾移寒于肝也。惟黄狗下颏方神验。兼助以胃气。更宜外刺委中穴。出黑血自瘥。
附骨疽(生大腿外侧) 咬骨疽(生大腿内侧) 肿下而坚者发于筋骨。乃阴寒入骨之病也。初起则
寒热交作。稍似风邪。随后筋骨作痛。不红不热。疼至彻骨。甚者不能曲伸。或皮肉微急。洪洪如肥状。
是症皆宜灸之熨之。以散毒瓦斯。补阳气。温脾气为主。
灸法。于痛处周遭。灸之百壮。起泡可治。无泡难治。或以箸头点痛处。墨记之。艾灸百壮。以爆为度。又
以患者觉骨中疼为效。又附骨疽灸悬钟穴七壮。咬骨疽灸阴包穴三七壮。环跳穴痛灸昆仑穴二
七壮。
初起寒热作痛者。以绀珠丹汗之。次以大防风汤。行经络活血补虚。生于尻臀。漫肿作痛者。内托羌
活汤。生内股近膝。漫肿不痛者。内托 柴汤。生腿外侧。漫肿作痛者。内托酒煎汤。
然必外兼灸之。熨之。淋洗之。以助其阳。盖肾主骨。肾虚则骨冷。寒邪乘之。则气血凝滞。但能为肿。不
能为脓。故流注者。乃伤寒之余毒。由表之未尽也。附骨疽者。乃流注之坏症。由凉药之误也。久之阴
极生阳。寒化为热。热甚则肉腐。化而为脓也。
欲作脓者。附子八珍汤。脓成胀痛者针之。实者脓稠。十全大补汤。虚者脓清。保元大成汤。若气败者
死。食少体倦者。香砂六君子汤。脾虚寒热者。补中益气汤。久溃不已者。必出朽骨。视其脓。脓白清稀
者。朽骨初脱。肉深难取。脓白而稠者。朽骨将出。肉浅可取。
大抵疮疽。旬日不退。则宜托里。有脓针之。有腐取之。虚则补之。方能收十全之功。有因复犯房欲劳
伤。致令寒热互变。气血乖违。经脉横解。受病日深。以成斯疾者。则大腿渐渐肿如冬瓜。上过胯腹。下
连足底。牵连漫肿。日久溃脓。色白腥秽。肿痛不减。元气日衰者。终为不治。
腿游风 外腿忽然赤肿热痛。按之如泥不复起者。由风热相搏所致。宜砭去恶血。服当归拈痛汤。及
绀珠丹和之。
羌活散:治疗手发背(生于手背的痈疽)以及手掌毒(手掌部的疔疮)。
药材:羌活、独活、前胡、桔梗、乌药、荆芥、当归、升麻、薄桂(肉桂)、威灵仙、甘草。
用法:用水、酒各一钟,煎至一钟,饭后服用。
代指膏:治疗代指(指甲周围红肿疼痛的病症)。
药材:雄黄、朴硝(芒硝,等量)。
用法:用猪胆汁,少加香油调和后涂抹。
藜芦膏:治疗疮疡瘙痒疼痛,黄水浸淫蔓延。
药材:藜芦、苦参(各一两),猪脂(半斤)。
用法:浸泡七日,煎煮十余沸,去渣,加入松香一两使其融化,离火后,加入雄黄末、枯矾末各一两,搅拌均匀后涂抹,以痊愈为度。
二矾散:治疗鹅掌风(手部皮肤角化过度性疾病),表现为皮肤枯厚、破裂作痛。此方越重越好。
药材:白矾(四两)、皂矾(绿矾,四两)、儿茶、侧柏叶(半斤)。
用法:用水十碗,煎煮数次滚沸备用。先用桐油涂抹患处,然后用纸捻蘸取桐油,点燃后向患处熏烤片刻。接着将前面的药汤趁热装入干净的桶内,将手架在桶上,用布盖住桶口,利用药气熏蒸,不要漏气。待药汤微热时倒入盆内,蘸洗患处较长时间,一次即可痊愈。七天内不可见水。
替代疗法一:用妇女经布,用滚水洗下,炸敷患处,有效。
二油膏:治疗鹅掌风及血风等疮疡。
药材:油(基质)、牛油、香油(各一两)、黄蜡(一两)、银朱、铅粉(二钱)、麝香(二钱)。
用法:制成膏剂,涂抹患处,用火烘烤,直到油干为止。
绀珠丹、内疏黄连汤、阳燧锭子、离宫锭子(均见于首卷)、蟾酥丸、拔疔散(均见于疔门章节)。
股部(足三阳经脉在外侧称为髀,足三阴经脉在内侧称为股)
经络分布:前廉为足阳明胃经,后廉为足太阳膀胱经,外廉为足少阳胆经,内廉为足厥阴肝经,内前廉为足太阴脾经,内后廉为足少阴肾经。
股阴疽:生于股内侧阴囊之侧,形状长而微赤,疼痛剧烈,膝盖弯曲困难。病灶向上发展容易治疗,向下发展难以医治。可灸商丘穴七壮,或灸膝下外侧横骨尽头处。
阴疽:生于夹缝之下三寸,位于左侧,漫肿,疼痛牵连阴器,上至小腹,下至大腿。可灸中都穴十四壮。
肚门痈:生在大腿肚(腓肠肌部位)。
箕门痈:生在股内侧近膝处。
股阳疽:生在股外侧。《灵枢》云:肿胀不变色,内部逼近骨骼。
按上述症状,初起红肿疼痛者,用神授卫生散;漫肿大痛者,用内托黄芪汤;疼痛且筋脉拘挛,脉弦紧者,用绀珠丹发汗解表。疼痛停止后,改用神应养真丹。遍身走窜疼痛,两日后脚面结肿,腿股结块,脉浮缓者,由寒邪外袭所致,用绀珠丹发汗解表。疼痛停止后,则宜托里透脓,倍加人参、白术、当归、川芎。若肿胀伴便秘,烦躁喜冷饮,脉数者,由热邪蕴结于内所致,用内疏黄连汤、贵金丸攻下。若肿痛寒热,口渴,脉洪数有力,饮食如常者,由足三阳经湿热壅滞所致,用槟苏败毒散。肿痛寒热停止后,改用逍遥散。若肿痛颜色不变,伴有寒热,食少体倦者,由脾虚湿痰下注所致,用补中益气汤加茯苓、半夏、芍药。患此病期间行房事,导致肿硬、大小便不通者,用六味地黄丸料加牛膝、车前子。大小便通畅后仍用补中益气汤。
溃破后脓液清稀者,用十全大补汤加牛膝。外用豆豉饼灸之。若疮口紫陷者,再加大附子,外用附子饼灸之。食少者属胃弱,诸虚皆禀受于胃,宜用六君子汤加藿香、当归。待食欲增进后,再用十全大补汤。脓出后恶寒不食,脉细如丝者,用人参一两、附子三钱,加姜、枣煎服。溃破后反而疼痛,属气血虚弱,需峻补。补益则气化功能恢复,气化则疼痛自除。
另外,环跳疽是由脾脏移寒于肝脏所致。唯有黄狗下颏方神验,兼助胃气,更宜外刺委中穴,放出黑血自然痊愈。
附骨疽(生在大腿外侧)、咬骨疽(生在大腿内侧):肿胀坚硬者,发于筋骨,乃阴寒入骨的病症。初起则寒热交作,稍似风邪,随后筋骨作痛,不红不热,疼至彻骨,严重者不能屈伸,或皮肉微急,洪洪如肥胖状。此症皆宜灸之熨之,以散毒瓦斯,补阳气,温脾气为主。
灸法:在痛处周遭,灸之百壮,起泡者可治,无泡难治。或用筷子头点痛处,墨记之,艾灸百壮,以爆裂声为度。又以患者感觉骨中疼痛为效。另外,附骨疽灸悬钟穴七壮,咬骨疽灸阴包穴二十一壮,环跳穴痛灸昆仑穴十四壮。
初起寒热作痛者,用绀珠丹发汗解表,次用大防风汤,行经络活血补虚。生于尻臀,漫肿作痛者,用内托羌活汤。生在内股近膝,漫肿不痛者,用内托柴胡汤。生在腿外侧,漫肿作痛者,用内托酒煎汤。
然而必须外兼灸之、熨之、淋洗之,以助其阳气。盖肾主骨,肾虚则骨冷,寒邪乘之,则气血凝滞,但能为肿,不能为脓。故流注者,乃伤寒之余毒,由表之未尽也。附骨疽者,乃流注之坏症,由凉药之误也。久之阴至极而生阳,寒化为热,热甚则肉腐,化而为脓也。
欲作脓者,用附子八珍汤。脓成胀痛者针之。实证脓稠,用十全大补汤;虚证脓清,用保元大成汤。若气败者死。食少体倦者,用香砂六君子汤。脾虚寒热者,用补中益气汤。久溃不已者,必出朽骨。视其脓,脓白清稀者,朽骨初脱,肉深难取;脓白而稠者,朽骨将出,肉浅可取。
大抵疮疽,旬日不退,则宜托里。有脓针之,有腐取之,虚则补之,方能收十全之功。有因复犯房欲劳伤,致令寒热互变,气血乖违,经脉横解,受病日深,以成斯疾者,则大腿渐渐肿如冬瓜,上过胯腹,下连足底,牵连漫肿,日久溃脓,色白腥秽,肿痛不减,元气日衰者,终为不治。
Qianghuo San (Notopterygium Decoction): Treats hand back carbuncle (carbuncle on the dorsum of the hand) and palm toxicity (carcinoma/boil on the palm).
Herbs: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Wuyao (Linderae Radix), Jingjie (Schizonepetae Herba), Danggui (Angelicae Sinensis Radix), Shengma (Cimicifugae Rhizoma), Bo Gui (Cinnamomi Cortex, thin variety), Weilingxian (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Usage: Decoct with one cup of water and one cup of wine until reduced to one cup. Take after meals.
Daizhi Gao (Finger-nail Ointment): Treats Daizhi (paronychia/infection around the fingernail).
Herbs: Xionghuang (Realgar), Puxiao (Mirabilite, equal parts).
Usage: Mix with pig bile and a small amount of sesame oil, then apply.
Lilu Gao (Veratrum Ointment): Treats sores with itching and pain, oozing yellow fluid.
Herbs: Lilu (Veratri Rhizoma), Kushen (Sophorae Flavescentis Radix) (each 1 liang), Zhuzhi (Pig Fat) (0.5 jin).
Usage: Soak for seven days, boil for more than ten times, remove dregs, add Songxiang (Pini Resina) 1 liang to melt. Remove from fire, add Xionghuang powder and Kufan (Alumen Exsiccatum) powder, each 1 liang. Stir well and apply. Continue until healed.
Er Fan San (Two Alum Powder): Treats E Zhang Feng (keratoderma of the hands), characterized withered and thick skin, cracking and pain. The stronger the effect, the better.
Herbs: Bai Fan (Alumen) (4 liang), Zao Fan (Melanteritum) (4 liang), Ercha (Catechu) (5 qian), Cebaiye (Platycladi Cacumen) (0.5 jin).
Usage: Decoct with ten bowls of water until boiling several times. First, apply tung oil to the affected area. Then, dip a paper twist in tung oil, light it, and fumigate the affected area for a while. Next, pour the decoction into a clean bucket while hot. Place the hand over the bucket, cover with cloth to fumigate, ensuring no steam escapes. When the liquid is slightly warm, pour it into a basin, soak and wash the affected area for a long time. One treatment can cure it. Avoid water contact for seven days.
Alternative method 1: Use menstrual cloth from women, rinse with boiling water, and fry/apply to the affected area. Effective.
Eryou Gao (Two Oil Ointment): Treats E Zhang Feng and blood wind sores.
Ingredients: Oil (base), Niuyou (Bovine Fat), Xiangyou (Sesame Oil) (each 1 liang), Huangla (Beeswax) (1 liang), Yinzhu (Vermilion), Qianfen (Lead White Powder) (2 qian), Muxiang (Moschus) (2 qian).
Usage: Make into an ointment, apply to the affected area, and bake with fire until the oil is dry.
Ganzhu Dan, Neishu Huanglian Tang, Yangsui Dingzi, Ligong Dingzi (all seen in the first volume), Chansu Wan, Bading San (all seen in the Ding section).
Thigh Region (The three yang meridians of the foot run on the outside and are called Bi; the three yin meridians of the foot run on the inside and are called Gu.)
Meridian Distribution: The anterior aspect is the Foot-Yangming Stomach Meridian, the posterior aspect is the Foot-Taiyang Bladder Meridian, the lateral aspect is the Foot-Shaoyang Gallbladder Meridian, the medial aspect is the Foot-Jueyin Liver Meridian, the anteromedial aspect is the Foot-Taiyin Spleen Meridian, and the posteromedial aspect is the Foot-Shaoyin Kidney Meridian.
Guyin Ju (Yin Abscess of the Thigh): Occurs on the inner side of the thigh near the scrotum. It is elongated, slightly red, and extremely painful. Knee flexion is difficult. If it spreads upward, it is easy to treat; if it spreads downward, it is difficult to treat. Moxibustion at Shangqiu (SP-5) for seven moxa cones, or at the end of the horizontal bone below the knee on the lateral side.
Yin Ju (Yin Abscess): Occurs three cun below the crease, on the left side. It presents as diffuse swelling, pain radiating to the genitals, extending up to the lower abdomen and down to the thigh. Moxibustion at Zhongdu (LR-6) for fourteen moxa cones.
Xuan Ju (Black Abscess): Occurs below the crease, on the right side. Moxibustion at Ligou (LR-5) for twenty-one moxa cones.
Futu (Rabbit Hiding Point): Occurs five to six cun below the groin, accompanied by chills and fever. Swelling without a head, pain penetrating the heart.
Dumen Yong (Abscess at the Belly Gate): Occurs in the belly of the thigh (gastrocnemius muscle).
Jimen Yong (Abscess at the Basket Gate): Occurs in the inner thigh near the knee.
Guyang Ju (Yang Abscess of the Thigh): Occurs on the lateral side of the thigh. *Ling Shu* states: Swelling does not change color, pressing internally against the bone.
Huantiao Ju (Abscess at Huantiao): Occurs at the Huantiao (GB-30) point. Diffuse swelling with hidden pain, Chi pulse is deep and tight, leg cannot extend.
Regarding the above symptoms: For early-stage redness, swelling, and pain, use Shenshou Weisheng San. For diffuse large swelling and severe pain, use Neituo Huangqi Tang. For pain with tendon spasm and wiry-tight pulse, use Ganzhu Dan to induce sweating. Once pain stops, switch to Shenyang Zhen Dan. For wandering pain throughout the body, with swelling on the dorsum of the foot after two days and lumps in the legs and thighs, with floating and slow pulse, caused by external invasion of cold pathogen, use Ganzhu Dan to induce sweating. Once pain stops, proceed to support the interior, doubling the dosage of Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), and Chuanxiong (Chuanxiong Rhizoma). For swelling with constipation, irritability, preference for cold drinks, and rapid pulse, caused by heat pathogen stagnating internally, use Neishu Huanglian Tang and Guijin Wan to purge. For swelling, pain, chills, fever, thirst, forceful and rapid洪 pulse, with normal appetite, caused by damp-heat stagnation in the Foot-Yangming meridians, use Bin Su Baidu San. Once swelling, pain, chills, and fever stop, switch to Xiaoyao San. For swelling with unchanged color, chills, fever, poor appetite, and fatigue, caused by spleen deficiency with damp-phlegm sinking downward, use Buzhong Yiqi Tang plus Fuling (Poria), Banxia (Pinelliae Tuber), and Shaoyao (Paeoniae Radix Alba). If intercourse during illness leads to hardness and urinary/fecal retention, use Liuwei Dihuang Wan formula plus Niuxi (Achyranthis Bidentatae Radix) and Cheqianzi (Plantaginis Semen). After urination and defecation normalize, continue with Buzhong Yiqi Tang.
For ulcerated sores with clear pus, use Shiquan Dabu Tang plus Niuxi (Achyranthis Bidentatae Radix). Externally, apply fermented soybean cake moxibustion. If the sore opening is purple and sunken, add larger amounts of Fuzi (Aconiti Lateralis Radix Praeparata) and apply Aconite cake moxibustion externally. Poor appetite indicates weak stomach; all deficiencies rely on the stomach. Use Liujunzi Tang plus Huoxiang (Agastaches Herba) and Danggui (Angelicae Sinensis Radix). Once appetite improves, use Shiquan Dabu Tang. For post-ulceration chills, anorexia, and thread-like pulse, use 1 liang of Renshen (Ginseng Radix), 3 qian of Fuzi (Aconiti Lateralis Radix Praeparata), decocted with ginger and jujube. Post-ulceration pain indicates qi and blood deficiency; strongly tonify. Tonification restores qi transformation, which eliminates pain.
Furthermore, Huantiao Ju is caused by cold transferring from the spleen to the liver. Only the Lower Jaw of Yellow Dog Formula is effective, combined with supporting stomach qi. Additionally, puncture Weizhong (BL-40) externally to release dark blood for natural recovery.
Fugu Ju (Bone-attached Abscess) (occurs on the lateral thigh), Yaogu Ju (Bone-biting Abscess) (occurs on the medial thigh): Swelling that is hard originates in the sinews and bones, a disease of yin-cold entering the bone. Initially, there are alternating chills and fever, resembling wind pathogen. Subsequently, sinew and bone pain occurs, without redness or heat, pain penetrating to the bone. Severe cases cannot bend or extend, or the skin and flesh are slightly tense, appearing swollen like obesity. These conditions should all be treated with moxibustion and warming compresses to dissipate toxic vapors, tonify yang qi, and warm spleen qi.
Moxibustion method: Around the painful area, apply one hundred moxa cones. If blisters form, it is treatable; if not, it is difficult. Mark the painful spot with ink using a chopstick tip, apply moxibustion for one hundred cones, stopping when popping sounds occur. Effectiveness is indicated when the patient feels pain in the bone. Additionally, for Fugu Ju, moxibustion at Xuanzhong (GB-39) for seven cones; for Yaogu Ju, moxibustion at Yinbao (LR-9) for twenty-one cones; for Huantiao pain, moxibustion at Kunlun (BL-60) for fourteen cones.
For initial chills, fever, and pain, use Ganzhu Dan to induce sweating, followed by Dafengfang Tang to unblock meridians, invigorate blood, and tonify deficiency. For occurrence at the buttocks with diffuse swelling and pain, use Neituo Qianghuo Tang. For occurrence in the inner thigh near the knee with diffuse swelling but no pain, use Neituo Chaihu Tang. For occurrence on the lateral leg with diffuse swelling and pain, use Neituo Jiu Jian Tang.
However, external moxibustion, warming compresses, and washing must be combined to assist yang qi. The kidney governs the bones; kidney deficiency leads to cold bones. Cold pathogen takes advantage, causing qi and blood stagnation, resulting only in swelling, not suppuration. Therefore, Liuzhu (flowing deposits) is residual toxin from cold damage, incomplete resolution from the exterior. Fugu Ju is a deteriorated stage of Liuzhu, caused by error in using cooling medicines. Over time, extreme yin generates yang, cold transforms into heat. Extreme heat causes flesh rot, transforming into pus.
For impending suppuration, use Fuzi Bazhen Tang. For formed pus with distending pain, lance it. In excess cases with thick pus, use Shiquan Dabu Tang; in deficiency cases with clear pus, use Baoyuan Dacheng Tang. If qi fails, death ensues. For poor appetite and fatigue, use Xiangsha Liujunzi Tang. For spleen deficiency with chills and fever, use Buzhong Yiqi Tang. For chronic non-healing ulcers, dead bone will emerge. Observe the pus: white and thin pus indicates initial shedding of dead bone, deep flesh makes removal difficult; white and thick pus indicates imminent shedding of dead bone, shallow flesh allows removal.
Generally, for sores and abscesses not resolving within ten days, support the interior is indicated. Lance if pus exists, remove necrotic tissue if present, tonify if deficient, to achieve complete success. Cases due to relapse into sexual activity and labor injury, causing alternating chills and fever, disharmony of qi and blood, disordered meridians, deepening pathology, result in the thigh swelling gradually like a winter melon, extending up to the hip and abdomen, down to the sole, with diffuse swelling. Long-term ulceration yields white, foul-smelling pus, persistent swelling and pain, declining yuan qi; these are ultimately untreatable.
Tui You Feng (Wandering Wind of the Leg): Sudden redness, swelling, heat, and pain on the outer leg, leaving an indentation like mud when pressed, caused by struggle between wind and heat. Indicate pricking to remove bad blood, take Danggui Nian Tong Tang, and harmonize with Ganzhu Dan.