《内经》曰∶膏粱之变,足生大疔。多由膏粱浓味之所致,或因卒中饮食之毒,或感四
时不正之气,或感蛇虫之毒,或感死畜之秽,各宜审而治之。其毒多生于头面四肢,形色不一,
或如小疮,或如水泡,或疼痛,或麻木,或寒热作痛,或呕吐恶心,或肢体拘急,并用隔蒜
灸,并服解毒之剂。若不省人事,或牙关紧急者,以夺命丹为末,葱酒调灌之。
若生两足者,多有红丝至脐;生两手者,多
有红丝至心;生唇面口内者,多有红丝入喉。皆急用针挑破其丝,使出恶血,以泄其毒。若
患于偏僻之处,药所难导者,惟灸法大有回生之功。然疔之名状,虽有十三种之不同,而治
法但审其元气虚实,邪之表里,而庶无误人于夭札也。若专泥于疏利表散,非惟无益,而反
害之。凡人暴死,多是疔毒,急取灯遍照其身。若是小疮,即是其毒,宜急灸之,并服夺命
丹等药,亦有复苏者。
治验
长洲庠苏子忠鼻梁患之,症属表邪,但气血俱虚,不胜发散,遂用补中益气为主,佐以
防风、白芷而愈。
一男子小指患之,或为针刺出血,敷以凉药,掌指皆肿三四倍,色黯神昏,此邪气郁遏
。余先以夺命丹一服,活命饮二剂,稍可。余因他往,或为遍刺其手,出鲜血碗许,臂肿如瓠,
指大数倍,用大剂参、 、归、术之类,及频灸遍身而肿消。但大便不实,时常泄气,此元
气下陷,以补中益气加骨脂、肉蔻、吴茱、五味;又日以人参五钱,麦门三钱,五味二钱,
水煎代茶饮;又用大补药,五十余帖而愈。设此症初不用解毒之剂,后不用大补之药,死无
白莲泾陈伯和子,唇患之,有紫脉延至口内,将及于喉。余曰∶紫脉过喉,则难治矣,
须针
口内肿胀,针不能入,乃砭面、唇出黑血碗许,势虽少退,终至不起。惜哉!
《黄帝内经》说:长期食用肥甘厚味,会导致身体产生严重的疔疮。这大多是由于饮食过于油腻浓烈所致,也可能是突然中了饮食中的毒素,或者感受了四时不正之气,或是感染了蛇虫的毒液,又或者是接触了死畜的污秽之气,应当仔细辨别原因后进行治疗。这种毒邪多生长在头面或四肢,形态和颜色各不相同,有的像小疮,有的像水泡,有的疼痛,有的麻木,有的伴有寒热发作时的疼痛,有的出现呕吐恶心,有的肢体拘挛紧急,这些情况都适宜用隔蒜灸法治疗,并服用解毒的药物。如果患者神志不清,或者牙关紧闭,可将夺命丹研成粉末,用葱酒调匀灌服。
如果疔疮生在双脚,通常会有红丝延伸至肚脐;生在手上的,多有红丝延伸至心脏部位;生在嘴唇、面部或口腔内的,多有红丝延伸至咽喉。这些都应立即用针挑破红丝,放出恶血,以泄出毒邪。如果患处在偏僻难以用药直达的地方,只有灸法具有极大的起死回生功效。然而疔疮的名称和形态虽然有一十三种不同,但治疗方法只需审察患者元气的虚实以及邪气在表在里的情况,这样才不至于误人性命。如果一味拘泥于疏风解表发散的方法,不仅无益,反而有害。凡人突然死亡,很多是因为疔毒作祟,此时应迅速取灯火遍照全身。如果发现是小疮,那就是毒邪所在,宜立即施灸,并服用夺命丹等药物,也有复苏的案例。
医案记录:
长洲县庠生苏子忠鼻梁上患了疔疮,症状属于表邪,但他气血俱虚,不能耐受发散疗法,于是我用补中益气汤为主方,佐以防风、白芷,最终治愈。
一男子小指患了疔疮,有人为他针刺出血,并敷上凉性药物,导致手掌和手指肿胀三四倍,颜色暗紫,神志昏沉,这是邪气被郁遏在内。我先让他服用一剂夺命丹,两剂活命饮,病情稍有好转。后来我因事外出,有人为他遍刺手部,流出鲜血约一碗,手臂肿得像葫芦一样大,手指肿大数倍。我使用大剂量的人参、黄芪、当归、白术等药物,并频繁对全身进行艾灸,最终消肿。但他大便不成形,时常排气,这是元气下陷的表现,我用补中益气汤加骨脂、肉豆蔻、吴茱萸、五味子;又每天用人参五钱、麦门冬三钱、五味子二钱,水煎代茶饮用;后来又用大补药物,共五十余帖而痊愈。假如这个病症初期不用解毒药,后期不用大补药,必然致死。
白莲泾陈伯和的儿子,嘴唇患了疔疮,有紫色脉络延伸至口腔内,即将到达咽喉。我说:“紫色脉络过喉,就很难治了。”当时口内肿胀,针无法进入,于是用砭石刺破面部和嘴唇,流出黑血约一碗,势头虽然稍退,但最终未能挽回生命,可惜啊!
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Changes from rich and greasy foods can give rise to major Ding sores." These are mostly caused by a diet overly rich in fatty and strong flavors, or sudden poisoning from food, or contracting the abnormal Qi of the four seasons, or being infected with venom from snakes and insects, or contact with filth from dead livestock. Each case should be carefully examined and treated accordingly. The toxin often arises on the head, face, or limbs, with varying shapes and colors; it may resemble a small sore, a blister, cause pain, numbness, pain accompanied by chills and fever, vomiting, nausea, or limb stiffness and urgency. In all these cases, Garlic-Separated Moxibustion is suitable, along with administering detoxifying agents. If the patient loses consciousness or suffers from trismus (lockjaw), pulverize Duoming Dan (Life-Restoring Pill), mix it with scallion wine, and force-feed it.
If the Ding sore occurs on both feet, red threads often extend to the umbilicus; if on both hands, red threads often extend to the heart region; if on the lips, face, or inside the mouth, red threads often extend into the throat. In all such instances, immediately puncture the threads with a needle to release foul blood and drain the toxin. If the lesion is in a remote area where medicinal application is difficult, only moxibustion has significant life-saving power. Although Ding sores have thirteen different names and presentations, treatment relies solely on assessing the deficiency or excess of Yuan Qi (Primal Qi) and whether the pathogen is exterior or interior, thereby avoiding fatal errors. Relying exclusively on dispersing and releasing the exterior methods is not only ineffective but harmful. Sudden death in humans is often due to Ding toxicity; urgently use a lamp to illuminate the entire body. If a small sore is found, it indicates the location of the toxin, requiring immediate moxibustion and administration of Duoming Dan and similar medicines, with some patients recovering.
Clinical Case Record:
Su Zizhong, a student at the Changzhou county school, developed a Ding sore on his nasal bridge. The syndrome belonged to exterior pathogens, but his Qi and Blood were both deficient, making him unable to tolerate dispersing therapies. I therefore used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) as the main formula, supplemented with Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica), resulting in a cure.
A man developed a Ding sore on his little finger. Someone pricked it to bleed and applied cooling herbs, causing the palm and fingers to swell three to four times their normal size, with dark discoloration and coma. This indicated entrapment of pathogenic factors. I first administered one dose of Duoming Dan (Life-Restoring Pill) and two doses of Huoming Yin (Living Life Decoction), after which his condition slightly improved. Due to other commitments, I left, and someone else pricked his hand extensively, releasing about a bowlful of fresh blood. His arm swelled like a gourd, and his fingers enlarged several times. I prescribed large doses of Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelica Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma), along with frequent whole-body moxibustion, until the swelling subsided. However, he had loose stools and frequent flatus, indicating sinking of Yuan Qi (Primal Qi). I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Guzhi (Cistanches Herba), Roukou (Myristicae Semen), Wuzhuyu (Evodiae Fructus), and Wuweizi (Schisandrae Fructus). Additionally, I prescribed daily tea made from 5 qian of Renshen (Ginseng Radix et Rhizoma), 3 qian of Maimendong (Ophiopogonis Radix), and 2 qian of Wuweizi (Schisandrae Fructus) decocted in water. Finally, using large tonifying formulas for over fifty doses, he recovered. Had detoxifying agents not been used initially, nor large tonics later, he would certainly have died.
The son of Chen Bohe from Bailianjing developed a Ding sore on his lip, with purple veins extending into the mouth, approaching the throat. I stated, "If purple veins cross the throat, it is difficult to treat." At that time, the inside of the mouth was too swollen for needles to enter, so I used Bian Shi (Stone Lancet) to pierce the face and lips, releasing about a bowlful of black blood. Although the severity slightly receded, he ultimately did not survive. What a pity!