初起寒热如疟,喜复衣被,口干好饮热汤,宜当发散。已成 热作痈,内热口干喜冷,大便秘涩者,微利
之。日久内脓已成,不破头而胀痛者,急针之,法当补托。溃后脓水清稀,虚热不退,肿痛不消者,宜滋阴健
脾。疮口不敛,饮食减少,余肿不消,新肉不生,峻补脾胃。
一男子结肿四日,作痒微痛。以九龙丹一服,利五、六次,其肿渐消;又以四物汤加花粉、黄柏、知母而愈。
一男子患此十余日, 肿作痛,至晚发热尤甚,又兼小水不利。以龙胆泻肝汤二服,小水稍通,微痛不止,
此欲作脓,以托里消毒散加穿山甲、皂角刺、泽泻,二服而脓出,又以十全大补汤服之月余而敛。
一男子患此肿甚胀痛,此内脓已成。即针之,出臭脓碗许,疼痛顿减;以十全大补汤十余服而饮食渐进,
痛亦消,惟疮口原溃之甚,不易完合,间用制甘草吞蜡矾丸,外以附子饼灸之,调理三月而愈。
一男子素有痰火,久服降下之药,致此结肿疼痛,脉细而数,此阴虚湿热流注而成,溃后必难收敛,辞不
治。后果出臭脓,不禁日渐开大,发热不止,饮食不进,强以温中健脾、补托气血药,终至不应而殁。
滋阴八物汤
滋阴八物汤生地 赤芍丹皮花粉归
甘草川芎泽泻等 灯心为引效堪推
治悬痈初起,状如莲子,红赤渐肿,悠悠作痛者。
川芎 当归 赤芍 生地 牡丹皮 天花粉 甘草节(各一钱) 泽泻(五分) 大黄(便秘加,蜜炒,
一钱)
水二钟,灯心二十根,煎八分,食前服。
炙粉草膏
炙粉草膏药二般 当归甘草效常堪
制度熬膏好酒服 悬痈肿痛尽成欢
治悬痈已成,服药不得内消者服之,未成者即消,已成者即溃,既溃者即敛,此治悬痈良药也。
大粉草四两,用长流水浸透,炭火上炙干,再浸再炙,如此三度,切片,甘草三两,当归身三两,水三碗,
慢火煎至稠膏,去渣再煎,稠浓为度。每日三钱,无灰好热酒一大杯,化膏空心服之最妙。
还元保真汤
还元保真汤四物 参苓丹皮并白术
甘草黄 枸杞同 附子肉桂泽泻入
治悬痈已溃,疮口开张,脓水淋漓,不能收敛者。
当归 川芎 白芍 熟地 白术 茯苓 人参 黄 (各一钱) 牡丹皮 枸杞子(各八分) 甘草(炙)
熟附子(各五分) 肉桂 泽泻(各三分)
水二钟,煨姜三片,大枣二枚,煎八分,食前服。
滋阴九宝饮
滋阴九宝饮芎归 白芍黄连生地随
花粉知母并黄柏 大黄煎服效堪题
治悬痈浓味膏粱、蕴热结肿,小水涩滞,大便秘结,内热口干,烦渴饮冷,及六脉沉实有力者服。
川芎 当归 白芍 生地 黄连 天花粉 知母 黄柏 大黄(蜜水拌炒,各二钱)
水二钟,煎八分,空心服。
初起时出现寒热往来如疟疾状,患者喜欢多穿衣盖被子,口干且喜欢喝热汤,此时应当采用发散表邪的方法治疗。如果脓肿已经形成,表现为内部发热、口干喜冷饮,大便秘结不通的,用轻微通下的方法治疗。如果病程日久,内部脓液已经形成,但疮口未破且感到胀痛,应当立即针刺排脓,治法应当以补益气血、托毒外出为主。溃破后如果脓水清稀,虚热不退,肿痛不消的,应当采用滋阴健脾的方法。如果疮口不能愈合,饮食减少,余肿不消,新肉不生的,应当峻补脾胃。
有一个男子患此病四天,局部结肿,发痒且微痛。服用一剂九龙丹,腹泻五六次后,肿胀逐渐消退;又服用四物汤加天花粉、黄柏、知母而痊愈。
另一个男子患此病十多天,肿胀疼痛,傍晚发热尤其严重,又兼有小便不利。服用两剂龙胆泻肝汤,小便稍通,但微痛不止,这是将要化脓的表现,于是用托里消毒散加穿山甲、皂角刺、泽泻,服用两剂后脓液排出,又服用十全大补汤一个多月后疮口愈合。
第三个男子患此病肿胀严重且胀痛,这是内部脓液已经形成。立即针刺,流出约一碗的臭脓,疼痛顿时减轻;服用十余剂十全大补汤后饮食逐渐增加,疼痛也消失,只是疮口原本溃烂得很严重,不易完全愈合,间断使用制甘草吞服蜡矾丸,外用附子饼灸疗,调理三个月后痊愈。
第四个男子素有痰火之症,长期服用降气下行的药物,导致此处结肿疼痛,脉象细而数,这是阴虚湿热流注而成,溃破后必然难以收敛,患者推辞不治。后果流出臭脓,疮口不禁日渐扩大,发热不止,饮食不进,强行使用温中健脾、补托气血的药物,最终无效而死亡。
滋阴八物汤
滋阴八物汤由生地、赤芍、丹皮、花粉、当归、甘草、川芎、泽泻等组成,以灯心草为引,疗效显著。
主治悬痈初起,形状像莲子,颜色红赤并逐渐肿胀,隐隐作痛的情况。
组成:川芎、当归、赤芍、生地、牡丹皮、天花粉、甘草节(各一钱),泽泻(五分),大黄(若便秘则加入,蜜炒,一钱)。
用法:水二钟,灯心草二十根,煎至八分,饭前服用。
炙粉草膏
炙粉草膏有两种制法,其中当归配甘草的效果常令人满意。
制度熬膏后用好酒送服,可令悬痈肿痛尽愈。
主治悬痈已经形成,服药无法内消的情况。服用此药,未成脓者可消散,已成脓者可溃破,已溃者可收敛,这是治疗悬痈的良药。
组成:大粉草四两,用长流水浸透,在炭火上烤干,再浸再烤,如此三次,切片;甘草三两,当归身三两。
用法:水三碗,慢火煎至稠膏,去渣后再煎至浓稠。每日三钱,用无灰好热酒一大杯,空腹化开膏剂服用最佳。
还元保真汤
还元保真汤由四物汤加上人参、茯苓、丹皮、白术、甘草、黄芩、枸杞、附子、肉桂、泽泻组成。
主治悬痈已溃破,疮口开张,脓水淋漓,不能收敛的情况。
组成:当归、川芎、白芍、熟地、白术、茯苓、人参、黄芩(各一钱),牡丹皮、枸杞子(各八分),甘草(炙)、熟附子(各五分),肉桂、泽泻(各三分)。
用法:水二钟,煨姜三片,大枣二枚,煎至八分,饭前服用。
滋阴九宝饮
滋阴九宝饮由川芎、当归、白芍、黄连、生地、天花粉、知母、黄柏、大黄组成,煎服疗效显著。
主治因食用肥甘厚味导致蕴热结肿,小便涩滞,大便秘结,内部发热口干,烦躁口渴喜冷饮,以及六脉沉实有力的悬痈患者。
组成:川芎、当归、白芍、生地、黄连、天花粉、知母、黄柏、大黄(蜜水拌炒,各二钱)。
用法:水二钟,煎至八分,空腹服用。
At the initial stage, chills and fever occur alternatingly like malaria; the patient prefers to wear more clothes and cover with quilts, feels dry in the mouth, and desires hot drinks. At this time, dispersing methods should be used. If the abscess has formed, presenting with internal heat, dry mouth preferring cold drinks, and constipation, mild purgation should be employed. If the disease has persisted for a long time and pus has formed internally, but the skin is unbroken causing distending pain, immediate needle drainage is required, and the treatment method should focus on tonifying and pushing out toxins. After ulceration, if the discharge is thin and clear, lingering deficiency-heat persists, and swelling and pain do not subside, nourishing yin and strengthening the spleen are indicated. If the wound fails to close, appetite decreases, residual swelling remains, and new flesh does not grow, vigorous tonification of the spleen and stomach is necessary.
A male patient presented with a localized swelling after four days, accompanied by itching and slight pain. One dose of Jiulong Dan was administered, resulting in five or six bowel movements, after which the swelling gradually subsided. He was then cured by taking Siwu Tang (Four Substances Decoction) added with Tianhuafen (Spikenard Root), Huangbai (Phellodendron Bark), and Zhimu (Anemarrhena Rhizome).
Another male patient suffered from this condition for over ten days, experiencing swollen pain, severe fever especially in the evening, and difficulty in urination. Two doses of Longdan Xiegan Tang (Gentian Liver-Draining Decoction) were given, slightly improving urination, but slight pain persisted, indicating impending suppuration. Tuoli Xiaodu San (Interior-Tonifying and Toxin-Expelling Powder) was prescribed with additions of Chanshanjia (Pangolin Scales), Zaojiaoci (Gleditsia Spine), and Zexie (Alisma Rhizome). After two doses, pus was discharged. The patient then took Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) for over a month until the wound healed.
A third male patient had severe swelling and distending pain, indicating that pus had already formed internally. He was immediately needled, discharging approximately one bowl of foul-smelling pus, and the pain decreased instantly. After taking more than ten doses of Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction), his diet gradually improved, and pain subsided. However, the original ulceration was severe and difficult to heal completely. Intermittently, he swallowed Zhigancas (Prepared Licorice Root) with Lafan Wan (Wax Pill), and externally received moxibustion using Fuzi Bing (Aconite Cake). After three months of regulation, he recovered.
A fourth male patient had a history of phlegm-fire and had long taken descending medications, leading to localized swelling and pain. His pulse was fine and rapid, indicating that yin deficiency with damp-heat stagnation had formed. It was predicted that healing would be difficult after ulceration, so he declined treatment. Consequently, foul pus was discharged, the wound widened daily, fever persisted, and appetite vanished. Despite forced administration of warming middle-jiao, strengthening spleen, and tonifying qi-blood medicines, he ultimately died due to ineffectiveness.
Ziyin Bawu Tang (Nourishing Yin Eight-Ingredient Decoction)
Ziyin Bawu Tang consists of Dihuang (Rehmannia Root), Chishao (Red Peony Root), Danpi (Moutan Cortex), Huafen (Tianhuafen/Trichosanthes Root), Danggui (Angelica Sinensis), Gancao (Licorice Root), Chuanxiong (Ligusticum Rhizome), and Zexie (Alisma Rhizome), with Dengxincao (Juncus Effusus Pith) as a guide. Its efficacy is remarkable.
Indications: Initial stage of Xuanyong (Hanging Abscess), resembling a lotus seed, red and gradually swelling with dull pain.
Composition: Chuanxiong, Danggui, Chishao, Dihuang, Mudanpi, Tianhuafen, Gancaojie (Licorice Joint) (each 1 qian); Zexie (0.5 qian); Dahuang (Rhubarb Rhizome) (added if constipated, honey-fried, 1 qian).
Administration: Boil 2 zhong of water with 20 roots of Dengxincao to 0.8 zhong; take before meals.
Zhifencao Gao (Roasted Licorice Paste)
Zhifencao Gao has two preparations; the combination of Danggui and Gancao is often effective.
When prepared as a paste and taken with good wine, it brings joy by resolving swelling and pain of Xuanyong.
Indications: For established Xuanyong where oral medication cannot resolve the swelling internally. It resolves unformed swellings, induces rupture of formed ones, and promotes closure of ulcers. This is an excellent medicine for treating Xuanyong.
Composition: Dafengcao (Large Licorice Root) 4 liang, soaked in running water, dried over charcoal fire, soaked and dried again, repeated three times, then sliced; Gancao (Licorice Root) 3 liang, Dangguishen (Angelica Root Body) 3 liang.
Administration: Boil in 3 bowls of water over slow fire until thick paste forms. Remove dregs and boil further until concentrated. Take 3 qian daily, dissolved in a large cup of good non-fermented hot wine, taken on an empty stomach for best results.
Huanyuan Baozhen Tang (Restoring Origin and Preserving Truth Decoction)
Huanyuan Baozhen Tang consists of Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng Root), Fuling (Poria), Mudanpi (Moutan Cortex), Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root), Huangqin (Scutellaria Root), Gouqi (Goji Berry), Fuzi (Aconite Lateral Root), Rougui (Cinnamon Bark), and Zexie (Alisma Rhizome).
Indications: Established Xuanyong with open wounds, dripping pus, and failure to heal.
Composition: Danggui, Chuanxiong, Baishao (White Peony Root), Shudi (Prepared Rehmannia Root), Baizhu, Fuling, Renshen, Huangqin (each 1 qian); Mudanpi, Gouqizi (Goji Berry) (each 0.8 qian); Zhigancao (Roasted Licorice Root), Shufuzi (Prepared Aconite Lateral Root) (each 0.5 qian); Rougui, Zexie (each 0.3 qian).
Administration: Boil 2 zhong of water with 3 slices of Weijiang (Baked Ginger) and 2 Jujubes to 0.8 zhong; take before meals.
Ziyin Jiubao Yin (Nourishing Yin Nine-Treasure Drink)
Ziyin Jiubao Yin consists of Chuanxiong, Danggui, Baishao, Huanglian (Coptis Rhizome), Dihuang, Tianhuafen, Zhimu, Huangbai, and Dahuang. Its efficacy upon decoction and ingestion is praiseworthy.
Indications: For Xuanyong caused by accumulation of heat from rich foods, with stagnant urination, constipation, internal heat, dry mouth, irritability, thirst for cold drinks, and deep, solid, and forceful pulses throughout all positions.
Composition: Chuanxiong, Danggui, Baishao, Dihuang, Huanglian, Tianhuafen, Zhimu, Huangbai, Dahuang (mixed with honey water and stir-fried, each 2 qian).
Administration: Boil 2 zhong of water to 0.8 zhong; take on an empty stomach.