(附颐毒)
一人年逾三十。夏月热病后患颐毒。积日不溃。气息奄奄。饮食少思。大便不禁诊脉如
经曰。脉息如无似有细而微者。阳气衰也。齐氏曰。饮食不入。大便滑利。肠胃虚也。以六
君子加炮姜、肉豆蔻、破故纸数剂。泄稍止。食稍进。更加黄柏、当归、肉桂。溃而脓水清
稀。前药每服加熟附一钱。数剂泄止。食进。脓渐稠。再以十全大补汤加酒炒芍药、白蔹。
月余而愈。(此凭脉症也。)
一人年逾四十。胃气素弱。面常生疮。盗汗发热。用黄 建中汤少愈。更用补中益气汤
而平。(此凭症也。)
东垣云。气虚则腠理不密。邪气从之。逆于肉理。故多生疮。若以甘温之剂实其根本。
则腠理自固。即无他疾。
一人年三十。面患疮。溃已作渴。自服托里及降火药不应。脉浮而弱。丹溪曰。溃疡作
属气血俱虚。遂以参、 各三钱。归、 、术各二钱。数服渴止。又以八珍汤加黄 数剂。
脉敛而愈。(此凭脉症也。)
一人年四十。头面生疮数枚。 痛饮冷。积日不溃。服清热消毒不应。脉数。按之即实
。用防风通圣散(六)二剂顿退。又以荆防败毒散(七)而愈。(此凭脉症也。)
一人年逾六十。素食浓味。颊腮患毒未溃而肉先死。脉数无力。此胃经积毒所致。然颊
属胃经。未溃肉死。则胃气虚极。老人岂宜患此。果殁。经曰。膏粱之变。足生大疔。受如
持虚。此之谓也。
(附:颐毒)
有一位年过三十岁的人。在夏季患热病之后,得了颐毒(生于下颌部的痈肿)。经过多日仍未溃破。气息微弱,饮食减少且缺乏食欲,大便失禁。诊察脉象如同《内经》所说:“脉息若无似有,细而微者”,这是阳气衰弱的表现。齐氏说:“饮食不入,大便滑利”,这是肠胃虚弱的表现。于是用六君子汤加入炮姜、肉豆蔻、补骨脂,服用数剂后,泄泻稍微停止,饮食稍进。再加黄柏、当归、肉桂。疮疡溃破后脓水清稀。前面的药方每服加熟附子一钱。服用数剂后泄泻停止,饮食增加,脓液逐渐变稠。再用十全大补汤加入酒炒芍药、白蔹。月余后痊愈。(这是依据脉象和症状判断的。)
有一位年过四十岁的人。胃气素来虚弱,面部经常生疮,盗汗发热。使用黄芪建中汤后病情稍有好转。又改用补中益气汤而平复。(这是依据症状判断的。)
李东垣说:“气虚则腠理不密,邪气从之,逆于肉理,故多生疮。”如果用甘温的药物充实其根本,那么腠理自然坚固,即使没有其他疾病。
有一位年三十岁的人。面部患疮,溃破后出现口渴。自行服用托里透脓及降火药物无效。脉象浮而弱。朱丹溪说:“溃疡作渴属于气血俱虚。”于是用人参、黄芪各三钱,当归、地黄、白术各二钱。服用数剂后口渴停止。又以八珍汤加入黄芪,服用数剂。脉象收敛而痊愈。(这是依据脉象和症状判断的。)
有一位年四十岁的人。头面部长了数个疮疡,疼痛且喜饮冷水,多日未溃。服用清热消毒药物无效。脉象数,重按即实。使用防风通圣散两剂后迅速消退。又用荆防败毒散而痊愈。(这是依据脉象和症状判断的。)
有一位年过六十岁的人。平时喜好浓味食物,颊腮患毒未溃而肌肉先坏死。脉象数而无力。这是胃经积毒所致。然而颊部属于胃经,未溃而肉死,说明胃气极度虚弱。老年人岂能患此病?果然死亡。《内经》说:“膏粱之变,足生大疔。受如持虚。”说的就是这种情况。
(Attached: Yi Du [Abscess of the Jaw])
A man over thirty years old developed Yi Du (abscess of the jaw) after suffering from a febrile disease in summer. After many days, it had not yet suppurated. His breath was faint, his appetite was poor with little desire for food, and he suffered from fecal incontinence. The pulse was examined as described in the *Neijing* (Classic of Internal Medicine): "When the pulse seems absent yet present, fine and minute, it indicates the decline of Yang Qi." Qi Shi stated: "Inability to eat and loose stools indicate deficiency of the intestines and stomach." Therefore, Liu Junzi Tang (Six Gentlemen Decoction) was administered with added Pao Jiang (Processed Ginger), Roudoukou (Nutmeg), and Pogostemonis Herba (Guizhi, though text says Po Gu Zhi which is Psoraleae Fructus/Bu Gu Zhi). After several doses, the diarrhea slightly stopped, and food intake slightly increased. Huangbai (Phellodendri Cortex), Danggui (Angelicae Sinensis Radix), and Rougui (Cinnamon Bark) were added. The abscess eventually suppurated, discharging clear and thin pus. In previous prescriptions, Shu Fuzi (Prepared Aconiti Lateralis Radix) one qian was added per dose. After several doses, diarrhea ceased, food intake improved, and the pus gradually became thicker. Finally, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) was used with Jiu Chao Shaoyao (Wine-fried Peony Root) and Bailian (Ixiae Bulbus). He recovered after more than a month. (This diagnosis relied on pulse and symptoms.)
A man over forty years old had inherently weak Stomach Qi, frequently developing sores on his face, accompanied by night sweats and fever. Huangqi Jianzhong Tang (Astragalus Middle-Builder Decoction) provided slight relief. Subsequently, Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) was used to bring the condition under control. (This diagnosis relied on symptoms.)
Li Dongyuan said: "Qi deficiency leads to lax interstices (Cou Li), allowing pathogenic factors to enter and stagnate within the muscle tissue, thus causing frequent sores. If sweet-warm agents are used to strengthen the root, the interstices will naturally become solid, preventing other diseases."
A thirty-year-old man developed facial sores. After they ulcerated, he felt thirsty. Self-medication with Tuoli (Interior-supporting) and Jianghuo (Fire-descending) herbs was ineffective. The pulse was floating and weak. Zhu Danxi stated: "Thirst following ulceration belongs to deficiency of both Qi and Blood." Therefore, Renshen (Ginseng Radix) and Huangqi (Astragali Radix) three qian each, Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) two qian each were prescribed. After several doses, thirst ceased. Bajun Tang (Eight Treasures Decoction) with added Huangqi was administered for several doses. The pulse normalized, and he recovered. (This diagnosis relied on pulse and symptoms.)
A forty-year-old man had several sores on his head and face. They were painful, and he craved cold drinks. After many days without suppuration, Qingre Xiaodu (Clear Heat and Detoxify) herbs were ineffective. The pulse was rapid; upon deep pressure, it felt firm. Fangfeng Tongsheng San (Saposhnikovia Universal Relief Powder) was given for two doses, leading to rapid resolution. Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder) was then used to achieve full recovery. (This diagnosis relied on pulse and symptoms.)
A man over sixty years old, accustomed to rich and greasy foods, developed an abscess in his cheeks and jaws. Before it could suppurate, the flesh died first. The pulse was rapid and forceless. This was caused by accumulated toxin in the Stomach Meridian. Since the cheek area belongs to the Stomach Meridian, flesh death before suppuration indicates extreme deficiency of Stomach Qi. How could an elderly person suffer from this? He indeed died. The *Neijing* states: "Changes due to rich food and drink can produce large carbuncles. The body receives them as easily as holding emptiness." This refers to such cases.