疮疡出血,因五脏之气亏损,虚火而错经妄行也。当求其经,审其因而治之。若肝
热而血妄行者,四物炒山栀丹皮苓术。肝虚而不能藏血者,六味地黄丸。心虚而不能主
血者,四物炒连丹皮苓术。脾虚热而不能统血者,四君炒栀丹皮。若脾经郁结,用归脾
汤加五味子。脾肺气虚,用补中益气加五味子。气血俱虚,用十全大补汤。阴火动,用
六味丸加五味子。大凡失血过多,见烦热发渴等证,勿论其脉,急用独参汤以补气。经
云∶血生于气。苟非参 归术甘温等剂,以生心肝之血,决不能愈。若发热脉大者不治,
凡患血症,皆当以犀角地黄汤为主。(芹洲氏云∶失血症有瘀者,寒凉慎用。)
治背疮肉长疾,皮不及裹,见风即成僵。以寒水石烧研,为细末敷疮上,再用铜绿细
末上之,肉即不作僵矣。(梅)
古方疗恶疮痈肿,或连阴髀间疼痛急挛,牵入小腹不可忍,一宿则杀人。用茴香苗叶,
捣取汁一升服之,日三四,用其滓以贴肿上,冬月根亦可用。此外国方,永嘉以来用之,起
死神效。(《图经》)
身热而欲衣者,热在皮毛,寒在骨髓,温之。身不热而欲去衣者,寒在皮毛,热在骨髓,清之。
肿时不食,为痛伤胃气,溃后痛止,自
能食也。垣云∶疮疡食肉,反补胃气,乃自弃也。此禁之膏粱丹石之变,非藜藿及虚弱
者之通论也。若脾胃弱者,即有所禁忌,亦当少与之,不与则逆其胃气,反不思食。禁
忌之要,在生冷伤脾,硬物难化,肥腻滑肠,惟宜斟酌与之可也。又服药后,忌饮冷水,犯
之效迟,脓必再作。
疮疡出血,是由于五脏之气亏损,虚火扰动导致血液不循常道而妄行。治疗时应当追溯其所属经络,审察病因后进行治疗。如果是肝热导致血液妄行的,用四物汤加入炒山栀、丹皮、茯苓、白术。如果是肝虚不能藏血的,用六味地黄丸。心虚不能主司血液的,用四物汤加入炒黄连、丹皮、茯苓、白术。脾虚有热不能统摄血液的,用四君子汤加入炒山栀、丹皮。如果是脾经气机郁结,用归脾汤加五味子。脾肺气虚,用补中益气汤加五味子。气血俱虚,用十全大补汤。阴火妄动,用六味丸加五味子。大凡失血过多,出现烦热、口渴等症状时,不论脉象如何,急用独参汤来补气。《内经》说:血由气所生。如果不是用人参、当归、白术、甘草等甘温的药物,来化生心和肝的血,一定不能痊愈。如果发热且脉大的,属于不治之症。凡是患有血症的,都应当以犀角地黄汤为主方。(芹洲氏说:失血症中有瘀血的,慎用寒凉药物。)
治疗背部疮疡肌肉生长缓慢,皮肤不足以包裹创面,见风就会变成僵硬的。将寒水石烧红研成细末敷在疮上,再用铜绿细末覆盖在上面,肌肉就不会变僵硬了。(梅)
古方治疗恶疮痈肿,或者牵连阴部和大腿间疼痛紧急拘挛,牵引至小腹不可忍受,一晚上就能致死。用茴香的苗叶,捣取汁液一升服用,每天三四次,用剩下的药渣贴在肿胀处,冬天也可以用根部。这是外国的方子,自永嘉以来使用,起死回生效果显著。(《图经本草》)
身体发热却想穿衣的,是热在皮毛,寒在骨髓,用温法治疗。身体不发热却想脱衣的,是寒在皮毛,热在骨髓,用清法治疗。
肿胀时不想吃东西,是因为疼痛损伤了胃气;溃破后疼痛停止,自然就能进食了。罗天益说:疮疡患者吃肉,反而补充胃气,这是自我放弃(指违背禁忌)。这是针对食用膏粱厚味及丹药金石之人产生的病变而言的,并不是对吃粗茶淡饭及体质虚弱者的普遍理论。如果脾胃虚弱的人,即使有所禁忌,也应当少量给予,如果不给则违背了胃气,反而更不想吃东西。饮食禁忌的关键,在于避免生冷伤脾、硬物难消化、肥腻滑肠,只应当斟酌情况给予即可。另外服药后,忌饮冷水,违反此条疗效迟缓,脓液必然再次产生。
Hemorrhage from sores and ulcers is caused by the deficiency of Qi in the five Zang organs, where deficient fire disturbs the vessels, causing blood to flow recklessly. Treatment should seek the affected meridian, examine the etiology, and then treat accordingly. If liver heat causes reckless bleeding, use Siwu Tang (Four Substances Decoction) with stir-fried Gardenia Fruit (Shanzhi), Moutan Cortex (Danpi), Poria (Lingzhu), and Atractylodis Rhizoma (Baizhu). If liver deficiency fails to store blood, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If heart deficiency fails to govern blood, use Siwu Tang (Four Substances Decoction) with stir-fried Coptis Rhizome (Lian), Moutan Cortex (Danpi), Poria (Lingzhu), and Atractylodis Rhizoma (Baizhu). If spleen deficiency with heat fails to control blood, use Sijunzi Tang (Four Gentlemen Decoction) with stir-fried Gardenia Fruit (Shanzhi) and Moutan Cortex (Danpi). If there is stagnation in the spleen meridian, use Guipi Tang (Restore the Spleen Decoction) added with Schisandra Berry (Wuweizi). If spleen and lung Qi are deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Schisandra Berry (Wuweizi). If both Qi and blood are deficient, use Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction). If yin fire moves recklessly, use Liuwei Wan (Six-Ingredient Pill) added with Schisandra Berry (Wuweizi). Generally, when excessive blood loss presents with symptoms such as irritability, heat, and thirst, regardless of the pulse, immediately use Danshen Tang (Single Ginseng Decoction) to tonify Qi. The Classics state: "Blood is generated by Qi." Unless one uses sweet-warm agents such as Ginseng Radix (Renshen), Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu), and Glycyrrhizae Radix et Rhizoma (Gancao) to generate the blood of the heart and liver, recovery is impossible. If fever is accompanied by a large pulse, it is incurable. For all hemorrhagic diseases, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) should be used as the primary formula. (Qinzhou Shi stated: In hemorrhagic diseases with blood stasis, cold-cooling herbs should be used with caution.)
To treat back sores where flesh grows slowly and skin is insufficient to cover the wound, becoming stiff upon exposure to wind, calcined and finely powdered Metasideritum (Han Shui Shi) should be applied to the sore, followed by a layer of finely powdered Verdigris (Tong Lü); this prevents the flesh from becoming stiff. (Mei)
Ancient formulas for treating malignant sores and carbuncles, or pain and urgent spasms extending from the perineum to the thighs, pulling into the lower abdomen unbearably, which can cause death within one night, involve using Fennel Herba (Huixiang miao ye). Crush and extract one sheng of juice to drink, three to four times daily. Apply the dregs to the swelling. The root may also be used in winter. This is a foreign formula, used since the Yongjia era, producing miraculous effects in reviving the dying. (Tu Jing Ben Cao)
When the body feels hot but the patient desires to wear clothes, the heat is in the skin and hair, while the cold is in the bone marrow; treat with warming methods. When the body does not feel hot but the patient desires to remove clothes, the cold is in the skin and hair, while the heat is in the bone marrow; treat with cooling methods.
During the swelling stage, lack of appetite is due to pain damaging stomach Qi. After ulceration, when pain ceases, appetite returns naturally. Luo Tianyi stated: Consuming meat during sores and ulcers actually tonifies stomach Qi; refusing it is self-sabotage. This prohibition applies to changes caused by rich foods and mineral drugs, not as a general rule for those eating coarse grains or who are physically weak. For those with weak spleen and stomach, even if there are taboos, small amounts should be given. Withholding food violates stomach Qi and further suppresses appetite. The key to dietary taboos is avoiding raw and cold items that damage the spleen, hard-to-digest solids, and greasy foods that cause loose stools; one should exercise discretion. Additionally, after taking medicine, drinking cold water is taboo; violating this delays efficacy and causes pus to reappear.