治缓疽方。
初作宜服五香连翘汤, 去血,以小豆薄涂之,其间数以 针去血,又薄之,取消良也。
不消,色未变青KT 者,以练石薄薄之。若失时不得消已烂者,犹服五香连翘汤及漏芦汤
下之,随热多少投方也。外以升麻汤 洗之,敷升麻膏。若生臭恶肉者,可以单行一物白
茹散敷之。青黑肉去尽便敷也。好肉熟生,但敷生麻膏良。肉不生,敷单行一物黄 散也。
若敷白 茹散积日,青黑恶肉不尽者,可以漆头赤皮 茹散取半钱匕,和杂三大钱匕白 茹
散中合冶之,稍以敷之,恶肉去尽,还淳用白 茹散也。视好肉欲生,可敷黄 散也。
白 茹散
漆头 茹散
黄 散
上三方,并一物单行,随多少舂下筛用耳。
治缓疽,初作即以小豆薄涂之,亦消也。
附骨疽,一名 疽,以其无头附骨成脓故也。又名痈疽,以其广大竟体有脓故也。附骨
急疽,与贼风实相似也。其附骨疽者,由人体盛有热,久当风冷入骨解中,风与热相搏,其
始候,为欲眠、沉重、惚惚耳。急者热多风少,缓者风多热少也。
贼风者,其人体平无热,中暴风冷,则骨解深痛。附骨疽久者则肿见结脓,贼风久则枯
或结瘰 ,以此为异也。是附骨疽而作贼风治,则益其病,深脓多也。是贼风而作附骨疽
治,则加其冷,风增遂成瘰 、偏枯、挛曲之疾也。
附骨急疽者,其痛处壮热,体中乍寒乍热,索索恶寒不用热,小便或赤,大便或难,无
汗也。即得治下去热,便得消也。纵不消尽,亦得浮浅近外易得坏溃,其不复附骨也。贼风
之证,但痛应骨不可按抑,痛处不壮热,体不仁,乍寒乍热,但觉体KT 以冷,欲得热,
热熨痛处即小宽,时有汗也。即得针灸熨,服治风温药,便效也。
初得附骨疽,即服漏芦汤下之,敷小豆薄得消也。下利,利已虚而肿处未消者,可除大
黄用生地黄及干地黄也。热渐退余风未歇者,可服五香连翘汤除大黄也。余热未消,可敷升
麻膏佳。若失时不消成脓者,用火针膏散如治痈法也。
治疗缓疽的方剂。
初起时适宜服用五香连翘汤,排出瘀血,用赤小豆捣碎后薄涂患处,期间多次用针刺破排血,再次薄涂,这样就能取得良好疗效。
如果肿块未消退,颜色也未变为青黑色KT(此处疑为衍文或特定描述,暂译为“青黑之色”),可用练石粉薄薄地敷在患处。如果延误时机未能消退且已经溃烂,仍应服用五香连翘汤及漏芦汤来攻下热毒,根据热毒的轻重投药。外用升麻汤清洗患处,并敷上升麻膏。如果长出恶臭的腐肉,可以单味使用白茹散外敷。待青黑色的腐肉去尽后再行敷药。若好肉即将生出,仅敷生麻膏即可。若肌肉不生,则敷单味黄散。
如果长期敷用白茹散,而青黑色的恶肉仍未去尽,可以使用漆头赤皮茹散半钱匕,与三大钱匕的白茹散混合研磨均匀,逐渐敷用。待恶肉去尽后,再改用纯净的白茹散。观察好肉欲生时,可敷黄散。
白茹散
漆头茹散
黄散
以上三方,均为单味药单独使用,根据需要捣碎过筛后使用即可。
治疗缓疽,初起即用赤小豆捣碎薄涂,也能消退。
附骨疽,又称“贴骨疽”,因为它没有脓头,紧贴骨骼化脓,所以叫这个名字。又因为疮面广大,全身都有脓液,所以也叫“痈疽”。附骨急疽,症状与贼风非常相似。这种附骨疽,是由于人体内部素有积热,长时间受风寒侵袭,寒气深入骨节缝隙中,风邪与热邪相互搏结所致。其初始症状表现为嗜睡、身体沉重、精神恍惚、耳鸣。发病急骤者,热多风少;发病缓慢者,风多热少。
贼风患者,平时身体平和无热,一旦遭受暴风冷袭击,则骨节深处剧烈疼痛。附骨疽日久则会肿胀并形成脓液,贼风日久则会导致肢体枯瘦或形成瘰疬(颈部淋巴结结核),以此作为鉴别点。如果是附骨疽却按贼风治疗,会使病情加重,导致深部脓液增多。如果是贼风却按附骨疽治疗,会加重寒邪,风邪加剧最终导致瘰疬、半身不遂、筋脉拘挛弯曲等疾病。
附骨急疽的患者,疼痛部位灼热,身体忽冷忽热,瑟瑟发抖怕冷而不喜温暖,小便有时发红,大便有时困难,无汗。此时应立即治疗以去除热毒,病证即可消退。即使不能完全消退,也会变得浮浅接近体表,容易破溃,不再紧贴骨骼。贼风的证候,只是疼痛对应骨骼部位,不可按压,疼痛处不灼热,身体麻木不仁,忽冷忽热,只感觉身体寒冷,想要温暖,用热敷疼痛处可稍感缓解,偶尔有汗出。此时立即进行针灸、熨法,服用治风温的药物,就会见效。
刚患上附骨疽时,立即服用漏芦汤攻下,并敷赤小豆薄涂,即可消退。如果服药后腹泻,泻后正气虚弱但肿胀处未消,可以去掉大黄,改用生地黄和干地黄。如果热势渐退但余风未息,可服用五香连翘汤去掉大黄。如果余热未消,敷升麻膏效果最佳。如果延误时机未能消退已成脓,则用火针、膏药、散剂,按照治疗痈的方法处理。
Decoction for Treating Huan Ju (Slow-Developing Abscess).
In the initial stage, it is appropriate to take Wuxiang Liaoqiao Tang (Five-Spice and Forsythia Decoction) to expel blood stasis. Apply a thin layer of crushed Adzuki Bean (Vigna angularis) to the affected area. During this period, puncture the area with a needle multiple times to drain blood, then reapply the crushed beans. This method yields excellent results.
If the swelling does not subside and the color has not turned cyanotic or blackish, apply a thin layer of polished stone powder (Lian Shi) to the lesion. If the condition is neglected and fails to resolve, leading to ulceration, continue administering Wuxiang Liaoqiao Tang and Loulu Tang (Euphorbiae Humifusae Decoction) to purge heat toxins, adjusting the dosage according to the severity of the heat. Wash the external wound with Shengma Tang (Cimicifugae Decoction) and apply Shengma Ointment. If foul-smelling necrotic tissue grows, apply Baoru San (White Rhizome Powder) alone externally. Once the cyanotic and black necrotic tissue is completely removed, resume application. When healthy granulation tissue begins to regenerate, applying raw Hemp Seed Oil Ointment (Sheng Ma Gao) is beneficial. If flesh fails to regenerate, apply Huang San (Yellow Powder) alone.
If prolonged application of Baoru San fails to remove all cyanotic and black necrotic tissue, mix half a measure of Qitou Chipi Ru San (Lac-Head Red-Bark Rhizome Powder) with three large measures of Baoru San, grind them together thoroughly, and apply gradually. Once all necrotic tissue is removed, revert to using pure Baoru San. Observe when healthy tissue is about to grow; at this point, apply Huang San.
Baoru San (White Rhizome Powder)
Qitou Chipi Ru San (Lac-Head Red-Bark Rhizome Powder)
Huang San (Yellow Powder)
The above three formulas consist of single herbs used independently. Crush and sieve them as needed for use.
To treat Huan Ju, apply crushed Adzuki Beans thinly in the early stages; this can also resolve the condition.
Fugu Ju (Abscess Attached to Bone), also known as Tie Gu Ju (Bone-Clinging Abscess), derives its name from the absence of a head and the formation of pus adhering closely to the bone. It is also called Yong Ju (Carbuncle-Abscess) because the lesion is extensive and involves widespread suppuration throughout the body. Fugu Ji Ju (Acute Abscess Attached to Bone) presents symptoms similar to Zei Feng (Thief Wind). This condition arises when internal heat accumulates in the body, and prolonged exposure to wind-cold allows cold pathogens to penetrate deep into the interstices of the bones. The wind and heat pathogens then contend with each other. Initial signs include somnolence, heaviness of the body, mental confusion, and tinnitus. In acute cases, heat predominates over wind; in chronic cases, wind predominates over heat.
Patients with Zei Feng typically have a normal body temperature without internal heat. Upon sudden exposure to violent cold winds, they experience deep pain in the bone joints. Chronic Fugu Ju leads to swelling and pus formation, whereas chronic Zei Feng may result in emaciation or the development of Lu Li (Scrofula/Lymphatic Tuberculosis). This distinction serves as a diagnostic criterion. Treating Fugu Ju as Zei Feng exacerbates the disease, increasing deep-seated pus. Conversely, treating Zei Feng as Fugu Ju aggravates the cold pathogen, potentially leading to complications such as Lu Li, hemiplegia, and tendon contraction/deformity.
In patients with Acute Fugu Ju, the painful area is hot to the touch, accompanied by alternating chills and fever, shivering aversion to cold (disliking warmth), reddish urine, difficult defecation, and anhidrosis. Immediate treatment to clear heat will lead to resolution. Even if complete resolution does not occur, the lesion becomes superficial and easier to rupture, ceasing to adhere deeply to the bone. The syndrome of Zei Feng is characterized by pain localized to the bone that cannot be pressed, absence of local heat, numbness, alternating chills and fever, a sensation of coldness in the body, and a desire for warmth. Pain relief can be achieved through hot compresses on the painful area, sometimes accompanied by sweating. Immediate acupuncture, moxibustion, and hot iron therapy (Wen), along with administration of wind-warming herbal medicines, yield effective results.
Upon the onset of Fugu Ju, immediately administer Loulu Tang to purge, and apply crushed Adzuki Beans thinly to resolve the swelling. If diarrhea occurs after purging, leaving the patient deficient while the swelling persists, replace Da Huang (Rhei Radix et Rhizoma) with Sheng Di Huang (Rehmanniae Radix Recens) and Gan Di Huang (Rehmanniae Radix Preparata). As heat subsides but residual wind remains, administer Wuxiang Liaoqiao Tang without Da Huang. If residual heat persists, applying Shengma Ointment is optimal. If the condition is neglected and suppuration forms, treat it using fire needles, ointments, and powders according to the protocols for treating Yong (Carbuncles).