(附论)
夫痈有脓者。由寒气搏于肌肉。折血气结聚乃成痈也。凡痈不瘥。不复可消者。若按之
都牢强者。未有脓也。按之牢强半软者有脓也。又手掩上不热者为无脓。若热甚者有脓也。
凡觉宜急破之。不尔、侵蚀筋骨也。
方
托里排脓散(出圣惠方)治痈疽一切疮肿。
木香(一分) 黄 (三分锉) 白蔹(一分) 占斯 芎 当归(锉微炒) 细辛 桔
梗
(去芦头) 赤芍药 槟榔 败酱 甘草(炙微赤锉) 桂心 羌活 白芷(各一分) 上
为细
散。每服二钱。食前甘草汤调下。
雄黄散(出圣惠方)治痈疽赤肿疼痛。未得脓溃。贴成脓。
雄黄(三两细研) 麝香(一两细研) 木香(半两) 川大黄(三分) 黄连(一两)
白芷
(二分) 桂心(半两) 当归(三分麸微炒) 黄柏(三分锉) 槟榔(二分) 芎 (半
两) 麒
麟竭(三分) 上为细散。用腊月猪脂调令匀。涂于绢上。贴肿处。候脓溃后。即用膏药搜
脓
生肌。
龙骨散(出圣惠方)治痈疽赤肿。未得脓溃。化脓止痛。
龙骨(一两) 川大黄(半两生用) 白蔹(半两) 黄 (半两锉) 黄芩(半两) 白
芨(半
两) 牡蛎(半两烧为粉) 雌黄(半两细研) 甘草(半两) 芎 (半两) 上为细散。
用猪胆调
令如膏。摊于帛上。涂贴。取穴为度。
大黄散(出圣惠方)治痈肿已作脓。宜贴之。
川大黄 当归(各一两) 细辛(半两) 木通(锉) 芎 黄连 赤芍药 黄 (锉)
白
芨(各一两) 上为细散。每用以鸡子白和。涂于故细布上。以贴肿处。燥复易之。
黄 散(出圣惠方)治痈肿恶疮。排脓。
黄 (一两半锉) 白蔹 赤芍药 芎 赤小豆(各一两) 附子 羊桃根(锉)
茹
牡蒙(各半两) (案∶此方缺制法及服法。)
当归散(出圣惠方)治痈疽疮等。热毒炽盛不散。已成脓溃。痛不可忍。止痛
搜脓。
当归(一两) 羊桃根(一两锉) 桂心(半两) 白蔹(一两) 木香(半两) 丁
香榆白皮
(一两锉) 汉防己(一两) 上为细散。用醋浆水调如膏。贴于肿上。干即易之。
丹粉散(出圣惠方)治痈肿恶疮中脓水。及新疮口未干。宜用此散令干方。
黄丹(二两) 定粉(二两) 白矾(二两) 上药研入瓷瓶内。用盐泥固济。慢火
令干后。
即用大火 通赤。候冷。将出细研。敷疮。
密陀僧散(出圣惠方)治痈肿穴后。及恶疮脓水虽减。肌肉不生。宜此。
密陀僧(一两) 黄连(一两去须) 槟榔(二分) 上为细散。日三贴之。
治痈肿恶疮内。脓不止。(出圣惠方)
用 皮烧灰。细研。内疮孔中。
(附论)
凡是痈疽已经化脓的,是由于寒气侵袭肌肉,导致气血阻滞凝结而形成的痈。凡是痈疽久治不愈、无法通过内服药物消散的,如果用手按压感觉坚硬牢固的,说明还没有化脓;如果按压时一半坚硬一半柔软的,说明已经有脓了。另外,用手覆盖在患处感觉不热的,说明没有脓;如果感觉热势严重的,说明有脓了。凡是感觉到有脓的,应当立即破溃排脓,否则脓液会侵蚀筋骨。
方剂
托里排脓散(出自《圣惠方》),治疗各种痈疽疮肿。
木香(一分)、黄芪(三分,锉碎)、白蔹(一分)、豆蔻、川芎、当归(锉碎后微炒)、细辛、桔梗(去掉芦头)、赤芍药、槟榔、败酱草、甘草(炙至微红并锉碎)、桂心、羌活、白芷(各一分)。以上药材研成细散。每次服用二钱,饭前用甘草汤调服。
雄黄散(出自《圣惠方》),治疗痈疽红肿疼痛。适用于尚未化脓溃破,或已结成脓包的情况。
雄黄(三两,细细研磨)、麝香(一两,细细研磨)、木香(半两)、川大黄(三分)、黄连(一两)、白芷(二分)、桂心(半两)、当归(三分,麸皮微炒)、黄柏(三分,锉碎)、槟榔(二分)、川芎(半两)、麒麟竭(三分)。以上药材研成细散。用腊月里的猪油调和均匀,涂抹在绢布上,贴在肿胀处。等到脓液溃破后,立即使用膏药拔脓生肌。
龙骨散(出自《圣惠方》),治疗痈疽红肿。适用于尚未化脓溃破,旨在化脓止痛。
龙骨(一两)、川大黄(半两,生用)、白蔹(半两)、黄芪(半两,锉碎)、黄芩(半两)、白及(半两)、牡蛎(半两,烧制成粉)、雌黄(半两,细细研磨)、甘草(半两)、川芎(半两)。以上药材研成细散。用猪胆汁调和如膏状,摊在帛布上,涂贴患处。以穴位为限度进行敷贴。
大黄散(出自《圣惠方》),治疗痈肿已经化脓,适宜外贴。
川大黄、当归(各一两)、细辛(半两)、木通(锉碎)、川芎、黄连、赤芍药、黄芪(锉碎)、白及(各一两)。以上药材研成细散。每次使用时用鸡蛋清调和,涂抹在旧的细布上,贴在肿胀处。干燥后再更换。
黄芪散(出自《圣惠方》),治疗痈肿恶疮,具有排脓功效。
黄芪(一两半,锉碎)、白蔹、赤芍药、川芎、赤小豆(各一两)、附子、羊桃根(锉碎)、茹草、牡蒙(各半两)。(案语:此方缺少制作方法和服用方法。)
当归散(出自《圣惠方》),治疗痈疽疮疡等症。适用于热毒炽盛不散,已经化脓溃破,疼痛难忍的情况,具有止痛和拔脓功效。
当归(一两)、羊桃根(一两,锉碎)、桂心(半两)、白蔹(一两)、木香(半两)、丁香、榆白皮(一两,锉碎)、汉防己(一两)。以上药材研成细散。用醋浆水调和如膏状,贴在肿胀处,干燥即更换。
丹粉散(出自《圣惠方》),治疗痈肿恶疮中的脓水,以及新伤口未干的情况,适宜用此散剂使伤口干燥。
黄丹(二两)、定粉(二两)、白矾(二两)。将上述药物放入瓷瓶中研磨,用盐泥密封固定。先用慢火加热至干燥,然后用大火烧至通红。冷却后取出,细细研磨,敷于疮口。
密陀僧散(出自《圣惠方》),治疗痈肿溃烂后,以及恶疮脓水虽减少但肌肉不生长的情况,适宜使用此方。
密陀僧(一两)、黄连(一两,去掉须根)、槟榔(二分)。以上药材研成细散。每天贴敷三次。
(Attached Discussion)
When an abscess (Yong, 痈) has formed pus, it is caused by cold pathogenic factors attacking the muscles, leading to the stagnation and coagulation of Qi and Blood, which results in the formation of the abscess. For any abscess that fails to heal and cannot be resolved through internal medication: if palpation reveals a firm and hard texture, pus has not yet formed; if palpation reveals a texture that is half firm and half soft, pus has formed. Additionally, if covering the area with the hand does not feel hot, there is no pus; if there is severe heat sensation, pus has formed. Whenever pus is suspected, it should be lanced immediately; otherwise, the pus will erode the sinews and bones.
Formulas
Tuoli Paimeng San (Supporting the Interior and Expelling Pus Powder) (from *Shenghui Fang*), treating all types of carbuncles, sores, and swellings.
Muxiang (Aquilariae Lignum Resinatum), Huangqi (Astragali Radix, 3 fen, sliced), Bailian (Bletillae Rhizoma), Doukou (Amomi Fructus Rotundus), Xiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix, sliced and lightly stir-fried), Xixin (Asari Radix et Rhizoma), Jiegeng (Platycodonis Radix, radix removed), Chi Shaoyao (Paeoniae Radix Rubra), Binglang (Arecae Semen), Baijiangcao (Patriniae Herba), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried until slightly red and sliced), Guixin (Cinnamomi Ramulus), Qianghuo (Notopterygii Rhizoma et Radix), Baizhi (Angelicae Dahuricae Radix) (each 1 fen). Grind the above ingredients into a fine powder. Take 2 qian each time, mixed with Licorice Decoction before meals.
Xionghuang San (Realgar Powder) (from *Shenghui Fang*), treating carbuncles and sores with redness, swelling, and pain. Indicated for cases where pus has not yet ulcerated or when a pustule has formed.
Xionghuang (Realgar, 3 liang, finely ground), Shexiang (Moschus, 1 liang, finely ground), Muxiang (Aquilariae Lignum Resinatum, 0.5 liang), Chuan Dahuang (Rhei Radix et Rhizoma, 3 fen), Huanglian (Coptidis Rhizoma, 1 liang), Baizhi (Angelicae Dahuricae Radix, 2 fen), Guixin (Cinnamomi Ramulus, 0.5 liang), Danggui (Angelicae Sinensis Radix, 3 fen, lightly stir-fried with bran), Huangbai (Phellodendri Cortex, 3 fen, sliced), Binglang (Arecae Semen, 2 fen), Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Qilinjie (Dragon's Blood), 3 fen). Grind the above ingredients into a fine powder. Mix evenly with pig fat from the twelfth lunar month, apply onto silk cloth, and paste over the swollen area. After the pus ulcerates, immediately use ointment to drain pus and promote tissue regeneration.
Longgu San (Dragon Bone Powder) (from *Shenghui Fang*), treating carbuncles and sores with redness and swelling. Indicated for cases where pus has not yet ulcerated, aiming to resolve pus and relieve pain.
Longgu (Fossilia Ossis Mastodi et Scapulae, 1 liang), Chuan Dahuang (Rhei Radix et Rhizoma, 0.5 liang, raw), Bailian (Bletillae Rhizoma, 0.5 liang), Huangqi (Astragali Radix, 0.5 liang, sliced), Huangqin (Scutellariae Radix, 0.5 liang), Baiji (Bletillae Rhizoma, 0.5 liang), Muli (Concha Ostreae, 0.5 liang, calcined to powder), Cihuang (Orpiment, 0.5 liang, finely ground), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang), Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang). Grind the above ingredients into a fine powder. Mix with pig bile to form a paste, spread on cloth, and apply to the affected area. Apply according to acupoint indications.
Dahuang San (Rhubarb Powder) (from *Shenghui Fang*), treating abscesses that have already formed pus, suitable for external application.
Chuan Dahuang (Rhei Radix et Rhizoma), Danggui (Angelicae Sinensis Radix) (each 1 liang), Xixin (Asari Radix et Rhizoma, 0.5 liang), Mutong (Akebiae Caulis, sliced), Xiong (Ligustici Chuanxiong Rhizoma), Huanglian (Coptidis Rhizoma), Chi Shaoyao (Paeoniae Radix Rubra), Huangqi (Astragali Radix, sliced), Baiji (Bletillae Rhizoma) (each 1 liang). Grind the above ingredients into a fine powder. Each time, mix with egg white, apply to old fine cloth, and paste over the swollen area. Replace when dry.
Huangqi San (Astragalus Powder) (from *Shenghui Fang*), treating abscesses and malignant sores, promoting pus drainage.
Huangqi (Astragali Radix, 1.5 liang, sliced), Bailian (Bletillae Rhizoma), Chi Shaoyao (Paeoniae Radix Rubra), Xiong (Ligustici Chuanxiong Rhizoma), Chixiaodou (Adzuki Bean) (each 1 liang), Fuzi (Aconiti Lateralis Radix Praeparata), Yangtaogen (Root of Prunus armeniaca, sliced), Rucao (Herba Siegesbeckiae), Mumeng (Radix Bupleuri? Note: Term obscure, likely specific local herb) (each 0.5 liang). (Note: This formula lacks preparation and administration instructions.)
Danggui San (Angelica Powder) (from *Shenghui Fang*), treating carbuncles, sores, etc. Indicated for intense heat toxins that do not dissipate, after pus has formed and ulcerated, causing unbearable pain. It relieves pain and drains pus.
Danggui (Angelicae Sinensis Radix, 1 liang), Yangtaogen (Root of Prunus armeniaca, 1 liang, sliced), Guixin (Cinnamomi Ramulus, 0.5 liang), Bailian (Bletillae Rhizoma, 1 liang), Muxiang (Aquilariae Lignum Resinatum, 0.5 liang), Dingxiang (Caryophylli Flos), Yubaipi (Cortex Ulmi), Hanfangji (Stephaniae Tetrandrae Radix) (each 1 liang). Grind the above ingredients into a fine powder. Mix with vinegar water to form a paste, apply to the swelling, and replace when dry.
Danfen San (Vermilion Powder) (from *Shenghui Fang*), treating pus and discharge in abscesses and malignant sores, and for new wounds that are not yet dry. Suitable for drying the wound.
Huandan (Minii Oxidum Rubrum, 2 liang), Dingfen (Calamina, 2 liang), Baifan (Alumen, 2 liang). Grind the above medicines into a porcelain bottle, seal tightly with salt mud. Heat slowly until dry, then fire strongly until red-hot. Cool down, take out, grind finely, and apply to the sore.
Miduoseng San (Lead Monoxide Powder) (from *Shenghui Fang*), treating post-ulceration of abscesses, and malignant sores where pus discharge has decreased but flesh does not grow. Suitable for this condition.
Miduoseng (Galena, 1 liang), Huanglian (Coptidis Rhizoma, 1 liang, remove roots), Binglang (Arecae Semen, 2 fen). Grind the above ingredients into a fine powder. Apply three times daily.
Treating continuous pus discharge inside abscesses and malignant sores. (from *Shenghui Fang*)
Burn tree bark to ash, grind finely, and insert into the wound cavity.