李氏曰∶人病疽多有,愈后发渴而不救者,十有八九;或先渴而后患疽者,尤为难治。急用
加减八味丸可免前患。若疽安而渴者,服此丸则渴止。疽安而未渴者,预服此丸,则永不生
渴。或未发疽而先发渴者,服此不惟渴止,且疽亦不作,气血加壮,真神剂也。又曰∶痈疽
已安之后,或未安之际,口舌燥黄,如鸡内金者,乃肾水枯竭,心火上炎。此证最恶。古人
云∶玉华池竭七朝亡。若误投以丹药,则祸在反掌,急用加减八味丸、桑枝煎、五味子汤,
以滋补之。又云∶一贵人病疽未安而渴作,一日饮水数升。予以加减八味丸治之,诸医大笑
云,此能止渴,我辈当不复业医。皆用木瓜、紫苏、乌梅、人参、茯苓、百药煎等剂,服多
而渴愈甚。不得已用此药,三日渴止,久服遂不复渴,饮食加倍,健于少壮。盖此药非出鄙
见,自为儿时,闻先君言有人病渴,用渴药累年不愈,一名医使服此药,降心火,生肾水为
最。家藏此方,亲用尝验,患者当知所鉴。(详《外科精要》)
马益卿曰∶痈疽作渴,乃气血两虚,宜用参 以补气,当归、地黄以养血,或用黄 六
一汤,或用忍冬丸。其方以忍冬藤入瓶内,加无灰酒,微火煨一宿,取出晒干。少加甘草,
俱为末,仍用余酒调糊,为丸桐子大。每服百余丸,温酒下,兼治五痔诸瘿气。
立斋曰∶尺脉大或无力而渴者,宜滋阴降火。上部脉沉实而渴者,宜泻火。上部脉洪数
而渴者,宜降火。胃脉数而渴者,宜清胃火。气虚不能生津液而渴者,宜补中气。脉大无力
或微弱而渴者,宜补气血。脓血大泄或疮口出血而渴者,宜大补气血。如不应,急用独参汤。
薛氏《枢要》曰∶疮疡作渴,若 肿发热,便利调和者,上焦热也,用竹叶石膏汤。
肿痛发热,大便秘涩者,五内热也,用四顺清凉饮。 肿痛甚者,热毒蕴结也,用仙方活
命饮。漫肿微痛者,气血虚壅也,用补中益气汤。若胃火消烁而津液短少者,用竹叶黄 汤
。若胃气虚弱不生津液者,用补中益气汤。若胃气受伤内无津液者,用七味白术散。若肾水
干涸作渴,或口舌干燥者,用加减八味丸。或先口干作渴,小便频数,而后患疽,或疽愈后
作渴饮水,或舌黄干硬小便数而疽生者,尤其恶也,苟能逆知其因,预服加减八味丸、补中
益气汤,以滋化源,可免是患。《心法》曰∶予治疮疡作渴,不问肿溃,但脉数发热而渴,
以竹叶黄 汤治之。脉不数,不发热,或脉数无力而渴,或口干,以补中益气汤。若脉数而
便秘,以清凉饮。若尺脉洪大,按之无力而渴,以加减八味丸,若治口燥舌黄,饮水不歇,
此丸尤妙。
李氏说:患痈疽的人很多,在病情缓解后出现口渴而不加以救治的,十有八九;或者先出现口渴随后才患痈疽的,尤其难以治疗。紧急时使用加减八味丸可以避免上述祸患。如果痈疽已经安定但仍有口渴,服用此丸则口渴停止。痈疽安定且没有口渴的人,预先服用此丸,则永远不会再生渴病。或者尚未发作痈疽却先出现口渴的人,服用此药不仅口渴停止,而且痈疽也不会发作,气血更加强壮,真是神效的药剂。又说:痈疽已经安定之后,或尚未安定的时候,口舌干燥发黄,像鸡内金一样,这是肾水枯竭、心火上炎。这种证候最为凶险。古人说:“玉华池枯竭七朝亡。”如果误用丹药,灾祸就在反掌之间,紧急时使用加减八味丸、桑枝煎、五味子汤,来滋补身体。又说:一位贵人患痈疽未安定而口渴发作,一天饮水数升。我用加减八味丸治疗他,众医生大笑说,这药能止渴,我们这一行医当不再从事了。大家都用木瓜、紫苏、乌梅、人参、茯苓、百药煎等方剂,服了很多但口渴反而更严重。不得已用了我的药,三天后口渴停止,长期服用便不再口渴,饮食加倍,比年轻人还健壮。大概这个药并非我个人的见解,从我小时候起,就听先父说有人患渴病,用治渴药多年不愈,一位名医让他服用此药,认为降心火、生肾水是最关键的。我家藏有此方,亲自使用并验证有效,患者应当知晓借鉴。(详见《外科精要》)
马益卿说:痈疽引起口渴,是气血两虚,应该用人参以补气,当归、地黄以养血,或者使用黄芪六一汤,或者使用忍冬丸。其方是将忍冬藤放入瓶内,加入无灰酒,用微火煨一夜,取出晒干。稍加甘草,都研为末,仍用剩下的酒调成糊状,制成梧桐子大小的丸药。每次服用一百多丸,温酒送下,兼治五痔和各种瘿气。
立斋说:尺脉大或无力而口渴的,应当滋阴降火。上部脉沉实而口渴的,应当泻火。上部脉洪数而口渴的,应当降火。胃脉数而口渴的,应当清胃火。气虚不能生津液而口渴的,应当补中气。脉大无力或微弱而口渴的,应当补气血。脓血大量流失或疮口出血而口渴的,应当大补气血。如果无效,紧急时使用独参汤。
薛氏《枢要》说:疮疡引起口渴,如果红肿发热,二便调和的,是上焦热,使用竹叶石膏汤。肿痛发热,大便秘结涩滞的,是五脏内热,使用四顺清凉饮。肿痛严重的,是热毒蕴结,使用仙方活命饮。漫肿微痛的,是气血虚壅,使用补中益气汤。如果是胃火消烁导致津液短少的,使用竹叶黄芪汤。如果是胃气虚弱不能生津液的,使用补中益气汤。如果是胃气受伤内部没有津液的,使用七味白术散。如果是肾水干涸引起口渴,或口舌干燥的,使用加减八味丸。或者先口干口渴,小便频数,然后患痈疽,或痈疽痊愈后口渴饮水,或舌黄干硬小便数且生出痈疽的,尤其凶险,如果能预先知道原因,提前服用加减八味丸、补中益气汤,以滋养化源,可以避免这种祸患。《心法》说:我治疗疮疡引起口渴,不问是否肿胀溃破,只要脉数发热而口渴,就用竹叶黄芪汤治疗。脉不数,不发热,或脉数无力而口渴,或口干,就用补中益气汤。如果脉数而便秘,用清凉饮。如果尺脉洪大,按之无力而口渴,用加减八味丸,如果治疗口燥舌黄,饮水不停,此丸尤为奇妙。
Li stated: Among those suffering from carbuncles and sores (Chongju, 痈疽), many develop thirst after the condition has subsided; if left untreated, eight or nine out of ten will suffer severe consequences. Alternatively, those who experience thirst before developing carbuncles are particularly difficult to treat. Urgently using Jiawei Bawei Wan (Modified Eight-Ingredient Pill with Rehmannia) can prevent such misfortunes. If the carbuncle has stabilized but thirst persists, taking this pill will stop the thirst. For those whose carbuncles have stabilized and who do not feel thirsty, preemptive use of this pill ensures they will never develop thirst again. For those who develop thirst before the onset of a carbuncle, taking this medicine not only stops the thirst but also prevents the carbuncle from forming, thereby strengthening Qi and Blood; it is truly a miraculous remedy. He further stated: After a carbuncle has stabilized, or while it is still unstable, if the mouth and tongue become dry and yellow like chicken gizzard lining, this indicates exhaustion of Kidney Water and flaming up of Heart Fire. This syndrome is extremely ominous. The ancients said, "If the Jade Pool dries up, death follows in seven days." If one mistakenly administers elixirs (Dan Yao, 丹药), disaster will strike instantly. Urgently, one should use Jiawei Bawei Wan, Sang Zhi Jian (Mulberry Twig Decoction), and Wuweizi Tang (Schisandra Decoction) to nourish and tonify. He also recounted: A nobleman suffered from an unstable carbuncle accompanied by intense thirst, drinking several liters of water daily. I treated him with Jiawei Bawei Wan. The other physicians laughed, saying, "This medicine stops thirst? We might as well quit practicing medicine." They all prescribed formulas containing Papaya (Mugua, 木瓜), Perilla (Zisu, 紫苏), Smoked Plum (Wumei, 乌梅), Ginseng (Renshen, 人参), Poria (Fuling, 茯苓), and Tea Cakes (Baiyaojian, 百药煎). Despite heavy usage, the thirst worsened. Reluctantly, they used my prescription. After three days, the thirst ceased; long-term use prevented recurrence, doubled food intake, and restored vitality surpassing that of the young. This formula was not my own invention; since childhood, I heard my father say that a patient suffered from chronic thirst for years without relief from standard antithirst medicines. A renowned physician advised using this formula, emphasizing that descending Heart Fire and generating Kidney Water were paramount. My family preserved this prescription, and its efficacy was verified through personal use. Patients should take note. (See *Waike Jingyao* [Essentials of Surgery])
Ma Yiqing stated: Thirst caused by carbuncles and sores results from deficiency of both Qi and Blood. One should use Ginseng (Renshen, 人参) to tonify Qi, and Angelica Sinensis (Danggui, 当归) and Rehmannia (Dihuang, 地黄) to nourish Blood. Alternatively, one may use Huangqi Liuyi Tang (Astragalus Six-to-One Decoction) or Rendong Wan (Lonicera Pill). The method involves placing Lonicera Japonica Vine (Rendong Teng, 忍冬藤) in a jar, adding unadulterated wine, and simmering gently over low heat overnight. Remove, dry, add a small amount of Licorice (Gancao, 甘草), grind all into powder, and mix with the remaining wine to form a paste. Shape into pills the size of paulownia seeds. Take over one hundred pills at a time, washed down with warm wine. This also treats hemorrhoids and various goiters.
Lizhai stated: If the Chi pulse (Radial pulse at the distal position) is large or weak accompanied by thirst, one should nourish Yin and descend Fire. If the upper pulses are deep and solid with thirst, one should purge Fire. If the upper pulses are surging and rapid with thirst, one should descend Fire. If the Stomach pulse is rapid with thirst, one should clear Stomach Fire. If Qi deficiency fails to generate body fluids leading to thirst, one should tonify Middle Qi. If the pulse is large, weak, or faint with thirst, one should tonify Qi and Blood. If there is massive loss of pus and blood or bleeding from the wound causing thirst, one must strongly tonify Qi and Blood. If there is no improvement, urgently use Dushen Tang (Single Ginseng Decoction).
Xue Shi's *Shuya* stated: For thirst caused by sores and ulcers: If there is swelling, redness, fever, and normal bowel/bladder function, it is Heat in the Upper Jiao; use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). If there is swelling, pain, fever, and constipation, it is Heat within the Five Zang organs; use Sishun Qingliang Yin (Four-Obedience Cooling Drink). If swelling and pain are severe, it is accumulation of Toxic Heat; use Xianfang Huoming Yin (Immortal Life Preserving Decoction). If there is diffuse swelling with mild pain, it is deficiency and stagnation of Qi and Blood; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If Stomach Fire consumes fluids leading to scarcity of body fluids, use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction). If Weak Stomach Qi fails to generate fluids, use Buzhong Yiqi Tang. If Stomach Qi is injured and internal fluids are depleted, use Qiwei Baizhu San (Six-Ingredient Powder with Atractylodes). If Kidney Water is exhausted causing thirst or dry mouth/tongue, use Jiawei Bawei Wan. If one first experiences dry mouth and thirst with frequent urination, followed by carbuncles, or develops thirst and drinks water after recovery, or presents with a yellow, dry, hard tongue with frequent urination and carbuncles, the prognosis is especially ominous. If the cause is anticipated early, preemptive use of Jiawei Bawei Wan and Buzhong Yiqi Tang to nourish the source of transformation can prevent this affliction. *Xinfa* stated: In treating thirst caused by sores and ulcers, regardless of whether swelling or ulceration is present, if the pulse is rapid, there is fever, and thirst exists, treat with Zhuye Huangqi Tang. If the pulse is not rapid, there is no fever, or the pulse is rapid but weak with thirst, or there is dry mouth, treat with Buzhong Yiqi Tang. If the pulse is rapid with constipation, use Qingliang Yin. If the Chi pulse is surging and large but weak upon pressure with thirst, use Jiawei Bawei Wan. For treating dry mouth, yellow tongue, and incessant drinking, this pill is particularly excellent.