云间曹于容,为室人中风灌药,误咬去指半节, 痛寒热。外敷大黄等药,内服清热败
毒,患处不痛不溃,脓清寒热愈甚。余曰∶此因凉药遏绝隧道而然也。遂敷玉龙膏以散寒气
,更服六君子汤以壮脾胃。数日后患处微痛,肿处渐消,此阳气运达患处也,果出稠脓,不
数日半指溃脱,更服托里药而敛。
上舍王天爵,伤足 肿,内热作渴,内服外敷,皆寒凉败毒,患处益肿而不溃,且恶寒
少食,欲作呕吐。余曰∶此气血俱虚,又因寒药凝结隧道,损伤胃气,以致前症耳。遂用香
砂六君子、芎、归、炮姜,外症悉退。惟体倦晡热,饮食不甘,以补中益气汤,加地骨皮、
五味、麦门,治之而愈。
州守王廷用伤指,即用帛裹之,瘀血内溃, 肿至手。余谓∶宜解患处,以出瘀血,更
用推陈致新之剂。不信。乃敷凉药,痛虽少止,次日复作,又敷之,数日后手心背俱溃出瘀
秽脓水,尚服败毒之剂,气血益虚,色黯脓清,饮食少思。仍请余治,投以壮脾胃、生气血
之剂,由是脓水渐稠而愈。
一男子孟冬火伤臂作痛,喘嗽发热,此火毒刑肺金之症。用人参平肺散治之,喘嗽乃止
。因劳又恶寒发热,此气血虚也,以八珍汤加桔梗、白芷,治之而退。再加薄桂三分以助药
热、温气血,坏肉溃之而愈。若初起 赤作痛,用神效当归膏敷之,轻者自愈,重者自腐,
生肌神效。或用侧柏叶末,蜡油调敷亦效。若发热作渴,小便赤色,其脉洪数而实者,用四
物、茯苓、木通、生甘草、炒黄连。脉虽洪数而虚者,用八珍。若患处不溃而色黯者,四君
、芎、归、黄 之类。若肉死已溃而不生肌者,用四君、黄 、当归、炮姜。若愈后而恶寒
,阳气未复也,急用十全大补,切不可用寒凉,反伤脾胃。
云间人曹于容,因妻子中风灌药时,误咬去手指半节,出现疼痛、恶寒和发热的症状。外用大黄等药物敷贴,内服清热败毒的药物,结果患处不痛也不溃烂,脓液清稀,恶寒发热反而加重。我说:这是因为凉药遏制了经络通道所致。于是外敷玉龙膏以散寒气,再服用六君子汤以强壮脾胃。几天后患处微微作痛,肿胀逐渐消退,这是阳气运行到达患处的表现,果然流出稠厚的脓液,不出几天半指溃烂脱落,接着服用托里药使伤口愈合。
上舍王天爵,脚部受伤肿胀,伴有内热和口渴,内服和外敷都使用寒凉败毒的药物,导致患处更加肿胀且不溃烂,并且出现怕冷、食欲减退、想要呕吐的症状。我说:这是气血俱虚,又因寒凉药物凝结经络通道,损伤了胃气,从而导致上述症状。于是使用香砂六君子汤,加上川芎、当归、炮姜,外症全部消退。只有身体疲倦、下午发热、饮食无味,用补中益气汤,加地骨皮、五味子、麦门冬治疗而痊愈。
州守王廷用手指受伤,立即用布包裹,瘀血在内部溃散,肿胀蔓延到手部。我认为应该解开患处,让瘀血排出,再用推陈致新的药剂。他不相信。于是敷上凉药,疼痛虽然稍止,第二天又发作,再次敷药,几天后手心手背都溃烂流出瘀秽的脓水,还继续服用败毒的药物,气血更加虚弱,面色暗黑,脓液清稀,饮食减少不想吃。仍然请我治疗,投用强壮脾胃、生气血的药剂,从此脓水逐渐变稠而痊愈。
一个男子在初冬用火烫伤手臂引起疼痛,气喘咳嗽发热,这是火毒伤害肺金的病症。用人参平肺散治疗,气喘咳嗽才停止。因为劳累又出现恶寒发热,这是气血虚的表现,用八珍汤加桔梗、白芷治疗而退去。再加薄桂三分以助药力热力、温补气血,坏死肌肉溃烂脱落而痊愈。如果起初红肿疼痛,用神效当归膏敷贴,轻者自愈,重者自行腐坏,生肌效果极佳。或者用侧柏叶粉末,用蜡油调匀敷贴也有效。如果发热口渴,小便颜色红赤,脉象洪大数急而有力,用四物汤、茯苓、木通、生甘草、炒黄连。脉象虽然洪大数急但虚弱无力的,用八珍汤。如果患处不溃烂且颜色暗黑的,用四君子汤、川芎、当归、黄芪之类。如果肌肉已死溃烂但不长新肉的,用四君子汤、黄芪、当归、炮姜。如果痊愈后怕冷,是阳气未恢复,急忙用十全大补汤,切不可用寒凉药,反而伤及脾胃。
Cao Yurong from Yunjian, due to his wife suffering from wind-stroke and being administered medicine, accidentally bit off half a joint of his finger. He experienced pain, aversion to cold, and fever. External application of rhubarb (Rhei Radix et Rhizoma) and other herbs, along with internal administration of heat-clearing and toxin-resolving medicines, resulted in the affected area neither hurting nor suppurating; the pus was thin, and the aversion to cold and fever worsened. I said: This is caused by cooling medicines obstructing the meridians and collaterals. Therefore, Yulong Ointment (Jade Dragon Ointment) was applied externally to disperse cold qi, and Liujunzi Tang (Six Gentlemen Decoction) was taken internally to strengthen the spleen and stomach. After several days, the affected area became slightly painful, and the swelling gradually subsided; this indicated that yang qi had reached the affected area. Indeed, thick pus was discharged, and within a few days, half the finger ulcerated and fell off. Subsequently, interior-supporting medicines were taken to promote healing.
Wang Tianjue, a Shangshe (scholar-official), suffered from foot injury and swelling, accompanied by internal heat and thirst. Both internal and external treatments involved cold and cooling toxin-resolving medicines, causing the affected area to swell more without suppurating. He also experienced aversion to cold, poor appetite, and nausea. I said: This is due to deficiency of both qi and blood, compounded by cold medicines congealing the meridians and collaterals, damaging stomach qi, thereby leading to these symptoms. Thus, Xiangsha Liujunzi Tang (Aucklandia and Magnolia Bark Six Gentlemen Decoction) was used, supplemented with Chuanxiong Rhizome (Chuanxiong Rhizoma) and Angelicae Sinensis Radix (Danggui), and fried ginger (Zingiberis Rhizoma Praeparatum). The external symptoms completely receded. Only fatigue and afternoon fever remained, with poor taste in the mouth; Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) was prescribed with added Osteospermum Root (Digutpi), Schisandra Fruit (Wuweizi), and Ophiopogon Tuber (Maimendong), leading to recovery.
Wang Tingyong, a Prefectural Governor, injured his finger. It was immediately wrapped with cloth, causing blood stasis to rupture internally, with swelling extending to the hand. I advised unbinding the affected area to allow the discharge of blood stasis, followed by administering a formula to eliminate stale matter and generate new tissue. He did not believe me. Instead, cooling medicines were applied. Although the pain ceased temporarily, it returned the next day. After further application, after several days, both the palm and back of the hand ulcerated, discharging turbid pus and bloody fluid. He continued taking toxin-resolving medicines, further depleting qi and blood, resulting in dark complexion, thin pus, and loss of appetite. He requested my treatment again. I administered formulas to strengthen the spleen and stomach and generate qi and blood. Consequently, the pus became thicker, and he recovered.
A man burned his arm with fire in early winter, experiencing pain, wheezing, coughing, and fever. This was a case of fire-toxin injuring lung metal. Ren Shen Ping Fei San (Ginseng Powder for Calming the Lungs) was used, which stopped the wheezing and coughing. Due to overexertion, he subsequently developed aversion to cold and fever, indicating qi and blood deficiency. Bazhen Tang (Eight Treasures Decoction) with added Platycodon Root (Jiegeng) and Angelica Dahurica Root (Baizhi) was administered, resolving the symptoms. An additional three fen of Cinnamomi Cortex (Guizhi) was added to enhance the warming effect of the medicine and warm qi and blood; the necrotic tissue ulcerated and sloughed off, leading to recovery. If redness and pain appeared initially, Shenxiao Danggui Gao (Miraculous Efficacy Angelica Ointment) could be applied; mild cases would heal spontaneously, while severe cases would undergo self-necrosis, promoting miraculous tissue regeneration. Alternatively, powder of Platycladi Cacumen (Cebaiye) mixed with beeswax oil for topical application was also effective. If fever and thirst occurred with reddish urine, and the pulse was surging, rapid, and forceful, Siwu Tang (Four Substances Decoction) combined with Poria Sclerotium (Fuling), Akebia Caulis (Mutong), raw licorice root (Sheng Gancao), and stir-fried Coptis Rhizome (Chuang Huanglian) was used. If the pulse was surging and rapid but deficient, Bazhen Tang was used. If the affected area did not ulcerate and appeared dark, Sijunzi Tang (Four Gentlemen Decoction) combined with Chuanxiong Rhizome, Angelicae Sinensis Radix, and Astragali Radix (Huangqi) was appropriate. If the flesh was dead, ulcerated, but failed to regenerate tissue, Sijunzi Tang combined with Astragali Radix, Angelicae Sinensis Radix, and fried ginger was used. If chills persisted after recovery, it indicated incomplete restoration of yang qi; Shiquan Dabu Tang (Complete Great Tonifying Decoction) should be urgently administered. Cold and cooling medicines must strictly be avoided, as they would damage the spleen and stomach.