王肯堂曰∶冬瓜串生两臂膊间,长二三寸,红赤高肿,疼痛而无处觅头者是也。
照痈疽门施治。(《准绳》)
验方(《纲目》) 萆麻子捣膏贴之,一夜自愈。
又方(《准绳》) 羊粪不拘多少,麻油同研敷。
申斗垣曰∶陈肝疮,乃手少阳三焦经,生于左右臂上三五处,如疖肿,痛不可忍,
不可挨擦。如有头,二七可刺;无头,身热虚硬面赤者,二八日死。又名蚤疽,彻
手生疮,变生于手三阴、三阳经,三年而死;痒甚者一月而死。(《启玄》)
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陈实功曰∶此证得于思虑伤脾,脾气郁结而成。其患多生于两手,初起骨中作
疼,渐生漫肿,坚硬,不热不红,手背及内关前后连肿数块,不能转侧,日久出如
豆腐浆汁,串通诸窍,日夜淋漓,肿痛仍在,患者必面黄肌瘦,饮食减少,惟调和
气血,扶助脾胃,其中可生者,十有二三,如治之不善,妄投寒凉克伐,损伤脾胃,则
活者鲜矣。施治之法,首尾宜用益气养荣汤,加味逍遥散主之。(《正宗》)
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又曰∶是疾多生于气血浇薄者。盖四肢属脾土,所以多生两手。
李东垣曰∶蝼蛄串,所谓蝼蛄者,虫名也,形似蜻蜒,翅短而尾长,善近风喜
水,故患此者,不破则易已,如溃不断其
脓水,势必贯串上延肩井,下串臂肘,一串二,二则串三。失治则脓血侵蚀,筋骨
惨痛。此缘五脏受湿,六腑蓄热,故外伤皮肤,遂成斯毒。
朱丹溪曰∶蝼蛄串生于臂内中廉,属包络经,由思虑伤脾,脾伤则运化迟,故
生浊液,流于肌肉,脾气郁滞不舒,凝结而成。初起筋骨如中流矢,疼痛渐增,漫
肿坚硬,不红不热,连肿数块,臂膊不能转动;日久其肿块渐次溃破,孔孔时流白
浆,内溃串通诸孔,外势肿破不消,脓血淋沥如漏。虚证来添如面黄食少削瘦,甚
则午后寒热交作,而成败证也。初宜逍遥散,次用人参养荣汤,调和气血,扶助脾
胃,十中可保三四。
王肯堂说:冬瓜串生于两臂之间,长二三寸,红肿高起,疼痛且找不到脓头。
按照痈疽门的法则进行治疗。(出自《准绳》)
验方(出自《纲目》)将蓖麻子捣烂成膏贴敷,一夜即可自愈。
又一方(出自《准绳》)取羊粪不限多少,与麻油一同研磨后外敷。
申斗垣说:陈肝疮,属于手少阳三焦经病变,生于左右手臂上三五处,像疖肿一样,疼痛难忍,不可触碰摩擦。如果有脓头,十四天可以刺破;如果没有脓头,出现身热、身体虚硬、面色赤红的症状,二十八天会死亡。又名蚤疽,彻手生疮,变生于手三阴、手三阳经,三年死亡;瘙痒严重的一个月死亡。(出自《启玄》)
陈实功说:此证因思虑伤脾,脾气郁结而成。患处多生于双手,初起时骨中作痛,逐渐产生漫肿,坚硬,不热不红,手背及内关穴前后连肿数块,不能转动,日久流出如豆腐浆样的汁液,串通诸窍,日夜淋漓,肿痛仍在,患者必然面黄肌瘦,饮食减少,只有调和气血,扶助脾胃,其中能治愈的,十人中有一二三人;如果治疗不当,妄投寒凉克伐药物,损伤脾胃,则存活者极少了。施治的方法,从头到尾宜用益气养荣汤,以加味逍遥散为主方。(出自《正宗》)
又说:此病多生于气血虚弱的人。因为四肢属脾土,所以多生于双手。
李东垣说:蝼蛄串,所谓蝼蛄,是虫名,形状像蜻蜓,翅膀短尾巴长,喜欢靠近风和水,所以患此病的人,如果不破溃就容易痊愈,如果溃破后不断流脓水,势必贯穿向上延至肩井穴,向下串至臂肘,一串二,二则串三。失治则脓血侵蚀,筋骨惨痛。这是因为五脏受湿,六腑蓄热,所以外伤皮肤,遂成此毒。
朱丹溪说:蝼蛄串生于臂内侧中间,属于心包络经,由思虑伤脾,脾伤则运化迟缓,所以产生浊液,流于肌肉,脾气郁滞不舒,凝结而成。初起时筋骨感觉像被流箭射中,疼痛逐渐增加,漫肿坚硬,不红不热,连肿数块,臂膊不能转动;日久肿块逐渐溃破,孔孔时流白浆,内部溃破串通诸孔,外部肿胀破溃不消,脓血淋沥如漏。虚证表现为面黄食少消瘦,甚至午后寒热交作,而成败证。初起宜用逍遥散,随后用人参养荣汤,调和气血,扶助脾胃,十人中可保三四。
Wenkang Wang stated: Donggua Chuan (Winter Melon String) arises between the two arms, measuring two to three cun in length, presenting with redness, swelling, and elevation, accompanied by pain and an absence of a discernible head.
It should be treated according to the principles for treating carbuncles and sores (Yong Ju Men). (From *Zhunsheng*)
Verified Prescription (From *Gangmu*): Mash castor seeds (*Ricini Semen*, 蓖麻子) into a paste and apply it; it will heal spontaneously overnight.
Another Prescription (From *Zhunsheng*): Take an unspecified amount of sheep feces, grind it together with sesame oil, and apply externally.
Shouyuan Shen stated: Chen Gan Chuang (Chronic Liver Sore) is a pathology of the Hand-Shaoyang Sanjiao Meridian (Triple Burner Meridian of Hand-Taiyang). It appears in three to five locations on both upper arms, resembling boils, with unbearable pain that cannot be touched or rubbed. If there is a head, it can be punctured after fourteen days; if there is no head, and symptoms include fever, flaccid hardness of the body, and ruddy complexion, death will occur within twenty-eight days. It is also known as Zao Ju (Flea Carbuncle). Sores arising from the hand may transform and spread along the Hand-Yin and Hand-Yang meridians, leading to death in three years; if itching is severe, death occurs within one month. (From *Qixuan*)
Shigong Chen stated: This condition results from excessive thinking injuring the Spleen, causing Qi stagnation in the Spleen. The lesions mostly arise on both hands. Initially, there is pain deep in the bone, gradually developing into diffuse swelling that is hard, without heat or redness. Multiple swollen areas appear on the back of the hand and around the Neiguan acupoint, preventing movement. Over time, fluid resembling tofu curd leaks out, connecting various orifices, dripping day and night, while pain and swelling persist. The patient inevitably presents with sallow complexion, emaciation, and reduced appetite. Only by harmonizing Qi and Blood and supporting the Spleen and Stomach can survival be expected; among ten cases, one or two may recover. If treatment is improper, and cold-cooling and purgative drugs are recklessly administered, damaging the Spleen and Stomach, few will survive. The treatment method involves using Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) from beginning to end, primarily guided by Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). (From *Zhengzong*)
He further stated: This disease mostly affects individuals with thin and deficient Qi and Blood. Since the four limbs belong to the Earth element of the Spleen, they predominantly occur on both hands.
Dongyuan Li stated: Lougu Chuan (Mole Cricket String), named after the mole cricket, is an insect whose shape resembles a dragonfly, with short wings and a long tail, fond of wind and water. Therefore, patients with this condition will heal easily if not ulcerated; however, if ulcerated and pus continues to drain, it will inevitably spread upward to the Jianjing acupoint and downward to the elbow. One lesion spreads to two, two to three. Neglected treatment leads to erosion by pus and blood, causing severe bone and tendon pain. This originates from dampness affecting the Five Zang organs and heat accumulating in the Six Fu organs, thus damaging the skin externally and forming this toxicity.
Danxi Zhu stated: Lougu Chuan arises on the medial aspect of the arm, belonging to the Pericardium Meridian. It is caused by excessive thinking injuring the Spleen; when the Spleen is injured, its transportation and transformation slow down, producing turbid fluids that flow into the muscles. Spleen Qi stagnates and fails to circulate freely, condensing to form the lesion. Initially, the bones and tendons feel as if struck by an arrow, with increasing pain, diffuse swelling that is hard, non-red, and non-hot, involving multiple swollen areas, rendering the arm immobile. Over time, the mass gradually ulcerates, leaking white fluid from each pore. Internal ulceration connects various holes, while external swelling and rupture do not subside, with pus and blood dripping like a leak. Deficiency patterns manifest as sallow complexion, poor appetite, and emaciation; even worse, alternating chills and fever in the afternoon develop, resulting in a critical stage. Initially, Xiaoyao San (Free and Easy Wanderer Powder) should be used, followed by Renshen Yangrong Tang (Ginseng Decoction for Nourishing Qi and Blood) to harmonize Qi and Blood and support the Spleen and Stomach; among ten cases, three or four may be saved.