蝉花散(《东医宝鉴》) 夏月诸般伤损溃烂,蛆虫极盛,臭不可近。
蛇蜕(烧存性,一两) 蝉蜕 青黛(各五钱) 细辛(二钱五分)
(上为末,每三钱,酒调下,日二次。)
夏月诸疮臭烂 寒水石研细掺。
辟恶气(张仲景) 苍术同猪蹄甲烧烟熏。
又方 红枣、茶叶烧烟置房中。
又方 荔枝壳烧烟解秽。
自巅顶起至发鬓额角眉目止,凡一切痈疽疔毒,皆汇于此部,以便检阅参治。
王肯堂曰∶百会疽一名玉顶疽,(百会穴,一名三阳五会,在前庭后一寸五分,顶中央旋毛中陷容
豆,督脉足太阳之交会。)初发如麦米,顿增痛楚,寒热大作,由阳虚浮泛,宜盐汤下八味丸,
引火归源。若元气素浓,六阳经受风邪,风火相煽,脏腑热毒上攻而成者,宜黄连消
毒饮,七日无脓者死。(《准绳》)
\r百会疽\p04-a41a45.bmp\r
申斗垣曰∶脑发生于巅顶之上泥丸宫穴,乃足太阳膀胱经兼督脉相并而作,多
血少气,状如火燎浆泡,大如铜钱,色如葡萄,头如米粒,四围坚硬,赤色可治,闷
乱神不定者死,如八日有脓,可刺者生。(《启玄》)
又曰∶前脑疽即脑痈,俗云囟门荡子发痈是也。有生囟门,有生脑前、脑后、脑
侧者,皆由当风睡卧,风寒入脑内,气血凝滞,遂生此证,四五日可治,半月二旬
以外,毒瓦斯深入脑内,难治。又有肾经虚热,壅于脑户,伏结成毒,但溃久成穴,脑
髓外流者,不治。治与痈疽同。
胡公弼曰∶顶门乃三阳经脉聚会之所,其穴名曰百会穴,此处前后生毒,最易伤
犯脑髓,脑髓一陷,最不易治。是阳经亢极,热气不散,气血凝滞,结聚巅顶而成。
此疽系心经受证,治之忌灸,如有用灸者,艾柱宜小,壮数宜少,若火气太过,会合
阳经,毒流头面溃烂难治,故曰不宜灸也。(《青囊》)
蒋示吉曰∶脑发疽生巅顶之上,由督脉太阳经所主,受病在心,乃阴阳不调,热
气上壅,聚而不散而成。若不速治,顶裂髓枯,不可救矣。
《心法》曰∶百会疽生头顶中央,自侧面观之,正对耳尖者是。
又曰∶已溃,开疮看视,务宜密室中揭膏拭脓收拾,切忌外风袭入,以免漫肿抽搐之虞。
澄曰∶头为诸阳之首,巅乃脑髓之穴,此处患毒,非诸阳蕴热亢极,即心事劳攘
火炎,或素有蓄热,醇酒炙 而成,或过服升、柴,提动积热而起。初起如粟,根
脚坚硬,不红不 ,痛疼彻脑,头如顶石,
破后无脓,鼻流秽物者死。如初起红肿,根脚分明,溃后得脓者吉,但不可轻敷凉药,
逼毒入脑,施治之法,悉遵痈疽治法,毋庸分门立方。
蝉花散(出自《东医宝鉴》):夏季各种外伤溃烂,蛆虫极多,气味恶臭难以靠近。
蛇蜕(烧至存性,一两) 蝉蜕 青黛(各五钱) 细辛(二钱五分)
(以上药物研为粉末,每次取三钱,用酒调服,每日两次。)
夏季各种疮疡恶臭腐烂:用寒水石研成细粉撒敷。
辟除恶气(张仲景方):苍术同猪蹄甲一起烧烟熏蒸。
又一方:红枣、茶叶烧烟放置在房中。
又一方:荔枝壳烧烟以解除秽气。
从头顶正中央起,直至发际、鬓角、额头、眼角和眉毛止,凡是一切痈疽疔毒,都汇总在此部分,以便于查阅参考治疗。
王肯堂说:百会疽又名玉顶疽。(百会穴,又名三阳五会,位于前庭后一寸五分,头顶中央旋毛中的凹陷处,可容纳一颗豆子,是督脉与足太阳膀胱经的交会穴。)初起时像麦粒大小,突然增加疼痛痛苦,寒热症状剧烈发作,这是由于阳气虚浮泛溢所致,适宜用盐汤送服八味丸,以引火归源。如果元气本来充足,六条阳经受风邪侵袭,风火相互煽动,脏腑热毒上攻而形成的,适宜用黄连消毒饮,若七天后没有脓液形成则死亡。(出自《医学准绳六要》)
[图片:百会疽]
申斗垣说:脑发疽生于头顶之上的泥丸宫穴,是由足太阳膀胱经兼督脉共同作用而成,此处多血少气,形状像火烧起的浆泡,大如铜钱,颜色像葡萄,顶部像米粒,四周坚硬,赤色者可治,出现烦闷混乱、神志不安者死,如果第八天有脓液,可以刺破排脓者生。(出自《外科启玄》)
又说:前脑疽即脑痈,俗称囟门荡子发痈。有的生在囟门,有的生在脑前、脑后、脑侧,都是由对着风睡觉卧息,风寒进入脑内,气血凝滞,于是产生此证,四五日尚可治疗,超过半月二十天以外,毒瓦斯深入脑内,难以治疗。又有肾经虚热,壅塞于脑户,潜伏结聚成毒,只是溃烂日久成为空洞,脑髓外流的,无法治疗。治疗方法与痈疽相同。
胡公弼说:顶门是三阳经脉聚会的地方,其穴位名叫百会穴,此处前后生毒,最容易伤犯脑髓,脑髓一旦下陷,最不容易治疗。这是阳经亢盛至极,热气不散,气血凝滞,结聚在头顶而成。此疽属于心经受证,治疗时忌讳艾灸,如果有使用艾灸的,艾柱宜小,壮数宜少,如果火气太过,会合阳经,毒气流窜头面溃烂难治,所以说不宜艾灸。(出自《青囊秘传》)
蒋示吉说:脑发疽生于头顶之上,由督脉和太阳经所主,受病在心,是阴阳不调,热气上壅,聚积不散而形成的。如果不迅速治疗,头顶裂开、脑髓枯竭,不可救治了。
《医宗金鉴·心法要诀》说:百会疽生于头顶中央,从侧面观察,正对耳尖的位置就是。
又说:已经溃破,打开疮口查看,务必在密室中揭开膏药擦拭脓液收拾伤口,切忌外风侵入,以免发生漫肿抽搐的危险。
顾世澄说:头部是诸阳经的首领,巅顶是脑髓所在的穴位,此处患毒,如果不是诸阳蕴热亢盛至极,就是心事劳扰导致火炎,或者素有蓄热,因饮用醇酒、吃炙烤食物而成,或者过服升麻、柴胡,提动积热而起。初起时像粟米大小,根脚坚硬,不红不亮,疼痛彻脑,头部感觉像顶着石头,破溃后没有脓液,鼻流秽物者死。如果初起红肿,根脚分明,溃破后得到脓液的吉利,但不可轻易敷用凉药,逼迫毒气入脑,施治的方法,完全遵循痈疽的治疗方法,不需要分门别类另立处方。
Chanhua San (Cicada Flower Powder, from *Dongui Bogam*): For various injuries and ulcerations in summer with excessive maggot infestation and unbearable foul odor.
Ophidia Skin (burned to retain its properties, 1 liang) Cicada Slough Qingdai (Indigo Naturalis, each 5 qian) Xixin (Asarum, 2.5 qian)
(Grind the above into powder. Take 3 qian each time, mixed with wine for oral administration, twice daily.)
For foul-smelling and rotting sores in summer: Apply finely ground Hanshuishi (Aqua Calcitae).
Expelling Evil Qi (Formula by Zhang Zhongjing): Burn Cangzhu (Atractylodis Rhizoma) together with pig trotter nails to produce smoke for fumigation.
Another formula: Burn red dates and tea leaves; place the smoke in the room.
Another formula: Burn litchi shells to eliminate foul odors.
From the vertex of the head down to the hairline, temples, forehead, eyes, and eyebrows, all types of carbuncles, ulcers, and furuncles are compiled here for easy reference and treatment.
Wang Kentang stated: Baihui Ju (Baihui Carbuncle), also known as Yuding Ju (Jade Top Carbuncle). [The Baihui acupoint, also called Sanyang Wuhui, is located 1.5 cun posterior to the anterior hairline, in the depression at the center of the vertex where the hair whorls, capable of holding a bean; it is the intersection of the Du Meridian and the Foot-Taiyang Bladder Meridian.] Initially appearing like a millet grain, it suddenly increases in pain and suffering, accompanied by severe chills and fever. This arises from deficient Yang floating superficially; it is suitable to administer Bawei Wan (Eight-Ingredient Pill) with salt water to guide fire back to its source. If the original Qi is robust, and the Six Yang Meridians are invaded by Wind pathogen, with Wind and Fire fanning each other, causing Heat-Toxin from the Zang-Fu organs to attack upwards, Huanglian Xiaodu Yin (Coptis Decoction for Eliminating Toxins) is suitable. If no pus forms after seven days, death ensues. (*Yixue Zhunsheng*)
[Image: Baihui Ju]
Shen Douyuan stated: Naofa Ju (Brain Hair Carbuncle) occurs on the Niwan Palace acupoint at the vertex. It is caused by the concurrent involvement of the Foot-Taiyang Bladder Meridian and the Du Meridian. This area has abundant blood but scarce Qi. Its appearance resembles a blister formed by fire burning, large as a copper coin, colored like grapes, with a head like a millet grain, and hard surroundings. Redness indicates treatability; restlessness and unsettled spirit indicate death. If pus appears on the eighth day and can be lanced, survival is possible. (*Waike Qixuan*)
He further stated: The Anterior Brain Carbuncle is also called Brain Abscess, commonly known as "Fontanelle Swinging Child Carbuncle." It may occur at the fontanelle, front of the brain, back of the brain, or sides of the brain. All result from sleeping or lying exposed to wind, allowing Cold-Wind to enter the brain, causing Qi and Blood stagnation, thus generating this condition. It is treatable within four to five days. If more than half a month passes, the Toxic Gas penetrates deeply into the brain, making it difficult to treat. There are also cases of Deficient Heat in the Kidney Meridian obstructing the Naohu point, latent and condensing into toxin. If it ulcerates over a long period forming a cavity with brain marrow flowing out, it is untreatable. The treatment is the same as for general carbuncles and ulcers.
Hu Gongbi stated: The top of the head is the gathering place of the Three Yang Meridians, and the acupoint is named Baihui. Sores occurring here are most likely to damage the brain marrow. Once the brain marrow collapses, it is extremely difficult to treat. This results from extreme hyperactivity of Yang Meridians, un-dispersed Heat Qi, and stagnation of Qi and Blood condensing at the vertex. This carbuncle belongs to the Heart Meridian syndrome. Moxibustion is contraindicated in treatment. If moxibustion must be used, the moxa cone should be small, and the number of moxa moxibustions few. If the Fire Qi is too excessive, combining with Yang Meridians, the toxin flows to the head and face causing difficult-to-treat ulceration. Hence, it is said that moxibustion is not suitable. (*Qingnang*)
Jiang Shiji stated: Naofa Ju arises at the vertex, governed by the Du Meridian and Taiyang Meridian, with pathology centered in the Heart. It is caused by disharmony of Yin and Yang, with Heat Qi obstructing upwards, accumulating and failing to disperse. If not treated promptly, the vertex will split and brain marrow wither, becoming incurable.
*Xinfa* states: Baihui Ju occurs at the central vertex; viewed from the side, it aligns directly with the tip of the ear.
It further states: After ulceration, when opening the wound for inspection, one must strictly work in a sealed room, remove the plaster, wipe the pus, and dress the wound. One must strictly avoid invasion by external Wind to prevent the risk of diffuse swelling and convulsions.
Gu Shicheng stated: The head is the summit of all Yang Meridians, and the vertex is the acupoint of the brain marrow. Sores here arise either from extreme hyperactivity of accumulated Heat in all Yang Meridians, or from mental labor disturbing the Heart leading to flaming Fire, or from pre-existing accumulated heat due to consuming rich wines and roasted foods, or from excessive use of Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), which lift and activate accumulated heat. Initially, it appears like a millet grain, with a hard base, neither red nor bright, with pain penetrating to the brain, feeling as if the head is weighed down by a stone. If it ruptures without pus and nasal discharge of foul matter occurs, death ensues. If initially red and swollen with a distinct base, and pus forms upon rupture, it is auspicious. However, cold-natured medicines should not be lightly applied, as this may force the toxin into the brain. The therapeutic methods should entirely follow the principles for treating carbuncles and ulcers, without needing separate formulas for different categories.