护膜散
白蜡 白芨（各等分）
研末，轻者用一钱，微重用二钱，重者用三钱，或酒或米汤调下。
王肯堂曰∶石疽生腰胯之间，肉色不变，坚硬如石，经月不溃者，此系属少阳、
阳明二经积热所致。邪毒固结，元气不足，故不能起发。若黑陷不起，麻木不痛，呕
哕不食，精神昏乱，脉散或代者死。（《准绳》）
汪省之曰∶石疽乃寒气所作，深伏于骨髓之间，腿膝有肿与皮肉相似，苦疼而
坚硬如石，故谓之石疽。治宜温补。（《理例》）
\r肾俞发\p04-a41a175.bmp\r
王肯堂曰∶肾俞发即腰疽，又名连肾发，又名下搭，生十四椎傍腰肾之间，由
房劳太过，致伤肾水，令人口干，寒热大作，百节俱痛。治之稍缓，溃烂透膜者死。
若见咳嗽呕哕，腰间似折，不能俯仰，饮食不纳者死；溃而脓水清稀，腐烂腥秽，迷
闷不醒厥逆者不治。（《准绳》）
陈远公曰∶有腰眼间忽生疽毒，疼痛呼叫，似乎阳证，然腰肾乃至阴之地，未
可作阳证治之也。此证虽本于忍精欲泄不泄以成，此毒似乎纯是阴分之过，但腰虽
不远于内肾，火发而毒成，则阴中有阳，未可纯以阴证治之也。必阴阳并治，以化毒
则毒去如扫。倘不补阴，竟治其毒，则肾益伤而毒难速化；即补阴而不补阳，则阴
无以生，毒且深藏肾宫，不得外泄矣。两治散∶白术、杜仲、当归各一两，金银花
三两， 草三钱，防己一钱，水煎，一
服痛轻，二剂痛止，三剂痊愈。（《冰鉴》。此方以杜仲、白术利其腰脐，气通毒自难结，又得银花、当
归补中有散，而防己、 直入肾宫，祛湿热之毒，阴阳无偏胜之虞，邪正有解纷之妙，自然二三剂成功也。）
申斗垣曰∶腰疽乃足太阳膀胱经多血少气，生于腰间肾俞胃仓二穴。托之得脓
则安。若上赤下黑，二十日不溃，或青黑色，无脓出血水者死。（《启玄》）
又曰∶腰痈发于软肋下，近腰乃带脉、五枢、维道穴，是少阳经多气少血，寒热
肿作痛。余曾治一人，脓出一桶余，内托大补而愈。
窦汉卿曰∶此证切忌怒气行房，犯之不治。
又曰∶治宜补肾，加知母、黄柏、没药、广胶。
胡公弼曰∶此发生于两腰陷肉之间，或生两腰中间，在大杼下第十二椎是也。此
乃欲火消阴，十五日前后必死，若疮形红
活高肿有脓，尚有可生机括。（《青囊》）
陈实功曰∶肾俞发生于两腰内肾陷肉之间，或正中亦发。凡生于此，最为险候。
盖肾为性命根本，藏精藏气藏神，又乃受命先天，育女、育男、育寿，此必房劳过
度，气竭精伤，欲火销阴，外阳煽动，以致真阴从此而耗，既耗之后，其脏必虚，所
以诸火诸邪乘虚而入。如本脏稍有真阴制火，疮形自可高肿红活为脓，治以人参养
荣汤加山萸肉、北五味子、知母、黄柏，及加减八味丸以救其源。若疮形紫黑干枯，坚
硬不作脓者，为真阴内败，再无可生之理，死在十五日前后。（《正宗》）
护膜散
白蜡、白芨（各取等量）
研磨成粉末，病情轻者服用一钱，病情稍重者服用二钱，病情重者服用三钱，可用酒或米汤调服。
王肯堂说：石疽生于腰胯之间，皮肤颜色不变，质地坚硬如石头，经过一个月也不溃破的，这属于少阳经、阳明二经积热所致。邪毒固结，元气不足，所以不能起发化脓。如果出现黑色下陷不起、麻木不痛、呕吐呃逆、无法进食、精神昏乱、脉象散乱或代脉的，主死。（《医学准绳六要》）
汪省之说：石疽是由寒气引起的，深伏在骨髓之间，腿膝部位肿胀且皮肉外观相似，痛苦疼痛且坚硬如石头，所以称为石疽。治疗应当温补。（《理例》）
肾俞发
王肯堂说：肾俞发即腰疽，又名连肾发，又名下搭，生于第十四椎骨旁腰肾之间，由于房事过度，导致损伤肾水，使人口干，寒热大作，全身关节都疼痛。治疗稍微迟缓，溃烂穿透筋膜的就会死亡。如果见到咳嗽呕吐呃逆，腰部像折断一样，不能俯仰，饮食无法进入的就会死亡；溃破后脓水清稀，腐烂腥臭，昏迷不醒、四肢厥冷的无法治疗。（《医学准绳六要》）
陈远公说：有腰眼间忽然生出疽毒，疼痛呼叫，似乎属于阳证，然而腰肾是至阴之地，不可以当作阳证来治疗。此证虽然本于忍精欲泄而不泄而成，此毒似乎纯粹是阴分的过错，但腰部虽不离内肾，火发而毒成，则是阴中有阳，不可以纯以阴证来治疗。必须阴阳并治，以化解毒则毒去如扫。如果不补阴，竟只治其毒，则肾更受伤而毒难以快速化解；即使补阴而不补阳，则阴无以生，毒且深藏于肾宫，不得外泄了。两治散：白术、杜仲、当归各一两，金银花三两，甘草三钱，防己一钱，水煎服，一服疼痛减轻，二剂疼痛停止，三剂痊愈。（《辨证录》。此方以杜仲、白术利其腰脐，气通毒自难结，又得银花、当归补中有散，而防己、甘草直入肾宫，祛湿热之毒，阴阳无偏胜之虞，邪正有解纷之妙，自然二三剂成功也。）
申斗垣说：腰疽乃足太阳膀胱经多血少气，生于腰间肾俞、胃仓二穴。托毒透脓则安。如果上赤下黑，二十日不溃破，或青黑色，无脓出血水的就会死亡。（《外科启玄》）
又说：腰痈发于软肋下，近腰乃是带脉、五枢、维道穴，是少阳经多气少血，寒热肿作痛。我曾经治疗一个人，脓出一桶余，用内托大补法而痊愈。
窦汉卿说：此证切忌怒气行房，犯之不治。
又说：治疗宜补肾，加知母、黄柏、没药、广胶。
胡公弼说：此发生于两腰陷肉之间，或生两腰中间，在大杼下第十二椎处。这是欲火消阴，十五日前后必死，如果疮形红活高肿有脓，尚有可生机括。（《青囊秘传》）
陈实功说：肾俞发生于两腰内肾陷肉之间，或正中亦发。凡生于此，最为险候。盖肾为性命根本，藏精藏气藏神，又乃受命先天，育女、育男、育寿，此必房劳过度，气竭精伤，欲火销阴，外阳煽动，以致真阴从此而耗，既耗之后，其脏必虚，所以诸火诸邪乘虚而入。如本脏稍有真阴制火，疮形自可高肿红活为脓，治以人参养荣汤加山萸肉、北五味子、知母、黄柏，及加减八味丸以救其源。若疮形紫黑干枯，坚硬不作脓者，为真阴内败，再无可生之理，死在十五日前后。（《外科正宗》）
Hu Mo San (Protective Membrane Powder)
Bai La (White Beeswax), Bai Ji (Bletilla Rhizome) (equal parts each)
Grind into powder. For mild cases, take one qian; for slightly severe cases, take two qians; for severe cases, take three qians. Take with wine or rice soup.
Wang Kentang stated: Shi Ju (Stone Abscess) arises between the waist and hips. The skin color remains unchanged, and the mass is hard as stone. If it does not suppurate after a month, this is caused by accumulated heat in the Shaoyang (Lesser Yang) and Yangming (Yang Brightness) meridians. The pathogenic toxins are firmly consolidated, and the Yuan Qi (Original Qi) is insufficient, thus failing to rise and suppurate. If black depression occurs without rising, numbness and absence of pain, vomiting and hiccups, inability to eat, mental confusion, and a scattered or intermittent pulse appear, death ensues. (*Yi Xue Zhun Sheng*)
Wang Shengzhi stated: Shi Ju (Stone Abscess) is caused by cold pathogens lying deep within the bone marrow. There is swelling in the legs and knees resembling normal skin and flesh, accompanied by severe pain and hardness like stone, hence the name Shi Ju (Stone Abscess). Treatment should employ warming and tonifying methods. (*Li Li*)
Shen Shu Fa (Eruption at the Kidney Shu Point)
Wang Kentang stated: Shen Shu Fa is also known as Yao Ju (Waist Abscess), Lian Shen Fa (Connecting to Kidney Eruption), or Xia Da. It arises beside the fourteenth vertebra between the waist and kidneys. It results from excessive sexual activity damaging Kidney Yin (Essence/Fluids), causing dry mouth, severe alternating chills and fever, and pain throughout all joints. If treatment is delayed even slightly, and ulceration penetrates the membrane, death ensues. If coughing, vomiting, and hiccups occur, the waist feels as if broken, inability to bend or straighten, and inability to ingest food, death ensues. If ulcerated with clear and thin pus, foul-smelling rotting tissue, coma, and cold limbs (Jue Ni), it is untreatable. (*Yi Xue Zhun Sheng*)
Chen Yuangong stated: Sometimes a toxic abscess suddenly appears in the eye of the waist, causing painful crying, which seems to be a Yang syndrome. However, the waist and kidneys are the realm of extreme Yin, so it cannot be treated as a Yang syndrome. Although this condition originates from retaining semen during desire to ejaculate without doing so, making the toxin seem purely a Yin branch disorder, the waist is close to the inner Kidneys. When Fire erupts and toxins form, there is Yang within Yin, so it cannot be treated purely as a Yin syndrome. One must treat both Yin and Yang simultaneously to transform the toxin, removing it easily. If Yin is not tonified while only treating the toxin, the Kidneys will be further injured, and the toxin will be difficult to resolve quickly. Even if Yin is tonified but Yang is not, Yin has no means to generate, and the toxin will hide deeply in the Kidney Palace, unable to exit externally. Liang Zhi San (Dual-Regulation Powder): Bai Zhu (Atractylodes Macrocephala Rhizome), Du Zhong (Eucommia Bark), Dang Gui (Angelica Sinensis Root) each 1 liang; Jin Yin Hua (Honeysuckle Flower) 3 liang; Gan Cao (Licorice Root) 3 qian; Fang Ji (Stephania Tetrandra Root) 1 qian. Decoct in water. After one dose, pain lightens; after two doses, pain stops; after three doses, recovery is achieved. (*Bian Zheng Lu*. This formula uses Du Zhong and Bai Zhu to benefit the waist and umbilical region, allowing Qi to flow so toxins cannot consolidate. Combined with Jin Yin Hua and Dang Gui, it tonifies while dispersing. Fang Ji and Gan Cao enter the Kidney Palace directly to dispel damp-heat toxins. There is no fear of Yin-Yang imbalance, and the interaction between pathogenic factors and healthy Qi resolves discordantly, naturally achieving success in two or three doses.)
Shen Douyuan stated: Yao Ju (Waist Abscess) involves the Foot-Taiyang Bladder Meridian, which is rich in blood but deficient in Qi. It arises at the Shen Shu and Wei Cang acupoints on the waist. If suppuration is promoted, safety is ensured. If the upper part is red and the lower part black, and it does not suppurate after twenty days, or if it is cyan-black with no pus but bleeding fluid, death ensues. (*Wai Ke Qi Xuan*)
He also stated: Yao Yong (Waist Carbuncle) arises below the soft ribs, near the waist at the Dai Mai, Wu Shu, and Wei Dao acupoints. This involves the Shaoyang (Lesser Yang) Meridian, which is rich in Qi but deficient in blood, presenting with chills, fever, swelling, and pain. I once treated a patient who drained over a bucket of pus, cured using internal support and major tonification.
Dou Hanqing stated: This condition strictly forbids anger and sexual intercourse; violating this leads to untreatability.
He also stated: Treatment should tonify the Kidneys, adding Zhi Mu (Anemarrhena Rhizome), Huang Bo (Phellodendron Bark), Mo Yao (Myrrh), and Guang Jiao (Donkey-Hide Gelatin).
Hu Gongbi stated: This arises between the depressed muscles of both waists, or in the middle of both waists, at the twelfth vertebra below Da Bu. This is due to desire-fire consuming Yin. Death is certain around fifteen days later. If the sore shape is red, vibrant, high, swollen, and contains pus, there is still a chance for survival. (*Qing Nang Mi Chuan*)
Chen Shigong stated: Shen Shu Fa arises between the depressed muscles inside the kidneys on both waists, or in the center. Any occurrence here is a most dangerous condition. The Kidneys are the root of life and destiny, storing Essence, Qi, and Spirit. They receive mandate from Pre-Heaven, nurturing daughters, sons, and longevity. This is necessarily due to excessive sexual labor, exhausting Qi and injuring Essence, where desire-fire consumes Yin, stirring external Yang, leading to the consumption of True Yin. Once consumed, the organ becomes deficient, allowing various fires and pathogens to enter through deficiency. If the organ retains some True Yin to control fire, the sore shape can naturally become high, swollen, red, vibrant, and suppurate. Treat with Ren Shen Yang Rong Tang (Ginseng Decoction for Nourishing Qi and Blood) added with Shan Yu Rou (Cornus Fruit), Bei Wu Wei Zi (Schisandra Berry), Zhi Mu (Anemarrhena Rhizome), Huang Bo (Phellodendron Bark), and Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) to save the source. If the sore shape is purple-black, dry, hard, and fails to suppurate, it indicates internal failure of True Yin, with no possibility of survival, leading to death around fifteen days later. (*Wai Ke Zheng Zong*)