胁痈。
地榆 金银花(各五钱) 川贝母 当归(各二钱) 穿山甲(炮) 赤芍(各三钱) 皂角刺
连翘 白芷(各一钱五分) 甘草节(一钱) 夏枯草(一两)
先煎后入药 鼠粘子(一钱五分) 紫花地丁(一两)
煎滤汁再入 鲜菊花根一两捣汁和服。
\r内发丹毒\p04-a41a144.bmp\r
王肯堂曰∶内发丹毒,胁下至腰胯间肿痛,赤色如霞。治之稍缓,毒攻于内,呕
哕昏迷,胸腹 胀者死。二便不通,遍身青紫者死,急砭出恶血,服防风通圣散去
白术、甘草,紫金丹、胜金丹汗之。服汗剂得汗则生;无汗则死。呕吐不食谵语者死。(《准绳》)
《心法》曰∶内发丹毒,由肝脾二经热极生风所致。生于肋骨,延及腰胯,色赤
如霞,游走如云,痛如火燎,急向红肿周遭砭出紫黑血,以瘦牛肉或羊肉片贴之,其
毒即可减去一半。若呕哕昏愦,胸腹 胀,遍身青紫者,则为毒瓦斯内攻,属逆。
\r侠荧疽\p04-a41a145.bmp\r
《鬼遗方》云∶侠荧疽,肿起发肋及两肩肘头,二十日不穴死。九日可刺,发赤
白相间,脓多可治,赤白全无者不治。又云∶两肋起疽名为发肋。初肿盛至数日不
穴,攻即肿大如杯碗,高如鏊背,痛彻内肠绞刺,左边患应右边痛,右边患应左边痛,唯有此处多是内毒,却入攻而死
者多。人有斯患,急以针刺出脓血,则免内攻伤内矣。
《心法》曰∶肋疽,即侠荧疽,生于肋条骨间,由肝火郁怒结聚而成。初如梅李,
渐大如碗,色紫 痛,连及肩肘,患在左痛牵右肋,患在右痛牵左肋,二十一日得稠脓为顺,届期溃出清水者逆。
胁痈。
地榆、金银花(各五钱)、川贝母、当归(各二钱)、穿山甲(炮制)、赤芍(各三钱)、皂角刺、连翘、白芷(各一钱五分)、甘草节(一钱)、夏枯草(一两)。
先煎煮后加入药物:鼠粘子(即牛蒡子,一钱五分)、紫花地丁(一两)。
煎煮过滤取汁后,再加入鲜菊花根一两捣碎取汁混合服用。
内发丹毒
王肯堂说:内发丹毒,表现为胁下至腰胯之间肿痛,皮肤颜色红赤如晚霞。治疗如果稍有迟缓,毒邪攻入体内,出现呕吐呃逆、昏迷,胸腹胀满的会死亡;大小便不通,全身青紫色的也会死亡。应当紧急用砭石刺破放出恶血,服用防风通圣散去掉白术和甘草,或者服用紫金丹、胜金丹以发汗。服用发汗药后若能出汗则生还;若无汗则死亡。若出现呕吐、不能进食、胡言乱语的会死亡。(出自《医学准绳六要》)
《医宗金鉴·心法要诀》说:内发丹毒,是由肝脾两经热极生风所致。生于肋骨部位,蔓延至腰胯,颜色红赤如霞,游走不定如云,疼痛如火烧燎原。应紧急在红肿周围用砭石刺出紫黑色血液,用瘦牛肉或羊肉片贴敷,其毒性即可减去一半。如果出现呕吐呃逆、神志昏沉,胸腹胀满,全身青紫色的,则是毒气内攻,属于逆证。
侠荧疽
《鬼遗方》说:侠荧疽,肿胀隆起并发于肋部及两肩肘头,二十天不排脓就会死亡。第九天可以刺破,若流出赤白相间的脓液且脓多者可治,若赤白全无者不可治。又说:两肋起疽名为发肋。初起肿胀严重,数日不排脓,一旦溃破则肿大如杯碗,高耸如鏊背(一种铁锅),疼痛彻入内脏如绞刺,左边患病右边痛,右边患病左边痛,只有此处多是内毒,攻入体内而死亡的很多。人若有此病患,紧急用针刺出脓血,则可避免内攻损伤内脏。
《医宗金鉴·心法要诀》说:肋疽,即侠荧疽,生于肋条骨之间,由肝火郁结愤怒而成。初起像梅李一样小,逐渐增大如碗,颜色紫暗疼痛,牵连肩肘,患在左侧疼痛牵引右肋,患在右侧疼痛牵引左肋,二十一天得到稠脓为顺证,到期若溃破流出清水则为逆证。
Carbuncle of the Hypochondrium.
*Sanguisorbae Radix* (Di Yu), *Honeysuckle Flower* (Jinyinhua) (each 5 qian); *Fritillariae Cirrhosae Bulbus* (Chuan Beimu), *Angelicae Sinensis Radix* (Danggui) (each 2 qian); *Manis Squama* (Chuanshanjia, prepared by frying); *Paeoniae Rubra Radix* (Chishao) (each 3 qian); *Gleditsiae Sinensis Spina* (Zaociao Ci), *Scutellariae Barbatae Herba* (Lianqiao), *Angelicae Dahuricae Radix* (Baizhi) (each 1.5 qian); *Glycyrrhizae Radix et Rhizoma* (Gancao Jie) (1 qian); *Prunellae Spica* (Xiakucao) (1 liang).
Decoct first, then add: *Arctii Fructus* (Shuniuzi, 1.5 qian); *Viola Yedoensis Herba* (Zihua Diding) (1 liang).
After decocting and filtering the juice, mix with fresh juice extracted from pounding 1 liang of *Chrysanthemi Indici Radix* (Xian Juhua Gen) and take orally.
Nei Fa Dan Du (Internal Onset Erysipelas)
Wang Kentang stated: Nei Fa Dan Du presents with swelling and pain from the hypochondrium to the waist and hip region, with skin redness like rosy clouds. If treatment is delayed slightly, the toxin attacks internally, leading to vomiting, hiccups, coma, and abdominal distension, which results in death; if there is obstruction of urination and defecation, and the whole body turns cyanotic/purple, it also results in death. Urgently use bian stone (stone lancet) to puncture and release foul blood. Administer *Fangfeng Tongsheng San* (Saposhnikovia Decoction for Unblocking the Supreme Health) excluding *Atractylodis Macrocephalae Rhizoma* (Baizhu) and *Glycyrrhizae Radix et Rhizoma* (Gancao), or administer *Zijin Dan* (Purple Gold Pill) and *Shengjin Dan* (Winning Gold Pill) to induce sweating. If sweating occurs after taking the diaphoretic agent, the patient survives; if no sweat occurs, the patient dies. Vomiting, inability to eat, and delirium indicate death. (From *Yixue Zhunsheng*)
*Yizong Jinjian: Xinfa Yaoyue* states: Nei Fa Dan Du is caused by extreme heat in the Liver and Spleen meridians generating wind. It arises in the ribs, extends to the waist and hips, appears red like rosy clouds, moves freely like clouds, and burns with pain like fire. Urgently puncture the periphery of the redness and swelling with a bian stone to release dark purple-black blood, and apply slices of lean beef or mutton to reduce the toxicity by half. If vomiting, hiccups, confusion, abdominal distension, and whole-body cyanosis occur, it indicates internal attack by toxic qi, which is a adverse prognosis (Ni syndrome).
Xia Ying Ju (Parasternal Carbuncle)
*Guiyi Fang* states: Xia Ying Ju presents with swelling rising to involve the ribs and both shoulders and elbows. If not drained within twenty days, death ensues. It can be punctured on the ninth day. If pus mixed with red and white discharge is profuse, it is treatable; if there is no red or white discharge, it is untreatable. It further states: Carbuncles arising in both hypochondria are named "Fa Lei" (Erupting Ribs). Initially, the swelling is severe; if not drained after several days, upon rupture, it swells like a cup or bowl, rises high like the back of an iron griddle, and causes pain piercing into the internal intestines as if wringing and stabbing. Pain in the left side corresponds to pain in the right, and vice versa. This location often involves internal toxins that attack inward, causing many deaths. For such conditions, urgently puncture with a needle to drain pus and blood to avoid internal damage.
*Yizong Jinjian: Xinfa Yaoyue* states: Lei Ju (Rib Carbuncle), also known as Xia Ying Ju, arises between the rib bones and is formed by the stagnation and accumulation of Liver Fire due to depression and anger. It initially resembles a plum or apricot, gradually enlarging to the size of a bowl, appearing purple and painful, extending to the shoulders and elbows. Lesions on the left cause pain radiating to the right hypochondrium, and lesions on the right cause pain radiating to the left hypochondrium. Obtaining thick pus by the twenty-first day is a favorable sign (Shun); if clear fluid oozes out when the time comes, it is an adverse sign (Ni).