一切痈疽,须分是何部位,属何经络,用何药向导,施治庶易于奏效也。
太阳∶上羌活,下黄柏。阳明∶上白芷、升麻,下石膏。少阳∶上柴胡,下青
皮。太阴∶上桔梗,下白芍。厥阴∶上柴胡,下青皮。少阴∶上独活,下知母。
蒋示吉曰∶用药引经,庶药力直攻患处,如太阳用防风、羌活,阳明用白芷、升
麻,少阳用柴胡,太阴用白芍、升麻,少阴用独活,厥阴用柴胡、青皮,佐之以桂。
随经者,引经必要之药也。引者,导引也,引领也。如将之用兵,不识其路,纵
兵强将勇,不能取胜,如贼入无抵,脚不能入其巢穴,叩之箱篑,此理也。故用引
经药,不可不知。太阳经疮疽,生于巅顶之上,必用羌活、 本、麻黄,在下黄柏。
少阳经耳前上用升麻、柴胡,下用柴胡、连翘。阳明经面上用葛根、白芷、黄芩,下
用花粉。太阴经中府、云门、尺泽,上用条芩、连翘,下则箕门、血海,用苍术、防
己。少阴经少冲、少海,上用细辛,下涌泉、照海,用知母。厥阴经中冲、内泽,上
用川芎、菖蒲,下大敦、曲泉,柴胡之类。上则言其手经,下则言其足经,当察其此。
《灵枢》曰∶伏兔一、腓二、(腓者, 也,即足肚。)背(三)、五脏俞(四)、项(五),
此五部有痈疽者死。
王海藏曰∶脑、颐、须、鬓,亦为痈疽必死之处也。
《鬼遗方》云∶不可患痈疽者七处∶眼后虚处一,颐接骨处二,耳门前后、车骨接
处(三),阴根上毛间,胯与尻骨接处(四),诸因小腹风水所成痈疽(五),颔骨下,近耳后虚处
(六),鼻骨中(七),并能害人,但以诸法疗之,或有得瘥,惟眼后虚处最险。
蒋示吉曰∶险恶疮生背上有九处∶入发际为玉枕,又为舌本(一),颈项节(二),第三
椎为崇骨(三),第四大椎为五脏(四),第五椎脊骨两旁肺俞(五),第六夹脊两旁,脾俞及肝俞
(六),第七脊骨两旁肾俞(七),第八后心对鸠尾(八,鸠尾,即心盖骨。)鸠尾骨穴(九)。
又曰∶正面有六处∶喉骨为垂膺(一),当胸为神舍(二),心鸠尾(即心盖骨,三,)两乳穴(四),
脐中为神阙(五),脐下二寸,为阳屈曲间(六)。
又曰∶侧面有三处∶耳下近耳后,牙车尖缺陷中,为喉脉(一),当膊下为肩骨(二),承
山上三寸, 肠(三)。
又曰∶忌生恶毒部位∶脑、伏兔、髭、腓 、鬓、背、颐、项、迎香、瞳子 、舌、
五脏俞,患则多险。
一切痈疽,必须分辨是发生在什么部位,归属于哪条经络,使用什么药物作为引经药,施治才容易取得疗效。
太阳经:上部用羌活,下部用黄柏。阳明经:上部用白芷、升麻,下部用石膏。少阳经:上部用柴胡,下部用青皮。太阴经:上部用桔梗,下部用白芍。厥阴经:上部用柴胡,下部用青皮。少阴经:上部用独活,下部用知母。
蒋示吉说:用药引经,才能使药力直接攻击患处,就像太阳经用防风、羌活,阳明经用白芷、升麻,少阳经用柴胡,太阴经用白芍、升麻,少阴经用独活,厥阴经用柴胡、青皮,并辅以桂枝。随经者,就是引经必不可少的药物。所谓“引”,就是导引、引领的意思。就像将领用兵,如果不认识道路,即使士兵强壮、将领勇敢,也不能取胜;这就像贼人进入没有抵抗的地方,脚不能踏入巢穴,敲击箱笼(无法触及核心),这是同样的道理。所以使用引经药,不可不知道。太阳经的疮疽,如果生在头顶之上,必须用羌活、藁本、麻黄,在下部则用黄柏。少阳经耳前上方用升麻、柴胡,下方用柴胡、连翘。阳明经面部上方用葛根、白芷、黄芩,下方用天花粉。太阴经的中府、云门、尺泽穴,上方用条芩(黄芩)、连翘,下方则是箕门、血海穴,用苍术、防己。少阴经的少冲、少海穴,上方用细辛,下方涌泉、照海穴,用知母。厥阴经的中冲、内关穴,上方用川芎、石菖蒲,下方大敦、曲泉穴,用柴胡之类的药物。上面说的是手经,下面说的是足经,应当仔细考察这一点。
《灵枢》说:伏兔穴一、腓二(腓者,腨也,即小腿肚)、背三、五脏俞四、项五,这五个部位如果有痈疽,就会死亡。
《鬼遗方》说:不可患痈疽的七个部位:眼后虚处一,颐接骨处二,耳门前后、车骨接处三,阴根上毛间,胯与尻骨接处四,各种因小腹风水所成的痈疽五,颔骨下,近耳后虚处六,鼻骨中七,这些都能害人,虽然用各种方法治疗,或许有的能痊愈,只有眼后虚处最危险。
蒋示吉说:险恶疮生在背上有九处:入发际为玉枕,又为舌本一,颈项节二,第三椎为崇骨三,第四大椎为五脏四,第五椎脊骨两旁肺俞五,第六夹脊两旁,脾俞及肝俞六,第七脊骨两旁肾俞七,第八后心对鸠尾八(鸠尾,即心盖骨),鸠尾骨穴九。
又说:正面有六处:喉骨为垂膺一,当胸为神舍二,心鸠尾(即心盖骨)三,两乳穴四,脐中为神阙五,脐下二寸,为阳屈曲间六。
又说:侧面有三处:耳下近耳后,牙车尖缺陷中,为喉脉一,当膊下为肩骨二,承山上三寸,大肠三。
All carbuncles and sores (Yongju, 痈疽) must be differentiated by their location, the meridian they belong to, and the guiding herbs used; only then can treatment be effective.
Taiyang Meridian: Upper part uses Qianghuo (Notopterygii Rhizoma et Radix), lower part uses Huangbai (Phellodendri Cortex). Yangming Meridian: Upper part uses Baizhi (Angelicae Dahuricae Radix) and Shengma (Cimicifugae Rhizoma), lower part uses Shigao (Gypsum Fibrosum). Shaoyang Meridian: Upper part uses Chaihu (Bupleuri Radix), lower part uses Qingpi (Citri Reticulatae Pericarpium Viride). Taiyin Meridian: Upper part uses Jiegeng (Platycodonis Radix), lower part uses Baishao (Paeoniae Radix Alba). Jueyin Meridian: Upper part uses Chaihu (Bupleuri Radix), lower part uses Qingpi (Citri Reticulatae Pericarpium Viride). Shaoyin Meridian: Upper part uses Duhuo (Angelicae Pubescentis Radix), lower part uses Zhimu (Anemarrhenae Rhizoma).
Jiang Shiji stated: Using guiding herbs allows medicinal power to strike directly at the lesion site. For example, for the Taiyang meridian, use Fangfeng (Saposhnikoviae Radix) and Qianghuo (Notopterygii Rhizoma et Radix); for Yangming, use Baizhi (Angelicae Dahuricae Radix) and Shengma (Cimicifugae Rhizoma); for Shaoyang, use Chaihu (Bupleuri Radix); for Taiyin, use Baishao (Paeoniae Radix Alba) and Shengma (Cimicifugae Rhizoma); for Shaoyin, use Duhuo (Angelicae Pubescentis Radix); for Jueyin, use Chaihu (Bupleuri Radix) and Qingpi (Citri Reticulatae Pericarpium Viride), assisted by Guizhi (Cinnamomi Ramulus). "Suijing" refers to essential guiding herbs. "Yin" means to guide or lead. It is like a general using troops: if one does not know the path, even with strong soldiers and brave generals, victory cannot be achieved. This is akin to an enemy entering a place without resistance but unable to penetrate the nest or reach the core chest; this is the same principle. Therefore, one must understand the use of guiding herbs. For sores and carbuncles of the Taiyang meridian occurring on the vertex, one must use Qianghuo (Notopterygii Rhizoma et Radix), Gaoben (Ligustici Rhizoma et Radix), and Mahuang (Ephedrae Herba); in the lower part, use Huangbai (Phellodendri Cortex). For the Shaoyang meridian in front of the ear, upper part uses Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), lower part uses Chaihu (Bupleuri Radix) and Lianqiao (Forsythiae Fructus). For the Yangming meridian on the face, upper part uses Gegen (Puerariae Lobatae Radix), Baizhi (Angelicae Dahuricae Radix), and Huangqin (Scutellariae Radix), lower part uses Huafen (Trichosanthis Radix). For the Taiyin meridian at Zhongfu (LU1), Yunmen (LU2), and Chize (LU5), upper part uses Tiaoqin (Huangqin, Scutellariae Radix) and Lianqiao (Forsythiae Fructus); lower part involves Jimen (SP11) and Xuehai (SP10), using Cangzhu (Atractylodis Rhizoma) and Fangji (Stephaniae Tetrandrae Radix). For the Shaoyin meridian at Shaochong (HT9) and Shaohai (HT3), upper part uses Xixin (Asari Radix et Rhizoma); lower part at Yongquan (KI1) and Zhaohai (KI6), use Zhimu (Anemarrhenae Rhizoma). For the Jueyin meridian at Zhongchong (PC9) and Neiguan (PC6), upper part uses Chuanxiong (Ligustici Chuanxiong Rhizoma) and Changpu (Acori Tatarinowii Rhizoma); lower part at Dadun (LR1) and Ququan (LR8), use herbs like Chaihu (Bupleuri Radix). The above refers to the Hand meridians, and the below refers to the Foot meridians; one should examine this carefully.
The *Ling Shu* states: Fusitu (ST32) one, Fei (calf muscle area) two (Fei refers to Chu, i.e., calf belly), Bei (back) three, Wuzangshu (Back-Shu points of Five Zang organs) four, Xiang (neck) five. If carbuncles and sores occur in these five areas, death ensues.
Wang Haicang stated: Nao (brain/skull), Yi (jaw/chin), Xu (beard), Bin (temples) are also places where carbuncles and sores are invariably fatal.
The *Gui Yi Fang* states: There are seven places where one should not suffer from carbuncles and sores: behind the eyes in the hollow area one; where the jaw connects to the bone two; before and after the ear gate, where the mandible bone connects three; between the hairs above the root of the yin; where the hip connects to the sacrum four; any carbuncle formed due to wind-water in the lower abdomen five; below the mandible, near the hollow area behind the ear six; in the middle of the nasal bone seven. These can all harm people. Although treated with various methods, some may recover, but the hollow area behind the eyes is the most dangerous.
Jiang Shiji stated: There are nine dangerous locations for malignant sores on the back: entering the hairline is Yuzhen, also called Sheben one; the cervical vertebra joint two; the third vertebral process is Chonggu three; the fourth Da Zhui (GV14) corresponds to the Five Zang four; the sides of the fifth thoracic vertebra are Feishu (BL13) five; the sides of the sixth interscapular region are Pishu (BL20) and Ganshu (BL18) six; the sides of the seventh thoracic vertebra are Shenshu (BL23) seven; the eighth point opposite Jiwei (CV15) on the back eight (Jiwei is the xiphoid process bone); the Jiwei acupoint nine.
He further stated: There are six locations on the front: the laryngeal cartilage is Chuixing one; the center of the chest is Shenshe two; Xin Jiwei (heart xiphoid process, i.e., heart cover bone) three; the two breast acupoints four; the umbilicus is Shenque (CV8) five; two cun below the umbilicus is Yangququjian six.
He further stated: There are three locations on the side: below the ear near the posterior ear, in the defect of the angular mandible, is Houmai one; below the shoulder blade is Jianggu two; three cun above Chengshan (BL57) is Dachang three.
He further stated: Locations contraindicated for toxic sores include: Nao (brain), Fusitu (ST32), Zi (mustache), Fei (calf), Bin (temple), Bei (back), Yi (jaw), Xiang (neck), Yingxiang (LI20), Tongziliao (GB1), She (tongue), Wuzangshu (Back-Shu points of Five Zang organs). Affliction here is mostly perilous.