华元化曰∶疔有五色属五脏。红属心,发于舌根;青属肝,发于目下;黄属脾,发
于口唇;白属肺,发于右鼻;黑属肾,发于耳前。以种类言之。
孙真人《千金方》论疔疮一十三种∶一曰麻子疔,其状肉起,头如黍米,色稍黑,
四边微赤多痒。(忌食麻子油,衣麻衣,入麻田中行。)二曰石疔,其状皮肉相连,色如黑豆,甚
硬,刺之不入肉微痛。(忌瓦砾砖石之属。)三曰雄疔,其状 起头黑靥,四畔仰 将起,有
水出色黄,大如钱孔形高者。(忌房室。)四曰雌疔,其状疮稍黄,向里压亦似灸疮,四
边浆起,心凹色赤如钱孔者。(忌房室。)五曰火疔,其状如汤火烧灼,疮头黑靥,四
边有烟浆,又如赤粟米者(忌火烧烙)。六曰烂疔,其状色稍黑,有白斑,疮中有脓水流
出,疮形大小如匙面者。(忌热食烂物。)七曰三十六疔,其状头黑浮起,形如黑豆,四畔
起赤色,今日生一,明日生二,及到十,若满三十六,药所不能治,未满三十六可治。
(忌嗔怒、蓄积愁恨。)八曰蛇眼疔,其状疮头黑,皮浮生,形如小豆,状似蛇眼大,体硬。(忌
恶眼人看,并嫉妒人见,忌毒疮。)九曰盐肤疔,其状大如匙面,四边皆赤,有黑粟粒起大。(忌
食盐。)十曰水洗疔,其状大如钱形,如钱孔,头白里黑靥汁出,中硬。(忌饮浆水,水洗,渡河。)
十一曰刃镰疔,其状阔狭如薤菜大,长一
寸,左侧肉黑如烧烙。(忌刺及刀镰切割、铁刃所伤,可以药治,不可乱攻。)十二曰浮沤疔,其状
疮体圆曲,少许不合,长而狭如薤菜大,肉黄外黑,黑处刺之不痛,黄处刺之痛。十
三曰牛狗疔,其状肉色 起,掐不破。以上疔疮十三种,初起疮心先痒后痛,先寒
后热,热定则寒,多四肢沉重,心惊眼花。若重者则呕逆,呕逆则难治。麻子疔一种,
始终惟痒。以上忌禁者,不得触犯,如触犯者,发作难治。惟浮沤、牛狗二疔无所
禁忌,纵不医亦不害人,其状寒热与诸疔不同,故不杀人也。凡疔起后,背强疮痛
极甚不可忍者,是触犯禁忌,以此为辨。(此条与《外台秘要》《神巧不全》所论颇同。)
王肯堂曰∶疔之四围有赤肿,名曰护场,为可治。疔之四围无赤肿,名曰不护场,不可治。(准绳)
又曰∶疮证急者有应。如生一疔之外,别处肉上再生一小疮即是有应,可用针挑
破护场;疮四围有赤肿,生多疮者谓之满天星,饮食如常,头痛身热手足温。
陈实功曰∶疔疮有朝发夕死,随发随死,诚外科证中迅速之病也。凡治此证,贵
在乎早。如在头面,头乃诸阳之首,亢阳热极所致。其形虽小,其恶甚大,再加艾
灸,火益其势,逼毒内攻,反为倒陷走黄之证作矣;既作之后,头面耳项俱能发肿,
形如胖尸,七恶顿起,治虽有法,百中难保一二,不可不慎。(《正宗》)
又曰∶毒发于心经者,生为火焰疔。多生心脏之俞募井之端,唇口手掌指节或手
之小指。初生一点红黄小泡,抓破痛痒非常,左右肢体麻木,心烦发躁,言语昏愦。
又曰∶毒瓦斯发于肝经者,生为紫燕疔。多生手足腰胁筋骨之间,或足大指。初生
便是紫泡,次日破流血水,三日后串烂筋骨,疼痛苦楚,眼红目暗,指甲纯青,睡语惊惕。
又曰∶毒瓦斯发于脾经者,生为黄鼓疔。初生黄泡光亮明润,四面红色缠绕,多生
口角腮颧,眼胞上下及太阳正面之处。便作麻痒,绷急硬强,重则恶心呕吐,烦渴干哕。
又曰∶毒瓦斯发于肺经者,生为白刃疔。多生手大指。初生白泡,顶硬根突,破流
脂水,痒痛骤然,易腐易陷,腮损咽焦,毛耸肌热,咳吐脓痰,鼻掀气急。
又曰∶毒瓦斯发于肾经者,生为黑 疔。多生耳窍、胸腹、腰肾,及足小指涌泉偏
僻软肉之间。初生黑斑紫泡,毒串皮肤,渐至肌肉,顽硬如钉,痛沏骨髓;重则手足
青紫,惊悸沉困,软陷孔深,目睛透露。
又曰∶红丝疔起于手足节间。初起形似小疮,渐发红丝上攻手膊,或攻大腿,令
人寒热,恶心呕吐。迟者红丝至心,常能坏人。急用针于红丝尽处挑断出血,寻至
疔上挑破,插入蟾酥条,膏盖,内服蟾酥丸发汗,追出疔根,得脓自愈。
又曰∶唇下疔又名马口疔。
又曰∶手掌心疔又名擎珠疔。
又曰∶患疔经五六日不瘥,目中见火光,心神昏昧,口干心烦,呕吐不定,皆属疔毒内陷,均须速治。
冯鲁瞻曰∶疔者,经曰∶膏梁之变。盖因膏梁之人皮肉浓密,内多滞热,故变为
疔。然古方计有一十三种,三十六疔之分,总由脏腑积受热毒,邪气搏于经络,以致
血凝毒滞,注于毛孔、手足、头面,各随脏腑部位而发。其形如粟米,或痛或痒,渐
至遍身麻木,头眩寒热,时生呕逆,甚则四肢沉重,心惊眼花,经虽所载疔色有五,
以应五脏,其实紫黑及黄泡者居多,先痒后痛,先寒后热也。宜内服发散解毒攻托
之剂,外敷拔毒菊花叶、苍耳草之类。大概疔已成脓,则毒已外泄,可无他虑。惟
在初起,最宜谨慎,疔毒攻心,祸如反掌。盖疔由心火蕴结,故其疼痛异常,为害甚
速,病患口嚼生豆,不觉豆腥者即是也。若于耳后方圆一寸发者尤甚。盖水枯火炽之极也,
不可妄动,如抓破见风毒,即内攻不救。(《锦囊》)
又曰∶红丝疔者,又名血丝疔,发于两手指,而作红丝,渐渐行至关节,势必
杀人。可先以线扎住红纹之处,次将银针砭去恶血,以药涂之,上者血红,次者血
紫,下者血黑。若一失治,则稽留不散,轻则烂伤堕指,重则入腹而死。
又曰∶《内经》以白疔发于右鼻,赤疔发于舌根,黄疔发于口唇,黑疔发于耳门,
青疔发于目下,盖取五色以应五脏,各有所属部们。又有发于或肩或背,或腰或足,
发无定处。如在手、足、头、面、骨节间者最急,其余犹可缓也。
李东垣曰∶疔上按之碜痛应心者,是疔也。秋冬寒毒久结皮肤中,变作疔疮,不
急治之,日夜根长,流入诸脉数道,如箭入身,颤掉不已。若不慎口味房室,死不旋踵。(《精义》)
申斗垣曰∶夫疔疮取治,其法不一,当先看其缓急。如缓者,一日疮 白色而小,
二日色白微大,三日色微紫,四日色真紫,此候之缓也;急者五日色青紫小,六日色
深青大紧,七日色黑如火灸疮之状,此最急之候。假如身上生一疮,而他处又生一
小疮,为之应候。先用针挑破小疮,则泄其毒谓之可治;若只有一疔,他处无小疮,
谓之无应候,不可治。疔无应候,是毒瓦斯之甚,故不可治也。大抵疔疮四围有红赤
肿者,名曰有护场。如疔疮四围不赤肿者,即是不护场,不可治也;有护场方可
治也。疔之生者,身热头疼,手足温暖,饮食如常,是常疔也。疔之危者,眼转大渴
而喘,唇面青,不进食,五心肿,无有脉,四肢冷,不起床,不精神,腹痛甚于常,是有内疔也。(《启玄》)
周文采曰∶凡疗疔疮,皆宜刺疮中心至痛处,又刺四边十余下,令血出,去尽
恶血,敷药。药力得入针孔中方佳,若药不达中,药力难达,反致误事。又看口中
颊边舌上,有赤黑如珠子者,是疔也。(《集验》)
《养生篇》曰∶人汗入肉,食之则生疔疮,不可不慎。
窦汉卿曰∶凡疔疮针刺患人手足中指不痛者,难治。又曰∶如疔在头面、手足、
骨节间者,甚急。又曰∶疔疮头陷碧绿色者,不可用针刀出血。又曰∶疔疮日久溃
烂者,不可用针出血,只可用刀割去腐肉。又曰∶疔疮生根入腹者便死,用磨针刀铁
浆水一碗,丝绵滤净,银锅内煎三四沸,服之,病者须臾肠鸣,行得一二次苏醒方妙。
又曰∶疔疮不破则毒入肠胃,惟蝉蜕极效,用一两为末,蜜调下。又曰∶疔发于太阳
眼边者,名曰钉脑疔,十死一生。又曰∶疔疮脓水出,孔如蜂窠,病易瘥也。又曰∶凡
人暴死多是疔毒,急取灯遍照其身,若是小疮,即是其毒,宜急灸之,并服飞龙夺
命丹等药,亦有复苏者。(《全书》)
窦梦麟曰∶嘴唇痘疔,初生米大,或粉刺挤破,入汤火风气,即要变为疵疮,疵
疮即疔之别名也。先用葱白同飞龙夺命丹五粒和嚼烂,熟酒半碗送下,以衣覆患上,
略出汗为妙。上午服药,下午即将绝利磁锋划破疮口十字,即掺飞龙夺命丹末在内,
而外用蟾舌研烂,蟾肚底皮贴之,内服追疔汤剂。若发须发者,即剃去须发。如前
法治之。此法静夜细思,试而行之,百发百中,活人多矣,焉敢自秘,遂并梓行。病
人一个月内无色欲者,患处平妥无 肉,乃其征也。(《全书》)
陈远公曰∶有生疔疮者,疼痛非常,亦阳毒也。初生之时,人最难辨,但以生黄
豆令嚼之,不知腥者便是。其疮头必发黄泡中现紫黑之色,细看泡中必有红白一线
通出泡外。凡疔生足上,红线由足入脐,疔
生手上,红线由手走心,如生唇面,红线由唇面至喉,如见此红线,即于尽处以针
刺出毒血,则免毒攻心。若现白丝,不必刺也。总以消毒泻火为主,世人戒用官料
之药,此乃不知医之语,毒非药安得除哉!拔疔散治之,紫花地丁、甘菊花各一两,水
煎服。一剂红线除,二剂疔散,三剂痊愈,不必外治挑疔之多事也。若已溃烂,加当
归二两治之,不必四剂,毒尽肉生也。(《冰鉴》)
胡公弼曰∶猪疔其形圆而小,口内有油,忌食猪油、猪肉。牛疔其形圆而小,口
内无油, 起掐之不破,有寒热,忌食牛肉。狗疔其形长而带尖,色赤,有寒热,忌
食狗肉。羊疔其形长而带白色,有寒热,忌食羊肉。瓜藤疔不计其数,其形圆长如瓜
形,因食瓜毒而生,忌食诸瓜。豆腐疔其状白泡,三日内顶陷,因食豆腐,内有人
汗而生,忌食豆腐。气疔其形或大或小, 白如有气在内,因感恚怒而生,忌气恼。鬼
疔其形大小不一,因中邪毒之气而生,异于诸疔,比气疔更甚,令人言语如见鬼状。
红丝疔其形缕缕赤色如丝线,周身缠绕,宜松针刺去血,忌热物。内疔言其于内,脏
腑上腔子里面,喉内、口内,与外疔更不同利害,宜托里追疔。萝葡疔其形黑兼紫
如水晶,故名之。 白黑血毒水宜去之,宜托毒。杨梅疔形黑紫如熏梅,状若遍身杨
梅疮,内杂疔疮一二个,则令通身疮不起发,须针刺出毒,服托里土茯苓等药。鱼
脐疔如鱼之肚脐,多生胳膊肚、小腿肚上,乃手足阳明经分毒瓦斯,治宜加引经药。蜈
蚣疔形长如蜈蚣,亦有头足,发寒热,因饮食中被蜈蚣游走遗毒于内而生,宜加雄黄。
程山龄曰∶治疗之法,贵在乎早,初起即治者,十全十活,稍迟者十全五六,失
治者十全一二,内服莫妙于菊花甘草汤。项之以上,三阳受毒,必用针刺挑断疔根,插
药膏盖;项之以下,三阴受毒,即当艾灸。
灸之不痛,亦须针刺插药自效。(《十法》)
凡是疔疮(一种发病迅速、危险性较大的急性化脓性疾病)、杨梅结毒(梅毒晚期表现),都汇集在这一部分中,以便于查阅和参考治疗。
华元化曰∶疔有五色属五脏。红属心,发于舌根;青属肝,发于目下;黄属脾,发
于口唇;白属肺,发于右鼻;黑属肾,发于耳前。以种类言之。
华佗(字元化)说:疔疮有五种颜色,分别对应五脏。红色对应心,发作在舌根;青色对应肝,发作在眼下;黄色对应脾,发作在口唇;白色对应肺,发作在右鼻;黑色对应肾,发作在耳前。这是从种类上来论述的。
孙真人《千金方》论疔疮一十三种∶一曰麻子疔,其状肉起,头如黍米,色稍黑,
四边微赤多痒。(忌食麻子油,衣麻衣,入麻田中行。)二曰石疔,其状皮肉相连,色如黑豆,甚
硬,刺之不入肉微痛。(忌瓦砾砖石之属。)三曰雄疔,其状 起头黑靥,四畔仰 将起,有
水出色黄,大如钱孔形高者。(忌房室。)四曰雌疔,其状疮稍黄,向里压亦似灸疮,四
边浆起,心凹色赤如钱孔者。(忌房室。)五曰火疔,其状如汤火烧灼,疮头黑靥,四
边有烟浆,又如赤粟米者(忌火烧烙)。六曰烂疔,其状色稍黑,有白斑,疮中有脓水流
出,疮形大小如匙面者。(忌热食烂物。)七曰三十六疔,其状头黑浮起,形如黑豆,四畔
起赤色,今日生一,明日生二,及到十,若满三十六,药所不能治,未满三十六可治。
(忌嗔怒、蓄积愁恨。)八曰蛇眼疔,其状疮头黑,皮浮生,形如小豆,状似蛇眼大,体硬。(忌
恶眼人看,并嫉妒人见,忌毒疮。)九曰盐肤疔,其状大如匙面,四边皆赤,有黑粟粒起大。(忌
食盐。)十曰水洗疔,其状大如钱形,如钱孔,头白里黑靥汁出,中硬。(忌饮浆水,水洗,渡河。)
十一曰刃镰疔,其状阔狭如薤菜大,长一
寸,左侧肉黑如烧烙。(忌刺及刀镰切割、铁刃所伤,可以药治,不可乱攻。)十二曰浮沤疔,其状
疮体圆曲,少许不合,长而狭如薤菜大,肉黄外黑,黑处刺之不痛,黄处刺之痛。十
三曰牛狗疔,其状肉色 起,掐不破。以上疔疮十三种,初起疮心先痒后痛,先寒
后热,热定则寒,多四肢沉重,心惊眼花。若重者则呕逆,呕逆则难治。麻子疔一种,
始终惟痒。以上忌禁者,不得触犯,如触犯者,发作难治。惟浮沤、牛狗二疔无所
禁忌,纵不医亦不害人,其状寒热与诸疔不同,故不杀人也。凡疔起后,背强疮痛
极甚不可忍者,是触犯禁忌,以此为辨。(此条与《外台秘要》《神巧不全》所论颇同。)
孙思邈在《千金方》中论述了十三种疔疮:第一种叫麻子疔,症状是皮肤隆起,顶端像黍米一样,颜色稍黑,四周微红且很痒。(禁忌食用麻子油,穿麻布衣服,进入麻田行走。)第二种叫石疔,症状是皮肉连在一起,颜色像黑豆,非常坚硬,针刺不进,肉微痛。(禁忌接触瓦砾砖石之类的东西。)第三种叫雄疔,症状是顶端有黑色痂皮,四周向上翻起,流出黄色水液,形状像铜钱孔那样高耸。(禁忌性生活。)第四种叫雌疔,症状是疮面稍黄,向内按压也像灸疮,四周渗出浆液,中心凹陷,颜色赤红像铜钱孔。(禁忌性生活。)第五种叫火疔,症状像被热水或火灼烧,疮头有黑色痂皮,四周有烟雾状的浆液,又像红色的粟米粒。(禁忌用火烤或烙烫。)第六种叫烂疔,症状颜色稍黑,有白斑,疮中有脓液流出,疮形大小像汤匙面。(禁忌吃热的腐烂食物。)第七种叫三十六疔,症状是顶端黑色浮起,形状像黑豆,四周发红,今天长一个,明天长两个,等到长了十个,如果满了三十六个,药物无法治愈,未满三十六个还可以治疗。(禁忌发怒、积聚愁恨。)第八种叫蛇眼疔,症状是疮头黑,表皮浮起,形状像小豆,大小像蛇眼,质地坚硬。(禁忌被恶毒的人看,以及嫉妒的人看见,禁忌有毒的疮疡。)第九种叫盐肤疔,症状大小像汤匙面,四周都红,有黑色的粟米粒突起。(禁忌吃盐。)第十种叫水洗疔,症状大小像铜钱,像铜钱孔,头白里面黑痂流出汁液,中间坚硬。(禁忌喝生水,用水洗,过河。)第十一种叫刃镰疔,症状宽窄像薤菜叶那么大,长一寸,左侧肌肉黑得像被烧烙过。(禁忌被刺、刀镰切割、铁器划伤,可以用药物治疗,不可胡乱攻伐。)第十二种叫浮沤疔,症状是疮体圆曲,稍微不合拢,长而窄像薤菜叶,肉黄外面黑,黑的地方针刺不痛,黄的地方针刺痛。第十三种叫牛狗疔,症状是肉质隆起,掐不破。以上十三种疔疮,初起时疮心先痒后痛,先怕冷后发热,热退后则怕冷,大多四肢沉重,心慌眼花。如果病情重的会出现呕吐逆气,呕吐逆气就很难治。只有麻子疔这一种,从头到尾只是痒。以上提到的禁忌,不得触犯,如果触犯了,发作时就难以治疗。只有浮沤疔、牛狗疔这两种没有禁忌,即使不医治也不害人,它们的寒热症状与其他疔疮不同,所以不会致死。凡是疔疮发生后,背部僵硬、疮痛极度剧烈无法忍受的,就是触犯了禁忌,以此作为辨别依据。(这一条与《外台秘要》《神巧不全》中的论述大致相同。)
王肯堂曰∶疔之四围有赤肿,名曰护场,为可治。疔之四围无赤肿,名曰不护场,不可治。(准绳)
又曰∶疮证急者有应。如生一疔之外,别处肉上再生一小疮即是有应,可用针挑
破护场;疮四围有赤肿,生多疮者谓之满天星,饮食如常,头痛身热手足温。
王肯堂说:疔疮四周如果有红肿,名叫“护场”,表示可以治疗。疔疮四周如果没有红肿,名叫“不护场”,表示不可治疗。(出自《医学准绳六要》)
又说:病情急迫的疔疮会有“应候”。如果在生了一个疔疮之外,身体其他部位肉上再长出一个小疮,这就是有应候,可以用针挑破护场;如果疮四周有红肿,生出很多小疮的叫做“满天星”,此时患者饮食正常,头痛身热,手足温暖。
陈实功曰∶疔疮有朝发夕死,随发随死,诚外科证中迅速之病也。凡治此证,贵
在乎早。如在头面,头乃诸阳之首,亢阳热极所致。其形虽小,其恶甚大,再加艾
灸,火益其势,逼毒内攻,反为倒陷走黄之证作矣;既作之后,头面耳项俱能发肿,
形如胖尸,七恶顿起,治虽有法,百中难保一二,不可不慎。(《正宗》)
又曰∶毒发于心经者,生为火焰疔。多生心脏之俞募井之端,唇口手掌指节或手
之小指。初生一点红黄小泡,抓破痛痒非常,左右肢体麻木,心烦发躁,言语昏愦。
又曰∶毒瓦斯发于肝经者,生为紫燕疔。多生手足腰胁筋骨之间,或足大指。初生
便是紫泡,次日破流血水,三日后串烂筋骨,疼痛苦楚,眼红目暗,指甲纯青,睡语惊惕。
又曰∶毒瓦斯发于脾经者,生为黄鼓疔。初生黄泡光亮明润,四面红色缠绕,多生
口角腮颧,眼胞上下及太阳正面之处。便作麻痒,绷急硬强,重则恶心呕吐,烦渴干哕。
又曰∶毒瓦斯发于肺经者,生为白刃疔。多生手大指。初生白泡,顶硬根突,破流
脂水,痒痛骤然,易腐易陷,腮损咽焦,毛耸肌热,咳吐脓痰,鼻掀气急。
又曰∶毒瓦斯发于肾经者,生为黑 疔。多生耳窍、胸腹、腰肾,及足小指涌泉偏
僻软肉之间。初生黑斑紫泡,毒串皮肤,渐至肌肉,顽硬如钉,痛沏骨髓;重则手足
青紫,惊悸沉困,软陷孔深,目睛透露。
又曰∶红丝疔起于手足节间。初起形似小疮,渐发红丝上攻手膊,或攻大腿,令
人寒热,恶心呕吐。迟者红丝至心,常能坏人。急用针于红丝尽处挑断出血,寻至
疔上挑破,插入蟾酥条,膏盖,内服蟾酥丸发汗,追出疔根,得脓自愈。
又曰∶唇下疔又名马口疔。
又曰∶手掌心疔又名擎珠疔。
又曰∶患疔经五六日不瘥,目中见火光,心神昏昧,口干心烦,呕吐不定,皆属疔毒内陷,均须速治。
陈实功说:疔疮有的早晨发作晚上就死,刚发作就死,这确实是外科病症中发展迅速的疾病。凡是治疗这种病,贵在早期。如果生在头面部,头部是诸阳经汇聚之首,是由于阳气亢盛、热极所致。它的形状虽然小,但危害极大,如果再加以艾灸,火势会助长邪势,逼迫毒素内攻,反而导致“倒陷”或“走黄”(疔毒扩散入血引起的危重证候)的证候发生;一旦形成之后,头面耳朵颈部都会肿胀,形状像浮肿的尸体,“七恶”(中医外科判断预后的七种危重征象)顿时出现,虽然治疗方法存在,但百人中难保一二,不可不谨慎。(出自《外科正宗》)
又说:毒素发作在心经的,生成火焰疔。多发生在心脏的俞穴、募穴或井穴对应的体表部位,如嘴唇、口腔、手掌、手指关节或小指。初生时是一个红黄色的小水泡,抓破后疼痛瘙痒剧烈,左右肢体麻木,心烦意乱,胡言乱语。
又说:毒素发作在肝经的,生成紫燕疔。多发生在手足、腰部、胁肋、筋骨之间,或者足大趾。初生就是紫色水泡,第二天破裂流出血水,三天后腐蚀筋骨,疼痛痛苦,眼睛发红视力昏暗,指甲纯青,睡眠中说梦话且易惊醒。
又说:毒素发作在脾经的,生成黄鼓疔。初生黄色水泡,光亮润泽,四面红色环绕,多发生在嘴角、脸颊颧骨、眼睑上下及太阳穴正面等处。随即感到麻木瘙痒,紧绷僵硬,重则恶心呕吐,烦躁口渴,干呕。
又说:毒素发作在肺经的,生成白刃疔。多发生在手大拇指。初生白色水泡,顶端硬根部突出,破裂流出脂水,突然感到痒痛,容易腐烂下陷,腮帮受损咽喉干燥,毫毛竖起肌肉发热,咳嗽吐出脓痰,鼻孔翕动呼吸急促。
又说:毒素发作在肾经的,生成黑疔。多发生在耳窍、胸腹、腰肾,以及足小趾涌泉穴附近的偏僻软肉之间。初生黑色斑点紫色水泡,毒素蔓延皮肤,逐渐深入肌肉,顽固坚硬如钉子,疼痛彻骨;重则手足青紫,惊恐心悸,精神萎靡,疮口软陷很深,眼球突出。
又说:红丝疔起始于手足关节之间。初起形状像小疮,逐渐发出红丝向上攻入手臂,或攻入大腿,使人寒热往来,恶心呕吐。如果迟缓不治,红丝到达心脏,常常会导致败坏死亡。急需用针在红丝的尽头挑断出血,找到疔疮处挑破,插入蟾酥条,用膏药覆盖,内服蟾酥丸发汗,追出疔根,得到脓液后即可自愈。
又说:唇下的疔疮又名马口疔。
又说:手掌心的疔疮又名擎珠疔。
又说:患疔疮经过五六天不好转,眼中看到火光,心神昏沉模糊,口干心烦,呕吐不止,都属于疔毒内陷,都必须迅速治疗。
冯鲁瞻曰∶疔者,经曰∶膏梁之变。盖因膏梁之人皮肉浓密,内多滞热,故变为
疔。然古方计有一十三种,三十六疔之分,总由脏腑积受热毒,邪气搏于经络,以致
血凝毒滞,注于毛孔、手足、头面,各随脏腑部位而发。其形如粟米,或痛或痒,渐
至遍身麻木,头眩寒热,时生呕逆,甚则四肢沉重,心惊眼花,经虽所载疔色有五,
以应五脏,其实紫黑及黄泡者居多,先痒后痛,先寒后热也。宜内服发散解毒攻托
之剂,外敷拔毒菊花叶、苍耳草之类。大概疔已成脓,则毒已外泄,可无他虑。惟
在初起,最宜谨慎,疔毒攻心,祸如反掌。盖疔由心火蕴结,故其疼痛异常,为害甚
速,病患口嚼生豆,不觉豆腥者即是也。若于耳后方圆一寸发者尤甚。盖水枯火炽之极也,
不可妄动,如抓破见风毒,即内攻不救。(《锦囊》)
冯鲁瞻说:疔疮,医经中说:这是由于长期食用肥甘厚味(膏粱)引起的病变。大概是因为吃得好的人皮肉致密,体内多有郁滞的热邪,所以变成疔疮。然而古方记载共有十三种,分为三十六疔,总归是由脏腑积聚了热毒,邪气搏击于经络,导致血液凝滞、毒素淤堵,灌注于毛孔、手足、头面,各自随着脏腑所属的部位而发作。其形状像粟米,有时痛有时痒,逐渐发展到全身麻木,头晕寒热,时常产生呕吐逆气,严重时四肢沉重,心慌眼花。医经虽然记载疔疮颜色有五种,以对应五脏,但实际上紫色、黑色及黄色水泡的居多,都是先痒后痛,先怕冷后发热。适宜内服发散解毒、攻逐托里的药剂,外敷拔毒的菊花叶、苍耳草之类。大概疔疮已经成脓,则毒素已经向外排泄,就可以没有其他顾虑了。只有在初起阶段,最需谨慎,疔毒攻心,灾祸发生得就像翻转手掌一样快。因为疔疮是由心火蕴结而成,所以疼痛异常,危害非常迅速,病人嘴里嚼生豆子,感觉不到豆腥味,就是这种情况。如果在耳后方圆一寸处发生的尤其严重。这是因为阴水枯竭、阳火炽盛的极致表现,不可妄加触动,如果抓破见到风毒,就会内攻而无法救治。(出自《疡医锦囊》)
又曰∶红丝疔者,又名血丝疔,发于两手指,而作红丝,渐渐行至关节,势必
杀人。可先以线扎住红纹之处,次将银针砭去恶血,以药涂之,上者血红,次者血
紫,下者血黑。若一失治,则稽留不散,轻则烂伤堕指,重则入腹而死。
又说:红丝疔,又名血丝疔,发作在两手指,出现红丝,逐渐行进到关节,势必致死。可以先用线扎住红纹的地方,然后用银针刺破排出恶血,涂上药物,流出鲜红血的为上等,流出紫血的是中等,流出黑血的是下等。如果一旦失治,毒素就会滞留不散,轻则腐烂损伤导致手指脱落,重则毒素入腹而死。
又曰∶《内经》以白疔发于右鼻,赤疔发于舌根,黄疔发于口唇,黑疔发于耳门,
青疔发于目下,盖取五色以应五脏,各有所属部们。又有发于或肩或背,或腰或足,
发无定处。如在手、足、头、面、骨节间者最急,其余犹可缓也。
又说:《黄帝内经》认为白疔发于右鼻,赤疔发于舌根,黄疔发于口唇,黑疔发于耳门,青疔发于眼下,大概是取五色来对应五脏,各有其所属的部位。又有发于肩膀、背部、腰部或脚部的,发作没有固定位置。如果在手、足、头、面、骨节间发生的最为急迫,其他的还可以稍缓处理。
李东垣曰∶疔上按之碜痛应心者,是疔也。秋冬寒毒久结皮肤中,变作疔疮,不
急治之,日夜根长,流入诸脉数道,如箭入身,颤掉不已。若不慎口味房室,死不旋踵。(《精义》)
李东垣说:在疔疮上按压,感到刺痛且痛感直达心底的,就是疔疮。秋冬季节寒毒长久结聚在皮肤中,变化成为疔疮,如果不紧急治疗,日夜之间根基生长,流入多条经脉,像箭射入身体一样,颤抖不停。如果不注意饮食口味和节制房事,死亡就在眨眼之间。(出自《脾胃论精义》)
申斗垣曰∶夫疔疮取治,其法不一,当先看其缓急。如缓者,一日疮 白色而小,
二日色白微大,三日色微紫,四日色真紫,此候之缓也;急者五日色青紫小,六日色
深青大紧,七日色黑如火灸疮之状,此最急之候。假如身上生一疮,而他处又生一
小疮,为之应候。先用针挑破小疮,则泄其毒谓之可治;若只有一疔,他处无小疮,
谓之无应候,不可治。疔无应候,是毒瓦斯之甚,故不可治也。大抵疔疮四围有红赤
肿者,名曰有护场。如疔疮四围不赤肿者,即是不护场,不可治也;有护场方可
治也。疔之生者,身热头疼,手足温暖,饮食如常,是常疔也。疔之危者,眼转大渴
而喘,唇面青,不进食,五心肿,无有脉,四肢冷,不起床,不精神,腹痛甚于常,是有内疔也。(《启玄》)
申斗垣说:治疗疔疮的方法不一,应当先看其病情的缓急。如果是缓症,第一天疮面白色且小,第二天白色稍大,第三天颜色微紫,第四天颜色真紫,这是病情缓和的征候;如果是急症,第五天颜色青紫且小,第六天颜色深青且大紧,第七天颜色黑得像火灸过的疮状,这是最危急的征候。假如身上生了一个疮,而其他部位又生出一个小疮,这叫应候。先用针挑破小疮,从而泄出毒素,这叫可治;如果只有一个疔疮,其他地方没有小疮,这叫无应候,不可治。疔疮没有应候,说明毒素非常猛烈,所以不可治。大体上疔疮四周有红赤肿胀的,名叫有护场。如果疔疮四周不红不肿的,就是无护场,不可治;有护场才可以治疗。疔疮发作时,身体发热头痛,手足温暖,饮食正常,这是普通疔疮。疔疮危重的,眼睛转动、大渴且气喘,嘴唇面色青,不进食,手心脚心及心口肿,摸不到脉搏,四肢冰冷,不能起床,精神萎靡,腹痛比平时严重,这是内疔。(出自《外科启玄》)
周文采曰∶凡疗疔疮,皆宜刺疮中心至痛处,又刺四边十余下,令血出,去尽
恶血,敷药。药力得入针孔中方佳,若药不达中,药力难达,反致误事。又看口中
颊边舌上,有赤黑如珠子者,是疔也。(《集验》)
周文采说:凡是治疗疔疮,都应该针刺疮的中心最痛处,又针刺四周十余下,让血流出,排尽恶血,然后敷药。药力进入针孔中才好,如果药力达不到中心,药效难以到达,反而耽误事情。还要看口腔颊边舌头上的,如果有赤黑色像珠子一样的,就是疔疮。(出自《疡医集验》)
《养生篇》曰∶人汗入肉,食之则生疔疮,不可不慎。
《养生篇》说:人的汗液混入肉类食物中,吃了就会生疔疮,不可不谨慎。
窦汉卿曰∶凡疔疮针刺患人手足中指不痛者,难治。又曰∶如疔在头面、手足、
骨节间者,甚急。又曰∶疔疮头陷碧绿色者,不可用针刀出血。又曰∶疔疮日久溃
烂者,不可用针出血,只可用刀割去腐肉。又曰∶疔疮生根入腹者便死,用磨针刀铁
浆水一碗,丝绵滤净,银锅内煎三四沸,服之,病者须臾肠鸣,行得一二次苏醒方妙。
又曰∶疔疮不破则毒入肠胃,惟蝉蜕极效,用一两为末,蜜调下。又曰∶疔发于太阳
眼边者,名曰钉脑疔,十死一生。又曰∶疔疮脓水出,孔如蜂窠,病易瘥也。又曰∶凡
人暴死多是疔毒,急取灯遍照其身,若是小疮,即是其毒,宜急灸之,并服飞龙夺
命丹等药,亦有复苏者。(《全书》)
窦汉卿说:凡是疔疮,针刺患者的手或足的中指如果不痛的,很难治疗。又说:如果疔疮生在头面、手足、骨节间的,非常急迫。又说:疔疮顶部凹陷呈碧绿色的,不可用针刀放血。又说:疔疮日久溃烂的,不可用针放血,只能用刀割去腐肉。又说:疔疮生根深入腹部的就会死亡,用磨针刀的铁锈水一碗,用丝绵过滤干净,在银锅内煎煮三四沸,服用它,病人一会儿肠鸣,走动一两次后苏醒才妙。又说:疔疮不破裂则毒素进入肠胃,只有蝉蜕效果极佳,用一两研为粉末,蜂蜜调服。又说:疔疮发于太阳穴眼边的,名叫钉脑疔,十死一生。又说:疔疮脓水流出,孔洞像蜂巢一样,病容易痊愈。又说:凡人突然死亡多半是疔毒,急忙拿灯遍照其身体,如果是小疮,就是它的毒源,应该紧急艾灸,并服用飞龙夺命丹等药,也有复苏的。(出自《疮疡全书》)
窦梦麟曰∶嘴唇痘疔,初生米大,或粉刺挤破,入汤火风气,即要变为疵疮,疵
疮即疔之别名也。先用葱白同飞龙夺命丹五粒和嚼烂,熟酒半碗送下,以衣覆患上,
略出汗为妙。上午服药,下午即将绝利磁锋划破疮口十字,即掺飞龙夺命丹末在内,
而外用蟾舌研烂,蟾肚底皮贴之,内服追疔汤剂。若发须发者,即剃去须发。如前
法治之。此法静夜细思,试而行之,百发百中,活人多矣,焉敢自秘,遂并梓行。病
人一个月内无色欲者,患处平妥无 肉,乃其征也。(《全书》)
窦梦麟说:嘴唇痘疔,初生时像米粒大,或者是粉刺挤破后,受到水火风气的侵袭,就要变成疵疮,疵疮就是疔疮的别名。先用葱白同飞龙夺命丹五粒一起嚼烂,用半碗热酒送下,用衣服覆盖患处,微微出汗为妙。上午服药,下午就用锋利的磁片将疮口划成十字,随即掺入飞龙夺命丹粉末在内,而外用蟾蜍舌头研烂,蟾蜍肚皮底下的皮贴在上面,内服追疔汤剂。如果长出胡须头发的,就剃去须发。按照前面的方法治疗。这个方法在安静的夜晚仔细思考,尝试实行,百发百中,救活的人很多了,怎敢自己保密,于是一并刊印发行。病人在一个月内没有性欲行为的,患处平整妥当没有突起赘肉,就是痊愈的迹象。(出自《疮疡全书》)
陈远公曰∶有生疔疮者,疼痛非常,亦阳毒也。初生之时,人最难辨,但以生
豆令嚼之,不知腥者便是。其疮头必发黄泡中现紫黑之色,细看泡中必有红白一线
通出泡外。凡疔生足上,红线由足入脐,疔
生手上,红线由手走心,如生唇面,红线由唇面至喉,如见此红线,即于尽处以针
刺出毒血,则免毒攻心。若现白丝,不必刺也。总以消毒泻火为主,世人戒用官料
之药,此乃不知医之语,毒非药安得除哉!拔疔散治之,紫花地丁、甘菊花各一两,水
煎服。一剂红线除,二剂疔散,三剂痊愈,不必外治挑疔之多事也。若已溃烂,加当
归二两治之,不必四剂,毒尽肉生也。(《冰鉴》)
陈远公说:有生疔疮的,疼痛非常剧烈,也是阳毒。初生之时,人们最难辨别,只要让病人嚼生豆子,感觉不到豆腥味的就是了。其疮头一定发黄泡,泡中显现紫黑色,仔细看泡中必定有一条红白相间的线通出泡外。凡是疔疮生在脚上,红线从脚进入肚脐;疔疮生在手上的,红线从手走向心脏;如果生在嘴唇面部,红线从唇面走向喉咙,如果看到这条红线,就在红线尽头用针刺出毒血,就能避免毒气攻心。如果出现白丝,不必针刺。总体以消毒泻火为主,世人告诫不要使用官方配方的药物,这是不懂医术的话,毒素不用药物怎么能清除呢!用拔疔散治疗,紫花地丁、甘菊花各一两,水煎服。一剂后红线消失,二剂后疔疮消散,三剂后痊愈,不必进行外部挑治等多余的事情。如果已经溃烂,加入当归二两治疗,不需要四剂,毒素排尽新肉就会生长。(出自《外科医镜》)
胡公弼曰∶猪疔其形圆而小,口内有油,忌食猪油、猪肉。牛疔其形圆而小,口
内无油, 起掐之不破,有寒热,忌食牛肉。狗疔其形长而带尖,色赤,有寒热,忌
食狗肉。羊疔其形长而带白色,有寒热,忌食羊肉。瓜藤疔不计其数,其形圆长如瓜
形,因食瓜毒而生,忌食诸瓜。豆腐疔其状白泡,三日内顶陷,因食豆腐,内有人
汗而生,忌食豆腐。气疔其形或大或小, 白如有气在内,因感恚怒而生,忌气恼。鬼
疔其形大小不一,因中邪毒之气而生,异于诸疔,比气疔更甚,令人言语如见鬼状。
红丝疔其形缕缕赤色如丝线,周身缠绕,宜松针刺去血,忌热物。内疔言其于内,脏
腑上腔子里面,喉内、口内,与外疔更不同利害,宜托里追疔。萝葡疔其形黑兼紫
如水晶,故名之。 白黑血毒水宜去之,宜托毒。杨梅疔形黑紫如熏梅,状若遍身杨
梅疮,内杂疔疮一二个,则令通身疮不起发,须针刺出毒,服托里土茯苓等药。鱼
脐疔如鱼之肚脐,多生胳膊肚、小腿肚上,乃手足阳明经分毒瓦斯,治宜加引经药。蜈
蚣疔形长如蜈蚣,亦有头足,发寒热,因饮食中被蜈蚣游走遗毒于内而生,宜加雄黄。
胡公弼说:猪疔形状圆而小,口内有油脂,禁忌食用猪油、猪肉。牛疔形状圆而小,口内无油脂,隆起掐不破,伴有寒热,禁忌食用牛肉。狗疔形状长而带尖,颜色赤红,伴有寒热,禁忌食用狗肉。羊疔形状长而带白色,伴有寒热,禁忌食用羊肉。瓜藤疔数量无数,形状圆长像瓜果,因为食用瓜果毒素而生,禁忌食用各种瓜果。豆腐疔形状是白色水泡,三天内顶端凹陷,因为食用豆腐,内含人汗而生,禁忌食用豆腐。气疔形状或大或小,苍白好像里面有气,因为感受愤怒情绪而生,禁忌生气恼怒。鬼疔形状大小不一,因为中了邪毒之气而生,不同于其他疔疮,比气疔更严重,让人说话像见到鬼的样子。红丝疔形状一缕缕赤色像丝线,周身缠绕,适宜用松针刺去血,禁忌热性食物。内疔是指位于内部,脏腑上腔子里面,喉咙内、口腔内,与外疔的危害不同,适宜托里追疔。萝卜疔形状黑兼紫像水晶,所以这样命名。苍白黑血毒水适宜去除,适宜托毒。杨梅疔形状黑紫像熏制的梅子,样子像遍身杨梅疮,内部夹杂一两个疔疮,就会导致全身疮疡不起发,必须针刺出毒,服用托里土茯苓等药物。鱼脐疔像鱼的肚脐,多生在胳膊肚子、小腿肚上,是手足阳明经分的毒瓦斯,治疗适宜加引经药。蜈蚣疔形状长像蜈蚣,也有头足,发作寒热,因为饮食中被蜈蚣游走遗留毒素在内而生,适宜加雄黄。
程山龄曰∶治疗之法,贵在乎早,初起即治者,十全十活,稍迟者十全五六,失
治者十全一二,内服莫妙于菊花甘草汤。项之以上,三阳受毒,必用针刺挑断疔根,插
药膏盖;项之以下,三阴受毒,即当艾灸。
灸之不痛,亦须针刺插药自效。(《十法》)
程山龄说:治疗的方法,贵在早期,初起就治疗的,十个能治好十个,稍晚治疗的十个能治好五六个,失治的十个只能治好一两个,内服没有比菊花甘草汤更好的了。脖子以上的,三阳经受毒,必须用针刺挑断疔根,插入药膏覆盖;脖子以下的,三阴经受毒,就应当艾灸。
艾灸如果不痛,也必须针刺插药才能见效。(出自《疡医十法》)
All types of Ding sores (acute, dangerous purulent diseases with rapid onset) and Yangmei Jiedu (late-stage manifestations of syphilis) are compiled in this section for easy reference and treatment consultation.
Hua Yuanhua stated: Ding sores have five colors corresponding to the Five Zang Organs. Red corresponds to the Heart, appearing at the root of the tongue; Green corresponds to the Liver, appearing under the eyes; Yellow corresponds to the Spleen, appearing on the lips; White corresponds to the Lungs, appearing on the right nostril; Black corresponds to the Kidneys, appearing in front of the ears. This classification is based on types.
Sun Simiao discussed thirteen types of Ding sores in the *Qianjin Fang*:
1. Mazi Ding (Hemp Seed Ding): The lesion protrudes from the skin, the head resembles a millet seed, the color is slightly black, and the surrounding area is slightly red and very itchy. (Contraindications: Do not consume hemp seed oil, wear hemp clothing, or walk in hemp fields.)
2. Shi Ding (Stone Ding): The skin and flesh are connected, the color is like a black bean, it is extremely hard, cannot be pierced by a needle, and causes slight pain in the flesh. (Contraindications: Avoid contact with gravel, bricks, and stones.)
3. Xiong Ding (Male Ding): The head has a black crust, the surrounding edges turn upward, yellow fluid oozes out, and it is raised high like the hole of a coin. (Contraindications: Abstain from sexual intercourse.)
4. Ci Ding (Female Ding): The sore is slightly yellow, pressing inward resembles a moxibustion scar, the edges ooze serum, and the center is depressed and red like a coin hole. (Contraindications: Abstain from sexual intercourse.)
5. Huo Ding (Fire Ding): Resembles a burn from hot water or fire, the head has a black crust, the edges have smoky serum, and it looks like red millet grains. (Contraindications: Avoid burning or cauterizing.)
6. Lan Ding (Rotting Ding): The color is slightly black with white spots, pus flows from the sore, and the shape is as large as the surface of a spoon. (Contraindications: Avoid eating hot, rotten food.)
7. San Shi Liu Ding (Thirty-Six Ding): The head is black and floating, shaped like a black bean, with redness around the edges. One appears today, two tomorrow. If it reaches ten, it is treatable; if it fills up to thirty-six, it is untreatable by medicine. (Contraindications: Avoid anger and harboring resentment.)
8. Sheyan Ding (Snake Eye Ding): The head is black, the skin floats, shaped like a small bean, size resembling a snake eye, and the body is hard. (Contraindications: Avoid being looked at by malicious people or those jealous of you; avoid toxic sores.)
9. Yianfu Ding (Salt Skin Ding): As large as a spoon surface, all edges are red, with large black millet-like grains protruding. (Contraindications: Avoid salt.)
10. Shuixi Ding (Water Wash Ding): As large as a coin, like a coin hole, the head is white with a black crust inside exuding fluid, and the center is hard. (Contraindications: Avoid drinking raw water, washing with water, or crossing rivers.)
11. Renlian Ding (Blade Scythe Ding): Width and narrowness like a scallion leaf, one cun long, the left side muscle is black as if burned. (Contraindications: Avoid piercing, cutting with blades/scythes, or injury from iron edges; treat with medicine, do not attack recklessly.)
12. Fou'ou Ding (Floating Bubble Ding): The sore body is round and curved, slightly unclosed, long and narrow like a scallion leaf, flesh is yellow outside and black inside. Piercing the black part does not hurt, but piercing the yellow part hurts.
13. Niugou Ding (Cow-Dog Ding): The flesh rises, cannot be broken by pinching.
For the above thirteen types of Ding sores, initially the center of the sore itches then hurts, chills precede fever, and after the fever subsides, chills return. There is often heaviness in the four limbs, palpitations, and blurred vision. In severe cases, there is vomiting and regurgitation, which is difficult to treat. Only Mazi Ding itches throughout its course without pain. The aforementioned contraindications must not be violated; if violated, the outbreak becomes difficult to treat. Only Fou'ou Ding and Niugou Ding have no contraindications; even without medical treatment, they do not harm the person, as their chills and fever differ from other Ding sores, hence they are not fatal. After a Ding sore arises, if the back becomes stiff and the sore pain is unbearable, it indicates a violation of contraindications, which serves as a diagnostic criterion. (This item aligns closely with discussions in *Waitai Miyao* and *Shenqiao Buquan*.)
Wang Kentang stated: If there is redness and swelling around the Ding sore, it is called "Huchang" (Protective Field), indicating it is treatable. If there is no redness or swelling around the Ding sore, it is called "Bu Huchang," indicating it is untreatable. (*Yixue Zhunsheng*)
He also stated: Urgent sore conditions have an "Yinghou" (Response Sign). For example, if besides one Ding sore, another small sore appears on the flesh elsewhere, this is a Response Sign. One can pierce the Huchang with a needle. If the sore has redness and swelling around it and produces many sores, it is called "Man Tian Xing" (Stars Filling the Sky); the patient eats and drinks normally, has headache and body heat, but warm hands and feet.
Chen Shigong stated: Ding sores can cause death from morning to evening, or immediately upon onset; indeed, they are rapid diseases among surgical conditions. Treating such conditions prioritizes early intervention. If located on the head and face, the head is the summit of all Yang meridians, caused by extreme hyperactive Yang heat. Although small in form, its malignancy is great. Adding moxibustion increases the fire's momentum, forcing toxins inward, leading to "Dao Xian" (Collapse) or "Zou Huang" (Roaming Yellow - systemic toxicity). Once formed, the head, face, ears, and neck swell, resembling a bloated corpse, and the "Seven Evils" (seven critical prognostic signs) arise instantly. Although treatments exist, only one or two in a hundred survive; caution is essential. (*Waike Zhengzong*)
He also stated: When toxins manifest in the Heart Meridian, they generate Huoyan Ding (Flame Ding). They often appear at the Shu, Mu, or Jing-Well points of the Heart, or on the lips, mouth, palm, finger joints, or little finger. Initially, a small red-yellow blister appears; scratching it causes intense pain and itching, numbness in the limbs, mental restlessness, and confused speech.
When toxins manifest in the Liver Meridian, they generate Ziyan Ding (Purple Swallow Ding). They often appear between the hands, feet, waist, ribs, tendons, and bones, or on the big toe. Initially, a purple blister appears; it breaks the next day bleeding watery blood; after three days, it corrodes tendons and bones, causing severe pain, red eyes, dim vision, and blue nails, with sleep-talking and startle.
When toxins manifest in the Spleen Meridian, they generate Huanggu Ding (Yellow Drum Ding). Initially, a bright, moist yellow blister appears, surrounded by redness. It often appears at the corners of the mouth, cheeks, zygomatic arch, upper and lower eyelids, and the frontal region near the temporalis. It feels numb and itchy, tight and hard; severely, it causes nausea, vomiting, irritability, thirst, and dry heaving.
When toxins manifest in the Lung Meridian, they generate Bairren Ding (White Blade Ding). It often appears on the thumb. Initially, a white blister appears with a hard top and protruding base; breaking it leaks fatty fluid, causing sudden itch and pain. It easily rots and sinks, damaging the cheek, drying the throat, raising hair, heating the muscle, causing coughing of purulent sputum, flaring nostrils, and rapid breathing.
When toxins manifest in the Kidney Meridian, they generate Hei Ding (Black Ding). It often appears in the ear canal, chest, abdomen, waist, kidneys, and the soft flesh between the little toe and Yongquan point. Initially, black spots and purple blisters appear; toxins spread through the skin to the muscles, becoming hard as a nail, penetrating bone with pain. Severely, hands and feet turn blue-purple, with palpitations and lethargy, deep soft depressions, and protruding eyeballs.
He also stated: Hongsi Ding (Red Thread Ding) begins between the joints of the hands and feet. Initially resembling a small sore, red threads gradually ascend to the arm or thigh, causing chills, fever, nausea, and vomiting. If delayed, the red thread reaches the heart, often causing ruin. Urgently use a needle to pierce and bleed at the end of the red thread, find the Ding sore, pierce it, insert a Chan Su strip, cover with plaster, and internally administer Chan Su pills to induce sweating, expel the Ding root, and heal upon suppuration.
He also stated: Ding below the lip is also called Makou Ding.
Ding on the palm is also called Qingzhu Ding.
If a Ding sore persists for five or six days without improvement, with visual hallucinations of firelight, mental confusion, dry mouth, irritability, and irregular vomiting, it belongs to internal sinking of Ding toxin and requires rapid treatment.
Feng Luzhan stated: The classics say Ding is a change due to rich diet (Gao Liang). This is because people consuming rich foods have dense flesh and internal stagnant heat, transforming into Ding. Ancient formulas list thirteen types and Thirty-Six Dings, all resulting from accumulated heat-toxin in the Zang-Fu organs, fighting in the meridians, causing blood coagulation and toxin stagnation, pouring into pores, hands, feet, and head/face, erupting according to organ locations. Their shape resembles millet, sometimes painful, sometimes itchy, gradually leading to whole-body numbness, dizziness, chills/fever, and occasional vomiting. Severely, limbs feel heavy, heart palpitates, and vision blurs. Although classics mention five colors corresponding to five organs, purple/black and yellow blisters are most common, always itching before hurting, chills before fever. Internal administration of dispersing, detoxifying, and pushing-out agents is suitable; externally apply detoxifying herbs like Chrysanthemum leaves and Xanthium grass. Generally, once a Ding suppurates, the toxin is expelled outward, and no further worry is needed. However, in the initial stage, utmost caution is required; Ding toxin attacking the heart brings disaster swiftly. Since Ding stems from Heart Fire accumulation, pain is abnormal and harm is rapid. A sign is chewing raw beans without detecting their fishy/raw smell. If it occurs within one cun behind the ear, it is especially severe, representing extreme water depletion and fire blazing. Do not disturb it rashly; if scratched open exposing wind-toxin, it attacks internally and is incurable. (*Yuyi Jinang*)
He also stated: Hongsi Ding, also called Xuexian Ding, starts on fingers, forming red threads that gradually reach joints, inevitably causing death. Tie a thread around the red mark first, then use a silver needle to bleed out evil blood, and apply medicine. Bright red blood is superior, purple is medium, black is inferior. If untreated, toxins linger, causing mild cases to rot fingers off, or severe cases to die from abdominal invasion.
The *Neijing* states White Ding appears on the right nostril, Red Ding on the tongue root, Yellow Ding on lips, Black Ding at the ear gate, and Green Ding under the eyes, taking five colors to correspond to five organs, each with specific locations. Others appear on shoulders, back, waist, or feet, without fixed sites. Those on hands, feet, head, face, and joints are most urgent; others are less so.
Li Dongyuan stated: Pressing on a Ding causes stinging pain reaching the heart; this is a Ding. In autumn and winter, cold toxins accumulate in the skin, transforming into Ding sores. If not treated urgently, roots grow day and night, flowing into multiple meridians like arrows entering the body, causing tremors. Without caution regarding diet and sexual activity, death follows instantly. (*Jingyi*)
Shen Douyuan stated: Treatment methods for Ding vary; first assess urgency. Slow cases: Day 1 white and small; Day 2 white and slightly larger; Day 3 slightly purple; Day 4 truly purple. This is slow. Urgent cases: Day 5 blue-purple and small; Day 6 deep blue, large and tight; Day 7 black like a moxa scar. This is most urgent. If a sore appears elsewhere besides the main Ding, it is a "Yinghou" (Response). Pierce the small sore first to drain toxin; this is treatable. If only one Ding exists with no small sores elsewhere, it is "No Yinghou," untreatable. No Yinghou means extreme toxin, thus untreatable. Generally, red/swollen surroundings indicate "Huchang" (treatable); lack thereof indicates "Bu Huchang" (untreatable). A growing Ding with fever, headache, warm limbs, and normal appetite is ordinary. A critical Ding with wide-open eyes, extreme thirst, panting, blue lips/face, anorexia, swollen five centers, absent pulse, cold limbs, inability to rise, lethargy, and severe abdominal pain indicates Neiding (Internal Ding). (*Waike Qixuan*)
Zhou Wencai stated: To treat Ding, pierce the center and most painful spot, then pierce the surrounding area over ten times to bleed out evil blood, then apply medicine. Medicine enters well via needle holes; if it doesn't reach the center, efficacy fails, causing delay. Also check the cheeks and tongue for red-black bead-like lesions; these are Ding. (*Jiyan*)
*Yangsheng Pian* stated: Human sweat entering meat, if eaten, generates Ding sores; one must be cautious.
Dou Hanqing stated: If needling the middle finger of the hand or foot elicits no pain in a Ding patient, it is difficult to treat. Ding on head/face, hands/feet, or joints is very urgent. If the Ding head is depressed and green-blue, do not use needles/blades to bleed. If old and ulcerated, do not needle to bleed; only cut away necrotic tissue. If roots enter the abdomen, death ensues. Remedy: Use one bowl of iron-rust water (from grinding needles/blades), filter through silk cotton, boil three to four times in a silver pot, and drink. Intestinal rumbling and walking once or twice leads to recovery. If the Ding does not break, toxin enters stomach/intestines; Cicada Slough (Chan Tui) is highly effective. One liang powdered, taken with honey. Ding at the edge of the Taiyang eye is called Dingnao Ding (Nail Brain Ding), ten deaths to one survival. If pus flows from holes like a bee hive, the disease heals easily. Sudden death is often due to Ding toxin; illuminate the body with a lamp; if small sores are found, they are the source, moxa urgently, and administer Feilong Duoming Dan; some recover. (*Quanshu*)
Dou Menglin stated: Lip Dou Ding starts rice-sized. If a pimple is squeezed, exposing it to fire/water/wind, it becomes Cici Chuang (Defect Sore), another name for Ding. First, chew green onion white with five Feilong Duoming Dan pills, swallow with half bowl warm wine, cover the site with cloth until slight sweating occurs. Take medicine in the morning; in the afternoon, cross-hatch the wound with a sharp porcelain shard, sprinkle Feilong Duoming Dan powder inside, apply crushed toad tongue and toad belly skin externally, and internally administer Zhuoding Decoction. If hair grows, shave it. Treat as above. Reflecting quietly at night, I tested this method; it is 100% effective, saving many lives. I dare not keep it secret, so I publish it. Absence of sexual desire for one month and flat, non-protruding healing tissue at the site are signs of cure. (*Quanshu*)
Chen Yuangong stated: Ding sores cause extreme pain and are Yang Toxin. Hard to distinguish initially; chew raw beans; no fishy smell confirms it. The head shows a yellow blister with purple-black color inside; carefully observe a red-white line extending out. If on the foot, the red line goes to the navel; if on the hand, to the heart; if on lips/face, to the throat. Seeing this line, pierce the end to bleed toxin, preventing heart attack. White lines need no piercing. Main principle: Disinfect and purge fire. People warn against official medicines; this is ignorance. How else to remove toxin? Use Batuo San: Zi Hua Di Ding and Gan Ju Hua, one liang each, decocted. One dose removes red line, two doses disperse Ding, three doses cure. External picking is unnecessary. If ulcerated, add Dang Gui (two liangs); cure without four doses as toxin clears and flesh regenerates. (*Bingjian*)
Hu Gongbi stated: Zhu Ding (Pig Ding) is round/small, oily inside; avoid pork fat/meat. Niu Ding (Cow Ding) is round/small, non-oily, unbreakable by pinching, with chills/fever; avoid beef. Gou Ding (Dog Ding) is long/sharp, red, with chills/fever; avoid dog meat. Yang Ding (Sheep Ding) is long/white, with chills/fever; avoid mutton. Guateng Ding (Melon Vine Ding) is numerous, round/long like melons, from melon toxin; avoid melons. Doufu Ding (Tofu Ding) is white blister, sunken top within three days, from tofu containing human sweat; avoid tofu. Qi Ding (Qi Ding) varies in size, pale with internal gas sensation, from anger; avoid anger. Gui Ding (Ghost Ding) varies in size, from evil qi, worse than Qi Ding, causing ghost-like speech. Hongsi Ding (Red Thread Ding) is thread-like red, wrapping the body; prick with pine needle to bleed, avoid hot foods. Neiding (Internal Ding) is inside cavities/throat/mouth, different from external Ding; use interior-supporting and toxin-pushing methods. Luobo Ding (Radish Ding) is black/purple like crystal. Pale/black bloody toxin water should be removed; support toxin expulsion. Yangmei Ding (Mulberry Berry Ding) is black/purple like smoked plums, resembling generalized syphilitic sores with one or two internal Dings, preventing general eruption; needle to bleed toxin, take Tufuling and interior-supporting drugs. Yuqi Ding (Fish Umbilicus Ding) resembles fish belly button, often on arms/calves, from Yangming meridian toxin; add guiding herbs. Wugong Ding (Centipede Ding) is long like a centipede with head/legs, chills/fever, from centipede venom in food; add Xionghuang (Realgar).
Cheng Shanling stated: Treatment prioritizes early action. Treated at onset: 100% cure. Slightly late: 50-60% cure. Neglected: 10-20% cure. Internally, nothing beats Juhua Gancao Tang (Chrysanthemum and Licorice Decoction). Above the neck, Three Yang meridians receive toxin; must needle to sever root and insert plaster. Below the neck, Three Yin meridians receive toxin; must use moxibustion. If moxa does not hurt, still needle and insert medicine for effect. (*Shifa*)