论肺痈开刀 论欠伸两手不能下
天师曰∶缚治者,乃肺中生痈,必须开刀,有不可内消者。必其人不守禁忌,犯色而变者也。毒结成
于肺叶之下,吐痰即痛欲死,手按痛处,亦痛欲死。此等肺痈,必须开刀。将病患用绵丝绳缚在柱上,必
须牢紧妥当,不可使病患知,手执二寸之刀,令一人以凉水急浇其头面,乘病患惊呼之际,看定痛处,以
刀刺入一分,必有脓射出如注,乃解其缚,任其流脓流血,不可以药敷之,后以前膏药贴之。不可遽入生
肌散,三日后加之可也。此缚治之法也。问服煎药否?天师曰∶方用金银花一两,元参五钱,人参三
钱,甘草三钱,足矣。可用四剂,不必再用。肝痈不用刺。
张公曰,缚治法妙极,亦无可言。
华君曰∶同。然予尚有一症。凡人有伸欠,而两手不能下者,将人抱住,缚在柱上,又把木棒打
去,病患自然把手来遮隔,而两手自下矣。下后用当归一两,川芎五钱,红花五分,生地五钱,桃仁五
个,甘草一钱,大黄一钱,丹皮二钱,水煎服。二帖全愈。比有妇人而得此症者,亦缚在柱上,令一人
解其下衣,而彼怕羞,自然以两手下来遮隔,亦一时手下,亦以前汤与之可愈也。
论气虚多痰
天师曰∶肥治者,治肥人之病也。肥人多痰,乃气虚也。虚则气不能营运,故痰生之。则治痰焉
可仅治痰哉,必须补其气,而后带消其痰为得耳。然而气之补法,又不可纯补脾胃之土,而当兼补其命门
之火。盖火能生士,而土自生气,气足而痰自消,不治痰,正所以治痰也。方用人参三两,白术五两,
茯苓二两,薏仁五两,芡实五两,熟地八两,山茱萸四两,北五味一两,杜仲三两,肉桂二两,砂仁五钱,
益智仁一两,白芥子三两,桔红一两,各为末,蜜为丸。每日白滚水送下五钱,(〔批〕火土两培丹。)
此方之佳,全在肉桂之妙,妙在补命门心包之火。心包之火足,自能开胃以去痰;命门之火足,始能健脾
以去湿。况方中纯是补心补肾之味,肉桂于补药之中,行其地天之泰,水自归经,痰从何积。此肥人之
治法有如此。
张公曰∶妙。肥人治法,不过如此,无可再言。此乃丸
药方也,若有人不肯服丸药,当用煎方。予定一方,用人参三钱,白术五钱,茯苓三钱,熟地一两,山
茱萸四钱,肉桂一钱,砂仁一钱,益智仁一钱,半夏一钱,陈皮五分,神曲一钱,水煎服。(〔批〕补气
消痰饮。)此方治气虚而兼补肾水、肾火者也。肾中水火足,而脾胃之气自健,痰亦渐消矣。此方肥
人可常用也。
华君曰∶同。
论肺痈切开疗法 论呵欠伸展时双手无法放下
天师说:缚治法,是针对肺中生成痈脓,必须切开引流,有些情况无法通过内服药物消除的。这必定是因为患者不遵守禁忌,纵欲后病情变化的结果。毒邪结聚在肺叶之下,吐痰时疼痛难忍甚至痛不欲生,用手按压疼痛部位,也痛不欲生。这类肺痈,必须切开。将病人用丝绳绑在柱子上,必须绑得牢固妥当,不能让病人察觉。手持两寸长的刀,让一人用凉水急速浇淋病人的头面部,趁病人惊呼之际,看准疼痛处,用刀刺入一分深,必然有脓液如注般射出,然后解开束缚,任由脓血流出,不要用药敷盖,之后贴上之前的膏药。不可立即撒入生肌散,三天后再使用即可。这就是缚治的方法。问:需要服用煎剂吗?天师说:方子用金银花一两,玄参五钱,人参三钱,甘草三钱,足够了。可用四剂,不必再用。肝痈不需要针刺。
张公说:缚治法非常精妙,也没什么可多说的了。
华君说:同意。然而我还有一个病症。凡是有人打哈欠伸展身体,但双手无法放下的,将人抱住,绑在柱子上,又用木棒敲打(其下体),病人自然会用手来遮挡,双手自然就放下了。放下后服用当归一两,川芎五钱,红花五分,生地五钱,桃仁五个,甘草一钱,大黄一钱,丹皮二钱,水煎服。两帖即可痊愈。近来有妇人得了这个病,也被绑在柱子上,让人解开她的下衣,但她因为害羞,自然会用双手下来遮挡,也是一瞬间手就放下了,也用前面的汤药给她就可以痊愈。
天师说:肥治法,是治疗肥胖人的疾病。肥胖人多痰,这是因为气虚。气虚则气不能正常运行,所以产生痰。那么治疗痰怎么可以仅仅治疗痰呢,必须补气,然后兼以消痰才是得当的。然而补气的办法,又不可以单纯补益脾胃之土,而应当兼补命门之火。因为火能生土,土自然生气,气充足而痰自然消除,不直接治痰,正是为了治痰。方用人参三两,白术五两,茯苓二两,薏苡仁五两,芡实五两,熟地黄八两,山茱萸四两,北五味子一两,杜仲三两,肉桂二两,砂仁五钱,益智仁一两,白芥子三两,桔红一两,各研为末,蜂蜜制成丸药。每日用白开水送服五钱。(批注:火土两培丹。)这个方的佳处,全在于肉桂的妙用,妙在补益命门和心包之火。心包之火充足,自然能开胃去痰;命门之火充足,才能健脾祛湿。况且方中全是补心补肾的药物,肉桂在补药之中,起到交通心肾、调和阴阳的作用,水液自然归经,痰从哪里积聚呢。治疗肥胖人的方法就是这样。
张公说:精妙。肥胖人的治疗方法,不过如此,没什么可再说的了。这是丸药方,如果有人不肯服用丸药,应当用煎剂。拟定一方,用人参三钱,白术五钱,茯苓三钱,熟地黄一两,山茱萸四钱,肉桂一钱,砂仁一钱,益智仁一钱,半夏一钱,陈皮五分,神曲一钱,水煎服。(批注:补气消痰饮。)这个方子是治疗气虚兼补肾阴肾阳的。肾中水火充足,脾胃之气自然强健,痰也会逐渐消除。这个方子肥胖人可以常用。
华君说:同意。
On the Incision Treatment for Lung Abscess and on the Condition of Inability to Lower Hands During Yawning and Stretching
The Heavenly Master said: The "binding treatment" (Fu Zhi) is used for lung abscesses where incision is necessary, as some cases cannot be resolved through internal medication. This condition invariably arises from patients failing to observe dietary and lifestyle taboos, specifically engaging in sexual activity which exacerbates the illness. Toxic pathogens accumulate beneath the pulmonary lobes; expectoration causes excruciating pain, bordering on death, and palpation of the painful area also induces severe agony. Such lung abscesses require surgical incision. The patient must be bound tightly and securely to a pillar with silk ropes, without their knowledge. Holding a two-cun long knife, an assistant should rapidly pour cold water over the patient's head and face. Seizing the moment of the patient's startled cry, the surgeon identifies the precise point of pain and inserts the knife one fen deep. Pus will then gush out like a stream. The bindings are then removed, allowing pus and blood to drain freely. No topical medication should be applied initially; instead, apply the previously mentioned plaster afterward. Do not immediately apply Shengji San (Regenerate Flesh Powder); it may be added after three days. This constitutes the binding treatment method. Question: Is decoction required? Answer: The prescription consists of Jin Yin Hua (Lonicerae Japonicae Flos, Honeysuckle Flower) 1 liang, Yuan Shen (Scrophulariae Radix, Figwort Root) 5 qian, Ren Shen (Ginseng Radix, Ginseng Root) 3 qian, and Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) 3 qian. This is sufficient. Four doses may be administered; no further dosage is needed. Liver abscesses do not require puncturing.
Master Zhang said: The binding treatment is extremely ingenious, leaving little to add.
Master Hua said: I agree. However, I have another condition to discuss. When a person yawns and stretches but cannot lower their hands, one should embrace the person, bind them to a pillar, and strike their lower body with a wooden stick. The patient will naturally raise their hands to shield themselves, thereby lowering them. Afterward, administer a decoction of Dang Gui (Angelicae Sinensis Radix, Dong Quai Root) 1 liang, Chuan Xiong (Chuanxiong Rhizoma, Szechwan Lovage Rhizome) 5 qian, Hong Hua (Carthami Flos, Safflower) 5 fen, Sheng Di Huang (Rehmanniae Radix, Rehmannia Root) 5 qian, Tao Ren (Persicae Semen, Peach Kernel) 5 pieces, Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) 1 qian, Da Huang (Rhei Radix et Rhizoma, Rhubarb Root) 1 qian, and Mu Dan Pi (Moutan Cortex, Tree Peony Bark) 2 qian. Decoct in water and take orally. Two doses result in complete recovery. Recently, a woman suffered from this condition; she was also bound to a pillar. When someone attempted to undress her lower garments, her modesty caused her to instinctively use her hands to cover herself, thus lowering them instantly. She too was cured using the aforementioned decoction.
On Phlegm Excess Due to Qi Deficiency
The Heavenly Master said: The "fatness treatment" (Fei Zhi) addresses diseases prevalent in obese individuals. Obese people tend to have excessive phlegm due to Qi deficiency. When Qi is deficient, it fails to circulate and transport effectively, leading to phlegm production. Therefore, treating phlegm cannot rely solely on resolving phlegm; one must tonify Qi and simultaneously resolve phlegm. However, the method of tonifying Qi should not focus exclusively on tonifying the Earth element of the Spleen and Stomach, but must also supplement the Fire of the Mingmen (Gate of Vitality). Since Fire generates Earth, Earth subsequently generates Qi. When Qi is sufficient, phlegm dissipates naturally. Thus, by not directly targeting phlegm, one effectively treats it. The prescription uses Ren Shen (Ginseng Radix, Ginseng Root) 3 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma, White Atractylodes Rhizome) 5 liang, Fu Ling (Poria, Poria Cocos), Yi Yi Ren (Coicis Semen, Job's Tears Seed) 5 liang, Qian Shi (Euryales Semen, Foxnut) 5 liang, Shu Di Huang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) 8 liang, Shan Zhu Yu (Corni Fructus, Dogwood Fruit) 4 liang, Bei Wu Wei Zi (Schisandrae Chinensis Fructus, Schisandra Berry) 1 liang, Du Zhong (Eucommiae Cortex, Eucommia Bark) 3 liang, Rou Gui (Cinnamomi Cortex, Cinnamon Bark) 2 liang, Sha Ren (Amomi Fructus Rotundus, Cardamom Fruit) 5 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, Alpinia Fruit) 1 liang, Bai Jie Zi (Sinapis Semen, Mustard Seed) 3 liang, and Ju Hong (Citri Reticulatae Pericarpium Rubrum, Red Tangerine Peel) 1 liang. Each ingredient is powdered, and honey is used to form pills. Take 5 qian daily with warm boiled water. (Annotation: Huo Tu Liang Pei Dan [Fire and Earth Dual Tonification Pill].) The excellence of this formula lies entirely in the efficacy of Rou Gui (Cinnamomi Cortex, Cinnamon Bark), which benefits the Fire of the Mingmen (Gate of Vitality) and Xin Bao (Pericardium). When the Fire of the Xin Bao (Pericardium) is sufficient, it naturally opens the stomach and resolves phlegm; when the Fire of the Mingmen (Gate of Vitality) is sufficient, it strengthens the Spleen to eliminate dampness. Moreover, since the formula primarily tonifies the Heart and Kidney, Rou Gui facilitates the harmonious interaction between Heaven and Earth within the context of these tonic herbs, ensuring fluids return to their proper channels, preventing phlegm accumulation. This illustrates the treatment approach for obesity.
Master Zhang said: Ingenious. The treatment for obese individuals is essentially as described, with nothing further to add. This is a pill formula. If a patient refuses pills, a decoction should be used. A prescribed formula includes: Ren Shen (Ginseng Radix, Ginseng Root) 3 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma, White Atractylodes Rhizome) 5 qian, Fu Ling (Poria, Poria Cocos) 3 qian, Shu Di Huang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) 1 liang, Shan Zhu Yu (Corni Fructus, Dogwood Fruit) 4 qian, Rou Gui (Cinnamomi Cortex, Cinnamon Bark) 1 qian, Sha Ren (Amomi Fructus Rotundus, Cardamom Fruit) 1 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, Alpinia Fruit) 1 qian, Ban Xia (Pinelliae Rhizoma, Pinellia Tuber) 1 qian, Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel) 5 fen, and Shen Qu (Medicated Leaven, Medicated Leaven) 1 qian. Decoct in water and take orally. (Annotation: Bu Qi Xiao Tan Yin [Qi-Tonifying and Phlegm-Resolving Decoction].) This formula treats Qi deficiency while simultaneously tonifying Kidney Water and Kidney Fire. When the Water and Fire within the Kidneys are sufficient, the Qi of the Spleen and Stomach becomes robust, and phlegm gradually dissipates. This formula can be commonly used by obese individuals.
Master Hua said: I agree.