或问∶百会穴生疽何如?曰∶此名玉顶发,初如麦米,顿增痛楚,寒热大作,由虚
阳浮泛,宜以盐汤下八味丸,引火归源,甚则黑锡丹。或元气素浓,六阳经受风邪,风
火相扇,脏腑热毒上攻而然者,宜黄连消毒饮兼玉枢丹、胜金丹,更以附子切片,置涌
泉穴灸五壮,以泄其毒。七日无脓者死。
或问∶顶门生痈何如?曰∶此属太阳经风热所至,一名佛顶疽,穴名上星。由脏腑
阴阳不调,热毒上壅而成,宜服活命饮加芩、连、栀子、 本,清热之剂,及紫金丹、乌
金散、夺命丹汗之。虚者十全大补汤加羌活。稍迟,溃烂黑陷,恶证多,脉大神昏,二便
闭结者,不治。
《鬼遗方》云∶左额、右额发赤疽。不拘大小,状如桃李,急宜药贴破,见脓无害。右
额角一处发毒疽及恶疖,为近太阳穴,如肿满太阳,即成虚损。为近穴而难消,不可破,
如破后伤外风水,即能害人,亦宜用药溃脓后,速敛合疮口,如经冬月,即成冷疮。缘
此处近太阳穴,上至额角,都为险处。或问∶当额生疽何如?曰∶此属阳明胃积热,宜服
活命饮加升麻、桔梗、羌活,水酒煎服。壮实者,一粒金丹下之,老弱者,十全大补汤
或十宣散、黄 内托散托之,过时溃烂,脑髓出者死。
《鬼遗》云∶左右太阳穴,或发疽疖及痈,五七日不溃,毒瓦斯流入眼眶攻眼,眼合不开,
用药贴破,破后慎外风水,所入即损其睛,疰损眼脸而成大疾。或问∶两太阳生疽何如?曰∶
此名勇疽,亦名脑发。疽属足阳明胃经,状如伏鼠,寒热并作,面目浮肿,宜活命饮加
升麻、桔梗,乌金散。十一日刺得黄白脓者生,清稀黑血者,及溃烂透脑者死。
有人问:在百会穴发生疽证是怎样的?回答说:这叫做玉顶发,初起时像麦粒大小,突然增加疼痛和苦楚,寒战和高热同时发作,这是由于虚阳浮越上泛所致,适宜用盐汤送服八味丸,以引火归源;病情严重的,则使用黑锡丹。如果是元气原本充足的人,六阳经受到风邪侵袭,风与火相互煽动,脏腑的热毒向上攻冲而形成的,适宜服用黄连消毒饮,兼服玉枢丹、胜金丹,再用附子切片,放置在涌泉穴上进行艾灸五壮,以泄出体内的毒邪。如果七天后没有化脓的,就会死亡。
有人问:在头顶门发生痈肿是怎样的?回答说:这属于太阳经的风热邪气所致,一名叫做佛顶疽,穴位名称是上星。这是由于脏腑阴阳不调,热毒向上壅滞而成,适宜服用活命饮,加入黄芩、黄连、栀子、本(藁本),作为清热类的药剂,以及紫金丹、乌金散、夺命丹来发汗解表。体质虚弱者,服用十全大补汤并加入羌活。如果治疗稍微迟缓,出现溃烂且颜色黑陷,恶候很多,脉象盛大且神志昏迷,大小便闭结不通的,无法治愈。
《鬼遗方》说:左侧额角、右侧额角发生的赤疽。不论大小,形状像桃子和李子一样,应当紧急用药贴使其破溃,见到脓液排出就没有危害。如果在右额角一处发生毒疽及恶疖,因为靠近太阳穴,如果肿胀充满太阳穴部位,就会形成虚损病症。因为靠近穴位而难以消散,不可强行破溃,如果破溃后损伤了外部的风水邪气侵入,就能伤害人,也适宜用药使脓液溃破后,迅速收敛愈合疮口,如果经过冬天月份,就会变成冷疮。因为这个部位靠近太阳穴,向上至额角,都属于危险之处。有人问:当额部发生疽证是怎样的?回答说:这属于阳明胃经积热所致,适宜服用活命饮,加入升麻、桔梗、羌活,用水和酒煎煮后服用。身体强壮结实的人,用一粒金丹泻下通便;年老体弱的人,用十全大补汤或十宣散、黄芪内托散来托毒外出,如果过时不愈导致溃烂,脑髓流出的,就会死亡。
《鬼遗方》说:左右太阳穴,或者发生疽疖及痈肿,五到七天不溃破,毒瓦斯流入眼眶攻击眼睛,导致眼睛闭合无法睁开,用药贴使其破溃,破溃后要谨慎防止外感风水邪气侵入,一旦侵入就会损害眼睛,注毒损伤眼睑而形成大病。有人问:两侧太阳穴发生疽证是怎样的?回答说:这叫做勇疽,也叫做脑发。疽证属于足阳明胃经,形状像趴着的老鼠,寒战和高热同时发作,面部和眼部浮肿,适宜服用活命饮加入升麻、桔梗,以及乌金散。十一天时刺破能流出黄白色脓液的可以生存,流出清稀黑血的,以及溃烂穿透脑部的,就会死亡。
A question was asked: What is the condition like when a carbuncle (ju, 疽) occurs at the Baihui acupoint? The answer is: This is named Yuding Fa (Jade Top Eruption). Initially, it resembles a wheat grain, suddenly increasing in pain and distress, with severe chills and high fever occurring simultaneously. This is caused by floating and overflowing deficient Yang. It is appropriate to administer Bawei Wan (Eight-Ingredient Pill) with salt water to guide the fire back to its source; for severe cases, Heixi Dan (Black Tin Pill) may be used. If the person's primordial Qi is originally robust, and the Six Yang meridians are invaded by wind pathogen, with wind and fire fanning each other, causing heat toxin from the Zang-Fu organs to attack upwards, it is appropriate to take Huanglian Xiaodu Yin (Coptis Decoction for Eliminating Toxins), combined with Yushu Dan (Jade Pivot Pill) and Shengjin Dan (Winning Gold Pill). Additionally, slices of Fuzi (Prepared Aconite Root) should be placed on the Yongquan acupoint and moxa-needled five times (five moxa cones) to drain the toxin. If there is no suppuration after seven days, death ensues.
Another question was asked: What is the condition like when a carbuncle (yi, 痈) occurs at the top of the head? The answer is: This belongs to wind-heat affecting the Taiyang Meridian, also known as Foding Ju (Buddha's Head Carbuncle), located at the Shangxing acupoint. It arises from disharmony of Yin and Yang in the Zang-Fu organs, leading to heat toxin congesting upwards. It is appropriate to take Mianing Yin (Life-Saving Decoction) added with Huangqin (Scutellaria Root), Lian (Coptis Rhizome), Zhizi (Gardenia Fruit), and Ben Cao (Ligusticum Wallichii Rhizome) as heat-clearing agents, along with Zijin Dan (Purple Gold Pill), Wujin San (Black Gold Powder), and Duoming Dan (Life-Taking Pill) to induce sweating. For those with deficiency, Shiquan Dabu Tang (Decoction for Perfect Great Tonification) added with Qianghuo (Notopterygium Rhizome) is suitable. If treatment is slightly delayed, resulting in ulceration with black depression, many ominous signs, a surging pulse, coma, and constipation of both bowels and bladder, it is incurable.
The Gui Yi Fang states: Red carbuncles (chi ju, 赤疽) occur at the left or right frontal eminence. Regardless of size, they resemble peaches or plums. Medicinal patches should be applied urgently to rupture them; seeing pus discharge is harmless. If a toxic carbuncle or malignant boil occurs at one spot on the right frontal angle, because it is near the Taiyang acupoint, if swelling fills the Taiyang area, it leads to deficiency and damage. Because it is near the acupoint, it is difficult to resolve and should not be ruptured. If ruptured, injury to external wind-water pathogens can harm the patient. It is also appropriate to use medication to suppurate, then quickly close the wound after pus drainage. If this persists through winter months, it becomes a cold sore. Since this area is near the Taiyang acupoint and extends up to the frontal angle, it is considered a dangerous location. A question was asked: What is the condition like when a carbuncle occurs on the forehead? The answer is: This belongs to accumulated heat in the Yangming Stomach meridian. It is appropriate to take Mianing Yin added with Shengma (Cimicifuga Rhizome), Jiegeng (Platycodon Root), and Qianghuo, decocted with water and wine. For robust individuals, Yili Jindan (One-Pill Golden Pill) is used to purge downwards; for the elderly and weak, Shiquan Dabu Tang or Shixuan San (Ten-Aperture Powder) or Huangqi Neituo San (Astragalus Internal Support Powder) is used to support internally and expel toxins. If neglected until ulceration occurs with brain matter protruding, death ensues.
The Gui Yi Fang states: At the left or right Taiyang acupoints, carbuncles, boils, or abscesses may occur. If they do not suppurate within five to seven days, toxic vapors flow into the eye sockets and attack the eyes, causing them to remain closed. Medicinal patches should be used to rupture them. After rupture, care must be taken to prevent external wind-water pathogens from entering; once entered, they will damage the eyes, injecting toxins into the eyelids and causing major diseases. A question was asked: What is the condition like when carbuncles occur at both Taiyang acupoints? The answer is: This is named Yong Ju (Brave Carbuncle), also known as Nao Fa (Brain Eruption). The carbuncle belongs to the Foot-Yangming Stomach meridian, resembling a crouching mouse, with simultaneous chills and fever, and swelling of the face and eyes. It is appropriate to take Mianing Yin added with Shengma and Jiegeng, along with Wujin San. If yellow-white pus is obtained upon puncture on the eleventh day, survival is possible; if clear, thin black blood flows, or if ulceration penetrates the brain, death ensues.