与痈毒门痈疽论参看。
王洪绪曰∶阴毒之症,皆皮色不变。然有肿与不肿者,有痛与不痛者,有坚硬难移,有
柔软如绵者,不可不为之辨。夫肿而不坚,痛而难忍者,流柱也;肿而坚硬微痛者,贴骨、
鹤膝、横 、骨槽等类也;不肿而痛,骨骱麻木,手足不仁者,风湿也;坚硬如核、初起不
痛者,乳岩、瘰 也;不痛而坚、形大如拳者,恶核、失荣也;不痛不坚,软而渐大者,瘿
瘤也;不痛而坚,坚如金石,形大如升斗者,石疽也。此等症候尽属阴虚,无论平塌大小,
毒发五脏,皆曰阴疽。如其疼痛者易消,重按不痛而坚者,毒根深固,消之不易,则治之尤
不容缓也。
王洪绪曰∶初起之形宽大平塌,根盘散漫,不肿不痛,色不明亮,此阴疽最险之症。倘
误服寒凉,其色变如隔夜猪肝,毒攻内腑,神昏即死。夫色之不明而散漫者,乃气血两虚也
;患之不痛而平塌者,毒痰凝结也。治之之法,非麻黄不能开其腠理,非肉桂、炮姜不能解
其凝结,此三味虽酷暑不能缺其一也。腠理一开,凝结一解,气血能行,行则凝结之毒随消
,乃一定而不可移之法。后列阳和汤、阳和膏、犀黄丸、小金丹诸方,均为阴疽要药,照方
治之,万无一失。如若增减,定无功效。
又曰∶小孩如患各种阴疽不能服药,初起以小金丹化服,至消乃止。如已成脓亦须日日
服之,可使不痛而穿,俟毒去尽,用保元汤(见痈毒门)加肉桂五分,水煎,日服收功。
又曰∶凡患一应色白大小等疽,忌用洞天膏。又膏药熬太嫩者,贴则寒凝愈结。又膏药
有巴豆、蓖麻,万不可贴,贴则被其提拔成功,每见横 、乳岩贴至致命,孕妇贴则堕胎,
凡诸阴疽溃后宜贴阳和解凝膏为妙。
与痈毒门中的痈疽论篇参看。
王洪绪说:阴毒这类病症,皮肤颜色都不改变。然而有的肿胀、有的不肿胀;有的疼痛、有的不疼痛;有的坚硬难以推动,有的柔软像棉絮一样,不能不加以辨别。那种肿胀但不坚硬、疼痛且难以忍受的,是流注(一种发于肌肉深部的化脓性疾病);那种肿胀且坚硬微痛的,是贴骨疽、鹤膝风、横痃(腹股沟淋巴结结核)、骨槽风等类型;不肿胀但疼痛,骨骼关节麻木,手足感觉迟钝的,是风湿病;坚硬像核状、初起时不痛的,是乳岩(乳腺癌)、瘰疬(颈部淋巴结结核);不痛而坚硬、形状大如拳头的,是恶核、失荣(晚期恶性肿瘤);不痛也不坚硬,柔软且逐渐增大的,是瘿瘤(甲状腺肿或颈部肿瘤);不痛而坚硬,硬如金石,形状大如升斗的,是石疽。这些症候都属于阴虚,无论平塌还是大小,毒气发于五脏,都称为阴疽。如果疼痛的容易消散,重按不痛而且坚硬的,说明毒根深固,难以消除,那么治疗就更不容迟缓了。
王洪绪说:初起时形状宽大平塌,根基散漫,不肿不痛,颜色不明亮,这是阴疽最危险的症候。倘若误服寒凉药物,其颜色会变成像隔夜的猪肝色,毒气攻入内脏,神志昏迷随即死亡。那种颜色不明亮且散漫的,是气血两虚;患处不痛且平塌的,是毒痰凝结所致。治疗的方法,非麻黄不能打开腠理(皮肤毛孔及纹理),非肉桂、炮姜不能化解凝结,这三味药即使在酷暑也不能缺少其中一味。腠理一旦打开,凝结一旦化解,气血就能运行,气血运行则凝结的毒气随之消散,这是一定且不可更改的方法。后文列出的阳和汤、阳和膏、犀黄丸、小金丹等方剂,都是治疗阴疽的重要药物,按照方子治疗,万无一失。如果有增减,必定没有功效。
又说:小孩如果患各种阴疽不能服药,初起时用小金丹化开服用,直到肿块消散为止。如果已经成脓,也必须每天服用,可以使患者不痛而破溃,等到毒气去尽后,用保元汤(见痈毒门)加五分肉桂,水煎服,每日服用以收功。
又说:凡是患各种颜色发白、大小不同的疽,忌用洞天膏。另外,膏药熬制太嫩的话,贴敷会导致寒凝更加结实。还有含有巴豆、蓖麻的膏药,万万不可贴敷,贴敷会被其提拔而促成病情恶化,常见横痃、乳岩患者贴敷至致命,孕妇贴敷则会堕胎。凡是各种阴疽溃烂后,适宜贴敷阳和解凝膏为妙。
Refer to the discussion on carbuncles and sores in the section on toxic carbuncles.
Wang Hongxu stated: In cases of Yin poison, the skin color remains unchanged. However, there are cases with swelling and those without; pain and those without; hardness that is difficult to move, and softness like cotton. These distinctions must not be overlooked. Swelling without hardness, accompanied by unbearable pain, is known as *Liuzhu* (Flowing Pillar, a suppurative disease deep in the muscles); swelling with hardness and slight pain refers to types such as *Tiegujju* (Bone-Adhering Carbuncle), *Hexifen* (Crane's Knee Wind), *Hengxuan* (Groin Buboes), and *Guchao Feng* (Bone Trough Wind); no swelling but with pain, numbness in bone joints, and insensitivity in hands and feet indicates *Fengshi* (Wind-Dampness); hardness like a kernel, with no initial pain, refers to *Luyan* (Breast Rock, breast cancer) and *Luoli* (Scrofula); no pain but hard, shaped like a fist, refers to *Ehe* (Evil Nodule) and *Shirong* (Loss of Glory); no pain, not hard, soft and gradually enlarging, refers to *Yingliu* (Goiter/Tumor); no pain but hard, hard as metal and stone, large as a measuring vessel, refers to *Shiju* (Stone Carbuncle). All these conditions belong to Yin deficiency. Regardless of whether they are flat or large, and regardless of which of the five z-organs the toxin originates from, they are all termed *Yin Ju* (Yin Carbuncle). If painful, it is easier to resolve; if painless upon heavy pressure and hard, the toxin root is deep and solidified, making resolution difficult; thus, treatment must not be delayed.
Wang Hongxu stated: When initially presenting with a wide, flat shape, scattered roots, no swelling or pain, and dull color, this is the most dangerous manifestation of *Yin Ju*. If cold-natured medicines are mistakenly administered, the color will change to that of overnight pork liver, the toxin attacks the internal organs, and death follows immediately with coma. A dull and scattered color indicates deficiency of both Qi and Blood; a painless and flat lesion indicates congealed toxin-phlegm. The method of treatment requires Ephedrae Herba (Mahuang, 麻黄) to open the interstices (couli); without Cinnamon Twig (Rougui, 肉桂) and Prepared Ginger Root (Paojiang, 炮姜), the congealment cannot be resolved. Even in intense summer heat, one cannot omit any of these three herbs. Once the interstices are opened and the congealment resolved, Qi and Blood can circulate; once circulating, the congealed toxin dissipates. This is a fixed and unchangeable principle. The formulas listed subsequently—Yanghe Decoction (Yanghe Tang), Yanghe Plaster (Yanghe Gao), Xihuang Pill (Xihuang Wan), and Xiaojin Dan—are essential medicines for treating *Yin Ju*. Following the prescription ensures success without error. Any addition or subtraction will render them ineffective.
He also said: If children suffer from various *Yin Ju* and cannot take oral medicine, administer Xiaojin Dan dissolved orally at the onset, continuing until the swelling subsides. If suppuration has already formed, it must still be taken daily to allow painless rupture. Once the toxin is completely expelled, use Baoyuan Decoction (see Section on Toxic Carbuncles) with 5 fen of Cinnamon Twig, decocted in water, taken daily to complete the cure.
He further stated: For any sores that are white in color and vary in size, Dongtian Plaster is contraindicated. Furthermore, plasters that are boiled too lightly (too tender) will cause cold congealment to become more solid upon application. Plasters containing Crotonis Semen (Badou, 巴豆) or Ricini Semen (Bima, 蓖麻) must never be applied, as their stimulating nature may aggravate the condition; cases of Hengxuan and Luyan becoming fatal due to application, and miscarriages in pregnant women, are common observations. After any *Yin Ju* ulcerates, it is advisable to apply Yanghe Jie Ning Plaster (Yanghe Jie Ning Gao).