Xu Ping Surgery Orthodoxy Annotations

Author: Chen Shigong
Publisher:
Publish Date: 1997-10-01
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Excerpt: Difficult to treat when swollen and indistinct, easy to treat when red and swollen. The general theory in the middle can be relied upon. A swollen and indistinct sore refers to a swollen flesh without a swollen sore; a red and swollen sore refers to a swollen sore without swollen flesh. Here, the yin and yang of sores are distinguished, and the order and disorder of symptoms are decided. When a sore first appears, it should be allowed to rise and develop. After it ruptures and swells, it should not be allowed to dissipate internally; instead, lifting medicine should be used. If it does not respond, it means the poison overpowers the qi and blood, and death will occur within ten days. If it has already broken out but does not decompose, the root is hard, or it is red and scattered, urgent lifting medicine should be administered, along with strengthening the spleen and stomach. If it does not respond, death will occur within twenty days. If it has already ruptured but the color is not vibrant, it does not generate new tissue or contract, the sore opening is large, swelling and pain do not decrease, and the stomach qi does not return, urgent and strong nourishment is required. If it does not respond, it means the spleen collapses, and death will occur within a month. All sores should be discussed separately, how can they be lightly interfered with and disrupt this presentation.
General Theory of Treatment for Abscesses and Carbuncles - Part Two: How to Treat an Abscess or Carbuncle on the Back
Regardless of yin or yang, first apply moxibustion.① This sentence is written by Xu, with a note: Avoid moxibustion on the head and face for yang.② Not painful, apply moxibustion until it becomes painful; painful until it is no longer painful. When examining a major abscess or carbuncle, first calmly establish a plan, starting from the date it was first seen to the present day. Check if the sore's appearance corresponds to the number of days. If it corresponds, it is more auspicious; if not, it is more dangerous. Next, examine the source of the illness—what organs it originates from and what parts of the body it appears in. Then, assess the danger of the upper and lower body parts, the order and disorder of the appearance, the presence or absence of spirit, the age (young or old), the strength or weakness of qi and blood, whether it manifests as yin or yang, and how deep the poison is. Yang is easier to treat and more likely to live, while yin is harder to treat and more likely to die. Then, take the pulse to determine its deficiency or excess, to decide the danger or safety. Before it ruptures, the pulse should be slightly too strong by one or two beats; after it ruptures, it should be slightly too weak by two or three parts. This is called pulse and disease corresponding, and it will not change. If it is the opposite, be cautious of unexpected outcomes. All these observations must be clearly understood, comprehensively assessing the interior and exterior, to determine the treatment method. For sores before the seventh day, the condition is not yet fully formed, and the essence is not weak. Regardless of yin or yang, exterior or interior, cold or heat, deficiency or excess, moxibustion① should be applied. For mild cases, the poison will disperse with the fire; for severe cases, it will draw out the accumulated poison, penetrating both internally and externally, transforming yin into yang, allowing the sore to swell and cause pain, making it possible to sweat or attack, or to resolve or lift it. Both the root and the branch must be treated, ensuring the disease matches the pulse and the medicine matches the disease, so as not to misdiagnose. Neither the beginning nor the end should damage the essence, especially the spleen and stomach, which are most important.
Note by Mei: Xu said avoiding moxibustion on the head and face,② and other books also mention this. Later generations cited Gao Jun's③ moxibustion case for Yuan Haoquan④'s carbuncle to refute it. But this is a countermeasure against the principle, and it can only be done with the will of Yi Yin. Internally, take one dose of the toad venom pill, and externally, apply divine fire to three branches.