钱，黄芩、麦冬、荆芥各三钱，甘草、茯苓、陈皮、神曲各一钱。煎成，牙抉不开，以匙挑灌鼻窍，渗入喉中，
顷渗半瓯，牙门露隙，从牙隙又灌半瓯。煎二剂成，渐灌渐醒。至一鼓，忽舌吐出，众惊取视，乃舌上所生之
壳，中空外实；五鼓始知人事；三日后，肿处干绉，从头褪下如面釜一具。此后耳、鼻、唇、颐、手、膊，次
第大块而下，一如 面之形。（程华仲）
泰和二年四月间，民多疫疠。初觉憎寒发热，次传头面肿盛，目不能开，喘促，咽喉不利，舌干口燥。俗
云∶大头天行，染之多死。东垣曰∶身半以上，天之气也。邪热客于心肺之间，上攻头面而为肿盛。制方名普
济消毒饮，服之皆愈，人谓仙方。（《东垣十书》）
洪德敷女，于初冬发热，头痛，胸满不食。服发散消导药，至第六日，身痛腹疼，欲圊不得，口鼻上唇忽
起黑色成片，光亮如漆，与玳瑁无异，医骇辞去。石顽诊之，喘汗脉促，神气昏愦。虽证脉俱危，喜其黑色四
围红晕鲜泽，许以可治。先与葛根芩连汤，加犀角、连翘、荆芥、防风、紫荆，以人中黄解其肌表毒邪；俟其
黑色发透，乃以凉膈散加人中黄、紫荆皮、犀角，微下二次；又与犀角地黄汤加人中黄调理而安。此证书所不
载，惟庞安常有“玳瑁瘟”之名，而治法未备，人罕能识。（《张氏医通》）
附方
干一老人汤 料豆、金银花、生甘草、鲜黄土。
新制救疫汤 料豆、绿豆、扁豆、赤小豆、生甘草、金银花、玉竹、生首乌、当归、丹皮、贝母、鲜黄
土、生姜。
Case of Patient Qian: Huangqin (Scutellariae Radix), Maidong (Ophiopogonis Tuber), and Jingjie (Schizonepetae Herba) each 3 qian; Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), and Shenqu (Massa Medicata Fermentata) each 1 qian. After decoction, the patient's teeth were clenched shut, so the medicine was scooped into the nasal cavity with a spoon to seep into the throat. In a short while, half a ou (unit of volume) had seeped in, and a gap appeared in the jaw; another half ou was then poured through the gap between the teeth. Two doses were prepared and gradually administered, leading to gradual awakening. By the first watch, the tongue suddenly protruded, causing alarm among the crowd who examined it, revealing a shell-like growth on the tongue, hollow inside and solid outside. Consciousness was restored by the fifth watch. Three days later, the swollen area dried and wrinkled, peeling off from the head like a face mask. Subsequently, large pieces peeled off sequentially from the ears, nose, lips, chin, hands, and arms, resembling the shape of a mask. (Cheng Huazhong)
In the fourth month of the Taihe era, second year, many people suffered from epidemics. Initially, there was aversion to cold and fever, followed by severe swelling of the head and face, inability to open the eyes, panting, difficulty in the throat, dry tongue, and dry mouth. Commonly known as "Big Head Epidemic," infection often led to death. Li Dongyuan stated: The upper half of the body is governed by the Qi of Heaven. Pathogenic heat lodges between the Heart and Lungs, attacking upward to the head and face, causing severe swelling. He formulated the prescription Puji Xiaodu Yin (General Benefit Detoxification Decoction). Those who took it recovered completely, and people called it an Immortal Prescription. (*Dongyuan Shishu*)
The daughter of Hong Defu developed fever, headache, chest fullness, and loss of appetite in early winter. After taking dispersing and digesting medicines, by the sixth day, she experienced body pain, abdominal pain, inability to defecate, and sudden onset of black patches on the mouth, nose, and upper lip, shiny like lacquer and indistinguishable from hawksbill turtle shell. The physicians fled in horror. Shiwan diagnosed her condition as panting, sweating, rapid pulse, and confused spirit. Although the symptoms and pulse indicated danger, he noted the fresh red halo around the black areas and predicted recoverability. First, he prescribed Gegen Qinlian Tang (Kudzu and Scutellaria Decoction) added with Xijiao (Rhinocerotis Cornu - now substituted with Buffalo Horn), Lianqiao (Forsythiae Fructus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), and Zijing (Bauhiniae Flos), using Renzhonghuang (Human Manure Ash) to resolve surface toxic pathogens. Once the black eruption fully manifested, he administered Liangge San (Cool the Diaphragm Powder) added with Renzhonghuang, Zijingpi (Bauhiniae Cortex), and Xijiao (Rhinocerotis Cornu), inducing mild purgation twice. Finally, he used Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Renzhonghuang for conditioning, resulting in stability. This case is not recorded in standard texts; only Pang Anchang mentioned the name "Hawksbill Turtle Shell Plague," but his treatment methods were incomplete, making it rarely recognized by others. (*Zhangshi Yitong*)
Attached Prescriptions:
Gan Yi Laoren Tang (Old Man Gan Yi Decoction): Liaodou (Vigna angularis seed), Jinyinhua (Lonicerae Japonicae Flos), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Xian Huangtu (Fresh Yellow Earth).
Xin Zhi Jiuyi Tang (Newly Formulated Epidemic Rescue Decoction): Liaodou (Vigna angularis seed), Lüdou (Phaseolus radiatus seed), Biandou (Dolichos lablab seed), Chixiaodou (Vigna umbellata seed), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Jinyinhua (Lonicerae Japonicae Flos), Yuzhu (Polygonati Odorati Rhizoma), Sheng Shouwu (Raw Polygoni Multiflori Radix), Danggui (Angelicae Sinensis Radix), Danpi (Moutan Cortex), Beimu (Fritillariae Thunbergii Bulbus), Xian Huangtu (Fresh Yellow Earth), Shengjiang (Zingiberis Rhizoma Recens).