倪仲贤治吴陵盛架阁内子。左右肩背上下患痒。至两臂头面皆然。屡以艾灼痒处。暂止
复作。如是数年。老人切其脉曰。左关浮盛。右口沉实。此酒食滋味所致也。投以清热化食
行滞之剂。其痒遂止。
江汝洁治一妇人。患上身至头面俱痒。刺痛起块。众医皆谓大风等证。江诊得左手三部
俱细。右手三部皆微实。大都六脉俱数。经曰。微者为虚。弱者为虚。细者气血俱虚。盖心
主血。肝藏血。乃血虚无疑。肾藏精属水。其部见微。乃为水不足。水既不足。相火妄行无
制。以致此疾。经曰。诸痛疮痒。皆属心火。右手寸脉实。实者阳也。脉经曰。诸阳为热。
乃热在肺分。火克金故也。且肺主皮毛。皮毛之疾。肺气主之。胸膈及皮毛之疾。为至高之
疾也。右关微实。乃火在土分。土得火则燥。肌肉之间。脾气主之。肌肉及皮毛痛痒。皆火
热在上明矣。右尺微实。火居火位。两火合明。阳多阴少。治宜补水以制火。养金以伐木。
若作风治。未免以火济火。以燥益燥也。乃以生地、白芍各一钱。参、 各六分、连翘、丹
皮各六分。麦冬八分。柏皮、防风、甘草各四分。五味子九粒。黄连四分。水煎温服。渣内
加苦参一两。再煎洗。十数剂而安。
立斋治一女子十二岁。善怒。遍身作痒。用柴胡、川芎、山栀、芍药以清肝火。生地、
当归、黄芩以凉肝血。白术、茯苓、甘草以健脾土而愈。半载后。遍身起赤痕。或时眩晕。
此肝火炽甚。血得热而妄行。是夜果经至。
意庵治一人。因田间收稻。忽然遍身痒入骨髓。用食盐九钱。泡汤三碗。每进一碗。探
而吐之。如是者三。而痒释矣。
一小儿遍身作痒。以生姜捣烂。以布包擦之而止。
震按河间谓痒为美疾。以其搔爬有趣。且与身命无伤也。然亦有屡治不效者。以不得病
因。而漫以凉血祛风为治耳。今观倪江薛三案见解。用药俱精细周到。可见。昔贤虽遇轻证
亦不肯忽略。
Ni Zhongxian treated the wife of Sheng Jiage from Wuling. She suffered from itching on her left and right shoulders, back, upper and lower body, which extended to both arms, head, and face. Repeated moxibustion on the itchy areas provided only temporary relief before the symptoms recurred. This persisted for several years. The physician palpated her pulse and stated: "The left Guan position is floating and vigorous, while the right Cun position (note: original text says 'Kou', likely a typo for 'Cun') is deep and solid. This is caused by alcohol consumption and rich food intake." He administered a formula to clear heat, resolve food stagnation, and promote qi circulation, after which the itching ceased.
Jiang Rujie treated a woman whose upper body, extending to the head and face, was itchy, accompanied by stinging pain and raised plaques. Other physicians diagnosed this as Big Wind disease or similar conditions. Jiang palpated the pulse and found all three positions on the left hand to be fine (Xi), while all three positions on the right hand were slightly solid (Shi). Generally, all six pulse positions were rapid (Shu). The Classic states: "A fine pulse indicates deficiency; a weak pulse indicates deficiency; a fine pulse signifies deficiency of both Qi and Blood." Since the Heart governs Blood and the Liver stores Blood, this is undoubtedly Blood deficiency. The Kidney stores Essence and belongs to Water; the appearance of a fine pulse in its position indicates insufficient Kidney Water. With insufficient Water, Ministerial Fire flares up without restraint, leading to this disease. The Classic states: "All pain, sores, and itching belong to Heart Fire." The right Cun position is solid, indicating Yang excess. The Pulse Classic states: "All Yang pulses indicate Heat." Thus, Heat resides in the Lung sector, as Fire overacts on Metal. Furthermore, the Lung governs the skin and hair, so diseases of the skin and hair are under the jurisdiction of Lung Qi. Diseases of the chest, diaphragm, and skin are considered high-level diseases. The right Guan position is slightly solid, indicating Fire in the Earth sector. When Earth receives Fire, it becomes dry; the Spleen Qi governs the muscles. Therefore, pain and itching in the muscles and skin clearly indicate Heat and Fire located above. The right Chi position is slightly solid, with Fire occupying the Fire position. Two Fires combine to illuminate, resulting in excessive Yang and deficient Yin. The treatment should involve nourishing Water to control Fire and nourishing Metal to subdue Wood. Treating it as Wind pathogen would be akin to adding fire to fire and dryness to dryness. The prescription consisted of Sheng Di Huang (Rehmanniae Radix) and Bai Shao (Paeoniae Radix Alba), each 1 qian; Ren Shen (Ginseng Radix et Rhizoma) and [missing character, likely Huang Qi or Dang Shen], each 6 fen; Lian Qiao (Forsythiae Fructus) and Dan Pi (Moutan Cortex), each 6 fen; Mai Dong (Ophiopogonis Tuber), 8 fen; Huang Bo (Phellodendri Cortex), Fang Feng (Saposhnikoviae Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma), each 4 fen; Wu Wei Zi (Schisandrae Fructus), 9 grains. Decocted in water and taken warm. The dregs were mixed with Ku Shen (Sophorae Flavescentis Radix), 1 liang, decocted again, and used for external washing. After more than ten doses, the patient recovered.
Xue Lizhai treated a twelve-year-old girl who was prone to anger and suffered from generalized itching. He used Chai Hu (Bupleuri Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Shan Zhi (Gardeniae Fructus), and Shao Yao (Paeoniae Radix) to clear Liver Fire; Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), and Huang Qin (Scutellariae Radix) to cool Liver Blood; and Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), and Gan Cao (Glycyrrhizae Radix et Rhizoma) to strengthen Spleen Earth, resulting in a cure. Half a year later, red marks appeared all over her body, and she experienced occasional dizziness. This indicated intense Liver Fire causing Blood to move recklessly due to heat. That night, her menstruation indeed commenced.
Yi An treated a man who, while harvesting rice in the fields, suddenly developed severe itching that felt as if it penetrated to the bone marrow. He prescribed 9 qian of edible salt dissolved in three bowls of hot water. The patient drank one bowl at a time and induced vomiting by stimulating the throat. This process was repeated three times, after which the itching resolved.
A child suffering from generalized itching was treated by applying mashed fresh ginger wrapped in cloth to the skin, which stopped the itching.
Yu Zhen commented: Liu Hejian considered itching a mild ailment because scratching provides pleasure and does not endanger life. However, there are cases where treatment fails repeatedly because the cause is not identified, and cooling blood and dispelling wind are applied indiscriminately. Observing the cases of Ni, Jiang, and Xue, their insights were unique, and their prescriptions were precise and comprehensive. This demonstrates that ancient sages did not neglect even mild conditions.