发际疮生发际边,形如黍豆痒疼坚,顶白肉赤初易治,胖人肌浓最缠绵。
\r发际疮图\p04-34a41.bmp\r
【注】此证生项后发际,形如黍豆,顶白肉赤坚硬,痛如锥刺,痒如火燎,破津脓水,
亦有浸淫发内者,此由内郁湿热,外兼受风相搏而成也,初宜绀珠丹汗之,次有酒制防
风通圣散清解之,外搽黄连膏效。惟胖人项后发际,肉浓而多折纹,其发反刺疮内,因
循日久不瘥,又兼受风寒凝结,形如卧瓜,破烂津水,时破时敛,俗名谓之肉龟。经年不
愈,亦无伤害,常用琥珀膏贴之,可稍轻也。
琥珀膏
定粉(一两) 血余(八钱) 轻粉(四钱) 银朱(七钱) 花椒(十四粒) 黄蜡(四两)
琥珀(末,五分) 麻油(十二两)
将血余、花椒、麻油炸焦,捞去渣,下黄蜡溶化尽,用夏布滤净,倾入瓷碗内,预
将定粉、银朱、轻粉、琥珀四味,各研极细,共合一处,徐徐下入油内,用柳枝不时搅之,
以冷为度。绵燕脂摊贴,红绵纸摊贴亦可。
【方歌】琥珀膏能治诸疮,活瘀解毒化腐良,定血轻朱椒蜡珀,麻油熬膏亦疗疡。
绀珠丹(即万灵丹,见肿疡门)
防风通圣散(见前秃疮)
黄连膏(见鼻部鼻疮)
头风引目眉棱痛,风火寒痰有四因,或由杨梅毒攻顶,或因产后被风侵。
【注】此证畏寒、恶风,其痛走注不定,得暖少减者,风痛也;寒热口苦,大渴,二
便秘,不眠者,火痛也;手足厥冷,面青唇白,气逆不渴,小水白者,寒痛也;身重肢
酸,胸烦作呕,口吐痰沫者,痰痛也。以上四证,旧有古方羌活冲和汤倍川芎加菊花,随
经形证,加引治之。倘若因循失治,风攻眉棱酸痛,眼皮跳动,渐攻睛珠,起蓝云遮睛,
多致损目。若只眉棱酸痛,以碧云散常吸之甚效。
羌活冲和汤
防风 白芷(各一钱) 细辛 甘草(生,各五分) 生地 苍术 黄芩(各一钱)
羌活(一钱五分) 川芎(二钱)
引加葱头三根、生姜一片、红枣肉二枚,水煎食远服。痛由顶后起,属膀胱经,倍羌
活加 本。痛由耳后起,属胆经,加柴胡。痛由太阳牵引头额两目,属胃经,倍白芷加葛
根、 石膏。头痛兼有腹痛身重,属脾经,倍苍术。头痛兼有足冷,气逆,属肾经,倍细
辛;甚者加麻黄、生附子,减黄芩。头痛兼有呕涎沫,手足厥冷者,属肝经,加吴茱萸。
头痛有火热渴,倍酒洗黄芩,加生石膏。便秘者加生大黄。头痛吐痰涎,四肢不冷者,加半夏。
【方歌】冲和头风风伤目,风火寒痰四因生,日久眉棱酸痛跳,遮睛损目此能清。防
风白芷细辛草,生地苍芩羌活芎,详在随加引经药,葱姜红枣水煎成。
碧云散
川芎 鹅不食草(各一两) 细辛 辛荑(各二钱) 青黛(一钱)
共为细末,患者口噙凉水,令人以芦筒吹入左右鼻孔内,取嚏为效。每用少许,鼻
常吸之,其效缓。
【方歌】碧云散去头风证,眉棱酸痛更堪医,鹅不食草辛荑黛,芎细同研不时吸。
贴两太阳穴法 治头痛如破。
雀脑川芎 白附子(各等分)
研末,葱汁调稠,纸摊贴左右太阳穴效。
产后风寒侵脑,头痛不可发汗,宜用四物汤倍川芎加荆芥穗服之,其效缓。
杨梅毒入脑髓,以致头痛者,治在本门。
四物汤(见溃疡门)
Faji Chuang (Hairline Sore) arises at the edge of the hairline, resembling a millet seed or bean, with itching and pain, and a hard texture. The top is white while the surrounding flesh is red; it is easy to treat in the early stage. However, in obese individuals with thick muscle layers, the condition tends to be lingering and difficult to cure.
[Annotation] This syndrome occurs at the hairline behind the neck, shaped like a millet seed or bean, with a white top and red, hard surrounding flesh. The pain feels like being pierced by an awn, and the itching feels like burning. Upon rupture, pus flows out. It may also spread into the hair. This is caused by internal stagnation of damp-heat combined with external wind pathogen attack. Initially, Gan Zhu Dan (Crimson Pearl Pill) should be used to induce sweating. Subsequently, Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking and Purging) prepared with wine should be used to clear heat and resolve the exterior. Applying Huanglian Gao (Coptis Ointment) externally is effective. Specifically, in obese individuals, the hairline behind the neck has thick flesh with many folds, causing hair to pierce into the sore. If neglected for a long time, combined with cold-damp coagulation, it resembles a lying melon, becoming ulcerated and weeping fluid, alternating between breaking and healing. Commonly known as "Rou Gui" (Flesh Turtle). Although it may persist for years without serious harm, applying Hupo Gao (Amber Ointment) regularly can provide slight relief.
Hupo Gao (Amber Ointment) Formula: Ding Fen (Lead Carbonate, 1 liang), Xue Yu (Burnt Human Hair, 8 qian), Qing Fen (Calomel, 4 qian), Yin Zhu (Red Mercury Sulfide, 7 qian), Huajiao (Zanthoxylum Fruit, 14 grains), Huang La (Yellow Beeswax, 4 liang), Hupo (Amber powder, 5 fen), Mayou (Sesame Oil, 12 liang).
Preparation: Fry Xue Yu, Huajiao, and Mayou until scorched, remove dregs, add Huang La and melt completely. Filter through linen cloth, pour into a porcelain bowl. Pre-grind Ding Fen, Yin Zhu, Qing Fen, and Hupo into fine powders, mix them together, and slowly add to the hot oil while stirring continuously with a willow branch until cooled. Apply using Mian Yanzhi (cotton pad impregnated with ointment) or Hong Mian Zhi (red cotton paper).
[Fang Ge - Prescription Verse] Hupo Gao treats various sores, effectively activating blood, resolving stasis, detoxifying, and transforming rot. Ding Fen, Xue Yu, Qing Fen, Yin Zhu, Huajiao, Huang La, and Hupo, boiled in Mayou to make an ointment also heals ulcers.
Gan Zhu Dan (i.e., Wan Ling Dan, see Swelling Ulcer Section)
Fangfeng Tongsheng San (see previous Alopecia Areata section)
Huanglian Gao (see Nasal Ulcer section)
Tou Feng Yin Mu Mei Leng Tong (Headwind Causing Eyebrow Bone Pain): The causes are Wind, Fire, Cold, and Phlegm. It may also result from Yangmei Du (Syphilis toxin) attacking the vertex, or due to wind invasion postpartum.
[Annotation] Symptoms include aversion to cold and fear of wind, with wandering pain that slightly decreases with warmth; this is Wind Pain. Fever, bitter taste in mouth, extreme thirst, constipation, and insomnia indicate Fire Pain. Cold extremities, blueish complexion, pale lips, rebellious Qi without thirst, and clear urine indicate Cold Pain. Heavy body, sore limbs, chest irritability, vomiting, and spitting of phlegm foam indicate Phlegm Pain. For these four syndromes, the ancient prescription Qianghuo Chonghe Tang (Notopterygium Decoction for Harmonizing) with doubled Chuanxiong and added Juhua (Chrysanthemum) should be used. Based on the meridian and specific symptoms, appropriate guiding herbs should be added. If neglected, wind attacks the eyebrow bone causing sour ache, eyelid twitching, gradually invading the eyeball, causing blue clouds obscuring vision, often leading to eye damage. If only eyebrow bone sour ache exists, Bi Yun San (Green Cloud Powder) inhaled into the nose is very effective.
Qianghuo Chonghe Tang Formula: Fangfeng (Saposhnikovia Root), Baizhi (Angelicae Dahuricae Radix) (each 1 qian); Xixin (Asarum Root), Gancao (Licorice Root, raw) (each 0.5 qian); Shengdi (Rehmanniae Radix), Cangzhu (Atractylodis Rhizoma), Huangqin (Scutellariae Radix) (each 1 qian); Qianghuo (Notopterygii Rhizoma et Radix) (1.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma) (2 qian).
Guiding Herbs: Add 3 scallion heads, 1 slice of fresh ginger, and 2 dates (pitted). Decoct in water and take after meals.
Modifications based on location/meridian:
- Pain starting from the back of the head (Bladder Meridian): Double Qianghuo, add Gaoben (Ligustici Wallichii Rhizoma).
- Pain starting from behind the ear (Gallbladder Meridian): Add Chaihu (Bupleuri Radix).
- Pain radiating from Taiyang to forehead and eyes (Stomach Meridian): Double Baizhi, add Gegen (Puerariae Lobatae Radix), Shigao (Gypsum Fibrosum).
- Headache with abdominal pain and heavy body (Spleen Meridian): Double Cangzhu.
- Headache with cold feet and rebellious Qi (Kidney Meridian): Double Xixin; severe cases add Mahuang (Ephedrae Herba), Sheng Fuzi (Aconiti Lateralis Radix Preparata? No, Raw Aconite), reduce Huangqin.
- Headache with vomiting saliva and cold extremities (Liver Meridian): Add Wuzhuyu (Evodiae Fructus).
- Headache with fire-heat and thirst: Double wine-washed Huangqin, add Shigao.
- Constipation: Add Dashuang (Rhei Radix et Rhizoma).
- Headache with spitting phlegm/saliva and warm extremities: Add Banxia (Pinelliae Rhizoma).
[Fang Ge - Prescription Verse] Chonghe Tang treats headwind affecting eyes, generated by wind, fire, cold, and phlegm. Long-term eyebrow sour ache and twitching, obscuring vision and damaging eyes can be cleared by this. Fangfeng, Baizhi, Xixin, Gancao, Shengdi, Cangzhu, Huangqin, Qianghuo, Chuanxiong. Carefully add meridian-guiding herbs, decoct with scallion, ginger, and red dates in water.
Bi Yun San Formula: Chuanxiong, E Bushi Cao (Centipedas Herb) (each 1 liang); Xixin, Xin Yi (Magnolia Flower) (each 2 qian); Qingdai (Indigo Naturalis) (1 qian).
Grind all into fine powder. The patient holds cool water in their mouth. An assistant blows the powder into the left and right nostrils using a reed tube until sneezing occurs, which indicates efficacy. Using a small amount frequently for nasal inhalation yields slower results.
[Fang Ge - Prescription Verse] Bi Yun San eliminates headwind syndromes, treating eyebrow sour ache effectively. E Bushi Cao, Xin Yi, Qingdai, Chuanxiong, and Xixin ground together, inhaled occasionally.
Application to Both Taiyang Acupoints Method: Treats severe headache feeling like breaking.
Que Nao Chuanxiong (Chuanxiong from the brain area), Baifuzi (Typhonii Rhizoma) (equal parts).
Grind into powder, mix with Cong Jiang (Scallion Juice) to form a thick paste. Apply on paper to both Taiyang acupoints. Effective.
Postpartum wind-cold invading the brain causing headache: Sweating is contraindicated. Use Siwu Tang (Four Substances Decoction) with doubled Chuanxiong and added Jingjie Sui (Schizonepeta Spike) orally. Effects are gradual.
Yangmei Du (Syphilis toxin) entering the brain marrow causing headache: Treatment is described in the relevant section.
Siwu Tang (see Ulcer Section)