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Fa Yi (Parotitis) presents with swelling and pain in the parotid region, with masses hard like tubercles. The syndrome belongs to the Yangming channel, accompanied by fever and aversion to cold. If due to Shanghan (Cold Damage) or rash toxins failing to be released through sweating, leading to swelling extending to the throat, treatment becomes difficult.

[Note] This syndrome is also known as "Han Du" (Sweat Poison). It occurs between the mandible and cheek, belonging to the Foot-Yangming Stomach Channel. Initially, there is aversion to cold and fever, with a mass resembling a tubercle, slightly hot and painful. Gradually, it swells like a peach or plum, with doubled pain. This condition arises from incomplete sweating in Shanghan, or failure of the rash to fully emerge, causing stagnation and accumulation. At the onset, Jingfang Baidu San (Astragalus and Saposhnikovia Decoction for Overcoming Toxins) should be used to induce sweating, and Erwei Baidu San (Two-Ingredient Decoction for Extracting Toxins) applied externally to dissipate the swelling. If dissipation fails and swelling and pain increase daily, suppuration will inevitably occur; Tuoli Tou Nong Tang (Decoction for Supporting the Interior and Penetrating Pus) should be taken. After ulceration, treat according to the methods for Ulcerated Carbuncles and Sores. If this syndrome is neglected or mistreated with cold-cooling and draining medicines, the toxin will sink inward. Swelling extends to the throat, with surging phlegm and blocked qi, making it difficult to swallow liquids; this is a Ni syndrome (adverse prognosis).

Fa Yi Diagram \p04-34a49.bmp\

Jingfang Baidu San (See Neck Brain Carbuncle section)
Erwei Baidu San (See Swollen Ulcer Section)
Tuoli Tou Nong Tang (See Head Invading Brain Carbuncle section)

Shi Du (Seasonal Epidemic Toxin) initially resembles Shanghan, presenting with diffuse swelling without a head in the neck region. It is caused by contracting the abnormal Qi of the four seasons. Treatment requires differentiation based on the strength or weakness of the constitution, using dispersing and resolving methods for recovery.

[Note] At the onset, this syndrome resembles Shanghan, with aversion to cold and fever, causing mental restlessness and limb soreness, sometimes accompanied by sore throat. Within one or two days, it appears on the neck, cheeks, and jaw, swelling diffusely without a head, gradually becoming red and painful. Some resemble rooted tubercles, while others are diffusely swollen and red. All result from contracting abnormal seasonal pathogens lodging in the collaterals and meridians, brewing and knotting together; it is not the Ji Du (Jaw Poison) occurring after an illness. The key lies in the physician's precise observation of the lesion's color to distinguish deficiency and excess. The treatment method must focus on dispersing and resolving; sudden use of cold-cooling herbs must be avoided to prevent the toxin from failing to exit outward and instead attacking the throat internally, which would be dangerous. Initially, take Jingfang Baidu San to induce sweating. If the swelling does not subside, take Lianqiao Xiaodu Yin (Forsythia Decoction for Disinfecting Toxins); if swelling persists and suppuration is imminent, those with strong constitutions should take Tou Nong San (Pus-Penetrating Powder), while those with weak constitutions should take Tuoli Tou Nong Tang. Apply Erwei Baidu San externally. Once the pus is ripe, puncture with a needle. After ulceration, treat according to the methods for Ulcerated Carbuncles and Sores.

Shi Du Diagram \p04-34a50.bmp\

Jingfang Baidu San (See Neck Brain Carbuncle section)
Lianqiao Xiaodu Yin (See Back Wine-Toxic Eruption section)
Tou Nong San (See Swollen Ulcer section)
Tuoli Tou Nong Tang (See Head Invading Brain Carbuncle section)
Erwei Baidu San (See Swollen Ulcer section)