腮属足阳明胃经，或外因风热所乘，或内因积热所致。若肿痛寒热者，白芷胃风汤。
内热肿痛者，升麻黄连汤。外肿作痛，内热口干者，犀角升麻汤。内伤寒凉，不能消溃者，补中
益气汤。发热作渴，大便秘结者，加味清凉饮。表里俱解而仍肿痛者，欲作脓也，托里散。
若饮食少思，胃气虚弱也，六君子汤。肢体倦怠，阳气虚弱也，补中益气汤。脓毒既溃，肿
痛不减，热毒未解也，托里消毒散。脓出而反痛，气血虚也，人参内托散。发热晡热，阴血
虚也，八珍汤。恶寒发热，气血俱虚也，十全大补汤。若肿 痛连耳下者，属手足少阳经，
当清肝火。若连颐及耳后者，属足少阴经虚火，当补肾水。患此而有不治者，多泥风热，执
用克伐之药耳。
治验
地官陈用之，服发散之剂，寒热已退，肿痛不消。此血凝滞而欲作脓也，用托里消毒散
而脓
上舍卢懋树，两尺脉数，症属肾经不足，误服消毒之剂，致损元气而不能愈，余用补中
益气、六味丸料，服之而痊。
上舍熊栋卿，颐后患之。脓清体瘦，遗精盗汗，晡热口渴，痰气上涌，久而不愈。脉洪
大，按之微细，属肾经亏损所致。遂用加减八味丸料并十全大补汤而愈。
一妇人素内热，因怒，耳下至颈，肿痛寒热。此肝胆经火燥而血虚，用柴胡栀子散，而
肿痛消；用加味逍遥散而寒热退；用八珍汤加丹皮而内热止。
The cheek swelling (Parotitis) belongs to the Foot-Yangming Stomach Meridian. Its etiology may be either external invasion by Wind-Heat pathogenic factors or internal accumulation of Heat. If accompanied by swelling, pain, aversion to cold, and fever, Baizhi Weifeng Tang (Angelica Dahurica and Stomach-Wind Decoction) is indicated.
If swelling and pain are caused by internal Heat, Shengma Lianhuang Tang (Cimicifuga and Coptis Decoction) is used. If there is external swelling and pain with internal Heat and dry mouth, Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction) is prescribed. If internal injury from Cold-Cool substances prevents the resolution and suppuration of pus, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is administered. If fever, thirst, and constipation occur, Jiawei Qingliang Yin (Modified Cooling Drink) is used. If exterior and interior conditions have both resolved but swelling and pain persist, it indicates that suppuration is imminent; Tuoli San (Support the Interior Powder) is applied.
If appetite is diminished due to weak Stomach Qi, Liujunzi Tang (Six Gentlemen Decoction) is used. If limb fatigue occurs due to weak Yang Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is prescribed. If pus has ulcerated but swelling and pain remain unrelieved, indicating unresolved Heat-Toxin, Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder) is used. If pain increases after pus discharge, indicating deficiency of Qi and Blood, Renshen Neituo San (Ginseng Internal Support Powder) is administered. If afternoon fever (Buhu Re) occurs, indicating deficiency of Yin-Blood, Bazhen Tang (Eight Treasures Decoction) is used. If aversion to cold and fever occur simultaneously, indicating deficiency of both Qi and Blood, Shiquan Dabu Tang (Ten Great Tonifying Decoction) is prescribed.
If swelling and pain extend to below the ear, it belongs to the Hand and Foot Shaoyang Meridians, and Liver Fire should be cleared. If it extends to the lower jaw and behind the ear, it belongs to deficiency Fire of the Foot-Shaoyin Meridian, and Kidney Water should be nourished. Cases that are difficult to cure often result from rigid adherence to the concept of Wind-Heat and the indiscriminate use of attacking and reducing medications.
Clinical Case 1:
Chen Yongzhi, a local official, took dispersing agents. Although his aversion to cold and fever subsided, the swelling and pain did not resolve. This indicated blood stasis and impending suppuration. Tuoli Xiaodu San (Support the Interior and Eliminate Toxin Powder) was used, leading to suppuration.
Clinical Case 2:
Lu Maoshu, a scholar, presented with rapid pulses at both Chi positions, indicating insufficiency of the Kidney Meridian. He had mistakenly taken detoxifying agents, damaging his Yuan Qi and preventing recovery. I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) ingredients, resulting in a cure.
Clinical Case 3:
Xiong Dongqing, a scholar, suffered from lesions behind the jaw. His pus was thin, he was emaciated, experienced nocturnal emission and night sweats, afternoon fever, thirst, and rising phlegm-Qi, with no improvement over time. His pulse was large and forceful on superficial palpation but faint and fine on deep pressure, indicating Kidney Meridian depletion. Jiajian Bawei Wan (Modified Eight-Ingredient Pill) ingredients combined with Shiquan Dabu Tang (Ten Great Tonifying Decoction) were used, leading to recovery.
Clinical Case 4:
A woman with a constitution prone to internal heat became angry, resulting in swelling, pain, aversion to cold, and fever from below the ear to the neck. This was diagnosed as Dryness-Fire in the Liver and Gallbladder Meridians with Blood deficiency. Chaihu Zhizi San (Bupleurum and Gardenia Powder) was used to eliminate swelling and pain; Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was used to resolve aversion to cold and fever; and Bazhen Tang (Eight Treasures Decoction) added with Mudanpi (Tree Peony Bark) was used to stop internal heat.