王好古曰。走马疳。疳蚀之极也。乃五脏蒸热上攻。甚即偏沿作崩沙候。牙边肉肿烂。口内气臭。身微潮热。吃食
不得。牙缝出鲜血。常动摇似欲脱。肉烂自漏落。治之先以淡盐汤洗口。即下紫金散掺之。日三次。揩杀牙边肉内虫。
如大段甚。即下秋霜散掺之。然后以天竺黄散。夹地黄膏调理即安。如不退。先落齿一两三个。即死不治。相次面光发。
腮漏见骨而殂。
鳌按。曾氏治法。先去积热。用当归散合三棱散。加姜枣煎服。次投芦荟丸、玉露饮。及以盐温水灌漱。或以
软鸡翎蘸盐水拂洗拭干。以密陀僧散敷之。若经久不愈。传于唇之上下。成崩沙症。腮穿齿落而死。
危亦林曰。如疳痨疳泻。面槁色夭。齿张骨露。腹硬不食。皆疳之症也。
李 曰。肝疳目带青。左胁下硬。多吐沫。眼头黑者。不治。心疳。耳边有青脉。舌上有焦点者。不治。脾疳肚大
青筋。唇口无血色。人中平。下利不止者。不治。肺疳嗽逆气急。泻白水。身上黑斑者。不治。肾疳要吃咸酸。饮水不
住。小便如粉汁。齿黑有疮。骨出耳干脑焦。不治。疳渴饮水不止。舌黑者死。疳痨气促者死。疳泻痢咳逆脱肛者。不
治。
病有轻重。无不热 。热不一端。内外久暴。阴虚内烧。阳盛外燥。病久骨蒸。病暴液耗。惊食风寒。疳痰癖懊。
皆令发热。昏迷颠倒。各有兼症。均宜详校。而此诸热。五脏分搅。额赤切牙。掌中若燎。渴饮或呕。心热可料。左颊
先赤。便难筋掉。多怒多惊。肝热如告。鼻赤嗜卧。肢体惰傲。遇夜益甚。脾热堪道。喘嗽气粗。右颊红冒。手掐眉目。
肺热宜悼。足不喜覆。颏赤声噪。骨酥如虫。肾热与较。更参虚实。理无或拗。热必发烦。热必发躁。症异原同。俱非
易疗。如何谓烦。火入肺窍。如何谓躁。火入肾HT 。其火维何。必君独耀。金燔水涸。病日以 。HT 煎不安。心
经热闹。HT 不定。心经风铰。皆足生惊。急慢天钓。发热烦躁。往往齐到。寻源溯流。全凭性巧。对症立方。病根
是扫。
Wang Haogu stated: Zouma Gan (Running Horse Gangrene) is the extreme stage of Gan erosion syndrome. It results from steaming heat rising from the five zang organs attacking upwards. In severe cases, it presents as "Bengsha Hou" (a condition resembling crumbling sand along the gums), with swelling and rotting of the gingiva near the teeth, foul breath, mild tidal fever, difficulty in eating, bleeding from the gum spaces, teeth becoming loose as if falling out, and gingival tissue rotting and falling off spontaneously. Treatment should first involve rinsing the mouth with light salt water, followed by applying Zijin San (Purple Gold Powder) three times daily to eliminate worms/toxins within the gingival flesh. If the condition is extremely severe, Qiushuang San (Autumn Frost Powder) should be applied. Subsequently, Tianzhu Huang San (Tianzhu Huang Powder) combined with Dihuang Gao (Rehmannia Paste) should be used for conditioning to stabilize the condition. If the condition does not recede and one or two teeth fall out initially, death is inevitable and untreatable. Subsequently, the face becomes shiny, the cheeks ulcerate exposing bone, leading to death.
Shen Jin'ao noted in his commentary: Zeng's treatment method first removes accumulated heat using Danggui San (Angelica Decoction) combined with Sanleng San (Curcuma Decoction), decocted with Shengjiang (Fresh Ginger) and Dazao (Jujube). This is followed by administering Lushui Wan (Aloe Pill) and Yulu Yin (Jade Dew Drink), gargling with warm salt water, or gently wiping the area clean with a soft chicken feather dipped in salt water, then applying Miduoseng San (Lead Monoxide Powder). If it persists without healing and spreads to the upper and lower lips, forming the Bengsha syndrome, with cheek perforation and tooth loss, death ensues.
Wei Yilin stated: Conditions such as Gan Lao (Gan Consumption) and Gan Xie (Gan Diarrhea), characterized withered and dull complexion, protruding teeth and exposed bones, hard abdomen and inability to eat, are all symptoms of Gan disease.
Li stated: Gan Gan of the Liver presents with bluish eyes, hardness under the left hypochondrium, frequent spitting of foam, and blackening at the corners of the eyes; this is untreatable. Gan Gan of the Heart presents with bluish veins behind the ears and focal black spots on the tongue; this is untreatable. Gan Gan of the Spleen presents with a distended abdomen and visible blue collaterals, lack of blood color in the lips and mouth, flat philtrum, and incessant diarrhea; this is untreatable. Gan Gan of the Lung presents with cough, reverse flow of qi, rapid breathing, discharge of white watery stool, and black spots on the body; this is untreatable. Gan Gan of the Kidney presents with cravings for salty and sour foods, incessant drinking, urine resembling powder juice, black teeth with sores, protruding bones, dry ears, and scorched brain matter; this is untreatable. Gan Ke (Gan Thirst) with incessant drinking and black tongue leads to death. Gan Lao with shortness of breath leads to death. Gan Xie accompanied by dysentery, cough, reverse flow of qi, and rectal prolapse is untreatable.
Diseases vary in severity but invariably involve fever. The causes of fever are diverse, arising from internal or external factors, chronic or acute conditions. Yin deficiency causes internal burning, while Yang excess causes external dryness. Chronic illness leads to bone-steaming consumption, while acute illness depletes body fluids. Startle, food stagnation, wind-cold, Gan phlegm, Pi accumulation, and Ao'ao (restlessness/annoyance) all cause fever. Coma and confusion occur, each with accompanying symptoms that require detailed differentiation. These various fevers are stirred by the five zang organs: red forehead, clenched teeth, palms feeling like burning embers, thirst with drinking or vomiting indicate Heart Heat; redness starting on the left cheek, difficult defecation, tendon twitching, irritability, and fright indicate Liver Heat; red nose, lethargy, slack limbs, worsening at night indicate Spleen Heat; wheezing, cough, coarse breathing, redness covering the right cheek, scratching brows and eyes indicate Lung Heat; dislike of covering feet, red chin, noisy voice, brittle bones as if eaten by insects indicate Kidney Heat. One must further differentiate deficiency and excess, adhering to principles without deviation. Heat inevitably causes Fan (vexation) and Zao (restlessness/agitation); although symptoms differ, the root is the same, making them difficult to treat. What is "Fan"? It is fire entering the Lung orifices. What is "Zao"? It is fire entering the Kidney meridian. What is this fire? It is the solitary brilliance of the Heart Sovereign. When Metal burns and Water dries up, the disease worsens day by day, causing torment and unrest. Excessive heat in the Heart meriphery, instability in the Heart meridian, and wind affecting the Heart meridian are sufficient to generate Jing Feng (Wind Agitation). Ji Jing Feng (Acute Wind Agitation), Man Jing Feng (Chronic Wind Agitation), and Tian Diao (Heavenly Hook) often present simultaneously with fever and restlessness. Tracing the source and flow relies entirely on the physician's spiritual acuity. Prescribing formulas according to symptoms sweeps away the root of the disease.