唇燥者,阳明热也。时疫见此,当辨其色。深赤为大
热,宜清、下。淡白为亡津液,宜滋润。色如常,为津液不流通,热在经脉,宜葛根。
时疫齿燥有三。轻浅者为阳明经热,前板齿燥,身热目疼,鼻干不得卧,此将发斑疹及衄血之先兆,葛根为
主,黄芩、知母、石膏为辅。重者为胃府燥热,通口皆燥,甚则黑如煤炭,三承气、三黄石膏选用。至重者为阴
火煎熬,亡血太甚,肾水涸竭,当峻补其阴,知母、黄柏、生地、元参、天冬、麦冬、丹皮,每味两许,大作汤
液,加童便、金汁,昼夜兼进。若药轻治缓,则不及矣。
时疫鼻孔干有四。风热则鼻鸣,荆、防、葛根、薄荷为主。阳明经热则烦躁,葛根、石膏为主。胃热腑证则大
渴,舌黄,三黄石膏为主。亡津液肺燥,麦冬、生地、五味为主。
大抵风热、经热者,十之五、六;腑热、亡液者,十
之二、三。非谓热深而鼻孔反不干也,以烦、渴、大热证见,则不觉鼻孔之干与否耳。
耳聋者,少阳邪热挟痰上壅也。时疫耳聋者多,盖邪之传变,出表入里,必干少阳,又时疫属热,热至上升,
挟痰涎浊气上壅隧道,故耳聋也。治法以疫邪大势为主,
见于初起传表时,于表药中加荆、防、川芎;见于入里时,于里药中加黄芩、知母。屡经汗、下,耳聋不愈,不
可急治,养阴调胃为主。须待粥食如常,二便调匀,始由渐而愈也。
Dryness of the lips indicates Heat in the Yangming (Bright Yang) channel. When seen in epidemic febrile diseases, one must distinguish the color. A deep red color indicates intense Heat, suitable for clearing Heat and purging; a pale white color indicates depletion of Body Fluids (Jin Ye), suitable for moistening and nourishing; a normal color indicates stagnation of Body Fluid circulation with Heat in the channels, suitable for using Ge Gen (Puerariae Radix).
There are three types of dry teeth in epidemic febrile diseases. The mild type is Heat in the Yangming channel, characterized by dryness of the anterior incisors, fever, eye pain, nasal dryness, and inability to lie down; this is a precursor to the eruption of macules/papules and epistaxis, treated primarily with Ge Gen (Puerariae Radix), assisted by Huang Qin (Scutellariae Radix), Zhi Mu (Anemarrhenae Rhizoma), and Shi Gao (Gypsum Fibrosum). The severe type is Dry-Heat in the Stomach Fu organ, characterized by dryness throughout the mouth, and in extreme cases, blackening like coal; treat with San Cheng Qi Tang (Three Purging Decoctions) or San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction). The most severe type is caused by Yin Fire simmering, excessive blood loss, and exhaustion of Kidney Water; it requires vigorous tonification of Yin, using Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Sheng Di Huang (Rehmanniae Radix), Yuan Shen (Scrophulariae Radix), Tian Dong (Asparagi Rhizoma), Mai Dong (Ophiopogonis Radix), and Dan Pi (Moutan Cortex), each in large doses (approx. 30g), decocted heavily, added with Tong Bian (Child's Urine) and Jin Zhi (Gold Juice/Charcoal-infused liquid), administered day and night. If the medication is too mild or treatment too slow, it will be ineffective.
There are four types of dry nostrils in epidemic febrile diseases. Wind-Heat causes nasal whistling/sounds, treated primarily with Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Ge Gen (Puerariae Radix), and Bo He (Menthae Haplocalycis Herba). Yangming channel Heat causes irritability, treated primarily with Ge Gen (Puerariae Radix) and Shi Gao (Gypsum Fibrosum). Stomach Heat Fu syndrome causes extreme thirst and yellow tongue coating, treated primarily with San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction). Depletion of Body Fluids with Lung dryness is treated primarily with Mai Dong (Ophiopogonis Radix), Sheng Di Huang (Rehmanniae Radix), and Wu Wei Zi (Schisandrae Chinensis Fructus).
Generally, Wind-Heat and Channel Heat account for 50-60%; Fu Heat and Fluid Depletion account for 20-30%. This does not mean that intense Heat results in non-dry nostrils; rather, when symptoms like irritability, thirst, and high fever appear, the dryness of the nostrils goes unnoticed.
Deafness is caused by Shaoyang (Lesser Yang) pathogenic Heat carrying Phlegm turbidity upward to obstruct the orifices. Deafness is common in epidemic febrile diseases because as pathogens transmit from exterior to interior, they inevitably affect the Shaoyang. Since epidemics are Heat-type diseases, Heat rises, carrying Phlegm-saliva and turbid Qi to obstruct the meridians and tunnels, causing deafness. Treatment focuses on the main trend of the epidemic pathogen: if seen during the initial exterior transmission stage, add Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), and Chuan Xiong (Ligustici Chuanxiong Rhizoma) to exterior-releasing formulas; if seen during the interior stage, add Huang Qin (Scutellariae Radix) and Zhi Mu (Anemarrhenae Rhizoma) to interior-clearing formulas. If deafness persists after repeated sweating and purging, do not treat urgently; instead, focus on nourishing Yin and regulating the Stomach. Recovery will only occur gradually after dietary intake returns to normal and bowel/bladder functions become regular.