灵枢云。十二经脉三百六十五络。其血气皆上于面而走空窍。其精阳气。上走于目而为睛。
其别气走于耳而为听。其宗气出于鼻而为臭。其浊气出于胃走唇舌而为味。其气之津液。皆上熏
于面。而皮又浓。其肉坚。故天气甚寒。不能胜之也。风邪入皮肤。痰饮积腑脏。则面 黯。脾
肺二经风湿。搏而为热湿。故面生疮。面肿曰风。两颊赤肿。其状如痱。酒调消风散。食后服之。
或用羌活、防风、升麻、白芷、牛蒡子之属。甚则凉膈散、生姜、葱豉汗之。外杵杏仁如膏。加
玄明粉、硫黄敷之。风热面肿而痛。升麻汤加犀角、黄连、白芷、川芎、薄荷、荆芥。风热面肿
痛。或咽喉不利者。犀角升麻汤。虚风证。能食麻瞀。牙关急搐。目内 动。胃中有风。故面独
肿。升麻胃风汤。
面热面寒 饮食不节则胃病。胃病则气短精神少而生大热。有时火上行而独燎其面。针经云。
面热者足阳明
病。调胃承气汤加犀角、川连。脉数实有力。精神茂泽。升麻汤加川连。甚者。凉膈散。咳逆倚
息不得卧。面热如醉。此为胃热上冲熏其面。桂苓五味甘草汤加大黄利之。左半边面及耳热耳鸣。
觉从少腹左胁冲上者。属肝火。实则当归龙荟丸。虚则加减八味丸。虚甚。地黄饮子。面寒为阳
虚。阴寒郁遏所致。升麻汤加熟附子。甚者。附子理中汤。阳明经虚。面热而赤者。补中益气加
熟附子二三分。面赤为邪气怫郁在经。宜表不宜下。面戴阳。下虚也。伤寒用四逆汤。杂证用地
黄饮子。面白善嚏。脉紧者寒也。羌活、防风、甘草、 本四味。泻足太阳。少加附子以通其脉。
悲恐者。更加桂、附。面目浮肿。或紫黑。或风刺瘾疹。消风散加减。面上风痒。或如火丹。鼠
粘子散。不应。加人参一钱。数服即效。面部生疮。或鼻脸赤。风刺粉刺。百药不效。及面上细
疮。常出黄水者。并宜硫黄膏涂之。上焦风热。则面生小疮。通圣散。脾胃虚。或吐泻后面目浮
肿者。脉必缓弱。或气口虚大。六君子汤加减。面青肝虚。面白肺虚。面黄脾虚。两颊红阴虚。
面如漆柴。手足少阴气俱绝。为血先死。若面黑而不至于枯者。六味丸。面尘脱色。为肝木失荣。
人参养荣汤。面色忽黑。乃因臭气所冲而成。或头痛。或腹痛。或呕吐。或腹胀。一味香附末。
淡盐汤下三钱。面上豆痕。或斑 密陀僧细末。夜以人乳调敷。面上雀斑。白丁香、鹰屎白、
密陀僧。唾调搽之。面上赤斑癣。鹿角灰猪脂调涂。指爪破面。轻粉研细。生姜汁调敷。无瘢痕。
肋肿属风热。干葛、甘、桔、升麻、薄荷。湿热脉洪大者。羌活胜湿汤加甘、桔、黄芩。 腮。
赤小豆末。鸡子清调敷。井底泥亦得。三因方。凡伸欠颊车蹉。但开不能合。以酒饮之令大醉。
睡中吹皂角末搐鼻。嚏透即愈。正后以补中益气加骨碎补调之。
The *Ling Shu* (Spiritual Pivot) states: The twelve meridians and their three hundred and sixty-five collaterals, all ascend their blood and qi to the face and traverse the orifices. Their refined yang qi ascends to the eyes, forming vision. The branch qi ascends to the ears, forming hearing. The ancestral qi (Zong Qi) emerges from the nose, forming smell. The turbid qi emerges from the stomach, ascending to the lips and tongue, forming taste. The fluids of these qi all steam upwards to moisten the face. Furthermore, the facial skin is thick, and the muscles are firm; therefore, even if the weather is extremely cold, it cannot overcome this defense and cause disease.
When wind pathogens enter the skin, and phlegm-fluids accumulate in the zang-fu organs, the complexion becomes dull. If damp-wind invades the Spleen and Lung meridians, they knot together to transform into heat-dampness, causing sores on the face. Facial edema is termed "Wind". Redness and swelling of the cheeks, resembling prickly heat, can be treated with Xiao Feng San (Eliminate Wind Powder) mixed with wine, taken after meals. Alternatively, use herbs such as Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Sheng Ma (Cimicifugae Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), and Niu Bang Zi (Arctii Fructus). For severe cases, use Liang Ge San (Cool the Diaphragm Powder) combined with Sheng Jiang (Zingiberis Rhizoma Recens) and Cong Chi (Allii Tuberosi Bulbus) to induce sweating. Externally, crush Xing Ren (Armeniacae Semen Amarum) into a paste, add Xuan Ming Fen (Mirabilite) and Liu Huang (Sulfur), and apply to the affected area.
For facial swelling and pain due to wind-heat, use Sheng Ma Tang (Cimicifuga Decoction) added with Xi Jiao (Rhinocerotis Cornu - *note: substitute with Buffalo Horn in modern practice*), Huang Lian (Coptidis Rhizoma), Bai Zhi, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bo He (Menthae Haplocalycis Herba), and Jing Jie (Schizonepetae Spica). For facial swelling and pain due to wind-heat, or accompanied by throat obstruction, use Xi Jiao Sheng Ma Tang (Rhinoceros Horn and Cimicifuga Decoction). For deficiency-wind syndrome, characterized by the ability to eat but blurred vision (Ma Mao), tight jaw spasms, and internal eye tremors, this indicates wind in the Stomach, causing isolated facial swelling; treat with Sheng Ma Wei Feng Tang (Cimicifuga and Stomach-Wind Decoction).
**Facial Heat and Cold:** Irregular diet damages the Stomach. Stomach disease leads to shortness of breath, lack of spirit, and generation of intense heat. Sometimes fire qi ascends, burning only the face. The *Zhen Jing* (Needle Classic) states: Facial heat indicates disease of the Foot-Yangming Meridian. Treat with Tiao Wei Cheng Qi Tang (Regulate the Stomach and Purge the Bowels Decoction) added with Xi Jiao and Chuan Lian (Huang Lian). If the pulse is rapid, full, and forceful, and the spirit is abundant and lustrous, use Sheng Ma Tang added with Chuan Lian. For severe cases, use Liang Ge San. Cough and counterflow qi, inability to lie flat, with facial heat resembling drunkenness, indicates Stomach heat rushing upward to steam the face; treat with Gui Ling Wu Wei Gan Cao Tang (Atractylodes, Poria, Schisandra, and Licorice Decoction) added with Da Huang (Rhei Radix et Rhizoma) to promote purgation. Heat in the left half of the face and ear tinnitus, with a sensation of qi rushing up from the lower abdomen and left hypochondrium, belongs to Liver Fire. For excess patterns, use Dang Gui Long Hui Wan (Angelica and Gardenia Pill); for deficiency patterns, use Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill); for severe deficiency, use Di Huang Yin Zi (Rehmannia Elixir).
Facial cold is caused by Yang deficiency and depression of yin-cold; treat with Sheng Ma Tang added with Shu Fu Zi (Prepared Aconite Root). For severe cases, use Fu Zi Li Zhong Tang (Aconite and Ginger Decoction to Warm the Middle). Deficiency of the Yangming Meridian, presenting with facial heat and redness, is treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with 2-3 fen of Shu Fu Zi. Facial redness due to pathogenic stagnation in the meridians requires releasing the exterior rather than purging. Dai Yang syndrome (false yang floating upward, characterized by pale face with malar flush) indicates lower jiao deficiency; for Cold Damage diseases, use Si Ni Tang (Frigid Extremities Decoction); for miscellaneous diseases, use Di Huang Yin Zi.
White complexion with frequent sneezing and a tight pulse indicates cold; use Qiang Huo, Fang Feng, Gan Cao (Licoriza Root), and Gao Ben (Ligustici Wallichii Rhizoma) to drain the Foot-Taiyang meridian, adding a small amount of Fu Zi to unblock the pulse. In cases of grief or fear, add Rou Gui (Cinnamon Bark) and Fu Zi. Facial and ocular edema, purple-black discoloration, or wind-stinging urticaria are treated with modified Xiao Feng San. Facial wind-itch or fire-like erysipelas are treated with Shu Niu Zi San (Arctii Powder); if ineffective, add 1 qian of Ren Shen (Ginseng Radix et Rhizoma), showing effect after several doses. Sores on the face, redness of the nose and cheeks, wind-stinging acne, unresponsive to various medicines, or fine facial pustules discharging yellow fluid, should all be coated with Liu Huang Gao (Sulfur Ointment). Upper jiao wind-heat causing small facial sores is treated with Tong Sheng San (Universal Salvation Powder). Spleen-Stomach deficiency, or facial edema following vomiting and diarrhea, presents with a slow-weak pulse or a deficient-large pulse at the Qi Kou position; treat with Liu Jun Zi Tang (Six Gentlemen Decoction) modified.
Greenish complexion indicates Liver deficiency; white indicates Lung deficiency; yellow indicates Spleen deficiency; red cheeks indicate Yin deficiency. Complexion like dry firewood indicates exhaustion of Qi in both Hand-Shaoyin and Foot-Shaoyin meridians, signifying death of blood first. If the complexion is black but not emaciated, use Liu Wei Wan (Six-Ingredient Pill). Dusty, faded complexion indicates Liver Wood losing nourishment; treat with Ren Shen Yang Rong Tang (Ginseng and Nourish-Virtue Decoction). Sudden darkening of the complexion is caused by offensive odors; accompanied by headache, abdominal pain, vomiting, or abdominal distension; treat with a single powder of Xiang Fu (Cyperi Rhizoma), taken with light salt water, 3 qian per dose.
Acne scars or dense spots on the face: apply Metuo Seng (Lead Monoxide) fine powder mixed with human milk at night. Freckles on the face: mix Bai Ding Xiang (Streblus Seed), Ying Shi Bai (Eagle Droppings White), and Metuo Seng, apply with saliva. Red patch tinea on the face: apply Lu Jiao Hui (Deer Antler Ash) mixed with Zhu Zhi (Pork Fat). Scratches on the face from fingernails: apply Qing Fen (Calomel) finely ground, mixed with Sheng Jiang Zhi (Ginger Juice), to prevent scarring.
Swelling in the ribs due to wind-heat: use Gan Ge (Puerariae Radix), Gan Cao, Jie Geng (Platycodonis Radix), Sheng Ma, and Bo He. For damp-heat with a surging pulse: use Qiang Huo Sheng Shi Tang (Notopterygium and Dampness-Overcoming Decoction) added with Gan Cao, Jie Geng, and Huang Qin (Scutellariae Radix). For mumps (Ying Mian): apply Chi Xiao Dou (Vigna Semen Rubrum) powder mixed with Ji Zi Qing (Egg White); well mud from wells is also effective. According to the *San Yin Fang*: For jaw dislocation where the mouth opens but cannot close, intoxicate the patient with wine until drunk, blow Sao Jiao Mo (Gleditsiae Sinensis Spine Powder) into the nose while sleeping; recovery occurs once sneezing is thorough. Afterwards, regulate with Bu Zhong Yi Qi Tang added with Gu Sui Bu (Drynariae Rhizoma).