王肯堂曰∶腮颔发生腮脸,属足阳明经风热所致。(《准绳》)
又曰∶金腮疮,生于颊腮,初如米粒,渐大如豆,久而不治,溃蚀透颊,属阳明
经。治不得法,溃烂不敛,口吐臭痰,喘急神昏者死。
冯鲁瞻曰∶腮痈,乃胃家经络也。(《锦囊》)
又曰∶咽痛颔肿,脉洪大面赤者,羌活胜湿汤加黄芩、甘草、桔梗各五分。
朱丹溪治两腮肿,用细辛、草乌等分为末,入蚌粉、猪脂调敷。口含白梅,置
腮边良久,出涎,肿退消时,肿必先向下。
古一人因惊骇后,常用手指甲掐住两颊,遂致两颊破损,心懊 不安,脉数而
实,诸药不愈。用《活幼方》中牛黄清心凉膈丸,数服而愈。
澄曰∶腮颔发者,其势大,即腮痈,又名鱼腮毒。而金腮疮者,其势小,多生于
嗜酒之人,糟粕之味熏蒸胃腑,是以腮颔结肿 痛。初起,四妙汤主之,寒热加荆
芥、防风、葛根、赤芍;已成加白芷;将溃加穿山甲、皂角刺;溃后四妙汤加白芷
排脓。二三剂脓尽,速于生肌收口,不得妄自追蚀提药,防其透膜。此症全赖补托,
兼戒房事,庶不致收口腮凹,亦可免夫成鱼腮漏,终年淌水也。均照痈疽门治法,毋
庸另立主方。
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Kui Guang stated: Tuo Sai Yong (Cheek Abscess) arises below the cheek, formed by the accumulation of rich and heavy dietary flavors, strong wine, and heat-toxin.
Wang Kentang stated: The occurrence of facial swelling in the cheek and jaw region belongs to wind-heat affecting the Foot-Yangming Meridian. (From *Yi Zong Bi Du*)
He further stated: Jin Sai Chuang (Golden Cheek Sore) arises on the cheek and jaw. Initially resembling a grain of rice, it gradually enlarges to the size of a bean. If left untreated for a long time, it ulcerates and erodes through the cheek, belonging to the Yangming Meridian. If treated improperly, leading to non-healing ulcers, with symptoms of spitting foul phlegm, rapid breathing, and coma, the prognosis is fatal.
Feng Luzhan stated: Sai Yong (Cheek Abscess) is a pathology of the Stomach meridians. (From *Jin Nang Mi Lu*)
He further stated: For sore throat, submandibular swelling, with a surging pulse and red face, treat with Qiang Huo Sheng Shi Tang (Notopterygium Decoction to Overcome Dampness) added with Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Jie Geng (Platycodonis Radix), each 5 fen.
Zhu Danxi treated bilateral cheek swelling by grinding Xixin (Asari Radix) and Caowu (Aconiti Radix Preparata) into equal parts powder, mixing it with Bang Fen (Margarita) and pig fat for external application. The patient held a white plum in the mouth near the cheek for a long time; upon discharge of saliva, the swelling subsided, moving downward first.
An ancient case involved a person who, after being startled, frequently scratched both cheeks with fingernails, causing skin damage. The patient felt inner restlessness and agitation, with a rapid and forceful pulse. Various medicines failed. Treatment with Niuhuang Qingxin Liangge Wan (Calculus Bovis Clear Heart and Cool Diaphragm Pill) from *Huoyou Xinshu* cured the condition after several doses.
Gu Shicheng stated: Sai Han Fa (Cheek and Jaw Swelling) has a large scope, also known as Sai Yong (Cheek Abscess) or Yu Sai Du (Fish Cheek Toxin). In contrast, Jin Sai Chuang has a smaller scope and often occurs in people addicted to alcohol, due to the steaming of food residues affecting the Stomach Fu-organ, resulting in swelling and pain in the cheeks and jaw. At the initial stage, Si Miao Tang (Four Marvels Decoction) is the primary formula. If accompanied by chills and fever, add Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), and Chishao (Paeoniae Radix Rubra). If the mass has formed, add Baizhi (Angelicae Dahuricae Radix). If impending rupture, add Chuanshanjia (Manis Squama) and Zaojiaoci (Gleditsiae Spina). After rupture, add Baizhi to Si Miao Tang to drain pus. After two or three doses, when pus is exhausted, promote tissue regeneration and wound closure rapidly. Do not recklessly use caustic or drawing agents to prevent perforation of the fascia. This condition relies entirely on tonification and expulsion methods. Concurrently, sexual intercourse must be prohibited to avoid sunken cheeks upon healing and to prevent the formation of Yu Sai Lou (Fish Cheek Fistula) with chronic discharge. Treat according to the methods for Carbuncles and Ulcers; there is no need to establish a separate primary formula.