苏颂曰∶黔人治疥癣遍体诸药不效者，生取白花蛇切断，以砖烧红，沃醋，令气蒸，置蛇于上，
以盆覆一夜，如此三次，去骨取肉， 以五味令烂，顿食之。瞑睡一昼夜乃醒，疮 随皮便退，其疾
便愈。（《本草纲目》）
张子和曰∶货生药焦百善云，有荛夫来买苦参，欲治疥，不识药性缓急，但闻人言可治，浓煎一
碗服之。须臾，大吐痰涎一盆，二三日，疥作痂矣。
潘埙曰∶予蔓孙患脓疥三年，身无完肤，下体尤甚，内治外治，百无一效。乃治制一方，名和中
固气汤，以苍术一钱燥湿，白术一钱固脾，黄 一钱实腠理，升麻八分、柴胡一钱引清气，元参八分
散上焦火，芩、连各七厘清中焦火，黄柏七分伏下焦火，归身一钱养心血，甘草、陈皮、人参各五分
调中气。煎服存渣，加白蒺藜、金银花煎洗，十数剂而全愈。（楮记室）
姚应凤诊一人，遍体发小疥如粟。应凤曰∶是名净海疮，不治生，治死。其人不信，治之死。
（《钱塘县志》）
元希声侍郎治卒发疥秘验方∶锻石随多少，和醋浆水调涂，随手即减。一法用锻石炒红，出火气，
香油调敷。
薛立斋治稽勋李龙冈，患疥，腿足为甚，日晡益 ，口干作渴，小便频赤。此肾经虚热，用补中
益气汤、五味丸而痊。
一儒者善嚏，患疥，以为内有湿热，腠理不密，外邪所搏也，与补中益气汤加白芷、川芎治之。
不从，自
服荆防败毒散，痛处发肿，小便赤涩。此肺肾阴虚，用补中益气汤加五味、麦冬而愈。
一儒者患疥，误用攻伐之剂，元气虚而不能愈。用补中益气汤加茯苓，其疮顿愈。又因调养失宜，
日晡益甚，其腿日肿夜消，以为气血虚而有热，朝用补中益气，夕用加味逍遥而愈。
一男子时疫愈后，所患如前，用前药补养而愈。有同患，用砭法出血而死。此因阴虚血热，色黑
作痒也，何乃反伤阴血哉？
一妇人疥久不愈，食少体倦。此肝脾亏损而虚热，先用补中益气汤加川芎、炒栀，元气渐复，更
以逍遥散而愈。若复闻谵语，此热入血分，用小柴胡汤加生地治之。血虚者，四物合小柴胡汤。热退
却，用逍遥散，以补胃生阴血。或有寒热如疟，亦治以前药。
一妇人患疥作痒，脓水不止，脉浮无力，以消风散四剂少愈。更以四生丸，月余而平。
一男子痒少痛多，无脓水，以芩、连、荆、防、山栀、薄荷、白芍、归梢，治之而愈。
一男子患疥 痛，发热，脉浮数，以人参败毒散，四剂少愈。更以当归饮子，数剂而愈。
一男子患疥 痛，寒热便秘，脉数有力，以防风通圣散，二剂少愈。更以荆防败毒散加黄芩、山
栀，四剂而愈。
一妇人患疥作痒，午后尤甚，以当归饮子，数剂少愈。更以人参、荆芥，数剂而安。
薛立斋治一男子，患疥久不愈，搔起白屑，耳作蝉声。以四生散，白附子、黄 、独活、蒺藜，
数服痒止。更以当归饮子，数剂而痊。
一男子患疥，下体居多， 痛，日晡尤甚，腿腕筋紫而胀，脉洪大，此血热而然也。就于紫处刺
去瘀血，以四物汤加芩、连、地骨皮、柴胡，四剂而安。患在上体，若臂腕筋紫胀，亦宜刺去其血，
以前汤加柴胡、黄芩即愈。
一男子搔痒成疮，日晡痛甚，以四物加芩、连、荆、防，数剂而止。更以四物加蒺藜、首乌、黄
，二十剂而愈。
智化寺一僧，病疮疥，自用雄黄、艾叶等药，燃于被中熏之。翌日遍身 肿，皮破出水，饮食不
入，投以解药不应而死。盖药熏入腹内而散真气，其祸如此。
（丁丑，予举家生疮，家人亦用此方熏之，疮不愈。未几，銮儿出痘，症极凶，药不能下咽而殁，
殆亦受其毒耳。）
一男子患疮疥，搔破出脓水，面赤作渴，大便坚实，脉洪数，左关寸为甚，此木火相搏也。先用
泻青丸料煎服，热势顿减。又用栀子柴胡散、加味逍遥散而疮愈。
一儒者遍身生疮，搔痒，脓水淋漓。自知医，服八珍、荆防之类，益甚。脉洪大，按之无力，谓
此气血虚热也，用八珍汤加丹皮治之而愈。继娶后，两足生疮，久不愈，尺脉数而无力，用地黄丸、
八珍汤而痊。
一男子患疥，干痒作痛，以芩、连、荆、防、山栀、薄荷、白芍、归梢，治之而愈。
蒋仲芳治一僧，初患疥，自以水银、蕲艾熏之，遂喘息胸满，遍身浮肿。或投五皮饮，不效。投
椒目、大黄等，喘肿愈甚。曰∶气道皮肤，肺气热也。复以火熏，火毒伤肺，遂失降下之令，气道塞，
水道闭，喘息溺涩，浮肿之所由来也。今复推荡，阴血又伤，若非童真，难免于死矣。以麦冬、黄芩、
山栀、桑皮、花粉、滑石、木通、灯草与之，四剂而愈。（薛案∶有一僧，亦用熏法致死。）
胡氏子年二十余，生脓窠已一年，服药无算，长卧床席，二三日间，昏晕数次。入其室，秽气盈
溢，脓血痛苦，仰卧不能转侧，两手背皆疮，不能诊候。问其饮食恶心否？云∶尚可饮食。曰∶胃气
在，可生也。即以黄 、白术、当归、甘草、广胶为主，佐以银花、浮萍，煎之以酒，六剂疮愈大半，
二十剂而全愈。
姚氏妇有子，而胸乳肥疮如桃，背及下半身俱满，异痛异痒，脓血淋漓，已经三月，不时寒热，
渐作恶心。蒋曰∶病急矣，但喜其日未久，因乳子气血骤虚，因多卧而饮食不运也。亦以前方加黄柏、
连翘、陈皮、香附，
外以大黄、朴硝、松香、东丹为末，少加飞盐，麻油调敷，亦不久而愈。此二人者，胡予清热消运之
品，俱为日久虚弱者设也。若初起壮实者，粒如小粟而多痒，曰疥疮，风热为胜，理以苦参、黄柏、
荆芥、防风为君；脓泡如痘而多痛，曰脓窠，湿热居多，理宜苍术、秦艽、银花、连翘为主。俱加天
麦门冬、酒炒黄芩以清肺。盖肺主皮毛，肺热则皮毛有是疾也。若日久则肺虚，又宜补肺，而不宜清
肺矣。此意先哲未及，故附之。
Su Song stated: When people in Qian (Guizhou) suffer from widespread scabies and tinea that resist all medications, they catch a white-flowers snake alive, cut it into pieces, heat bricks until red-hot, pour vinegar on them to generate steam, place the snake on top, cover with a basin overnight, and repeat this three times. After removing the bones and taking the meat, they rot it using five flavors of seasoning and consume it in one dose. The patient falls into a deep sleep for a day and night before waking up; the sores then peel off with the skin, and the disease is cured. (From *Bencao Gangmu*)
Zihehe said: Jiao Baishan, a seller of raw medicinal herbs, told me that a woodcutter bought Sophora flavescens root (Kushen) to treat scabies. Unaware of the drug's mild or potent nature, but having heard it could cure the condition, he decocted a strong bowl and drank it. Shortly after, he vomited a basin full of phlegm and saliva. Within two to three days, the scabies formed crusts.
Pan Xun said: My nephew Mansun suffered from pustular scabies for three years, leaving no intact skin on his body, especially on the lower extremities. Internal and external treatments numbered in the hundreds, yet none were effective. Therefore, I formulated a prescription named Hezhong Guqi Tang (Harmonizing Middle and Consolidating Qi Decoction). It uses Cangzhu (Atractylodis Rhizoma) 1 qian to dry dampness, Baizhu (Atractylodis Macrocephalae Rhizoma) 1 qian to strengthen the spleen, Huangqi (Astragali Radix) 1 qian to solidify the interstices, Shengma (Cimicifugae Rhizoma) 8 fen and Chaihu (Bupleuri Radix) 1 qian to guide clear qi upward, Xuanshen (Scrophulariae Radix) 8 fen to dissipate fire in the upper jiao, Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) each 7 li to clear fire in the middle jiao, Huangbai (Phellodendri Cortex) 7 fen to subdue fire in the lower jiao, Danggui Shen (Angelicae Sinensis Radix) 1 qian to nourish heart blood, and Gancao (Glycyrrhizae Radix), Chenpi (Citri Reticulatae Pericarpium), and Renshen (Ginseng Radix) each 5 fen to regulate middle qi. The medicine is decocted and taken orally, while the dregs are retained. White Jili (Tribuli Fructus) and Yinjinhua (Lonicerae Japonicae Flos) are added to decoct water for washing. After more than ten doses, complete recovery was achieved. (From *Chuji Shi*)
Yao Yingfeng diagnosed a patient whose entire body was covered with small scabies lesions like millet grains. Yao said: This disease is called Jinghai Chuang (Pure Sea Sore); if untreated, the patient will die; if treated, the patient will also die. The patient did not believe him, insisted on treatment, and subsequently died. (From *Qiantang County Annals*)
Yuan Xisheng, Vice Minister, had a secret effective formula for sudden onset of scabies: Take an appropriate amount of Duanshi (Calcined Lime), mix with vinegar and water, apply topically, and relief follows immediately. Another method involves frying Duanshi until red-hot, removing the fire heat, and applying it mixed with sesame oil.
Xue Lizhai treated Li Longgang, a Jixun Lang (Official of the Bureau of Merits), who suffered from scabies, particularly severe on the legs and feet. Symptoms worsened in the late afternoon, accompanied by dry mouth, thirst, frequent urination, and dark urine. This was identified as deficiency-heat in the Kidney meridian. Treatment with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Wuwei Wan (Five-Flavor Pill) led to recovery.
A scholar frequently sneezed and suffered from scabies. It was considered that internal damp-heat combined with loose interstices allowed external pathogens to invade. He was prescribed Buzhong Yiqi Tang plus Baizhi (Angelicae Dahuricae Radix) and Chuanxiong (Ligustici Chuanxiong Rhizoma). He refused, self-medicating with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity), which caused swelling at the lesion sites and painful, dark, scanty urination. This was diagnosed as Yin deficiency of the Lung and Kidney. Treatment with Buzhong Yiqi Tang plus Wuweizi (Schisandrae Chinensis Fructus) and Maidong (Ophiopogonis Radix) resulted in recovery.
Another scholar suffered from scabies but mistakenly used purgative drugs, damaging his Yuanqi (Primal Qi) and preventing healing. Treatment with Buzhong Yiqi Tang plus Fuling (Poria) led to immediate resolution of the sores. Later, due to improper care, symptoms worsened in the late afternoon, with leg edema appearing during the day and subsiding at night. This was attributed to Qi and Blood deficiency with heat. Morning administration of Buzhong Yiqi Tang and evening administration of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) led to recovery.
A man, after recovering from an epidemic disease, developed similar symptoms. He recovered through supplementation with the aforementioned medicines. A fellow sufferer died after undergoing phlebotomy (Bianfa). This case illustrates that Yin deficiency with Blood-heat causes blackening and itching; why would one harm Yin and Blood?
A woman suffered from chronic scabies with reduced appetite and fatigue. This was Liver-Spleen deficiency causing deficiency-heat. Initially treated with Buzhong Yiqi Tang plus Chuanxiong and Chao Zhizi (Fried Gardenia), her Yuanqi gradually recovered. Subsequent treatment with Xiaoyao San led to full recovery. If delirium occurred later, indicating Heat entering the Blood level, Xiao Chaihu Tang (Minor Arcanine Decoction) plus Shengdi (Rehmanniae Radix) would be used. For Blood deficiency, Siwu Tang (Four Substance Decoction) combined with Xiao Chaihu Tang is indicated. After heat subsides, Xiaoyao San is used to tonify Stomach Qi and generate Yin-Blood. In cases of alternating chills and fever resembling malaria, the same medicines are applied.
A woman suffered from itchy scabies with continuous pus discharge and a floating, weak pulse. Four doses of Xiaofeng San (Wind-Expelling Powder) brought slight improvement. Subsequent treatment with Sisheng Wan (Four Living Pills) resolved the condition over a month.
A man experienced less itching but more pain, without pus. He was treated with Huangqin, Huanglian, Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Shanzhi (Gardeniae Fructus), Bohe (Menthae Haplocalycis Herba), Baishao (Paeoniae Radix Alba), and Gongshao (Radix Angelicae Sinensis Cauda) and recovered.
A man suffered from painful scabies with fever and a floating, rapid pulse. Ren Shen Bai Du San (Ginseng Powder to Overcome Toxicity) for four doses brought slight improvement. Subsequent treatment with Danggui Yinzi (Angelica Drink) for several doses led to recovery.
A man suffered from painful scabies with chills, fever, constipation, and a forceful, rapid pulse. Fangfeng Tongsheng San (Saposhnikovia Powder to Unblock and Generate) for two doses brought slight improvement. Subsequent treatment with Jingfang Baidu San plus Huangqin and Shanzhi for four doses led to recovery.
A woman suffered from itchy scabies, worse in the afternoon. Danggui Yinzi for several doses brought slight improvement. Subsequent treatment with Renshen and Jingjie for several doses stabilized the condition.
Xue Lizhai treated a man with chronic scabies, scratching leading to white scales and a buzzing sound in the ears. Sisheng San (Four Living Powder) containing Baifuzi (Typhonii Rhizoma), Huangqi, Duhuo (Angelicae Pubescentis Radix), and Jili was administered for several doses, stopping the itch. Subsequent treatment with Danggui Yinzi led to recovery.
A man suffered from scabies predominantly on the lower body, with pain worsening in the late afternoon. His ankle veins were purple and swollen, with a洪大 (Surging-Large) pulse, indicating Blood-heat. Pricking the purple areas to release stasis, followed by Siwu Tang plus Huangqin, Huanglian, Digupi (Lycii Cortex), and Chaihu for four doses, brought peace. If lesions were on the upper body with purple, swollen arm veins, pricking to release stasis and using the previous formula plus Chaihu and Huangqin would lead to recovery.
A man scratched until sores formed, with severe pain in the late afternoon. Siwu Tang plus Huangqin, Huanglian, Jingjie, and Fangfeng stopped the pain after several doses. Subsequent treatment with Siwu Tang plus Jili, Shouwu (Polygoni Multiflori Radix), and Huangqi for twenty doses led to recovery.
A monk at Zhihua Temple suffered from sores and scabies. He self-treated by burning Xionghuang (Realgar) and Aiye (Artemisiae Argyi Folium) under his blankets. The next day, his whole body swelled, skin broke and wept fluid, and he could not eat. Antidotes failed, and he died. The fumigation likely entered the abdomen, dispersing True Qi, causing such disaster. (In the Dingchou year, my whole family suffered from sores, and my family also used this fumigation method; the sores did not heal. Soon after, my son Luan contracted smallpox with extremely fierce symptoms, could not swallow medicine, and died, likely due to poisoning from this method.)
A man suffered from sores and scabies, scratching until pus flowed. His face was red, he was thirsty, stool was hard, and his pulse was Surging-Rapid, especially at the Left Guan and Cun positions. This indicated Wood-Fire conflict. Xieqing Wan (Drain Green Pill) decoction was given first, rapidly reducing heat. Subsequent treatment with Zhizi Chaihu San (Gardenia and Bupleurum Powder) and Jiawei Xiaoyao San healed the sores.
A scholar had widespread sores, itching, and dripping pus. Knowing medicine, he took Bazhen Tang (Eight Treasure Decoction) and Jingfang-type formulas, which worsened the condition. His pulse was Surging-Large but empty upon pressure, indicating Qi and Blood deficiency with heat. Bazhen Tang plus Danpi (Moutan Cortex) healed him. After remarrying, he developed sores on both feet that persisted. His Chi pulse was Rapid and weak. Dihuang Wan (Rehmannia Pill) and Bazhen Tang led to recovery.
A man suffered from dry, itchy, and painful scabies. Treatment with Huangqin, Huanglian, Jingjie, Fangfeng, Shanzhi, Bohe, Baishao, and Gongshao led to recovery.
Jiang Zhongfang treated a monk who initially had scabies. Self-treating with mercury and Qiai (Artemisia argyi) fumigation caused wheezing, chest fullness, and generalized edema. Wupi Yin (Five Peel Decoction) was ineffective. Further treatment with Jiaomu (Zanthoxyli Semen) and Dahuang (Rhei Radix et Rhizoma) worsened the wheezing and edema. Jiang said: The airways and skin indicate Lung-Heat. Re-applying fire fumigation injured the Lung with Fire-Toxin, losing its descending function. Airway blockage and Water-Dao closure caused wheezing, difficult urination, and edema. Using pushing/purgative methods now injures Yin-Blood further. Unless he is a celibate youth, death is inevitable. He was given Maidong, Huangqin, Shanzhi, Sangbai Pi (Mori Cortex), Huafen (Trichosanthis Radix), Huashi (Talcum), Mutong (Akebiae Caulis), and Dengcao (Junci Medulla). Four doses led to recovery. (Xue Case: Another monk also died from fumigation.)
Hu's son, over twenty years old, had had pustular scabs for a year. He took countless medicines, remained bedridden, and fainted several times every few days. Entering his room, foul odor filled the air. He lay supine unable to turn, with sores on both hands making pulse diagnosis impossible. Asked about nausea with food, he replied he could still eat. I said: As long as Stomach Qi remains, there is hope. I prescribed Huangqi, Baizhu, Danggui, and Gancao as main ingredients, assisted by Yinhua (Honeysuckle Flower) and Fuping (Spirodela), decocted in wine. Six doses improved half the sores; twenty doses led to complete recovery.
Mrs. Yao, who had children, developed peach-sized sores on her chest and breasts, covering her back and lower body. She experienced strange pain and itching, dripping pus and blood for three months, with intermittent chills/fever and growing nausea. Jiang said: The disease is critical, but fortunately, it has not been long. Breastfeeding causes sudden Qi and Blood deficiency, and prolonged lying down impairs digestion. I used the previous formula plus Huangbai, Lianqiao (Forsythiae Fructus), Chenpi, and Xiangfu (Cyperi Rhizoma). Externally, Dahuang, Puxiao (Natrii Sulfas), Songxiang (Colophonium), and Dongdan (Red Lead Oxide) were powdered, mixed with a little Feiyan (Sublimated Mercury Chloride) and sesame oil for application. She recovered soon. These two cases required clearing heat and promoting transformation, suitable for those weakened by long duration. For early-stage robust patients with millet-grain-like itchy lesions (Scabies), Wind-Heat predominates; Kushen, Huangbai, Jingjie, and Fangfeng should be the sovereign herbs. For pustule-like painful lesions (Pustular Scabies), Damp-Heat predominates; Cangzhu, Qinjiao (Magnoliae Officinalis Cortex), Yinhua, and Lianqiao should be primary. Tianmendong (Asparagi Radix), Maimendong, and Jiu Chao Huangqin (Wine-fried Scutellaria) should be added to clear the Lung. Since the Lung governs skin and hair, Lung-Heat causes these dermatological issues. If prolonged, Lung deficiency occurs, requiring tonification rather than clearing. This insight was missed by earlier masters, so I append it.