上唇生疮虫食脏。下唇生疮虫食肛。此名狐惑非佳候。化 丸儿酌治良。
上下唇口多疮。其声嗄哑者。名曰狐惑。其义云何。乃出自伤寒指掌之言。谓上唇多疮者。虫
食其脏。名曰狐。下唇多疮者。虫食其肛。名曰惑。盖取其进退犹豫之义也。大非美候。宜以秘本
化丸。或古方化 丸。酌量而治之。如更烦躁、昏闷、失声者。死症也。
秘本化 丸
君子肉 芦荟（ ） 龙胆草（各二钱） 五灵脂（一钱五分） 黄连（二钱） 川楝子（一钱
五分） 乌梅 为末。以乌梅去核、捣烂、合丸。白水下。
古方化 丸
黄连（五钱） 蜀椒（闭目者勿用、去杆、炒二钱。） 苦楝树根白皮（晒干二钱） 为末
。用乌梅肉、七枚。以艾汤浸、捣烂、合丸。艾汤下。
切牙之症非痘比。痘有寒热二症分。喜食热物四肢冷。下血咽痛见阎君。
切牙虽非痘症比。亦有寒热二症分。未曾服药从热治。过用寒凉又宜温。
麻之切牙。非若痘比。痘症切牙。有寒热二症之分。而麻症切牙。皆属热候。乃阳陷于阴。故
多发渴。而手足俱热。喜饮食冷物。治宜滋阴降火。以麦冬汤。去白芍。加丹皮治之。若手足俱不
热。而反厥冷。喜食热物。此为热邪内亢。后必下血、咽痛、痰鸣而死。即以白虎汤（见二十六条）
治之。然多不可救。若饮食犯椒姜辛辣助热等物。更非所宜。然麻后切牙。亦有虚实。不可执泥无
虚实之说。但不与痘症比耳。麻后切牙。其先未曾服药而切牙者。乃实症也。解毒乃止。而三味消
毒饮（见三十三条）之类。可以随证加减而用。若已经服药而切牙者。恐服寒凉之药过多。有伤
气血而然。宜以四物汤（见二十五条）加人参治之。
朱曰 实证宜解毒。易治。多服寒凉伤气血。非大医不能治矣。
麦冬汤 治痘症。便实而渴。
生地黄 当归身 白芍药 麦冬 水煎服。
The appearance of sores on the upper lip indicates that parasites are eating the internal organs. The appearance of sores on the lower lip indicates that parasites are eating the anus. This condition is named Hu-Huo (Fox and Charm, a disease characterized by oral and genital ulcers), which is an unfavorable prognosis. One should carefully prescribe Hua Wan (Transforming Pill) for treatment, which yields good results.
When there are many sores on the upper and lower lips and mouth, accompanied by hoarseness, it is named Hu-Huo. What is the meaning behind this? This concept originates from *Shanghan Zhizhang* (Guiding Principles of Cold Damage). It states that when there are many sores on the upper lip, it means parasites are eating the internal organs, named "Hu" (Fox); when there are many sores on the lower lip, it means parasites are eating the anus, named "Huo" (Charm). This is likely derived from the imagery of the fox's hesitant and indecisive nature. This is certainly not a good sign. One should use the secret version of Hua Wan or the ancient formula Hua Wan, prescribing according to the specific situation. If accompanied by irritability, mental confusion, and loss of voice, it is a fatal syndrome.
Secret Version Hua Wan Formula:
Junzi Rou (Buckthorn Fruit), Lvhui (Aloe), Longdancao (Gentian Root) (each 2 qian), Wulingzhi (Trogopterus Dung) (1.5 qian), Huanglian (Coptis Rhizome) (2 qian), Chuanlianzi (Szechwan Chinaberry Fruit) (1.5 qian). Grind these into powder. Remove the pits from Wu Mei (Mume Fruit), mash them, mix with the powder to form pills. Take with plain water.
Ancient Formula Hua Wan:
Huanglian (Coptis Rhizome) (5 qian), Shujiao (Sichuan Pepper) (Do not use those with closed eyes; remove stems, stir-fry 2 qian), Kulian Shugen Baipi (White Bark of Toosendan Tree Root) (sun-dried 2 qian). Grind these into powder. Use seven Wu Mei (Mume Fruit) meats, soak in Mugwort Decoction, mash, and mix with the powder to form pills. Take with Mugwort Decoction.
Teeth-grinding (Qie Ya) symptoms should not be compared with smallpox (Dou Zheng). Smallpox presents with two types: cold and heat syndromes. If the patient prefers hot foods and has cold limbs, followed by bloody stools and sore throat, death ensues.
Although teeth-grinding cannot be directly compared to smallpox, it is also divided into cold and heat types. If no medication has been taken yet, treat as a heat syndrome; if caused by excessive use of cold-natured medicines, treat with warmth.
Teeth-grinding caused by measles is different from smallpox. Smallpox-related teeth-grinding has cold and heat distinctions, whereas measles-related teeth-grinding belongs entirely to heat syndromes. This occurs because Yang Qi sinks into Yin, causing patients to generally feel thirsty, have hot hands and feet, and prefer cold foods and drinks. Treatment should focus on nourishing Yin and descending fire, using Maidong Tang (Ophiopogon Decoction), removing Baishao (White Peony Root), and adding Danpi (Moutan Cortex). If the hands and feet are not hot but instead cold (Jue Leng), and the patient prefers hot foods, this indicates hyperactive internal heat pathogens. Subsequently, bloody stools, sore throat, and rattling phlegm will occur, leading to death. At this stage, Baihu Tang (White Tiger Decoction) (see Article 26) can be used, but recovery is rare. Consuming pungent, ginger, garlic, or other heat-assisting foods is strictly contraindicated. However, teeth-grinding after measles also has deficiency and excess patterns; one must not rigidly adhere to the idea that there is no deficiency. It simply differs from smallpox. For teeth-grinding after measles where no prior medication was taken, it is an excess syndrome; stop it with detoxification methods. Sanwei Xiaodu Yin (Three-Ingredient Detoxifying Drink) (see Article 33) can be used with modifications based on symptoms. If teeth-grinding occurs after taking medication, it is likely due to excessive intake of cold-natured drugs damaging Qi and Blood. In this case, Siwu Tang (Four Substance Decoction) (see Article 25) added with Renshen (Ginseng) should be used.
Master Zhu said: Excess syndromes are suitable for detoxification and are easy to treat. If Qi and Blood are damaged by excessive consumption of cold medicines, only a great physician can treat it.
Maidong Tang: Treats smallpox with constipation and thirst.
Ingredients: Sheng Dihuang (Rehmannia Root), Danggui Shen (Angelica Sinensis Root Body), Baishao Yao (White Peony Root), Maidong (Ophiopogon Tuber). Decoct in water and take orally.