头顶圆形或不规则形白癣1年多。医诊头癣。先用西药治疗8个多月不效，继用中药芫花膏、川楝子膏外涂，内服防风通圣丸治疗5个多月亦无明显改善。细审其证，头顶发际内数片圆形及不规则形的皮损，中间之头发干枯脱落，极痒，咽喉干燥，舌苔薄白，脉沉而弦。综合脉证，诊为风邪人于血分，络脉瘀滞，血燥生风。治拟养血润燥，活血散风。处方：桃仁9克，红花6克，当归12克，白芍15克，川芎6克，生地9克，蝉蜕6克，白蒺藜9克，防风9克，元参15克，秦艽10克，白头翁10克。
服药2剂，奇痒大减，白痂减，皮损缩小l／3左右。但近几天却发现在两肩臂上出现大量如小米大的红色皮疹，左耳耳鸣，舌苔白，脉浮。综合脉证，思之：此乃血中风热解而在表之风仍未除也。治宜疏风清热。处方：银花15克，连翘15克，竹叶9克，荆芥9克，牛蒡子9克，元参15克，芦根15克，薄荷6克，桔梗9克，豆豉9克，甘草6克，蝉蜕9克，黄芩9克。
服药6剂，上臂皮疹消失，头癣消退80％左右。加白头翁9克，服药10剂，愈。
某医云：头癣因何用白头翁?答曰：白头翁不但能治热痢便血，亦且能人血分，散头部、关节之风邪，故血分有热而兼风邪者多用之。
手足癣
1．审其病位，知其脏腑，思其经络，养血润燥，散风止痒，始愈
黎××，男，30岁。
手掌干裂脱皮，皮肤增厚3年多。医诊为手癣。先用西药外涂5个多月无效。继又以中药谷糠油、红花油等外涂治疗5个多月仍无效。细审其证，两手的掌面及指缝间的皮肤有大量如小米大的水疱疹，呈半透明状，有的疱疹溃破后流出少量白水，有的溃后脱皮，奇痒。大量疱疹簇拥处溃破，皮肤呈鲜红色，不脱皮处皮肤较它部皮肤明显增厚变硬，中间有的已干裂，有的部位干厚裂纹皮肤与鲜红而薄的皮肤相间存在，所有指缝皮肤均呈鲜红色，舌苔薄白，舌质嫩红，脉沉细。综合脉证，思之：手掌属脾心，心主血，脾统血，今脉沉细而手掌皲裂脱皮疱疹者，乃血虚燥热，风邪内动也。治宜养血润燥，散风止痒。处方：生地12克，熟地10克，白蒺藜9克，川牛膝9克，菟丝子9克，知母6克，黄柏6克，枸杞子6克，独活3克。
服药1剂，手痒大减，继服10剂，不但奇痒消失，而且丘疹、疱疹、脱皮、皮肤增厚干裂均霍然而愈。
2．审其昼夜，合之脉证，知病在血，予养血活血祛风始愈
邹××，女，35岁。
手掌脱皮痒痛5年多。医诊手癣。全身奇痒难忍2个多月。医诊皮炎。先用西药治数年不效，继又配合中药除湿清热散风数月而痒痛更剧。细审其证，手掌及指缝皮肤疱疹脱皮，间有部分皮肤增厚，全身奇痒，不住的用手搔抓，到处是血性抓痕，尤其是腋部、乳房皱襞、脐周、肩胛间区、肘窝、肛门周围更为明显，大小鱼际处有很深的裂口6个，裂口处并有血液渗出，烦躁不安，舌苔白，脉弦细。综合脉证，反复思考：手掌者心脾所主也，手掌奇痒干裂脱皮者血中燥热也；奇痒搔破有血印者，血燥生风也；脉弦细者，肝血虚也。治宜养血润燥祛风。处方：当归12克，生地15克，元参30克，熟地10克，丹皮10克，何首乌15克，白蒺藜10克，僵蚕10克，红花10克，甘草6克，独活6克，枸杞子10克，知母10克。
服药6剂，身痒大减，夜间已经可以入睡2～3小时，但手掌脱皮、干裂出血无甚改变；继服上药12剂，不但身痒全部消失，亦且手掌脱皮，干裂亦愈。
某医问：手癣、皮炎本是两个疾病，何以一方而皆愈?答日：两病虽属两个截然不同的疾病，然其病因、病位却相一致，故一方治之而皆愈也。
3．胶泥湿热，不审脉证，不察标本，不知随证，因循固守，其病不愈
温××，女，50岁。
两足趾缝间每至夏季即皮肤湿烂8年多，今年人夏以来更加严重。医诊脚癣。先用西药治疗4天，湿烂奇痒不但不减，而且更加严重。继又邀中医治之，处以加减草薜渗湿汤内服，外涂洗除湿清热之品，不但不减，反而更加严重。审其两足趾缝、足蹠、足跟及足弓部皮肤均湿烂奇臭，其边缘皮肤鲜红既痒且痛，昼夜不能入睡，身热，舌苔白，质红，脉滑数。综合脉证，思之：足心者，肾之所主也，足蹠热痛而红赤者，肾阴不足，火邪内炽也。脉滑数者，热也。阴虚火邪炽盛者，治宜滋阴降火。处方：元参30克，生地15克，麦冬10克。
服药1剂，湿烂、红肿、痒痛均大减，继服6剂，愈。
某医问：足癣湿烂前用加减萆薢渗湿汤等治疗3个月而更甚，今但用增液汤7剂即瘳，其故何也?答曰：足癣湿烂属湿热者恒多，故多以除湿清热之方治之，然今阴虚火炽反用除湿以伤阴津则火更炽盛，故不除而反甚也。王冰称此火只可壮水以制火，不可苦寒以降火，疏达以助火。前方之使病加剧者在于动而不静也。
4．胶于湿热，泥于火邪，不察其脉，不知寒变，阳虚作热，治之不愈
郑××，女，50岁。
两足足缝湿烂奇痒时轻时重2年多。医诊脚癣。近几个月来日渐加重。先以西药治疗6～7天，病情不但不减，反见更加严重，后又以中药燥湿止痒之剂外涂，湿烂奇痒的面积迅速扩大。又邀某医先予加减三妙，后予加减萆薢渗湿汤7～8剂，湿烂痒痛迅速扩大。细察其证，两足趾缝、足蹠、足跟、足背两侧均痒痛湿烂，整个两足均红肿不能触地，味极臭秽，足心热痛难忍，舌苔白，舌质淡，脉沉细尺弱。综合脉证，思之：湿烂之证应属湿热，湿热之证应予除湿清热治之，然其不效者何也?《内经》曾云：谨守病机，各司其属，有者求之，无者求之。此病发于足蹠，足蹠者肝肾所主，湿烂者虽多属湿热，然脉沉细尺弱，舌质淡，却为肾气不足。故先以补肾为要。至其阳复湿化其病可愈。处方：生地24克，山药12克，五味子9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参15克，麦冬15克，车前子12克(布包煎)，怀牛膝10克。
服药1剂，两足湿烂，红肿痒痛均明显改善，继服8剂，愈。
某医云：湿脚气诸书均云为脾胃湿热下注而成，主用萆薢渗湿汤加减，而本证却用之无效；十味地黄汤乃治肾虚虚火上浮之方，今用于此证反效者，其故为何也?答曰：湿热之证采用化湿清热、燥湿清热、利湿清热，这无疑是正确的治疗方法，但是湿热之证有湿热之邪所致者，有正虚而湿热内生者。若湿热之邪所致者，当除其湿热之邪；若正虚湿热内生者，则必须扶正以除邪。反之，若湿热者给予扶正则必然邪气更炽，正虚者给予祛邪则必然正伤而邪不除。补正以除邪湿法，有补肾，补脾之别，若肾虚而兼湿热者，又多阴阳俱虚，故以十味地黄汤补阴益阳，滋阴降火。
湿疹
1．胶于病名，固于湿邪，不审昼夜，不察脉证，血燥反用燥药，伤血损阴，风邪因生
霍××，女，成。
全身瘙痒，皮疹反复不愈十几年。医诊湿疹。先用西药治疗数年不效，继又用中药祛风除湿清热之剂3年多亦不见功，不得已，改用中、西药联合治疗3个月，病情不但不减，反见日渐加重，特别是近l周来，病情更加严重。细审其证，全身满布小者如针尖，大者如高粱的斑丘疹，皮肤粗糙，夜间痒甚，常常非抓出血不能减轻痒感，舌苔白，脉沉细。综合脉证，思之：脉沉细，而夜间痒甚者，阴虚血燥生风之证也。治宜养血活血，凉血祛风。处方：丹参15克，当归10克，川芎10克，白芍10克，生地10克，银花12克，连翘12克，薄荷3克。
服药4剂，身痒稍减，继服10剂，诸证均失，愈。
某医问：湿疹诸医多主张采用除湿清热之法治之，而本病反治愈甚，其故何也?答曰：湿疹以湿热所致者为多，故多以除湿清热之剂治之，然而兼有血中燥热者亦有之，若兼血中燥热者，但予除湿清热而不兼予养血益阴，则非但湿热不能除，亦且血中燥热更甚耳，故今以养血润燥而得愈。
2．审其脉证，知其气郁夹湿，予健脾除湿，理气散风始愈
靳××，男，69岁。
尾骶部皮损如掌大一片瘙痒流水十几年。医诊慢性湿疹。先用西药治疗数年不效，后又配以中药清热燥湿解毒之剂治疗数年亦无功。特别是近1个月来，不但尾骶部湿疹有所扩大，而且全身各个部分都出现大量湿疹。细审其证，尾骶有一比手掌稍大的密集皮肤增厚，浸润，棕红色区，间有散在的丘疹、疱疹，全身到处是边界不清的水肿性红斑，红斑上有小丘疹，尤其是小腿、手、膝窝、足、肘窝、外阴、肛门等处更为严重，整日瘙痒不已，胃脘、大腹均胀满，舌苔白，脉沉。综合脉证，思之：全身痒疹者风也；流汁水者湿也；脉沉，腹满者，气郁也。治宜健脾除湿，理气散风，清热。处方：羌活6克，防风6克，荆芥6克，川芎10克，厚朴10克，党参10克，茯苓10克，陈皮10克，甘草6克，僵蚕6克，藿香10克，苦参12克。同时外用：艾叶10克，苦参30克，花椒10克，水煎，外洗。
内外兼治6天之后，瘙痒大减，皮损亦有所减少，继服12剂，愈。
某医问：余亦曾用健脾燥湿，祛风清热之剂治之，然其不效者何也?答曰：本病非但有一脾虚，二湿热，三风邪，亦且有气滞耳。你所处方但治其三，而未治其四，即未予理气，故不愈也。
3．知病位，审脏腑，明经络，其病得治
甄××，男，成。
肛门周围湿痒丘疹8年多。医诊湿疹。始以西药治之不效，继又配合中药燥湿清热之剂数年亦无明显改善。细审其证，肛门周围如掌大一片皮肤增厚区，间有湿烂小丘疹，瘙痒，胸脘满胀，心烦易怒，舌苔薄白，脉虚大弦紧。综合脉证，思之：弦大紧脉者，气阴两虚为本，湿热为标也。肛门者，亦称魄门，大肠所主也。合而论之：乃气阴两虚为本，脾虚湿郁，气血郁滞，湿热下注为标。治宜益气养阴以培本，燥湿健脾，理气活血以治标。处方：党参30克，麦冬12克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，三棱10克，莪术10克，柴胡IO克，薄荷6克，夜交藤30克。
服药4剂，非但胸脘痞满好转，亦且肛门周围湿疹均愈。
某医问：加味一贯煎本为治疗肝、胃病方，今用于湿疹反愈者何也?答曰：加味一贯煎具有四个功能：一者补气养阴，二者燥湿健脾，三者疏肝理气，四者破气破血。今此病虽为肛门周围湿疹，然其病机不外是：一者气阴两虚，二者湿郁不化，三者血络瘀滞，四者肝气不舒，故以此方治之而获效。
带状疱疹
见病位知所主，察脉象知病性，治用理肝宣肺，清热解毒，愈
牛××，男，40岁。
右胁疼痛难忍，疱疹成串4天。医诊带状疱疹。先用西药治疗3天其症不减，继又配用中药清热解毒剂1天亦不效。细审其证，右侧胸胁部疱疹成片，并沿肋间分布，疼痛难忍，舌苔白，脉弦滑。综合脉证，思之：胸胁者，肝肺所主之位也；脉弦滑者，痰火郁结也。治宜宣肺理肝，解毒化痰。处方：柴胡10克，枳实10克，桔梗10克，赤芍10克，瓜蒌15克，橘叶10克，青皮10克，夏枯草30克，连翘10克。同时加用：耳针压痛点、外关，浅刺，留针2小时。服药2剂，次日诸证全失，愈。某医问：昼夜兼进2剂即疹退痛失，余未闻之也，请明示其理。答曰：根据经验但予解毒而疹退者多留有疼痛之不解，审其机制多与：一不化痰，二不活血有关，今之所以疹与痛俱失者，恐在方中具有化痰、活血之药耳。
疥疮
审其昼夜，知其在血，予养血活血，解毒而愈
张××，男，26岁。
全身皮疹，奇痒1年多。医诊疥疮。先以西药外涂久治不效，继又配合中药硫黄制剂外涂亦无明显效果。细审其证，两手指缝间、手腕、肘窝屈伸、腋窝、乳房下、腹部、脐周、阴部、大腿内侧呈散在的小丘疹、水疱及灰白色、浅灰色细纹线，夜间奇痒，到处是抓搔的血痂，舌苔白，脉弦细。综合脉证，思之：夜间痒甚者血分燥热生风也。治宜活血养血，凉血祛风。处方：丹参15克，当归10克，川芎10克，生地10克，白芍10克，银花10克，连翘10克，薄荷3克。
服药4剂，痒疹全失，继服4剂，愈。
某医云：诸书皆云硫黄善治疥疮，而本病用此久治不效者何也?答曰：硫黄者，杀疥虫之药也，故疥疮用此多奇效。然硫黄酸咸大热有毒，若病邪入于血分而血燥生风者，不宜用之，因其以热助热也。今以丹参银翘饮治之而愈者，因其养血活血，凉血解毒也。
斑秃
审其病位，察其脉舌，知其病因，明其病位，治以养阴补肾，益气升阳，始愈
梁××，男，43岁。
头顶出现圆形或不规则形状的白癣，病程已一年多。医生诊断为头癣。先使用西药治疗8个多月无效，随后外用中药芫花膏、川楝子膏，内服防风通圣丸治疗5个多月，也无明显改善。仔细审查其证候，头顶发际内有数片圆形及不规则形的皮损，中间的头发干枯脱落，瘙痒剧烈，咽喉干燥，舌苔薄白，脉象沉而弦。综合脉象与症状，诊断为风邪侵入血分，络脉瘀滞，血燥生风。治疗拟定养血润燥，活血散风。处方：桃仁9克，红花6克，当归12克，白芍15克，川芎6克，生地9克，蝉蜕6克，白蒺藜9克，防风9克，元参15克，秦艽10克，白头翁10克。
服用2剂后，剧烈瘙痒大幅减轻，白色痂皮减少，皮损缩小约三分之一。但近几天发现两肩臂上出现大量如小米粒大小的红色皮疹，左耳耳鸣，舌苔白，脉象浮。综合脉象与症状，思考认为：这是血中风热已解，但在表之风邪仍未清除。治疗宜疏风清热。处方：银花15克，连翘15克，竹叶9克，荆芥9克，牛蒡子9克，元参15克，芦根15克，薄荷6克，桔梗9克，豆豉9克，甘草6克，蝉蜕9克，黄芩9克。
服用6剂后，上臂皮疹消失，头癣消退约80%。加入白头翁9克，继续服药10剂，痊愈。
某医生说：头癣为何使用白头翁？回答是：白头翁不仅能治疗热痢便血，也能进入血分，疏散头部、关节的风邪，因此血分有热兼有风邪者多用此药。
手足癣
1. 审察病位，知晓所属脏腑，思考经络走向，养血润燥，散风止痒，始得痊愈
黎××，男，30岁。
手掌干裂脱皮，皮肤增厚3年多。医生诊断为手癣。先外用西药治疗5个多月无效。随后又用中药谷糠油、红花油等外涂治疗5个多月仍无效。仔细审查其证候，两手掌面及指缝间的皮肤有大量如小米粒大小的水疱疹，呈半透明状，有的疱疹溃破后流出少量白水，有的溃破后脱皮，瘙痒剧烈。大量疱疹簇拥处溃破，皮肤呈鲜红色，未脱皮处皮肤较其他部位明显增厚变硬，中间有的已干裂，有的部位干厚裂纹皮肤与鲜红而薄的皮肤相间存在，所有指缝皮肤均呈鲜红色，舌苔薄白，舌质嫩红，脉象沉细。综合脉象与症状，思考认为：手掌属脾心所主，心主血，脾统血，现脉沉细而手掌皲裂脱皮疱疹，乃血虚燥热，风邪内动所致。治疗宜养血润燥，散风止痒。处方：生地12克，熟地10克，白蒺藜9克，川牛膝9克，菟丝子9克，知母6克，黄柏6克，枸杞子6克，独活3克。
服用1剂，手部瘙痒大幅减轻，继服10剂，不仅剧烈瘙痒消失，而且丘疹、疱疹、脱皮、皮肤增厚干裂均迅速痊愈。
2. 审察昼夜变化，结合脉证，知晓病在血分，予养血活血祛风始得痊愈
邹××，女，35岁。
手掌脱皮痒痛5年多。医生诊断为手癣。全身剧烈瘙痒难忍2个多月。医生诊断为皮炎。先用西药治疗数年无效，随后配合中药除湿清热散风数月，反而痒痛加剧。仔细审查其证候，手掌及指缝皮肤疱疹脱皮，间有部分皮肤增厚，全身剧烈瘙痒，不住用手搔抓，到处是血性抓痕，尤其是腋部、乳房皱襞、脐周、肩胛间区、肘窝、肛门周围更为明显，大小鱼际处有很深的裂口6个，裂口处并有血液渗出，烦躁不安，舌苔白，脉象弦细。综合脉象与症状，反复思考：手掌由心脾所主，手掌剧烈瘙痒干裂脱皮者，为血中燥热；剧烈瘙痒搔破有血印者，为血燥生风；脉弦细者，为肝血虚。治疗宜养血润燥祛风。处方：当归12克，生地15克，元参30克，熟地10克，丹皮10克，何首乌15克，白蒺藜10克，僵蚕10克，红花10克，甘草6克，独活6克，枸杞子10克，知母10克。
服用6剂，身体瘙痒大幅减轻，夜间已经可以入睡2～3小时，但手掌脱皮、干裂出血无甚改变；继服上方12剂，不仅身体瘙痒全部消失，而且手掌脱皮、干裂也痊愈了。
某医问：手癣、皮炎本是两个疾病，为何一方而皆愈？回答是：两病虽属两个截然不同的疾病，但其病因、病位却相一致，故一方治之而皆愈。
3. 胶着于湿热，不审脉证，不察标本，不知随证变化，因循固守，其病不愈
温××，女，50岁。
两足趾缝间每至夏季即皮肤湿烂8年多，今年入夏以来更加严重。医生诊断为脚癣。先使用西药治疗4天，湿烂奇痒不减，反而更加严重。随后又请中医诊治，处以加减草薢渗湿汤内服，外涂洗除湿清热之品，不减反增。审察其两足趾缝、足蹠、足跟及足弓部皮肤均湿烂奇臭，其边缘皮肤鲜红既痒且痛，昼夜不能入睡，身热，舌苔白，质红，脉滑数。综合脉象与症状，思考认为：足心者，肾之所主也，足蹠热痛而红赤者，肾阴不足，火邪内炽也。脉滑数者，热也。阴虚火邪炽盛者，治宜滋阴降火。处方：元参30克，生地15克，麦冬10克。
服用1剂，湿烂、红肿、痒痛均大减，继服6剂，痊愈。
某医问：足癣湿烂前用加减萆薢渗湿汤等治疗3个月而更甚，今但用增液汤7剂即瘳，其故何也？回答是：足癣湿烂属湿热者恒多，故多以除湿清热之方治之，然今阴虚火炽反用除湿以伤阴津则火更炽盛，故不除而反甚也。王冰称此火只可壮水以制火，不可苦寒以降火，疏达以助火。前方之使病加剧者在于动而不静也。
4. 胶着于湿热，泥于火邪，不察其脉，不知寒变，阳虚作热，治之不愈
郑××，女，50岁。
两足足缝湿烂奇痒时轻时重2年多。医生诊断为脚癣。近几个月来日渐加重。先以西药治疗6～7天，病情不减，反见更加严重，后又以中药燥湿止痒之剂外涂，湿烂奇痒的面积迅速扩大。又邀某医先予加减三妙，后予加减萆薢渗湿汤7～8剂，湿烂痒痛迅速扩大。细察其证，两足趾缝、足蹠、足跟、足背两侧均痒痛湿烂，整个两足均红肿不能触地，味极臭秽，足心热痛难忍，舌苔白，舌质淡，脉沉细尺弱。综合脉象与症状，思考认为：湿烂之证应属湿热，湿热之证应予除湿清热治之，然其不效者何也？《内经》曾云：谨守病机，各司其属，有者求之，无者求之。此病发于足蹠，足蹠者肝肾所主，湿烂者虽多属湿热，然脉沉细尺弱，舌质淡，却为肾气不足。故先以补肾为要。至其阳复湿化其病可愈。处方：生地24克，山药12克，五味子9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参15克，麦冬15克，车前子12克(布包煎)，怀牛膝10克。
服用1剂，两足湿烂，红肿痒痛均明显改善，继服8剂，痊愈。
某医云：湿脚气诸书均云为脾胃湿热下注而成，主用萆薢渗湿汤加减，而本证却用之无效；十味地黄汤乃治肾虚虚火上浮之方，今用于此证反效者，其故为何也？回答是：湿热之证采用化湿清热、燥湿清热、利湿清热，这无疑是正确的治疗方法，但是湿热之证有湿热之邪所致者，有正虚而湿热内生者。若湿热之邪所致者，当除其湿热之邪；若正虚湿热内生者，则必须扶正以除邪。反之，若湿热者给予扶正则必然邪气更炽，正虚者给予祛邪则必然正伤而邪不除。补正以除邪湿法，有补肾，补脾之别，若肾虚而兼湿热者，又多阴阳俱虚，故以十味地黄汤补阴益阳，滋阴降火。
湿疹
1. 胶着于病名，固于湿邪，不审昼夜，不察脉证，血燥反用燥药，伤血损阴，风邪因生
霍××，女，成（年）。
全身瘙痒，皮疹反复不愈十几年。医生诊断为湿疹。先用西药治疗数年无效，继又用中药祛风除湿清热之剂3年多亦不见功，不得已，改用中、西药联合治疗3个月，病情不减，反见日渐加重，特别是近1周来，病情更加严重。仔细审查其证候，全身满布小者如针尖，大者如高粱的斑丘疹，皮肤粗糙，夜间痒甚，常常非抓出血不能减轻痒感，舌苔白，脉沉细。综合脉象与症状，思考认为：脉沉细，而夜间痒甚者，阴虚血燥生风之证也。治疗宜养血活血，凉血祛风。处方：丹参15克，当归10克，川芎10克，白芍10克，生地10克，银花12克，连翘12克，薄荷3克。
服用4剂，身体瘙痒稍减，继服10剂，诸证均失，痊愈。
某医问：湿疹诸医多主张采用除湿清热之法治之，而本病反治愈甚，其故何也？回答是：湿疹以湿热所致者为多，故多以除湿清热之剂治之，然而兼有血中燥热者亦有之，若兼血中燥热者，但予除湿清热而不兼予养血益阴，则非但湿热不能除，亦且血中燥热更甚耳，故今以养血润燥而得愈。
2. 审察脉证，知晓其气郁夹湿，予健脾除湿，理气散风始得痊愈
靳××，男，69岁。
尾骶部皮损如掌大一片瘙痒流水十几年。医生诊断为慢性湿疹。先用西药治疗数年无效，后又配以中药清热燥湿解毒之剂治疗数年亦无功。特别是近1个月来，不但尾骶部湿疹有所扩大，而且全身各个部分都出现大量湿疹。仔细审查其证候，尾骶有一比手掌稍大的密集皮肤增厚，浸润，棕红色区，间有散在的丘疹、疱疹，全身到处是边界不清的水肿性红斑，红斑上有小丘疹，尤其是小腿、手、膝窝、足、肘窝、外阴、肛门等处更为严重，整日瘙痒不已，胃脘、大腹均胀满，舌苔白，脉沉。综合脉象与症状，思考认为：全身痒疹者风也；流汁水者湿也；脉沉，腹满者，气郁也。治疗宜健脾除湿，理气散风，清热。处方：羌活6克，防风6克，荆芥6克，川芎10克，厚朴10克，党参10克，茯苓10克，陈皮10克，甘草6克，僵蚕6克，藿香10克，苦参12克。同时外用：艾叶10克，苦参30克，花椒10克，水煎，外洗。
内外兼治6天之后，瘙痒大减，皮损亦有所减少，继服12剂，痊愈。
某医问：余亦曾用健脾燥湿，祛风清热之剂治之，然其不效者何也？回答是：本病非但有一脾虚，二湿热，三风邪，亦且有气滞耳。你所处方但治其三，而未治其四，即未予理气，故不愈也。
3. 知晓病位，审察脏腑，明辨经络，其病得治
甄××，男，成（年）。
肛门周围湿痒丘疹8年多。医生诊断为湿疹。始以西药治之不效，继又配合中药燥湿清热之剂数年亦无明显改善。仔细审查其证候，肛门周围如掌大一片皮肤增厚区，间有湿烂小丘疹，瘙痒，胸脘满胀，心烦易怒，舌苔薄白，脉虚大弦紧。综合脉象与症状，思考认为：弦大紧脉者，气阴两虚为本，湿热为标也。肛门者，亦称魄门，大肠所主也。合而论之：乃气阴两虚为本，脾虚湿郁，气血郁滞，湿热下注为标。治疗宜益气养阴以培本，燥湿健脾，理气活血以治标。处方：党参30克，麦冬12克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，三棱10克，莪术10克，柴胡IO克，薄荷6克，夜交藤30克。
服用4剂，非但胸脘痞满好转，亦且肛门周围湿疹均愈。
某医问：加味一贯煎本为治疗肝、胃病方，今用于湿疹反愈者何也？回答是：加味一贯煎具有四个功能：一者补气养阴，二者燥湿健脾，三者疏肝理气，四者破气破血。今此病虽为肛门周围湿疹，然其病机不外是：一者气阴两虚，二者湿郁不化，三者血络瘀滞，四者肝气不舒，故以此方治之而获效。
带状疱疹
见病位知所主，察脉象知病性，治用理肝宣肺，清热解毒，愈
牛××，男，40岁。
右胁疼痛难忍，疱疹成串4天。医生诊断为带状疱疹。先用西药治疗3天其症不减，继又配用中药清热解毒剂1天亦不效。仔细审查其证候，右侧胸胁部疱疹成片，并沿肋间分布，疼痛难忍，舌苔白，脉弦滑。综合脉象与症状，思考认为：胸胁者，肝肺所主之位也；脉弦滑者，痰火郁结也。治疗宜宣肺理肝，解毒化痰。处方：柴胡10克，枳实10克，桔梗10克，赤芍10克，瓜蒌15克，橘叶10克，青皮10克，夏枯草30克，连翘10克。同时加用：耳针压痛点、外关，浅刺，留针2小时。服药2剂，次日诸证全失，痊愈。某医问：昼夜兼进2剂即疹退痛失，余未闻之也，请明示其理。回答是：根据经验但予解毒而疹退者多留有疼痛之不解，审其机制多与：一不化痰，二不活血有关，今之所以疹与痛俱失者，恐在方中具有化痰、活血之药耳。
疥疮
审察昼夜，知晓其在血分，予养血活血，解毒而愈
张××，男，26岁。
全身皮疹，剧烈瘙痒1年多。医生诊断为疥疮。先以西药外涂久治无效，继又配合中药硫黄制剂外涂亦无明显效果。仔细审查其证候，两手指缝间、手腕、肘窝屈伸、腋窝、乳房下、腹部、脐周、阴部、大腿内侧呈散在的小丘疹、水疱及灰白色、浅灰色细纹线，夜间剧烈瘙痒，到处是抓搔的血痂，舌苔白，脉弦细。综合脉象与症状，思考认为：夜间痒甚者血分燥热生风也。治疗宜活血养血，凉血祛风。处方：丹参15克，当归10克，川芎10克，生地10克，白芍10克，银花10克，连翘10克，薄荷3克。
服用4剂，痒疹全失，继服4剂，痊愈。
某医云：诸书皆云硫黄善治疥疮，而本病用此久治无效者何也？回答是：硫黄者，杀疥虫之药也，故疥疮用此多奇效。然硫黄酸咸大热有毒，若病邪入于血分而血燥生风者，不宜用之，因其以热助热也。今以丹参银翘饮治之而愈者，因其养血活血，凉血解毒也。
Round or irregular-shaped white tinea on the top of the head for over one year. The physician diagnosed it as Tinea Capitis (Head Ringworm). Western medicine treatment was used first for over 8 months without effect. Subsequently, traditional Chinese herbal pastes Yuanhua Gao (Genkwa Flower Paste) and Chuanlianzi Gao (Toosendan Fruit Paste) were applied externally, and Fangfeng Tongsheng Wan (Saposhnikovia Decoction to Unblock the Bowels) was taken internally for over 5 months, also showing no significant improvement. Careful examination of the syndrome revealed several round and irregular skin lesions within the hairline on the crown of the head; the hair in the center was dry and falling out, accompanied by severe itching, dry throat, thin white tongue coating, and a deep, wiry pulse. Synthesizing the pulse and symptoms, the diagnosis was Wind pathogen invading the Blood level, causing collateral stasis, leading to Blood dryness generating Wind. The treatment principle was to nourish Blood and moisten dryness, invigorate Blood and disperse Wind. Prescription: Tao Ren (Peach Seed) 9g, Hong Hua (Safflower) 6g, Dang Gui (Angelica Sinensis Root) 12g, Bai Shao (White Peony Root) 15g, Chuan Xiong (Ligusticum Rhizome) 6g, Sheng Di (Rehmannia Root) 9g, Chan Tui (Cicada Slough) 6g, Bai Ji Li (Tribulus Fruit) 9g, Fang Feng (Saposhnikovia Root) 9g, Yuan Shen (Scrophularia Root) 15g, Qin Jiao (Gentiana Macrophylla Root) 10g, Bai Tou Weng (Pulsatilla Root) 10g.
After taking 2 doses, the severe itching decreased significantly, the white crusts reduced, and the skin lesions shrank by about one-third. However, in recent days, numerous red rashes the size of millet seeds appeared on both shoulders and arms, with tinnitus in the left ear, white tongue coating, and a floating pulse. Synthesizing the pulse and symptoms, it was reasoned: This indicates that the Wind-Heat in the Blood has resolved, but the Wind pathogen at the Exterior level remains unremoved. The treatment should focus on dispersing Wind and clearing Heat. Prescription: Yin Hua (Honeysuckle Flower) 15g, Lian Qiao (Forsythia Fruit) 15g, Zhu Ye (Bamboo Leaf) 9g, Jing Jie (Schizonepeta Spike) 9g, Niu Bang Zi (Arctium Fruit) 9g, Yuan Shen (Scrophularia Root) 15g, Lu Gen (Reed Rhizome) 15g, Bo He (Mint Herb) 6g, Jie Geng (Platycodon Root) 9g, Dou Chi (Prepared Soybean) 9g, Gan Cao (Licorice Root) 6g, Chan Tui (Cicada Slough) 9g, Huang Qin (Scutellaria Root) 9g.
After taking 6 doses, the rash on the upper arms disappeared, and the Tinea Capitis receded by about 80%. Bai Tou Weng (Pulsatilla Root) 9g was added, and after taking another 10 doses, the patient recovered.
A certain doctor asked: Why use Bai Tou Weng (Pulsatilla Root) for Tinea Capitis? The answer is: Bai Tou Weng not only treats dysentery with blood in stool but also enters the Blood level to disperse Wind pathogen from the head and joints. Therefore, it is commonly used for cases where there is Heat in the Blood combined with Wind pathogen.
Tinea Manuum and Pedis
1. Examine the disease location, know the associated Zang-Fu organs, contemplate the meridians, nourish Blood and moisten dryness, disperse Wind and stop itching, then recovery begins.
Li XX, Male, 30 years old.
Dry cracking and peeling of the palms, with skin thickening for over 3 years. Diagnosed as Tinea Manuum (Hand Ringworm). External Western medicine treatment for over 5 months was ineffective. Subsequent external application of Gu Kang You (Rice Bran Oil) and Hong Hua You (Safflower Oil) for over 5 months was also ineffective. Careful examination revealed numerous translucent vesicles the size of millet seeds on the palmar surface and between the fingers of both hands. Some vesicles ruptured, exuding a small amount of clear fluid, while others peeled after rupture, accompanied by severe itching. In areas where many vesicles clustered, the skin became bright red upon rupture. Areas without peeling showed significantly thickened and hardened skin compared to other parts. Some centers were dry and cracked, while other areas showed alternating patches of thick, cracked skin and thin, bright red skin. All interdigital skin was bright red. The tongue coating was thin and white, the tongue body tender and red, and the pulse was deep and fine. Synthesizing the pulse and symptoms, it was reasoned: The palms are governed by the Spleen and Heart. The Heart governs Blood, and the Spleen controls Blood. A deep, fine pulse with fissures, peeling, and vesicles on the palms indicates Blood deficiency with Dryness-Heat and internal movement of Wind pathogen. The treatment should be to nourish Blood and moisten dryness, disperse Wind and stop itching. Prescription: Sheng Di (Rehmannia Root) 12g, Shu Di (Prepared Rehmannia Root) 10g, Bai Ji Li (Tribulus Fruit) 9g, Chuan Niu Xi (Cyathula Root) 9g, Tu Si Zi (Cuscuta Seed) 9g, Zhi Mu (Anemarrhena Rhizome) 6g, Huang Bai (Phellodendron Bark) 6g, Gou Qi Zi (Goji Berry) 6g, Du Huo (Angelica Pubescens Root) 3g.
After taking 1 dose, hand itching decreased significantly. After continuing for 10 doses, not only did the severe itching disappear, but also the papules, vesicles, peeling, and skin thickening/cracking resolved rapidly.
2. Examine day and night variations, combine with pulse and symptoms, know the disease is in the Blood, nourish Blood, invigorate Blood, and dispel Wind for recovery.
Zou XX, Female, 35 years old.
Peeling, itching, and pain of the palms for over 5 years. Diagnosed as Tinea Manuum. Generalized unbearable itching for over 2 months. Diagnosed as Dermatitis. Western medicine treatment for several years was ineffective. Subsequent combination with TCM herbs to drain Dampness, clear Heat, and disperse Wind for several months resulted in worsened itching and pain. Careful examination revealed vesicles and peeling on the palms and between fingers, with some skin thickening. Generalized severe itching led to constant scratching, leaving bloody scratch marks everywhere, especially prominent in the axillae, breast folds, periumbilical area, interscapular region, antecubital fossae, and perianal area. There were 6 deep fissures on the thenar and hypothenar eminences, oozing blood. The patient was restless. Tongue coating was white, pulse was wiry and fine. Synthesizing the pulse and symptoms, reflecting repeatedly: The palms are governed by the Heart and Spleen. Severe itching, dryness, cracking, and peeling of the palms indicate Dryness-Heat in the Blood. Scratching until bleeding indicates Blood dryness generating Wind. A wiry, fine pulse indicates Liver Blood deficiency. The treatment should be to nourish Blood, moisten dryness, and dispel Wind. Prescription: Dang Gui (Angelica Sinensis Root) 12g, Sheng Di (Rehmannia Root) 15g, Yuan Shen (Scrophularia Root) 30g, Shu Di (Prepared Rehmannia Root) 10g, Dan Pi (Moutan Cortex) 10g, He Shou Wu (Polygonum Multiflorum Root) 15g, Bai Ji Li (Tribulus Fruit) 10g, Jiang Can (Bombyx Batryticatus) 10g, Hong Hua (Safflower) 10g, Gan Cao (Licorice Root) 6g, Du Huo (Angelica Pubescens Root) 6g, Gou Qi Zi (Goji Berry) 10g, Zhi Mu (Anemarrhena Rhizome) 10g.
After taking 6 doses, body itching decreased significantly, allowing sleep of 2-3 hours at night. However, palm peeling, dryness, cracking, and bleeding remained unchanged. After continuing the same prescription for 12 doses, body itching completely disappeared, and palm peeling and cracking also healed.
A doctor asked: Tinea Manuum and Dermatitis are two different diseases. How can one formula cure both? The answer is: Although these two diseases are distinct, their etiology and disease location are consistent. Therefore, treating them with one formula cures both.
3. Stuck on Damp-Heat, failing to examine pulse and symptoms, failing to observe root and branch, failing to adjust according to syndrome changes, adhering rigidly leads to non-recovery.
Wen XX, Female, 50 years old.
Skin maceration between toes every summer for over 8 years, worsening since this summer. Diagnosed as Tinea Pedis (Athlete's Foot). Western medicine treatment for 4 days failed to reduce maceration and severe itching, making it worse. Subsequent TCM treatment with modified Caobai Shen Shi Tang (Rhizoma Dioscoreae Hypoglaucae Decoction to Drain Dampness) internally and external washes to drain Dampness and clear Heat also failed, worsening the condition. Examination revealed maceration and foul odor between toes, sole, heel, and arch. Edges were bright red, itchy, and painful. Insomnia day and night, fever, white tongue coating, red tongue body, slippery and rapid pulse. Synthesizing pulse and symptoms, reasoning: The sole is governed by the Kidney. Heat, pain, and redness of the sole indicate Kidney Yin deficiency with blazing Fire pathogen internally. A slippery, rapid pulse indicates Heat. For Yin deficiency with blazing Fire pathogen, the treatment should be to nourish Yin and descend Fire. Prescription: Yuan Shen (Scrophularia Root) 30g, Sheng Di (Rehmannia Root) 15g, Mai Dong (Ophiopogon Tuber) 10g.
After taking 1 dose, maceration, redness, swelling, itching, and pain decreased significantly. After continuing for 6 doses, the patient recovered.
A doctor asked: Tinea Pedis with maceration was treated for 3 months with modified Caobai Shen Shi Tang etc., worsening the condition. Why did Zengye Tang (Increase Fluids Decoction) for 7 doses cure it now? The answer is: Tinea Pedis with maceration is mostly due to Damp-Heat, so formulas draining Dampness and clearing Heat are commonly used. However, in this case of Yin deficiency with blazing Fire, using damp-draining herbs damages Yin fluids, causing Fire to blaze more fiercely, thus worsening rather than curing the disease. Wang Bing stated that this Fire can only be controlled by strengthening Water to subdue Fire, not by bitter cold to descend Fire, nor by dispersing which aids Fire. The previous formula aggravated the disease because it was "moving" rather than "still."
4. Stuck on Damp-Heat, mired in Fire pathogen, failing to examine pulse, unaware of Cold transformation, Yang deficiency presenting as Heat, treatment fails.
Zheng XX, Female, 50 years old.
Maceration and severe itching between toes, fluctuating in severity for over 2 years. Diagnosed as Tinea Pedis. Condition worsened in recent months. Western medicine for 6-7 days failed, worsening the condition. External application of drying-dampness and stopping-itching TCM herbs rapidly expanded the area of maceration and itching. Another doctor prescribed modified San Miao Powder followed by modified Caobai Shen Shi Tang for 7-8 doses, rapidly expanding maceration, itching, and pain. Detailed examination revealed itching, pain, and maceration between toes, sole, heel, and dorsum of feet. Both feet were red, swollen, unable to touch the ground, with extreme foul odor. Sole heat and pain were unbearable. White tongue coating, pale tongue body, deep, fine pulse with weak Chi position. Synthesizing pulse and symptoms, reasoning: Maceration should belong to Damp-Heat, and Damp-Heat should be treated by draining Dampness and clearing Heat. Why did it fail? The Nei Jing states: Strictly observe the disease mechanism, assign each to its category, seek what exists, seek what does not exist. This disease occurs on the sole, which is governed by the Liver and Kidney. Although maceration is mostly Damp-Heat, a deep, fine pulse with weak Chi position and pale tongue body indicates Kidney Qi deficiency. Therefore, tonifying the Kidney is essential first. Once Yang recovers and Dampness transforms, the disease will heal. Prescription: Sheng Di (Rehmannia Root) 24g, Shan Yao (Dioscorea Rhizome) 12g, Wu Wei Zi (Schisandra Fruit) 9g, Fu Ling (Poria) 9g, Ze Xie (Alisma Rhizome) 9g, Dan Pi (Moutan Cortex) 9g, Fu Zi (Aconite Root) 9g, Rou Gui (Cinnamon Bark) 9g, Yuan Shen (Scrophularia Root) 15g, Mai Dong (Ophiopogon Tuber) 15g, Che Qian Zi (Plantago Seed) 12g (wrapped and decocted), Huai Niu Xi (Cyathula Root) 10g.
After taking 1 dose, maceration, redness, swelling, itching, and pain of both feet improved significantly. After continuing for 8 doses, the patient recovered.
A doctor said: Various books state that Wet Tinea Pedis is caused by Damp-Heat descending from the Spleen and Stomach, primarily treated with modified Caobai Shen Shi Tang. Why was it ineffective here? Shiwei Dihuang Tang is for Kidney deficiency with floating deficient Fire. Why effective here? The answer is: Treating Damp-Heat with damp-resolving, heat-clearing, or damp-draining methods is undoubtedly correct. However, Damp-Heat can be caused by Damp-Heat pathogens or by righteous deficiency generating internal Damp-Heat. If caused by pathogens, eliminate the pathogens. If caused by righteous deficiency, support righteousness to eliminate pathogens. Conversely, supporting righteousness in Damp-Heat cases exacerbates pathogens, while eliminating pathogens in deficiency cases damages righteousness and fails to remove pathogens. Supporting righteousness to eliminate dampness differs between tonifying Kidney and Spleen. If Kidney deficiency with Damp-Heat, often both Yin and Yang are deficient, so Shiwei Dihuang Tang tonifies Yin and benefits Yang, nourishes Yin and descends Fire.
Eczema
1. Stuck on disease name, fixed on Dampness pathogen, failing to examine day/night, failing to observe pulse/symptoms, using drying herbs for Blood dryness, damaging Blood and Yin, generating Wind pathogen.
Huo XX, Female, Adult age.
Generalized itching, recurrent rash for over ten years. Diagnosed as Eczema. Western medicine for several years ineffective. TCM herbs to disperse Wind, drain Dampness, and clear Heat for over 3 years ineffective. Forced to use combined TCM/Western medicine for 3 months, condition worsened, especially in the last week. Careful examination revealed generalized maculopapular rash, needle-tip to sorghum-sized, rough skin, severe itching at night, often requiring scratching until bleeding to relieve itch. White tongue coating, deep fine pulse. Synthesizing pulse and symptoms, reasoning: Deep, fine pulse with severe night itching indicates Yin deficiency, Blood dryness generating Wind. Treatment should nourish Blood, invigorate Blood, cool Blood, and dispel Wind. Prescription: Dan Shen (Salvia Root) 15g, Dang Gui (Angelica Sinensis Root) 10g, Chuan Xiong (Ligusticum Rhizome) 10g, Bai Shao (White Peony Root) 10g, Sheng Di (Rehmannia Root) 10g, Yin Hua (Honeysuckle Flower) 12g, Lian Qiao (Forsythia Fruit) 12g, Bo He (Mint Herb) 3g.
After taking 4 doses, body itching slightly decreased. After continuing for 10 doses, all symptoms disappeared, and the patient recovered.
A doctor asked: Most physicians advocate draining Dampness and clearing Heat for Eczema. Why did this method fail here? The answer is: Eczema is mostly caused by Damp-Heat, so draining Dampness and clearing Heat is common. However, some cases involve Dryness-Heat in the Blood. If Dryness-Heat in Blood is present, merely draining Dampness and clearing Heat without nourishing Blood and benefiting Yin will fail to remove Damp-Heat and may worsen Blood Dryness-Heat. Thus, nourishing Blood and moistening dryness achieved recovery.
2. Examine pulse and symptoms, know Qi stagnation with Dampness, strengthen Spleen, drain Dampness, regulate Qi, disperse Wind for recovery.
Jin XX, Male, 69 years old.
Palms-sized itchy, weeping lesion on sacrum for over ten years. Diagnosed as Chronic Eczema. Western medicine for several years ineffective. TCM herbs to clear Heat, dry Dampness, and detoxify for several years ineffective. In the last month, sacral eczema expanded, and large amounts of eczema appeared all over the body. Careful examination revealed a dense, thickened, infiltrated, brown-red area on the sacrum, slightly larger than a palm, with scattered papules and vesicles. Generalized ill-defined edematous erythema with small papules, severe on calves, hands, popliteal fossae, feet, antecubital fossae, vulva, and anus. Constant itching. Epigastric and abdominal fullness. White tongue coating, deep pulse. Synthesizing pulse and symptoms, reasoning: Generalized pruritic rash is Wind; weeping fluid is Dampness; deep pulse and abdominal fullness indicate Qi stagnation. Treatment should strengthen Spleen, drain Dampness, regulate Qi, disperse Wind, and clear Heat. Prescription: Qiang Huo (Notopterygium Rhizome) 6g, Fang Feng (Saposhnikovia Root) 6g, Jing Jie (Schizonepeta Spike) 6g, Chuan Xiong (Ligusticum Rhizome) 10g, Hou Po (Magnolia Bark) 10g, Dang Shen (Codonopsis Root) 10g, Fu Ling (Poria) 10g, Chen Pi (Citrus Peel) 10g, Gan Cao (Licorice Root) 6g, Jiang Can (Bombyx Batryticatus) 6g, Huo Xiang (Patchouli Herb) 10g, Ku Shen (Sophora Root) 12g. External use simultaneously: Ai Ye (Mugwort Leaf) 10g, Ku Shen (Sophora Root) 30g, Hua Jiao (Sichuan Pepper) 10g, decocted in water for washing.
After 6 days of internal and external treatment, itching decreased significantly, lesions reduced. After continuing for 12 doses, the patient recovered.
A doctor asked: I also used spleen-strengthening, damp-drying, wind-dispersing, heat-clearing herbs, but they failed. Why? The answer is: This disease involves not only Spleen deficiency, Damp-Heat, and Wind pathogen, but also Qi stagnation. Your prescription treated only three aspects, neglecting the fourth, regulating Qi, hence failure.
3. Know disease location, examine Zang-Fu, clarify meridians, disease gets treated.
Zhen XX, Male, Adult age.
Itchy, weeping papules around anus for over 8 years. Diagnosed as Eczema. Western medicine ineffective. TCM herbs to dry Dampness and clear Heat for several years ineffective. Careful examination revealed a palms-sized thickened skin area around anus, with wet macerating papules, itching, chest/epigastric fullness, irritability. Thin white tongue coating, empty, large, wiry, tight pulse. Synthesizing pulse and symptoms, reasoning: Empty, large, tight pulse indicates Qi and Yin deficiency as root, Damp-Heat as branch. Anus, also called Po Men, is governed by Large Intestine. Combined: Qi and Yin deficiency as root, Spleen deficiency with Dampness stagnation, Qi/Blood stagnation, Damp-Heat descending as branch. Treatment should benefit Qi and nourish Yin to tonify root, dry Dampness, strengthen Spleen, regulate Qi, and invigorate Blood to treat branch. Prescription: Dang Shen (Codonopsis Root) 30g, Mai Dong (Ophiopogon Tuber) 12g, Sheng Di (Rehmannia Root) 30g, Cang Zhu (Atractylodes Rhizome) 15g, Bai Zhu (Atractylodes Macrocephala Rhizome) 10g, Qing Pi (Unripe Citrus Peel) 10g, Chen Pi (Citrus Peel) 10g, San Leng (Burreed Tuber) 10g, E Zhu (Curcuma Rhizome) 10g, Chai Hu (Bupleurum Root) 10g, Bo He (Mint Herb) 6g, Ye Jiao Teng (Polygonum Vine) 30g.
After taking 4 doses, chest/epigastric stuffiness improved, and perianal eczema healed.
A doctor asked: Jiawei Yiguan Jian is originally for Liver/Stomach diseases. Why effective for eczema? The answer is: Jiawei Yiguan Jian has four functions: 1. Benefit Qi and nourish Yin, 2. Dry Dampness and strengthen Spleen, 3. Soothe Liver and regulate Qi, 4. Break Qi and Blood stagnation. Although this is perianal eczema, the pathology is: 1. Qi and Yin deficiency, 2. Dampness stagnation not transforming, 3. Blood collateral stasis, 4. Liver Qi constraint. Hence, this formula was effective.
Herpes Zoster
Observe disease location to know governing organs, examine pulse to know disease nature, treat with regulating Liver, diffusing Lung, clearing Heat, detoxifying, recovery.
Niu XX, Male, 40 years old.
Unbearable right hypochondriac pain, grouped blisters for 4 days. Diagnosed as Herpes Zoster. Western medicine for 3 days ineffective. TCM Heat-clearing, detoxifying herbs for 1 day ineffective. Careful examination revealed grouped blisters on right chest/hypochondrium, distributed along intercostal spaces, unbearable pain. White tongue coating, wiry slippery pulse. Synthesizing pulse and symptoms, reasoning: Chest/hypochondrium is governed by Liver and Lung. Wiry slippery pulse indicates Phlegm-Fire stagnation. Treatment should diffuse Lung, regulate Liver, clear Heat, detoxify, and resolve Phlegm. Prescription: Chai Hu (Bupleurum Root) 10g, Zhi Shi (Aurantii Fructus Immaturus) 10g, Jie Geng (Platycodon Root) 10g, Chi Shao (Red Peony Root) 10g, Gua Lou (Trichosanthes Fruit) 15g, Ju Ye (Citrus Leaf) 10g, Qing Pi (Unripe Citrus Peel) 10g, Xia Ku Cao (Prunella Spike) 30g, Lian Qiao (Forsythia Fruit) 10g. Auricular acupuncture on pressure points and Waiguan (TE5), shallow insertion, retained for 2 hours. After taking 2 doses, all symptoms disappeared next day, recovery. A doctor asked: Two doses given day and night cleared rash and pain, unheard of before. Please explain. The answer is: Based on experience, merely clearing Heat to clear rash often leaves unresolved pain. Mechanism relates to: 1. Not resolving Phlegm, 2. Not invigorating Blood. The reason both rash and pain disappeared here is likely due to Phlegm-resolving and Blood-invigorating herbs in the formula.
Scabies
Examine day/night, know it is in Blood, nourish Blood, invigorate Blood, detoxify, recovery.
Zhang XX, Male, 26 years old.
Generalized rash, severe itching for over 1 year. Diagnosed as Scabies. External Western medicine long-term ineffective. External TCM Sulfur preparations ineffective. Careful examination revealed scattered small papules, vesicles, and gray/whitish burrows between fingers, wrists, antecubital fossae, axillae, under breasts, abdomen, periumbilical area, genitals, inner thighs. Severe night itching, bloody scabs from scratching everywhere. White tongue coating, wiry fine pulse. Synthesizing pulse and symptoms, reasoning: Severe night itching indicates Blood level Dryness-Heat generating Wind. Treatment should invigorate Blood, nourish Blood, cool Blood, and dispel Wind. Prescription: Dan Shen (Salvia Root) 15g, Dang Gui (Angelica Sinensis Root) 10g, Chuan Xiong (Ligusticum Rhizome) 10g, Sheng Di (Rehmannia Root) 10g, Bai Shao (White Peony Root) 10g, Yin Hua (Honeysuckle Flower) 10g, Lian Qiao (Forsythia Fruit) 10g, Bo He (Mint Herb) 3g.
After taking 4 doses, pruritic rash disappeared. After continuing for 4 doses, recovery.
A doctor said: Books state Sulfur is good for Scabies. Why ineffective here? The answer is: Sulfur kills scabies mites, hence often effective. However, Sulfur is sour, salty, very hot, toxic. If pathogen enters Blood level causing Blood dryness and Wind, it should not be used, as it adds Heat to Heat. Recovery with Danshen Yinqiao Yin (Salvia and Honeysuckle Decoction) here is due to its ability to nourish Blood, invigorate Blood, cool Blood, and detoxify.
Alopecia Areata
Examine disease location, observe pulse/tongue, know etiology, clarify pathology, treat with nourishing Yin, tonifying Kidney, benefiting Qi, raising Yang, recovery.
Liang XX, Male, 43 years old.