五疥 五癣 血风疮 癞风 杨梅疮 疔疮 多骨疽 翻花疮 流注 瘭痼 暑热疮 痱痤疮 寒冷疮
冻疮 手足皲 蜗疮 HT 疮 浸淫疮 白蛇缠 汤火疮 肥疮 疣疮 漆疮 竹木刺 折伤 破伤风
五疥干湿虫砂脓，
五疥由五脏蕴毒而发，属足三阴者尤多。
便秘为实利虚风；
疮有遍体难分经络，必凭外证以断虚实。 肿作痛，便秘硬，发热者，为风毒湿热；漫肿痒痛，晡热，
或时寒热，体倦少食，便顺利者，为血虚风热。
干疥瘙痒肺燥甚，
干疥瘙痒，皮枯屑起，便秘者，为心肝火郁于肺，四顺清凉饮、古荆黄汤、搜风顺气丸；久者，天门冬
膏。便利者为相火郁于肺，活血润燥生津饮，或四物汤加黄芩、连翘、天门冬；久者，肾气丸；久虚，古乌荆
丸。如素有肺风，面上多粉刺者，桦皮散。
湿毒 肿脾胃攻。
湿疥 肿作痛，久则水流如黑豆汁，便秘者为脾郁湿热毒，防风通圣散（俱酒蒸或炒，大黄另用酒煨炒
三次）加木鳖子，或升麻葛根汤加天麻、蝉蜕。气滞，复元通气散；湿胜者，除湿丹。便利者，为脾虚湿热，
补中益气汤量加芩、连清热，芎、芷燥湿；胃火作渴者，竹叶黄 汤；脾郁盗汗不寝者，归脾汤；溺涩腹胀
者，胃苓汤加黄连；久者，二炒苍柏丸；湿胜，单苍术膏；脾肺风毒者，何首乌散。
砂细作疼心血滞，
砂疥，如砂子细个，或痛或痒，抓之有水， 赤。乃心血凝滞。便秘者，当归丸，或凉膈散合四物汤；久
者，酒蒸黄连丸；胸烦多痰者，牛黄清心丸；心烦口干，小便不利者，连翘饮。便利者，活血四物汤；久者，
当归饮。
虫疥如癣肝火冲；
火盛生虫，即腐草为萤意也。虫疥，痒不知痛，延蔓易于传染。便秘者，肝风热甚，芦荟丸，或败毒散，磨
羚羊角汁刺之；久者，古苦皂丸。便利者，肝经火郁，逍遥散，磨羚羊角汁刺之；久不愈者，胡麻散。但诸疮久
则生虫，须兼外治敷洗。
脓窠 痛脾壅热，痛慢虚火肾不充；
含浆稠脓色浓， 痛便秘者，为湿热，五香连翘汤、升麻和气饮，或竹叶石膏汤合四物汤；含浆脓清色
淡，不痛便利者，为肾虚火，八味逍遥散，或四物汤加知母、黄柏，或四生散、肾气丸。
更分上下与肥瘦，
上体多兼风热，下体多兼风湿；肥人多风湿，瘦人多血热。瘦弱虚损，肾枯火炎，纵有便秘、发热、作
渴等证，只宜滋阴降火，略加秦艽、苍耳、连翘之类，决不可纯用风药凉血伤胃，因皮肤之疾而坏脏腑者有之。
通用连归汤。气虚，四君子汤；血虚，合四物汤；风，合消毒饮；湿，合平胃散。
开郁退热杀其虫。
开毒郁，须辛温，吴萸、白芷之类；退肌热，须苦寒，芩、连、大黄之类；杀虫，须水银之类，此丹溪
外治三法也。干疥，吴茱萸散，或黄连、大黄为末，猪胆汁调搽；湿疥，一上散；砂疥，剪草散；虫疥，硫黄
饼；脓窠，三黄散。通用摩风膏。洗药∶用荆芥、黄柏、苦参等分煎汤，痒加蛇床子、川椒；肿加葱白。
五癣湿顽风马牛，总皆血热肺邪留；
疥癣皆血分热燥，以致风毒克于皮肤，浮浅者为疥，深沉者为癣；疥多挟热，癣多挟湿；疥发手足遍身，
癣则肌肉瘾疹，或圆或斜，或如苔梅走散。风癣即干癣，搔之则有白屑；湿癣如虫行，搔之则有汁出；顽癣全然
不知痛痒；牛癣如牛颈皮，浓且坚；马癣微痒，白点相连，
又曰狗癣。
清热杀虫祛风湿，久则补肾自然收。
诸风湿虫癣，与疥疮大同。初起有可下者，打脓散去黄连、金银花、穿山甲、芒硝，加赤芍、白芍，水、
酒各半煎，临熟入大黄，露一宿，五更服；有可汗者，四物汤加荆芥、麻黄各五钱，浮萍一两，葱、豉煎服取
汗。一切癞癣皆效。经久不敢汗下者，只用防风通圣散去硝、黄，加浮萍、皂刺，水煎服。久年不愈，体盛者，
兼吞顽癣丸，或古龙虎丹，用何首乌、白芷、苏木等分，入猪油及盐少许，浸酒送下。体虚者，不可妄用风药。
气虚者，何首乌散、消风散；血燥者，四圣不老丹，或肾气丸，久服自效；有虫者，俱宜间服蜡矾丸。外治∶
干癣，用野狼毒、草乌各二钱半，斑蝥七枚，生为末，津唾调搽。湿癣，用枯矾、黄连各五钱，胡粉、黄丹、水
银各二钱，为末，用猪脂油二两夹研，令水银星散尽，瓷罐收贮，搽之。牛癣，用旧皮鞋底，烧存性，入轻粉
少许，为末，麻油调敷。马疥癣，用马鞭草（不犯铁器），捣自然汁半盏，饮尽，十日即愈。通用麻油二两，
入巴豆、蓖麻子各十四粒，斑蝥七粒，熬煎三味枯黑去渣，却入白蜡五钱，芦荟末三钱，搅匀，瓷罐收贮，
括破涂之；或用川槿皮、浙剪草、木鳖子等分为末，醋调敷。洗药∶用紫苏、樟脑、苍耳、浮萍煎汤。
血风血燥风热郁，初发疙瘩或如丹；瘙痒抓破痛有水，妄投风药血益悭。
血风疮，乃三阴经风热、郁火、血燥所致。瘙痒不常，抓破成疮，脓水淋沥，内证晡热盗汗，恶寒，少食体
倦，所以不敢妄用风药。大概肝风血燥，寒热作痛者、当归饮加柴胡、山栀；痛痒寒热者，小柴胡汤加山栀、
黄连；夜热谵语者，小柴胡汤加生地；肝脾郁火，食少寒热者，八味逍遥散；脾虚晡热盗汗，不寐者，归脾汤加
山栀、熟地；肾虚有热，作渴咳痰者，肾气丸。通用∶遍身者，四物汤加浮萍、黄芩等分，甚者，紫云风丸、
换骨丸、三蛇丹；两足痛痒者，当归拈痛汤。如因饮酒后，遍身痒如风疮，抓至出血又痛者，用蝉蜕、薄荷等
分为末，每二钱，水酒调服。凡身发痒者通用。外治∶摩风膏、大马齿膏。
癞风审因分上下，
癞，即《内经》疠风。受天地间肃杀风气，酷烈暴悍，最为可畏。一因风毒，或汗出解衣入水，或酒后
当风；二因湿毒，或坐卧湿地，或冒雨露；三因传染。然未必皆由外也，内伤饮食，热毒过甚，大寒大热，房
劳秽污，以致火动血热，更加外感风寒、冷湿而发。初起身上虚痒，或起白屑、紫云如癜风然，或发紫 疙瘩
流脓。上先见者，气分受病，上体必多；下先见者，血分受病，下体必多；上下俱见者，气血俱病。从上而
下者，为顺风；从下而上者，为逆风。但从上、从下，以渐来者可治，顿发者难愈。治失其法，以致皮死，
麻木不仁；脉死，血溃成脓；肉死，割切不痛；筋死，手足缓纵；骨死，鼻梁崩塌，与夫眉落、眼昏、唇翻、
声噎，甚则蚀伤眼目、腐烂玉茎、挛拳肢体，病至于此，天刑难解。
总是阳明血热化；热甚痰瘀腐为虫，追虫取涎药必伯；
胃与大肠，无物不受，脾主肌肉，肺主皮毛。然疮痂虽见于皮肉，而热毒必归于肠胃，故法必先治阳明，
初起宜防风通圣散，在上用麻黄，以去外毒；在下用硝、黄，以去内毒；上下俱见者，用正料防风通圣散，以
解表攻里。三五日后，即服醉仙散，以吐恶涎。服后，又服防风通圣散去硝、黄，麻黄，多服久服。待胃气稍
定，用再造散以下其虫。又有宜先下虫而后吐涎者。吐、下后，仍以防风通圣散量加参、 、熟地以固气血；
或脾胃弱者，白术当倍用。
虫已蚀脏坏五形，清肝凉血火须泻。
虫因火盛，气血沸腾，充满经络，外疮延蔓，内虫攻注，蚀肝眉脱，蚀心足底穿，蚀脾声
哑，蚀肺鼻崩，蚀肾耳鸣如雷，宜先服泻青丸以泻肝火，次随证救治。虚痒者，四物汤加酒芩，调浮萍末；痒
甚加荆芥、蝉蜕；瘙痒皮皴白屑者，白花蛇丸；眉发落者，三蛇丹，或柏叶煎；眉脱鼻崩者，换肌散、补气泻
荣汤；蚀眼者，芦荟丸∶肢节废者，蠲痹散。通用∶凌霄花散、胡麻散、加味苦参丸、大枫丸、换骨丸、大麻
风丸、紫云风丸、活神丹、肾气丸、四圣不老丹、八味汤。外治∶摩风膏、浴癞方。发落不生者，先用生姜擦
三次，后用半夏为末，麻油调擦。更与四卷末须发条参看。
杨梅疮因风湿热，或伤气分或伤血；
杨梅疮，因、治与癞大同。多由肝肾脾内风湿热之毒，间有天行湿毒传染，但各俗呼名不一，有呼杨梅为
天者，有呼杨梅为大麻风者，以理推之，形如杨梅， 红湿烂痒痛属心，多生乳胁、形如鼓钉、黄豆者属脾，
多生满面，谓之大风痘；形如绵花属肺，多生毛发；形如紫葡萄，按之紧痛者属肝肾，多丛生豚臀及筋骨之
处∶形如鱼 ，内多白水，按之不紧者，谓之天 疮，乃此类之轻者。如发于鬓、额、口、鼻、谷道边者，
属阳明及少阳、太阳。如发于足胫、阴茎、胁肋者，属肝肾及太阴。大抵上先见者，气分受病，上体必多；下
先见者，血分受病，下体必多；上下俱见者，气血俱病。
初宜疏泻久补虚，免成痈癣与漏缺。
初起即服防风通圣散一帖，去麻黄用硝、黄以去内毒，待胃气稍定，再以一帖，去硝、黄用麻黄发汗以去外
毒。以后用加减通圣散、丸多服。此方内通脏腑、外发经络，为首尾要药。轻者服此一剂，更加搽、洗足矣；重
者十帖后，宜服化毒散三日，却用吹药三日，疮干痂欲脱落，再服化毒散三日，后量用防风通圣散加减。上体多
者，兼服败毒散加荆、防、钩藤；下体多者，兼服龙胆泻肝汤。从鼻准肿起，遍身生疮，面上尤多者，桦皮散；便燥
者，搜风顺气丸，以此调理断根。失治久则风毒深入经络，挟湿而成顽癣，或气血虚败而成漏，或误服轻粉、水银
及不遵禁戒，而成风堆肿烂，流脓出汁，谓之痈。病至于此，亦有蚀伤眼鼻、腐烂玉茎、拳掌肢体，与癞无异，
治宜消毒，兼以补虚。消毒∶顽癣者，皂根丸；筋骨痛者，皂刺丸、换骨丸；成漏者，象牙丸；肿块者，仙遗
粮丸。通用加味苦参丸、大枫丸、蜡矾丸、单苦参酒。消毒补虚，仙遗粮汤加钩藤，或补气泻营汤、胡麻散。补
虚∶气虚者，单人参汤、补中益气汤；血虚者，四物汤加山栀、钩藤、金银花、甘草节，或肾气丸、四圣不老
丹；气血俱虚者，八物汤、八味丸，单仙遗粮丸。外贴∶太乙膏、白蜡膏。
疔疮全是饮食毒，发因灾畜暴 伤；
经曰∶膏粱之变，足生大疔。恣食辛辣浓味，炙爆腥荤，及误食自死禽兽，蕴毒于中而即发者有之；或卒
遇大风、大雾、大暑、大寒，天地暴 之气，袭注经络，触动其毒而发者；或因感死畜蛇虫毒瓦斯而发者，其死
尤速。初发或因衣物触着而疼痛忽生，或因发疹抓破而成 ，仅一小疮，杀人一二日间，比之痈疽尤毒。
生于四肢及头面，
疔发无定处，或肩、背、腰尤缓，在头面、耳、鼻、口、目、舌根、唇上及手足骨节间者最急。如生
两足，多有红丝至脐；生两手，多有红丝至心；生唇、面、口内，多有红丝入喉者，俱难治。须急看，以针挑
拨其丝，出血以泄其毒瓦斯，方可保生。
顶硬根突近寸长。变黑肿烂透深孔，形色不一极痛痒；
疮头黑硬如钉，四畔带赤如火，盘根突起寸余，随变焦黑，未几肿大而光，转为湿烂，深孔透肌，如大针
穿之状。其形初起大小不一，或如水泡，如吴萸，如豆，如石榴子，其色有五，《内经》分应五脏，各有所属
部位。《局方》别一十三种∶一、麻子疔。状如黍米稍
黑。忌麻仁、麻衣。二、石疔。如黑豆甚硬。忌瓦砾、砖石。三、雄疔。四畔仰， 浆起，色黄，大如钱孔。四、
雌疔。四面 浆起，心凹，色稍黄，如钱孔，俱忌房室。五、火疔。状如汤火烧，四畔有烟焰。忌火烧烙。六、
烂疔。色稍黑，脓出流出。忌沸汤、热食、烂物。七、三十六疔。状如黑豆，今日生一，明日生二，及满三十
六数即死。忌嗔怒。八、蛇眼疔。状如蛇眼。忌恶眼人及嫉妒人见。九、盐肤疔。状大如匙，面色赤，中有黑
粒。忌食盐。十、水洗疔。状大如钱，头白里黑，汁出中硬。忌饮浆水、水洗、渡河。十一、刀镰疔。状如薤
叶大，长一寸，肉黑如烧烙。忌刺及刀镰切割。十二、浮沤疔。其状曲圆，少许不合，大如薤叶，内黄外黑，
黑处刺之不痛，黄处刺之痛，十三、牛狗疔。色赤， 起掐不破。以上皆宜根据法将护，若或触犯，则脊强、疮
痛不可忍。惟浮沤、牛狗无忌，不治自愈。又有一种鱼脐疔，疮头黑深，形如鱼脐，破之黄水渗出，四畔浮浆；
其毒尤甚。用丝瓜叶、连须葱、韭叶，捣烂以酒和服。其渣贴腋下，如病在左手，贴左腋下，在左足，贴左
胯下；右手足同；在中贴心脐，并用布缚住。候肉下红丝处皆白则安。有潮热者亦宜。却令人抱住，恐其颤倒，
倒则难治。或用蛇蜕烧灰，鸡子清调敷。一种水疔疮，用黄荆叶十四片，独头蒜三个，百草霜二钱，擂酒服，取
汗，大效。
或不痛痒只麻木，寒热眼中流火光。牙关急紧时惊惕，甚则呕吐毒陷肠；
诸证惟呕吐最危。
治分虚实豁心火，
实者，初服赛命丹三丸，以葱酒发汗。表证多者，追疔汤，或败毒散加蝉蜕、僵蚕、金银花；里证多者，
活命饮、五圣汤；便利溺涩者，黄连消毒散，此散初起服之内消；欲作脓者，托里消毒散。虚者，初服保生锭
五疥、五癣、血风疮、癞风（麻风病）、杨梅疮、疔疮、多骨疽、翻花疮、流注、瘭痼、暑热疮、痱痤疮、寒冷疮、冻疮、手足皲裂、蜗疮、HT疮、浸淫疮、白蛇缠（带状疱疹）、汤火疮、肥疮、疣疮、漆疮、竹木刺伤、折伤、破伤风。
五种疥疮的干湿、虫砂脓，
五种疥疮是由五脏蕴积毒邪而发作，归属于足三阴经的尤为多见。
便秘属于实证，便利（大便通畅）属于虚证受风；
疮疡遍布全身难以分辨经络归属，必须凭借外部症状来判断虚实。肿胀且疼痛，大便秘结坚硬，伴有发热者，属于风毒湿热；漫肿且痒痛，午后潮热，或时有寒热往来，身体疲倦食欲不振，大便通畅者，属于血虚风热。
干疥瘙痒因肺燥严重，
干疥瘙痒，皮肤干枯脱屑，大便秘结者，为心肝之火郁结于肺，可用四顺清凉饮、古荆黄汤、搜风顺气丸；病程久者，用天门冬膏。大便通畅者，为相火郁结于肺，可用活血润燥生津饮，或四物汤加黄芩、连翘、天门冬；病程久者，用肾气丸；长期体虚者，用古乌荆丸。如果素来患有肺风，面部有很多粉刺者，用桦皮散。
湿毒肿胀由脾胃攻伐所致。
湿疥肿胀作痛，日久则流水如黑豆汁，大便秘结者为脾郁湿热毒，可用防风通圣散（均用酒蒸或炒制，大黄另用酒煨炒三次）加木鳖子，或升麻葛根汤加天麻、蝉蜕。气滞者，用复元通气散；湿气盛者，用除湿丹。大便通畅者，为脾虚湿热，补中益气汤酌情加黄芩、黄连清热，川芎、白芷燥湿；胃火作渴者，用竹叶石膏汤；脾郁盗汗不眠者，用归脾汤；小便涩滞腹胀者，用胃苓汤加黄连；病程久者，用二炒苍柏丸；湿气盛，单用苍术膏；脾肺风毒者，用何首乌散。
砂疥细小作痛因心血凝滞，
砂疥，像沙子一样细小，或痛或痒，抓之有水流出，色赤。这是心血凝滞。大便秘结者，用当归丸，或凉膈散合四物汤；病程久者，用酒蒸黄连丸；胸中烦闷多痰者，用牛黄清心丸；心烦口干，小便不利者，用连翘饮。大便通畅者，用活血四物汤；病程久者，用当归饮。
虫疥如癣因肝火冲逆；
火盛生虫，即腐草化为萤火虫之意。虫疥，只痒不知痛，蔓延易于传染。大便秘结者，为肝风热甚，用芦荟丸，或败毒散，磨羚羊角汁点刺患处；病程久者，用古苦皂丸。大便通畅者，为肝经火郁，用逍遥散，磨羚羊角汁点刺患处；久不愈者，用胡麻散。但各种疮疡日久都会生虫，必须兼用外治敷洗。
脓窠疮痛因脾壅热，痛慢因虚火肾不充；
含浆稠脓颜色浓，伴疼痛大便秘结者，为湿热，用五香连翘汤、升麻和气饮，或竹叶石膏汤合四物汤；含浆脓液清稀颜色淡，不痛且大便通畅者，为肾虚火，用八味逍遥散，或四物汤加知母、黄柏，或四生散、肾气丸。
更要区分上下部位与体型肥瘦，
上体多兼风热，下体多兼风湿；肥胖人多风湿，消瘦人多血热。瘦弱虚损，肾枯火炎，即使有大便秘结、发热、作渴等症状，只宜滋阴降火，略加秦艽、苍耳、连翘之类，决不可纯用风药凉血伤胃，因为皮肤疾病而坏脏腑的情况是有的。通用连归汤。气虚，用四君子汤；血虚，合四物汤；有风邪，合消毒饮；有湿邪，合平胃散。
开郁退热杀灭其虫。
开解毒邪郁结，须用辛温药，如吴茱萸、白芷之类；退肌肤之热，须用苦寒药，如黄芩、黄连、大黄之类；杀虫，须用水银之类，这是朱丹溪的外治三法。干疥，用吴茱萸散，或黄连、大黄研末，猪胆汁调搽；湿疥，用一上散；砂疥，用剪草散；虫疥，用硫黄饼；脓窠，用三黄散。通用摩风膏。洗药：用荆芥、黄柏、苦参等分煎汤，痒加蛇床子、川椒；肿加葱白。
五种癣疾湿顽如风马牛不相及，总皆血热肺邪留滞；
疥和癣都是血分热燥，导致风毒克于皮肤，浮浅的为疥，深沉的为癣；疥多挟热，癣多挟湿；疥发于手足遍身，癣则在肌肉瘾疹，或圆或斜，或如苔梅走散。风癣即干癣，搔之则有白屑；湿癣如虫行，搔之则有汁出；顽癣全然不知痛痒；牛癣如牛颈皮，浓且坚；马癣微痒，白点相连，
又说叫狗癣。
清热杀虫祛风湿，日久则补肾自然收效。
各种风湿虫癣，与疥疮大同小异。初起有可下法的，用打脓散去黄连、金银花、穿山甲、芒硝，加赤芍、白芍，水、酒各半煎，临熟入大黄，露置一夜，五更时服；有可汗法的，用四物汤加荆芥、麻黄各五钱，浮萍一两，葱、豉煎服取汗。一切癞癣皆有效。经久不敢用汗下法的，只用防风通圣散去硝、黄，加浮萍、皂刺，水煎服。多年不愈，体质壮实者，兼吞顽癣丸，或古龙虎丹，用何首乌、白芷、苏木等分，入猪油及少许盐，浸酒送下。体质虚弱者，不可妄用风药。气虚者，用何首乌散、消风散；血燥者，用四圣不老丹，或肾气丸，久服自效；有虫者，都适宜间服蜡矾丸。外治：干癣，用野狼毒、草乌各二钱半，斑蝥七枚，生研为末，津唾调搽。湿癣，用枯矾、黄连各五钱，胡粉、黄丹、水银各二钱，研为末，用猪脂油二两夹研，令水银星散尽，瓷罐收贮，搽之。牛癣，用旧皮鞋底，烧存性，入轻粉少许，研为末，麻油调敷。马疥癣，用马鞭草（不犯铁器），捣自然汁半盏，饮尽，十日即愈。通用麻油二两，入巴豆、蓖麻子各十四粒，斑蝥七粒，熬煎三味枯黑去渣，却入白蜡五钱，芦荟末三钱，搅匀，瓷罐收贮，括破涂之；或用川槿皮、浙剪草、木鳖子等分为末，醋调敷。洗药：用紫苏、樟脑、苍耳、浮萍煎汤。
血风血燥风热郁结，初发疙瘩或如丹毒；瘙痒抓破痛有水，妄投风药血益悭（少）。
血风疮，乃三阴经风热、郁火、血燥所致。瘙痒无常，抓破成疮，脓水淋沥，内证午后潮热盗汗，恶寒，少食体倦，所以不敢妄用风药。大概肝风血燥，寒热作痛者，用当归饮加柴胡、山栀；痛痒寒热者，用小柴胡汤加山栀、黄连；夜热谵语者，用小柴胡汤加生地；肝脾郁火，食少寒热者，用八味逍遥散；脾虚晡时潮热盗汗，不寐者，用归脾汤加山栀、熟地；肾虚有热，作渴咳痰者，用肾气丸。通用：遍身者，用四物汤加浮萍、黄芩等分，甚者，用紫云风丸、换骨丸、三蛇丹；两足痛痒者，用当归拈痛汤。如因饮酒后，遍身痒如风疮，抓至出血又痛者，用蝉蜕、薄荷等分为末，每二钱，水酒调服。凡身发痒者通用。外治：摩风膏、大马齿膏。
癞风审察病因分上下，
癞，即《内经》中的疠风。受天地间肃杀风气，酷烈暴悍，最为可畏。一因风毒，或汗出解衣入水，或酒后当风；二因湿毒，或坐卧湿地，或冒雨露；三因传染。然而未必皆由外感，内伤饮食，热毒过甚，大寒大热，房劳秽污，以致火动血热，更加外感风寒、冷湿而发。初起身上虚痒，或起白屑、紫云如癜风然，或发紫疙瘩流脓。先见于上部者，气分受病，上体必多；先见于下部者，血分受病，下体必多；上下俱见者，气血俱病。从上而下者，为顺风；从下而上者，为逆风。但从上、从下，以渐来者可治，顿发者难愈。治疗失法，以致皮死麻木不仁；脉死血溃成脓；肉死割切不痛；筋死手足缓纵；骨死鼻梁崩塌，以及眉落、眼昏、唇翻、声噎，甚则蚀伤眼目、腐烂玉茎、挛拳肢体，病至于此，天刑难解。
总是阳明血热化生；热甚痰瘀腐化为虫，追虫取涎药必伯（专主）；
胃与大肠，无物不受，脾主肌肉，肺主皮毛。然而疮痂虽见于皮肉，而热毒必归于肠胃，故法必先治阳明，初起宜用防风通圣散，在上用麻黄，以去外毒；在下用硝、黄，以去内毒；上下俱见者，用正料防风通圣散，以解表攻里。三五日后，即服醉仙散，以吐恶涎。服后，又服防风通圣散去硝、黄、麻黄，多服久服。待胃气稍定，用再造散以下其虫。又有宜先下虫而后吐涎者。吐、下后，仍以防风通圣散量加人参、黄芪、熟地以固气血；或脾胃弱者，白术当倍用。
虫已蚀脏坏五形，清肝凉血火须泻。
虫因火盛，气血沸腾，充满经络，外疮延蔓，内虫攻注，蚀肝眉脱，蚀心足底穿，蚀脾声哑，蚀肺鼻崩，蚀肾耳鸣如雷，宜先服泻青丸以泻肝火，次随证救治。虚痒者，用四物汤加酒芩，调浮萍末；痒甚加荆芥、蝉蜕；瘙痒皮皴白屑者，用白花蛇丸；眉发落者，用三蛇丹，或柏叶煎；眉脱鼻崩者，用换肌散、补气泻荣汤；蚀眼者，用芦荟丸；肢节废者，用蠲痹散。通用：凌霄花散、胡麻散、加味苦参丸、大枫丸、换骨丸、大麻风丸、紫云风丸、活神丹、肾气丸、四圣不老丹、八味汤。外治：摩风膏、浴癞方。发落不生者，先用生姜擦三次，后用半夏为末，麻油调擦。更与第四卷末须发条参看。
杨梅疮因风湿热，或伤气分或伤血分；
杨梅疮，病因与治疗与癞风大同。多由肝肾脾内风湿热之毒，间有天行湿毒传染，但各地俗呼名不一，有呼杨梅为天者，有呼杨梅为大麻风者，以理推之，形如杨梅，红湿烂痒痛属心，多生乳胁；形如鼓钉、黄豆者属脾，多生满面，谓之大风痘；形如棉花属肺，多生毛发；形如紫葡萄，按之紧痛者属肝肾，多丛生豚臀及筋骨之处；形如鱼鳃，内多白水，按之不紧者，谓之天疱疮，乃此类之轻者。如发于鬓、额、口、鼻、谷道边者，属阳明及少阳、太阳。如发于足胫、阴茎、胁肋者，属肝肾及太阴。大抵上先见者，气分受病，上体必多；下先见者，血分受病，下体必多；上下俱见者，气血俱病。
初宜疏泻久补虚，免成痈癣与漏缺。
初起即服防风通圣散一帖，去麻黄用硝、黄以去内毒，待胃气稍定，再以一帖，去硝、黄用麻黄发汗以去外毒。以后用加减通圣散、丸多服。此方内通脏腑、外发经络，为首尾要药。轻者服此一剂，更加搽、洗足矣；重者十帖后，宜服化毒散三日，却用吹药三日，疮干痂欲脱落，再服化毒散三日，后量用防风通圣散加减。上体多者，兼服败毒散加荆、防、钩藤；下体多者，兼服龙胆泻肝汤。从鼻准肿起，遍身生疮，面上尤多者，用桦皮散；便燥者，用搜风顺气丸，以此调理断根。失治久则风毒深入经络，挟湿而成顽癣，或气血虚败而成漏，或误服轻粉、水银及不遵禁戒，而成风堆肿烂，流脓出汁，谓之痈。病至于此，亦有蚀伤眼鼻、腐烂玉茎、拳掌肢体，与癞无异，治宜消毒，兼以补虚。消毒：顽癣者，用皂根丸；筋骨痛者，用皂刺丸、换骨丸；成漏者，用象牙丸；肿块者，用仙遗粮丸。通用加味苦参丸、大枫丸、蜡矾丸、单苦参酒。消毒补虚，用仙遗粮汤加钩藤，或补气泻营汤、胡麻散。补虚：气虚者，用单人参汤、补中益气汤；血虚者，用四物汤加山栀、钩藤、金银花、甘草节，或肾气丸、四圣不老丹；气血俱虚者，用八物汤、八味丸，单仙遗粮丸。外贴：太乙膏、白蜡膏。
疔疮全是饮食毒，发因灾畜暴戾伤；
经曰：膏粱之变，足生大疔。恣食辛辣浓味，炙爆腥荤，及误食自死禽兽，蕴毒于中而即发者有之；或卒遇大风、大雾、大暑、大寒，天地暴戾之气，袭注经络，触动其毒而发者；或因感死畜蛇虫毒瓦斯而发者，其死尤速。初发或因衣物触着而疼痛忽生，或因发疹抓破而成疔，仅一小疮，杀人一二日间，比之痈疽尤毒。
生于四肢及头面，
疔发无定处，或肩、背、腰尤缓，在头面、耳、鼻、口、目、舌根、唇上及手足骨节间者最急。如生两足，多有红丝至脐；生两手，多有红丝至心；生唇、面、口内，多有红丝入喉者，俱难治。须急看，以针挑拨其丝，出血以泄其毒瓦斯，方可保生。
顶硬根突近寸长。变黑肿烂透深孔，形色不一极痛痒；
疮头黑硬如钉，四畔带赤如火，盘根突起寸余，随变焦黑，未几肿大而光，转为湿烂，深孔透肌，如大针穿之状。其形初起大小不一，或如水泡，如吴萸，如豆，如石榴子，其色有五，《内经》分应五脏，各有所属部位。《局方》别一十三种：一、麻子疔。状如黍米稍黑。忌麻仁、麻衣。二、石疔。如黑豆甚硬。忌瓦砾、砖石。三、雄疔。四畔仰，浆起，色黄，大如钱孔。四、雌疔。四面浆起，心凹，色稍黄，如钱孔，俱忌房室。五、火疔。状如汤火烧，四畔有烟焰。忌火烧烙。六、烂疔。色稍黑，脓出流出。忌沸汤、热食、烂物。七、三十六疔。状如黑豆，今日生一，明日生二，及满三十六数即死。忌嗔怒。八、蛇眼疔。状如蛇眼。忌恶眼人及嫉妒人见。九、盐肤疔。状大如匙，面色赤，中有黑粒。忌食盐。十、水洗疔。状大如钱，头白里黑，汁出中硬。忌饮浆水、水洗、渡河。十一、刀镰疔。状如薤叶大，长一寸，肉黑如烧烙。忌刺及刀镰切割。十二、浮沤疔。其状曲圆，少许不合，大如薤叶，内黄外黑，黑处刺之不痛，黄处刺之痛，十三、牛狗疔。色赤，浆起掐不破。以上皆宜根据法将护，若或触犯，则脊强、疮痛不可忍。惟浮沤、牛狗无忌，不治自愈。又有一种鱼脐疔，疮头黑深，形如鱼脐，破之黄水渗出，四畔浮浆；其毒尤甚。用丝瓜叶、连须葱、韭叶，捣烂以酒和服。其渣贴腋下，如病在左手，贴左腋下，在左足，贴左胯下；右手足同；在中贴心脐，并用布缚住。候肉下红丝处皆白则安。有潮热者亦宜。却令人抱住，恐其颤倒，倒则难治。或用蛇蜕烧灰，鸡子清调敷。一种水疔疮，用黄荆叶十四片，独头蒜三个，百草霜二钱，擂酒服，取汗，大效。
或不痛痒只麻木，寒热眼中流火光。牙关急紧时惊惕，甚则呕吐毒陷肠；
诸证惟呕吐最危。
治分虚实豁心火，
实者，初服赛命丹三丸，以葱酒发汗。表证多者，用追疔汤，或败毒散加蝉蜕、僵蚕、金银花；里证多者，用活命饮、五圣汤；便利溺涩者，用黄连消毒散，此散初起服之内消；欲作脓者，用托里消毒散。虚者，初服保生锭
Five Jie (Scabies), Five Xuan (Tinea), Blood Wind Sores, Lai Feng (Leprosy), Yangmei Chuang (Syphilis), Ding Chuang (Carbuncle/Furuncle), Duogu Ju (Osteomyelitis with sequestrum), Fan Hua Chuang (Everted Flower Sore), Liuzhu (Abscess), Biaogu, Summer Heat Sores, Fei Cuochuang (Prickly Heat/Acne), Cold Sores, Frostbite, Hand and Foot Fissures, Wo Chuang, HT Chuang, Jin Yin Chuang (Ecthyma/Spreading Eczema), Bai She Chan (Herpes Zoster/Shingles), Tang Huo Chuang (Burns/Scalds), Fei Chuang (Tinea Capitis), You Chuang (Warts), Qi Chuang (Poison Ivy Dermatitis), Bamboo/Wood Splinters, Fractures, Po Shang Feng (Tetanus).
The dryness, dampness, insects, sand, and pus of the five types of Jie,
The five types of Jie arise from toxic accumulation in the five Zang organs, with those belonging to the Foot Three Yin meridians being particularly common.
Constipation indicates excess; normal bowel movements indicate deficiency with wind pathogen.
Sores covering the whole body are difficult to attribute to specific meridians; one must rely on external signs to distinguish between excess and deficiency. Swelling with pain, constipation, hardness, and fever indicate Wind-Toxic Damp-Heat; diffuse swelling with itching and pain, afternoon tidal fever, or alternating chills and fever, along with fatigue and poor appetite, but with normal bowel movements, indicate Blood Deficiency with Wind-Heat.
Dry Jie causes severe itching due to Lung Dryness.
Dry Jie presents with itching, dry skin, and scaling, accompanied by constipation; this is Heart and Liver Fire stagnating in the Lung. Treat with Si Shun Qing Liang Yin, Ancient Jing Huang Tang, or Sou Feng Shun Qi Wan; for chronic cases, use Tian Men Dong Gao. If bowel movements are normal, it is Ministerial Fire stagnating in the Lung; treat with Huo Xue Run Zao Sheng Jin Yin, or Si Wu Tang added with Huang Qin, Lian Qiao, and Tian Men Dong; for chronic cases, use Shen Qi Wan; for long-term deficiency, use Gu Wu Jing Wan. If the patient has a history of Lung Wind with many facial acneiform eruptions, use Hua Pi San.
Damp Toxicity causes swelling due to Spleen and Stomach attack.
Damp Jie presents with swelling and pain; if prolonged, fluid flows like black bean juice. Constipation indicates Spleen Stagnation with Damp-Heat Toxicity; treat with Fang Feng Tong Sheng San (all ingredients wine-steamed or stir-fried, Da Huang separately wine-baked and stir-fried three times) added with Mu Bie Zi, or Sheng Ma Ge Gen Tang added with Tian Ma and Chan Tui. For Qi stagnation, use Fu Yuan Tong Qi San; for predominant Dampness, use Chu Shi Dan. Normal bowel movements indicate Spleen Deficiency with Damp-Heat; use Bu Zhong Yi Qi Tang with added Huang Qin and Huang Lian to clear heat, and Xiong (Chuan Xiong) and Bai Zhi to dry dampness. For Stomach Fire causing thirst, use Zhu Ye Huang Qin Tang; for Spleen Stagnation with night sweats and insomnia, use Gui Pi Tang; for scanty urination and abdominal distension, use Wei Ling Tang added with Huang Lian; for chronic cases, use Er Chao Cang Bai Wan; for predominant Dampness, use single Cang Zhu Gao; for Spleen-Lung Wind-Toxicity, use He Shou Wu San.
Sand Jie causes fine pain due to Heart Blood stasis.
Sand Jie resembles fine grains of sand, causing pain or itching, with fluid upon scratching and redness. This is Heart Blood coagulation and stasis. Constipation indicates treatment with Dang Gui Wan, or Liang Ge San combined with Si Wu Tang; for chronic cases, use Jiu Zheng Huang Lian Wan. For chest irritability and phlegm, use Niu Huang Qing Xin Wan; for heart irritability, dry mouth, and difficult urination, use Lian Qiao Yin. Normal bowel movements indicate treatment with Huo Xue Si Wu Tang; for chronic cases, use Dang Gui Yin.
Insect Jie resembles tinea due to Liver Fire surging.
Excessive fire generates "insects" (parasites/pathogens), analogous to decaying grass producing fireflies. Insect Jie causes intense itching without pain, spreads easily, and is contagious. Constipation indicates severe Liver Wind-Heat; treat with Lu Hui Wan, or Bai Du San, applying ground Ling Yang Jiao (Antelope Horn) juice topically; for chronic cases, use Gu Ku Zao Wan. Normal bowel movements indicate Liver Meridian Fire stagnation; treat with Xiao Yao San, applying ground Ling Yang Jiao juice topically; for non-healing chronic cases, use Hu Ma San. However, all sores may generate parasites when chronic, requiring topical treatments and washes.
Nong Ke (Pustular) sores hurt due to Spleen Heat obstruction; slow pain indicates Kidney Deficiency failing to fill.
Thick, purulent exudate with strong color, pain, and constipation indicates Damp-Heat; treat with Wu Xiang Lian Qiao Tang, Sheng Ma He Qi Yin, or Zhu Ye Shi Gao Tang combined with Si Wu Tang. Clear, thin pus with pale color, no pain, and normal bowel movements indicate Kidney Deficiency Fire; treat with Ba Wei Xiao Yao San, or Si Wu Tang added with Zhi Mu and Huang Bo, or Si Sheng San, or Shen Qi Wan.
One must further distinguish upper/lower body locations and fat/thin constitutions.
Upper body conditions often combine Wind-Heat; lower body conditions often combine Damp-Wind. Obese individuals tend toward Damp-Wind; thin individuals tend toward Blood-Heat. For thin, weak, and deficient patients with dried-up Kidneys and flaming fire, even if presenting with constipation, fever, and thirst, only nourish Yin and descend fire, slightly adding Qin Jiao, Cang Er, and Lian Qiao. Never use purely wind-dispelling drugs to cool blood and damage the stomach, as skin diseases can harm internal organs. General formula: Lian Gui Tang. For Qi deficiency, use Si Jun Zi Tang; for Blood deficiency, combine with Si Wu Tang; for Wind, combine with Xiao Du Yin; for Dampness, combine with Ping Wei San.
Open stagnation, reduce heat, and kill the parasites.
To open toxic stagnation, use acrid-warm herbs such as Wu Yu (Evodia) and Bai Zhi; to reduce muscular heat, use bitter-cold herbs such as Huang Qin, Huang Lian, and Da Huang; to kill parasites, use mercury compounds. These are the three external treatment methods of Danxi. For Dry Jie, use Wu Zhu Yu San, or powder Huang Lian and Da Huang mixed with pig bile for application; for Damp Jie, use Yi Shang San; for Sand Jie, use Jian Cao San; for Insect Jie, use Liu Huang Bing; for Nong Ke, use San Huang San. General ointment: Mo Feng Gao. Wash: Decoct Jing Jie, Huang Bo, and Ku Shen in equal parts; add She Chuang Zi and Chuan Jiao for itching; add Cong Bai for swelling.
The five types of Xuan are stubborn dampness, unrelated to wind, horses, or cattle; they all stem from Blood Heat and Lung Evil retention.
Jie and Xuan both result from Heat-Dryness in the Blood level, leading to Wind-Toxicity attacking the skin. Superficial ones are Jie; deep ones are Xuan. Jie often combines with Heat; Xuan often combines with Dampness. Jie appears on hands, feet, and whole body; Xuan appears as macules on muscles, round or oblique, spreading like moss or plum patterns. Feng Xuan is Dry Xuan, shedding white scales when scratched; Shi Xuan feels like insects crawling, weeping fluid when scratched; Wan Xuan has no sensation of pain or itch; Niu Xuan resembles cow neck skin, thick and hard; Ma Xuan is mildly itchy with connected white spots, also called Gou Xuan.
Clear heat, kill parasites, dispel wind-dampness; long-term cases require Kidney tonification for natural resolution.
Various wind-damp-parasite Xuan are similar to Jie sores. For early stages suitable for purgation, use Da Nong San removing Huang Lian, Jin Yin Hua, Shan Zhan Jia, and Mang Xiao, adding Chi Shao and Bai Shao, decocted half water half wine, adding Da Huang near completion, exposed overnight, taken at dawn. For stages suitable for sweating, use Si Wu Tang added with Jing Jie and Ma Huang (5 qian each), Fu Ping (1 liang), Cong, and Chi, decocted to induce sweat. Effective for all leprosy/tinea. For chronic cases where sweating/purgation is contraindicated, use Fang Feng Tong Sheng San removing Xiao and Huang, adding Fu Ping and Zao Ci, decocted in water. For years-long non-healing cases in robust individuals, swallow Wan Xuan Wan or Gu Long Hu Dan made of He Shou Wu, Bai Zhi, Su Mu in equal parts, mixed with lard and salt, taken with wine. Weak individuals should not recklessly use wind-dispelling drugs. For Qi deficiency, use He Shou Wu San, Xiao Feng San; for Blood dryness, use Si Sheng Bu Lao Dan or Shen Qi Wan, taken long-term for effect; for parasitic involvement, take La Fan Wan intermittently. External treatment: For Dry Xuan, use Ye Lang Du and Cao Wu (2.5 qian each), Ban Mao (7 pieces), ground raw, mixed with saliva for application. For Wet Xuan, use Ku Fan and Huang Lian (5 qian each), Hu Fen, Huang Dan, Shui Yin (2 qian each), ground, mixed with 2 liang pork lard until mercury disperses, stored in porcelain jar for application. For Niu Xuan, burn old leather shoe soles to retain character, add slight Qian Fen, ground, mixed with sesame oil for application. For Ma Jie/Xuan, use Ma Bian Cao (avoid iron), crush for half cup natural juice, drink completely, cured in ten days. General: 2 liang sesame oil, boil Ba Dou, Bi Ma Zi (14 grains each), Ban Mao (7 grains) until black, strain, add Bai La (5 qian), Lu Hui powder (3 qian), mix well, store in porcelain jar, apply to broken sores; or use Chuan Jin Pi, Zhe Jian Cao, Mu Bie Zi in equal parts, ground, mixed with vinegar for application. Wash: Decoct Zi Su, Zhang Nao, Cang Er, Fu Ping.
Blood Wind, Blood Dryness, Wind-Heat stagnation; initial eruption of nodules resembling erysipelas; itching, scratching breaks skin causing pain and fluid; reckless use of wind-drugs worsens Blood deficiency.
Blood Wind Chuang results from Wind-Heat, stagnant fire, and Blood Dryness in the Three Yin meridians. Itching is irregular; scratching breaks skin into sores with dripping pus/water. Internal signs include afternoon tidal fever, night sweats, aversion to cold, poor appetite, and fatigue; thus, wind-drugs must not be used recklessly. Generally, for Liver Wind-Blood Dryness with alternating cold/heat and pain, use Dang Gui Yin added with Chai Hu and Shan Zhi; for pain/itching with cold/heat, use Xiao Chai Hu Tang added with Shan Zhi and Huang Lian; for night fever and delirium, use Xiao Chai Hu Tang added with Sheng Di; for Liver-Spleen stagnant fire with poor appetite and cold/heat, use Ba Wei Xiao Yao San; for Spleen deficiency with afternoon tidal fever, night sweats, and insomnia, use Gui Pi Tang added with Shan Zhi and Shu Di; for Kidney deficiency with heat, thirst, and cough with phlegm, use Shen Qi Wan. General: For whole body, use Si Wu Tang added with Fu Ping and Huang Qin in equal parts; for severe cases, use Zi Yun Feng Wan, Huan Gu Wan, San She Dan; for painful/itchy legs, use Dang Gui Nian Tong Tang. If itching all over after drinking alcohol, scratching to bleeding and pain, use Chan Tui and Bo He in equal parts, ground, 2 qian per dose, mixed with water and wine. Universal for body itching. External: Mo Feng Gao, Da Ma Chi Gao.
Assess Lai Feng etiology distinguishing upper and lower.
Lai refers to Li Feng in Neijing. It is caused by the austere, violent, and fierce wind qi of heaven and earth, most to be feared. Etiology 1: Wind toxicity, e.g., undressing and entering water after sweating, or exposing to wind after drinking. Etiology 2: Damp toxicity, e.g., sitting/sleeping on damp ground, or exposure to rain/dew. Etiology 3: Contagion. However, it is not solely external; internal injury from diet, excessive heat toxicity, extreme cold/heat, sexual exhaustion, and filth cause fire movement and Blood Heat, compounded by external Wind-Cold and Cold-Damp. Initial stage: vague itching on body, white scales, purple clouds resembling vitiligo, or purple nodules weeping pus. Manifesting first on upper body indicates Qi level disease, predominantly upper; manifesting first on lower body indicates Blood level disease, predominantly lower; simultaneous manifestation indicates Qi and Blood disease. Progression from top to bottom is Shun Feng (favorable); bottom to top is Ni Feng (unfavorable). Gradual onset is treatable; sudden onset is difficult to cure. Improper treatment leads to dead skin (numbness), dead vessels (pus), dead flesh (insensitivity to cutting), dead sinews (limp limbs), dead bones (collapsed nasal bridge), loss of eyebrows/hair, blurred vision, lip eversion, hoarseness, eye erosion, genital rot, and limb contracture. Such advanced disease is incurable heavenly punishment.
It is always Yangming Blood Heat transformation; severe heat, phlegm, and stasis rot into parasites; drugs to chase parasites and draw out phlegm are essential.
Stomach and Large Intestine receive everything; Spleen governs muscles; Lung governs skin/hair. Although crusts appear on skin/flesh, heat-toxicity returns to intestines/stomach. Thus, treatment must first address Yangming. Early stage: Fang Feng Tong Sheng San. Upper use Ma Huang to expel external toxin; lower use Xiao/Huang to purge internal toxin; simultaneous use standard formula to release exterior and purge interior. After 3-5 days, take Zui Xian San to vomit foul saliva. Then take Fang Feng Tong Sheng San removing Xiao, Huang, Ma Huang, taken long-term. Once Stomach Qi stabilizes, use Zai Zao San to expel parasites. Some cases require purging parasites before vomiting saliva. After vomiting/purging, resume Fang Feng Tong Sheng San with added Ren Shen, Huang Qi, Shu Di to secure Qi/Blood; or double Bai Zhu for weak Spleen/Stomach.
Parasites have eroded viscera damaging five forms; clear Liver, cool Blood, and drain fire.
Parasites thrive on excessive fire, boiling Qi/Blood, filling meridians. External sores spread; internal parasites attack viscera. Eroding Liver causes eyebrow loss; eroding Heart causes sole perforation; eroding Spleen causes hoarseness; eroding Lung causes nasal collapse; eroding Kidney causes thunder-like tinnitus. First take Xie Qing Wan to drain Liver Fire, then treat according to symptoms. For vague itching, use Si Wu Tang added with Jiu Huang Qin, mixed with Fu Ping powder; for severe itching, add Jing Jie, Chan Tui; for peeling skin with white scales, use Bai Hua She Wan; for hair loss, use San She Dan or Bai Ye Jian; for eyebrow/nasal loss, use Huan Ji San, Bu Qi Xie Rong Tang; for eye erosion, use Lu Hui Wan; for joint disability, use Juan Bi San. General: Ling Xiao Hua San, Hu Ma San, Jia Wei Ku Shen Wan, Da Feng Wan, Huan Gu Wan, Da Ma Feng Wan, Zi Yun Feng Wan, Huo Shen Dan, Shen Qi Wan, Si Sheng Bu Lao Dan, Ba Wei Tang. External: Mo Feng Gao, Yu Lai Fang. For hair regrowth, rub ginger three times, then apply Bai Zhu powder mixed with sesame oil. Refer to Volume 4, Hair/Nails section.
Yangmei Chuang caused by Wind-Damp-Heat, injuring either Qi or Blood levels.
Yangmei Chuang etiology and treatment are similar to Lai Feng. Mostly due to internal Wind-Damp-Heat toxicity in Liver/Kidney/Spleen, occasionally contagious epidemic damp-toxicity. Local names vary. Morphologically: Red, wet, ulcerated, itchy/painful resembling bayberry belongs to Heart, often on breasts/flanks; drum-nail/soybean shaped belongs to Spleen, often on face (Da Feng Dou); cotton-like belongs to Lung, often on hair-bearing areas; purple grape-like, tight/painful on pressure belongs to Liver/Kidney, often on buttocks/joints; fish-gill-like, watery inside, soft on pressure is Tian Pao Chuang (mild form). Locations on temples/forehead/mouth/nose/anus belong to Yangming/Shaoyang/Taiyang. Locations on shins/genitals/flanks belong to Liver/Kidney/Taiyin. Generally, upper onset indicates Qi disease (upper body); lower onset indicates Blood disease (lower body); simultaneous indicates Qi/Blood disease.
Initially疏泻 (drain/disperse), later tonify deficiency, avoiding carbuncles, tinea, and fistulas.
Initial stage: One dose of Fang Feng Tong Sheng San, remove Ma Huang, use Xiao/Huang to purge internal toxin. Once Stomach Qi stabilizes, another dose, remove Xiao/Huang, use Ma Huang to sweat out external toxin. Thereafter, use modified Tong Sheng San/pills long-term. This formula connects internal organs and releases meridians, essential for head-to-tail treatment. Mild cases: one dose plus topical/wash therapy. Severe cases: Ten doses, then Hua Du San for three days, followed by insufflation for three days. When scabs dry/fall, Hua Du San for three more days, then modified Fang Feng Tong Sheng San. Upper body predominant: combine Bai Du San added with Jing, Fang, Gou Teng. Lower body predominant: combine Long Dan Xie Gan Tang. Onset from nose tip with widespread facial sores: Hua Pi San; dry stool: Sou Feng Shun Qi Wan, regulate to cure root. Untreated chronic cases: Wind-toxin enters meridians, combines with damp to form stubborn tinea, or Qi/Blood failure forms fistulas, or misuse of Qian Fen/Shui Yin/breaking taboos causes wind-piles, swelling, rotting, weeping pus, called Yong. Advanced cases resemble Lai Feng (eye/nose erosion, genital rot, limb contracture). Treatment: Disinfect and tonify deficiency. Disinfect: Stubborn tinea - Zao Gen Wan; bone/joint pain - Zao Ci Wan, Huan Gu Wan; fistulas - Xiang Ya Wan; masses - Xian Yi Liang Wan. General: Jia Wei Ku Shen Wan, Da Feng Wan, La Fan Wan, Dan Ku Shen Jiu. Disinfect/Tonify: Xian Yi Liang Tang added with Gou Teng, or Bu Qi Xie Ying Tang, Hu Ma San. Tonify: Qi deficiency - Dan Ren Shen Tang, Bu Zhong Yi Qi Tang; Blood deficiency - Si Wu Tang added with Shan Zhi, Gou Teng, Jin Yin Hua, Gan Cao Jie, or Shen Qi Wan, Si Sheng Bu Lao Dan; Qi/Blood dual deficiency - Ba Wu Tang, Ba Wei Wan, single Xian Yi Liang Wan. External paste: Tai Yi Gao, Bai La Gao.
Ding Chuang is entirely dietary toxicity, triggered by disaster animals/violent injury.
Classic says: Changes from rich food produce large Ding. Indulgence in spicy/heavy flavors, roasted/fried meats, or accidental ingestion of dead poultry/beasts causes mid-body toxin accumulation and immediate eruption. Or sudden exposure to great wind/fog/heat/cold, violent heaven-earth qi attacks meridians, triggering toxin eruption. Or infection from dead beasts/snakes/insects poison gas, death is rapid. Initial eruption: sudden pain from clothing contact, or scratching rash into Ding. Small sore, kills within 1-2 days, more toxic than carbuncles.
Occurring on limbs and head/face.
Ding has no fixed location; shoulder/back/waist are slower; head/face/ears/nose/mouth/eyes/tongue base/lips/hand-foot joints are most urgent. Legs: red thread to navel; Hands: red thread to heart; Mouth/face/internal: red thread to throat; all difficult to treat. Urgent needle puncture to bleed and drain toxin gas to save life.
Hard apex, protruding root nearly one cun. Turns black, swollen, rotten, penetrating deep holes; varied shapes/colors, extremely painful/itchy.
Sore head black/hard like nail, surrounding red like fire, root protrudes over one cun, turns black, swells shiny, becomes wet/rotten, deep hole piercing muscle like large needle. Initial size varies: water blister, Wu Yu, bean, pomegranate seed. Five colors correspond to Five Zang in Neijing. Ju Fang lists 13 types: 1. Ma Zi Ding (sesame-like, slightly black). Avoid hemp seeds/clothes. 2. Shi Ding (black bean-like, very hard). Avoid gravel/bricks. 3. Xiong Ding (upward edges, yellow pus, coin-sized). 4. Ci Ding (surrounding pus, depressed center, slightly yellow, coin-sized). Avoid sex. 5. Huo Ding (burn-like, smoky edges). Avoid fire/cautery. 6. Lan Ding (slightly black, flowing pus). Avoid hot soup/food/rotten matter. 7. San Shi Liu Ding (black bean-like, one today two tomorrow, dies at 36). Avoid anger. 8. She Yan Ding (snake-eye shape). Avoid evil-eyed/envious people. 9. Yan Fu Ding (spoon-sized, red face, black grain center). Avoid salt. 10. Xi Shui Ding (coin-sized, white head/black inside, hard core). Avoid drinking water/washing/river crossing. 11. Dao Lian Ding (scallion leaf shape, one cun long, black meat). Avoid stabbing/cutting. 12. Fu Ao Ding (curved round, slight gap, scallion leaf size, yellow inside/black outside, black part painless to prick, yellow part painful). 13. Niu Gou Ding (red, pus-filled, unbreakable). Above require strict care; violation causes stiff spine/unbearable pain. Only Fu Ao and Niu Gou heal spontaneously. Fish Umbilicus Ding: black/deep head, fish-umbilicus shape, yellow water渗出, floating pus around; highly toxic. Use Loofah leaf, green onion with roots, chive leaves, crushed, mixed with wine to drink. Dregs applied to armpit (left arm/left foot -> left armpit/left groin; right same; middle -> heart/navel, bound with cloth). When red threads under skin turn white, safe. Also for tidal fever. Hold patient to prevent fainting (hard to treat if fallen). Or snake shed ash mixed with egg white for application. Water Ding Chuang: Huang Jing Ye (14 leaves), Du Tou Suan (3 cloves), Bai Cao Shuang (2 qian), pounded with wine to drink, induce sweat, highly effective.
Or no pain/itch, only numbness; chills/fever, sparks in eyes. Jaw stiffness, fright; severe vomiting, toxin sinking to intestines.
Among all symptoms, vomiting is most critical.
Treatment distinguishes excess/deficiency, clears Heart Fire.
Excess: Initially Sai Ming Dan (3 pills), sweat with Cong Jiu. Exterior predominant: Zhui Ding Tang, or Bai Du San added with Chan Tui, Jiang Can, Jin Yin Hua. Interior predominant: Huo Ming Yin, Wu Sheng Tang. Normal stool/scanty urine: Huang Lian Xiao Du San (internal resolution early); suppuration: Tuo Li Xiao Du San. Deficiency: Initially Bao Sheng Ding