〔《素》〕帝曰∶病胁下满气逆,二三岁不已,是为何病?岐伯曰∶病名曰息积,此不妨于食,不可灸刺,
积为导引服药,药不能独治也。(奇病论 王注云∶气逆息难故名息积也,用息奔法治之亦可。)
〔无〕磨积丸
胡椒(一百五十粒) 木香(二钱半) 全蝎(十枚,去毒)
上为末,粟米丸,绿豆大,每十五丸,陈皮汤下。
化气汤 治息积。
砂仁 桂心 木香(各二钱半) 甘草(炙) 茴香(炒) 丁香皮 青皮(炒) 陈皮 干姜
蓬术(炮。各半两) 胡椒 沉香(各一钱)
上为末,每服二钱,姜苏盐汤调下,妇人醋汤服。
陈无择云∶导引法随意行之皆可。愚谓或按摩满处,或手足相屈伸,或八段锦,或六字气之类,以气通为效。
〔《灵》〕黄帝曰∶首面与身,形也,属骨连筋,同血合于气耳。天寒则裂地凌冰,其卒寒,或手足懈惰,
然而其面不裂,何也?岐伯答曰∶十二经脉,三百六十五络,其血气皆上于面而走空窍,其精阳气上走于目而
为睛,其别气走于耳而为听,其宗气上出于鼻而为臭,其浊气出于胃走唇舌而为味。其气之津液,皆上熏于面,
而皮又浓,其肉坚,故天热甚寒,不能胜之也。(邪气脏腑病形篇)
〔丹〕朱奶两腮热肿,膈壅之病也。
干葛 桔梗(一钱半) 升麻(一钱) 苏叶(一钱半) 甘草(炙,七分) 薄荷(一钱) 姜(一片) 水煎
服。
〔垣〕咽痛颔肿,脉洪大,面赤者,羌活胜湿汤加黄芩、桔梗、甘草各半钱治之。如耳鸣目黄,颊颔肿,
颈肩 肘臂外后廉痛,面赤,脉洪大者,以羌活、防风、甘草、 本通其经血,加黄连、黄芩消其肿,以人参、
黄益其元气而泻其火邪。
〔丹〕两腮肿。细辛、草乌等分为末,入蚌粉,以猪脂调敷肿处,口含白梅置腮边,良久肿退出涎患消矣。
消时,肿必先向下。
〔世〕治 腮。
竹叶 车前草 柏子仁
杵碎,热敷患处。
腮肿,用赤小豆末敷之,立效。
〔《山》〕 腮。鸡子清调赤小豆末,及喉下诸般肿痛,用蜗牛飞面研匀,贴肿处。
〔《素》〕面肿曰风。(平人气象论)
〔《千》〕主卒中风,头面肿。杵杏仁如膏敷之。
针灸 面颊肿痛有三法∶
其一取手阳明。经云∶ 痛刺足阳明曲周动脉,见血立已。不已,按人迎于经,立已。又云∶厥胸满面肿,
唇漯漯然,暴言难,甚则不能言,取足阳明。又云∶厥头痛,面若肿起而烦心,取之足阳明太阴为烦心也。又
云∶ 痛,刺手阳明与 之盛脉出血是也。
其二取手太阳。经云∶手太阳之脉是动,则颔肿不可以顾,所生病者,目黄颊痛,视盛虚热寒,陷下取之也。
其三取手足少阳。经云∶三焦手少阳之脉,所生病者颊痛。又云∶胆足少阳之脉,所生病者颔肿,视盛
虚热寒陷下取之也。又云∶肝气逆则头痛,耳聋,颊痛,取血者,盖取足少阳之血也。
〔《东》〕面赤颊热,恶风寒,颔痛∶攒竹、玉枕(灸三壮,妙) 巨 (灸五壮。)
〔《集》〕颔肿生疮,名枯曹风∶合谷、列缺、地仓、颊车(不应,再取下穴)、人中、承浆、玉液、金津、
三里。
〔《甲》〕面肿,目痈肿,刺陷谷,出血立止。 肿唇痈,颧 主之。颊肿痛,天窗主之。颊肿口急,颊车
痛,不可以嚼,颊车主之。
【《黄帝内经·素问》】黄帝问道:胁下胀满,气机上逆,两三年不愈,这是什么病?岐伯回答说:这种病名叫息积。它不影响饮食,不能用灸法和针刺治疗,应当采用导引配合服药的方法,因为单靠药物不能治愈。(出自《奇病论》,王冰注解说:因气逆呼吸困难所以叫息积,用治疗喘息奔豚的方法也可以。)
【无作者名】磨积丸
胡椒(一百五十粒) 木香(二钱半) 全蝎(十枚,去毒)
以上研为细末,用粟米糊制成丸药,大小如绿豆,每次服用十五丸,用陈皮汤送服。
化气汤 治疗息积。
砂仁 桂心 木香(各二钱半) 甘草(炙) 茴香(炒) 丁香皮 青皮(炒) 陈皮 干姜
蓬术(炮制。各半两) 胡椒 沉香(各一钱)
以上研为细末,每次服用二钱,用生姜、紫苏、盐煎成的汤调服,妇女用醋汤送服。
陈无择说:导引法随意练习都可以。我认为或者按摩胀满的部位,或者手足相互屈伸,或者练习八段锦,或者练习六字诀之类,以气机通畅为见效标准。
【《黄帝内经·灵枢》】黄帝问道:头面与身体,都是形体的一部分,属于骨骼连接筋脉,气血共同汇聚于气的运行。天气寒冷时大地开裂、冰雪覆盖,突然受寒,有时手足懈怠无力,然而面部皮肤却不破裂,为什么呢?岐伯回答说:十二经脉,三百六十五络穴,它们的气血都上行于面部并通达各个孔窍,其中精阳气上行至眼睛而成为视觉,别气上行至耳朵而成为听觉,宗气上行出于鼻子而成为嗅觉,浊气出于胃上行至口唇舌头而成为味觉。这些气中的津液,都向上熏蒸于面部,而且面部皮肤又厚,肌肉坚实,所以即使天气极热或极寒,也不能损伤它。(出自《邪气脏腑病形篇》)
【朱丹溪】朱某乳房两侧腮部发热肿胀,这是膈间壅滞的病证。
干葛 桔梗(一钱半) 升麻(一钱) 苏叶(一钱半) 甘草(炙,七分) 薄荷(一钱) 姜(一片) 水煎服。
【李东垣】咽痛下颌肿胀,脉象洪大,面色发红的,用羌活胜湿汤加黄芩、桔梗、甘草各半钱治疗。如果耳鸣目黄,脸颊和下颌肿胀,颈肩肘臂外侧后方疼痛,面色发红,脉象洪大的,用羌活、防风、甘草、藁本疏通经络气血,加黄连、黄芩消除肿胀,用人参、黄芪补益元气以泻火邪。
【朱丹溪】两侧腮部肿胀。细辛、草乌等分为末,加入蚌粉,用猪油调和敷在肿胀处,口中含白梅置于腮边,很久后肿胀消退并吐出涎液,病患痊愈。消肿时,肿胀必须先向下移动。
【世传方】治疗腮肿。
竹叶 车前草 柏子仁
捣碎,热敷患处。
腮部肿胀,用赤小豆粉末外敷,立即见效。
【《山》】治疗腮肿。鸡蛋清调和赤小豆粉末,以及喉下各种肿痛,用蜗牛和飞面研匀,贴敷肿胀处。
【《素问》】面部浮肿称为风病。(出自《平人气象论》)
针灸治疗面颊肿痛有三种方法:
其一取手阳明经。经文说:疼痛刺足阳明曲周动脉,见血立止。不止,按压人迎穴于经中,立止。又说:厥逆胸满面肿,嘴唇湿润,突然说话困难,严重时不能说话,取足阳明经。又说:厥头痛,面部像肿胀起来且心烦,取足阳明、足太阴经以除烦心。又说:疼痛,刺手阳明及盛脉出血即是。
其二取手太阳经。经文说:手太阳经脉发生变动,则下颌肿胀不能回顾,所生的疾病有,目黄颊痛,观察盛虚热寒,陷下者取之。
其三取手足少阳经。经文说:三焦手少阳经脉,所生的疾病有颊痛。又说:胆足少阳经脉,所生的疾病有颔肿,观察盛虚热寒陷下取之。又说:肝气逆则头痛,耳聋,颊痛,取血者,大概是取足少阳经的血。
【《东》】面赤颊热,恶风寒,颔痛:攒竹、玉枕(灸三壮,妙) 巨髎(灸五壮。)
【《集》】下颌肿胀生疮,名叫枯曹风:合谷、列缺、地仓、颊车(无效,再取下穴)、人中、承浆、玉液、金津、足三里。
【《甲乙经》】面肿,目痈肿,刺陷谷穴,出血立止。唇痈,颧骨部位主治。颊肿痛,天窗穴主治。颊肿口急,颊车痛,不能咀嚼,颊车穴主治。
[Suwen] The Yellow Emperor asked: What disease is characterized by fullness under the hypochondrium, rebellious Qi, persisting for two or three years without resolution? Qibo replied: This disease is named Xi Ji (Breathing Accumulation). It does not affect eating and drinking, and moxibustion and acupuncture are contraindicated. It should be treated with Daoyin (guiding and pulling exercises) combined with herbal medicine, as herbs alone cannot cure it. (From *Qi Bing Lun*, Wang Bing's commentary states: Because of rebellious Qi and difficulty in breathing, it is called Xi Ji; treating it using methods for Xi Ben [panting and running piglet syndrome] is also acceptable.)
[Wu Zuo Zhe Ming] Mo Ji Wan (Grinding Accumulation Pill)
Hu Jiao (Pepper, 150 grains), Mu Xiang (Aucklandiae Radix, 2.5 qian), Quan Xie (Scorpio, 10 pieces, detoxified).
Grind the above into powder, make pills with millet paste, size of mung beans. Take 15 pills each time, administered with Chen Pi Tang (Tangerine Peel Decoction).
Hua Qi Tang (Transform Qi Decoction) Treats Xi Ji.
Sha Ren (Amomi Fructus), Gui Xin (Cinnamomi Cortex), Mu Xiang (Aucklandiae Radix) (each 2.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted), Hui Xiang (Foeniculi Fructus, stir-fried), Ding Xiang (Caryophylli Flos), Qing Pi (Citri Reticulatae Pericarpium Viride, stir-fried), Chen Pi (Citri Reticulatae Pericarpium), Gan Jiang (Zingiberis Rhizoma).
Peng Zhu (Curcumae Longae Rhizoma, processed) (each 0.5 liang), Hu Jiao (Pepper), Chen Xiang (Aquilariae Lignum Resinatum) (each 1 qian).
Grind the above into powder. Take 2 qian each time, mixed with a decoction of Sheng Jiang (Zingiberis Rhizoma Recens), Zi Su Ye (Perillae Folium), and Yan (Sal). Women take it with Cu Tang (Vinegar Decoction).
Chen Wuyue said: Daoyin can be practiced at will. I believe that massaging the full area, flexing and extending hands and feet, practicing Ba Duan Jin (Eight Section Brocade), or Liu Zi Jue (Six Healing Sounds), etc., are all effective as long as Qi circulation is unobstructed.
[Lingshu] The Yellow Emperor asked: The head and face constitute the form, connected to bones and tendons, with blood and Qi harmonizing together. When heaven is cold, the earth cracks and ice forms; upon sudden cold exposure, hands and feet may become flaccid and weak, yet the face skin does not crack. Why? Qibo answered: The Twelve Meridians and 365 Acupoints have their Blood and Qi ascending to the face and entering the orifices. The essence-Yang Qi ascends to the eyes to form vision; the branch Qi ascends to the ears to form hearing; the Zong Qi (Pectoral Qi) ascends through the nose to form smell; the turbid Qi from the Stomach ascends to the lips and tongue to form taste. The fluids of these Qi all steam upwards onto the face. Moreover, the facial skin is thick and the flesh firm, so extreme heat or cold cannot overcome it. (From *Xie Qi Zang Fu Bing Xing Pian*)
[Zhu Danxi] Zhu suffered from hot swelling of both cheeks, which is a disorder of Di Ge (Diaphragmatic Obstruction).
Ge Gen (Puerariae Lobatae Radix), Jie Geng (Platycodonis Radix) (1.5 qian), Sheng Ma (Cimicifugae Rhizoma) (1 qian), Su Ye (Perillae Folium) (1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (0.7 qian), Bo He (Menthae Haplocalycis Herba) (1 qian), Jiang (Zingiberis Rhizoma Recens) (one slice). Decoct in water and take orally.
[Li Dongyuan] For sore throat, submandibular swelling, large pulse, and red face, treat with Qiang Huo Sheng Shi Tang (Notopterygii Rhizoma et Radix Decoction for Expelling Dampness) plus Huang Qin (Scutellariae Radix), Jie Geng (Platycodonis Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma), half qian each. If there is tinnitus, yellow eyes, cheek and submandibular swelling, pain on the outer posterior aspect of the neck, shoulder, elbow, and arm, red face, and large pulse, use Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Gao Ben (Ligustici Rhizoma et Radix) to unblock meridian Blood and Qi, add Huang Lian (Coptidis Rhizoma) and Huang Qin (Scutellariae Radix) to reduce swelling, and add Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) to tonify Yuan Qi and drain Fire Evil.
[Zhu Danxi] Swelling of both cheeks. Equal parts of Xi Xin (Asari Radix et Rhizoma) and Cao Wu (Aconiti Radix Preparata) ground into powder, mixed with Bang Fen (Concha Margaritifera Interior), and applied to the swollen area with Zhu Zhi (Porcine Fat). Hold a white plum in the mouth near the cheek. After a long time, the swelling subsides, saliva is expelled, and the patient recovers. During resolution, the swelling must first move downward.
[Worldly Prescription] Treat Cheek Swelling.
Zhu Ye (Bambusae Folium), Che Qian Cao (Plantaginis Herba), Bai Zi Ren (Biota Semen).
Pound until broken, apply as a hot compress to the affected area.
For cheek swelling, apply Chi Xiao Dou (Vigna Semen Rubrum) powder externally; immediate effect.
[Shan] Treat Cheek Swelling. Mix Chi Xiao Dou (Vigna Semen Rubrum) powder with Ji Zi Qing (Album Ovi Galli) and apply. For various swellings and pains below the throat, mix Wo Niu (Helix) and Fei Mian (Fly Ash/Powder) evenly and apply to the swollen area.
[Suwen] Facial edema is termed Feng (Wind). (From *Ping Ren Qi Xiang Lun*)
[Qian Jin] Mainly treats sudden Wind Stroke with head and face swelling. Pound Xing Ren (Armeniacae Semen Amarum) into a paste and apply.
Acupuncture has three methods for treating facial and cheek swelling:
First, select the Hand Yangming Meridian. The classic says: For pain, puncture the Qu Zhou arterial pulse of the Foot Yangming Meridian until bleeding occurs, and it stops immediately. If not, press the Ren Ying point on the meridian, and it stops immediately. It also says: For Jue (Rebellious) chest and full facial swelling, wet lips, difficulty speaking suddenly, or inability to speak when severe, select the Foot Yangming Meridian. It also says: For Jue Headache, where the face appears swollen and there is vexation, select the Foot Yangming and Foot Taiyin meridians to relieve vexation. It also says: For pain, puncture the Hand Yangming Meridian and the abundant vessels to bleed.
Second, select the Hand Taiyang Meridian. The classic says: When the Hand Taiyang Meridian moves abnormally, there is submandibular swelling and inability to turn the head; diseases generated include yellow eyes and cheek pain. Observe abundance, deficiency, heat, and cold; for sinking points, select them.
Third, select the Hand and Foot Shaoyang Meridians. The classic says: Diseases generated by the San Jiao Hand Shaoyang Meridian include cheek pain. It also says: Diseases generated by the Gallbladder Foot Shaoyang Meridian include submandibular swelling. Observe abundance, deficiency, heat, cold, and sinking points to select them. It also says: When Liver Qi rebels, there is headache, deafness, and cheek pain; selecting blood implies selecting the blood of the Foot Shaoyang Meridian.
[Dong] Red face, hot cheeks, aversion to wind and cold, submandibular pain: Zan Zhu (Blade-Edge Bamboo Point), Yu Zhen (Jade Pillow Point) (Moxibustion 3 zhu, excellent); Ju Liao (Giant Crevice Point) (Moxibustion 5 zhu).
[Ji] Submandibular swelling with sores, named Ku Cao Feng (Withered Cao Wind): He Gu (Union Valley), Lie Que (Broken Sequence), Di Cang (Earth Granary), Jia Che (Jaw Bone), Ren Zhong (Human Middle), Cheng Jiang (Receiving Fluid), Yu Ye (Jade Fluid), Jin Jin (Golden Fluid), Zu San Li (Leg Three Li).
[Jia Yi Jing] For facial edema and eye carbuncle swelling, puncture Xian Gu (Sunken Valley) and bleed for immediate cessation. For lip carbuncles, the Zygomatic bone area governs. For cheek swelling and pain, Tian Chuang (Heaven Window) governs. For cheek swelling with tight mouth, Jia Che pain, and inability to chew, Jia Che (Jaw Bone) governs.