【方歌】枯筋箭由肝失荣，筋气外发赤豆形，破突筋头如花蕊，
或系或灸便成功。
【注】此证一名疣子，由肝失血养，以致筋气外发。初起如赤
豆，枯则微槁，日久破裂，钻出筋头，蓬松枯槁，如花
之蕊，多生于手、足、胸乳之间。根蒂细小者，宜用药
线齐根系紧，七日后其患自落，以月白珍珠散掺之，其
疤收敛。根大顶小者，用铜钱一文套疣子上，以草纸穣
代艾连灸三壮，其患枯落，疣形若大，用草纸蘸湿，套
在疣上灸之。
方剂：药线（见臀部痔疮）
月白珍珠散（见溃疡门）
【方歌】疥疮干湿虫砂脓，各经蕴毒风化成，治论上下分肥瘦，
清风利湿兼杀虫。
【注】此证有干、湿、虫、砂、脓之分，其形虽有五种，总由
各经蕴毒，日久生火，兼受风湿，化生斯疾，或传染而
生。凡疥先从手丫生起，绕遍周身，瘙痒无度。如肺经
燥盛，则生干疥，瘙痒皮枯，而起白屑；如脾经湿盛，
则生湿疥，〔兴〕肿作痛，破津黄水，甚流黑汁；如肝
经风盛，则生虫疥，瘙痒彻骨，挠不知疼；如心血凝滞
，则生砂疥，形如细砂，焮赤痒痛，抓之有水；如肾经
湿热，则生脓窠，疥形如豆粒，便利作痒，脓清淡白；
或脾经湿盛，亦生脓窠疥，但顶含稠脓，痒疼相兼为异
。疥虽有余之证，而体虚之人亦生，以便秘为实，便利
为虚。亦有虚而便燥者，如风秘则便燥，血分枯燥则便
涩。又在疮形色重色淡，及脉息之有力、无力辨之。初
起有余之人，俱宜防风通圣散服之；虚者服荆防败毒散
透发之。及形势已定，则无论虚实，干疥服消风散，湿
疥服苍术膏，疥虫服芦荟丸，砂疥服犀角饮子，脓窠疥
服秦艽丸，经久不愈，血燥者，服当归饮子。外治：干
疥者，擦绣毯丸；湿者，擦臭灵丹，润燥杀虫俱效。疥
生上体多者，偏风热盛；下体多者，偏风湿盛。肥人多
风湿，瘦人多血热，详辨治之。
方剂：苍术膏
组成：南苍术（切片，入砂锅内水煮减半，取汁再加水煮如前
，以术无味为度，并汁一处，用小砂锅再煎，
如干一寸加汁一寸，煎成膏，加蜂蜜四两和匀
，十斤）
每服二羹匙，空心，白滚水调服。
【方歌】苍术膏医湿疥疮，切片入锅煮成汤，熬膏加蜜空心服，
湿除热散胜群方。
又方：犀角饮子
组成：犀角（镑） 赤芍
甘菊花 元参
木通 赤小豆（炒）
石菖蒲（各一钱五分） 甘草（生，一钱）
生姜三片，水二钟，煎八分服。
【方歌】犀角饮子砂疥生，痒疼色赤出心经，芍菊元参通赤豆，
菖蒲姜草水煎成。
又方：秦艽丸
组成：秦艽 苦参
大黄（酒蒸） 黄耆（各二两）
防风 漏芦
黄连（各一两五钱）
乌蛇肉（酒浸，焙干，五钱）
共为细末，炼蜜为丸，如梧桐子大。每服三十丸，
食后温酒送下。
【方歌】秦艽丸服脓疥愈，清热痒除疮自去，若参大黄风漏芦，
乌蛇黄连耆蜜聚。
又方：当归饮子
组成：当归 生地
白芍（酒炒） 川芎
何首乌 荆芥
防风 白蒺藜（各一钱）
黄耆 甘草（生，各五分）
水二钟，煎八分，食远服。
【方歌】当归饮子脓疥久，痒添血燥不能除，四物黄耆何首草，
荆防蒺入风自疏。
又方：绣珠丸
组成：川椒 轻粉
樟脑 雄黄
枯白矾 水银（各二钱）
大风子肉
共研细末，同大风子肉再碾匀，加〔木臼〕油一两
，化开和药，搅匀作丸，以二掌合搓如圆眼大。先以鼻
闻，次擦患处。
【方歌】绣球丸用椒轻粉，樟脑雄黄矾水银，大风子研〔木臼〕
油兑，干疥搓擦效如神。
又方：臭灵丹
组成：硫黄末 油核桃
生猪脂油（各一两） 水银（一钱）
捣膏用，擦患处。
【方歌】臭灵丹擦脓湿疥，硫黄末共油核桃，生猪脂油各一两，
水银一钱同捣膏。
又方：防风通圣散（见头部秃疮）
荆防败毒散（见项部脑疽）
消风散（见项部钮扣风）
芦荟丸（见齿部牙衄）
【方歌】枯筋箭由肝失荣，筋气外发赤豆形，破突筋头如花蕊，或系或灸便成功。
【注】此证一名疣子（寻常疣），由肝血不足失于濡养，导致筋脉之气外发而成。初起时如赤豆大小，干枯后略显萎缩，日久破裂，钻出筋头，蓬松且干枯，形状像花蕊一样，多生长在手、足、胸部和乳房之间。根蒂细小者，宜用药线（一种腐蚀性的细线）齐根部系紧，七日后患处自行脱落，撒上月白珍珠散，疤痕即可收敛愈合。根粗顶小者，用一枚铜钱套在疣子上，以草纸芯代替艾绒连续灸三壮，患处便会干枯脱落；若疣体较大，用草纸蘸湿，套在疣上灸之。
方剂：药线（见臀部痔疮章节）
月白珍珠散（见溃疡门章节）
【方歌】疥疮干湿虫砂脓，各经蕴毒风化成，治论上下分肥瘦，清风利湿兼杀虫。
【注】此病证有干疥、湿疥、虫疥、砂疥、脓窠疥五种分类，虽然形态有五种不同，但总归是由于各经络蕴积毒素，日久化火，兼受风湿之邪，化生此疾，也可能通过传染而发病。凡是疥疮先从手指缝间开始发作，蔓延遍全身，瘙痒无度。如果肺经燥热偏盛，则生干疥，表现为皮肤干枯瘙痒，起白色皮屑；如果脾经湿气偏盛，则生湿疥，表现为肿胀作痛，破溃流出黄水，严重时流出黑汁；如果肝经风邪偏盛，则生虫疥，瘙痒深入骨髓，抓挠不知疼痛；如果心血凝滞，则生砂疥，形态如细砂粒，红肿痒痛，抓破有水渗出；如果肾经湿热下注，则生脓窠疥，疥疮形状如豆粒，二便不利且瘙痒，脓液清淡色白；或者是脾经湿气偏盛，也会生脓窠疥，但特点是顶部含有稠厚脓液，痒痛并见，这是其不同之处。疥疮虽然是表浅有余之证，但体质虚弱的人也会得，以便秘为实证，以便溏为虚证。也有因虚而导致大便干燥的，如风秘则大便干燥，血分枯燥则大便涩滞。又根据疮形色泽深浅，以及脉搏气息的有力无力来辨别虚实。初起属于实证的人，都宜服用防风通圣散；虚证者服用荆防败毒散透发邪气。等到病情稳定后，则无论虚实，干疥服用消风散，湿疥服用苍术膏，虫疥服用芦荟丸，砂疥服用犀角饮子，脓窠疥服用秦艽丸，经久不愈且血燥者，服用当归饮子。外治法：干疥者，擦涂绣毯丸；湿疥者，擦涂臭灵丹，润燥杀虫均有效。疥疮生在身体上部多的，偏向风热盛；生在身体下部多的，偏向风湿盛。肥胖人多患风湿，消瘦人多患血热，需详细辨别治疗。
方剂：苍术膏
组成：南苍术（切片，放入砂锅内水煮至减半，取汁再加水煮如前法，以苍术无味为度，将汁液合并一处，用小砂锅再煎，如液体减少一寸就加汁液一寸，煎成膏状，加入蜂蜜四两和匀，共十斤）
每服两羹匙，空腹，用白开水调服。
【方歌】苍术膏医湿疥疮，切片入锅煮成汤，熬膏加蜜空心服，湿除热散胜群方。
又方：犀角饮子
组成：犀角（镑片） 赤芍
甘菊花 元参
木通 赤小豆（炒）
石菖蒲（各一钱五分） 甘草（生用，一钱）
生姜三片，水两钟，煎至八分服。
【方歌】犀角饮子砂疥生，痒疼色赤出心经，芍菊元参通赤豆，菖蒲姜草水煎成。
又方：秦艽丸
组成：秦艽 苦参
大黄（酒蒸） 黄耆（各二两）
防风 漏芦
黄连（各一两五钱）
乌蛇肉（酒浸，焙干，五钱）
共研为细末，炼蜜为丸，如梧桐子大。每服三十丸，食后温酒送下。
【方歌】秦艽丸服脓疥愈，清热痒除疮自去，若参大黄风漏芦，乌蛇黄连耆蜜聚。
又方：当归饮子
组成：当归 生地
白芍（酒炒） 川芎
何首乌 荆芥
防风 白蒺藜（各一钱）
黄耆 甘草（生用，各五分）
水两钟，煎至八分，饭后久时服。
【方歌】当归饮子脓疥久，痒添血燥不能除，四物黄耆何首草，荆防蒺入风自疏。
又方：绣珠丸（原文方歌误作绣球丸，此处依组成及上下文修正为绣珠/毯丸之意，但提取实体时保留原文“绣珠丸”或“绣毯丸”，根据方歌“绣球丸”及正文“绣毯丸”，此处统一按正文“绣毯丸”理解，但方歌写的是绣球，故提取时需注意。根据常规《医宗金鉴》版本，外用药多为“绣毯丸”。此处依原文文本提取。）
组成：川椒 轻粉
樟脑 雄黄
枯白矾 水银（各二钱）
大风子肉
共研细末，同大风子肉再碾匀，加植物油一两，化开和药，搅匀作丸，以两掌合搓如龙眼核大。先以鼻闻，次擦患处。
【方歌】绣球丸用椒轻粉，樟脑雄黄矾水银，大风子研植物油兑，干疥搓擦效如神。
又方：臭灵丹
组成：硫黄末 油核桃
生猪脂油（各一两） 水银（一钱）
捣成膏用，擦患处。
【方歌】臭灵丹擦脓湿疥，硫黄末共油核桃，生猪脂油各一两，水银一钱同捣膏。
又方：防风通圣散（见头部秃疮章节）
荆防败毒散（见项部脑疽章节）
消风散（见项部钮扣风章节）
芦荟丸（见齿部牙衄章节）
[Prescription Verse] "Ku Jin Jian" (Withered Tendon Arrow) arises from the Liver failing to nourish, with tendon Qi manifesting externally in the shape of a red bean; when the tendon head breaks through like a flower stamen, tying it off or moxibustion will succeed.
[Note] This condition is also known as a wart (Verruca vulgaris), caused by Liver blood deficiency failing to nourish, leading to the external manifestation of tendon Qi. Initially, it appears the size of a red bean; as it dries, it becomes slightly shriveled. After a long time, it cracks open, and a tendon-like head protrudes, appearing fluffy and dry, resembling a flower stamen. It commonly grows on the hands, feet, chest, and breasts. For those with a fine pedicle, it is appropriate to tie tightly with medicinal thread (a corrosive thin cord) at the base; after seven days, the lesion will fall off naturally. Sprinkle Yuebai Zhenzhu San (Pearl White Powder) upon it to promote scar contraction and healing. For those with a thick pedicle and small top, place a copper coin over the wart, use grass paper core instead of moxa, and perform three moxa cones (Zhuang); the lesion will dry and fall off. If the wart is large, wet the grass paper, place it over the wart, and apply moxibustion.
Formulas: Yao Xian (Medicinal Thread) (See Hemorrhoids of the Buttocks chapter)
Yuebai Zhenzhu San (Pearl White Powder) (See Ulcer Section)
[Prescription Verse] Scabies presents as dry, damp, insect, sand, or pustular types; toxins accumulate in various meridians, transforming into wind. Treatment distinguishes between upper/lower body locations and fat/thin constitutions, employing methods to clear wind, drain dampness, and kill parasites.
[Note] This disease category includes five types: dry scabies, damp scabies, insect scabies, sand scabies, and pustular scabies. Although there are five morphological variations, they all originate from toxin accumulation in the meridians, which generates fire over time, combined with wind-dampness, resulting in this ailment, which may also be contagious. Scabies typically begins in the finger webs and spreads throughout the body, causing intense itching. If Lung meridian dryness is predominant, dry scabies occurs, characterized by dry, itchy skin with white scales. If Spleen meridian dampness is predominant, damp scabies occurs, presenting with swelling and pain, oozing yellow fluid upon rupture, and potentially black fluid in severe cases. If Liver meridian wind is predominant, insect scabies occurs, with itching penetrating to the bone, where scratching does not relieve pain. If Heart blood stagnates, sand scabies occurs, appearing like fine sand grains, with redness, itching, and pain, exuding water when scratched. If Kidney meridian damp-heat is present, pustular scabies occurs, with lesions the size of bean grains, accompanied by difficult urination/bowel movements and itching, discharging clear, pale pus. Alternatively, Spleen dampness can also cause pustular scabies, but the distinguishing feature is thick pus in the top, with both itching and pain. Although scabies is generally a superficial excess condition, individuals with weak constitutions may also suffer from it; constipation indicates excess, while loose stools indicate deficiency. There are also cases of deficiency leading to dry stool, such as wind constipation causing dry stool, or dry blood constitution causing涩 (obstructed/difficult) stool. Differentiation is further made based on the depth and lightness of the lesion's color, and the strength or weakness of the pulse. In early stages for patients with excess conditions, Fangfeng Tongsheng San (Saposhnikovia and Sage Decoction) should be taken; for deficiency, Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction) is used to vent the pathogen. Once the condition stabilizes, regardless of excess or deficiency, dry scabies is treated with Xiaofeng San (Wind-Expelling Powder), damp scabies with Cangzhu Gao (Atractylodes Ointment), insect scabies with Lushui Wan (Aloe Pill), sand scabies with Xijiao Yinzi (Rhinoceros Horn Drink), and pustular scabies with Qinjiao Wan (Gentiana Pill). For chronic cases not healing due to blood dryness, Danggui Yinzi (Angelica Decoction) is prescribed. External treatment: for dry scabies, apply Xiutan Wan (Embroidery Carpet Pill); for damp scabies, apply Chouling Dan (Stinky Spirit Elixir), both effective for moisturizing, drying, and killing parasites. Scabies predominantly on the upper body suggests wind-heat excess; predominantly on the lower body suggests wind-damp excess. Obese individuals tend toward wind-damp, while thin individuals tend toward blood-heat; these must be carefully differentiated and treated.
Formula: Cangzhu Gao (Atractylodes Ointment)
Composition: Nan Cangzhu (Southern Atractylodes Rhizome, sliced, boiled in a clay pot until reduced by half, juice extracted; boiled again similarly until the herb has no taste; juices combined and further decocted in a small clay pot; for every inch of liquid reduction, add an inch of juice; once formed into an ointment, mix with four taels of honey, total ten jin).
Dosage: Two dessert spoons per dose, taken fasting, mixed with boiling water.
[Prescription Verse] Cangzhu Gao treats damp scabies, slices boiled into soup, ointment made with honey taken fasting, removing dampness and dispersing heat surpasses other prescriptions.
Another Formula: Xijiao Yinzi (Rhinoceros Horn Drink)
Composition: Xijiao (Rhinoceros Horn, shaved) Chi Shao (Red Peony Root) Gan Ju Hua (Chrysanthemum Flower) Yuan Shen (Scrophularia Root) Mu Tong (Akebia Stem) Chi Xiao Dou (Adzuki Bean, stir-fried) Shi Chang Pu (Acorus Rhizome) (each 1.5 qian) Gan Cao (Licorice Root, raw, 1 qian) Sheng Jiang (Fresh Ginger, 3 slices). Water two zhong, decoct to eight fen, take orally.
[Prescription Verse] Xijiao Yinzi treats sand scabies, itching and pain with redness originating from the Heart meridian; Peony, Chrysanthemum, Scrophularia, Akebia, Adzuki Bean, Acorus, Ginger, and Licorice decocted in water.
Another Formula: Qinjiao Wan (Gentiana Pill)
Composition: Qin Jiao (Gentiana Macrophylla Root) Ku Shen (Sophora Root) Da Huang (Rhubarb Root, steamed with wine) Huang Qi (Astragalus Root) (each 2 liang) Fang Feng (Saposhnikovia Root) Lou Lu (Leuzea Rhizome) Huang Lian (Coptis Rhizome) (each 1.5 liang) Wu She Rou (Agkistrodon Snake Meat, soaked in wine, dried, 5 qian). Grind into fine powder, bind with refined honey into pills the size of paulownia seeds. Dosage: 30 pills per dose, taken after meals with warm wine.
[Prescription Verse] Qinjiao Wan cures pustular scabies, clearing heat and relieving itching causes the sore to heal; if one considers Rhubarb, Wind-Expelling Herb, Leuzea, Agkistrodon, Coptis, Astragalus, and Honey gathering together.
Another Formula: Danggui Yinzi (Angelica Decoction)
Composition: Dang Gui (Angelica Sinensis Root) Sheng Di (Rehmannia Root, fresh) Bai Shao (White Peony Root, stir-fried with wine) Chuan Xiong (Ligusticum Rhizome) He Shou Wu (Polygonum Multiflorum Root) Jing Jie (Schizonepeta Spike) Fang Feng (Saposhnikovia Root) Bai Ji Li (Tribulus Fruit) (each 1 qian) Huang Qi (Astragalus Root) Gan Cao (Licorice Root, raw) (each 0.5 qian). Water two zhong, decoct to eight fen, take well after meals.
[Prescription Verse] Danggui Yinzi treats chronic pustular scabies, itching added by blood dryness cannot be removed; Four Substances, Astragalus, Polygonum, Licorice, Schizonepeta, Saposhnikovia, and Tribulus enter to疏 (vent) the wind naturally.
Another Formula: Xiuzhu Wan (Embroidery Pearl Pill) [Note: Text mentions Xiutan Wan in note, Xiuzhu/Xiuqiu in verse. Extracting as per text entities.]
Composition: Chuan Jiao (Sichuan Pepper) Qing Fen (Calomel) Zhang Nao (Camphor) Xiong Huang (Realgar) Ku Bai Fan (Alum, calcined) Shui Yin (Mercury) (each 2 qian) Da Feng Zi Rou (Semecarpus Anacardium Nut Meat). Grind into fine powder, grind together with Semecarpus Anacardium Nut Meat again, add one tael of vegetable oil, melt and mix with medicine, stir evenly into pills, rub between palms to the size of a longan seed. First smell with nose, then rub on affected area.
[Prescription Verse] Xiuqiu Wan uses Pepper and Calomel, Camphor, Realgar, Alum, and Mercury; Semecarpus ground with vegetable oil mixed, rubbing dry scabies is effective as a miracle.
Another Formula: Chouling Dan (Stinky Spirit Elixir)
Composition: Liu Huang Mo (Sulfur Powder) You Tao He (Oil Walnut) Sheng Zhu Zhi You (Raw Pig Lard Fat) (each 1 liang) Shui Yin (Mercury) (1 qian). Pound into ointment for application, rub on affected area.
[Prescription Verse] Chouling Dan rubs pustular and damp scabies, Sulfur powder with Oil Walnut, Raw Pig Lard Fat each one tael, Mercury one qian pounded into ointment together.
Another Formula: Fangfeng Tongsheng San (Saposhnikoviae et Salviae Decoction) (See Alopecia of Scalp chapter)
Jingfang Baidu San (Schizonepetae et Saposhnikoviae Decoction) (See Carbuncle of Neck chapter)
Xiaofeng San (Wind-Expelling Powder) (See Urticaria of Neck chapter)
Lushui Wan (Aloe Pill) (See Gingival Bleeding of Teeth chapter)