（俗名脑漏）
生生子曰∶按书云∶鼻流清涕者为鼻鼽，流浊涕者为鼻渊。《内经·气厥论篇》曰∶“胆移热于脑，则
辛鼻渊。鼻渊者，浊涕下不止也。传为衄蔑瞑目，故得之气厥也。”启玄子注曰∶厥者，逆也，脑液下
渗，则为浊涕，涕下不止，如彼水泉，故曰鼻渊也。足太阳脉，起于目内 ，上额交巅，上入络脑。足阳
明脉，起于鼻交 中，傍约太阳之脉。今脑热，则足太阳逆与阳明之脉俱盛，薄于 中，故鼻 辛也。辛，
谓酸痛。予尝以防风通圣散，除硝、黄，其滑石、石膏减半，倍加辛夷花，先服三五帖，再用此为丸，每
服七十丸，早晚白汤吞服，半斤则瘳矣。
余弟于六月赴邑，途行受热，且过劳，性多躁暴，忽左胁痛，皮肤上一片红如碗大，发水泡疮三五
点，脉七至而弦，夜重于昼。医作肝经郁火治之，以黄连、青皮、香附、川芎、柴胡之类，进一服，其
夜痛极，且增热。次早看之，其皮肤上红大如盘，水泡疮又加至三十余粒。医教以白矾研未，井水调敷，
仍于前药加青黛。龙胆草进之。其夜痛苦不已，叫号之声，彻于四邻，胁中痛如钩摘之状。次早观之，其
红已及半身矣，水泡疮又增至百数。予心甚不怿，乃载归以询先师黄古潭先生，先生观脉案药方，哂曰
∶切脉认病则审矣，制药订方则未也。夫用药如用兵，知已知彼，百战百胜，今病势有烧眉之急，迭卵
之危，岂可执寻常泻肝之剂正治耶？是谓驱羊搏虎矣！且苦寒之药，愈资其燥，以故病转增剧。水泡疮发
于外者，肝郁既久，不得发越，乃侮其所不胜，故皮腠为之溃也，至于自焚则死矣，可惧之甚！为订一方
，以大栝蒌一枚，重
一二两者，连皮捣烂，加粉草二钱，红花五分。戌时进药，少顷就得睡，至子丑时方醒，问之，
已不痛矣。乃索食，予禁止之，恐邪火未尽退也。急煎药渣与之，又睡至天明时，微利一度，复
睡至辰时。起视皮肤之红，皆已冰释，而水泡疮亦尽敛矣，后亦不服他药。夫病重三日，饮食不
进，呻吟不辍口，一剂而愈，真可谓之神矣。夫栝蒌味甘寒，《经》云∶“泄其肝者，缓其中。
”且其为物，柔而滑润，于郁不逆，甘缓润下，又如油之洗物，未尝不洁。考之本草，栝蒌能治
插胁之痛，盖为其缓中润燥，以致于流通，故痛自然止也。
（俗名脑漏）
生生子说：查阅医书记载，鼻流清涕的称为鼻鼽，流浊涕的称为鼻渊。《内经·气厥论篇》说：“胆经的热邪移注于脑，则导致鼻渊。鼻渊的症状是浊涕不断流出。若病情传变，会出现鼻出血、视物模糊或眼睛失明等症状，这都是由于气机逆乱所致。”启玄子（王冰）注释说：厥，就是逆乱的意思。脑中的津液向下渗漏，就形成浊涕，涕下不止，就像泉水涌出一样，所以叫作鼻渊。足太阳膀胱经，起于目内眦，上行至额部，交会于头顶，向上进入络属脑部。足阳明胃经，起于鼻旁，交于鼻根中，旁边约束着足太阳经脉的走向。现在脑中受热，导致足太阳经气逆乱，与阳明经脉之气共同亢盛，搏结于鼻窍之中，所以鼻子感到酸痛。辛，指的是酸楚疼痛的感觉。我曾经用防风通圣散治疗此病，去掉芒硝和大黄，将滑石、石膏减半，加倍加入辛夷花，先服用三五剂，然后再将此方制成丸药，每次服用七十丸，早晚用白开水送服，服用半斤药即可痊愈。
我的弟弟在六月前往县城，途中受热，且过度劳累，他性格急躁暴烈，突然左胁部疼痛，皮肤上出现一片如碗大的红斑，并发出水泡疮三五点，脉搏跳动七次一息且呈弦象，夜间症状比白天严重。医生将其诊断为肝经郁火证进行治疗，使用了黄连、青皮、香附、川芎、柴胡等药物，服用一剂后，当夜疼痛加剧，并且增加了发热。第二天早上查看，皮肤上的红斑扩大如盘子大小，水泡疮又增加到三十多粒。医生建议用白矾研成粉末，井水调匀外敷，同时在之前的药方中加入青黛和龙胆草服用。当夜痛苦不堪，呼叫声传到四邻，胁中疼痛如同被钩摘一般。第二天早上观察，红斑已经蔓延到半身，水泡疮又增加到上百个。我心里非常不安，于是将他载回家去请教先师黄古潭先生。先生看了脉案和药方，笑着说：“切脉辨病倒是准确了，但制药定方就不对了。用药如同用兵，知己知彼才能百战百胜，如今病势有火烧眉毛般的紧急，叠卵般的危险，怎么能拘泥于寻常泻肝的药物进行正治呢？这叫做驱赶羊群去搏斗老虎！况且苦寒的药物，只会更加助长其燥性，因此病情反而加重。水泡疮发于体表，是因为肝气郁结日久，不能疏泄发散，于是反侮其所不胜（脾土），导致皮肤腠理溃烂，如果发展到自焚的地步就会死亡，这真是令人恐惧啊！”于是为他制定一方，用大栝蒌一枚，重量在一二两左右的，连皮捣烂，加入粉甘草二钱，红花五分。戌时服药，不久便入睡，直到子丑时才醒来，询问他，已经不再疼痛了。于是索要食物，我禁止他进食，担心邪火尚未完全消退。急忙煎煮药渣给他喝，他又睡到天明，轻微腹泻一次，又睡到辰时。起来查看，皮肤上的红斑都已消散，水泡疮也都收敛了，后来也没有再服用其他药物。这病重达三日，饮食不进，呻吟不停，一剂药就痊愈了，真可以称得上神奇了。栝蒌味甘性寒，《内经》说：“治疗肝病，要舒缓其中的急迫。”而且栝蒌这种药物，性质柔润滑利，对于气郁不会造成违背，甘缓润下，又像油清洗物品一样，没有不洁净的。考证本草记载，栝蒌能治疗两胁刺痛，大概是因为它能舒缓中焦、润燥，使气机流通，所以疼痛自然停止。
(Vulgarly known as "Brain Leakage")
Mr. Shengsheng said: According to medical texts, nasal discharge of clear mucus is called Biqiu (Nasal Rhinitis), while discharge of turbid mucus is called Biyuan (Nasal Sinusitis). The *Neijing* (Classic of Internal Medicine) · Chapter on Qi Reversal states: "When Gallbladder heat transfers to the brain, it results in Biyuan. In Biyuan, turbid mucus flows incessantly. If transmitted further, it leads to epistaxis, blurred vision, or blindness; thus, it is caused by Qi reversal." Qixuanzi (Wang Bing) annotated: "Jue" means reversal. When brain fluids seep downward, they become turbid mucus. The incessant flow of mucus resembles a spring, hence it is called Biyuan. The Foot-Taiyang Bladder Meridian originates from the inner canthus, ascends to the forehead, intersects at the vertex, and enters to connect with the brain. The Foot-Yangming Stomach Meridian originates beside the nose, intersects at the root of the nose, and runs alongside to constrain the Taiyang meridian. Currently, heat in the brain causes the Foot-Taiyang Qi to reverse, causing both the Taiyang and Yangming meridians to flourish. They clash within the nasal cavity, resulting in nasal soreness and pain. "Xin" refers to this sensation of sourness and pain. I once treated this condition using Fangfeng Tongsheng San (Wind-Protecting Universal Rescue Powder), removing Mangxiao (Mirabilite) and Dahuang (Rhubarb), halving the dosage of Huashi (Talcum) and Shigao (Gypsum), and doubling the amount of Xinyihua (Magnolia Flower). The patient should take three to five doses first, then prepare this formula into pills. Each time, take 70 pills, swallowed with plain warm water morning and evening. Consuming half a jin (approx. 500g) of the medicine will lead to recovery.
My younger brother traveled to the county town in June. He was exposed to heat during the journey and suffered from overwork. His nature was irritable and violent. Suddenly, he experienced pain in his left hypochondrium. On the skin, there appeared a red patch as large as a bowl, accompanied by three to five blisters. His pulse beat seven times per breath and felt wiry. Symptoms were worse at night than during the day. Physicians diagnosed it as Liver Meridian Stagnant Fire and treated him with herbs such as Huanglian (Coptis Rhizome), Qingpi (Aurantium Peel), Xiangfu (Cyperi Rhizome), Chuanxiong (Ligusticum Rhizome), and Chaihu (Bupleuri Radix). After one dose, the pain intensified that night, and fever increased. The next morning, the red patch had expanded to the size of a plate, and the number of blisters increased to more than thirty. The physician advised applying powder made from Baijian (Alumen) mixed well water externally, and adding Qingdai (Indigo Naturalis) and Longdancao (Gentian Root) to the previous herbal prescription. That night, he suffered unbearable pain, crying out so loudly that it reached neighboring houses. The pain in the hypochondrium felt like being hooked and torn. The next morning, the redness had spread to half of his body, and the blisters increased to over a hundred. I was deeply distressed, so I carried him home to consult my former teacher, Mr. Huang Gutan. After reviewing the pulse records and prescriptions, Mr. Huang smiled and said: "Your pulse diagnosis and disease identification are accurate, but your formulation of medicine and prescription is incorrect. Using medicine is like using troops; knowing oneself and the enemy ensures victory in every battle. Now, the disease presents an urgency akin to burning eyebrows and a danger akin to stacked eggs. How can one rigidly adhere to ordinary Liver-draining agents for standard treatment? This is like driving sheep to fight tigers! Moreover, bitter-cold medicines only exacerbate dryness, which is why the condition worsened. The blisters appearing on the exterior indicate that long-standing Liver stagnation could not vent outward, leading it to insult its unconquered element (Spleen/Earth), causing the skin and pores to ulcerate. If it progresses to self-immolation, death ensues; this is truly terrifying!" Therefore, he prescribed a formula consisting of one large Gualou (Trichosanthes Fruit), weighing approximately one to two liang (approx. 30-60g), smashed whole including the peel, added with Fugancao (Licorice Root) 2 qian (approx. 6g) and Honghua (Carthamus Flower) 5 fen (approx. 1.5g). The medicine was administered at Xu hour (7-9 PM). Shortly after, he fell asleep and woke up at Zi-Chou hours (11 PM - 3 AM). Upon inquiry, he reported no pain. He then asked for food, but I prohibited it, fearing the pathogenic fire had not fully subsided. I hastily decocted the dregs of the herbs for him to drink. He slept again until dawn, passed stool slightly once, and slept until Chen hour (7-9 AM). Upon rising, the redness on the skin had completely dissipated, and the blisters had all healed. He did not take any other medication afterward. The illness lasted severely for three days, with no intake of food and ceaseless moaning, yet it was cured with a single dose. Truly, this can be called miraculous. Gualou has a sweet flavor and cold nature. The *Classic* states: "To treat the Liver, soothe its interior." Furthermore, this substance is soft, smooth, and lubricating; it does not oppose stagnation. Its sweet, soothing, and moistening-lowering properties act like oil cleaning objects, ensuring thorough cleansing. Consulting materia medica, Gualou treats stabbing pain in the hypochondrium. This is likely because it soothes the middle jiao and moistens dryness, promoting free flow, thereby naturally stopping the pain.