痒KT 乃风热、湿痰所生,有冬温后天时不正感发传染者多。两腮肿痛,初发寒热,以柴胡葛根汤散之,
外敷如意金黄散。在里内热口干,二便不利者,四顺清凉饮利之。表里俱解,肿仍不消,必欲作脓,托里消毒
散,脓成者即针之。体虚人兼服补托自愈。
柴胡葛根汤(见伤寒发颐门)
四顺清凉饮(见汤泼门)
痰包乃痰饮乘火流行凝注舌下,结而匏肿。绵软不硬,有妨言语,作痛不安,用利剪刀当包剪破,流出黄
痰;若蛋清稠粘难断,捺尽以冰硼散搽之,内服二陈汤加黄芩、黄连、薄荷数服,忌煎炒,火酒等件。
加味二陈汤
加味二陈汤半夏 茯苓甘草共陈皮
芩连薄荷姜三片 痰饮生来服此宜
治痰饮流注舌下,发肿作痛,针刺已破者服之。
陈皮 半夏 茯苓 甘草 黄芩(各八分) 黄连 薄荷(各五分)
水二钟,姜三片,煎八分,食前服。
冰硼散(见咽喉门)
癞风乃阳明湿热沸腾于肌表,或外受风寒侵袭而成。其患初起水泡,作痒成疮,破流脂水,痒至彻骨;久
则成片,传及遍身,好浴热汤,形如风癞。初起上体多者,防风通圣散去硝黄、加葱头三茎,发汗以散外毒。下
体多者,去麻黄以攻内毒,久服祛风换肌丸,初服消风消燥汤,外搽诸疮一扫光。成片流水者,真君妙贴散;
皮肤顽浓有虫者,麦饯散搽之。
消风清燥汤
消风清燥汤生地 芎芍防归芩黄连
花粉苦参并蝉蜕 甘草灵仙共此全
川芎 当归 白芍 生地 防风 黄芩 黄连 天花粉 蝉蜕 苦参 灵仙(各一钱) 甘草(五分)
水二钟,煎八分,食远服。
瘙痒性疮疡(KT,指伴有瘙痒的疮疡)是由风热、湿痰引起的,多因冬季气候反常,感受不正之气而传染发病。症状表现为两侧腮部肿胀疼痛,初起时伴有恶寒发热,治疗应用柴胡葛根汤疏散表邪,外部敷用如意金黄散。若病邪在里,出现内热、口干、大小便不通利的情况,应用四顺清凉饮通利二便。若表里之邪均已解除,但肿胀仍未消退,且必然化脓,则应用托里消毒散托毒排脓,脓液成熟者立即针刺排脓。体质虚弱者兼服补益托毒之剂可自愈。
痰包是指痰饮随着火热之气流行,凝结注于舌下,形成如匏瓜状的肿块。质地绵软不硬,妨碍言语,感到疼痛不安。治疗时用利剪刀直接剪破肿块,流出黄色痰液;若痰液像蛋清一样稠粘难以切断,需按压排尽,然后以冰硼散外搽患处。内服加味二陈汤(即二陈汤加入黄芩、黄连、薄荷),服用数剂后,忌食煎炒食物及火酒等刺激性物品。
加味二陈汤
组成:半夏、茯苓、甘草、陈皮各若干,黄芩、黄连、薄荷、生姜三片。
功效:治疗痰饮流注于舌下,导致肿胀疼痛,经针刺破溃后服用此方。
具体剂量:陈皮、半夏、茯苓、甘草、黄芩(各八分),黄连、薄荷(各五分)。
用法:水两钟,生姜三片,煎至八分,饭前服用。
冰硼散(参见咽喉门)
癞风是由于阳明经湿热沸腾于肌表,或因外受风寒侵袭而成。病症初起为水泡,瘙痒并发展为疮疡,破溃后流出脂水,瘙痒剧烈直至彻骨;日久则成片状,蔓延至全身,患者喜欢洗热水澡,形态类似风癞。初起时上部身体病变较多者,用防风通圣散去芒硝、大黄,加葱头三茎,通过发汗以疏散外毒。下部身体病变较多者,去麻黄以攻逐内毒,久服祛风换肌丸,初服消风清燥汤,外部搽涂诸疮一扫光。成片流水者,使用真君妙贴散;皮肤顽固化脓且有虫感者,用麦饯散外搽。
消风清燥汤
组成:生地、川芎、白芍、防风、当归、黄芩、黄连、天花粉、苦参、蝉蜕、甘草、灵仙。
具体剂量:川芎、当归、白芍、生地、防风、黄芩、黄连、天花粉、蝉蜕、苦参、灵仙(各一钱),甘草(五分)。
用法:水两钟,煎至八分,饭后远时服用。
Itchy sores (KT, referring to sores accompanied by itching) are caused by wind-heat and damp-phlegm. They are often contracted due to abnormal winter warmth and infection by pathogenic factors that deviate from the normal seasonal climate. The symptoms include swelling and pain in both cheeks. At the initial stage, with aversion to cold and fever, Chaihu Gegen Tang (Bupleurum and Kudzu Decoction) is used to disperse the exterior, while Ruyi Jinhuang San (Ruyi Golden Yellow Powder) is applied externally. If the pathogen is interior with internal heat, dry mouth, and difficulty in urination and defecation, Sishun Qingliang Yin (Sishun Cooling and Clearing Drink) is used to promote the flow of urine and stool. When both exterior and interior pathogens are resolved but swelling persists and suppuration is inevitable, Tuoli Xiaodu San (Tuoli Detoxification Powder) is employed to support the healthy qi and expel toxins; if pus has formed, it should be incised immediately. Patients with weak constitution can recover spontaneously by concurrently taking tonifying and supporting formulas.
Chaihu Gegen Tang (See "Fayi" section in Shanghan Lun)
Sishun Qingliang Yin (See "Tangpo" section)
Tanbao (Phlegm Sac) refers to phlegm-fluids flowing with fire-heat and condensing under the tongue, forming a soft, gourd-like swelling. It is soft and not hard, interferes with speech, and causes painful discomfort. Treatment involves using sharp scissors to cut open the sac directly, draining yellow phlegm. If the discharge is thick and sticky like egg white and difficult to sever, it must be pressed out completely, followed by application of Bingpeng San (Bingpeng Powder). Internally, Erchen Tang (Two-Aged Decoction) modified with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Bohe (Menthae Haplocalycis Herba) is taken for several doses. Fried foods and alcoholic beverages are contraindicated.
Modified Erchen Tang
Composition: Banxia (Pinelliae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Huangqin, Huanglian, Bohe, and three slices of Shengjiang (Zingiberis Rhizoma Recens).
Indication: Used after needle incision for phlegm-fluids flowing under the tongue causing swelling and pain.
Dosage: Chenpi, Banxia, Fuling, Gancao, Huangqin (each 8 fen); Huanglian, Bohe (each 5 fen).
Administration: Decoct two zhong of water with three slices of ginger until reduced to eight fen; take before meals.
Bingpeng San (See "Yanhou" section)
Laifeng (Leprosy-like Wind Disease) arises from boiling damp-heat in the Yangming channel manifesting on the skin surface, or from external invasion of wind-cold. Initially, it presents as blisters that itch and develop into sores; upon rupture, they exude serous fluid, with intense itching penetrating to the bone. Over time, lesions merge into patches spreading over the whole body. Patients often prefer hot baths, resembling leprosy. For cases predominantly affecting the upper body, Fangfeng Tongsheng San (Fangfeng Unblocking and Protecting Powder) is used with Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) removed, plus three stalks of Congbai (Allii Cepae Bulbus), to induce sweating and disperse external toxins. For cases predominantly affecting the lower body, Mahuang (Ephedrae Herba) is removed to attack internal toxins. Long-term use of Qufeng Huanji Wan (Qufeng Muscle-Rejuvenating Pills) is recommended, initially combined with Xiaofeng Xiaozao Tang (Xiaofeng Moisture-Clearing Decoction), and externally applying Zhuchuang Yisaoguang (Zhuchuang One-Sweep Brightness Ointment). For weeping patches, Zhenjun Miaotie San (Zhenjun Miraculous Paste Powder) is used; for stubborn, purulent skin lesions with a sensation of insects, Maijian San (Maijian Powder) is applied externally.
Xiaofeng Qingzao Tang
Composition: Shengdi (Rehmanniae Radix), Chuanxiong (Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Huangqin, Huanglian, Tianhuafen (Trichosanthis Radix), Kushen (Sophorae Flavescentis Radix), Chantui (Cicadae Periostracum), Gancao, Lingxian (Syneilesis Rhizoma).
Dosage: Chuanxiong, Danggui, Baishao, Shengdi, Fangfeng, Huangqin, Huanglian, Tianhuafen, Chantui, Kushen, Lingxian (each 1 qian); Gancao (5 fen).
Administration: Decoct two zhong of water until reduced to eight fen; take long after meals.