〔《大》〕夫妇人体虚,为风邪气客于皮肤,复伤风寒,所以则发风瘙瘾疹。若赤疹
者,由寒湿客于肌中极热,热结则成赤疹也。得大热则发,取冷则瘥也。白疹者,由风气
客于肌中热,热与风相搏则成白疹也。得天阴雨寒则发出,风伤亦发,得晴暖则减,着
衣暖亦瘥。脉浮而洪,浮即为风,洪则为气,风气相搏,则生瘾疹,身体瘙痒。凡人汗出
不可当风露卧,及浴后出早,使人身振寒热,以生风疹也。
药隐老人云∶治妇人遍身时发瘙痒,或赤肿瘾疹,五心烦热,血风攻疰,与人参荆
芥散。(虚劳血风。)消风散、(杂病头痛。)四物汤(通治。)加荆芥或人参,当归散或逍遥散兼服导赤
丸。如不通者,食后服皂角丸。气虚老人不可久服,如服皂角丸不退者,此凝滞热甚者,
宜先服青木香丸三两服,以开气道,服蒺藜散立效。
〔薛〕前证有身发疙瘩,或如丹毒,痒痛不常,或脓水淋漓,发热烦渴,或头目昏
眩,日晡益甚,或寒热发热,月经不调,皆肝经风热血燥,用加味逍遥散(调经为主。)佐以
四君、芎、归。若忿怒身发疙瘩,痛痒寒热,乃肝火血燥,用加味小柴胡汤。(热入血室。)气
血俱虚,用八珍加柴胡、牡丹皮。若夜间发热,作渴谵语,乃热入血室,用小柴胡汤加
生地黄。血虚,四物合小柴胡,后用加味逍遥散调理。若郁结食少体倦,内热晡热,乃
脾经血燥,用加味归脾汤。寒热,加山栀、熟地黄。若游走瘙痒,乃血风走注,用何首乌
散。血虚、逍遥散。风热,消风散。若专用风药,复伤阴血,必致筋挛等证。一妇人
身发疙瘩,或如丹毒,痒痛不常,搔碎成疮,脓水淋漓,发热烦渴,头目眩晕,日晡益甚。
此血虚内热之证也,以当归饮加柴胡、山栀仁治之而愈。一妇人患前证,肢体疼痛,头
目不清,自汗盗汗,月水不调,肚腹作痛,食少倦怠,先用人参荆芥散,后用逍遥散治之
而痊。一妇人因忿怒,身发疙瘩,憎寒发热。余谓肝火,用小柴胡汤加山栀、黄连治
之而愈。后口苦胁痛,小便淋漓,复用前药全愈。一妇人患前症发热,夜间谵语,此
血分有热,以小柴胡汤加生地黄治之而安。后用四物加柴胡、山栀、丹皮而热退,又用逍
遥散全愈。一室女年十四岁,天癸未至,身发赤斑痒痛,左关脉弦数。此因肝火血热,以
小柴胡汤加山栀、生地黄、牡丹皮治之而愈。若因怒而致者,又当治以前药。
何首乌散 治妇人血风,皮肤瘙痒,心神烦闷,及血风游走不定,并宜服之。
何首乌 防风 白蒺藜 枳壳 天麻
僵蚕 胡麻 茺蔚子 蔓荆子(各等分)
上为细末,每服二钱,煎茵陈汤调下,无时。
蒺藜散 治妇人风瘙,皮肤中如虫行,及生瘾疹,搔之作疮,面肿心烦,并宜服之。
白蒺藜(炒) 莽草(炒) 羚羊角屑(各七钱半) 黄芩 人参(去芦) 苦参(去芦)
蛇床子 秦艽(去芦) 防风(去芦) 麻黄(去节) 当归(炒,去芦) 甘草(炙)
枳壳(麸炒,去幅) 细草(去苗,各半两)
上 咀,每服五钱,水一中盏半,煎至一大盏,去滓温服,不拘时,日进二服。
治妇人风痒瘾疹不瘥。
苍耳花、叶、子(各等分)
上为细末,每服二钱,豆淋酒调下,不拘时候,日进二服。
治瘾疹。
上用白蜜不以多少,好酒调下,已试有验。
治皮肤有风热,遍身生瘾疹。
牛蒡子(水煮一两净,晒干,炒令香) 浮萍(蒸过,焙干,等分)
上为细末,每服二钱,薄荷汤调下,日二服。
又治风气客于皮肤,搔之不已。
蝉蜕(洗) 大叶薄荷
上等分为细末,每服二三钱,温酒调下,无时。
又方
露蜂房(洗过,蜜炙令焦) 蛇蜕(洗,炙令焦,各等分)
上为细末,每服一二钱,温酒调下,不拘时。
治妇人风瘙瘾疹,身痒不止,宜用淋渍方。
马蔺 茺蔚子 白矾 白蒺藜 茵芋 羊桃根 凌霄花(各二两) 蒴 根 蓖麻叶(各一两)
上 咀,以水二斗,煮取一斗,去 ,于避风处洗之。
又方
凌霄花(三两) 蒴 根(半斤)
上件药以水七升,煮取三升,滤去滓,入白矾末二两,搅匀,以绵渍频拭于疹上,后
煮槐柳汤浴之。
又方 以醋浆水磨白矾涂之。
【《大》】妇女体质虚弱,风邪之气客居在皮肤之中,又受到风寒的侵袭,所以会发作风瘙瘾疹(一种以皮肤突发瘙痒、起疹为特征的疾病)。如果是赤色疹子,是因为寒湿之气客居于肌肉之中,郁积至极热,热邪结聚就形成了赤疹。遇到大热天气就会发作,接触冷凉则病情缓解。白色疹子,是因为风气客居于肌肉之中产生热,热与风相互搏结就形成了白疹。遇到阴雨寒冷天气就会发作,受风也会发作,遇到晴朗温暖天气则减轻,穿着暖和的衣服也能痊愈。脉象浮而洪大,浮脉主风,洪脉主气,风邪与气邪相互搏结,就会产生瘾疹,身体瘙痒。凡是出汗的时候不能对着风吹露宿,以及洗澡后过早外出,会导致人体出现寒战发热,从而生出风疹。
药隐老人说:治疗妇人全身时常发作瘙痒,或者赤肿瘾疹,五心烦热(手心、脚心和心口烦热),血风攻注(风邪随血行窜动),用人参荆芥散。(适用于虚劳引起的血风。)消风散、四物汤(通用方)加入荆芥或人参,当归散或逍遥散配合服用导赤丸。如果大便不通的,饭后服用皂角丸。气虚的老人不可久服,如果服用皂角丸后症状不退,这是凝滞热盛的表现,应当先服用青木香丸三剂,以开通气道,再服用蒺藜散立即见效。
【薛己】上述病症有身上发出疙瘩,或者像丹毒一样,痒痛无常,或者脓水淋漓,发热烦躁口渴,或者头目昏眩,傍晚时分加重,或者寒热往来,月经不调,这些都是肝经风热血燥所致,使用加味逍遥散(以调经为主)佐以四君子汤、川芎、当归。如果因愤怒导致身上发疙瘩,痛痒寒热,这是肝火血燥,使用加味小柴胡汤。(热入血室证。)气血俱虚的,使用八珍汤加柴胡、牡丹皮。如果夜间发热,口渴谵语,这是热入血室,使用小柴胡汤加生地黄。血虚的,用四物汤合小柴胡汤,之后用加味逍遥散调理。如果因郁结导致食少体倦,内热及傍晚发热,这是脾经血燥,使用加味归脾汤。伴有寒热的,加山栀、熟地黄。如果游走性瘙痒,这是血风走注,使用何首乌散。血虚的用逍遥散。风热的用消风散。如果专用风药,反而损伤阴血,必然导致筋挛等病症。有一位妇人身上发出疙瘩,或者像丹毒,痒痛无常,抓破成疮,脓水淋漓,发热烦躁口渴,头目眩晕,傍晚加重。这是血虚内热的证候,用当归饮子加柴胡、山栀仁治疗而痊愈。另一位妇人患上述病症,肢体疼痛,头目不清爽,自汗盗汗,月经不调,肚腹作痛,食少倦怠,先用的人参荆芥散,后用逍遥散治疗而痊愈。还有一位妇人因愤怒,身上发疙瘩,憎寒发热。我认为是肝火,用小柴胡汤加山栀、黄连治疗而痊愈。后来出现口苦胁痛,小便淋漓不畅,再次用前面的药物全部治愈。还有一位妇人患上述病症发热,夜间谵语,这是血分有热,用小柴胡汤加生地黄治疗而安定。之后用四物汤加柴胡、山栀、丹皮使热退,又用逍遥散完全治愈。有一位十四岁的少女,天癸(月经)尚未到来,身上发赤斑痒痛,左关脉弦数。这是因为肝火血热,用小柴胡汤加山栀、生地黄、牡丹皮治疗而痊愈。如果是因愤怒导致的,又应当用前面的药物治疗。
何首乌散 治疗妇人血风,皮肤瘙痒,心神烦闷,以及血风游走不定,都适宜服用。
何首乌 防风 白蒺藜 枳壳 天麻
僵蚕 胡麻 茺蔚子 蔓荆子(各等分)
以上药物研为细末,每次服用二钱,用茵陈煎汤调服,不限时间。
蒺藜散 治疗妇人风瘙,皮肤中感觉如虫爬行,以及生成瘾疹,搔抓后成为疮疡,面部肿胀心烦,都适宜服用。
白蒺藜(炒) 莽草(炒) 羚羊角屑(各七钱半) 黄芩 人参(去芦头) 苦参(去芦头)
蛇床子 秦艽(去芦头) 防风(去芦头) 麻黄(去节) 当归(炒,去芦头) 甘草(炙)
枳壳(麸炒,去瓤) 细辛(去苗,各半两)
以上药物切碎,每次服用五钱,用水一盏半,煎至一大盏,去渣温服,不限时间,每日进两次药。
治疗妇人风痒瘾疹不愈。
苍耳花、叶、子(各等分)
以上药物研为细末,每次服用二钱,用豆淋酒调服,不限时候,每日进两次药。
治疗瘾疹。
以上药物用白蜜不限多少,用好酒调服,已经试用有效。
治疗皮肤有风热,全身生瘾疹。
牛蒡子(水煮一两洗净,晒干,炒令香) 浮萍(蒸过,焙干,等分)
以上药物研为细末,每次服用二钱,用薄荷汤调服,每日两次。
又治疗风气客于皮肤,搔抓不止。
蝉蜕(洗) 大叶薄荷
以上药物研为细末,每次服用二三钱,用温酒调服,不限时间。
又一方
露蜂房(洗过,蜜炙令焦) 蛇蜕(洗,炙令焦,各等分)
以上药物研为细末,每次服用一二钱,用温酒调服,不限时间。
治疗妇人风瘙瘾疹,身痒不止,宜用淋渍方。
马蔺 茺蔚子 白矾 白蒺藜 茵芋 羊桃根 凌霄花(各二两) 蒴藋根 蓖麻叶(各一两)
以上药物切碎,用水二斗,煮取一斗,去渣,在避风处清洗患处。
又一方
凌霄花(三两) 蒴藋根(半斤)
以上药物用水七升,煮取三升,滤去渣,加入白矾末二两,搅匀,用棉布浸药液频繁擦拭疹子上,之后再煮槐柳汤洗浴。
又一方 用醋浆水磨白矾涂抹患处。
[From "Da"] Women with a deficient constitution are susceptible to pathogenic wind-qi lodging in the skin. If additionally injured by wind-cold, wind-sao yin-zhen (a disease characterized by sudden onset of itching and urticaria) will erupt. If the rash is red, it is caused by cold-dampness lodging in the muscles, stagnating into extreme heat; when heat knots, red rashes form. These flare up in great heat and improve upon exposure to cold. If the rash is white, it is caused by wind-qi lodging in the muscles generating heat; when heat and wind struggle against each other, white rashes form. These appear during cloudy and rainy cold weather or upon wind injury, but subside in sunny and warm weather or when kept warm by clothing. The pulse is floating and surging; floating indicates wind, while surging indicates qi. When wind and qi struggle, yin-zhen arises, accompanied by body itching. Generally, one should not sleep exposed to wind while sweating, nor go out too early after bathing, as this causes chills and fever, leading to wind-rash.
The Hermit Sage states: To treat women with generalized intermittent itching, or red-swollen yin-zhen, five-palm center heat (heat sensation in the palms, soles, and chest), and blood-wind attacking (wind pathogens moving with blood circulation), use Renshen Jingjie San (Ginseng and Schizonepeta Decoction). [Indicated for deficiency-consumption blood-wind.] Xiaofeng San (Wind-Dispersing Powder), Siwu Tang (Four Substances Decoction) added with Jingjie or Renshen, Danggui San (Angelica Decoction), or Xiaoyao San (Free and Easy Wanderer Powder) may be taken concurrently with Daochi Wan (Guide Out Red Pill). For those with constipation, take Zaojiao Wan (Soap Pod Pill) after meals. Elderly persons with Qi deficiency should not take this long-term. If symptoms do not recede after taking Zaojiao Wan, it indicates severe stagnant heat; one should first take Qingmuxiang Wan (Aucklandia Pill) for three doses to open the Qi mechanism, then take Jili San (Tribulus Powder) for immediate effect.
[Xue Ji] The aforementioned conditions include eruptions of nodules on the body, resembling erysipelas, with variable itching and pain, or weeping pus and water, accompanied by fever, restlessness, thirst, dizziness, worsening in the late afternoon, alternating chills and fever, or irregular menstruation. All these stem from Wind-Fire and Blood-Dryness in the Liver Meridian. Use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder, primarily for regulating menstruation) assisted with Sijunzi Tang (Four Gentlemen Decoction), Chuanxiong, and Danggui. If nodules erupt due to anger, accompanied by pain, itching, chills, and fever, this is Liver Fire causing Blood-Dryness; use Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction). [Indicated for Heat entering the Blood Chamber.] For combined Qi and Blood deficiency, use Bazhen Tang (Eight Treasures Decoction) added with Chaihu and Mudanpi. For night fevers, thirst, and delirium, this is Heat entering the Blood Chamber; use Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Shengdihuang. For Blood deficiency, combine Siwu Tang with Xiao Chaihu Tang, followed by Jiawei Xiaoyao San for regulation. For depression-related anorexia and fatigue, with internal heat and afternoon fever, this is Blood-Dryness in the Spleen Meridian; use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). Add Zhizi and Shudihuang if chills and fever are present. For wandering itching, this is Blood-Wind moving about; use Heshouwu San (Polygonum Multiflorum Powder). For Blood deficiency, use Xiaoyao San. For Wind-Heat, use Xiaofeng San. If exclusively using Wind-dispersing herbs, Yin-Blood will be further damaged, inevitably leading to tendon spasms and other syndromes.
Case 1: A woman had nodules erupting like erysipelas, variable itching/pain, scratching led to ulcers with weeping pus, fever, thirst, dizziness, worsening in the late afternoon. This was Blood deficiency with internal heat. Treated with Danggui Yin (Angelica Drink) added with Chaihu and Zhiren (Gardenia seed), resulting in recovery.
Case 2: A woman suffered from limb pain, unclear head/eyes, spontaneous and nocturnal sweating, irregular menstruation, abdominal pain, anorexia, and fatigue. Initially treated with Renshen Jingjie San, then Xiaoyao San, resulting in recovery.
Case 3: A woman erupted in nodules with aversion to cold and fever due to anger. I diagnosed Liver Fire and treated with Xiao Chaihu Tang added with Zhizi and Huanglian, resulting in recovery. Later, she experienced bitter taste and hypochondriac pain with dribbling urination; repeating the previous prescription led to full recovery.
Case 4: A woman had fever and night delirium, indicating Heat in the Blood aspect. Treated with Xiao Chaihu Tang added with Shengdihuang, stabilizing her condition. Afterwards, Siwu Tang added with Chaihu, Zhizi, and Danpi reduced the fever, and Xiaoyao San completed the cure.
Case 5: A fourteen-year-old maiden whose Tian Gui (menstruation) had not yet arrived presented with red spots, itching, and pain, and a wiry-numerous pulse at the left Guan position. This was due to Liver Fire and Blood-Heat. Treated with Xiao Chaihu Tang added with Zhizi, Shengdihuang, and Mudanpi, resulting in recovery. If caused by anger, treat with the aforementioned prescriptions.
Heshouwu San (Polygonum Multiflorum Powder) treats women's Blood-Wind, skin itching, mental restlessness, and wandering Blood-Wind.
He Shou Wu (Polygoni Multiflori Radix), Fang Feng (Saposhnikoviae Radix), Bai Jili (Tribuli Fructus), Zhi Qiao (Aurantii Fructus Immaturus), Tian Ma (Gastrodiae Rhizoma), Jiang Can (Bombyx Batryticatus), Hu Ma (Sesami Semen), Chong Wei Zi (Leonuri Fructus), Man Jing Zi (Vittaginis Fructus) [Equal parts].
Grind into fine powder. Take 2 qian per dose, mixed with Yinchen decoction, at any time.
Jili San (Tribulus Powder) treats women's wind-sao, sensation of insects crawling in the skin, formation of yin-zhen, scratching leading to sores, facial swelling, and mental restlessness.
Bai Jili (Tribuli Fructus, stir-fried), Mang Cao (Artemisiae Argyi Folium, stir-fried), Lingyang Jiao Xie (Saigae Tataricae Cornu, equal parts 7.5 qian), Huang Qin (Scutellariae Radix), Renshen (Ginseng Radix et Rhizoma, remove rhizome), Kushen (Sophorae Flavescentis Radix, remove rhizome), She Chuang Zi (Cnidii Fructus), Qin Jiao (Gentianae Macrophyllae Radix, remove rhizome), Fang Feng (Saposhnikoviae Radix, remove rhizome), Mahuang (Ephedrae Herba, remove joints), Danggui (Angelicae Sinensis Radix, stir-fried, remove rhizome), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Zhi Qiao (Aurantii Fructus Immaturus, bran-fried, remove placenta), Xi Xin (Asari Radix et Rhizoma, remove soil, equal parts 0.5 liang).
Cut into pieces. Take 5 qian per dose, boil in 1.5 cups of water until reduced to 1 cup, strain, and take warm at any time. Two doses daily.
For treating women's wind-itch and yin-zhen that does not heal.
Canger Hua, Ye, Zi (Xanthii Fructus cum Spina, leaves, and seeds) [Equal parts].
Grind into fine powder. Take 2 qian per dose, mixed with Doulin Jiu (Bean-infused Wine), at any time. Two doses daily.
For treating yin-zhen.
Use Bai Mi (Honey) in appropriate amounts, mixed with good wine, taken orally. Proven effective.
For treating skin Wind-Heat with generalized yin-zhen.
Niubang Zi (Arctii Fructus, boiled in water for 1 liang until clean, dried, stir-fried until fragrant), Fuping (Mint's surface algae/Enteromorpha, steamed, dried, equal parts).
Grind into fine powder. Take 2 qian per dose, mixed with Bohe Tang (Mint Decoction). Two doses daily.
Another formula for Wind-Qi lodging in the skin causing incessant scratching.
Chantui (Cicadae Periostracum, washed), Daye Bohe (Menthae Haplocalycis Herba).
Grind into fine powder. Take 2-3 qian per dose, mixed with warm wine, at any time.
Another prescription.
Lufengfang (Rhodotyphi Nidus, washed, honey-roasted until scorched), Shetui (Serpentis Shed Skin, washed, roasted until scorched, equal parts).
Grind into fine powder. Take 1-2 qian per dose, mixed with warm wine, at any time.
For women's wind-sao yin-zhen with incessant body itching, use the Linzhi Formula.
Malin (Iris pseudacori Radix et Rhizoma), Chongwei Zi (Leonuri Fructus), Bai Fan (Alumen), Bai Jili (Tribuli Fructus), Yinyu (Farfarae Flos), Yangtao Gen (Actinidia Polystachya Radix), Lingxiao Hua (Campsis Grandiflorae Flos) [Each 2 liang], Shuodi Gen (Dioscoreae Hypoglaucae Rhizoma), Bimaye (Ricini Folium) [Each 1 liang].
Cut into pieces. Boil in 2 dou of water until reduced to 1 dou, remove residue, and wash the affected area in a wind-sheltered place.
Another prescription.
Lingxiao Hua (Campsis Grandiflorae Flos, 3 liang), Shuodi Gen (Dioscoreae Hypoglaucae Rhizoma, 0.5 jin).
Boil these herbs in 7 sheng of water until reduced to 3 sheng, filter out residue, add 2 liang of Bai Fan powder, mix well, soak cotton in the solution, and frequently wipe the rash. Afterwards, bathe in Huai Liu Tang (Locust and Willow Decoction).
Another prescription: Grind Bai Fan with Cu Jiangshui (Vinegar-water) and apply topically.