疳热攻肺成鼻疳，鼻塞赤痒痛难堪，浸淫溃烂连唇际，咳嗽气促发毛干。热盛清金化毒
效，疳虫蚀鼻化虫丸，调敷须用鼻疳散，吹鼻蝉壳效通仙。
【注】鼻疳者，因疳热攻肺而成。盖鼻为肺窍，故发时鼻塞赤痒，疼痛浸淫溃烂，下
连唇际成疮，咳嗽气促，毛发焦枯也。热盛者，宜清金散、蒋氏化毒丹主之；虫蚀者，用
化虫丸主之。外用鼻疳散敷之，或以吹鼻蝉壳散吹入鼻内。
清金散
生栀子 黄芩 枇杷叶（蜜炙） 生地黄 天花粉 连翘（去心） 麦冬（去心） 薄荷 元参 生
甘草 桔梗
引用灯心，水煎服。
【方歌】清金散治肺壅热，栀子黄芩枇杷叶，生地花粉翘麦冬，薄荷元参甘草桔。
蒋氏化毒丹（方见胎赤）
化虫丸
芜荑 芦荟（生） 青黛 川芎 白芷梢 胡黄连 川黄连 虾蟆（灰，各等分）
上为细末，猪胆汁浸糕为丸，如麻子大，每服二十丸，食后杏仁煎汤下。
鼻疳散
青黛（一钱） 麝香（少许） 熊胆（五分）
上为细末，干者用猪骨髓调贴，湿者干上。
吹鼻蝉壳散
蝉壳（微炒） 青黛（研） 蛇蜕皮（灰） 滑石 麝香（各等分细研）
上为细末，每用绿豆大，吹入鼻中，日三用之，疳虫尽出。
疳成毒热内攻胃，上发龈肉赤烂疼，口鼻血出牙枯落，穿腮蚀唇命多倾。攻毒消疳芜荑效，继以芦荟
肥儿灵，外用牙疳散时上，能食堪药始能生。
【注】牙疳者，因毒热攻胃而成。故热毒
上发，龈肉赤烂疼痛，口臭血出，牙枯脱落，穿腮蚀唇，病势危急。急用消疳芜荑汤泻其
毒热，继以芦荟肥儿丸清其余热。外用牙疳散，时时敷之自愈。总之，此证必胃强能食，
堪胜峻药，始有生机，否则难治也。
清疳芜荑汤
大黄 芒硝 芜荑 芦荟（生） 川连 胡黄连 黄芩 雄黄
水煎服，服后便软及不食者，去大黄、芒硝，加石膏、羚羊角。
【方歌】芜荑消疳大黄硝，芦荟芜荑二连标，黄芩雄黄一同入，能清积热牙疳消。
芦荟肥儿丸（方见肝疳）
牙疳散
人中白（ 存性） 绿矾（烧红） 五倍子（炒黑，各等分） 冰片（少许）
上为极细末，先用水拭净牙齿，再以此散敷之，有虫者加槟榔。
疳积之热邪上攻于肺，形成鼻疳。症状表现为鼻塞、鼻孔赤红瘙痒、疼痛难忍，病变浸淫溃烂并延伸至唇部边缘，伴有咳嗽、气促及毛发干枯。若热势炽盛，宜采用清泻肺金（清肺）、化解毒邪的方法，疗效显著；若为疳虫侵蚀鼻腔，则使用化虫丸治疗。外治需配合使用鼻疳散调敷，或用吹鼻蝉壳散吹入鼻中，效果如通神般灵验。
【注】鼻疳，是由于疳积热邪上攻于肺所致。因为鼻是肺的窍道，所以发病时出现鼻塞、鼻孔赤红瘙痒，疼痛且浸淫溃烂，向下连及唇际形成疮疡，同时伴有咳嗽、气促、毛发焦枯等症状。若热势亢盛者，适宜用清金散或蒋氏化毒丹主治；若为虫蚀所致者，用化虫丸主治。外用鼻疳散敷贴患处，或者将吹鼻蝉壳散吹入鼻内。
清金散
组成：生栀子、黄芩、枇杷叶（蜜炙）、生地黄、天花粉、连翘（去心）、麦冬（去心）、薄荷、玄参、生甘草、桔梗。
用法：引用灯心草，加水煎服。
【方歌】清金散治疗肺壅热证，方含栀子、黄芩、枇杷叶，生地、花粉、连翘、麦冬，薄荷、玄参、甘草、桔梗。
化虫丸
组成：芜荑、芦荟（生用）、青黛、川芎、白芷梢、胡黄连、川黄连、虾蟆（烧灰，各等分）。
制法与用法：上述药材研为细末，用猪胆汁浸泡米糕制成丸药，大小如麻子。每次服用二十丸，饭后用杏仁煎汤送服。
鼻疳散
组成：青黛（一钱）、麝香（少许）、熊胆（五分）。
制法与用法：上述药材研为细末。干燥型病灶用猪骨髓调和后贴敷，湿润型病灶直接干撒药粉。
吹鼻蝉壳散
组成：蝉壳（微炒）、青黛（研细）、蛇蜕皮（烧灰）、滑石、麝香（各等分，细研）。
制法与用法：上述药材研为细末。每次取绿豆大小用量，吹入鼻中，每日三次，可使疳虫尽出。
疳积日久化为毒热，内攻于胃，向上发于牙龈，导致牙龈红肿溃烂疼痛，口鼻出血，牙齿枯槁脱落，甚至穿腮蚀唇，病情危急，多危及生命。治疗宜先用攻毒消疳的芜荑汤，继以芦荟肥儿丸调理。外用牙疳散频繁敷贴，若能进食并能耐受峻猛药物，才有生机。
【注】牙疳，是由于毒热内攻于胃所致。因此热毒上炎，导致牙龈红肿溃烂疼痛，口臭出血，牙齿枯槁脱落，穿腮蚀唇，病势危急。急需用消疳芜荑汤泻除毒热，随后用芦荟肥儿丸清除残余热邪。外用牙疳散，时时敷贴即可自愈。总之，此证患者必须胃气强盛、能进食，能够承受峻猛药物的攻伐，始有生机，否则难以治愈。
清疳芜荑汤
组成：大黄、芒硝、芜荑、芦荟（生用）、川黄连、胡黄连、黄芩、雄黄。
用法：加水煎服。服药后若大便变软及不能进食者，去掉大黄、芒硝，加入石膏、羚羊角。
【方歌】芜荑消疳配大黄、芒硝，芦荟、芜荑、川连、胡黄连为标，黄芩、雄黄一同入药，能清积热使牙疳消除。
牙疳散
组成：人中白（存性）、绿矾（烧红）、五倍子（炒黑，各等分）、冰片（少许）。
制法与用法：上述药材研为极细末。先用水擦拭干净牙齿，再将此药散敷于患处。若有虫者，加槟榔。
Fan-heat attacking the Lung forms Bi Gan (Nasal Fungus). Symptoms include nasal congestion, redness and itching of the nostrils, unbearable pain, exudative ulceration extending to the lip margins, accompanied by cough, shortness of breath, and dry hair. If heat is excessive, clearing Metal (clearing the Lung) and resolving toxicity is effective; if caused by fan-worms eroding the nose, Huachong Wan (Worm-Expelling Pill) is used. For external treatment, Bigan San (Nasal Fungus Powder) should be mixed and applied, or Chuanbi Chanke San (Cicada Slough Powder for Blowing into Nose) blown into the nose, with effects as miraculous as divine intervention.
[Note] Bi Gan (Nasal Fungus) arises from Fan-heat attacking the Lung. Since the nose is the orifice of the Lung, symptoms upon onset include nasal congestion, redness and itching of the nostrils, pain with exudative ulceration extending downward to the lips forming sores, cough, shortness of breath, and scorched, dry hair. In cases of excessive heat, Qingjin San (Clear Metal Powder) or Jiangshi Huadu Dan (Jiang's Toxin-Resolving Pill) are indicated; in cases of worm erosion, Huachong Wan (Worm-Expelling Pill) is indicated. Externally, apply Bigan San (Nasal Fungus Powder), or blow Chuanbi Chanke San (Cicada Slough Powder for Blowing into Nose) into the nasal cavity.
Qingjin San (Clear Metal Powder)
Ingredients: Sheng Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Pipa Ye (Loquat Leaf, honey-fried), Sheng Dihuang (Rehmanniae Radix), Tianhuafen (Trichosanthis Radix), Lianqiao (Forsythiae Fructus, heart removed), Maidong (Ophiopogonis Radix, heart removed), Bohe (Menthae Haplocalycis Herba), Yuan Shen (Scrophulariae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix).
Usage: Use Dengxincao (Junci Medullia) as a guiding herb, decoct in water and take orally.
[Fang Ge - Prescription Verse] Qingjin San treats Lung obstruction due to heat, containing Zhizi, Huangqin, Pipa Ye, Shengdi, Tianhuafen, Lianqiao, Maidong, Bohe, Yuan Shen, Gancao, and Jiegeng.
Jiangshi Huadu Dan (Jiang's Toxin-Resolving Pill) (See formula under "Tai Chi" / Neonatal Erythema)
Huachong Wan (Worm-Expelling Pill)
Ingredients: Wuyi (Chrysobalanus fructus), Lushen (Aloe), Qingdai (Indigo Naturalis), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi Shao (Angelicae Dahuricae Radix tip), Huhuanglian (Picrorhizae Rhizoma), Chuanlianzhong (Coptidis Rhizoma), Xama (Bufo Skin, calcined), all in equal parts.
Preparation and Usage: Grind the above ingredients into fine powder. Soak rice cake in Pig Bile (Suis Fel) to form pills, size similar to hemp seeds. Take 20 pills per dose, washed down with Apricot Kernel (Xingren) decoction after meals.
Bigan San (Nasal Fungus Powder)
Ingredients: Qingdai (Indigo Naturalis, 1 qian), Shexiang (Moschus, a small amount), Xiongdan (Ursi Fel, 5 fen).
Preparation and Usage: Grind the above ingredients into fine powder. For dry lesions, mix with Pig Marrow (Zhui Suigu) and apply; for wet lesions, sprinkle the powder directly.
Chuanbi Chanke San (Cicada Slough Powder for Blowing into Nose)
Ingredients: Chanke (Cicada Slough, lightly stir-fried), Qingdai (Indigo Naturalis, ground), Shetui Pi (Bovis Serpentis Cutis, calcined), Huashi (Talcum), Shexiang (Moschus), all in equal parts, finely ground.
Preparation and Usage: Grind the above ingredients into fine powder. Use an amount the size of a mung bean each time, blow into the nose, three times daily, until all fan-worms are expelled.
Fan accumulation transforms into toxic heat, attacking the Stomach internally and manifesting upwards on the gums, causing redness, ulceration, and pain of the gingival flesh. Blood flows from the mouth and nose, teeth become withered and fall out, cheeks are perforated and lips eroded, leading to a critical condition with high mortality. Treatment requires Gongdu Xiaogan (Attacking Toxicity and Eliminating Fan) using Wuyi Tang, followed by Lushen Fei'er Ling. Externally, apply Yagan San (Dental Fungus Powder) frequently. Survival depends on the patient's ability to eat and tolerate strong medications.
[Note] Yagan (Dental Fungus) is caused by toxic heat attacking the Stomach. Thus, toxic heat flares upward, causing redness, ulceration, and pain of the gingival flesh, bad breath, bleeding, withered and falling teeth, perforation of cheeks and erosion of lips, indicating a critical disease state. Urgently use Xiao gan Wuyi Tang (Eliminate Fan Wuyi Decoction) to purge toxic heat, then follow with Lushen Fei'er Wan (Aloe Child-Nourishing Pill) to clear residual heat. Externally apply Yagan San (Dental Fungus Powder) frequently for self-healing. In summary, this condition requires strong Stomach Qi and the ability to eat, allowing the patient to withstand harsh drugs, to have a chance of survival; otherwise, it is difficult to treat.
Qinggan Wuyi Tang (Clear Fan Wuyi Decoction)
Ingredients: Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Wuyi (Chrysobalanus fructus), Lushen (Aloe, raw), Chuanlian (Coptidis Rhizoma), Huhuanglian (Picrorhizae Rhizoma), Huangqin (Scutellariae Radix), Xionghuang (Realgar).
Usage: Decoct in water and take orally. If stool becomes soft and appetite is lost after taking the medicine, remove Dahuang and Mangxiao, and add Shigao (Gypsum Fibrosum) and Lingyangjiao (Saiga Tataricae Cornu).
[Fang Ge - Prescription Verse] Wuyi eliminates Fan combined with Dahuang and Mangxiao; Lushen, Wuyi, Chuanlian, and Huhuanglian address the root; Huangqin and Xionghuang enter together, clearing accumulated heat and eliminating dental fungus.
Lushen Fei'er Wan (Aloe Child-Nourishing Pill) (See formula under "Gan Gan" / Liver Fan)
Yagan San (Dental Fungus Powder)
Ingredients: Renzhongbai (Calcinata Uraei), Lvfan (Vitriolum Viride, fired red), Wubeizi (Galla Chinensis, stir-fried black), Bingpian (Borneolum Syntheticum), all in equal parts except Bingpian which is a small amount.
Preparation and Usage: Grind the above ingredients into extremely fine powder. First clean the teeth with water, then apply this powder to the affected area. If worms are present, add Binglang (Arecae Semen).