脾经脉络绕唇口,出痘始终贵润红,紫裂焦黑急宜治,葛根解毒二方从。
【注】脾经之脉络绕于唇口,故经曰∶六腑之华在唇。必津液充足,气血和畅,唇口
方能红润,故出痘之始终以此为贵。不然,一为毒火所制,则毒乘于中,热炽于外,不惟
不能红润,且或赤、或紫、或焦裂者,治皆不可缓也。初宜加味升麻葛根汤,起胀后,则
以黄连解毒汤治之。
加味升麻葛根汤
赤芍 栀子 藿香 升麻 葛根 生甘草 防风 石膏
水煎服。
【方歌】加味升麻葛根汤,赤芍栀子与藿香,升麻葛根生甘草,防风石膏共煎尝。
黄连解毒汤(方见结痂落痂证治)
痘后牙疳毒热攻,口臭龈肿多痛疼,内服清热凉血饮,外敷中白散极灵。
【注】痘后生牙疳者,乃余毒未解,上攻牙齿而然也。初起口臭龈肿,牙缝出血,尚
觉疼痛;甚则色黑腐烂,牙齿脱落,穿腮破颊,蚀透鼻唇,多至不救。见之须急急调治,
内服清毒凉血饮,外敷人中白散。
清毒凉血饮
知母 石膏 生地 黄连 当归 赤芍 大黄 山栀子 丹皮 荆芥穗 连翘(去心)
水煎服。
【方歌】清毒凉血治牙疳,知母石膏生地连,归芍大黄山栀子,丹皮荆穗连翘煎。
人中白散
人中白( ,二钱) 雄黄(八分) 冰片(四分) 硼砂 青黛 儿茶(各一钱)
共为细末,搽敷患处。
脾经的脉络环绕嘴唇和口腔,在出痘(天花)的过程中,唇口始终保持滋润红润是最为珍贵的。如果出现紫色、开裂、焦黑等症状,必须紧急治疗,遵循葛根解毒汤的两个方剂进行治疗。
【注释】脾经的脉络环绕于嘴唇和口腔,所以医经中说:“六腑的精气荣华表现在嘴唇。”只有津液充足,气血运行和畅,嘴唇和口腔才能呈现红润状态,因此在出痘的全过程中,以唇口红润为贵。如果不是这样,一旦受到毒火的制约,毒邪就会乘虚侵入体内,热势在体表炽盛,不仅不能保持红润,反而会出现红色、紫色或焦裂的情况,治疗都不可迟缓。初期适宜使用加味升麻葛根汤,在痘疹起发之后,则使用黄连解毒汤进行治疗。
加味升麻葛根汤
赤芍 栀子 藿香 升麻 葛根 生甘草 防风 石膏
用水煎煮后服用。
【方歌】加味升麻葛根汤,由赤芍、栀子和藿香组成,加上升麻、葛根和生甘草,再用防风、石膏共同煎煮服用。
黄连解毒汤(该方见结痂落痂证治章节)
痘疹痊愈后出现牙疳,是毒热上攻所致,表现为口臭、牙龈肿胀且多伴有疼痛,内服清热凉血饮,外敷中白散效果极佳。
【注释】痘疹后发生牙疳,是因为余毒未解,向上攻冲牙齿而导致的。初期表现为口臭、牙龈肿胀,牙缝出血,尚且感到疼痛;严重时则颜色变黑腐烂,牙齿脱落,甚至穿透腮帮、打破脸颊,腐蚀透鼻唇部位,大多导致无法救治。见到这种情况必须紧急调治,内服清毒凉血饮,外敷人中白散。
清毒凉血饮
知母 石膏 生地 黄连 当归 赤芍 大黄 山栀子 丹皮 荆芥穗 连翘(去心)
用水煎煮后服用。
The meridians of the Spleen channel encircle the lips and mouth. Throughout the course of variola (smallpox), it is most valuable for the lips and mouth to remain moist and ruddy. If they turn purple, crack, or become scorched and black, immediate treatment is required, following the two formulas of Gegen Jiedu Tang (Kudzu Root Detoxification Decoction).
[Note] The meridians of the Spleen channel encircle the lips and mouth; hence, the classic texts state: "The brilliance of the six fu-organs manifests in the lips." Only when body fluids are sufficient and qi and blood flow smoothly can the lips and mouth appear ruddy. Therefore, throughout the onset of variola, maintaining ruddy lips and mouth is paramount. Otherwise, if constrained by toxic heat, the toxin penetrates inward while heat blazes outward. Not only will the lips fail to remain ruddy, but they may also turn red, purple, or scorched and cracked. In such cases, treatment must not be delayed. Initially, Jiawei Shengma Gegen Tang (Modified Cinnamon Twig and Kudzu Root Decoction) is appropriate; after the pustules have risen, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) should be used.
Jiawei Shengma Gegen Tang (Modified Cinnamon Twig and Kudzu Root Decoction)
Chi Shao (Radix Paeoniae Rubra), Zhi Zi (Fructus Gardeniae), Huo Xiang (Herba Pogostemonis), Sheng Ma (Rhizoma Cimicifugae), Ge Gen (Radix Puerariae), Sheng Gan Cao (Radix Glycyrrhizae Preparata), Fang Feng (Radix Saposhnikoviae), Shi Gao (Gypsum Fibrosum).
Decoct in water and take orally.
[Formula Song] Jiawei Shengma Gegen Tang consists of Chi Shao, Zhi Zi, and Huo Xiang; combined with Sheng Ma, Ge Gen, and Sheng Gan Cao, decocted together with Fang Feng and Shi Gao for consumption.
Huanglian Jiedu Tang (See section on Crusting and Scabbing for formula details).
After recovery from variola, if noma (gangrenous stomatitis) occurs due to toxic heat attacking upward, symptoms include bad breath, swollen gums, and significant pain. Internally administer Qingre Liangxue Yin (Clear Heat and Cool Blood Decoction); externally apply Zhongbai San (Middle White Powder) for excellent efficacy.
[Note] Noma occurring after variola results from residual toxins that have not been resolved, attacking upward to the teeth. In the early stage, there is bad breath, gum swelling, bleeding from the gingival sulcus, and pain. In severe cases, the tissue turns black and rots, teeth fall out, and the condition perforates the cheeks and breaks the facial skin, eroding through the nose and lips, often leading to untreatable outcomes. Upon observing this, urgent treatment is necessary: internally administer Qingdu Liangxue Yin (Clear Toxin and Cool Blood Decoction) and externally apply Renzhongbai San (Human Urine Deposit Powder).
Qingdu Liangxue Yin (Clear Toxin and Cool Blood Decoction)
Zhi Mu (Rhizoma Anemarrhenae), Shi Gao (Gypsum Fibrosum), Sheng Di Huang (Radix Rehmanniae Preparata), Huang Lian (Rhizoma Coptidis), Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), Da Huang (Radix et Rhizoma Rhei), Shan Zhi Zi (Fructus Gardeniae), Dan Pi (Cortex Moutan), Jing Jie Sui (Herba Schizonepetae), Lian Qiao (Fructus Forsythiae, heart removed).
Decoct in water and take orally.
[Formula Song] Qingdu Liangxue Yin treats noma; it contains Zhi Mu, Shi Gao, Sheng Di, and Huang Lian. Combined with Dang Gui, Chi Shao, Da Huang, Shan Zhi Zi, Dan Pi, Jing Jie Sui, and Lian Qiao, decoct for use.
Renzhongbai San (Human Urine Deposit Powder)
Renzhong Bai (Calculus Humanus, calcined, 2 qian), Xiong Huang (Realgar, 8 fen), Bing Pian (Borneolum Syntheticum, 4 fen), Peng Sha (Borax), Qing Dai (Indigo Naturalis), Er Cha (Camellia Seed, each 1 qian).
Grind all into a fine powder and apply topically to the affected area.