帝曰∶首面与身形也,属骨连筋同血,合于气耳。天寒则冽,地凌则冰。其卒寒,或手足懈
惰,然其面不衣何也?岐伯曰∶十二经脉,三百六十五络,其气血皆上于面而走空窍。其精阳气
上走于目而为晴;其别气走于耳而为听;其宗气上出于鼻而为臭;其浊气出于胃,走唇舌而为味
。其气之津液,皆上熏于面,而皮浓肉坚,故大寒、甚热不能胜之也。又曰∶头者,诸阳之会也
。然诸阳脉皆上于头,而面之寒热,由足阳明胃经之虚实。本经多血多气,木实则风热上行,或
面鼻红紫,风刺、瘾疹兼而作焉。其面之浮肿,有二者之别。肿属肝风,胃火为实,风火上炎,
红肿而热,按之作痛。此邪气有余,脉必
躁急紧实,当用防风通圣散之类(方见中风)散而泻之。浮属脾土,肺金为虚,脾伤劳役,肺气
失度,或时作喘,此正气不足,脉必虚浮无力。当用利水实脾汤之类(方见湿证)导而利之。
主方 (面生疮疹)
防风(一钱) 连翘 黄连 酒芩 桔梗 川芎 白芷 栀子(炒。各七分) 薄荷 升麻(
各五分) 甘草(三分)水煎服。加竹沥尤佳。
头面疮加芍、地、玄、荆之类。便实,大黄。
升麻附子汤 治面作寒,畏风冷。
升麻 葛根 附子(炮) 黄 白芷(各七分) 人参 草豆蔻 益智仁 炙草(各三分)
上加葱白三茎,水煎服。
犀角黄连汤 治面作热,燥赤。
犀角 黄连 白芍 酒芩 白芷 炙草 川芎(各五分) 薄荷 荆芥(各三分) 升麻
葛根(各钱半)
水煎服。膏粱之士,面热生疮加大黄、芒硝、连翘,去芷、芎、葛,研末调服。
美容膏 治面生黑 雀斑,单用密陀僧研末,人乳敷亦妙。
防风 零陵 本(各二两) 白芨 白附子 白蔹 天粉 绿豆粉 僵蚕 白芷(各一两)
甘松 三奈 茅香(各五钱) 肥皂(去皮弦)
共为末,蜜和捣匀擦。或白茯苓、白芨,白附、白蔹为末,密陀僧、淀粉、白石脂(另研)
等分,人乳
调敷过夜。
简便方 面疮毒。
黄连、黄柏为末,入铅粉,油调敷。
指爪伤面∶生姜自然汁调轻粉敷,无痕。
面 ∶僵蚕、白芷、细辛等分为末,人乳和丸芡实大,洗面化涂。
粉刺∶菟丝子,浸数日,捣绞汁涂。或白矾末酒调搽。
面上卒得紫黑丹如疹,至遍身杀人。急用鹿角烧灰,香油调搽。
面目身上赤斑作痒肿, 羊角烧灰研细,鸡子清调搽。
黄帝问道:头部和面部与身体其他部位相比,虽然都归属于骨骼、连接着筋脉、共同拥有血液,并合于气机运行。天气寒冷时变得凛冽,地气寒冷时结成冰凌。当突然遭遇严寒时,有时会出现手足懈怠无力的情况,然而为什么面部却不需要衣物保暖呢?
岐伯回答说:十二经脉以及三百六十五络脉,它们的气血都向上汇聚于面部并通达各个孔窍。其中精纯的阳气上行至眼睛而形成视觉;别行之气上行至耳朵而形成听觉;宗气上行出于鼻腔而形成嗅觉;浊气从胃中出来,经过嘴唇和舌头而形成味觉。这些气中的津液,也都向上熏蒸于面部,加上面部皮肤厚实、肌肉坚实,所以极寒或极热的气候都不能伤害它。
又说:头部是诸阳经交汇的地方。既然所有阳经的脉气都上达头部,那么面部的寒热变化,主要取决于足阳明胃经的虚实状况。本经(足阳明胃经)多血多气,如果木气(肝气)亢盛则导致风热上行,可能出现鼻部和面部红紫,伴有风刺(粉刺)、瘾疹(荨麻疹)等症状同时发作。
面部的浮肿,有两种不同的区别。肿胀属于肝风内动,若兼有胃火实证,风火之气上炎,会导致面部红肿且发热,按压时会感到疼痛。这是邪气有余的表现,脉象必定躁急紧实,应当使用防风通圣散之类的方剂来疏散并泻下邪气。浮肿属于脾土虚弱,肺金不足,因脾胃受损、劳役过度,导致肺气失去调节,有时出现喘息症状,这是正气不足的表现,脉象必定虚浮无力。应当使用利水实脾汤之类的方剂来引导并利水消肿。
主方(治疗面部生疮疹):
防风一钱,连翘、黄连、酒炒黄芩、桔梗、川芎、白芷、栀子(炒制,各七分),薄荷、升麻(各五分),甘草三分。用水煎服。加入竹沥效果更佳。
若头面部疮疡加重,可加芍药、地黄、玄参、荆芥等药物。若大便干结,加用大黄。
升麻附子汤:治疗面部感觉寒冷,怕风冷。
升麻、葛根、炮附子、黄芪、白芷(各七分),人参、草豆蔻、益智仁、炙甘草(各三分)。上方加入葱白三茎,用水煎服。
犀角黄连汤:治疗面部感觉发热,干燥赤红。
犀角、黄连、白芍、酒炒黄芩、白芷、炙甘草、川芎(各五分),薄荷、荆芥(各三分),升麻、葛根(各钱半)。
用水煎服。对于饮食肥甘厚味之人,若面部发热生疮,加大黄、芒硝、连翘,去掉白芷、川芎、葛根,研成粉末调服。
美容膏:治疗面部产生黑斑、雀斑。单用密陀僧研成粉末,用人乳调和敷贴也很奇妙。
防风、零陵香、藁本(各二两),白及、白附子、白蔹、天花粉、绿豆粉、僵蚕、白芷(各一两),甘松、三奈、茅香(各五钱),肥皂(去皮和弦)。
以上药物共研为细末,用蜂蜜调和捣匀后擦拭。或者使用白茯苓、白及、白附子、白蔹研成粉末,与密陀僧、淀粉、白石脂(分别研细)等量混合,用人乳调和过夜敷贴。
简便方:治疗面部疮毒。
黄连、黄柏研成粉末,加入铅粉,用油调和后敷贴。
指甲抓伤面部:用生姜自然汁调和轻粉敷贴,不留痕迹。
面部黧黑:将僵蚕、白芷、细辛等分研成粉末,用人乳调和制成如芡实大小的丸剂,洗脸时化开涂抹。
粉刺:菟丝子浸泡数日,捣碎绞取汁液涂抹。或者用白矾粉末调酒搽擦。
面上突然得到紫黑色丹毒如疹状,甚至遍及全身会致死。紧急情况下用鹿角烧成灰,用香油调和搽擦。
面目身上出现红色斑块,瘙痒肿胀:用羚羊角烧成灰研细,用鸡蛋清调和搽擦。
The Yellow Emperor asked: The head and face, compared to the rest of the body, are connected to bones and tendons, share blood, and integrate with Qi. When heaven is cold, it becomes biting; when earth is cold, ice forms. In sudden severe cold, sometimes the limbs become flaccid and weak, yet why does the face not require clothing for warmth?
Qibo replied: The twelve primary meridians and the three hundred and sixty-five collaterals all direct their Qi and Blood upward to the face and through its orifices. The refined Yang Qi ascends to the eyes to form vision; the branch Qi ascends to the ears to form hearing; the Zong Qi (Gathering Qi) ascends out of the nose to form smell; the turbid Qi emerges from the Stomach, passing through the lips and tongue to form taste. The fluids and essence of these Qi all steam upward to bathe the face. Furthermore, the facial skin is thick and the flesh firm, so extreme cold or extreme heat cannot overcome it.
It is also said: The head is the convergence point of all Yang meridians. Since all Yang meridians ascend to the head, the coldness or heat of the face depends on the deficiency or excess of the Foot-Yangming Stomach Meridian. This meridian is abundant in both Blood and Qi. If Wood Qi (Liver Qi) becomes excessive, wind-heat ascends, potentially causing redness and purpleness of the face and nose, accompanied by acneiform eruptions and urticaria.
Facial edema has two distinct types. Swelling associated with Liver Wind, combined with Stomach Fire excess, causes wind-fire to flare upward, resulting in red, swollen, hot areas that are painful upon pressure. This indicates an excess of pathogenic factors, and the pulse will be restless, rapid, tight, and solid. One should use formulas such as Fangfeng Tongsheng San (Saposhnikovia Decoction to Unblock the Heroic) to disperse and purge the pathogen. Edema associated with Spleen Earth deficiency and Lung Metal insufficiency, often due to Spleen damage from overwork, leading to loss of Lung Qi regulation and occasional panting, indicates a deficiency of righteous Qi. The pulse will be deficient, floating, and forceless. One should use formulas such as Lishui Shipi Tang (Water-Draining Spleen-Strengthening Decoction) to guide and promote diuresis.
Main Formula (for facial carbuncles and rashes):
Fangfeng (Radix Saposhnikoviae, 1 qian), Lianqiao (Fructus Forsythiae), Huanglian (Rhizoma Coptidis), Jiu Qin (Radix Scutellariae prepared with wine), Jiegeng (Radix Platycodonis), Chuanxiong (Rhizoma Chuanxiong), Baizhi (Radix Angelicae Dahuricae), Zhizi (Fructus Gardeniae, stir-fried, each 0.7 fen), Bohe (Herba Menthae), Shengma (Rhizoma Cimicifugae, each 0.5 fen), Gancao (Radix Glycyrrhizae, 0.3 fen). Decoct in water and take orally. Adding Zhuli (Bamboo Sap) is especially effective.
For worsening head and facial sores, add Shaoyao (Radix Paeoniae Alba), Dihuang (Radix Rehmanniae), Xuanshen (Radix Scrophulariae), Jingjie (Herba Schizonepetae). For constipation, add Dahuang (Radix et Rhizoma Rhei).
Shengma Fuzi Tang (Cimicifuga and Aconite Decoction): Treats facial coldness and aversion to wind and cold.
Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae), Paofu Zi (Radix Aconiti Lateralis Preparata), Huangqi (Radix Astragali), Baizhi (Radix Angelicae Dahuricae, each 0.7 fen), Renshen (Radix Ginseng), Caodoukou (Fructus Cardamomi), Yizhiren (Semen Alpiniae Oxyphyllae), Zhigancao (Radix Glycyrrhizae Preparata, each 0.3 fen). Add three stalks of Congbai (White part of Allium fistulosum) to the above, decoct in water, and take orally.
Xijiao Huanglian Tang (Rhinoceros Horn and Coptis Decoction): Treats facial heat, dryness, and redness.
Xijiao (Cornu Rhinocerotis), Huanglian (Rhizoma Coptidis), Baishao (Radix Paeoniae Alba), Jiu Qin (Radix Scutellariae prepared with wine), Baizhi (Radix Angelicae Dahuricae), Zhigancao (Radix Glycyrrhizae Preparata), Chuanxiong (Rhizoma Chuanxiong, each 0.5 fen), Bohe (Herba Menthae), Jingjie (Herba Schizonepetae, each 0.3 fen), Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae, each 1.5 qian).
Decoct in water and take orally. For individuals consuming rich and greasy foods, if facial heat generates sores, add Dahuang (Radix et Rhizoma Rhei), Mangxiao (Natrii Sulfas), Lianqiao (Fructus Forsythiae); remove Baizhi, Chuanxiong, and Gegen; grind into powder and mix for oral administration.
Meirong Gao (Beauty Paste): Treats facial black spots and freckles. Using Miduoseng (Litharge) ground into powder and applied with human milk is also excellent.
Fangfeng (Radix Saposhnikoviae), Lingling (Herba Lingzhi), Ben (Radix Ligustici Wallichii, each 2 liang), Baiji (Tuber Bletillae), Baifuzi (Rhizoma Typhonii), Bailian (Bulbus Lilii), Tianfen (Radix Trichosanthis), Lvdoufen (Pulse Vigna Radiatae Amylum), Jiangcan (Bombyx Batryticatus), Baizhi (Radix Angelicae Dahuricae, each 1 liang), Gansong (Rhizoma Nardostachyos), Sansai (Rhizoma Kaempferiae), Maoxiang (Rhizoma Cyperi Rotundi, each 5 qian), Feizaobi (Pericarpium Citri Reticulatae, peeled and deseeded).
Grind all into powder, mix evenly with honey, and rub onto the skin. Alternatively, use Baifuling (Poria), Baiji (Tuber Bletillae), Baifuzi (Rhizoma Typhonii), Bailian (Bulbus Lilii) ground into powder, mixed equally with Miduoseng (Litharge), Dianfen (Starch), Baishizhi (Kaolinite), separately ground fine, and applied overnight mixed with human milk.
Simple Prescription: For facial carbuncle toxins.
Huanglian (Rhizoma Coptidis) and Huangbai (Cortex Phellodendri) ground into powder, mixed with Qianfen (Basic Lead Carbonate), and applied with oil.
Scratches from fingernails on the face: Apply Qingfen (Calomel) mixed with fresh ginger juice; leaves no scar.
Darkened complexion: Jiangcan (Bombyx Batryticatus), Baizhi (Radix Angelicae Dahuricae), Xixin (Radix Asari) ground into equal parts powder, mixed with human milk to form pills the size of Euryale seed, dissolve and apply while washing the face.
Acne: Tusi Zi (Semen Cuscutae) soaked for several days, crushed, juiced, and applied. Or apply Baifan (Alumen) powder mixed with wine.
Sudden purple-black dan-toxin resembling rash on the face, spreading to the whole body which can be fatal: Urgently use Lu Jiao (Cornu Cervi) burned to ash, mixed with sesame oil and applied.
Red patches on face and body, itchy and swollen: Lingyang Jiao (Cornu Saigae Tataricae) burned to ash, finely ground, mixed with egg white and applied.