薛 憎寒发热头痛，脑如雷鸣，一夕顶发块 甚多，延及项后，都成疙瘩。俗医以为外症，用敷药罔效。
诊其脉浮大，审知为雷头风，按东垣先生论此症状，类伤寒，病在三阳，不可过用寒凉重剂，诛伐无过，故刘河
间立清震汤治之。用升麻（三钱）、苍术（米泔浸，炒，四钱）、青荷叶（一枝）、薄荷（三钱），如法，
二服立消。此痰火上升，故成结核肿痛。用苍术除湿痰，薄荷散风火，升麻、荷叶引入巅顶，升发阳气，自得汗
而肿消。
（肾脏风 绣球风 雁来风 蛇皮风 鹅掌风 赤白游风 紫白癜风 紫云风 癣疥癞斑 附）
疠风，恶疾也，俗名大麻风。其症皮肉麻顽，身面疙瘩，摄之则痒痛腐溃，渐至目红鼻赤，四体挛搐，
头面突肿。盖中天地间一种风毒厉气，淫于腑脏骨髓，注于经络肢节，久而后发，亦有骨肉传染而得者。立斋分
别五脏受病，谓眉先落者毒在肺，面发紫泡者毒在肝，足底痛或穿者毒在肾，遍身如癣者毒在脾，目
先损者毒在心。一皮死，麻木不仁；二肉死，针刺不痛；三血死，溃烂流脓；四筋死，指脱趾堕；五骨死，
鼻柱崩塌。至于声哑目盲，皆为难治。《内经》治法，以锐针刺其肿上，出恶血，重泄毒也。其恶血滞在肌
表经络者，宜汗宜刺，汗用紫萍散，刺取委中穴。毒蕴腑脏，非荡涤不除，如凉膈双解之类。毒在外，非砭针
不散，砭刺臂腿手足指缝出血。表里毒盛，非外砭内泄不退。上体患多，以醉仙散取毒血从齿缝中出，并刺臂
腕指缝。下体患多，以再造散取虫积从谷道中出，仍针腿胫趾缝。上下相等，用必胜散兼取。治法内通腑脏，外
达经络，养营益卫，补正逐邪。若妄投燥热，脓水淋漓，肝血益涸，风热益炽，肾水益伤矣。初起头面搔痒，
发出红紫疹块者，用防风通圣散加苦参、天麻、蝉蜕数服，接服八珍汤，圣愈汤。外用白玉蟾浴汤加羌活、薄
荷、葱白煎洗。浴后，白玉蟾擦药搽。凡遍体肿块，以生姜蘸擦药擦之。其燥起白屑，系血不荣肤。四物汤加
荆、防、白芷、地骨皮。搔如隔帛，系气不充表。养营汤。面部麻木，系气血不能上荣。补中益气汤加川芎、
白附。瘾疹赤晕，系风热入营。实者胡麻散，虚者祛风丸。疙瘩破痒，系风毒伤血。羌活当归散，或当归饮加
山栀、钩藤。指节挛拳，系阴火烁筋。加味逍遥散加钩藤，与换肌散间服。鼻赤眉落，属肺经风热。人参消风
散加天麻、僵蚕。面发紫泡、属肝经风毒。栀子清肝汤加钩藤、金银花，兼服六味丸。筋骨挛痛，属肝肾阴虚。
六味地黄汤。口眼 斜，属风动痉厥。用全蝎酒洗，盐焙，研，僵蚕、白附子末各七钱，每服钱半。寒热往来，
小柴胡汤。阳虚怯冷，补中益气汤、十全大补汤。疮久溃烂，掺红玉散、敷坎离膏。足心穿破，服六味汤、
掺香珠散。气血亏败，固命丹。通治风癞， 丸、胡麻丸。一切毒疠危症，五龙丸、千年药、东华玉髓、
冯夷琼浆，诸方选用。若夫疠疡类症，则有两 如癣，虫蚀成疮者，为肾脏风。用四生散以去风邪，六味丸以滋
肾水。肾囊湿痒者，为绣球风。蛇床子汤加川椒、茴香、葱。皮顽肌燥，至秋痒发者，为雁来风。宜羌活白芷
散，或加味逍遥散。肤裂痒痛，形似蛇纹者，为蛇皮风。初用火龙散，继服补剂，外用雄黄、硫黄、朱砂、
赭石、枯矾、川椒、樟脑研，香油调擦。掌心顽浓，白皮鳞屑者，为鹅
掌风。内服大消风散，外用土槿皮、川椒煎汤熏洗，再用桐油调鸽粪擦之。臂腿 ，游走不定者，为赤白游
风。赤用加味逍遥散，白用人参消风散。其肌肉斑驳，紫白为紫白癜风。通用川附、硫黄研末，姜汁调匀，
茄蒂擦之，或用水银、轻粉，调姜汁擦之。身发紫斑，延晕如霞者，为紫云风。何首乌散加 、蛇床子、
夏枯草煎洗。牛皮顽癣，用火酒浸土槿皮、大枫子、雄黄、川椒、羌活、斑蝥、朝脑、红砒、烟膏、明矾，
以穿山甲刮破，笔擦之。新久疥癫，一扫光。夏月汗斑、用密陀僧末、洋糖，醋调，黄瓜蒂擦之。雀斑酒刺，
白屑风痒，玉肌散擦。此因疠风类及之。他如脱跟、鱼鳞、 蚝、虼蚤、鸡爪等风，不过多立名色。前明沈
氏专科，前明沈之间着《解围元薮》四卷，皆论风癞治法。以祛风、泻火、杀虫、排毒为先，补血、壮元、导
滞、坚筋相济。忌用熏刺锋镰轻粉，戒房室，禁炙爆盐酱，大枫子性畏盐。及一切辛荤动风食品，方可延生，
否则愈而再发，必死。昔孙真人治此症百余人，得免于死者二。朱丹溪治五人，得免者仅一妇人，然则疠岂
易治哉？
薛氏医案：患者憎寒发热、头痛，头部感觉如雷鸣般作响，一夜之间头顶长出许多肿块，蔓延至后颈部，全部结成疙瘩。庸医误认为是外部皮肤病，使用外敷药物无效。
诊察其脉象浮大，确知为雷头风证。依据李东垣先生对此症状的论述，此病类似伤寒，病位在三阳经，不可过度使用寒凉重剂，以免无端损伤正气。因此刘河间创立了清震汤来治疗此病。方用升麻（三钱）、苍术（米泔水浸泡，炒制，四钱）、青荷叶（一枝）、薄荷（三钱），按常规方法煎服，服用两剂后症状立即消除。这是因为痰火上升，从而形成结核肿痛。方中苍术用于除湿化痰，薄荷疏散风火，升麻和荷叶引导药力到达头顶，升发阳气，自然得汗而肿胀消退。
（附：肾脏风、绣球风、雁来风、蛇皮风、鹅掌风、赤白游风、紫白癜风、紫云风、癣疥癞斑）
疠风是一种恶疾，俗称大麻风。其症状表现为皮肤肌肉麻木僵硬，身体面部出现疙瘩，抓挠则感到痒痛、腐烂溃破，逐渐发展到眼睛发红、鼻子赤红，四肢抽搐拘挛，头面部突然肿胀。这大概是天地间一种风毒厉气，侵入脏腑骨髓，流注于经络肢节，日久后才发作，也有通过骨肉接触传染而得的。薛立斋分别论述五脏受邪的情况，认为眉毛先脱落的是毒在肺，面部出现紫色水泡的是毒在肝，足底疼痛或穿孔的是毒在肾，全身像癣一样的是毒在脾，眼睛先受损的是毒在心。第一种情况是皮死，表现为麻木不仁；第二种是肉死，针刺不觉疼痛；第三种是血死，溃烂流脓；第四种是筋死，手指脚趾脱落；第五种是骨死，鼻梁崩塌。至于声音嘶哑、双目失明，都属于难治之症。《内经》的治疗方法是，用锐针刺破肿胀处，放出恶血，以重泄毒素。对于滞留在肌表经络中的恶血，宜用发汗法或针刺法，发汗可用紫萍散，针刺选取委中穴。若毒蕴结在脏腑，非荡涤清除不能去除，如凉膈双解散之类的方剂。若毒在体表，非砭石针刺不能消散，需砭刺手臂、腿部、手足指缝出血。若表里毒盛，非外用砭刺、内用泻下不能退除。上部患病多者，用醉仙散取毒血从齿缝中流出，并针刺手臂手腕指缝。下部患病多者，用再造散取虫积从肛门排出，仍针刺腿胫趾缝。上下患病相等者，用必胜散兼取。治疗方法内部通达脏腑，外部达于经络，滋养营血、益固卫气，补益正气、驱逐邪气。如果妄投燥热药物，会导致脓水淋漓，肝血更加枯竭，风热更加炽盛，肾水更加受伤。初起时头面搔痒，发出红紫色疹块者，用防风通圣散加苦参、天麻、蝉蜕服用数剂，接着服用八珍汤、圣愈汤。外用白玉蟾浴汤加羌活、薄荷、葱白煎水清洗。洗浴后，用白玉蟾擦药涂抹。凡是遍体肿块，用生姜蘸擦药擦拭。皮肤干燥起白屑，属于血不能荣养肌肤。用四物汤加荆芥、防风、白芷、地骨皮。搔痒感如同隔着布帛，属于气不能充实体表。用养营汤。面部麻木，属于气血不能上荣。用补中益气汤加川芎、白附子。瘾疹伴有红色晕圈，属于风热入营。实证用胡麻散，虚证用祛风丸。疙瘩破溃瘙痒，属于风毒伤血。用羌活当归散，或当归饮子加山栀、钩藤。指节挛缩成拳状，属于阴火灼伤筋脉。用加味逍遥散加钩藤，与换肌散交替服用。鼻子赤红、眉毛脱落，属于肺经风热。用人参消风散加天麻、僵蚕。面部出现紫色水泡，属于肝经风毒。用栀子清肝汤加钩藤、金银花，兼服六味丸。筋骨挛缩疼痛，属于肝肾阴虚。用六味地黄汤。口眼歪斜，属于风动痉厥。用全蝎酒洗，盐焙，研末，与僵蚕、白附子末各七钱混合，每次服用一钱半。寒热往来，用小柴胡汤。阳虚怯冷，用补中益气汤、十全大补汤。疮口久不愈合溃烂，掺红玉散，敷坎离膏。足心穿破，服用六味汤，掺香珠散。气血亏败，用固命丹。通用治疗风癞，用[缺失药名]丸、胡麻丸。一切毒疠危重症，选用五龙丸、千年药、东华玉髓、冯夷琼浆等方剂。至于疠疡类病症，有两种情况如癣，虫蚀成疮的，称为肾脏风。用四生散以祛除风邪，六味丸以滋补肾水。肾囊湿痒的，称为绣球风。用蛇床子汤加川椒、茴香、葱。皮肤僵硬肌肉干燥，到秋天瘙痒发作的，称为雁来风。宜用羌活白芷散，或加味逍遥散。皮肤开裂痒痛，形状似蛇纹的，称为蛇皮风。初起用火龙散，继服补剂，外用雄黄、硫黄、朱砂、赭石、枯矾、川椒、樟脑研末，香油调匀擦拭。掌心僵硬流脓，有白色皮屑的，称为鹅掌风。内服大消风散，外用土槿皮、川椒煎汤熏洗，再用桐油调和鸽粪擦拭。手臂腿部[缺失症状描述]，游走不定的，称为赤白游风。红色用加味逍遥散，白色用人参消风散。肌肉斑驳，紫白相间的，称为紫白癜风。通用川乌、硫黄研末，姜汁调匀，用茄蒂擦拭，或用水银、轻粉，调姜汁擦拭。身体发出紫斑，蔓延晕圈如霞光的，称为紫云风。用何首乌散加[缺失药名]、蛇床子、夏枯草煎水清洗。牛皮顽癣，用火酒浸泡土槿皮、大枫子、雄黄、川椒、羌活、斑蝥、樟脑、红砒、烟膏、明矾，用穿山甲刮破患处，用笔涂抹。新久疥癫，用一扫光。夏季汗斑，用密陀僧末、洋糖，醋调，黄瓜蒂擦拭。雀斑酒刺，白屑风痒，用玉肌散擦拭。这些是因为疠风类同而提及的。其他如脱跟、鱼鳞、[缺失]、蚝、虼蚤、鸡爪等风，不过是多立名目而已。前明沈氏专科医生，著有《解围元薮》四卷，都是论述风癞的治疗方法。以祛风、泻火、杀虫、排毒为先，补血、壮元、导滞、坚筋相辅相成。忌用熏刺锋镰轻粉，戒除房事，禁食炙爆盐酱，大枫子性畏盐。以及一切辛荤动风食品，方可延寿，否则痊愈后再发，必死无疑。昔日孙真人治疗此症百余人，免于死亡的只有两人。朱丹溪治疗五人，免于死亡的仅一名妇人，那么疠风难道容易治疗吗？
Case Record of Xue: The patient suffered from aversion to cold, fever, headache, and a sensation in the head as if thunder were rumbling. Overnight, many lumps appeared on the top of the head, extending to the back of the neck, all forming nodules. Quack doctors mistakenly considered it an external skin disease and applied topical medicines without effect.
Upon palpating the pulse, which was floating and large, it was confirmed as Lei Tou Feng (Thunder Head Wind). According to Li Dongyuan's discussion on these symptoms, this condition resembles Taiyang Cold Damage (Shanghan), involving the Three Yang meridians. It is inadvisable to overuse heavy cold-natured agents, as this would unjustly attack healthy qi. Therefore, Liu Hejian established Qing Zhen Tang (Clearing and Rising Decoction) to treat it. The prescription consists of Shengma (Rhizoma Cimicifugae, 3 qian), Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried, 4 qian), Qing Heye (Green Lotus Leaf, 1 piece), and Bohe (Menthae Haplocalycis Herba, 3 qian). Prepared according to standard methods, two doses resulted in immediate resolution. This occurred because phlegm-fire ascended, leading to tubercular swelling and pain. Cangzhu removes dampness and transforms phlegm; Bohe disperses wind-heat; Shengma and Heye guide the medicinal properties to the vertex, raising and diffusing yang qi. Consequently, sweating occurs naturally, and the swelling subsides.
(Attached: Shen Jing Feng [Kidney Wind], Xiu Qiu Feng [Embroidered Ball Wind], Yan Lai Feng [Wild Goose Coming Wind], She Pi Feng [Snake Skin Wind], E Zhang Feng [Goose Palm Wind], Chi Bai You Feng [Red and White Wandering Wind], Zi Bai Feng Biao [Purple and White Wind Rash], Zi Yun Feng [Purple Cloud Wind], Xuan Jie Lai Ban [Tinea, Scabies, Leprosy, and Macules])
Li Feng (Leprosy) is a malignant disease, commonly known as Da Ma Feng (Big Hemp Wind). Its symptoms include numbness and hardness of the skin and flesh, nodules on the body and face, itching, pain, rotting, and ulceration upon scratching. Gradually, the eyes become red, the nose turns crimson, limbs contract and twitch, and the head and face swell suddenly. This is due to a type of wind-toxin and fierce qi in the world, invading the zang-fu organs and bone marrow, flowing into the collaterals and joints, manifesting only after a long time. It can also be transmitted through contact with flesh and bones. Xue Lizhai differentiated the diseases based on the five zang organs, stating that if eyebrows fall out first, the toxin is in the Lung; if purple blisters appear on the face, the toxin is in the Liver; if the soles of the feet hurt or perforate, the toxin is in the Kidney; if the whole body resembles tinea, the toxin is in the Spleen; if the eyes are damaged first, the toxin is in the Heart. In the first stage, the skin dies, resulting in numbness and insensitivity; in the second, the flesh dies, rendering acupuncture painless; in the third, the blood dies, causing ulceration and pus discharge; in the fourth, the sinews die, leading to the shedding of fingers and toes; in the fifth, the bones die, causing the collapse of the nasal bridge. Hoarseness and blindness are both difficult to treat. The *Neijing* treatment method involves using sharp needles to puncture the swollen areas to release evil blood, thereby heavily draining the toxin. For evil blood stagnating in the muscle surface and collaterals, diaphoresis or acupuncture is suitable. Diaphoresis uses Zi Ping San (Duckweed Powder); acupuncture selects Weizhong (BL-40). If toxin accumulates in the zang-fu, it cannot be removed without purging, such as with Liang Ge Shuang Jie (Cooling the Chest and Dual Resolution). If toxin is external, it cannot be dispersed without bian stone therapy (scarification); scarify the arms, legs, and finger/toe webs to bleed. If toxin is severe in both exterior and interior, external scarification and internal purging are required. If upper body lesions predominate, use Zui Xian San (Intoxicating Immortal Powder) to extract toxic blood from between the teeth, and prick arm, wrist, and finger webs. If lower body lesions predominate, use Zai Zao San (Recreation Powder) to expel worm accumulation via the anus, and still prick leg, shin, and toe webs. If upper and lower lesions are equal, use Bi Sheng San (Invincible Victory Powder) for combined extraction. Treatment methods internally unblock the zang-fu, externally reach the collaterals, nourish Ying (Nutritive Qi), strengthen Wei (Defensive Qi), tonify righteous qi, and expel pathogenic factors. If dry-hot herbs are wrongly administered, copious pus will flow, Liver blood will further deplete, wind-heat will intensify, and Kidney water will further injure. At the onset, if the head and face itch and emit red-purple rash blocks, use Fang Feng Tong Sheng San (Saposhnikovia Unblocking the Interior and Exterior Powder) added with Kushen (Phellodendri Cortex), Tianma (Gastrodiae Rhizoma), and Chantui (Cicadae Periostracum) for several doses, followed by Ba Zhen Tang (Eight Treasures Decoction) and Sheng Yu Tang (Sage’s Blood Nourishing Decoction). Externally, wash with Bai Yu Chan Bath Soup added with Qianghuo (Notopterygii Rhizoma et Radix), Bohe, and Congbai (Scallion Stalk) decocted. After bathing, apply Bai Yu Chan Rubbing Medicine. For widespread nodules, rub with ginger dipped in rubbing medicine. Dryness with white scales indicates blood failing to nourish the skin; use Si Wu Tang (Four Substances Decoction) added with Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), and Digupi (Lycii Cortex). Itching as if through cloth indicates qi failing to fill the exterior; use Yang Ying Tang (Nourishing Nutritive Decoction). Facial numbness indicates qi and blood failing to ascend and nourish; use Bu Zhong Yi Qi Tang (Tonifying the Middle and Augmenting Qi Decoction) added with Chuanxiong (Chuanxiong Rhizoma) and Baifu (Typhonii Rhizoma). Urticaria with red halos indicates wind-heat entering Ying; excess cases use Hu Ma San (Sesame Powder), deficiency cases use Qu Feng Wan (Expelling Wind Pill). Ruptured and itchy nodules indicate wind-toxin injuring blood; use Qianghuo Danggui San (Notopterygium and Angelica Powder) or Danggui Yinzi (Angelica Infusion) added with Zhizi (Gardeniae Fructus) and Gouteng (Uncariae Ramulus cum Uncis). Contracted knuckles indicate yin fire scorching sinews; use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) added with Gouteng, taken alternately with Huan Ji San (Transforming Sinew Powder). Red nose and falling eyebrows belong to Lung meridian wind-heat; use Ren Shen Xiao Feng San (Ginseng Expelling Wind Powder) added with Tianma and Jiangcan (Bombyx Batryticatus). Purple blisters on the face belong to Liver meridian wind-toxin; use Zhizi Qing Gan Tang (Gardenia Clearing Liver Decoction) added with Gouteng and Jinyinhua (Lonicerae Japonicae Flos), taken concurrently with Liu Wei Wan (Six Ingredients Pill). Tendon and bone contraction and pain belong to Liver and Kidney yin deficiency; use Liu Wei Di Huang Tang (Six Ingredients Rehmannia Decoction). Deviated mouth and eyes belong to wind stirring and spasmodic convulsion; use Quanxie (Scorpio) washed in wine, salt-roasted, powdered, mixed with Jiangcan and Baifuzi (Typhonii Rhizoma) powder, each 7 qian, taken 1.5 qian per dose. Alternating chills and fever use Xiao Chai Hu Tang (Minor Bupleurum Decoction). Yang deficiency with fear of cold uses Bu Zhong Yi Qi Tang and Shi Quan Da Bu Tang (Ten Complete Tonifying Decoction). Long-standing ulcerated sores are dusted with Hong Yu San (Red Jade Powder) and covered with Kan Li Gao (Kan-Li Ointment). Pierced soles take Liu Wei Tang and dust with Xiang Zhu San (Fragrant Pearl Powder). Qi and blood depletion uses Gu Ming Dan (Life-Securing Elixir). General treatment for wind-leprosy uses [Missing Name] Wan and Hu Ma Wan. For all toxic leprosy critical conditions, select from Wu Long Wan (Five Dragons Pill), Qian Nian Yao (Thousand-Year Medicine), Dong Hua Yu Sui (Eastern Auspicious Jade Marrow), and Feng Yi Qiong Jiang (Fengyi Nectar). Regarding leprosy-like ulcers, there are two types resembling tinea, eroded by worms into sores, called Shen Jing Feng. Use Si Sheng San (Four Generations Powder) to dispel wind-pathogens and Liu Wei Wan to nourish Kidney water. Damp and itchy scrotum is called Xiu Qiu Feng. Use She Chuang Zi Tang (Cnidium Decoction) added with Chuanjiao (Zanthoxyli Pericarpium), Huixiang (Foeniculi Fructus), and Cong. Hard skin and dry muscle, itching in autumn, is called Yan Lai Feng. Use Qianghuo Baizhi San or Jia Wei Xiao Yao San. Cracked, itchy, painful skin resembling snake patterns is called She Pi Feng. Initially use Huo Long San, then tonics; externally rub with Xionghuang (Realgar), Liuhuang (Sulfur), Zhusha (Cinnabar), Zhesshi (Hematitum), Gufan (Alumen), Chuanjiao, and Zhangnao (Camphora) powdered and mixed with Sesame Oil. Hard palms with thick pus and white scales are called E Zhang Feng. Internally take Da Xiao Feng San; externally fumigate and wash with Tu Jin Pi (Phellodendri Amurensis Cortex) and Chuanjiao decoction, then rub with Tung Oil mixed with Pigeon Droppings. Migratory arm and leg [symptoms missing] is called Chi Bai You Feng. Red uses Jia Wei Xiao Yao San; white uses Ren Shen Xiao Feng San. Mottled muscle, purple and white, is called Zi Bai Feng Biao. Generally rub with Chuanfu (Aconiti Lateralis Radix Preparata) and Liuhuang powdered, mixed with Ginger Juice, using Eggplant Stalks, or Mercury and Qingfen (Calomelas) mixed with Ginger Juice. Purple spots spreading like rosy clouds are called Zi Yun Feng. Wash with He Shou Wu San added with [Missing Name], She Chuang Zi, and Xiakucao (Prunellae Spica) decocted. Cowhide stubborn tinea uses Fire Wine infused with Tu Jin Pi, Da Feng Zi (Seminar Crotonis Tiglii), Xionghuang, Chuanjiao, Qianghuo, Banmao (Mylabris), Naohao (Borneolum Syntheticum), Hongpi (Arsenicum Rubrum), Yanguo (Tobacco), and Mingfan (Alumen), scraped onto broken skin with Pangshanjia (Manis Squama) and applied with a brush. New and old scabies/leprosy uses Yi Sao Guang. Summer sweat spots use Mituo Seng (Litharge) powder and sugar, mixed with vinegar, rubbed with Cucumber Stalks. Freckles, acne, white scale itching use Yu Ji San (Jade Skin Powder) for rubbing. These are mentioned due to similarity with Li Feng. Others like Tuo Gen, Yu Lin, [Missing], Hao, Ga Zao, Ji Zhua, etc., are merely different names. Shen, a specialist in the previous Ming Dynasty, wrote "Jie Wei Yuan Sou" (Source of Resolving Encirclement), four volumes, discussing wind-leprosy treatments. Prioritizing dispelling wind, purging fire, killing insects, and detoxifying; complementing with nourishing blood, strengthening yuan, guiding stagnation, and firming sinews. Avoid fumigation, acupuncture, blades, and Qingfen. Abstain from sexual activity. Prohibit roasted, fried, salty, and soy sauce foods. Da Feng Zi fears salt. Avoid all pungent, aromatic, wind-stirring foods. Only then can life be prolonged; otherwise, recurrence leads to certain death. Sun Simiao treated over a hundred cases, saving only two. Zhu Danxi treated five, saving only one woman. Thus, is Li Feng easy to treat?