面肿为风，宜用羌活、防风、升麻、白芷、牛蒡子之属。外杵杏仁如膏敷之。余见水肿门。
丹溪云∶面热火气，因郁热。面寒属胃虚。东垣云∶饮食不节则胃病，胃病则气短精神少，而生
大热，有时而火上行独燎其面。《针经》云∶面热者，足阳明病。咳逆停息不得卧，面热如醉，此为
胃热上冲熏其面，茯苓桂枝五味子甘草汤加大黄以利之。罗谦甫疗杨郎中之内，五十一岁，身体肥盛，
患头目昏闷，面赤热多，服清上药不效，诊其脉洪大有力。《内经》云∶面热者，足阳明病。《脉经》
云∶阳明经气盛有余，则身已前皆热，况其人素膏粱积热于胃，阳明多血多气，木实则风热上行，诸
阳皆会于头目，故面热之病生矣。先以调胃承气汤七钱，加黄连三钱，犀角一钱，疏下一两行，彻其
本热，次以升麻加黄连汤，去经络中风热上行，如此则标本之邪俱退矣。又治尼长老，六十一岁，身
体瘦弱，十月间病头面不耐寒气，弱不敢当风行，诸治不效。诊之，其脉皆弦细而微，其人年高，素
食茶果而已，阳明之经本虚。《脉经》云∶气不足则身以前皆寒栗，又加看诵损气，由此胃气虚，经
络
之气亦虚，不能上荣头面，故恶风寒。先以附子理中丸温其中气，次以升麻汤加附子主之。或曰升麻
加黄连汤治面热，升麻加附子汤治面寒，有何根据？答曰∶出自仲景，云岐子注《伤寒论》中辨葛根
汤云∶尺寸脉俱长者，阳明受病也，当二三日发，以其脉夹鼻络目，故身热目疼鼻干，不得卧，此阳
明经受病也。始于鼻，交 中，从头至足，行身之前，为表之里。阳明经标热本实，从标脉浮而长，
从本脉沉而实。阳明为病，主蒸蒸而热，不恶寒，身热为标病；阳明本实者，胃中燥，鼻干目疼为本
病。阳明为肌肉之本，禁不可发汗；在本者不禁下，发之则变黄证。太阳主表，荣卫是也。荣卫之下，
肌肉属阳明。二阳并病，葛根汤主之。卫者桂枝，荣者麻黄，荣卫之中，桂枝麻黄汤各半主之。荣卫
之下，肌肉之分者，葛根汤主之。又名解肌汤。故阳明为肌肉之本，非专于发汗止汗之治。桂枝麻黄
两方，互并为一方，加葛根者，便作葛根汤，故荣卫肌肉之次也。桂枝、芍药、生姜、甘草、大枣止
汗，麻黄、桂枝、生姜、甘草发汗，葛根味薄，独加一味者，非发汗止汗也。从葛根以解肌，故名葛
根汤。钱仲阳制升麻汤，治伤寒瘟疫，风热壮热，头痛肢体痛，疮疹已发未发，用葛根为君，升麻为
佐，甘草、芍药安其中气。朱奉议作《活人书》，将升麻汤列作阳明经解药。予诊杨氏妇，阳明经标
本俱实，先攻其里，后泻经络中
风热，故用升麻汤加黄连，以寒治热也。尼长老，阳明经标本俱虚，先实其里，次行经络，故用升麻
汤加附子，以热治寒也。仲景乃群方之祖，信哉。
面部浮肿属于风邪侵袭，适宜使用羌活、防风、升麻、白芷、牛蒡子这类药物。外用将杏仁捣烂如膏状敷于患处。其余内容参见水肿门。
朱丹溪说：面部发热如火，是因为郁热所致；面部发冷属于胃气虚弱。李东垣说：饮食不节制会导致胃病，胃病则导致气短、精神不足，从而产生大热，有时火热之气上行，唯独烧灼面部。《针经》说：面部发热，是足阳明经发病。咳嗽气逆、呼吸暂停不能平卧，面部发热如同醉酒，这是胃热上冲熏蒸面部，用茯苓桂枝五味子甘草汤加大黄来通利它。罗谦甫治疗杨郎中的妻子，五十一岁，身体肥胖，患头目昏沉闷胀，面部赤红发热多，服用清上焦的药物无效，诊察其脉象洪大有力。《内经》说：面部发热，是足阳明经发病。《脉经》说：阳明经气盛有余，则身体前侧都发热，何况此人平时喜好肥甘厚味，积热在胃，阳明经多血多气，肝木实盛则风热上行，所有阳经都汇聚于头目，所以产生了面部发热的病证。先用调胃承气汤七钱，加黄连三钱，犀角一钱，疏泄通便一两行，彻底清除根本的热邪，再用升麻加黄连汤，去除经络中风热上行的病邪，这样标本的邪气都退去了。又治疗尼长老，六十一岁，身体瘦弱，十月间患病，头面不耐受寒气，虚弱得不敢当风，各种治疗无效。诊察她，脉象都弦细而微弱，此人年事已高，平时只喝茶吃水果而已，阳明经本来虚弱。《脉经》说：气不足则身体前侧都寒冷战栗，又加上看诵书损伤了气，因此胃气虚，经络的气也虚，不能上行荣养头面，所以厌恶风寒。先用附子理中丸温补其中气，再用升麻汤加附子主治。有人问：升麻加黄连汤治疗面部发热，升麻加附子汤治疗面部发冷，有什么依据？回答说：出自张仲景，云岐子在注释《伤寒论》中辨析葛根汤时说：寸尺脉都长的，是阳明经受病，应当在二三天发作，因为它的经脉夹鼻络目，所以身体发热、眼睛疼痛、鼻子干、不能平卧，这是阳明经受病。起始于鼻，交于人中穴，从头到足，行走于身体前侧，属于表之里。阳明经标热本实，从标脉浮而长，从本脉沉而实。阳明为病，主要表现为蒸蒸而热，不恶寒，身体发热是标病；阳明本实者，胃中干燥，鼻子干眼睛痛是本病。阳明是肌肉的根本，禁止不可发汗；在本者不禁下法，发汗则会变成发黄证。太阳主表，营卫就是表。营卫之下，肌肉属阳明。二阳并病，用葛根汤主治。卫分用桂枝，营分用麻黄，营卫之中，用桂枝麻黄各半汤主治。营卫之下，肌肉之分野，用葛根汤主治。又名解肌汤。所以阳明是肌肉的根本，不是专门用于发汗或止汗的治疗。桂枝和麻黄两方，合并为一方的基础上，加入葛根，就成为葛根汤，这是按照营卫肌肉的次序。桂枝、芍药、生姜、甘草、大枣止汗，麻黄、桂枝、生姜、甘草发汗，葛根气味淡薄，单独加一味，不是为了发汗或止汗。通过葛根来解肌，所以名叫葛根汤。钱乙制定升麻汤，治疗伤寒瘟疫，风热壮热，头痛肢体痛，疮疹已发或未发，用葛根为君药，升麻为佐药，甘草、芍药安固其中气。朱奉议编写《活人书》，将升麻汤列为阳明经解表药。我诊察杨氏妇人，阳明经标本俱实，先攻逐里实，后泻除经络中风热，所以用升麻汤加黄连，以寒治热。尼长老，阳明经标本俱虚，先充实其里，再疏通经络，所以用升麻汤加附子，以热治寒。张仲景是群方之祖，确实可信啊。
Facial edema is caused by Wind, and it is appropriate to use herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Niubangzi (Arctii Fructus). Externally, Almond (Prunus armeniaca seed) should be pounded into a paste for application. For other details, refer to the section on Edema.
Zhu Danxi stated: Facial heat resembling fire is due to stagnant Heat. Facial coldness belongs to Stomach deficiency. Li Dongyuan stated: Irregular diet leads to Stomach disease; Stomach disease leads to shortness of breath and diminished spirit, generating intense Heat. Sometimes, Fire Qi ascends and burns only the face. The *Zhenjing* (Needle Classic) states: Facial heat indicates disease of the Foot-Yangming channel. Cough with inverted Qi, dyspnea preventing lying flat, and facial heat resembling drunkenness indicate Stomach Heat rushing upward to scorch the face. This is treated with Fuling Guizhi Wuweizi Gancao Tang (Poria, Cinnamon Twig, Schisandra, and Licorice Decoction) plus Dahuang (Rhei Radix et Rhizoma) to promote drainage. Luo Qianfu treated the wife of Assistant Physician Yang, aged 51, who was obese and suffered from dizziness and oppression in the head and eyes, with frequent redness and heat in the face. Medicines clearing the upper jiao were ineffective. Her pulse was surging and forceful. The *Neijing* (Inner Canon) states: Facial heat indicates disease of the Foot-Yangming channel. The *Maijing* (Pulse Classic) states: When Qi of the Yangming channel is excessive, the anterior part of the body becomes hot. Moreover, this person habitually consumed rich and sweet foods, accumulating Heat in the Stomach. The Yangming channel has abundant Blood and Qi; when Liver Wood is excess, Wind-Heat ascends. All Yang channels converge at the head and eyes, thus causing facial heat. First, Tiaowei Chengqi Tang (Regulate the Stomach and Order the Bowels Decoction) 7 qian, plus Huanglian (Coptidis Rhizoma) 3 qian, and Xijiao (Rhino Horn, now substituted with Water Buffalo Horn) 1 qian, were used to purge and drain one or two times, thoroughly eliminating the root Heat. Subsequently, Shengma Jia Huanglian Tang (Burdock and Coptis Decoction) was used to clear Wind-Heat ascending in the collaterals, so that both root and branch pathogens receded.
He also treated Elder Nun, aged 61, who was emaciated. In October, she suffered from intolerance to cold air on the head and face, feeling too weak to withstand wind. Various treatments failed. Her pulse was wiry, thin, and faint. Being elderly and consuming only tea and fruits, her Yangming channel was inherently deficient. The *Maijing* states: Insufficiency of Qi causes cold and shivering in the anterior part of the body. Additionally, reading and chanting damaged Qi, leading to Stomach Qi deficiency and insufficiency of Qi in the collaterals, which could not ascend to nourish the head and face, resulting in aversion to Wind and Cold. First, Fuzi Lizhong Wan (Aconite and Poria Pill) was used to warm the middle Qi, followed by Shengma Tang (Burdock Decoction) plus Fuzi (Aconiti Lateralis Radix Praeparata).
Someone asked: What is the basis for using Shengma Jia Huanglian Tang to treat facial heat and Shengma Jia Fuzi Tang to treat facial coldness? The answer is: It originates from Zhang Zhongjing. Yun Qizi, in his commentary on Gegen Tang (Kudzu Decoction) in the *Shanghan Lun* (Treatise on Cold Damage), stated: If the Cun and Chi pulses are both long, it indicates Yangming channel disease, which should manifest in two to three days. Because its channel connects the nose and eyes, symptoms include body heat, eye pain, nasal dryness, and inability to lie flat. This is Yangming channel disease. Starting at the nose, crossing at the Renzhong point, it runs from head to foot along the anterior body, representing the interior of the exterior. Yangming channel pathology involves superficial Heat and substantial root conditions. Superficially, the pulse is floating and long; substantially, the pulse is deep and solid. Yangming disease primarily presents with steaming heat and aversion to cold is absent; body heat is the superficial manifestation. Yangming substantial excess involves dryness in the Stomach, nasal dryness, and eye pain, which are the root manifestations. Yangming is the root of muscles; sweating is strictly prohibited. However, purgation is not prohibited for root conditions; inducing sweat would transform the condition into Jaundice. Taiyang governs the exterior, represented by Ying and Wei. Below Ying and Wei, muscles belong to Yangming. In combined diseases of Taiyang and Yangming, Gegen Tang is indicated. Wei is governed by Guizhi, Ying by Mahuang. Within Ying and Wei, Guizhi Mahuang Banxia Tang (Half Dosage) is used. Below Ying and Wei, in the realm of muscles, Gegen Tang is used, also known as Jiemi Tang (Muscle-Releasing Decoction). Thus, Yangming is the root of muscles, and treatment is not solely focused on inducing or stopping sweat. Combining Guizhi Tang and Mahuang Tang into one formula and adding Gegen creates Gegen Tang, following the order of Ying, Wei, and Muscle. Guizhi, Shaoyao, Shengjiang, Gancao, and Dazao stop sweat; Mahuang, Guizhi, Shengjiang, and Gancao induce sweat. Gegen has a light flavor; adding it alone is neither for inducing nor stopping sweat. It releases the muscle layer via Gegen, hence the name Gegen Tang. Qian Zhongyang formulated Shengma Tang to treat cold damage and plague, characterized by high fever from Wind-Heat, headache, limb pain, and eruptive diseases whether erupted or not. It uses Gegen as the Sovereign herb, Shengma as the Minister herb, and Gancao and Shaoyao to stabilize the Middle Qi. Zhu Fengyi, in the *Huo Ren Shu* (Book to Save Lives), listed Shengma Tang as a resolving agent for the Yangming channel. I diagnosed Mrs. Yang, whose Yangming channel had both superficial and substantial excess. I first attacked the interior, then drained Wind-Heat from the collaterals, using Shengma Tang plus Huanglian to treat Heat with Cold. Elder Nun had both superficial and substantial deficiency in the Yangming channel. I first fortified the interior, then circulated the collaterals, using Shengma Tang plus Fuzi to treat Cold with Heat. Zhang Zhongjing is the ancestor of all formulas; this is indeed true.