面痛皆属火。盖诸阳之会，皆在于面，而火阳类也。心者生之本，神之变，其华在面，而心君火
也。暴痛多实，久痛多虚。高者抑之，郁者开之。血热者凉血，气虚者补气。不可专以苦寒泻火为事。
许学士医检正患鼻 间痛，或麻痹不仁，如
是数年，忽一日连口唇颊车发际皆痛，不开口言语，饮食皆妨。在 与颊上常如糊，手触之则痛，此
足阳明经络受风毒，传入经络，血凝滞而不行，故有此证。或以排风、小续命、透体丹之类与之，皆
不效。制犀角升麻汤赠之，数日愈。夫足阳明胃也。经云∶肠胃为市。又云∶阳明多血多气，胃之中
腥膻五味无所不纳，如市厘无所不有也。以其腐熟饮食之毒聚于胃，此方以犀角为主，解饮食之毒也。
阳明经脉环唇挟舌，起于鼻，合 中，循颊车，上耳前，过客主人，循发际至头颅，今所患皆一经络
也。故以升麻佐之。余药皆涤除风热。升麻、黄芩专入胃经。老母年七十余，累岁患颊车痛，每多言
伤气、不寐伤神则大发，发之剧则上连头，下至喉内及牙龈，皆如针刺火灼，不可手触。乃至口不得
开，言语饮食并废，自觉火光如闪电，寻常涎唾稠粘，如丝不断，每劳与饿则甚，得卧与食则稍安，
知其虚也。始以清胃散、犀角升麻汤、人参白虎汤、羌活胜湿汤加黄芩、甘、桔皆不效，后改用参、
、白术、芎、归、升、柴、甘、桔之类，稍佐以芩、栀、连翘、黍粘，空腹进之，而食远则服加减
甘露饮，始渐安。第老人性躁不耐闲，劳与多言时有之，不能除去病根，然发亦稀少，即发亦不如往
岁之剧矣。从子 因丧子郁结，复多饵鹿
角胶诸种子药，或于食后临卧辄进之，以至积成胃热，遂患面痛如老母证。服清胃散、甘露饮，大加
石膏过当，而见虚证。又服参、耆等补药过当，而复见火证。门人施生以越鞠加山栀、连翘、贝母、
橘红之属，开其郁结，而始向安。诸方书无面痛门，今补之。且具载上三条，以见用药不可执一耳，
非三条之足以尽是病也。
面痛这一病症，大多归属于火邪。因为头面部是诸阳经汇聚之处，而火与阳同类。心是生命的根本，神志变化的根源，其荣华表现于面部，而心主君火。突然发作的疼痛多属实证，长期持续的疼痛多属虚证。病位高的要用抑制的方法，气机郁结的要加以疏解。血热的要凉血，气虚的要补气。不能专门依靠苦寒药物来泻火。
许学士（许叔微）曾诊治一位检正官，患鼻旁间疼痛，有时麻木不仁，如此持续数年。忽然有一天，连口唇、颊车穴及发际处都疼痛，无法开口言语，饮食也受影响。患处皮肤常像涂了糊一样，手触摸则疼痛，这是足阳明经络受风毒侵袭，传入经络，导致血液凝滞而不运行，所以出现这种证候。有人用排风汤、小续命汤、透体丹等方剂给他服用，都没有效果。于是制作犀角升麻汤赠送给他，几天后痊愈。足阳明经属于胃。医经说：“肠胃如同集市。”又说：“阳明经多血多气。”胃中容纳各种腥膻五味，就像集市里无所不有一样。因为食物腐熟过程中产生的毒素积聚在胃，此方以犀角为主药，旨在解除饮食之毒。阳明经脉环绕嘴唇、挟持舌头，起于鼻部，交汇于鼻根中，沿颊车穴上行至耳前，经过客主人穴，沿发际直至头颅，现在所患的都是这一条经络的病。所以用升麻作为辅助药。其余药物都是清除风热。升麻、黄芩专门入胃经。
还有一位七十多岁的老妇人，多年患颊车穴疼痛，每次多说话伤气、失眠伤神就会剧烈发作。发作严重时，疼痛向上连及头部，向下至喉咙内部及牙龈，都像针刺火灼一样，不可用手触碰。以至于嘴巴无法张开，言语和饮食都停止，自觉火光如闪电般闪过，平时唾液稠粘，像丝一样不断。每当劳累或饥饿时症状加重，得到休息和进食后稍安，可知这是虚证。起初用清胃散、犀角升麻汤、人参白虎汤、羌活胜湿汤加黄芩、甘草、桔梗，都没有效果。后来改用参、[缺字]、白术、川芎、当归、升麻、柴胡、甘草、桔梗之类，稍微佐以黄芩、栀子、连翘、牛蒡子，空腹服用；而在饭后则服用加减甘露饮，这才逐渐安稳。只是这位老人性情急躁，不耐清闲，劳累和多说话的情况时有发生，不能除去病根，但发作次数减少，即使发作也不像往年那样剧烈了。
许学士的侄子因丧子之痛导致郁结，又多次服用鹿角胶等助孕种子药，或者在饭后临睡前进服，以致积成胃热，于是患上像那位老妇人一样的面痛。他服用清胃散、甘露饮，过大量使用石膏，反而出现了虚证。又服用人参、黄芪等补药过量，又重新出现火证。门人施生用越鞠丸加山栀、连翘、贝母、橘红等药物，疏解他的郁结，病情才开始好转。各种方书没有面痛专篇，现在补充进来。并且详细记载上述三条案例，以说明用药不可固执一端，并非这三条案例足以穷尽该病的所有情况。
Facial pain is generally attributed to Fire. This is because the face is the convergence point of all Yang meridians, and Fire belongs to the Yang category. The Heart is the root of life and the source of spiritual transformation, its luster manifesting on the face, and the Heart governs Ministerial Fire (Jun Huo). Sudden onset of pain often indicates excess syndromes, while chronic pain often indicates deficiency syndromes. For conditions located high, suppression methods should be used; for stagnation, unblocking methods should be employed. For blood heat, cool the blood; for Qi deficiency, tonify Qi. One cannot rely solely on bitter-cold herbs to purge Fire.
Scholar Xu (Xu Shuwei) once treated an official titled Jianzheng who suffered from pain between the nose and cheek, sometimes accompanied by numbness and insensitivity, persisting for several years. Suddenly, one day, the pain extended to the lips, Jiache acupoint (ST6), and hairline, making it impossible to open the mouth or speak, and interfering with eating and drinking. The skin in the affected area felt as if coated with paste, and touch caused pain. This was due to Wind-Toxin invading the Foot-Yangming Meridian and transmitting into the collaterals, causing blood stasis and obstruction, thus resulting in this syndrome. Others prescribed formulas such as Paifeng Tang (Wind-Expelling Decoction), Xiao Xuming Tang (Minor Continuation of Life Decoction), and Toudan Dan (Body-Penetrating Pill), but none were effective. A decoction of Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction) was prepared and gifted to him, leading to recovery within a few days. The Foot-Yangming Meridian belongs to the Stomach. The Classics state: "The Intestines and Stomach are like a market." It also states: "The Yangming meridian has abundant Blood and Qi." The Stomach accepts all kinds of fishy, fatty, and pungent flavors, just as a market contains everything. Because toxins accumulate in the Stomach from the rotting and ripening of food, this formula uses Rhinoceros Horn (Xijiao) as the chief herb to resolve dietary toxins. The Yangming meridian circles the lips, flanks the tongue, originates at the nose, converges in the middle of the nose, follows along Jiache, ascends anterior to the ear, passes through Kerenren (ST7), follows the hairline to the head. The current ailment involves this single meridian. Therefore, Cimicifuga (Shengma) is used as an assistant herb. The remaining herbs clear Wind-Heat. Cimicifuga and Scutellaria (Huangqin) specifically enter the Stomach meridian.
Another case involved an elderly woman over seventy years old, who suffered from Jiache pain for many years. Severe attacks occurred whenever excessive speech injured Qi or insomnia injured Shen (Spirit). During severe attacks, the pain extended upward to the head and downward to the throat interior and gums, feeling like needle pricks or fire burning, intolerable to touch. Her mouth could not open, and speech and diet ceased. She felt flashes of light like lightning, and her saliva was thick and sticky, unbroken like silk. Symptoms worsened with fatigue and hunger, and improved slightly with rest and food, indicating a deficiency syndrome. Initially, Qingwei San (Stomach-Clearing Powder), Xijiao Shengma Tang, Ren Shen Baihu Tang (Ginseng White Tiger Decoction), and Qianghuo Shengshi Tang (Notopterygium and Drynaria Decoction) added with Huangqin, Gancao, and Jiegeng were ineffective. Later, a formula containing Ginseng, [missing character], Atractylodes (Baizhu), Ligusticum (Chuanxiong), Angelica Sinensis (Danggui), Cimicifuga, Bupleurum (Chaihu), Gancao, and Jiegeng was used, slightly supplemented with Huangqin, Gardenia (Zhizi), Forsythia (Lianqiao), and Arctium (Niubangzi), taken on an empty stomach. Additionally, Jiangan Ganlu Yin (Modified Sweet Dew Drink) was taken after meals. Gradually, she stabilized. However, the elderly patient had an irritable nature and could not remain idle; fatigue and excessive speech occurred occasionally, preventing the removal of the root cause. Nevertheless, attacks became less frequent and less severe than in previous years.
Scholar Xu’s nephew suffered from depression due to the loss of his son and repeatedly consumed Deer Antler Glue (Lujiaojiao) and other fertility-promoting medicines, often taking them after meals or before bed. This accumulated into Stomach Heat, leading to facial pain similar to the elderly woman's condition. He took Qingwei San and Ganlu Yin, but the excessive use of Gypsum (Shigao) led to deficiency symptoms. Subsequently, he took tonics like Ginseng and Astragalus (Huangqi) excessively, which re-triggered Fire symptoms. His student, Shi Sheng, prescribed Yueju Wan (Yueju Pill) added with Gardenia, Forsythia, Fritillaria (Beimu), and Tangerine Peel (Juhong) to resolve the depression, after which the condition began to improve. Various medical texts lack a dedicated section on facial pain; this is now supplemented. These three cases are recorded in detail to illustrate that medication should not be applied rigidly, and these three cases do not exhaustively cover all aspects of the disease.