人有身热之后,其身不凉,遍身俱红紫之色,名曰火丹,人以为热在胸膈,谁知热在皮
肤乎。夫火丹似与发斑相同,何分二名?不知二病热虽相同,而症实各异。
盖发斑者,红白相间也;火丹者,一身尽红也。发斑,热郁于内而发于外;火丹,热郁于
外而趋于内。发于外者,有日散之机;趋于内者,有日深之势。故发斑之症轻,火丹之病
重。然不知消火之法,轻者未必不变为重,苟知散郁之方,重者亦变为轻也。故治火丹之
病,补其水之不足,散其火之有余,使火外出,不在内攻可也。方用消丹饮∶
玄参(三两) 升麻(二钱) 麦冬(一两) 桔梗(二钱) 生甘草(一钱)水煎
服。一剂丹化,不必二剂。
此方用玄参解其浮游之火,以麦冬滋其肺金之气,用桔梗、升麻表散于毛窍之间,用甘
草调和于脏腑、经络之内,引火外行,所以奏功神速耳。
此症亦可用防桔汤治之。
防风(一钱) 麦冬 玄参(各一两) 桔梗(三钱) 甘草(一钱) 天花粉(二
钱) 黄芩(二钱)水煎服。一剂轻,二剂愈。
人有赤白游风,往来不定,小儿最多此症,似乎发斑,但发斑有一定之根,赤白游风无
一定之色,人以为三焦之实火,谁知是胃火之郁热乎。夫胃火不郁,必有发汗亡阳之祸,正
惟火郁不宣,则热不在外而在内矣。然而火盛自必由内达外,而
外又不可遽达,于是或发于此而移于彼,或现乎白而改乎红,竟无有定象耳。论其治法,自
宜以清热为主,而清热必须凉血。然血寒则凝滞不行,虽血能止火,而终难散火,必须行血
以舒热耳。方用清火消丹汤∶
生地(一两) 丹皮(三钱) 甘草(一钱) 玄参(三钱) 牛膝(二钱) 赤芍(
三钱) 荆芥(二钱) 天花粉(一钱)水煎服。连服二剂而丹消矣,再服二剂全愈。
此方凉血而兼行血,清火而并散火,既无大寒之虞,自无甚热之虑,郁易开而火易达矣。
此症用荆芥祛风汤治之。
荆芥(二钱) 甘草(一钱) 半夏(五分) 麦冬(五分) 当归(三钱) 白芍(三
钱)水煎服。
人有满身发斑,色皆黄白,斑上有水流出,时而作疼,久之皮烂,人以为心肝二经之火,
谁知脾肺之湿热乎。盖火丹原有二症,一赤火丹,一白火丹也。赤丹皮干,白丹皮湿,赤丹
属心肝之火,白丹属脾肺之湿。然而热郁于皮毛,则赤白、干湿一也。夫湿从下受,其病宜
在下体,何上身亦成黄白之丹乎?盖脾为肺之母,脾病子愿代母以受其苦,将湿气分散于皮
毛,火热亦随之而外越,然而脾病,肺尚不
至十分之切肤,所以湿热之邪,畏肺气之健,不敢径从皮毛而泄,反留恋于皮毛之中,而
色乃外现黄白耳。治法利其水湿之气,解其火热之炎,仍从膀胱下走,皮毛正不必外逐也。
盖湿热之盛,原在脾不在肺,母逐其仇,子有不随之而共逐者乎。所以祛其脾之湿热,而
肺中之湿热不逐自散。方用除湿逐丹汤∶
防风(三分) 苍术(三钱) 赤茯苓(五钱) 陈皮(五分) 浓朴(一钱) 猪
苓(一钱) 山栀子(三钱) 甘草(三分) 白术(三钱) 薄桂(三分)水煎服。连
饮数剂,丹退而愈。
此方利水多于散火者,以湿重难消,水消则火亦易消也。
此症用桑白分解散亦效。
薏仁(二两) 泽泻(三钱) 升麻(一钱) 天花粉(三钱) 桑白皮(三钱) 神
曲(三钱)水煎服。
有人在身体发热之后,体温不再下降,全身呈现红紫色,这种病称为火丹。人们通常认为热邪在胸膈部位,却不知热邪实际上在皮肤。火丹看起来与发斑相似,为什么要分为两个名称?不知道这两种病虽然热邪性质相同,但症状确实不同。
大概发斑的症状是红色和白色相间;而火丹则是全身通红。发斑是热邪郁结在体内而发散到体表;火丹则是热邪郁结在体表而趋向于体内。发散到体表的,有日渐消散的趋势;趋向于体内的,有日渐深入的势头。所以发斑的病证较轻,火丹的病势较重。然而如果不了解消除火邪的方法,轻症未必不会转变为重症;如果懂得疏散郁结的方剂,重症也能转变为轻症。因此治疗火丹病,要补充阴水的不足,疏散火邪的有余,使火邪向外排出,不在体内攻冲就可以了。方剂用消丹饮:玄参(三两)、升麻(二钱)、麦冬(一两)、桔梗(二钱)、生甘草(一钱),用水煎服。服用一剂后丹毒化解,不需要服用第二剂。
这个方子用玄参解除浮游之火,用麦冬滋养肺金之气,用桔梗、升麻在毛孔之间表散,用甘草在脏腑、经络之内调和,引导火气向外运行,所以能取得神速的功效。
这种病症也可以用防桔汤来治疗。防风(一钱)、麦冬、玄参(各一两)、桔梗(三钱)、甘草(一钱)、天花粉(二钱)、黄芩(二钱),用水煎服。服用一剂症状减轻,两剂痊愈。
有人身上出现赤白相间的游风,位置往来不定,小儿最多见这种病症,看起来像发斑,但发斑有一定的根基固定,赤白游风没有固定的颜色。人们认为是三焦的实火,却不知这是胃火的郁热。胃火如果不郁结,必然会有发汗导致亡阳的祸患,正因为火邪郁结不能宣散,所以热邪不在体表而在体内。然而火势旺盛自然会从内部通达外部,而外部又不能完全迅速通达,于是有时在这里发作而转移到那里,有时表现为白色而改为红色,完全没有固定的形态。论述其治疗方法,自然应该以清热为主,而清热必须凉血。但是血液寒凉就会凝滞不行,虽然血能止住火,但最终难以散除火邪,必须通过行血来舒展热邪。方剂用清火消丹汤:生地(一两)、丹皮(三钱)、甘草(一钱)、玄参(三钱)、牛膝(二钱)、赤芍(三钱)、荆芥(二钱)、天花粉(一钱),用水煎服。连续服用两剂后丹毒消退,再服用两剂完全痊愈。
这个方子既凉血又行血,既清火又散火,既没有大寒的担忧,也就没有甚热的顾虑,郁结容易打开,火邪容易通达了。
这种病症用荆芥祛风汤治疗也有效。荆芥(二钱)、甘草(一钱)、半夏(五分)、麦冬(五分)、当归(三钱)、白芍(三钱),用水煎服。
有人满身发斑,颜色都是黄白色,斑上有水流出,时而疼痛,时间久了皮肤溃烂。人们认为是心肝二经的火邪,却不知这是脾肺的湿热。大概火丹原本有两种病症,一种是赤火丹,一种是白火丹。赤丹皮肤干燥,白丹皮肤湿润,赤丹属于心肝之火,白丹属于脾肺之湿。然而热邪郁结在皮毛,那么赤白、干湿就是一样的了。湿气从下部受邪,病情适宜在下半身,为什么上半身也会形成黄白色的丹毒呢?因为脾是肺的母亲,脾有病,子女愿意代替母亲承受痛苦,将湿气分散到皮毛,火热也随之向外发散,然而脾有病,肺尚且不至于十分切肤之痛,所以湿热之邪,畏惧肺气的强健,不敢直接从皮毛排泄,反而留恋在皮毛之中,从而颜色外现黄白色。治疗方法是利导水湿之气,解除火热之炎,仍然让邪气从膀胱向下走,皮毛正不必强行向外驱逐。因为湿热的盛衰,原本在于脾而不在于肺,母亲驱逐仇敌,子女有不随之共同驱逐的吗?所以祛除脾的湿热,而肺中的湿热不驱逐自然消散。方剂用除湿逐丹汤:防风(三分)、苍术(三钱)、赤茯苓(五钱)、陈皮(五分)、浓朴(一钱)、猪苓(一钱)、山栀子(三钱)、甘草(三分)、白术(三钱)、薄桂(三分),用水煎服。连续饮用数剂,丹毒退去而痊愈。
这个方子利水多于散火,是因为湿重难以消除,水湿消除了火邪也容易消除。
这种病症用桑白分解散治疗也有效。薏仁(二两)、泽泻(三钱)、升麻(一钱)、天花粉(三钱)、桑白皮(三钱)、神曲(三钱),用水煎服。
A person, after experiencing body heat, finds that the temperature does not subside, and the entire body presents a red-purple color. This condition is called Huodan (Fire Erysipelas). People generally believe that the heat is located in the chest and diaphragm, little do they know that the heat actually resides in the skin. Huodan appears similar to Faban (Eruption of Spots), so why are there two distinct names? It is unknown that although the heat nature of both diseases is the same, their symptoms are indeed different.
Generally speaking, Faban manifests as an intermingling of red and white colors; whereas Huodan presents as the whole body being entirely red. Faban involves heat stagnating internally and erupting externally; Huodan involves heat stagnating externally and trending inward. Conditions erupting externally have the potential to dissipate day by day; conditions trending inward have the momentum to deepen day by day. Therefore, the syndrome of Faban is mild, while the disease of Huodan is severe. However, without knowing the method to extinguish fire, a mild case may not necessarily fail to transform into a severe one; conversely, if one knows the prescription to disperse stagnation, a severe case can also transform into a mild one. Thus, to treat Huodan, one should replenish the insufficiency of Yin water and disperse the excess of Fire, allowing the Fire to exit outward rather than attacking inward. The formula used is Xiaodan Yin (Eliminate Erysipelas Decoction): Xuan Shen (Radix Scrophulariae) (3 liang), Sheng Ma (Rhizoma Cimicifugae) (2 qian), Mai Dong (Tuber Ophiopogonis) (1 liang), Jie Geng (Radix Platycodi) (2 qian), Sheng Gan Cao (Raw Radix Glycyrrhizae) (1 qian). Decoct in water and take orally. After one dose, the erysipelas resolves; a second dose is unnecessary.
This formula uses Xuan Shen to resolve floating fire, Mai Dong to nourish the Qi of Lung Metal, Jie Geng and Sheng Ma to disperse via the hair follicles, and Gan Cao to harmonize within the Zang-Fu organs and meridians, guiding the Fire to move outward, thereby achieving swift efficacy.
This syndrome can also be treated with Fangjie Tang (Saposhnikovia and Platycodon Decoction). Fang Feng (Radix Saposhnikoviae) (1 qian), Mai Dong (1 liang), Xuan Shen (1 liang), Jie Geng (3 qian), Gan Cao (1 qian), Tian Hua Fen (Radix Trichosanthis) (2 qian), Huang Qin (Radix Scutellariae) (2 qian). Decoct in water and take orally. Symptoms alleviate after one dose and resolve after two doses.
Some people suffer from Youfeng (Wandering Wind) presenting as red and white patches, moving unpredictably. This condition is most common in infants and children. It resembles Faban, but while Faban has a fixed root, Youfeng lacks a fixed color. People attribute this to Excess Fire of the Sanjiao (Triple Burner), yet they fail to realize it is actually Stagnant Heat of the Stomach Fire. If Stomach Fire were not stagnant, it would inevitably lead to the disaster of Yang collapse due to excessive sweating. Precisely because the Fire is stagnant and cannot be vented, the heat remains internal rather than external. However, when Fire is abundant, it naturally tends to reach the exterior, but the exterior cannot immediately accommodate it. Consequently, eruptions may shift from one location to another, or change from white to red, resulting in no fixed manifestation. Regarding treatment, the primary approach should be clearing Heat, which necessitates cooling Blood. However, if Blood becomes too cold, it stagnates and fails to circulate. Although Blood can suppress Fire, it ultimately struggles to disperse it; therefore, one must promote Blood circulation to relieve Heat. The formula used is Qinghuo Xiaodan Tang (Clear Fire Eliminate Erysipelas Decoction): Sheng Di (Radix Rehmanniae Preparata) (1 liang), Dan Pi (Cortex Moutan) (3 qian), Gan Cao (1 qian), Xuan Shen (3 qian), Niu Xi (Radix Achyranthis Bidentatae) (2 qian), Chi Shao (Radix Paeoniae Rubra) (3 qian), Jing Jie (Herba Schizonepetae) (2 qian), Tian Hua Fen (1 qian). Decoct in water and take orally. After continuous administration for two doses, the erysipelas subsides; after two more doses, full recovery occurs.
This formula cools and invigorates Blood, clears and disperses Fire. It avoids the risk of excessive Cold and thus eliminates concerns of lingering Heat. Stagnation is easily opened, and Fire is easily discharged.
This syndrome can also be effectively treated with Jingjie Qufeng Tang (Schizonepeta Anti-Wind Decoction). Jing Jie (2 qian), Gan Cao (1 qian), Ban Xia (Rhizoma Pinelliae Preparata) (5 fen), Mai Dong (5 fen), Dang Gui (Radix Angelicae Sinensis) (3 qian), Bai Shao (Radix Paeoniae Lactiflorae) (3 qian). Decoct in water and take orally.
Some people present with widespread spots that are yellowish-white, oozing fluid, causing intermittent pain. Over time, the skin ulcerates. People attribute this to Fire in the Heart and Liver meridians, yet they fail to recognize it as Damp-Heat of the Spleen and Lung. Huodan originally comprises two syndromes: Chihuodan (Red Fire Erysipelas) and Baihuodan (White Fire Erysipelas). Chidan features dry skin, while Bidan features moist skin. Chidan belongs to Heart-Liver Fire, while Bidan belongs to Spleen-Lung Dampness. However, when Heat stagnates in the skin and hair, the distinction between red/white and dry/moist becomes indistinguishable. Dampness typically enters from below, suggesting the pathology should reside in the lower body. Why does the upper body also develop yellow-white erysipelas? Because Spleen is the mother of Lung; when Spleen is diseased, the "child" (Lung) wishes to share the suffering with the "mother," dispersing dampness into the skin and hair. Fire follows and escapes outward. However, since Spleen disease does not cause immediate acute distress to the Lung, the Damp-Heat pathogen fears the robustness of Lung Qi and dares not excrete directly through the skin. Instead, it lingers within the skin, manifesting externally as yellow-white coloration. The treatment method involves promoting the drainage of Damp-Fluids and resolving the inflammation of Fire, allowing the pathogen to descend via the Bladder. There is no need to forcibly expel it from the skin. Since the abundance of Damp-Heat originates in the Spleen rather than the Lung, if the mother drives away the enemy, will not the child follow suit? Therefore, by eliminating Spleen Damp-Heat, the Damp-Heat in the Lung will dissipate spontaneously. The formula used is Chushi Zhudan Tang (Remove Dampness Expel Erysipelas Decoction): Fang Feng (3 fen), Cang Zhu (Rhizoma Atractylodis Macrocephalae) (3 qian), Chi Fu Ling (Poria with Red Mycelium) (5 qian), Chen Pi (Pericarpium Citri Reticulatae) (5 fen), Hou Po (Cortex Magnoliae Officinalis) (1 qian), Zhu Ling (Poria) (1 qian), Shan Zhi Zi (Fructus Gardeniae) (3 qian), Gan Cao (3 fen), Bai Zhu (Rhizoma Atractylodis Macrocephalae) (3 qian), Bo Gui (Cortex Cinnamomi) (3 fen). Decoct in water and take orally. After continuous consumption for several doses, the erysipelas recedes and the patient recovers.
This formula focuses more on draining Water than dispersing Fire, because Dampness is heavy and difficult to eliminate; once Water is drained, Fire is easily eliminated.
This syndrome can also be effectively treated with Sangbai Fenjie San (Mulberry Bark Resolution Powder). Yi Ren (Semen Coicis) (2 liang), Ze Xie (Rhizoma Alismatis) (3 qian), Sheng Ma (1 qian), Tian Hua Fen (3 qian), Sang Bai Pi (Cortex Mori Radicis) (3 qian), Shen Qu (Massa Medicata Fermentata) (3 qian). Decoct in water and take orally.