上唇生疮虫食脏。下唇生疮虫食肛。此名狐惑非佳候。化 丸儿酌治良。
上下唇口多疮。其声嗄哑者。名曰狐惑。其义云何。乃出自伤寒指掌之言。谓上唇多疮者。虫
食其脏。名曰狐。下唇多疮者。虫食其肛。名曰惑。盖取其进退犹豫之义也。大非美候。宜以秘本
化丸。或古方化 丸。酌量而治之。如更烦躁、昏闷、失声者。死症也。
秘本化 丸
君子肉 芦荟（ ） 龙胆草（各二钱） 五灵脂（一钱五分） 黄连（二钱） 川楝子（一钱
五分） 乌梅 为末。以乌梅去核、捣烂、合丸。白水下。
古方化 丸
黄连（五钱） 蜀椒（闭目者勿用、去杆、炒二钱。） 苦楝树根白皮（晒干二钱） 为末
。用乌梅肉、七枚。以艾汤浸、捣烂、合丸。艾汤下。
切牙之症非痘比。痘有寒热二症分。喜食热物四肢冷。下血咽痛见阎君。
切牙虽非痘症比。亦有寒热二症分。未曾服药从热治。过用寒凉又宜温。
麻之切牙。非若痘比。痘症切牙。有寒热二症之分。而麻症切牙。皆属热候。乃阳陷于阴。故
多发渴。而手足俱热。喜饮食冷物。治宜滋阴降火。以麦冬汤。去白芍。加丹皮治之。若手足俱不
热。而反厥冷。喜食热物。此为热邪内亢。后必下血、咽痛、痰鸣而死。即以白虎汤（见二十六条）
治之。然多不可救。若饮食犯椒姜辛辣助热等物。更非所宜。然麻后切牙。亦有虚实。不可执泥无
虚实之说。但不与痘症比耳。麻后切牙。其先未曾服药而切牙者。乃实症也。解毒乃止。而三味消
毒饮（见三十三条）之类。可以随证加减而用。若已经服药而切牙者。恐服寒凉之药过多。有伤
气血而然。宜以四物汤（见二十五条）加人参治之。
朱曰 实证宜解毒。易治。多服寒凉伤气血。非大医不能治矣。
麦冬汤 治痘症。便实而渴。
生地黄 当归身 白芍药 麦冬 水煎服。
上唇生疮，是虫蚀内脏的表现。下唇生疮，是虫蚀肛门的表现。这种情况称为狐惑，属于不良的预后。应斟酌使用化丸进行治疗，效果良好。
上下嘴唇及口腔多处生疮，声音嘶哑的，称为狐惑。这是什么意思呢？这一说法出自《伤寒指掌》。书中说，上唇多生疮的，是虫蚀其内脏，称为“狐”；下唇多生疮的，是虫蚀其肛门，称为“惑”。大概是取狐狸进退犹豫不定的含义。这绝不是好的征象，应当使用秘本化丸，或者古方化丸，酌情治疗。如果伴有烦躁、神志昏闷、失声等症状，则是死症。
秘本化丸配方：
君子肉、芦荟（各二钱）、龙胆草（各二钱）、五灵脂（一钱五分）、黄连（二钱）、川楝子（一钱五分）。将上述药材研为细末。用乌梅去核、捣烂，与药末混合制成丸剂。白开水送服。
古方化丸配方：
黄连（五钱）、蜀椒（双目紧闭者不可用，需去梗，炒制二钱）、苦楝树根白皮（晒干二钱）。将上述药材研为细末。用七枚乌梅肉，以艾叶汤浸泡后捣烂，与药末混合制成丸剂。艾叶汤送服。
切牙的症状不能与痘症相比。痘症有寒证和热证两种分型。若喜食热物且四肢冰冷，随后出现便血、咽痛，则预示死亡。
切牙虽然不能与痘症相提并论，但也分为寒热两型。如果未曾服药，应按热证治疗；如果因过用寒凉药物导致，则宜用温法治疗。
麻疹引起的切牙，不像痘症那样有寒热之分，麻疹切牙都属于热证。这是由于阳气陷入阴分所致，所以患者大多口渴，手足发热，喜欢饮食冷物。治疗宜滋阴降火，使用麦冬汤，去掉白芍，加入丹皮进行治疗。如果手足不发热反而厥冷，喜欢热物，这是热邪内盛亢奋，后续必然会出现便血、咽痛、痰鸣而死亡。此时即用白虎汤（见第二十六条）治疗，但大多无法挽救。如果饮食中触犯花椒、生姜、辛辣助热之物，更加不宜。然而，麻疹后的切牙也有虚实之分，不可拘泥于无虚实的说法，只是不与痘症相比罢了。麻疹后切牙，如果先前未曾服药就出现切牙，属于实证，需用解毒法止住，可以使用三味消毒饮（见第三十三条）之类，随证加减应用。如果已经服药后才出现切牙，恐怕是服用寒凉药物过多，损伤了气血所致，宜用四物汤（见第二十五条）加人参治疗。
The appearance of sores on the upper lip indicates that parasites are eating the internal organs. The appearance of sores on the lower lip indicates that parasites are eating the anus. This condition is named Hu-Huo (Fox and Charm, a disease characterized by oral and genital ulcers), which is an unfavorable prognosis. One should carefully prescribe Hua Wan (Transforming Pill) for treatment, which yields good results.
When there are many sores on the upper and lower lips and mouth, accompanied by hoarseness, it is named Hu-Huo. What is the meaning behind this? This concept originates from *Shanghan Zhizhang* (Guiding Principles of Cold Damage). It states that when there are many sores on the upper lip, it means parasites are eating the internal organs, named "Hu" (Fox); when there are many sores on the lower lip, it means parasites are eating the anus, named "Huo" (Charm). This is likely derived from the imagery of the fox's hesitant and indecisive nature. This is certainly not a good sign. One should use the secret version of Hua Wan or the ancient formula Hua Wan, prescribing according to the specific situation. If accompanied by irritability, mental confusion, and loss of voice, it is a fatal syndrome.
Secret Version Hua Wan Formula:
Junzi Rou (Buckthorn Fruit), Lvhui (Aloe), Longdancao (Gentian Root) (each 2 qian), Wulingzhi (Trogopterus Dung) (1.5 qian), Huanglian (Coptis Rhizome) (2 qian), Chuanlianzi (Szechwan Chinaberry Fruit) (1.5 qian). Grind these into powder. Remove the pits from Wu Mei (Mume Fruit), mash them, mix with the powder to form pills. Take with plain water.
Ancient Formula Hua Wan:
Huanglian (Coptis Rhizome) (5 qian), Shujiao (Sichuan Pepper) (Do not use those with closed eyes; remove stems, stir-fry 2 qian), Kulian Shugen Baipi (White Bark of Toosendan Tree Root) (sun-dried 2 qian). Grind these into powder. Use seven Wu Mei (Mume Fruit) meats, soak in Mugwort Decoction, mash, and mix with the powder to form pills. Take with Mugwort Decoction.
Teeth-grinding (Qie Ya) symptoms should not be compared with smallpox (Dou Zheng). Smallpox presents with two types: cold and heat syndromes. If the patient prefers hot foods and has cold limbs, followed by bloody stools and sore throat, death ensues.
Although teeth-grinding cannot be directly compared to smallpox, it is also divided into cold and heat types. If no medication has been taken yet, treat as a heat syndrome; if caused by excessive use of cold-natured medicines, treat with warmth.
Teeth-grinding caused by measles is different from smallpox. Smallpox-related teeth-grinding has cold and heat distinctions, whereas measles-related teeth-grinding belongs entirely to heat syndromes. This occurs because Yang Qi sinks into Yin, causing patients to generally feel thirsty, have hot hands and feet, and prefer cold foods and drinks. Treatment should focus on nourishing Yin and descending fire, using Maidong Tang (Ophiopogon Decoction), removing Baishao (White Peony Root), and adding Danpi (Moutan Cortex). If the hands and feet are not hot but instead cold (Jue Leng), and the patient prefers hot foods, this indicates hyperactive internal heat pathogens. Subsequently, bloody stools, sore throat, and rattling phlegm will occur, leading to death. At this stage, Baihu Tang (White Tiger Decoction) (see Article 26) can be used, but recovery is rare. Consuming pungent, ginger, garlic, or other heat-assisting foods is strictly contraindicated. However, teeth-grinding after measles also has deficiency and excess patterns; one must not rigidly adhere to the idea that there is no deficiency. It simply differs from smallpox. For teeth-grinding after measles where no prior medication was taken, it is an excess syndrome; stop it with detoxification methods. Sanwei Xiaodu Yin (Three-Ingredient Detoxifying Drink) (see Article 33) can be used with modifications based on symptoms. If teeth-grinding occurs after taking medication, it is likely due to excessive intake of cold-natured drugs damaging Qi and Blood. In this case, Siwu Tang (Four Substance Decoction) (see Article 25) added with Renshen (Ginseng) should be used.
Master Zhu said: Excess syndromes are suitable for detoxification and are easy to treat. If Qi and Blood are damaged by excessive consumption of cold medicines, only a great physician can treat it.
Maidong Tang: Treats smallpox with constipation and thirst.
Ingredients: Sheng Dihuang (Rehmannia Root), Danggui Shen (Angelica Sinensis Root Body), Baishao Yao (White Peony Root), Maidong (Ophiopogon Tuber). Decoct in water and take orally.