白秃疮俗称白癩痢，癞痢头。初起者，多因风热相搏或膀胱经与督脉湿热生虫，兼受风邪外袭所致，因此外用杀虫剂被很多医家认为是治疗的关键。《中医外科学》认为内治宜散风清热。《中医外科学简编》认为内治宜祛风清热，除湿杀虫，止痒。但是病程较久，气血结聚不散，气血不潮，皮肉干枯者，应用以上治法往往无效。例如：患者凌××，女，42岁。头上出癣一年多。某院皮科诊为发癣。初用西药无效，后又用中药外涂，内服防风通圣丸、消风散等仍无效。审其头顶部有数片圆形或不规形之癣，上罩白痴，中间之头发干枯脱落，极度瘙痒，咽喉干燥，舌苔薄白，脉沉而弦。综合脉证，诊为久病入于血分，络脉瘀滞，血燥生风。治以养血活血，润燥祛风。处方：桃仁9克，红花6克，当归12克，白芍15克，川芎6克，生地9克，蝉蜕6克，白蒺藜9克，防风9克，元参15克，秦艽10克，白头翁10克。2剂后，头癣缩小三分之一左右，而且白屑、奇痒亦明显好转，但左耳却出现耳鸣，两臂、背部出现大量红色皮疹，脉由沉转浮。此血脉得养，络脉已通，风邪由里达表也，治宜疏散风热，以解表邪，此正《伤寒论》所说之先治里，后解表之意。银翘散加减。银花15克，连翘15克，竹叶9克，荆芥9克，牛蒡子9克，元参15克，芦根15克，薄荷6克，桔梗9克，豆豉9克，甘草6克，蝉衣9克，黄芩9克。服药6剂后，头癣仅存约豆大一片，全身皮疹消失，再加白头翁9克，服药10剂，愈。
痤
《素问·生气通天论》说：“汗出见湿，乃生痤疿……劳汗当风，寒薄为鼓，郁乃痤。”张介宾说：“形劳汗出，坐卧当风，寒气薄之，液凝为鼓。”王肯堂主张用旋覆花丸，《医宗余鉴》主张用枇杷清肺饮，归纳起来均从散风、宣肺来治，但用之临床多有不效。细审本病多发于肾气旺而尚未平均之年龄的青年男女，其质多为木形，痤又多见湿，故试用柴胡加龙骨牡蛎汤，服药后果然效如桴鼓，霍然而愈。例如：高××，男。22岁。面、颈、胸部痤疮3年多，久治不效，近半年来更加严重。察其面、颈、胸有散在或密集的大量丘疹，有的黑色，有的鲜红色，有的暗紫色，有的如针头大，有的如豌豆大．甚或如樱桃大，有的合并有白色的脓点，有的密布，有的散在，有的数个结节密集在一起，面赤，头晕头痛，心烦口苦，舌苔白，脉弦。证脉合参，诊为肝郁化火，营卫失调，湿郁不化。为拟柴胡加龙骨牡蛎汤加减。处方：柴胡9克，半夏9克，黄芩9克，党参9克，桂枝9克，茯苓9克，川军6克，甘草6克，生姜3片，大枣5个，龙骨15克，牡蛎15克。服药3剂，面部痤疮稍减，6剂后，面部痤疮消失，胸、颈部者好转，又服6剂(前后15剂)，胸、颈部痤疮消失而愈。惟头痛头晕虽减而未瘳。
筋聚
腱鞘囊肿，中医称为筋聚或筋结。《中医伤科学》认为多因用力扭转或跌扑所致，其表现为腕部微肿，疼痛逐渐加剧，在桡骨茎突部阳溪穴处有显著压痛，且可牵引至手指、手以及前臂。初起时活动略有障碍，患手握拳拇指在内四指在外，腕向尺侧屈曲时疼痛增加，拇指运动乏力。后期则轻度用力也不可能。如在掌部用力扭转则疼痛加剧，旋转腕部可听到筋腱摩擦音。并提出治法主要有四：一为理筋手法，二为针灸，三为封闭，四为手术。四法虽各具千秋，但没有列内服药如何治疗。余宗肝主筋，肝藏血，肝血不足，筋脉失养，则挛缩为聚为结之意，试用于一些筋聚患者，亦多有效。例如：冯××，文．21岁。左手腕背侧腱鞘囊肿如枣大一年多，用力或手腕活动时疼痛加重。某院以可的松封闭，针灸及理筋手法治之不效。细察其证，除以上症状外，并见胸满心烦，舌苔薄白，脉弦。综合脉证，诊为血虚筋脉失养，为拟养血疏肝理筋，四物汤加味。处方：当归15克，川芎9克，白芍12克，木瓜12克，熟地12克，片姜黄9克，晚蚕砂12克，五加皮15克，海桐皮9克。服药2剂，疼痛、肿胀竞减轻七八，继服6剂，霍然而愈。
尿道口血疱
曾治患者李××，男，28岁。尿热尿痛，排尿不利一年多。诸医以泌尿系感染论治不效，近数月来因排尿时痛苦至甚，仔细视之，见尿道口内有一小豆大之血泡，色紫，触之疼痛。某院外科检查后未确诊。又请某医以八正散6剂服之，诸证不减。审视其证，腰痛腰冷，足冷至膝，手冷至腕，尿频尿痛尿少，舌苔薄白，脉沉细涩。证脉合参，诊为肾阳不足为本，湿热为标。为拟补肾壮阳，利湿清热，肾气丸加减。处方：生地24克，山药9克，肉苁蓉15克，土茯苓15克，泽泻10克，丹皮10克，车前子10克(布包)，五味子10克，附子10克，肉桂10克，怀牛膝10克。药服3剂，尿痛尿频、排尿困难消失，血泡消退，但腰酸腰痛，手足厥冷未减，乃继予上方调理之。某医问：尿急尿频尿痛为膀胱湿热，为什么用清热通淋之八正散不效?答曰：淋证有石淋、劳淋、血淋、气淋、膏淋等五种，石淋、劳淋、血淋、气淋、膏淋都有一个共同的表现——小便涩痛，欲便不出，不便自来，淋漓不断，甚则闷塞，滴沥难出、劳淋还有遇劳即发，小便淋沥不绝，如水滴沥而不断的特点。李中梓认为劳于脾者，应补中益气汤与五苓散分进；思虑而致者，宜归脾汤；劳于肾者，宜生地黄丸，而寒者则宜金匮肾气丸。薛立斋认为肾虚精败之淋，茎中涩痛者，惟金匮肾气丸可救，若大小便牵引而痛，愈痛则欲便，愈便则欲痛，宜倍桂、附，以滋化源，不可误用淡渗之剂与知母、黄柏，以泻其阳，耗其阴。本证虽有尿频尿热尿痛，不可作湿热在膀胱论治，否则必泻其阳，耗其阴而成难治之证。
脂肪瘤与造釉细胞瘤
瘤虽有骨、脂、肉、脓、血的不同，但成因都离不开气滞。陈无择说：“瘤则随气凝结”，所以瘤的治疗必须理气。又因正气盛衰的不同，邪气性质的差异。陈实功说：“脾主肌肉，郁结伤脾，肌肉消薄，土气不行，逆于肉里而为肿，曰肉瘤；肺主气，劳伤元气，腠理不密，外寒搏而为肿，曰气瘤。”“肉瘤者，软若绵，硬似馒，皮色不变，不紧不宽，终年只以覆肝，然治当理脾宽中，疏通戊土，开郁行痰，调理饮食，加味归脾丸是也。气瘤者，软而不坚，皮色如故，或消或长，无热无寒，治当清肺气，调经脉，理劳伤，和营卫，通气散坚丸是也。”脂肪瘤柔软而皮色不变，故以开郁行痰，调理饮食治疗有效。例如：刘×，男，54岁，四肢、腰腹发现肿瘤七八年。某院病理学检查结果为脂肪瘤。近半年多来更加增多。因患者拒绝手术，邀余治疗。察其四肢、腰、腹部有肿瘤30多个，不红不痛，大者如核桃，小者如杏核，按之柔软，并见胃脘痞满，泛酸等证，舌苔薄白，脉沉细弦。脉证合参，诊为气滞痰郁，凝结成瘤。乃拟理气化痰软坚散结。温胆汤加味：竹茹15克，枳壳12克，半夏10克，茯苓10克，乌蛇9克，全虫6克，白芥子3克，白蒺藜6克，牛膝9克，黄药子6克，陈皮12克。连进12剂肿瘤竞消失70％，胃脘痞满好转，又进60剂肿瘤全部消失而愈。又如王x×，男，成。四肢、腰、腹部发现肿瘤3个多月，大者如蜜桃，小者如杏，不红不痛。某院诊为脂肪瘤。因不愿手术，邀余治疗。诊时除40多个肿瘤外，别无所苦，舌苔白，脉弦滑。综合症脉，诊为痰气郁玷，凝结成瘤。乃拟化痰散结之温胆汤加减：夏枯草30克，赤芍9克，橘叶9克，青皮9克，白蒺藜9克，竹茹12克，枳壳9克，半夏9克，橘红9克，黄药子12克，全虫4．5克。乌蛇6克，茯苓9克，白芥子1．5克，连翘4．5克。连服20剂肿瘤开始缩小，35剂后突然大部消失，仅在右膝内侧残存一核桃大和一杏仁大的肿瘤，加白芥子3克、连翘6克、全虫6克。继服30剂肿瘤全部消失。在治疗过程中，不但要注意发病的原因，而且要注意发病的部位和脏腑。如牙龈部的肿瘤，由于牙龈属胃，牙齿属肾，所以应加入补肾之品。尹××，女，45岁。两年前齿龈上出现一个紫泡。针挑破后不但没有消失，反而更加扩大。半年来下颌骨明显肿大，门齿至臼齿间的齿龈上有4个杏核大的紫红色肿物，不痛不痒，但张口咀嚼均感困难。某院下颌拍片后确诊为下颌造釉细胞瘤。舌苔白，脉弦滑。综合脉症，诊为肾虚阳浮，痰凝血滞，结为肿瘤。乃拟补肾化痰，软坚活血之剂：附子4．5克，南星9克，全虫6克，白芷9克，元参4．5克，郁金9克，首乌15克，生苡米30克，骨碎补6克，黄药子12克，乌蛇4．5克。服药10剂后，肿胀好转，紫红色转变为青白色，由杏仁大缩小至黄豆大，牙刷由不能进颊部转为能塞进颊部。加鸟梢蛇1．5克，又服10剂，高起之肿物已全部消退，色与正常齿龈相同，但发现牙痛，乃加入地骨皮30克、生地15克，再进50剂恢复正常。
白秃疮俗称白癞痢、癞痢头。初起时，多因风热相互搏结，或膀胱经与督脉湿热蕴结生虫，兼受风邪外袭所致，因此外用杀虫剂被许多医家认为是治疗的关键。《中医外科学》认为内治宜疏散风热。《中医外科学简编》认为内治宜祛风清热，除湿杀虫，止痒。但是病程较长，气血结聚不散，气血不能濡养肌肤，皮肉干枯者，应用上述治法往往无效。例如：患者凌某某，女，42岁。头上出癣一年多。某医院皮肤科诊断为发癣。起初使用西药无效，后又用中药外涂，内服防风通圣丸（Fangfeng Tongsheng Wan）、消风散（Xiaofeng San）等仍无效。审视其头顶部有数片圆形或不规则形的癣，上覆白色鳞屑，中间的头发干枯脱落，极度瘙痒，咽喉干燥，舌苔薄白，脉沉而弦。综合脉象与症状，诊断为久病入于血分，络脉瘀滞，血燥生风。治以养血活血，润燥祛风。处方：桃仁9克，红花6克，当归12克，白芍15克，川芎6克，生地9克，蝉蜕6克，白蒺藜9克，防风9克，元参15克，秦艽10克，白头翁10克。服药2剂后，头癣缩小约三分之一，且白屑、奇痒亦明显好转，但左耳却出现耳鸣，两臂、背部出现大量红色皮疹，脉由沉转浮。此乃血脉得养，络脉已通，风邪由里达表之象，治宜疏散风热，以解表邪，这正是《伤寒论》所说的先治里，后解表之意。方用银翘散（Yinqiao San）加减。银花15克，连翘15克，竹叶9克，荆芥9克，牛蒡子9克，元参15克，芦根15克，薄荷6克，桔梗9克，豆豉9克，甘草6克，蝉衣9克，黄芩9克。服药6剂后，头癣仅存约豆大一片，全身皮疹消失，再加白头翁9克，继续服药10剂，痊愈。
痤疮
《素问·生气通天论》说：“汗出见湿，乃生痤疿……劳汗当风，寒薄为鼓，郁乃痤。”张介宾说：“形体劳累汗出，坐卧当风，寒气侵袭，津液凝滞为疱。”王肯堂主张用旋覆花丸，《医宗余鉴》主张用枇杷清肺饮，归纳起来均从散风、宣肺来治疗，但在临床应用中多有不效。仔细审视本病多发于肾气旺盛但尚未平衡的青年男女，其体质多为木形，痤疮又多见湿邪，故试用柴胡加龙骨牡蛎汤（Chaihu Jia Longgu Muli Tang），服药后果然效如桴鼓，霍然而愈。例如：高某某，男，22岁。面、颈、胸部痤疮3年多，久治不效，近半年来更加严重。观察其面、颈、胸有散在或密集的大量丘疹，有的黑色，有的鲜红色，有的暗紫色，有的如针头大，有的如豌豆大，甚或如樱桃大，有的合并有白色的脓点，有的密布，有的散在，有的数个结节密集在一起，面赤，头晕头痛，心烦口苦，舌苔白，脉弦。证脉合参，诊断为肝郁化火，营卫失调，湿郁不化。拟柴胡加龙骨牡蛎汤加减。处方：柴胡9克，半夏9克，黄芩9克，党参9克，桂枝9克，茯苓9克，川军6克，甘草6克，生姜3片，大枣5个，龙骨15克，牡蛎15克。服药3剂，面部痤疮稍减，6剂后，面部痤疮消失，胸、颈部者好转，又服6剂（前后共15剂），胸、颈部痤疮消失而愈。惟头痛头晕虽减但未完全痊愈。
筋聚
腱鞘囊肿，中医称为筋聚或筋结。《中医伤科学》认为多因用力扭转或跌扑所致，其表现为腕部微肿，疼痛逐渐加剧，在桡骨茎突部阳溪穴（Yangxi, SI5）处有显著压痛，且可牵引至手指、手以及前臂。初起时活动略有障碍，患手握拳拇指在内四指在外，腕向尺侧屈曲时疼痛增加，拇指运动乏力。后期则轻度用力也不可能。如在掌部用力扭转则疼痛加剧，旋转腕部可听到筋腱摩擦音。并提出治法主要有四：一为理筋手法，二为针灸，三为封闭，四为手术。四法虽各具特色，但没有列出内服药如何治疗。我宗“肝主筋，肝藏血”理论，认为肝血不足，筋脉失养，则挛缩为聚为结之意，试用于一些筋聚患者，亦多有效。例如：冯某某，女，21岁。左手腕背侧腱鞘囊肿如枣大一年多，用力或手腕活动时疼痛加重。某医院以可的松封闭，针灸及理筋手法治疗不效。仔细察其证，除以上症状外，并见胸满心烦，舌苔薄白，脉弦。综合脉证，诊断为血虚筋脉失养，拟养血疏肝理筋，方用四物汤（Siwu Tang）加味。处方：当归15克，川芎9克，白芍12克，木瓜12克，熟地12克，片姜黄9克，晚蚕砂12克，五加皮15克，海桐皮9克。服药2剂，疼痛、肿胀竟减轻七八成，继服6剂，霍然而愈。
尿道口血疱
曾治疗患者李某某，男，28岁。尿热尿痛，排尿不利一年多。诸医以泌尿系感染论治不效，近数月来因排尿时痛苦至极，仔细视之，见尿道口内有一小豆大之血泡，色紫，触之疼痛。某医院外科检查后未确诊。又请某医生以八正散（Bazheng San）6剂服之，诸证不减。审视其证，腰痛腰冷，足冷至膝，手冷至腕，尿频尿痛尿少，舌苔薄白，脉沉细涩。证脉合参，诊断为肾阳不足为本，湿热为标。拟补肾壮阳，利湿清热，方用肾气丸（Shenqi Wan）加减。处方：生地24克，山药9克，肉苁蓉15克，土茯苓15克，泽泻10克，丹皮10克，车前子10克（布包），五味子10克，附子10克，肉桂10克，怀牛膝10克。药服3剂，尿痛尿频、排尿困难消失，血泡消退，但腰酸腰痛，手足厥冷未减，乃继予上方调理之。某医生问：尿急尿频尿痛为膀胱湿热，为什么用清热通淋之八正散不效？答曰：淋证有石淋、劳淋、血淋、气淋、膏淋等五种，石淋、劳淋、血淋、气淋、膏淋都有一个共同的表现——小便涩痛，欲便不出，不便自来，淋漓不断，甚则闷塞，滴沥难出。劳淋还有遇劳即发，小便淋沥不绝，如水滴沥而不断的特点。李中梓认为劳于脾者，应补中益气汤（Buzhong Yiqi Tang）与五苓散（Wuling San）分进；思虑而致者，宜归脾汤（Guipi Tang）；劳于肾者，宜生地黄丸，而寒者则宜金匮肾气丸（Jinkui Shenqi Wan）。薛立斋认为肾虚精败之淋，茎中涩痛者，惟金匮肾气丸可救，若大小便牵引而痛，愈痛则欲便，愈便则欲痛，宜倍桂、附，以滋化源，不可误用淡渗之剂与知母、黄柏，以泻其阳，耗其阴。本证虽有尿频尿热尿痛，不可作湿热在膀胱论治，否则必泻其阳，耗其阴而成难治之证。
脂肪瘤与造釉细胞瘤
瘤虽有骨、脂、肉、脓、血的不同，但成因都离不开气滞。陈无择说：“瘤则随气凝结”，所以瘤的治疗必须理气。又因正气盛衰的不同，邪气性质的差异。陈实功说：“脾主肌肉，郁结伤脾，肌肉消薄，土气不行，逆于肉里而为肿，曰肉瘤；肺主气，劳伤元气，腠理不密，外寒搏而为肿，曰气瘤。”“肉瘤者，软若绵，硬似馒，皮色不变，不紧不宽，终年只以覆肝，然治当理脾宽中，疏通戊土，开郁行痰，调理饮食，加味归脾丸是也。气瘤者，软而不坚，皮色如故，或消或长，无热无寒，治当清肺气，调经脉，理劳伤，和营卫，通气散坚丸是也。”脂肪瘤柔软而皮色不变，故以开郁行痰，调理饮食治疗有效。例如：刘某某，男，54岁，四肢、腰腹发现肿瘤七八年。某医院病理学检查结果为脂肪瘤。近半年多来更加增多。因患者拒绝手术，邀余治疗。察其四肢、腰、腹部有肿瘤30多个，不红不痛，大者如核桃，小者如杏核，按之柔软，并见胃脘痞满，泛酸等证，舌苔薄白，脉沉细弦。脉证合参，诊断为气滞痰郁，凝结成瘤。乃拟理气化痰软坚散结。温胆汤（Wendan Tang）加味：竹茹15克，枳壳12克，半夏10克，茯苓10克，乌蛇9克，全虫6克，白芥子3克，白蒺藜6克，牛膝9克，黄药子6克，陈皮12克。连进12剂肿瘤竟消失70%，胃脘痞满好转，又进60剂肿瘤全部消失而愈。又如王某某，男，成年。四肢、腰、腹部发现肿瘤3个多月，大者如蜜桃，小者如杏，不红不痛。某医院诊为脂肪瘤。因不愿手术，邀余治疗。诊时除40多个肿瘤外，别无所苦，舌苔白，脉弦滑。综合症脉，诊断为痰气郁结，凝结成瘤。乃拟化痰散结之温胆汤加减：夏枯草30克，赤芍9克，橘叶9克，青皮9克，白蒺藜9克，竹茹12克，枳壳9克，半夏9克，橘红9克，黄药子12克，全虫4.5克，乌蛇6克，茯苓9克，白芥子1.5克，连翘4.5克。连服20剂肿瘤开始缩小，35剂后突然大部消失，仅在右膝内侧残存一核桃大和一杏仁大的肿瘤，加白芥子3克、连翘6克、全虫6克。继服30剂肿瘤全部消失。在治疗过程中，不但要注意发病的原因，而且要注意发病的部位和脏腑。如牙龈部的肿瘤，由于牙龈属胃，牙齿属肾，所以应加入补肾之品。尹某某，女，45岁。两年前齿龈上出现一个紫泡。针挑破后不但没有消失，反而更加扩大。半年来下颌骨明显肿大，门齿至臼齿间的齿龈上有4个杏核大的紫红色肿物，不痛不痒，但张口咀嚼均感困难。某医院下颌拍片后确诊为下颌造釉细胞瘤。舌苔白，脉弦滑。综合脉症，诊断为肾虚阳浮，痰凝血滞，结为肿瘤。乃拟补肾化痰，软坚活血之剂：附子4.5克，南星9克，全虫6克，白芷9克，元参4.5克，郁金9克，首乌15克，生苡米30克，骨碎补6克，黄药子12克，乌蛇4.5克。服药10剂后，肿胀好转，紫红色转变为青白色，由杏仁大缩小至黄豆大，牙刷由不能进颊部转为能塞进颊部。加鸟梢蛇1.5克，又服10剂，高起之肿物已全部消退，色与正常齿龈相同，但发现牙痛，乃加入地骨皮30克、生地15克，再进50剂恢复正常。
Tinea Capitis (White Baldness)
Tinea capitis is commonly known as "white tinea" or "scalded head." In its early stage, it is mostly caused by the struggle between wind and heat, or damp-heat accumulating in the Bladder Meridian and Governing Vessel generating parasites, combined with external invasion of wind pathogen. Therefore, many physicians consider topical insecticidal agents to be key to treatment. *Zhongyi Waike Xue* (TCM Dermatology) suggests that internal treatment should focus on dispersing wind and clearing heat. *Zhongyi Waike Jianbian* (Brief Compilation of TCM Dermatology) suggests that internal treatment should focus on dispelling wind and clearing heat, removing dampness and killing insects, and relieving itching. However, in cases where the disease course is prolonged, qi and blood accumulate and do not dissipate, qi and blood fail to nourish the skin and flesh, resulting in dry and withered skin and muscles, the aforementioned treatments are often ineffective. For example: Patient Ling XX, female, 42 years old. Had scalp tinea for over a year. Diagnosed with tinea capitis by the dermatology department of a certain hospital. Initial treatment with Western medicine was ineffective; subsequent topical Chinese herbal medicine and oral administration of Fangfeng Tongsheng Wan (Windproof Unblocking Pill) and Xiaofeng San (Wind-Dispersing Powder) were also ineffective. Examination revealed several circular or irregular patches of tinea on the top of the head, covered with white scales, with dry and falling hair in the center, extreme itching, dry throat, thin white tongue coating, and a deep and wiry pulse. Synthesizing the pulse and symptoms, the diagnosis was chronic illness entering the blood level, collateral stasis, and blood dryness generating wind. The treatment principle was to nourish blood and invigorate blood circulation, moisten dryness and dispel wind. Prescription: Tao Ren (Peach Kernel) 9g, Hong Hua (Safflower) 6g, Dang Gui (Angelica Sinensis) 12g, Bai Shao (White Peony Root) 15g, Chuan Xiong (Ligusticum) 6g, Sheng Di (Rehmannia) 9g, Chan Tui (Cicada Slough) 6g, Bai Ji Li (Tribulus) 9g, Fang Feng (Saposhnikovia) 9g, Yuan Shen (Scrophularia) 15g, Qin Jiao (Gentiana Macrophylla) 10g, Bai Tou Weng (Pulsatilla) 10g. After 2 doses, the scalp tinea shrank by about one-third, and the white scales and severe itching improved significantly. However, tinnitus appeared in the left ear, and numerous red rashes appeared on both arms and the back. The pulse changed from deep to floating. This indicates that the blood vessels have been nourished, collaterals are unblocked, and wind pathogen has moved from interior to exterior. The treatment should focus on dispersing wind and clearing heat to resolve the exterior pathogen, which aligns with the principle in *Shanghan Lun* (Treatise on Cold Damage) of treating the interior first and then resolving the exterior. Modified Yinqiao San (Honeysuckle and Forsythia Decoction): Yin Hua (Honeysuckle Flower) 15g, Lian Qiao (Forsythia Fruit) 15g, Zhu Ye (Bamboo Leaf) 9g, Jing Jie (Schizonepeta) 9g, Niu Bang Zi (Arctium Seed) 9g, Yuan Shen (Scrophularia) 15g, Lu Gen (Reed Rhizome) 15g, Bo He (Mint) 6g, Jie Geng (Platycodon) 9g, Dou Chi (Fermented Soybean) 9g, Gan Cao (Licorice) 6g, Chan Yi (Cicada Slough) 9g, Huang Qin (Scutellaria) 9g. After 6 doses, only a bean-sized patch of tinea remained, and systemic rashes disappeared. Add Bai Tou Weng (Pulsatilla) 9g, continue taking for 10 doses, and the condition was cured.
Acne
The *Suwen: Shengqi Tongtian Lun* states: "When sweat meets dampness, acne and miliaria arise... When labor-induced sweat encounters wind, cold condenses it into blisters, and stagnation leads to acne." Zhang Jiebin stated: "Physical exertion causing sweating, sitting or lying in the wind, cold air invading, fluid coagulating into blisters." Wang Kentang advocated using Xuanfu Hua Wan (Inula Pill), while *Yizong Yujian* advocated using Pipa Qingfei Yin (Loquat Lung-Clearing Decoction). Summarizing these approaches, they all treat from the perspective of dispersing wind and diffusing lung qi, but clinical application often yields poor results. Careful observation shows this disease mainly affects young men and women whose kidney qi is vigorous but not yet balanced, typically having a Wood constitution, and acne is often associated with dampness. Thus, Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) was tried, and indeed, the effect was immediate and curative. For example: Patient Gao XX, male, 22 years old. Acne on face, neck, and chest for over 3 years, refractory to long-term treatment, worsening in the past half-year. Observation revealed scattered or dense papules on the face, neck, and chest, varying in color (black, bright red, dark purple), size (pinhead, pea, cherry), some with white pus points, densely distributed or scattered, some clustered nodules. Symptoms included flushed face, dizziness, headache, irritability, bitter taste in mouth, white tongue coating, and wiry pulse. Synthesizing syndrome and pulse, the diagnosis was liver qi stagnation transforming into fire, disharmony of Ying and Wei, and stagnant dampness not resolving. A modified Chaihu Jia Longgu Muli Tang was prescribed: Chai Hu (Bupleurum) 9g, Ban Xia (Pinellia) 9g, Huang Qin (Scutellaria) 9g, Dang Shen (Codonopsis) 9g, Gui Zhi (Cinnamon Twig) 9g, Fu Ling (Poria) 9g, Chuan Jun (Rhubarb) 6g, Gan Cao (Licorice) 6g, Sheng Jiang (Fresh Ginger) 3 slices, Da Zao (Jujube) 5 pieces, Long Gu (Dragon Bone) 15g, Mu Li (Oyster Shell) 15g. After 3 doses, facial acne slightly decreased; after 6 doses, facial acne disappeared, and chest/neck lesions improved. Another 6 doses (total 15 doses) resulted in complete resolution of chest and neck acne. Headache and dizziness decreased but did not fully resolve.
Tendon Sheath Cyst (Jin Ju)
Tendon sheath cysts are referred to as Jin Ju (Tendon Aggregation) or Jin Jie (Tendon Knot) in TCM. *Zhongyi Shangke Xue* (TCM Traumatology) attributes them mostly to forceful twisting or falls. Manifestations include slight wrist swelling, gradually increasing pain, significant tenderness at Yangxi (SI5) on the radial styloid process, radiating to fingers, hand, and forearm. Early stage shows slight movement obstruction; pain increases when making a fist with thumb inside and four fingers outside, and wrist ulnar flexion; thumb movement is weak. Late stage makes even mild effort impossible. Forceful twisting of the palm exacerbates pain; rotating the wrist may produce tendon friction sounds. Four main treatments are proposed: 1. Tendon-manipulation techniques, 2. Acupuncture, 3. Blockade therapy, 4. Surgery. While each method has its merits, none specify internal herbal treatment. Relying on the theory that "the Liver governs tendons and stores blood," insufficient Liver blood fails to nourish tendons, leading to contraction and aggregation/knotting. This approach proved effective for some Jin Ju patients. For example: Patient Feng XX, female, 21 years old. Tendon sheath cyst on the dorsal aspect of the left wrist, date-sized, for over a year, pain worsened by effort or wrist movement. Treatment with cortisone blockade, acupuncture, and tendon manipulation at another hospital was ineffective. Detailed examination revealed, besides the above symptoms, chest fullness, irritability, thin white tongue coating, and wiry pulse. Synthesizing pulse and symptoms, the diagnosis was blood deficiency failing to nourish tendons. The treatment principle was to nourish blood, soothe the Liver, and regulate tendons, using Siwu Tang (Four Substances Decoction) with modifications. Prescription: Dang Gui (Angelica Sinensis) 15g, Chuan Xiong (Ligusticum) 9g, Bai Shao (White Peony Root) 12g, Mu Gua (Chaenomeles) 12g, Shu Di (Prepared Rehmannia) 12g, Pian Jiang Huang (Turmeric) 9g, Wan Can Sha (Mulberry Midge Larvae) 12g, Wu Jia Pi (Acanthopanax Bark) 15g, Hai Tong Pi (Cryptocarya Bark) 9g. After 2 doses, pain and swelling reduced by 70-80%; continuing for 6 doses resulted in immediate cure.
Blood Blister at Urethral Orifice
Patient Li XX, male, 28 years old, was treated for urinary heat, dysuria, and difficulty urinating for over a year. Previous treatments for urinary tract infection were ineffective. Recently, urination became extremely painful. Careful examination revealed a small bean-sized purple blood blister inside the urethral orifice, tender to touch. Surgical examination at a certain hospital yielded no definitive diagnosis. Another physician prescribed Bazheng San (Eight Corrects Powder) for 6 doses, with no improvement. Examination revealed lower back pain and coldness, feet cold to knees, hands cold to wrists, frequent/painful/scanty urination, thin white tongue coating, and deep, fine, choppy pulse. Synthesizing syndrome and pulse, the diagnosis was Kidney Yang deficiency as the root, with damp-heat as the branch. The treatment principle was to tonify Kidney and strengthen Yang, drain dampness and clear heat, using Shenqi Wan (Kidney Qi Pill) with modifications. Prescription: Sheng Di (Rehmannia) 24g, Shan Yao (Dioscorea) 9g, Rou Cong Rong (Cistanche) 15g, Tu Fu Ling (Smilax Glabra Rhizome) 15g, Ze Xie (Alisma) 10g, Dan Pi (Moutan) 10g, Che Qian Zi (Plantago Seed) 10g (wrapped), Wu Wei Zi (Schisandra) 10g, Fu Zi (Aconite) 10g, Rou Gui (Cinnamon Bark) 10g, Huai Niu Xi (Achyranthes) 10g. After 3 doses, urinary pain, frequency, and difficulty disappeared, and the blood blister resolved. However, lower back soreness/coldness and cold extremities persisted, so the same formula was continued for regulation. A colleague asked: Urinary urgency, frequency, and pain indicate Bladder damp-heat; why was Bazheng San (clearing heat and promoting urination) ineffective? I replied: Lin Syndrome includes Stone Lin, Labor Lin, Blood Lin, Qi Lin, and Turbid Lin. All share common symptoms: painful, difficult urination, feeling incomplete emptying, dribbling, severe cases showing blockage and difficulty passing drops. Labor Lin is characterized by onset upon exertion and continuous dribbling like dripping water. Li Zhongzi believed that Spleen-fatigue Lin should be treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Wuling San (Five-Ingredient Poria Pill); Mind-worry Lin with Guipi Tang (Restore the Spleen Decoction); Kidney-fatigue Lin with Shengdi Huang Wan (Rehmannia Pill), and Cold type with Jinkui Shenqi Wan (Golden Cabinet Kidney Qi Pill). Xue Lizhai believed that for Lin due to Kidney deficiency and essence depletion with涩 pain in the penis, only Jinkui Shenqi Wan can save the case. If large and small bowel movements cause pulling pain, worsening pain increases urge to defecate/urinate and vice versa, increase Gui and Fu Zi to nourish the source of transformation; do not mistakenly use diuretic agents or Zhi Mu (Anemarrhena) and Huang Bai (Phellodendron) to drain Yang and consume Yin. Although this case presents with urinary frequency, heat, and pain, it should not be treated as Bladder damp-heat; otherwise, draining Yang and consuming Yin will lead to a difficult-to-treat condition.
Lipoma and Ameloblastoma
Although tumors vary by bone, fat, meat, pus, and blood, their formation always involves Qi stagnation. Chen Wuyue stated: "Tumors form with Qi condensation," so tumor treatment must regulate Qi. Due to differences in Zheng Qi (Upright Qi) strength and pathogen nature, Chen Shigong said: "The Spleen governs muscles; stagnation injures the Spleen, muscles become thin, Earth Qi fails to circulate, reversing into flesh causing swelling, called Meat Tumor; The Lung governs Qi; labor damages Yuan Qi, pores are not tight, external cold combines causing swelling, called Qi Tumor." "Meat Tumor is soft as cotton, hard as steamed bun, skin color unchanged, neither tight nor loose, persisting throughout the year; treatment should regulate Spleen, broaden middle, unblock Earth Qi, open depression and move phlegm, regulate diet, using Jiawei Guipi Wan (Modified Restore the Spleen Pill). Qi Tumor is soft but not firm, skin color unchanged, fluctuating in size, without heat or cold; treatment should clear Lung Qi, regulate meridians, address labor injury, harmonize Ying and Wei, using Tongqi Sanjian Wan (Move Qi and Dissolve Hardness Pill)." Lipomas are soft with unchanged skin color, so treatment focusing on opening depression, moving phlegm, and regulating diet is effective. For example: Patient Liu XX, male, 54 years old. Tumors on limbs, waist, and abdomen for 7-8 years. Pathology confirmed lipoma. Increased in number over the past half-year. Patient refused surgery, sought my treatment. Examination revealed over 30 tumors on limbs, waist, and abdomen, non-red, non-painful, walnut-sized to apricot-kernel-sized, soft on palpation. Accompanied by epigastric fullness, acid regurgitation, thin white tongue coating, and deep, fine, wiry pulse. Synthesizing pulse and symptoms, diagnosis was Qi stagnation and Phlegm depression, condensing into tumor. Treatment principle: Regulate Qi, transform Phlegm, soften hardness, and dissipate nodules. Wendan Tang (Warm Gallbladder Decoction) with modifications: Zhu Ru (Bamboo Shavings) 15g, Zhi Ke (Bitter Orange) 12g, Ban Xia (Pinellia) 10g, Fu Ling (Poria) 10g, Wu She (Zaocys) 9g, Quan Chong (Scorpion) 6g, Bai Jie Zi (Mustard Seed) 3g, Bai Ji Li (Tribulus) 6g, Niu Xi (Achyranthes) 9g, Huang Yao Zi (Dioscorea Hypoglauca) 6g, Chen Pi (Tangerine Peel) 12g. After 12 doses, tumors disappeared by 70%, epigastric fullness improved. After another 60 doses, all tumors disappeared, and the patient was cured. Another case: Patient Wang XX, male, adult. Tumors on limbs, waist, and abdomen for over 3 months, peach-sized to apricot-sized, non-red, non-painful. Diagnosed as lipoma. Refused surgery, sought treatment. Apart from over 40 tumors, no other complaints, white tongue coating, slippery wiry pulse. Synthesizing syndrome and pulse, diagnosis was Phlegm-Qi depression, condensing into tumor. Prescribed Wendan Tang modified to transform Phlegm and dissipate nodules: Xia Ku Cao (Prunella) 30g, Chi Shao (Red Peony Root) 9g, Ju Ye (Tangerine Leaf) 9g, Qing Pi (Green Tangerine Peel) 9g, Bai Ji Li (Tribulus) 9g, Zhu Ru (Bamboo Shavings) 12g, Zhi Ke (Bitter Orange) 9g, Ban Xia (Pinellia) 9g, Ju Hong (Aged Tangerine Peel) 9g, Huang Yao Zi (Dioscorea Hypoglauca) 12g, Quan Chong (Scorpion) 4.5g, Wu She (Zaocys) 6g, Fu Ling (Poria) 9g, Bai Jie Zi (Mustard Seed) 1.5g, Lian Qiao (Forsythia) 4.5g. After 20 doses, tumors began to shrink; after 35 doses, most suddenly disappeared, leaving only walnut-sized and almond-sized tumors on the inner right knee. Added Bai Jie Zi 3g, Lian Qiao 6g, Quan Chong 6g. Continued for 30 doses, all tumors disappeared. During treatment, attention must be paid not only to the cause but also to the location and related Zang-Fu organs. For gum tumors, since gums belong to the Stomach and teeth to the Kidney, Kidney-tonifying herbs should be added. Patient Yin XX, female, 45 years old. A purple blister appeared on the gingiva two years ago. After puncturing, it did not disappear but expanded. Over the past half-year, the mandible swelled significantly. On the gingiva between incisors and molars, there were 4 apricot-kernel-sized purplish-red masses, painless and non-itchy, but causing difficulty in opening mouth and chewing. Mandibular X-ray confirmed ameloblastoma. White tongue coating, slippery wiry pulse. Synthesizing pulse and symptoms, diagnosis was Kidney deficiency with floating Yang, Phlegm coagulation and Blood stasis, forming tumor. Prescribed Kidney-tonifying, Phlegm-transforming, hardness-softening, and blood-invigorating formula: Fu Zi (Aconite) 4.5g, Nan Xing (Arisaema) 9g, Quan Chong (Scorpion) 6g, Bai Zhi (Angelica Dahurica) 9g, Yuan Shen (Scrophularia) 4.5g, Yu Jin (Curcuma) 9g, Shou Wu (Polygonum Multiflorum) 15g, Sheng Yi Mi (Coix Seed) 30g, Gu Sui Bu (Drynaria) 6g, Huang Yao Zi (Dioscorea Hypoglauca) 12g, Wu She (Zaocys) 4.5g. After 10 doses, swelling improved, color changed from purplish-red to cyan-white, size reduced from almond to soybean, toothbrush could enter cheek. Added Niao Shao She (Zaocys) 1.5g, continued for 10 doses, raised masses completely receded, color matched normal gingiva. Toothache developed, so added Di Gu Pi (Lycium Bark) 30g, Sheng Di (Rehmannia) 15g, continued for 50 doses, returned to normal.