甘石（二钱） 镜面朱砂（二分） 牛黄（五厘） 珍珠（五厘， ）
共研细，日敷三次。
己巳春，阅沪上《福祉医学报》载有章×之言，有误用藤黄，治愈走马牙疳之事，甚为奇异。兹特录其原文
于下，以供医界之研究∶
丁卯三月，余偕友数人，偶至仁溏观优。有潘氏子，年四岁，患走马牙疳，起才三日，牙龈腐化，门牙已
脱数枚，下唇已溃穿，其势甚剧。问尚有可救之理否？询其由，则在发麻之后。实为邪热入胃，毒火猖狂，一
发难遏，证情危险。告以只有白马乳凉饮，并不时洗之，涂以人中白，内服大剂白虎汤，或有可救。但势已穿
唇，效否不敢必耳。因书生石膏、生知母、生打寒水石、象贝等为方与之。其时同游者，有老医倪××，因谓之
曰，牛黄研末，外掺腐烂之处，亦或可治。遂彼此各散。后数日，则此儿竟已痊愈，但下唇缺不能完。因询其
用何物疗治，乃得速效若斯，则曰，用倪××说，急购藤黄屑而掺之，果然一掺腐势即定，血水不流，渐以结靥
落痂，只三日耳。内服石膏等一方，亦仅三服。此儿获愈，因其无识，误听牛黄为藤黄。然以此一误，而竟治
愈极重之危证。开药学中从古未有之实验，胡可以不志也。尝考李氏《本草纲目》，蔓草中曾载藤黄，而功用
甚略。至赵恕轩《本草纲目拾遗》，言之甚详。虽曰有毒，而可为内服之品，且引《粤志》谓，其性最寒，可
治眼疾，味酸涩，治痈肿，止血化毒，敛金疮，能除虫，同麻油、白蜡熬膏，敷金疮、汤火等伤，止疼收口，
其效如神。而其束疮消毒之用又甚多，可知
此药，竟是外科中绝妙良药。而世多不知用者，误于李氏《海药本草》有毒之两字。而张石顽更以能治蛀齿，
点之即落，而附会为毒，损骨伤肾，于是畏之甚于蛇蝎，实不知石顽不可信。今之画家，常以入口，虽曰与花
青并用，可解其毒，余以为亦理想之谈耳。既曰性寒，毒于何有？然后知能愈牙疳，正是寒凉作用。且其味酸
涩，止血、止疼、收口、除虫皆其能治牙疳之切实发明也。
按∶走马牙疳之原因，有内伤外感之殊。得于由内伤者轻而缓，由外感者重而急。此幼童得于麻疹之后，
其胃中蕴有瘟毒上攻，是以三日之间，即腐烂如此。幸内服石膏、寒水石，外敷藤黄，内外夹攻，皆中要肯，
是以其毒易消，结痂亦在三日内也。若当牙疳初起之时，但能用药消其内蕴之毒热，即外不敷药，亦可治愈。
曾治天津于氏幼童，年六七岁，身出麻疹，旬日之外热不退，牙龈微见腐烂。其家人惧甚，恐成走马牙疳，延
愚诊视。脉象有力而微弦，知毒热虽实，因病久者，气分有伤也。问其大便，三日未行。遂投以大剂白虎加人
参汤，方中生石膏用三两，野党参用四钱，又加连翘数钱，以托疹毒外出。煎汤三茶盅，俾分三次温饮下。又
用羚羊角一钱，煎水一大茶盅，分数次当茶饮之，尽剂热退而病愈。牙龈腐烂之处，亦遂自愈。
甘石（二钱） 镜面朱砂（二分） 牛黄（五厘） 珍珠（五厘，研细）
共同研磨成细粉，每日外敷三次。
己巳年春天，我阅读上海《福祉医学报》上记载的章×某的话，其中有误用藤黄治愈走马牙疳（一种发病迅速、病情严重的口腔腐败性疾病）的案例，觉得非常奇异。特此将其原文记录如下，供医学界研究：
丁卯年三月，我和几位朋友，偶然去仁溏观看戏。有个姓潘人家的孩子，四岁，患了走马牙疳，发病才三天，牙龈已经腐烂，门牙脱落了几颗，下嘴唇也已经溃烂穿孔，形势非常严重。问还有没有可救的道理？询问病因，是因为在出过麻疹之后。实际上是邪热进入胃中，毒火猖狂，一旦发作难以遏制，证情危险。告诉他只有喝白马乳来清热，并不时清洗患处，涂抹人中白（一种中药），内服大剂量的白虎汤（清热生津的名方），或许还有救。但是既然嘴唇已经穿破，疗效如何不敢保证。于是开出了生石膏、生知母、生打寒水石、象贝（浙贝母的别名）等药物组成方剂给他。当时一同游玩的，有一位老医生倪××，便对他说，将牛黄研成末，外掺在腐烂的地方，也许也能治好。于是大家各自散去。过了几天，这个孩子竟然痊愈了，只是下嘴唇缺损无法复原。于是询问他用了什么药治疗，能取得如此速效，回答说，用了倪××的建议，急忙购买藤黄屑掺入患处，果然一掺上去，腐烂之势立即停止，血水不再流出，逐渐结痂脱落，仅仅三天而已。内服的石膏等一方，也只服了三剂。这个孩子获得痊愈，是因为无知，误把牛黄听成了藤黄。然而因为这一错误，竟然治好了极重的危证。开创了药学中从古以来未曾有过的实验，怎么能不记录下来呢？曾经考察李氏的《本草纲目》，蔓草类中曾记载藤黄，但功用描述得很简略。到了赵恕轩的《本草纲目拾遗》，说得非常详细。虽然说是“有毒”，但可以作为内服的药物，并且引用《粤志》说，它的性质最寒，可以治疗眼疾，味道酸涩，治疗痈肿，止血解毒，收敛金疮（金属利器造成的伤口），能杀虫，同麻油、白蜡熬制成膏，敷于金疮、烫伤等伤口，止痛收口，其效果如神。而且它束疮消毒的用途又很多，可知此药，竟是外科中绝妙的良药。而世人大多不知道使用，是被李氏《海药本草》中“有毒”这两个字误导了。而张石顽更认为它能治疗蛀齿，点涂即落，并附会说是毒性，损伤骨骼肾脏，于是人们害怕它胜过蛇蝎，实在不知道张石顽不可信。现在的画家，常以藤黄入口，虽然说与花青并用，可以解其毒，我认为这也是理想化的谈论罢了。既然性质寒凉，毒在哪里呢？然后知道能治愈牙疳，正是寒凉作用的结果。况且它味道酸涩，止血、止痛、收口、杀虫都是它能治疗牙疳的确切功效证明。
按语：走马牙疳的原因，有内伤和外感的不同。得于内伤的较轻且缓慢，得于外感的较重且急迫。这个幼童是在麻疹之后得的，他胃中蕴含有瘟毒上攻，所以在三天之内，就腐烂到这种程度。幸亏内服石膏、寒水石，外敷藤黄，内外夹攻，都击中了要害，所以毒素容易消除，结痂也在三天内完成。如果在牙疳初起的时候，只要能用药消除体内蕴藏的毒热，即使外部不敷药，也可以治愈。曾经治疗天津于家的一个幼童，六七岁，身上出了麻疹，十天以后热度不退，牙龈微微见到腐烂。他的家人非常恐惧，担心发展成走马牙疳，请我诊治。脉象有力而微弦，知道毒热虽然实证，但因为病久，气分有所损伤。问他的大便，三天未行。于是投以大剂量白虎加人参汤（清热益气生津的方剂），方中生石膏用三两，野党参用四钱，又加连翘数钱，以托举疹毒外出。煎汤三茶盅，让分三次温饮下。又用羚羊角一钱，煎水一大茶盅，分数次当茶饮之，药尽后热度退去而病愈。牙龈腐烂之处，也随之自愈。
Calcined Calamine (2 qian), Mirror-polished Cinnabar (2 fen), Calculus Bovis (5 li), Pearl (5 li, finely ground).
Grind all together into a fine powder. Apply externally three times daily.
In the spring of the Jisi year, I read in Shanghai's *Welfare Medical Journal* a statement by Mr. Zhang X regarding a case where Tu Huang was mistakenly used to cure "Zouma Yagan" (a rapidly progressing and severe form of necrotizing gingivitis/stomatitis), which seemed quite extraordinary. I hereby record its original text below for the medical community's study:
In March of the Dingmao year, accompanied by several friends, I happened to go to Ren Tang Guan to watch an opera performance. There was a four-year-old boy from the Pan family suffering from Zouma Yagan. The onset had been only three days; his gums were already necrotic, several incisors had fallen out, and his lower lip was ulcerated and perforated. The condition was extremely severe. I asked if there was any hope for rescue. Upon inquiry into the etiology, it was found that this occurred after he had suffered from measles. Essentially, pathogenic heat had entered the Stomach, causing toxic fire to rage uncontrollably once triggered, making the prognosis dangerous. I advised that drinking cool horse milk and frequently washing the area, applying Baituozhong (Human Tooth Ash), and internally administering a large dose of Baihu Tang (White Tiger Decoction) might offer a chance of survival. However, since the lip was already perforated, I could not guarantee efficacy. Therefore, I prescribed a formula containing Raw Gypsum (Shigao), Raw Anemarrhena Rhizome (Zhimu), Raw Calcined Aragonite (Hanshuishi), and Fritillaria Thunbergii Bulb (Xiangbei). Among those present was an old physician, Mr. Ni XX, who suggested to him: "Grind Calculus Bovis into powder and apply it externally to the necrotic areas; this might also be curative." Thus, we parted ways. A few days later, the child had actually recovered, although the lower lip remained defective and could not fully heal. When asked what medication produced such rapid results, he replied that he followed Mr. Ni XX's advice, hastily purchased fragments of Tu Huang (Garcinia Hanburyi Resin) and applied them to the lesion. Indeed, upon application, the progression of necrosis stopped immediately, bleeding and exudate ceased, and scabs gradually formed and fell off within just three days. He had taken the internal prescription of Gypsum and others for only three doses. The child recovered because, due to ignorance, he mistook Calculus Bovis for Tu Huang. Yet, through this error, a critical and severe condition was cured, creating an unprecedented experiment in pharmacology. How can this not be recorded? I previously examined Li Shizhen's *Compendium of Materia Medica*, which mentions Tu Huang under creeping plants but describes its functions briefly. It was Zhao Shuxuan's *Supplement to Compendium of Materia Medica* that detailed it extensively. Although stated as "toxic," it can be taken internally. Citing *Guangdong Gazetteer*, it states that its nature is extremely cold, treating eye diseases; its taste is sour and astringent, treating carbuncles and swellings, stopping bleeding, detoxifying, healing metal wounds, expelling parasites, and when boiled with sesame oil and beeswax into a plaster, it stops pain and promotes wound closure for trauma and burns with miraculous effect. Its uses in binding sores and disinfecting are numerous, indicating that this herb is indeed an excellent medicine for surgery. However, most people do not know how to use it, misled by the two characters "toxic" in Li Shi's *Sea Medicinal Materia Medica*. Furthermore, Zhang Shiwen claimed it treats dental caries, causing teeth to fall off upon application, and falsely attributed this to toxicity damaging bones and kidneys. Consequently, people fear it more than snakes and scorpions, failing to realize that Zhang Shiwen is unreliable. Modern painters often ingest Tu Huang; although it is said that using it with Indigo Naturalis can neutralize its toxicity, I consider this merely theoretical speculation. If its nature is cold, where is the toxicity? Thus, we understand that its ability to cure Yagan is precisely due to its cooling action. Moreover, its sour and astringent taste, along with its abilities to stop bleeding, relieve pain, promote wound closure, and kill parasites, are concrete proofs of its efficacy in treating Yagan.
Note: The causes of Zouma Yagan differ between internal injury and external contraction. Cases arising from internal injury are mild and slow, while those from external contraction are severe and acute. This toddler contracted it after measles; his Stomach harbored epidemic toxins attacking upward, leading to such extensive necrosis within three days. Fortunately, the combination of internal administration of Gypsum and Calcined Aragonite and external application of Tu Huang attacked the disease from both inside and outside, hitting the key points effectively. Thus, the toxin was easily eliminated, and scabbing occurred within three days. If, at the initial stage of Yagan, one can use medication to eliminate the internal accumulated toxic heat, even without external applications, it can be cured. I once treated a toddler from the Yu family in Tianjin, aged six or seven, who had developed measles. After ten days, the fever persisted, and slight gum necrosis appeared. His family was terrified, fearing it would develop into Zouma Yagan, and sought my consultation. His pulse was forceful yet slightly wiry. I determined that although the toxic heat was excess, the prolonged illness had damaged the Qi level. Asking about his bowel movements, he had not defecated for three days. I therefore administered a large dose of Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). The formula contained Raw Gypsum (3 liang), Wild Codonopsis Root (4 qian), and several qian of Forsythia Fruit (Lianqiao) to vent the measles toxin outward. The decoction was divided into three tea cups, to be taken warm in three portions. Additionally, one qian of Antelope Horn (Lingyangjiao) was decocted in a large tea cup of water, to be drunk in divided doses. After completing the dosage, the fever subsided, and the illness resolved. The necrotic areas on the gums also healed spontaneously.