【方歌】虎髭毒在颏下生,胃肾积热入任经,痈焮肿痛速溃易,
疽坚硬痛麻痒疔。
【注】此毒一名欬痈,肿痛焮赤,速溃易治;一名承浆疽,坚
硬痛肿,迟溃难治。若根深,形小似豆,麻痒痛甚,恶
寒发热,心烦作呕者疔也,当从疔治。皆由过食炙〔火
搏〕,以致胃肾二经积热上攻任脉而成。痈疽二证初起
,宜服仙方活命饮,加升麻、桔梗消之,若便秘、唇焦
、大渴者,宜内疏黄连汤清之。其余内外治法,俱按痈
疽、肿疡溃疡门。初起麻痒如疔,治法按疔门。
方剂:仙方活命饮、内疏黄连汤(俱见肿疡门)
【方歌】燕窝疮在下颏生,如攒粟豆痒热疼,形类黄水疮破烂,
此证原来湿热成。
【注】此证生于下颏,俗名羊胡子疮。初生小者如粟,大者如
豆,色红热痒微痛,破津黄水,形类黄水疮,浸淫成片
,但疙瘩如攒,由脾胃湿热而成。宜服芩连平胃汤,外
搽碧玉散即效。
方剂:芩连平胃汤
组成:黄芩(一钱五分)黄连(一钱)厚朴(姜炒,一钱)苍
术(炒,二钱)甘草(生,五分)陈皮(一钱)
水二钟,姜一片,煎八分,食后服。
【方歌】芩连平胃燕窝疮,除湿清热服更良,姜炒厚朴苍术草,
陈皮同煎引生姜。
又方:碧玉散
组成:黄柏末 红枣肉(烧炭存性,各五钱)
共研极细末,香油调搽患处。
【方歌】碧玉散搽燕窝疮,色红疙瘩津水黄,枣炭柏末香油拌,
消疼止痒渗湿方。
【方歌】虎髭毒(发生于颏下的痈疽类疾病)生于下巴下方,因胃经和肾经的积热侵入任脉所致。痈表现为红肿热痛,容易溃破且易治愈;疽表现为坚硬、疼痛伴麻木瘙痒,属于疔疮范畴。
【注】这种毒疮又名“咳痈”,特点是肿痛、红热,容易溃破且易于治疗;又名“承浆疽”,特点是坚硬、肿胀疼痛,难以溃破且难治。如果病灶根深蒂固,形状小而像豆子,伴有麻木、瘙痒和剧烈疼痛,以及恶寒发热、心烦作呕等症状,则属于疔疮,应当按疔疮的方法治疗。这些病症皆因过食炙烤食物,导致胃经和肾经积热上攻任脉而形成。对于痈和疽两种证候的初期,适宜服用仙方活命饮,并加入升麻、桔梗以消散肿块;若出现便秘、嘴唇焦枯、极度口渴的症状,适宜服用内疏黄连汤以清热泻火。其余内外治疗方法,均参照痈疽、肿疡、溃疡章节执行。初期若出现类似疔疮的麻木瘙痒症状,治疗方法参照疔疮章节执行。
方剂:仙方活命饮、内疏黄连汤(均见于肿疡门)
【方歌】燕窝疮(一种发生于颏下的皮肤病)生于下巴下方,形态如同聚集的粟米或豆类,伴有瘙痒、发热和疼痛,外形类似黄水疮且容易破溃,此证原本是由湿热邪气引起的。
【注】此证生于下巴下方,俗称“羊胡子疮”。初起时小的如粟米,大的如豆类,颜色红、感觉热、瘙痒且微痛,破溃后流出黄色液体,外形类似黄水疮,浸淫成片,但疙瘩聚集在一起,由脾胃湿热引起。适宜服用芩连平胃汤,外部涂抹碧玉散即可见效。
方剂:芩连平胃汤
组成:黄芩(一钱五分)、黄连(一钱)、厚朴(姜炒,一钱)、苍术(炒,二钱)、甘草(生用,五分)、陈皮(一钱)。
用水两钟,生姜一片,煎至八分,饭后服用。
【方歌】芩连平胃汤治疗燕窝疮,除湿清热服用效果更佳,姜炒厚朴配苍术甘草,加陈皮同煎并用生姜引药。
[Formula Song] Huzi Du (a carbuncle-like disease occurring below the chin) arises in the submental region, caused by accumulated heat in the Stomach and Kidney meridians invading the Ren Mai (Conception Vessel). Carbuncles present with redness, swelling, heat, and pain, are prone to suppuration, and heal easily; Jū (deep-seated abscesses) present with hardness, pain accompanied by numbness and itching, falling under the category of Ding (hard chancre/furuncle).
[Note] This toxic condition is also known as Kai Yong (Cough Abscess), characterized by swelling, pain, redness, and heat, which suppurates quickly and is easy to treat; it is also known as Chengjiang Ju (Chengjiang Deep Abscess), characterized by hardness, swelling, and pain, which suppurates slowly and is difficult to treat. If the root is deep, the shape is small like a bean, accompanied by severe numbness, itching, and pain, along with aversion to cold, fever, mental restlessness, and vomiting, it is classified as Ding (Hard Chancre/Furuncle) and should be treated according to Ding protocols. All these conditions result from excessive consumption of roasted or fried foods, leading to accumulated heat in the Stomach and Kidney meridians attacking upward into the Ren Mai. In the initial stage of both Carbuncle and Jū syndromes, it is appropriate to administer Xianfang Huoming Yin (Immortal Life Elixir Decoction) added with Shengma (Cimicifugae Rhizoma) and Jiegeng (Platycodonis Radix) to dissipate the swelling. If constipation, dry cracked lips, and extreme thirst are present, Neishu Huanglian Tang (Internal Purging Coptis Decoction) should be used to clear heat. For other internal and external treatment methods, refer to the sections on Carbuncles and Jū, Swollen Sores, and Ulcerated Sores. If initial symptoms resemble Ding (numbness and itching), follow the Ding treatment protocols.
Formulas: Xianfang Huoming Yin (Immortal Life Elixir Decoction), Neishu Huanglian Tang (Internal Purging Coptis Decoction) (both see section on Swollen Sores)
[Formula Song] Yanwo Chuang (Swallow's Nest Sore, a dermatological condition below the chin) occurs in the submental region, resembling clusters of millet seeds or beans, accompanied by itching, heat, and pain. Its appearance resembles Huangshui Chuang (Yellow Water Sore) and tends to rupture easily; this syndrome originates from Damp-Heat pathogenic factors.
[Note] This condition arises in the submental region, commonly known as "Sheep Beard Sore." Initially, lesions are small like millet seeds or large like beans, appearing red, hot, itchy, and slightly painful. Upon rupture, they exude yellow fluid, resembling Huangshui Chuang (Yellow Water Sore), spreading into patches but with clustered nodules. It is caused by Damp-Heat in the Spleen and Stomach. It is appropriate to take Qinlian Pingwei Tang (Coptis and Coptis-Pingwei Decoction) and externally apply Biyu San (Jade Powder) for effective results.
Formula: Qinlian Pingwei Tang (Coptis and Coptis-Pingwei Decoction)
Composition: Huangqin (Scutellariae Radix, 1.5 qian), Huanglian (Coptidis Rhizoma, 1 qian), Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger, 1 qian), Cangzhu (Atractylodis Rhizoma, stir-fried, 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, raw, 0.5 qian), Chenpi (Citri Reticulatae Pericarpium, 1 qian).
Add two zhong of water and one slice of ginger, decoct until reduced to eight fen, and take after meals.
[Formula Song] Qinlian Pingwei Tang treats Yanwo Chuang (Swallow's Nest Sore); clearing dampness and heat yields better results. Ginger-fried Houpo combined with Cangzhu and Gancao, decocted together with Chenpi and guided by ginger.
Another Formula: Biyu San (Jade Powder)
Composition: Huangbai (Phellodendri Cortex) powder, Hongzaorou (Ziziphi Jujubae Fructus flesh, charred to retain efficacy, each 5 qian).
Grind together into an extremely fine powder, mix with sesame oil, and apply topically to the affected area.
[Formula Song] Apply Biyu San (Jade Powder) to Yanwo Chuang (Swallow's Nest Sore) for red nodules and yellow exudate; mixing charred jujube flesh with Phellodendri powder and sesame oil constitutes a formula for relieving pain, stopping itching, and draining dampness.