【方歌】赤白游风如粟形,浮肿焮热痒兼疼,表虚风袭怫郁久,
血赤气白热化成。
【注】此证发于肌肤,游走无定,起如云片,浮肿焮热,痛痒
相兼,高累如粟,由脾肺燥热,而兼表虚腠理不密,风
邪袭入,怫郁日久,与热相搏则化热益盛而成。滞于血
分者,则发赤色;滞在气分者,则发白色,故名赤白游
风也。初俱宜荆防败毒散疏解之。赤者次服四物消风饮
;白者次服补中益气汤加防风、蝉蜕、僵蚕、生何首乌
治之。初俱用牛肉片贴之(猪羊俱可)。游走太速者,
砭之。定停者,以真君妙贴散鸡子清调敷。其看顺逆之
法,与丹毒门参考。忌鱼腥、鸡、鹅、动风燥血之物,
犯则难愈。
方剂:四物消风饮
组成:生地(三钱) 当归(二钱)
荆芥 防风(各一钱五分)
赤芍 川芎
白鲜皮 蝉蜕
薄荷(各一钱) 独活
柴胡(各七分)
红枣肉二枚,水二钟,煎八分,去渣服。
【方歌】四物消风饮调荣,血滋风减赤色平,荆防藓蝉兼独活,
柴薄红枣水煎浓。
又方:荆防败毒散(见项部脑疽)
补中益气汤(见溃疡门)
真君妙贴散(见肿疡门)
【方歌】紫白癜风无痒痛,白因气滞紫血凝,热体风侵湿相搏,
毛窍闭塞发斑形。
【注】此证俗名汗斑,有紫、白二种。紫因血滞,白因气滞。
总由热体风邪、湿气,侵入毛孔,与气血凝滞,毛窍闭
塞而成。多生面项,斑点游走,延蔓成片,初无痛痒,
久之微痒。初起宜万灵丹汗之,次以胡麻丸常服;外用
蜜陀僧散擦患处,令汗出,风湿自解。古今治法虽多,
取效甚少,得其证者,当忌鱼腥、煎炒、火酒、动风、
发物。
方剂:胡麻丸
组成:大胡麻(四两)苦参防风石菖蒲威灵仙(各二凛)白附
子独活(各一两)甘草(生,五钱)
共为细末,白酒浆和丸,如菉豆大。每服二钱,形
瘦者,一钱五分,食后临卧白滚水送下。
【方歌】胡麻丸治紫白癜,除去风湿不致延,苦参白附防风草,
菖蒲独活威灵仙。
又方:蜜陀僧散
组成:雄黄 硫黄
蛇床子(各二钱) 蜜陀僧
石黄(各一钱) 轻粉(五分)
共研末,醋调搽患上。
【方歌】蜜陀僧散风湿患,入腠成癜紫白斑,雄硫轻粉蛇床子,
石黄共末醋搽痊。
又方:万灵丹(见肿疡门)
【方歌】赤白游风的症状表现为皮肤出现如粟米大小的疹形,伴有浮肿、红肿发热以及瘙痒和疼痛。这是由于表虚导致风邪侵袭,郁结日久,血分受热则发赤色,气分受热则发白色,最终化热而成。
【注】此病证发作于肌肤之间,位置游走不定,起初像云片一样,伴有浮肿、红肿发热,疼痛与瘙痒并存,隆起部分如同粟米。其病因是由于脾肺燥热,兼有体表虚弱、腠理(皮肤纹理及汗孔)不紧密,风邪乘虚侵入,郁结日久,与体内热气相互搏结,使得热势更加旺盛而发病。病邪滞留在血分者,则发出红色;滞留在气分者,则发出白色,因此称为赤白游风。初期都适宜使用荆防败毒散来疏风解表。发赤色的患者,随后服用四物消风饮;发白色的患者,随后服用补中益气汤并加入防风、蝉蜕、僵蚕、生何首乌进行治疗。初期都可以用牛肉片贴敷患处(猪肉、羊肉也可以)。如果皮疹游走速度过快,可以使用砭石刺破放血。如果皮疹固定不动,则用真君妙贴散,以鸡蛋清调和后外敷。判断病情顺逆的方法,可参考丹毒章节的内容。忌食鱼腥、鸡肉、鹅肉以及动风燥血的食物,如果触犯这些禁忌,则难以痊愈。
方剂:四物消风饮
组成:生地(三钱) 当归(二钱)
荆芥 防风(各一钱五分)
赤芍 川芎
白鲜皮 蝉蜕
薄荷(各一钱) 独活
柴胡(各七分)
红枣肉两枚,水两钟,煎至八分,去药渣服用。
【方歌】四物消风饮调理营血,血液滋润则风邪减退,赤色平复,方中含荆芥、防风、白鲜皮、蝉蜕兼独活,柴胡、薄荷配红枣用水煎浓服。
又方:荆防败毒散(见项部脑疽章节)
补中益气汤(见溃疡门章节)
真君妙贴散(见肿疡门章节)
【方歌】紫白癜风没有瘙痒和疼痛,白色是因为气机阻滞,紫色是因为血液凝滞,体质偏热又受风邪侵袭,湿气相搏,导致毛窍闭塞,形成斑片状皮损。
【注】此病俗名汗斑,分为紫色和白色两种。紫色是因为血行不畅,白色是因为气机阻滞。总归是由体质偏热,风邪、湿气侵入毛孔,与气血凝滞,毛窍闭塞而成。多生长在面部和颈部,斑点游走,蔓延成片,初起时没有疼痛和瘙痒,时间久了会有轻微瘙痒。初起时适宜使用万灵丹发汗治疗,随后常服胡麻丸;外用蜜陀僧散擦拭患处,令其出汗,风湿之邪自然解除。古今治疗方法虽然很多,但见效的很少,患有此病的人,应当忌食鱼腥、煎炸炒制食物、烈性酒、动风之物以及发物。
方剂:胡麻丸
组成:大胡麻(四两)苦参、防风、石菖蒲、威灵仙(各二两)白附子、独活(各一两)甘草(生用,五钱)
共研为细末,用白酒和浆液调和制成丸药,大小如绿豆。每次服用二钱,形体消瘦者服用一钱五分,饭后临睡前用白开水送服。
【方歌】胡麻丸治疗紫白癜风,去除风湿不再蔓延,方中含苦参、白附子、防风、甘草,石菖蒲、独活、威灵仙。
又方:蜜陀僧散
组成:雄黄、硫黄、蛇床子(各二钱)蜜陀僧、石黄(各一钱)轻粉(五分)
共研为粉末,用醋调和涂抹患处。
【方歌】蜜陀僧散治疗风湿引起的紫白斑,药物入腠理成癜,方中含雄黄、硫黄、轻粉、蛇床子、石黄,共研末用醋调搽可痊愈。
又方:万灵丹(见肿疡门章节)
[Prescription Verse] Chi Bai You Feng (Red and White Wandering Wind) presents with skin lesions resembling millet grains, accompanied by edema, erythema, heat, pruritus, and pain. This condition arises from exterior deficiency allowing wind pathogen invasion; after lingering for a long time, stagnation transforms into heat. Heat in the blood level manifests as redness, while heat in the qi level manifests as whiteness.
[Annotation] This syndrome occurs on the skin and muscles, wandering without a fixed location. It begins like cloud patches, presenting with edema, erythema, and heat, with both pain and pruritus. The raised lesions resemble millet grains. The etiology involves dryness-heat in the Spleen and Lung, combined with exterior deficiency and loose Cou Li (skin texture and pores). Wind pathogen invades due to this laxity, lingers for a long time, and combats with internal heat, causing the heat to intensify and form the disease. When the pathogen stagnates in the Blood level, red lesions appear; when it stagnates in the Qi level, white lesions appear, hence the name Chi Bai You Feng (Red and White Wandering Wind). In the initial stage, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction) is suitable for dispersing and resolving the exterior. For red lesions, Si Wu Xiao Feng Yin (Four Substances Wind-Extinguishing Decoction) should be taken subsequently; for white lesions, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fang Feng (Saposhnikovia Root), Chan Tui (Cicada Slough), Jiang Can (Bombyx Batryticatus), and Sheng He Shou Wu (Polygoni Multiflori Radix Praeparata) should be taken subsequently. Initially, beef slices can be applied to the affected area (pork or mutton are also acceptable). If the lesions wander too rapidly, Bian Shi (stone piercing/bleeding) therapy should be used. If the lesions are stationary, Zhen Jun Miao Tie San (True Lord's Miraculous Paste Powder) mixed with egg white should be applied externally. Methods for determining favorable or unfavorable prognosis refer to the Dan Du (Erysipelas) section. Avoid fishy smells, chicken, goose, and foods that stir wind or dry blood; violating these taboos will make recovery difficult.
Formula: Si Wu Xiao Feng Yin (Four Substances Wind-Extinguishing Decoction)
Composition: Di Huang (Rehmanniae Radix, 3 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian); Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix, 1.5 qian each); Chi Shao (Paeoniae Radix Rubra), Chuan Xiong (Ligustici Chuanxiong Rhizoma); Bai Xian Pi (Dictamni Cortex), Chan Tui (Cicadae Periostracum); Bo He (Menthae Haplocalycis Herba), Du Huo (Angelicae Pubescentis Radix, 1 qian each); Chai Hu (Bupleuri Radix, 0.7 qian); Two pieces of Hong Zao (Jujubae Fructus), two zhong of water, decocted to eight fen, strain and take.
[Prescription Verse] Si Wu Xiao Feng Yin regulates Ying (Nutritive) Qi; nourishing the blood reduces wind and calms the redness. It contains Jing Jie, Fang Feng, Bai Xian Pi, Chan Tui, and Du Huo, along with Chai Hu, Bo He, and Hong Zao, decocted strongly in water.
Another Formula: Jing Fang Bai Du San (See Neck Carbuncle Section)
Bu Zhong Yi Qi Tang (See Ulcer Section)
Zhen Jun Miao Tie San (See Swelling/Ulcer Section)
[Prescription Verse] Zi Bai Dian Feng (Purple and White Vitiligo/Mottling) has no pruritus or pain. Whiteness is due to Qi stagnation, purple color is due to Blood coagulation. A hot constitution invaded by wind and dampness causes hair follicles to close, forming macular lesions.
[Annotation] This condition is commonly known as Sweat Spot (Han Ban), existing in purple and white varieties. Purple is due to Blood stagnation, white is due to Qi stagnation. Generally, it results from a hot constitution where wind pathogen and dampness invade the pores, combining with stagnant Qi and Blood, closing the hair follicles. It mostly appears on the face and neck, with wandering spots spreading into patches. Initially, there is no pain or pruritus, but mild pruritus may develop over time. In the early stage, Wan Ling Dan (Ten Thousand Spirits Pill) should be used to induce sweating, followed by regular intake of Hu Ma Wan (Sesame Pill). Externally, Mi Tuo Seng San (Lead Monoxide Powder) should be rubbed on the affected area to induce sweating, thereby resolving wind-dampness. Although ancient and modern treatments are numerous, few are effective. Patients should avoid fishy smells, fried foods, strong alcohol, wind-stirring foods, and "Fa Wu" (trigger foods).
Formula: Hu Ma Wan (Sesame Pill)
Composition: Da Hu Ma (Sesami Semen, 4 liang); Ku Shen (Sophorae Flavescentis Radix), Fang Feng, Shi Chang Pu (Acori Tatarinowii Rhizoma), Wei Ling Xian (Clematidis Radix, 2 liang each); Fu Zi (Aconiti Lateralis Radix Praeparata), Du Huo (Angelicae Pubescentis Radix, 1 liang each); Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 5 qian).
Grind into fine powder, mix with white wine and starch paste to form pills the size of green beans. Take 2 qian per dose; for emaciated patients, take 1.5 qian. Take after meals before bed with plain boiled water.
[Prescription Verse] Hu Ma Wan treats Purple and White Vitiligo, removing wind-dampness to prevent spread. It contains Ku Shen, Fu Zi, Fang Feng, and Gan Cao, along with Shi Chang Pu, Du Huo, and Wei Ling Xian.
Another Formula: Mi Tuo Seng San (Lead Monoxide Powder)
Composition: Xiong Huang (Realgar), Huang Zhu (Sulfur), She Chuang Zi (Cnidii Fructus, 2 qian each); Mi Tuo Seng (Galena), Shi Huang (Orpiment), Qing Fen (Calomel, 1 qian each, 0.5 qian respectively).
Grind into powder, mix with vinegar and apply to the affected area.
[Prescription Verse] Mi Tuo Seng San treats wind-dampness causing purple and white spots entering the Cou Li. It contains Xiong Huang, Huang Zhu, Qing Fen, She Chuang Zi, and Shi Huang, ground together and applied with vinegar for cure.
Another Formula: Wan Ling Dan (See Swelling/Ulcer Section)