（附鼻渊。有卒倒等症为中，无卒倒等症为伤，下各篇仿此。）
甚者遍传经络，已见《伤寒论》。此言其轻浅者，邪止犯皮毛。皮毛为肺之合，
皮毛闭则肺气不得外泄，故上壅而嚏。蒸成涕液，壅塞鼻中，故声出重浊。肺气郁
而成热，故肺痒而咳。其人平素体气寒者则无汗，热者则有汗。或发热或不发热，
或头痛或不头痛，盖虽轻症，其中又分轻重也。虚者参苏饮，（见发热。）实者川芎茶调
散。此症与鼻渊相似而不同，伤风属肺有喷嚏，且为寒邪，故涕清；鼻渊属脑，故
无喷嚏，且系热邪，故涕浊。甚则有秽气，鼻出血。盖鼻渊属风热入脑，热气涌涕
伤鼻，两孔气出如火，痛，或成疮。热不得泄，伤及所过营血则衄矣。初起苍耳散
散之；久病热深，防风通圣散。（见中风）清之；衄者，犀角地黄汤（见血）凉之；鼻孔痛成疮，
猪胆汁调冰硼散（见口）涂之。（此《医宗金鉴》云尔。然鼻渊属脑热，云无嚏，于理未的，详欠嚏篇可见矣。）
或破损，或疮溃，风从破处入，郁遏正气为热，理同伤寒。而或甚者，以曾经
去血挟虚也，故多搐痉等症。先须辨疮口，平而无水者，止于郁热而已。若肿而出
水，则热郁而蒸成湿矣。脉浮在表，宜汗，羌活防风汤、九味羌活汤。表解后，以
白术防风汤补之。脉弦者，半表半里，宜和解，小柴胡汤、（见寒热。）羌活汤、地榆防
风散。脉沉实不大便，在里，宜下，大芎黄汤、江鳔丸，后服羌活汤。发表药宜辛
凉，不宜辛热。服风药过多，汗不止者，白术黄 汤。搐痉不已，蠲痉汤。凡痉搐，
须养血润燥加引经药。背后搐者，羌活、独活、防风、甘草；面前搐者，升麻、白
芷、独活、防风、甘草；两旁搐者，柴胡、防风、甘草，右搐加滑石。（右属脾湿也。）手
足颤掉不已，朱砂指甲散。头目青黑，额上汗珠不流，眼小目瞪，痛不在疮处者，
伤经络也，并不治。亦有疮热郁结，多着白痂，疮口闭塞，气不宣通，郁热生风者，
此为内风，但须清热解郁。外治法∶初于人家粪堆内，或烂草房上，取蛴螬虫一枚，
捏住其背，待虫口吐水，就抹在疮口上，觉麻即汗出立愈。或玉真散敷之，或杏仁
去皮细嚼，和雄黄、白面敷，肿消为度。牙关不开，蜈蚣一条，焙干研末擦牙、吐
涎立苏。
（附注鼻渊。出现突然昏倒等症状的称为“中”，没有突然昏倒等症状的称为“伤”，以下各篇仿照此例。）
病情严重的，邪气会遍传经络，这已在《伤寒论》中论述过。这里说的是病情轻浅的情况，邪气仅侵犯皮毛。皮毛是肺的外合，皮毛闭塞则肺气不能向外宣泄，因此向上壅滞而打喷嚏。热气蒸腾形成涕液，堵塞在鼻中，所以声音发出时显得重浊。肺气郁结而化热，所以肺部发痒而咳嗽。平时体质偏寒的人则无汗，体质偏热的人则有汗。有的发热，有的不发热；有的头痛，有的不头痛。虽然属于轻症，但其中又分为轻重程度不同。体虚者参用参苏饮（见发热章节），实证者用川芎茶调散。此症与鼻渊相似但不同，伤风病位在肺且有喷嚏，且由寒邪引起，所以鼻涕清稀；鼻渊病位在脑，所以无喷嚏，且由热邪引起，所以鼻涕浑浊。严重的甚至有秽臭气味，或鼻出血。大概是因为鼻渊属风热入脑，热气涌出损伤鼻涕和鼻腔，两鼻孔呼出的气像火一样，疼痛，或者形成疮疡。热邪不得宣泄，损伤经过的营血就会导致鼻衄。初起时用苍耳散发散；久病热邪深重，用防风通圣散清解（见中风章节）；鼻出血者，用犀角地黄汤凉血止血（见血证章节）；鼻孔疼痛形成疮疡，用猪胆汁调和冰硼散涂抹（见口齿章节）。（这是《医宗金鉴》的说法。然而鼻渊属脑热，说没有喷嚏，从道理上讲并不确切，详见欠嚏篇即可明白。）
如果是皮肤破损，或者疮疡溃烂，风邪从破口进入，郁遏正气化为热邪，其机理同于伤寒。如果更严重些，是因为曾经失血兼有虚损，所以多有抽搐痉挛等症状。首先必须辨别疮口，平坦且无渗水的，只是郁热而已。如果肿胀且出水，则是热邪郁结蒸腾成湿邪了。脉象浮在表，宜用发汗法，用羌活防风汤、九味羌活汤。表证解除后，用白术防风汤补益。脉弦的，属半表半里，宜用和解法，用小柴胡汤（见寒热章节）、羌活汤、地榆防风散。脉沉实且不大便的，病在里，宜用攻下法，用大芎黄汤、江鳔丸，之后服用羌活汤。发表药宜用辛凉之品，不宜用辛热之品。服用风药过多导致汗出不止的，用白术黄芪汤。抽搐痉挛不止的，用蠲痉汤。凡是痉挛抽搐，必须养血润燥并加入引经药。背部抽搐的，用羌活、独活、防风、甘草；面部抽搐的，用升麻、白芷、独活、防风、甘草；两侧抽搐的，用柴胡、防风、甘草，右侧抽搐加滑石。（右侧属脾湿。）手足颤抖不已的，用朱砂指甲散。头目青黑，额头汗珠凝聚不流，眼睛变小且直视，疼痛不在疮口处的，是损伤了经络，属于不治之症。也有因疮疡热邪郁结，多附着白色痂皮，疮口闭塞，气机不宣通，郁热生风的，这属于内风，只需清热解郁。外治法：起初可在别人家的粪堆内，或烂草房顶上，取一只蛴螬虫，捏住其背部，待虫口吐出液体，就涂抹在疮口上，感觉麻木就会出汗并立即痊愈。或者用玉真散敷贴，或者将杏仁去皮细嚼，混合雄黄、白面敷贴，以消肿为度。牙关紧闭不开，取蜈蚣一条，焙干研末擦牙，吐涎后立刻苏醒。
(Note on Bi Yuan (Nasal Sinusitis). Cases presenting with sudden collapse are termed "Zhong" (Stroke/Severe Wind Strike), while those without such symptoms are termed "Shang" (Injury/Mild Wind Strike); subsequent chapters follow this convention.)
In severe cases, the pathogen spreads throughout the meridians, as discussed in *Shanghan Lun* (Treatise on Cold Damage). This passage refers to mild and superficial cases where the pathogen only affects the skin and hair. The skin and hair are the exterior correspondence of the Lung. When the skin pores are closed, Lung Qi cannot diffuse outward, causing it to congest upward and resulting in sneezing. Heat steams fluids into nasal discharge, blocking the nose, thus making the voice sound heavy and turbid. Lung Qi stagnates and transforms into heat, causing itching in the lungs and coughing. Individuals with a constitutionally cold Qi will have no sweat, while those with a hot constitution will have sweat. Some may have fever, others not; some may have headache, others not. Although these are mild conditions, they can be further divided into degrees of severity. For deficiency patterns, Shen Su Yin (Ginseng and Perilla Decoction) is used (see Fever chapter); for excess patterns, Chuanxiong Chatiao San (Ligusticum Chuanxiong Tea-Powder Powder) is used. This condition resembles Bi Yuan but differs: Shang Feng (Wind Injury) involves the Lung and presents with sneezing, caused by Cold pathogen, resulting in clear discharge; Bi Yuan involves the Brain, presents without sneezing, is caused by Heat pathogen, and results in turbid discharge. In severe cases, there may be foul odor or epistaxis (nosebleed). Generally, Bi Yuan is due to Wind-Heat entering the brain; surging heat damages the nasal mucosa and discharge, breath from both nostrils feels like fire, causing pain or ulceration. If Heat cannot dissipate, it injures the Ying and Blood vessels along its pathway, leading to epistaxis. At the onset, Cang Er San (Xanthium Powder) is used to disperse; for chronic cases with deep-seated heat, Fangfeng Tongsheng San (Saposhnikovia Universal Relief Powder) is used to clear heat (see Stroke chapter); for epistaxis, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is used to cool blood (see Blood Disorders chapter); for painful ulcers in the nostrils, Zhuyedan Zhi Bingpeng San (Pig Bile mixed with Ice Borax Powder) is applied externally (see Oral Diseases chapter). (This is stated in *Yizong Jinjian*. However, stating that Bi Yuan, which belongs to Brain Heat, has no sneezing is theoretically inaccurate; see the chapter on Sneezing for details.)
If the skin is broken or an ulcer has ruptured, Wind enters through the wound, obstructing Zheng Qi (Upright Qi) and transforming into Heat, following the same mechanism as Shang Han (Cold Damage). If more severe, it is because previous blood loss accompanied deficiency, often leading to convulsions and spasms. First, one must examine the wound: if flat and without exudate, it is merely stagnant Heat. If swollen with exudate, Heat stagnation has steamed into Dampness. If the pulse is floating (superficial), sweating therapy is indicated, using Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) or Jiwei Qianghuo Tang (Eight-Ingredient Notopterygium Decoction). After the exterior is resolved, Baizhu Fangfeng Tang (Atractylodes Macrocephala and Saposhnikovia Decoction) is used to tonify. If the pulse is wiry, the pathogen is at the Shaoyang level (half-exterior, half-interior), requiring harmonizing therapy, using Xiao Chaihu Tang (Minor Bupleurum Decoction), Qianghuo Tang, or Diyü Fangfeng San (Sanguisorba and Saposhnikovia Powder). If the pulse is deep and solid with constipation, the pathogen is interior, requiring purgative therapy, using Da Xionghuang Tang (Large Ligusticum and Rhubarb Decoction) or Jiangbiao Wan, followed by Qianghuo Tang. Exterior-releasing herbs should be Acrid-Cool, not Acrid-Hot. If excessive use of Wind-dispelling herbs causes unceasing sweating, Baizhu Huangqi Tang (Atractylodes Macrocephala and Astragalus Decoction) is used. If convulsions and spasms persist, Juan Jing Tang (Spasm-Relieving Decoction) is used. For all spasms, nourishing Blood and moistening dryness with meridian-guiding herbs is necessary. For spasms at the back, use Qianghuo, Duhuo, Fangfeng, Gancao; for spasms at the front of the face, use Shengma, Baizhi, Duhuo, Fangfeng, Gancao; for spasms on the sides, use Chaihu, Fangfeng, Gancao, adding Huashi (Pyrophyllite) for right-sided spasms (Right side relates to Spleen Dampness). For incessant trembling of hands and feet, Zhusha Zhijia San (Cinnabar and Nail Powder) is used. If the head and eyes appear dark/blue, sweat beads on the forehead do not flow, eyes are small and staring, and pain is not at the wound site, the meridians and collaterals are damaged, and it is incurable. There are also cases where ulcer heat stagnates, forming white crusts, closing the wound, preventing Qi circulation, and generating internal Wind from stagnant Heat. This is Internal Wind, requiring clearing Heat and resolving stagnation. External treatment: Initially, take one larva of *Alphitobius diaperinus* (wireworm/Tenebrio molitor larva) from a manure pile or rotten straw roof elsewhere. Pinch its back until fluid exudes from its mouth, then apply this fluid directly to the wound. Numbness will occur, followed by sweating and immediate recovery. Alternatively, apply Yuzhen San (True Jade Powder), or chew peeled almonds thoroughly, mix with Xionghuang (Realgar) and wheat flour, and apply until swelling subsides. For trismus (lockjaw), roast one centipede, grind into powder, rub on teeth; salivation will follow, and consciousness will return immediately.