病
《难经》曰∶人面独能耐寒者,何也?盖人头者,诸阳之会也,
诸阴脉皆至颈、胸中而还,独诸阳脉皆上至头,故令面耐寒也。一
云∶手只六阳之经,虽皆上至头,而足阳明胃之经,起鼻交额中,入齿中,侠口环唇,倚颊车上耳前,
过客主人穴,或其胃中风热,或风热乘之,令人面肿,或面鼻色紫,风刺瘾疹,或面热面寒,随其经证而治之。
方
升麻黄连汤 治面热。
升麻(一钱半) 葛根(一钱半) 白芍(七分半) 川芎(四分半) 白芷(二分) 薄
荷(三分) 荆芥(三分) 苍术(八分半) 黄连(五分,酒洗) 黄芩(六分,酒洗) 犀角
(四分半) 甘草(五分)
上锉一服,水煎,食后服。
升麻白芷汤 治面唇紫黑,乃阳明经气不足也。
升麻(一钱) 葛根(一钱半) 芍药(三分) 防风(一钱) 白芷(一钱) 苍术(三分)
黄(七分) 人参(七分) 甘草(四分)
上锉一剂,姜、枣煎服,宜早饭后,午时前,取天气上升于中,使阳易达于面也。
连翘散 治面生谷嘴疮,俗名粉刺。
连翘 川芎 白芷 黄连 苦参 荆芥 贝母 甘草 桑白皮 山栀子
上锉,水煎,食后临卧服。
清上防风汤 清上焦火,治头面疮疖,风热毒。
防风(一钱) 荆芥(五分) 连翘(八分) 栀子(五分) 黄连(五分) 黄芩(七分,
酒炒) 薄荷(五分) 川芎(七分) 白芷(八分) 桔梗(八分) 枳壳(五分) 甘草(三分)
上锉一剂,水煎,食后服,加竹沥尤效。
姜黄丸 治头面肿大疼痛,并喉痹。
僵蚕(一两) 大黄(二两)
上为末,姜汁丸如弹子大。每服一丸,井水入蜜少许,研,徐
徐食后呷服。
苦参丸 治肺风皮肤瘙痒,或生瘾疥癣,有人病遍身风热,细
疹痒痛,不可忍者,连胸胫脐腹,及近隐处皆然,涎痰亦多,夜不得睡。
苦参(一斤,为末) 皂角(去皮,并子)
上用水一斗,将皂角浸揉去浓汁,滤去渣,熬成膏,和苦参末
为丸,如梧桐子大。每服三十丸,荆芥薄荷酒下,惟酒下亦可。
麦门冬膏(黄宾江) 治面上肺风疮。
麦门冬(去心,一斤) 橘红(去白,四两)
上用水煎汁,熬成膏,入蜜二两,再熬成,入水中一夜去火
毒。每服五匙,滚水化开,食后服,夜将后春容散擦之。
春容散(黄宾江)
白附子(六钱) 枯矾(三钱) 硫黄(五钱) 黑铅(炒枯,三钱) 密陀僧(二两)
轻粉(一钱) 黄丹(飞过,一钱) 麝香(二分)
上为末,先将冷水擦红处,湿后以末药擦之,不可擦破,忌酒色、恼怒。
玉容散 治面生 ,或生小疮,或生痉痱、粉刺之类,并皮肤瘙痒,能去垢腻。
皂角(三斤,去皮) 升麻(八两) 楮实子(五两) 甘松(五钱) 三奈(三钱
)砂仁(连皮,五钱) 天花粉(一两) 白芷(一两) 白芨(一两) 糯米(一升,另研) 白
丁香(五钱,须腊月收者) 绿豆(一两,另研)
上为末,和匀,量用洗面,不惟馨香,亦且去垢。一方加藿香五钱,樟脑一钱,为末,炼蜜为丸,如弹
子大,清晨洗面最奇。
如玉散(宗橘泉)〔批〕(按此方治外之剂) 治面上一切酒刺、风刺、黑靥斑子。
白芷 藿香 牙皂(去皮、子,各一钱) 甘松 三奈 水泽 白丁香
(另研,各一钱) 天花粉 白茯苓(各一钱半) 杏仁(去皮,另研) 细辛 蜜陀
僧(各一钱) 樟脑(五分,另研) 白芨(少许)
上为末,临卧用津唾调,或乳汁调,敷面上,明早温水洗去,其面如玉。
治抓破面皮。
用生姜自然汁,调轻粉搽患处,更无痕迹。
【病机论述】
《难经》说:为什么唯独人脸能够耐受寒冷呢?大概因为人的头部是诸阳经汇聚的地方,所有阴经的脉气都只到达颈部和胸部就返回了,只有诸阳经的脉气都上行至头部,所以使得面部能够耐寒。另一种说法认为:手部的六条阳经虽然都上行至头部,但足阳明胃经起于鼻旁,交叉于额中,进入齿龈中,挟口唇环绕嘴唇,经过颊车穴和耳前,过客主人穴。如果胃经受风热邪气侵袭,或者风热乘虚而入,会导致面部肿胀,或者面鼻部颜色发紫,出现风刺(类似痤疮)和瘾疹(荨麻疹),或者面部感觉发热或发冷,治疗时应根据其所涉经脉的证候进行辨证施治。
【方剂】
升麻黄连汤:治疗面部发热。
处方组成:升麻(一钱半)、葛根(一钱半)、白芍(七分半)、川芎(四分半)、白芷(二分)、薄荷(三分)、荆芥(三分)、苍术(八分半)、黄连(五分,用酒清洗)、黄芩(六分,用酒清洗)、犀角(四分半)、甘草(五分)。
用法:将上述药材切碎为一服量,加水煎煮,饭后服用。
升麻白芷汤:治疗面部和嘴唇紫黑,这是由于阳明经气不足所致。
处方组成:升麻(一钱)、葛根(一钱半)、芍药(三分)、防风(一钱)、白芷(一钱)、苍术(三分)、黄芪(七分)、人参(七分)、甘草(四分)。
用法:将上述药材切碎为一剂,加生姜、大枣煎服。宜在早饭后、午时之前服用,以顺应天气阳气上升于中焦,使阳气容易达于面部。
连翘散:治疗面部生长“谷嘴疮”,俗称粉刺。
处方组成:连翘、川芎、白芷、黄连、苦参、荆芥、贝母、甘草、桑白皮、山栀子。
用法:将上述药材切碎,加水煎煮,饭后及临睡前服用。
清上防风汤:清除上焦火热,治疗头面部的疮疖以及风热毒邪。
处方组成:防风(一钱)、荆芥(五分)、连翘(八分)、栀子(五分)、黄连(五分)、黄芩(七分,用酒炒)、薄荷(五分)、川芎(七分)、白芷(八分)、桔梗(八分)、枳壳(五分)、甘草(三分)。
用法:将上述药材切碎为一剂,加水煎煮,饭后服用。加入竹沥效果更佳。
姜黄丸:治疗头面部肿大疼痛,并伴有喉痹(咽喉肿痛闭塞)。
处方组成:僵蚕(一两)、大黄(二两)。
用法:将上述药材研为细末,用姜汁制作成如弹子大小的丸剂。每次服用一丸,取井水少许加入蜂蜜,将药丸研碎,饭后慢慢呷服。
苦参丸:治疗肺风引起的皮肤瘙痒,或者生长瘾疥癣。有人患遍身风热,出现细密皮疹,痒痛难忍,波及胸部、小腿、肚脐腹部,甚至接近隐蔽部位也是如此,且涎痰较多,夜间无法入睡。
处方组成:苦参(一斤,研为细末)、皂角(去皮及种子)。
用法:用水一斗,将皂角浸泡并揉搓去除浓汁,过滤去渣,熬制成膏,与苦参末混合制成梧桐子大小的丸剂。每次服用三十丸,用荆芥、薄荷酒送下,仅用酒送下也可以。
麦门冬膏(作者:黄宾江):治疗面部的肺风疮。
处方组成:麦门冬(去心,一斤)、橘红(去白瓤,四两)。
用法:用水煎煮取汁,熬制成膏,加入蜂蜜二两,再次熬制,放入水中一夜以去除火毒。每次服用五匙,用滚开水化开,饭后服用,夜间随后使用春容散擦拭面部。
春容散(作者:黄宾江)
处方组成:白附子(六钱)、枯矾(三钱)、硫黄(五钱)、黑铅(炒至枯焦,三钱)、密陀僧(二两)、轻粉(一钱)、黄丹(飞炼过,一钱)、麝香(二分)。
用法:将上述药材研为细末。先用冷水擦拭发红处,待湿润后用粉末药物擦拭患处,不可擦破皮肤。忌食酒类、房事及恼怒情绪。
玉容散:治疗面部生长黑斑,或者生小疮,或者生长痉痱、粉刺之类疾病,以及皮肤瘙痒,能去除污垢油腻。
处方组成:皂角(三斤,去皮)、升麻(八两)、楮实子(五两)、甘松(五钱)、三奈(三钱)、砂仁(带皮,五钱)、天花粉(一两)、白芷(一两)、白芨(一两)、糯米(一升,单独研磨)、白丁香(五钱,须腊月采集者)、绿豆(一两,单独研磨)。
用法:将上述药材研为细末,混合均匀,适量用于洗面,不仅香气宜人,而且能去除污垢。另一配方加藿香五钱、樟脑一钱,研为细末,用炼蜜制成如弹子大小的丸剂,清晨洗面时使用效果奇特。
如玉散(作者:宗橘泉)[批注:此方为外用制剂]:治疗面部一切酒刺、风刺、黑靥斑子。
处方组成:白芷、藿香、牙皂(去皮、子,各一钱)、甘松、三奈、水泽、白丁香(另研,各一钱)、天花粉、白茯苓(各一钱半)、杏仁(去皮,另研)、细辛、密陀僧(各一钱)、樟脑(五分,另研)、白芨(少许)。
用法:将上述药材研为细末,临睡前用唾液或乳汁调匀,敷于面部,次日清晨用温水洗去,面部肌肤将如玉般光洁。
治疗抓破面部皮肤。
用法:用生姜自然汁,调和轻粉涂抹患处,不留痕迹。
[Disease Mechanism Discussion]
The *Nan Jing* (Classic of Difficult Issues) states: Why is it that only the human face can endure cold? This is because the head is the convergence point of all Yang meridians. The Yin meridians all ascend only to the neck and chest before returning, whereas all Yang meridians ascend to the head; thus, the face is able to resist cold. Another view holds that although the six Yang meridians of the hand all ascend to the head, the Foot-Yangming Stomach Meridian originates beside the nose, crosses the forehead, enters the gums, surrounds the mouth and lips, passes through Jiache (ST6) and Erqian (ST7), and passes through Guest Master (ST4). If the Stomach channel is invaded by wind-heat pathogenic factors, or if wind-heat takes advantage of deficiency, it may cause facial swelling, purplish discoloration of the face and nose, "wind thorns" (acne-like lesions), or urticaria (hives), or sensations of heat or cold in the face. Treatment should be based on the syndrome of the affected meridian.
[Formulas]
Shengma Lianlian Decoction (Coptis Rhizome and Cimicifuga Decoction): Treats facial heat.
Ingredients: Shengma (Cimicifugae Rhizoma, 1.5 qian), Gegen (Puerariae Radix, 1.5 qian), Baishao (Paeoniae Radix Alba, 0.75 qian), Chuanxiong (Chuanxiong Rhizoma, 0.45 qian), Baizhi (Angelicae Dahuricae Radix, 0.2 qian), Bohe (Menthae Haplocalycis Herba, 0.3 qian), Jingjie (Schizonepetae Spica, 0.3 qian), Cangzhu (Atractylodis Rhizoma, 0.85 qian), Huanglian (Coptidis Rhizoma, 0.5 qian, washed with wine), Huangqin (Scutellariae Radix, 0.6 qian, washed with wine), Xijiao (Rhinocerotis Cornu, 0.45 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian).
Usage: Coarsely crush the ingredients for one dose, decoct with water, and take after meals.
Shengma Baizhi Decoction (Cimicifuga and Angelica Dahurica Decoction): Treats purple-black discoloration of the face and lips, caused by deficiency of Qi in the Yangming channels.
Ingredients: Shengma (Cimicifugae Rhizoma, 1 qian), Gegen (Puerariae Radix, 1.5 qian), Shaoyao (Paeoniae Radix, 0.3 qian), Fangfeng (Saposhnikoviae Radix, 1 qian), Baizhi (Angelicae Dahuricae Radix, 1 qian), Cangzhu (Atractylodis Rhizoma, 0.3 qian), Huangqi (Astragali Radix, 0.7 qian), Renshen (Ginseng Radix et Rhizoma, 0.7 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.4 qian).
Usage: Coarsely crush the ingredients for one dose, decoct with fresh ginger and jujubes. It is advisable to take this after breakfast but before noon (Wu hour), to align with the ascending nature of heavenly Qi in the middle jiao, facilitating the arrival of Yang Qi to the face.
Lianqiao San (Forsythia Powder): Treats "grain-mouth sores" growing on the face, commonly known as acne comedones.
Ingredients: Lianqiao (Forsythiae Fructus), Chuanxiong (Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Huanglian (Coptidis Rhizoma), Kushen (Sophorae Flavescentis Radix), Jingjie (Schizonepetae Spica), Beimu (Fritillariae Thunbergii Bulbus), Gancao (Glycyrrhizae Radix et Rhizoma), Sangbaipi (Mori Cortex), Shanzhizi (Gardeniae Fructus).
Usage: Coarsely crush the ingredients, decoct with water, and take after meals and before bedtime.
Qingshang Fangfeng Tang (Clear Upper Wind-Dispersing Decoction): Clears fire from the Upper Jiao; treats carbuncles and boils on the head and face, and wind-heat toxicity.
Ingredients: Fangfeng (Saposhnikoviae Radix, 1 qian), Jingjie (Schizonepetae Spica, 0.5 qian), Lianqiao (Forsythiae Fructus, 0.8 qian), Zhizi (Gardeniae Fructus, 0.5 qian), Huanglian (Coptidis Rhizoma, 0.5 qian), Huangqin (Scutellariae Radix, 0.7 qian, stir-fried with wine), Bohe (Menthae Haplocalycis Herba, 0.5 qian), Chuanxiong (Chuanxiong Rhizoma, 0.7 qian), Baizhi (Angelicae Dahuricae Radix, 0.8 qian), Jiegeng (Platycodonis Radix, 0.8 qian), Zhiqiao (Aurantii Fructus, 0.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 qian).
Usage: Coarsely crush the ingredients for one dose, decoct with water, and take after meals. Adding Zhu Li (Bamboo Sap) enhances efficacy.
Jianghuang Wan (Stiff Silkworm Pill): Treats swelling and pain of the head and face, accompanied by Hou Bi (obstruction of the throat).
Ingredients: Jiangcan (Bombyx Batryticatus, 1 liang), Dahuang (Rhei Radix et Rhizoma, 2 liang).
Usage: Grind into fine powder, make pills using Ginger Juice (Zingiberis Rhizoma Recens Succus) the size of a bullet. Take one pill per dose. Mix with well water and a little honey, grind the pill, and slowly sip after meals.
Kushen Wan (Sophora Root Pill): Treats skin itching caused by Lung Wind, or the growth of urticaria, tinea, and psoriasis. In cases where a patient suffers from generalized wind-heat, presenting with fine rashes causing unbearable itching and pain extending to the chest, shins, umbilicus, abdomen, and even near genital areas, accompanied by excessive phlegm-saliva and insomnia at night.
Ingredients: Kushen (Sophorae Flavescentis Radix, 1 jin, ground into powder), Zaojiao (Gleditsiae Sinensis Fructus, peeled and seeds removed).
Usage: Use one dou (unit of volume) of water. Soak and rub the Gleditsiae Sinensis Fructus to extract thick juice, filter out the residue, and boil down to a paste. Mix with Sophora Root powder to form pills the size of Loropetalum chinense seeds. Take 30 pills per dose, administered with Jingjie and Bohe wine, or plain wine alone.
Mendong Gao (Ophiopogon Paste) [Author: Huang Binjiang]: Treats Lung Wind sores on the face.
Ingredients: Mendong (Ophiopogonis Radix, dehearted, 1 jin), Juhong (Citri Reticulatae Pericarpium Rubrum, pith removed, 4 liang).
Usage: Decoct with water to extract juice, boil down to a paste. Add 2 liang of honey and boil again. Place in water overnight to remove "fire toxicity." Take 5 spoons per dose, dissolved in boiling water, taken after meals. At night, subsequently apply Chunrong San to the face.
Chunrong San (Spring Beauty Powder) [Author: Huang Binjiang]
Ingredients: Fuzi (Aconiti Lateralis Radix Praeparata, 6 qian), Kufan (Alumen, 3 qian), Liuhuang (Sulfur, 5 qian), Qian (Lead, stir-fried until dry/crumbly, 3 qian), Tuoseng (Lithargyrum, 2 liang), Qingfen (Calomel, 1 qian), Hongdan (Minii Litharge, refined, 1 qian), Shexiang (Moschus, 0.2 qian).
Usage: Grind all ingredients into fine powder. First, wipe the reddened area with cold water. Once moist, apply the powder medication. Do not break the skin. Avoid alcohol, sexual activity, and anger.
Yurong San (Jade Face Powder): Treats black spots on the face, small sores, prickly heat, acne, and skin itching. It removes dirt and grease.
Ingredients: Zaojiao (Gleditsiae Sinensis Fructus, peeled, 3 jin), Shengma (Cimicifugae Rhizoma, 8 liang), Chushizi (Celtis Sinensis Fructus, 5 liang), Gansong (Nardostachyos Radix et Rhizoma, 5 qian), Sanai (Kaempferiae Galanga Rhizoma, 3 qian), Sharen (Amomi Fructus, with peel, 5 qian), Tianhuafen (Trichosanthis Radix, 1 liang), Baizhi (Angelicae Dahuricae Radix, 1 liang), Baiji (Bletillae Rhizoma, 1 liang), Nuomi (Oryza Sativa Glutinosa, 1 sheng, ground separately), Baidingxiang (Vivera Civetta, collected in the twelfth lunar month, 5 qian), Lvdou (Phaseoli Angularis Semen, 1 liang, ground separately).
Usage: Grind all ingredients into fine powder, mix evenly, and use an appropriate amount to wash the face. It leaves a pleasant fragrance and removes dirt. An alternative formula adds Huoxiang (Agastaches Herba, 5 qian) and Zhangnao (Camphora, 1 qian), ground into powder, and formed into pills with refined honey the size of bullets. Using this to wash the face early in the morning yields remarkable results.
Ruyu San (Like-Jade Powder) [Author: Zong Juquan] [Note: This is an external preparation]: Treats all types of alcoholic acne, wind acne, and dark spots/melasma on the face.
Ingredients: Baizhi (Angelicae Dahuricae Radix), Huoxiang (Agastaches Herba), Yazao (Gleditsiae Sinensis Fructus, peeled and seeded, 1 qian each), Gansong (Nardostachyos Radix et Rhizoma), Sanai (Kaempferiae Galanga Rhizoma), Shuize (likely referring to a specific mineral or plant source, contextually unclear, kept as Shuize), Baidingxiang (Vivera Civetta, ground separately, 1 qian each), Tianhuafen (Trichosanthis Radix), Baifuling (Poria, 1.5 qian each), Xingren (Pruni Armeniaci Semen Amarum, peeled, ground separately), Xixin (Asari Radix et Rhizoma), Tuoseng (Lithargyrum, 1 qian each), Zhangnao (Camphora, 0.5 qian, ground separately), Baiji (Bletillae Rhizoma, a small amount).
Usage: Grind all ingredients into fine powder. Before bedtime, mix with saliva or milk, apply to the face, and wash off with warm water the next morning. The face will become smooth like jade.
Treatment for scratched/broken facial skin.
Usage: Use natural juice of fresh ginger (Shengjiang Ziran Zhi), mix with Calomel (Qingfen), and apply to the affected area. No scars will remain.