游风者。为肌肤倏然 赤肿痛。游走无定。由风热壅滞。荣卫不宣。则善行而数变矣。较之丹毒。只红肿
起粟而不走。故与游风为异耳。其风热者。则色赤。宜小柴胡汤。加防风、连翘清之。内热甚者。紫雪散下
之。肿势甚者。砭之。风寒者。则色白。宜荆防败毒散散之。再血热者。四物汤加柴胡、栀子、丹皮。胃虚者。补
中益气汤。加防风、羌活。肝肾虚热者。宜加味逍遥散、六味地黄丸。以滋化源。则火自息。风自定。痒自止
矣。误用祛风辛热之药。复伤元气。则容风内淫。血随火化。反为难治。赤肿游入腹者不治。宜与小儿赤
游风门参考。
有因过饮烧酒而得者。饮冷米醋一二杯即解。此又是似而非也。宜细辨之。
荆防败毒散 补中益气汤 六味地黄丸(俱见首卷) 加味逍遥散 小柴胡汤(俱见瘰 门)
瘾疹者。生小粒靥于皮肤之中。憎寒发热。遍身瘙痒。经云。劳汗当风。薄为郁。乃痱痤。热微色赤。热甚色
黑。由痰热在肺。治宜清肺降痰解表。如消毒饮子。有可下者。大柴胡汤。虚者补中益气汤。或总以加味
羌活散治之。
疹属少阴君火斑则无头 肿于外。属少阳相火。自吐自利。身温身凉者吉。忌敷凉药。首尾慎下。若便
闭者。微利之。故凡瘾疹瘙痒。疙瘩丹毒等症。皆宜凉血润燥。如加味逍遥散。加味小柴胡汤。慎用风药。
复伤元气。反致筋挛。若愈后肌生白屑。搔之如帛所隔者。气血虚也。十全大补汤。或灸曲池穴。(见灸门)
加味羌活汤 治风寒暑湿外搏肌肤。发为瘾疹。憎寒发热。遍身瘙痒。或赤或白。甚则心迷闷乱。口苦
咽干。
羌活 前胡(各一两) 人参 桔梗 甘草(炙) 枳壳 川芎 天麻 茯苓(各五钱) 蝉蜕(去头)
薄荷(各三钱)
上为末。每服三四钱。生姜三片。水一钟。煎七分。去渣温服。
羽液膏 治斑疹。风痒不止。
白矾(五两) 童便(一升) 黄酒(三合)
合煎如稀糊。以棉帛蘸药擦之。立消。
补中益气汤 十全大补汤(俱见首卷) 加味小柴胡汤 加味逍遥散(俱见瘰 门)
游风,是指肌肤突然发红、肿胀、疼痛,且游走不定。这是由于风热邪气壅滞,导致营卫之气运行不畅,因此具有善行而多变的特性。与丹毒相比,丹毒只是红肿并起粟粒状皮疹而不游走,所以与游风不同。属于风热证的,颜色发红,适宜用小柴胡汤,加入防风、连翘以清热;内热严重的,用紫雪散攻下;肿势严重的,用砭石刺破放血。属于风寒证的,颜色发白,适宜用荆防败毒散发散。若是血热证,用四物汤加入柴胡、栀子、牡丹皮。胃气虚弱者,用补中益气汤,加入防风、羌活。肝肾阴虚有热者,适宜用加味逍遥散、六味地黄丸,以滋养化源,则火自平息,风自安定,痒自然停止。如果误用祛风辛热的药物,再次损伤元气,就会导致风邪内侵,血液随火势变化,反而难以治疗。赤色肿胀游走进入腹部的,属于不治之症。宜参考小儿赤游风门的内容。
有的因过量饮用烧酒而得病,喝一二杯冷米醋即可缓解。这又是看似相同实则不同的情况,需要仔细辨别。
荆防败毒散、补中益气汤、六味地黄丸(均见首卷)、加味逍遥散、小柴胡汤(均见瘰疬门)。
瘾疹,是在皮肤中生出的小颗粒疹子,伴有怕冷发热,全身瘙痒。《内经》说:“劳汗当风,薄为郁,乃痱痤。”热轻的,颜色发红;热重的,颜色发黑。这是由于痰热在肺所致,治疗适宜清肺降痰解表,如消毒饮子。有可用下法的,用大柴胡汤。虚证者用补中益气汤。或者总以加味羌活散来治疗。
疹属于少阴君火,斑则无头,肿于外部,属于少阳相火。出现自吐自利,身体温和或凉爽的是吉兆。忌用敷凉药。治疗首尾慎用泻下法。若大便闭结的,轻微通利它。所以凡是瘾疹瘙痒、疙瘩、丹毒等病症,都适宜凉血润燥,如加味逍遥散、加味小柴胡汤。慎用风药,以免再次损伤元气,反而导致筋脉拘挛。如果痊愈后皮肤生出白色皮屑,搔抓时感觉像隔着帛一样,这是气血虚弱的表现,用十全大补汤,或者灸曲池穴。(见灸门)
加味羌活汤:治疗风寒暑湿外搏肌肤,引发瘾疹,怕冷发热,全身瘙痒,或红或白,严重则心闷神乱,口苦咽干。
药材:羌活、前胡(各一两),人参、桔梗、甘草(炙)、枳壳、川芎、天麻、茯苓(各五钱),蝉蜕(去头)、薄荷(各三钱)。
将上述药物研为细末。每次服用三四钱,生姜三片,水一钟,煎至七分,去渣温服。
混合煎煮成稀糊状,用棉帛蘸药擦拭患处,立即消除。
You Feng (Wandering Wind) refers to the sudden onset of redness, swelling, and pain on the skin and muscles, which migrates without a fixed location. This is caused by the stagnation of Wind-Heat pathogenic factors, leading to the impairment of Ying (Nutritive Qi) and Wei (Defensive Qi) circulation, thus exhibiting characteristics of rapid movement and frequent changes. Compared with Dan Du (Erysipelas), which presents only with redness, swelling, and millet-grain-like papules without migration, You Feng is distinct. For cases attributed to Wind-Heat, characterized by red coloration, Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used with added Fang Feng (Saposhnikovia Root) and Lian Qiao (Forsythia Fruit) to clear heat. In cases with severe internal heat, Zi Xue San (Purple Snow Powder) should be administered to purge; if the swelling is severe, Bian Shi therapy (scarification) should be employed. For cases attributed to Wind-Cold, characterized by pale coloration, Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Powder to Resolve Toxicity) should be used to disperse. If it is a Blood-Heat pattern, Si Wu Tang (Four Substances Decoction) with added Chai Hu (Bupleurum Root), Zhi Zi (Gardenia Fruit), and Dan Pi (Moutan Cortex) is indicated. For Spleen-Stomach deficiency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Fang Feng and Qiang Huo (Notopterygium Root) is suitable. For Liver-Kidney Yin deficiency with empty heat, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) should be used to nourish the source of transformation, thereby extinguishing fire, settling wind, and stopping itching. Misuse of acrid-warm wind-dispelling herbs will further damage Yuan Qi (Original Qi), causing Wind pathogen to invade internally and blood to transform with fire, making treatment difficult. Red swelling that migrates into the abdomen is incurable. Refer to the section on Infantile Red Wandering Wind for reference.
Some cases arise from excessive consumption of distilled spirits; drinking one or two cups of cold rice vinegar can resolve it. This is a case that appears similar but is actually different, requiring careful differentiation.
Jing Fang Bai Du San, Bu Zhong Yi Qi Tang, Liu Wei Di Huang Wan (all see Volume 1), Jia Wei Xiao Yao San, Xiao Chai Hu Tang (all see the Scrofula Section).
Yin Zhen (Itchy Rash) manifests as small granular papules within the skin, accompanied by aversion to cold, fever, and generalized pruritus. The Classic states: "Sweat from labor exposed to wind causes stagnation, resulting in Fei Cuo (heat rash)." When heat is mild, the color is red; when heat is severe, the color is black. This is due to Phlegm-Heat residing in the Lung. Treatment should focus on clearing the Lung, descending Phlegm, and releasing the exterior, such as using Xiao Du Yin Zi (Toxin-Resolving Drink). If purgation is indicated, Da Chai Hu Tang (Greater Bupleurum Decoction) may be used. For deficiency patterns, Bu Zhong Yi Qi Tang is appropriate. Alternatively, Jia Wei Qiang Huo San (Modified Notopterygium Powder) can be used generally.
Rashes belong to Shaoyin Jun Huo (Ministerial Fire of Shaoyin); Maculae have no head and swell externally, belonging to Shaoyang Xiang Huo (Ministerial Fire of Shaoyang). Spontaneous vomiting and diarrhea, with the body being warm or cool, are auspicious signs. Topical cooling medicines are contraindicated. Purgatives should be used cautiously at both the beginning and end of treatment. If constipation occurs, mild purgation is sufficient. Therefore, for conditions such as Yin Zhen pruritus, nodules, and Dan Du, blood-cooling and dryness-moistening methods are appropriate, such as Jia Wei Xiao Yao San or Jia Wei Xiao Chai Hu Tang. Wind-dispelling herbs should be used cautiously to avoid damaging Yuan Qi, which could lead to tendon spasms. If white scales appear on the skin after recovery, and scratching feels like passing through silk, this indicates Qi and Blood deficiency. Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) should be used, or Quchi (LI11) moxibustion may be applied (see Moxibustion Section).
Jia Wei Qiang Huo Tang: Treats Yin Zhen caused by external invasion of Wind, Cold, Summer-Heat, and Dampness clashing with the skin and muscles, presenting with aversion to cold, fever, generalized pruritus, redness or pallor, and in severe cases, mental confusion, bitter taste in the mouth, and dry throat.
Herbs: Qiang Huo (Notopterygium Rhizome and Root), Qian Hu (Peucedani Radix) (each 1 liang); Ren Shen (Ginseng Radix), Jie Geng (Platycodon Root), Gan Cao (Licorice Root, honey-fried), Zhi Ke (Aurantii Fructus), Chuan Xiong (Ligusticum Rhizome), Tian Ma (Gastrodia Rhizome), Fu Ling (Poria) (each 5 qian); Chan Tui (Cicada Slough, heads removed), Bo He (Menthae Haplocalycis Herba) (each 3 qian).
Grind the above into powder. Take 3–4 qian per dose, with 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens) and 1 zhong of water, decoct until 0.7 zhong remains, strain, and take warm.
Yu Ye Gao (Feather Fluid Ointment): Treats maculopapular rashes and persistent wind-induced pruritus.
Ingredients: Bai Fan (Alumen) (5 liang), Tong Bian (Child's Urine) (1 sheng), Huang Jiu (Yellow Wine) (3 he).
Decoct together until a thin paste forms. Dip cotton cloth in the medicine and rub the affected area; relief is immediate.
Bu Zhong Yi Qi Tang, Shi Quan Da Bu Tang (both see Volume 1), Jia Wei Xiao Chai Hu Tang, Jia Wei Xiao Yao San (both see the Scrofula Section).